A practical approach for calculating reliable cost estimates from observational data: application to cost analyses in maternal and child health.

PubMed

Salemi, Jason L; Comins, Meg M; Chandler, Kristen; Mogos, Mulubrhan F; Salihu, Hamisu M

2013-08-01

Comparative effectiveness research (CER) and cost-effectiveness analysis are valuable tools for informing health policy and clinical care decisions. Despite the increased availability of rich observational databases with economic measures, few researchers have the skills needed to conduct valid and reliable cost analyses for CER. The objectives of this paper are to (i) describe a practical approach for calculating cost estimates from hospital charges in discharge data using publicly available hospital cost reports, and (ii) assess the impact of using different methods for cost estimation in maternal and child health (MCH) studies by conducting economic analyses on gestational diabetes (GDM) and pre-pregnancy overweight/obesity. In Florida, we have constructed a clinically enhanced, longitudinal, encounter-level MCH database covering over 2.3 million infants (and their mothers) born alive from 1998 to 2009. Using this as a template, we describe a detailed methodology to use publicly available data to calculate hospital-wide and department-specific cost-to-charge ratios (CCRs), link them to the master database, and convert reported hospital charges to refined cost estimates. We then conduct an economic analysis as a case study on women by GDM and pre-pregnancy body mass index (BMI) status to compare the impact of using different methods on cost estimation. Over 60 % of inpatient charges for birth hospitalizations came from the nursery/labor/delivery units, which have very different cost-to-charge markups (CCR = 0.70) than the commonly substituted hospital average (CCR = 0.29). Using estimated mean, per-person maternal hospitalization costs for women with GDM as an example, unadjusted charges ($US14,696) grossly overestimated actual cost, compared with hospital-wide ($US3,498) and department-level ($US4,986) CCR adjustments. However, the refined cost estimation method, although more accurate, did not alter our conclusions that infant/maternal hospitalization costs were significantly higher for women with GDM than without, and for overweight/obese women than for those in a normal BMI range. Cost estimates, particularly among MCH-related services, vary considerably depending on the adjustment method. Our refined approach will be valuable to researchers interested in incorporating more valid estimates of cost into databases with linked hospital discharge files.

Bone histomorphometry using free and commonly available software.

PubMed

Egan, Kevin P; Brennan, Tracy A; Pignolo, Robert J

2012-12-01

Histomorphometric analysis is a widely used technique to assess changes in tissue structure and function. Commercially available programs that measure histomorphometric parameters can be cost-prohibitive. In this study, we compared an inexpensive method of histomorphometry to a current proprietary software program. Image J and Adobe Photoshop(®) were used to measure static and kinetic bone histomorphometric parameters. Photomicrographs of Goldner's trichrome-stained femurs were used to generate black-and-white image masks, representing bone and non-bone tissue, respectively, in Adobe Photoshop(®) . The masks were used to quantify histomorphometric parameters (bone volume, tissue volume, osteoid volume, mineralizing surface and interlabel width) in Image J. The resultant values obtained using Image J and the proprietary software were compared and differences found to be statistically non-significant. The wide-ranging use of histomorphometric analysis for assessing the basic morphology of tissue components makes it important to have affordable and accurate measurement options available for a diverse range of applications. Here we have developed and validated an approach to histomorphometry using commonly and freely available software that is comparable to a much more costly, commercially available software program. © 2012 Blackwell Publishing Limited.

Bone histomorphometry using free and commonly available software

PubMed Central

Egan, Kevin P.; Brennan, Tracy A.; Pignolo, Robert J.

2012-01-01

Aims Histomorphometric analysis is a widely used technique to assess changes in tissue structure and function. Commercially-available programs that measure histomorphometric parameters can be cost prohibitive. In this study, we compared an inexpensive method of histomorphometry to a current proprietary software program. Methods and results Image J and Adobe Photoshop® were used to measure static and kinetic bone histomorphometric parameters. Photomicrographs of Goldner’s Trichrome stained femurs were used to generate black and white image masks, representing bone and non-bone tissue, respectively, in Adobe Photoshop®. The masks were used to quantify histomorphometric parameters (bone volume, tissue volume, osteoid volume, mineralizing surface, and interlabel width) in Image J. The resultant values obtained using Image J and the proprietary software were compared and found to be statistically non-significant. Conclusions The wide ranging use of histomorphometric analysis for assessing the basic morphology of tissue components makes it important to have affordable and accurate measurement options that are available for a diverse range of applications. Here we have developed and validated an approach to histomorphometry using commonly and freely available software that is comparable to a much more costly, commercially-available software program. PMID:22882309

Can deficits in social problem-solving in people with personality disorder be reversed?

PubMed

Crawford, M J

2007-04-01

Research evidence is beginning to emerge that social problem-solving can improve the social functioning of people with personality disorder. This approach is particularly important because it may be relatively easy to train healthcare workers to deliver this intervention. However, the costs and cost-effectiveness of social problem-solving need to be established if it is to be made more widely available.

Will available bit rate (ABR) services give us the capability to offer virtual LANs over wide-area ATM networks?

NASA Astrophysics Data System (ADS)

Ferrandiz, Ana; Scallan, Gavin

1995-10-01

The available bit rate (ABR) service allows connections to exceed their negotiated data rates during the life of the connections when excess capacity is available in the network. These connections are subject to flow control from the network in the event of network congestion. The ability to dynamically adjust the data rate of the connection can provide improved utilization of the network and be a valuable service to end users. ABR type service is therefore appropriate for the transmission of bursty LAN traffic over a wide area network in a manner that is more efficient and cost effective than allocating bandwdith at the peak cell rate. This paper describes the ABR service and discusses if it is realistic to operate a LAN like service over a wide area using ABR.

An improved set of standards for finding cost for cost-effectiveness analysis.

PubMed

Barnett, Paul G

2009-07-01

Guidelines have helped standardize methods of cost-effectiveness analysis, allowing different interventions to be compared and enhancing the generalizability of study findings. There is agreement that all relevant services be valued from the societal perspective using a long-term time horizon and that more exact methods be used to cost services most affected by the study intervention. Guidelines are not specific enough with respect to costing methods, however. The literature was reviewed to identify the problems associated with the 4 principal methods of cost determination. Microcosting requires direct measurement and is ordinarily reserved to cost novel interventions. Analysts should include nonwage labor cost, person-level and institutional overhead, and the cost of development, set-up activities, supplies, space, and screening. Activity-based cost systems have promise of finding accurate costs of all services provided, but are not widely adopted. Quality must be evaluated and the generalizability of cost estimates to other settings must be considered. Administrative cost estimates, chiefly cost-adjusted charges, are widely used, but the analyst must consider items excluded from the available system. Gross costing methods determine quantity of services used and employ a unit cost. If the intervention will affect the characteristics of a service, the method should not assume that the service is homogeneous. Questions are posed for future reviews of the quality of costing methods. The analyst must avoid inappropriate assumptions, especially those that bias the analysis by exclusion of costs that are affected by the intervention under study.

Watershed Management Optimization Support Tool (WMOST) Webinar

EPA Pesticide Factsheets

EPA’s WMOST is a publicly available tool that can be used by state and local managers to screen a wide-range of options for cost-effective management of water resources, and it supports a broader integrated watershed management approach.

Sensor Technology and Performance Characteristics

EPA Science Inventory

The US EPA is currently involved in detailed laboratory and/or field studies involving a wide variety of low cost air quality sensors currently being made available to potential citizen scientists. These devices include sensors associated with the monitoring of nitrogen dioxide (...

Pareto-optimal phylogenetic tree reconciliation

PubMed Central

Libeskind-Hadas, Ran; Wu, Yi-Chieh; Bansal, Mukul S.; Kellis, Manolis

2014-01-01

Motivation: Phylogenetic tree reconciliation is a widely used method for reconstructing the evolutionary histories of gene families and species, hosts and parasites and other dependent pairs of entities. Reconciliation is typically performed using maximum parsimony, in which each evolutionary event type is assigned a cost and the objective is to find a reconciliation of minimum total cost. It is generally understood that reconciliations are sensitive to event costs, but little is understood about the relationship between event costs and solutions. Moreover, choosing appropriate event costs is a notoriously difficult problem. Results: We address this problem by giving an efficient algorithm for computing Pareto-optimal sets of reconciliations, thus providing the first systematic method for understanding the relationship between event costs and reconciliations. This, in turn, results in new techniques for computing event support values and, for cophylogenetic analyses, performing robust statistical tests. We provide new software tools and demonstrate their use on a number of datasets from evolutionary genomic and cophylogenetic studies. Availability and implementation: Our Python tools are freely available at www.cs.hmc.edu/∼hadas/xscape. Contact: mukul@engr.uconn.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:24932009

Low cost infrared and near infrared sensors for UAVs

NASA Astrophysics Data System (ADS)

Aden, S. T.; Bialas, J. P.; Champion, Z.; Levin, E.; McCarty, J. L.

2014-11-01

Thermal remote sensing has a wide range of applications, though the extent of its use is inhibited by cost. Robotic and computer components are now widely available to consumers on a scale that makes thermal data a readily accessible resource. In this project, thermal imagery collected via a lightweight remote sensing Unmanned Aerial Vehicle (UAV) was used to create a surface temperature map for the purpose of providing wildland firefighting crews with a cost-effective and time-saving resource. The UAV system proved to be flexible, allowing for customized sensor packages to be designed that could include visible or infrared cameras, GPS, temperature sensors, and rangefinders, in addition to many data management options. Altogether, such a UAV system could be used to rapidly collect thermal and aerial data, with a geographic accuracy of less than one meter.

Fire retardancy using applied materials

NASA Technical Reports Server (NTRS)

Feldman, R.

1971-01-01

An example of advanced technology transfer from the Little Joe, Surveyor, Comsat, re-entry and Apollo age to everyday fire protection needs is presented. Utilizing the principle of sublimation cooling for thermostatic temperature control, the material meets a wide range of fire retardancy and heat transmission control requirements. Properties vary from flexible tape for conduits and electrical cables to rigid coatings for column protection, with a broad spectrum of sublimation temperatures available. The material can be applied in the field or in the factory, utilizing mass production techniques, yielding a product that is reliable, effective, widely available and low in cost.

Cost-Effectiveness of Magnetic Resonance Imaging with a New Contrast Agent for the Early Diagnosis of Alzheimer's Disease

PubMed Central

Biasutti, Maria; Dufour, Natacha; Ferroud, Clotilde; Dab, William; Temime, Laura

2012-01-01

Background Used as contrast agents for brain magnetic resonance imaging (MRI), markers for beta-amyloid deposits might allow early diagnosis of Alzheimer's disease (AD). We evaluated the cost-effectiveness of such a diagnostic test, MRI+CLP (contrastophore-linker-pharmacophore), should it become clinically available. Methodology/Principal Findings We compared the cost-effectiveness of MRI+CLP to that of standard diagnosis using currently available cognition tests and of standard MRI, and investigated the impact of a hypothetical treatment efficient in early AD. The primary analysis was based on the current French context for 70-year-old patients with Mild Cognitive Impairment (MCI). In alternative “screen and treat” scenarios, we analyzed the consequences of systematic screenings of over-60 individuals (either population-wide or restricted to the ApoE4 genotype population). We used a Markov model of AD progression; model parameters, as well as incurred costs and quality-of-life weights in France were taken from the literature. We performed univariate and probabilistic multivariate sensitivity analyses. The base-case preferred strategy was the standard MRI diagnosis strategy. In the primary analysis however, MRI+CLP could become the preferred strategy under a wide array of scenarios involving lower cost and/or higher sensitivity or specificity. By contrast, in the “screen and treat” analyses, the probability of MRI+CLP becoming the preferred strategy remained lower than 5%. Conclusions/Significance It is thought that anti-beta-amyloid compounds might halt the development of dementia in early stage patients. This study suggests that, even should such treatments become available, systematically screening the over-60 population for AD would only become cost-effective with highly specific tests able to diagnose early stages of the disease. However, offering a new diagnostic test based on beta-amyloid markers to elderly patients with MCI might prove cost-effective. PMID:22532859

Satellite economics in the 1980's

NASA Astrophysics Data System (ADS)

Morgan, W. L.

1980-01-01

Satellite traffic, competition, and decreasing costs are discussed, as are capabilities in telecommunication (including entertainment) and computation. Also considered are future teleconferencing and telecommuting to offset the cost of transportation, the establishment of a manufacturer-to-user link for increased home minicomputer capability, and an increase of digital over analog traffic. It is suggested that transcontinental bulk traffic, high-speed data, and multipoint private networks will eventually be handled by satellites which are cost-insensitive to distance, readily match dynamically varying multipoint networks, and have uniformly wide bandwidths available to both major cities and isolated towns.

Cutting-edge technologies: GPS/Satellite communications-based tracking

USDA-ARS?s Scientific Manuscript database

Despite wide-spread adoption of GPS and satellite-communication technologies within the freight and transportation industries, commercially-available telemetry tracking systems have not kept pace with the evolving demands of ecological research. Commercial GPS tracking collars are costly ($1,500 to...

Curve identification for high friction surface treatment (HFST) installation recommendation : final report.

DOT National Transportation Integrated Search

2016-09-01

The objectives of this study are to develop and deploy a means for cost-effectively extracting curve information using the widely available GPS and GIS data to support high friction surface treatment (HFST) installation recommendations (i.e., start a...

Home Infotainment Platform - A Ubiquitous Access Device for Masses

NASA Astrophysics Data System (ADS)

Pal, Arpan; Prashant, M.; Ghose, Avik; Bhaumik, Chirabrata

There is tremendous need for a low-cost Internet-Enabled Platform for developing countries like India that uses TV as the display medium and can connect to Internet using various available connectivity solutions. The paper presents how a generic framework middleware can be used to create a Home Infotainment Platform that can support variety of value-added applications. It also talks about the innovative designs employed to bring about the low-cost solution keeping in mind both the limitations of TV as a display and non-availability of high quality-of-service networks. Finally the social, economic and environmental implications of wide-spread deployment of the proposed solution are outlined.

Cardiac rehabilitation costs.

PubMed

Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L

2017-10-01

Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.

Survey of coatings for solar collectors. [ceramic enamels and chromium

NASA Technical Reports Server (NTRS)

Mcdonald, G. E.

1974-01-01

Ceramic enamel is found to be more solar selective, (i.e., has high solar absorptance in combination with low infrared emittance) than organic enamel, but neither is as solar selective as black chrome, black copper, black zinc, or black nickel. Ceramic enamel is matched only by black chrome in durability and wide availability. Ceramic enamel and organic enamel have approximately the same cost, and both are currently slightly lower in cost than black chrome, black copper, or black zinc. Black nickel is relatively unavailable and, because of that, realistic cost comparisons are not possible.

Availability and accessibility of evidence-based information resources provided by medical libraries in Australia.

PubMed

Ritchie, A; Sowter, B

2000-01-01

This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.

Nonintravenous rescue medications for pediatric status epilepticus: A cost-effectiveness analysis.

PubMed

Sánchez Fernández, Iván; Gaínza-Lein, Marina; Loddenkemper, Tobias

2017-08-01

To quantify the cost-effectiveness of rescue medications for pediatric status epilepticus: rectal diazepam, nasal midazolam, buccal midazolam, intramuscular midazolam, and nasal lorazepam. Decision analysis model populated with effectiveness data from the literature and cost data from publicly available market prices. The primary outcome was cost per seizure stopped ($/SS). One-way sensitivity analyses and second-order Monte Carlo simulations evaluated the robustness of the results across wide variations of the input parameters. The most cost-effective rescue medication was buccal midazolam (incremental cost-effectiveness ratio ([ICER]: $13.16/SS) followed by nasal midazolam (ICER: $38.19/SS). Nasal lorazepam (ICER: -$3.8/SS), intramuscular midazolam (ICER: -$64/SS), and rectal diazepam (ICER: -$2,246.21/SS) are never more cost-effective than the other options at any willingness to pay. One-way sensitivity analysis showed the following: (1) at its current effectiveness, rectal diazepam would become the most cost-effective option only if its cost was $6 or less, and (2) at its current cost, rectal diazepam would become the most cost-effective option only if effectiveness was higher than 0.89 (and only with very high willingness to pay of $2,859/SS to $31,447/SS). Second-order Monte Carlo simulations showed the following: (1) nasal midazolam and intramuscular midazolam were the more effective options; (2) the more cost-effective option was buccal midazolam for a willingness to pay from $14/SS to $41/SS and nasal midazolam for a willingness to pay above $41/SS; (3) cost-effectiveness overlapped for buccal midazolam, nasal lorazepam, intramuscular midazolam, and nasal midazolam; and (4) rectal diazepam was not cost-effective at any willingness to pay, and this conclusion remained extremely robust to wide variations of the input parameters. For pediatric status epilepticus, buccal midazolam and nasal midazolam are the most cost-effective nonintravenous rescue medications in the United States. Rectal diazepam is not a cost-effective alternative, and this conclusion remains extremely robust to wide variations of the input parameters. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Damage and protection cost curves for coastal floods within the 600 largest European cities

NASA Astrophysics Data System (ADS)

Prahl, Boris F.; Boettle, Markus; Costa, Luís; Kropp, Jürgen P.; Rybski, Diego

2018-03-01

The economic assessment of the impacts of storm surges and sea-level rise in coastal cities requires high-level information on the damage and protection costs associated with varying flood heights. We provide a systematically and consistently calculated dataset of macroscale damage and protection cost curves for the 600 largest European coastal cities opening the perspective for a wide range of applications. Offering the first comprehensive dataset to include the costs of dike protection, we provide the underpinning information to run comparative assessments of costs and benefits of coastal adaptation. Aggregate cost curves for coastal flooding at the city-level are commonly regarded as by-products of impact assessments and are generally not published as a standalone dataset. Hence, our work also aims at initiating a more critical discussion on the availability and derivation of cost curves.

Damage and protection cost curves for coastal floods within the 600 largest European cities.

PubMed

Prahl, Boris F; Boettle, Markus; Costa, Luís; Kropp, Jürgen P; Rybski, Diego

2018-03-20

The economic assessment of the impacts of storm surges and sea-level rise in coastal cities requires high-level information on the damage and protection costs associated with varying flood heights. We provide a systematically and consistently calculated dataset of macroscale damage and protection cost curves for the 600 largest European coastal cities opening the perspective for a wide range of applications. Offering the first comprehensive dataset to include the costs of dike protection, we provide the underpinning information to run comparative assessments of costs and benefits of coastal adaptation. Aggregate cost curves for coastal flooding at the city-level are commonly regarded as by-products of impact assessments and are generally not published as a standalone dataset. Hence, our work also aims at initiating a more critical discussion on the availability and derivation of cost curves.

Colleges Organize Campuswide Efforts to Recycle Wastes.

ERIC Educational Resources Information Center

Magner, Denise K.

1989-01-01

Spurred by soaring garbage-disposal costs and the closings of local landfills, colleges and universities are organizing campus wide recycling programs. The Association of Physical Plant Administrators of Universities and Colleges will soon be adding the subject to its computerized list of information available to member colleges. (MLW)

Cost-Effectiveness Analysis: a proposal of new reporting standards in statistical analysis

PubMed Central

Bang, Heejung; Zhao, Hongwei

2014-01-01

Cost-effectiveness analysis (CEA) is a method for evaluating the outcomes and costs of competing strategies designed to improve health, and has been applied to a variety of different scientific fields. Yet, there are inherent complexities in cost estimation and CEA from statistical perspectives (e.g., skewness, bi-dimensionality, and censoring). The incremental cost-effectiveness ratio that represents the additional cost per one unit of outcome gained by a new strategy has served as the most widely accepted methodology in the CEA. In this article, we call for expanded perspectives and reporting standards reflecting a more comprehensive analysis that can elucidate different aspects of available data. Specifically, we propose that mean and median-based incremental cost-effectiveness ratios and average cost-effectiveness ratios be reported together, along with relevant summary and inferential statistics as complementary measures for informed decision making. PMID:24605979

Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence

PubMed Central

2013-01-01

Background High levels of adherence to medications for HIV infection are essential for optimal clinical outcomes and to reduce viral transmission, but many patients do not achieve required levels. Clinician-delivered interventions can improve patients’ adherence, but usually require substantial effort by trained individuals and may not be widely available. Computer-delivered interventions can address this problem by reducing required staff time for delivery and by making the interventions widely available via the Internet. We previously developed a computer-delivered intervention designed to improve patients’ level of health literacy as a strategy to improve their HIV medication adherence. The intervention was shown to increase patients’ adherence, but it was not clear that the benefits resulting from the increase in adherence could justify the costs of developing and deploying the intervention. The purpose of this study was to evaluate the relation of development and deployment costs to the effectiveness of the intervention. Methods Costs of intervention development were drawn from accounting reports for the grant under which its development was supported, adjusted for costs primarily resulting from the project’s research purpose. Effectiveness of the intervention was drawn from results of the parent study. The relation of the intervention’s effects to changes in health status, expressed as utilities, was also evaluated in order to assess the net cost of the intervention in terms of quality adjusted life years (QALYs). Sensitivity analyses evaluated ranges of possible intervention effectiveness and durations of its effects, and costs were evaluated over several deployment scenarios. Results The intervention’s cost effectiveness depends largely on the number of persons using it and the duration of its effectiveness. Even with modest effects for a small number of patients the intervention was associated with net cost savings in some scenarios and for durations greater than three months and longer it was usually associated with a favorable cost per QALY. For intermediate and larger assumed effects and longer durations of intervention effectiveness, the intervention was associated with net cost savings. Conclusions Computer-delivered adherence interventions may be a cost-effective strategy to improve adherence in persons treated for HIV. Trial registration Clinicaltrials.gov identifier NCT01304186. PMID:23446180

Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence.

PubMed

Ownby, Raymond L; Waldrop-Valverde, Drenna; Jacobs, Robin J; Acevedo, Amarilis; Caballero, Joshua

2013-02-28

High levels of adherence to medications for HIV infection are essential for optimal clinical outcomes and to reduce viral transmission, but many patients do not achieve required levels. Clinician-delivered interventions can improve patients' adherence, but usually require substantial effort by trained individuals and may not be widely available. Computer-delivered interventions can address this problem by reducing required staff time for delivery and by making the interventions widely available via the Internet. We previously developed a computer-delivered intervention designed to improve patients' level of health literacy as a strategy to improve their HIV medication adherence. The intervention was shown to increase patients' adherence, but it was not clear that the benefits resulting from the increase in adherence could justify the costs of developing and deploying the intervention. The purpose of this study was to evaluate the relation of development and deployment costs to the effectiveness of the intervention. Costs of intervention development were drawn from accounting reports for the grant under which its development was supported, adjusted for costs primarily resulting from the project's research purpose. Effectiveness of the intervention was drawn from results of the parent study. The relation of the intervention's effects to changes in health status, expressed as utilities, was also evaluated in order to assess the net cost of the intervention in terms of quality adjusted life years (QALYs). Sensitivity analyses evaluated ranges of possible intervention effectiveness and durations of its effects, and costs were evaluated over several deployment scenarios. The intervention's cost effectiveness depends largely on the number of persons using it and the duration of its effectiveness. Even with modest effects for a small number of patients the intervention was associated with net cost savings in some scenarios and for durations greater than three months and longer it was usually associated with a favorable cost per QALY. For intermediate and larger assumed effects and longer durations of intervention effectiveness, the intervention was associated with net cost savings. Computer-delivered adherence interventions may be a cost-effective strategy to improve adherence in persons treated for HIV. Clinicaltrials.gov identifier NCT01304186.

Integral approaches to wastewater treatment plant upgrading for odor prevention: Activated Sludge and Oxidized Ammonium Recycling.

PubMed

Estrada, José M; Kraakman, N J R; Lebrero, R; Muñoz, R

2015-11-01

Traditional physical/chemical end-of-the-pipe technologies for odor abatement are relatively expensive and present high environmental impacts. On the other hand, biotechnologies have recently emerged as cost-effective and environmentally friendly alternatives but are still limited by their investment costs and land requirements. A more desirable approach to odor control is the prevention of odorant formation before being released to the atmosphere, but limited information is available beyond good design and operational practices of the wastewater treatment process. The present paper reviews two widely applicable and economic alternatives for odor control, Activated Sludge Recycling (ASR) and Oxidized Ammonium Recycling (OAR), by discussing their fundamentals, key operating parameters and experience from the available pilot and field studies. Both technologies present high application potential using readily available plant by-products with a minimum plant upgrading, and low investment and operating costs, contributing to the sustainability and economic efficiency of odor control at wastewater treatment facilities. Copyright © 2015 Elsevier Ltd. All rights reserved.

Nitrogen-doped graphdiyne as a metal-free catalyst for high-performance oxygen reduction reactions

NASA Astrophysics Data System (ADS)

Liu, Rongji; Liu, Huibiao; Li, Yuliang; Yi, Yuanping; Shang, Xinke; Zhang, Shuangshuang; Yu, Xuelian; Zhang, Suojiang; Cao, Hongbin; Zhang, Guangjin

2014-09-01

Fuel cells and metal-air batteries will only become widely available in everyday life when the expensive platinum-based electrocatalysts used for the oxygen reduction reactions are replaced by other efficient, low-cost and stable catalysts. We report here the use of nitrogen-doped graphdiyne as a metal-free electrode with a comparable electrocatalytic activity to commercial Pt/C catalysts for the oxygen reduction reaction in alkaline fuel cells. Nitrogen-doped graphdiyne has a better stability and increased tolerance to the cross-over effect than conventional Pt/C catalysts.Fuel cells and metal-air batteries will only become widely available in everyday life when the expensive platinum-based electrocatalysts used for the oxygen reduction reactions are replaced by other efficient, low-cost and stable catalysts. We report here the use of nitrogen-doped graphdiyne as a metal-free electrode with a comparable electrocatalytic activity to commercial Pt/C catalysts for the oxygen reduction reaction in alkaline fuel cells. Nitrogen-doped graphdiyne has a better stability and increased tolerance to the cross-over effect than conventional Pt/C catalysts. Electronic supplementary information (ESI) available: Detailed RDE and RRDE experiments, additional tables and figures. See DOI: 10.1039/c4nr03185g

Geothermal Technologies Office FY 2017 Budget At-A-Glance

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

None

2016-03-01

The Geothermal Technologies Office (GTO) accelerates deployment of clean, domestic geothermal energy by supporting innovative technologies that reduce the cost and risks of development. This abundant resource generates energy around the clock and has the potential to supply more than 100 GWe of electricity—roughly one-tenth of America’s energy demand. By optimizing the value stream for electricity production and cascaded uses, the office aims to make geothermal energy a fully cost-competitive, widely available, and geographically diverse component of the national energy mix.

COST-BENEFIT Analysis in Railway Noise Control

NASA Astrophysics Data System (ADS)

OERTLI, J.

2000-03-01

A method to calculate the network-wide costs of realizing different noise control possibilities and their benefits in terms of noise reduction for lineside inhabitants has been implemented in Switzerland. These studies have shown that an optimal cost distribution consists of spending 65% of the available finances on rolling stock improvement, 30% on noise control barriers and 5% on insulated windows. This mix protects 70% of the lineside population for 30% of the cost necessary to attain threshold levels for all inhabitants. This noise control strategy has been accepted by the federal traffic and environment agencies involved and will save billions of Swiss francs. The success of the calculation methodology has prompted development of a Europe-wide decision support system to the same effect. Along two freight freeways the relationship between rolling stock improvement, noise barriers, insulated windows, operational measures and track characteristics is being studied. The decision support system will allow determination of those combinations with the best cost-benefit ratios. The study is currently being undertaken as a joint venture by the railways of Switzerland, France, Germany and the Netherlands as well as the European Rail Research Institute. The results constitute part of the negotiating strategy of the railways with European and national legislators.

Novel methods to optimize genotypic imputation for low-coverage, next-generation sequence data in crop plants

USDA-ARS?s Scientific Manuscript database

Next-generation sequencing technology such as genotyping-by-sequencing (GBS) made low-cost, but often low-coverage, whole-genome sequencing widely available. Extensive inbreeding in crop plants provides an untapped, high quality source of phased haplotypes for imputing missing genotypes. We introduc...

Evaluating Online Mathematics Resources: A Practical Approach for Teachers

ERIC Educational Resources Information Center

Handal, Boris; Handal, Parvin; Herrington, Tony

2006-01-01

Gradually Internet-based educational resources are making their way into the school mathematics curriculum. Online resources are potentially useful compared to normal courseware because of their abundance, availability at no cost, platform-free accessibility, and wide reaching accessibility. On the other hand, a major limitation of online…

101 Computer Projects for Libraries. 101 Micro Series.

ERIC Educational Resources Information Center

Dewey, Patrick R.

The projects collected in this book represent a wide cross section of the way microcomputers are used in libraries. Each project description includes organization and contact information, hardware and software used, cost and project length estimates, and Web or print references when available. Projects come from academic and public libraries,…

Will Digital Texts Succeed?

ERIC Educational Resources Information Center

Acker, Stephen R.

2008-01-01

With faculty changing instructional practices to take advantage of customizable, focused content (and digital delivery of that content), many people assume that digital distribution is the answer to bringing the costs of course content delivery in line. But the picture just isn't that simple. A wide continuum of options is available to faculty and…

West Virginia Interpretive Guide Training: A Collaborative Effort

ERIC Educational Resources Information Center

Balcarczyk, Kelly; McKenney, Kathryn; Smaldone, Dave; Arborgast, Doug

2013-01-01

West Virginia University's Extension Service partnered with the Recreation, Parks, and Tourism Resources Program to improve guide performance in West Virginia's tourism industry. The result of this partnership is a West Virginia Interpretive Guide Training program aimed at providing low-cost, widely available training to guides throughout the…

Should Prisoners Have Access to Collegiate Education? A Policy Issue.

ERIC Educational Resources Information Center

Taylor, Jon Marc

1994-01-01

Although postsecondary correctional education (PSCE) programs are available in most state and federal prisons, some taxpayers object to such "largesse" in the face of increasing higher education costs. This article addresses the most common objections to PSCE programming, refutes those arguments, and demonstrates the wide-ranging positive results,…

Robotic technology in surgery: current status in 2008.

PubMed

Murphy, Declan G; Hall, Rohan; Tong, Raymond; Goel, Rajiv; Costello, Anthony J

2008-12-01

There is increasing patient and surgeon interest in robotic-assisted surgery, particularly with the proliferation of da Vinci surgical systems (Intuitive Surgical, Sunnyvale, CA, USA) throughout the world. There is much debate over the usefulness and cost-effectiveness of these systems. The currently available robotic surgical technology is described. Published data relating to the da Vinci system are reviewed and the current status of surgical robotics within Australia and New Zealand is assessed. The first da Vinci system in Australia and New Zealand was installed in 2003. Four systems had been installed by 2006 and seven systems are currently in use. Most of these are based in private hospitals. Technical advantages of this system include 3-D vision, enhanced dexterity and improved ergonomics when compared with standard laparoscopic surgery. Most procedures currently carried out are urological, with cardiac, gynaecological and general surgeons also using this system. The number of patients undergoing robotic-assisted surgery in Australia and New Zealand has increased fivefold in the past 4 years. The most common procedure carried out is robotic-assisted laparoscopic radical prostatectomy. Published data suggest that robotic-assisted surgery is feasible and safe although the installation and recurring costs remain high. There is increasing acceptance of robotic-assisted surgery, especially for urological procedures. The da Vinci surgical system is becoming more widely available in Australia and New Zealand. Other surgical specialties will probably use this technology. Significant costs are associated with robotic technology and it is not yet widely available to public patients.

Damage and protection cost curves for coastal floods within the 600 largest European cities

PubMed Central

Prahl, Boris F.; Boettle, Markus; Costa, Luís; Kropp, Jürgen P.; Rybski, Diego

2018-01-01

The economic assessment of the impacts of storm surges and sea-level rise in coastal cities requires high-level information on the damage and protection costs associated with varying flood heights. We provide a systematically and consistently calculated dataset of macroscale damage and protection cost curves for the 600 largest European coastal cities opening the perspective for a wide range of applications. Offering the first comprehensive dataset to include the costs of dike protection, we provide the underpinning information to run comparative assessments of costs and benefits of coastal adaptation. Aggregate cost curves for coastal flooding at the city-level are commonly regarded as by-products of impact assessments and are generally not published as a standalone dataset. Hence, our work also aims at initiating a more critical discussion on the availability and derivation of cost curves. PMID:29557944

Ethanol production using a soy hydrolysate-based medium or a yeast autolysate-based medium

DOEpatents

Ingram, Lonnie O.

2000-01-01

This invention presents a method for the production of ethanol that utilizes a soy hydrolysate-based nutrient medium or a yeast autolysate-based medium nutrient medium in conjunction with ethanologenic bacteria and a fermentable sugar for the cost-effective production of ethanol from lignocellulosic biomass. The invention offers several advantages over presently available media for use in ethanol production, including consistent quality, lack of toxins and wide availability.

Present and Future of M2M

NASA Astrophysics Data System (ADS)

Ono, Satoru; Watanabe, Takashi

In recent years, the rapid progress in the development of hardware and software technologies enables tiny and low cost information devices hereinafter referred to as Machine to be widely available. M2M (Machine to Machine) has been of much attention where many tiny machines are connected to each other through networks with minimal human intervention to provide smooth and intelligent management. M2M is a promising core technology providing timely, flexible, efficient and comprehensive service at low cost. M2M has wide variety of applications including energy management system, environmental monitoring system, intelligent transport system, industrial automation system and other applications. M2M consists of terminals and networks that connect them. In this paper, we mainly focus on M2M networking and mention the future direction of the technology.

Lessons learned: Infrastructure development and financial management for large, publically funded, international trials

PubMed Central

Larson, Gregg S; Carey, Cate; Grarup, Jesper; Hudson, Fleur; Sachi, Karen; Vjecha, Michael J; Gordin, Fred

2015-01-01

Background/Aims Randomized clinical trials are widely recognized as essential to address world-wide clinical and public health research questions. However, for many conditions, their size and duration can overwhelm available public and private resources. To remain competitive in international research settings, advocates and practitioners of clinical trials must implement practices that reduce their cost. We identify approaches and practices for large, publicly-funded, international trials that reduce cost without compromising data integrity, and recommend an approach to cost reporting that permits comparison of clinical trials. Methods We describe the organizational and financial characteristics of INSIGHT, an infectious disease research network that conducts multiple, large, long-term, international trials, and examine challenges associated with simple and streamlined governance and an infrastructure and financial management model that is based on performance, transparency, and accountability. Results It is possible to reduce costs of participant follow-up and not compromise clinical trial quality or integrity. The INSIGHT network has successfully completed four large HIV trials using cost-efficient practices that have not adversely affected investigator enthusiasm, accrual rates, loss-to-follow-up, adherence to the protocol, and completion of data collection. This experience is relevant to the conduct of large, publically funded trials in other disease areas, particularly trials dependent on international collaborations. Conclusion New approaches, or creative adaption of traditional clinical trial infrastructure and financial management tools, can render large, international clinical trials more cost-efficient by emphasizing structural simplicity; minimal up-front costs; payments for performance; and uniform algorithms and fees-for-service, irrespective of location. However, challenges remain. They include institutional resistance to financial change, growing trial complexity, and the difficulty of sustaining network infrastructure absent stable research work. There is also a need for more central monitoring, improved and harmonized regulations, and a widely-applied metric for measuring and comparing cost efficiency in clinical trials. ClinicalTrials.gov is recommended as a location where standardized trial cost information could be made publicly accessible. PMID:26908541

Turning Access into a web-enabled secure information system for clinical trials.

PubMed

Dongquan Chen; Chen, Wei-Bang; Soong, Mayhue; Soong, Seng-Jaw; Orthner, Helmuth F

2009-08-01

Organizations that have limited resources need to conduct clinical studies in a cost-effective, but secure way. Clinical data residing in various individual databases need to be easily accessed and secured. Although widely available, digital certification, encryption, and secure web server, have not been implemented as widely, partly due to a lack of understanding of needs and concerns over issues such as cost and difficulty in implementation. The objective of this study was to test the possibility of centralizing various databases and to demonstrate ways of offering an alternative to a large-scale comprehensive and costly commercial product, especially for simple phase I and II trials, with reasonable convenience and security. We report a working procedure to transform and develop a standalone Access database into a secure Web-based secure information system. For data collection and reporting purposes, we centralized several individual databases; developed, and tested a web-based secure server using self-issued digital certificates. The system lacks audit trails. The cost of development and maintenance may hinder its wide application. The clinical trial databases scattered in various departments of an institution could be centralized into a web-enabled secure information system. The limitations such as the lack of a calendar and audit trail can be partially addressed with additional programming. The centralized Web system may provide an alternative to a comprehensive clinical trial management system.

Tumor Angiogenesis as a Target for Dietary Cancer Prevention

PubMed Central

Li, William W.; Li, Vincent W.; Hutnik, Michelle; Chiou, Albert S.

2012-01-01

Between 2000 and 2050, the number of new cancer patients diagnosed annually is expected to double, with an accompanying increase in treatment costs of more than $80 billion over just the next decade. Efficacious strategies for cancer prevention will therefore be vital for improving patients' quality of life and reducing healthcare costs. Judah Folkman first proposed antiangiogenesis as a strategy for preventing dormant microtumors from progressing to invasive cancer. Although antiangiogenic drugs are now available for many advanced malignancies (colorectal, lung, breast, kidney, liver, brain, thyroid, neuroendocrine, multiple myeloma, myelodysplastic syndrome), cost and toxicity considerations preclude their broad use for cancer prevention. Potent antiangiogenic molecules have now been identified in dietary sources, suggesting that a rationally designed antiangiogenic diet could provide a safe, widely available, and novel strategy for preventing cancer. This paper presents the scientific, epidemiologic, and clinical evidence supporting the role of an antiangiogenic diet for cancer prevention. PMID:21977033

Industrial ecology: Quantitative methods for exploring a lower carbon future

NASA Astrophysics Data System (ADS)

Thomas, Valerie M.

2015-03-01

Quantitative methods for environmental and cost analyses of energy, industrial, and infrastructure systems are briefly introduced and surveyed, with the aim of encouraging broader utilization and development of quantitative methods in sustainable energy research. Material and energy flow analyses can provide an overall system overview. The methods of engineering economics and cost benefit analysis, such as net present values, are the most straightforward approach for evaluating investment options, with the levelized cost of energy being a widely used metric in electricity analyses. Environmental lifecycle assessment has been extensively developed, with both detailed process-based and comprehensive input-output approaches available. Optimization methods provide an opportunity to go beyond engineering economics to develop detailed least-cost or least-impact combinations of many different choices.

Functional toxicogenomic assessment of triclosan in human HepG2 cells using genome-wide CRISPR-Cas9 screen

EPA Science Inventory

Thousands of chemicals for which limited toxicological data are available are used and then detected in humans and the environment. Rapid and cost-effective approaches for assessing the toxicological properties of chemicals are needed. We used CRISPR-Cas9 functional genomic scree...

Global Wind Map

ERIC Educational Resources Information Center

Journal of College Science Teaching, 2005

2005-01-01

This brief article describes a new global wind-power map that has quantified global wind power and may help planners place turbines in locations that can maximize power from the winds and provide widely available low-cost energy. The researchers report that their study can assist in locating wind farms in regions known for strong and consistent…

Inexpensive optical tweezers for undergraduate laboratories

NASA Astrophysics Data System (ADS)

Smith, Stephen P.; Bhalotra, Sameer R.; Brody, Anne L.; Brown, Benjamin L.; Boyda, Edward K.; Prentiss, Mara

1999-01-01

Single beam gradient force optical traps, or tweezers, are a powerful tool for a wide variety of experiments in physics, chemistry, and biology. We describe how to build an optical tweezer with a total cost of ≈6500 using only commercially available optics and mounts. We also suggest measurements that could be made using the apparatus.

The Web as a Reference Tool: Comparisons with Traditional Sources.

ERIC Educational Resources Information Center

Janes, Joseph; McClure, Charles R.

1999-01-01

This preliminary study suggests that the same level of timeliness and accuracy can be obtained for answers to reference questions using resources in freely available World Wide Web sites as with traditional print-based resources. Discusses implications for library collection development, new models of consortia, training needs, and costing and…

Wallops Arc Second Pointer: WASP Description Subsystems X-Calibur Flight 2017 Test Flight Current Collaborations

NASA Technical Reports Server (NTRS)

Stuchlik, David William

2017-01-01

WASP is a NASA developed Fine Pointing System adaptable to a variety of Science Instruments. Standardized System with Reusable Parts to Minimize the Cost to Users and NASA. Supports Multiple Science Disciplines and a wide range of Masses and Inertias. Currently Operational and Available for Science Collaborations.

Medicare Part D Roulette: Potential Implications of Random Assignment and Plan Restrictions

PubMed Central

Patel, Rajul A.; Walberg, Mark P.; Woelfel, Joseph A.; Amaral, Michelle M.; Varu, Paresh

2013-01-01

Background Dual-eligible (Medicare/Medicaid) beneficiaries are randomly assigned to a benchmark plan, which provides prescription drug coverage under the Part D benefit without consideration of their prescription drug profile. To date, the potential for beneficiary assignment to a plan with poor formulary coverage has been minimally studied and the resultant financial impact to beneficiaries unknown. Objective We sought to determine cost variability and drug use restrictions under each available 2010 California benchmark plan. Methods Dual-eligible beneficiaries were provided Part D plan assistance during the 2010 annual election period. The Medicare Web site was used to determine benchmark plan costs and prescription utilization restrictions for each of the six California benchmark plans available for random assignment in 2010. A standardized survey was used to record all de-identified beneficiary demographic and plan specific data. For each low-income subsidy-recipient (n = 113), cost, rank, number of non-formulary medications, and prescription utilization restrictions were recorded for each available 2010 California benchmark plan. Formulary matching rates (percent of beneficiary's medications on plan formulary) were calculated for each benchmark plan. Results Auto-assigned beneficiaries had only a 34% chance of being assigned to the lowest cost plan; the remainder faced potentially significant avoidable out-of-pocket costs. Wide variations between benchmark plans were observed for plan cost, formulary coverage, formulary matching rates, and prescription utilization restrictions. Conclusions Beneficiaries had a 66% chance of being assigned to a sub-optimal plan; thereby, they faced significant avoidable out-of-pocket costs. Alternative methods of beneficiary assignment could decrease beneficiary and Medicare costs while also reducing medication non-compliance. PMID:24753963

Valuing the Economic Costs of Allergic Rhinitis, Acute Bronchitis, and Asthma from Exposure to Indoor Dampness and Mold in the US

PubMed Central

2016-01-01

Two foundational methods for estimating the total economic burden of disease are cost of illness (COI) and willingness to pay (WTP). WTP measures the full cost to society, but WTP estimates are difficult to compute and rarely available. COI methods are more often used but less likely to reflect full costs. This paper attempts to estimate the full economic cost (2014$) of illnesses resulting from exposure to dampness and mold using COI methods and WTP where the data is available. A limited sensitivity analysis of alternative methods and assumptions demonstrates a wide potential range of estimates. In the final estimates, the total annual cost to society attributable to dampness and mold is estimated to be $3.7 (2.3–4.7) billion for allergic rhinitis, $1.9 (1.1–2.3) billion for acute bronchitis, $15.1 (9.4–20.6) billion for asthma morbidity, and $1.7 (0.4–4.5) billion for asthma mortality. The corresponding costs from all causes, not limited to dampness and mold, using the same approach would be $24.8 billion for allergic rhinitis, $13.5 billion for acute bronchitis, $94.5 billion for asthma morbidity, and $10.8 billion for asthma mortality. PMID:27313630

Low-cost information distribution - New directions for technology developments

NASA Technical Reports Server (NTRS)

Catoe, C. E.

1978-01-01

The use of space satellites for data storage and retrieval is discussed with respect to short-term (1978-1985) and long-term (1985-2000) developments. The present structure, where access to satellite-transmitted data is controlled largely by the Federal Government for its own use, will be gradually replaced by a continually expanding user-community with a broadening scope of needs. Technological improvements in satellite-communication and data-processing will drive down the cost of both transmitting and receiving hardware, making such hardware available to more and more people. By the closing years of the century, personal, direct satellite communication should be available to every American household, providing video, printed, and archivable data over a wide range of subjects, from bank statements to medical records.

The use of a resource-based relative value scale (RBRVS) to determine practice expense costs: a novel technique of practice management for the vascular surgeon.

PubMed

Mabry, C D

2001-03-01

Vascular surgeons have had to contend with rising costs while their reimbursements have undergone steady reductions. The use of newer accounting techniques can help vascular surgeons better manage their practices, plan for future expansion, and control costs. This article reviews traditional accounting methods, together with activity-based costing (ABC) principles that have been used in the past for practice expense analysis. The main focus is on a new technique-resource-based costing (RBC)-which uses the widely available Resource-Based Relative Value Scale (RBRVS) as its basis. The RBC technique promises easier implementation as well as more flexibility in determining true costs of performing various procedures, as opposed to more traditional accounting methods. It is hoped that RBC will assist vascular surgeons in coping with decreasing reimbursement. Copyright 2001 by W.B. Saunders Company

The big hurt: Trauma system funding in today's health care environment.

PubMed

Geehan, Douglas

2010-01-01

Trauma systems provide effective care of the injured patient but require major financial costs in readiness and availability of the extensive trauma team and specialized equipment. Traditional billing and collection practices do not fully recoup these costs. Effective use of the standard billing system is vital to the stability of a trauma system; however, a system wide funding mechanism provides an optimal, stable foundation. Efforts to provide sustainable trauma system funding are ongoing. Numerous state initiatives have been successful in funding trauma systems but a universal solution has yet to be found.

Incidence of Exposure of Patients in the United States to Multiple Drugs for Which Pharmacogenomic Guidelines Are Available.

PubMed

Samwald, Matthias; Xu, Hong; Blagec, Kathrin; Empey, Philip E; Malone, Daniel C; Ahmed, Seid Mussa; Ryan, Patrick; Hofer, Sebastian; Boyce, Richard D

2016-01-01

Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a sufficient number of medications are covered by a single test and future medication exposure can be anticipated. We analysed the incidence of exposure of individual patients in the United States to multiple drugs for which pharmacogenomic guidelines are available (PGx drugs) within a selected four-year period (2009-2012) in order to identify and quantify the incidence of pharmacotherapy in a nation-wide patient population that could be impacted by pre-emptive PGx testing based on currently available clinical guidelines. In total, 73 024 095 patient records from private insurance, Medicare Supplemental and Medicaid were included. Patients enrolled in Medicare Supplemental age > = 65 or Medicaid age 40-64 had the highest incidence of PGx drug use, with approximately half of the patients receiving at least one PGx drug during the 4 year period and one fourth to one third of patients receiving two or more PGx drugs. These data suggest that exposure to multiple PGx drugs is common and that it may be beneficial to implement wide-scale pre-emptive genomic testing. Future work should therefore concentrate on investigating the cost-effectiveness of multiplexed pre-emptive testing strategies.

Implementation of an Integrated Neuroscience Unit.

PubMed

Breslin, Rory P; Franker, Lauren; Sterchi, Suzanne; Sani, Sepehr

2016-02-01

Many challenges exist in today's health care delivery system, and much focus and research are invested into ways to improve care with cost-effective measures. Specialty-specific dedicated care units are one solution for inpatient hospital care because they improve outcomes and decrease mortality. The neuroscience population encompasses a wide variety of diagnoses of spinal to cranial issues with a wide spectrum of needs varying from one patient to the next. Neuroscience care must be patient-specific during the course of frequent acuity changes, and one way to achieve this is through a neuroscience-focused unit. Few resources are available on how to implement this type of unit. Advanced practice nurses are committed to providing high-quality, safe, and cost-effective care and are instrumental in the success of instituting a unit dedicated to the care of neuroscience patients.

Developing Induced Pluripotent Stem Cell-Based Therapy for the Masses.

PubMed

Rao, Mahendra S; Atala, Anthony

2016-02-01

The discovery of induced pluripotent stem cells and the ability to manufacture them using clinically compliant protocols has the potential to revolutionize the field of regenerative medicine. However, realizing this potential requires the development of processes that are reliable, reproducible, and cost-effective and that at the same time do not compromise the safety of the individuals receiving this therapy. In the present report, we discuss how cost reductions can be obtained using our experience with obtaining approval of biologic agents, autologous therapy, and the recent approval of cord blood banks. Significance: For therapy to be widely available, the cost of manufacturing stem cells must be reduced. The steps proposed in the present report, when implemented, have the potential to reduce these costs significantly. ©AlphaMed Press.

Organize to manage reliability

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

Ricketts, R.

An analysis of maintenance costs in hydrocarbon processing industry (HPI) plants has revealed that attitudes and practices of personnel are the major single bottom line factor. In reaching this conclusion, Solomon Associates examined comparative analysis of plant records over the past decade. The authors learned that there was a wide range of performance independent of refinery age, capacity, processing complexity, and location. Facilities of all extremes in these attributes are included in both high-cost and low-cost categories. Those in the lowest quartile of performance posted twice the resource consumption as the best quartile. Furthermore, there was almost no similarity betweenmore » refineries within a single company. The paper discusses cost versus availability, maintenance spending, two organizational approaches used (repair focused and reliability focused), and organizational style and structure.« less

ESMO International Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in countries outside of Europe.

PubMed

Cherny, N I; Sullivan, R; Torode, J; Saar, M; Eniu, A

2017-11-01

The availability and affordability of safe, effective, high-quality, affordable anticancer therapies are a core requirement for effective national cancer control plans. Online survey based on a previously validated approach. The aims of the study were to evaluate (i) the availability on national formulary of licensed antineoplastic medicines across the globe, (ii) patient out-of-pocket costs for the medications, (iii) the actual availability of the medication for a patient with a valid prescription, (iv) information relating to possible factors adversely impacting the availability of antineoplastic agents and (v) the impact of the country's level of economic development on these parameters. A total of 304 field reporters from 97 countries were invited to participate. The preliminary set of data was posted on the ESMO website for open peer review and amendments have been incorporated into the final report. Surveys were submitted by 135 reporters from 63 countries and additional peer-review data were submitted by 54 reporters from 19 countries. There are substantial differences in the formulary availability, out-of-pocket costs and actual availability for many anticancer medicines. The most substantial issues are in lower-middle- and low-income countries. Even among medications on the WHO Model List of Essential Medicines (EML) the discrepancies are profound and these relate to high out-of-pocket costs (in low-middle-income countries 32.0% of EML medicines are available only at full cost and 5.2% are not available at all, and for low-income countries, the corresponding figures are even worse at 57.7% and 8.3%, respectively). There is wide global variation in formulary availability, out-of-pocket expenditures and actual availability for most licensed anticancer medicines. Low- and low-middle-income countries have significant lack of availability and high out-of-pocket expenditures for cancer medicines on the WHO EML, with much less availability of new, more expensive targeted agents compared with high-income countries. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

ESMO International Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in countries outside of Europe

PubMed Central

Cherny, N I; Sullivan, R; Torode, J; Saar, M; Eniu, A

2017-01-01

Abstract Background The availability and affordability of safe, effective, high-quality, affordable anticancer therapies are a core requirement for effective national cancer control plans. Method Online survey based on a previously validated approach. The aims of the study were to evaluate (i) the availability on national formulary of licensed antineoplastic medicines across the globe, (ii) patient out-of-pocket costs for the medications, (iii) the actual availability of the medication for a patient with a valid prescription, (iv) information relating to possible factors adversely impacting the availability of antineoplastic agents and (v) the impact of the country’s level of economic development on these parameters. A total of 304 field reporters from 97 countries were invited to participate. The preliminary set of data was posted on the ESMO website for open peer review and amendments have been incorporated into the final report. Results Surveys were submitted by 135 reporters from 63 countries and additional peer-review data were submitted by 54 reporters from 19 countries. There are substantial differences in the formulary availability, out-of-pocket costs and actual availability for many anticancer medicines. The most substantial issues are in lower-middle- and low-income countries. Even among medications on the WHO Model List of Essential Medicines (EML) the discrepancies are profound and these relate to high out-of-pocket costs (in low-middle-income countries 32.0% of EML medicines are available only at full cost and 5.2% are not available at all, and for low-income countries, the corresponding figures are even worse at 57.7% and 8.3%, respectively). Conclusions There is wide global variation in formulary availability, out-of-pocket expenditures and actual availability for most licensed anticancer medicines. Low- and low-middle-income countries have significant lack of availability and high out-of-pocket expenditures for cancer medicines on the WHO EML, with much less availability of new, more expensive targeted agents compared with high-income countries. PMID:28950323

Jerusalem artichoke (Helianthus tuberosus, L.) maintains high inulin, tuber yield, and antioxidant capacity under moderately-saline irrigation waters

USDA-ARS?s Scientific Manuscript database

The scarcity of good quality water in semiarid regions of the world is the main limiting factor for increased irrigated agriculture in those regions. Saline water is generally widely available in arid regions at reduced costs, and can be a viable alternative for crop irrigation. However, the literat...

National Implementation of an Evidence-Based HIV Prevention and Reproductive Health Program for Bahamian Youth

ERIC Educational Resources Information Center

Knowles, Valerie; Kaljee, Linda; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Stanton, Bonita

2012-01-01

A wide range of behavioral prevention interventions have been demonstrated through longitudinal, randomized controlled trials to reduce sexual risk behaviors. Many of these interventions have been made available at little cost for implementation on a public health scale. However, efforts to utilize such programs typically have been met with a…

Viability of Commercially Available Bleach for Water Treatment in Developing Countries

PubMed Central

2009-01-01

Treating household water with low-cost, widely available commercial bleach is recommended by some organizations to improve water quality and reduce disease in developing countries. I analyzed the chlorine concentration of 32 bleaches from 12 developing countries; the average error between advertised and measured concentration was 35% (range = –45%–100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing. PMID:19762657

Viability of commercially available bleach for water treatment in developing countries.

PubMed

Lantagne, Daniele S

2009-11-01

Treating household water with low-cost, widely available commercial bleach is recommended by some organizations to improve water quality and reduce disease in developing countries. I analyzed the chlorine concentration of 32 bleaches from 12 developing countries; the average error between advertised and measured concentration was 35% (range = -45%-100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing.

Low-cost embedded systems for democratizing ocean sensor technology in the coastal zone

NASA Astrophysics Data System (ADS)

Glazer, B. T.; Lio, H. I.

2017-12-01

Environmental sciences suffer from undersampling. Enabling sustained and unattended data collection in the coastal zone typically involves expensive instrumentation and infrastructure deployed as cabled observatories or moorings with little flexibility in deployment location following initial installation. High costs of commercially-available or custom instruments have limited the number of sensor sites that can be targeted by academic researchers, and have also limited engagement with the public. We have developed a novel, low-cost, open-source sensor and software platform to enable wireless data transfer of biogeochemical sensors in the coastal zone. The platform is centered upon widely available, low-cost, single board computers and microcontrollers. We have used a blend of on-hand research-grade sensors and low-cost open-source electronics that can be assembled by tech-savvy non-engineers. Robust, open-source code that remains customizable for specific miniNode configurations can match a specific site's measurement needs, depending on the scientific research priorities. We have demonstrated prototype capabilities and versatility through lab testing and field deployments of multiple sensor nodes with multiple sensor inputs, all of which are streaming near-real-time data from Kaneohe Bay over wireless RF links to a shore-based base station.

Application of low-cost adsorbents for dye removal--a review.

PubMed

Gupta, V K; Suhas

2009-06-01

Dyes are an important class of pollutants, and can even be identified by the human eye. Disposal of dyes in precious water resources must be avoided, however, and for that various treatment technologies are in use. Among various methods adsorption occupies a prominent place in dye removal. The growing demand for efficient and low-cost treatment methods and the importance of adsorption has given rise to low-cost alternative adsorbents (LCAs). This review highlights and provides an overview of these LCAs comprising natural, industrial as well as synthetic materials/wastes and their application for dyes removal. In addition, various other methods used for dye removal from water and wastewater are also complied in brief. From a comprehensive literature review, it was found that some LCAs, in addition to having wide availability, have fast kinetics and appreciable adsorption capacities too. Advantages and disadvantages of adsorbents, favourable conditions for particular adsorbate-adsorbent systems, and adsorption capacities of various low-cost adsorbents and commercial activated carbons as available in the literature are presented. Conclusions have been drawn from the literature reviewed, and suggestions for future research are proposed.

Cell Lines Models of Drug Response: Successes and Lessons from this Pharmacogenomic Model

PubMed Central

Jack, J.; Rotroff, D.; Motsinger-Reif, A.

2015-01-01

A new standard for medicine is emerging that aims to improve individual drug responses through studying associations with genetic variations. This field, pharmacogenomics, is undergoing a rapid expansion due to a variety of technological advancements that are enabling higher throughput with reductions in cost. Here we review the advantages, limitations, and opportunities for using lymphoblastoid cell lines (LCL) as a model system for human pharmacogenomic studies. There are a wide range of publicly available resources with genome-wide data available for LCLs from both related and unrelated populations, removing the cost of genotyping the data for drug response studies. Furthermore, in contrast to human clinical trials or in vivo model systems, with high-throughput in vitro screening technologies, pharmacogenomics studies can easily be scaled to accommodate large sample sizes. An important component to leveraging genome-wide data in LCL models is association mapping. Several methods are discussed herein, and include multivariate concentration response modeling, issues with multiple testing, and successful examples of the ‘triangle model’ to identify candidate variants. Once candidate gene variants have been determined, their biological roles can be elucidated using pathway analyses and functionally confirmed using siRNA knockdown experiments. The wealth of genomics data being produced using related and unrelated populations is creating many exciting opportunities leading to new insights into the genetic contribution and heritability of drug response. PMID:25109794

Economic costs of drug abuse: financial, cost of illness, and services.

PubMed

Cartwright, William S

2008-03-01

This article examines costs as they relate to the financial costs of providing drug abuse treatment in private and public health plans, costs to society relating to drug abuse, and many smaller costing studies of various stakeholders in the health care system. A bibliography is developed from searches across PubMed, Web of Science, and other bibliographic sources. The review indicates that a wide collection of cost findings is available to policy makers. For example, the financial aspects of health plans have been dominated by considerations of actuarial costs of parity for drug abuse treatment. Cost-of-illness methods have been developed and extended to drug abuse costing to measure the national level of burden and are important to the economic evaluation of interventions at the program level. Costing is done in many small and focused studies, reflecting the interests of different stakeholders in the health care system. For costs in programs and health plans, as well as cost offsets of the impact of substance abuse treatment on medical expenditures, findings are surprisingly important to policy makers. Maintaining ongoing research that is highly policy relevant from the point of view of health services, more is needed on costing concepts and measurement applications.

Funds allocation in NPOs: the role of administrative cost ratios.

PubMed

Burkart, Christian; Wakolbinger, Tina; Toyasaki, Fuminori

2018-01-01

Performance measurement of Non-Profit Organizations (NPOs) is of increasing importance for aid agencies, policy-makers and donors. A widely used benchmark for measuring the efficiency of NPOs is the overhead cost ratio, consisting of the total money spent on administration and fundraising relative to the budget. Donors generally favor a lower overhead cost ratio as it ensures that more money directly reaches beneficiaries. Unlike fundraising expenses, administrative costs do not contribute to advertising the actions of an NPO even though they account for a significant proportion of overhead cost. Reducing administrative expenses is a logical consequence from a financial viewpoint, but might negatively affect NPOs through the resulting administrative capacities. This phenomenon is known as "Nonprofit Starvation Cycle". This work provides an analytical framework for analyzing NPO decision making concerning administrative costs. The paper provides answers to important research questions on the optimal level of administrative spending, the influencing factors and the effects of available information on NPOs. The research shows that focusing on financial performance measurements can result in reduced utility created for NPOs. Less transparency often leads to increased utility for NPOs, but more transparency can increase NPOs' utility if the information available exceeds a certain threshold. Fluctuating donations are challenging for NPOs' planning and may impact administrative capacities negatively.

Optimal subhourly electricity resource dispatch under multiple price signals with high renewable generation availability

DOE PAGES

Chassin, David P.; Behboodi, Sahand; Djilali, Ned

2018-01-28

This article proposes a system-wide optimal resource dispatch strategy that enables a shift from a primarily energy cost-based approach, to a strategy using simultaneous price signals for energy, power and ramping behavior. A formal method to compute the optimal sub-hourly power trajectory is derived for a system when the price of energy and ramping are both significant. Optimal control functions are obtained in both time and frequency domains, and a discrete-time solution suitable for periodic feedback control systems is presented. The method is applied to North America Western Interconnection for the planning year 2024, and it is shown that anmore » optimal dispatch strategy that simultaneously considers both the cost of energy and the cost of ramping leads to significant cost savings in systems with high levels of renewable generation: the savings exceed 25% of the total system operating cost for a 50% renewables scenario.« less

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

PubMed

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

2013-01-01

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

Optimal subhourly electricity resource dispatch under multiple price signals with high renewable generation availability

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

Chassin, David P.; Behboodi, Sahand; Djilali, Ned

This article proposes a system-wide optimal resource dispatch strategy that enables a shift from a primarily energy cost-based approach, to a strategy using simultaneous price signals for energy, power and ramping behavior. A formal method to compute the optimal sub-hourly power trajectory is derived for a system when the price of energy and ramping are both significant. Optimal control functions are obtained in both time and frequency domains, and a discrete-time solution suitable for periodic feedback control systems is presented. The method is applied to North America Western Interconnection for the planning year 2024, and it is shown that anmore » optimal dispatch strategy that simultaneously considers both the cost of energy and the cost of ramping leads to significant cost savings in systems with high levels of renewable generation: the savings exceed 25% of the total system operating cost for a 50% renewables scenario.« less

A Cost Framework for the Economic Feasibility of Wide-Scale Biochar Production

NASA Astrophysics Data System (ADS)

Pourhashem, G.; Masiello, C. A.; Medlock, K. B., III

2017-12-01

Biochar is a product of biomass pyrolysis, one of the main thermal pathways of producing biofuels. In addition to sequestering carbon, biochar's soil application helps sustainable agriculture by enhancing soil's structure and ecological functions, as well as lowering NO release from fertilized soils. However, wide-scale biochar land amendment has been limited in part due to its high cost. To examine biochar's cost dynamics, we develop a comprehensive framework for a representative biochar production facility and identify system inputs that are the key drivers of cost and profitability. We assess the production cost of fast and slow pyrolysis-biochar considering a range of parameters e.g. biomass type, process design and scale. We analyzed techno-economic cost data for producing biochar using simulated data from academic literature, and active producer data collected under confidentiality agreement. The combined approach was used to enhance the depth of the dataset and allowed for a reasonable check on published simulated data. Fast and slow pyrolysis have different biofuel and biochar yields and profit. A slow pyrolysis facility recovers its expenses mainly through biochar sale while a fast pyrolysis facility generates its primary revenue through biofuel sale, largely considering biochar a byproduct. Unlike fast pyrolysis that has received most attention in techno-economic studies, publicly available techno-economic data of slow pyrolysis is sparse. This limits the ability to run a thorough cost-benefit analysis to inform the feasibility of wider adoption of biochar for capturing its carbon sequestration and broader environmental benefits. Our model allows for consideration of various market-based policy instruments and can be used as an analytical decision making tool for investors and policy makers to estimate the cost and optimum facility size. This dynamic framework can also be adapted to account for the availability of new data as technology improves and industry evolves. Our study helps identify pyrolysis pathways that are most economically suitable for scaling up biochar production for ecosystem carbon storage and environmental improvement. Finally, we discuss the market development or policy strategies that can make biochar an attractive environmental mitigation tool for decision makers.

Review of Real-Time Simulator and the Steps Involved for Implementation of a Model from MATLAB/SIMULINK to Real-Time

NASA Astrophysics Data System (ADS)

Mikkili, Suresh; Panda, Anup Kumar; Prattipati, Jayanthi

2015-06-01

Nowadays the researchers want to develop their model in real-time environment. Simulation tools have been widely used for the design and improvement of electrical systems since the mid twentieth century. The evolution of simulation tools has progressed in step with the evolution of computing technologies. In recent years, computing technologies have improved dramatically in performance and become widely available at a steadily decreasing cost. Consequently, simulation tools have also seen dramatic performance gains and steady cost decreases. Researchers and engineers now have the access to affordable, high performance simulation tools that were previously too cost prohibitive, except for the largest manufacturers. This work has introduced a specific class of digital simulator known as a real-time simulator by answering the questions "what is real-time simulation", "why is it needed" and "how it works". The latest trend in real-time simulation consists of exporting simulation models to FPGA. In this article, the Steps involved for implementation of a model from MATLAB to REAL-TIME are provided in detail.

Mumps vaccine virus strains and aseptic meningitis.

PubMed

Bonnet, Marie-Claude; Dutta, Anil; Weinberger, Clement; Plotkin, Stanley A

2006-11-30

Mumps immunization can easily be included in national schedules, particularly if combined with measles or measles and rubella vaccines, but debate continues concerning the relative safety of various licensed mumps vaccine strains. The opportunities for control of mumps are also being affected by differences in the cost of the vaccines prepared with different strains of mumps virus. The present report evaluates available data on the association of the Urabe and other strains of mumps vaccine with the occurrence of aseptic meningitis. We also review the comparative immunogenicity and efficacies of the most widely used mumps vaccines in controlled clinical trials and field evaluations, and briefly examine relative cost as it relates to the implementation of national immunization programs. We conclude that extensive experience with the most widely used mumps vaccine strains in many countries has shown that the risk-benefit ratio of live mumps vaccines is highly favourable for vaccination, despite the occasional occurence of aseptic meningitis.

Lead (Pb) Hohlraum: Target for Inertial Fusion Energy

PubMed Central

Ross, J. S.; Amendt, P.; Atherton, L. J.; Dunne, M.; Glenzer, S. H.; Lindl, J. D.; Meeker, D.; Moses, E. I.; Nikroo, A.; Wallace, R.

2013-01-01

Recent progress towards demonstrating inertial confinement fusion (ICF) ignition at the National Ignition Facility (NIF) has sparked wide interest in Laser Inertial Fusion Energy (LIFE) for carbon-free large-scale power generation. A LIFE-based fleet of power plants promises clean energy generation with no greenhouse gas emissions and a virtually limitless, widely available thermonuclear fuel source. For the LIFE concept to be viable, target costs must be minimized while the target material efficiency or x-ray albedo is optimized. Current ICF targets on the NIF utilize a gold or depleted uranium cylindrical radiation cavity (hohlraum) with a plastic capsule at the center that contains the deuterium and tritium fuel. Here we show a direct comparison of gold and lead hohlraums in efficiently ablating deuterium-filled plastic capsules with soft x rays. We report on lead hohlraum performance that is indistinguishable from gold, yet costing only a small fraction. PMID:23486285

Lead (Pb) hohlraum: target for inertial fusion energy.

PubMed

Ross, J S; Amendt, P; Atherton, L J; Dunne, M; Glenzer, S H; Lindl, J D; Meeker, D; Moses, E I; Nikroo, A; Wallace, R

2013-01-01

Recent progress towards demonstrating inertial confinement fusion (ICF) ignition at the National Ignition Facility (NIF) has sparked wide interest in Laser Inertial Fusion Energy (LIFE) for carbon-free large-scale power generation. A LIFE-based fleet of power plants promises clean energy generation with no greenhouse gas emissions and a virtually limitless, widely available thermonuclear fuel source. For the LIFE concept to be viable, target costs must be minimized while the target material efficiency or x-ray albedo is optimized. Current ICF targets on the NIF utilize a gold or depleted uranium cylindrical radiation cavity (hohlraum) with a plastic capsule at the center that contains the deuterium and tritium fuel. Here we show a direct comparison of gold and lead hohlraums in efficiently ablating deuterium-filled plastic capsules with soft x rays. We report on lead hohlraum performance that is indistinguishable from gold, yet costing only a small fraction.

Printed wide-slot antenna design with bandwidth and gain enhancement on low-cost substrate.

PubMed

Samsuzzaman, M; Islam, M T; Mandeep, J S; Misran, N

2014-01-01

This paper presents a printed wide-slot antenna design and prototyping on available low-cost polymer resin composite material fed by a microstrip line with a rotated square slot for bandwidth enhancement and defected ground structure for gain enhancement. An I-shaped microstrip line is used to excite the square slot. The rotated square slot is embedded in the middle of the ground plane, and its diagonal points are implanted in the middle of the strip line and ground plane. To increase the gain, four L-shaped slots are etched in the ground plane. The measured results show that the proposed structure retains a wide impedance bandwidth of 88.07%, which is 20% better than the reference antenna. The average gain is also increased, which is about 4.17 dBi with a stable radiation pattern in the entire operating band. Moreover, radiation efficiency, input impedance, current distribution, axial ratio, and parametric studies of S11 for different design parameters are also investigated using the finite element method-based simulation software HFSS.

Printed Wide-Slot Antenna Design with Bandwidth and Gain Enhancement on Low-Cost Substrate

PubMed Central

Samsuzzaman, M.; Islam, M. T.; Mandeep, J. S.; Misran, N.

2014-01-01

This paper presents a printed wide-slot antenna design and prototyping on available low-cost polymer resin composite material fed by a microstrip line with a rotated square slot for bandwidth enhancement and defected ground structure for gain enhancement. An I-shaped microstrip line is used to excite the square slot. The rotated square slot is embedded in the middle of the ground plane, and its diagonal points are implanted in the middle of the strip line and ground plane. To increase the gain, four L-shaped slots are etched in the ground plane. The measured results show that the proposed structure retains a wide impedance bandwidth of 88.07%, which is 20% better than the reference antenna. The average gain is also increased, which is about 4.17 dBi with a stable radiation pattern in the entire operating band. Moreover, radiation efficiency, input impedance, current distribution, axial ratio, and parametric studies of S11 for different design parameters are also investigated using the finite element method-based simulation software HFSS. PMID:24696661

Automated Low-Cost Smartphone-Based Lateral Flow Saliva Test Reader for Drugs-of-Abuse Detection.

PubMed

Carrio, Adrian; Sampedro, Carlos; Sanchez-Lopez, Jose Luis; Pimienta, Miguel; Campoy, Pascual

2015-11-24

Lateral flow assay tests are nowadays becoming powerful, low-cost diagnostic tools. Obtaining a result is usually subject to visual interpretation of colored areas on the test by a human operator, introducing subjectivity and the possibility of errors in the extraction of the results. While automated test readers providing a result-consistent solution are widely available, they usually lack portability. In this paper, we present a smartphone-based automated reader for drug-of-abuse lateral flow assay tests, consisting of an inexpensive light box and a smartphone device. Test images captured with the smartphone camera are processed in the device using computer vision and machine learning techniques to perform automatic extraction of the results. A deep validation of the system has been carried out showing the high accuracy of the system. The proposed approach, applicable to any line-based or color-based lateral flow test in the market, effectively reduces the manufacturing costs of the reader and makes it portable and massively available while providing accurate, reliable results.

NASA Innovation Builds Better Nanotubes

NASA Technical Reports Server (NTRS)

2008-01-01

Nanotailor Inc., based in Austin, Texas, licensed Goddard Space Flight Center's unique single-walled carbon nanotube (SWCNT) fabrication process with plans to make high-quality, low-cost SWCNTs available commercially. Carbon nanotubes are being used in a wide variety of applications, and NASA's improved production method will increase their applicability in medicine, microelectronics, advanced materials, and molecular containment. Nanotailor built and tested a prototype based on Goddard's process, and is using this technique to lower the cost and improve the integrity of nanotubes, offering a better product for use in biomaterials, advanced materials, space exploration, highway and building construction, and many other applications.

Cool Tools for the New Frontier: Technological Advances Help Associates Tell Their Story.

ERIC Educational Resources Information Center

Hersch, James

1998-01-01

Argues that creation of a World Wide Web site that makes good use of the available digital audio and visual technologies can be useful in campus activities planning and advertising. The design of a good Web site and the potential uses of digital video and compact discs are discussed. Costs of these technologies are also outlined. (MSE)

Persuasive Email Messages for Patient Communication

PubMed Central

Walji, Muhammad; Johnson-Throop, Kathy; Johnson, Todd; Bernstam, Elmer; Zhang, Jiajie

2005-01-01

To improve health and reduce costs, we need to encourage patients to make better health care decisions. Since email is widely available, it may be useful for patient-directed interventions. However, we know little about how the contents of an email message can influence a health-related decision. We propose a model to understand how patients may process persuasive email messages. PMID:16779434

Galilean Moons, Kepler's Third Law, and the Mass of Jupiter

ERIC Educational Resources Information Center

Bates, Alan

2013-01-01

Simulations of physical systems are widely available online, with no cost, and are ready to be used in our classrooms. Such simulations offer an accessible tool that can be used for a range of interactive learning activities. The Jovian Moons Apple allows the user to track the position of Jupiter's four Galilean moons with a variety of…

Laboratory diagnostics of malaria

NASA Astrophysics Data System (ADS)

Siahaan, L.

2018-03-01

Even now, malaria treatment should only be administered after laboratory confirmation. There are several principal methods for diagnosing malaria. All these methods have their disadvantages.Presumptive treatment of malaria is widely practiced where laboratory tests are not readily available. Microscopy of Giemsa-stained thick and thin blood films remains the gold standard for the diagnosis of malaria infection. The technique of slide preparation, staining and reading are well known and standardized, and so is the estimate of the parasite density and parasite stages. Microscopy is not always available or feasible at primary health services in limited resource settings due to cost, lack of skilled manpower, accessories and reagents required. Rapid diagnostic tests (RDTs) are potential tools for parasite-based diagnosis since the tests are accurate in detecting malaria infections and are easy to use. The test is based on the capture of parasite antigen that released from parasitized red blood cells using monoclonal antibodies prepared against malaria antigen target. Polymerase Chain Reaction (PCR), depend on DNA amplification approaches and have higher sensitivity than microscopy. PCR it is not widely used due to the lack of a standardized methodology, high costs, and the need for highly-trained staff.

Dynamic simulation of crime perpetration and reporting to examine community intervention strategies.

PubMed

Yonas, Michael A; Burke, Jessica G; Brown, Shawn T; Borrebach, Jeffrey D; Garland, Richard; Burke, Donald S; Grefenstette, John J

2013-10-01

To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents' behavioral probabilities modify depending on the individual's experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect sustainability. ABM illustrates how intervention models might be used to investigate community-supported crime intervention programs.

Drug formularies--good or evil? A view using prescribing analyses and cost trends data.

PubMed

Chapman, S

1994-01-01

In the UK, the drugs bill has almost trebled in the last 10 years and is consuming an increasing proportion of the total National Health Service spend. If the drugs bill can be limited, greater funds will be available for other areas of the health service. Therefore, cost containment measures which include prescribing from a formulary or generic prescribing are now widely encouraged. Prescribing analyses and cost trends data generated from pharmacists sending dispensed general practitioners' prescriptions to a central point for reimbursement are a valuable tool in the assessment of prescribing habits and can be used by general practitioners when preparing a formulary. In the West Midlands, such data have been used to identify areas of growth in cardiovascular drugs and problem areas where prescribing an expensive formulation has led to a dramatic increase in costs.

Do We Really Know how Much it Costs to Construct High Performance Buildings?

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

Livingston, Olga V.; Dillon, Heather E.; Halverson, Mark A.

2012-08-31

Understanding the cost of energy efficient construction is critical to decision makers in building design, code development, and energy analysis. How much does it cost to upgrade from R-13 to R-19 in a building wall? How much do low-e windows really cost? Can we put a dollar figure on commissioning? Answers to these questions have a fuzzy nature, based on educated guesses and industry lore. The response depends on location, perspective, bulk buying, and hand waving. This paper explores the development of a web tool intended to serve as a publicly available repository of building component costs. In 2011 themore » U.S. Department of Energy (DOE) funded the launch of a web tool called the Building Component Cost Community (BC3), dedicated to publishing building component costs from documented sources, actively gathering verifiable cost data from the users, and collecting feedback from a wide range of participants on the quality of the posted cost data. The updated BC3 database, available at http://bc3.pnnl.gov, went live on April 30, 2012. BC3 serves as the ultimate source of the energy-related component costs for DOE’s residential code development activities, including cost-effectiveness analyses. The paper discusses BC3 objectives, structure, functionality and the current content of the database. It aims to facilitate a dialog about the lack of verifiable transparent cost data, as well as introduce a web tool that helps to address the problem. The questions posed above will also be addressed by this paper, but they have to be resolved by the user community by providing feedback and cost data to the BC3 database, thus increasing transparency and removing information asymmetry.« less

Potential public sector cost-savings from over-the-counter access to oral contraceptives.

PubMed

Foster, Diana G; Biggs, M Antonia; Phillips, Kathryn A; Grindlay, Kate; Grossman, Daniel

2015-05-01

This study estimates how making oral contraceptive pills (OCPs) available without a prescription may affect contraceptive use, unintended pregnancies and associated contraceptive and pregnancy costs among low-income women. Based on published figures, we estimate two scenarios [low over-the-counter (OTC) use and high OTC use] of the proportion of low-income women likely to switch to an OTC pill and predict adoption of OCPs according to the out-of-pocket costs per pill pack. We then estimate cost-savings of each scenario by comparing the total public sector cost of providing OCPs OTC and medical care for unintended pregnancy. Twenty-one percent of low-income women at risk for unintended pregnancy are very likely to use OCPs if they were available without a prescription. Women's use of OTC OCPs varies widely by the out-of-pocket pill pack cost. In a scenario assuming no out-of-pocket costs for the over-the counter pill, an additional 11-21% of low-income women will use the pill, resulting in a 20-36% decrease in the number of women using no method or a method less effective than the pill, and a 7-25% decrease in the number of unintended pregnancies, depending on the level of use and any effect on contraceptive failure rates. If out-of-pocket costs for such pills are low, OTC access could have a significant effect on use of effective contraceptives and unintended pregnancy. Public health plans may reduce expenditures on pregnancy and contraceptive healthcare services by covering oral contraceptives as an OTC product. Interest in OTC access to oral contraceptives is high. Removing the prescription barrier, particularly if pill packs are available at low or zero out-of-pocket cost, could increase the use of effective methods of contraception and reduce unintended pregnancy and healthcare costs for contraceptive and pregnancy care. Copyright © 2015 Elsevier Inc. All rights reserved.

Estimated costs of production and potential prices for the WHO Essential Medicines List

PubMed Central

Hill, Andrew M; Barber, Melissa J

2018-01-01

Introduction There are persistent gaps in access to affordable medicines. The WHO Model List of Essential Medicines (EML) includes medicines considered necessary for functional health systems. Methods A generic price estimation formula was developed by reviewing published analyses of cost of production for medicines and assuming manufacture in India, which included costs of formulation, packaging, taxation and a 10% profit margin. Data on per-kilogram prices of active pharmaceutical ingredient exported from India were retrieved from an online database. Estimated prices were compared with the lowest globally available prices for HIV/AIDS, tuberculosis (TB) and malaria medicines, and current prices in the UK, South Africa and India. Results The estimation formula had good predictive accuracy for HIV/AIDS, TB and malaria medicines. Estimated generic prices ranged from US$0.01 to US$1.45 per unit, with most in the lower end of this range. Lowest available prices were greater than estimated generic prices for 214/277 (77%) comparable items in the UK, 142/212 (67%) in South Africa and 118/298 (40%) in India. Lowest available prices were more than three times above estimated generic price for 47% of cases compared in the UK and 22% in South Africa. Conclusion A wide range of medicines in the EML can be profitably manufactured at very low cost. Most EML medicines are sold in the UK and South Africa at prices significantly higher than those estimated from production costs. Generic price estimation and international price comparisons could empower government price negotiations and support cost-effectiveness calculations. PMID:29564159

Cost and cost-effectiveness of HIV/AIDS prevention strategies in developing countries: is there an evidence base?

PubMed

Walker, Damian

2003-03-01

Many donors and countries are striving to respond to the HIV/AIDS epidemic by implementing prevention programmes. However, the resources available for providing these activities relative to needs are limited. Hence, decision-makers must choose among various types of interventions. Cost information, both measures of cost and cost-effectiveness, serves as a critical input into the processes of setting priorities and allocating resources efficiently. This paper reviews the cost and cost-effectiveness evidence base of HIV/AIDS prevention programmes in low- and middle-income countries (LMICs). None of the studies found have complete cost data for a full range of HIV/AIDS prevention programmes in any one country. However, the range of studies highlight the relative emphasis of different types of HIV/AIDS prevention strategies by region, reflecting the various modes of transmission and hence, to a certain extent, the stage of the epidemic. The costing methods applied and results obtained in this review give rise to questions of reliability, validity and transparency. First, not all of the studies report the methods used to calculate the costs, and/or do not provide all the necessary data inputs such that recalculation of the results is possible. Secondly, methods that are documented vary widely, rendering different studies, even within the same country and programme setting, largely incomparable. Finally, even with consistent and replicable measurement, the results as presented are generally not comparable because of the lack of a common outcome measure. Therefore, the extent to which the available cost and cost-effectiveness evidence base on HIV/AIDS prevention strategies can provide guidance to decision-makers is limited, and there is an urgent need for the generation of this knowledge for planning and decision-making.

Hurricane Loss Estimation Models: Opportunities for Improving the State of the Art.

NASA Astrophysics Data System (ADS)

Watson, Charles C., Jr.; Johnson, Mark E.

2004-11-01

The results of hurricane loss models are used regularly for multibillion dollar decisions in the insurance and financial services industries. These models are proprietary, and this “black box” nature hinders analysis. The proprietary models produce a wide range of results, often producing loss costs that differ by a ratio of three to one or more. In a study for the state of North Carolina, 324 combinations of loss models were analyzed, based on a combination of nine wind models, four surface friction models, and nine damage models drawn from the published literature in insurance, engineering, and meteorology. These combinations were tested against reported losses from Hurricanes Hugo and Andrew as reported by a major insurance company, as well as storm total losses for additional storms. Annual loss costs were then computed using these 324 combinations of models for both North Carolina and Florida, and compared with publicly available proprietary model results in Florida. The wide range of resulting loss costs for open, scientifically defensible models that perform well against observed losses mirrors the wide range of loss costs computed by the proprietary models currently in use. This outcome may be discouraging for governmental and corporate decision makers relying on this data for policy and investment guidance (due to the high variability across model results), but it also provides guidance for the efforts of future investigations to improve loss models. Although hurricane loss models are true multidisciplinary efforts, involving meteorology, engineering, statistics, and actuarial sciences, the field of meteorology offers the most promising opportunities for improvement of the state of the art.

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

Hummon, M.; Kiliccote, S.

Demand response (DR) resources present a potentially important source of grid flexibility however, DR in grid models is limited by data availability and modeling complexity. This presentation focuses on the co-optimization of DR resources to provide energy and ancillary services in a production cost model of the Colorado "test system". We assume each DR resource can provide energy services by either shedding load or shifting its use between different times, as well as operating reserves: frequency regulation, contingency reserve, and flexibility (or ramping) reserve. There are significant variations in the availabilities of different types of DR resources, which affect bothmore » the operational savings as well as the revenue for each DR resource. The results presented include the system-wide avoided fuel and generator start-up costs as well as the composite revenue for each DR resource by energy and operating reserves.« less

Using MODIS Terra 250 m Imagery to Map Concentrations of Total Suspended Matter in Coastal Waters

NASA Technical Reports Server (NTRS)

Miller, Richard L.; McKee, Brent A.

2004-01-01

High concentrations of suspended particulate matter in coastal waters directly effect or govern numerous water column and benthic processes. The concentration of suspended sediments derived from bottom sediment resuspension or discharge of sediment-laden rivers is highly variable over a wide range of time and space scales. Although there has been considerable effort to use remotely sensed images to provide synoptic maps of suspended particulate matter, there are limited routine applications of this technology due in-part to the low spatial resolution, long revisit period, or cost of most remotely sensed data. In contrast, near daily coverage of medium-resolution data is available from the MODIS Terra instrument without charge from several data distribution gateways. Equally important, several display and processing programs are available that operate on low cost computers.

The burden of multiple sclerosis 2015: Methods of data collection, assessment and analysis of costs, quality of life and symptoms.

PubMed

Kobelt, Gisela; Eriksson, Jennifer; Phillips, Glenn; Berg, Jenny

2017-08-01

This article describes the methods used to perform this large European-wide burden-of-illness study on multiple sclerosis (MS) using individual patient data. The study collected all MS-related resource consumption, workforce participation, prevalent disease symptoms and health-related quality of life (HRQoL). Patients were recruited by national patient associations and, after informed consent, completed a specific questionnaire either on-line or on paper. Analyses were performed by country as well as for the study overall. Costs were estimated from the societal perspective, using publicly available unit costs and reported in national currencies and in EUR 2015 adjusted for purchasing power parity. The results are reported by disease severity groups according to self-assessed Expanded Disability Status Scale (EDSS) (mild, moderate, severe) and by EDSS point to highlight the development of costs as disability progresses. A total of 16,808 patients in 16 countries participated in the study: Austria, Belgium, Denmark, Czech Republic, France, Germany, Hungary, Italy, the Netherlands, Poland, Portugal, Russia, Spain, Sweden, Switzerland and the United Kingdom. This study, endorsed by the European Platform of MS Societies, provides up-to-date information on costs and expands the previously available information on HRQoL and symptoms.

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy

PubMed Central

Narra, Roberta; Maestri, Marcello; Budke, Christine M.; Tamarozzi, Francesca; Mariconti, Mara; Nicoletti, Giovanni J.; Rinaldi, Francesca; Brunetti, Enrico

2016-01-01

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the “San Matteo” Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach. PMID:27273641

Direct cost analysis of intensive care unit stay in four European countries: applying a standardized costing methodology.

PubMed

Tan, Siok Swan; Bakker, Jan; Hoogendoorn, Marga E; Kapila, Atul; Martin, Joerg; Pezzi, Angelo; Pittoni, Giovanni; Spronk, Peter E; Welte, Robert; Hakkaart-van Roijen, Leona

2012-01-01

The objective of the present study was to measure and compare the direct costs of intensive care unit (ICU) days at seven ICU departments in Germany, Italy, the Netherlands, and the United Kingdom by means of a standardized costing methodology. A retrospective cost analysis of ICU patients was performed from the hospital's perspective. The standardized costing methodology was developed on the basis of the availability of data at the seven ICU departments. It entailed the application of the bottom-up approach for "hotel and nutrition" and the top-down approach for "diagnostics," "consumables," and "labor." Direct costs per ICU day ranged from €1168 to €2025. Even though the distribution of costs varied by cost component, labor was the most important cost driver at all departments. The costs for "labor" amounted to €1629 at department G but were fairly similar at the other departments (€711 ± 115). Direct costs of ICU days vary widely between the seven departments. Our standardized costing methodology could serve as a valuable instrument to compare actual cost differences, such as those resulting from differences in patient case-mix. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessment of Solid Sorbent Systems for Post-Combustion Carbon Dioxide Capture at Coal-Fired Power Plants

NASA Astrophysics Data System (ADS)

Glier, Justin C.

In an effort to lower future CO2 emissions, a wide range of technologies are being developed to scrub CO2 from the flue gases of fossil fuel-based electric power and industrial plants. This thesis models one of several early-stage post-combustion CO2 capture technologies, solid sorbent-based CO2 capture process, and presents performance and cost estimates of this system on pulverized coal power plants. The spreadsheet-based software package Microsoft Excel was used in conjunction with AspenPlus modelling results and the Integrated Environmental Control Model to develop performance and cost estimates for the solid sorbent-based CO2 capture technology. A reduced order model also was created to facilitate comparisons among multiple design scenarios. Assumptions about plant financing and utilization, as well as uncertainties in heat transfer and material design that affect heat exchanger and reactor design were found to produce a wide range of cost estimates for solid sorbent-based systems. With uncertainties included, costs for a supercritical power plant with solid sorbent-based CO2 capture ranged from 167 to 533 per megawatt hour for a first-of-a-kind installation (with all costs in constant 2011 US dollars) based on a 90% confidence interval. The median cost was 209/MWh. Post-combustion solid sorbent-based CO2 capture technology is then evaluated in terms of the potential cost for a mature system based on historic experience as technologies are improved with sequential iterations of the currently available system. The range costs for a supercritical power plant with solid sorbent-based CO2 capture was found to be 118 to 189 per megawatt hour with a nominal value of 163 per megawatt hour given the expected range of technological improvement in the capital and operating costs and efficiency of the power plant after 100 GW of cumulative worldwide experience. These results suggest that the solid sorbent-based system will not be competitive with currently available liquid amine-systems in the absence of significant new improvements in solid sorbent properties and process system design to reduce the heat exchange surface area in the regenerator and cross-flow heat exchanger. Finally, the importance of these estimates for policy makers is discussed.

A national survey of UK health libraries investigating the cost of interlibrary loan services and assessing the accessibility to key orthopaedic journals.

PubMed

Tahim, Arpan; Stokes, Oliver; Vedi, Vikas

2012-06-01

 NHS Library Services are utilised by NHS staff and junior trainees to locate scientific papers that provide them with the evidence base required for modern medical practice. The cost of accessing articles can be considerable particularly for junior trainees.  This survey looks at variations in cost of journal article loans and investigates access to particular orthopaedic journals across the country.  A national survey of UK Health Libraries was performed. Access to and costs of journals and interlibrary loan services were assessed. Availability of five wide-reaching orthopaedic journals was investigated.  Seven hundred and ten libraries were identified. One hundred and ten libraries completed the questionnaire (16.7%). Of these, 96.2% reported free access to scientific journals for users. 99.1% of libraries used interlibrary loan services with 38.2% passing costs on to the user at an average of £2.99 per article. 72.7% of libraries supported orthopaedic services. Journal of Bone and Joint Surgery (British) had greatest onsite availability.  The study demonstrates fluctuations in cost of access to interlibrary loan services and variation in access to important orthopaedic journals. It provides a reflection of current policy of charging for the acquisition of medical evidence by libraries in the UK. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

“Lost in translation”: accounting for between-country differences in the analysis of multinational cost-effectiveness data§

PubMed Central

Manca, Andrea; Willan, Andrew R.

2008-01-01

Background Cost-effectiveness analysis has gained status over the last 15 years as an important tool for assisting resource allocation decisions in a budged-limited environment such as healthcare. Randomised (multicentre) multinational controlled trials are often the main vehicle to collect primary patient-level information on resource use, cost and clinical effectiveness associated with alternative treatment strategies. However, trial-wide cost-effectiveness results may not be directly applicable to any one of the countries that participate in a multinational trial, requiring some form of additional modelling to customise the results to the country of interest. Objective The aim is to produce recommendations regarding methods that can be (currently) considered ‘good practice’ when exploring the geographical generalisability of cost-effectiveness data. The manuscript proposes an algorithm to assist with the choice of the appropriate analytical strategy when facing the task of adapting the study results from one country to another. The algorithm considers different scenarios characterised by whether or not (a) the country of interest participated in the trial, and (b) individual patient-level data (IPD) from the trial are available. Methods Structured review with description and discussion of case studies. Conclusions Methods to reflect between-country variability in cost-effectiveness data are available. It is important to be transparent regarding the assumptions made in the analysis and (where possible) assess their impact on the study results. PMID:17067195

CLIPS: An expert system building tool

NASA Technical Reports Server (NTRS)

Riley, Gary

1991-01-01

The C Language Integrated Production System (CLIPS) is an expert system building tool, which provides a complete environment for the development and delivery of rule and/or object based expert systems. CLIPS was specifically designed to provide a low cost option for developing and deploying expert system applications across a wide range of hardware platforms. The commercial potential of CLIPS is vast. Currently, CLIPS is being used by over 3,300 individuals throughout the public and private sector. Because the CLIPS source code is readily available, numerous groups have used CLIPS as a basis for their own expert system tools. To date, three commercially available tools have been derived from CLIPS. In general, the development of CLIPS has helped to improve the ability to deliver expert system technology throughout the public and private sectors for a wide range of applications and diverse computing environments.

Nano-imprint lithography using poly (methyl methacrylate) (PMMA) and polystyrene (PS) polymers

NASA Astrophysics Data System (ADS)

Ting, Yung-Chiang; Shy, Shyi-Long

2016-04-01

Nano-imprinting lithography (NIL) technology, as one of the most promising fabrication technologies, has been demonstrated to be a powerful tool for large-area replication up to wafer-level, with features down to nanometer scale. The cost of resists used for NIL is important for wafer-level large-area replication. This study aims to develop capabilities in patterning larger area structure using thermal NIL. The commercial available Poly (Methyl Methacrylate) (PMMA) and Polystyrene (PS) polymers possess a variety of characteristics desirable for NIL, such as low material cost, low bulkvolumetric shrinkage, high spin coating thickness uniformity, high process stability, and acceptable dry-etch resistance. PMMA materials have been utilized for positive electron beam lithography for many years, offering high resolution capability and wide process latitude. In addition, it is preferable to have a negative resist like PMMA, which is a simple polymer with low cost and practically unlimited shelf life, and can be dissolved easily using commercial available Propylene glycol methyl ether acetate (PGMEA) safer solvent to give the preferred film thickness. PS is such a resist, as it undergoes crosslinking when exposed to deep UV light or an electron beam and can be used for NIL. The result is a cost effective patterning larger area structure using thermal nano-imprint lithography (NIL) by using commercial available PMMA and PS ploymers as NIL resists.

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

PubMed

Vaidya, Gaurang Nandkishor

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

A Cost Analysis of Kidney Replacement Therapy Options in Palestine

PubMed Central

Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

2015-01-01

This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. PMID:25765018

A cost analysis of kidney replacement therapy options in Palestine.

PubMed

Younis, Mustafa; Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

2015-01-01

This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16,277 for the first year; the estimated cost of HD per patient averaged US$16,085 per year--nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. © The Author(s) 2015.

Open-source meteor detection software for low-cost single-board computers

NASA Astrophysics Data System (ADS)

Vida, D.; Zubović, D.; Šegon, D.; Gural, P.; Cupec, R.

2016-01-01

This work aims to overcome the current price threshold of meteor stations which can sometimes deter meteor enthusiasts from owning one. In recent years small card-sized computers became widely available and are used for numerous applications. To utilize such computers for meteor work, software which can run on them is needed. In this paper we present a detailed description of newly-developed open-source software for fireball and meteor detection optimized for running on low-cost single board computers. Furthermore, an update on the development of automated open-source software which will handle video capture, fireball and meteor detection, astrometry and photometry is given.

IEA Wind Task 26 - Multi-national Case Study of the Financial Cost of Wind Energy; Work Package 1 Final Report

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

Schwabe, P.; Lensink, S.; Hand, M.

2011-03-01

The lifetime cost of wind energy is comprised of a number of components including the investment cost, operation and maintenance costs, financing costs, and annual energy production. Accurate representation of these cost streams is critical in estimating a wind plant's cost of energy. Some of these cost streams will vary over the life of a given project. From the outset of project development, investors in wind energy have relatively certain knowledge of the plant's lifetime cost of wind energy. This is because a wind energy project's installed costs and mean wind speed are known early on, and wind generation generallymore » has low variable operation and maintenance costs, zero fuel cost, and no carbon emissions cost. Despite these inherent characteristics, there are wide variations in the cost of wind energy internationally, which is the focus of this report. Using a multinational case-study approach, this work seeks to understand the sources of wind energy cost differences among seven countries under International Energy Agency (IEA) Wind Task 26 - Cost of Wind Energy. The participating countries in this study include Denmark, Germany, the Netherlands, Spain, Sweden, Switzerland, and the United States. Due to data availability, onshore wind energy is the primary focus of this study, though a small sample of reported offshore cost data is also included.« less

Accuracy of Immunofluorescence in the Diagnosis of Primary Ciliary Dyskinesia

PubMed Central

Frost, Emily; Dixon, Mellisa; Ollosson, Sarah; Kilpin, Kate; Patel, Mitali; Scully, Juliet; Rogers, Andrew V.; Mitchison, Hannah M.; Bush, Andrew; Hogg, Claire

2017-01-01

Rationale: The standard approach to diagnosis of primary ciliary dyskinesia (PCD) in the United Kingdom consists of assessing ciliary function by high-speed microscopy and ultrastructure by election microscopy, but equipment and expertise is not widely available internationally. The identification of biallelic disease-causing mutations is also diagnostic, but many disease-causing genes are unknown, and testing is not widely available outside the United States. Fluorescent antibodies to ciliary proteins are used to validate research genetic studies, but diagnostic utility in this disease has not been systematically evaluated. Objectives: To determine utility of a panel of six fluorescent labeled antibodies as a diagnostic tool for PCD. Methods: The study used immunofluorescent labeling of nasal brushings from a discovery cohort of 35 patients diagnosed with PCD by ciliary ultrastructure, and a diagnostic accuracy cohort of 386 patients referred with symptoms suggestive of disease. The results were compared with diagnostic outcome. Measurements and Main Results: Immunofluorescence correctly identified mislocalized or absent staining in 100% of the discovery cohort. In the diagnostic cohort immunofluorescence successfully identified 22 of 25 patients with PCD and normal staining in all 252 in whom PCD was considered highly unlikely. In addition, immunofluorescence provided a result in 55% (39) of cases that were previously inconclusive. Immunofluorescence results were available within 14 days, costing $187 per sample compared with electron microscopy (27 days; cost $1,452). Conclusions: Immunofluorescence is a highly specific diagnostic test for PCD, and it improves the speed and availability of diagnostic testing. However, sensitivity is limited and immunofluorescence is not suitable as a stand-alone test. PMID:28199173

Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review.

PubMed

Fesenfeld, Michaela; Hutubessy, Raymond; Jit, Mark

2013-08-20

The World Health Organization recommends establishing that human papillomavirus vaccination is cost-effective before vaccine introduction. We searched Pubmed, Embase and the Cochrane Library to 1 April 2012 for economic evaluations of human papillomavirus vaccination in low and middle income countries. We found 25 articles, but almost all low income countries and many middle income countries lacked country-specific studies. Methods, assumptions and consequently results varied widely, even for studies conducted for the same country. Despite the heterogeneity, most studies conclude that vaccination is likely to be cost-effective and possibly even cost saving, particularly in settings without organized cervical screening programmes. However, study uncertainty could be reduced by clarity about vaccine prices and vaccine delivery costs. The review supports extending vaccination to low income settings where vaccine prices are competitive, donor funding is available, cervical cancer burden is high and screening options are limited. Copyright © 2013 Elsevier Ltd. All rights reserved.

The human and economic cost of hidden hunger.

PubMed

Stein, Alexander J; Qaim, Matin

2007-06-01

Micronutrient malnutrition is a public health problem in many developing countries. Its negative impact on income growth is recognized in principle, but there are widely varying estimates of the related economic cost. To discuss available studies that quantify the cost of micronutrient malnutrition, and to develop an alternative framework and apply it to India. Detailed burden of disease calculations are used to estimate the economic cost of micronutrient malnutrition based on disability-adjusted life years (DALYs) lost. The short-term economic cost of micronutrient malnutrition in India amounts to 0.8% to 2.5% of the gross domestic product. Although the results confirm that micronutrient malnutrition is a huge economic problem, the estimates are lower than those of most previous studies. The differences may be due to differences in underlying assumptions, quality of data, and precision of calculation, but also to dynamic interactions between nutrition, health, and economic productivity, which are difficult to capture. Clear explanation of all calculation details would be desirable for future studies in order to increase credibility and transparency.

Targeted next-generation sequencing in monogenic dyslipidemias.

PubMed

Hegele, Robert A; Ban, Matthew R; Cao, Henian; McIntyre, Adam D; Robinson, John F; Wang, Jian

2015-04-01

To evaluate the potential clinical translation of high-throughput next-generation sequencing (NGS) methods in diagnosis and management of dyslipidemia. Recent NGS experiments indicate that most causative genes for monogenic dyslipidemias are already known. Thus, monogenic dyslipidemias can now be diagnosed using targeted NGS. Targeting of dyslipidemia genes can be achieved by either: designing custom reagents for a dyslipidemia-specific NGS panel; or performing genome-wide NGS and focusing on genes of interest. Advantages of the former approach are lower cost and limited potential to detect incidental pathogenic variants unrelated to dyslipidemia. However, the latter approach is more flexible because masking criteria can be altered as knowledge advances, with no need for re-design of reagents or follow-up sequencing runs. Also, the cost of genome-wide analysis is decreasing and ethical concerns can likely be mitigated. DNA-based diagnosis is already part of the clinical diagnostic algorithms for familial hypercholesterolemia. Furthermore, DNA-based diagnosis is supplanting traditional biochemical methods to diagnose chylomicronemia caused by deficiency of lipoprotein lipase or its co-factors. The increasing availability and decreasing cost of clinical NGS for dyslipidemia means that its potential benefits can now be evaluated on a larger scale.

Noise Source Visualization Using a Digital Voice Recorder and Low-Cost Sensors

PubMed Central

Cho, Yong Thung

2018-01-01

Accurate sound visualization of noise sources is required for optimal noise control. Typically, noise measurement systems require microphones, an analog-digital converter, cables, a data acquisition system, etc., which may not be affordable for potential users. Also, many such systems are not highly portable and may not be convenient for travel. Handheld personal electronic devices such as smartphones and digital voice recorders with relatively lower costs and higher performance have become widely available recently. Even though such devices are highly portable, directly implementing them for noise measurement may lead to erroneous results since such equipment was originally designed for voice recording. In this study, external microphones were connected to a digital voice recorder to conduct measurements and the input received was processed for noise visualization. In this way, a low cost, compact sound visualization system was designed and introduced to visualize two actual noise sources for verification with different characteristics: an enclosed loud speaker and a small air compressor. Reasonable accuracy of noise visualization for these two sources was shown over a relatively wide frequency range. This very affordable and compact sound visualization system can be used for many actual noise visualization applications in addition to educational purposes. PMID:29614038

The Cost of Relapse in Schizophrenia.

PubMed

Pennington, Mark; McCrone, Paul

2017-09-01

Schizophrenia is a chronic and debilitating mental illness characterised by periods of relapse that require resource intensive management. Quantifying the cost of relapse is central to the evaluation of the cost effectiveness of treating schizophrenia. We aimed to undertake a comprehensive search of the available literature on the cost of relapse. We performed a search on multiple databases (MEDLINE, Embase, PsycINFO and Health Management Information Consortium) for any study reporting a cost of relapse or data from which such a cost could be calculated. Costs are reported in 2015 international dollars. We found 16 studies reporting costs associated with relapse over a defined period of time and identified a cost associated with hospitalisation for relapse in 43 studies. Eight clinical decision analyses also provided cost estimates. Studies from the US report excess costs of relapse of $6033-$32,753 (2015 Purchasing Power Parity dollars [PPP$]) over periods of 12-15 months. European studies report excess costs of $8665-$18,676 (2015 PPP$) over periods of 6-12 months. Estimates of the cost of hospitalisation for relapse are more diverse, and associated with marked differences in typical length of stay across jurisdictions. Wide ranges in the estimated cost of relapse may reflect differences in sample section and relapse definition as well as practice styles and differences in resource costs. Selection of the most appropriate cost estimate should be guided by the definition of relapse and the analysis setting.

2 CFR Appendix V to Part 200 - State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans

Code of Federal Regulations, 2014 CFR

2014-01-01

... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans V Appendix V to Part 200 Grants and Agreements Office of Management..., App. V Appendix V to Part 200—State/Local Government and Indian Tribe-Wide Central Service Cost...

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

PubMed

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

2017-11-07

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

Automated Low-Cost Smartphone-Based Lateral Flow Saliva Test Reader for Drugs-of-Abuse Detection

PubMed Central

Carrio, Adrian; Sampedro, Carlos; Sanchez-Lopez, Jose Luis; Pimienta, Miguel; Campoy, Pascual

2015-01-01

Lateral flow assay tests are nowadays becoming powerful, low-cost diagnostic tools. Obtaining a result is usually subject to visual interpretation of colored areas on the test by a human operator, introducing subjectivity and the possibility of errors in the extraction of the results. While automated test readers providing a result-consistent solution are widely available, they usually lack portability. In this paper, we present a smartphone-based automated reader for drug-of-abuse lateral flow assay tests, consisting of an inexpensive light box and a smartphone device. Test images captured with the smartphone camera are processed in the device using computer vision and machine learning techniques to perform automatic extraction of the results. A deep validation of the system has been carried out showing the high accuracy of the system. The proposed approach, applicable to any line-based or color-based lateral flow test in the market, effectively reduces the manufacturing costs of the reader and makes it portable and massively available while providing accurate, reliable results. PMID:26610513

Design, demonstration and testing of low F-number LWIR panoramic imaging relay optics

NASA Astrophysics Data System (ADS)

Furxhi, Orges; Frascati, Joe; Driggers, Ronald

2018-04-01

Panoramic imaging is inherently wide field of view. High sensitivity uncooled Long Wave Infrared (LWIR) imaging requires low F-number optics. These two requirements result in short back working distance designs that, in addition to being costly, are challenging to integrate with commercially available uncooled LWIR cameras and cores. Common challenges include the relocation of the shutter flag, custom calibration of the camera dynamic range and NUC tables, focusing, and athermalization. Solutions to these challenges add to the system cost and make panoramic uncooled LWIR cameras commercially unattractive. In this paper, we present the design of Panoramic Imaging Relay Optics (PIRO) and show imagery and test results with one of the first prototypes. PIRO designs use several reflective surfaces (generally two) to relay a panoramic scene onto a real, donut-shaped image. The PIRO donut is imaged on the focal plane of the camera using a commercially-off-the-shelf (COTS) low F-number lens. This approach results in low component cost and effortless integration with pre-calibrated commercially available cameras and lenses.

Mobile Phone Diabetes Project Led To Improved Glycemic Control And Net Savings For Chicago Plan Participants

PubMed Central

Nundy, Shantanu; Dick, Jonathan J.; Chou, Chia-Hung; Nocon, Robert S.; Chin, Marshall H.; Peek, Monica E.

2014-01-01

Even with the best health care available, patients with chronic illnesses typically spend no more than a few hours a year in a health care setting, while their outcomes are largely determined by their activities during the remaining 5,000 waking hours of the year. As a widely available, low-cost technology, mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. We examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes who belonged to an academic medical center’s employee health plan. In addition to pre-post improvements in glycemic control (p = 0.01) and patients’ satisfaction with overall care (p = 0.04), we observed a net cost savings of 8.8 percent. Those early results suggest that mHealth programs can support health care organizations’ pursuit of the triple aim of improving patients’ experiences with care, improving population health, and reducing the per capita cost of health care. PMID:24493770

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

Hull, G; Zaitseva, N; Cherepy, N

Efficient, readily-available, low-cost, high-energy neutron detectors can play a central role in detecting illicit nuclear weapons since neutrons are a strong indication for the presence of fissile material such as Plutonium and Highly-Enriched Uranium. The main challenge in detecting fast neutrons consists in the discrimination of the signal from the gamma radiation background. At present, the only well-investigated organic crystal scintillator for fast neutron detection, in a n/{gamma} mixed field, is stilbene, which while offering good pulse shape discrimination, is not widely used because of its limited availability and high cost. In this work we report the results of ourmore » studies made with a number of new organic crystals, which exhibit pulse shape discrimination for detection of fast neutrons. In particular 1,1,4,4-tetraphenyl-1,3-butadiene features a light yield higher than anthracene and a Figure of Merit (FOM) for the pulse shape discrimination better than stilbene. New crystals are good candidates for the low-cost solution growth method, thus representing promising organic scintillators for widespread deployment for high-energy neutron detection.« less

Towards a Metadata Schema for Characterizing Lesson Plans Supported by Virtual and Remote Labs in School Science Education

ERIC Educational Resources Information Center

Zervas, Panagiotis; Tsourlidaki, Eleftheria; Sotiriou, Sofoklis; Sampson, Demetrios G.

2015-01-01

Technological advancements in the field of World Wide Web have led to a plethora of remote and virtual labs (RVLs) that are currently available online and they are offered with or without cost. However, using a RVL to teach a specific science subject might not be a straightforward task for a science teacher. As a result, science teachers need to…

Report to Congress on the Activities of the DoD Office of Technology Transition

DTIC Science & Technology

2001-02-01

known as Magnetorheological Finishing (MRF), that provides significant cost savings in the manufacture of precision optical surfaces. Compared to...The programs included: - The Army’s Advanced Optics Manufacturing program developed a multi- axis, computer-controlled optical finishing technology...percent. The MRF finishing machine is commercially available, and has received industry-wide acclaim, winning two of the optical industry’s most

DOD Space Test Program (STP)

NASA Technical Reports Server (NTRS)

Smith, Llwyn

1995-01-01

This paper describes the Space Test Program (STP) which provides access to space for the DOD-wide space research and development (R&D) community. STP matches a ranked list of sanctioned experiments with available budgets and searches for the most cost effective mechanisms to get the experiments into space. The program has successfully flown over 350 experiments, using dedicated freeflyer spacecraft, secondary space on the Space Shuttle, and various host satellites.

Design and evaluation of a low-cost smartphone pulse oximeter.

PubMed

Petersen, Christian L; Chen, Tso P; Ansermino, J Mark; Dumont, Guy A

2013-12-06

Infectious diseases such as pneumonia take the lives of millions of children in low- and middle-income countries every year. Many of these deaths could be prevented with the availability of robust and low-cost diagnostic tools using integrated sensor technology. Pulse oximetry in particular, offers a unique non-invasive and specific test for an increase in the severity of many infectious diseases such as pneumonia. If pulse oximetry could be delivered on widely available mobile phones, it could become a compelling solution to global health challenges. Many lives could be saved if this technology was disseminated effectively in the affected regions of the world to rescue patients from the fatal consequences of these infectious diseases. We describe the implementation of such an oximeter that interfaces a conventional clinical oximeter finger sensor with a smartphone through the headset jack audio interface, and present a simulator-based systematic verification system to be used for automated validation of the sensor interface on different smartphones and media players. An excellent agreement was found between the simulator and the audio oximeter for both oxygen saturation and heart rate over a wide range of optical transmission levels on 4th and 5th generations of the iPod TouchTM and iPhoneTM devices.

Design and Evaluation of a Low-Cost Smartphone Pulse Oximeter

PubMed Central

Petersen, Christian L.; Chen, Tso P.; Ansermino, J. Mark; Dumont, Guy A.

2013-01-01

Infectious diseases such as pneumonia take the lives of millions of children in low- and middle-income countries every year. Many of these deaths could be prevented with the availability of robust and low-cost diagnostic tools using integrated sensor technology. Pulse oximetry in particular, offers a unique non-invasive and specific test for an increase in the severity of many infectious diseases such as pneumonia. If pulse oximetry could be delivered on widely available mobile phones, it could become a compelling solution to global health challenges. Many lives could be saved if this technology was disseminated effectively in the affected regions of the world to rescue patients from the fatal consequences of these infectious diseases. We describe the implementation of such an oximeter that interfaces a conventional clinical oximeter finger sensor with a smartphone through the headset jack audio interface, and present a simulator-based systematic verification system to be used for automated validation of the sensor interface on different smartphones and media players. An excellent agreement was found between the simulator and the audio oximeter for both oxygen saturation and heart rate over a wide range of optical transmission levels on 4th and 5th generations of the iPod Touch™ and iPhone™ devices. PMID:24322563

A low-cost spectrometer for NMR measurements in the Earth's magnetic field

NASA Astrophysics Data System (ADS)

Michal, Carl A.

2010-10-01

We describe and demonstrate an inexpensive, easy-to-build, portable spectrometer for nuclear magnetic resonance measurements in the Earth's magnetic field. The spectrometer is based upon a widely available inexpensive microcontroller, which acts as a pulse programmer, audio-frequency synthesizer and digitizer, replacing what are typically the most expensive specialized components of the system. The microcontroller provides the capability to execute arbitrarily long and complicated sequences of phase-coherent, phase-modulated excitation pulses and acquire data sets of unlimited duration. Suitably packaged, the spectrometer is amenable to measurements in the research lab, in the field or in the teaching lab. The choice of components was heavily weighted by cost and availability, but required no significant sacrifice in performance. Using an existing personal computer, the resulting design can be assembled for as little as US200. The spectrometer performance is demonstrated with spin-echo and Carr-Purcell-Meiboom-Gill pulse sequences on a water sample.

ROBucket: A low cost operant chamber based on the Arduino microcontroller.

PubMed

Devarakonda, Kavya; Nguyen, Katrina P; Kravitz, Alexxai V

2016-06-01

The operant conditioning chamber is a cornerstone of animal behavioral research. Operant boxes are used to assess learning and motivational behavior in animals, particularly for food and drug reinforcers. However, commercial operant chambers cost several thousands of dollars. We have constructed the Rodent Operant Bucket (ROBucket), an inexpensive and easily assembled open-source operant chamber based on the Arduino microcontroller platform, which can be used to train mice to respond for sucrose solution or other liquid reinforcers. The apparatus contains two nose pokes, a drinking well, and a solenoid-controlled liquid delivery system. ROBucket can run fixed ratio and progressive ratio training schedules, and can be programmed to run more complicated behavioral paradigms. Additional features such as motion sensing and video tracking can be added to the operant chamber through the array of widely available Arduino-compatible sensors. The design files and programming code are open source and available online for others to use.

CHALLENGES AND STRATEGIES ON FIBROUS FEEDSTUFFS DENSIFICATION AND ITS INTERACTION WITH LIQUID INGREDIENTS

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

Pordesimo, Lester O.; Tumuluru, Jaya Shankar

2015-10-01

There has been continuing interest and support in using herbaceous biomass, mostly agricultural crop residues, in the U.S. as feedstocks for producing bioenergy, liquid transportation fuels, and industrial chemicals/materials. With the potential of greater collection of agricultural crop residues for the foregoing industrial applications there will be a commensurate greater availability of crop residues for utilization in agricultural production. Agricultural crop residues are typically used in agricultural production as roughage or bedding for cattle. Use of herbaceous biomass, corn stover of greatest interest at the present time, and processing coproducts thereof, as a feed ingredient presents an opportunity to reducemore » ration costs and improve livestock enterprise profitability by replacing an amount of corn and other feed grains in livestock diets with proper formulation. The obvious advantage of utilizing corn stover is its wide availability and low cost.« less

Factors that influence producer decisions to implement management strategies.

PubMed

Field, Thomas G

2014-12-01

Cow-calf enterprises in the USA are widely divergent in size, locale, resource availability, management skill, and market focus. Furthermore, variation exists in dependence on the cow-calf enterprise as a primary source of income, perception about the utility of a particular management practice or technology, and assessment of cost: benefit resulting from implementation impact decisions. Enterprises with larger cow inventories, greater dependence on income from the cattle enterprise, and that retain ownership further into the supply chain beyond the cow-calf operation are more likely to institute management protocols such as vaccination programs, defined calving seasons, and reproductive technologies. Successful cow-calf managers place the highest priority on herd nutrition, pasture and range management, herd health, financial management marketing, production management, and genetics. Management practices are more likely to be adopted when they align with a manager's perception of the utility, labor availability, favorable cost: benefit outcomes and profit motivation.

Suppression subtractive hybridization as a tool to identify anthocyanin metabolism-related genes in apple skin.

PubMed

Ban, Yusuke; Moriguchi, Takaya

2010-01-01

The pigmentation of anthocyanins is one of the important determinants for consumer preference and marketability in horticultural crops such as fruits and flowers. To elucidate the mechanisms underlying the physiological process leading to the pigmentation of anthocyanins, identification of the genes differentially expressed in response to anthocyanin accumulation is a useful strategy. Currently, microarrays have been widely used to isolate differentially expressed genes. However, the use of microarrays is limited by its high cost of special apparatus and materials. Therefore, availability of microarrays is limited and does not come into common use at present. Suppression subtractive hybridization (SSH) is an alternative tool that has been widely used to identify differentially expressed genes due to its easy handling and relatively low cost. This chapter describes the procedures for SSH, including RNA extraction from polysaccharides and polyphenol-rich samples, poly(A)+ RNA purification, evaluation of subtraction efficiency, and differential screening using reverse northern in apple skin.

Long-term care cost drivers and expenditure projection to 2036 in Hong Kong

PubMed Central

Chung, Roger Y; Tin, Keith YK; Cowling, Benjamin J; Chan, King Pan; Chan, Wai Man; Lo, Su Vui; Leung, Gabriel M

2009-01-01

Background Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC) expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036. Methods We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions. Results Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure. Conclusion The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning. PMID:19775476

Long-term care cost drivers and expenditure projection to 2036 in Hong Kong.

PubMed

Chung, Roger Y; Tin, Keith Yk; Cowling, Benjamin J; Chan, King Pan; Chan, Wai Man; Lo, Su Vui; Leung, Gabriel M

2009-09-24

Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC) expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036. We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions. Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure. The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning.

Cloud computing for comparative genomics

PubMed Central

2010-01-01

Background Large comparative genomics studies and tools are becoming increasingly more compute-expensive as the number of available genome sequences continues to rise. The capacity and cost of local computing infrastructures are likely to become prohibitive with the increase, especially as the breadth of questions continues to rise. Alternative computing architectures, in particular cloud computing environments, may help alleviate this increasing pressure and enable fast, large-scale, and cost-effective comparative genomics strategies going forward. To test this, we redesigned a typical comparative genomics algorithm, the reciprocal smallest distance algorithm (RSD), to run within Amazon's Elastic Computing Cloud (EC2). We then employed the RSD-cloud for ortholog calculations across a wide selection of fully sequenced genomes. Results We ran more than 300,000 RSD-cloud processes within the EC2. These jobs were farmed simultaneously to 100 high capacity compute nodes using the Amazon Web Service Elastic Map Reduce and included a wide mix of large and small genomes. The total computation time took just under 70 hours and cost a total of $6,302 USD. Conclusions The effort to transform existing comparative genomics algorithms from local compute infrastructures is not trivial. However, the speed and flexibility of cloud computing environments provides a substantial boost with manageable cost. The procedure designed to transform the RSD algorithm into a cloud-ready application is readily adaptable to similar comparative genomics problems. PMID:20482786

Cloud computing for comparative genomics.

PubMed

Wall, Dennis P; Kudtarkar, Parul; Fusaro, Vincent A; Pivovarov, Rimma; Patil, Prasad; Tonellato, Peter J

2010-05-18

Large comparative genomics studies and tools are becoming increasingly more compute-expensive as the number of available genome sequences continues to rise. The capacity and cost of local computing infrastructures are likely to become prohibitive with the increase, especially as the breadth of questions continues to rise. Alternative computing architectures, in particular cloud computing environments, may help alleviate this increasing pressure and enable fast, large-scale, and cost-effective comparative genomics strategies going forward. To test this, we redesigned a typical comparative genomics algorithm, the reciprocal smallest distance algorithm (RSD), to run within Amazon's Elastic Computing Cloud (EC2). We then employed the RSD-cloud for ortholog calculations across a wide selection of fully sequenced genomes. We ran more than 300,000 RSD-cloud processes within the EC2. These jobs were farmed simultaneously to 100 high capacity compute nodes using the Amazon Web Service Elastic Map Reduce and included a wide mix of large and small genomes. The total computation time took just under 70 hours and cost a total of $6,302 USD. The effort to transform existing comparative genomics algorithms from local compute infrastructures is not trivial. However, the speed and flexibility of cloud computing environments provides a substantial boost with manageable cost. The procedure designed to transform the RSD algorithm into a cloud-ready application is readily adaptable to similar comparative genomics problems.

Cohort Profile Update: The TRacking Adolescents’ Individual Lives Survey (TRAILS)

PubMed Central

Oldehinkel, Albertine J; Rosmalen, Judith GM; Buitelaar, Jan K; Hoek, Hans W; Ormel, Johan; Raven, Dennis; Reijneveld, Sijmen A; Veenstra, René; Verhulst, Frank C; Vollebergh, Wilma AM; Hartman, Catharina A

2015-01-01

TRAILS consists of a population cohort (N = 2230) and a clinical cohort (N = 543), both of which were followed from about age 11 years onwards. To date, the population cohort has been assessed five times over a period of 11 years, with retention rates ranging between 80% and 96%. The clinical cohort has been assessed four times over a period of 8 years, with retention rates ranging between 77% and 85%. Since the IJE published a cohort profile on the TRAILS in 2008, the participants have matured from adolescents into young adults. The focus shifted from parents and school to entry into the labour market and family formation, including offspring. Furthermore, psychiatric diagnostic interviews were administered, the database was linked to a Psychiatric Case Registry, and the availability of genome-wide SNP variations opened the door to genome-wide association studies regarding a wide range of (endo)phenotypes. With some delay, TRAILS data are available to researchers outside the TRAILS consortium without costs; access can be obtained by submitting a publication proposal (see www.trails.nl). PMID:25431468

High-quality macromolecular graphics on mobile devices: a quick starter's guide.

PubMed

Yiu, Chin-Pang Benny; Chen, Yu Wai

2014-01-01

With the rise of tablets, truly portable molecular graphics are now available for wide use by scientists to share structural information in real time at a reasonable cost. We have surveyed the existing software available on Apple iPads and on Android tablets in order to make a recommendation to potential users, primarily based on the product features. Among 12 apps, iMolview (available on both platforms) stands out to be our choice, with PyMOL app (iOS) a close alternative and RCSB PDB Mobile viewer/NDKmol (both platforms) offering some uniquely useful functions. Finally, we include a tutorial on how to get started using iMolview to do some simple visualization in 10 min.

Cost calculator methods for estimating casework time in child welfare services: A promising approach for use in implementation of evidence-based practices and other service innovations.

PubMed

Holmes, Lisa; Landsverk, John; Ward, Harriet; Rolls-Reutz, Jennifer; Saldana, Lisa; Wulczyn, Fred; Chamberlain, Patricia

2014-04-01

Estimating costs in child welfare services is critical as new service models are incorporated into routine practice. This paper describes a unit costing estimation system developed in England (cost calculator) together with a pilot test of its utility in the United States where unit costs are routinely available for health services but not for child welfare services. The cost calculator approach uses a unified conceptual model that focuses on eight core child welfare processes. Comparison of these core processes in England and in four counties in the United States suggests that the underlying child welfare processes generated from England were perceived as very similar by child welfare staff in California county systems with some exceptions in the review and legal processes. Overall, the adaptation of the cost calculator for use in the United States child welfare systems appears promising. The paper also compares the cost calculator approach to the workload approach widely used in the United States and concludes that there are distinct differences between the two approaches with some possible advantages to the use of the cost calculator approach, especially in the use of this method for estimating child welfare costs in relation to the incorporation of evidence-based interventions into routine practice.

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy.

PubMed

Narra, Roberta; Maestri, Marcello; Budke, Christine M; Tamarozzi, Francesca; Mariconti, Mara; Nicoletti, Giovanni J; Rinaldi, Francesca; Brunetti, Enrico

2016-08-03

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the "San Matteo" Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach. © The American Society of Tropical Medicine and Hygiene.

Cost-effectiveness of different human papillomavirus vaccines in Singapore.

PubMed

Lee, Vernon J; Tay, Sun Kuie; Teoh, Yee Leong; Tok, Mei Yin

2011-03-31

Human papillomavirus (HPV) vaccines are widely available and there have been studies exploring their potential clinical impact and cost-effectiveness. However, few studies have compared the cost-effectiveness among the 2 main vaccines available - a bivalent vaccine against HPV 16/18, and a quadrivalent vaccine against 6/11/16/18. We explore the cost-effectiveness of these two HPV vaccines in tropical Singapore. We developed a Markov state-transition model to represent the natural history of cervical cancer to predict HPV infection, cancer incidence, mortality, and costs. Cytologic screening and treatment of different outcomes of HPV infection were incorporated. Vaccination was provided to a cohort of 12-year old females in Singapore, followed up until death. Based on available vaccines on the market, the bivalent vaccine had increased effectiveness against a wider range of HPV types, while the quadrivalent vaccine had effectiveness against genital warts. Incremental cost-effectiveness ratios (ICER) compared vaccination to no-vaccination, and between the two vaccines. Sensitivity analyses explored differences in vaccine effectiveness and uptake, and other key input parameters. For the no vaccination scenario, 229 cervical cancer cases occurred over the cohort's lifetime. The total discounted cost per individual due to HPV infection was SGD$275 with 28.54 discounted life-years. With 100% vaccine coverage, the quadrivalent vaccine reduced cancers by 176, and had an ICER of SGD$12,866 per life-year saved. For the bivalent vaccine, 197 cancers were prevented with an ICER of $12,827 per life-year saved. Comparing the bivalent to the quadrivalent vaccine, the ICER was $12,488 per life-year saved. However, the cost per QALY saved for the quadrivalent vaccine compared to no vaccine was $9,071, while it was $10,392 for the bivalent vaccine, with the quadrivalent vaccine dominating the bivalent vaccine due to the additional QALY effect from reduction in genital warts. The overall outcomes were most sensitive to vaccine cost and coverage. HPV vaccination is a cost-effective strategy, and should be considered a possible strategy to reduce the impact of HPV infection.

Archipelago-wide island restoration in the Galápagos Islands: reducing costs of invasive mammal eradication programs and reinvasion risk.

PubMed

Carrion, Victor; Donlan, C Josh; Campbell, Karl J; Lavoie, Christian; Cruz, Felipe

2011-05-11

Invasive alien mammals are the major driver of biodiversity loss and ecosystem degradation on islands. Over the past three decades, invasive mammal eradication from islands has become one of society's most powerful tools for preventing extinction of insular endemics and restoring insular ecosystems. As practitioners tackle larger islands for restoration, three factors will heavily influence success and outcomes: the degree of local support, the ability to mitigate for non-target impacts, and the ability to eradicate non-native species more cost-effectively. Investments in removing invasive species, however, must be weighed against the risk of reintroduction. One way to reduce reintroduction risks is to eradicate the target invasive species from an entire archipelago, and thus eliminate readily available sources. We illustrate the costs and benefits of this approach with the efforts to remove invasive goats from the Galápagos Islands. Project Isabela, the world's largest island restoration effort to date, removed >140,000 goats from >500,000 ha for a cost of US$10.5 million. Leveraging the capacity built during Project Isabela, and given that goat reintroductions have been common over the past decade, we implemented an archipelago-wide goat eradication strategy. Feral goats remain on three islands in the archipelago, and removal efforts are underway. Efforts on the Galápagos Islands demonstrate that for some species, island size is no longer the limiting factor with respect to eradication. Rather, bureaucratic processes, financing, political will, and stakeholder approval appear to be the new challenges. Eradication efforts have delivered a suite of biodiversity benefits that are in the process of revealing themselves. The costs of rectifying intentional reintroductions are high in terms of financial and human resources. Reducing the archipelago-wide goat density to low levels is a technical approach to reducing reintroduction risk in the short-term, and is being complemented with a longer-term social approach focused on education and governance.

Archipelago-Wide Island Restoration in the Galápagos Islands: Reducing Costs of Invasive Mammal Eradication Programs and Reinvasion Risk

PubMed Central

Carrion, Victor; Donlan, C. Josh; Campbell, Karl J.; Lavoie, Christian; Cruz, Felipe

2011-01-01

Invasive alien mammals are the major driver of biodiversity loss and ecosystem degradation on islands. Over the past three decades, invasive mammal eradication from islands has become one of society's most powerful tools for preventing extinction of insular endemics and restoring insular ecosystems. As practitioners tackle larger islands for restoration, three factors will heavily influence success and outcomes: the degree of local support, the ability to mitigate for non-target impacts, and the ability to eradicate non-native species more cost-effectively. Investments in removing invasive species, however, must be weighed against the risk of reintroduction. One way to reduce reintroduction risks is to eradicate the target invasive species from an entire archipelago, and thus eliminate readily available sources. We illustrate the costs and benefits of this approach with the efforts to remove invasive goats from the Galápagos Islands. Project Isabela, the world's largest island restoration effort to date, removed >140,000 goats from >500,000 ha for a cost of US$10.5 million. Leveraging the capacity built during Project Isabela, and given that goat reintroductions have been common over the past decade, we implemented an archipelago-wide goat eradication strategy. Feral goats remain on three islands in the archipelago, and removal efforts are underway. Efforts on the Galápagos Islands demonstrate that for some species, island size is no longer the limiting factor with respect to eradication. Rather, bureaucratic processes, financing, political will, and stakeholder approval appear to be the new challenges. Eradication efforts have delivered a suite of biodiversity benefits that are in the process of revealing themselves. The costs of rectifying intentional reintroductions are high in terms of financial and human resources. Reducing the archipelago-wide goat density to low levels is a technical approach to reducing reintroduction risk in the short-term, and is being complemented with a longer-term social approach focused on education and governance. PMID:21589656

Survey and evaluation of current design of evacuated collectors. Final technical report

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

Graham, B. J.

The general development of these collectors, is described and a description of numerous evacuated collectors is given which vary from collectors that have been widely used in various applications to others which are still being developed in the laboratory. A table summarizing all of the available collectors, along with their characteristics, is presented. There are four evacuated collectors which have been tested, used in demonstration sites, and developed for the market. These collectors are described in detail, and they are compared in performance and cost with a well-engineered, double glazed, selectively coated, flat plate collector. A rather simple model systemmore » of about 2000 ft/sup 2/ of collector area for each of the four evacuated collectors and the flat plate collector is described, along with the support structure and the piping for each. Details of the cost are presented in order to compare collector costs with component costs. All of the available efficiency curves of collectors were plotted for comparison with the efficiency curve of a good, flat plate collector. To show the extent of use of evacuated collectors, a list according to manufacturers and to location of all of the sites at which these collectors are being used is presented.« less

Gaussian Multiscale Aggregation Applied to Segmentation in Hand Biometrics

PubMed Central

de Santos Sierra, Alberto; Ávila, Carmen Sánchez; Casanova, Javier Guerra; del Pozo, Gonzalo Bailador

2011-01-01

This paper presents an image segmentation algorithm based on Gaussian multiscale aggregation oriented to hand biometric applications. The method is able to isolate the hand from a wide variety of background textures such as carpets, fabric, glass, grass, soil or stones. The evaluation was carried out by using a publicly available synthetic database with 408,000 hand images in different backgrounds, comparing the performance in terms of accuracy and computational cost to two competitive segmentation methods existing in literature, namely Lossy Data Compression (LDC) and Normalized Cuts (NCuts). The results highlight that the proposed method outperforms current competitive segmentation methods with regard to computational cost, time performance, accuracy and memory usage. PMID:22247658

Gaussian multiscale aggregation applied to segmentation in hand biometrics.

PubMed

de Santos Sierra, Alberto; Avila, Carmen Sánchez; Casanova, Javier Guerra; del Pozo, Gonzalo Bailador

2011-01-01

This paper presents an image segmentation algorithm based on Gaussian multiscale aggregation oriented to hand biometric applications. The method is able to isolate the hand from a wide variety of background textures such as carpets, fabric, glass, grass, soil or stones. The evaluation was carried out by using a publicly available synthetic database with 408,000 hand images in different backgrounds, comparing the performance in terms of accuracy and computational cost to two competitive segmentation methods existing in literature, namely Lossy Data Compression (LDC) and Normalized Cuts (NCuts). The results highlight that the proposed method outperforms current competitive segmentation methods with regard to computational cost, time performance, accuracy and memory usage.

Fusion energy in context: its fitness for the long term.

PubMed

Holdren, J P

1978-04-14

Long-term limits to growth in energy will be imposed not by inability to expand supply, but by the rising environmental and social costs of doing so. These costs will therefore be central issues in choosing long-term options. Fusion, like solar energy, is not one possibility but many, some with very attractive environmental characteristics and others perhaps little better in these regards than fission. None of the fusion options will be cheap, and none is likely to be widely available before the year 2010. The most attractive forms of fusion may require greater investments of time and money to achieve, but they are the real reason for wanting fusion at all.

Development of a Multivariable Parametric Cost Analysis for Space-Based Telescopes

NASA Technical Reports Server (NTRS)

Dollinger, Courtnay

2011-01-01

Over the past 400 years, the telescope has proven to be a valuable tool in helping humankind understand the Universe around us. The images and data produced by telescopes have revolutionized planetary, solar, stellar, and galactic astronomy and have inspired a wide range of people, from the child who dreams about the images seen on NASA websites to the most highly trained scientist. Like all scientific endeavors, astronomical research must operate within the constraints imposed by budget limitations. Hence the importance of understanding cost: to find the balance between the dreams of scientists and the restrictions of the available budget. By logically analyzing the data we have collected for over thirty different telescopes from more than 200 different sources, statistical methods, such as plotting regressions and residuals, can be used to determine what drives the cost of telescopes to build and use a cost model for space-based telescopes. Previous cost models have focused their attention on ground-based telescopes due to limited data for space telescopes and the larger number and longer history of ground-based astronomy. Due to the increased availability of cost data from recent space-telescope construction, we have been able to produce and begin testing a comprehensive cost model for space telescopes, with guidance from the cost models for ground-based telescopes. By separating the variables that effect cost such as diameter, mass, wavelength, density, data rate, and number of instruments, we advance the goal to better understand the cost drivers of space telescopes.. The use of sophisticated mathematical techniques to improve the accuracy of cost models has the potential to help society make informed decisions about proposed scientific projects. An improved knowledge of cost will allow scientists to get the maximum value returned for the money given and create a harmony between the visions of scientists and the reality of a budget.

Archival storage solutions for PACS

NASA Astrophysics Data System (ADS)

Chunn, Timothy

1997-05-01

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

Technical description of space ultra reliable modular computer (SUMC), model 2 B

NASA Technical Reports Server (NTRS)

1975-01-01

The design features of the SUMC-2B computer, also called the IBM-HTC are described. It is general purpose digital computer implemented with flexible hardware elements and microprograming to enable low cost customizing to a wide range of applications. It executes the S/360 standard instruction set to maintain problem state compability. Memory technology, extended instruction sets, and I/O channel variations are among the available options.

Real-Time, Wide Area Dispatch of Mobil Tank Trucks

DTIC Science & Technology

1987-01-01

human dispatchers it assists. Using CAD, Mobil has substantially re- duced costs and staff while improving customer service. I n the spring of 1985, a...process by establishing the Mobil order response center (MORC). To use MORC, the customer dials a toll-free number, available 24 hours a day, seven...MATS Figwe 3: Mobil light products order and dispatch information flow. Customers call an audio re- sponse computer system named MORC ( Mobil order

Changing the status of drugs from prescription to over-the-counter availability.

PubMed

Brass, E P

2001-09-13

The availability of drugs on an over-the-counter basis, including those previously available only by prescription, provides patients with improved access to effective therapies. Removal of the requirement for prescriptions saves both the health care professional and the patient time. However, the overall effect on health care costs is complex. One such effect may be that costs shift from third-party payers to patients. In addition, short-term cost savings may be offset over the long term by problems due to inappropriate use or suboptimal therapy. Optimal therapy with an over-the-counter drug requires that the consumer diagnose the underlying condition correctly and use the drug in a manner that minimizes risk. Assessment of the ability of patients to use drugs in this manner is a critical component of the regulatory review of over-the-counter drugs. The available data arouse the concern that without the supervision of a health care professional, some patients may not be able to use over-the-counter drugs appropriately for certain diagnoses or chronic conditions or in high-risk situations. On the other hand, the widespread use of over-the-counter aspirin on a long-term basis for cardiovascular-risk reduction illustrates the potential value of increased drug availability for long-term therapy. Advances in technology may facilitate the growth of over-the-counter drug therapy. For example, the wide availability and acceptance of reliable methods for measuring serum cholesterol in nonmedical settings may eventually contribute to the safety and effectiveness of over-the-counter treatments for hyperlipidemia. Thus, the future promises increases in the number of drugs available over the counter and in the variety of indications for their use.

Patterns of fruit and vegetable availability and price competitiveness across four seasons are different in local food outlets and supermarkets.

PubMed

Valpiani, Natalie; Wilde, Parke; Rogers, Beatrice; Stewart, Hayden

2015-10-01

To explore the effect of seasonality on fruit and vegetable availability and prices across three outlet types (farmers' markets, roadside stands and conventional supermarkets). Cross-sectional survey of geographically clustered supermarkets, farmers' markets and roadside stands. Enumerators recorded the availability and lowest price for eleven fruits and eighteen vegetables in each season of 2011. Price data were collected at retail outlets located in central and eastern North Carolina. The sample consisted of thirty-three supermarkets, thirty-four farmers' markets and twenty-three roadside stands. Outside the local harvest season, the availability of many fruits and vegetables was substantially lower at farmers' markets and roadside stands compared with supermarkets. Given sufficient availability, some items were significantly cheaper (P<0·05) at direct retail outlets in the peak season (e.g. cantaloupe cost 36·0 % less at roadside stands than supermarkets), while others were significantly more expensive (e.g. carrots cost 137·9 % more at farmers' markets than supermarkets). Although small samples limited statistical power in many non-peak comparisons, these results also showed some differences by item: two-thirds of fruits were cheaper at one or both direct outlets in the spring and autumn, whereas five of eighteen vegetables cost more at direct retail year-round. Commonly consumed fruits and vegetables were more widely available at supermarkets in central and eastern North Carolina than at direct retail outlets, in each season. Contingent on item availability, price competitiveness of the direct retail outlets varied by fruit and vegetable. For many items, the outlets compete on price in more than one season.

Value-based insurance design: embracing value over cost alone.

PubMed

Fendrick, A Mark; Chernew, Michael E; Levi, Gary W

2009-12-01

The US healthcare system is in crisis, with documented gaps in quality, safety, access, and affordability. Many believe the solution to unsustainable cost increases is increased patient cost-sharing. From an overall cost perspective, reduced consumption of certain essential services may yield short-term savings but lead to worse health and markedly higher costs down the road--in complications, hospitalizations, and increased utilization. Value-based insurance design (VBID) can help plug the inherent shortfalls in "across-the-board" patient cost-sharing. Instead of focusing on cost or quality alone, VBID focuses on value, aligning the financial and nonfinancial incentives of the various stakeholders and complementing other current initiatives to improve quality and subdue costs, such as high-deductible consumer-directed health plans, pay-for-performance programs, and disease management. Mounting evidence, both peer-reviewed and empirical, indicates not only that VBID can be implemented, but also leads to desired changes in behavior. For all its documented successes and recognized promise, VBID is in its infancy and is not a panacea for the current healthcare crisis. However, the available research and documented experiences indicate that as an overall approach, and in its fully evolved and widely adopted form, VBID will promote a healthier population and therefore support cost-containment efforts by producing better health at any price point.

The direct and indirect costs of both overweight and obesity: a systematic review

PubMed Central

2014-01-01

Background The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included. Methods A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies. Results Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs. Conclusion A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons. PMID:24739239

The direct and indirect costs of both overweight and obesity: a systematic review.

PubMed

Dee, Anne; Kearns, Karen; O'Neill, Ciaran; Sharp, Linda; Staines, Anthony; O'Dwyer, Victoria; Fitzgerald, Sarah; Perry, Ivan J

2014-04-16

The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included. A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies. Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs. A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons.

[Cost effectiveness in treatment of acute myeloid leukemia].

PubMed

Nordmann, P; Schaffner, A; Dazzi, H

2000-12-23

Although the rise in health costs is a widely debated issue, in Switzerland it was until recently taken for granted that patients are given the best available treatment regardless of cost. An example of a disease requiring costly treatment is acute myelogenous leukaemia (AML). To relate cost to benefit we calculated expenditure per life years gained. To assess costs we determined the real cost of treatment up to total remission, followed by consolidation or withdrawal of treatment or death. For survival time exceeding the 2-year observation period we used data from recent literature. The average cost of treatment ranges up to 107,592 Swiss francs (CHF). In 1997 we treated 23 leukaemia patients at Zurich University Hospital and gained a total of 210 life years. This represents an average cost of CHF 11,741 per life year gained. Chief cost items were therapy and personnel costs for nursing staff, followed by hotel business and personnel costs for doctors and diagnosis. Our results for AML treatment are far removed from the $61,500 ranging up to $166,000 discussed in the literature as the "critical" QALY (quality adjusted life years) value. This is the first time the actual costs of AML therapy have been shown for a Swiss cohort. Despite high initial treatment costs and success only in a limited number of patients, the expenditure per QALY is surprisingly low and shows clearly the effectiveness of apparently costly acute medicine.

A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial.

PubMed

Kamamoto, Fabio; Lima, Ana Lucia Munhoz; Rezende, Marcelo Rosa de; Mattar-Junior, Rames; Leonhardt, Marcos de Camargo; Kojima, Kodi Edson; Santos, Carla Chineze Dos

2017-12-01

Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC). This is a randomized, controlled, non-inferiority, unblinded trial. Patients admitted with complex injuries to a trauma center in a public referral hospital who were indicated for orthopedic surgery were randomized to a USP or VAC group. The primary outcome was the time required to achieve a "ready for surgery condition", which was defined as a wound bed with healthy granulation tissue and without necrosis or purulent secretion. Wound bed area contraction, granulation tissue growth and the direct costs of the dressings were secondary outcomes. Variation in area and granulation tissue growth were essentially the same between the systems, and healing time was equal between the groups (p=0.379). In both systems, serial debridement increased wound area (p=0.934), and granulation tissue was also increased (p=0.408). The mean treatment cost was US$ 15.15 in the USP group and US$ 872.59 in the VAC group. For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC.

Delayed Hospital Discharges of Older Patients: A Systematic Review on Prevalence and Costs.

PubMed

Landeiro, Filipa; Roberts, Kenny; Gray, Alastair Mcintosh; Leal, José

2017-05-23

To determine the prevalence of delayed discharges of elderly inpatients and associated costs. We searched Medline, Embase, Global Health, CAB Abstracts, Econlit, Web of Knowledge, EBSCO - CINAHL, The Cochrane Library, Health Management Information Consortium, and SCIE - Social Care Online for evidence published between 1990 and 2015 on number of days or proportion of delayed discharges for elderly inpatients in acute hospitals. Descriptive and regression analyses were conducted. Data on proportions of delayed discharges were pooled using a random effects logistic model and the association of relevant factors was assessed. Mean costs of delayed discharge were calculated in USD adjusted for Purchasing Power Parity (PPP). Of 64 studies included, 52 (81.3%) reported delayed discharges as proportions of total hospital stay and 9 (14.1%) estimated the respective costs for these delays. Proportions of delayed discharges varied widely, from 1.6% to 91.3% with a weighted mean of 22.8%. This variation was also seen in studies from the same country, for example, in the United Kingdom, they ranged between 1.6% and 60.0%. No factor was found to be significantly associated with delays. The mean costs of delayed discharge also varied widely (between 142 and 31,935 USD PPP adjusted), reflecting the variability in mean days of delay per patient. Delayed discharges occur in most countries and the associated costs are significant. However, the variability in prevalence of delayed discharges and available data on costs limit our knowledge of the full impact of delayed discharges. A standardization of methods is necessary to allow comparisons to be made, and additional studies are required-preferably by disease area-to determine the postdischarge needs of specific patient groups and the estimated costs of delays. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A query theory account of the effect of memory retrieval on the sunk cost bias.

PubMed

Ting, Hsuchi; Wallsten, Thomas S

2011-08-01

The sunk cost bias occurs when individuals continue to invest in the same option when better alternatives are available. Many researchers believe that this bias is due to overemphasizing the past investment over the (missed) opportunities offered by alternatives. As an alternative or complement to this view, we show that memory retrieval and attention play important roles in the sunk cost bias. In two experiments, individuals generated more reasons for pursuing the invested option than for an alternative; they generated those reasons earlier in a sequence of reasons; and these effects increased as the individuals made progress toward attaining the reward yielded by the invested option. Associated with these effects, individuals perceived an increasingly wide gap in value between the invested and alternative options as they progressed toward the goal, thereby creating the sunk cost bias. Forcing individuals to reverse the order in which they generated reasons for the invested and alternative options reduced the bias. [corrected

Cost-effectiveness evaluation of vaccination against Haemophilus influenzae invasive diseases in France.

PubMed

Livartowski, A; Boucher, J; Detournay, B; Reinert, P

1996-04-01

A cost-effectiveness analysis of a vaccination program against Haemophilus influenzae type b (Hib) was conducted using French epidemiological data. The vaccine would be added as a fifth valence to the tetravalent vaccines (DTCP) widely used in France. The permanent sequelae of the Hib invasive diseases which might be avoided by vaccination were weighted to determine Quality Adjusted Life Years gained. In a stable French population of 3,746,000 children aged < 5 years old (1990), and for a followup period of ten years, the cost-effectiveness ratio of such a program for the French national health insurance system would equal 54,084 FF per year of life added or 34,050 FF per QALY. The net cost of the program during that period would be 1.02 billion FF for the French national health insurance system and 920 million FF for patients' families. Comparison of these projections with available information supports, a posteriori, the decision of the French government to authorize the licensing of the pentavalent vaccine.

The economic and operational value of using drones to transport vaccines.

PubMed

Haidari, Leila A; Brown, Shawn T; Ferguson, Marie; Bancroft, Emily; Spiker, Marie; Wilcox, Allen; Ambikapathi, Ramya; Sampath, Vidya; Connor, Diana L; Lee, Bruce Y

2016-07-25

Immunization programs in low and middle income countries (LMICs) face numerous challenges in getting life-saving vaccines to the people who need them. As unmanned aerial vehicle (UAV) technology has progressed in recent years, potential use cases for UAVs have proliferated due to their ability to traverse difficult terrains, reduce labor, and replace fleets of vehicles that require costly maintenance. Using a HERMES-generated simulation model, we performed sensitivity analyses to assess the impact of using an unmanned aerial system (UAS) for routine vaccine distribution under a range of circumstances reflecting variations in geography, population, road conditions, and vaccine schedules. We also identified the UAV payload and UAS costs necessary for a UAS to be favorable over a traditional multi-tiered land transport system (TMLTS). Implementing the UAS in the baseline scenario improved vaccine availability (96% versus 94%) and produced logistics cost savings of $0.08 per dose administered as compared to the TMLTS. The UAS maintained cost savings in all sensitivity analyses, ranging from $0.05 to $0.21 per dose administered. The minimum UAV payloads necessary to achieve cost savings over the TMLTS, for the various vaccine schedules and UAS costs and lifetimes tested, were substantially smaller (up to 0.40L) than the currently assumed UAV payload of 1.5L. Similarly, the maximum UAS costs that could achieve savings over the TMLTS were greater than the currently assumed costs under realistic flight conditions. Implementing a UAS could increase vaccine availability and decrease costs in a wide range of settings and circumstances if the drones are used frequently enough to overcome the capital costs of installing and maintaining the system. Our computational model showed that major drivers of costs savings from using UAS are road speed of traditional land vehicles, the number of people needing to be vaccinated, and the distance that needs to be traveled. Copyright © 2016. Published by Elsevier Ltd.

Improving The Discipline of Cost Estimation and Analysis

NASA Technical Reports Server (NTRS)

Piland, William M.; Pine, David J.; Wilson, Delano M.

2000-01-01

The need to improve the quality and accuracy of cost estimates of proposed new aerospace systems has been widely recognized. The industry has done the best job of maintaining related capability with improvements in estimation methods and giving appropriate priority to the hiring and training of qualified analysts. Some parts of Government, and National Aeronautics and Space Administration (NASA) in particular, continue to need major improvements in this area. Recently, NASA recognized that its cost estimation and analysis capabilities had eroded to the point that the ability to provide timely, reliable estimates was impacting the confidence in planning many program activities. As a result, this year the Agency established a lead role for cost estimation and analysis. The Independent Program Assessment Office located at the Langley Research Center was given this responsibility. This paper presents the plans for the newly established role. Described is how the Independent Program Assessment Office, working with all NASA Centers, NASA Headquarters, other Government agencies, and industry, is focused on creating cost estimation and analysis as a professional discipline that will be recognized equally with the technical disciplines needed to design new space and aeronautics activities. Investments in selected, new analysis tools, creating advanced training opportunities for analysts, and developing career paths for future analysts engaged in the discipline are all elements of the plan. Plans also include increasing the human resources available to conduct independent cost analysis of Agency programs during their formulation, to improve near-term capability to conduct economic cost-benefit assessments, to support NASA management's decision process, and to provide cost analysis results emphasizing "full-cost" and "full-life cycle" considerations. The Agency cost analysis improvement plan has been approved for implementation starting this calendar year. Adequate financial and human resources are being made available to accomplish the goals of this important effort, and all indications are that NASA's cost estimation and analysis core competencies will be substantially improved within the foreseeable future.

Clinical impact and cost-effectiveness of making third-line antiretroviral therapy available in sub-Saharan Africa: a model-based analysis in Côte d'Ivoire.

PubMed

Ouattara, Eric N; Ross, Eric L; Yazdanpanah, Yazdan; Wong, Angela Y; Robine, Marion; Losina, Elena; Moh, Raoul; Walensky, Rochelle P; Danel, Christine; Paltiel, A David; Eholié, Serge P; Freedberg, Kenneth A; Anglaret, Xavier

2014-07-01

In sub-Saharan Africa, HIV-infected adults who fail second-line antiretroviral therapy (ART) often do not have access to third-line ART. We examined the clinical impact and cost-effectiveness of making third-line ART available in Côte d'Ivoire. We used a simulation model to compare 4 strategies after second-line ART failure: continue second-line ART (C-ART2), continue second-line ART with an adherence reinforcement intervention (AR-ART2), immediate switch to third-line ART (IS-ART3), and continue second-line ART with adherence reinforcement, switching patients with persistent failure to third-line ART (AR-ART3). Third-line ART consisted of a boosted-darunavir plus raltegravir-based regimen. Primary outcomes were 10-year survival and lifetime incremental cost-effectiveness ratios (ICERs), in $/year of life saved (YLS). ICERs below $3585 (3 times the country per capita gross domestic product) were considered cost-effective. Ten-year survival was 6.0% with C-ART2, 17.0% with AR-ART2, 35.4% with IS-ART3, and 37.2% with AR-ART3. AR-ART2 was cost-effective ($1100/YLS). AR-ART3 had an ICER of $3600/YLS and became cost-effective if the cost of third-line ART decreased by <1%. IS-ART3 was less effective and more costly than AR-ART3. Results were robust to wide variations in the efficacy of third-line ART and of the adherence reinforcement, as well as in the cost of second-line ART. Access to third-line ART combined with an intense adherence reinforcement phase, used as a tool to distinguish between patients who can still benefit from their current second-line regimen and those who truly need third-line ART would provide substantial survival benefits. With minor decreases in drug costs, this strategy would be cost-effective.

Implementation and Operational Research: A Cost-Effective, Clinically Actionable Strategy for Targeting HIV Preexposure Prophylaxis to High-Risk Men Who Have Sex With Men.

PubMed

Ross, Eric L; Cinti, Sandro K; Hutton, David W

2016-07-01

Preexposure prophylaxis (PrEP) is effective at preventing HIV infection among men who have sex with men (MSM), but there is uncertainty about how to identify high-risk MSM who should receive PrEP. We used a mathematical model to assess the cost-effectiveness of using the HIV Incidence Risk Index for MSM (HIRI-MSM) questionnaire to target PrEP to high-risk MSM. We simulated strategies of no PrEP, PrEP available to all MSM, and eligibility thresholds set to HIRI-MSM scores between 5 and 45, in increments of 5 (where a higher score predicts greater HIV risk). Based on the iPrEx, IPERGAY, and PROUD trials, we evaluated PrEP efficacies from 44% to 86% and annual costs from $5900 to 8700. We designate strategies with incremental cost-effectiveness ratio (ICER) ≤$100,000/quality-adjusted life-year (QALY) as "cost-effective." Over 20 years, making PrEP available to all MSM is projected to prevent 33.5% of new HIV infections, with an ICER of $1,474,000/QALY. Increasing the HIRI-MSM score threshold reduces the prevented infections, but improves cost-effectiveness. A threshold score of 25 is projected to be optimal (most QALYs gained while still being cost-effective) over a wide range of realistic PrEP efficacies and costs. At low cost and high efficacy (IPERGAY), thresholds of 15 or 20 are optimal across a range of other input assumptions; at high cost and low efficacy (iPrEx), 25 or 30 are generally optimal. The HIRI-MSM provides a clinically actionable means of guiding PrEP use. Using a score of 25 to determine PrEP eligibility could facilitate cost-effective use of PrEP among high-risk MSM who will benefit from it most.

The economic and operational value of using drones to transport vaccines

PubMed Central

Haidari, Leila A.; Brown, Shawn T.; Ferguson, Marie; Bancroft, Emily; Spiker, Marie; Wilcox, Allen; Ambikapathi, Ramya; Sampath, Vidya; Connor, Diana L.; Lee, Bruce Y.

2017-01-01

Background Immunization programs in low and middle income countries (LMICs) face numerous challenges in getting life-saving vaccines to the people who need them. As unmanned aerial vehicle (UAV) technology has progressed in recent years, potential use cases for UAVs have proliferated due to their ability to traverse difficult terrains, reduce labor, and replace fleets of vehicles that require costly maintenance. Methods Using a HERMES-generated simulation model, we performed sensitivity analyses to assess the impact of using an unmanned aerial system (UAS) for routine vaccine distribution under a range of circumstances reflecting variations in geography, population, road conditions, and vaccine schedules. We also identified the UAV payload and UAS costs necessary for a UAS to be favorable over a traditional multi-tiered land transport system (TMLTS). Results Implementing the UAS in the baseline scenario improved vaccine availability (96% versus 94%) and produced logistics cost savings of $0.08 per dose administered as compared to the TMLTS. The UAS maintained cost savings in all sensitivity analyses, ranging from $0.05 to $0.21 per dose administered. The minimum UAV payloads necessary to achieve cost savings over the TMLTS, for the various vaccine schedules and UAS costs and lifetimes tested, were substantially smaller (up to 0.40 L) than the currently assumed UAV payload of 1.5 L. Similarly, the maximum UAS costs that could achieve savings over the TMLTS were greater than the currently assumed costs under realistic flight conditions. Conclusion Implementing a UAS could increase vaccine availability and decrease costs in a wide range of settings and circumstances if the drones are used frequently enough to overcome the capital costs of installing and maintaining the system. Our computational model showed that major drivers of costs savings from using UAS are road speed of traditional land vehicles, the number of people needing to be vaccinated, and the distance that needs to be traveled. PMID:27340098

Pork as a Source of Omega-3 (n-3) Fatty Acids

PubMed Central

Dugan, Michael E.R.; Vahmani, Payam; Turner, Tyler D.; Mapiye, Cletos; Juárez, Manuel; Prieto, Nuria; Beaulieu, Angela D.; Zijlstra, Ruurd T.; Patience, John F.; Aalhus, Jennifer L.

2015-01-01

Pork is the most widely eaten meat in the world, but typical feeding practices give it a high omega-6 (n-6) to omega-3 (n-3) fatty acid ratio and make it a poor source of n-3 fatty acids. Feeding pigs n-3 fatty acids can increase their contents in pork, and in countries where label claims are permitted, claims can be met with limited feeding of n-3 fatty acid enrich feedstuffs, provided contributions of both fat and muscle are included in pork servings. Pork enriched with n-3 fatty acids is, however, not widely available. Producing and marketing n-3 fatty acid enriched pork requires regulatory approval, development costs, quality control costs, may increase production costs, and enriched pork has to be tracked to retail and sold for a premium. Mandatory labelling of the n-6/n-3 ratio and the n-3 fatty acid content of pork may help drive production of n-3 fatty acid enriched pork, and open the door to population-based disease prevention polices (i.e., food tax to provide incentives to improve production practices). A shift from the status-quo, however, will require stronger signals along the value chain indicating production of n-3 fatty acid enriched pork is an industry priority. PMID:26694475

Pork as a Source of Omega-3 (n-3) Fatty Acids.

PubMed

Dugan, Michael E R; Vahmani, Payam; Turner, Tyler D; Mapiye, Cletos; Juárez, Manuel; Prieto, Nuria; Beaulieu, Angela D; Zijlstra, Ruurd T; Patience, John F; Aalhus, Jennifer L

2015-12-16

Pork is the most widely eaten meat in the world, but typical feeding practices give it a high omega-6 (n-6) to omega-3 (n-3) fatty acid ratio and make it a poor source of n-3 fatty acids. Feeding pigs n-3 fatty acids can increase their contents in pork, and in countries where label claims are permitted, claims can be met with limited feeding of n-3 fatty acid enrich feedstuffs, provided contributions of both fat and muscle are included in pork servings. Pork enriched with n-3 fatty acids is, however, not widely available. Producing and marketing n-3 fatty acid enriched pork requires regulatory approval, development costs, quality control costs, may increase production costs, and enriched pork has to be tracked to retail and sold for a premium. Mandatory labelling of the n-6/n-3 ratio and the n-3 fatty acid content of pork may help drive production of n-3 fatty acid enriched pork, and open the door to population-based disease prevention polices (i.e., food tax to provide incentives to improve production practices). A shift from the status-quo, however, will require stronger signals along the value chain indicating production of n-3 fatty acid enriched pork is an industry priority.

Price Estimation Guidelines

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Aster, R. W.; Firnett, P. J.; Miller, M. A.

1985-01-01

Improved Price Estimation Guidelines, IPEG4, program provides comparatively simple, yet relatively accurate estimate of price of manufactured product. IPEG4 processes user supplied input data to determine estimate of price per unit of production. Input data include equipment cost, space required, labor cost, materials and supplies cost, utility expenses, and production volume on industry wide or process wide basis.

The Affording Mars Workshop: Background and Recommendations

NASA Technical Reports Server (NTRS)

Thronson, Harley A.; Carberry, Christopher

2014-01-01

A human mission to Mars is the stated "ultimate" goal for NASA and is widely believed by the public to be the most compelling destination for America's space program. However, widely cited enormous costs - perhaps as much as a trillion dollars for a many-decade campaign - seem to be an impossible hurdle, although political and budget instability over many years may be equally challenging. More recently, a handful of increasingly detailed architectures for initial Mars missions have been developed by commercial companies that have estimated costs much less than widely believed and roughly comparable with previous major human space flight programs: the Apollo Program, the International Space Station, and the space shuttle. Several of these studies are listed in the bibliography to the workshop report. As a consequence of these new scenarios, beginning in spring, 2013 a multiinstitutional planning team began developing the content and invitee list for a winter workshop that would critically assess concepts, initiatives, technology priorities, and programmatic options to reduce significantly the costs of human exploration of Mars. The output of the workshop - findings and recommendations - would be presented in a number of forums and discussed with national leaders in human space flight. It would also be made available to potential international partners. This workshop was planned from the start to be the first in a series. Subsequent meetings, conferences, and symposia will concentrate on topics not able to be covered in December. In addition, to make progress in short meeting, a handful of ground rules were adopted by the planning team and agreed to by the participants. Perhaps the two most notable such ground rules were (1) the Space Launch System (SLS) and Orion would be available during the time frame considered by the participants and (2) the International Space Station (ISS) would remain the early linchpin in preparing for Mars exploration over the coming decade. The workshop was organized around three topical breakout sessions: 1. The ISS and the path to Mars: The critical coming decade 2. Affordability and sustainability: what does it mean and what are its implications within guidelines established at the start of the workshop? 3. Notional sequence(s) of cost-achievable missions for the 2020s to 2030s, including capability objectives at each stage and opportunities for coordinated robotic partnerships.

Oral Sedation in the Dental Office.

PubMed

Sebastiani, Francesco R; Dym, Harry; Wolf, Joshua

2016-04-01

This article highlights the commonly used medications used in dentistry and oral surgery. General dentists and specialists must be knowledgeable about the pharmacology of the drugs currently available along with their risks and benefits. Enteral sedation is a useful adjunct for the treatment of anxious adult and pediatric patients. When enteral sedation is used within the standards of care, the interests of the public and the dental profession are served through a cost-effective, effective service that can be widely available. Oral sedation enables dentists to provide dental care to millions of individuals who otherwise would have unmet dental needs. Copyright © 2016 Elsevier Inc. All rights reserved.

Annual Surveillance Summary: Escherichia coli (E. coli) Infections in the Military Health System (MHS), 2015

DTIC Science & Technology

2017-03-01

2015 NMCPHC-EDC-TR-187-2017 By Toni-Marie Hudson and Uzo Chukwuma EpiData Center Department Prepared March 2017 Approved for public ...available today, resulting in wide-ranging global public health implications. Bacterial genes responsible for carbapenem-resistance typically confer other...each year, of which 75,000 resulted in death and cost $28-$45 billion annually. 19,20 From 2011-2014, the Centers for Disease Control and Prevention’s

The Galileo Spacecraft: A Telecommunications Legacy for Future Space Flight

NASA Technical Reports Server (NTRS)

Deutsch, Leslie J.

1997-01-01

The Galileo mission to Jupiter has implemented a wide range of telecommunication inprovements in response to the loss of its high gain antenna. While necessity dictated the use of these new techniques for Galileo, now that they have been proven in flight, they are available for use on future deep space missions. This telecommunications legacy of Galileo will aid in our ability to conduct a meaningful exploration of the solar system, and beyond, at a reasonable cost.

Compact Full-Field Ion Detector System for CubeSat Science Beyond LEO

NASA Technical Reports Server (NTRS)

Wrbanek, John D.; Wrbanek, Susan Y.; Fralick, Gustave C.; Clark, Pamela E.

2013-01-01

NASA Glenn Research Center (GRC) is applying its expertise and facilities in harsh environment instrumentation to develop a Compact Full-Field Ion Detector System (CFIDS). The CFIDS is designed to be an extremely compact, low cost instrument, capable of being flown on a wide variety of deep space platforms, to provide comprehensive (composition, velocity, and direction) in situ measurements of heavy ions in space plasma environments with higher fidelity, than previously available.

The availability of smoking-permitted accommodations from Airbnb in 12 Canadian cities

PubMed Central

Kennedy, Ryan David; Douglas, Ornell; Stehouwer, Lindsay; Dawson, Jackie

2018-01-01

Purpose Airbnb is a web-based peer-to-peer (P2P) service that enables potential hosts and guests to broker accommodations in private homes as an alternative to traditional hotels. The hospitality sector has increasingly gone smoke-free over the last decade. This study identified the availability and cost of smoking-permitted accommodations identified on Airbnb. Methods The study team searched for Airbnb accommodations in 12 Canadian cities across each of Canada’s 10 provinces. Searches included availability for a single person for a private room, or double occupancy for an entire home/apartment; searches were for 1-night and 1-week stays. Results Cities across Canada, including Regina, Fredericton and Charlottetown, had no smoking-permitted accommodations available for the searches conducted. The proportion of private rooms available for one night that permitted smoking ranged from 2% in Calgary, 4% in Winnipeg and St. John’s, 10% in Halifax and Victoria, 18% in Toronto, 45% in Vancouver and 69% in Montréal. The average cost for a private room for one night in Vancouver was $128, while the cost for a private room that permits smoking was $62; however, in other markets prices were more similar. Discussion Across Canada, there is a wide range of smoking-permitted accommodations available through Airbnb. In some markets, smoking-permitted accommodation may be significantly less expensive than smoke-free options. As hotel chains increasingly go smoke-free, it is possible that the marketplace will respond with offerings to fulfil consumer demand. As policy makers consider how to regulate P2P services like Airbnb, public health considerations should be included. PMID:28219974

The availability of smoking-permitted accommodations from Airbnb in 12 Canadian cities.

PubMed

Kennedy, Ryan David; Douglas, Ornell; Stehouwer, Lindsay; Dawson, Jackie

2018-01-01

Airbnb is a web-based peer-to-peer (P2P) service that enables potential hosts and guests to broker accommodations in private homes as an alternative to traditional hotels. The hospitality sector has increasingly gone smoke-free over the last decade. This study identified the availability and cost of smoking-permitted accommodations identified on Airbnb. The study team searched for Airbnb accommodations in 12 Canadian cities across each of Canada's 10 provinces. Searches included availability for a single person for a private room, or double occupancy for an entire home/apartment; searches were for 1-night and 1-week stays. Cities across Canada, including Regina, Fredericton and Charlottetown, had no smoking-permitted accommodations available for the searches conducted. The proportion of private rooms available for one night that permitted smoking ranged from 2% in Calgary, 4% in Winnipeg and St. John's, 10% in Halifax and Victoria, 18% in Toronto, 45% in Vancouver and 69% in Montréal. The average cost for a private room for one night in Vancouver was $128, while the cost for a private room that permits smoking was $62; however, in other markets prices were more similar. Across Canada, there is a wide range of smoking-permitted accommodations available through Airbnb. In some markets, smoking-permitted accommodation may be significantly less expensive than smoke-free options. As hotel chains increasingly go smoke-free, it is possible that the marketplace will respond with offerings to fulfil consumer demand. As policy makers consider how to regulate P2P services like Airbnb, public health considerations should be included. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Health Monitoring System Technology Assessments: Cost Benefits Analysis

NASA Technical Reports Server (NTRS)

Kent, Renee M.; Murphy, Dennis A.

2000-01-01

The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

Biomass supply chain optimisation for Organosolv-based biorefineries.

PubMed

Giarola, Sara; Patel, Mayank; Shah, Nilay

2014-05-01

This work aims at providing a Mixed Integer Linear Programming modelling framework to help define planning strategies for the development of sustainable biorefineries. The up-scaling of an Organosolv biorefinery was addressed via optimisation of the whole system economics. Three real world case studies were addressed to show the high-level flexibility and wide applicability of the tool to model different biomass typologies (i.e. forest fellings, cereal residues and energy crops) and supply strategies. Model outcomes have revealed how supply chain optimisation techniques could help shed light on the development of sustainable biorefineries. Feedstock quality, quantity, temporal and geographical availability are crucial to determine biorefinery location and the cost-efficient way to supply the feedstock to the plant. Storage costs are relevant for biorefineries based on cereal stubble, while wood supply chains present dominant pretreatment operations costs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Employer-sponsored health insurance in New York: findings from the 2003 Commonwealth Fund/HRET survey.

PubMed

Edwards, Jennifer N; How, Sabrina; Whitmore, Heidi; Gabel, Jon R; Hawkins, Samantha; Pickreign, Jeremy D

2004-05-01

A 2003 Commonwealth Fund/Health Research and Educational Trust survey of 576 New York State firms found that, in order to manage rising health costs, employers are increasing the share of the insurance premium that employees pay, delaying the start of benefits, and increasing cost-sharing at the point of service. This has enabled employers to preserve health benefits, but has raised costs for workers and their families. On average, workers' contributions for family coverage rose 54 percent, from $1,392 per year in 2001 to $2,148 per year in 2003. During that time period, fewer workers selected family coverage. Employers are receptive to a wide range of approaches to make coverage more available and affordable for their employees, but they have limited familiarity with public programs that could cover their lower-wage workers, such as Healthy New York, Family Health Plus, or Child Health Plus.

Controlling mechanisms over the internet

NASA Astrophysics Data System (ADS)

Lumia, Ronald

1997-01-01

The internet, widely available throughout the world, can be used to control robots, machine tools, and other mechanisms. This paper will describe a low-cost virtual collaborative environment (VCE) which will connect users with distant equipment. The system is based on PC technology, and incorporates off-line-programming with on-line execution. A remote user programs the systems graphically and simulates the motions and actions of the mechanism until satisfied with the functionality of the program. The program is then transferred from the remote site to the local site where the real equipment exists. At the local site, the simulation is run again to check the program from a safety standpoint. Then, the local user runs the program on the real equipment. During execution, a camera in the real workspace provides an image back to the remote user through a teleconferencing system. The system costs approximately 12,500 dollars and represents a low-cost alternative to the Sandia National Laboratories VCE.

Tradable credits system design and cost savings for a national low carbon fuel standard for road transport

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

Rubin, Jonathan; Leiby, Paul N.

2012-06-11

This research examines the economic implications of different designs for a national low carbon fuel standard (NLCFS) for the road transportation sector. A NLCFS based on the average Carbon Intensity (CI) of all fuels sold in the gasoline and diesel markets will generate an incentive for fuel suppliers to reduce the measured CI of their petroleum fuels. The economic impacts of a NLCFS are fundamentally determined by: the availability of low carbon fuels; the compliance path; the reference level CI of the fuel baseline; and the degree of flexibility in the credit system. To quantitatively examine the implications of amore » NLCFS, we created the Transportation Regulation and Credit Trading (TRACT) Model. With TRACT, we model a NLCFS credit trading system among profit maximizing fuel suppliers for light- and heavy-duty vehicle fuel use for the United States from 2012 - 2030. Given the wide range of cost and availability of biofuels, we find that credit trading across gasoline and diesel fuel markets combined with credit banking can significantly reduce compliance costs and stabilize credit prices. We make policy recommendations on how to combine a NLCFS with other existing regulations for transportation fuels.« less

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

Cory, K.; Coughlin, J.; Coggeshall, C.

State and local governments have grown increasingly aware of the economic, environmental, and societal benefits of taking a lead role in U.S. implementation of renewable energy, particularly distributed photovoltaic (PV) installations. Recently, solar energy's cost premium has declined as a result of technology improvements and an increase in the cost of traditional energy generation. At the same time, a nationwide public policy focus on carbon-free, renewable energy has created a wide range of financial incentives to lower the costs of deploying PV even further. These changes have led to exponential increases in the availability of capital for solar projects, andmore » tremendous creativity in the development of third-party ownership structures. As significant users of electricity, state and local governments can be an excellent example for solar PV system deployment on a national scale. Many public entities are not only considering deployment on public building rooftops, but also large-scale applications on available public lands. The changing marketplace requires that state and local governments be financially sophisticated to capture as much of the economic potential of a PV system as possible. This report examines ways that state and local governments can optimize the financial structure of deploying solar PV for public uses.« less

Antiviral agents for influenza: a comparison of cost-effectiveness data.

PubMed

Lynd, Larry D; Goeree, Ron; O'Brien, Bernie J

2005-01-01

The economic burden of influenza-related illness has been estimated to be 71.3-166 billion US dollars in the US, the majority of which is attributable to indirect costs as a result of lost productivity. There are currently four antiviral drugs available for the treatment of influenza: two ion channel blockers, amantadine and rimantadine; and two neuraminidase inhibitors, zanamivir and oseltamivir. The objective of this paper was to review the studies evaluating the cost effectiveness of currently available antiviral treatment and prophylaxis management strategies for influenza. Published studies that reported both costs and effectiveness of influenza management were extracted using MEDLINE, pre-MEDLINE and EMBASE. To facilitate a broad comparison, all costs were inflated to 2003 US dollars. Fifteen studies met the inclusion criteria of the review, with 14 analyses based on decision-analytic modelling and one economic analysis performed alongside a clinical trial. Management strategies included antiviral influenza prophylaxis or vaccination, empiric treatment of suspected disease, or antiviral treatment following rapid influenza testing. Study populations included healthy adults, adults at risk of influenza-related adverse outcomes, institutionalised and non-institutionalised elderly, and children. The comparator in all studies was standard care (i.e. over-the-counter medications only), and analyses were carried out from both the societal and payer perspectives. The only dominant strategy relative to standard care was vaccination of the institutionalised elderly. All other strategies in all populations were both more costly and more effective than standard care. Depending on the population and the perspective, the incremental cost-effectiveness ratios (ICERs) for antiviral treatment strategies ranged from 5000 US dollars/QALY for amantadine in test-and-treat studies to >400,000 US dollars/QALY for zanamivir or oseltamivir treatment in children. Sensitivity analysis in all studies consistently reported a strong influence of the population prevalence or diagnostic accuracy of influenza on the cost effectiveness of all strategies. Baseline influenza prevalence varied widely between studies, ranging from 15% to 68%. There was also a wide variation in the assumption about the disutility of influenza (ranging from -0.137 to -0.983 for the elderly requiring hospitalisation), which also impacted the cost effectiveness. Given the variation in the ICERs of antiviral treatment and prophylaxis, the uncertainty around many model parameters, and the dynamic nature of influenza from year to year, one can only conclude that antiviral treatment or prophylaxis for influenza is likely to be more cost effective in specific populations at specific times during the influenza season, and during influenza seasons when the population prevalence reaches epidemic levels or there is mismatch between the vaccine and the circulating virus.

EMSAR: estimation of transcript abundance from RNA-seq data by mappability-based segmentation and reclustering.

PubMed

Lee, Soohyun; Seo, Chae Hwa; Alver, Burak Han; Lee, Sanghyuk; Park, Peter J

2015-09-03

RNA-seq has been widely used for genome-wide expression profiling. RNA-seq data typically consists of tens of millions of short sequenced reads from different transcripts. However, due to sequence similarity among genes and among isoforms, the source of a given read is often ambiguous. Existing approaches for estimating expression levels from RNA-seq reads tend to compromise between accuracy and computational cost. We introduce a new approach for quantifying transcript abundance from RNA-seq data. EMSAR (Estimation by Mappability-based Segmentation And Reclustering) groups reads according to the set of transcripts to which they are mapped and finds maximum likelihood estimates using a joint Poisson model for each optimal set of segments of transcripts. The method uses nearly all mapped reads, including those mapped to multiple genes. With an efficient transcriptome indexing based on modified suffix arrays, EMSAR minimizes the use of CPU time and memory while achieving accuracy comparable to the best existing methods. EMSAR is a method for quantifying transcripts from RNA-seq data with high accuracy and low computational cost. EMSAR is available at https://github.com/parklab/emsar.

Enrichment methods provide a feasible approach to comprehensive and adequately powered investigations of the brain methylome

PubMed Central

Chan, Robin F.; Shabalin, Andrey A.; Xie, Lin Y.; Adkins, Daniel E.; Zhao, Min; Turecki, Gustavo; Clark, Shaunna L.; Aberg, Karolina A.

2017-01-01

Abstract Methylome-wide association studies are typically performed using microarray technologies that only assay a very small fraction of the CG methylome and entirely miss two forms of methylation that are common in brain and likely of particular relevance for neuroscience and psychiatric disorders. The alternative is to use whole genome bisulfite (WGB) sequencing but this approach is not yet practically feasible with sample sizes required for adequate statistical power. We argue for revisiting methylation enrichment methods that, provided optimal protocols are used, enable comprehensive, adequately powered and cost-effective genome-wide investigations of the brain methylome. To support our claim we use data showing that enrichment methods approximate the sensitivity obtained with WGB methods and with slightly better specificity. However, this performance is achieved at <5% of the reagent costs. Furthermore, because many more samples can be sequenced simultaneously, projects can be completed about 15 times faster. Currently the only viable option available for comprehensive brain methylome studies, enrichment methods may be critical for moving the field forward. PMID:28334972

Investigating DRG cost weights for hospitals in middle income countries.

PubMed

Ghaffari, Shahram; Doran, Christopher; Wilson, Andrew; Aisbett, Chris; Jackson, Terri

2009-01-01

Identifying the cost of hospital outputs, particularly acute inpatients measured by Diagnosis Related Groups (DRGs), is an important component of casemix implementation. Measuring the relative costliness of specific DRGs is useful for a wide range of policy and planning applications. Estimating the relative use of resources per DRG can be done through different costing approaches depending on availability of information and time and budget. This study aims to guide costing efforts in Iran and other countries in the region that are pursuing casemix funding, through identifying the main issues facing cost finding approaches and introducing the costing models compatible with their hospitals accounting and management structures. The results show that inadequate financial and utilisation information at the patient's level, poorly computerized 'feeder systems'; and low quality data make it impossible to estimate reliable DRGs costs through clinical costing. A cost modelling approach estimates the average cost of 2.723 million Rials (Iranian Currency) per DRG. Using standard linear regression, a coefficient of 0.14 (CI = 0.12-0.16) suggests that the average cost weight increases by 14% for every one-day increase in average length of stay (LOS).We concluded that calculation of DRG cost weights (CWs) using Australian service weights provides a sensible starting place for DRG-based hospital management; but restructuring hospital accounting systems, designing computerized feeder systems, using appropriate software, and development of national service weights that reflect local practice patterns will enhance the accuracy of DRG CWs.

[Detailed methodological recommendations for the treatment of Clostridium difficile-associated diarrhea with faecal transplantation].

PubMed

Nagy, Gergely György; Várvölgyi, Csaba; Balogh, Zoltán; Orosi, Piroska; Paragh, György

2013-01-06

The incidence of Clostridium difficile associated enteral disease shows dramatic increase worldwide, with appallingly high treatment costs, mortality figures, recurrence rates and treatment refractoriness. It is not surprising, that there is significant interest in the development and introduction of alternative therapeutic strategies. Among these only stool transplantation (or faecal bacteriotherapy) is gaining international acceptance due to its excellent cure rate (≈92%), low recurrence rate (≈6%), safety and cost-effectiveness. Unfortunately faecal transplantation is not available for most patients, although based on promising international results, its introduction into the routine clinical practice is well justified and widely expected. The authors would like to facilitate this process, by presenting a detailed faecal transplantation protocol prepared in their Institution based on the available literature and clinical rationality. Officially accepted national methodological guidelines will need to be issued in the future, founded on the expert opinion of relevant professional societies and upcoming advances in this field.

Cohort Profile Update: the TRacking Adolescents' Individual Lives Survey (TRAILS).

PubMed

Oldehinkel, Albertine J; Rosmalen, Judith Gm; Buitelaar, Jan K; Hoek, Hans W; Ormel, Johan; Raven, Dennis; Reijneveld, Sijmen A; Veenstra, René; Verhulst, Frank C; Vollebergh, Wilma Am; Hartman, Catharina A

2015-02-01

TRAILS consists of a population cohort (N=2230) and a clinical cohort (N=543), both of which were followed from about age 11 years onwards. To date, the population cohort has been assessed five times over a period of 11 years, with retention rates ranging between 80% and 96%. The clinical cohort has been assessed four times over a period of 8 years, with retention rates ranging between 77% and 85%. Since the IJE published a cohort profile on the TRAILS in 2008, the participants have matured from adolescents into young adults. The focus shifted from parents and school to entry into the labour market and family formation, including offspring. Furthermore, psychiatric diagnostic interviews were administered, the database was linked to a Psychiatric Case Registry, and the availability of genome-wide SNP variations opened the door to genome-wide association studies regarding a wide range of (endo)phenotypes. With some delay, TRAILS data are available to researchers outside the TRAILS consortium without costs; access can be obtained by submitting a publication proposal (see www.trails.nl). © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

VARED: Verification and Analysis of Requirements and Early Designs

NASA Technical Reports Server (NTRS)

Badger, Julia; Throop, David; Claunch, Charles

2014-01-01

Requirements are a part of every project life cycle; everything going forward in a project depends on them. Good requirements are hard to write, there are few useful tools to test, verify, or check them, and it is difficult to properly marry them to the subsequent design, especially if the requirements are written in natural language. In fact, the inconsistencies and errors in the requirements along with the difficulty in finding these errors contribute greatly to the cost of the testing and verification stage of flight software projects [1]. Large projects tend to have several thousand requirements written at various levels by different groups of people. The design process is distributed and a lack of widely accepted standards for requirements often results in a product that varies widely in style and quality. A simple way to improve this would be to standardize the design process using a set of tools and widely accepted requirements design constraints. The difficulty with this approach is finding the appropriate constraints and tools. Common complaints against the tools available include ease of use, functionality, and available features. Also, although preferable, it is rare that these tools are capable of testing the quality of the requirements.

Long-term disease and economic outcomes of prior authorization criteria for Hepatitis C treatment in Pennsylvania Medicaid.

PubMed

Kabiri, Mina; Chhatwal, Jagpreet; Donohue, Julie M; Roberts, Mark S; James, A Everette; Dunn, Michael A; Gellad, Walid F

2017-09-01

Several highly effective but costly therapies for hepatitis C virus (HCV) are available. As a consequence of their high price, 36 state Medicaid programs limited treatment coverage to patients with more advanced HCV stages. States have only limited information available to predict the long-term impact of these decisions. We adapted a validated hepatitis C microsimulation model to the Pennsylvania Medicaid population to estimate the existing HCV prevalence in Pennsylvania Medicaid and estimate the impact of various HCV drug coverage policies on disease outcomes and costs. Outcome measures included rates of advanced-stage HCV outcomes and treatment and disease costs in both Medicaid and Medicare. We estimated that 46,700 individuals in Pennsylvania Medicaid were infected with HCV in 2015, 33% of whom were still undiagnosed. By expanding treatment to include mild fibrosis stage (Metavir F2), Pennsylvania Medicaid will spend an additional $273 million on medications in the next decade with no substantial reduction in the incidence of liver cancer or liver-related death. Medicaid patients who are not eligible for treatment under restricted policies would get treatment once they transition to the Medicare program, which would incur 10% reduction in HCV-related costs due to early treatment in Medicaid. Further expanding treatment to patients with early fibrosis stages (F0 or F1) would cost Medicaid an additional $693 million during the next decade but would reduce the number of individuals in need of treatment in Medicare by 46% and decrease Medicare treatment costs by 23%. In some scenarios, outcomes could worsen with eligibility expansion if there is inadequate capacity to treat all patients. Expansion of HCV treatment coverage to less severe stages of liver disease may not substantially improve liver related outcomes for patients in Pennsylvania Medicaid in scenarios in which coverage through Medicare is widely available. Published by Elsevier Inc.

Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

PubMed Central

Alouki, Koffi; Delisle, Hélène; Besançon, Stéphane; Baldé, Naby; Sidibé-Traoré, Assa; Drabo, Joseph; Djrolo, François; Mbanya, Jean-Claude; Halimi, Serge

2015-01-01

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularly patients with complications. METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin, Burkina Faso, Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines, published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications. RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes (in the public sector) would amount to 21%-34% of the country’s gross national income per capita, 26%-47% in the presence of retinopathy, and above 70% for nephropathy, the most expensive complication. CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders. PMID:26617974

Cost-effectiveness of methadone maintenance therapy as HIV prevention in an Indonesian high-prevalence setting: a mathematical modeling study.

PubMed

Wammes, Joost J G; Siregar, Adiatma Y; Hidayat, Teddy; Raya, Reynie P; van Crevel, Reinout; van der Ven, André J; Baltussen, Rob

2012-09-01

Indonesia faces an HIV epidemic that is in rapid transition. Injecting drug users (IDUs) are among the most heavily affected risk populations, with estimated prevalence of HIV reaching 50% or more in most parts of the country. Although Indonesia started opening methadone clinics in 2003, coverage remains low. We used the Asian Epidemic Model and Resource Needs Model to evaluate the long-term population-level preventive impact of expanding Methadone Maintenance Therapy (MMT) in West Java (43 million people). We compared intervention costs and the number of incident HIV cases in the intervention scenario with current practice to establish the cost per infection averted by expanding MMT. An extensive sensitivity analysis was performed on costs and epidemiological input, as well as on the cost-effectiveness calculation itself. Our analysis shows that expanding MMT from 5% coverage now to 40% coverage in 2019 would avert approximately 2400 HIV infections, at a cost of approximately US$7000 per HIV infection averted. Sensitivity analyses demonstrate that the use of alternative assumptions does not change the study conclusions. Our analyses suggest that expanding MMT is cost-effective, and support government policies to make MMT widely available as an integrated component of HIV/AIDS control in West Java. Copyright © 2012 Elsevier B.V. All rights reserved.

A comparative study of orphan drug prices in Europe

PubMed Central

Young, Katherine Eve; Soussi, Imen; Hemels, Michiel; Toumi, Mondher

2017-01-01

ABSTRACT Background and Objective: This study assessed price differences by comparing annual treatment costs of similarly available orphan drugs in France, Germany, Italy, Norway, Spain, Sweden, and UK. Methods: Annual treatment costs per drug were calculated using ex-factory prices from IHS POLI and country price databases. The treatment cost in the comparator country was compared to the UK and ratios were analysed. Subanalyses were done on disease areas and UK cost quartiles. Results: 120 orphan drugs were included. Compared to the UK, the average costs were more expensive in France (1.13), Germany (1.11), Italy (1.08), Spain (1.07), and were cheaper in Sweden (0.99) and Norway (0.88). The average ratios offered a restrictive view as ratios were greatly heterogeneous (0.26 to 1.92) which was also seen in the different disease areas. The averaged ratios varied minimally among the cost quartiles which shows that cost differences were similar for the most expensive and least expensive orphan drugs in the UK. Conclusions: Individual orphan drug prices can vary widely across European countries, although on average these differences are relatively minor. This study suggests that in Europe, we may not be able predict which country may have higher or lower prices for orphan drugs. PMID:28473887

Comparison of Very Low Energy Diet Products Available in Australia and How to Tailor Them to Optimise Protein Content for Younger and Older Adult Men and Women

PubMed Central

Gibson, Alice A.; Franklin, Janet; Pattinson, Andrea L.; Cheng, Zilvia G. Y.; Samman, Samir; Markovic, Tania P.; Sainsbury, Amanda

2016-01-01

Very low energy diets (VLED) are efficacious in inducing rapid weight loss but may not contain adequate macronutrients or micronutrients for individuals with varying nutritional requirements. Adequate protein intake during weight loss appears particularly important to help preserve fat free mass and control appetite, and low energy and carbohydrate content also contributes to appetite control. Therefore, the purpose of this study was to compare the nutritional content (with a focus on protein), nutritional adequacy and cost of all commercially-available VLED brands in Australia. Nutritional content and cost were extracted and compared between brands and to the Recommended Dietary Intake (RDI) or adequate intake (AI) of macronutrients and micronutrients for men and women aged 19–70 years or >70 years. There was wide variability in the nutritional content, nutritional adequacy and cost of VLED brands. Most notably, even brands with the highest daily protein content, based on consuming three products/day (KicStart™ and Optislim®, ~60 g/day), only met estimated protein requirements of the smallest and youngest women for whom a VLED would be indicated. Considering multiple options to optimise protein content, we propose that adding pure powdered protein is the most suitable option because it minimizes additional energy, carbohydrate and cost of VLEDs. PMID:27657150

Current and emerging applications of 3D printing in medicine.

PubMed

Liaw, Chya-Yan; Guvendiren, Murat

2017-06-07

Three-dimensional (3D) printing enables the production of anatomically matched and patient-specific devices and constructs with high tunability and complexity. It also allows on-demand fabrication with high productivity in a cost-effective manner. As a result, 3D printing has become a leading manufacturing technique in healthcare and medicine for a wide range of applications including dentistry, tissue engineering and regenerative medicine, engineered tissue models, medical devices, anatomical models and drug formulation. Today, 3D printing is widely adopted by the healthcare industry and academia. It provides commercially available medical products and a platform for emerging research areas including tissue and organ printing. In this review, our goal is to discuss the current and emerging applications of 3D printing in medicine. A brief summary on additive manufacturing technologies and available printable materials is also given. The technological and regulatory barriers that are slowing down the full implementation of 3D printing in the medical field are also discussed.

Creating New Economic Incentives for Repurposing Generic Drugs for Unsolved Diseases Using Social Finance.

PubMed

Bloom, Bruce E

2015-12-01

Repurposing research improves patient lives by taking drugs approved for one disease and clinically testing them to create a treatment for a different disease. Repurposing drugs that are generic, inexpensive, and widely available and that can be taken in their current dosage and formulation in the new indication provide a quick, affordable, and effective way to create "new" treatments. However, generic drug repurposing often provides no profit potential, and so there is no economic incentive for industry to pursue this, and philanthropy and government funds are often insufficient. One way to create new economic incentive for the repurposing of generic drugs is through social finance. This perspective describes how social finance can create a new economic incentive by using a social impact bond, or similar financial structure, to repay for-profit investors who fund the repurposing research from the proceeds of healthcare cost reductions generated when these affordable, effective, and widely available repurposed therapies improve healthcare outcomes.

An Evaluation of the Productivity Enhancing Capital Investment Process at the Shore Intermediate Maintenance Activity Little Creek, Virginia.

DTIC Science & Technology

1985-12-01

PECI program sets aside funds in the annual budget and makes them available to managers and personnel for a 10 %[ wide range of cost and labor- saving ... money to fund PECI projects of particular concern to the individual services. [Ref. 4:pp. 3-4] The OSD-sponsored projects include two programs that... money is used by Navy non-industrial funded activities. Although - the line item amount is approved by Congress, individual project approval is the

An engineering perspective on 3D printed personalized scaffolds for tracheal suspension technique

PubMed Central

An, Jia

2016-01-01

3D printing is a large family of many distinct technologies covering a wide range of topics. From an engineering point of view, there should be considerations for selection of design, material, and process when using 3D printing for surgical technique innovation such as personalized scaffolds. Moreover, cost should also be considered if there are equally effective alternatives to the innovation. Furthermore, engineering considerations and options should be clearly communicated and readily available to surgeons for advancement in future. PMID:28149624

Compact antenna arrays with wide bandwidth and low sidelobe levels

DOEpatents

Strassner, II, Bernd H.

2014-09-09

Highly efficient, low cost, easily manufactured SAR antenna arrays with lightweight low profiles, large instantaneous bandwidths and low SLL are disclosed. The array topology provides all necessary circuitry within the available antenna aperture space and between the layers of material that comprise the aperture. Bandwidths of 15.2 GHz to 18.2 GHz, with 30 dB SLLs azimuthally and elevationally, and radiation efficiencies above 40% may be achieved. Operation over much larger bandwidths is possible as well.

(abstract) The Galileo Spacecraft: A Telecommunications Legacy for Future Space Flight

NASA Technical Reports Server (NTRS)

Deutsch, Leslie J.

1997-01-01

The Galileo mission to Jupiter has implemented a wide range of telecommunication improvements in response to the loss of its high gain antenna. While necessity dictated the use of these new techniques for Galileo, now that they have been proven in flight, they are available for use on future deep space missions. This telecommunications legacy of Galileo will aid in our ability to conduct a meaningful exploration of the solar system, and beyond, at a reasonable cost.

Flight test and evaluation of Omega navigation for general aviation

NASA Technical Reports Server (NTRS)

Hwoschinsky, P. V.

1975-01-01

A seventy hour flight test program was performed to determine the suitability and accuracy of a low cost Omega navigation receiver in a general aviation aircraft. An analysis was made of signal availability in two widely separated geographic areas. Comparison is made of the results of these flights with other navigation systems. Conclusions drawn from the test experience indicate that developmental system improvement is necessary before a competent fail safe or fail soft area navigation system is offered to general aviation.

An engineering perspective on 3D printed personalized scaffolds for tracheal suspension technique.

PubMed

An, Jia; Chua, Chee Kai

2016-12-01

3D printing is a large family of many distinct technologies covering a wide range of topics. From an engineering point of view, there should be considerations for selection of design, material, and process when using 3D printing for surgical technique innovation such as personalized scaffolds. Moreover, cost should also be considered if there are equally effective alternatives to the innovation. Furthermore, engineering considerations and options should be clearly communicated and readily available to surgeons for advancement in future.

An economic evaluation of home management of malaria in Uganda: an interactive Markov model.

PubMed

Lubell, Yoel; Mills, Anne J; Whitty, Christopher J M; Staedke, Sarah G

2010-08-27

Home management of malaria (HMM), promoting presumptive treatment of febrile children in the community, is advocated to improve prompt appropriate treatment of malaria in Africa. The cost-effectiveness of HMM is likely to vary widely in different settings and with the antimalarial drugs used. However, no data on the cost-effectiveness of HMM programmes are available. A Markov model was constructed to estimate the cost-effectiveness of HMM as compared to conventional care for febrile illnesses in children without HMM. The model was populated with data from Uganda, but is designed to be interactive, allowing the user to adjust certain parameters, including the antimalarials distributed. The model calculates the cost per disability adjusted life year averted and presents the incremental cost-effectiveness ratio compared to a threshold value. Model output is stratified by level of malaria transmission and the probability that a child would receive appropriate care from a health facility, to indicate the circumstances in which HMM is likely to be cost-effective. The model output suggests that the cost-effectiveness of HMM varies with malaria transmission, the probability of appropriate care, and the drug distributed. Where transmission is high and the probability of appropriate care is limited, HMM is likely to be cost-effective from a provider perspective. Even with the most effective antimalarials, HMM remains an attractive intervention only in areas of high malaria transmission and in medium transmission areas with a lower probability of appropriate care. HMM is generally not cost-effective in low transmission areas, regardless of which antimalarial is distributed. Considering the analysis from the societal perspective decreases the attractiveness of HMM. Syndromic HMM for children with fever may be a useful strategy for higher transmission settings with limited health care and diagnosis, but is not appropriate for all settings. HMM may need to be tailored to specific settings, accounting for local malaria transmission intensity and availability of health services.

Lessons learned: Infrastructure development and financial management for large, publicly funded, international trials.

PubMed

Larson, Gregg S; Carey, Cate; Grarup, Jesper; Hudson, Fleur; Sachi, Karen; Vjecha, Michael J; Gordin, Fred

2016-04-01

Randomized clinical trials are widely recognized as essential to address worldwide clinical and public health research questions. However, their size and duration can overwhelm available public and private resources. To remain competitive in international research settings, advocates and practitioners of clinical trials must implement practices that reduce their cost. We identify approaches and practices for large, publicly funded, international trials that reduce cost without compromising data integrity and recommend an approach to cost reporting that permits comparison of clinical trials. We describe the organizational and financial characteristics of The International Network for Strategic Initiatives in Global HIV Trials, an infectious disease research network that conducts multiple, large, long-term, international trials, and examine challenges associated with simple and streamlined governance and an infrastructure and financial management model that is based on performance, transparency, and accountability. It is possible to reduce costs of participants' follow-up and not compromise clinical trial quality or integrity. The International Network for Strategic Initiatives in Global HIV Trials network has successfully completed three large HIV trials using cost-efficient practices that have not adversely affected investigator enthusiasm, accrual rates, loss-to-follow-up, adherence to the protocol, and completion of data collection. This experience is relevant to the conduct of large, publicly funded trials in other disease areas, particularly trials dependent on international collaborations. New approaches, or creative adaption of traditional clinical trial infrastructure and financial management tools, can render large, international clinical trials more cost-efficient by emphasizing structural simplicity, minimal up-front costs, payments for performance, and uniform algorithms and fees-for-service, irrespective of location. However, challenges remain. They include institutional resistance to financial change, growing trial complexity, and the difficulty of sustaining network infrastructure absent stable research work. There is also a need for more central monitoring, improved and harmonized regulations, and a widely applied metric for measuring and comparing cost efficiency in clinical trials. ClinicalTrials.gov is recommended as a location where standardized trial cost information could be made publicly accessible. © The Author(s) 2016.

An empiric estimate of the value of life: updating the renal dialysis cost-effectiveness standard.

PubMed

Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

2009-01-01

Proposals to make decisions about coverage of new technology by comparing the technology's incremental cost-effectiveness with the traditional benchmark of dialysis imply that the incremental cost-effectiveness ratio of dialysis is seen a proxy for the value of a statistical year of life. The frequently used ratio for dialysis has, however, not been updated to reflect more recently available data on dialysis. We developed a computer simulation model for the end-stage renal disease population and compared cost, life expectancy, and quality adjusted life expectancy of current dialysis practice relative to three less costly alternatives and to no dialysis. We estimated incremental cost-effectiveness ratios for these alternatives relative to the next least costly alternative and no dialysis and analyzed the population distribution of the ratios. Model parameters and costs were estimated using data from the Medicare population and a large integrated health-care delivery system between 1996 and 2003. The sensitivity of results to model assumptions was tested using 38 scenarios of one-way sensitivity analysis, where parameters informing the cost, utility, mortality and morbidity, etc. components of the model were by perturbed +/-50%. The incremental cost-effectiveness ratio of dialysis of current practice relative to the next least costly alternative is on average $129,090 per quality-adjusted life-year (QALY) ($61,294 per year), but its distribution within the population is wide; the interquartile range is $71,890 per QALY, while the 1st and 99th percentiles are $65,496 and $488,360 per QALY, respectively. Higher incremental cost-effectiveness ratios were associated with older age and more comorbid conditions. Sensitivity to model parameters was comparatively small, with most of the scenarios leading to a change of less than 10% in the ratio. The value of a statistical year of life implied by dialysis practice currently averages $129,090 per QALY ($61,294 per year), but is distributed widely within the dialysis population. The spread suggests that coverage decisions using dialysis as the benchmark may need to incorporate percentile values (which are higher than the average) to be consistent with the Rawlsian principles of justice of preserving the rights and interests of society's most vulnerable patient groups.

Assessment of global guidelines for preventive chemotherapy against schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study.

PubMed

Lo, Nathan C; Lai, Ying-Si; Karagiannis-Voules, Dimitrios-Alexios; Bogoch, Isaac I; Coulibaly, Jean T; Bendavid, Eran; Utzinger, Jürg; Vounatsou, Penelope; Andrews, Jason R

2016-09-01

WHO guidelines recommend annual treatment for schistosomiasis or soil-transmitted helminthiasis when prevalence in school-aged children is at or above a threshold of 50% and 20%, respectively. Separate treatment guidelines are used for these two helminthiases, and integrated community-wide treatment is not recommended. We assessed the cost-effectiveness of changing prevalence thresholds and treatment guidelines under an integrated delivery framework. We developed a dynamic, age-structured transmission and cost-effectiveness model that simulates integrated preventive chemotherapy programmes against schistosomiasis and soil-transmitted helminthiasis. We assessed a 5-year treatment programme with praziquantel (40 mg/kg per treatment) against schistosomiasis and albendazole (400 mg per treatment) against soil-transmitted helminthiasis at 75% coverage. We defined strategies as highly cost-effective if the incremental cost-effectiveness ratio was less than the World Bank classification for a low-income country (gross domestic product of US$1045 per capita). We calculated the prevalence thresholds for cost-effective preventive chemotherapy of various strategies, and estimated treatment needs for sub-Saharan Africa. Annual preventive chemotherapy against schistosomiasis was highly cost-effective in treatment of school-aged children at a prevalence threshold of 5% (95% uncertainty interval [UI] 1·7-5·2; current guidelines recommend treatment at 50% prevalence) and for community-wide treatment at a prevalence of 15% (7·3-18·5; current recommendation is unclear, some community treatment recommended at 50% prevalence). Annual preventive chemotherapy against soil-transmitted helminthiasis was highly cost-effective in treatment of school-aged children at a prevalence of 20% (95% UI 5·4-30·5; current guidelines recommend treatment at 20% prevalence) and the entire community at 60% (35·3-85·1; no guidelines available). When both helminthiases were co-endemic, prevalence thresholds using integrated delivery were lower. Using this revised treatment framework, we estimated that treatment needs would be six times higher than WHO guidelines for praziquantel and two times higher for albendazole. An additional 21·3% (95% Bayesian credible interval 20·4-22·2) of the population changed from receiving non-integrated treatment under WHO guidelines to integrated treatment (both praziquantel and albendazole). Country-specific economic differences resulted in heterogeneity around these prevalence thresholds. Annual preventive chemotherapy programmes against schistosomiasis and soil-transmitted helminthiasis are likely to be highly cost-effective at prevalences lower than WHO recommendations. These findings support substantial treatment scale-up, community-wide coverage, integrated treatment in co-endemic settings that yield substantial cost synergies, and country-specific treatment guidelines. Doris Duke Charitable Foundation, Mount Sinai Hospital-University Health Network AMO Innovation Fund, and Stanford University Medical Scholars Programme. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of the Availability, Cost, and Motivations for Use over Time of the New Psychoactive Substances-Benzodiazepines Diclazepam, Flubromazepam, and Pyrazolam-in the UK.

PubMed

Abouchedid, Rachelle; Gilks, Thea; Dargan, Paul I; Archer, John R H; Wood, David M

2018-06-01

There has been increasing interest in the availability of non-prescription benzodiazepines and their sale as new psychoactive substances. We wanted to determine UK availability from Internet suppliers and motivations for use of three benzodiazepines (diclazepam, flubromazepam, and pyrazolam). In November 2014 and March 2016, using the European Monitoring Centre for Drugs and Drug Addiction Snapshot Methodology, Internet search engines ( google.co.uk , uk. yahoo.com and ask.com.uk ) were searched using the terms 'buy diclazepam', 'buy flubromazepam' and 'buy pyrazolam'. Threads from drug-user forums ( bluelight.org , drugs-forum.com , erowid.org , legalhighsforum.com ) were analysed using a general inductive approach. Data were converted into price per gram/pellet to allow cost comparisons and to determine motivations for use. There was an increase in websites selling these benzodiazepines between 2014 and 2016: diclazepam (49 in 2014 to 55 in 2016), pyrazolam (33 to 35), and flubromazepam (39 to 45). Thirty-eight (63.3%) sites were based in the UK/Europe. Drugs were sold as pellets (49 websites, 81.7%), powder (19, 31.7%), and blotters (1, 1.7%). Pill forms were not available, and one (1.7%) website sold diclazepam/flubromazepam in liquid form. The cost reduced with increasing purchase quantities. Main motivations for use included anxiolysis, management of benzodiazepine withdrawal, sedation/sleep aid, and management of stimulant withdrawal. These three benzodiazepines are widely available online, most commonly as pellets, and are (mis)used for a number of reasons. This study could be used to support triangulation of data from other sources to inform harm minimisation strategies.

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

Costs of community-based interventions from the Community Transformation Grants.

PubMed

Khavjou, Olga A; Honeycutt, Amanda A; Yarnoff, Benjamin; Bradley, Christina; Soler, Robin; Orenstein, Diane

2018-07-01

Limited data are available on the costs of evidence-based community-wide prevention programs. The objective of this study was to estimate the per-person costs of strategies that support policy, systems, and environmental changes implemented under the Community Transformation Grants (CTG) program. We collected cost data from 29 CTG awardees and estimated program costs as spending on labor; consultants; materials, travel, and services; overhead activities; partners; and the value of in-kind contributions. We estimated costs per person reached for 20 strategies. We assessed how per-person costs varied with the number of people reached. Data were collected in 2012-2015, and the analysis was conducted in 2015-2016. Two of the tobacco-free living strategies cost less than $1.20 per person and reached over 6 million people each. Four of the healthy eating strategies cost less than $1.00 per person, and one of them reached over 6.5 million people. One of the active living strategies cost $2.20 per person and reached over 7 million people. Three of the clinical and community preventive services strategies cost less than $2.30 per person, and one of them reached almost 2 million people. Across all 20 strategies combined, an increase of 10,000 people in the number of people reached was associated with a $0.22 reduction in the per-person cost. Results demonstrate that interventions, such as tobacco-free indoor policies, which have been shown to improve health outcomes have relatively low per-person costs and are able to reach a large number of people. Copyright © 2018 Elsevier Inc. All rights reserved.

Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey

PubMed Central

2013-01-01

The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications. PMID:24267412

Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey.

PubMed

Stussman, Barbara J; Bethell, Christina D; Gray, Caroline; Nahin, Richard L

2013-11-23

The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications.

A history of detachable coils: 1987-2012.

PubMed

Hui, Ferdinand K; Fiorella, David; Masaryk, Thomas J; Rasmussen, Peter A; Dion, Jacques E

2014-03-01

The development of detachable coils is one of the most pivotal developments in neurointervention, providing a tool that could be used to treat a wide variety of hemorrhagic stroke. From the original Guglielmi detachable coil, a number of different coil designs and delivery designs have evolved. This article reviews the history of commercially available detachable coils. A timeline of detachable coils was constructed and coil design philosophies were reviewed. A complete list of commercially available coils is presented in a timeline format. Detachable coil technology continues to evolve. Advances in construction and design have yielded products which may benefit patients in terms of safety, radiation dose reduction and cost of treatment. Continued evolution is expected, irrespective of competing disruptive technologies.

A Decision-Tree Approach to Cost Comparison of Newborn Screening Strategies for Cystic Fibrosis

PubMed Central

Wells, Janelle; Rosenberg, Marjorie; Hoffman, Gary; Anstead, Michael

2012-01-01

OBJECTIVE: Because cystic fibrosis can be difficult to diagnose and treat early, newborn screening programs have rapidly developed nationwide but methods vary widely. We therefore investigated the costs and consequences or specific outcomes of the 2 most commonly used methods. METHODS: With available data on screening and follow-up, we used a simulation approach with decision trees to compare immunoreactive trypsinogen (IRT) screening followed by a second IRT test against an IRT/DNA analysis. By using a Monte Carlo simulation program, variation in the model parameters for counts at various nodes of the decision trees, as well as for costs, are included and applied to fictional cohorts of 100 000 newborns. The outcome measures included the numbers of newborns given a diagnosis of cystic fibrosis and costs of screening strategy at each branch and cost per newborn. RESULTS: Simulations revealed a substantial number of potential missed diagnoses for the IRT/IRT system versus IRT/DNA. Although the IRT/IRT strategy with commonly used cutoff values offers an average overall cost savings of $2.30 per newborn, a breakdown of costs by societal segments demonstrated higher out-of-pocket costs for families. Two potential system failures causing delayed diagnoses were identified relating to the screening protocols and the follow-up system. CONCLUSIONS: The IRT/IRT screening algorithm reduces the costs to laboratories and insurance companies but has more system failures. IRT/DNA offers other advantages, including fewer delayed diagnoses and lower out-of-pocket costs to families. PMID:22291119

Estimating the opportunity costs of bed‐days

PubMed Central

Robotham, Julie V.; Deeny, Sarah R.; Edmunds, W. John; Jit, Mark

2017-01-01

Abstract Opportunity costs of bed‐days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second‐best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed‐days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed‐days in terms of health forgone for the second‐best patient, but expressed monetarily. This alternative approach effectively re‐connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed‐days. PMID:29105894

Industrial bioconversion of renewable resources as an alternative to conventional chemistry.

PubMed

Willke, Th; Vorlop, K-D

2004-12-01

There are numerous possibilities for replacing chemical techniques with biotechnological methods based on renewable resources. The potential of biotechnology (products, technologies, metabolic pathways) is for the most part well known. Often the costs are still the problem. Biotechnological advances have the best chances for replacing some fine chemicals. While the raw material costs are less of a consideration here, the environmental benefit is huge, as chemical-technical processes often produce a wide range of undesirable/harmful by-products or waste. In the case of bulk chemicals (<1 US dollar/kg) the product price is affected mainly by raw material costs. As long as fossil raw materials are still relatively inexpensive, alternatives based on renewable resources cannot establish themselves. Residues and waste, which are available even at no cost in some cases, are an exception. The introduction of new technologies for the efficient use of such raw materials is currently being promoted. The utilisation of residual wood, plant parts, waste fat, and crude glycerol, for example, provides great potential. For industrial chemicals (2-4 US dollars/kg), process and recovery costs play a greater role. Here, innovative production technologies and product recovery techniques (e.g. on-line product separation) can increase competitiveness.

Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a psychiatric setting: an open trial.

PubMed

Hedman, Erik; Ljótsson, Brjánn; Andersson, Erik; Rück, Christian; Andersson, Gerhard; Lindefors, Nils

2010-01-01

Hypochondriasis is highly prevalent in medical settings, has detrimental effects for affected individuals, and is associated with high societal costs. Although cognitive behavior therapy (CBT) has been shown to be effective in the treatment of hypochondriasis, it is not widely available because of a lack of properly trained therapists. Therefore, it is essential to evaluate therapy forms that require less therapist time. The authors investigated the effect and economic impact of group CBT delivered in a psychiatric setting among 24 people with hypochondriasis. A within-group design with prolonged baseline was used, and all participants received 10 weeks of group-based treatment. The primary outcome measures were the Health Anxiety Inventory and the Illness Attitude Scales. Results indicate significant improvement on both measures at posttreatment and 6-month follow-up (Cohen's d = 1.03-1.72). Medical and nonmedical costs were substantially lowered. The authors conclude that group-based CBT delivered in a psychiatric setting is an effective and potentially highly cost-effective treatment for hypochondriasis.

Accuracy and cost-effectiveness of dynamic contrast-enhanced CT in the characterisation of solitary pulmonary nodules-the SPUtNIk study.

PubMed

Qureshi, N R; Rintoul, R C; Miles, K A; George, S; Harris, S; Madden, J; Cozens, K; Little, L A; Eichhorst, K; Jones, J; Moate, P; McClement, C; Pike, L; Sinclair, D; Wong, W L; Shekhdar, J; Eaton, R; Shah, A; Brindle, L; Peebles, C; Banerjee, A; Dizdarevic, S; Han, S; Poon, F W; Groves, A M; Kurban, L; Frew, A J; Callister, M E; Crosbie, P; Gleeson, F V; Karunasaagarar, K; Kankam, O; Gilbert, F J

2016-01-01

Solitary pulmonary nodules (SPNs) are common on CT. The most cost-effective investigation algorithm is still to be determined. Dynamic contrast-enhanced CT (DCE-CT) is an established diagnostic test not widely available in the UK currently. The SPUtNIk study will assess the diagnostic accuracy, clinical utility and cost-effectiveness of DCE-CT, alongside the current CT and 18-flurodeoxyglucose-positron emission tomography) ( 18 FDG-PET)-CT nodule characterisation strategies in the National Health Service (NHS). Image acquisition and data analysis for 18 FDG-PET-CT and DCE-CT will follow a standardised protocol with central review of 10% to ensure quality assurance. Decision analytic modelling will assess the likely costs and health outcomes resulting from incorporation of DCE-CT into management strategies for patients with SPNs. Approval has been granted by the South West Research Ethics Committee. Ethics reference number 12/SW/0206. The results of the trial will be presented at national and international meetings and published in an Health Technology Assessment (HTA) Monograph and in peer-reviewed journals. ISRCTN30784948; Pre-results.

A low-cost digital filing system for echocardiography data with MPEG4 compression and its application to remote diagnosis.

PubMed

Umeda, Akira; Iwata, Yasushi; Okada, Yasumasa; Shimada, Megumi; Baba, Akiyasu; Minatogawa, Yasuyuki; Yamada, Takayasu; Chino, Masao; Watanabe, Takafumi; Akaishi, Makoto

2004-12-01

The high cost of digital echocardiographs and the large size of data files hinder the adoption of remote diagnosis of digitized echocardiography data. We have developed a low-cost digital filing system for echocardiography data. In this system, data from a conventional analog echocardiograph are captured using a personal computer (PC) equipped with an analog-to-digital converter board. Motion picture data are promptly compressed using a moving pictures expert group (MPEG) 4 codec. The digitized data with preliminary reports obtained in a rural hospital are then sent to cardiologists at distant urban general hospitals via the internet. The cardiologists can evaluate the data using widely available movie-viewing software (Windows Media Player). The diagnostic accuracy of this double-check system was confirmed by comparison with ordinary super-VHS videotapes. We have demonstrated that digitization of echocardiography data from a conventional analog echocardiograph and MPEG 4 compression can be performed using an ordinary PC-based system, and that this system enables highly efficient digital storage and remote diagnosis at low cost.

Costs to Automate Demand Response - Taxonomy and Results from Field Studies and Programs

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

Piette, Mary A.; Schetrit, Oren; Kiliccote, Sila

During the past decade, the technology to automate demand response (DR) in buildings and industrial facilities has advanced significantly. Automation allows rapid, repeatable, reliable operation. This study focuses on costs for DR automation in commercial buildings with some discussion on residential buildings and industrial facilities. DR automation technology relies on numerous components, including communication systems, hardware and software gateways, standards-based messaging protocols, controls and integration platforms, and measurement and telemetry systems. This report compares cost data from several DR automation programs and pilot projects, evaluates trends in the cost per unit of DR and kilowatts (kW) available from automated systems,more » and applies a standard naming convention and classification or taxonomy for system elements. Median costs for the 56 installed automated DR systems studied here are about $200/kW. The deviation around this median is large with costs in some cases being an order of magnitude great or less than the median. This wide range is a result of variations in system age, size of load reduction, sophistication, and type of equipment included in cost analysis. The costs to automate fast DR systems for ancillary services are not fully analyzed in this report because additional research is needed to determine the total cost to install, operate, and maintain these systems. However, recent research suggests that they could be developed at costs similar to those of existing hot-summer DR automation systems. This report considers installation and configuration costs and does include the costs of owning and operating DR automation systems. Future analysis of the latter costs should include the costs to the building or facility manager costs as well as utility or third party program manager cost.« less

The automotive battery of the future—the role of electronics

NASA Astrophysics Data System (ADS)

Kellaway, M. J.

The automotive battery is being asked to carry out more challenging duties than ever before. Many of these duties are a result of new types of electrical load. The way in which a battery is operated and managed within a vehicle can be optimized significantly through the use of battery-related electronics with embedded software. Potential benefits include extended life, early warning of deterioration and failure, greater availability and an improved match to the vehicle's requirements. The impact of electronics in other areas shows that there is considerable potential to go much further in this direction with battery systems. There are, however, important system-wide issues to be considered. The battery system must conform to a wide range of standards and practices applicable to automotive electronic systems and embedded software. The automotive industry is itself trying to come to terms with the inherent difficulties involved in developing, qualifying and upgrading complex networks of software-based controllers within the vehicle. The battery system must be compatible with the results of these initiatives. Cost will always be a major influence, but the cost model is different from that familiar to battery producers. This study outlines the main areas where the battery industry must consider a change from being a component to a system supplier, and makes some recommendations for an industry wide approach to smooth the transition.

A Dual Operational Refrigerator/Flow Cryostat with Wide Bore Medium Field Magnet for Application Demonstration

NASA Astrophysics Data System (ADS)

Young, E. A.; Bailey, W. O. S.; Al-Mosawi, M. K.; Beduz, C.; Yang, Y.; Chappell, S.; Twin, A.

Since stand alone cryocooler systems have become more widely available, there has been increased commercial interest in superconductor applications in the temperature range intermediate to liquid helium and liquid nitrogen. There are however few facilities that have large in-field bore size with variable temperatures. A large bore system can reduce costs associated with full scale demonstration magnets by testing smaller coils and qualify medium length (up to meters) conductors. A 5 T, wide bore, (170 mm) Nb3Sn Oxford Instrument magnet has been integrated into a custom built dual mode refrigerator/helium flow cryostat with 600A HTS current leads. In one mode the system can be used with zero field without cost of liquid helium relying for cooling on a Sumitomo GM cryocooler with 1.5W at 4.2K: (no He) this can be used either as the sole characterisation method, or as a preliminary check before more expensive and extensive measurements are taken. The first measurements using MgB2 wire from 10 to 20K were made using a transient current step of ∼5s duration, as opposed to a DC measurement. This has the advantage of not requiring thermal equilibrium to be achieved at nominal current. The feasibility of this technique for determining critical transport properties is discussed.

Antenna and Electronics Cost Tradeoffs For Large Arrays

NASA Technical Reports Server (NTRS)

D'Addario, Larry R.

2007-01-01

This viewgraph presentation describes the cost tradeoffs for large antenna arrays. The contents include: 1) Cost modeling for large arrays; 2) Antenna mechanical cost over a wide range of sizes; and 3) Cost of per-antenna electronics.

Availability, prices and affordability of essential medicines in Haiti

PubMed Central

Chahal, Harinder Singh; St. Fort, Nazaire; Bero, Lisa

2013-01-01

Background Haiti is the poorest country in the Western Hemisphere and faces numerous challenges, including inadequate medication access for its residents. The objective of this study was to determine the availability, prices, and affordability of essential medicines in Haiti and compare these findings to other countries. Methods We conducted a cross–sectional nationwide survey in 2011 of availability and consumer prices of 60 essential medicines in Haiti using a standardized methodology developed by the World Health Organization and Health Action International. The survey was conducted in 163 medicine outlets in four health care sectors (public, retail, nonprofit and mixed sectors). Medicine prices were expressed as ratios relative to the International Reference Price. Affordability was calculated by comparing the costs of treatment for common conditions with the salary of the lowest paid government worker and was compared to available data from four Latin American countries. Results For generic medicines, the availability in public, retail, nonprofit and mixed sectors was 20%, 37%, 24% and 23% of medications, respectively. Most of the available medicines were priced higher than the International Reference Price. The lowest paid government worker would need 2.5 days’ wages to treat an adult respiratory infection with generic medicines from the public sector. For treatment of common conditions with originator brands (OB) purchased from a retail pharmacy, costs were between 1.4 (anaerobic bacterial infection) and 13.7 (hyperlipidemia) days’ wages, respectively. Treatment of pediatric bacterial infections with the OB of ceftriaxone from a retail pharmacy would cost 24.6 days’ wages. Prices in Bolivia, Colombia, Mexico and Nicaragua were frequently lower for comparable medications. Conclusions The availability of essential medicines was low and prices varied widely across all four sectors. Over 75% of Haitians live on less than US$ 2.00 /day; therefore, most medication regimens are largely unaffordable. Inclusion of essential medications on the national formulary and working with organizations responsible for importing medications into Haiti, particularly drug donation agencies, are important first steps to increasing medication access. PMID:24363923

Development and evaluation of a low-cost and high-capacity DICOM image data storage system for research.

PubMed

Yakami, Masahiro; Ishizu, Koichi; Kubo, Takeshi; Okada, Tomohisa; Togashi, Kaori

2011-04-01

Thin-slice CT data, useful for clinical diagnosis and research, is now widely available but is typically discarded in many institutions, after a short period of time due to data storage capacity limitations. We designed and built a low-cost high-capacity Digital Imaging and COmmunication in Medicine (DICOM) storage system able to store thin-slice image data for years, using off-the-shelf consumer hardware components, such as a Macintosh computer, a Windows PC, and network-attached storage units. "Ordinary" hierarchical file systems, instead of a centralized data management system such as relational database, were adopted to manage patient DICOM files by arranging them in directories enabling quick and easy access to the DICOM files of each study by following the directory trees with Windows Explorer via study date and patient ID. Software used for this system was open-source OsiriX and additional programs we developed ourselves, both of which were freely available via the Internet. The initial cost of this system was about $3,600 with an incremental storage cost of about $900 per 1 terabyte (TB). This system has been running since 7th Feb 2008 with the data stored increasing at the rate of about 1.3 TB per month. Total data stored was 21.3 TB on 23rd June 2009. The maintenance workload was found to be about 30 to 60 min once every 2 weeks. In conclusion, this newly developed DICOM storage system is useful for research due to its cost-effectiveness, enormous capacity, high scalability, sufficient reliability, and easy data access.

AMDTreat 5.0+ with PHREEQC titration module to compute caustic chemical quantity, effluent quality, and sludge volume

USGS Publications Warehouse

Cravotta, Charles A.; Means, Brent P; Arthur, Willam; McKenzie, Robert M; Parkhurst, David L.

2015-01-01

Alkaline chemicals are commonly added to discharges from coal mines to increase pH and decrease concentrations of acidity and dissolved aluminum, iron, manganese, and associated metals. The annual cost of chemical treatment depends on the type and quantities of chemicals added and sludge produced. The AMDTreat computer program, initially developed in 2003, is widely used to compute such costs on the basis of the user-specified flow rate and water quality data for the untreated AMD. Although AMDTreat can use results of empirical titration of net-acidic or net-alkaline effluent with caustic chemicals to accurately estimate costs for treatment, such empirical data are rarely available. A titration simulation module using the geochemical program PHREEQC has been incorporated with AMDTreat 5.0+ to improve the capability of AMDTreat to estimate: (1) the quantity and cost of caustic chemicals to attain a target pH, (2) the chemical composition of the treated effluent, and (3) the volume of sludge produced by the treatment. The simulated titration results for selected caustic chemicals (NaOH, CaO, Ca(OH)2, Na2CO3, or NH3) without aeration or with pre-aeration can be compared with or used in place of empirical titration data to estimate chemical quantities, treated effluent composition, sludge volume (precipitated metals plus unreacted chemical), and associated treatment costs. This paper describes the development, evaluation, and potential utilization of the PHREEQC titration module with the new AMDTreat 5.0+ computer program available at http://www.amd.osmre.gov/.

A Space Testbed for Photovoltaics

NASA Technical Reports Server (NTRS)

Landis, Geoffrey A.; Bailey, Sheila G.

1998-01-01

The Ohio Aerospace Institute and the NASA Lewis Research Center are designing and building a solar-cell calibration facility, the Photovoltaic Engineering Testbed (PET) to fly on the International Space Station to test advanced solar cell types in the space environment. A wide variety of advanced solar cell types have become available in the last decade. Some of these solar cells offer more than twice the power per unit area of the silicon cells used for the space station power system. They also offer the possibilities of lower cost, lighter weight, and longer lifetime. The purpose of the PET facility is to reduce the cost of validating new technologies and bringing them to spaceflight readiness. The facility will be used for three primary functions: calibration, measurement, and qualification. It is scheduled to be launched in June of 2002.

SPS salvage and disposal alternatives

NASA Technical Reports Server (NTRS)

1980-01-01

A wide range of salvage options exist for the satellite power system (SPS) satellite, ranging from use in and beyond geosynchronous orbit to use in low Earth orbit to return and use on Earth. The satellite might be used intact to provide for various purposes, it might be cannibalized, or it might be melted down to supply materials for space- or ground-based products. The use of SPS beyond its nominal lifetime provides value that can be deducted from the SPS capital investment cost. It is shown that the present value of the salvage value of the SPS satellites, referenced to the system initial operation data, is likely to be on the order of five to ten percent of its on-orbit capital cost. (Given a 30 year satellite lifetime and a four percent discount rate, the theoretical maximum salvage value is 30.8 percent of the initial capital cost). The SPS demonstration satellite is available some 30 years earlier than the first full-scale SPS satellite and has a likely salvage value on the order of 80 percent of its on site capital cost. In the event that it becomes desirable to dispose of either the demonstration or full-scale SPS satellite, a number of disposal options appear to exist for which intact disposal costs are less than one percent of capital costs.

Satellite power system salvage and disposal alternatives

NASA Technical Reports Server (NTRS)

1980-01-01

A wide range of salvage options for the SPS satellite, ranging from use in and beyond geosynchronous orbit to use in low Earth orbit in return and use on Earth are presented. The satellite can be used intact to provide power for various purposes, it can be cannibalized or it can be melted down to supply materials for space or ground based products. The use of SPS beyond its nominal lifetime provides value that can be deducted from the SPS capital investment cost. The present value of the salvage value of the SPS satellites, referenced to the system initial operation data, is on the order of five to ten percent of its on-orbit capital cost. (Given a 30 year satellite lifetime and a four percent discount rate, the theoretical maximum salvage value is 30.8 percent of the capital cost.) The SPS demonstration satellite is available some 30 years earlier than the first full scale SPS satellite and has a salvage value on the order of 80 percent of its on-orbit capital cost. In the event that it becomes desirable to dispose of either the demonstration of full scale SPS satellite, a number of disposal options is presented for which intact disposal costs are less than one percent of capital costs.

A Summary Catalogue of Microbial Drinking Water Tests for Low and Medium Resource Settings

PubMed Central

Bain, Robert; Bartram, Jamie; Elliott, Mark; Matthews, Robert; McMahan, Lanakila; Tung, Rosalind; Chuang, Patty; Gundry, Stephen

2012-01-01

Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate test(s) for a particular budget, application and setting. To assist the selection process we identified the characteristics associated with low and medium resource settings and we specified the basic information that is needed for different forms of water quality monitoring. We then searched for available faecal indicator bacteria tests and collated this information. In total 44 tests have been identified, 18 of which yield a presence/absence result and 26 of which provide enumeration of bacterial concentration. The suitability of each test is assessed for use in the three settings. The cost per test was found to vary from $0.60 to $5.00 for a presence/absence test and from $0.50 to $7.50 for a quantitative format, though it is likely to be only a small component of the overall costs of testing. This article presents the first comprehensive catalogue of the characteristics of available and emerging low-cost tests for faecal indicator bacteria. It will be of value to organizations responsible for monitoring national water quality, water service providers, researchers and policy makers in selecting water quality tests appropriate for a given setting and application. PMID:22754460

A summary catalogue of microbial drinking water tests for low and medium resource settings.

PubMed

Bain, Robert; Bartram, Jamie; Elliott, Mark; Matthews, Robert; McMahan, Lanakila; Tung, Rosalind; Chuang, Patty; Gundry, Stephen

2012-05-01

Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate test(s) for a particular budget, application and setting. To assist the selection process we identified the characteristics associated with low and medium resource settings and we specified the basic information that is needed for different forms of water quality monitoring. We then searched for available faecal indicator bacteria tests and collated this information. In total 44 tests have been identified, 18 of which yield a presence/absence result and 26 of which provide enumeration of bacterial concentration. The suitability of each test is assessed for use in the three settings. The cost per test was found to vary from $0.60 to $5.00 for a presence/absence test and from $0.50 to $7.50 for a quantitative format, though it is likely to be only a small component of the overall costs of testing. This article presents the first comprehensive catalogue of the characteristics of available and emerging low-cost tests for faecal indicator bacteria. It will be of value to organizations responsible for monitoring national water quality, water service providers, researchers and policy makers in selecting water quality tests appropriate for a given setting and application.

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

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

Downing, M.; Graham, R.L.

1993-12-31

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

Lightweight ZERODUR: a cost-effective thermally stable approach to both large and small spaceborne telescopes

NASA Astrophysics Data System (ADS)

Hull, Tony; Westerhoff, Thomas

2014-06-01

ZERODUR®, known as the "gold standard" material for systems which require dimensional stability in the presence of gradients and transients, is now available lightweighted to the 85% to 90% level for use in high performance spaceborne telescopes and sensor systems. This establishes a design option that may have cost, testability, performance and risk advantages for an entire sensor system payload. The technical approach to making these primary mirrors is the same, whether the aperture is <0.3m to <4.0m. Since each mirror blank is made from a single monolithic billet of near zero-expansion, isotropic and homogeneous ZERODUR® material, the resulting mirror is very stable over a wide range of scenes and orbits, with minimal to no need for ancillary thermal stability and wavefront sensing and control systems. Telescopes using ZERODUR® and low expansion metering structures can accommodate thermal design challenges of both non-thermal (UV, VIS, LLLTV, NIR, SWIR and mm) and thermal (MWIR, LWIR) imaging systems, and deliver optimal performance. This lightweight mirror technology is discussed, with actual examples by SCHOTT of 0.3m and 1.2m mirrors presented. Lightweight ZERODUR® mirrors offer superior optical performance, attractive cost and aggressive lead times, and are available to present and future spaceborne sensor trades.

Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness.

PubMed

Striegel Weissman, Ruth; Rosselli, Francine

2017-01-01

Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of a hospital-wide PACS: costs and benefits of the Hammersmith PACS installation

NASA Astrophysics Data System (ADS)

Bryan, Stirling; Keen, Justin; Buxton, Martin J.; Weatherburn, Gwyneth C.

1992-07-01

The unusual nature of sites chosen for hospital-wide PACS implementations and the very small number of proposed implementations make evaluation a complex task. The UK Department of Health is funding both the evaluation and implementation of a hospital-wide PACS. The Brunel University evaluation of the Hammersmith Hospital PACS has two main components: an economic evaluation of the costs and benefits of hospital-wide PACS installations and an exercise in monitoring the implementation process. This paper concentrates on the economic component.

Development of a novel controllable, multidirectional, reusable metallic port with a wide working space.

PubMed

Hosaka, Seiji; Ohdaira, Takeshi; Umemoto, Satoshi; Hashizume, Makoto; Kawamoto, Shunji

2013-12-01

Endoscopic surgery is currently a standard procedure in many countries. Furthermore, conventional four-port laparoscopic cholecystectomy is developing into a single-port procedure. However, in many developing countries, disposable medical products are expensive and adequate medical waste disposable facilities are absent. Advanced medical treatments such as laparoscopic or single-port surgeries are not readily available in many areas of developing countries, and there are often no other sterilization methods besides autoclaving. Moreover, existing reusable metallic ports are impractical and are thus not widely used. We developed a novel controllable, multidirectional single-port device that can be autoclaved, and with a wide working space, which was employed in five patients. In all patients, laparoscopic cholecystectomy was accomplished without complications. Our device facilitates single-port surgery in areas of the world with limited sterilization methods and offers a novel alternative to conventional tools for creating a smaller incision, decrease postoperative pain, and improve cosmesis. This novel device can also lower the cost of medical treatment and offers a promising tool for major surgeries requiring a wide working space.

Evidence on the cost and cost-effectiveness of palliative care: a literature review.

PubMed

Smith, Samantha; Brick, Aoife; O'Hara, Sinéad; Normand, Charles

2014-02-01

In the context of limited resources, evidence on costs and cost-effectiveness of alternative methods of delivering health-care services is increasingly important to facilitate appropriate resource allocation. Palliative care services have been expanding worldwide with the aim of improving the experience of patients with terminal illness at the end of life through better symptom control, coordination of care and improved communication between professionals and the patient and family. To present results from a comprehensive literature review of available international evidence on the costs and cost-effectiveness of palliative care interventions in any setting (e.g. hospital-based, home-based and hospice care) over the period 2002-2011. Key bibliographic and review databases were searched. Quality of retrieved papers was assessed against a set of 31 indicators developed for this review. PubMed, EURONHEED, the Applied Social Sciences Index and the Cochrane library of databases. A total of 46 papers met the criteria for inclusion in the review, examining the cost and/or utilisation implications of a palliative care intervention with some form of comparator. The main focus of these studies was on direct costs with little focus on informal care or out-of-pocket costs. The overall quality of the studies is mixed, although a number of cohort studies do undertake multivariate regression analysis. Despite wide variation in study type, characteristic and study quality, there are consistent patterns in the results. Palliative care is most frequently found to be less costly relative to comparator groups, and in most cases, the difference in cost is statistically significant.

Comparative cost-effectiveness of HMG-CoA reductase inhibitors in secondary prevention of acute myocardial infarction.

PubMed

Elliott, W J; Weir, D R

1999-09-01

The cost-effectiveness of each of the six hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors currently available was studied. For a cohort of patients between the ages of 60 and 85 years with coronary heart disease (CHD) who were taking atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, or simvastatin, the number of survivors, the annual direct cost per survivor, and the annual indirect cost saving per survivor associated with the predicted reduction in the rate of nonfatal myocardial infarction recurrences were projected. Percent reductions in excess mortality due to CHD were derived from the relative risks of cardiac mortality in treatment versus control groups in the Scandinavian Simvastatin Survival Study (4S). Doses necessary to provide a long-term 35.57% reduction in low-density- lipoprotein (LDL) cholesterol, as seen in 4S, were estimated. One-way sensitivity analyses were performed to assess the importance of the baseline assumptions. The cost per year of life saved ranged from $5,421 with atorvastatin to $15,073 with lovastatin. The patient's age at time of diagnosis of CHD had a major impact on the cost-effectiveness of the drugs; cost-effectiveness per year of life saved was higher for older patients than younger patients. The six currently marketed HMG-CoA reductase inhibitors varied widely in cost and effectiveness in producing reductions in the LDL-cholesterol concentrations that have been shown to prevent recurrent MI; there was an approximately threefold difference in the cost per year of life saved between the most cost-effective and least cost-effective agents.

Natural precursor based hydrothermal synthesis of sodium carbide for reactor applications

NASA Astrophysics Data System (ADS)

Swapna, M. S.; Saritha Devi, H. V.; Sebastian, Riya; Ambadas, G.; Sankararaman, S.

2017-12-01

Carbides are a class of materials with high mechanical strength and refractory nature which finds a wide range of applications in industries and nuclear reactors. The existing synthesis methods of all types of carbides have problems in terms of use of toxic chemical precursors, high-cost, etc. Sodium carbide (Na2C2) which is an alkali metal carbide is the least explored one and also that there is no report of low-cost and low-temperature synthesis of sodium carbide using the eco-friendly, easily available natural precursors. In the present work, we report a simple low-cost, non-toxic hydrothermal synthesis of refractory sodium carbide using the natural precursor—Pandanus. The formation of sodium carbide along with boron carbide is evidenced by the structural and morphological characterizations. The sample thus synthesized is subjected to field emission scanning electron microscopy (FESEM), x-ray powder diffraction (XRD), ultraviolet (UV)—visible spectroscopy, Fourier transform infrared spectroscopy (FTIR), Raman, and photoluminescent (PL) spectroscopic techniques.

Removal of heavy metals from emerging cellulosic low-cost adsorbents: a review

NASA Astrophysics Data System (ADS)

Malik, D. S.; Jain, C. K.; Yadav, Anuj K.

2017-09-01

Heavy metal pollution is a major problems in the environment. The impact of toxic metal ions can be minimized by different technologies, viz., chemical precipitation, membrane filtration, oxidation, reverse osmosis, flotation and adsorption. But among them, adsorption was found to be very efficient and common due to the low concentration of metal uptake and economically feasible properties. Cellulosic materials are of low cost and widely used, and very promising for the future. These are available in abundant quantity, are cheap and have low or little economic value. Different forms of cellulosic materials are used as adsorbents such as fibers, leaves, roots, shells, barks, husks, stems and seed as well as other parts also. Natural and modified types of cellulosic materials are used in different metal detoxifications in water and wastewater. In this review paper, the most common and recent materials are reviewed as cellulosic low-cost adsorbents. The elemental properties of cellulosic materials are also discussed along with their cellulose, hemicelluloses and lignin contents.

Experiences addressing health-related financial challenges with disease management among African American women with asthma.

PubMed

Patel, Minal R; Caldwell, Cleopatra H; Id-Deen, Effat; Clark, Noreen M

2014-06-01

Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available.

Experiences addressing health-related financial challenges with disease management among African American women with asthma

PubMed Central

Patel, Minal R.; Caldwell, Cleopatra H.; Id-Deen, Effat; Clark, Noreen M.

2018-01-01

Objective Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. Methods In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Results Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Conclusions Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available. PMID:24471517

Novel low-cost thermotherapy for cutaneous leishmaniasis in Peru.

PubMed

Valencia, Braulio M; Miller, David; Witzig, Richard S; Boggild, Andrea K; Llanos-Cuentas, Alejandro

2013-01-01

Thermotherapy is an accepted alternative therapy for new-world cutaneous leishmaniasis, but current heat-delivery modalities are too costly to be made widely available to endemic populations. We adapted a low-cost heat pack named the HECT-CL device that delivers safe, reliable, and renewable conduction heat. 25 patients with cutaneous leishmaniasis completed treatment with the device at an initial temperature of 52°C ± 2°C for 3 minutes to each lesion, repeated daily for 7 days, and were followed up for 6 months by direct observation. The overall definitive clinical cure rate was 60%. Concurrently, 13 patients meeting minimally significant exclusion criteria received identical compassionate use treatment with a cumulative definitive cure rate of 68.4%, 75% for those who had experienced CL relapse after prior antimonial treatment. Therapy was well tolerated. Reversible second-degree burns occurred in two patients and no bacterial super-infections were observed. HECT-CL is a promising treatment and deserves further study to verify its safety and efficacy as adjuvant and mono- therapy.

Novel Low-Cost Thermotherapy for Cutaneous Leishmaniasis in Peru

PubMed Central

Witzig, Richard S.; Boggild, Andrea K.; Llanos-Cuentas, Alejandro

2013-01-01

Thermotherapy is an accepted alternative therapy for new-world cutaneous leishmaniasis, but current heat-delivery modalities are too costly to be made widely available to endemic populations. We adapted a low-cost heat pack named the HECT-CL device that delivers safe, reliable, and renewable conduction heat. 25 patients with cutaneous leishmaniasis completed treatment with the device at an initial temperature of 52°C±2°C for 3 minutes to each lesion, repeated daily for 7 days, and were followed up for 6 months by direct observation. The overall definitive clinical cure rate was 60%. Concurrently, 13 patients meeting minimally significant exclusion criteria received identical compassionate use treatment with a cumulative definitive cure rate of 68.4%, 75% for those who had experienced CL relapse after prior antimonial treatment. Therapy was well tolerated. Reversible second-degree burns occurred in two patients and no bacterial super-infections were observed. HECT-CL is a promising treatment and deserves further study to verify its safety and efficacy as adjuvant and mono- therapy. PMID:23658851

Cost of the treatment of complications of unsafe abortion in public hospitals.

PubMed

Naghma-e-Rehan

2011-02-01

To study the cost of induced abortions (unsafe abortion) and treatment of the complications of such abortions. Descriptive study was conducted between July, 2008 and December, 2008 in four tertiary care hospitals of Lahore: Sir Ganga Ram Hospital, Lady Wellingdon Hospital, General Hospital and Family Health Hospital of Family Planning Association of Pakistan. One hundred women admitted with complications of induced abortion were interviewed by lady doctors, who were trained to conduct the interviews. The data was collected through a structured pre-designed and pre-tested questionnaire approved by International Planned Parenthood Federation. Based on the information provided by the woman and/or her husband and hospital sources, the average cost of abortion was Rs.1686/-. The cost varied from Rs. 500/- to 7,000/-depending on the city, type of provider and facilities available at the clinic. The average cost of treating the complications was Rs. 4,197/- ranging from Rs. 1600/- to Rs 45,000/-. At the present exchange rate (September, 2009), the cost will be US$ 20/- to 560/-. Wide variation between two extremes was due to the type and extent of complications. Treatment for abortion-related complications consumes a large portion of hospital budgets for obstetrics and gynaecology and results in considerable mortality and morbidity. Due to restrictive laws and high cost of safe abortions, most women faced with an unwanted pregnancy resort to unsafe abortions.

[Cost-benefit analysis of primary prevention programs for mental health at the workplace in Japan].

PubMed

Yoshimura, Kensuke; Kawakami, Norito; Tsusumi, Akizumi; Inoue, Akiomi; Kobayashi, Yuka; Takeuchi, Ayano; Fukuda, Takashi

2013-01-01

To determine the cost-benefits of primary prevention programs for mental health at the workplace, we conducted a meta-analysis of published studies in Japan. We searched the literature, published as of 16 November 2011, using the Pubmed database and relevant key words. The inclusion criteria were: conducted in the workplace in Japan; primary prevention focus; quasi-experimental studies or controlled trials; and outcomes including absenteeism or presenteeism. Four studies were identified: one participatory work environment improvement, one individual-oriented stress management, and two supervisor education programs. Costs and benefits in yen were estimated for each program, based on the description of the programs in the literature, and additional information from the authors. The benefits were estimated based on each program's effect on work performance (measured using the WHO Health and Work Performance Questionnaire in all studies), as well as sick leave days, if available. The estimated relative increase in work performance (%) in the intervention group compared to the control group was converted into labor cost using the average bonus (18% of the total annual salary) awarded to employees in Japan as a base. Sensitive analyses were conducted using different models of time-trend of intervention effects and 95% confidence limits of the relative increase in work performance. For the participatory work environment improvement program, the cost was estimated as 7,660 yen per employee, and the benefit was 15,200-22,800 yen per employee. For the individual-oriented stress management program, the cost was 9,708 yen per employee, and the benefit was 15,200-22,920 yen per employee. For supervisor education programs, the costs and benefits were respectively 5,209 and 4,400-6,600 yen per employee, in one study, 2,949 and zero yen per employee in the other study. The 95% confidence intervals were wide for all these studies. For the point estimates based on these cases, the participatory work environment improvement program and the individual-oriented stress management program showed better cost-benefits. For the supervisor education programs, the costs were almost equal to or greater than the benefits. The results of the present study suggest these primary prevention programs for mental health at the workplace are economically advantageous to employers. Because the 95% confidence intervals were wide, further research is needed to clarify if these interventions yield statistically significant cost-benefits.

Impact of treatment heterogeneity on drug resistance and supply chain costs.

PubMed

Spiliotopoulou, Eirini; Boni, Maciej F; Yadav, Prashant

2013-09-01

The efficacy of scarce drugs for many infectious diseases is threatened by the emergence and spread of resistance. Multiple studies show that available drugs should be used in a socially optimal way to contain drug resistance. This paper studies the tradeoff between risk of drug resistance and operational costs when using multiple drugs for a specific disease. Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases. We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain. Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used. Our analysis shows that under a wide variety of scenarios for disease prevalence and drug cost, it is optimal to simultaneously deploy multiple drugs in the population. If the drug price is high, large volume purchasing discounts are available, and disease prevalence is high, it may be optimal to use only one drug. Our model lends insights to policy makers into the socially optimal size of drug assortment for a given context.

Openstage: A Low-Cost Motorized Microscope Stage with Sub-Micron Positioning Accuracy

PubMed Central

Campbell, Robert A. A.; Eifert, Robert W.; Turner, Glenn C.

2014-01-01

Recent progress in intracellular calcium sensors and other fluorophores has promoted the widespread adoption of functional optical imaging in the life sciences. Home-built multiphoton microscopes are easy to build, highly customizable, and cost effective. For many imaging applications a 3-axis motorized stage is critical, but commercially available motorization hardware (motorized translators, controller boxes, etc) are often very expensive. Furthermore, the firmware on commercial motor controllers cannot easily be altered and is not usually designed with a microscope stage in mind. Here we describe an open-source motorization solution that is simple to construct, yet far cheaper and more customizable than commercial offerings. The cost of the controller and motorization hardware are under $1000. Hardware costs are kept low by replacing linear actuators with high quality stepper motors. Electronics are assembled from commonly available hobby components, which are easy to work with. Here we describe assembly of the system and quantify the positioning accuracy of all three axes. We obtain positioning repeatability of the order of in X/Y and in Z. A hand-held control-pad allows the user to direct stage motion precisely over a wide range of speeds ( to ), rapidly store and return to different locations, and execute “jumps” of a fixed size. In addition, the system can be controlled from a PC serial port. Our “OpenStage” controller is sufficiently flexible that it could be used to drive other devices, such as micro-manipulators, with minimal modifications. PMID:24586468

Effect of germination temperatures on proteolysis of the gluten-free grains sorghum and millet during malting and mashing.

PubMed

Chiba, Y; Bryce, J H; Goodfellow, V; MacKinlay, J; Agu, R C; Brosnan, J M; Bringhurst, T A; Harrison, B

2012-04-11

Our study showed that sorghum and millet followed a similar pattern of changes when they were malted under similar conditions. When the malt from these cereals was mashed, both cereal types produced wide spectra of substrates (sugars and amino acids) that are required for yeast fermentation when malted at either lower or higher temperatures. At the germination temperatures of 20, 25, and 30 °C used in malting both cereal types, production of reducing sugars and that of free amino nitrogen (FAN) were similar. This is an important quality attribute for both cereals because it implies that variation in temperature during the malting of sorghum and millet, especially when malting temperature is difficult to control, and also reflecting temperature variations, experienced in different countries, will not have an adverse effect on the production and release of amino acids and sugars required by yeast during fermentation. Such consistency in the availability of yeast food (substrates) for metabolism during fermentation when sorghum and millet are malted at various temperatures is likely to reduce processing issues when their malts are used for brewing. Although sorghum has gained wide application in the brewing industry, and has been used extensively in brewing gluten-free beer on industrial scale, this is not the case with millet. The work described here provides novel information regarding the potential of millet for brewing. When both cereals were malted, the results obtained for millet in this study followed patterns similar to those of sorghum. This suggests that millet, in terms of sugars and amino acids, can play a role similar to that of sorghum in the brewing industry. This further suggests that millet, like sorghum, would be a good raw material for brewing gluten-free beer. Inclusion of millet as a brewing raw material will increase the availability of suitable materials (raw material sustainability) for use in the production of gluten-free beer, beverages, and other products. The availability of wider range of raw materials will not only help to reduce costs of beer production, but by extension, the benefit of reduced cost of production can be gained by consumers of gluten-free beer as the product would be cheaper and more widely available.

The cost-effectiveness of diagnostic management strategies for adults with minor head injury.

PubMed

Holmes, M W; Goodacre, S; Stevenson, M D; Pandor, A; Pickering, A

2012-09-01

To estimate the cost-effectiveness of diagnostic management strategies for adults with minor head injury. A mathematical model was constructed to evaluate the incremental costs and effectiveness (Quality Adjusted Life years Gained, QALYs) of ten diagnostic management strategies for adults with minor head injuries. Secondary analyses were undertaken to determine the cost-effectiveness of hospital admission compared to discharge home and to explore the cost-effectiveness of strategies when no responsible adult was available to observe the patient after discharge. The apparent optimal strategy was based on the high and medium risk Canadian CT Head Rule (CCHRhm), although the costs and outcomes associated with each strategy were broadly similar. Hospital admission for patients with non-neurosurgical injury on CT dominated discharge home, whilst hospital admission for clinically normal patients with a normal CT was not cost-effective compared to discharge home with or without a responsible adult at £39 and £2.5 million per QALY, respectively. A selective CT strategy with discharge home if the CT scan was normal remained optimal compared to not investigating or CT scanning all patients when there was no responsible adult available to observe them after discharge. Our economic analysis confirms that the recent extension of access to CT scanning for minor head injury is appropriate. Liberal use of CT scanning based on a high sensitivity decision rule is not only effective but also cost-saving. The cost of CT scanning is very small compared to the estimated cost of caring for patients with brain injury worsened by delayed treatment. It is recommended therefore that all hospitals receiving patients with minor head injury should have unrestricted access to CT scanning for use in conjunction with evidence based guidelines. Provisionally the CCHRhm decision rule appears to be the best strategy although there is considerable uncertainty around the optimal decision rule. However, the CCHRhm rule appears to be the most widely validated and it therefore seems appropriate to conclude that the CCHRhm rule has the best evidence to support its use. Copyright © 2011 Elsevier Ltd. All rights reserved.

Measuring the costs of schizophrenia. Implications for the post-institutional era in the US.

PubMed

Terkelsen, K G; Menikoff, A

1995-09-01

Schizophrenia is a stress-related biomedical condition of the brain, characterised by unusual internal experiences, severe and often persistent functional disability and socially inappropriate behaviour. It is estimated that schizophrenia affects approximately 1% of all adults worldwide. Young adults are especially vulnerable. It is an illness with profound economic impact on patients, their families and society at large. Before the 1950s, most patients with schizophrenia were admitted to hospital for long inpatient stays. Keeping the patient in an institutional setting was all that psychiatry could offer, because there was little active treatment available. After World War II, and especially following the introduction of chlorpromazine in 1954, treatment was offered increasingly in outpatient settings. At present, more than 90% of individuals with schizophrenia will receive most healthcare services in outpatient facilities, supplemented by brief hospital treatment. The trend toward community-based care continues into the 1990s, supported in part by recent pharmacotherapeutic developments that are making a new generation of drug treatment options available. Clozapine, the most widely used of these new drugs, has been the subject of several studies that compared its costs with those of conventional drug treatments. These early studies suggest that further reductions in the cost of hospital treatment are possible in the near future. At the same time, despite the increasing availability of effective treatment in outpatient settings, the shift of resources from institutional to community care will not occur as quickly as some might wish. Delays in the transformation of care systems are caused by political interest groups and the sheer inertia of the infrastructure left over from the era of institutional care. These factors must be taken into account in estimating the cost of schizophrenia care during the next decade. The aim of this review is to provide a clinical picture of schizophrenia, emphasising features that contribute most to the cost of illness. We define and quantify the direct and indirect costs of the illness, discuss the cost implications of new pharmacotherapeutic and psychosocial treatments, and critique strategies for measuring the economic efficacy of these new treatments. The difficulties in measuring the costs of schizophrenia that are related to the transition from institutional to community-based systems of care in the US are also reviewed.

Virtualization in education: Information Security lab in your hands

NASA Astrophysics Data System (ADS)

Karlov, A. A.

2016-09-01

The growing demand for qualified specialists in advanced information technologies poses serious challenges to the education and training of young personnel for science, industry and social problems. Virtualization as a way to isolate the user from the physical characteristics of computing resources (processors, servers, operating systems, networks, applications, etc.), has, in particular, an enormous influence in the field of education, increasing its efficiency, reducing the cost, making it more widely and readily available. The study of Information Security of computer systems is considered as an example of use of virtualization in education.

Dataset Lifecycle Policy

NASA Technical Reports Server (NTRS)

Armstrong, Edward; Tauer, Eric

2013-01-01

The presentation focused on describing a new dataset lifecycle policy that the NASA Physical Oceanography DAAC (PO.DAAC) has implemented for its new and current datasets to foster improved stewardship and consistency across its archive. The overarching goal is to implement this dataset lifecycle policy for all new GHRSST GDS2 datasets and bridge the mission statements from the GHRSST Project Office and PO.DAAC to provide the best quality SST data in a cost-effective, efficient manner, preserving its integrity so that it will be available and usable to a wide audience.

Guidelines for establishing a donor human milk depot.

PubMed

Geraghty, Sheela R; List, Betsy A; Morrow, Georgia B

2010-02-01

Human milk is the preferred choice for infant feeding. When a sick or premature infant's own mother's milk is unavailable, donor human milk is becoming more widely used. Many potential milk donors do not live within close proximity to the 10 North American not-for-profit milk banks. Transporting milk via commercial carriers can be inconvenient and costly for recipient banks. A network of donor human milk depots is one practical way to increase the quantity of available donor human milk. This article provides guidelines and practical suggestions for establishing a donor human milk depot.

Privacy, confidentiality, and electronic medical records.

PubMed Central

Barrows, R C; Clayton, P D

1996-01-01

The enhanced availability of health information in an electronic format is strategic for industry-wide efforts to improve the quality and reduce the cost of health care, yet it brings a concomitant concern of greater risk for loss of privacy among health care participants. The authors review the conflicting goals of accessibility and security for electronic medical records and discuss nontechnical and technical aspects that constitute a reasonable security solution. It is argued that with guiding policy and current technology, an electronic medical record may offer better security than a traditional paper record. PMID:8653450

Optical testing of aspheres based on photochromic computer-generated holograms

NASA Astrophysics Data System (ADS)

Pariani, Giorgio; Bianco, Andrea; Bertarelli, Chiara; Spanó, Paolo; Molinari, Emilio

2010-07-01

Aspherical optics are widely used in modern optical telescopes and instrumentation because of their ability to reduce aberrations with a simple optical system. Testing their optical quality through null interferometry is not trivial as reference optics are not available. Computer-Generated Holograms (CGHs) are efficient devices that allow to generate a well-defined optical wavefront. We developed rewritable Computer Generated Holograms for the interferometric test of aspheres based on photochromic layers. These photochromic holograms are cost-effective and the method of production does not need any post exposure process.

Low-Thrust Transfers from Distant Retrograde Orbits to L2 Halo Orbits in the Earth-Moon System

NASA Technical Reports Server (NTRS)

Parrish, Nathan L.; Parker, Jeffrey S.; Hughes, Steven P.; Heiligers, Jennette

2016-01-01

Enable future missions Any mission to a DRO or halo orbit could benefit from the capability to transfer between these orbits Chemical propulsion could be used for these transfers, but at high propellant cost Fill gaps in knowledge A variety of transfers using SEP or solar sails have been studied for the Earth-Moon system Most results in literature study a single transfer This is a step toward understanding the wide array of types of transfers available in an N-body force model.

Using personal glucose meters and functional DNA sensors to quantify a variety of analytical targets

PubMed Central

Xiang, Yu; Lu, Yi

2012-01-01

Portable, low-cost and quantitative detection of a broad range of targets at home and in the field has the potential to revolutionize medical diagnostics and environmental monitoring. Despite many years of research, very few such devices are commercially available. Taking advantage of the wide availability and low cost of the pocket-sized personal glucose meter—used worldwide by diabetes sufferers—we demonstrate a method to use such meters to quantify non-glucose targets, ranging from a recreational drug (cocaine, 3.4 μM detection limit) to an important biological cofactor (adenosine, 18 μM detection limit), to a disease marker (interferon-gamma of tuberculosis, 2.6 nM detection limit) and a toxic metal ion (uranium, 9.1 nM detection limit). The method is based on the target-induced release of invertase from a functional-DNA–invertase conjugate. The released invertase converts sucrose into glucose, which is detectable using the meter. The approach should be easily applicable to the detection of many other targets through the use of suitable functional-DNA partners (aptamers DNAzymes or aptazymes). PMID:21860458

Using personal glucose meters and functional DNA sensors to quantify a variety of analytical targets

NASA Astrophysics Data System (ADS)

Xiang, Yu; Lu, Yi

2011-09-01

Portable, low-cost and quantitative detection of a broad range of targets at home and in the field has the potential to revolutionize medical diagnostics and environmental monitoring. Despite many years of research, very few such devices are commercially available. Taking advantage of the wide availability and low cost of the pocket-sized personal glucose meter—used worldwide by diabetes sufferers—we demonstrate a method to use such meters to quantify non-glucose targets, ranging from a recreational drug (cocaine, 3.4 µM detection limit) to an important biological cofactor (adenosine, 18 µM detection limit), to a disease marker (interferon-gamma of tuberculosis, 2.6 nM detection limit) and a toxic metal ion (uranium, 9.1 nM detection limit). The method is based on the target-induced release of invertase from a functional-DNA-invertase conjugate. The released invertase converts sucrose into glucose, which is detectable using the meter. The approach should be easily applicable to the detection of many other targets through the use of suitable functional-DNA partners (aptamers, DNAzymes or aptazymes).

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects.

PubMed

Rustemeyer, Jan; Melenberg, Alex; Sari-Rieger, Aynur

2014-12-01

This study aims to evaluate the additional costs incurred by using a computer-aided design/computer-aided manufacturing (CAD/CAM) technique for reconstructing maxillofacial defects by analyzing typical cases. The medical charts of 11 consecutive patients who were subjected to the CAD/CAM technique were considered, and invoices from the companies providing the CAD/CAM devices were reviewed for every case. The number of devices used was significantly correlated with cost (r = 0.880; p < 0.001). Significant differences in mean costs were found between cases in which prebent reconstruction plates were used (€3346.00 ± €29.00) and cases in which they were not (€2534.22 ± €264.48; p < 0.001). Significant differences were also obtained between the costs of two, three and four devices, even when ignoring the cost of reconstruction plates. Additional fees provided by statutory health insurance covered a mean of 171.5% ± 25.6% of the cost of the CAD/CAM devices. Since the additional fees provide financial compensation, we believe that the CAD/CAM technique is suited for wide application and not restricted to complex cases. Where additional fees/funds are not available, the CAD/CAM technique might be unprofitable, so the decision whether or not to use it remains a case-to-case decision with respect to cost versus benefit. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Emerging from the bottleneck: Benefits of the comparative approach to modern neuroscience

PubMed Central

Brenowitz, Eliot A.; Zakon, Harold H.

2015-01-01

Neuroscience historically exploited a wide diversity of animal taxa. Recently, however, research focused increasingly on a few model species. This trend accelerated with the genetic revolution, as genomic sequences and genetic tools became available for a few species, which formed a bottleneck. This coalescence on a small set of model species comes with several costs often not considered, especially in the current drive to use mice explicitly as models for human diseases. Comparative studies of strategically chosen non-model species can complement model species research and yield more rigorous studies. As genetic sequences and tools become available for many more species, we are poised to emerge from the bottleneck and once again exploit the rich biological diversity offered by comparative studies. PMID:25800324

Evaluation of the smoke density chamber as an apparatus for fire toxicity screening tests

NASA Technical Reports Server (NTRS)

Hilado, C. J.; Labossiere, L. A.

1976-01-01

The smoke density chamber is perhaps the most widely used apparatus for smoke measurements. Because of its availability, it has been proposed as an apparatus for evaluating fire toxicity. The standard apparatus and procedure were not found suitable for toxicity screening tests using laboratory animals, because not enough materials of interest produced animal mortality or even incapacitation under standard test conditions. With modifications, the chamber offers greater promise as a screening tool, but other tests specifically designed to measure relative toxicity may be more cost-effective. Where one-dimensional heat flux is a requirement, the chamber is the most suitable apparatus available. It should be improved in regard to visibility of animals and ease of cleaning.

Electric chiller handbook. Final report

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

NONE

1998-02-01

Electric chillers have dominated the market for large commercial cooling systems due to their history of reliable, economical operation. The phaseout of CFCs and deregulation of the utility industry are two factors that significantly impact the chiller market. The CFC phaseout is resulting in the upgrading or replacement of thousands of electric chillers nationwide. In a deregulated environment, utilities are finding increasing need to provide services that can win and retain new customers. Utility representatives need current information on applying and selecting cost-effective chiller systems. The objective of this report was to develop a comprehensive handbook that helps utility technicalmore » and marketing staff, their customers, and design professionals evaluate and select the best options for chilled-water systems in commercial buildings. Investigators used a variety of industry data sources to develop market-share information for electric and gas chiller systems and to determine applications according to building age, type, and region. Discussions with chiller manufacturers provided information on product availability, performance, and ownership cost. Using EPRI`s COMTECH software, investigators performed comprehensive cost analyses for placement of large and small chillers in three representative cities. Case studies of actual installations support these analyses. Electric Chiller Handbook provides a single source of current information on all major issues associated with chiller selection and application. Key issues include chiller availability and markets, rated performance, future viability of various refrigerant options, the cost-effectiveness of alternative chillers, and chilled-water system optimization. The Handbook also describes available hardware, outlines the features and costs of gas-fired competitive systems, and provides methods and comparisons of life-cycle costing of various chiller system options. Analyses of chiller features and economics show that electric chillers are preferable to gas chillers in the large majority of applications, consistent with current market trends. Furthermore, today`s chillers offer a wide range of efficiencies and refrigerant options to serve cooling system needs for the 20-year lifetime of the chiller. Finally, new higher-efficiency models of electric chillers offer very attractive paybacks.« less

Using Full Genomic Information to Predict Disease: Breaking Down the Barriers Between Complex and Mendelian Diseases.

PubMed

Jordan, Daniel M; Do, Ron

2018-04-11

While sequence-based genetic tests have long been available for specific loci, especially for Mendelian disease, the rapidly falling costs of genome-wide genotyping arrays, whole-exome sequencing, and whole-genome sequencing are moving us toward a future where full genomic information might inform the prognosis and treatment of a variety of diseases, including complex disease. Similarly, the availability of large populations with full genomic information has enabled new insights about the etiology and genetic architecture of complex disease. Insights from the latest generation of genomic studies suggest that our categorization of diseases as complex may conceal a wide spectrum of genetic architectures and causal mechanisms that ranges from Mendelian forms of complex disease to complex regulatory structures underlying Mendelian disease. Here, we review these insights, along with advances in the prediction of disease risk and outcomes from full genomic information. Expected final online publication date for the Annual Review of Genomics and Human Genetics Volume 19 is August 31, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

[Fixed-dose combination fluticasone propionate/formoterol for the treatment of asthma: a review of its pharmacology, efficacy and tolerability].

PubMed

Quintano Jiménez, J A; Ginel Mendoza, L; Entrenas Costa, L M; Polo García, J

2016-02-01

The fixed-dose combination fluticasone propionate/formoterol (FPF) is a novel combination of a widely known and used inhaled glucocorticoid (IGC) and a long-acting β2-adrenergic agonist (LABA), available for the first time in a single device. This fixed-dose combination of FPF has a demonstrated efficacy and safety profile in clinical trials compared with its individual components and other fixed-dose combinations of IGC/LABA and is indicated for the treatment of persistent asthma in adults and adolescents. FPF is available in a wide range of doses that can adequately cover the therapeutic steps recommended by treatment guidelines, constituting a fixed-dose combination of GCI/LABA that is effective, rapid, well tolerated and with a reasonable acquisition cost. Various assessment agencies of the Spanish Autonomous Communities consider this combination to be an appropriate alternative therapy for asthma in the primary care setting. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

HEALER: homomorphic computation of ExAct Logistic rEgRession for secure rare disease variants analysis in GWAS

PubMed Central

Wang, Shuang; Zhang, Yuchen; Dai, Wenrui; Lauter, Kristin; Kim, Miran; Tang, Yuzhe; Xiong, Hongkai; Jiang, Xiaoqian

2016-01-01

Motivation: Genome-wide association studies (GWAS) have been widely used in discovering the association between genotypes and phenotypes. Human genome data contain valuable but highly sensitive information. Unprotected disclosure of such information might put individual’s privacy at risk. It is important to protect human genome data. Exact logistic regression is a bias-reduction method based on a penalized likelihood to discover rare variants that are associated with disease susceptibility. We propose the HEALER framework to facilitate secure rare variants analysis with a small sample size. Results: We target at the algorithm design aiming at reducing the computational and storage costs to learn a homomorphic exact logistic regression model (i.e. evaluate P-values of coefficients), where the circuit depth is proportional to the logarithmic scale of data size. We evaluate the algorithm performance using rare Kawasaki Disease datasets. Availability and implementation: Download HEALER at http://research.ucsd-dbmi.org/HEALER/ Contact: shw070@ucsd.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26446135

Oculomatic: High speed, reliable, and accurate open-source eye tracking for humans and non-human primates.

PubMed

Zimmermann, Jan; Vazquez, Yuriria; Glimcher, Paul W; Pesaran, Bijan; Louie, Kenway

2016-09-01

Video-based noninvasive eye trackers are an extremely useful tool for many areas of research. Many open-source eye trackers are available but current open-source systems are not designed to track eye movements with the temporal resolution required to investigate the mechanisms of oculomotor behavior. Commercial systems are available but employ closed source hardware and software and are relatively expensive, limiting wide-spread use. Here we present Oculomatic, an open-source software and modular hardware solution to eye tracking for use in humans and non-human primates. Oculomatic features high temporal resolution (up to 600Hz), real-time eye tracking with high spatial accuracy (<0.5°), and low system latency (∼1.8ms, 0.32ms STD) at a relatively low-cost. Oculomatic compares favorably to our existing scleral search-coil system while being fully non invasive. We propose that Oculomatic can support a wide range of research into the properties and neural mechanisms of oculomotor behavior. Copyright © 2016 Elsevier B.V. All rights reserved.

Cost-effectiveness of treating multidrug-resistant tuberculosis.

PubMed

Resch, Stephen C; Salomon, Joshua A; Murray, Megan; Weinstein, Milton C

2006-07-01

Despite the existence of effective drug treatments, tuberculosis (TB) causes 2 million deaths annually worldwide. Effective treatment is complicated by multidrug-resistant TB (MDR TB) strains that respond only to second-line drugs. We projected the health benefits and cost-effectiveness of using drug susceptibility testing and second-line drugs in a lower-middle-income setting with high levels of MDR TB. We developed a dynamic state-transition model of TB. In a base case analysis, the model was calibrated to approximate the TB epidemic in Peru, a setting with a smear-positive TB incidence of 120 per 100,000 and 4.5% MDR TB among prevalent cases. Secondary analyses considered other settings. The following strategies were evaluated: first-line drugs administered under directly observed therapy (DOTS), locally standardized second-line drugs for previously treated cases (STR1), locally standardized second-line drugs for previously treated cases with test-confirmed MDR TB (STR2), comprehensive drug susceptibility testing and individualized treatment for previously treated cases (ITR1), and comprehensive drug susceptibility testing and individualized treatment for all cases (ITR2). Outcomes were costs per TB death averted and costs per quality-adjusted life year (QALY) gained. We found that strategies incorporating the use of second-line drug regimens following first-line treatment failure were highly cost-effective compared to strategies using first-line drugs only. In our base case, standardized second-line treatment for confirmed MDR TB cases (STR2) had an incremental cost-effectiveness ratio of 720 dollars per QALY (8,700 dollars per averted death) compared to DOTS. Individualized second-line drug treatment for MDR TB following first-line failure (ITR1) provided more benefit at an incremental cost of 990 dollars per QALY (12,000 dollars per averted death) compared to STR2. A more aggressive version of the individualized treatment strategy (ITR2), in which both new and previously treated cases are tested for MDR TB, had an incremental cost-effectiveness ratio of 11,000 dollars per QALY (160,000 dollars per averted death) compared to ITR1. The STR2 and ITR1 strategies remained cost-effective under a wide range of alternative assumptions about treatment costs, effectiveness, MDR TB prevalence, and transmission. Treatment of MDR TB using second-line drugs is highly cost-effective in Peru. In other settings, the attractiveness of strategies using second-line drugs will depend on TB incidence, MDR burden, and the available budget, but simulation results suggest that individualized regimens would be cost-effective in a wide range of situations.

34 CFR 76.568 - Occupancy and space maintenance costs-restricted rate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... organization-wide service functions (accounting, payroll, personnel) may be included as general management... costs associated with functions that are not organization-wide must be included with other expenditures... advance by the Secretary. (Authority: 20 U.S.C. 1221e-3(a)(1), 2831(a), 2974(b), and 3474) [59 FR 59584...

Application of Economic Analysis to School-Wide Positive Behavior Support (SWPBS) Programs

ERIC Educational Resources Information Center

Blonigen, Bruce A.; Harbaugh, William T.; Singell, Larry D.; Horner, Robert H.; Irvin, Larry K.; Smolkowski, Keith S.

2008-01-01

The authors discuss how to use economic techniques to evaluate educational programs and show how to apply basic cost analysis to implementation of school-wide positive behavior support (SWPBS). A description of cost analysis concepts used for economic program evaluation is provided, emphasizing the suitability of these concepts for evaluating…

Pharmacoeconomic analysis of antifungal therapy for primary treatment of invasive candidiasis caused by Candida albicans and non-albicans Candida species.

PubMed

Ou, Huang-Tz; Lee, Tsung-Ying; Chen, Yee-Chun; Charbonneau, Claudie

2017-07-10

Cost-effectiveness studies of echinocandins for the treatment of invasive candidiasis, including candidemia, are rare in Asia. No study has determined whether echinocandins are cost-effective for both Candida albicans and non-albicans Candida species. There have been no economic evaluations that compare non-echinocandins with the three available echinocandins. This study was aimed to assess the cost-effectiveness of individual echinocandins, namely caspofungin, micafungin, and anidulafungin, versus non-echinocandins for C. albicans and non-albicans Candida species, respectively. A decision tree model was constructed to assess the cost-effectiveness of echinocandins and non-echinocandins for invasive candidiasis. The probability of treatment success, mortality rate, and adverse drug events were extracted from published clinical trials. The cost variables (i.e., drug acquisition) were based on Taiwan's healthcare system from the perspective of a medical payer. One-way sensitivity analyses and probability sensitivity analyses were conducted. For treating invasive candidiasis (all species), as compared to fluconazole, micafungin and caspofungin are dominated (less effective, more expensive), whereas anidulafungin is cost-effective (more effective, more expensive), costing US$3666.09 for each life-year gained, which was below the implicit threshold of the incremental cost-effectiveness ratio in Taiwan. For C. albicans, echinocandins are cost-saving as compared to non-echinocandins. For non-albicans Candida species, echinocandins are cost-effective as compared to non-echinocandins, costing US$652 for each life-year gained. The results were robust over a wide range of sensitivity analyses and were most sensitive to the clinical efficacy of antifungal treatment. Echinocandins, especially anidulafungin, appear to be cost-effective for invasive candidiasis caused by C. albicans and non-albicans Candida species in Taiwan.

Cost Analysis of Cot-Side Screening Methods for Neonatal Hypoglycaemia.

PubMed

Glasgow, Matthew J; Harding, Jane E; Edlin, Richard

2018-06-12

Babies at risk of neonatal hypoglycaemia are often screened using cot-side glucometers, but non-enzymatic glucometers are inaccurate, potentially resulting in over-treatment and under-treatment, and low values require laboratory confirmation. More accurate enzymatic glucometers are available but at apparently higher costs. Our objective was to compare the cost of screening for neonatal hypoglycaemia using point-of-care enzymatic and non-enzymatic glucometers. We used a decision tree to model costs, including consumables and staff time. Sensitivity analyses assessed the impact of staff time, staff costs, probability that low results are confirmed via laboratory testing, false-positive and false-negative rates of non-enzymatic glucometers, and the blood glucose concentration threshold. In the primary analysis, screening using an enzymatic glucometer cost NZD 86.94 (USD 63.47) while using a non-enzymatic glucometer cost NZD 97.08 (USD 70.87) per baby. Sensitivity analyses showed that using an enzymatic glucometer is cost saving with wide variations in staff time and costs, irrespective of the false-positive level of non-enzymatic glucometers, and where ≥78% of low values are laboratory confirmed. Where non-enzymatic glucometers may be less costly (e.g., false-negative rate exceeds 15%), instances of hypoglycaemia will be missed. Reducing the blood glucose concentration threshold to 1.94 mmol/L reduced the incidence of hypoglycaemia from 52 to 13%, and the cost of screening using a non-enzymatic glucometer to NZD 47.71 (USD 34.83). In view of their lower cost in most circumstances and greater accuracy, enzymatic glucometers should be routinely utilised for point-of-care screening for neonatal hypoglycaemia. © 2018 S. Karger AG, Basel.

Skid Resistance Research

NASA Technical Reports Server (NTRS)

1977-01-01

Skidding causes many traffic accidents. Streets and highways with skid-resisting surfaces reduce the incidence of such accidents. In fact, resurfacing roads to improve skid resistance is now required by federal law. Skid resistance is measured by road testing with specially equipped skid trailers. A project underway at NASA-Langley may considerably reduce the cost of skid trailers, thus making them more widely available to highway departments. For testing the skid resistance of aircraft runways, Langley engineers developed a relatively inexpensive test vehicle and a "pulsed braking" technique that is now being applied experimentally to road testing. The vehicle is a standard automobile modified to incorporate instrumentation, special test tires and valves, and a trailing fifth wheel for monitoring distance and velocity. The instrumentation includes a low-cost meter, a set of accelerometers that sense motion changes, and a chart recorder.

Nanoliposome encapsulated anesthetics for local anesthesia application.

PubMed

Vahabi, Sepideh; Eatemadi, Ali

2017-02-01

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

White Cliffs: Operating Experience

NASA Technical Reports Server (NTRS)

Kaneff, S.

1984-01-01

The fourteen dish white cliffs solar power station area is remote and subject to extreme environmental conditions, solution of the associated problems required careful and thoughtful attention and the application of resources. Notwithstanding the wide range and harshness of conditions, the difficulties caused by remoteness and the lack of a technological base and the need for relatively rapid demonstration of success, the project has had a very positive outcome. Qualitative and quantitative information and lessons are now available to enable considerable simplifications to be made for a new system, reducing both hardware and operation and maintenance costs. Experience and lessons are presented, particularly in relation to: system performance in various environmental conditions; design philosophies for collectors, the array, control systems, engine and plant; operation and maintenance strategies and cost reducing possibilities. Experience so far gives encouragement for the future of such paraboloidal dish systems in appropriate areas.

Evaluating the delivery, impact, costs and benefits of an active lives programme for older people living in the community.

PubMed

Gandy, Rob; Bell, Amelia; McClelland, Bob; Roe, Brenda

2017-03-01

Aim Age UK Lancashire received Big Lottery funding to deliver an active lives programme from January 2012 to December 2014 to the population of West Lancashire aged over 50 years. The overall aims of the associated evaluation were to measure older people's experiences of participating in the programme, identify the impacts on their health and well-being and their suggestions for services development, and establish the costs and benefits of the programme. The World Health Organisation recommends older people should be able to achieve physical, social and mental well-being throughout their lives, and that international, national and local policies should be developed to support older adults, promote their independence and well-being, and encourage physical exercise. Consequently, the West Lancashire programme was to establish preventative community support for older people to assist in improving their well-being and physical and mental health, particularly those isolated due to age-related illness or disability. It was to provide interventions not available from local social care providers. A mixed methods approach was adopted, with the qualitative evaluation utilising focus groups to establish people's experiences, identify impacts on their health and well-being, and suggestions for services development. This paper describes the quantitative evaluation, which involved three surveys and a costs analysis. The surveys were scheduled to give timely feedback to management about programme delivery and content, and overall benefits of participation. Findings The active lives programme and groups offered a wide range of flexible and local activities that provided benefits for older people in terms of health and well-being, social well-being and quality of life, and reducing social isolation. There was interconnectivity between these benefits. The programme was delivered in an affordable and flexible manner. Such programmes should be made more widely available.

Pilot Project Technology Business Case: Mobile Work Packages

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

Thomas, Ken; Lawrie, Sean; Niedermuller, Josef

Performance advantages of the new pilot project technologies are widely acknowledged, but it has proven difficult for utilities to derive business cases for justifying investment in these new capabilities. Lack of a business case is often cited by utilities as a barrier to pursuing wide-scale application of digital technologies to nuclear plant work activities. The decision to move forward with funding usually hinges on demonstrating actual cost reductions that can be credited to budgets and thereby truly reduce O&M or capital costs. Technology enhancements, while enhancing work methods and making work more efficient, often fail to eliminate workload such thatmore » it changes overall staffing and material cost requirements. It is critical to demonstrate cost reductions or impacts on non-cost performance objectives in order for the business case to justify investment by nuclear operators. The Business Case Methodology (BCM) was developed in September of 2015 to frame the benefit side of II&C technologies to address the “benefit” side of the analysis—as opposed to the cost side—and how the organization evaluates discretionary projects (net present value (NPV), accounting effects of taxes, discount rates, etc.). The cost and analysis side is not particularly difficult for the organization and can usually be determined with a fair amount of precision (not withstanding implementation project cost overruns). It is in determining the “benefits” side of the analysis that utilities have more difficulty in technology projects and that is the focus of this methodology. The methodology is presented in the context of the entire process, but the tool provided is limited to determining the organizational benefits only. This report describes a the use of the BCM in building a business case for mobile work packages, which includes computer-based procedures and other automated elements of a work package. Key to those impacts will be identifying where the savings are “harvestable,” meaning they result in an actual reduction in headcount and/or cost. The report describes the specific activities conducted with a partner utility to examine the various work activities associated with mobile work packages to determine what time savings and error rate reductions are available. The report summarizes these findings in the form of a business case for the technology.« less

The Role of Non-Conventional Supports for Single-Atom Platinum-Based Catalysts in Fuel-Cell Technology: A Theoretical Surface Science Approach

DTIC Science & Technology

2013-02-05

could be a promising catalyst for PEM fuel cells. Introduction: Proton exchange membrane fuel cells ( PEMFCs ) have found wide potential...Unfortunately, due to their high cost and low lifespan, wide-scale commercialization of PEMFCs has been greatly impeded and much effort has been made to...lower its cost as well as to improve its durability over time. In an attempt to alleviate the high-cost associated with conventional PEMFC catalysts

The environmental and economic sustainability of carbon capture and storage.

PubMed

Hardisty, Paul E; Sivapalan, Mayuran; Brooks, Peter

2011-05-01

For carbon capture and storage (CCS) to be a truly effective option in our efforts to mitigate climate change, it must be sustainable. That means that CCS must deliver consistent environmental and social benefits which exceed its costs of capital, energy and operation; it must be protective of the environment and human health over the long term; and it must be suitable for deployment on a significant scale. CCS is one of the more expensive and technically challenging carbon emissions abatement options available, and CCS must first and foremost be considered in the context of the other things that can be done to reduce emissions, as a part of an overall optimally efficient, sustainable and economic mitigation plan. This elevates the analysis beyond a simple comparison of the cost per tonne of CO(2) abated--there are inherent tradeoffs with a range of other factors (such as water, NOx, SOx, biodiversity, energy, and human health and safety, among others) which must also be considered if we are to achieve truly sustainable mitigation. The full life-cycle cost of CCS must be considered in the context of the overall social, environmental and economic benefits which it creates, and the costs associated with environmental and social risks it presents. Such analysis reveals that all CCS is not created equal. There is a wide range of technological options available which can be used in a variety of industries and applications-indeed CCS is not applicable to every industry. Stationary fossil-fuel powered energy and large scale petroleum industry operations are two examples of industries which could benefit from CCS. Capturing and geo-sequestering CO(2) entrained in natural gas can be economic and sustainable at relatively low carbon prices, and in many jurisdictions makes financial sense for operators to deploy now, if suitable secure disposal reservoirs are available close by. Retrofitting existing coal-fired power plants, however, is more expensive and technically challenging, and the economic sustainability of post-combustion capture retrofit needs to be compared on a portfolio basis to the relative overall net benefit of CCS on new-build plants, where energy efficiency can be optimised as a first step, and locations can be selected with sequestration sites in mind. Examples from the natural gas processing, liquefied natural gas (LNG), and coal-fired power generation sectors, illustrate that there is currently a wide range of financial costs for CCS, depending on how and where it is applied, but equally, environmental and social benefits of emissions reduction can be considerable. Some CCS applications are far more economic and sustainable than others. CCS must be considered in the context of the other things that a business can do to eliminate emissions, such as far-reaching efforts to improve energy efficiency.

The Environmental and Economic Sustainability of Carbon Capture and Storage

PubMed Central

Hardisty, Paul E.; Sivapalan, Mayuran; Brooks, Peter

2011-01-01

For carbon capture and storage (CCS) to be a truly effective option in our efforts to mitigate climate change, it must be sustainable. That means that CCS must deliver consistent environmental and social benefits which exceed its costs of capital, energy and operation; it must be protective of the environment and human health over the long term; and it must be suitable for deployment on a significant scale. CCS is one of the more expensive and technically challenging carbon emissions abatement options available, and CCS must first and foremost be considered in the context of the other things that can be done to reduce emissions, as a part of an overall optimally efficient, sustainable and economic mitigation plan. This elevates the analysis beyond a simple comparison of the cost per tonne of CO2 abated—there are inherent tradeoffs with a range of other factors (such as water, NOx, SOx, biodiversity, energy, and human health and safety, among others) which must also be considered if we are to achieve truly sustainable mitigation. The full life-cycle cost of CCS must be considered in the context of the overall social, environmental and economic benefits which it creates, and the costs associated with environmental and social risks it presents. Such analysis reveals that all CCS is not created equal. There is a wide range of technological options available which can be used in a variety of industries and applications—indeed CCS is not applicable to every industry. Stationary fossil-fuel powered energy and large scale petroleum industry operations are two examples of industries which could benefit from CCS. Capturing and geo-sequestering CO2 entrained in natural gas can be economic and sustainable at relatively low carbon prices, and in many jurisdictions makes financial sense for operators to deploy now, if suitable secure disposal reservoirs are available close by. Retrofitting existing coal-fired power plants, however, is more expensive and technically challenging, and the economic sustainability of post-combustion capture retrofit needs to be compared on a portfolio basis to the relative overall net benefit of CCS on new-build plants, where energy efficiency can be optimised as a first step, and locations can be selected with sequestration sites in mind. Examples from the natural gas processing, liquefied natural gas (LNG), and coal-fired power generation sectors, illustrate that there is currently a wide range of financial costs for CCS, depending on how and where it is applied, but equally, environmental and social benefits of emissions reduction can be considerable. Some CCS applications are far more economic and sustainable than others. CCS must be considered in the context of the other things that a business can do to eliminate emissions, such as far-reaching efforts to improve energy efficiency. PMID:21655130

Commentary: public disclosure in the health field: is there a relevant option?

PubMed

Weil, T P

2001-01-01

Steadily increasing numbers of private, not-for-profit, and public agencies are releasing quality of care and financial information to enhance the market power of those purchasing America's health services. These sources range widely from the Health Plan Employer Data and Information Set (HEDIS) to the federal Securities and Exchange Commission (SEC). A growing interest in publicly disclosing performance information that concerns providers, as recently recommended by the Institute of Medicine (IOM) report on patient safety, until now has only achieved a modest impact. A major exception is in those metropolitan areas where acute-care facilities experience intense competition for patient admissions. Although the comparative quality and cost information currently available is for the most part in the public interest, it is concluded that, in the foreseeable future, these report cards as now structured will not result in any significant enhancement in access, improvement in quality, or reduction in cost. Options to encourage more public disclosure explored in this paper are Congress potentially passing legislation (a) to establish a Center for Patient Safety within the US Department of Health and Human Services as recommended by the recent Institute of IOM study, or (b) empowering the SEC beyond its current mandate to collect and disseminate all pertinent quality of care and cost information on every provider in the United States. The latter alternative would include user-friendly, comparative analyses to be provided on the Internet and elsewhere and would make readily available information from HEDIS, the Joint Commission on the Accreditation of Healthcare Organization (JCAHO), coronary artery bypass graft (CABG) surgery studies, cost comparisons based on Medicare cost reports and SEC filings, and other similar sources.

Efficacy of a hospital-wide environmental cleaning protocol on hospital-acquired methicillin-resistant Staphylococcus aureus rates.

PubMed

Watson, Paul Andrew; Watson, Luke Robert; Torress-Cook, Alfonso

2016-07-01

Environmental contamination has been associated with over half of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in hospitals. We explored if a hospital-wide environmental and patient cleaning protocol would lower hospital acquired MRSA rates and associated costs. This study evaluates the impact of implementing a hospital-wide environmental and patient cleaning protocol on the rate of MRSA infection and the potential cost benefit of the intervention. A retrospective, pre-post interventional study design was used. The intervention comprised a combination of enhanced environmental cleaning of high touch surfaces, daily washing of patients with benzalkonium chloride, and targeted isolation of patients with active infection. The rate of MRSA infection per 1000 patient days (PD) was compared with the rate after the intervention (Steiros Algorithm ® ) was implemented. A cost-benefit analysis based on the number of MRSA infections avoided was conducted. The MRSA rates decreased by 96% from 3.04 per 1000 PD to 0.11 per 1000 PD ( P <0.0001). This reduction in MRSA infections, avoided an estimated $1,655,143 in healthcare costs. Implementation of this hospital-wide protocol appears to be associated with a reduction in the rate of MRSA infection and therefore a reduction in associated healthcare costs.

Advanced musculoskeletal physiotherapists in post arthroplasty review clinics: a state wide implementation program evaluation.

PubMed

Harding, Paula; Burge, Angela; Walter, Kerrie; Shaw, Bridget; Page, Carolyn; Phan, Uyen; Terrill, Desiree; Liew, Susan

2018-03-01

To evaluate outcomes following a state-wide implementation of post arthroplasty review (PAR) clinics for patients following total hip and knee arthroplasty, led by advanced musculoskeletal physiotherapists in collaboration with orthopaedic specialists. A prospective observational study analysed data collected by 10 implementation sites (five metropolitan and five regional/rural centres) between September 2014 and June 2015. The Victorian Innovation and Reform Impact Assessment Framework was used to assess efficiency, effectiveness (access to care, safety and quality, workforce capacity, utilisation of skill sets, patient and workforce satisfaction) and sustainability (stakeholder engagement, succession planning and availability of ongoing funding). 2362 planned occasions of service (OOS) were provided for 2057 patients. Reduced patient wait times from referral to appointment were recorded and no adverse events occurred. Average cost savings across 10 sites was AUD$38 per OOS (Baseline $63, PAR clinic $35), representing a reduced pathway cost of 44%. Average annual predicted total value of increased orthopaedic specialist capacity was $11,950 per PAR clinic (range $6149 to $23,400). The Australian Orthopaedic Association review guidelines were met (8/10 sites, 80%) and patient-reported outcome measures were introduced as routine clinical care. High workforce and patient satisfaction were expressed. Eighteen physiotherapists were trained creating a sustainable workforce. Eight sites secured ongoing funding. The PAR clinics delivered a safe, cost-efficient model of care that improved patient access and quality of care compared to traditional specialist-led workforce models. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Estimating the opportunity costs of bed-days.

PubMed

Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark

2018-03-01

Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.

Computers in manufacturing

NASA Astrophysics Data System (ADS)

Hudson, C. A.

1982-02-01

CAD/CAM advances and applications for enhancing productivity in industry are explored. Wide-spread use of CAD/CAM devices are projected to occur by the time period 1992-1997, resulting in a higher percentage of technicians in the manufacturing process, while the cost of computers and software will continue to fall and become more widely available. Computer aided design is becoming a commercially viable system for design and geometric modeling, engineering analysis, kinematics, and drafting, and efforts to bridge the gap between CAD and CAM are indicated, with particular attention given to layering, wherein individual monitoring of different parts of the manufacturing process can be effected without crossover of unnecessary information. The potentials and barriers to the use of robotics are described, with the added optimism that displaced workers to date have moved up to jobs of higher skill and interest.

The economic value of Quebec's water fluoridation program.

PubMed

Tchouaket, Eric; Brousselle, Astrid; Fansi, Alvine; Dionne, Pierre Alexandre; Bertrand, Elise; Fortin, Christian

2013-01-01

Dental caries is a major public health problem worldwide, with very significant deleterious consequences for many people. The available data are alarming in Canada and the province of Quebec. The water fluoridation program has been shown to be the most effective means of preventing caries and reducing oral health inequalities. This article analyzes the cost-effectiveness of Quebec's water fluoridation program to provide decision-makers with economic information for assessing its usefulness. An approach adapted from economic evaluation was used to: (1) build a logic model for Quebec's water fluoridation program; (2) determine its implementation cost; and (3) analyze its cost-effectiveness. Documentary analysis was used to build the logic model. Program cost was calculated using data from 13 municipalities that adopted fluoridation between 2002 and 2010 and two that received only infrastructure grants. Other sources were used to collect demographic data and calculate costs for caries treatment including costs associated with travel and lost productivity. The analyses showed the water fluoridation program was cost-effective even with a conservatively estimated 1 % reduction in dental caries. The benefit-cost ratio indicated that, at an expected average effectiveness of 30 % caries reduction, one dollar invested in the program saved $71.05-$82.83 per Quebec's inhabitant in dental costs (in 2010) or more than $560 million for the State and taxpayers. The results showed that the drinking-water fluoridation program produced substantial savings. Public health decision-makers could develop economic arguments to support wide deployment of this population-based intervention whose efficacy and safety have been demonstrated and acknowledged.

Envisioning a Low-Cost Solar Future: Exploring the Potential Impact of Achieving the SunShot 2030 Targets for Photovoltaics

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

Cole, Wesley J; Frew, Bethany A; Gagnon, Pieter J

In the context of recent dramatic solar energy cost reductions, the U.S. Department of Energy set new levelized cost of energy goals for photovoltaics (PV) to achieve by 2030 to enable significantly greater PV adoption: $0.03/kWh for utility-scale, $0.04/kWh for commercial, and $0.05/kWh for residential PV systems. We analyze the potential impacts of achieving these 'SunShot 2030' cost targets for the contiguous United States using the Regional Energy Deployment System (ReEDS) and Distributed Generation (dGen) capacity expansion models. We consider the impacts under a wide range of future conditions. We find that PV could provide 13%-18% of U.S. electricity demandmore » in 2030 and 28%-64% of demand if the SunShot 2030 goals are achieved, with PV deployment increasing in every state. The availability of low-cost storage has the largest impact on projected deployment, followed by natural gas prices and electricity demand. For comparison, PV deployed under a business-as-usual scenario could provide only 5% of generation in 2030 and 17% in 2050. We find that the high levels of PV deployment explored here lead to lower electricity prices and system costs, lower carbon dioxide emissions, lower water consumption, increased renewable energy curtailment, and increased storage deployment compared with the business-as-usual scenario.« less

Small, Low Cost, Launch Capability Development

NASA Technical Reports Server (NTRS)

Brown, Thomas

2014-01-01

A recent explosion in nano-sat, small-sat, and university class payloads has been driven by low cost electronics and sensors, wide component availability, as well as low cost, miniature computational capability and open source code. Increasing numbers of these very small spacecraft are being launched as secondary payloads, dramatically decreasing costs, and allowing greater access to operations and experimentation using actual space flight systems. While manifesting as a secondary payload provides inexpensive rides to orbit, these arrangements also have certain limitations. Small, secondary payloads are typically included with very limited payload accommodations, supported on a non interference basis (to the prime payload), and are delivered to orbital conditions driven by the primary launch customer. Integration of propulsion systems or other hazardous capabilities will further complicate secondary launch arrangements, and accommodation requirements. The National Aeronautics and Space Administration's Marshall Space Flight Center has begun work on the development of small, low cost launch system concepts that could provide dedicated, affordable launch alternatives to small, high risk university type payloads and spacecraft. These efforts include development of small propulsion systems and highly optimized structural efficiency, utilizing modern advanced manufacturing techniques. This paper outlines the plans and accomplishments of these efforts and investigates opportunities for truly revolutionary reductions in launch and operations costs. Both evolution of existing sounding rocket systems to orbital delivery, and the development of clean sheet, optimized small launch systems are addressed.

Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use

PubMed Central

Cicchetti, Americo; Berrino, Alexandra; Casini, Marina; Codella, Paola; Facco, Giuseppina; Fiore, Alessandra; Marano, Giuseppe; Marchetti, Marco; Midolo, Emanuela; Minacori, Roberta; Refolo, Pietro; Romano, Federica; Ruggeri, Matteo; Sacchini, Dario; Spagnolo, Antonio G.; Urbina, Irene; Vaglio, Stefania; Grazzini, Giuliano; Liumbruno, Giancarlo M.

2016-01-01

Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains. Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed. PMID:27403740

A Cost-Minimization Analysis of Tissue-Engineered Constructs for Corneal Endothelial Transplantation

PubMed Central

Tan, Tien-En; Peh, Gary S. L.; George, Benjamin L.; Cajucom-Uy, Howard Y.; Dong, Di; Finkelstein, Eric A.; Mehta, Jodhbir S.

2014-01-01

Corneal endothelial transplantation or endothelial keratoplasty has become the preferred choice of transplantation for patients with corneal blindness due to endothelial dysfunction. Currently, there is a worldwide shortage of transplantable tissue, and demand is expected to increase further with aging populations. Tissue-engineered alternatives are being developed, and are likely to be available soon. However, the cost of these constructs may impair their widespread use. A cost-minimization analysis comparing tissue-engineered constructs to donor tissue procured from eye banks for endothelial keratoplasty was performed. Both initial investment costs and recurring costs were considered in the analysis to arrive at a final tissue cost per transplant. The clinical outcomes of endothelial keratoplasty with tissue-engineered constructs and with donor tissue procured from eye banks were assumed to be equivalent. One-way and probabilistic sensitivity analyses were performed to simulate various possible scenarios, and to determine the robustness of the results. A tissue engineering strategy was cheaper in both investment cost and recurring cost. Tissue-engineered constructs for endothelial keratoplasty could be produced at a cost of US$880 per transplant. In contrast, utilizing donor tissue procured from eye banks for endothelial keratoplasty required US$3,710 per transplant. Sensitivity analyses performed further support the results of this cost-minimization analysis across a wide range of possible scenarios. The use of tissue-engineered constructs for endothelial keratoplasty could potentially increase the supply of transplantable tissue and bring the costs of corneal endothelial transplantation down, making this intervention accessible to a larger group of patients. Tissue-engineering strategies for corneal epithelial constructs or other tissue types, such as pancreatic islet cells, should also be subject to similar pharmacoeconomic analyses. PMID:24949869

The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence

PubMed Central

Wesson, Hadley K H; Boikhutso, Nonkululeko; Bachani, Abdulgafoor M; Hofman, Karen J; Hyder, Adnan A

2014-01-01

Introduction Injuries are a significant cause of mortality and morbidity, of which more than 90% occur in low- and middle-income countries (LMICs). Given the extent of this burden being confronted by LMICs, there is need to place injury prevention at the forefront of public health initiatives and to understand the costs associated with injury. The aim of this article is to describe the extent to which injury-related costing studies have been conducted in LMICs. Methods A review of literature was performed to explore costing data available for injury and/or trauma care in LMICs. Study quality was described using recommendations from the Community Guide’s quality assessment tool for economic evaluations. Results The review identified 68 studies, of which 13 were full economic evaluations. Cost of injury varied widely with mean costs ranging from US$14 to US$17 400. In terms of injury-prevention interventions, cost per disability adjusted life year averted for injury-prevention interventions ranged from US$10.90 for speed bump installation to US$17 000 for drunk driving and breath testing campaigns in Africa. The studies varied in quality, ranging from very good to unsatisfactory. Discussion There is a lack of injury-related economic evidence from LMICs. Current costing research has considerable variability in the costs and cost descriptions of injury and associated prevention interventions. The generalizability of these studies is limited. Yet the economic burden of injury is high, suggesting significant potential for cost savings through injury prevention. A standardized approach to economic evaluation of injury in LMICs is needed to further prioritize investing in injury prevention. PMID:24097794

Obstructed Labor and Caesarean Delivery: The Cost and Benefit of Surgical Intervention

PubMed Central

Burns, Christy Turlington; Metzler, Ian S.; Farmer, Paul E.; Meara, John G.

2012-01-01

Background Although advances in the reduction of maternal mortality have been made, up to 273,000 women will die this year from obstetric etiologies. Obstructed labor (OL), most commonly treated with Caesarean delivery, has been identified as a major contributor to global maternal morbidity and mortality. We used economic and epidemiological modeling to estimate the cost per disability-adjusted life-year (DALY) averted and benefit-cost ratio of treating OL with Caesarean delivery for 49 countries identified as providing an insufficient number of Caesarean deliveries to meet demand. Methods and Findings Using publicly available data and explicit economic assumptions, we estimated that the cost per DALY (3,0,0) averted for providing Caesarean delivery for OL ranged widely, from $251 per DALY averted in Madagascar to $3,462 in Oman. The median cost per DALY averted was $304. Benefit-cost ratios also varied, from 0.6 in Zimbabwe to 69.9 in Gabon. The median benefit-cost ratio calculated was 6.0. The main limitation of this study is an assumption that lack of surgical capacity is the main factor responsible for DALYs from OL. Conclusions Using the World Health Organization's cost-effectiveness standards, investing in Caesarean delivery can be considered “highly cost-effective” for 48 of the 49 countries included in this study. Furthermore, in 46 of the 49 included countries, the benefit-cost ratio was greater than 1.0, implying that investment in Caesarean delivery is a viable economic proposition. While Caesarean delivery alone is not sufficient for combating OL, it is necessary, cost-effective by WHO standards, and ultimately economically favorable in the vast majority of countries included in this study. PMID:22558089

A cost-minimization analysis of tissue-engineered constructs for corneal endothelial transplantation.

PubMed

Tan, Tien-En; Peh, Gary S L; George, Benjamin L; Cajucom-Uy, Howard Y; Dong, Di; Finkelstein, Eric A; Mehta, Jodhbir S

2014-01-01

Corneal endothelial transplantation or endothelial keratoplasty has become the preferred choice of transplantation for patients with corneal blindness due to endothelial dysfunction. Currently, there is a worldwide shortage of transplantable tissue, and demand is expected to increase further with aging populations. Tissue-engineered alternatives are being developed, and are likely to be available soon. However, the cost of these constructs may impair their widespread use. A cost-minimization analysis comparing tissue-engineered constructs to donor tissue procured from eye banks for endothelial keratoplasty was performed. Both initial investment costs and recurring costs were considered in the analysis to arrive at a final tissue cost per transplant. The clinical outcomes of endothelial keratoplasty with tissue-engineered constructs and with donor tissue procured from eye banks were assumed to be equivalent. One-way and probabilistic sensitivity analyses were performed to simulate various possible scenarios, and to determine the robustness of the results. A tissue engineering strategy was cheaper in both investment cost and recurring cost. Tissue-engineered constructs for endothelial keratoplasty could be produced at a cost of US$880 per transplant. In contrast, utilizing donor tissue procured from eye banks for endothelial keratoplasty required US$3,710 per transplant. Sensitivity analyses performed further support the results of this cost-minimization analysis across a wide range of possible scenarios. The use of tissue-engineered constructs for endothelial keratoplasty could potentially increase the supply of transplantable tissue and bring the costs of corneal endothelial transplantation down, making this intervention accessible to a larger group of patients. Tissue-engineering strategies for corneal epithelial constructs or other tissue types, such as pancreatic islet cells, should also be subject to similar pharmacoeconomic analyses.

Economic evaluation of mobile phone text message interventions to improve adherence to HIV therapy in Kenya.

PubMed

Patel, Anik R; Kessler, Jason; Braithwaite, R Scott; Nucifora, Kimberly A; Thirumurthy, Harsha; Zhou, Qinlian; Lester, Richard T; Marra, Carlo A

2017-02-01

A surge in mobile phone availability has fueled low cost short messaging service (SMS) adherence interventions. Multiple systematic reviews have concluded that some SMS-based interventions are effective at improving antiretroviral therapy (ART) adherence, and they are hypothesized to improve retention in care. The objective of this study was to evaluate the cost-effectiveness of SMS-based adherence interventions and explore the added value of retention benefits. We evaluated the cost-effectiveness of weekly SMS interventions compared to standard care among HIV+ individuals initiating ART for the first time in Kenya. We used an individual level micro-simulation model populated with data from two SMS-intervention trials, an East-African HIV+ cohort and published literature. We estimated average quality adjusted life years (QALY) and lifetime HIV-related costs from a healthcare perspective. We explored a wide range of scenarios and assumptions in one-way and multivariate sensitivity analyses. We found that SMS-based adherence interventions were cost-effective by WHO standards, with an incremental cost-effectiveness ratio (ICER) of $1,037/QALY. In the secondary analysis, potential retention benefits improved the cost-effectiveness of SMS intervention (ICER = $864/QALY). In multivariate sensitivity analyses, the interventions remained cost-effective in most analyses, but the ICER was highly sensitive to intervention costs, effectiveness and average cohort CD4 count at ART initiation. SMS interventions remained cost-effective in a test and treat scenario where individuals were assumed to initiate ART upon HIV detection. Effective SMS interventions would likely increase the efficiency of ART programs by improving HIV treatment outcomes at relatively low costs, and they could facilitate achievement of the UNAIDS goal of 90% viral suppression among those on ART by 2020.

Low-cost feedback-controlled syringe pressure pumps for microfluidics applications.

PubMed

Lake, John R; Heyde, Keith C; Ruder, Warren C

2017-01-01

Microfluidics are widely used in research ranging from bioengineering and biomedical disciplines to chemistry and nanotechnology. As such, there are a large number of options for the devices used to drive and control flow through microfluidic channels. Commercially available syringe pumps are probably the most commonly used instruments for this purpose, but are relatively high-cost and have inherent limitations due to their flow profiles when they are run open-loop. Here, we present a low-cost ($110) syringe pressure pump that uses feedback control to regulate the pressure into microfluidic chips. Using an open-source microcontroller board (Arduino), we demonstrate an easily operated and programmable syringe pump that can be run using either a PID or bang-bang control method. Through feedback control of the pressure at the inlets of two microfluidic geometries, we have shown stability of our device to within ±1% of the set point using a PID control method and within ±5% of the set point using a bang-bang control method with response times of less than 1 second. This device offers a low-cost option to drive and control well-regulated pressure-driven flow through microfluidic chips.

Accuracy and cost-effectiveness of dynamic contrast-enhanced CT in the characterisation of solitary pulmonary nodules—the SPUtNIk study

PubMed Central

Qureshi, N R; Rintoul, R C; Miles, K A; George, S; Harris, S; Madden, J; Cozens, K; Little, L A; Eichhorst, K; Jones, J; Moate, P; McClement, C; Pike, L; Sinclair, D; Wong, W L; Shekhdar, J; Eaton, R; Shah, A; Brindle, L; Peebles, C; Banerjee, A; Dizdarevic, S; Han, S; Poon, F W; Groves, A M; Kurban, L; Frew, A J; Callister, M E; Crosbie, P; Gleeson, F V; Karunasaagarar, K; Kankam, O; Gilbert, F J

2016-01-01

Introduction Solitary pulmonary nodules (SPNs) are common on CT. The most cost-effective investigation algorithm is still to be determined. Dynamic contrast-enhanced CT (DCE-CT) is an established diagnostic test not widely available in the UK currently. Methods and analysis The SPUtNIk study will assess the diagnostic accuracy, clinical utility and cost-effectiveness of DCE-CT, alongside the current CT and 18-flurodeoxyglucose-positron emission tomography) (18FDG-PET)-CT nodule characterisation strategies in the National Health Service (NHS). Image acquisition and data analysis for 18FDG-PET-CT and DCE-CT will follow a standardised protocol with central review of 10% to ensure quality assurance. Decision analytic modelling will assess the likely costs and health outcomes resulting from incorporation of DCE-CT into management strategies for patients with SPNs. Ethics and dissemination Approval has been granted by the South West Research Ethics Committee. Ethics reference number 12/SW/0206. The results of the trial will be presented at national and international meetings and published in an Health Technology Assessment (HTA) Monograph and in peer-reviewed journals. Trial registration number ISRCTN30784948; Pre-results. PMID:27843550

Syringe Port: A Convenient, Safe, and Cost-Effective Tubular Retractor for Transportal Removal of Deep-Seated Lesions of the Brain.

PubMed

Singh, Harnarayan; Patir, Rana; Vaishya, Sandeep; Miglani, Rahul; Kaur, Amandeep

2018-06-01

Minimally invasive transportal resection of deep intracranial lesions has become a widely accepted surgical technique. Many disposable, mountable port systems are available in the market for this purpose, like the ViewSite Brain Access System. The objective of this study was to find a cost-effective substitute for these systems. Deep-seated brain lesions were treated with a port system made from disposable syringes. The syringe port could be inserted through minicraniotomies placed and planned with navigation. All deep-seated lesions like ventricular tumours, colloid cysts, deep-seated gliomas, and basal ganglia hemorrhages were treated with this syringe port system and evaluated for safety, operative site hematomas, and blood loss. 62 patients were operated on during the study period from January 2015 to July 2017, using this innovative syringe port system for deep-seated lesions of the brain. No operative site hematoma or contusions were seen along the port entry site and tract. Syringe port is a cost-effective and safe alternative to the costly disposable brain port systems, especially for neurosurgical setups in developing countries for minimally invasive transportal resection of deep brain lesions. Copyright © 2018 Elsevier Inc. All rights reserved.

Low-cost feedback-controlled syringe pressure pumps for microfluidics applications

PubMed Central

Lake, John R.; Heyde, Keith C.

2017-01-01

Microfluidics are widely used in research ranging from bioengineering and biomedical disciplines to chemistry and nanotechnology. As such, there are a large number of options for the devices used to drive and control flow through microfluidic channels. Commercially available syringe pumps are probably the most commonly used instruments for this purpose, but are relatively high-cost and have inherent limitations due to their flow profiles when they are run open-loop. Here, we present a low-cost ($110) syringe pressure pump that uses feedback control to regulate the pressure into microfluidic chips. Using an open-source microcontroller board (Arduino), we demonstrate an easily operated and programmable syringe pump that can be run using either a PID or bang-bang control method. Through feedback control of the pressure at the inlets of two microfluidic geometries, we have shown stability of our device to within ±1% of the set point using a PID control method and within ±5% of the set point using a bang-bang control method with response times of less than 1 second. This device offers a low-cost option to drive and control well-regulated pressure-driven flow through microfluidic chips. PMID:28369134

Educational Cost-Benefit Analysis. Education Research Paper. Knowledge & Research.

ERIC Educational Resources Information Center

Hough, J. R.

The use of educational cost-benefit analysis (CBA) is now widely accepted, not least in connection with the development of education systems in Third World countries. It has much to recommend it and is widely seen as preferable, both in theory and in practice, to the major alternative techniques, namely manpower planning and the social-demand…

Cost-benefit analysis of an area-wide pest management program to control Asian tiger mosquito in New Jersey

USDA-ARS?s Scientific Manuscript database

Area-wide pest management (AWPM) is recommended to control urban mosquitoes, such as Aedes albopictus (Asian tiger mosquito), which limit outdoor activities. We conducted a cost-benefit analysis for an AWPM in Mercer and Monmouth counties, New Jersey, as part of a controlled design with matched area...

ISO 50001 and SEP Faster and Cheaper - Exploring the Enterprise-Wide Approach

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

Liu, Jingjing; Rao, Prakash; Therkelsen, Peter

ISO 50001 and other management systems (e.g., ISO 9001 and ISO 14001) allow for implementation and certification at the enterprise level. The "Central Office" concept, which allows a small group of employees to manage and facilitate the organization’s energy management system (EnMS) at the enterprise level, was introduced within the ISO 50003 standard to provide guidance to ISO 50001 certification bodies. Four industrial companies have partnered with the United States Department of Energy to pilot the enterprise-wide ISO 50001/SEP concept under the Better Buildings Superior Energy Performance (SEP) Enterprise-wide Accelerator. Each organization developed a Central Office to host their EnMSmore » while implementing ISO 50001/SEP at multiple physically separated sites. The four corporate partners tailored their Central Office implementation model to meet their own specific circumstances and needs. This paper reviews the commonalities, differences, and benefits of each of these enterprise-wide implementation models, including organizational structures, Central Office staff responsibilities, and key strategies. The cost savings and benefits of using the enterprise-wide approach were assessed, including the cost per site compared with that of a conventional, single-site ISO 50001/SEP implementation approach. This paper also discusses the drivers for the cost reductions realized through these enterprise-wide approaches. The four partner companies worked with 30 total sites. On average, these 30 sites improved energy performance by 5% annually over their SEP achievement periods, saved more than $600,000 annually in energy costs and reduced implementation cost for ISO 50001 and SEP by $19,000 and 0.8 Full Time Equivalent × years (FTE-yr) of staff time per site. The results can inform other organizations seeking to implement enterprise-wide ISO 50001/SEP, as well as energy efficiency organizations seeking to promote wider adoption of ISO 50001 implementation.« less

Impact of Real-world Factors Influencing Investment Decisions on the Costs and Distribution of Climate Change Mitigation

NASA Astrophysics Data System (ADS)

Edmonds, J.; Iyer, G.; McJeon, H. C.; Leon, C.; Hultman, N.

2015-12-01

Strategies to mitigate dangerous anthropogenic climate change require a dramatic transformation of the energy system to reduce greenhouse gas emissions, that in turn requires large-scale investments. Investment decisions depend not only on investment capital availability but also on investment risks. A number of factors such as national policy environments, quality of public and private institutions, sector, firm and technology specific characteristics can affect investors' assessments of risks, leading to a wide variation in the business climate for investment. Such heterogeneity in investment risks can have important implications, as investors usually respond to risks by requiring higher returns for riskier projects; delaying or forgoing the investments; or preferring to invest in existing, familiar projects. We study the impact of variation in investment risks on regional patterns of emissions mitigation, the cost of emissions mitigation and patterns of technology deployment. We modify an integrated assessment model, widely used in global climate policy analyses (the Global Change Assessment Model) and incorporate decisions on investments based on risks along two dimensions. Along the first dimension, we vary perceived risks associated with particular technologies. To do so, we assign a higher cost of capital for investment in low-carbon technologies as these involve intrinsically higher levels of regulatory and market risk. The second dimension uses a proxy to vary investment risks across regions, based on an institutional quality metric published by the World Economic Forum. Explicit representation of investment risks has two major effects. First, it raises the cost of emissions mitigation relative to a world with uniform investment risks. Second, it shifts the pattern of emissions mitigation, with industrialized countries mitigating more, and developing countries mitigating less. Our results suggest that institutional reforms aimed at lowering investment risks could be an important element in lowering the cost of climate change mitigation solutions.

IonGAP: integrative bacterial genome analysis for Ion Torrent sequence data.

PubMed

Baez-Ortega, Adrian; Lorenzo-Diaz, Fabian; Hernandez, Mariano; Gonzalez-Vila, Carlos Ignacio; Roda-Garcia, Jose Luis; Colebrook, Marcos; Flores, Carlos

2015-09-01

We introduce IonGAP, a publicly available Web platform designed for the analysis of whole bacterial genomes using Ion Torrent sequence data. Besides assembly, it integrates a variety of comparative genomics, annotation and bacterial classification routines, based on the widely used FASTQ, BAM and SRA file formats. Benchmarking with different datasets evidenced that IonGAP is a fast, powerful and simple-to-use bioinformatics tool. By releasing this platform, we aim to translate low-cost bacterial genome analysis for microbiological prevention and control in healthcare, agroalimentary and pharmaceutical industry applications. IonGAP is hosted by the ITER's Teide-HPC supercomputer and is freely available on the Web for non-commercial use at http://iongap.hpc.iter.es. mcolesan@ull.edu.es or cflores@ull.edu.es Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

BioPartsDB: a synthetic biology workflow web-application for education and research.

PubMed

Stracquadanio, Giovanni; Yang, Kun; Boeke, Jef D; Bader, Joel S

2016-11-15

Synthetic biology has become a widely used technology, and expanding applications in research, education and industry require progress tracking for team-based DNA synthesis projects. Although some vendors are beginning to supply multi-kilobase sequence-verified constructs, synthesis workflows starting with short oligos remain important for cost savings and pedagogical benefit. We developed BioPartsDB as an open source, extendable workflow management system for synthetic biology projects with entry points for oligos and larger DNA constructs and ending with sequence-verified clones. BioPartsDB is released under the MIT license and available for download at https://github.com/baderzone/biopartsdb Additional documentation and video tutorials are available at https://github.com/baderzone/biopartsdb/wiki An Amazon Web Services image is available from the AWS Market Place (ami-a01d07c8). joel.bader@jhu.edu. © The Author 2016. Published by Oxford University Press.

DNA vaccines in veterinary use

PubMed Central

Redding, Laurel; Werner, David B

2015-01-01

DNA vaccines represent a new frontier in vaccine technology. One important application of this technology is in the veterinary arena. DNA vaccines have already gained a foothold in certain fields of veterinary medicine. However, several important questions must be addressed when developing DNA vaccines for animals, including whether or not the vaccine is efficacious and cost effective compared with currently available options. Another important question to consider is how to apply this developing technology in a wide range of different situations, from the domestic pet to individual fish in fisheries with several thousand animals, to wildlife programs for disease control. In some cases, DNA vaccines represent an interesting option for vaccination, while in others, currently available options are sufficient. This review will examine a number of diseases of veterinary importance and the progress being made in DNA vaccine technology relevant to these diseases, and we compare these with the conventional treatment options available. PMID:19722897

Managing healthcare information using short message service (SMS) in wireless broadband networks

NASA Astrophysics Data System (ADS)

Documet, Jorge; Tsao, Sinchai; Documet, Luis; Liu, Brent J.; Zhou, Zheng; Joseph, Anika O.

2007-03-01

Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and Communications System) data. SMS is a flexible and mobile method for real-time access and control of Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or any other localized signal. It provides a simple, reliable yet flexible method to communicate with an information system. In addition, SMS services are widely available for low costs from cellular phone service providers and allows for more mobility than other services such as wireless internet. This paper aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.

Measuring Snow Liquid Water Content with Low-Cost GPS Receivers

PubMed Central

Koch, Franziska; Prasch, Monika; Schmid, Lino; Schweizer, Jürg; Mauser, Wolfram

2014-01-01

The amount of liquid water in snow characterizes the wetness of a snowpack. Its temporal evolution plays an important role for wet-snow avalanche prediction, as well as the onset of meltwater release and water availability estimations within a river basin. However, it is still a challenge and a not yet satisfyingly solved issue to measure the liquid water content (LWC) in snow with conventional in situ and remote sensing techniques. We propose a new approach based on the attenuation of microwave radiation in the L-band emitted by the satellites of the Global Positioning System (GPS). For this purpose, we performed a continuous low-cost GPS measurement experiment at the Weissfluhjoch test site in Switzerland, during the snow melt period in 2013. As a measure of signal strength, we analyzed the carrier-to-noise power density ratio (C/N0) and developed a procedure to normalize these data. The bulk volumetric LWC was determined based on assumptions for attenuation, reflection and refraction of radiation in wet snow. The onset of melt, as well as daily melt-freeze cycles were clearly detected. The temporal evolution of the LWC was closely related to the meteorological and snow-hydrological data. Due to its non-destructive setup, its cost-efficiency and global availability, this approach has the potential to be implemented in distributed sensor networks for avalanche prediction or basin-wide melt onset measurements. PMID:25384007

Measuring snow liquid water content with low-cost GPS receivers.

PubMed

Koch, Franziska; Prasch, Monika; Schmid, Lino; Schweizer, Jürg; Mauser, Wolfram

2014-11-06

The amount of liquid water in snow characterizes the wetness of a snowpack. Its temporal evolution plays an important role for wet-snow avalanche prediction, as well as the onset of meltwater release and water availability estimations within a river basin. However, it is still a challenge and a not yet satisfyingly solved issue to measure the liquid water content (LWC) in snow with conventional in situ and remote sensing techniques. We propose a new approach based on the attenuation of microwave radiation in the L-band emitted by the satellites of the Global Positioning System (GPS). For this purpose, we performed a continuous low-cost GPS measurement experiment at the Weissfluhjoch test site in Switzerland, during the snow melt period in 2013. As a measure of signal strength, we analyzed the carrier-to-noise power density ratio (C/N0) and developed a procedure to normalize these data. The bulk volumetric LWC was determined based on assumptions for attenuation, reflection and refraction of radiation in wet snow. The onset of melt, as well as daily melt-freeze cycles were clearly detected. The temporal evolution of the LWC was closely related to the meteorological and snow-hydrological data. Due to its non-destructive setup, its cost-efficiency and global availability, this approach has the potential to be implemented in distributed sensor networks for avalanche prediction or basin-wide melt onset measurements.

Low cost rubber seismic isolators for masonry housing in developing countries

NASA Astrophysics Data System (ADS)

Habieb, A. B.; Milani, G.; Tavio, Milani, F.

2017-11-01

Rubber isolators are used widely in constructions which require a vibration or seismic isolation. It consists of rubber layers and reinforcements that can be steel or fiber lamina. The fiber reinforced isolator results in a lower cost of production and application than that of steel. Using fiber reinforced isolator allows us to make an unbonded model of rubber bearing. This model leads to a smaller horizontal stiffness and larger displacement of isolators. Researchers consider the Unbonded Fiber Reinforced Elastomeric Isolator (U-FREI) as a low-cost form of rubber bearings. U-FREIs are suitable to isolate seismically a masonry building, which is a common type of housing in developing countries. In this work, we present a finite element model (FEM) to predict the behavior of the U-FREIs undergoing moderate deformations. We adopt a Yeoh hyperelasticity model which is available in the standard package of Abaqus FE software and estimate its coefficients through the available experimental data. Then, we apply that isolation system onto masonry housing with some simplified methods. We also observe the horizontal behaviors of U-FREIs under different vertical loads and consider a critical condition when the isolators start to be unstable. In parallel, we perform an analytical model to predict the shear behavior and the deformation limit of isolators. Finally, the results show that the analytical model is sufficiently accurate compared to the FE analyses.

Availability of buprenorphine on the Internet for purchase without a prescription

PubMed Central

Bachhuber, Marcus A.; Cunningham, Chinazo O.

2012-01-01

Background Use of illicit buprenorphine is increasingly recognized, but it is unknown if the Internet currently represents an accessible source. Methods A series of Internet searches were conducted. Twenty searches were performed on two different search engines. The first 100 results of each search were classified into categories based on content. All Internet pharmacies were searched for buprenorphine preparations and if available, sites were examined to determine if a prescription was required for purchase, for the cost of buprenorphine, the geographical origin of the pharmacy, and evidence of validation by an online pharmacy verification service. Results Of the 2,000 links examined, 1422 were unique. Six percent of links were to illicit commercial sites, 2% were to legitimate commercial sites, and 2% were to illicit portal sites, which contained links to many illicit commercial sites. Twenty pharmacies offering buprenorphine for purchase without a prescription were identified. The monthly cost of a typical starting dose of 2 mg buprenorphine daily ranged between $232 and $1,163 USD. No pharmacies were listed by online pharmacy verification services. Conclusion Twenty online pharmacies advertising buprenorphine formulations for sale without a prescription were identified. Prices varied widely between illicit pharmacies but were uniformly more expensive than legitimate pharmacies. Illicitly obtained buprenorphine formulations appear to be relatively inaccessible and at high cost on the Internet. PMID:23201172

Shelf Life of PMR Polyimide Monomer Solutions and Prepregs Extended

NASA Technical Reports Server (NTRS)

Alston, William B.; Scheiman, Daniel A.

2000-01-01

PMR (Polymerization of Monomeric Reactants) technology was developed in the mid-1970's at the NASA Glenn Research Center at Lewis Field for fabricating high-temperature stable polyimide composites. This technology allowed a solution of polyimide monomers or prepreg (a fiber, such as glass or graphite, impregnated with PMR polyimide monomers) to be thermally cured without the release of volatiles that cause the formation of voids unlike the non-PMR technology used for polyimide condensation type resins. The initial PMR resin introduced as PMR 15 is still commercially available and is used worldwide by aerospace industries as the state-of-the-art resin for high-temperature polyimide composite applications. PMR 15 offers easy composite processing, excellent composite mechanical property retention, a long lifetime at use temperatures of 500 to 550 F, and relatively low cost. Later, second-generation PMR resin versions, such as PMR II 50 and VCAP 75, offer improvements in the upper-use temperature (to 700 F) and in the useful life at temperature without major compromises in processing and property retention but with significant increases in resin cost. Newer versions of nontoxic (non-methylene dianiline) PMR resins, such as BAX PMR 15, offer similar advantages as originally found for PMR 15 but also with significant increases in resin cost. Thus, the current scope of the entire PMR technology available meets a wide range of aeronautical requirements for polymer composite applications.

Cost-effectiveness and budget impact analyses of a long-term hypertension detection and control program for stroke prevention.

PubMed

Yamagishi, Kazumasa; Sato, Shinichi; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Tanigawa, Takeshi; Ohira, Tetsuya; Imano, Hironori; Kondo, Masahide; Okubo, Ichiro; Ishikawa, Yoshinori; Shimamoto, Takashi; Iso, Hiroyasu

2012-09-01

The nation-wide, community-based intensive hypertension detection and control program, as well as universal health insurance coverage, may well be contributing factors for helping Japan rank near the top among countries with the longest life expectancy. We sought to examine the cost-effectiveness of such a community-based intervention program, as no evidence has been available for this issue. The hypertension detection and control program was initiated in 1963 in full intervention and minimal intervention communities in Akita, Japan. We performed comparative cost-effectiveness and budget-impact analyses for the period 1964-1987 of the costs of public health services and treatment of patients with hypertension and stroke on the one hand, and incidence of stroke on the other in the full intervention and minimal intervention communities. The program provided in the full intervention community was found to be cost saving 13 years after the beginning of program in addition to the fact of effectiveness that; the prevalence and incidence of stroke were consistently lower in the full intervention community than in the minimal intervention community throughout the same period. The incremental cost was minus 28,358 yen per capita over 24 years. The community-based intensive hypertension detection and control program was found to be both effective and cost saving. The national government's policy to support this program may have contributed in part to the substantial decline in stroke incidence and mortality, which was largely responsible for the increase in Japanese life expectancy.

The health economics of bladder cancer: an updated review of the published literature.

PubMed

Yeung, Christina; Dinh, Tuan; Lee, Joseph

2014-11-01

The purpose of this paper is to provide a current view of the economic burden of bladder cancer, with a focus on the cost effectiveness of available interventions. This review updates a previous systematic review and includes 72 new papers published between 2000 and 2013. Bladder cancer continues to be one of the most common and expensive malignancies. The annual cost of bladder cancer in the USA during 2010 was $US4 billion and is expected to rise to $US5 billion by 2020. Ten years ago, urinary markers held the potential to lower treatment costs of bladder cancer. However, subsequent real-world experiments have demonstrated that further work is necessary to identify situations in which these technologies can be applied in a cost-effective manner. Adjunct cytology remains a part of diagnostic standard of care, but recent research suggests that it is not cost effective due to its low diagnostic yield. Analysis of intravesical chemotherapy after transurethral resection of bladder tumor (TURBT), neo-adjuvant therapy for cystectomy, and robot-assisted laparoscopic cystectomy suggests that these technologies are cost effective and should be implemented more widely for appropriate patients. The existing literature on the cost effectiveness of bladder cancer treatments has improved substantially since 2000. The body of work now includes many new models, registry analyses, and real-world studies. However, there is still a need for new implementation guidelines, new risk modeling tools, and a better understanding of the empirical burden of bladder cancer.

Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C.

PubMed

Petta, Salvatore; Cabibbo, Giuseppe; Enea, Marco; Macaluso, Fabio Salvatore; Plaia, Antonella; Bruno, Raffaele; Gasbarrini, Antonio; Bruno, Savino; Craxì, Antonio; Cammà, Calogero

2014-10-01

We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

When is Pharmacogenetic Testing for Antidepressant Response Ready for the Clinic? A Cost-effectiveness Analysis Based on Data from the STAR*D Study

PubMed Central

Perlis, Roy H.; Patrick, Amanda; Smoller, Jordan W.; Wang, Philip S.

2009-01-01

The potential of personalized medicine to transform the treatment of mood disorders has been widely touted in psychiatry, but has not been quantified. We estimated the costs and benefits of a putative pharmacogenetic test for antidepressant response in the treatment of major depressive disorder (MDD) from the societal perspective. Specifically, we performed cost-effectiveness analyses using state-transition probability models incorporating probabilities from the multicenter STAR*D effectiveness study of MDD. Costs and quality-adjusted life years were compared for sequential antidepressant trials, with or without guidance from a pharmacogenetic test for differential response to selective serotonin reuptake inhibitors (SSRIs). Likely SSRI responders received an SSRI, while likely nonresponders received the norepinephrine/dopamine reuptake inhibitor bupropion. For a 40-year-old with major depressive disorder, applying the pharmacogenetic test and using the non-SSRI bupropion for those at higher risk for nonresponse cost $93,520 per additional quality-adjusted life-year (QALY) compared with treating all patients with an SSRI first and switching sequentially in the case of nonremission. Cost/QALY dropped below $50,000 for tests with remission rate ratios as low as 1.5, corresponding to odds ratios ~1.8–2.0. Tests for differential antidepressant response could thus become cost-effective under certain circumstances. These circumstances, particularly availability of alternative treatment strategies and test effect sizes, can be estimated and should be considered before these tests are broadly applied in clinical settings. PMID:19494805

Sonographically guided intrasheath percutaneous release of the first annular pulley for trigger digits, part 2: randomized comparative study of the economic impact of 3 surgical models.

PubMed

Rojo-Manaute, Jose Manuel; Capa-Grasa, Alberto; Del Cerro-Gutiérrez, Miguel; Martínez, Manuel Villanueva; Chana-Rodríguez, Francisco; Martín, Javier Vaquero

2012-03-01

Trigger digit surgery can be performed by an open approach using classic open surgery, by a wide-awake approach, or by sonographically guided first annular pulley release in day surgery and office-based ambulatory settings. Our goal was to perform a turnover and economic analysis of 3 surgical models. Two studies were conducted. The first was a turnover analysis of 57 patients allocated 4:4:1 into the surgical models: sonographically guided-office-based, classic open-day surgery, and wide-awake-office-based. Regression analysis for the turnover time was monitored for assessing stability (R(2) < .26). Second, on the basis of turnover times and hospital tariff revenues, we calculated the total costs, income to cost ratio, opportunity cost, true cost, true net income (primary variable), break-even points for sonographically guided fixed costs, and 1-way analysis for identifying thresholds among alternatives. Thirteen sonographically guided-office-based patients were withdrawn because of a learning curve influence. The wide-awake (n = 6) and classic (n = 26) models were compared to the last 25% of the sonographically guided group (n = 12), which showed significantly less mean turnover times, income to cost ratios 2.52 and 10.9 times larger, and true costs 75.48 and 20.92 times lower, respectively. A true net income break-even point happened after 19.78 sonographically guided-office-based procedures. Sensitivity analysis showed a threshold between wide-awake and last 25% sonographically guided true costs if the last 25% sonographically guided turnover times reached 65.23 and 27.81 minutes, respectively. However, this trial was underpowered. This trial comparing surgical models was underpowered and is inconclusive on turnover times; however, the sonographically guided-office-based approach showed shorter turnover times and better economic results with a quick recoup of the costs of sonographically assisted surgery.

Planning and cost analysis of digital radiography services for a network of hospitals (the Veterans Integrated Service Network).

PubMed

Duerinckx, A J; Kenagy, J J; Grant, E G

1998-01-01

This study analysed the design and cost of a picture archiving and communications system (PACS), computerized radiography (CR) and a wide-area network for teleradiology. The Desert Pacific Healthcare Network comprises 10 facilities, including four tertiary medical centres and one small hospital. Data were collected on radiologists' workloads, and patient and image flow within and between these medical centres. These were used to estimate the size and cash flows associated with a system-wide implementation of PACS, CR and teleradiology services. A cost analysis model was used to estimate the potential cost savings in a filmless radiology environment. ATM technology was selected as the communications medium between the medical centres. A strategic plan and business plan were successfully developed. The cost model predicted the cost-effectiveness of the proposed PACS/CR configuration within four to six years, if the base costs were kept low. The experience gained in design and cost analysis of a PACS/teleradiology network will serve as a model for similar projects.

Development of an electronic manometer for intrapleural pressure monitoring.

PubMed

Krenke, Rafał; Guć, Maciej; Grabczak, Elżbieta Magdalena; Michnikowski, Marcin; Pałko, Krzysztof Jakub; Chazan, Ryszarda; Gólczewski, Tomasz

2011-01-01

Measurement of intrapleural pressure is useful during various pleural procedures. However, a pleural manometer is rarely available. The aim of this study was to (1) construct an electronic pleural manometer, (2) assess the accuracy of the measurements done with the new device, (3) calculate the costs of the manometer construction and (4) perform an initial evaluation of the device in a clinical setting. Only widely accessible elements were used to construct the device. A vascular pressure transducer was used to transform pressure into an electronic signal. Reliability of the measurements was evaluated in a laboratory setting in a prospective, single-blind manner by comparing the results with those measured by a water manometer. Functionality of the device was assessed during therapeutic thoracentesis. The cost of the new pleural manometer was calculated. We built a small, portable device which can precisely measure intrapleural pressure. The measurement results showed very high agreement with those registered with a water manometer (r = 0.999; p < 0.001). The initial evaluation of the electronic manometer during therapeutic thoracentesis showed it was easy to use. The total time needed for 6 measurements after withdrawal of different volumes of pleural fluid in 1 patient did not exceed 6 min. The total cost of the device was calculated to be <2,000 EUR. In the face of very limited offer of commercially available pleural manometers, it is possible to successfully construct a self-made, reliable, electronic pleural manometer at modest costs. The device is easy to use and enables data display and storage in the personal computer. Copyright © 2011 S. Karger AG, Basel.

Cost-Effectiveness Analysis of Bariatric Surgery for Morbid Obesity.

PubMed

Alsumali, Adnan; Eguale, Tewodros; Bairdain, Sigrid; Samnaliev, Mihail

2018-01-15

In the USA, three types of bariatric surgeries are widely performed, including laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic adjustable gastric banding (LAGB). However, few economic evaluations of bariatric surgery are published. There is also scarcity of studies focusing on the LSG alone. Therefore, this study is evaluating the cost-effectiveness of bariatric surgery using LRYGB, LAGB, and LSG as treatment for morbid obesity. A microsimulation model was developed over a lifetime horizon to simulate weight change, health consequences, and costs of bariatric surgery for morbid obesity. US health care prospective was used. A model was propagated based on a report from the first report of the American College of Surgeons. Incremental cost-effectiveness ratios (ICERs) in terms of cost per quality-adjusted life-year (QALY) gained were used in the model. Model parameters were estimated from publicly available databases and published literature. LRYGB was cost-effective with higher QALYs (17.07) and cost ($138,632) than LSG (16.56 QALYs; $138,925), LAGB (16.10 QALYs; $135,923), and no surgery (15.17 QALYs; $128,284). Sensitivity analysis showed initial cost of surgery and weight regain assumption were very sensitive to the variation in overall model parameters. Across patient groups, LRYGB remained the optimal bariatric technique, except that with morbid obesity 1 (BMI 35-39.9 kg/m 2 ) patients, LSG was the optimal choice. LRYGB is the optimal bariatric technique, being the most cost-effective compared to LSG, LAGB, and no surgery options for most subgroups. However, LSG was the most cost-effective choice when initial BMI ranged between 35 and 39.9 kg/m 2 .

Hepatic Resection for Colorectal Liver Metastases: A Cost-Effectiveness Analysis

PubMed Central

Beard, Stephen M.; Holmes, Michael; Price, Charles; Majeed, Ali W.

2000-01-01

Objective To analyze the cost-effectiveness of resection for liver metastases compared with standard nonsurgical cytotoxic treatment. Summary Background Data The efficacy of hepatic resection for metastases from colorectal cancer has been debated, despite reported 5-year survival rates of 20% to 40%. Resection is confined to specialized centers and is not widely available, perhaps because of lack of appropriate expertise, resources, or awareness of its efficacy. The cost-effectiveness of resection is important from the perspective of managed care in the United States and for the commissioning of health services in the United Kingdom. Methods A simple decision-based model was developed to evaluate the marginal costs and health benefits of hepatic resection. Estimates of resectability for liver metastases were taken from UK-reported case series data. The results of 100 hepatic resections conducted in Sheffield from 1997 to 1999 were used for the cost calculation of liver resection. Survival data from published series of resections were compiled to estimate the incremental cost per life-year gained (LYG) because of the short period of follow-up in the Sheffield series. Results Hepatic resection for colorectal liver metastases provides an estimated marginal benefit of 1.6 life-years (undiscounted) at a marginal cost of £6,742. If 17% of patients have only palliative resections, the overall cost per LYG is approximately £5,236 (£5,985 with discounted benefits). If potential benefits are extended to include 20-year survival rates, these figures fall to approximately £1,821 (£2,793 with discounted benefits). Further univariate sensitivity analysis of key model parameters showed the cost per LYG to be consistently less than £15,000. Conclusion In this model, hepatic resection appears highly cost-effective compared with nonsurgical treatments for colorectal-related liver metastases. PMID:11088071

The cost-effectiveness of directly observed highly-active antiretroviral therapy in the third trimester in HIV-infected pregnant women.

PubMed

McCabe, Caitlin J; Goldie, Sue J; Fisman, David N

2010-04-13

In HIV-infected pregnant women, viral suppression prevents mother-to-child HIV transmission. Directly observed highly-active antiretroviral therapy (HAART) enhances virological suppression, and could prevent transmission. Our objective was to project the effectiveness and cost-effectiveness of directly observed administration of antiretroviral drugs in pregnancy. A mathematical model was created to simulate cohorts of one million asymptomatic HIV-infected pregnant women on HAART, with women randomly assigned self-administered or directly observed antiretroviral therapy (DOT), or no HAART, in a series of Monte Carlo simulations. Our primary outcome was the quality-adjusted life expectancy in years (QALY) of infants born to HIV-infected women, with the rates of Caesarean section and HIV-transmission after DOT use as intermediate outcomes. Both self-administered HAART and DOT were associated with decreased costs and increased life-expectancy relative to no HAART. The use of DOT was associated with a relative risk of HIV transmission of 0.39 relative to conventional HAART; was highly cost-effective in the cohort as a whole (cost-utility ratio $14,233 per QALY); and was cost-saving in women whose viral loads on self-administered HAART would have exceeded 1000 copies/ml. Results were stable in wide-ranging sensitivity analyses, with directly observed therapy cost-saving or highly cost-effective in almost all cases. Based on the best available data, programs that optimize adherence to HAART through direct observation in pregnancy have the potential to diminish mother-to-child HIV transmission in a highly cost-effective manner. Targeted use of DOT in pregnant women with high viral loads, who could otherwise receive self-administered HAART would be a cost-saving intervention. These projections should be tested with randomized clinical trials.

Comparison of community-wide, integrated mass drug administration strategies for schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study.

PubMed

Lo, Nathan C; Bogoch, Isaac I; Blackburn, Brian G; Raso, Giovanna; N'Goran, Eliézer K; Coulibaly, Jean T; Becker, Sören L; Abrams, Howard B; Utzinger, Jürg; Andrews, Jason R

2015-10-01

More than 1·5 billion people are affected by schistosomiasis or soil-transmitted helminthiasis. WHO's recommendations for mass drug administration (MDA) against these parasitic infections emphasise treatment of school-aged children, using separate treatment guidelines for these two helminthiases groups. We aimed to evaluate the cost-effectiveness of expanding integrated MDA to the entire community in four settings in Côte d'Ivoire. We extended previously published, dynamic, age-structured models of helminthiases transmission to simulate costs and disability averted with integrated MDA (of praziquantel and albendazole) for schistosomiasis and soil-transmitted helminthiasis. We calibrated the model to data for prevalence and intensity of species-specific helminth infection from surveys undertaken in four communities in Côte d'Ivoire between March, 1997, and September, 2010. We simulated a 15-year treatment programme with 75% coverage in only school-aged children; school-aged children and preschool-aged children; adults; and the entire community. Treatment costs were estimated at US$0·74 for school-aged children and $1·74 for preschool-aged children and adults. The incremental cost-effectiveness ratio (ICER) was calculated in 2014 US dollars per disability-adjusted life-year (DALY) averted. Expanded community-wide treatment was highly cost effective compared with treatment of only school-aged children (ICER $167 per DALY averted) and WHO guidelines (ICER $127 per DALY averted), and remained highly cost effective even if treatment costs for preschool-aged children and adults were ten times greater than those for school-aged children. Community-wide treatment remained highly cost effective even when elimination of helminth infections was not achieved. These findings were robust across the four diverse communities in Côte d'Ivoire, only one of which would have received annual MDA for both schistosomiasis and soil-transmitted helminthiasis under the latest WHO guidelines. Treatment every 6 months was also highly cost effective in three out of four communities. Integrated, community-wide MDA programmes for schistosomiasis and soil-transmitted helminthiasis can be highly cost effective, even in communities with low disease burden in any helminth group. These results support an urgent need to re-evaluate current global guidelines for helminthiases control programmes to include community-wide treatment, increased treatment frequency, and consideration for lowered prevalence thresholds for integrated treatment. Stanford University Medical Scholars Programme, Mount Sinai Hospital-University Health Network AMO Innovation Fund. Copyright © 2015 Lo et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Financial Costs of Large Carnivore Translocations – Accounting for Conservation

PubMed Central

Weise, Florian J.; Stratford, Ken J.; van Vuuren, Rudolf J.

2014-01-01

Human-carnivore conflict continues to present a major conservation challenge around the world. Translocation of large carnivores is widely implemented but remains strongly debated, in part because of a lack of cost transparency. We report detailed translocation costs for three large carnivore species in Namibia and across different translocation scenarios. We consider the effect of various parameters and factors on costs and translocation success. Total translocation cost for 30 individuals in 22 events was $80,681 (US Dollars). Median translocation cost per individual was $2,393, and $2,669 per event. Median cost per cheetah was $2,760 (n = 23), and $2,108 per leopard (n = 6). One hyaena was translocated at a cost of $1,672. Tracking technology was the single biggest cost element (56%), followed by captive holding and feeding. Soft releases, prolonged captivity and orphaned individuals also increased case-specific costs. A substantial proportion (65.4%) of the total translocation cost was successfully recovered from public interest groups. Less than half the translocations were confirmed successes (44.4%, 3 unknown) with a strong species bias. Four leopards (66.7%) were successfully translocated but only eight of the 20 cheetahs (40.0%) with known outcome met these strict criteria. None of the five habituated cheetahs was translocated successfully, nor was the hyaena. We introduce the concept of Individual Conservation Cost (ICC) and define it as the cost of one successfully translocated individual adjusted by costs of unsuccessful events of the same species. The median ICC for cheetah was $6,898 and $3,140 for leopard. Translocations are costly, but we demonstrate that they are not inherently more expensive than other strategies currently employed in non-lethal carnivore conflict management. We conclude that translocation should be one available option for conserving large carnivores, but needs to be critically evaluated on a case-by-case basis. PMID:25126849

Financial costs of large carnivore translocations--accounting for conservation.

PubMed

Weise, Florian J; Stratford, Ken J; van Vuuren, Rudolf J

2014-01-01

Human-carnivore conflict continues to present a major conservation challenge around the world. Translocation of large carnivores is widely implemented but remains strongly debated, in part because of a lack of cost transparency. We report detailed translocation costs for three large carnivore species in Namibia and across different translocation scenarios. We consider the effect of various parameters and factors on costs and translocation success. Total translocation cost for 30 individuals in 22 events was $80,681 (US Dollars). Median translocation cost per individual was $2,393, and $2,669 per event. Median cost per cheetah was $2,760 (n = 23), and $2,108 per leopard (n = 6). One hyaena was translocated at a cost of $1,672. Tracking technology was the single biggest cost element (56%), followed by captive holding and feeding. Soft releases, prolonged captivity and orphaned individuals also increased case-specific costs. A substantial proportion (65.4%) of the total translocation cost was successfully recovered from public interest groups. Less than half the translocations were confirmed successes (44.4%, 3 unknown) with a strong species bias. Four leopards (66.7%) were successfully translocated but only eight of the 20 cheetahs (40.0%) with known outcome met these strict criteria. None of the five habituated cheetahs was translocated successfully, nor was the hyaena. We introduce the concept of Individual Conservation Cost (ICC) and define it as the cost of one successfully translocated individual adjusted by costs of unsuccessful events of the same species. The median ICC for cheetah was $6,898 and $3,140 for leopard. Translocations are costly, but we demonstrate that they are not inherently more expensive than other strategies currently employed in non-lethal carnivore conflict management. We conclude that translocation should be one available option for conserving large carnivores, but needs to be critically evaluated on a case-by-case basis.

Programme costs in the economic evaluation of health interventions

PubMed Central

Johns, Benjamin; Baltussen, Rob; Hutubessy, Raymond

2003-01-01

Estimating the costs of health interventions is important to policy-makers for a number of reasons including the fact that the results can be used as a component in the assessment and improvement of their health system performance. Costs can, for example, be used to assess if scarce resources are being used efficiently or whether there is scope to reallocate them in a way that would lead to improvements in population health. As part of its WHO-CHOICE project, WHO has been developing a database on the overall costs of health interventions in different parts of the world as an input to discussions about priority setting. Programme costs, defined as costs incurred at the administrative levels outside the point of delivery of health care to beneficiaries, may comprise an important component of total costs. Cost-effectiveness analysis has sometimes omitted them if the main focus has been on personal curative interventions or on the costs of making small changes within the existing administrative set-up. However, this is not appropriate for non-personal interventions where programme costs are likely to comprise a substantial proportion of total costs, or for sectoral analysis where questions of how best to reallocate all existing health resources, including administrative resources, are being considered. This paper presents a first effort to systematically estimate programme costs for many health interventions in different regions of the world. The approach includes the quantification of resource inputs, choice of resource prices, and accounts for different levels of population coverage. By using an ingredients approach, and making tools available on the World Wide Web, analysts can adapt the programme costs reported here to their local settings. We report results for a selected number of health interventions and show that programme costs vary considerably across interventions and across regions, and that they can contribute substantially to the overall costs of interventions. PMID:12773220

Estimated generic prices for novel treatments for drug-resistant tuberculosis.

PubMed

Gotham, Dzintars; Fortunak, Joseph; Pozniak, Anton; Khoo, Saye; Cooke, Graham; Nytko, Frederick E; Hill, Andrew

2017-04-01

The estimated worldwide annual incidence of MDR-TB is 480 000, representing 5% of TB incidence, but 20% of mortality. Multiple drugs have recently been developed or repurposed for the treatment of MDR-TB. Currently, treatment for MDR-TB costs thousands of dollars per course. To estimate generic prices for novel TB drugs that would be achievable given large-scale competitive manufacture. Prices for linezolid, moxifloxacin and clofazimine were estimated based on per-kilogram prices of the active pharmaceutical ingredient (API). Other costs were added, including formulation, packaging and a profit margin. The projected costs for sutezolid were estimated to be equivalent to those for linezolid, based on chemical similarity. Generic prices for bedaquiline, delamanid and pretomanid were estimated by assessing routes of synthesis, costs/kg of chemical reagents, routes of synthesis and per-step yields. Costing algorithms reflected variable regulatory requirements and efficiency of scale based on demand, and were validated by testing predictive ability against widely available TB medicines. Estimated generic prices were US$8-$17/month for bedaquiline, $5-$16/month for delamanid, $11-$34/month for pretomanid, $4-$9/month for linezolid, $4-$9/month for sutezolid, $4-$11/month for clofazimine and $4-$8/month for moxifloxacin. The estimated generic prices were 87%-94% lower than the current lowest available prices for bedaquiline, 95%-98% for delamanid and 94%-97% for linezolid. Estimated generic prices were $168-$395 per course for the STREAM trial modified Bangladesh regimens (current costs $734-$1799), $53-$276 for pretomanid-based three-drug regimens and $238-$507 for a delamanid-based four-drug regimen. Competitive large-scale generic manufacture could allow supplies of treatment for 5-10 times more MDR-TB cases within current procurement budgets. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

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

Brush, Adrian; Masanet, Eric; Worrell, Ernst

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

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

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

Masanet, Eric; Masanet, Eric; Worrell, Ernst

2008-01-01

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

Towards Optimal Spectral and Spatial Documentation of Cultural Heritage. Cosch - AN Interdisciplinary Action in the Cost Framework

NASA Astrophysics Data System (ADS)

Boochs, F.; Bentkowska-Kafel, A.; Degringy, C.; Hautta-Kasari, M.; Rizvic, S.; Sitnik, R.; Tremeau, A.

2013-07-01

This paper introduces the aims and early activities of Colour and Space in Cultural Heritage (COSCH), an interdisciplinary European network of experts in the latest optical measuring techniques and electronic imaging applied to documentation of artefacts. COSCH is a forum open to organisations, institutions and companies interested in collaboration within the emerging field of precise spectral and spatial imaging techniques, in physical and chemical sciences applied to cultural heritage objects, as well as in research and applications to conservation and art-historical analysis of such objects. COSCH started in November 2012. Funded by COST, an intergovernmental framework for European Cooperation in Science and Technology, COSCH networking activities enable knowledge exchange and coordination of nationally-funded research on a European level with occasional contribution of experts from other countries. Funding has been made available for four years (2012-2016). Participation is open to researchers across a wide range of disciplines, including computer scientists and museum professionals, art historians and academics in heritage-related fields. COSCH is a trans-domain Action (TD1201) of the COST Domain Materials, Physics and Nanosciences (MPNS) which facilitates and promotes innovation in material science. The work of COSCH is defined in the Memorandum of Understanding between the COST Office and the Chairman of COSCH. The Memorandum is available from http://www.cost.eu/domains_actions/mpns/Actions/TD1201 alongside the latest progress report and other documents. The scientific work draws on earlier and current research of the participants and is organised around the following areas: spectral and spatial object documentation; algorithms and procedures; analysis and restoration of surfaces and objects of material culture; visualisation of cultural heritage objects and its dissemination. Up-to-date information about COSCH activities, including its scientific and training programmes, abstracts of presentations and a list of participants, can all be found on the Action website at http://www.cosch.info.

2 CFR 200.400 - Policy guide.

Code of Federal Regulations, 2014 CFR

2014-01-01

... educate and engage students in research, the dual role of students as both trainees and employees... indirect cost proposals, the cognizant agency for indirect costs should generally assure that the non... negotiation of indirect cost proposals. Where wide variations exist in the treatment of a given cost item by...

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

Shonder, J.A.

Geothermal heat pumps (GHPs) have been shown to have a number of benefits over other technologies used to heat and cool buildings and provide hot water, combining high levels of occupant comfort with low operating and maintenance costs. Public facilities represent an increasingly important market for GHPs, and schools are a particularly good application, given the large land area that normally surrounds them. Nevertheless, some barriers remain to the increased use of GHPs in institutional and commercial applications. First, because GHPs are perceived as having higher installation costs than other space conditioning technologies, they are sometimes not considered as anmore » option in feasibility studies. When they are considered, it can be difficult to compile the information required to compare them with other technologies. For example, a life cycle cost analysis requires estimates of installation costs and annually recurring energy and maintenance costs. But most cost estimators are unfamiliar with GHP technology, and no published GHP construction cost estimating guide is available. For this reason, estimates of installed costs tend to be very conservative, furthering the perception that GHPs are more costly than other technologies. Because GHP systems are not widely represented in the various softwares used by engineers to predict building energy use, it is also difficult to estimate the annual energy use of a building having GHP systems. Very little published data is available on expected maintenance costs either. Because of this lack of information, developing an accurate estimate of the life cycle cost of a GHP system requires experience and expertise that are not available in all institutions or in all areas of the country. In 1998, Oak Ridge National Laboratory (ORNL) entered into an agreement with the Lincoln, Nebraska, Public School District and Lincoln Electric Service, the local electric utility in the Lincoln area, to study four new, identical elementary schools built in the district that are served by GHPs. ORNL was provided with complete as-built construction plans for the schools and associated equipment, access to original design calculations and cost estimates, extensive equipment operating data [both from the buildings' energy management systems (EMSs) and from utility meters], and access to the school district's complete maintenance record database, not only for the four GHP schools, but for the other schools in the district using conventional space conditioning equipment. Using this information, we were able to reproduce the process used by the Lincoln school district and the consulting engineering firm to select GHPs over other options to provide space conditioning for the four schools. The objective was to determine whether this decision was the correct one, or whether some other technology would have been more cost-effective. An additional objective was to identify all of the factors that make it difficult for building owners and their engineers to consider GHPs in their projects so that ongoing programs can remove these impediments over time.« less

Trends in procurement costs for HIV commodities: a 7-year retrospective analysis of global fund data across 125 countries.

PubMed

Wafula, Francis; Agweyu, Ambrose; Macintyre, Kate

2014-04-01

Nearly 40% of Global Fund money goes toward procurement. However, no analyses have been published to show how costs vary across regions and time, despite the availability of procurement data collected through the Global Fund's price and quality reporting system. We analyzed data for the 3 most widely procured commodities for the prevention, diagnosis, and treatment of HIV. These were male condoms, HIV rapid tests, and the antiretroviral (ARV) combination of lamivudine/nevirapine/zidovudine. The compared costs, first across time (2005-2012), then across regions, and finally, between individual procurement reported through the price and quality reporting and pooled procurement reported through the Global Fund's voluntary pooled procurement system. All costs were adjusted for inflation and reported in US dollars. There were 2337 entries from 578 grants in 125 countries. The procurement cost for the ARV dropped substantially over the period, whereas those for condoms and HIV tests remained relatively stable. None of the commodity prices increased. Regional variations were pronounced for HIV tests, but minimal for condoms and the ARV. The unit cost for the 3-table ARV combination, for instance, varied between US$0.15 and US$0.23 in South Asia and the Eastern Europe/Central Asia regions, respectively, compared with a range of $0.23 (South Asia)-$1.50 (Eastern Europe/Central Asia) for a single diagnostic test. Pooled procurement lowered costs for condoms but not the other commodities. We showed how global procurement costs vary by region and time. Such analyses should be done more often to identify and correct market insufficiencies.

Comparison of cost accounting methods from different DRG systems and their effect on health care quality.

PubMed

Leister, Jan Eric; Stausberg, Jürgen

2005-09-28

Diagnosis related groups (DRGs) are a well-established provider payment system. Because of their imminent potential of cost reduction, they have been widely introduced. In addition to cost cutting, several social objectives - e.g., improving overall health care quality - feed into the DRG system. The WHO compared different provider payment systems with regard to the following objectives: prevention of further health problems, providing services and solving health problems, and responsiveness to people's legitimate expectations. However, no study has been published which takes the impact of different cost accounting systems across the DRG systems into account. We compared the impact of different cost accounting methods within DRG-like systems by developing six criteria: integration of patients' health risk into pricing practice, incentives for quality improvement and innovation, availability of high class evidence based therapy, prohibition of economically founded exclusions, reduction of fragmentation incentives, and improvement of patient oriented treatment. We set up a first overview of potential and actual impacts of the pricing practices within Yale-DRGs, AR-DRGs, G-DRGs, Swiss AP-DRGs adoption and Swiss MIPP. It could be demonstrated that DRGs are not only a 'homogenous' group of similar provider payment systems but quite different by fulfilling major health care objectives connected with the used cost accounting methods. If not only the possible cost reduction is used to put in a good word for DRG-based provider payment systems, maximum accurateness concerning the method of cost accounting should prevail when implementing a new DRG-based provider payment system.

How to optimize radiological images captured from digital cameras, using the Adobe Photoshop 6.0 program.

PubMed

Chalazonitis, A N; Koumarianos, D; Tzovara, J; Chronopoulos, P

2003-06-01

Over the past decade, the technology that permits images to be digitized and the reduction in the cost of digital equipment allows quick digital transfer of any conventional radiological film. Images then can be transferred to a personal computer, and several software programs are available that can manipulate their digital appearance. In this article, the fundamentals of digital imaging are discussed, as well as the wide variety of optional adjustments that the Adobe Photoshop 6.0 (Adobe Systems, San Jose, CA) program can offer to present radiological images with satisfactory digital imaging quality.

Remote sensing of vegetation pattern and condition to monitor changes in Everglades biogeochemistry

USGS Publications Warehouse

Jones, John W.

2011-01-01

Ground-based studies of biogeochemistry and vegetation patterning yield process understanding, but the amount of information gained by ground-based studies can be greatly enhanced by efficient, synoptic, and temporally resolute monitoring afforded by remote sensing. The variety of presently available Everglades vegetation maps reflects both the wide range of application requirements and the need to balance cost and capability. More effort needs to be applied to documenting and understanding vegetation distribution and condition as indicators of biogeochemistry and contamination. Ground-based and remote sensing studies should be modified to maximize their synergy and utility for adaptive management.

Application of future remote sensing systems to irrigation

NASA Technical Reports Server (NTRS)

Miller, L. D.

1982-01-01

Area estimates of irrigated crops and knowledge of crop type are required for modeling water consumption to assist farmers, rangers, and agricultural consultants in scheduling irrigation for distributed management of crop yields. Information on canopy physiology and soil moisture status on a spatial basis is potentially available from remote sensors, so the questions to be addressed relate to: (1) timing (data frequency, instantaneous and integrated measurement); and scheduling (widely distributed spatial demands); (2) spatial resolution; (3) radiometric and geometric accuracy and geoencoding; and (4) information/data distribution. This latter should be overnight, with no central storage, onsite capture, and low cost.

Multi-tasking computer control of video related equipment

NASA Technical Reports Server (NTRS)

Molina, Rod; Gilbert, Bob

1989-01-01

The flexibility, cost-effectiveness and widespread availability of personal computers now makes it possible to completely integrate the previously separate elements of video post-production into a single device. Specifically, a personal computer, such as the Commodore-Amiga, can perform multiple and simultaneous tasks from an individual unit. Relatively low cost, minimal space requirements and user-friendliness, provides the most favorable environment for the many phases of video post-production. Computers are well known for their basic abilities to process numbers, text and graphics and to reliably perform repetitive and tedious functions efficiently. These capabilities can now apply as either additions or alternatives to existing video post-production methods. A present example of computer-based video post-production technology is the RGB CVC (Computer and Video Creations) WorkSystem. A wide variety of integrated functions are made possible with an Amiga computer existing at the heart of the system.

Parametric study for use of stainless steel as a material for thermal shield in PIP2IT transferline at Fermilab

NASA Astrophysics Data System (ADS)

Rane, Tejas; Chakravarty, Anindya; Klebaner, Arkadiy

2017-12-01

Transferline thermal shields are cooled by dedicated cooling lines welded/brazed to the shield at a single point along the circumference. Copper/Aluminium is widely used to fabricate thermal shields because of their higher thermal diffusivity. This causes uniformity of temperature along the surface of the shield thus reducing thermal stresses within allowable values. However, factors such as raw material price, the cost of fabrication depending on standard sizes of pipes/tubes, often drives up the final price of thermal shields. To reduce the cost by making use of easily available stock of standard pipe/tube, it is decided to use stainless steel as a material for thermal shields in the PIP2IT transferline. The present paper discusses the design approach, various factors affecting the conservative selection of thermal shield design.

Implementation of laser speckle contrast analysis as connection kit for mobile phone for assessment of skin blood flow

NASA Astrophysics Data System (ADS)

Jakovels, Dainis; Saknite, Inga; Spigulis, Janis

2014-05-01

Laser speckle contrast analysis (LASCA) offers a non-contact, full-field, and real-time mapping of capillary blood flow and can be considered as an alternative method to Laser Doppler perfusion imaging. LASCA technique has been implemented in several commercial instruments. However, these systems are still too expensive and bulky to be widely available. Several optical techniques have found new implementations as connection kits for mobile phones thus offering low cost screening devices. In this work we demonstrate simple implementation of LASCA imaging technique as connection kit for mobile phone for primary low-cost assessment of skin blood flow. Stabilized 650 nm and 532 nm laser diode modules were used for LASCA illumination. Dual wavelength illumination could provide additional information about skin hemoglobin and oxygenation level. The proposed approach was tested for arterial occlusion and heat test. Besides, blood flow maps of injured and provoked skin were demonstrated.

Laserprinter applications in a medical graphics department.

PubMed

Lynch, P J

1987-01-01

Our experience with the Apple Macintosh and LaserWriter equipment has convinced us that lasergraphics holds much current and future promise in the creation of line graphics and typography for the biomedical community. Although we continue to use other computer graphics equipment to produce color slides and an occasional pen-plotter graphic, the most rapidly growing segment of our graphics workload is in material well-suited to production on the Macintosh/LaserWriter system. At present our goal is to integrate all of our computer graphics production (color slides, video paint graphics and monochrome print graphics) into a single Macintosh-based system within the next two years. The software and hardware currently available are capable of producing a wide range of science graphics very quickly and inexpensively. The cost-effectiveness, versatility and relatively low initial investment required to install this equipment make it an attractive alternative for cost-recovery departments just entering the field of computer graphics.

Galilean Moons, Kepler's Third Law, and the Mass of Jupiter

NASA Astrophysics Data System (ADS)

Bates, Alan

2013-10-01

Simulations of physical systems are widely available online, with no cost, and are ready to be used in our classrooms. ,2 Such simulations offer an accessible tool that can be used for a range of interactive learning activities. The Jovian Moons Applet2 allows the user to track the position of Jupiter's four Galilean moons with a variety of viewing options. For this activity, data are obtained from the orbital period and orbital radii charts. Earlier experiments have used telescopes to capture the orbital motion of the Galilean moons,3 although observation of astronomical events and the measurement of quantities may be difficult to achieve due to a combination of cost, training, and observing conditions. The applet allows a suitable set of data to be generated and data analysis that verifies Kepler's third law of planetary motion, which leads to a calculated value for the mass of Jupiter.

Use of single-well simulators and economic performance criteria to optimize fracturing treatment design

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

Anderson, R.W.; Phillips, A.M.

1990-02-01

Low-permeability reservoirs are currently being propped with sand, resin-coated sand, intermediate-density proppants, and bauxite. This wide range of proppant cost and performance has resulted in the proliferation of proppant selection models. Initially, a rather vague relationship between well depth and proppant strength dictated the choice of proppant. More recently, computerized models of varying complexity that use net-present-value (NPV) calculations have become available. The input is based on the operator's performance goals for each well and specific reservoir properties. Simpler, noncomputerized approaches include cost/performance comparisons and nomographs. Each type of model, including several of the computerized models, is examined here. Bymore » use of these models and NPV calculations, optimum fracturing treatment designs have been developed for such low-permeability reservoirs as the Prue in Oklahoma. Typical well conditions are used in each of the selection models, and the results are compared.« less

High-frequency, long-duration water sampling in acid mine drainage studies: a short review of current methods and recent advances in automated water samplers

USGS Publications Warehouse

Chapin, Thomas

2015-01-01

Hand-collected grab samples are the most common water sampling method but using grab sampling to monitor temporally variable aquatic processes such as diel metal cycling or episodic events is rarely feasible or cost-effective. Currently available automated samplers are a proven, widely used technology and typically collect up to 24 samples during a deployment. However, these automated samplers are not well suited for long-term sampling in remote areas or in freezing conditions. There is a critical need for low-cost, long-duration, high-frequency water sampling technology to improve our understanding of the geochemical response to temporally variable processes. This review article will examine recent developments in automated water sampler technology and utilize selected field data from acid mine drainage studies to illustrate the utility of high-frequency, long-duration water sampling.

Performance and cost of materials for lithium-based rechargeable automotive batteries

NASA Astrophysics Data System (ADS)

Schmuch, Richard; Wagner, Ralf; Hörpel, Gerhard; Placke, Tobias; Winter, Martin

2018-04-01

It is widely accepted that for electric vehicles to be accepted by consumers and to achieve wide market penetration, ranges of at least 500 km at an affordable cost are required. Therefore, significant improvements to lithium-ion batteries (LIBs) in terms of energy density and cost along the battery value chain are required, while other key performance indicators, such as lifetime, safety, fast-charging ability and low-temperature performance, need to be enhanced or at least sustained. Here, we review advances and challenges in LIB materials for automotive applications, in particular with respect to cost and performance parameters. The production processes of anode and cathode materials are discussed, focusing on material abundance and cost. Advantages and challenges of different types of electrolyte for automotive batteries are examined. Finally, energy densities and costs of promising battery chemistries are critically evaluated along with an assessment of the potential to fulfil the ambitious targets of electric vehicle propulsion.

Standard Hardware Acquisition and Reliability Program's (SHARP's) efforts in incorporating fiber optic interconnects into standard electronic module (SEM) connectors

NASA Astrophysics Data System (ADS)

Riggs, William R.

1994-05-01

SHARP is a Navy wide logistics technology development effort aimed at reducing the acquisition costs, support costs, and risks of military electronic weapon systems while increasing the performance capability, reliability, maintainability, and readiness of these systems. Lower life cycle costs for electronic hardware are achieved through technology transition, standardization, and reliability enhancement to improve system affordability and availability as well as enhancing fleet modernization. Advanced technology is transferred into the fleet through hardware specifications for weapon system building blocks of standard electronic modules, standard power systems, and standard electronic systems. The product lines are all defined with respect to their size, weight, I/O, environmental performance, and operational performance. This method of defining the standard is very conducive to inserting new technologies into systems using the standard hardware. This is the approach taken thus far in inserting photonic technologies into SHARP hardware. All of the efforts have been related to module packaging; i.e. interconnects, component packaging, and module developments. Fiber optic interconnects are discussed in this paper.

Grading Multiple Choice Exams with Low-Cost and Portable Computer-Vision Techniques

NASA Astrophysics Data System (ADS)

Fisteus, Jesus Arias; Pardo, Abelardo; García, Norberto Fernández

2013-08-01

Although technology for automatic grading of multiple choice exams has existed for several decades, it is not yet as widely available or affordable as it should be. The main reasons preventing this adoption are the cost and the complexity of the setup procedures. In this paper, Eyegrade, a system for automatic grading of multiple choice exams is presented. While most current solutions are based on expensive scanners, Eyegrade offers a truly low-cost solution requiring only a regular off-the-shelf webcam. Additionally, Eyegrade performs both mark recognition as well as optical character recognition of handwritten student identification numbers, which avoids the use of bubbles in the answer sheet. When compared with similar webcam-based systems, the user interface in Eyegrade has been designed to provide a more efficient and error-free data collection procedure. The tool has been validated with a set of experiments that show the ease of use (both setup and operation), the reduction in grading time, and an increase in the reliability of the results when compared with conventional, more expensive systems.

Low cost sensing technology for type 2 diabetes monitoring

NASA Astrophysics Data System (ADS)

Sarswat, Prashant; Free, Michael

2015-03-01

Alpha-hydroxybutyrate (2-hydroxybutyrate or α-HB) is becoming more widely recognized as an important metabolic biomarker that has been shown to be highly correlated with prediabetes and other metabolic diseases. In 2012 there were 86 million Americans with prediabetes, many of whom are not aware they have prediabetes, but could be diagnosed and treated to prevent type 2 diabetes if a simple, low-cost, convenient test were available. We have developed new, low-cost, accurate α-HB detection methods that can be used for the detection and monitoring of diseases such as prediabetes, type 2 diabetes, β-cell dysfunction, and early hyperglycemia. The new sensing method utilizes a diol recognition moiety, additives and a photoinitiator to detect α-HB at levels near 1 micro g/l in the presence of serum compounds such as lactic acid, sodium pyruvate, and glucose. The objective of this research is to improve the understanding of the interactions that enhance α-HB detection to enable additional improvements in α-HB detection as well as improvements in other biosensor applications.

Next Generation Sequencing Technologies: The Doorway to the Unexplored Genomics of Non-Model Plants

PubMed Central

Unamba, Chibuikem I. N.; Nag, Akshay; Sharma, Ram K.

2015-01-01

Non-model plants i.e., the species which have one or all of the characters such as long life cycle, difficulty to grow in the laboratory or poor fecundity, have been schemed out of sequencing projects earlier, due to high running cost of Sanger sequencing. Consequently, the information about their genomics and key biological processes are inadequate. However, the advent of fast and cost effective next generation sequencing (NGS) platforms in the recent past has enabled the unearthing of certain characteristic gene structures unique to these species. It has also aided in gaining insight about mechanisms underlying processes of gene expression and secondary metabolism as well as facilitated development of genomic resources for diversity characterization, evolutionary analysis and marker assisted breeding even without prior availability of genomic sequence information. In this review we explore how different Next Gen Sequencing platforms, as well as recent advances in NGS based high throughput genotyping technologies are rewarding efforts on de-novo whole genome/transcriptome sequencing, development of genome wide sequence based markers resources for improvement of non-model crops that are less costly than phenotyping. PMID:26734016

Passive designs and renewable energy systems optimization of a net zero energy building in Embrun/France

NASA Astrophysics Data System (ADS)

Harkouss, F.; Biwole, P. H.; Fardoun, F.

2018-05-01

Buildings’ optimization is a smart method to inspect the available design choices starting from passive strategies, to energy efficient systems and finally towards the adequate renewable energy system to be implemented. This paper outlines the methodology and the cost-effectiveness potential for optimizing the design of net-zero energy building in a French city; Embrun. The non-dominated sorting genetic algorithm is chosen in order to minimize thermal, electrical demands and life cycle cost while reaching the net zero energy balance; and thus getting the Pareto-front. Elimination and Choice Expressing the Reality decision making method is applied to the Pareto-front so as to obtain one optimal solution. A wide range of energy efficiency measures are investigated, besides solar energy systems are employed to produce required electricity and hot water for domestic purposes. The results indicate that the appropriate selection of the passive parameters is very important and critical in reducing the building energy consumption. The optimum design parameters yield to a decrease of building’s thermal loads and life cycle cost by 32.96% and 14.47% respectively.

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

Jeffery, D.J.

This report considers a wide range of possible methods for improving the route guidance information available to drivers, and for saving up to L600M per year of national resource costs which are effectively wasted by drivers who fail to select optimum routes for unfamiliar journeys. The methods considered include improvements to maps and roadsigns, both of which could prove highly cost effective although they would leave some 80 per cent of the wastage unrecovered. A substantial proportion of this remaining wastage might be avoided with a Viewdata route planning and guidance scheme which could be achieved at relatively low costmore » to public funds, or with automatic systems. Of a range of automatic electronic guidance systems considered the most cost effective solution would be provided by a system which used buried loops to provide a two-way communication link between a roadside and a vehicle unit. Such a scheme would necessarily involve a considerable investment from public funds, but would offer the greatest potential for further development and, in particular, could provide the basis of a comprehensive traffic control tool.« less

Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment.

PubMed

Donohue, Julie M; Pincus, Harold Alan

2007-01-01

Depression is a highly prevalent condition that results in substantial functional impairment. Advocates have attempted in recent years to make the 'business case' for investing in quality improvement efforts in depression care, particularly in primary care settings. The business case suggests that the costs of depression treatment may be offset by gains in worker productivity and/or reductions in other healthcare spending. In this paper, we review the evidence in support of this argument for improving the quality of depression treatment. We examined the impact of depression on two of the primary drivers of the societal burden of depression: healthcare utilisation and worker productivity. Depression leads to higher healthcare utilisation and spending, most of which is not the result of depression treatment costs. Depression is also a leading cause of absenteeism and reduced productivity at work. It is clear that the economic burden of depression is substantial; however, critical gaps in the literature remain and need to be addressed. For instance, we do not know the economic burden of untreated and/or inappropriately treated versus appropriately treated depression. There remain considerable problems with access to and quality of depression treatment. Progress has been made in terms of access to care, but quality of care is seldom consistent with national treatment guidelines. A wide range of effective treatments and care programmes for depression are available, yet rigorously tested clinical models to improve depression care have not been widely adopted by healthcare systems. Barriers to improving depression care exist at the patient, healthcare provider, practice, plan and purchaser levels, and may be both economic and non-economic. Studies evaluating interventions to improve the quality of depression treatment have found that the cost per QALY associated with improved depression care ranges from a low of 2519 US dollars to a high of 49,500 US dollars. We conclude from our review of the literature that effective treatment of depression is cost effective, but that evidence of a medical or productivity cost offset for depression treatment remains equivocal, and this points to the need for further research in this area.

Variation in cost and performance of routine immunisation service delivery in India

PubMed Central

Chatterjee, Susmita; Das, Palash; Nigam, Aditi; Nandi, Arindam; Brenzel, Logan; Ray, Arindam; Haldar, Pradeep; Aggarwal, Mahesh Kumar; Laxminarayan, Ramanan

2018-01-01

A comprehensive understanding of the costs of routine vaccine delivery is essential for planning, budgeting and sustaining India’s Universal Immunisation Programme. India currently allocates approximately US$25 per child for vaccines and operational costs. This budget is prepared based on historical expenditure data as information on cost is not available. This study estimated the cost of routine immunisation services based on a stratified, random sample of 255 public health facilities from 24 districts across seven states—Bihar, Gujarat, Kerala, Meghalaya, Punjab, Uttar Pradesh and West Bengal. The economic cost for the fiscal year 2013–2014 was measured by adapting an internationally accepted approach for the Indian context. Programme costs included the value of personnel, vaccines, transport, maintenance, training, cold chain equipment, building and other recurrent costs. The weighted average national level cost per dose delivered was US$2.29 including vaccine costs, and the cost per child vaccinated with the third dose of diphtheria–pertussis–tetanus (DPT) vaccine (a proxy for full immunisation) was US$31.67 (at 2017 prices). There was wide variation in the weighted average state-level cost per dose delivered inclusive of vaccine costs (US$1.38 to US$2.93) and, for the cost per DTP3 vaccinated child (US$20.08 to US$34.81). Lower costs were incurred by facilities and districts that provided the largest number of doses of vaccine. Out of the total cost, the highest amount (57%) was spent on personnel. This costing study, the most comprehensive conducted to date in India, provides evidence, which should help improve planning and budgeting for the national programme. The budget generally considers financial costs, while this study focused on economic costs. For using this study’s results for planning and budgeting, the collected data can be used to extract the relevant financial costs. Variation in cost per dose and doses administered across facilities, districts and states need to be further investigated to understand the drivers of cost and measure the efficiency of service delivery. PMID:29946488

Robotic Head and Neck Surgery: History, Technical Evolution and the Future.

PubMed

Garas, George; Arora, Asit

2018-06-20

The first application of robotic technology in surgery was described in 1985 when a robot was used to define the trajectory for a stereotactic brain biopsy. Following its successful application in a variety of surgical operations, the da Vinci® robot, the most widely used surgical robot at present, made its clinical debut in otorhinolaryngology and head and neck surgery in 2005 when the first transoral robotic surgery (TORS) resections of base of tongue neoplasms were reported. Subsequently, the indications for TORS rapidly expanded, and they now include tumours of the oropharynx, hypopharynx, parapharyngeal space, and supraglottic larynx, as well as obstructive sleep apnoea (OSA). The da Vinci® robot has also been successfully used for scarless-in-the-neck thyroidectomy and parathyroidectomy. At present, the main barrier to the wider uptake of robotic surgery is the prohibitive cost of the da Vinci® robotic system. Several novel, flexible surgical robots are currently being developed that are likely to not only enhance patient safety and expand current indications but also drive down costs, thus making this innovation more widely available. Future directions relate to overlay technology through augmented reality/AR that allows real-time image-guidance, miniaturisation (nanorobots), and the development of autonomous robots. © 2018 S. Karger AG, Basel.

Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

ERIC Educational Resources Information Center

Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

2014-01-01

In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

Medical equipment libraries: implementation, experience and user satisfaction.

PubMed

Keay, S; McCarthy, J P; Carey-Smith, B E

2015-01-01

The hospital-wide pooling and sharing of certain types of medical equipment can lead to both significant improvements in patient safety and financial advantages when compared with a department or ward-level equipment ownership system. In September 2003, a Medical Equipment Loan Service (MELS) was established, focusing initially on infusion pumps. The aims and expected benefits included; improving availability of equipment for both patients and clinical users, managing and reducing clinical risk, reducing equipment diversity, improving equipment management and reducing the overall cost of equipment provision. A user survey was carried out in 2005 and repeated in 2011. The results showed wide and continued satisfaction with the service. The process and difficulties of establishing the service and its development to include additional types of equipment are described. The benefits of managing medical equipment which is in widespread general use, through a MELS as part of a Clinical Engineering Department, are presented.

Affordable Digital Planetariums with WorldWide Telescope

NASA Astrophysics Data System (ADS)

Rosenfield, P.; Connolly, A.; Fay, J.; Sayres, C.; Tofflemire, B.

2011-09-01

Digital planetariums can provide a broader range of educational experiences than the more classical planetariums that use star-balls. This is because of their ability to project images, content from current research, and the 3-D distribution of the stars and galaxies. While there are hundreds of planetariums in the country, the reason that few of these are fully digital is the cost. In collaboration with Microsoft Research (MSR), we have developed a way to digitize existing planetariums for approximately $40,000 using freely available software. We describe here how off the shelf equipment, together with a WorldWide Telescope client, can provide a rich and truly interactive experience. This will enable students and the public to pan though multi-wavelength full-sky scientific data sets, explore 3-D visualizations of our Solar System (including trajectories of millions of minor planets), near-by stars, and the SDSS galaxy catalog.

Wood energy-commercial applications

NASA Technical Reports Server (NTRS)

Kennel, R. P.

1978-01-01

Wood energy is being widely investigated in many areas of the country because of the many obvious benefits of wood fuel such as the low price per million Btus relative to coal, oil, and gas; the wide availability of noncommercial wood and the proven ability to harvest it; established technology which is reliable and free of pollution; renewable resources; better conservation for harvested land; and the potential for jobs creation. The Southeastern United States has a specific leadership role in wood energy based on its established forest products industry experience and the potential application of wood energy to other industries and institutions. Significant questions about the widespread usage of wood energy are being answered in demonstrations around the country as well as the Southeast in areas of wood storage and bulk handling; high capitalization costs for harvesting and combustion equipment; long term supply and demand contracts; and the economic feasibility of wood energy outside the forest products industry.

Imaging acute complications in cancer patients: what should be evaluated in the emergency setting?

PubMed Central

2014-01-01

Increased incidence world-wide of cancer and increased survival has also resulted in physicians seeing more complications in patients with cancer. In many cases, complications are the first manifestations of the disease. They may be insidious and develop over a period of months, or acute and manifest within minutes to days. Imaging examinations play an essential role in evaluating cancer and its complications. Plain radiography and ultrasonography (US) are generally performed initially in an urgent situation due to their wide availability, low cost, and minimal or no radiation exposure. However, depending on a patient’s symptoms, evaluation with cross-sectional imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) is often necessary. In this review article, we discuss some of the most important acute noninfectious oncological complications for which imaging methods play an essential role in diagnosis. PMID:25609051

Lessons from the recent rise in use of female sterilization in Malawi.

PubMed

Jacobstein, Roy

2013-03-01

Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Malawi, however, despite daunting constraints, has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2 percent across Africa, and demand to limit births now exceeds demand to space births. Malawi's female sterilization prevalence surpasses that of some high-resource countries. Key service-delivery factors enabling this achievement include supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers. Challenges remain, but Malawi's achievement offers lessons for other countries with low availability of female sterilization and similar resource constraints. © 2013 The Population Council, Inc.

Wide-field depth-sectioning fluorescence microscopy using projector-generated patterned illumination

NASA Astrophysics Data System (ADS)

Delica, Serafin; Mar Blanca, Carlo

2007-10-01

We present a simple and cost-effective wide-field, depth-sectioning, fluorescence microscope utilizing a commercial multimedia projector to generate excitation patterns on the sample. Highly resolved optical sections of fluorescent pollen grains at 1.9 μm axial resolution are constructed using the structured illumination technique. This requires grid excitation patterns to be scanned across the sample, which is straightforwardly implemented by creating slideshows of gratings at different phases, projecting them onto the sample, and synchronizing camera acquisition with slide transition. In addition to rapid dynamic pattern generation, the projector provides high illumination power and spectral excitation selectivity. We exploit these properties by imaging mouse neural cells in cultures multistained with Alexa 488 and Cy3. The spectral and structural neural information is effectively resolved in three dimensions. The flexibility and commercial availability of this light source is envisioned to open multidimensional imaging to a broader user base.

IAEA Nuclear Data Section: provision of atomic and nuclear databases for user applications.

PubMed

Humbert, Denis P; Nichols, Alan L; Schwerer, Otto

2004-01-01

The Nuclear Data Section (NDS) of the International Atomic Energy Agency (IAEA) provides a wide range of atomic and nuclear data services to scientists worldwide, with particular emphasis placed on the needs of developing countries. Highly focused Co-ordinated Research Projects and multinational data networks are sponsored under the auspices of the IAEA for the development and assembly of databases through the organised participation of specialists from Member States. More than 100 data libraries are readily available cost-free through the Internet, CD-ROM and other media. These databases are used in a wide range of applications, including fission- and fusion-energy, non-energy applications and basic research studies. Further information concerning the various services can be found through the web address of the IAEA Nuclear Data Section: and a mirror site at IPEN, Brazil that is maintained by NDS staff:.

TU-G-BRCD-01: Will the High Cost of Proton Therapy Facilities Limit the Availability of Proton Therapy Treatment?

PubMed

Maughan, R

2012-06-01

The potential dose distribution advantages associated with proton therapy, and particularly with pencil beam scanning (PBS) techniques, have lead to considerable interest in this modality in recent years. However, the large capital expenditure necessary for such a project requires careful financial consideration and business planning. The complexity of the beam delivery systems impacts the capital expenditure and the PBS only systems presently being advocated can reduce these costs. Also several manufacturers are considering "one-room" facilities as less expensive alternatives to multi-room facilities. This presentation includes a brief introduction to beam delivery options (passive scattering, uniform and modulated scanning) and some of the new technologies proposed for providing less expensive proton therapy systems. Based on current experience, data on proton therapy center start-up costs, running costs and the financial challenges associated with making this highly conformal therapy more widely available will be discussed. Issues associated with proton therapy implementation that are key to project success include strong project management, vendor cooperation and collaboration, staff recruitment and training. Time management during facility start up is a major concern, particularly in multi-room systems, where time must be shared between continuing vendor system validation, verification and acceptance testing, and user commissioning and patient treatments. The challenges associated with facility operation during this period and beyond are discussed, focusing on how standardization of process, downtime and smart scheduling can influence operational efficiency. 1. To understand the available choices for proton therapy facilities, the different beam delivery systems and the financial implications associated with these choices. 2. To understand the key elements necessary for successfully implementing a proton therapy program. 3. To understand the challenges associated with on-going facility management to achieve an efficient fully operational system. © 2012 American Association of Physicists in Medicine.

Design of a tracked ultrasound calibration phantom made of LEGO bricks

NASA Astrophysics Data System (ADS)

Walsh, Ryan; Soehl, Marie; Rankin, Adam; Lasso, Andras; Fichtinger, Gabor

2014-03-01

PURPOSE: Spatial calibration of tracked ultrasound systems is commonly performed using precisely fabricated phantoms. Machining or 3D printing has relatively high cost and not easily available. Moreover, the possibilities for modifying the phantoms are very limited. Our goal was to find a method to construct a calibration phantom from affordable, widely available components, which can be built in short time, can be easily modified, and provides comparable accuracy to the existing solutions. METHODS: We designed an N-wire calibration phantom made of LEGO® bricks. To affirm the phantom's reproducibility and build time, ten builds were done by first-time users. The phantoms were used for a tracked ultrasound calibration by an experienced user. The success of each user's build was determined by the lowest root mean square (RMS) wire reprojection error of three calibrations. The accuracy and variance of calibrations were evaluated for the calibrations produced for various tracked ultrasound probes. The proposed model was compared to two of the currently available phantom models for both electromagnetic and optical tracking. RESULTS: The phantom was successfully built by all ten first-time users in an average time of 18.8 minutes. It cost approximately $10 CAD for the required LEGO® bricks and averaged a 0.69mm of error in the calibration reproducibility for ultrasound calibrations. It is one third the cost of similar 3D printed phantoms and takes much less time to build. The proposed phantom's image reprojections were 0.13mm more erroneous than those of the highest performing current phantom model The average standard deviation of multiple 3D image reprojections differed by 0.05mm between the phantoms CONCLUSION: It was found that the phantom could be built in less time, was one third the cost, compared to similar 3D printed models. The proposed phantom was found to be capable of producing equivalent calibrations to 3D printed phantoms.

Performance of the Emotiv Epoc headset for P300-based applications

PubMed Central

2013-01-01

Background For two decades, EEG-based Brain-Computer Interface (BCI) systems have been widely studied in research labs. Now, researchers want to consider out-of-the-lab applications and make this technology available to everybody. However, medical-grade EEG recording devices are still much too expensive for end-users, especially disabled people. Therefore, several low-cost alternatives have appeared on the market. The Emotiv Epoc headset is one of them. Although some previous work showed this device could suit the customer’s needs in terms of performance, no quantitative classification-based assessments compared to a medical system are available. Methods This paper aims at statistically comparing a medical-grade system, the ANT device, and the Emotiv Epoc headset by determining their respective performances in a P300 BCI using the same electrodes. On top of that, a review of previous Emotiv studies and a discussion on practical considerations regarding both systems are proposed. Nine healthy subjects participated in this experiment during which the ANT and the Emotiv systems are used in two different conditions: sitting on a chair and walking on a treadmill at constant speed. Results The Emotiv headset performs significantly worse than the medical device; observed effect sizes vary from medium to large. The Emotiv headset has higher relative operational and maintenance costs than its medical-grade competitor. Conclusions Although this low-cost headset is able to record EEG data in a satisfying manner, it should only be chosen for non critical applications such as games, communication systems, etc. For rehabilitation or prosthesis control, this lack of reliability may lead to serious consequences. For research purposes, the medical system should be chosen except if a lot of trials are available or when the Signal-to-Noise Ratio is high. This also suggests that the design of a specific low-cost EEG recording system for critical applications and research is still required. PMID:23800158

Performance of the Emotiv Epoc headset for P300-based applications.

PubMed

Duvinage, Matthieu; Castermans, Thierry; Petieau, Mathieu; Hoellinger, Thomas; Cheron, Guy; Dutoit, Thierry

2013-06-25

For two decades, EEG-based Brain-Computer Interface (BCI) systems have been widely studied in research labs. Now, researchers want to consider out-of-the-lab applications and make this technology available to everybody. However, medical-grade EEG recording devices are still much too expensive for end-users, especially disabled people. Therefore, several low-cost alternatives have appeared on the market. The Emotiv Epoc headset is one of them. Although some previous work showed this device could suit the customer's needs in terms of performance, no quantitative classification-based assessments compared to a medical system are available. This paper aims at statistically comparing a medical-grade system, the ANT device, and the Emotiv Epoc headset by determining their respective performances in a P300 BCI using the same electrodes. On top of that, a review of previous Emotiv studies and a discussion on practical considerations regarding both systems are proposed. Nine healthy subjects participated in this experiment during which the ANT and the Emotiv systems are used in two different conditions: sitting on a chair and walking on a treadmill at constant speed. The Emotiv headset performs significantly worse than the medical device; observed effect sizes vary from medium to large. The Emotiv headset has higher relative operational and maintenance costs than its medical-grade competitor. Although this low-cost headset is able to record EEG data in a satisfying manner, it should only be chosen for non critical applications such as games, communication systems, etc. For rehabilitation or prosthesis control, this lack of reliability may lead to serious consequences. For research purposes, the medical system should be chosen except if a lot of trials are available or when the Signal-to-Noise Ratio is high. This also suggests that the design of a specific low-cost EEG recording system for critical applications and research is still required.

Cost-utility analysis of competing treatment strategies for drug-resistant epilepsy in children with Tuberous Sclerosis Complex.

PubMed

Fallah, Aria; Weil, Alexander G; Wang, Shelly; Lewis, Evan; Baca, Christine B; Mathern, Gary W

2016-10-01

The management of drug-resistant epilepsy in children with Tuberous Sclerosis Complex (TSC) is challenging because of the multitude of treatment options, wide range of associated costs, and uncertainty of seizure outcomes. The most cost-effective approach for children whose epilepsy has failed to improve with first-line medical therapy is uncertain. A review of MEDLINE from 1990 to 2015 was conducted. A cost-utility analysis, from a third-party payer perspective, was performed for children with drug-resistant epilepsy that had failed to improve with 2 antiseizure drugs (ASDs) and that was amenable to resective epilepsy surgery, across a time-horizon of 5years. Four strategies were included: (1) resective epilepsy surgery, (2) vagus nerve stimulator (VNS) implantation, (3) ketogenic diet, and (4) addition of a third ASD (specifically, carbamazepine). The incremental cost per quality-adjusted life year (QALY) gained was analyzed. Given a willingness-to-pay (WTP) of $100,000 per QALY, the addition of a third ASD ($6600 for a gain of 4.14 QALYs) was the most cost-effective treatment strategy. In a secondary analysis, if the child whose epilepsy had failed to improve with 3 ASDs, ketogenic diet, addition of a fourth ASD, and resective epilepsy surgery were incrementally cost-effective treatment strategies. Vagus nerve stimulator implantation was more expensive yet less effective than alternative strategies and should not be prioritized. The addition of a third ASD is a universally cost-effective treatment option in the management of children with drug-resistant epilepsy that has failed to improve with 2 ASDs. For children whose epilepsy has failed to improve with 3 ASDs, the most cost-effective treatment depends on the health-care resources available reflected by the WTP. Copyright © 2016 Elsevier Inc. All rights reserved.

Deep Needle Procedures: Improving Safety With Ultrasound Visualization

PubMed Central

Peabody, Christopher R.; Mandavia, Diku

2017-01-01

Abstract Promoting patient safety and increasing health care quality have dominated the health care landscape during the last 15 years. Health care regulators and payers are now tying patient safety outcomes and best practices to hospital reimbursement. Many health care leaders are searching for new technologies that not only make health care for patients safer but also reduce overall health care costs. New advances in ultrasonography have made this technology available to health care providers at the patient’s bedside. Point-of-care ultrasound assistance now aids providers with real-time diagnosis and with visualization for procedural guidance. This is especially true for common deep needle procedures such as central venous catheter insertion, thoracentesis, and paracentesis. There is now mounting evidence that clinician-performed point-of-care ultrasound improves patient safety, enhances health care quality, and reduces health care cost for deep needle procedures. Furthermore, the miniaturization, ease of use, and the evolving affordability of ultrasound have now made this technology widely available. The adoption of point-of-care ultrasonography has reached a tipping point and should be seriously considered the safety standard for all hospital-based deep needle procedures. PMID:24786918

Infrared Thermal Imaging System on a Mobile Phone

PubMed Central

Lee, Fu-Feng; Chen, Feng; Liu, Jing

2015-01-01

A novel concept towards pervasively available low-cost infrared thermal imaging system lunched on a mobile phone (MTIS) was proposed and demonstrated in this article. Through digestion on the evolutional development of milestone technologies in the area, it can be found that the portable and low-cost design would become the main stream of thermal imager for civilian purposes. As a representative trial towards this important goal, a MTIS consisting of a thermal infrared module (TIM) and mobile phone with embedded exclusive software (IRAPP) was presented. The basic strategy for the TIM construction is illustrated, including sensor adoption and optical specification. The user-oriented software was developed in the Android environment by considering its popularity and expandability. Computational algorithms with non-uniformity correction and scene-change detection are established to optimize the imaging quality and efficiency of TIM. The performance experiments and analysis indicated that the currently available detective distance for the MTIS is about 29 m. Furthermore, some family-targeted utilization enabled by MTIS was also outlined, such as sudden infant death syndrome (SIDS) prevention, etc. This work suggests a ubiquitous way of significantly extending thermal infrared image into rather wide areas especially health care in the coming time. PMID:25942639

Practical insights into gluten-free diets.

PubMed

See, Jacalyn A; Kaukinen, Katri; Makharia, Govind K; Gibson, Peter R; Murray, Joseph A

2015-10-01

Coeliac disease is a global disease, and the only currently available treatment is a gluten-free diet (GFD). Although conceptually simple, the diet changes are substantial and have a profound effect on a patient's life. Untreated coeliac disease is associated with complications, including excess mortality, most of which can be avoided with a strict GFD. However, there are many barriers, including availability, cost and safety of gluten-free foods, and gluten cross-contamination. The GFD can be restrictive in social situations, leading to poor quality of life and, ultimately, nonadherence. As the number of patients with coeliac disease increases worldwide, clinicians need to be aware of the challenges patients face. Heightened awareness by physicians, dietitians and other providers can help maximize successful treatment, improve outcomes, and reduce health-care costs and disease burden. Routine follow-up is necessary to reinforce the need for a GFD, provide social and emotional support, and achieve mucosal healing, leading to reduced risk of complications. Unfortunately, there is wide variation in follow-up practices. The objective of this Review is to increase awareness of the challenges, management and follow-up of patients with coeliac disease to help them achieve GFD adherence and prevent complications whilst preserving their quality of life.

NordicDB: a Nordic pool and portal for genome-wide control data.

PubMed

Leu, Monica; Humphreys, Keith; Surakka, Ida; Rehnberg, Emil; Muilu, Juha; Rosenström, Päivi; Almgren, Peter; Jääskeläinen, Juha; Lifton, Richard P; Kyvik, Kirsten Ohm; Kaprio, Jaakko; Pedersen, Nancy L; Palotie, Aarno; Hall, Per; Grönberg, Henrik; Groop, Leif; Peltonen, Leena; Palmgren, Juni; Ripatti, Samuli

2010-12-01

A cost-efficient way to increase power in a genetic association study is to pool controls from different sources. The genotyping effort can then be directed to large case series. The Nordic Control database, NordicDB, has been set up as a unique resource in the Nordic area and the data are available for authorized users through the web portal (http://www.nordicdb.org). The current version of NordicDB pools together high-density genome-wide SNP information from ∼5000 controls originating from Finnish, Swedish and Danish studies and shows country-specific allele frequencies for SNP markers. The genetic homogeneity of the samples was investigated using multidimensional scaling (MDS) analysis and pairwise allele frequency differences between the studies. The plot of the first two MDS components showed excellent resemblance to the geographical placement of the samples, with a clear NW-SE gradient. We advise researchers to assess the impact of population structure when incorporating NordicDB controls in association studies. This harmonized Nordic database presents a unique genome-wide resource for future genetic association studies in the Nordic countries.

NordicDB: a Nordic pool and portal for genome-wide control data

PubMed Central

Leu, Monica; Humphreys, Keith; Surakka, Ida; Rehnberg, Emil; Muilu, Juha; Rosenström, Päivi; Almgren, Peter; Jääskeläinen, Juha; Lifton, Richard P; Kyvik, Kirsten Ohm; Kaprio, Jaakko; Pedersen, Nancy L; Palotie, Aarno; Hall, Per; Grönberg, Henrik; Groop, Leif; Peltonen, Leena; Palmgren, Juni; Ripatti, Samuli

2010-01-01

A cost-efficient way to increase power in a genetic association study is to pool controls from different sources. The genotyping effort can then be directed to large case series. The Nordic Control database, NordicDB, has been set up as a unique resource in the Nordic area and the data are available for authorized users through the web portal (http://www.nordicdb.org). The current version of NordicDB pools together high-density genome-wide SNP information from ∼5000 controls originating from Finnish, Swedish and Danish studies and shows country-specific allele frequencies for SNP markers. The genetic homogeneity of the samples was investigated using multidimensional scaling (MDS) analysis and pairwise allele frequency differences between the studies. The plot of the first two MDS components showed excellent resemblance to the geographical placement of the samples, with a clear NW–SE gradient. We advise researchers to assess the impact of population structure when incorporating NordicDB controls in association studies. This harmonized Nordic database presents a unique genome-wide resource for future genetic association studies in the Nordic countries. PMID:20664631

Microalgae harvesting techniques: A review.

PubMed

Singh, Gulab; Patidar, S K

2018-07-01

Microalgae with wide range of commercial applications have attracted a lot of attention of the researchers in the last few decades. However, microalgae utilization is not economically sustainable due to high cost of harvesting. A wide range of solid - liquid separation techniques are available for microalgae harvesting. The techniques include coagulation and flocculation, flotation, centrifugation and filtration or a combination of various techniques. Despite the importance of harvesting to the economics and energy balance, there is no universal harvesting technique for microalgae. Therefore, this review focuses on assessing technical, economical and application potential of various harvesting techniques so as to allow selection of an appropriate technology for cost effectively harvesting of microalgae from their culture medium. Various harvesting and concentrating techniques of microalgae were reviewed to suggest order of suitability of the techniques for four main microalgae applications i.e biofuel, human and animal food, high valued products, and water quality restoration. For deciding the order of suitability, a comparative analysis of various harvesting techniques based on the six common criterions (i.e biomass quality, cost, biomass quantity, processing time, species specific and toxicity) has been done. Based on the order of various techniques vis-a-vis various criteria and preferred order of criteria for various applications, order of suitability of harvesting techniques for various applications has been decided. Among various harvesting techniques, coagulation and flocculation, centrifugation and filtration were found to be most suitable for considered applications. These techniques may be used alone or in combination for increasing the harvesting efficiency. Copyright © 2018 Elsevier Ltd. All rights reserved.

High-tech breakthrough DNA scanner for reading sequence and detecting gene mutation: A powerful 1 lb, 20 {mu}m resolution, 16-bit personal scanner (PS) that scans 17inch x 14inch x-ray film in 48 s, with laser, uv and white light sources

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

Zeineh, J.A.; Zeineh, M.M.; Zeineh, R.A.

1993-06-01

The 17inch x 14inch X-ray film, gels, and blots are widely used in DNA research. However, DNA laser scanners are costly and unaffordable for the majority of surveyed biotech scientists who need it. The high-tech breakthrough analytical personal scanner (PS) presented in this report is an inexpensive 1 lb hand-held scanner priced at 2-4% of the bulky and costly 30-95 lb conventional laser scanners. This PS scanner is affordable from an operation budget and biotechnologists, who originate most science breakthroughs, can acquire it to enhance their speed, accuracy, and productivity. Compared to conventional laser scanners that are currently available onlymore » through hard-to-get capital-equipment budgets, the new PS scanner offers improved spatial resolution of 20 {mu}m, higher speed (scan up to 17inch x 14inch molecular X-ray film in 48 s), 1-32,768 gray levels (16-bits), student routines, versatility, and, most important, affordability. Its programs image the film, read DNA sequences automatically, and detect gene mutation. In parallel to the wide laboratory use of PC computers instead of mainframes, this PS scanner might become an integral part of a PC-PS powerful and cost-effective system where the PS performs the digital imaging and the PC acts on the data.« less

Toward a defense-dominated world

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

Wood, L.

1993-08-01

Maintaining the large-scale peace in a defense-dominated world necessarily will require not only passive but also active defenses against large-scale aggression that are technically feasible, practical and easy to employ -- and robust against perversion into support of aggression. Such peace maintenance tool-sets will feature means for effectively rebuking aggression as well as providing timely and very widely available seaming of aggression underway anywhere. This report discusses the technology base which currently exists to provide world-wide, high-quality imagery at moderate (5--10 meter) spatial resolution or imagery of 1% of the Earth`s land surface at high ({le} 1 meter) resolution nomore » less frequently than daily, at a total cost of the order of $1 B, with operational capability in the later `90s. Such systems could provide timely warning of aggressive actions anywhere. Similarly, space-based means of defeating aggression conducted with even quite short-range ballistic missiles anywhere in the world could be brought into existence by the end of the `90s for a total cost of about $10 B, and small high-altitude, long flight-duration robotic aircraft carrying high-performance sensors and interceptor missilery could provide both seaming and active defenses against attacks conducted with very short range ballistic missiles, as well as attacks launched with air-breathing threats such as bombers and cruise missiles, for a cost per defended area of the order of $10/km{sup 2}. It appears that all of the associated sensors can find apt dual-use as high-performance systems for monitoring physical aspects of the human environment.« less

An economical fluorescence detector for lab-on-a-chip devices with a light emitting photodiode and a low-cost avalanche photodiode.

PubMed

Wu, Jing; Liu, Xianhu; Wang, Lili; Dong, Lijun; Pu, Qiaosheng

2012-01-21

An economical fluorescence detector was developed with an LED as the exciting source and a low-cost avalanche photodiode (APD) module as a photon sensor. The detector was arranged in an epifluorescence configuration using a microscope objective (20× or 40×) and a dichroic mirror. The low-cost APD was biased by a direct current (DC) high voltage power supply at 121 V, which is much lower than that normally used for a PMT. Both DC and square wave (SW) supplies were used to power the LED and different data treatment protocols, such as simple average for DC mode, software based lock-in amplification and time specific average for SW mode, were tested to maximize the signal-to-noise ratio. Using an LED at a DC mode with simple data averaging, a limit of detection of 0.2 nmol L(-1) for sodium fluorescein was attained, which is among the lowest ever achieved with an LED as an excitation source. The detector was successfully used in both capillary and chip electrophoresis. The most significant advantages of the detector are the compact size and low cost of its parts. The aim of the work is to prove that widely available, low-cost components for civilian use can be successfully used for miniaturized analytical devices.

The Costs of Employing Older Workers. An Information Paper Prepared for Use by the Special Committee on Aging, United States Senate.

ERIC Educational Resources Information Center

Morrison, Malcolm; Rappaport, Anna

Analysis of the costs of employing older workers indicates that some types of employment costs do vary by age and that overall compensation costs increase with age, largely because of increasing employee benefit costs. There is, however, no statistical evidence that direct salary costs increase by age on an economy-wide basis. The belief that…

Recent advances in genetic testing for familial hypercholesterolemia.

PubMed

Iacocca, Michael A; Hegele, Robert A

2017-07-01

Familial hypercholesterolemia (FH) is a common genetic cause of premature coronary heart disease that is widely underdiagnosed and undertreated. To improve the identification of FH and initiate timely and appropriate treatment strategies, genetic testing is becoming increasingly offered worldwide as a central part of diagnosis. Areas covered: Recent advances have been propelled by an improved understanding of the genetic determinants of FH together with substantially reduced costs of appropriate screening strategies. Here we review the various methods available for obtaining a molecular diagnosis of FH, and highlight the particular advantages of targeted next-generation sequencing (NGS) platforms as the most robust approach. Furthermore, we note the importance of screening for copy number variants and common polymorphisms to aid in molecularly defining suspected FH cases. Expert commentary: The need for genetic analysis of FH will increase, both for diagnosis and reimbursement of new therapies. An effective molecular diagnostic method must detect: 1) molecular and gene locus heterogeneity; 2) a wide range of mutation types; and 3) the polygenic component of FH. As availability of genetic testing for FH expands, standardization of variant curation, maintenance of clinical databases and registries, and wider health care provider education all assume greater importance.

Hydrogel Encapsulation Facilitates Rapid-Cooling Cryopreservation of Stem Cell-Laden Core-Shell Microcapsules as Cell-Biomaterial Constructs.

PubMed

Zhao, Gang; Liu, Xiaoli; Zhu, Kaixuan; He, Xiaoming

2017-12-01

Core-shell structured stem cell microencapsulation in hydrogel has wide applications in tissue engineering, regenerative medicine, and cell-based therapies because it offers an ideal immunoisolative microenvironment for cell delivery and 3D culture. Long-term storage of such microcapsules as cell-biomaterial constructs by cryopreservation is an enabling technology for their wide distribution and ready availability for clinical transplantation. However, most of the existing studies focus on cryopreservation of single cells or cells in microcapsules without a core-shell structure (i.e., hydrogel beads). The goal of this study is to achieve cryopreservation of stem cells encapsulated in core-shell microcapsules as cell-biomaterial constructs or biocomposites. To this end, a capillary microfluidics-based core-shell alginate hydrogel encapsulation technology is developed to produce porcine adipose-derived stem cell-laden microcapsules for vitreous cryopreservation with very low concentration (2 mol L -1 ) of cell membrane penetrating cryoprotective agents (CPAs) by suppressing ice formation. This may provide a low-CPA and cost-effective approach for vitreous cryopreservation of "ready-to-use" stem cell-biomaterial constructs, facilitating their off-the-shelf availability and widespread applications. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

CLIPS: The C language integrated production system

NASA Technical Reports Server (NTRS)

Riley, Gary

1994-01-01

Expert systems are computer programs which emulate human expertise in well defined problem domains. The potential payoff from expert systems is high: valuable expertise can be captured and preserved, repetitive and/or mundane tasks requiring human expertise can be automated, and uniformity can be applied in decision making processes. The C Language Integrated Production System (CLIPS) is an expert system building tool, developed at the Johnson Space Center, which provides a complete environment for the development and delivery of rule and/or object based expert systems. CLIPS was specifically designed to provide a low cost option for developing and deploying expert system applications across a wide range of hardware platforms. The commercial potential of CLIPS is vast. Currently, CLIPS is being used by over 5,000 individuals throughout the public and private sector. Because the CLIPS source code is readily available, numerous groups have used CLIPS as the basis for their own expert system tools. To date, three commercially available tools have been derived from CLIPS. In general, the development of CLIPS has helped to improve the ability to deliver expert system technology throughout the public and private sectors for a wide range of applications and diverse computing environments.

The Evolving Landscape of HIV Drug Resistance Diagnostics for Expanding Testing in Resource-Limited Settings.

PubMed

Inzaule, Seth C; Hamers, Ralph L; Paredes, Roger; Yang, Chunfu; Schuurman, Rob; Rinke de Wit, Tobias F

2017-01-01

Global scale-up of antiretroviral treatment has dramatically changed the prospects of HIV/AIDS disease, rendering life-long chronic care and treatment a reality for millions of HIV-infected patients. Affordable technologies to monitor antiretroviral treatment are needed to ensure long-term durability of limited available drug regimens. HIV drug resistance tests can complement existing strategies in optimizing clinical decision-making for patients with treatment failure, in addition to facilitating population-based surveillance of HIV drug resistance. This review assesses the current landscape of HIV drug resistance technologies and discusses the strengths and limitations of existing assays available for expanding testing in resource-limited settings. These include sequencing-based assays (Sanger sequencing assays and nextgeneration sequencing), point mutation assays, and genotype-free data-based prediction systems. Sanger assays are currently considered the gold standard genotyping technology, though only available at a limited number of resource-limited setting reference and regional laboratories, but high capital and test costs have limited their wide expansion. Point mutation assays present opportunities for simplified laboratory assays, but HIV genetic variability, extensive codon redundancy at or near the mutation target sites with limited multiplexing capability have restricted their utility. Next-generation sequencing, despite high costs, may have potential to reduce the testing cost significantly through multiplexing in high-throughput facilities, although the level of bioinformatics expertise required for data analysis is currently still complex and expensive and lacks standardization. Web-based genotype-free prediction systems may provide enhanced antiretroviral treatment decision-making without the need for laboratory testing, but require further clinical field evaluation and implementation scientific research in resource-limited settings.

Outbreak Investigation Using High-Throughput Genome Sequencing within a Diagnostic Microbiology Laboratory

PubMed Central

Sherry, Norelle L.; Porter, Jessica L.; Seemann, Torsten; Watkins, Andrew; Stinear, Timothy P.

2013-01-01

Next-generation sequencing (NGS) of bacterial genomes has recently become more accessible and is now available to the routine diagnostic microbiology laboratory. However, questions remain regarding its feasibility, particularly with respect to data analysis in nonspecialist centers. To test the applicability of NGS to outbreak investigations, Ion Torrent sequencing was used to investigate a putative multidrug-resistant Escherichia coli outbreak in the neonatal unit of the Mercy Hospital for Women, Melbourne, Australia. Four suspected outbreak strains and a comparator strain were sequenced. Genome-wide single nucleotide polymorphism (SNP) analysis demonstrated that the four neonatal intensive care unit (NICU) strains were identical and easily differentiated from the comparator strain. Genome sequence data also determined that the NICU strains belonged to multilocus sequence type 131 and carried the blaCTX-M-15 extended-spectrum beta-lactamase. Comparison of the outbreak strains to all publicly available complete E. coli genome sequences showed that they clustered with neonatal meningitis and uropathogenic isolates. The turnaround time from a positive culture to the completion of sequencing (prior to data analysis) was 5 days, and the cost was approximately $300 per strain (for the reagents only). The main obstacles to a mainstream adoption of NGS technologies in diagnostic microbiology laboratories are currently cost (although this is decreasing), a paucity of user-friendly and clinically focused bioinformatics platforms, and a lack of genomics expertise outside the research environment. Despite these hurdles, NGS technologies provide unparalleled high-resolution genotyping in a short time frame and are likely to be widely implemented in the field of diagnostic microbiology in the next few years, particularly for epidemiological investigations (replacing current typing methods) and the characterization of resistance determinants. Clinical microbiologists need to familiarize themselves with these technologies and their applications. PMID:23408689

The impact of high-resolution topography on landslide characterization using DInSAR

NASA Astrophysics Data System (ADS)

Tiampo, K. F.; Barba, M.; Jacquemart, M. F.; Willis, M. J.; González, P. J.; McKee, C.; Samsonov, S. V.; Feng, W.

2017-12-01

Differential interferometric synthetic aperture radar (DInSAR) can measure surface deformation at the centimeter level and, as a result, has been used to investigate a wide variety of natural hazards since the 1990s. In general, short spatial and temporal baselines are selected to reduce decorrelation and the effect of incorrect removal of the topographic component in differential interferograms. The nearly global coverage of the Shuttle Radar Topography Mission (SRTM) digital elevation models (DEMs) significantly simplified and improved the modelling and removal of topography for differential interferometric applications. However, DEMs are produced today at much finer resolutions, although with varying availability and cost. SRTM DEMs are freely available at 30 m resolution world-wide and 10 m resolution in the US. The TanDEM-X mission has produced a worldwide DEM at 12 m, although it is not generally free of cost. Light Detection and Ranging (LiDAR) DEMs can provide better than 1m resolution, but are expensive to produce over limited extents. Finally, DEMs from optical data can be produced from Digital Globe satellite images over larger regions at resolutions of less than 1 m, subject to various restrictions. It can be shown that the coherence quality of a DInSAR image is directly related to the DEM resolution, improving recovery of the differential phase by significantly reducing the geometric decorrelation, and that the number of recovered pixels significantly increases with higher resolutions, particularly in steep topography. In this work we quantify that improvement for varying resolutions, from 1 to 30 m, and slopes and investigate its effect on the characterization of landslides in different regions and with a variety of surface conditions, including Greenland, Alaska, California, and the Canary Islands.

Cranioplasty with a low-cost customized polymethylmethacrylate implant using a desktop 3D printer.

PubMed

Morales-Gómez, Jesús A; Garcia-Estrada, Everardo; Leos-Bortoni, Jorge E; Delgado-Brito, Miriam; Flores-Huerta, Luis E; De La Cruz-Arriaga, Adriana A; Torres-Díaz, Luis J; de León, Ángel R Martínez-Ponce

2018-06-15

OBJECTIVE Cranioplasty implants should be widely available, low in cost, and customized or easy to mold during surgery. Although autologous bone remains the first choice for repair, it cannot always be used due to infection, fragmentation, bone resorption, or other causes, which led to use of synthetic alternatives. The most frequently used allogenic material for cranial reconstructions with long-term results is polymethylmethacrylate (PMMA). Three-dimensional printing technology has allowed the production of increasingly popular customized, prefabricated implants. The authors describe their method and experience with a customized PMMA prosthesis using a precise and reliable low-cost implant that can be customized at any institution with open-source or low-cost software and desktop 3D printers. METHODS A review of 22 consecutive patients undergoing CT-based, low-cost, customized PMMA cranioplasty over a 1-year period at a university teaching hospital was performed. Preoperative data included patient sex and age; CT modeling parameters, including the surface area of the implant (defect); reason for craniectomy; date(s) of injury and/or resections; the complexity of the defect; and associated comorbidities. Postoperative data included morbiditiy and complications, such as implant exposure, infection, hematoma, seroma, implant failure, and seizures; the cost of the implant; and cosmetic outcome. RESULTS Indications for the primary craniectomy were traumatic brain injury (16, 73%), tumor resection (3, 14%), infection (1, 4%), and vascular (2, 9%). The median interval between previous surgery and PMMA cranioplasty was 12 months. The operation time ranged from 90 to 150 minutes (mean 126 minutes). The average cranial defect measured 65.16 cm 2 (range 29.31-131.06 cm 2 ). During the recovery period, there was no sign of infection, implant rejection, or wound dehiscence, and none of the implants had to be removed over a follow-up ranging from 1 to 6 months. The aesthetic appearance of all patients was significantly improved, and the implant fit was excellent. CONCLUSIONS The use of a customized PMMA was associated with excellent patient, family, and surgeon satisfaction at follow-up at a fraction of the cost associated with commercially available implants. This technique could be an attractive option to all patients undergoing cranioplasty.

Space Technology: Game Changing Development Deep Space Engine (DSE) 100 lbf and 5 lbf Thruster Development and Qualification

NASA Technical Reports Server (NTRS)

Barnett, Gregory

2017-01-01

Science mission studies require spacecraft propulsion systems that are high-performance, lightweight, and compact. Highly matured technology and low-cost, short development time of the propulsion system are also very desirable. The Deep Space Engine (DSE) 100-lbf thruster is being developed to meet these needs. The overall goal of this game changing technology project is to qualify the DSE thrusters along with 5-lbf attitude control thrusters for space flight and for inclusion in science and exploration missions. The aim is to perform qualification tests representative of mission duty cycles. Most exploration missions are constrained by mass, power and cost. As major propulsion components, thrusters are identified as high-risk, long-lead development items. NASA spacecraft primarily rely on 1960s' heritage in-space thruster designs and opportunities exist for reducing size, weight, power, and cost through the utilization of modern materials and advanced manufacturing techniques. Advancements in MON-25/MMH hypergolic bipropellant thrusters represent a promising avenue for addressing these deficiencies with tremendous mission enhancing benefits. DSE is much lighter and costs less than currently available thrusters in comparable thrust classes. Because MON-25 propellants operate at lower temperatures, less power is needed for propellant conditioning for in-space propulsion applications, especially long duration and/or deep-space missions. Reduced power results in reduced mass for batteries and solar panels. DSE is capable of operating at a wide propellant temperature range (between -22 F and 122 F) while a similar existing thruster operates between 45 F and 70 F. Such a capability offers robust propulsion operation as well as flexibility in design. NASA's Marshall Space Flight Center evaluated available operational Missile Defense Agency heritage thrusters suitable for the science and lunar lander propulsion systems.

Use of Intermediate Endpoints in the Economic Evaluation of New Treatments for Advanced Cancer and Methods Adopted When Suitable Overall Survival Data are Not Available.

PubMed

Beauchemin, Catherine; Lapierre, Marie-Ève; Letarte, Nathalie; Yelle, Louise; Lachaine, Jean

2016-09-01

This study assessed the use of intermediate endpoints in the economic evaluation of new treatments for advanced cancer and the methodological approaches adopted when overall survival (OS) data are unavailable or of limited use. A systematic literature review was conducted to identify economic evaluations of treatments for advanced cancer published between 2003 and 2013. Cost-effectiveness and cost-utility analyses expressed in cost per life-year gained and cost per quality-adjusted life-year using an intermediate endpoint as an outcome measure were eligible. Characteristics of selected studies were extracted and comprised population, treatment of interest, comparator, line of treatment, study perspective, and time horizon. Use of intermediate endpoints and methods adopted when OS data were lacking were analyzed. In total, 7219 studies were identified and 100 fulfilled the eligibility criteria. Intermediate endpoints mostly used were progression-free survival and time to progression, accounting for 92 % of included studies. OS data were unavailable for analysis in nearly 25 % of economic evaluations. In the absence of OS data, studies most commonly assumed an equal risk of death for all treatment groups. Other methods included use of indirect comparison based on numerous assumptions, use of a proxy for OS, consultation with clinical experts, and use of published external information from different treatment settings. Intermediate endpoints are widely used in the economic evaluation of new treatments for advanced cancer in order to estimate OS. Currently, different methods are used in the absence of suitable OS data and the choice of an appropriate method depends on many factors including the data availability.

Pediatric Price Transparency: Still Opaque With Opportunities for Improvement.

PubMed

Faherty, Laura J; Wong, Charlene A; Feingold, Jordyn; Li, Joan; Town, Robert; Fieldston, Evan; Werner, Rachel M

2017-10-01

Price transparency is gaining importance as families' portion of health care costs rise. We describe (1) online price transparency data for pediatric care on children's hospital Web sites and state-based price transparency Web sites, and (2) the consumer experience of obtaining an out-of-pocket estimate from children's hospitals for a common procedure. From 2015 to 2016, we audited 45 children's hospital Web sites and 38 state-based price transparency Web sites, describing availability and characteristics of health care prices and personalized cost estimate tools. Using secret shopper methodology, we called children's hospitals and submitted online estimate requests posing as a self-paying family requesting an out-of-pocket estimate for a tonsillectomy-adenoidectomy. Eight children's hospital Web sites (18%) listed prices. Twelve (27%) provided personalized cost estimate tool (online form n = 5 and/or phone number n = 9). All 9 hospitals with a phone number for estimates provided the estimated patient liability for a tonsillectomy-adenoidectomy (mean $6008, range $2622-$9840). Of the remaining 36 hospitals without a dedicated price estimate phone number, 21 (58%) provided estimates (mean $7144, range $1200-$15 360). Two of 4 hospitals with online forms provided estimates. Fifteen (39%) state-based Web sites distinguished between prices for pediatric and adult care. One had a personalized cost estimate tool. Meaningful prices for pediatric care were not widely available online through children's hospital or state-based price transparency Web sites. A phone line or online form for price estimates were effective strategies for hospitals to provide out-of-pocket price information. Opportunities exist to improve pediatric price transparency. Copyright © 2017 by the American Academy of Pediatrics.

Application of Emerging Open-source Embedded Systems for Enabling Low-cost Wireless Mini-observatory Nodes in the Coastal Zone

NASA Astrophysics Data System (ADS)

Glazer, B. T.

2016-02-01

Here, we describe the development of novel, low-cost, open-source instrumentation to enable wireless data transfer of biogeochemical sensors in the coastal zone. The platform is centered upon the Beaglebone Black single board computer. Process-inquiry in environmental sciences suffers from undersampling; enabling sustained and unattended data collection typically involves expensive instrumentation and infrastructure deployed as cabled observatories with little flexibility in deployment location following initial installation. High cost of commercially-available or custom electronic packages have not only limited the number of sensor node sites that can be targeted by reasonably well-funded academic researchers, but have also entirely prohibited widespread engagement with K-12, public non-profit, and `citizen scientist' STEM audiences. The new platform under development represents a balanced blend of research-grade sensors and low-cost open-source electronics that are easily assembled. Custom, robust, open-source code that remains customizable for specific node configurations can match a specific deployment's measurement needs, depending on the scientific research priorities. We have demonstrated prototype capabilities and versatility through lab testing and field deployments of multiple sensor nodes with multiple sensor inputs, all of which are streaming near-real-time data over wireless RF links to a shore-based base station. On shore, first-pass data processing QA/QC takes place and near-real-time plots are made available on the World Wide Web. Specifically, we have worked closely with an environmental and cultural management and restoration non-profit organization, and middle and high school science classes, engaging their interest in STEM application to local watershed processes. Ultimately, continued successful development of this pilot project can lead to a coastal oceanographic analogue of the popular Weather Underground personal weather station model.

Real-world healthcare costs of ipilimumab in patients with advanced cutaneous melanoma in The Netherlands.

PubMed

Franken, Margreet G; Leeneman, Brenda; Jochems, Anouk; Schouwenburg, Maartje G; Aarts, Maureen J B; van Akkooi, Alexander C J; van den Berkmortel, Franchette W P J; van den Eertwegh, Alfonsus J M; de Groot, Jan Willem B; van der Hoeven, Koos J M; Hospers, Geke A P; Kapiteijn, Ellen; Koornstra, Rutger; Kruit, Wim H J; Louwman, Marieke W J; Piersma, Djura; van Rijn, Rozemarijn S; Suijkerbuijk, Karijn P M; Ten Tije, Albert J; Vreugdenhil, Gerard; Wouters, Michel W J M; van Zeijl, Michiel; Haanen, John B A G; Uyl-de Groot, Carin A

2018-07-01

There is limited evidence on the costs associated with ipilimumab. We investigated healthcare costs of all Dutch patients with advanced cutaneous melanoma who were treated with ipilimumab. Data were retrieved from the nation-wide Dutch Melanoma Treatment Registry. Costs were determined by applying unit costs to individual patient resource use. A total of 807 patients who were diagnosed between July 2012 and July 2015 received ipilimumab in Dutch practice. The mean (median) episode duration was 6.27 (4.61) months (computed from the start of ipilimumab until the start of a next treatment, death, or the last date of follow-up). The average total healthcare costs amounted to &OV0556;81 484, but varied widely (range: &OV0556;18 131-&OV0556;160 002). Ipilimumab was by far the most important cost driver (&OV0556;73 739). Other costs were related to hospital admissions (&OV0556;3323), hospital visits (&OV0556;1791), diagnostics and imaging (&OV0556;1505), radiotherapy (&OV0556;828), and surgery (&OV0556;297). Monthly costs for resource use other than ipilimumab were &OV0556;1997 (SD: &OV0556;2629). Treatment-naive patients (n=344) had higher total costs compared with previously-treated patients (n=463; &OV0556;85 081 vs. &OV0556;78 811). Although patients with colitis (n=106) had higher costs for resource use other than ipilimumab (&OV0556;11 426) compared with patients with other types of immune-related adverse events (n=90; &OV0556;9850) and patients with no immune-related adverse event (n=611; &OV0556;6796), they had lower total costs (&OV0556;76 075 vs. &OV0556;87 882 and &OV0556;81 480, respectively). In conclusion, this nation-wide study provides valuable insights into the healthcare costs of advanced cutaneous melanoma patients who were treated with ipilimumab in clinical practice. Most of the costs were attributable to ipilimumab, but the costs and its distribution varied considerably across subgroups.

47 CFR 54.518 - Support for wide area networks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Support for wide area networks. 54.518 Section... area networks. To the extent that states, schools, or libraries build or purchase a wide area network to provide telecommunications services, the cost of such wide area networks shall not be eligible for...

Systematic review and quality assessment of cost-effectiveness analysis of pharmaceutical therapies for advanced colorectal cancer.

PubMed

Leung, Henry W C; Chan, Agnes L F; Leung, Matthew S H; Lu, Chin-Li

2013-04-01

To systematically review and assess the quality of cost-effectiveness analyses (CEAs) of pharmaceutical therapies for metastatic colorectal cancer (mCRC). The MEDLINE, EMBASE, Cochrane, and EconLit databases were searched for the Medical Subject Headings or text key words quality-adjusted, QALY, life-year gained (LYG), and cost-effectiveness (January 1, 1999-December 31, 2009). Original CEAs of mCRC pharmacotherapy published in English were included. CEAs that measured health effects in units other than quality-adjusted life years or LYG and letters to the editor, case reports, posters, and editorials were excluded. Each article was independently assessed by 2 trained reviewers according to a quality checklist created by the Panel on Cost-Effectiveness in Health and Medicine. Twenty-four CEA studies pertaining to pharmaceutical therapies for mCRC were identified. All studies showed a wide variation in methodologic approaches, which resulted in a different range of incremental cost-effectiveness ratios reported for each regimen. We found common methodologic flaws in a significant number of CEA studies, including lack of clear description for critique of data quality; lack of method for adjusting costs for inflation and methods for obtaining expert judgment; no results of model validation; wide differences in the types of perspective, time horizon, study design, cost categories, and effect outcomes; and no quality assessment of data (cost and effectiveness) for the interventions evaluation. This study has shown a wide variation in the methodology and quality of cost-effectiveness analysis for mCRC. Improving quality and harmonization of CEA for cancer treatment is needed. Further study is suggested to assess the quality of CEA methodology outside the mCRC disease state.

Impact of treatment heterogeneity on drug resistance and supply chain costs☆

PubMed Central

Spiliotopoulou, Eirini; Boni, Maciej F.; Yadav, Prashant

2013-01-01

The efficacy of scarce drugs for many infectious diseases is threatened by the emergence and spread of resistance. Multiple studies show that available drugs should be used in a socially optimal way to contain drug resistance. This paper studies the tradeoff between risk of drug resistance and operational costs when using multiple drugs for a specific disease. Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases. We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain. Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used. Our analysis shows that under a wide variety of scenarios for disease prevalence and drug cost, it is optimal to simultaneously deploy multiple drugs in the population. If the drug price is high, large volume purchasing discounts are available, and disease prevalence is high, it may be optimal to use only one drug. Our model lends insights to policy makers into the socially optimal size of drug assortment for a given context. PMID:25843982

Molecular diagnostics for low resource settings

NASA Astrophysics Data System (ADS)

Weigl, Bernhard H.

2010-03-01

As traditional high quality diagnostic laboratories are not widely available or affordable in developing country health care settings, microfluidics-based point-of-care diagnostics may be able to address the need to perform complex assays in under-resourced areas. Many instrument-based as well as non-instrumented microfluidic prototype diagnostics are currently being developed. In addition to various engineering challenges, the greatest remaining issue is the search for truly low-cost disposable manufacturing methods. Diagnostics for global health, and specifically microfluidics and molecular-based low resource diagnostics, have become a very active research area over the last five years, thanks in part to new funding that became available from the Bill and Melinda Gates Foundation, the National Institutes of Health, and other sources. This has led to a number of interesting prototype devices that are now in advanced development or clinical validation. These devices include disposables and instruments that perform multiplexed PCR-based lab-on-a-chips for enteric, febrile, and vaginal diseases, as well as immunoassays for diseases such as malaria, HIV, and various sexually transmitted diseases. More recently, instrument-free diagnostic disposables based on isothermal nucleic acid amplification have been developed as well. Regardless of platform, however, the search for truly low-cost manufacturing methods that would result in cost of goods per disposable of around US1/unit at volume remains a big challenge. This talk will give an overview over existing platform development efforts as well as present some original research in this area at PATH.

SwarmSight: Measuring the Temporal Progression of Animal Group Activity Levels from Natural Scene and Laboratory Videos

PubMed Central

Birgiolas, Justas; Jernigan, Christopher M.; Smith, Brian H.; Crook, Sharon M.

2016-01-01

We describe SwarmSight (available at: https://github.com/justasb/SwarmSight), a novel, open-source, Microsoft Windows software tool for quantitative assessment of the temporal progression of animal group activity levels from recorded videos. The tool utilizes a background subtraction machine vision algorithm and provides an activity metric that can be used to quantitatively assess and compare animal group behavior. Here we demonstrate the tool utility by analyzing defensive bee behavior as modulated by alarm pheromones, wild bird feeding onset and interruption, and cockroach nest finding activity. While more sophisticated, commercial software packages are available, SwarmSight provides a low-cost, open-source, and easy-to-use alternative that is suitable for a wide range of users, including minimally trained research technicians and behavioral science undergraduate students in classroom laboratory settings. PMID:27130170

Geometric Calibration and Radiometric Correction of the Maia Multispectral Camera

NASA Astrophysics Data System (ADS)

Nocerino, E.; Dubbini, M.; Menna, F.; Remondino, F.; Gattelli, M.; Covi, D.

2017-10-01

Multispectral imaging is a widely used remote sensing technique, whose applications range from agriculture to environmental monitoring, from food quality check to cultural heritage diagnostic. A variety of multispectral imaging sensors are available on the market, many of them designed to be mounted on different platform, especially small drones. This work focuses on the geometric and radiometric characterization of a brand-new, lightweight, low-cost multispectral camera, called MAIA. The MAIA camera is equipped with nine sensors, allowing for the acquisition of images in the visible and near infrared parts of the electromagnetic spectrum. Two versions are available, characterised by different set of band-pass filters, inspired by the sensors mounted on the WorlView-2 and Sentinel2 satellites, respectively. The camera details and the developed procedures for the geometric calibrations and radiometric correction are presented in the paper.

Technical guidance for the development of a solid state image sensor for human low vision image warping

NASA Technical Reports Server (NTRS)

Vanderspiegel, Jan

1994-01-01

This report surveys different technologies and approaches to realize sensors for image warping. The goal is to study the feasibility, technical aspects, and limitations of making an electronic camera with special geometries which implements certain transformations for image warping. This work was inspired by the research done by Dr. Juday at NASA Johnson Space Center on image warping. The study has looked into different solid-state technologies to fabricate image sensors. It is found that among the available technologies, CMOS is preferred over CCD technology. CMOS provides more flexibility to design different functions into the sensor, is more widely available, and is a lower cost solution. By using an architecture with row and column decoders one has the added flexibility of addressing the pixels at random, or read out only part of the image.

Emerging from the bottleneck: benefits of the comparative approach to modern neuroscience.

PubMed

Brenowitz, Eliot A; Zakon, Harold H

2015-05-01

Neuroscience has historically exploited a wide diversity of animal taxa. Recently, however, research has focused increasingly on a few model species. This trend has accelerated with the genetic revolution, as genomic sequences and genetic tools became available for a few species, which formed a bottleneck. This coalescence on a small set of model species comes with several costs that are often not considered, especially in the current drive to use mice explicitly as models for human diseases. Comparative studies of strategically chosen non-model species can complement model species research and yield more rigorous studies. As genetic sequences and tools become available for many more species, we are poised to emerge from the bottleneck and once again exploit the rich biological diversity offered by comparative studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Benefits, Limitations, and Cost-Effectiveness of Advanced Technologies in the Management of Patients With Diabetes Mellitus

PubMed Central

Vigersky, Robert A.

2015-01-01

Background: Hypoglycemia mitigation is critical for appropriately managing patients with diabetes. Advanced technologies are becoming more prevalent in diabetes management, but their benefits have been primarily judged on the basis of hemoglobin A1c. A critical appraisal of the effectiveness and limitations of advanced technologies in reducing both A1c and hypoglycemia rates has not been previously performed. Methods: The cost of hypoglycemia was estimated using literature rates of hypoglycemia events resulting in hospitalizations. A literature search was conducted on the effect on A1c and hypoglycemia of advanced technologies. The cost-effectiveness of continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitors (RT-CGM) was reviewed. Results: Severe hypoglycemia in insulin-using patients with diabetes costs $4.9-$12.7 billion. CSII reduces A1c in some but not all studies. CSII improves hypoglycemia in patients with high baseline rates. Bolus calculators improve A1c and improve the fear of hypoglycemia but not hypoglycemia rates. RT-CGM alone and when combined with CSII improve A1c with a neutral effect on hypoglycemia rates. Low-glucose threshold suspend systems reduce hypoglycemia with a neutral effect on A1c, and low-glucose predictive suspend systems reduce hypoglycemia with a small increase in plasma glucose levels. In short-term studies, artificial pancreas systems reduce both hypoglycemia rates and plasma glucose levels. CSII and RT-CGM are cost-effective technologies, but their wide adoption is limited by cost, psychosocial, and educational factors. Conclusions: Most currently available technologies improve A1c with a neutral or improved rate of hypoglycemia. Advanced technologies appear to be cost-effective in diabetes management, especially when including the underlying cost of hypoglycemia. PMID:25555391

Probabilistic cost estimates for climate change mitigation.

PubMed

Rogelj, Joeri; McCollum, David L; Reisinger, Andy; Meinshausen, Malte; Riahi, Keywan

2013-01-03

For more than a decade, the target of keeping global warming below 2 °C has been a key focus of the international climate debate. In response, the scientific community has published a number of scenario studies that estimate the costs of achieving such a target. Producing these estimates remains a challenge, particularly because of relatively well known, but poorly quantified, uncertainties, and owing to limited integration of scientific knowledge across disciplines. The integrated assessment community, on the one hand, has extensively assessed the influence of technological and socio-economic uncertainties on low-carbon scenarios and associated costs. The climate modelling community, on the other hand, has spent years improving its understanding of the geophysical response of the Earth system to emissions of greenhouse gases. This geophysical response remains a key uncertainty in the cost of mitigation scenarios but has been integrated with assessments of other uncertainties in only a rudimentary manner, that is, for equilibrium conditions. Here we bridge this gap between the two research communities by generating distributions of the costs associated with limiting transient global temperature increase to below specific values, taking into account uncertainties in four factors: geophysical, technological, social and political. We find that political choices that delay mitigation have the largest effect on the cost-risk distribution, followed by geophysical uncertainties, social factors influencing future energy demand and, lastly, technological uncertainties surrounding the availability of greenhouse gas mitigation options. Our information on temperature risk and mitigation costs provides crucial information for policy-making, because it clarifies the relative importance of mitigation costs, energy demand and the timing of global action in reducing the risk of exceeding a global temperature increase of 2 °C, or other limits such as 3 °C or 1.5 °C, across a wide range of scenarios.

Cost-effectiveness of health care service delivery interventions in low and middle income countries: a systematic review.

PubMed

Watson, Samuel I; Sahota, Harvir; Taylor, Celia A; Chen, Yen-Fu; Lilford, Richard J

2018-01-01

Low and middle income countries (LMICs) face severe resource limitations but the highest burden of disease. There is a growing evidence base on effective and cost-effective interventions for these diseases. However, questions remain about the most cost-effective method of delivery for these interventions. We aimed to review the scope, quality, and findings of economic evaluations of service delivery interventions in LMICs. We searched PUBMED, MEDLINE, EconLit, and NHS EED for studies published between 1st January 2000 and 30th October 2016 with no language restrictions. We included all economic evaluations that reported incremental costs and benefits or summary measures of the two such as an incremental cost effectiveness ratio. Studies were grouped by both disease area and outcome measure and permutation plots were completed for similar interventions. Quality was judged by the Drummond checklist. Overall, 3818 potentially relevant abstracts were identified of which 101 studies were selected for full text review. Thirty-seven studies were included in the final review. Twenty-three studies reported on interventions we classed as "changing by whom and where care was provided", specifically interventions that entailed task-shifting from doctors to nurses or community health workers or from facilities into the community. Evidence suggests this type of intervention is likely to be cost-effective or cost-saving. Nine studies reported on quality improvement initiatives, which were generally found to be cost-effective. Quality and methods differed widely limiting comparability of the studies and findings. There is significant heterogeneity in the literature, both methodologically and in quality. This renders further comparisons difficult and limits the utility of the available evidence to decision makers.

Joint impacts of minimum legal drinking age and beer taxes on US youth traffic fatalities, 1975 to 2001.

PubMed

Ponicki, William R; Gruenewald, Paul J; LaScala, Elizabeth A

2007-05-01

There is a considerable body of prior research indicating that a number of public policies that limit alcohol availability affect youth traffic fatalities. These limitations can be economic (e.g., beverage taxation), physical (e.g., numbers or operating hours of alcohol outlets), or demographic (e.g., minimum legal drinking age). The estimated impacts of these policies differ widely across studies. A full-price theoretical approach suggests that people weigh the benefits of drinking against the sum of all the associated costs, including the price of the beverages themselves plus the difficulty of obtaining them and any additional risks of injury or punishment related to their use. This study tested one prediction of this model, namely that the impact from changing one availability-related cost depends on the level of other components of full cost. The current analyses concentrate on 2 forms of limitations on availability that have been shown to affect youth traffic fatalities: minimum legal drinking age (MLDA) laws and beer taxes. The interdependence between the impacts of MLDA and taxes is investigated using a panel of 48 US states over the period 1975 to 2001. All age-group-specific models control for numerous other variables previously shown to affect vehicle fatalities, as well as fixed effects to account for unexplained crosssectional and time-series variation. The analyses showed that raising either MLDA or beer taxes in isolation led to fewer youth traffic fatalities. As expected, a given change in MLDA causes a larger proportional change in fatalities when beer taxes are low than when they are high. These findings suggest that a community's expected benefit from a proposed limitation on alcohol availability depends on its current regulatory environment. Specifically, communities with relatively strong existing policies might expect smaller impacts than suggested by prior research, while places with weak current regulations might expect larger benefits from the same policy initiative.

Implementing a Cost Effectiveness Analyzer for Web-Supported Academic Instruction: A Campus Wide Analysis

ERIC Educational Resources Information Center

Cohen, Anat; Nachmias, Rafi

2009-01-01

This paper describes the implementation of a quantitative cost effectiveness analyzer for Web-supported academic instruction that was developed in Tel Aviv University during a long term study. The paper presents the cost effectiveness analysis of Tel Aviv University campus. Cost and benefit of 3,453 courses were analyzed, exemplifying campus-wide…

Habitat improvement costs on state-owned wildlife management areas in New York

Treesearch

Ronald J. Glass

1989-01-01

Estimates of management costs on New York's wildlife management areas indicate that human management is more costly than habitat management. Agricultural agreements and timber sales make a major contribution to habitat inhancement, and a wide variety of wildlife species benefit.

Computer programs for estimating civil aircraft economics

NASA Technical Reports Server (NTRS)

Maddalon, D. V.; Molloy, J. K.; Neubawer, M. J.

1980-01-01

Computer programs for calculating airline direct operating cost, indirect operating cost, and return on investment were developed to provide a means for determining commercial aircraft life cycle cost and economic performance. A representative wide body subsonic jet aircraft was evaluated to illustrate use of the programs.

A broad-band microseismometer for planetary operations

NASA Technical Reports Server (NTRS)

Banerdt, W. B.; Vanzandt, T.; Kaiser, W. J.; Kenny, T. W.

1993-01-01

There has recently been renewed interest in the development of instrumentation for making measurements on the surface of Mars. This is due to the Mars Environmental Survey (MESUR) Mission, for which approximately 16 small, long-lived (2-10 years), relatively inexpensive surface stations will be deployed in a planet-wide network. This will allow the investigation of processes (such as seismology and meteorology) which require the simultaneous measurement of phenomena at many widely spaced locations on the surface over a considerable length of time. Due to the large number of vehicles involved, the mass, power, and cost of the payload will be severely constrained. A seismometer has been identified as one of the highest priority instruments in the MESUR straw-man payload. The requirements for an effective seismic experiment on Mars place a number of constraints on any viable sensor design. First, a large number of sensors must be deployed in a long-lived global network in order to be able to locate many events reliably, provide good spatial sampling of the interior, and increase the probability of seismic detection in the event of localized seismicity and/or high attenuation. From a practical standpoint, this means that individual surface stations will necessarily be constrained in terms of cost, mass, and power. Landing and thermal control systems will probably be simple, in order to minimize cost, resulting in large impact accelerations and wide daily and seasonal thermal swings. The level of seismic noise will determine the maximum usable sensitivity for seismometer. Unfortunately, the ambient seismic noise level for Mars is not well known. However lunar seismic noise levels are several orders of magnitude below that of the Earth. Sensitivities on the order of 10(exp -11)g over a bandwidth of .04 to 20 Hz are thought to be necessary to fulfill the science objectives for a seimometer placed on the Martian surface. Silicon micromachined sensor technology offers techniques for the fabrication of monolithic, robust, compact, lower power and mass accelerometers. Conventional micro-machined accelerometers have been developed and are commercially available for high frequency and large acceleration measurements. The new seismometer we are developing incorporates certain principles of conventional silicon micromachined accelerometer technology. However, currently available silicon micromachined sensors offer inadequate sensitivity and bandwidth for the Mars seismometer application. Our implementation of an advanced silicon micromachined seismometer is based on principles recently developed at JPL for high-sensitivity position sensor technology.

Association between surgeon volume and hospitalisation costs for patients with oral cancer: a nationwide population base study in Taiwan.

PubMed

Lee, C-C; Ho, H-C; Jack, Lee C-C; Su, Y-C; Lee, M-S; Hung, S-K; Chou, Pesus

2010-02-01

Oral cancer leads to a considerable use of and expenditure on health care. Wide resection of the tumour and reconstruction with a pedicle flap/free flap is widely used. This study was conducted to explore the relationship between hospitalisation costs and surgeon case volume when this operation was performed. A population-based study. This study uses data for the years 2005-2006 obtained from the National Health Insurance Research Database published in the Taiwanese National Health Research Institute. From this population-based data, the authors selected a total of 2663 oral cancer patients who underwent tumour resection and reconstruction. Case volume relationships were based on the following criteria; low-, medium-, high-, very high-volume surgeons were defined by or= 56 resections with reconstruction, respectively. Hierarchical linear regression analysis was subsequently performed to explore the relationship between surgeon case volume and the cost and length of hospitalisation. The mean hospitalisation cost among the 2663 patients was US$ 9528 (all costs are given in US dollars). After adjusting for physician, hospital, and patient characteristics in a hierarchical linear regression model, the cost per patient for low-volume surgeons was found to be US$ 741 (P = 0.012) higher than that for medium-volume surgeons, US$ 1546 (P < 0.001) higher than that for high-volume surgeons, and US$ 1820 (P < 0.001) higher than that for very-high-volume surgeons. After adjustment for physician, hospital, and patient characteristics, the hierarchical linear regression model revealed that the mean length of stay per patient for low-volume surgeons was the highest (P < 0.001). After adjustment for physician, hospital, and patient characteristics, low-volume surgeons performing wide excision with reconstructive surgery in oral cancer patients incurred significantly higher costs and longer hospital stays per patient than did other surgeons. Treatment strategies adopted by high- and very-high-volume surgeons should be analysed further and utilised more widely.

Cost-effectiveness of magnetic resonance imaging versus ultrasound for the detection of symptomatic full-thickness supraspinatus tendon tears.

PubMed

Gyftopoulos, Soterios; Guja, Kip E; Subhas, Naveen; Virk, Mandeep S; Gold, Heather T

2017-12-01

The purpose of this study was to determine the value of magnetic resonance imaging (MRI) and ultrasound-based imaging strategies in the evaluation of a hypothetical population with a symptomatic full-thickness supraspinatus tendon (FTST) tear using formal cost-effectiveness analysis. A decision analytic model from the health care system perspective for 60-year-old patients with symptoms secondary to a suspected FTST tear was used to evaluate the incremental cost-effectiveness of 3 imaging strategies during a 2-year time horizon: MRI, ultrasound, and ultrasound followed by MRI. Comprehensive literature search and expert opinion provided data on cost, probability, and quality of life estimates. The primary effectiveness outcome was quality-adjusted life-years (QALYs) through 2 years, with a willingness-to-pay threshold set to $100,000/QALY gained (2016 U.S. dollars). Costs and health benefits were discounted at 3%. Ultrasound was the least costly strategy ($1385). MRI was the most effective (1.332 QALYs). Ultrasound was the most cost-effective strategy but was not dominant. The incremental cost-effectiveness ratio for MRI was $22,756/QALY gained, below the willingness-to-pay threshold. Two-way sensitivity analysis demonstrated that MRI was favored over the other imaging strategies over a wide range of reasonable costs. In probabilistic sensitivity analysis, MRI was the preferred imaging strategy in 78% of the simulations. MRI and ultrasound represent cost-effective imaging options for evaluation of the patient thought to have a symptomatic FTST tear. The results indicate that MRI is the preferred strategy based on cost-effectiveness criteria, although the decision between MRI and ultrasound for an imaging center is likely to be dependent on additional factors, such as available resources and workflow. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Technical Note: Characterization of custom 3D printed multimodality imaging phantoms.

PubMed

Bieniosek, Matthew F; Lee, Brian J; Levin, Craig S

2015-10-01

Imaging phantoms are important tools for researchers and technicians, but they can be costly and difficult to customize. Three dimensional (3D) printing is a widely available rapid prototyping technique that enables the fabrication of objects with 3D computer generated geometries. It is ideal for quickly producing customized, low cost, multimodal, reusable imaging phantoms. This work validates the use of 3D printed phantoms by comparing CT and PET scans of a 3D printed phantom and a commercial "Micro Deluxe" phantom. This report also presents results from a customized 3D printed PET/MRI phantom, and a customized high resolution imaging phantom with sub-mm features. CT and PET scans of a 3D printed phantom and a commercial Micro Deluxe (Data Spectrum Corporation, USA) phantom with 1.2, 1.6, 2.4, 3.2, 4.0, and 4.8 mm diameter hot rods were acquired. The measured PET and CT rod sizes, activities, and attenuation coefficients were compared. A PET/MRI scan of a custom 3D printed phantom with hot and cold rods was performed, with photon attenuation and normalization measurements performed with a separate 3D printed normalization phantom. X-ray transmission scans of a customized two level high resolution 3D printed phantom with sub-mm features were also performed. Results show very good agreement between commercial and 3D printed micro deluxe phantoms with less than 3% difference in CT measured rod diameter, less than 5% difference in PET measured rod diameter, and a maximum of 6.2% difference in average rod activity from a 10 min, 333 kBq/ml (9 μCi/ml) Siemens Inveon (Siemens Healthcare, Germany) PET scan. In all cases, these differences were within the measurement uncertainties of our setups. PET/MRI scans successfully identified 3D printed hot and cold rods on PET and MRI modalities. X-ray projection images of a 3D printed high resolution phantom identified features as small as 350 μm wide. This work shows that 3D printed phantoms can be functionally equivalent to commercially available phantoms. They are a viable option for quickly distributing and fabricating low cost, customized phantoms.

A genome-wide association study implicates diacylglycerol kinase eta (DGKH) and several other genes in the etiology of bipolar disorder

PubMed Central

Baum, AE; Akula, N; Cabanero, M; Cardona, I; Corona, W; Klemens, B; Schulze, TG; Cichon, S; Rietschel, M; Nöthen, MM; Georgi, A; Schumacher, J; Schwarz, M; Jamra, R Abou; Höfels, S; Propping, P; Satagopan, J; Detera-Wadleigh, SD; Hardy, J; McMahon, FJ

2008-01-01

The genetic basis of bipolar disorder has long been thought to be complex, with the potential involvement of multiple genes, but methods to analyze populations with respect to this complexity have only recently become available. We have carried out a genome-wide association study of bipolar disorder by genotyping over 550,000 SNPs in two independent case-control samples of European origin. The initial association screen was performed using pooled DNA; selected SNPs were confirmed by individual genotyping. While DNA pooling reduces power to detect genetic associations, there is a substantial cost savings and gain in efficiency. A total of 88 SNPs representing 80 different genes met the prior criteria for replication in both samples. Effect sizes were modest: no single SNP of large effect was detected. Of 37 SNPs selected for individual genotyping, the strongest association signal was detected at a marker within the first intron of DGKH (p = 1.5 × 10−8, experiment-wide p<0.01, OR= 1.59). This gene encodes diacylglycerol kinase eta, a key protein in the lithium-sensitive phosphatidyl inositol pathway. This first genome-wide association study of bipolar disorder shows that several genes, each of modest effect, reproducibly influence disease risk. Bipolar disorder may be a polygenic disease. PMID:17486107

Alcoa World Alumina: Plant-Wide Assessment at Arkansas Operations Reveals More than$900,000 in Potential Annual Savings

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

Not Available

2003-07-01

The plant-wide energy-efficiency assessment performed in 2001 at the Alcoa World Alumina Arkansas Operations in Bauxite, Arkansas, identified seven opportunities to save energy and reduce costs. By implementing five of these improvements, the facility can save 15,100 million British thermal units per year in natural gas and 8.76 million kilowatt-hours per year in electricity. This translates into approximate annual savings of$925,300 in direct energy costs and non-fuel operating and maintenance costs. The required capital investment is estimated at$271,200. The average payback period for all five projects would be approximately 8 months.

Alcoa World Alumina: Plant Wide Assessment at Arkansas Operation Reveals More than $900,000 in Potential Annual Savings

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

None

2003-07-01

The plant-wide energy-efficiency assessment performed in 2001 at the Alcoa World Alumina Arkansas Operations in Bauxite, Arkansas, identified seven opportunities to save energy and reduce costs. By implementing five of these improvements, the facility can save 15,100 million British thermal units per year in natural gas and 8.76 million kilowatt-hours per year in electricity. This translates into approximate annual savings of $925,300 in direct energy costs and non-fuel operating and maintenance costs. The required capital investment is estimated at $271,200. The average payback period for all five projects would be approximately 8 months.

Turbine Manufacture

NASA Technical Reports Server (NTRS)

1979-01-01

The machinery pictured is a set of Turbodyne steam turbines which power a sugar mill at Bell Glade, Florida. A NASA-developed computer program called NASTRAN aided development of these and other turbines manufactured by Turbodyne Corporation's Steam Turbine Division, Wellsville, New York. An acronym for NASA Structural Analysis Program, NASTRAN is a predictive tool which advises development teams how a structural design will perform under service use conditions. Turbodyne uses NASTRAN to analyze the dynamic behavior of steam turbine components, achieving substantial savings in development costs. One of the most widely used spinoffs, NASTRAN is made available to private industry through NASA's Computer Software Management Information Center (COSMIC) at the University of Georgia.

Cluster analysis as a tool for evaluating the exploration potential of Known Geothermal Resource Areas

DOE PAGES

Lindsey, Cary R.; Neupane, Ghanashym; Spycher, Nicolas; ...

2018-01-03

Although many Known Geothermal Resource Areas in Oregon and Idaho were identified during the 1970s and 1980s, few were subsequently developed commercially. Because of advances in power plant design and energy conversion efficiency since the 1980s, some previously identified KGRAs may now be economically viable prospects. Unfortunately, available characterization data vary widely in accuracy, precision, and granularity, making assessments problematic. In this paper, we suggest a procedure for comparing test areas against proven resources using Principal Component Analysis and cluster identification. The result is a low-cost tool for evaluating potential exploration targets using uncertain or incomplete data.

Cluster analysis as a tool for evaluating the exploration potential of Known Geothermal Resource Areas

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

Lindsey, Cary R.; Neupane, Ghanashym; Spycher, Nicolas

Although many Known Geothermal Resource Areas in Oregon and Idaho were identified during the 1970s and 1980s, few were subsequently developed commercially. Because of advances in power plant design and energy conversion efficiency since the 1980s, some previously identified KGRAs may now be economically viable prospects. Unfortunately, available characterization data vary widely in accuracy, precision, and granularity, making assessments problematic. In this paper, we suggest a procedure for comparing test areas against proven resources using Principal Component Analysis and cluster identification. The result is a low-cost tool for evaluating potential exploration targets using uncertain or incomplete data.

Bandages and difficulty with bathing: introducing Seal-Tight.

PubMed

Lindsay, Ellie

2005-06-01

Patients with compression bandages experience difficulty with bathing due to the possibility that bandages may become wet and affect the wound. Bandage and dressing changes resulting from accidental wetting also cost the NHS considerable time and money. This product focus highlights the social and psychological impact on the patient when they are unable to bathe and offers a solution to the problem. Seal-Tight is a product that has been newly placed on the drug tariff, making it widely available to all patients who wear bandages (or plaster casts). Seal-Tight enables the patient to bathe, in some cases for the first time for months or even years.

Tunable External Cavity Quantum Cascade Lasers (EC-QCL): an application field for MOEMS based scanning gratings

NASA Astrophysics Data System (ADS)

Grahmann, Jan; Merten, André; Ostendorf, Ralf; Fontenot, Michael; Bleh, Daniela; Schenk, Harald; Wagner, Hans-Joachim

2014-03-01

In situ process information in the chemical, pharmaceutical or food industry as well as emission monitoring, sensitive trace detection and biological sensing applications would increasingly rely on MIR-spectroscopic anal­ysis in the 3 μm - 12 μm wavelength range. However, cost effective, portable, low power consuming and fast spectrometers with a wide tuning range are not available so far. To provide these MIR-spectrometer properties, the combination of quantum cascade lasers with a MOEMS scanning grating as wavelength selective element in the external cavity is addressed to provide a very compact and fast tunable laser source for spectroscopic analysis.

The NDCX-II engineering design

NASA Astrophysics Data System (ADS)

Waldron, W. L.; Abraham, W. J.; Arbelaez, D.; Friedman, A.; Galvin, J. E.; Gilson, E. P.; Greenway, W. G.; Grote, D. P.; Jung, J.-Y.; Kwan, J. W.; Leitner, M.; Lidia, S. M.; Lipton, T. M.; Reginato, L. L.; Regis, M. J.; Roy, P. K.; Sharp, W. M.; Stettler, M. W.; Takakuwa, J. H.; Volmering, J.; Vytla, V. K.

2014-01-01

The Neutralized Drift Compression Experiment (NDCX-II) is a user facility located at Lawrence Berkeley National Laboratory which is uniquely designed for ion-beam-driven high energy density laboratory physics and heavy ion fusion research. Construction was completed in March 2012 and the facility is now in the commissioning phase. A significant amount of engineering was carried out in order to meet the performance parameters required for a wide range of target heating experiments while making the most cost-effective use of high-value hardware available from a decommissioned high current electron induction accelerator. The technical challenges and design of this new ion induction accelerator facility are described.

Remote sensing of vegetation pattern and condition to monitor changes in everglades biogeochemistry

USGS Publications Warehouse

Jones, J.W.

2011-01-01

Ground-based studies of biogeochemistry and vegetation patterning yield process understanding, but the amount of information gained by ground-based studies can be greatly enhanced by efficient, synoptic, and temporally resolute monitoring afforded by remote sensing. The variety of presently available Everglades vegetation maps reflects both the wide range of application requirements and the need to balance cost and capability. More effort needs to be applied to documenting and understanding vegetation distribution and condition as indicators of biogeochemistry and contamination. Ground-based and remote sensing studies should be modified to maximize their synergy and utility for adaptive management. Copyright ?? 2011 Taylor & Francis Group, LLC.

Newborn Sequencing in Genomic Medicine and Public Health

PubMed Central

Agrawal, Pankaj B.; Bailey, Donald B.; Beggs, Alan H.; Brenner, Steven E.; Brower, Amy M.; Cakici, Julie A.; Ceyhan-Birsoy, Ozge; Chan, Kee; Chen, Flavia; Currier, Robert J.; Dukhovny, Dmitry; Green, Robert C.; Harris-Wai, Julie; Holm, Ingrid A.; Iglesias, Brenda; Joseph, Galen; Kingsmore, Stephen F.; Koenig, Barbara A.; Kwok, Pui-Yan; Lantos, John; Leeder, Steven J.; Lewis, Megan A.; McGuire, Amy L.; Milko, Laura V.; Mooney, Sean D.; Parad, Richard B.; Pereira, Stacey; Petrikin, Joshua; Powell, Bradford C.; Powell, Cynthia M.; Puck, Jennifer M.; Rehm, Heidi L.; Risch, Neil; Roche, Myra; Shieh, Joseph T.; Veeraraghavan, Narayanan; Watson, Michael S.; Willig, Laurel; Yu, Timothy W.; Urv, Tiina; Wise, Anastasia L.

2017-01-01

The rapid development of genomic sequencing technologies has decreased the cost of genetic analysis to the extent that it seems plausible that genome-scale sequencing could have widespread availability in pediatric care. Genomic sequencing provides a powerful diagnostic modality for patients who manifest symptoms of monogenic disease and an opportunity to detect health conditions before their development. However, many technical, clinical, ethical, and societal challenges should be addressed before such technology is widely deployed in pediatric practice. This article provides an overview of the Newborn Sequencing in Genomic Medicine and Public Health Consortium, which is investigating the application of genome-scale sequencing in newborns for both diagnosis and screening. PMID:28096516

Ultrasound Imaging of the Musculoskeletal System.

PubMed

Cook, Cristi R

2016-05-01

Musculoskeletal ultrasound is a rapidly growing field within veterinary medicine. Ultrasound for musculoskeletal disorders has been commonly used in equine and human medicine and is becoming more commonly performed in small animal patients due to the increase in the recognition of soft tissue injuries. Ultrasound is widely available, cost-effective, but technically difficult to learn. Advantages of musculoskeletal ultrasound are the opposite limb is commonly used for comparison to evaluate symmetry of the tendinous structures and the ease of repeat examinations to assess healing. The article discusses the major areas of shoulder, stifle, iliopsoas, gastrocnemius, and musculoskeletal basics. Copyright © 2016 Elsevier Inc. All rights reserved.

SQC: secure quality control for meta-analysis of genome-wide association studies.

PubMed

Huang, Zhicong; Lin, Huang; Fellay, Jacques; Kutalik, Zoltán; Hubaux, Jean-Pierre

2017-08-01

Due to the limited power of small-scale genome-wide association studies (GWAS), researchers tend to collaborate and establish a larger consortium in order to perform large-scale GWAS. Genome-wide association meta-analysis (GWAMA) is a statistical tool that aims to synthesize results from multiple independent studies to increase the statistical power and reduce false-positive findings of GWAS. However, it has been demonstrated that the aggregate data of individual studies are subject to inference attacks, hence privacy concerns arise when researchers share study data in GWAMA. In this article, we propose a secure quality control (SQC) protocol, which enables checking the quality of data in a privacy-preserving way without revealing sensitive information to a potential adversary. SQC employs state-of-the-art cryptographic and statistical techniques for privacy protection. We implement the solution in a meta-analysis pipeline with real data to demonstrate the efficiency and scalability on commodity machines. The distributed execution of SQC on a cluster of 128 cores for one million genetic variants takes less than one hour, which is a modest cost considering the 10-month time span usually observed for the completion of the QC procedure that includes timing of logistics. SQC is implemented in Java and is publicly available at https://github.com/acs6610987/secureqc. jean-pierre.hubaux@epfl.ch. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Validation of a risk stratification tool for fall-related injury in a state-wide cohort.

PubMed

McCoy, Thomas H; Castro, Victor M; Cagan, Andrew; Roberson, Ashlee M; Perlis, Roy H

2017-02-06

A major preventable contributor to healthcare costs among older individuals is fall-related injury. We sought to validate a tool to stratify such risk based on readily available clinical data, including projected medication adverse effects, using state-wide medical claims data. Sociodemographic and clinical features were drawn from health claims paid in the state of Massachusetts for individuals aged 35-65 with a hospital admission for a period spanning January-December 2012. Previously developed logistic regression models of hospital readmission for fall-related injury were refit in a testing set including a randomly selected 70% of individuals, and examined in a training set comprised of the remaining 30%. Medications at admission were summarised based on reported adverse effect frequencies in published medication labelling. The Massachusetts health system. A total of 68 764 hospitalised individuals aged 35-65 years. Hospital readmission for fall-related injury defined by claims code. A total of 2052 individuals (3.0%) were hospitalised for fall-related injury within 90 days of discharge, and 3391 (4.9%) within 180 days. After recalibrating the model in a training data set comprised of 48 136 individuals (70%), model discrimination in the remaining 30% test set yielded an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI 0.72 to 0.76). AUCs were similar across age decades (0.71 to 0.78) and sex (0.72 male, 0.76 female), and across most common diagnostic categories other than psychiatry. For individuals in the highest risk quartile, 11.4% experienced fall within 180 days versus 1.2% in the lowest risk quartile; 57.6% of falls occurred in the highest risk quartile. This analysis of state-wide claims data demonstrates the feasibility of predicting fall-related injury requiring hospitalisation using readily available sociodemographic and clinical details. This translatable approach to stratification allows for identification of high-risk individuals in whom interventions are likely to be cost-effective. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Efficacy of a Low-Cost Bubble CPAP System in Treatment of Respiratory Distress in a Neonatal Ward in Malawi

PubMed Central

Kawaza, Kondwani; Machen, Heather E.; Brown, Jocelyn; Mwanza, Zondiwe; Iniguez, Suzanne; Gest, Al; Smith, E. O'Brian; Oden, Maria; Richards-Kortum, Rebecca R.; Molyneux, Elizabeth

2014-01-01

Background Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. Methods We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. Findings 87 neonates (62 bCPAP, 25 controls) were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62) compared with 44.0% (11/25) for controls. 65.5% (19/29) of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13) of controls. 64.6% (31/48) of neonates with respiratory distress syndrome (RDS) receiving bCPAP survived to discharge, compared to 23.5% (4/17) of controls. 61.5% (16/26) of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. Interpretation Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries. PMID:24489715

Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

PubMed

Kawaza, Kondwani; Machen, Heather E; Brown, Jocelyn; Mwanza, Zondiwe; Iniguez, Suzanne; Gest, Al; O'Brian Smith, E; Oden, Maria; Richards-Kortum, Rebecca R; Molyneux, Elizabeth

2016-09-01

Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. 87 neonates (62 bCPAP, 25 controls) were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62) compared with 44.0% (11/25) for controls. 65.5% (19/29) of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13) of controls. 64.6% (31/48) of neonates with respiratory distress syndrome (RDS) receiving bCPAP survived to discharge, compared to 23.5% (4/17) of controls. 61.5% (16/26) of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

PubMed

Kawaza, Kondwani; Machen, Heather E; Brown, Jocelyn; Mwanza, Zondiwe; Iniguez, Suzanne; Gest, Al; Smith, E O'Brian; Oden, Maria; Richards-Kortum, Rebecca R; Molyneux, Elizabeth

2014-01-01

Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. 87 neonates (62 bCPAP, 25 controls) were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62) compared with 44.0% (11/25) for controls. 65.5% (19/29) of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13) of controls. 64.6% (31/48) of neonates with respiratory distress syndrome (RDS) receiving bCPAP survived to discharge, compared to 23.5% (4/17) of controls. 61.5% (16/26) of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

The plasma separation process as a pre-cursor for large scale radioisotope production

NASA Astrophysics Data System (ADS)

Stevenson, Nigel R.

2001-07-01

Radioisotope production generally employs either accelerators or reactors to convert stable (usually enriched) isotopes into the desired product species. Radioisotopes have applications in industry, environmental sciences, and most significantly in medicine. The production of many potentially useful radioisotopes is significantly hindered by the lack of availability or by the high cost of key enriched stable isotopes. To try and meet this demand, certain niche enrichment processes have been developed and commercialized. Calutrons, centrifuges, and laser separation processes are some of the devices and techniques being employed to produce large quantities of selective enriched stable isotopes. Nevertheless, the list of enriched stable isotopes in sufficient quantities remains rather limited and this continues to restrict the availability of many radioisotopes that otherwise could have a significant impact on society. The Plasma Separation Process is a newly available commercial technique for producing large quantities of a wide range of enriched isotopes and thereby holds promise of being able to open the door to producing new and exciting applications of radioisotopes in the future.

Analysis of post-mining excavations as places for municipal waste

NASA Astrophysics Data System (ADS)

Górniak-Zimroz, Justyna

2018-01-01

Waste management planning is an interdisciplinary task covering a wide range of issues including costs, legal requirements, spatial planning, environmental protection, geography, demographics, and techniques used in collecting, transporting, processing and disposing of waste. Designing and analyzing this issue is difficult and requires the use of advanced analysis methods and tools available in GIS geographic information systems containing readily available graphical and descriptive databases, data analysis tools providing expert decision support while selecting the best-designed alternative, and simulation models that allow the user to simulate many variants of waste management together with graphical visualization of the results of performed analyzes. As part of the research study, there have been works undertaken concerning the use of multi-criteria data analysis in waste management in areas located in southwestern Poland. These works have proposed the inclusion in waste management of post-mining excavations as places for the final or temporary collection of waste assessed in terms of their suitability with the tools available in GIS systems.

Design and optimization of all-optical networks

NASA Astrophysics Data System (ADS)

Xiao, Gaoxi

1999-10-01

In this thesis, we present our research results on the design and optimization of all-optical networks. We divide our results into the following four parts: 1.In the first part, we consider broadcast-and-select networks. In our research, we propose an alternative and cheaper network configuration to hide the tuning time. In addition, we derive lower bounds on the optimal schedule lengths and prove that they are tighter than the best existing bounds. 2.In the second part, we consider all-optical wide area networks. We propose a set of algorithms for allocating a given number of WCs to the nodes. We adopt a simulation-based optimization approach, in which we collect utilization statistics of WCs from computer simulation and then perform optimization to allocate the WCs. Therefore, our algorithms are widely applicable and they are not restricted to any particular model and assumption. We have conducted extensive computer simulation on regular and irregular networks under both uniform and non-uniform traffic. We see that our method can get nearly the same performance as that of full wavelength conversion by using a much smaller number of WCs. Compared with the best existing method, the results show that our algorithms can significantly reduce (1)the overall blocking probability (i.e., better mean quality of service) and (2)the maximum of the blocking probabilities experienced at all the source nodes (i.e., better fairness). Equivalently, for a given performance requirement on blocking probability, our algorithms can significantly reduce the number of WCs required. 3.In the third part, we design and optimize the physical topology of all-optical wide area networks. We show that the design problem is NP-complete and we propose a heuristic algorithm called two-stage cut saturation algorithm for this problem. Simulation results show that (1)the proposed algorithm can efficiently design networks with low cost and high utilization, and (2)if wavelength converters are available to support full wavelength conversion, the cost of the links can be significantly reduced. 4.In the fourth part, we consider all-optical wide area networks with multiple fibers per link. We design a node configuration for all-optical networks. We exploit the flexibility that, to establish a lightpath across a node, we can select any one of the available channels in the incoming link and any one of the available channels in the outgoing link. As a result, the proposed node configuration requires a small number of small optical switches while it can achieve nearly the same performance as the existing one. And there is no additional crosstalk other than the intrinsic crosstalk within each single-chip optical switch.* (Abstract shortened by UMI.) *Originally published in DAI Vol. 60, No. 2. Reprinted here with corrected author name.

Costs of IQ Loss from Leaded Aviation Gasoline Emissions

PubMed Central

Wolfe, Philip J.; Giang, Amanda; Ashok, Akshay; Selin, Noelle E.; Barrett, Steven R. H.

2017-01-01

In the United States, general aviation piston-driven aircraft are now the largest source of lead emitted to the atmosphere. Elevated lead concentrations impair children’s IQ and can lead to lower earnings potentials. This study is the first assessment of the nationwide annual costs of IQ losses from aircraft lead emissions. We develop a general aviation emissions inventory for the continental United States and model its impact on atmospheric concentrations using the Community Multi-Scale Air Quality Model (CMAQ). We use these concentrations to quantify the impacts of annual aviation lead emissions on the U.S. population using two methods: through static estimates of cohort-wide IQ deficits and through dynamic economy-wide effects using a computational general equilibrium model. We also examine the sensitivity of these damage estimates to different background lead concentrations, showing the impact of lead controls and regulations on marginal costs. We find that aircraft-attributable lead contributes to $1.06 billion 2006 USD ($0.01 – $11.6) in annual damages from lifetime earnings reductions, and that dynamic economy-wide methods result in damage estimates that are 54% larger. Because the marginal costs of lead are dependent on background concentration, the costs of piston-driven aircraft lead emissions are expected to increase over time as regulations on other emissions sources are tightened. PMID:27494542

Costs of IQ Loss from Leaded Aviation Gasoline Emissions.

PubMed

Wolfe, Philip J; Giang, Amanda; Ashok, Akshay; Selin, Noelle E; Barrett, Steven R H

2016-09-06

In the United States, general aviation piston-driven aircraft are now the largest source of lead emitted to the atmosphere. Elevated lead concentrations impair children's IQ and can lead to lower earnings potentials. This study is the first assessment of the nationwide annual costs of IQ losses from aircraft lead emissions. We develop a general aviation emissions inventory for the continental United States and model its impact on atmospheric concentrations using the community multi-scale air quality model (CMAQ). We use these concentrations to quantify the impacts of annual aviation lead emissions on the U.S. population using two methods: through static estimates of cohort-wide IQ deficits and through dynamic economy-wide effects using a computational general equilibrium model. We also examine the sensitivity of these damage estimates to different background lead concentrations, showing the impact of lead controls and regulations on marginal costs. We find that aircraft-attributable lead contributes to $1.06 billion 2006 USD ($0.01-$11.6) in annual damages from lifetime earnings reductions, and that dynamic economy-wide methods result in damage estimates that are 54% larger. Because the marginal costs of lead are dependent on background concentration, the costs of piston-driven aircraft lead emissions are expected to increase over time as regulations on other emissions sources are tightened.

Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence.

PubMed

Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G

2014-11-13

The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375 ($254 - $507) billion, or 80%, represents the added BIR costs of the current multi-payer system. A simplified financing system in the U.S. could result in cost savings exceeding $350 billion annually, nearly 15% of health care spending.

BRACING IN THE TREATMENT OF CHILDREN WITH CLUBFOOT: PAST, PRESENT, AND FUTURE

PubMed Central

Desai, Lajja; Oprescu, Florin; DiMeo, Andrew; Morcuende, Jose A

2010-01-01

Bracing is a critical component of the current standard of treatment for clubfoot. Adherence to the bracing protocol is the main factor for the long-term success of the treatment The purpose of this paper is to provide a review of clubfoot braces, best practices in brace design and recommendations for bracing in order to improve adherence with the bracing phase of the clubfoot treatment. There are a number of designs and offerings of braces available in various regions of the world. Although many new brace designs are being proposed and developed, evidence in the literature regarding biomechanical effects, clinical outcomes, functionality and patient adherence is limited. The current research that is available regarding brace design focuses on increasing patient comfort and satisfaction to improve adherence. Although the currently available braces are widely distributed in developed countries, access is limited to many parts of the world. When considering the future of the clubfoot treatment and prevention of relapses, since 80% of the cases are in developing countries with limited resources, brace cost and availability needs to be assessed. PMID:21045966

Determinants of Habitat Selection by Hatchling Australian Freshwater Crocodiles

PubMed Central

Somaweera, Ruchira; Webb, Jonathan K.; Shine, Richard

2011-01-01

Animals almost always use habitats non-randomly, but the costs and benefits of using specific habitat types remain unknown for many types of organisms. In a large lake in northwestern Australia (Lake Argyle), most hatchling (<12-month-old) freshwater crocodiles (Crocodylus johnstoni) are found in floating vegetation mats or grassy banks rather than the more widely available open banks. Mean body sizes of young crocodiles did not differ among the three habitat types. We tested four potential explanations for non-random habitat selection: proximity to nesting sites, thermal conditions, food availability, and exposure to predation. The three alternative habitat types did not differ in proximity to nesting sites, or in thermal conditions. Habitats with higher food availability harboured more hatchlings, and feeding rates (obtained by stomach-flushing of recently-captured crocodiles) were highest in such areas. Predation risk may also differ among habitats: we were twice as likely to capture a crocodile after seeing it in open-bank sites than in the other two habitat types. Thus, habitat selection of hatchling crocodiles in this system may be driven both by prey availability and by predation risk. PMID:22163308

Access to high-tech health care. Ethics.

PubMed

Merrill, J M

1991-03-15

Access to health care has always been limited by personal and social economics. Poverty remains one element that correlates with poor prognosis in all varieties of cancer. Prior to becoming standard therapy, elements of high-tech health care are often widely available as research protocols, participation in which is generally available without considerations of insurance coverage or personal wealth. Any person may still volunteer participation in research protocols and thereby partake in high-tech advances even before these become standard therapy. However, recent developments in the conduct of research now may limit participation. Medicare and third party insurance payers proscribe payment for research project care and always have. Recently, more than ever before, reimbursements to physicians and health care institutions have been more closely scrutinized to reject all payment in research settings. In situations in which cost and availability of the new technology, whether machine or drug, limit participation, research entrepreneurs have made research participation available to only those who can pay for it. These and similar developments threaten to limit access to high-tech health care and to actually impede cancer research.

A rapid situation assessment of the market for surrogate and illegal alcohols in Tallinn, Estonia.

PubMed

Pärna, Kersti; Lang, Katrin; Raju, Kadi; Väli, Marika; McKee, Martin

2007-01-01

To understand the phenomenon of consumption of surrogate and illegal alcohols in Tallinn, capital of Estonia. This study, conducted in Tallinn in May 2006, used rapid situation assessment. Interviews with key informants in relevant settings such as emergency departments of hospitals, accommodation for the homeless, police etc. (n = 22), with alcohol abusers (n = 33), natural observations of surrogate sale and consumption venues (n = 46), and tracking of trade data were carried out. Key informants confirmed that consumption of illegal and surrogate alcohols are widely used by alcohol abusers, a finding confirmed by the alcohol abusers. Availability of surrogates varied by area of the city, mainly sold from street kiosks. Illegally produced spirits were also easily available. Sales of surrogates appear to have increased in recent years. A range of alcohol-containing substances that appear to be easily available at low cost, and that have high concentration of ethanol or contaminants known to be toxic, were identified in Tallinn. Alcohol policies in Estonia should address the consumption and availability of these substances.

Scale-up of 2G wire manufacturing at American Superconductor Corporation

NASA Astrophysics Data System (ADS)

Fleshler, S.; Buczek, D.; Carter, B.; Cedrone, P.; DeMoranville, K.; Gannon, J.; Inch, J.; Li, X.; Lynch, J.; Otto, A.; Podtburg, E.; Roy, D.; Rupich, M.; Sathyamurthy, S.; Schreiber, J.; Thieme, C.; Thompson, E.; Tucker, D.; Nagashima, K.; Ogata, M.

2009-10-01

American Superconductor Corporation (AMSC) has developed the base technology and a manufacturing line for initial volume production of low-cost second generation high temperature superconductor (2G HTS) wire for commercial and military applications. The manufacturing line is based on reel-to-reel processing of wide HTS strips using rolling assisted bi-axially textured substrate (RABiTS™) for the template and Metal Organic Deposition (MOD) for the HTS layer. AMSC’s wide strip process is a low cost manufacturing technology since multiple wires are produced in a single manufacturing pass by slitting the wide strip to narrower width in the last stage of the manufacturing process. Industry standard 4.4 mm wide wires are produced by laminating metallic foils, such as copper, stainless steel or any other material, to the HTS insert wire, and are chosen to tailor the electrical, thermal and mechanical properties of the wire for specific applications. The laminated, 4.4 mm wide wires are known as “344 superconductors.” In this paper, we summarize the status of AMSC’s manufacturing capability, the performance of the wire presently being produced, as well as the cost and technical advantages of AMSC’s manufacturing approach. In addition, future direction for research and development to improve electrical performance is presented.

Database Organisation in a Web-Enabled Free and Open-Source Software (foss) Environment for Spatio-Temporal Landslide Modelling

NASA Astrophysics Data System (ADS)

Das, I.; Oberai, K.; Sarathi Roy, P.

2012-07-01

Landslides exhibit themselves in different mass movement processes and are considered among the most complex natural hazards occurring on the earth surface. Making landslide database available online via WWW (World Wide Web) promotes the spreading and reaching out of the landslide information to all the stakeholders. The aim of this research is to present a comprehensive database for generating landslide hazard scenario with the help of available historic records of landslides and geo-environmental factors and make them available over the Web using geospatial Free & Open Source Software (FOSS). FOSS reduces the cost of the project drastically as proprietary software's are very costly. Landslide data generated for the period 1982 to 2009 were compiled along the national highway road corridor in Indian Himalayas. All the geo-environmental datasets along with the landslide susceptibility map were served through WEBGIS client interface. Open source University of Minnesota (UMN) mapserver was used as GIS server software for developing web enabled landslide geospatial database. PHP/Mapscript server-side application serve as a front-end application and PostgreSQL with PostGIS extension serve as a backend application for the web enabled landslide spatio-temporal databases. This dynamic virtual visualization process through a web platform brings an insight into the understanding of the landslides and the resulting damage closer to the affected people and user community. The landslide susceptibility dataset is also made available as an Open Geospatial Consortium (OGC) Web Feature Service (WFS) which can be accessed through any OGC compliant open source or proprietary GIS Software.

The effect of transfers between health care facilities on costs and length of stay for pediatric burn patients.

PubMed

Myers, John; Smith, Michael; Woods, Charles; Espinosa, Claudia; Lehna, Carlee

2015-01-01

Hospitals vary widely in the services they offer to care for pediatric burn patients. When a hospital does not have the ability or capacity to handle a pediatric burn, the decision often is made to transfer the patient to another short-term hospital. Transfers may be based on available specialty coverage for children; which adult and non-teaching hospitals may not have available. The effect these transfers have on costs and length of stay (LOS) has on pediatric burn patients is not well established and is warranted given the prominent view that pediatric hospitals are inefficient or more costly. The authors examined inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. ICD-9-CM codes 940 to 947 were used to define burn injury. The authors tested if transfer status was associated with LOS and total charges for pediatric burn patients, while adjusting for traditional risk factors (eg, age, TBSA, insurance status, type of hospital [pediatric vs adult; teaching vs nonteaching]) by using generalized linear mixed-effects modeling. A total of n = 28,777 children had a burn injury. Transfer status (P < .001) and TBSA (P < .001) was independently associated with LOS, while age, insurance status, and type of hospital were not associated with LOS. Similarly, transfer status (P < .001) and TBSA (P < .001) was independently associated with total charges, while age, insurance status, and type of hospital were not associated with total charges. In addition, the data suggest that the more severe pediatric burn patients are being transferred from adult and non-teaching hospitals to pediatric and teaching hospitals, which may explain the increased costs and LOS seen at pediatric hospitals. Larger more severe burns are being transferred to pediatric hospitals with the ability or capacity to handle these conditions in the pediatric population, which has a dramatic impact on costs and LOS. As a result, unadjusted, pediatric hospitals are seen as being inefficient in treating pediatric burns. However, since pediatric hospitals see more severe cases, after adjustment, type of hospital did not influence costs and LOS. TBSA and transfer status were the predictors studied that independently affect costs and LOS.

As Health Costs Skyrocket, Colleges and Employees Ail.

ERIC Educational Resources Information Center

Lifely, Kit

2000-01-01

Examines implications of increasing health costs borne by colleges and universities and their employees. Notes that institutions of higher education have a wide spectrum of plans with increased costs this year averaging over 12 percent. Also finds decreased competition among insurance companies and physician networks and political complications…

FASTSim: Future Automotive Systems Technology Simulator | Transportation

Science.gov Websites

on light-, medium-, and heavy-duty vehicle efficiency, performance, cost, and battery life. This < 10 seconds to estimate vehicle efficiency, fuel economy, acceleration, battery life, and cost < ; 5 minutes to perform powertrain comparisons of efficiency and cost. FASTSim models a wide variety of

Library Labor Cost Accounting System.

ERIC Educational Resources Information Center

Du Bois, Dan

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

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

PubMed

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

2015-03-15

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

Maximizing the Performance of Automated Low Cost All-sky Cameras

NASA Technical Reports Server (NTRS)

Bettonvil, F.

2011-01-01

Thanks to the wide spread of digital camera technology in the consumer market, a steady increase in the number of active All-sky camera has be noticed European wide. In this paper I look into the details of such All-sky systems and try to optimize the performance in terms of accuracy of the astrometry, the velocity determination and photometry. Having autonomous operation in mind, suggestions are done for the optimal low cost All-sky camera.

Color calibration and fusion of lens-free and mobile-phone microscopy images for high-resolution and accurate color reproduction

NASA Astrophysics Data System (ADS)

Zhang, Yibo; Wu, Yichen; Zhang, Yun; Ozcan, Aydogan

2016-06-01

Lens-free holographic microscopy can achieve wide-field imaging in a cost-effective and field-portable setup, making it a promising technique for point-of-care and telepathology applications. However, due to relatively narrow-band sources used in holographic microscopy, conventional colorization methods that use images reconstructed at discrete wavelengths, corresponding to e.g., red (R), green (G) and blue (B) channels, are subject to color artifacts. Furthermore, these existing RGB colorization methods do not match the chromatic perception of human vision. Here we present a high-color-fidelity and high-resolution imaging method, termed “digital color fusion microscopy” (DCFM), which fuses a holographic image acquired at a single wavelength with a color-calibrated image taken by a low-magnification lens-based microscope using a wavelet transform-based colorization method. We demonstrate accurate color reproduction of DCFM by imaging stained tissue sections. In particular we show that a lens-free holographic microscope in combination with a cost-effective mobile-phone-based microscope can generate color images of specimens, performing very close to a high numerical-aperture (NA) benchtop microscope that is corrected for color distortions and chromatic aberrations, also matching the chromatic response of human vision. This method can be useful for wide-field imaging needs in telepathology applications and in resource-limited settings, where whole-slide scanning microscopy systems are not available.

Color calibration and fusion of lens-free and mobile-phone microscopy images for high-resolution and accurate color reproduction

PubMed Central

Zhang, Yibo; Wu, Yichen; Zhang, Yun; Ozcan, Aydogan

2016-01-01

Lens-free holographic microscopy can achieve wide-field imaging in a cost-effective and field-portable setup, making it a promising technique for point-of-care and telepathology applications. However, due to relatively narrow-band sources used in holographic microscopy, conventional colorization methods that use images reconstructed at discrete wavelengths, corresponding to e.g., red (R), green (G) and blue (B) channels, are subject to color artifacts. Furthermore, these existing RGB colorization methods do not match the chromatic perception of human vision. Here we present a high-color-fidelity and high-resolution imaging method, termed “digital color fusion microscopy” (DCFM), which fuses a holographic image acquired at a single wavelength with a color-calibrated image taken by a low-magnification lens-based microscope using a wavelet transform-based colorization method. We demonstrate accurate color reproduction of DCFM by imaging stained tissue sections. In particular we show that a lens-free holographic microscope in combination with a cost-effective mobile-phone-based microscope can generate color images of specimens, performing very close to a high numerical-aperture (NA) benchtop microscope that is corrected for color distortions and chromatic aberrations, also matching the chromatic response of human vision. This method can be useful for wide-field imaging needs in telepathology applications and in resource-limited settings, where whole-slide scanning microscopy systems are not available. PMID:27283459

Web-based home telemedicine system for orthopedics

NASA Astrophysics Data System (ADS)

Lau, Christopher; Churchill, Sean; Kim, Janice; Matsen, Frederick A., III; Kim, Yongmin

2001-05-01

Traditionally, telemedicine systems have been designed to improve access to care by allowing physicians to consult a specialist about a case without sending the patient to another location, which may be difficult or time-consuming to reach. The cost of the equipment and network bandwidth needed for this consultation has restricted telemedicine use to contact between physicians instead of between patients and physicians. Recently, however, the wide availability of Internet connectivity and client and server software for e- mail, world wide web, and conferencing has made low-cost telemedicine applications feasible. In this work, we present a web-based system for asynchronous multimedia messaging between shoulder replacement surgery patients at home and their surgeons. A web browser plug-in was developed to simplify the process of capturing video and transferring it to a web site. The video capture plug-in can be used as a template to construct a plug-in that captures and transfers any type of data to a web server. For example, readings from home biosensor instruments (e.g., blood glucose meters and spirometers) that can be connected to a computing platform can be transferred to a home telemedicine web site. Both patients and doctors can access this web site to monitor progress longitudinally. The system has been tested with 3 subjects for the past 7 weeks, and we plan to continue testing in the foreseeable future.

Color calibration and fusion of lens-free and mobile-phone microscopy images for high-resolution and accurate color reproduction.

PubMed

Zhang, Yibo; Wu, Yichen; Zhang, Yun; Ozcan, Aydogan

2016-06-10

Lens-free holographic microscopy can achieve wide-field imaging in a cost-effective and field-portable setup, making it a promising technique for point-of-care and telepathology applications. However, due to relatively narrow-band sources used in holographic microscopy, conventional colorization methods that use images reconstructed at discrete wavelengths, corresponding to e.g., red (R), green (G) and blue (B) channels, are subject to color artifacts. Furthermore, these existing RGB colorization methods do not match the chromatic perception of human vision. Here we present a high-color-fidelity and high-resolution imaging method, termed "digital color fusion microscopy" (DCFM), which fuses a holographic image acquired at a single wavelength with a color-calibrated image taken by a low-magnification lens-based microscope using a wavelet transform-based colorization method. We demonstrate accurate color reproduction of DCFM by imaging stained tissue sections. In particular we show that a lens-free holographic microscope in combination with a cost-effective mobile-phone-based microscope can generate color images of specimens, performing very close to a high numerical-aperture (NA) benchtop microscope that is corrected for color distortions and chromatic aberrations, also matching the chromatic response of human vision. This method can be useful for wide-field imaging needs in telepathology applications and in resource-limited settings, where whole-slide scanning microscopy systems are not available.

Costs and effects of a state-wide health promotion program in primary schools in Germany - the Baden-Württemberg Study: A cluster-randomized, controlled trial.

PubMed

Kesztyüs, Dorothea; Lauer, Romy; Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

2017-01-01

To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program "Join the Healthy Boat" in primary schools in Germany. Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. German Clinical Trials Register (DRKS), Freiburg University, Germany, DRKS-ID: DRKS00000494.

Costs and effects of a state-wide health promotion program in primary schools in Germany – the Baden-Württemberg Study: A cluster-randomized, controlled trial

PubMed Central

Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

2017-01-01

Aim To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program “Join the Healthy Boat” in primary schools in Germany. Methods Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. Results The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. Conclusion This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. Trial registration German Clinical Trials Register (DRKS), Freiburg University, Germany, DRKS-ID: DRKS00000494. PMID:28222101

Customer premise service study for 30/20 GHz satellite system

NASA Technical Reports Server (NTRS)

Milton, R. T.; Ross, D. P.; Harcar, A. R.; Freedenberg, P.; Schoen, D.

1983-01-01

Satellite systems in which the space segment operates in the 30/20 GHz frequency band are defined and compared as to their potential for providing various types of communications services to customer premises and the economic and technical feasibility of doing so. Technical tasks performed include: market postulation, definition of the ground segment, definition of the space segment, definition of the integrated satellite system, service costs for satellite systems, sensitivity analysis, and critical technology. Based on an analysis of market data, a sufficiently large market for services is projected so as to make the system economically viable. A large market, and hence a high capacity satellite system, is found to be necessary to minimize service costs, i.e., economy of scale is found to hold. The wide bandwidth expected to be available in the 30/20 GHz band, along with frequency reuse which further increases the effective system bandwidth, makes possible the high capacity system. Extensive ground networking is required in most systems to both connect users into the system and to interconnect Earth stations to provide spatial diversity. Earth station spatial diversity is found to be a cost effective means of compensating the large fading encountered in the 30/20 GHz operating band.

Deep Space Habitat Team: HEFT Phase 2 Effects

NASA Technical Reports Server (NTRS)

Toups, Larry D.; Smitherman, David; Shyface, Hilary; Simon, Matt; Bobkill, Marianne; Komar, D. R.; Guirgis, Peggy; Bagdigian, Bob; Spexarth, Gary

2011-01-01

HEFT was a NASA-wide team that performed analyses of architectures for human exploration beyond LEO, evaluating technical, programmatic, and budgetary issues to support decisions at the highest level of the agency in HSF planning. HEFT Phase I (April - September, 2010) and Phase II (September - December, 2010) examined a broad set of Human Exploration of Near Earth Objects (NEOs) Design Reference Missions (DRMs), evaluating such factors as elements, performance, technologies, schedule, and cost. At end of HEFT Phase 1, an architecture concept known as DRM 4a represented the best available option for a full capability NEO mission. Within DRM4a, the habitation system was provided by Deep Space Habitat (DSH), Multi-Mission Space Exploration Vehicle (MMSEV), and Crew Transfer Vehicle (CTV) pressurized elements. HEFT Phase 2 extended DRM4a, resulting in DRM4b. Scrubbed element-level functionality assumptions and mission Concepts of Operations. Habitation Team developed more detailed concepts of the DSH and the DSH/MMSEV/CTV Conops, including functionality and accommodations, mass & volume estimates, technology requirements, and DDT&E costs. DRM 5 represented an effort to reduce cost by scaling back on technologies and eliminating the need for the development of an MMSEV.

Improving Adherence to Treatment and Reducing Economic Costs of Hypertension: The Role of Olmesartan-Based Treatment.

PubMed

Costa, Francesco Vittorio

2017-09-01

Poor adherence to antihypertensive treatment is the single most important factor of unsatisfactory blood pressure (BP) control. This review focuses on therapy-related factors affecting adherence and suggests how to improve it with a wise choice of treatment schedule. Complex drug treatment schemes, poor tolerability and drug substitutions are frequent causes of poor adherence which, in turn, causes insufficient BP control, greater incidence of cardiovascular events and, finally, higher global health costs. The effects of prescribing generic drugs and of drug substitutions on adherence is also discussed. In terms of adherence, generic drugs do not seem to be better than branded drugs, unless patients have to bear very high "out of pocket" expenses to buy original drugs, suggesting no advantages in switching drug with the mere goal of reducing the cost of therapy. An important role in improving adherence (and thus cardiovascular events and health expenditure) is also played by the availability of fixed-dose combinations; among antihypertensive drugs, angiotensin receptor blockers (ARBs) are those associated with higher levels of adherence and persistence. Among ARBs, olmesartan stands out for a wide choice of effective fixed-dose combinations.

Using Social Media, Online Social Networks, and Internet Search as Platforms for Public Health Interventions: A Pilot Study.

PubMed

Huesch, Marco D; Galstyan, Aram; Ong, Michael K; Doctor, Jason N

2016-06-01

To pilot public health interventions at women potentially interested in maternity care via campaigns on social media (Twitter), social networks (Facebook), and online search engines (Google Search). Primary data from Twitter, Facebook, and Google Search on users of these platforms in Los Angeles between March and July 2014. Observational study measuring the responses of targeted users of Twitter, Facebook, and Google Search exposed to our sponsored messages soliciting them to start an engagement process by clicking through to a study website containing information on maternity care quality information for the Los Angeles market. Campaigns reached a little more than 140,000 consumers each day across the three platforms, with a little more than 400 engagements each day. Facebook and Google search had broader reach, better engagement rates, and lower costs than Twitter. Costs to reach 1,000 targeted users were approximately in the same range as less well-targeted radio and TV advertisements, while initial engagements-a user clicking through an advertisement-cost less than $1 each. Our results suggest that commercially available online advertising platforms in wide use by other industries could play a role in targeted public health interventions. © Health Research and Educational Trust.

MEDIAN-BASED INCREMENTAL COST-EFFECTIVENESS RATIOS WITH CENSORED DATA

PubMed Central

Bang, Heejung; Zhao, Hongwei

2016-01-01

Cost-effectiveness is an essential part of treatment evaluation, in addition to effectiveness. In the cost-effectiveness analysis, a measure called the incremental cost-effectiveness ratio (ICER) is widely utilized, and the mean cost and the mean (quality-adjusted) life years have served as norms to summarize cost and effectiveness for a study population. Recently, the median-based ICER was proposed for complementary or sensitivity analysis purposes. In this paper, we extend this method when some data are censored. PMID:26010599

Utilities Expense Report.

ERIC Educational Resources Information Center

Moore, Deborah P.

2001-01-01

Examines how deregulation has affected school district utility costs. Offers ideas that can help school districts save money and energy. Provides several examples of state-wide initiatives intended to help school districts control utility costs. (GR)

Cost and effects of different admission screening strategies to control the spread of methicillin-resistant Staphylococcus aureus.

PubMed

Gurieva, Tanya; Bootsma, Martin C J; Bonten, Marc J M

2013-01-01

Nosocomial infection rates due to antibiotic-resistant bacteriae, e.g., methicillin-resistant Staphylococcus aureus (MRSA) remain high in most countries. Screening for MRSA carriage followed by barrier precautions for documented carriers (so-called screen and isolate (S&I)) has been successful in some, but not all settings. Moreover, different strategies have been proposed, but comparative studies determining their relative effects and costs are not available. We, therefore, used a mathematical model to evaluate the effect and costs of different S&I strategies and to identify the critical parameters for this outcome. The dynamic stochastic simulation model consists of 3 hospitals with general wards and intensive care units (ICUs) and incorporates readmission of carriers of MRSA. Patient flow between ICUs and wards was based on real observations. Baseline prevalence of MRSA was set at 20% in ICUs and hospital-wide at 5%; ranges of costs and infection rates were based on published data. Four S&I strategies were compared to a do-nothing scenario: S&I of previously documented carriers ("flagged" patients); S&I of flagged patients and ICU admissions; S&I of flagged and group of "frequent" patients; S&I of all hospital admissions (universal screening). Evaluated levels of efficacy of S&I were 10%, 25%, 50% and 100%. Our model predicts that S&I of flagged and S&I of flagged and ICU patients are the most cost-saving strategies with fastest return of investment. For low isolation efficacy universal screening and S&I of flagged and "frequent" patients may never become cost-saving. Universal screening is predicted to prevent hardly more infections than S&I of flagged and "frequent" patients, albeit at higher costs. Whether an intervention becomes cost-saving within 10 years critically depends on costs per infection in ICU, costs of screening and isolation efficacy.

Cost and Effects of Different Admission Screening Strategies to Control the Spread of Methicillin-resistant Staphylococcus aureus

PubMed Central

Gurieva, Tanya; Bootsma, Martin C. J.; Bonten, Marc J. M.

2013-01-01

Nosocomial infection rates due to antibiotic-resistant bacteriae, e.g., methicillin-resistant Staphylococcus aureus (MRSA) remain high in most countries. Screening for MRSA carriage followed by barrier precautions for documented carriers (so-called screen and isolate (S&I)) has been successful in some, but not all settings. Moreover, different strategies have been proposed, but comparative studies determining their relative effects and costs are not available. We, therefore, used a mathematical model to evaluate the effect and costs of different S&I strategies and to identify the critical parameters for this outcome. The dynamic stochastic simulation model consists of 3 hospitals with general wards and intensive care units (ICUs) and incorporates readmission of carriers of MRSA. Patient flow between ICUs and wards was based on real observations. Baseline prevalence of MRSA was set at 20% in ICUs and hospital-wide at 5%; ranges of costs and infection rates were based on published data. Four S&I strategies were compared to a do-nothing scenario: S&I of previously documented carriers (“flagged” patients); S&I of flagged patients and ICU admissions; S&I of flagged and group of “frequent” patients; S&I of all hospital admissions (universal screening). Evaluated levels of efficacy of S&I were 10%, 25%, 50% and 100%. Our model predicts that S&I of flagged and S&I of flagged and ICU patients are the most cost-saving strategies with fastest return of investment. For low isolation efficacy universal screening and S&I of flagged and “frequent” patients may never become cost-saving. Universal screening is predicted to prevent hardly more infections than S&I of flagged and “frequent” patients, albeit at higher costs. Whether an intervention becomes cost-saving within 10 years critically depends on costs per infection in ICU, costs of screening and isolation efficacy. PMID:23436984

Comparison of costs for three hypothetical alternative kitchen waste management systems.

PubMed

Schiettecatte, Wim; Tize, Ronald; De Wever, Heleen

2014-11-01

Urban water and waste management continues to be a major challenge, with the Earth's population projected to rise to 9 billion by 2050, with 70% of this population expected to live in cities. A combined treatment of wastewater and the organic fraction of municipal solid waste offers opportunities for improved environmental protection and energy recovery, but the collection and transport of organic wastes must be cost effective. This study compares three alternative kitchen waste collection and transportation systems for a virtual modern urban area with 300,000 residents and a population density of 10,000 persons per square kilometre. Door-to-door collection, being the standard practice in modern urban centres, remains the most economically advantageous at a cost of 263 euros per tonne of kitchen waste. Important drawbacks are the difficult logistics, increased city traffic, air and noise pollution. The quieter, cleaner and more hygienic vacuum transport of kitchen waste comes with a higher cost of 367 euros per tonne, mainly resulting from a higher initial investment cost for the system installation. The third option includes the well-known use of under-sink food waste disposers (often called garbage grinders) that are connected to the kitchen's wastewater piping system, with a total yearly cost of 392 euros per tonne. Important advantages with this system are the clean operation and the current availability of a city-wide sewage conveyance pipeline system. Further research is recommended, for instance the application of a life cycle assessment approach, to more fully compare the advantages and disadvantages of each option. © The Author(s) 2014.

Toward the 1,000 dollars human genome.

PubMed

Bennett, Simon T; Barnes, Colin; Cox, Anthony; Davies, Lisa; Brown, Clive

2005-06-01

Revolutionary new technologies, capable of transforming the economics of sequencing, are providing an unparalleled opportunity to analyze human genetic variation comprehensively at the whole-genome level within a realistic timeframe and at affordable costs. Current estimates suggest that it would cost somewhere in the region of 30 million US dollars to sequence an entire human genome using Sanger-based sequencing, and on one machine it would take about 60 years. Solexa is widely regarded as a company with the necessary disruptive technology to be the first to achieve the ultimate goal of the so-called 1,000 dollars human genome - the conceptual cost-point needed for routine analysis of individual genomes. Solexa's technology is based on completely novel sequencing chemistry capable of sequencing billions of individual DNA molecules simultaneously, a base at a time, to enable highly accurate, low cost analysis of an entire human genome in a single experiment. When applied over a large enough genomic region, these new approaches to resequencing will enable the simultaneous detection and typing of known, as well as unknown, polymorphisms, and will also offer information about patterns of linkage disequilibrium in the population being studied. Technological progress, leading to the advent of single-molecule-based approaches, is beginning to dramatically drive down costs and increase throughput to unprecedented levels, each being several orders of magnitude better than that which is currently available. A new sequencing paradigm based on single molecules will be faster, cheaper and more sensitive, and will permit routine analysis at the whole-genome level.

Cost effective interventions for the prevention of cardiovascular disease in low and middle income countries: a systematic review.

PubMed

Shroufi, Amir; Chowdhury, Rajiv; Anchala, Raghupathy; Stevens, Sarah; Blanco, Patricia; Han, Tha; Niessen, Louis; Franco, Oscar H

2013-03-28

While there is good evidence to show that behavioural and lifestyle interventions can reduce cardiovascular disease risk factors in affluent settings, less evidence exists in lower income settings.This study systematically assesses the evidence on cost-effectiveness for preventive cardiovascular interventions in low and middle-income settings. Systematic review of economic evaluations on interventions for prevention of cardiovascular disease. PubMed, Web of Knowledge, Scopus and Embase, Opensigle, the Cochrane database, Business Source Complete, the NHS Economic Evaluations Database, reference lists and email contact with experts. we included economic evaluations conducted in adults, reporting the effect of interventions to prevent cardiovascular disease in low and middle income countries as defined by the World Bank. The primary outcome was a change in cardiovascular disease occurrence including coronary heart disease, heart failure and stroke. After selection of the studies, data were extracted by two independent investigators using a previously constructed tool and quality was evaluated using Drummond's quality assessment score. From 9731 search results we found 16 studies, which presented economic outcomes for interventions to prevent cardiovascular disease in low and middle income settings, with most of these reporting positive cost effectiveness results.When the same interventions were evaluated across settings, within and between papers, the likelihood of an intervention being judged cost effective was generally lower in regions with lowest gross national income. While population based interventions were in most cases more cost effective, cost effectiveness estimates for individual pharmacological interventions were overall based upon a stronger evidence base. While more studies of cardiovascular preventive interventions are needed in low and mid income settings, the available high-level of evidence supports a wide range of interventions for the prevention of cardiovascular disease as being cost effective across all world regions.

47 CFR 54.518 - Support for wide area networks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Support for wide area networks. 54.518 Section... area networks. To the extent that schools, libraries or consortia that include an eligible school or library build or purchase a wide area network to provide telecommunications services, the cost of such...

41 CFR 102-192.65 - What features must our finance systems have to keep track of mail costs?

Code of Federal Regulations, 2011 CFR

2011-01-01

... finance systems have to keep track of mail costs? 102-192.65 Section 102-192.65 Public Contracts and... What features must our finance systems have to keep track of mail costs? All agencies must have an... requirement, because the level at which it is cost-beneficial differs widely. The agency's finance system(s...

41 CFR 102-192.65 - What features must our finance systems have to keep track of mail costs?

Code of Federal Regulations, 2012 CFR

2012-01-01

... finance systems have to keep track of mail costs? 102-192.65 Section 102-192.65 Public Contracts and... What features must our finance systems have to keep track of mail costs? All agencies must have an... requirement, because the level at which it is cost-beneficial differs widely. The agency's finance system(s...

41 CFR 102-192.65 - What features must our finance systems have to keep track of mail costs?

Code of Federal Regulations, 2014 CFR

2014-01-01

... finance systems have to keep track of mail costs? 102-192.65 Section 102-192.65 Public Contracts and... What features must our finance systems have to keep track of mail costs? All agencies must have an... requirement, because the level at which it is cost-beneficial differs widely. The agency's finance system(s...

41 CFR 102-192.65 - What features must our finance systems have to keep track of mail costs?

Code of Federal Regulations, 2013 CFR

2013-07-01

... finance systems have to keep track of mail costs? 102-192.65 Section 102-192.65 Public Contracts and... What features must our finance systems have to keep track of mail costs? All agencies must have an... requirement, because the level at which it is cost-beneficial differs widely. The agency's finance system(s...

Public Perceptions of Regulatory Costs, Their Uncertainty and Interindividual Distribution.

PubMed

Johnson, Branden B; Finkel, Adam M

2016-06-01

Public perceptions of both risks and regulatory costs shape rational regulatory choices. Despite decades of risk perception studies, this article is the first on regulatory cost perceptions. A survey of 744 U.S. residents probed: (1) How knowledgeable are laypeople about regulatory costs incurred to reduce risks? (2) Do laypeople see official estimates of cost and benefit (lives saved) as accurate? (3) (How) do preferences for hypothetical regulations change when mean-preserving spreads of uncertainty replace certain cost or benefit? and (4) (How) do preferences change when unequal interindividual distributions of hypothetical regulatory costs replace equal distributions? Respondents overestimated costs of regulatory compliance, while assuming agencies underestimate costs. Most assumed agency estimates of benefits are accurate; a third believed both cost and benefit estimates are accurate. Cost and benefit estimates presented without uncertainty were slightly preferred to those surrounded by "narrow uncertainty" (a range of costs or lives entirely within a personally-calibrated zone without clear acceptance or rejection of tradeoffs). Certain estimates were more preferred than "wide uncertainty" (a range of agency estimates extending beyond these personal bounds, thus posing a gamble between favored and unacceptable tradeoffs), particularly for costs as opposed to benefits (but even for costs a quarter of respondents preferred wide uncertainty to certainty). Agency-acknowledged uncertainty in general elicited mixed judgments of honesty and trustworthiness. People preferred egalitarian distributions of regulatory costs, despite skewed actual cost distributions, and preferred progressive cost distributions (the rich pay a greater than proportional share) to regressive ones. Efficient and socially responsive regulations require disclosure of much more information about regulatory costs and risks. © 2016 Society for Risk Analysis.

Marketing in the HMO industry: an analysis of spending patterns and enrollment growth results.

PubMed

Menges, J J

1988-01-01

The purpose of this paper is to assess the level of marketing spending in the HMO industry and the enrollment growth HMOs have achieved in return for their marketing dollars. This study identifies industry norms that are designed to assist HMOs in the evaluation of their marketing performance. The study is based on data from 1985 to 1986 covering approximately half the HMOs in the country and comprising a substantial proportion of industry-wide enrollment (Table 1). The analyses are designed to allow operational HMOs to compare their marketing efforts, enrollment growth, and marketing costs per new member with industry norms within similar age, model type, enrollment level, and geographic categories. The marketing expenses provided by each HMO are an aggregate figure including sales staff salaries, benefits and commissions, advertising, costs for the production and printing of marketing materials, and all other expenses directly related to the marketing effort. Components of the aggregate marketing expenses, such as the amount spent on advertising versus sales staff compensation, were not available.

Low cost method for manufacturing a data acquisition system with USB connectivity

NASA Astrophysics Data System (ADS)

Niculescu, V.; Dobre, R. A.; Popovici, E.

2016-06-01

In the process of designing and manufacturing an electronic system the digital oscilloscope plays an essential role but it also represents one of the most expensive equipment present on the typical workbench. In order to make electronic design more accessible to students and hobbyists, an affordable data acquisition system was imagined. The paper extensively presents the development and testing of a low cost, medium speed, data acquisition system which can be used in a wide range of electronic measurement and debugging applications, assuring also great portability due to the small physical dimensions. Each hardware functional block and is thoroughly described, highlighting the challenges that occurred as well as the solutions to overcome them. The entire system was successfully manufactured using high quality components to assure increased reliability, and high frequency PCB materials and techniques were preferred. The measured values determined based on test signals were compared to the ones obtained using a digital oscilloscope available on the market and differences less than 1% were observed.

Municipal solid waste management: identification and analysis of engineering indexes representing demand and costs generated in virtuous Italian communities.

PubMed

Gamberini, R; Del Buono, D; Lolli, F; Rimini, B

2013-11-01

The definition and utilisation of engineering indexes in the field of Municipal Solid Waste Management (MSWM) is an issue of interest for technicians and scientists, which is widely discussed in literature. Specifically, the availability of consolidated engineering indexes is useful when new waste collection services are designed, along with when their performance is evaluated after a warm-up period. However, most published works in the field of MSWM complete their study with an analysis of isolated case studies. Conversely, decision makers require tools for information collection and exchange in order to trace the trends of these engineering indexes in large experiments. In this paper, common engineering indexes are presented and their values analysed in virtuous Italian communities, with the aim of contributing to the creation of a useful database whose data could be used during experiments, by indicating examples of MSWM demand profiles and the costs required to manage them. Copyright © 2013 Elsevier Ltd. All rights reserved.

BlueSky Cloud Framework: An E-Learning Framework Embracing Cloud Computing

NASA Astrophysics Data System (ADS)

Dong, Bo; Zheng, Qinghua; Qiao, Mu; Shu, Jian; Yang, Jie

Currently, E-Learning has grown into a widely accepted way of learning. With the huge growth of users, services, education contents and resources, E-Learning systems are facing challenges of optimizing resource allocations, dealing with dynamic concurrency demands, handling rapid storage growth requirements and cost controlling. In this paper, an E-Learning framework based on cloud computing is presented, namely BlueSky cloud framework. Particularly, the architecture and core components of BlueSky cloud framework are introduced. In BlueSky cloud framework, physical machines are virtualized, and allocated on demand for E-Learning systems. Moreover, BlueSky cloud framework combines with traditional middleware functions (such as load balancing and data caching) to serve for E-Learning systems as a general architecture. It delivers reliable, scalable and cost-efficient services to E-Learning systems, and E-Learning organizations can establish systems through these services in a simple way. BlueSky cloud framework solves the challenges faced by E-Learning, and improves the performance, availability and scalability of E-Learning systems.

Align and conquer: moving toward plug-and-play color imaging

NASA Astrophysics Data System (ADS)

Lee, Ho J.

1996-03-01

The rapid evolution of the low-cost color printing and image capture markets has precipitated a huge increase in the use of color imagery by casual end users on desktop systems, as opposed to traditional professional color users working with specialized equipment. While the cost of color equipment and software has decreased dramatically, the underlying system-level problems associated with color reproduction have remained the same, and in many cases are more difficult to address in a casual environment than in a professional setting. The proliferation of color imaging technologies so far has resulted in a wide availability of component solutions which work together poorly. A similar situation in the desktop computing market has led to the various `Plug-and-Play' standards, which provide a degree of interoperability between a range of products on disparate computing platforms. This presentation will discuss some of the underlying issues and emerging trends in the desktop and consumer digital color imaging markets.

Frequency Domain Reflectometry Modeling and Measurement for Nondestructive Evaluation of Nuclear Power Plant Cables

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

Glass, Samuel W.; Fifield, Leonard S.; Jones, Anthony M.

Cable insulation polymers are among the more susceptible materials to age-related degradation within a nuclear power plant. This is recognized by both regulators and utilities, so all plants have developed cable aging management programs to detect damage before critical component failure in compliance with regulatory guidelines. Although a wide range of tools are available to evaluate cables and cable systems, cable aging management programs vary in how condition monitoring and NDE is conducted as utilities search for the most reliable and cost-effective ways to assess cable system condition. Frequency domain reflectometry (FDR) is emerging as one valuable tool to locatemore » and assess damaged portions of a cable system with minimal cost and only requires access in most cases to one of the cable terminal ends. This work examines a physics-based model of a cable system and relates it to FDR measurements for a better understanding of specific damage influences on defect detectability.« less

A review of current sleep screening applications for smartphones.

PubMed

Behar, Joachim; Roebuck, Aoife; Domingos, João S; Gederi, Elnaz; Clifford, Gari D

2013-07-01

Sleep disorders are a common problem and contribute to a wide range of healthcare issues. The societal and financial costs of sleep disorders are enormous. Sleep-related disorders are often diagnosed with an overnight sleep test called a polysomnogram, or sleep study involving the measurement of brain activity through the electroencephalogram. Other parameters monitored include oxygen saturation, respiratory effort, cardiac activity (through the electrocardiogram), as well as video recording, sound and movement activity. Monitoring can be costly and removes the patients from their normal sleeping environment, preventing repeated unbiased studies. The recent increase in adoption of smartphones, with high quality on-board sensors has led to the proliferation of many sleep screening applications running on the phone. However, with the exception of simple questionnaires, no existing sleep-related application available for smartphones is based on scientific evidence. This paper reviews the existing smartphone applications landscape used in the field of sleep disorders and proposes possible advances to improve screening approaches.

Image Processing Occupancy Sensor

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

The Image Processing Occupancy Sensor, or IPOS, is a novel sensor technology developed at the National Renewable Energy Laboratory (NREL). The sensor is based on low-cost embedded microprocessors widely used by the smartphone industry and leverages mature open-source computer vision software libraries. Compared to traditional passive infrared and ultrasonic-based motion sensors currently used for occupancy detection, IPOS has shown the potential for improved accuracy and a richer set of feedback signals for occupant-optimized lighting, daylighting, temperature setback, ventilation control, and other occupancy and location-based uses. Unlike traditional passive infrared (PIR) or ultrasonic occupancy sensors, which infer occupancy based only onmore » motion, IPOS uses digital image-based analysis to detect and classify various aspects of occupancy, including the presence of occupants regardless of motion, their number, location, and activity levels of occupants, as well as the illuminance properties of the monitored space. The IPOS software leverages the recent availability of low-cost embedded computing platforms, computer vision software libraries, and camera elements.« less

An Asymptotically-Optimal Sampling-Based Algorithm for Bi-directional Motion Planning

PubMed Central

Starek, Joseph A.; Gomez, Javier V.; Schmerling, Edward; Janson, Lucas; Moreno, Luis; Pavone, Marco

2015-01-01

Bi-directional search is a widely used strategy to increase the success and convergence rates of sampling-based motion planning algorithms. Yet, few results are available that merge both bi-directional search and asymptotic optimality into existing optimal planners, such as PRM*, RRT*, and FMT*. The objective of this paper is to fill this gap. Specifically, this paper presents a bi-directional, sampling-based, asymptotically-optimal algorithm named Bi-directional FMT* (BFMT*) that extends the Fast Marching Tree (FMT*) algorithm to bidirectional search while preserving its key properties, chiefly lazy search and asymptotic optimality through convergence in probability. BFMT* performs a two-source, lazy dynamic programming recursion over a set of randomly-drawn samples, correspondingly generating two search trees: one in cost-to-come space from the initial configuration and another in cost-to-go space from the goal configuration. Numerical experiments illustrate the advantages of BFMT* over its unidirectional counterpart, as well as a number of other state-of-the-art planners. PMID:27004130

Eliciting management action: Using THERP to highlight human factors deficiencies for trip reduction programs

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

Fuld, R.; Cybert, S.

Methods and criteria for performing human factors evaluations of plant systems and procedures are well developed and available. For a design review to produce a positive impact on operations, however, it is not enough to simply document deficiences and solutions. The results must be presented to management in a clear and compelling form that will direct attention to the heart of a problem and present proposed solutions in terms of explicit, quantified cost/benefits. A proactive program of trip reduction provides an excellent opportunity to accomplish human factors-related upgrades. As an evaluative context, trip reduction imposes a uniform goodness criterion onmore » all situations: the probability of inadvertent plant trip. This in turn means that findings can be compared in terms of a common quantitative reference point: the cost of an inadvertent shutdown. To interpret human factors deficiencies in terms of trip probabilities, the Technique for Human Error Rate Prediction (THERP) can be used. THERP provides an accessible compilation of human reliability data for generic, discrete task elements. Sequences of such values are combined in standard event trees to determine the probability of failure (e.g., trip) for a given evolution. THERP is widely accepted as one of the best available alternatives for assessing human reliability.« less

Using DSLR cameras in digital holography

NASA Astrophysics Data System (ADS)

Hincapié-Zuluaga, Diego; Herrera-Ramírez, Jorge; García-Sucerquia, Jorge

2017-08-01

In Digital Holography (DH), the size of the bidimensional image sensor to record the digital hologram, plays a key role on the performance of this imaging technique; the larger the size of the camera sensor, the better the quality of the final reconstructed image. Scientific cameras with large formats are offered in the market, but their cost and availability limit their use as a first option when implementing DH. Nowadays, DSLR cameras provide an easy-access alternative that is worthwhile to be explored. The DSLR cameras are a wide, commercial, and available option that in comparison with traditional scientific cameras, offer a much lower cost per effective pixel over a large sensing area. However, in the DSLR cameras, with their RGB pixel distribution, the sampling of information is different to the sampling in monochrome cameras usually employed in DH. This fact has implications in their performance. In this work, we discuss why DSLR cameras are not extensively used for DH, taking into account the problem reported by different authors of object replication. Simulations of DH using monochromatic and DSLR cameras are presented and a theoretical deduction for the replication problem using the Fourier theory is also shown. Experimental results of DH implementation using a DSLR camera show the replication problem.

Air Sensor Guidebook | Science Inventory | US EPA

EPA Pesticide Factsheets

This Air Sensor Guidebook has been developed by the U.S. EPA to assist those interested in potentially using lower cost air quality sensor technologies for air quality measurements. Its development was in direct response to a request for such a document following a recent scientific conference (Apps and Sensors for Air Pollution-2012). Low cost air quality sensors ($100-$2500) are now commercially available in a wide variety of designs and capabilities. This is an emerging technology area and one that is quickly evolving. Even so, their availability has resulted in questions from many as to how they might be used appropriately. This document attempts to provide useful information concerning some of those questions. The National Exposure Research Laboratory’s (NERL’s) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA’s mission to protect human health and the environment. HEASD’s research program supports Goal 1 (Clean Air) and Goal 4 (Healthy People) of EPA’s strategic plan. More specifically, our division conducts research to characterize the movement of pollutants from the source to contact with humans. Our multidisciplinary research program produces Methods, Measurements, and Models to identify relationships between and characterize processes that link source emissions, environmental concentrations, human exposures, and target-tissue dose. The impact of these tools is improved regulatory programs and pol

High-field MRS in clinical drug development.

PubMed

Ross, Brian D

2013-07-01

Magnetic resonance spectroscopy (MRS) will continue to play an ever increasing role in drug discovery because MRS does readily define biomarkers for several hundreds of clinically distinct diseases. Published evidence based medicine (EBM) surveys, which generally conclude the opposite, are seriously flawed and do a disservice to the field of drug discovery. This article presents MRS and how it has guided several hundreds of practical human 'drug discovery' endeavors since its development. Specifically, the author looks at the process of 'reverse-translation' and its influence in the expansion of the number of preclinical drug discoveries from in vivo MRS. The author also provides a structured approach of eight criteria, including EBM acceptance, which could potentially re-open the field of MRS for productive exploration of existing and repurposed drugs and cost-effective drug-discovery. MRS-guided drug discovery is poised for future expansion. The cost of clinical trials has escalated and the use of biomarkers has become increasingly useful in improving patient selection for drug trials. Clinical MRS has uncovered a treasure-trove of novel biomarkers and clinical MRS itself has become better standardized and more widely available on 'routine' clinical MRI scanners. When combined with available new MRI sequences, MRS can provide a 'one stop shop' with multiple potential outcome measures for the disease and the drug in question.

Improved high-throughput quantification of luminescent microplate assays using a common Western-blot imaging system.

PubMed

Hawkins, Liam J; Storey, Kenneth B

2017-01-01

Common Western-blot imaging systems have previously been adapted to measure signals from luminescent microplate assays. This can be a cost saving measure as Western-blot imaging systems are common laboratory equipment and could substitute a dedicated luminometer if one is not otherwise available. One previously unrecognized limitation is that the signals captured by the cameras in these systems are not equal for all wells. Signals are dependent on the angle of incidence to the camera, and thus the location of the well on the microplate. Here we show that: •The position of a well on a microplate significantly affects the signal captured by a common Western-blot imaging system from a luminescent assay.•The effect of well position can easily be corrected for.•This method can be applied to commercially available luminescent assays, allowing for high-throughput quantification of a wide range of biological processes and biochemical reactions.

Building a virtual ligand screening pipeline using free software: a survey.

PubMed

Glaab, Enrico

2016-03-01

Virtual screening, the search for bioactive compounds via computational methods, provides a wide range of opportunities to speed up drug development and reduce the associated risks and costs. While virtual screening is already a standard practice in pharmaceutical companies, its applications in preclinical academic research still remain under-exploited, in spite of an increasing availability of dedicated free databases and software tools. In this survey, an overview of recent developments in this field is presented, focusing on free software and data repositories for screening as alternatives to their commercial counterparts, and outlining how available resources can be interlinked into a comprehensive virtual screening pipeline using typical academic computing facilities. Finally, to facilitate the set-up of corresponding pipelines, a downloadable software system is provided, using platform virtualization to integrate pre-installed screening tools and scripts for reproducible application across different operating systems. © The Author 2015. Published by Oxford University Press.

Building a virtual ligand screening pipeline using free software: a survey

PubMed Central

2016-01-01

Virtual screening, the search for bioactive compounds via computational methods, provides a wide range of opportunities to speed up drug development and reduce the associated risks and costs. While virtual screening is already a standard practice in pharmaceutical companies, its applications in preclinical academic research still remain under-exploited, in spite of an increasing availability of dedicated free databases and software tools. In this survey, an overview of recent developments in this field is presented, focusing on free software and data repositories for screening as alternatives to their commercial counterparts, and outlining how available resources can be interlinked into a comprehensive virtual screening pipeline using typical academic computing facilities. Finally, to facilitate the set-up of corresponding pipelines, a downloadable software system is provided, using platform virtualization to integrate pre-installed screening tools and scripts for reproducible application across different operating systems. PMID:26094053

Vaccines for leishmaniasis: from proteome to vaccine candidates.

PubMed

Schroeder, Juliane; Aebischer, Toni

2011-01-01

Leishmania spp. cause a wide spectrum of tropical diseases which are threatening an estimated 350 million people around the globe. While in most cases non-fatal, the disease is associated with high morbidity, social stigmata and poverty. However, the most severe form visceral leishmaniasis can be fatal if left untreated. Chemotherapeutics are available but show high toxicity, costs and are prone to resistance development due to prolonged treatment periods. Healing is associated with a life-long resistance to re-infection and this argues for the feasibility of vaccination. However, despite much effort, no such vaccine has become available yet. Here, the status of vaccine development in this field is briefly summarized before the focus is set on the promise of reverse vaccinology for anti-Leishmania vaccine development in the post-genomic era. We report on our own experience with this approach using an instructive example of successful candidate vaccine antigen identification.

Evaluation of the eZono 4000 with eZGuide for ultrasound-guided procedures.

PubMed

Gadsden, Jeff; Latmore, Malikah; Levine, Daniel M

2015-05-01

Ultrasound-guided procedures are increasingly common in a variety of acute care settings, such as the operating room, critical care unit and emergency room. However, accurate judgment of needle tip position using traditional ultrasound technology is frequently difficult, and serious injury can result from inadvertently advancing beyond or through the target. Needle navigation is a recent innovation that allows the clinician to visualize the needle position and trajectory in real time as it approaches the target. A novel ultrasound machine has recently been introduced that is portable and designed for procedural guidance. The eZono 4000™ features an innovative needle navigation technology that is simple to use and permits the use of a wide range of commercially available needles, avoiding the inconvenience and cost of proprietary equipment. This article discusses this new ultrasound machine in the context of other currently available ultrasound machines featuring needle navigation.