Pathfinder 2: In Situ Design Cost Trades (IDCT) Tool

DTIC Science & Technology

2003-05-01

collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT...Cost Analysis box in the center of the figure is represented as an ICOM box where input, controls , output, and mechanisms are denoted on each of the...characteristics (e.g. mission profile, maintenance plan). All of these are received in some form from domain experts. Controls are denoted at the top of the

Cost-effectiveness of using a gene expression profiling test to aid in identifying the primary tumour in patients with cancer of unknown primary.

PubMed

Hannouf, M B; Winquist, E; Mahmud, S M; Brackstone, M; Sarma, S; Rodrigues, G; Rogan, P; Hoch, J S; Zaric, G S

2017-06-01

We aimed to investigate the cost-effectiveness of a 2000-gene-expression profiling (GEP) test to help identify the primary tumor site when clinicopathological diagnostic evaluation was inconclusive in patients with cancer of unknown primary (CUP). We built a decision-analytic-model to project the lifetime clinical and economic consequences of different clinical management strategies for CUP. The model was parameterized using follow-up data from the Manitoba Cancer Registry, cost data from Manitoba Health administrative databases and secondary sources. The 2000-GEP-based strategy compared to current clinical practice resulted in an incremental cost-effectiveness ratio (ICER) of $44,151 per quality-adjusted life years (QALY) gained. The total annual-budget impact was $36.2 million per year. A value-of-information analysis revealed that the expected value of perfect information about the test's clinical impact was $4.2 million per year. The 2000-GEP test should be considered for adoption in CUP. Field evaluations of the test are associated with a large societal benefit.

The Global Ozone and Aerosol Profiles and Aerosol Hygroscopic Effect and Absorption Optical Depth (GOA2HEAD) Network Initiative

NASA Astrophysics Data System (ADS)

Gao, R. S.; Elkins, J. W.; Frost, G. J.; McComiskey, A. C.; Murphy, D. M.; Ogren, J. A.; Petropavlovskikh, I. V.; Rosenlof, K. H.

2014-12-01

Inverse modeling using measurements of ozone (O3) and aerosol is a powerful tool for deriving pollutant emissions. Because they have relatively long lifetimes, O3 and aerosol are transported over large distances. Frequent and globally spaced vertical profiles rather than ground-based measurements alone are therefore highly desired. Three requirements necessary for a successful global monitoring program are: Low equipment cost, low operation cost, and reliable measurements of known uncertainty. Conventional profiling using aircraft provides excellent data, but is cost prohibitive on a large scale. Here we describe a new platform and instruments meeting all three global monitoring requirements. The platform consists of a small balloon and an auto-homing glider. The glider is released from the balloon at about 5 km altitude, returning the light instrument package to the launch location, and allowing for consistent recovery of the payload. Atmospheric profiling can be performed either during ascent or descent (or both) depending on measurement requirements. We will present the specifications for two instrument packages currently under development. The first measures O3, RH, p, T, dry aerosol particle number and size distribution, and aerosol optical depth. The second measures dry aerosol particle number and size distribution, and aerosol absorption coefficient. Other potential instrument packages and the desired spatial/temporal resolution for the GOA2HEAD monitoring initiative will also be discussed.

Polio immunization policy in Mexico: economic assessment of current practice and future alternatives.

PubMed

Mascareñas, A; Salinas, J; Tasset-Tisseau, A; Mascareñas, C; Khan, M M

2005-06-01

The World Health Organization recommends that all children aged less than 5 years should be vaccinated against polio through intensive immunization programmes as well as routine immunization. A national immunization week (NIW) was held in February 2002 in the Monterrey district of Mexico. A prospective micro-costing study was conducted to measure the total cost to the state of the NIW, the cost profile, and the ratio of cost per immunization contact to cost per dose of oral polio vaccine (OPV), and to compare OPV and inactive polio vaccine (IPV) in economic terms. Two scenarios were used as the basis for calculation. The cost of volunteers was excluded from the "lower-cost scenario" and included in the "upper-cost scenario". The total cost of the NIW was USD 100,454 for the lower-cost scenario and USD 156,614 for the upper-cost scenario. The major part of the costs was personnel costs (67.30 and 77.53% of the total costs in the lower- and upper-cost scenario, respectively). The ratio of cost per immunization contact to cost per dose of OPV was 6.45 for the lower-cost scenario and 10.05 for the upper-cost scenario. Changing from the current OPV-based intensive and routine schedule to a sequential IPV-OPV routine schedule would save USD 14.52 per vaccinated child, and changing to a full IPV routine schedule would save USD 9.41 per vaccinated child.

Gene Scanning of an Internalin B Gene Fragment Using High-Resolution Melting Curve Analysis as a Tool for Rapid Typing of Listeria monocytogenes

PubMed Central

Pietzka, Ariane T.; Stöger, Anna; Huhulescu, Steliana; Allerberger, Franz; Ruppitsch, Werner

2011-01-01

The ability to accurately track Listeria monocytogenes strains involved in outbreaks is essential for control and prevention of listeriosis. Because current typing techniques are time-consuming, cost-intensive, technically demanding, and difficult to standardize, we developed a rapid and cost-effective method for typing of L. monocytogenes. In all, 172 clinical L. monocytogenes isolates and 20 isolates from culture collections were typed by high-resolution melting (HRM) curve analysis of a specific locus of the internalin B gene (inlB). All obtained HRM curve profiles were verified by sequence analysis. The 192 tested L. monocytogenes isolates yielded 15 specific HRM curve profiles. Sequence analysis revealed that these 15 HRM curve profiles correspond to 18 distinct inlB sequence types. The HRM curve profiles obtained correlated with the five phylogenetic groups I.1, I.2, II.1, II.2, and III. Thus, HRM curve analysis constitutes an inexpensive assay and represents an improvement in typing relative to classical serotyping or multiplex PCR typing protocols. This method provides a rapid and powerful screening tool for simultaneous preliminary typing of up to 384 samples in approximately 2 hours. PMID:21227395

Welding technology transfer task/laser based weld joint tracking system for compressor girth welds

NASA Technical Reports Server (NTRS)

Looney, Alan

1991-01-01

Sensors to control and monitor welding operations are currently being developed at Marshall Space Flight Center. The laser based weld bead profiler/torch rotation sensor was modified to provide a weld joint tracking system for compressor girth welds. The tracking system features a precision laser based vision sensor, automated two-axis machine motion, and an industrial PC controller. The system benefits are elimination of weld repairs caused by joint tracking errors which reduces manufacturing costs and increases production output, simplification of tooling, and free costly manufacturing floor space.

PHENIX Work Breakdown Structure. Cost and schedule review copy

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

Not Available

1994-02-01

The Work Breakdown Structure (WBS) Book begins with this Overview section, which contains the high-level summary cost estimate, the cost profile, and the global construction schedule. The summary cost estimate shows the total US cost and the cost in terms of PHENIX construction funds for building the PHENIX detector. All costs in the WBS book are shown in FY 1993 dollars. Also shown are the institutional and foreign contributions, the level of pre-operations funding, and the cost of deferred items. Pie charts are presented at PHENIX WBS level 1 and 2 that show this information. The PHENIX construction funds aremore » shown broken down to PHENIX WBS level 3 items per fiscal year, and the resulting profile is compared to the RHIC target profile. An accumulated difference of the two profiles is also shown. The PHENIX global construction schedule is presented at the end of the Overview section. Following the Overview are sections for each subsystem. Each subsystem section begins with a summary cost estimate, cost profile, and critical path. The total level 3 cost is broken down into fixed costs (M&S), engineering costs (EDIA) and labor costs. Costs are further broken down in terms of PHENIX construction funds, institutional and foreign contributions, pre-operations funding, and deferred items. Also shown is the contingency at level 3 and the level 4 breakdown of the total cost. The cost profile in fiscal years is shown at level 3. The subsystem summaries are followed by the full cost estimate and schedule sheets for that subsystem. These detailed sheets are typically carried down to level 7 or 8. The cost estimate shows Total, M&S, EDIA, and Labor breakdowns, as well as contingency, for each WBS entry.« less

Effect of pill burden on dosing preferences, willingness to pay, and likely adherence among patients with type 2 diabetes

PubMed Central

Hauber, A Brett; Han, Steven; Yang, Jui-Chen; Gantz, Ira; Tunceli, Kaan; Gonzalez, Juan Marcos; Brodovicz, Kimberly; Alexander, Charles M; Davies, Michael; Iglay, Kristy; Zhang, Qiaoyi; Radican, Larry

2013-01-01

Purpose To quantify willingness-to-pay (WTP) for reducing pill burden and dosing frequency among patients with type 2 diabetes mellitus (T2DM), and to examine the effect of dosing frequency and pill burden on likely medication adherence. Patients and methods Participants were US adults with T2DM on oral antihyperglycemic therapy. Each patient completed an online discrete-choice experiment (DCE) with eight choice questions, each including a pair of hypothetical medication profiles. Each profile was defined by reduction in average glucose (AG), daily dosing, chance of mild-to-moderate stomach problems, frequency of hypoglycemia, weight change, incremental risk of congestive heart failure (CHF), and cost. Patients were asked to rate their likely adherence to the profiles presented in each question. Choice questions were based on a predetermined experimental design. Choice data were analyzed using random-parameters logit. Likely treatment adherence was analyzed using a Heckman two-stage model. Results Of the 1,114 patients who completed the survey, 90 had lower dosing burden (<5 pills/day taken once/day or as needed) for all medications, and 1,024 had higher dosing burden (≥5 pills/day or more than once/day). Reduction in AG was valued most highly by patients. Hypoglycemia, chance of mild-to-moderate stomach problems, weight change, incremental risk of CHF, and daily dosing were less valued. Patients with higher current dosing burden had lower WTP for more convenient dosing schedules than patients with lower current dosing burden. Changes in dosing and cost impacted likely adherence. The magnitude of the impact of dosing on likely adherence was higher for patients with lower current dosing burden than for patients with higher current dosing burden. Conclusion Patients with T2DM were willing to pay for improvements in efficacy, side effects, and dosing. Patients’ WTP for more convenient dosing depended on current dosing burden, as did the effect of these attributes on likely adherence. PMID:24086104

Minimum-Cost Aircraft Descent Trajectories with a Constrained Altitude Profile

NASA Technical Reports Server (NTRS)

Wu, Minghong G.; Sadovsky, Alexander V.

2015-01-01

An analytical formula for solving the speed profile that accrues minimum cost during an aircraft descent with a constrained altitude profile is derived. The optimal speed profile first reaches a certain speed, called the minimum-cost speed, as quickly as possible using an appropriate extreme value of thrust. The speed profile then stays on the minimum-cost speed as long as possible, before switching to an extreme value of thrust for the rest of the descent. The formula is applied to an actual arrival route and its sensitivity to winds and airlines' business objectives is analyzed.

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

Not Available

The Work Breakdown Structure (WBS) Book begins with this Overview section, which contains the high-level summary cost estimate, the cost profile, and the global construction schedule. The summary cost estimate shows the total US cost and the cost in terms of PHENIX construction funds for building the PHENIX detector. All costs in the WBS book are shown in FY 1993 dollars. Also shown are the institutional and foreign contributions, the level of pre-operations funding, and the cost of deferred items. Pie charts are presented at PHENIX WBS level 1 and 2 that show this information. The PHENIX construction funds aremore » shown broken down to PHENIX WBS level 3 items per fiscal year, and the resulting profile is compared to the RHIC target profile. An accumulated difference of the two profiles is also shown. The PHENIX global construction schedule is presented at the end of the Overview section. Following the Overview are sections for each subsystem. Each subsystem section begins with a summary cost estimate, cost profile, and critical path. The total level 3 cost is broken down into fixed costs (M&S), engineering costs (EDIA) and labor costs. Costs are further broken down in terms of PHENIX construction funds, institutional and foreign contributions, pre-operations funding, and deferred items. Also shown is the contingency at level 3 and the level 4 breakdown of the total cost. The cost profile in fiscal years is shown at level 3. The subsystem summaries are followed by the full cost estimate and schedule sheets for that subsystem. These detailed sheets are typically carried down to level 7 or 8. The cost estimate Total, M&S, EDIA, and Labor breakdowns, as well as contingency, for each WBS entry.« less

Super Ball Bot - Structures for Planetary Landing and Exploration, NIAC Phase 2 Final Report

NASA Technical Reports Server (NTRS)

SunSpiral, Vytas; Agogino, Adrian; Atkinson, David

2015-01-01

Small, light-weight and low-cost missions will become increasingly important to NASA's exploration goals. Ideally teams of small, collapsible, light weight robots, will be conveniently packed during launch and would reliably separate and unpack at their destination. Such robots will allow rapid, reliable in-situ exploration of hazardous destination such as Titan, where imprecise terrain knowledge and unstable precipitation cycles make single-robot exploration problematic. Unfortunately landing lightweight conventional robots is difficult with current technology. Current robot designs are delicate, requiring a complex combination of devices such as parachutes, retrorockets and impact balloons to minimize impact forces and to place a robot in a proper orientation. Instead we are developing a radically different robot based on a "tensegrity" structure and built purely with tensile and compression elements. Such robots can be both a landing and a mobility platform allowing for dramatically simpler mission profile and reduced costs. These multi-purpose robots can be light-weight, compactly stored and deployed, absorb strong impacts, are redundant against single-point failures, can recover from different landing orientations and can provide surface mobility. These properties allow for unique mission profiles that can be carried out with low cost and high reliability and which minimizes the inefficient dependance on "use once and discard" mass associated with traditional landing systems. We believe tensegrity robot technology can play a critical role in future planetary exploration.

Remote Water Temperature Measurements Based on Brillouin Scattering with a Frequency Doubled Pulsed Yb:doped Fiber Amplifier

PubMed Central

Schorstein, Kai; Popescu, Alexandru; Göbel, Marco; Walther, Thomas

2008-01-01

Temperature profiles of the ocean are of interest for weather forecasts, climate studies and oceanography in general. Currently, mostly in situ techniques such as fixed buoys or bathythermographs deliver oceanic temperature profiles. A LIDAR method based on Brillouin scattering is an attractive alternative for remote sensing of such water temperature profiles. It makes it possible to deliver cost-effective on-line data covering an extended region of the ocean. The temperature measurement is based on spontaneous Brillouin scattering in water. In this contribution, we present the first water temperature measurements using a Yb:doped pulsed fiber amplifier. The fiber amplifier is a custom designed device which can be operated in a vibrational environment while emitting narrow bandwidth laser pulses. The device shows promising performance and demonstrates the feasibility of this approach. Furthermore, the current status of the receiver is briefly discussed; it is based on an excited state Faraday anomalous dispersion optical filter. PMID:27873842

Do differences in profiling criteria bias performance measurements? Economic profiling of medical clinics under the Korea National Health Insurance program: an observational study using claims data.

PubMed

Kang, Hee-Chung; Hong, Jae-Seok

2011-08-16

With a greater emphasis on cost containment in many health care systems, it has become common to evaluate each physician's relative resource use. This study explored the major factors that influence the economic performance rankings of medical clinics in the Korea National Health Insurance (NHI) program by assessing the consistency between cost-efficiency indices constructed using different profiling criteria. Data on medical care benefit costs for outpatient care at medical clinics nationwide were collected from the NHI claims database. We calculated eight types of cost-efficiency index with different profiling criteria for each medical clinic and investigated the agreement between the decile rankings of each index pair using the weighted kappa statistic. The exclusion of pharmacy cost lowered agreement between rankings to the lowest level, and differences in case-mix classification also lowered agreement considerably. A medical clinic may be identified as either cost-efficient or cost-inefficient, even when using the same index, depending on the profiling criteria applied. Whether a country has a single insurance or a multiple-insurer system, it is very important to have standardized profiling criteria for the consolidated management of health care costs.

Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin.

PubMed

Neff, Guy; Iii, Woodie Zachry

2018-04-12

Hepatic encephalopathy (HE), a common neurologic complication in cirrhosis, is associated with substantial disease and economic burden. Rifaximin is a non-systemic antibiotic that reduces the risk of overt HE recurrence and overt HE-related hospitalizations. Our objective was to provide an overview of the direct HE-related costs and cost benefits of rifaximin, lactulose, and rifaximin plus lactulose. A systematic review of PubMed and relevant meeting abstracts was conducted to identify publications since 1 January 2007 reporting economic data related to HE and rifaximin and/or lactulose. Further, a public database and published literature were used to estimate current costs of hospitalization for overt HE, and potential cost savings of HE-related hospitalizations with rifaximin. The methodological quality of included studies was evaluated using the Drummond checklist. A total of 16 reports were identified for inclusion in the systematic review. Globally, HE-related direct costs ranged from $US5370 to $US50,120 annually per patient. Rifaximin was associated with shorter hospital stays and reduced healthcare costs. Rifaximin also has the potential to reduce overt HE-related hospitalization risk by 50% compared with lactulose. Rifaximin was shown to have a favourable pharmacoeconomic profile compared with lactulose (based on the incremental cost-effectiveness ratio). In addition to its clinical benefits (e.g. reduction in the risk of recurrence of overt HE, overt HE-related hospitalizations, favourable adverse event profile), economic data are favourable for the use of rifaximin in patients with a history of overt HE.

[Operational costs and control of performance in surgical clinics between marketing and planning economics. Risk or perhaps quadrature of the circle].

PubMed

Kraus, T W; Weber, W; Mieth, M; Funk, H; Klar, E; Herfarth, C

2000-03-01

Surgical hospitals can be seen as operational or even industrial production systems. Doctors have a major impact on both medical performance and costs. For active participation in the management process, knowledge of industrial controlling mechanisms is required. German hospitals currently receive no procedure-related financial revenues, such as prices or tariffs for defined medical treatment activities. Maximum clinical revenues are, furthermore, limited by principles of planned economy and can be increased only slightly by greater medical performance. Costs are the only target that can be autonomously influenced by the management. Operative controlling in hospitals aims at horizontal and vertical coordination of subunits and decentralization of process regulations. Hospital medical performance is not clearly defined, its quantitative measurement very problematic. Process-orientated clinical activities are not taken into account. A high percentage of hospital costs are fixed and can be influenced only by major structural interventions in the long term. Variable costs are primarily dependent on the quantity of clinical activities, but also heavily influenced by patient structure (comorbidity and risk profile). The various forms of industrial cost calculations, such as internal budgeting, internal markets or flexible plan-cost balancing, cannot be directly applied in hospital management. Based on these analyses, current operational concepts and strategic trends are listed to describe cost-management options in hospitals with focus on the German health reforms.

The Thrifty Food Plan is not thrifty when labor cost is considered.

PubMed

Davis, George C; You, Wen

2010-04-01

Recent research has shown that the typical Supplemental Food Assistance Program (SNAP) family falls short in meeting the Thrifty Food Plan (TFP) nutritional guidelines that underlie the SNAP even when they typically have sufficient monetary resources to eat a healthful diet (i.e. to follow the TFP recommendations). However, the TFP does not consider labor cost. This study uses a basic labor economics technique to value labor in a home food production scenario that is required to reach the TFP nutrition and budget targets and calculates the total cost (inclusive of labor) associated with the TFP. This TFP consistent total cost is then compared, using several metrics, with the total cost associated with actual choices made by those families sharing the same profiles as current SNAP participants. Once labor is included, we find the TFP is not very thrifty and the mean household falls short of the TFP guidelines even with adequate monetary resources.

Is treatment with liraglutide efficient?

PubMed

Mezquita Raya, Pedro; Reyes García, Rebeca

2014-04-01

In the current context of limited economic and health resources, efficiency of drug treatments is of paramount importance, and their clinical effects and related direct costs should therefore be analyzed. Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of type 2 diabetes mellitus (T2DM) which, in addition to its normoglycemic effects, induces a significant improvement in body weight and several cardiovascular risk factors. The aim of this narrative review is to summarize the available evidence about the effects of liraglutide upon cardiovascular risk factors and how these improve its cost-effectiveness profile. Despite the relatively higher cost of liraglutide as compared to other alternative therapies, liraglutide has been shown to be cost-effective when clinical indicators and total costs associated to T2DM management are analyzed. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

OPTIMAL AIRCRAFT TRAJECTORIES FOR SPECIFIED RANGE

NASA Technical Reports Server (NTRS)

Lee, H.

1994-01-01

For an aircraft operating over a fixed range, the operating costs are basically a sum of fuel cost and time cost. While minimum fuel and minimum time trajectories are relatively easy to calculate, the determination of a minimum cost trajectory can be a complex undertaking. This computer program was developed to optimize trajectories with respect to a cost function based on a weighted sum of fuel cost and time cost. As a research tool, the program could be used to study various characteristics of optimum trajectories and their comparison to standard trajectories. It might also be used to generate a model for the development of an airborne trajectory optimization system. The program could be incorporated into an airline flight planning system, with optimum flight plans determined at takeoff time for the prevailing flight conditions. The use of trajectory optimization could significantly reduce the cost for a given aircraft mission. The algorithm incorporated in the program assumes that a trajectory consists of climb, cruise, and descent segments. The optimization of each segment is not done independently, as in classical procedures, but is performed in a manner which accounts for interaction between the segments. This is accomplished by the application of optimal control theory. The climb and descent profiles are generated by integrating a set of kinematic and dynamic equations, where the total energy of the aircraft is the independent variable. At each energy level of the climb and descent profiles, the air speed and power setting necessary for an optimal trajectory are determined. The variational Hamiltonian of the problem consists of the rate of change of cost with respect to total energy and a term dependent on the adjoint variable, which is identical to the optimum cruise cost at a specified altitude. This variable uniquely specifies the optimal cruise energy, cruise altitude, cruise Mach number, and, indirectly, the climb and descent profiles. If the optimum cruise cost is specified, an optimum trajectory can easily be generated; however, the range obtained for a particular optimum cruise cost is not known a priori. For short range flights, the program iteratively varies the optimum cruise cost until the computed range converges to the specified range. For long-range flights, iteration is unnecessary since the specified range can be divided into a cruise segment distance and full climb and descent distances. The user must supply the program with engine fuel flow rate coefficients and an aircraft aerodynamic model. The program currently includes coefficients for the Pratt-Whitney JT8D-7 engine and an aerodynamic model for the Boeing 727. Input to the program consists of the flight range to be covered and the prevailing flight conditions including pressure, temperature, and wind profiles. Information output by the program includes: optimum cruise tables at selected weights, optimal cruise quantities as a function of cruise weight and cruise distance, climb and descent profiles, and a summary of the complete synthesized optimal trajectory. This program is written in FORTRAN IV for batch execution and has been implemented on a CDC 6000 series computer with a central memory requirement of approximately 100K (octal) of 60 bit words. This aircraft trajectory optimization program was developed in 1979.

High Spectral Resolution LIDAR as a Tool for Air Quality Research

NASA Astrophysics Data System (ADS)

Eloranta, E. W.; Spuler, S.; Hayman, M. M.

2017-12-01

Many aspects of air quality research require information on the vertical distribution of pollution. Traditional measurements, obtained from surface based samplers, or passive satellite remote sensing, do not provide vertical profiles. Lidar can provide profiles of aerosol properties. However traditional backscatter lidar suffers from uncertain calibrations with poorly constrained algorithms. These problems are avoided using High Spectral Resolution Lidar (HSRL) which provides absolutely calibrated vertical profiles of aerosol properties. The University of Wisconsin HSRL systems measure 532 nm wavelength aerosol backscatter cross-sections, extinction cross-sections, depolarization, and attenuated 1064 nm backscatter. These instruments are designed for long-term deployment at remote sites with minimal local support. Processed data is provided for public viewing and download in real-time on our web site "http://hsrl.ssec.wisc.edu". Air pollution applications of HSRL data will be illustrated with examples acquired during air quality field programs including; KORUS-AQ, DISCOVER-AQ, LAMOS and FRAPPE. Observations include 1) long range transport of dust, air pollution and smoke. 2) Fumigation episodes where elevated pollution is mixed down to the surface. 3) visibility restrictions by aerosols and 4) diurnal variations in atmospheric optical depth. While HSRL is powerful air quality research tool, its application in routine measurement networks is hindered by the high cost of current systems. Recent technical advances promise a next generation HSRL using telcom components to greatly reduce system cost. This paper will present data generated by a prototype low cost system constructed at NCAR. In addition to lower cost, operation at a non-visible near 780 nm infrared wavelength removes all FAA restrictions on the operation.

Optimizing resource allocation for breast cancer prevention and care among Hong Kong Chinese women.

PubMed

Wong, Irene O L; Tsang, Janice W H; Cowling, Benjamin J; Leung, Gabriel M

2012-09-15

Recommendations about funding of interventions through the full spectrum of the disease often have been made in isolation. The authors of this report optimized budgetary allocations by comparing cost-effectiveness data for different preventive and management strategies throughout the disease course for breast cancer in Hong Kong (HK) Chinese women. Nesting a state-transition Markov model within a generalized cost-effectiveness analytic framework, costs and quality-adjusted life-years (QALYs) were compared to estimate average cost-effectiveness ratios for the following interventions at the population level: biennial mass mammography (ages 40-69 years or ages 40-79 years), reduced waiting time for postoperative radiotherapy (by 15% or by 25%), adjuvant endocrine therapy (either upfront aromatase inhibitor [AI] therapy or sequentially with tamoxifen followed by AI) in postmenopausal women with estrogen receptor-positive disease, targeted immunotherapy in those with tumors that over express human epidermal growth factor receptor 2, and enhanced palliative services (either at home or as an inpatient). Usual care for eligible patients in the public sector was the comparator. In descending order, the optimal allocation of additional resources for breast cancer would be the following: a 25% reduction in waiting time for postoperative radiotherapy (in US dollars: $5000 per QALY); enhanced, home-based palliative care ($7105 per QALY); adjuvant, sequential endocrine therapy ($17,963 per QALY); targeted immunotherapy ($62,092 per QALY); and mass mammography screening of women ages 40 to 69 years ($72,576 per QALY). Given the lower disease risk and different age profiles of patients in HK Chinese, among other newly emergent and emerging economies with similar transitioning epidemiologic profiles, the current findings provided direct evidence to support policy decisions that may be dissimilar to current Western practice. Copyright © 2012 American Cancer Society.

Is the use of colloids for fluid replacement harmless in children?

PubMed

Saudan, Sonja

2010-06-01

Albumin has been regarded as the gold standard for maintaining adequate colloid osmotic pressure in children, but increased cost, the lack of clear-cut benefits for survival, and fear of transmission of unknown viruses have contributed to its replacement by hydroxyethyl starch and gelatin preparations. Each of the synthetic colloids has unique physicochemical characteristics that determine their likely efficacy and adverse effect profile. This review will examine the advantages and disadvantages of the use of different colloid solutions in children with a particular focus on their safety profile. Dextrans are rarely used because of their negative effects on coagulation and potential for anaphylactic reactions. Gelatin and albumin have little effect on hemostasis, but the disadvantages of gelatin include its high anaphylactoid potential and limited beneficial volume effect. Tetrastarches have significantly fewer adverse effects on coagulation and renal function than the older hydroxyethyl starches and are now approved for children. Dissolving tetrastarches in a plasma-adapted, balanced solution rather than in saline further improves safety with regard to coagulation and acid-base balance. Tetrastarches offer the best currently available compromise between cost-effectiveness and safety profile in children with preexisting normal renal function and coagulation.

Optical Estimation of Depth and Current in a Ebb Tidal Delta Environment

NASA Astrophysics Data System (ADS)

Holman, R. A.; Stanley, J.

2012-12-01

A key limitation to our ability to make nearshore environmental predictions is the difficulty of obtaining up-to-date bathymetry measurements at a reasonable cost and frequency. Due to the high cost and complex logistics of in-situ methods, research into remote sensing approaches has been steady and has finally yielded fairly robust methods like the cBathy algorithm for optical Argus data that show good performance on simple barred beach profiles and near immunity to noise and signal problems. In May, 2012, data were collected in a more complex ebb tidal delta environment during the RIVET field experiment at New River Inlet, NC. The presence of strong reversing tidal currents led to significant errors in cBathy depths that were phase-locked to the tide. In this paper we will test methods for the robust estimation of both depths and vector currents in a tidal delta domain. In contrast to previous Fourier methods, wavenumber estimation in cBathy can be done on small enough scales to resolve interesting nearshore features.

Comparative Study of DC and AC Microgrids in Commercial Buildings Across Different Climates and Operating Profiles

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

Fregosi, Daniel; Ravula, Sharmila; Brhlik, Dusan

2015-06-07

Bosch has developed and demonstrated a novel direct current (DC) microgrid system that maximizes the efficiency of locally generated photovoltaic energy while offering high reliability, safety, redundancy, and reduced cost compared to equivalent alternating current (AC) systems. Several demonstration projects validating the system feasibility and expected efficiency gains have been completed and additional ones are in progress. This paper gives an overview of the Bosch DC microgrid system and presents key results from a large simulation study done to estimate the energy savings of the Bosch DC microgrid over conventional AC systems. The study examined the system performance in locationsmore » across the United States for several commercial building types and operating profiles. It found that the Bosch DC microgrid uses generated PV energy 6%-8% more efficiently than traditional AC systems.« less

Budget impact analysis of rivaroxaban vs. warfarin anticoagulation strategy for direct current cardioversion in non-valvular atrial fibrillation patients: the MonaldiVert Economic Study.

PubMed

Russo, Vincenzo; Rago, Anna; Papa, Andrea A; Bianchi, Valter; Tavoletta, Vincenzo; DE Vivo, Stefano; Cavallaro, Ciro; Nigro, Gerardo; D'Onofrio, Antonio

2018-02-01

Rivaroxaban is the first novel oral anticoagulant to receive regulatory approval for non-valvular atrial fibrillation (NVAF) patients who require cardioversion. The MonaldiVert real life experience showed positive benefit-risk profile of short term rivaroxaban administration for transesophageal echocardiogram guided cardioversion in patients who had not achieved adequate pre-procedural vitamin K antagonist (VKA) anticoagulation. Aim of our study was to perform a budget impact analysis of MonaldiVert anticoagulation strategy for direct current cardioversion in NVAF patients and to compare the following costs borne by the Regional Healthcare System (RHS) with those for a hypothetical cohort of identical patients underwent from the beginning to early rivaroxaban treatment before direct current cardioversion. The mean costs per each NVAF patient treated with VKA strategy and rivaroxaban rescue strategy were € 134.53 and € 189.83, respectively. Considering a hypothetical scenario in which all study population would be treated from the beginning with rivaroxaban (rivaroxaban early strategy), the mean cost per patient would have been € 81.11. The total cost borne by the RHS, including the cost of the cardioversion procedure, for the two therapeutic strategies carried out at Monaldi Hospital (VKA strategy and Rivaroxaban rescue strategy) was € 88,458.53. The total cost would be borne by the RHS for rivaroxaban early strategy, if applied to all study population, would have been € 69,989.15 with a saving of € 18,469.38 compared to the actually applied strategy. Rivaroxaban rescue strategy for transesophageal echocardiography guided direct current cardioversion in NVAF patients, who had not achieved adequate pre-procedural VKA anticoagulation, is an effective and safe strategy, which allows to not delay the procedure, reducing times and wastage of cardioversion slots, without substantial costs increase.

Cost profiles and budget impact of rechargeable versus non-rechargeable sacral neuromodulation devices in the treatment of overactive bladder syndrome.

PubMed

Noblett, Karen L; Dmochowski, Roger R; Vasavada, Sandip P; Garner, Abigail M; Liu, Shan; Pietzsch, Jan B

2017-03-01

Sacral neuromodulation (SNM) is a guideline-recommended third-line treatment option for managing overactive bladder. Current SNM devices are not rechargeable, and require neurostimulator replacement every 3-6 years. Our study objective was to assess potential cost effects to payers of adopting a rechargeable SNM neurostimulator device. We constructed a cost-consequence model to estimate the costs of long-term SNM-treatment with a rechargeable versus non-rechargeable device. Costs were considered from the payer perspective at 2015 reimbursement levels. Adverse events, therapy discontinuation, and programming rates were based on the latest published data. Neurostimulator longevity was assumed to be 4.4 and 10.0 years for non-rechargeable and rechargeable devices, respectively. A 15-year horizon was modeled, with costs discounted at 3% per year. Total budget impact to the United States healthcare system was estimated based on the computed per-patient cost findings. Over the 15-year horizon, per-patient cost of treatment with a non-rechargeable device was $64,111 versus $36,990 with a rechargeable device, resulting in estimated payer cost savings of $27,121. These cost savings were found to be robust across a wide range of scenarios. Longer analysis horizon, younger patient age, and longer rechargeable neurostimulator lifetime were associated with increased cost savings. Over a 15-year horizon, adoption of a rechargeable device strategy was projected to save the United States healthcare system up to $12 billion. At current reimbursement rates, our analysis suggests that rechargeable neurostimulator SNM technology for managing overactive bladder syndrome may deliver significant cost savings to payers over the course of treatment. Neurourol. Urodynam. 36:727-733, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Current costing models: are they suitable for allocating health resources? The example of fall injury prevention in Australia.

PubMed

Moller, Jerry

2005-01-01

The example of fall injury among older people is used to define and illustrate how current Australian systems for allocation of health resources perform for funding emerging public health issues. While the examples are Australian, the allocation and priority setting methods are common in the health sector in all developed western nations. With an ageing population the number of falls injuries in Australia and the cost of treatment will rise dramatically over the next 20-50 years. Current methods of allocating funds within the health system are not well suited to meeting this coming epidemic. The information requirements for cost-benefit and cost-effectiveness measures cannot be met. Marginal approaches to health funding are likely to continue to fund already well-funded treatment or politically driven prevention processes and to miss the opportunity for new prevention initiatives in areas that do not have a high political profile. Fall injury is one of many emerging areas that struggle to make claims for funding because the critical mass of intervention and evidence of its impact is not available. The beneficiaries of allocation failure may be those who treat the disease burden that could have been easily prevented. Changes to allocation mechanisms, data systems and new initiative funding practices are required to ensure that preventative strategies are able to compete on an equal footing with treatment approaches for mainstream health funding.

The Epi-TAF for Tenofovir Disoproxil Fumarate?

PubMed

Walensky, Rochelle P; Horn, Tim H; Paltiel, A David

2016-04-01

Approximately 84% of human immunodeficiency virus (HIV)-infected US residents on antiretroviral therapy currently receive some form of tenofovir disoproxil fumarate (TDF) as part of their HIV treatment regimen. The TDF analogue tenofovir alafenamide (TAF) has demonstrated equal efficacy but with decreased renal injury and bone mineral density loss compared with TDF. We examine how much more society ought to be willing to pay for TAF over TDF, in exchange for its improved toxicity profile. Using cost-effectiveness methods, we find that current conditions warrant an annual premium of up to $1000 over the average wholesale price (AWP) of TDF. Once generic coformulations of tenofovir/lamivudine become accessible, however, the appropriate premium for TAF will likely merit a downward adjustment, using generic TDF-based costs as the benchmark. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Gene expression inference with deep learning.

PubMed

Chen, Yifei; Li, Yi; Narayan, Rajiv; Subramanian, Aravind; Xie, Xiaohui

2016-06-15

Large-scale gene expression profiling has been widely used to characterize cellular states in response to various disease conditions, genetic perturbations, etc. Although the cost of whole-genome expression profiles has been dropping steadily, generating a compendium of expression profiling over thousands of samples is still very expensive. Recognizing that gene expressions are often highly correlated, researchers from the NIH LINCS program have developed a cost-effective strategy of profiling only ∼1000 carefully selected landmark genes and relying on computational methods to infer the expression of remaining target genes. However, the computational approach adopted by the LINCS program is currently based on linear regression (LR), limiting its accuracy since it does not capture complex nonlinear relationship between expressions of genes. We present a deep learning method (abbreviated as D-GEX) to infer the expression of target genes from the expression of landmark genes. We used the microarray-based Gene Expression Omnibus dataset, consisting of 111K expression profiles, to train our model and compare its performance to those from other methods. In terms of mean absolute error averaged across all genes, deep learning significantly outperforms LR with 15.33% relative improvement. A gene-wise comparative analysis shows that deep learning achieves lower error than LR in 99.97% of the target genes. We also tested the performance of our learned model on an independent RNA-Seq-based GTEx dataset, which consists of 2921 expression profiles. Deep learning still outperforms LR with 6.57% relative improvement, and achieves lower error in 81.31% of the target genes. D-GEX is available at https://github.com/uci-cbcl/D-GEX CONTACT: xhx@ics.uci.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Gene expression inference with deep learning

PubMed Central

Chen, Yifei; Li, Yi; Narayan, Rajiv; Subramanian, Aravind; Xie, Xiaohui

2016-01-01

Motivation: Large-scale gene expression profiling has been widely used to characterize cellular states in response to various disease conditions, genetic perturbations, etc. Although the cost of whole-genome expression profiles has been dropping steadily, generating a compendium of expression profiling over thousands of samples is still very expensive. Recognizing that gene expressions are often highly correlated, researchers from the NIH LINCS program have developed a cost-effective strategy of profiling only ∼1000 carefully selected landmark genes and relying on computational methods to infer the expression of remaining target genes. However, the computational approach adopted by the LINCS program is currently based on linear regression (LR), limiting its accuracy since it does not capture complex nonlinear relationship between expressions of genes. Results: We present a deep learning method (abbreviated as D-GEX) to infer the expression of target genes from the expression of landmark genes. We used the microarray-based Gene Expression Omnibus dataset, consisting of 111K expression profiles, to train our model and compare its performance to those from other methods. In terms of mean absolute error averaged across all genes, deep learning significantly outperforms LR with 15.33% relative improvement. A gene-wise comparative analysis shows that deep learning achieves lower error than LR in 99.97% of the target genes. We also tested the performance of our learned model on an independent RNA-Seq-based GTEx dataset, which consists of 2921 expression profiles. Deep learning still outperforms LR with 6.57% relative improvement, and achieves lower error in 81.31% of the target genes. Availability and implementation: D-GEX is available at https://github.com/uci-cbcl/D-GEX. Contact: xhx@ics.uci.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26873929

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

Mehra, S.; Bryce, T.

Sedco Forex has recently completed a new land drilling rig, currently deployed in Gabon, that integrates well construction activities with multiskilling to create cost savings across the board in drilling operations. Historically, operators have produced a comprehensive tender package specifying strictly the type and size of individual rig components and the number of personnel required to drill. In this case, the drilling contractor provides a fit-for-purpose rig, consistent with field location, well profile, operator`s priorities, and local constraints.

Profiling Pre-MicroRNA and Mature MicroRNA Expressions Using a Single Microarray and Avoiding Separate Sample Preparation

PubMed Central

Gan, Lin; Denecke, Bernd

2013-01-01

Mature microRNA is a crucial component in the gene expression regulation network. At the same time, microRNA gene expression and procession is regulated in a precise and collaborated way. Pre-microRNAs mediate products during the microRNA transcription process, they can provide hints of microRNA gene expression regulation or can serve as alternative biomarkers. To date, little effort has been devoted to pre-microRNA expression profiling. In this study, three human and three mouse microRNA profile data sets, based on the Affymetrix miRNA 2.0 array, have been re-analyzed for both mature and pre-microRNA signals as a primary test of parallel mature/pre-microRNA expression profiling on a single platform. The results not only demonstrated a glimpse of pre-microRNA expression in human and mouse, but also the relationship of microRNA expressions between pre- and mature forms. The study also showed a possible application of currently available microRNA microarrays in profiling pre-microRNA expression in a time and cost effective manner. PMID:27605179

Metabolic Cost of Experimental Exercises

NASA Technical Reports Server (NTRS)

Webb, James T.; Gernhardt, Michael L.

2009-01-01

Although the type and duration of activity during decompression was well documented, the metabolic cost of 1665 subject-exposures with 8 activity profiles from 17 altitude decompression sickness (DCS) protocols at Brooks City-Base, TX from 1983-2005 was not determined. Female and male human volunteers (30 planned, 4 completed) performed activity profiles matching those 8 activity profiles at ground level with continuous monitoring of metabolic cost. A Cosmed K4b2 Cardio Pulmonary Exercise Testing device was used to measure oxygen uptake (VO2) during the profiles. The results show levels of metabolic cost to the females for the profiles tested varied from 4.3 to 25.5 ml/kg/min and from 3.0 to 12.0 ml/kg/min to the males. The increase in VO2 from seated rest to the most strenuous of the 8 activity profiles was 3.6-fold for the females and 2.8-fold for the males. These preliminary data on 4 subjects indicate close agreement of oxygen uptake for activity performed during many subject-exposures as published earlier. The relatively low average oxygen uptake required to perform the most strenuous activity may imply the need for adjustment of modeling efforts using metabolic cost as a risk factor. Better definition of metabolic cost during exposure to altitude, a critical factor in DCS risk, may allow refinement of DCS prediction models.

[Cost per capita in outpatients by gender].

PubMed

Villarreal-Ríos, Enrique; Campos Esparza, Maribel; Galicia Rodríguez, Liliana; Martínez González, Lidia; Vargas Daza, Emma Rosa; Torres Labra, Guadalupe; Patiño Vega, Adolfo; Rivera Martínez, María Teresa; Aparicio Rojas, Raúl; Juárez Durán, Martín

2011-03-01

The objective of this study is to identify the annual cost per capita by gender in first level of attention. It is a cost study in Family Physician Units in Mexico. The information corresponded to the year of 2004 and the study divided in the use profile and cost attention. USE PROFILE OF SERVICES: it was studied 1,585 clinical registries of patients, use profile defined by average and attention reasons by department, gender and age group. COST ATTENTION: considered in American dollars it included fixed unit cost (departmentalization adjusted by productivity), variable unit cost (micro cost technical), department unite cost by type attention, and department unit cost by age and gender. The life expectancy was of 73 years for men and 78 for women. Three scenes were identified. The annual cost per capita is superior among woman [US$73.24 (IC 95% $11.38 - $197.49)] than in man [$ 53.11 (IC 95% 2.51 - 207.71)]. The conclusion found that in the first level of attention the cost per capita is greater in woman than in man.

Connectivity Mapping for Candidate Therapeutics Identification Using Next Generation Sequencing RNA-Seq Data

PubMed Central

McArt, Darragh G.; Dunne, Philip D.; Blayney, Jaine K.; Salto-Tellez, Manuel; Van Schaeybroeck, Sandra; Hamilton, Peter W.; Zhang, Shu-Dong

2013-01-01

The advent of next generation sequencing technologies (NGS) has expanded the area of genomic research, offering high coverage and increased sensitivity over older microarray platforms. Although the current cost of next generation sequencing is still exceeding that of microarray approaches, the rapid advances in NGS will likely make it the platform of choice for future research in differential gene expression. Connectivity mapping is a procedure for examining the connections among diseases, genes and drugs by differential gene expression initially based on microarray technology, with which a large collection of compound-induced reference gene expression profiles have been accumulated. In this work, we aim to test the feasibility of incorporating NGS RNA-Seq data into the current connectivity mapping framework by utilizing the microarray based reference profiles and the construction of a differentially expressed gene signature from a NGS dataset. This would allow for the establishment of connections between the NGS gene signature and those microarray reference profiles, alleviating the associated incurring cost of re-creating drug profiles with NGS technology. We examined the connectivity mapping approach on a publicly available NGS dataset with androgen stimulation of LNCaP cells in order to extract candidate compounds that could inhibit the proliferative phenotype of LNCaP cells and to elucidate their potential in a laboratory setting. In addition, we also analyzed an independent microarray dataset of similar experimental settings. We found a high level of concordance between the top compounds identified using the gene signatures from the two datasets. The nicotine derivative cotinine was returned as the top candidate among the overlapping compounds with potential to suppress this proliferative phenotype. Subsequent lab experiments validated this connectivity mapping hit, showing that cotinine inhibits cell proliferation in an androgen dependent manner. Thus the results in this study suggest a promising prospect of integrating NGS data with connectivity mapping. PMID:23840550

Competitive position of natural gas: industrial baking. Topical report, December 1986-January 1988

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

Minsker, B.S.; Salama, S.Y.

To quantify the competitive position of natural gas in industrial baking, market profiles were developed to define current technologies (single lap, tunnel, and Lanham ovens are predominant) and to characterize the applications and use of each technology in industrial baking. Important cost and performance parameters were identified and validated through interviews with industry representatives. Two areas of research that could improve technologies' effectiveness are advanced burner controls activated based on oven load that could reduce product loss, the largest coast associated with the oven, and cogeneration, which could penetrate the baking market if the high capital costs associated with existingmore » equipment could be reduced.« less

PanFP: Pangenome-based functional profiles for microbial communities

DOE PAGES

Jun, Se -Ran; Hauser, Loren John; Schadt, Christopher Warren; ...

2015-09-26

For decades there has been increasing interest in understanding the relationships between microbial communities and ecosystem functions. Current DNA sequencing technologies allows for the exploration of microbial communities in two principle ways: targeted rRNA gene surveys and shotgun metagenomics. For large study designs, it is often still prohibitively expensive to sequence metagenomes at both the breadth and depth necessary to statistically capture the true functional diversity of a community. Although rRNA gene surveys provide no direct evidence of function, they do provide a reasonable estimation of microbial diversity, while being a very cost effective way to screen samples of interestmore » for later shotgun metagenomic analyses. However, there is a great deal of 16S rRNA gene survey data currently available from diverse environments, and thus a need for tools to infer functional composition of environmental samples based on 16S rRNA gene survey data. As a result, we present a computational method called pangenome based functional profiles (PanFP), which infers functional profiles of microbial communities from 16S rRNA gene survey data for Bacteria and Archaea. PanFP is based on pangenome reconstruction of a 16S rRNA gene operational taxonomic unit (OTU) from known genes and genomes pooled from the OTU s taxonomic lineage. From this lineage, we derive an OTU functional profile by weighting a pangenome s functional profile with the OTUs abundance observed in a given sample. We validated our method by comparing PanFP to the functional profiles obtained from the direct shotgun metagenomic measurement of 65 diverse communities via Spearman correlation coefficients. These correlations improved with increasing sequencing depth, within the range of 0.8 0.9 for the most deeply sequenced Human Microbiome Project mock community samples. PanFP is very similar in performance to another recently released tool, PICRUSt, for almost all of survey data analysed here. But, our method is unique in that any OTU building method can be used, as opposed to being limited to closed reference OTU picking strategies against specific reference sequence databases. In conclusion, we developed an automated computational method, which derives an inferred functional profile based on the 16S rRNA gene surveys of microbial communities. The inferred functional profile provides a cost effective way to study complex ecosystems through predicted comparative functional metagenomes and metadata analysis. All PanFP source code and additional documentation are freely available online at GitHub.« less

PanFP: pangenome-based functional profiles for microbial communities.

PubMed

Jun, Se-Ran; Robeson, Michael S; Hauser, Loren J; Schadt, Christopher W; Gorin, Andrey A

2015-09-26

For decades there has been increasing interest in understanding the relationships between microbial communities and ecosystem functions. Current DNA sequencing technologies allows for the exploration of microbial communities in two principle ways: targeted rRNA gene surveys and shotgun metagenomics. For large study designs, it is often still prohibitively expensive to sequence metagenomes at both the breadth and depth necessary to statistically capture the true functional diversity of a community. Although rRNA gene surveys provide no direct evidence of function, they do provide a reasonable estimation of microbial diversity, while being a very cost-effective way to screen samples of interest for later shotgun metagenomic analyses. However, there is a great deal of 16S rRNA gene survey data currently available from diverse environments, and thus a need for tools to infer functional composition of environmental samples based on 16S rRNA gene survey data. We present a computational method called pangenome-based functional profiles (PanFP), which infers functional profiles of microbial communities from 16S rRNA gene survey data for Bacteria and Archaea. PanFP is based on pangenome reconstruction of a 16S rRNA gene operational taxonomic unit (OTU) from known genes and genomes pooled from the OTU's taxonomic lineage. From this lineage, we derive an OTU functional profile by weighting a pangenome's functional profile with the OTUs abundance observed in a given sample. We validated our method by comparing PanFP to the functional profiles obtained from the direct shotgun metagenomic measurement of 65 diverse communities via Spearman correlation coefficients. These correlations improved with increasing sequencing depth, within the range of 0.8-0.9 for the most deeply sequenced Human Microbiome Project mock community samples. PanFP is very similar in performance to another recently released tool, PICRUSt, for almost all of survey data analysed here. But, our method is unique in that any OTU building method can be used, as opposed to being limited to closed-reference OTU picking strategies against specific reference sequence databases. We developed an automated computational method, which derives an inferred functional profile based on the 16S rRNA gene surveys of microbial communities. The inferred functional profile provides a cost effective way to study complex ecosystems through predicted comparative functional metagenomes and metadata analysis. All PanFP source code and additional documentation are freely available online at GitHub ( https://github.com/srjun/PanFP ).

Effects of nutrient profiling and price changes based on NuVal® scores on food purchasing in an online experimental supermarket.

PubMed

Epstein, Leonard H; Finkelstein, Eric A; Katz, David L; Jankowiak, Noelle; Pudlewski, Corrin; Paluch, Rocco A

2016-08-01

The goal of the present study was to apply experimental economic methods in an online supermarket to examine the effects of nutrient profiling, and differential pricing based on the nutrient profile, on the overall diet quality, energy and macronutrients of the foods purchased, and diet cost. Participants were provided nutrient profiling scores or price adjustments based on nutrient profile scores while completing a hypothetical grocery shopping task. Prices of foods in the top 20 % of nutrient profiling scores were reduced (subsidized) by 25 % while those in the bottom 20 % of scores were increased (taxed) by 25 %. We evaluated the independent and interactive effects of nutrient profiling or price adjustments on overall diet quality of foods purchased as assessed by the NuVal® score, energy and macronutrients purchased and diet cost in a 2×2 factorial design. A large (>10 000 food items) online experimental supermarket in the USA. Seven hundred and eighty-one women. Providing nutrient profiling scores improved overall diet quality of foods purchased. Price changes were associated with an increase in protein purchased, an increase in energy cost, and reduced carbohydrate and protein costs. Price changes and nutrient profiling combined were associated with no unique benefits beyond price changes or nutrient profiling alone. Providing nutrient profile score increased overall NuVal® score without a reduction in energy purchased. Combining nutrient profiling and price changes did not show an overall benefit to diet quality and may be less useful than nutrient profiling alone to consumers who want to increase overall diet quality of foods purchased.

An analysis of 72% chromated glycerin used for sclerotherapy: sterility, potency, and cost after extended shelf life.

PubMed

Ghaznavi, Amir M; Nakamura, Mio; Tepper, Donna

2015-01-01

Sclerotherapy is the treatment of reticular veins and telangiectasias of the lower extremities. Sclerosants destroy endothelial tissue and expose subendothelial collagen fibers, which lead to subsequent fibrosis of vessels, thus preventing recanalization. There are several available sclerosants including sodium tetradecyl sulfate (STS), polidocanol (POL), and chromated glycerin (CG) with varying efficacy, potency, side effect profile, and cost. To identify the possible bacterial contamination and potency of CG beyond the current recommended shelf life of 3 months and to prove if CG is as cost effective as other available sclerosants. Samples of 72% CG underwent bacterial endotoxin, sterility, and potency analysis at Days 0, 24, and 183. In addition, cost comparison was performed with other commercially available sclerosants including STS and POL. No samples of CG showed any bacterial contamination. All aliquots of glycerin remained sterile at Day 14. Potency at Day 24 was 99.2%, which was the same at Day 183. Cost comparison with other sclerosants revealed that CG is lower cost per milliliter than STS and POL. Seventy-two percent CG has no contamination and maintains its reported potency up to 6 months while comparable with the cost of other commercially available sclerosants.

[Cost-effectiveness of rosuvastatin versus simvastatin, atorvastatin and pitavastatin in patients with high and very high cardiovascular risk in Spain].

PubMed

Cosin Sales, Juan; Fuentes Jiménez, Francisco José; Mantilla Morató, Teresa; Ruiz, Emilio; Becerra, Virginia; Aceituno, Susana; Ferrario, Maria Giovanna; Lizán, Luis; Gracia, Alfredo

2015-01-01

To estimate the cost-effectiveness of rosuvastatin versus simvastatin, atorvastatin and pitavastatin in Spain, according to the European guidelines for the treatment of dyslipidemias in patients with high and very high cardiovascular risk. A Markov long-term cost-effectiveness model of rosuvastatin versus simvastatin, atorvastatin and pitavastatin in patients with high and very high cardiovascular risk defined according to 5 factors (sex, age, smoking habit, baseline cholesterol level, and systolic blood pressure) using the SCORE system. The incremental cost-effectiveness ratio is expressed in euros per quality adjusted life years and is calculated according to the perspective of the Spanish National Health System. Rosuvastatin is associated with a greater health benefit than the other statins across the considered profiles. Rosuvastatin is cost-effective compared to simvastatin in patients with SCORE risk ≥8% in females and ≥6% in males, while between 5% and the indicated values its cost-effectiveness is conditional to the patient baseline c-LDL level. Rosuvastatin is more cost-effective versus atorvastatin in female profiles associated with a SCORE risk≥11% and male profiles with SCORE risk ≥10%. Rosuvastatin is superior versus pitavastatin in both female and male profiles with high and very high cardiovascular risk. Rosuvastatin is a cost-effective therapy in the treatment of hypercholesterolemia versus simvastatin, atorvastatin and pitavastatin, especially in specific profiles of patients with high and very high cardiovascular risk factors, according to the SCORE system, in Spain. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

Energy density, nutrient adequacy, and cost per serving can provide insight into food choices in the lower Mississippi delta.

USDA-ARS?s Scientific Manuscript database

Compare differences across food groups for food cost, energy and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in a representative sample of 18 counties across the [Blinded for Review]. Energy, nutrient, and cost profiles for food items were calculated using Naturally Nu...

Development of Low-Cost Instrumentation for Single Point Autofluorescence Lifetime Measurements.

PubMed

Lagarto, João; Hares, Jonathan D; Dunsby, Christopher; French, Paul M W

2017-09-01

Autofluorescence lifetime measurements, which can provide label-free readouts in biological tissues, contrasting e.g. different types and states of tissue matrix components and different cellular metabolites, may have significant clinical potential for diagnosis and to provide surgical guidance. However, the cost of the instrumentation typically used currently presents a barrier to wider implementation. We describe a low-cost single point time-resolved autofluorescence instrument, exploiting modulated laser diodes for excitation and FPGA-based circuitry for detection, together with a custom constant fraction discriminator. Its temporal accuracy is compared against a "gold-standard" instrument incorporating commercial TCSPC circuitry by resolving the fluorescence decays of reference fluorophores presenting single and double exponential decay profiles. To illustrate the potential to read out intrinsic contrast in tissue, we present preliminary measurements of autofluorescence lifetime measurements of biological tissues ex vivo. We believe that the lower cost of this instrument could enhance the potential of autofluorescence lifetime metrology for clinical deployment and commercial development.

Voltage stability index based optimal placement of static VAR compensator and sizing using Cuckoo search algorithm

NASA Astrophysics Data System (ADS)

Venkateswara Rao, B.; Kumar, G. V. Nagesh; Chowdary, D. Deepak; Bharathi, M. Aruna; Patra, Stutee

2017-07-01

This paper furnish the new Metaheuristic algorithm called Cuckoo Search Algorithm (CSA) for solving optimal power flow (OPF) problem with minimization of real power generation cost. The CSA is found to be the most efficient algorithm for solving single objective optimal power flow problems. The CSA performance is tested on IEEE 57 bus test system with real power generation cost minimization as objective function. Static VAR Compensator (SVC) is one of the best shunt connected device in the Flexible Alternating Current Transmission System (FACTS) family. It has capable of controlling the voltage magnitudes of buses by injecting the reactive power to system. In this paper SVC is integrated in CSA based Optimal Power Flow to optimize the real power generation cost. SVC is used to improve the voltage profile of the system. CSA gives better results as compared to genetic algorithm (GA) in both without and with SVC conditions.

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

Jun, Se -Ran; Hauser, Loren John; Schadt, Christopher Warren

For decades there has been increasing interest in understanding the relationships between microbial communities and ecosystem functions. Current DNA sequencing technologies allows for the exploration of microbial communities in two principle ways: targeted rRNA gene surveys and shotgun metagenomics. For large study designs, it is often still prohibitively expensive to sequence metagenomes at both the breadth and depth necessary to statistically capture the true functional diversity of a community. Although rRNA gene surveys provide no direct evidence of function, they do provide a reasonable estimation of microbial diversity, while being a very cost effective way to screen samples of interestmore » for later shotgun metagenomic analyses. However, there is a great deal of 16S rRNA gene survey data currently available from diverse environments, and thus a need for tools to infer functional composition of environmental samples based on 16S rRNA gene survey data. As a result, we present a computational method called pangenome based functional profiles (PanFP), which infers functional profiles of microbial communities from 16S rRNA gene survey data for Bacteria and Archaea. PanFP is based on pangenome reconstruction of a 16S rRNA gene operational taxonomic unit (OTU) from known genes and genomes pooled from the OTU s taxonomic lineage. From this lineage, we derive an OTU functional profile by weighting a pangenome s functional profile with the OTUs abundance observed in a given sample. We validated our method by comparing PanFP to the functional profiles obtained from the direct shotgun metagenomic measurement of 65 diverse communities via Spearman correlation coefficients. These correlations improved with increasing sequencing depth, within the range of 0.8 0.9 for the most deeply sequenced Human Microbiome Project mock community samples. PanFP is very similar in performance to another recently released tool, PICRUSt, for almost all of survey data analysed here. But, our method is unique in that any OTU building method can be used, as opposed to being limited to closed reference OTU picking strategies against specific reference sequence databases. In conclusion, we developed an automated computational method, which derives an inferred functional profile based on the 16S rRNA gene surveys of microbial communities. The inferred functional profile provides a cost effective way to study complex ecosystems through predicted comparative functional metagenomes and metadata analysis. All PanFP source code and additional documentation are freely available online at GitHub.« less

In Search of Easy-to-Use Methods for Calibrating ADCP's for Velocity and Discharge Measurements

USGS Publications Warehouse

Oberg, K.; ,

2002-01-01

A cost-effective procedure for calibrating acoustic Doppler current profilers (ADCP) in the field was presented. The advantages and disadvantages of various methods which are used for calibrating ADCP were discussed. The proposed method requires the use of differential global positioning system (DGPS) with sub-meter accuracy and standard software for collecting ADCP data. The method involves traversing a long (400-800 meter) course at a constant compass heading and speed, while collecting simultaneous DGPS and ADCP data.

Demonstration of Current Profile Shaping using Double Dog-Leg Emittance Exchange Beam Line at Argonne Wakefield Accelerator

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

Ha, Gwanghui; Cho, Moo-Hyun; Conde, Manoel

Emittance exchange (EEX) based longitudinal current profile shaping is the one of the promising current profile shaping technique. This method can generate high quality arbitrary current profiles under the ideal conditions. The double dog-leg EEX beam line was recently installed at the Argonne Wakefield Accelerator (AWA) to explore the shaping capability and confirm the quality of this method. To demonstrate the arbitrary current profile generation, several different transverse masks are applied to generate different final current profiles. The phase space slopes and the charge of incoming beam are varied to observe and suppress the aberrations on the ideal profile. Wemore » present current profile shaping results, aberrations on the shaped profile, and its suppression.« less

[Trends in hospital care].

PubMed

Vecina Neto, Gonzalo; Malik, Ana Maria

2007-01-01

This paper analyses trends in the delivery of hospital services in Brazil, considering the setting, the current situation and its challenges, examining what still remains to be done. The variables studied for the analysis of the setting are: demography, epidemiological profile, human resources, technology, medicalization, costs, review of the role of the citizen, legislation, equity, hospital-centricity and regionalization, care fractioning and bed availability. The Brazilian setting was studied through the supplementary healthcare model, financing and the healthcare area production chain. The observations of the current situation present external evaluation models, outsourcing, public-private relationships, de-hospitalization and financing. The analysis of the challenges examines the need for long range planning, the quest for new legal models for the 'business', the use of information and information systems, cost controls and the need for enhanced efficiency and compliance with legal directives, guaranteed universal access to full healthcare facilities, the inclusion of primary prevention in healthcare procedures, integrating the public and private sectors and engaging physicians in solving problems.

Total recall. [Refinancing of debt by utilities

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

Hemptstead, J.

1994-02-15

The dramatic rally in the US treasury markets in 1992 and 1993 offered utility treasurers a unique opportunity to radically restructure their outstanding debt profiles by redeeming and refunding callable and refundable bonds. Since January 1991, utility companies have issued over $100 billion of nonconvertible debt securities; 53 percent of these companies indicated [open quotes]refinancing fixed income securities[close quotes] as the primary use of proceeds. After approximately 18 months of heavy refunding activity, utility treasurers have nearly exhausted the supply of currently callable debt and are now looking at alternative methods of reducing their embedded cost of debt and increasingmore » cash flows. The two most common methods are to repurchase highest-cost noncallable and/or currently nonrefundable bonds through [open quotes]open-market repurchases[close quotes] and [open quotes]tender offers.[close quotes] A third, less popular and less used, method is the [open quotes]defeasance[close quotes]. This article describes the advantages, disadvantages, and economic effects of these three types of financing.« less

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

NASA Technical Reports Server (NTRS)

1983-01-01

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

1D profiling using highly dispersive guided waves

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

Volker, Arno; Zon, Tim van; Enthoven, Daniel

2015-03-31

Corrosion is one of the industries major issues regarding the integrity of assets. Currently inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collectedmore » in a pit-catch configuration at the 12 o'clock position using highly dispersive guided waves. The phase spectrum is used to invert for a wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. An EMAT sensor design has been made to measure at the 12 o'clock position of a pipe. The concept is evaluated on measured data, showing good sizing capabilities on a variety simple defect profiles.« less

Tailored electron bunches with smooth current profiles for enhanced transformer ratios in beam-driven acceleration

DOE PAGES

Lemery, F.; Piot, P.

2015-08-03

Collinear high-gradient O(GV/m) beam-driven wakefield methods for charged-particle acceleration could be critical to the realization of compact, cost-efficient, accelerators, e.g., in support of TeV-scale lepton colliders or multiple-user free-electron laser facilities. To make these options viable, the high accelerating fields need to be complemented with large transformer ratios >2, a parameter characterizing the efficiency of the energy transfer between a wakefield-exciting “drive” bunch to an accelerated “witness” bunch. While several potential current distributions have been discussed, their practical realization appears challenging due to their often discontinuous nature. In this paper we propose several alternative continuously differentiable (smooth) current profiles whichmore » support enhanced transformer ratios. We especially demonstrate that one of the devised shapes can be implemented in a photo-emission electron source by properly shaping the photocathode-laser pulse. We finally discuss a possible superconducting linear-accelerator concept that could produce shaped drive bunches at high-repetition rates to drive a dielectric-wakefield accelerator with accelerating fields on the order of ~60 MV/m and a transformer ratio ~5 consistent with a recently proposed multiuser free-electron laser facility.« less

Tailored electron bunches with smooth current profiles for enhanced transformer ratios in beam-driven acceleration

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

Lemery, F.; Piot, P.

Collinear high-gradient O(GV/m) beam-driven wakefield methods for charged-particle acceleration could be critical to the realization of compact, cost-efficient, accelerators, e.g., in support of TeV-scale lepton colliders or multiple-user free-electron laser facilities. To make these options viable, the high accelerating fields need to be complemented with large transformer ratios >2, a parameter characterizing the efficiency of the energy transfer between a wakefield-exciting “drive” bunch to an accelerated “witness” bunch. While several potential current distributions have been discussed, their practical realization appears challenging due to their often discontinuous nature. In this paper we propose several alternative continuously differentiable (smooth) current profiles whichmore » support enhanced transformer ratios. We especially demonstrate that one of the devised shapes can be implemented in a photo-emission electron source by properly shaping the photocathode-laser pulse. We finally discuss a possible superconducting linear-accelerator concept that could produce shaped drive bunches at high-repetition rates to drive a dielectric-wakefield accelerator with accelerating fields on the order of ~60 MV/m and a transformer ratio ~5 consistent with a recently proposed multiuser free-electron laser facility.« less

Energy Density, Nutrient Adequacy, and Cost per Serving Can Provide Insight into Food Choices in the Lower Mississippi Delta

ERIC Educational Resources Information Center

Connell, Carol L.; Zoellner, Jamie M.; Yadrick, M. Kathleen; Chekuri, Srinivasa C.; Crook, Lashaundrea B.; Bogle, Margaret L.

2012-01-01

Objective: To compare differences across food groups for food cost, energy, and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in 18 counties across the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. Methods: Energy, nutrient, and cost profiles for food items were calculated by using Naturally Nutrient…

Optimisation des trajectoires d'un systeme de gestion de vol d'avions pour la reduction des couts de vol

NASA Astrophysics Data System (ADS)

Sidibe, Souleymane

The implementation and monitoring of operational flight plans is a major occupation for a crew of commercial flights. The purpose of this operation is to set the vertical and lateral trajectories followed by airplane during phases of flight: climb, cruise, descent, etc. These trajectories are subjected to conflicting economical constraints: minimization of flight time and minimization of fuel consumed and environmental constraints. In its task of mission planning, the crew is assisted by the Flight Management System (FMS) which is used to construct the path to follow and to predict the behaviour of the aircraft along the flight plan. The FMS considered in our research, particularly includes an optimization model of flight only by calculating the optimal speed profile that minimizes the overall cost of flight synthesized by a criterion of cost index following a steady cruising altitude. However, the model based solely on optimization of the speed profile is not sufficient. It is necessary to expand the current optimization for simultaneous optimization of the speed and altitude in order to determine an optimum cruise altitude that minimizes the overall cost when the path is flown with the optimal speed profile. Then, a new program was developed. The latter is based on the method of dynamic programming invented by Bellman to solve problems of optimal paths. In addition, the improvement passes through research new patterns of trajectories integrating ascendant cruises and using the lateral plane with the effect of the weather: wind and temperature. Finally, for better optimization, the program takes into account constraint of flight domain of aircrafts which utilize the FMS.

Financial viability of perinatal centers in the longer term, taking legislative requirements into account. An examination of the cost-revenue structure of a Level I perinatal center.

PubMed

Lux, Michael P; Kraml, Florian; Wagner, Stefanie; Hack, Carolin C; Schulze, Christine; Faschingbauer, Florian; Winkler, Mathias; Fasching, Peter A; Beckmann, Matthias W; Hildebrandt, Thomas

2013-01-01

Debate is currently taking place over minimum case numbers for the care of premature infants and neonates in Germany. As a result of the Federal Joint Committee (Gemeinsamer Bundesauschuss, G-BA) guidelines for the quality of structures, processes, and results, requiring high levels of staffing resources, Level I perinatal centers are increasingly becoming the focus for health-economics questions, specifically, debating whether Level I structures are financially viable. Using a multistep contribution margin analysis, the operating results for the Obstetrics Section at the University Perinatal Center of Franconia (Universitäts-Perinatalzentrum Franken) were calculated for the year 2009. Costs arising per diagnosis-related group (DRG) (separated into variable costs and fixed costs) and the corresponding revenue generated were compared for 4,194 in-patients and neonates, as well as for 3,126 patients in the outpatient ultrasound and pregnancy clinics. With a positive operating result of € 374,874.81, a Level I perinatal center on the whole initially appears to be financially viable, from the obstetrics point of view (excluding neonatology), with a high bed occupancy rate and a profitable case mix. By contrast, the costs of prenatal diagnostics, with a negative contribution margin II of € 50,313, cannot be covered. A total of 79.4% of DRG case numbers were distributed to five DRGs, all of which were associated with pregnancies and neonates with the lowest risk profiles. A Level I perinatal center is currently capable of covering its costs. However, the cost-revenue ratio is fragile due to the high requirements for staffing resources and numerous economic, social, and regional influencing factors.

Deducing noninductive current profile from surface voltage evolution

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

Litwin, C.; Wukitch, S.; Hershkowitz, N.

Solving the resistive diffusion equation in the presence of a noninductive current source determines the time-evolution of the surface voltage. By inverting the problem the current drive profile can be determined from the surface voltage evolution. We show that under wide range of conditions the deduced profile is unique. If the conductivity profile is known, this method can be employed to infer the noninductive current profile, and, ipso facto, the profile of the total current. We discuss the application of this method to analyze the Alfven wave current drive experiments in Phaedrus-T.

Use of predefined biochemical admission profiles does not reduce the number of tests or total cost: a randomized-controlled pilot study.

PubMed

Pareek, Manan; Haidl, Felix; Folkestad, Lars; Brabrand, Mikkel

2014-02-01

The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost. This was a randomized-controlled trial of 191 adult patients admitted to a medical admission unit. Upon admission, the patients were randomized to have their blood tests determined by either using a predefined profile (used routinely and designed by the department head) or ordered individually by the treating physician. All patients were initially assessed by junior physicians. We compared the number of tests, estimated total cost, and length of stay. Data are presented as median (interquartile range). Differences were compared using the Wilcoxon rank-sum test and Fishers' exact test. Ninety-two patients were men, median age 65 years. Patients randomized to the use of the predefined profile had median 17 (14-22) blood tests drawn and patients randomized to physician discretion had median 17 (12-21) tests drawn (P=0.3). The median total cost of tests in the profile group was 618 DKK (493-803) and the cost in the physician group was 564 DKK (434-812) (P=0.19). Length of stay in the profile group was a median of 4 days (2-6 days) and 2 days (2-6 days) in the physician group (P=0.08). The use of a predefined blood test panel did not significantly affect the number of tests, total cost, or length of stay for acutely admitted medical patients compared with tests ordered at the discretion of the treating physician.

Impact of side-effects of atypical antipsychotics on non-compliance, relapse and cost.

PubMed

Mortimer, A; Williams, P; Meddis, D

2003-01-01

Atypical antipsychotics generally have milder side-effects than conventional antipsychotics, but also differ among themselves in this respect. This study aimed to compare the impact of different side-effect profiles of individual atypical antipsychotics on non-compliance, relapse and cost in schizophrenia. A state-transition model was built using literature data supplemented by expert opinion. The model found that quetiapine and ziprasidone were similar in estimated non-compliance and relapse rates. Olanzapine and risperidone had higher estimated non-compliance and relapse rates, and incremental, 1-year, per-patient direct costs, using US-based cost data, of approximately $530 (95% confidence interval [CI] approximately $275, $800), and approximately $485 (95% CI approximately $235, $800), respectively, compared with quetiapine. Incremental costs attributable to different side-effect profiles were highly significant. This study shows that differing side-effect profiles of the newer antipsychotic agents are likely to lead to different compliance rates, and consequent variation in relapse rates. The cost implications of these heterogenous clinical outcomes are substantial.

The Effect of Plug-in Electric Vehicles on Harmonic Analysis of Smart Grid

NASA Astrophysics Data System (ADS)

Heidarian, T.; Joorabian, M.; Reza, A.

2015-12-01

In this paper, the effect of plug-in electric vehicles is studied on the smart distribution system with a standard IEEE 30-bus network. At first, harmonic power flow analysis is performed by Newton-Raphson method and by considering distorted substation voltage. Afterward, proper sizes of capacitors is selected by cuckoo optimization algorithm to reduce the power losses and cost and by imposing acceptable limit for total harmonic distortion and RMS voltages. It is proposed that the impact of generated current harmonics by electric vehicle battery chargers should be factored into overall load control strategies of smart appliances. This study is generalized to the different hours of a day by using daily load curve, and then optimum time for charging of electric vehicles batteries in the parking lots are determined by cuckoo optimization algorithm. The results show that injecting harmonic currents of plug-in electric vehicles causes a drop in the voltage profile and increases power loss. Moreover, charging the vehicle batteries has more impact on increasing the power losses rather than the harmonic currents effect. Also, the findings showed that the current harmonics has a great influence on increasing of THD. Finally, optimum working times of all parking lots was obtained for the utilization cost reduction.

Nouvelle methode d'optimisation du cout d'un vol par l'utilisation d'un systeme de gestion de vol et sa validation sur un avion Lockheed L-1011 TriStar

NASA Astrophysics Data System (ADS)

Gagne, Jocelyn

Usually, flights optimization and planning will take place before flight, on ground. However, it is not always feasible to do such optimization, or sometime unpredictable events may force pilots to change the flight path. In those circumstances, the pilots can only rely on charts or their Flight Management System (FMS) in order to maintain an economic flight. However, those FMS often rely on those same charts, which will not take into consideration different parameters, such as the cost index, the length on the flight or the weather. Even if some FMS take into consideration the weather, they may only rely on manually entered or limited data that could be outdated, insufficient or incomplete. The alleviate these problems, the function program's that was developed is mainly to determine the optimum flight profile for an aircraft, or more precisely, at the lowest overall cost, considering a take-off weight and weather conditions. The total cost is based on the value of time as well as the cost of fuel, resulting in the use of a ratio called the cost index. This index allows both to prioritize either the time or fuel consumption according to the costs related to a specific flight and/or airline. Thus, from a weight, the weather (wind, temperature, pressure), and the cost index, the program will calculate from the "Performance DataBase" (PDB) of a specific airplane an optimal flight profile over a given distance. The algorithm is based on linear interpolations in the performances tables using the Lagrange method. Moreover, in order to fully optimize the flight, the current program can, according to departure date and coordinates, download the latest available forecast from environment Canada website and calculate the optimum flight accordingly. The forecast data use by the program take the form of a 0.6 × 0.6 degrees grid in which the effects of wind, pressure and temperature are interpolated according to the aircraft geographical position and time. Using these tables, performances and forecasts, the program is therefore able to calculate the optimum profile from ground, but also in flight, if any change would occur on the path. Because all data is tabulated and not calculated, the required calculation power remains low, resulting in a short calculation time. Keywords: optimization, algorithm, simulation, cost.

Preventing Terrorism in the Long Term: The Disutility of Racial Profiling in Preventing Crime and the Counterproductive Nature of Ethnic and Religious Profiling in Counterterrorism Policing

DTIC Science & Technology

2009-12-01

enforcement officers, many of whom are now or have been active participants in CT-operations, use in identifying suspicious behavior and building...provide benefits that are greater than the costs of using profiling as part of an overall counterterrorism strategy. 2 A. IMPORTANCE: TAKING SIDES ON...that the benefits of ethnic and religious profiling are trumped by the social costs and consequences of its use . More specifically, the ethnic and

The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain

PubMed Central

Cotler, Howard B; Chow, Roberta T; Hamblin, Michael R; Carroll, James

2015-01-01

Pain is the most common reason for physician consultation in the United States. One out of three Americans is affected by chronic pain annually. The number one reason for missed work or school days is musculoskeletal pain. Currently accepted therapies consist of non-steroidal anti-inflammatory drugs, steroid injections, opiate pain medications and surgery, each of which carries their own specific risk profiles. What is needed are effective treatments for pain which have an acceptably low risk-profile. For over forty years, low level laser (light) therapy (LLLT) and LED (light emitting diode) therapy (also known as photobiomodulation) has been shown to reduce inflammation and edema, induce analgesia, and promote healing in a range of musculoskeletal pathologies. The purpose of this paper is to review the use of LLLT for pain, the biochemical mechanisms of action, the dose response curves, and how LLLT may be employed by orthopedic surgeons to improve outcomes and reduce adverse events. With the predicted epidemic of chronic pain in developed countries, it is imperative to validate cost-effective and safe techniques for managing painful conditions which would allow people to live active and productive lives. Moreover the acceptance of LLLT (which is currently being used by many specialties around the world) into the armamentarium of the American health care provider would allow for additional treatment options for patients. A new cost-effective therapy for pain could elevate quality of life while reducing financial strains. PMID:26858986

Beam profile measurement on HITU transducers using a thermal intensity sensor technique

NASA Astrophysics Data System (ADS)

Wilkens, V.; Sonntag, S.; Jenderka, K.-V.

2011-02-01

Thermal intensity sensors based on the transformation of the incident ultrasonic energy into heat inside a small cylindrical absorber have been developed at PTB in the past, in particular to determine the acoustic output of medical diagnostic ultrasound equipment. Currently, this sensor technique is being expanded to match the measurement challenges of high intensity therapeutic ultrasound (HITU) fields. At the high acoustic power levels as utilized in the clinical application of HITU transducers, beam characterization using hydrophones is critical due to the possible damage of the sensitive and expensive measurement devices. Therefore, the low-cost and robust thermal sensors developed offer a promising alternative for the determination of high intensity output beam profiles. A sensor prototype with a spatial resolution of 0.5 mm was applied to the beam characterization of an HITU transducer operated at several driving amplitude levels. Axial beam plots and lateral profiles at focus were acquired. The absolute continuous wave output power was, in addition, determined using a radiation force balance.

Cost-effectiveness of staff and workload profiles in retaining patients on antiretroviral therapy in KwaZulu-Natal, South Africa.

PubMed

Vella, Venanzio; Govender, Thiloshini; Dlamini, Sicelo S; Moodley, Indres; David, Verona; Taylor, Myra; Jinabhai, Champaklal C

2011-09-01

There is paucity of information on the cost-effectiveness of delivery strategies to retain patients on antiretroviral therapy (ART) and this study tries to fill this gap. The analysis is based on a representative sample of 2835 patients attending 32 ART sites in KwaZulu-Natal (KZN), South Africa. Extended Cox regression and Kaplan Meier were used to estimate the transition probabilities to remain on ART among patients who attended sites with different staff and workload profiles. Annual costs per patient-year of observation for these delivery profiles were estimated. Probabilistic sensitivity analysis took into account parameters' uncertainty. The delivery sites with a full-time doctor and a full-time senior professional nurse and an intake of less than 200 new patients per doctor per year were the most cost-effective in retaining patients on ART. If 1000 new patients were followed up by this type of site, 724 patients would still be on ART after 10 years at a discounted cost of US$8.41 million at 2006 value with an incremental cost-effectiveness ratio of US$12,271 per extra retained patient over the second not dominated site profile. The results could be used to estimate the human resources needed for a sustainable scaling up of ART in KZN.

Accommodation and Health Costs of Deinstitutionalized People with Mental Illness Living in Residential Services in Brazil.

PubMed

Razzouk, Denise

2018-04-30

Health costs are the main hindrances for expanding community mental health services. Exploring patient profiles and cost predictors may be useful for optimising financial resources. However, the deinstitutionalisation process may burden health budgets in terms of supporting multiple community services based on varying levels of need. This study assessed accommodation and health service costs, quality of life and clinical and psychosocial profiles among individuals receiving mental healthcare through residential services. Specific accommodation cost predictors were also verified. Health costs were assessed from the perspective of a public health provider using a microcosting bottom-up approach at 20 residential services in São Paulo, Brazil. Instruments used to assess health costs and patient profiles included the Brazilian version of the Client Socio-demographic and Service Receipt Inventory (CSSRI), the Mini International Neuropsychiatric Interview (MINI), the Clinical Global Impression-Severity Scale (CGI-S), the Independent Living Skills Survey (ILLS), the Social Behaviour Scale (SBS) and the Quality of Life Scale (QLS). One hundred and forty-seven residents, predominantly experiencing psychotic disorders, were interviewed. The geographical region and length of time spent living in residential services or in a psychiatric hospital predicted 66% of the variance in accommodation costs. The CGI-S and ILLS scores and years of education explained 52.7% of the variance in quality of life. Accommodation costs were not driven by patient profile variables, while region and time spent in a hospital or in residential services were the main cost predictors. Semi-staffed homes may be an alternative for resource optimisation among individuals with mild impairment, particularly if strategies for psychosocial rehabilitation and improving quality of life are implemented.

Review article: Emergency department models of care in the context of care quality and cost: a systematic review.

PubMed

Wylie, Kate; Crilly, Julia; Toloo, Ghasem Sam; FitzGerald, Gerry; Burke, John; Williams, Ged; Bell, Anthony

2015-04-01

To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

A Model for Optimizing the Combination of Solar Electricity Generation, Supply Curtailment, Transmission and Storage

NASA Astrophysics Data System (ADS)

Perez, Marc J. R.

With extraordinary recent growth of the solar photovoltaic industry, it is paramount to address the biggest barrier to its high-penetration across global electrical grids: the inherent variability of the solar resource. This resource variability arises from largely unpredictable meteorological phenomena and from the predictable rotation of the earth around the sun and about its own axis. To achieve very high photovoltaic penetration, the imbalance between the variable supply of sunlight and demand must be alleviated. The research detailed herein consists of the development of a computational model which seeks to optimize the combination of 3 supply-side solutions to solar variability that minimizes the aggregate cost of electricity generated therefrom: Storage (where excess solar generation is stored when it exceeds demand for utilization when it does not meet demand), interconnection (where solar generation is spread across a large geographic area and electrically interconnected to smooth overall regional output) and smart curtailment (where solar capacity is oversized and excess generation is curtailed at key times to minimize the need for storage.). This model leverages a database created in the context of this doctoral work of satellite-derived photovoltaic output spanning 10 years at a daily interval for 64,000 unique geographic points across the globe. Underpinning the model's design and results, the database was used to further the understanding of solar resource variability at timescales greater than 1-day. It is shown that--as at shorter timescales--cloud/weather-induced solar variability decreases with geographic extent and that the geographic extent at which variability is mitigated increases with timescale and is modulated by the prevailing speed of clouds/weather systems. Unpredictable solar variability up to the timescale of 30 days is shown to be mitigated across a geographic extent of only 1500km if that geographic extent is oriented in a north/south bearing. Using technical and economic data reflecting today's real costs for solar generation technology, storage and electric transmission in combination with this model, we determined the minimum cost combination of these solutions to transform the variable output from solar plants into 3 distinct output profiles: A constant output equivalent to a baseload power plant, a well-defined seasonally-variable output with no weather-induced variability and a variable output but one that is 100% predictable on a multi-day ahead basis. In order to do this, over 14,000 model runs were performed by varying the desired output profile, the amount of energy curtailment, the penetration of solar energy and the geographic region across the continental United States. Despite the cost of supplementary electric transmission, geographic interconnection has the potential to reduce the levelized cost of electricity when meeting any of the studied output profiles by over 65% compared to when only storage is used. Energy curtailment, despite the cost of underutilizing solar energy capacity, has the potential to reduce the total cost of electricity when meeting any of the studied output profiles by over 75% compared to when only storage is used. The three variability mitigation strategies are thankfully not mutually exclusive. When combined at their ideal levels, each of the regions studied saw a reduction in cost of electricity of over 80% compared to when only energy storage is used to meet a specified output profile. When including current costs for solar generation, transmission and energy storage, an optimum configuration can conservatively provide guaranteed baseload power generation with solar across the entire continental United States (equivalent to a nuclear power plant with no down time) for less than 0.19 per kilowatt-hour. If solar is preferentially clustered in the southwest instead of evenly spread throughout the United States, and we adopt future expected costs for solar generation of 1 per watt, optimal model results show that meeting a 100% predictable output target with solar will cost no more than $0.08 per kilowatt-hour.

Development of the Multi-Angle Stratospheric Aerosol Radiometer (MASTAR) Instrument

NASA Astrophysics Data System (ADS)

DeLand, M. T.; Colarco, P. R.; Kowalewski, M. G.; Gorkavyi, N.; Ramos-Izquierdo, L.

2017-12-01

Aerosol particles in the stratosphere ( 15-25 km altitude), both produced naturally and perturbed by volcanic eruptions and anthropogenic emissions, continue to be a source of significant uncertainty in the Earth's energy budget. Stratospheric aerosols can offset some of the warming effects caused by greenhouse gases. These aerosols are currently monitored using measurements from the Ozone Mapping and Profiling Suite (OMPS) Limb Profiler (LP) instrument on the Suomi NPP satellite. In order to improve the sensitivity and spatial coverage of these aerosol data, we are developing an aerosol-focused compact version of the OMPS LP sensor called Multi-Angle Stratospheric Aerosol Radiometer (MASTAR) to fly on a 3U Cubesat satellite, using a NASA Instrument Incubator Program (IIP) grant. This instrument will make limb viewing measurements of the atmosphere in multiple directions simultaneously, and uses only a few selected wavelengths to reduce size and cost. An initial prototype version has been constructed using NASA GSFC internal funding and tested in the laboratory. Current design work is targeted towards a preliminary field test in Spring 2018. We will discuss the scientific benefits of MASTAR and the status of the project.

An assessment of the current municipal solid waste management system in Lahore, Pakistan.

PubMed

Masood, Maryam; Barlow, Claire Y; Wilson, David C

2014-09-01

The current status of solid waste management in Lahore, a metropolitan city of Pakistan, is reviewed in this article using an existing approach, the UN-Habitat city profile. This involves a systematic quantitative and qualitative assessment of physical components and governance features of the current waste management system. A material flow diagram (MFD) is developed, which allows visualisation of the current waste management system with all related inputs and outputs. This study shows that in the current system, waste collection and transportation is the main focus, however the collection coverage is only about 68%. There is no controlled or even semi-controlled waste disposal facility in Lahore. There is no official recycling system in the city. It is estimated that currently ~27% of waste by weight is being recycled through the informal sector. Making use of the organic content of the waste, a composting facility is operative in the city, producing 47,230 tonnes year(-1) of organic compost. Lahore does not perform very well in governance features. Inclusivity of users and providers of the waste management system is low in the city, as not all stakeholders are consulted in the decision making processes. Waste management costs US$20 per tonne of waste, where the main focus is only on waste collection, and the current user fees are much lower than the actual costs. This study recommends that recycling should be promoted by increasing public awareness and integrating the informal sector to make the current system sustainable and financially viable. © The Author(s) 2014.

Building America Top Innovations 2014 Profile: Cost-Optimized Attic Insulation Solution for Factory-Built Homes

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

none,

This 2014 Top Innovation profile describes a low-cost, low-tech attic insulation technique developed by the ARIES Building America team with help from Southern Energy Homes and Johns Manville. Increasing attic insulation in manufactured housing has been a significant challenge due to cost, production and transportation constraints. The simplicity of this dense-pack solution to increasing attic insulation R-value promises real hope for widespread industry adoption.

Computer programs for generation and evaluation of near-optimum vertical flight profiles

NASA Technical Reports Server (NTRS)

Sorensen, J. A.; Waters, M. H.; Patmore, L. C.

1983-01-01

Two extensive computer programs were developed. The first, called OPTIM, generates a reference near-optimum vertical profile, and it contains control options so that the effects of various flight constraints on cost performance can be examined. The second, called TRAGEN, is used to simulate an aircraft flying along an optimum or any other vertical reference profile. TRAGEN is used to verify OPTIM's output, examine the effects of uncertainty in the values of parameters (such as prevailing wind) which govern the optimum profile, or compare the cost performance of profiles generated by different techniques. A general description of these programs, the efforts to add special features to them, and sample results of their usage are presented.

Evaluation of the cost effectiveness of exenatide versus insulin glargine in patients with sub-optimally controlled Type 2 diabetes in the United Kingdom

PubMed Central

Woehl, Anette; Evans, Mark; Tetlow, Anthony P; McEwan, Philip

2008-01-01

Objective Exenatide belongs to a new therapeutic class in the treatment of diabetes (incretin mimetics), allowing glucose-dependent glycaemic control in Type 2 diabetes. Randomised controlled trial data suggest that exenatide is as effective as insulin glargine at reducing HbA1c in combination therapy with metformin and sulphonylureas; with reduced weight but higher incidence of adverse gastrointestinal events. The objective of this study is to evaluate the cost effectiveness of exenatide versus insulin glargine using RCT data and a previously published model of Type 2 diabetes disease progression that is based on the United Kingdom Prospective Diabetes Study; the perspective of the health-payer of the United Kingdom National Health Service. Methods The study used a discrete event simulation model designed to forecast the costs and health outcome of a cohort of 1,000 subjects aged over 40 years with sub-optimally-controlled Type 2 diabetes, following initiation of either exenatide, or insulin glargine, in addition to oral hypoglycaemic agents. Sensitivity analysis for a higher treatment discontinuation rate in exenatide patients was applied to the cohort in three different scenarios; (1) either ignored or (2) exenatide-failures excluded or (3) exenatide-failures switched to insulin glargine. Analyses were undertaken to evaluate the price sensitivity of exenatide in terms of relative cost effectiveness. Baseline cohort profiles and effectiveness data were taken from a published randomised controlled trial. Results The relative cost-effectiveness of exenatide and insulin glargine was tested under a variety of conditions, in which insulin glargine was dominant in all cases. Using the most conservative of assumptions, the cost-effectiveness ratio of exenatide vs. insulin glargine at the current UK NHS price was -£29,149/QALY (insulin glargine dominant) and thus exenatide is not cost-effective when compared with insulin glargine, at the current UK NHS price. Conclusion This study evaluated the relative cost effectiveness of insulin glargine versus exenatide in the management of Type 2 diabetes using a published model. Given no significant difference in glycaemic control and applying the additional effectiveness of exenatide over insulin glargine, with respect to weight loss, and using the current UK NHS prices, insulin glargine was found to be dominant over exenatide in all modelled scenarios. With current clinical evidence, exenatide does not appear to represent a cost-effective treatment option for patients with Type 2 diabetes when compared to insulin glargine. PMID:18694484

Territorial energy assessment. Phase I

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

Not Available

1981-07-31

The goal of the project is to provide a current perspective on territorial energy problems, to identify existing energy supply and demand data, and to identify energy resources that might be developed and appropriate technology options. The cost of the technical assessment and economic analysis activities required to support the development of specific energy plans is defined and estimated. Information is summarized for the US Territories, the Pacific Trust Territories, and Puerto Rico. An overview and analysis of the the Pacific Island Entities; profiles of the Pacifc Island Entities; and the Caribbean Island Entities are presented. (MCW)

Antivenoms for snakebite: design, function, and controversies.

PubMed

Lavonas, Eric J

2012-08-01

Animal-derived antivenoms have been used to treat snake envenomation for more than 100 years. Major technological advantages in the past 30 years have produced antivenoms that are highly purified and chemically modified to reduce the risk of acute hypersensitivity reactions. Like all pharmaceutical manufacture, commercial-scale antivenom production requires making trade-offs between cost, purity, pharmacokinetic profile, and production yield. This article reviews the current state of the art for antivenom production and development. Particular attention is paid to controversies and trade-offs used to achieve a balance between improved safety and pharmacokinetic performance.

Select medications that unexpectedly lower HbA1c levels.

PubMed

Tillman, F; Kim, J

2018-04-19

A variety of medication classes are available for diabetes; however, treatment options become limited due to adverse effect profiles and cost. Current diabetes guidelines include agents not originally developed for diabetes treatment, bromocriptine and colesevelam. Other non-diabetes medications demonstrating haemoglobin A1c lowering, including agents for weight loss, depression, anaemia and coronary artery disease, are described in this review article. More research looking into the impact of non-diabetes medications on blood glucose may offer additional diabetes treatment strategies. © 2018 John Wiley & Sons Ltd.

A Review on Cost-Effectiveness and Cost-Utility of Psychosocial Care in Cancer Patients

PubMed Central

Jansen, Femke; van Zwieten, Valesca; Coupé, Veerle M. H.; Leemans, C. René; Verdonck-de Leeuw, Irma M.

2016-01-01

Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies), group interventions (four studies), individual psychological support (two studies), and individual psycho-education (one study). Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years) while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]). One study did both. Costs included were intervention costs (three studies), intervention and direct medical costs (five studies), or intervention, direct medical, and direct nonmedical costs (three studies). In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses. PMID:27981151

Cost-effectiveness of vildagliptin for people with type 2 diabetes mellitus in Brazil; findings and implications.

PubMed

De Oliveira, Gustavo Laine Araujo; Guerra Júnior, Augusto Afonso; Godman, Brian; Acurcio, Francisco de Assis

2017-04-01

Vildagliptin is an inhibitor of the enzyme dipeptidyl peptidase 4, indicated for the treatment of type 2 diabetes mellitus, combined or not with metformin. This study aims to evaluate the cost-effectiveness of vildagliptin in the Brazilian context. Areas covered: Using MEDLINE, Cochrane Library, Lilacs and CRD, six studies were selected for the economic models. This study utilised cost data in the Brazilian health system to provide the context. Expert commentary: Type 2 diabetes mellitus is an epidemic disease and represents a challenge for all health care systems. Although guidelines clearly define first-line treatment, there are several other promising treatments. Vildagliptin is one of them, resulting in a mean lifetime increase of 0.31 years compared to metformin alone and 1.19 more life years compared to other metformin combinations. Considering observational data, life years with dual vildagliptin-containing treatments were 0.37 more compared to other dual treatments. However, its high cost versus generic metformin and its unclear safety profile weakens its subsequent cost-effectiveness. Consequently, the incorporation of vildagliptin or its combination with metformin is currently not recommended for the Brazilian Health Care System. This may change as more data becomes available.

Controlling air pollution from passenger ferries: cost-effectiveness of seven technological options.

PubMed

Farrell, Alexander E; Corbett, James J; Winebrake, James J

2002-12-01

Continued interest in improving air quality in the United States along with renewed interest in the expansion of urban passenger ferry service has created concern about air pollution from ferry vessels. This paper presents a methodology for estimating the air pollution emissions from passenger ferries and the costs of emissions control strategies. The methodology is used to estimate the emissions and costs of retrofitting or re-powering ferries with seven technological options (combinations of propulsion and emission control systems) onto three vessels currently in service in San Francisco Bay. The technologies include improved engine design, cleaner fuels (including natural gas), and exhaust gas cleanup devices. The three vessels span a range of ages and technologies, from a 25-year-old monohull to a modern, high-speed catamaran built only four years ago. By looking at a range of technologies, vessel designs, and service conditions, a sense of the broader implications of controlling emissions from passenger ferries across a range of vessels and service profiles is provided. Tier 2-certified engines are the most cost-effective choice, but all options are cost-effective relative to other emission control strategies already in place in the transportation system.

Effect of resistivity profile on current decay time of initial phase of current quench in neon-gas-puff inducing disruptions of JT-60U

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

Kawakami, S.; Ohno, N.; Shibata, Y.

2013-11-15

According to an early work [Y. Shibata et al., Nucl. Fusion 50, 025015 (2010)] on the behavior of the plasma current decay in the JT-60U disruptive discharges caused by the radiative collapse with a massive neon-gas-puff, the increase of the internal inductance mainly determined the current decay time of plasma current during the initial phase of current quench. To investigate what determines the increase of the internal inductance, we focus attention on the relationship between the electron temperature (or the resistivity) profile and the time evolution of the current density profile and carry out numerical calculations. As a result, wemore » find the reason of the increase of the internal inductance: The current density profile at the start of the current quench is broader than an expected current density profile in the steady state, which is determined by the temperature (or resistivity) profile. The current density profile evolves into peaked one and the internal inductance is increasing.« less

Logic gate scanner focus control in high-volume manufacturing using scatterometry

NASA Astrophysics Data System (ADS)

Dare, Richard J.; Swain, Bryan; Laughery, Michael

2004-05-01

Tool matching and optimal process control are critical requirements for success in semiconductor manufacturing. It is imperative that a tool"s operating conditions are understood and controlled in order to create a process that is repeatable and produces devices within specifications. Likewise, it is important where possible to match multiple systems using some methodology, so that regardless of which tool is used the process remains in control. Agere Systems is currently using Timbre Technologies" Optical Digital Profilometry (ODP) scatterometry for controlling Nikon scanner focus at the most critical lithography layer; logic gate. By adjusting focus settings and verifying the resultant changes in resist profile shape using ODP, it becomes possible to actively control scanner focus to achieve a desired resist profile. Since many critical lithography processes are designed to produce slightly re-entrant resist profiles, this type of focus control is not possible via Critical Dimension Scanning Electron Microscopy (CDSEM) where reentrant profiles cannot be accurately determined. Additionally, the high throughput and non-destructive nature of this measurement technique saves both cycle time and wafer costs compared to cross-section SEM. By implementing an ODP daily process check and after any maintenance on a scanner, Agere successfully enabled focus drift control, i.e. making necessary focus or equipment changes in order to maintain a desired resist profile.

Finite element design procedure for correcting the coining die profiles

NASA Astrophysics Data System (ADS)

Alexandrino, Paulo; Leitão, Paulo J.; Alves, Luis M.; Martins, Paulo A. F.

2018-05-01

This paper presents a new finite element based design procedure for correcting the coining die profiles in order to optimize the distribution of pressure and the alignment of the resultant vertical force at the end of the die stroke. The procedure avoids time consuming and costly try-outs, does not interfere with the creative process of the sculptors and extends the service life of the coining dies by significantly decreasing the applied pressure and bending moments. The numerical simulations were carried out in a computer program based on the finite element flow formulation that is currently being developed by the authors in collaboration with the Portuguese Mint. A new experimental procedure based on the stack compression test is also proposed for determining the stress-strain curve of the materials directly from the coin blanks.

Scaling by shrinking: empowering single-cell ‘omics’ with microfluidic devices

PubMed Central

Prakadan, Sanjay M.; Shalek, Alex K.; Weitz, David A.

2017-01-01

Recent advances in cellular profiling have demonstrated substantial heterogeneity in the behaviour of cells once deemed ‘identical’, challenging fundamental notions of cell ‘type’ and ‘state’. Not surprisingly, these findings have elicited substantial interest in deeply characterizing the diversity, interrelationships and plasticity among cellular phenotypes. To explore these questions, experimental platforms are needed that can extensively and controllably profile many individual cells. Here, microfluidic structures—whether valve-, droplet- or nanowell-based—have an important role because they can facilitate easy capture and processing of single cells and their components, reducing labour and costs relative to conventional plate-based methods while also improving consistency. In this article, we review the current state-of-the-art methodologies with respect to microfluidics for mammalian single-cell ‘omics’ and discuss challenges and future opportunities. PMID:28392571

[Morbidity profile and hospital expenses with elderly patients in Paraná State, Brazil, 2008-2012].

PubMed

Kernkamp, Clarice da Luz; Costa, Cassia Kely Favoretto; Massuda, Ely Mitie; Silva, Eraldo Schunk; Yamaguchi, Mirian Ueda; Bernuci, Marcelo Picinin

2016-07-21

Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Paraná State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.

Biomarkers for CNS involvement in pediatric lupus

PubMed Central

Rubinstein, Tamar B; Putterman, Chaim; Goilav, Beatrice

2015-01-01

CNS disease, or central neuropsychiatric lupus erythematosus (cNPSLE), occurs frequently in pediatric lupus, leading to significant morbidity and poor long-term outcomes. Diagnosing cNPSLE is especially difficult in pediatrics; many current diagnostic tools are invasive and/or costly, and there are no current accepted screening mechanisms. The most complicated aspect of diagnosis is differentiating primary disease from other etiologies; research to discover new biomarkers is attempting to address this dilemma. With many mechanisms involved in the pathogenesis of cNPSLE, biomarker profiles across several modalities (molecular, psychometric and neuroimaging) will need to be used. For the care of children with lupus, the challenge will be to develop biomarkers that are accessible by noninvasive measures and reliable in a pediatric population. PMID:26079959

Space Station needs, attributes and architectural options, volume 2, book 3: Cost and programmatics

NASA Technical Reports Server (NTRS)

1983-01-01

The cost and programmatic considerations which integrate mission requirements and architectural options into a cohesive system for exploitation of space opportunities within affordable limits are discussed. The mission requirements, baseline architecture, a top level baseline schedule, and acquisition costs are summarized. The work breakdown structure (WBS) used to structure the program, and the WBS dictionary are included. The costing approach used, including the operation of the primary costing tool, the SPACE cost model are described. The rationale for the choice of cost estimating relationships is given and costs at the module level are shown. Detailed costs at the subsystem level are shown. The baseline schedule and annual funding profiles are provided. Alternate schedules are developed to provide different funding profiles. Alternate funding sources are discussed and foreign and contractor participation is outlined. The results of the benefit analysis are given and the accrued benefits deriving from an implemented space station program are outlined.

Diode-laser-based water vapor differential absorption lidar (DIAL) profiler evaluation

NASA Astrophysics Data System (ADS)

Spuler, S.; Weckwerth, T.; Repasky, K. S.; Nehrir, A. R.; Carbone, R.

2012-12-01

We are in the process of evaluating the performance of an eye-safe, low-cost, diode-laser-based, water vapor differential absorption lidar (DIAL) profiler. This class of instrument may be capable of providing continuous water vapor and aerosol backscatter profiles at high vertical resolution in the atmospheric boundary layer (ABL) for periods of months to years. The technology potentially fills a national long term observing facility gap and could greatly benefit micro- and meso-meteorology, water cycle, carbon cycle and, more generally, biosphere-hydrosphere-atmosphere interaction research at both weather and climate variability time scales. For the evaluation, the Montana State University 3rd generation water vapor DIAL was modified to enable unattended operation for a period of several weeks. The performance of this V3.5 version DIAL was tested at MSU and NCAR in June and July of 2012. Further tests are currently in progress with Howard University at Beltsville, Maryland; and with the National Weather Service and Oklahoma University at Dallas/Fort Worth, Texas. The presentation will include a comparison of DIAL profiles against meteorological "truth" at the aforementioned locations including: radiosondes, Raman lidars, microwave and IR radiometers, AERONET and SUOMINET systems. Instrument reliability, uncertainty, systematic biases, detection height statistics, and environmental complications will be evaluated. Performance will be judged in the context of diverse scientific applications that range from operational weather prediction and seasonal climate variability, to more demanding climate system process studies at the land-canopy-ABL interface. Estimating the extent to which such research and operational applications can be satisfied with a low cost autonomous network of similar instruments is our principal objective.

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam.

PubMed

Levin, Carol E; Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

2013-08-01

To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Data were collected from a sample of facilities that participated in five demonstration projects for hpv vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services.

Labor market productivity costs for caregivers of children with spina bifida: a population-based analysis.

PubMed

Tilford, John M; Grosse, Scott D; Goodman, Allen C; Li, Kemeng

2009-01-01

Caregiver productivity costs are an important component of the overall cost of care for individuals with birth defects and developmental disabilities, yet few studies provide estimates for use in economic evaluations. This study estimates labor market productivity costs for caregivers of children and adolescents with spina bifida. Case families were recruited from a state birth defects registry in Arkansas. Primary caregivers of children with spina bifida (N = 98) reported their employment status in the past year and demographic characteristics. Controls were abstracted from the Current Population Survey covering the state of Arkansas for the same time period (N = 416). Estimates from regression analyses of labor market outcomes were used to calculate differences in hours worked per week and lifetime costs. Caregivers of children with spina bifida worked an annual average of 7.5 to 11.3 hours less per week depending on the disability severity. Differences in work hours by caregivers of children with spina bifida translated into lifetime costs of $133,755 in 2002 dollars using a 3% discount rate and an age- and sex-adjusted earnings profile. Including caregivers' labor market productivity costs in prevention effectiveness estimates raises the net cost savings per averted case of spina bifida by 48% over the medical care costs alone. Information on labor market productivity costs for caregivers can be used to better inform economic evaluations of prevention and treatment strategies for spina bifida. Cost-effectiveness calculations that omit caregiver productivity costs substantially overstate the net costs of the intervention and underestimate societal value.

Costs of novel tuberculosis diagnostics--will countries be able to afford it?

PubMed

Pantoja, Andrea; Kik, Sandra V; Denkinger, Claudia M

2015-04-01

Four priority target product profiles for the development of diagnostic tests for tuberculosis were identified: 1) Rapid sputum-based (RSP), 2) non-sputum Biomarker-based (BMT), 3) triage test followed by confirmatory test (TT), and 4) drug-susceptibility testing (DST). We assessed the cost of the new tests in suitable strategies and of the conventional diagnosis of tuberculosis as per World Health Organization guidelines, in 36 high tuberculosis and MDR burden countries. Costs were then compared to the available funding for tuberculosis at country level. Costs of diagnosing tuberculosis using RSP ranged US$93-187 million/year; if RSP unit cost is of US$2-4 it would be lower/similar cost than conventional strategy with sputum smear microscopy (US$ 119 million/year). Using BMT (with unit cost of US$2-4) would cost US$70-121 million/year and be lower/comparable cost than conventional diagnostics. Using TT with TPP characteristics (unit cost of US$1-2) followed by Xpert would reduce diagnostic costs up to US$36 million/year. Costs of using different novel DST strategies for the diagnosis of drug resistance would be higher compared with conventional diagnosis. Introducing a TT or a biomarker test with optimal characteristics would be affordable from a cost and affordability perspective at the current available funding for tuberculosis. Additional domestic or donor funding would be needed in most countries to achieve affordability for other new diagnostic tests. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Connection Map for Compounds (CMC): A Server for Combinatorial Drug Toxicity and Efficacy Analysis.

PubMed

Liu, Lei; Tsompana, Maria; Wang, Yong; Wu, Dingfeng; Zhu, Lixin; Zhu, Ruixin

2016-09-26

Drug discovery and development is a costly and time-consuming process with a high risk for failure resulting primarily from a drug's associated clinical safety and efficacy potential. Identifying and eliminating inapt candidate drugs as early as possible is an effective way for reducing unnecessary costs, but limited analytical tools are currently available for this purpose. Recent growth in the area of toxicogenomics and pharmacogenomics has provided with a vast amount of drug expression microarray data. Web servers such as CMap and LTMap have used this information to evaluate drug toxicity and mechanisms of action independently; however, their wider applicability has been limited by the lack of a combinatorial drug-safety type of analysis. Using available genome-wide drug transcriptional expression profiles, we developed the first web server for combinatorial evaluation of toxicity and efficacy of candidate drugs named "Connection Map for Compounds" (CMC). Using CMC, researchers can initially compare their query drug gene signatures with prebuilt gene profiles generated from two large-scale toxicogenomics databases, and subsequently perform a drug efficacy analysis for identification of known mechanisms of drug action or generation of new predictions. CMC provides a novel approach for drug repositioning and early evaluation in drug discovery with its unique combination of toxicity and efficacy analyses, expansibility of data and algorithms, and customization of reference gene profiles. CMC can be freely accessed at http://cadd.tongji.edu.cn/webserver/CMCbp.jsp .

In situ X-ray near-edge absorption spectroscopy investigation of the state of charge of all-vanadium redox flow batteries.

PubMed

Jia, Chuankun; Liu, Qi; Sun, Cheng-Jun; Yang, Fan; Ren, Yang; Heald, Steve M; Liu, Yadong; Li, Zhe-Fei; Lu, Wenquan; Xie, Jian

2014-10-22

Synchrotron-based in situ X-ray near-edge absorption spectroscopy (XANES) has been used to study the valence state evolution of the vanadium ion for both the catholyte and anolyte in all-vanadium redox flow batteries (VRB) under realistic cycling conditions. The results indicate that, when using the widely used charge-discharge profile during the first charge process (charging the VRB cell to 1.65 V under a constant current mode), the vanadium ion valence did not reach V(V) in the catholyte and did not reach V(II) in the anolyte. Consequently, the state of charge (SOC) for the VRB cell was only 82%, far below the desired 100% SOC. Thus, such incompletely charged mix electrolytes results in not only wasting the electrolytes but also decreasing the cell performance in the following cycles. On the basis of our study, we proposed a new charge-discharge profile (first charged at a constant current mode up to 1.65 V and then continuously charged at a constant voltage mode until the capacity was close to the theoretical value) for the first charge process that achieved 100% SOC after the initial charge process. Utilizing this new charge-discharge profile, the theoretical charge capacity and the full utilization of electrolytes has been achieved, thus having a significant impact on the cost reduction of the electrolytes in VRB.

Cost effectiveness of strategies to combat chronic obstructive pulmonary disease and asthma in sub-Saharan Africa and South East Asia: mathematical modelling study.

PubMed

Stanciole, Anderson E; Ortegón, Mónica; Chisholm, Dan; Lauer, Jeremy A

2012-03-02

To determine the population level costs, effects, and cost effectiveness of selected, individual based interventions to combat chronic obstructive pulmonary disease (COPD) and asthma in the context of low and middle income countries. Sectoral cost effectiveness analysis using a lifetime population model. Two World Health Organization sub-regions of the world: countries in sub-Saharan Africa with very high adult and high child mortality (AfrE); and countries in South East Asia with high adult and high child mortality (SearD). Disease rates and profiles were taken from the WHO Global Burden of Disease study; estimates of intervention effects and resource needs were drawn from clinical trials, observational studies, and treatment guidelines. Unit costs were taken from a WHO price database. Cost per disability adjusted life year (DALY) averted, expressed in international dollars ($Int) for the year 2005. In both regions low dose inhaled corticosteroids for mild persistent asthma was considered the most cost effective intervention, with average cost per DALY averted about $Int2500. The next best value strategies were influenza vaccine for COPD in Sear-D (incremental cost $Int4950 per DALY averted) and low dose inhaled corticosteroids plus long acting β agonists for moderate persistent asthma in Afr-E (incremental cost $Int9112 per DALY averted). COPD is irreversible and progressive, and current treatment options produce relatively little gains relative to the cost. The treatment options available for asthma, however, generally decrease chronic respiratory disease burden at a relatively low cost.

Microwave Radiometer Technology Acceleration Mission (MiRaTA): Advancing Weather Remote Sensing with Nanosatellites

NASA Astrophysics Data System (ADS)

Cahoy, K.; Blackwell, W. J.; Bishop, R. L.; Erickson, N.; Fish, C. S.; Neilsen, T. L.; Stromberg, E. M.; Bardeen, J.; Dave, P.; Marinan, A.; Marlow, W.; Kingsbury, R.; Kennedy, A.; Byrne, J. M.; Peters, E.; Allen, G.; Burianek, D.; Busse, F.; Elliott, D.; Galbraith, C.; Leslie, V. V.; Osaretin, I.; Shields, M.; Thompson, E.; Toher, D.; DiLiberto, M.

2014-12-01

The Microwave Radiometer Technology Acceleration (MiRaTA) is a 3U CubeSat mission sponsored by the NASA Earth Science Technology Office (ESTO). Microwave radiometer measurements and GPS radio occultation (GPSRO) measurements of all-weather temperature and humidity provide key contributions toward improved weather forecasting. The MiRaTA mission will validate new technologies in both passive microwave radiometry and GPS radio occultation: (1) new ultra-compact and low-power technology for multi-channel and multi-band passive microwave radiometers, and (2) new GPS receiver and patch antenna array technology for GPS radio occultation retrieval of both temperature-pressure profiles in the atmosphere and electron density profiles in the ionosphere. In addition, MiRaTA will test (3) a new approach to spaceborne microwave radiometer calibration using adjacent GPSRO measurements. The radiometer measurement quality can be substantially improved relative to present systems through the use of proximal GPSRO measurements as a calibration standard for radiometric observations, reducing and perhaps eliminating the need for costly and complex internal calibration targets. MiRaTA will execute occasional pitch-up maneuvers so that the radiometer and GPSRO observations sound overlapping volumes of atmosphere through the Earth's limb. To validate system performance, observations from both microwave radiometer (MWR) and GPSRO instruments will be compared to radiosondes, global high-resolution analysis fields, other satellite observations, and to each other using radiative transfer models. Both the radiometer and GPSRO payloads, currently at TRL5 but to be advanced to TRL7 at mission conclusion, can be accommodated in a single 3U CubeSat. The current plan is to launch from an International Space Station (ISS) orbit at ~400 km altitude and 52° inclination for low-cost validation over a ~90-day mission to fly in 2016. MiRaTA will demonstrate high fidelity, well-calibrated radiometric sensing from a nanosatellite platform, thereby enabling new architectural approaches for mission implementation at lower cost and risk with more flexible access to space.

Simulation of profile evolution from ramp-up to ramp-down and optimization of tokamak plasma termination with the RAPTOR code

NASA Astrophysics Data System (ADS)

Teplukhina, A. A.; Sauter, O.; Felici, F.; Merle, A.; Kim, D.; the TCV Team; the ASDEX Upgrade Team; the EUROfusion MST1 Team

2017-12-01

The present work demonstrates the capabilities of the transport code RAPTOR as a fast and reliable simulator of plasma profiles for the entire plasma discharge, i.e. from ramp-up to ramp-down. This code focuses, at this stage, on the simulation of electron temperature and poloidal flux profiles using prescribed equilibrium and some kinetic profiles. In this work we extend the RAPTOR transport model to include a time-varying plasma equilibrium geometry and verify the changes via comparison with ATSRA code simulations. In addition a new ad hoc transport model based on constant gradients and suitable for simulations of L-H and H-L mode transitions has been incorporated into the RAPTOR code and validated with rapid simulations of the time evolution of the safety factor and the electron temperature over the entire AUG and TCV discharges. An optimization procedure for the plasma termination phase has also been developed during this work. We define the goal of the optimization as ramping down the plasma current as fast as possible while avoiding any disruptions caused by reaching physical or technical limits. Our numerical study of this problem shows that a fast decrease of plasma elongation during current ramp-down can help in reducing plasma internal inductance. An early transition from H- to L-mode allows us to reduce the drop in poloidal beta, which is also important for plasma MHD stability and control. This work shows how these complex nonlinear interactions can be optimized automatically using relevant cost functions and constraints. Preliminary experimental results for TCV are demonstrated.

Determining the near-surface current profile from measurements of the wave dispersion relation

NASA Astrophysics Data System (ADS)

Smeltzer, Benjamin; Maxwell, Peter; Aesøy, Eirik; Ellingsen, Simen

2017-11-01

The current-induced Doppler shifts of waves can yield information about the background mean flow, providing an attractive method of inferring the current profile in the upper layer of the ocean. We present measurements of waves propagating on shear currents in a laboratory water channel, as well as theoretical investigations of inversion techniques for determining the vertical current structure. Spatial and temporal measurements of the free surface profile obtained using a synthetic Schlieren method are analyzed to determine the wave dispersion relation and Doppler shifts as a function of wavelength. The vertical current profile can then be inferred from the Doppler shifts using an inversion algorithm. Most existing algorithms rely on a priori assumptions of the shape of the current profile, and developing a method that uses less stringent assumptions is a focus of this study, allowing for measurement of more general current profiles. The accuracy of current inversion algorithms are evaluated by comparison to measurements of the mean flow profile from particle image velocimetry (PIV), and a discussion of the sensitivity to errors in the Doppler shifts is presented.

Measurement of antinuclear antibodies and their fine specificities: time for a change in strategy?

PubMed

Otten, Henny G; Brummelhuis, Walter J; Fritsch-Stork, Ruth; Leavis, Helen L; Wisse, Bram W; van Laar, Jacob M; Derksen, Ronald H W M

2017-01-01

The current strategy for antinuclear antibody (ANA) analysis involves screening for presence with a subsequent detailed analysis of their specificity. The aim of this study is to compare the clinical and financial efficacy of this strategy between different commercial tests in a large cohort of unselected patients. In all consecutive 1030 patients associations were defined between results from different ANA test systems and the pre-test probability for connective tissue disease (CTDs). Test systems were used for screening (ANA-IIF vs. CTD screen) and definition of their fine specificity (profile 3 line blot vs. CTD single analytes). Positive ANA-IIF and/or CTD screen results were found in 304 sera. Further analysis for ANA-specificity by profile 3 line blot and CTD single analytes showed 86 discrepant results of which more than a third are clinically relevant, with the CTD single analyte assay performing better than the line blot in supporting or confirming the presence of a CTD. Autoantigens present in one test but absent in the other were of minor practical use. The ANA screening and identification strategies currently employed are not cost-effective as 83% of tests were performed in order to find specific autoantibodies in patients without the fitting clinical signs or symptoms. This causes many unexpected positive results and subsequent confusion with regard to interpretation. We advocate that some autoantigens should be excluded from the line blot and CTD assays and propose the use of a cost-effective and selective ANA specificity testing purely based on clinical guidance.

Cost effectiveness of the stream-gaging program in Louisiana

USGS Publications Warehouse

Herbert, R.A.; Carlson, D.D.

1985-01-01

This report documents the results of a study of the cost effectiveness of the stream-gaging program in Louisiana. Data uses and funding sources were identified for the 68 continuous-record stream gages currently (1984) in operation with a budget of $408,700. Three stream gages have uses specific to a short-term study with no need for continued data collection beyond the study. The remaining 65 stations should be maintained in the program for the foreseeable future. In addition to the current operation of continuous-record stations, a number of wells, flood-profile gages, crest-stage gages, and stage stations, are serviced on the continuous-record station routes; thus, increasing the current budget to $423,000. The average standard error of estimate for data collected at the stations is 34.6%. Standard errors computed in this study are one measure of streamflow errors, and can be used as guidelines in comparing the effectiveness of alternative networks. By using the routes and number of measurements prescribed by the ' Traveling Hydrographer Program, ' the standard error could be reduced to 31.5% with the current budget of $423,000. If the gaging resources are redistributed, the 34.6% overall level of accuracy at the 68 continuous-record sites and the servicing of the additional wells or gages could be maintained with a budget of approximately $410,000. (USGS)

Mask industry assessment trend analysis

NASA Astrophysics Data System (ADS)

Shelden, Gilbert; Marmillion, Patricia; Hughes, Greg

2008-04-01

Microelectronics industry leaders routinely name the cost and cycle time of mask technology and mask supply as top critical issues. A survey was created with support from SEMATECH and administered by SEMI North America to gather information about the mask industry as an objective assessment of its overall condition. This year's survey data were presented in detail at BACUS and the detailed trend analysis presented at EMLC. The survey is designed with the input of semiconductor company mask technologists, merchant mask suppliers, and industry equipment makers. This year's assessment is the sixth in the current series of annual reports. With continued industry support, the report can be used as a baseline to gain perspective on the technical and business status of the mask and microelectronics industries. The report will continue to serve as a valuable reference to identify the strengths and opportunities of the mask industry. The results will be used to guide future investments on critical path issues. This year's survey is basically the same as the 2005 and 2006 surveys. Questions are grouped into eight categories: General Business Profile Information, Data Processing, Yields and Yield Loss, Mechanisms, Delivery Times, Returns and Services, Operating Cost Factors, and Equipment Utilization. Within each category is a multitude of questions that creates a detailed profile of both the business and technical status of the critical mask industry. Note: the questions covering operating cost factors and equipment utilization were added to the survey only in 2005; therefore, meaningful trend analysis is not available.

Business grants

NASA Astrophysics Data System (ADS)

Twelve small businesses who are developing equipment and computer programs for geophysics have won Small Business Innovative Research (SBIR) grants from the National Science Foundation for their 1989 proposals. The SBIR program was set up to encourage the private sector to undertake costly, advanced experimental work that has potential for great benefit.The geophysical research projects are a long-path intracavity laser spectrometer for measuring atmospheric trace gases, optimizing a local weather forecast model, a new platform for high-altitude atmospheric science, an advanced density logging tool, a deep-Earth sampling system, superconducting seismometers, a phased-array Doppler current profiler, monitoring mesoscale surface features of the ocean through automated analysis, krypton-81 dating in polar ice samples, discrete stochastic modeling of thunderstorm winds, a layered soil-synthetic liner base system to isolate buildings from earthquakes, and a low-cost continuous on-line organic-content monitor for water-quality determination.

First-Principles-Driven Model-Based Optimal Control of the Current Profile in NSTX-U

NASA Astrophysics Data System (ADS)

Ilhan, Zeki; Barton, Justin; Wehner, William; Schuster, Eugenio; Gates, David; Gerhardt, Stefan; Kolemen, Egemen; Menard, Jonathan

2014-10-01

Regulation in time of the toroidal current profile is one of the main challenges toward the realization of the next-step operational goals for NSTX-U. A nonlinear, control-oriented, physics-based model describing the temporal evolution of the current profile is obtained by combining the magnetic diffusion equation with empirical correlations obtained at NSTX-U for the electron density, electron temperature, and non-inductive current drives. In this work, the proposed model is embedded into the control design process to synthesize a time-variant, linear-quadratic-integral, optimal controller capable of regulating the safety factor profile around a desired target profile while rejecting disturbances. Neutral beam injectors and the total plasma current are used as actuators to shape the current profile. The effectiveness of the proposed controller in regulating the safety factor profile in NSTX-U is demonstrated via closed-loop predictive simulations carried out in PTRANSP. Supported by PPPL.

Foods and dietary patterns that are healthy, low-cost, and environmentally sustainable: a case study of optimization modeling for New Zealand.

PubMed

Wilson, Nick; Nghiem, Nhung; Ni Mhurchu, Cliona; Eyles, Helen; Baker, Michael G; Blakely, Tony

2013-01-01

Global health challenges include non-communicable disease burdens, ensuring food security in the context of rising food prices, and environmental constraints around food production, e.g., greenhouse gas [GHG] emissions. We therefore aimed to consider optimized solutions to the mix of food items in daily diets for a developed country population: New Zealand (NZ). We conducted scenario development and linear programming to model 16 diets (some with uncertainty). Data inputs included nutrients in foods, food prices, food wastage and food-specific GHG emissions. This study identified daily dietary patterns that met key nutrient requirements for as little as a median of NZ$ 3.17 per day (US$ 2.41/d) (95% simulation interval [SI] = NZ$ 2.86 to 3.50/d). Diets that included "more familiar meals" for New Zealanders, increased the cost. The optimized diets also had low GHG emission profiles compared with the estimate for the 'typical NZ diet' e.g., 1.62 kg CO2e/d for one scenario (95%SI = 1.39 to 1.85 kg CO2e) compared with 10.1 kg CO2e/d, respectively. All of the optimized low-cost and low-GHG dietary patterns had likely health advantages over the current NZ dietary pattern, i.e., lower cardiovascular disease and cancer risk. We identified optimal foods and dietary patterns that would lower the risk of non-communicable diseases at low cost and with low greenhouse gas emission profiles. These results could help guide central and local government decisions around which foods to focus policies on. That is which foods are most suitable for: food taxes (additions and exemptions); healthy food vouchers and subsidies; and for increased use by public institutions involved in food preparation.

Are Australian consumers willing to pay for the installation of reversing cameras in motor vehicles?

PubMed

Jones, Sandra C; Telenta, Joanne

2010-04-01

In Australia, more than one toddler per month dies from being run over in a driveway and many more are injured. While there is currently no regulation in Australia regarding reverse warning systems, the issue has been debated over the years following several high profile cases. A computer-assisted telephone interview (CATI) survey of NSW households was undertaken in March 2008. Respondents were asked about their willingness to pay for the installation of vehicle reversing cameras at the expense of the purchaser. The survey was completed by 590 respondents. There were no significant differences between males and females for willingness to pay $500 or $300 for a reversing camera in their current vehicle; however females were more willing to pay $150. There were no significant differences between age groups in willingness to pay for the installation. More than two-thirds of respondents would support legislation if it increased the cost of new cars by $300 and more than half if it increased by $500. This study suggests that the majority of adults would be prepared to pay a small amount of money to install a reversing camera in their current vehicle, but not sufficient to cover the full cost of installation.

Determination of the lead-acid battery's dynamic response using Butler-Volmer equation for advanced battery management systems in automotive applications

NASA Astrophysics Data System (ADS)

Piłatowicz, Grzegorz; Budde-Meiwes, Heide; Kowal, Julia; Sarfert, Christel; Schoch, Eberhard; Königsmann, Martin; Sauer, Dirk Uwe

2016-11-01

Micro-hybrid vehicles (μH) are currently starting to dominate the European market and seize constantly growing share of other leading markets in the world. On the one hand, the additional functionality of μH reduces the CO2 emissions and improves the fuel economy, but, on the other hand, the additional stress imposed on the lead-acid battery reduces significantly its expected service life in comparison to conventional vehicles. Because of that μH require highly accurate battery state detection solutions. They are necessary to ensure the vehicle reliability requirements, prolong service life and reduce warranty costs. This paper presents an electrical model based on Butler-Volmer equation. The main novelty of the presented approach is its ability to predict accurately dynamic response of a battery considering a wide range of discharge current rates, state-of-charges and temperatures. Presented approach is fully implementable and adaptable in state-of-the-art low-cost platforms. Additionally, shown results indicate that it is applicable as a supporting tool for state-of-charge and state-of-health estimation and scalable for the different battery technologies and sizes. Validation using both static pulses and dynamic driving profile resulted in average absolute error of 124 mV regarding cranking current rate of 800 A respectively.

Health insurance in South Africa: an empirical analysis of trends in risk-pooling and efficiency following deregulation.

PubMed

Söderlund, N; Hansl, B

2000-12-01

This paper reports an empirical investigation into the pattern of private health insurance coverage in South Africa before and after deregulation of the health insurance industry. More specifically, we sought to measure trends in risk-pooling over the period 1985-95, and to assess the impact of risk pooling on the costs of health insurance cover over this period. South African mutual health insurers (Medical Schemes) have existed for over 100 years, and have been regulated under a specific Act since 1967. Up until 1989, health insurers were required by law to community rate their premiums, and were not allowed to exclude high-risk enrolees from cover. In 1989 these regulations were removed, effectively allowing health insurers to risk-rate the cover which they provided, and exclude 'medically uninsurables'. Data were obtained from the office of the health insurance regulator (the Registrar of Medical Schemes) for the period 1985-95, and consisted of the statutory returns from all registered medical schemes for each year during the study period. Multiple regression methods were used to assess the determinants of changes in the risk pools of insurers, and their costs. Both cross-sectional and longitudinal models were estimated. Unadjusted data suggest changes in risk-pooling since the deregulation period after 1985. Health insurers with open enrolment had worse than average risk profiles in the 1980s, but this reversed by the early 1990s, leaving them with significantly better risk profiles by 1995. Worsening risk profiles were associated with decreasing fund size, higher loss-ratios and past premium increases. Most models showed that risk rating of premiums was consistently associated with higher premiums, after adjustment for risk, quality, scale and other environmental differences between insurers. Likely explanations include the additional costs required for marketing and underwriting risk-rated policies, insufficient incentives to use cost-control techniques, and higher levels of moral hazard associated with diminished risk-pooling. Current re-regulation of risk-pooling within medical schemes may thus improve both equity and efficiency of private health care cover.

An Improved Model Predictive Current Controller of Switched Reluctance Machines Using Time-Multiplexed Current Sensor

PubMed Central

Li, Bingchu; Ling, Xiao; Huang, Yixiang; Gong, Liang; Liu, Chengliang

2017-01-01

This paper presents a fixed-switching-frequency model predictive current controller using multiplexed current sensor for switched reluctance machine (SRM) drives. The converter was modified to distinguish currents from simultaneously excited phases during the sampling period. The only current sensor installed in the converter was time division multiplexing for phase current sampling. During the commutation stage, the control steps of adjacent phases were shifted so that sampling time was staggered. The maximum and minimum duty ratio of pulse width modulation (PWM) was limited to keep enough sampling time for analog-to-digital (A/D) conversion. Current sensor multiplexing was realized without complex adjustment of either driver circuit nor control algorithms, while it helps to reduce the cost and errors introduced in current sampling due to inconsistency between sensors. The proposed controller is validated by both simulation and experimental results with a 1.5 kW three-phase 12/8 SRM. Satisfied current sampling is received with little difference compared with independent phase current sensors for each phase. The proposed controller tracks the reference current profile as accurately as the model predictive current controller with independent phase current sensors, while having minor tracking errors compared with a hysteresis current controller. PMID:28513554

Donepezil dosing strategies: pharmacokinetic considerations.

PubMed

Gomolin, Irving H; Smith, Candace; Jeitner, Thomas M

2011-10-01

Donepezil (Aricept) is a cholinesterase inhibitor approved for the treatment of Alzheimer's disease. Immediate release formulations of 5- and 10-mg tablets were approved by the Food and Drug Administration in the United States in 1996. In July 2010, the Food and Drug Administration approved a 23-mg sustained release (SR) formulation. The SR formulation may provide additional benefit to patients receiving 10 mg daily but the incidence of adverse reactions is increased. We derived plasma concentration profiles for higher dose immediate-release formulations (15 mg once daily, 10 mg twice daily, and 20 mg once daily) and for the profile anticipated to result from the 23-mg SR formulation. Our model predicts similar steady-state concentration profiles for 10 mg twice daily, 20 mg once daily, and 23 mg SR once daily. This provides the theoretical basis for incremental immediate release dose escalation to minimize the emergence of adverse reactions and the potential to offer a cost-effective alternative to the SR formulation with currently approved generic immediate release formulations. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Prediction of Microbial Infection of Cultured Cells Using DNA Microarray Gene-Expression Profiles of Host Responses

PubMed Central

Park, Yu Rang; Chung, Tae Su; Lee, Young Joo; Song, Yeong Wook; Lee, Eun Young; Sohn, Yeo Won; Song, Sukgil; Park, Woong Yang

2012-01-01

Infection by microorganisms may cause fatally erroneous interpretations in the biologic researches based on cell culture. The contamination by microorganism in the cell culture is quite frequent (5% to 35%). However, current approaches to identify the presence of contamination have many limitations such as high cost of time and labor, and difficulty in interpreting the result. In this paper, we propose a model to predict cell infection, using a microarray technique which gives an overview of the whole genome profile. By analysis of 62 microarray expression profiles under various experimental conditions altering cell type, source of infection and collection time, we discovered 5 marker genes, NM_005298, NM_016408, NM_014588, S76389, and NM_001853. In addition, we discovered two of these genes, S76389, and NM_001853, are involved in a Mycolplasma-specific infection process. We also suggest models to predict the source of infection, cell type or time after infection. We implemented a web based prediction tool in microarray data, named Prediction of Microbial Infection (http://www.snubi.org/software/PMI). PMID:23091307

Estimating the cost-effectiveness profile of a universal vaccination programme with a nine-valent HPV vaccine in Austria.

PubMed

Boiron, L; Joura, E; Largeron, N; Prager, B; Uhart, M

2016-04-16

HPV is a major cancer-causing factor in both sexes in the cervix, vulva, vagina, anus, penis, oropharynx as well as the causal factor in other diseases such as genital warts and recurrent respiratory papillomatis. In the context of the arrival of a nonavalent HPV vaccine (6/11/16/18/31/33/45/52/58), this analysis aims to estimate the public health impact and the incremental cost-effectiveness of a universal (girls and boys) vaccination program with a nonavalent HPV vaccine as compared to the current universal vaccination program with a quadrivalent HPV vaccine (6/11/16/18), in Austria. A dynamic transmission model including a wide range of health and cost outcomes related to cervical, anal, vulvar, vaginal diseases and genital warts was calibrated to Austrian epidemiological data. The clinical impact due to the 5 new types was included for cervical and anal diseases outcomes only. In the base case, a two-dose schedule, lifelong vaccine type-specific protection and a vaccination coverage rate of 60% and 40% for girls and boys respectively for the 9-year old cohorts were assumed. A cost-effectiveness threshold of €30,000/QALY-gained was considered. Universal vaccination with the nonavalent vaccine was shown to reduce the incidence of HPV16/18/31/33/45/52/58 -related cervical cancer by 92%, the related CIN2/3 cases by 96% and anal cancer by 83% and 76% respectively in females and males after 100 years, relative to 75%, 76%, 80% and 74% with the quadrivalent vaccine, respectively. Furthermore, the nonavalent vaccine was projected to prevent an additional 14,893 cases of CIN2/3 and 2544 cases of cervical cancer, over 100 years. Depending on the vaccine price, the strategy was shown to be from cost-saving to cost-effective. The present evaluation showed that vaccinating 60% of girls and 40% of boys aged 9 in Austria with a 9-valent vaccine will substantially reduce the incidence of cervical cancer, CIN and anal cancer compared to the existing strategy. The vaccination strategies performed with the 9-valent vaccine in the current study were all found to be cost-effective compared to the current quadrivalent vaccination strategy by considering a cost-effectiveness threshold of 30,000€/QALY gained.

Wind Turbine Gust Prediction Using Remote Sensing Data

NASA Astrophysics Data System (ADS)

Towers, Paul; Jones, Bryn

2013-11-01

Offshore wind energy is a growing energy source as governments around the world look for environmentally friendly solutions to potential future energy shortages. In order to capture more energy from the wind, larger turbines are being designed, leading to the structures becoming increasingly vulnerable to damage caused by violent gusts of wind. Advance knowledge of such gusts will enable turbine control systems to take preventative action, reducing turbine maintenance costs. We present a system which can accurately forecast the velocity profile of an oncoming wind, given only limited spatial measurements from light detection and ranging (LiDAR) units, which are currently operational in industry. Our method combines nonlinear state estimation techniques with low-order models of atmospheric boundary-layer flows to generate flow-field estimates. We discuss the accuracy of our velocity profile predictions by direct comparison to data derived from large eddy simulations of the atmospheric boundary layer.

Real-Time Identification and Characterization of Asbestos and Concrete Materials with Radioactive Contamination

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

Xu, George; Zhang, Xi-Cheng

Concrete and asbestos-containing materials were widely used in U.S. Department of Energy (DOE) building construction in the 1940s and 1950s. Over the years, many of these porous building materials have been contaminated with radioactive sources, on and below the surface. This intractable radioactive-and-hazardous- asbestos mixed-waste-stream has created a tremendous challenge to DOE decontamination and decommissioning (D&D) project managers. The current practice to identify asbestos and to characterize radioactive contamination depth profiles involve bore sampling, and is inefficient, costly, and unsafe. A three-year research project was started on 10/1/98 at Rensselaer with the following ultimate goals: (1) development of novel non-destructivemore » methods for identifying the hazardous asbestos in real-time and in-situ, and (2) development of new algorithms and apparatus for characterizing the radioactive contamination depth profile in real-time and in-situ.« less

Real-Time Identification and Characterization of Asbestos and Concrete Materials with Radioactive Contamination

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

Xu, George; Zhang, Xi-Cheng

Concrete and asbestos-containing materials were widely used in U.S. Department of Energy (DOE) building construction in the 1940s and 1950s. Over the years, many of these porous building materials have been contaminated with radioactive sources, on and below the surface. This intractable radioactive-and-hazardous-asbestos mixed-waste stream has created a tremendous challenge to DOE decontamination and decommissioning (D&D) project managers. The current practice to identify asbestos and to characterize radioactive contamination depth profiles in based solely on bore sampling, which is inefficient, costly, and unsafe. A three-year research project was started 1998 at Rensselaer with the following ultimate goals: (1) development ofmore » novel non-destructive methods for identifying the hazardous asbestos in real-time and in-situ, and (2) development of new algorithms and apparatus for characterizing the radioactive contamination depth profile in real-time and in-situ.« less

Web-based resources for mass-spectrometry-based metabolomics: a user's guide.

PubMed

Tohge, Takayuki; Fernie, Alisdair R

2009-03-01

In recent years, a plethora of web-based tools aimed at supporting mass-spectrometry-based metabolite profiling and metabolomics applications have appeared. Given the huge hurdles presented by the chemical diversity and dynamic range of the metabolites present in the plant kingdom, profiling the levels of a broad range of metabolites is highly challenging. Given the scale and costs involved in defining the plant metabolome, it is imperative that data are effectively shared between laboratories pursuing this goal. However, ensuring accurate comparison of samples run on the same machine within the same laboratory, let alone cross-machine and cross-laboratory comparisons, requires both careful experimentation and data interpretation. In this review, we present an overview of currently available software that aids either in peak identification or in the related field of peak alignment as well as those with utility in defining structural information of compounds and metabolic pathways.

High-Speed Scanning Interferometer Using CMOS Image Sensor and FPGA Based on Multifrequency Phase-Tracking Detection

NASA Technical Reports Server (NTRS)

Ohara, Tetsuo

2012-01-01

A sub-aperture stitching optical interferometer can provide a cost-effective solution for an in situ metrology tool for large optics; however, the currently available technologies are not suitable for high-speed and real-time continuous scan. NanoWave s SPPE (Scanning Probe Position Encoder) has been proven to exhibit excellent stability and sub-nanometer precision with a large dynamic range. This same technology can transform many optical interferometers into real-time subnanometer precision tools with only minor modification. The proposed field-programmable gate array (FPGA) signal processing concept, coupled with a new-generation, high-speed, mega-pixel CMOS (complementary metal-oxide semiconductor) image sensor, enables high speed (>1 m/s) and real-time continuous surface profiling that is insensitive to variation of pixel sensitivity and/or optical transmission/reflection. This is especially useful for large optics surface profiling.

Bioinformatics and peptidomics approaches to the discovery and analysis of food-derived bioactive peptides.

PubMed

Agyei, Dominic; Tsopmo, Apollinaire; Udenigwe, Chibuike C

2018-06-01

There are emerging advancements in the strategies used for the discovery and development of food-derived bioactive peptides because of their multiple food and health applications. Bioinformatics and peptidomics are two computational and analytical techniques that have the potential to speed up the development of bioactive peptides from bench to market. Structure-activity relationships observed in peptides form the basis for bioinformatics and in silico prediction of bioactive sequences encrypted in food proteins. Peptidomics, on the other hand, relies on "hyphenated" (liquid chromatography-mass spectrometry-based) techniques for the detection, profiling, and quantitation of peptides. Together, bioinformatics and peptidomics approaches provide a low-cost and effective means of predicting, profiling, and screening bioactive protein hydrolysates and peptides from food. This article discuses the basis, strengths, and limitations of bioinformatics and peptidomics approaches currently used for the discovery and analysis of food-derived bioactive peptides.

Geodetic survey as a means of improving fast MASW (Multichannel Analysis Of Surface Waves) profiling in difficult terrain/land conditions

NASA Astrophysics Data System (ADS)

Matuła, Rafał; Lewińska, Paulina

2018-01-01

This paper revolves around newly designed and constructed system that can make 2D seismic measurement in natural, subsoil conditions and role of land survey in obtaining accurate results and linking them to 3D surface maps. A new type of land streamer, designed for shallow subsurface exploration is described in this paper. In land seismic data acquisition methods a vehicle tows a line of seismic cable, lying on construction called streamer. The measurements of points and shots are taken while the line is stationary, arbitrary placed on seismic profile. Exposed land streamer consists of 24 innovatory gimballed 10 Hz geophones. It eliminates the need for hand `planting' of geophones, reducing time and costs. With the use of current survey techniques all data obtained with this instrument are being transferred in to 2D and 3D maps. This process is becoming more automatic.

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

PubMed Central

Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

2013-01-01

Abstract Objective To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Methods Data were collected from a sample of facilities that participated in five demonstration projects for HPV vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. Findings The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). Conclusion The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services. PMID:23940406

Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries.

PubMed

Massad, Eduardo; Behrens, Ben C; Coutinho, Francisco A B; Behrens, Ronald H

2011-05-17

In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used. Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions) and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.

Evidence base and future research directions in the management of low back pain.

PubMed

Abbott, Allan

2016-03-18

Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.

Device-identified atrial fibrillation at pacing clinics. Should it guide anticoagulation?

PubMed

Merinopoulos, Ioannis; Raphael, Claire E; Yardley, Alaina; Goonewardene, Manoj; Vassiliou, Vassilios S

2016-03-15

In recent years, there has been a significant increase in the number of devices implanted following improvement in their safety profile, extension of indications and reduction in cost. Although the reason remains largely the beneficial effect on heart rhythm stabilisation, implanted devices might also have additional advantages, notably identification of silent arrhythmia. Should clinicians therefore act on device-identified atrial fibrillation (AF) and should such identification be used to guide anticoagulation management? This review evaluates the current evidence on the management of device-identified asymptomatic AF. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Economic evaluation of the new oral anticoagulants for the prevention of thromboembolic events: a cost-minimization analysis.

PubMed

Marcolino, Milena Soriano; Polanczyk, Carisi Anne; Bovendorp, Ana Carolina Caixeta; Marques, Naiara Silveira; Silva, Lilian Azevedo da; Turquia, Cintia Proveti Barbosa; Ribeiro, Antonio Luiz

2016-01-01

Randomized clinical trials have shown that the new oral anticoagulants have at least similar impact regarding reduction of thromboembolic events, compared with warfarin, with similar or improved safety profiles. There is little data on real costs within clinical practice. Our aim here was to perform economic analysis on these strategies from the perspective of Brazilian society and the public healthcare system. Cost-minimization analysis; anticoagulation clinic of Hospital Municipal Odilon Behrens, Belo Horizonte, MG, Brazil. Patients at the anticoagulation clinic were recruited between August and October 2011, with minimum follow-up of four weeks. Operational and non-operational costs were calculated and corrected to 2015. This study included 633 patients (59% women) of median age 62 years (interquartile range -49-73). The mean length of follow-up was 64 ± 28 days. The average cost per patient per month was $ 54.26 (US dollars). Direct costs accounted for 32.5% of the total cost. Of these, 69.5% were related to healthcare professionals. With regards to indirect costs, 52.4% were related to absence from work and 47.6% to transportation. Apixaban, dabigatran and rivaroxaban were being sold to Brazilian public institutions, on average, for $ 49.87, $ 51.40 and $ 52.16 per patient per month, respectively, which was lower than the costs relating to warfarin treatment. In the Brazilian context, from the perspective of society and the public healthcare system, the cumulative costs per patient using warfarin with follow-up in anticoagulation clinics is currently higher than the strategy of prescribing the new oral anticoagulants.

The cost-effectiveness of cervical self-sampling to improve routine cervical cancer screening: The importance of respondent screening history and compliance

PubMed Central

Burger, Emily A; Sy, Stephen; Nygård, Mari; Kim, Jane J

2016-01-01

Background Human papillomavirus (HPV) testing allows women to self-collect cervico-vaginal cells at home (i.e., self-sampling). Using primary data from a randomized pilot study, we evaluated the long-term consequences and cost-effectiveness of using self-sampling to improve participation to routine cervical cancer screening in Norway. Methods We compared a strategy reflecting screening participation (using reminder letters) to strategies that involved mailing self-sampling device kits to women non-compliant to screening within a 5-year or 10-year period under two scenarios: A) self-sampling respondents had moderate under-screening histories, or B) respondents to self-sampling had moderate and severe under-screening histories. Model outcomes included quality-adjusted life-years (QALY) and lifetime costs. The ‘most cost-effective’ strategy was identified as the strategy just below $100,000 per QALY gained. Results Mailing self-sampling device kits to all women non-compliant to screening within a 5-year or 10-year period can be more effective and less costly than the current reminder letter policy; however, the optimal self-sampling strategy was dependent on the profile of self-sampling respondents. For example, ‘10-yearly self-sampling’ is preferred ($95,500 per QALY gained) if ‘5-yearly self-sampling’ could only attract moderate under-screeners; however, ‘5-yearly self-sampling’ is preferred if this strategy could additionally attract severe under-screeners. Conclusions Targeted self-sampling of non-compliers likely represents good value-for-money; however, the preferred strategy is contingent on the screening histories and compliance of respondents. Impact The magnitude of the health benefit and optimal self-sampling strategy is dependent on the profile and behavior of respondents. Health authorities should understand these factors prior to selecting and implementing a self-sampling policy. PMID:27624639

The Cost-Effectiveness of Cervical Self-Sampling to Improve Routine Cervical Cancer Screening: The Importance of Respondent Screening History and Compliance.

PubMed

Burger, Emily A; Sy, Stephen; Nygård, Mari; Kim, Jane J

2017-01-01

Human papillomavirus (HPV) testing allows women to self-collect cervico-vaginal cells at home (i.e., self-sampling). Using primary data from a randomized pilot study, we evaluated the long-term consequences and cost-effectiveness of using self-sampling to improve participation to routine cervical cancer screening in Norway. We compared a strategy reflecting screening participation (using reminder letters) to strategies that involved mailing self-sampling device kits to women noncompliant to screening within a 5- or 10-year period under two scenarios: (A) self-sampling respondents had moderate under-screening histories, or (B) respondents to self-sampling had moderate and severe under-screening histories. Model outcomes included quality-adjusted life-years (QALY) and lifetime costs. The "most cost-effective" strategy was identified as the strategy just below $100,000 per QALY gained. Mailing self-sampling device kits to all women noncompliant to screening within a 5- or 10-year period can be more effective and less costly than the current reminder letter policy; however, the optimal self-sampling strategy was dependent on the profile of self-sampling respondents. For example, "10-yearly self-sampling" is preferred ($95,500 per QALY gained) if "5-yearly self-sampling" could only attract moderate under-screeners; however, "5-yearly self-sampling" is preferred if this strategy could additionally attract severe under-screeners. Targeted self-sampling of noncompliers likely represents good value-for-money; however, the preferred strategy is contingent on the screening histories and compliance of respondents. The magnitude of the health benefit and optimal self-sampling strategy is dependent on the profile and behavior of respondents. Health authorities should understand these factors prior to selecting and implementing a self-sampling policy. Cancer Epidemiol Biomarkers Prev; 26(1); 95-103. ©2016 AACR. ©2016 American Association for Cancer Research.

Development of an Airborne Micropulse Water Vapor DIAL

NASA Astrophysics Data System (ADS)

Nehrir, A. R.; Ismail, S.

2012-12-01

Water vapor plays a key role in many atmospheric processes affecting both weather and climate. Airborne measurements of tropospheric water vapor profiles have been a longstanding observational need to not only the active remote sensing community but also to the meteorological, weather forecasting, and climate/radiation science communities. Microscale measurements of tropospheric water vapor are important for enhancing near term meteorological forecasting capabilities while mesoscale and synopticscale measurements can lead to an enhanced understanding of the complex coupled feedback mechanisms between water vapor, temperature, aerosols, and clouds. To realize tropospheric measurements of water vapor profiles over the microscale-synopticscale areas of meteorological interest, a compact and cost effective airborne micropulse differential absorption lidar (DIAL) is being investigated using newly emerging semiconductor based laser technology. Ground based micropulse DIAL (MPD) measurements of tropospheric water vapor and aerosol profiles up to 6 km and 15 km, respectively, have been previously demonstrated using an all semiconductor based laser transmitter. The DIAL transmitter utilizes a master oscillator power amplifier (MOPA) configuration where two semiconductor seed lasers are used to seed a single pass traveling wave tapered semiconductor optical amplifier (TSOA), producing up to 7μJ pulse energies over a 1 μs pulse duration at a 10 kHz pulse repetition frequency (PRF). Intercomparisons between the ground based instrument measurements and radiosonde profiles demonstrating the MPD performance under varying atmospheric conditions will be presented. Work is currently ongoing to expand upon the ground based MPD concept and to develop a compact and cost effective system capable of deployment on a mid-low altitude aircraft such as the NASA Langley B200 King Air. Initial lab experiments show that a two-three fold increase in the laser energy compared to the ground based instrument is achievable via overdriven current pulses to the TSOA gain medium while maintaining a 1μs and 10 kHz pulse width and PRF, respectively. The increase in the laser transmitter pulse energy will allow for nighttime and daytime water vapor profile retrievals from an airborne platform operating at an 8 km altitude with 2-5 minute integration periods. Results from a numerical model demonstrating the performance of an airborne DIAL system with the mentioned transmitter enhancements will be presented and compared against the existing ground based instrument performance. Furthermore, results from laboratory experiments demonstrating the laser transmitter performance including maximum extractable energy, energy stability, and spectral purity will also be presented.

Profiles of childhood adversities in pathological gamblers - A latent class analysis.

PubMed

Lotzin, Annett; Ulas, Mehmet; Buth, Sven; Milin, Sascha; Kalke, Jens; Schäfer, Ingo

2018-06-01

Despite of high rates of adverse childhood experiences (ACEs) in pathological gamblers, researchers have rarely studied which types of ACEs often co-occur and how these profiles of ACEs are related to current psychopathology. We aimed to identify profiles of ACEs in pathological gamblers and examined how these profiles were related to gambling-related characteristics and current general psychopathology. In 329 current or lifetime pathological gamblers, diagnosed with the Composite Diagnostic Interview for DSM-IV, 10 types of ACEs were measured using the Adverse Childhood Experiences Questionnaire. Global psychopathology was assessed using the Symptom Checklist SCL-27. ACE profiles were identified using latent class analysis. Differences between ACE profiles in gambling-related characteristics and global psychopathology were analyzed using MANOVA. We found that four out of five gamblers (n=257, 78.1%) reported at least one ACE. Four distinct ACE profiles were identified: 'Low ACE', 'High ACE', 'Physical and emotional abuse', and 'Neglect'. The number of the fulfilled pathological gambling criteria and the severity of current global psychopathology differed between the ACE profiles: Gamblers with a 'High ACE' profile fulfilled more pathological gambling criteria and showed a more severe current psychopathology than gamblers of the 'Low ACE' profile. Gamblers with a 'Physical and emotional abuse' or an 'Emotion neglect' profile showed an intermediate severity of psychopathology. Our findings indicate that four different ACE profiles can be distinguished in pathological gamblers that differed in their gambling-related characteristics and current psychopathology. Systematic assessment of profiles of ACEs in pathological gamblers may inform about the severity of current global psychopathology that might be important to be addressed in addition to gambling-specific treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multigene assays and molecular markers in breast cancer: systematic review of health economic analyses.

PubMed

Rouzier, Roman; Pronzato, Paolo; Chéreau, Elisabeth; Carlson, Josh; Hunt, Barnaby; Valentine, William J

2013-06-01

Breast cancer is the most common female cancer and is associated with a significant clinical and economic burden. Multigene assays and molecular markers represent an opportunity to direct chemotherapy only to patients likely to have significant benefit. This systematic review examines published health economic analyses to assess the support for adjuvant therapy decision making. Literature searches of PubMed, the Cochrane Library, and congress databases were carried out to identify economic evaluations of multigene assays and molecular markers published between 2002 and 2012. After screening and data extraction, study quality was assessed using the Quality of Health Economic Studies instrument. The review identified 29 publications that reported evaluations of two assays: Oncotype DX(®) and MammaPrint. Studies of both tests provided evidence that their routine use was cost saving or cost-effective versus conventional approaches. Benefits were driven by optimal allocation of adjuvant chemotherapy and reduction in chemotherapy utilization. Findings were sensitive to variation in the frequency of chemotherapy prescription, chemotherapy costs, and patients' risk profiles. Evidence suggests that multigene assays are likely cost saving or cost-effective relative to current approaches to adjuvant therapy. They should benefit decision making in early-stage breast cancer in a variety of settings worldwide.

Modeling streamflow from coupled airborne laser scanning and acoustic Doppler current profiler data

USGS Publications Warehouse

Norris, Lam; Kean, Jason W.; Lyon, Steve

2016-01-01

The rating curve enables the translation of water depth into stream discharge through a reference cross-section. This study investigates coupling national scale airborne laser scanning (ALS) and acoustic Doppler current profiler (ADCP) bathymetric survey data for generating stream rating curves. A digital terrain model was defined from these data and applied in a physically based 1-D hydraulic model to generate rating curves for a regularly monitored location in northern Sweden. Analysis of the ALS data showed that overestimation of the streambank elevation could be adjusted with a root mean square error (RMSE) block adjustment using a higher accuracy manual topographic survey. The results of our study demonstrate that the rating curve generated from the vertically corrected ALS data combined with ADCP data had lower errors (RMSE = 0.79 m3/s) than the empirical rating curve (RMSE = 1.13 m3/s) when compared to streamflow measurements. We consider these findings encouraging as hydrometric agencies can potentially leverage national-scale ALS and ADCP instrumentation to reduce the cost and effort required for maintaining and establishing rating curves at gauging station sites similar to the Röån River.

One-step fabrication of nanostructure-covered microstructures using selective aluminum anodization based on non-uniform electric field

NASA Astrophysics Data System (ADS)

Park, Yong Min; Kim, Byeong Hee; Seo, Young Ho

2016-06-01

This paper presents a selective aluminum anodization technique for the fabrication of microstructures covered by nanoscale dome structures. It is possible to fabricate bulging microstructures, utilizing the different growth rates of anodic aluminum oxide in non-uniform electric fields, because the growth rate of anodic aluminum oxide depends on the intensity of electric field, or current density. After anodizing under a non-uniform electric field, bulging microstructures covered by nanostructures were fabricated by removing the residual aluminum layer. The non-uniform electric field induced by insulative micropatterns was estimated by computational simulations and verified experimentally. Utilizing computational simulations, the intensity profile of the electric field was calculated according to the ratio of height and width of the insulative micropatterns. To compare computational simulation results and experimental results, insulative micropatterns were fabricated using SU-8 photoresist. The results verified that the shape of the bottom topology of anodic alumina was strongly dependent on the intensity profile of the applied electric field, or current density. The one-step fabrication of nanostructure-covered microstructures can be applied to various fields, such as nano-biochip and nano-optics, owing to its simplicity and cost effectiveness.

Functional Status, Quality of Life, and Costs Associated With Fibromyalgia Subgroups: A Latent Profile Analysis.

PubMed

Luciano, Juan V; Forero, Carlos G; Cerdà-Lafont, Marta; Peñarrubia-María, María Teresa; Fernández-Vergel, Rita; Cuesta-Vargas, Antonio I; Ruíz, José M; Rozadilla-Sacanell, Antoni; Sirvent-Alierta, Elena; Santo-Panero, Pilar; García-Campayo, Javier; Serrano-Blanco, Antoni; Pérez-Aranda, Adrián; Rubio-Valera, María

2016-10-01

Although fibromyalgia syndrome (FM) is considered a heterogeneous condition, there is no generally accepted subgroup typology. We used hierarchical cluster analysis and latent profile analysis to replicate Giesecke's classification in Spanish FM patients. The second aim was to examine whether the subgroups differed in sociodemographic characteristics, functional status, quality of life, and in direct and indirect costs. A total of 160 FM patients completed the following measures for cluster derivation: the Center for Epidemiological Studies-Depression Scale, the Trait Anxiety Inventory, the Pain Catastrophizing Scale, and the Control over Pain subscale. Pain threshold was measured with a sphygmomanometer. In addition, the Fibromyalgia Impact Questionnaire-Revised, the EuroQoL-5D-3L, and the Client Service Receipt Inventory were administered for cluster validation. Two distinct clusters were identified using hierarchical cluster analysis ("hypersensitive" group, 69.8% and "functional" group, 30.2%). In contrast, the latent profile analysis goodness-of-fit indices supported the existence of 3 FM patient profiles: (1) a "functional" profile (28.1%) defined as moderate tenderness, distress, and pain catastrophizing; (2) a "dysfunctional" profile (45.6%) defined by elevated tenderness, distress, and pain catastrophizing; and (3) a "highly dysfunctional and distressed" profile (26.3%) characterized by elevated tenderness and extremely high distress and catastrophizing. We did not find significant differences in sociodemographic characteristics between the 2 clusters or among the 3 profiles. The functional profile was associated with less impairment, greater quality of life, and lower health care costs. We identified 3 distinct profiles which accounted for the heterogeneity of FM patients. Our findings might help to design tailored interventions for FM patients.

Profiling of the injected charge drift current transients by cross-sectional scanning technique

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

Gaubas, E., E-mail: eugenijus.gaubas@ff.vu.lt; Ceponis, T.; Pavlov, J.

2014-02-07

The electric field distribution and charge drift currents in Si particle detectors are analyzed. Profiling of the injected charge drift current transients has been implemented by varying charge injection position within a cross-sectional boundary of the particle detector. The obtained profiles of the induction current density and duration of the injected charge drift pulses fit well the simulated current variations. Induction current transients have been interpreted by different stages of the bipolar and monopolar drift of the injected carriers. Profiles of the injected charge current transients registered in the non-irradiated and neutron irradiated Si diodes are compared. It has beenmore » shown that the mixed regime of the competing processes of drift, recombination, and diffusion appears in the measured current profiles on the irradiated samples. The impact of the avalanche effects can be ignored based on the investigations presented. It has been shown that even a simplified dynamic model enabled us to reproduce the main features of the profiled transients of induced charge drift current.« less

Development of a low-cost detection method for miRNA microarray.

PubMed

Li, Wei; Zhao, Botao; Jin, Youxin; Ruan, Kangcheng

2010-04-01

MicroRNA (miRNA) microarray is a powerful tool to explore the expression profiling of miRNA. The current detection method used in miRNA microarray is mainly fluorescence based, which usually requires costly detection system such as laser confocal scanner of tens of thousands of dollars. Recently, we developed a low-cost yet sensitive detection method for miRNA microarray based on enzyme-linked assay. In this approach, the biotinylated miRNAs were captured by the corresponding oligonucleotide probes immobilized on microarray slide; and then the biotinylated miRNAs would capture streptavidin-conjugated alkaline phosphatase. A purple-black precipitation on each biotinylated miRNA spot was produced by the enzyme catalytic reaction. It could be easily detected by a charge-coupled device digital camera mounted on a microscope, which lowers the detection cost more than 100 fold compared with that of fluorescence method. Our data showed that signal intensity of the spot correlates well with the biotinylated miRNA concentration and the detection limit for miRNAs is at least 0.4 fmol and the detection dynamic range spans about 2.5 orders of magnitude, which is comparable to that of fluorescence method.

Tilt Current Meter Field Validation in the Surf Zone

NASA Astrophysics Data System (ADS)

Anarde, K.; Myres, H.; Figlus, J.

2016-12-01

Tilt current meters (TCMs) are a low-cost way of measuring current velocities in coastal waters. They consist of a slightly buoyant floater, tilt sensor assembly, and internal logger tethered to a fixed base. TCMs measure the tilt of the sensor induced by the forces of the flowing water to infer local current velocity. They have been successfully deployed to measure unidirectional flows in rivers and slowly oscillating flows in tidally influenced bodies of water where the inertia of the instrument does not create a problem. Here we attempt to validate an array of TCMs for use in the surf zone where waves, wave bores, and alongshore currents dominate the hydrodynamics in relatively shallow water (0.3 - 2.0 m) with relatively high oscillatory frequencies. A series of test deployments using seven measuring pods outfitted with TCMs and pressure transducers were conducted in the surf zone off Galveston Island, Texas. Field experiments were supported by laboratory tests of the instrument assemblies in a moveable-bed wave flume. Instrument pod design was optimized over the series of tests to minimize issues caused by scouring, sedimentation, and overturning. The end design consists of a low-profile concrete base plate secured to the bed by sand stakes. Field measurements of tilt and bearing were calibrated against co-located acoustic Doppler velocimeter (ADV) and wave-current profiler (ADCP) measurements as well as laboratory-supplied calibration curves. While optimization of the setup is ongoing, the initial field studies show good correlation between instrument pairs. If successfully validated, the TCMs will be used as part of an instrument array designed to measure overland flow dynamics during extreme storms. Other potential uses include detailed analysis of spatial and temporal gradients in nearshore hydrodynamics such as the complex flow scenarios through tidal inlets and around barrier islands.

Acoustic Doppler current profiler applications used in rivers and estuaries by the U.S. Geological Survey

USGS Publications Warehouse

Gotvald, Anthony J.; Oberg, Kevin A.

2009-01-01

The U.S. Geological Survey (USGS) has collected streamflow information for the Nation's streams since 1889. Streamflow information is used to predict floods, manage and allocate water resources, design engineering structures, compute water-quality loads, and operate water-control structures. The current (2007) size of the USGS streamgaging network is over 7,400 streamgages nationwide. The USGS has progressively improved the streamgaging program by incorporating new technologies and techniques that streamline data collection while increasing the quality of the streamflow data that are collected. The single greatest change in streamflow measurement technology during the last 100 years has been the development and application of high frequency acoustic instruments for measuring streamflow. One such instrument, the acoustic Doppler current profiler (ADCP), is rapidly replacing traditional mechanical current meters for streamflow measurement (Muste and others, 2007). For more information on how an ADCP works see Simpson (2001) or visit http://hydroacoustics.usgs.gov/. The USGS has used ADCPs attached to manned or tethered boats since the mid-1990s to measure streamflow in a wide variety of conditions (fig. 1). Recent analyses have shown that ADCP streamflow measurements can be made with similar or greater accuracy, efficiency, and resolution than measurements made using conventional current-meter methods (Oberg and Mueller, 2007). ADCPs also have the ability to measure streamflow in streams where traditional current-meter measurements previously were very difficult or costly to obtain, such as streams affected by backwater or tides. In addition to streamflow measurements, the USGS also uses ADCPs for other hydrologic measurements and applications, such as computing continuous records of streamflow for tidally or backwater affected streams, measuring velocity fields with high spatial and temporal resolution, and estimating suspended-sediment concentrations. An overview of these applications is provided in the fact sheet.

The injury profile and acute treatment costs of major trauma in older people in New South Wales.

PubMed

Curtis, Kate; Chan, Daniel Leonard; Lam, Mary Kit; Mitchell, Rebecca; King, Kate; Leonard, Liz; D'Amours, Scott; Black, Deborah

2014-12-01

To Describe injury profile and costs of older person trauma in New South Wales; quantify variations with peer group costs; and identify predictors of higher costs. Nine level 1 New South Wales trauma centres provided data on major traumas (aged ≥ 55 years) during 2008-2009 financial year. Trauma register and financial data of each institution were linked. Treatment costs were compared with peer group Australian Refined Diagnostic Related Groups costs, on which hospital funding is based. Variables examined through multivariate analyses. Six thousand two hundred and eighty-nine patients were admitted for trauma. Most common injury mechanism was falls (74.8%) then road trauma (14.9%). Median patient cost was $7044 (Q1-3: $3405-13 930) and total treatment costs $76 694 252. Treatment costs were $5 813 975 above peer group average. Intensive care unit admission, age, injury severity score, length of stay and traumatic brain injury were independent predictors of increased costs. Older person trauma attracts greater costs and length of stay. Cost increases with age and injury severity. Hospital financial information and trauma registry data provides accurate cost information that may inform future funding. © 2013 ACOTA.

The cost-effectiveness of bevacizumab, ranibizumab and aflibercept for the treatment of age-related macular degeneration-A cost-effectiveness analysis from a societal perspective.

PubMed

van Asten, Freekje; Michels, Charlotte T J; Hoyng, Carel B; van der Wilt, Gert Jan; Klevering, B Jeroen; Rovers, Maroeska M; Grutters, Janneke P C

2018-01-01

The discussion on the use of bevacizumab is still ongoing and often doctors are deterred from using bevacizumab due to legal or political issues. Bevacizumab is an effective, safe and inexpensive treatment option for neovascular age-related macular degeneration (AMD), albeit unregistered for the disease. Therefore, in some countries ophthalmologists use the equally effective but expensive drugs ranibizumab and aflibercept. We describe the economic consequences of this dilemma surrounding AMD treatment from a societal perspective. We modelled cost-effectiveness of treatment with ranibizumab (as-needed), aflibercept (bimonthly) and bevacizumab (as-needed). Effectiveness was estimated by systematic review and meta-analysis. The drug with the most favourable cost-effectiveness profile compared to bevacizumab was used for threshold analyses. First, we determined how much we overspend per injection. Second, we calculated the required effectiveness to justify the current price and the reasonable price for a drug leading to optimal vision. Finally, we estimated how much Europe overspends if bevacizumab is not first choice. Bevacizumab treatment costs €27,087 per year, about €4,000 less than aflibercept and €6,000 less than ranibizumab. With similar effectiveness for all drugs as shown by meta-analysis, bevacizumab was the most cost-effective. Aflibercept was chosen for threshold analyses. Aflibercept costs €943 per injection, but we determined that the maximum price to be cost-effective is €533. Alternatively, at its current price, aflibercept should yield about twice the visual gain. Even when optimal vision can be achieved, the maximum price for any treatment is €37,453 per year. Most importantly, Europe overspends €335 million yearly on AMD treatment when choosing aflibercept over bevacizumab. Bevacizumab is the most cost-effective treatment for AMD, yet is not the standard of care across Europe. The registered drugs ranibizumab and aflibercept lead to large overspending without additional health benefits. Health authorities should consider taking steps to implement bevacizumab into clinical practice as first choice.

Health economics in radiation oncology: introducing the ESTRO HERO project.

PubMed

Lievens, Yolande; Grau, Cai

2012-04-01

New evidence based regimens and novel high precision technology have reinforced the important role of radiotherapy in the management of cancer. Current data estimate that more than 50% of all cancer patients would benefit from radiotherapy during the course of their disease. Within recent years, the radiotherapy community has become more than conscious of the ever-increasing necessity to come up with objective data to endorse the crucial role and position of radiation therapy within the rapidly changing global oncology landscape. In an era of ever expanding health care costs, proven safety and effectiveness is not sufficient anymore to obtain funding, objective data about cost and cost-effectiveness are nowadays additionally requested. It is in this context that ESTRO is launching the HERO-project (Health Economics in Radiation Oncology), with the overall aim to develop a knowledge base and a model for health economic evaluation of radiation treatments at the European level. To accomplish these objectives, the HERO project will address needs, accessibility, cost and cost-effectiveness of radiotherapy. The results will raise the profile of radiotherapy in the European cancer management context and help countries prioritizing radiotherapy as a highly cost-effective treatment strategy. This article describes the different steps and aims within the HERO-project, starting from evidence on the role of radiotherapy within the global oncology landscape and highlighting weaknesses that may undermine this position. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Landslides in Colorado, USA--Impacts and loss estimation for 2010

USGS Publications Warehouse

Highland, Lynn M.

2012-01-01

The focus of this study is to investigate landslides and consequent losses which affected Colorado in the year 2010. By obtaining landslide reports from a variety of sources, this report will demonstrate the feasibility of creating a profile of landslides and their effects on communities. A short overview of the current status of landslide-loss studies for the United States is introduced, followed by a compilation of landslide occurrence and associated losses and impacts which affected Colorado for the year 2010. Direct costs are summarized in descriptive and tabular form, and where possible, indirect costs are also noted or estimated. Total direct costs of landslides in Colorado for the year 2010 were approximately $9,149,335.00 (2010 U.S. dollars). (Since not all data for damages and costs were obtained, this figure realistically could be considerably higher.) Indirect costs were noted where available but are not totaled due to the fact that most indirect costs were not obtainable for various reasons outlined later in this report. Casualty data are considered as being within the scope of loss evaluation, and are reported in Appendix 1, but are not assigned dollar losses. More details on the source material for loss data not found in the reference section are reported in Appendix 2, and Appendix 3 summarizes notes on landslide-loss investigations in general and lessons learned during the process of loss-data collection.

Cost-effectiveness analysis of ibrutinib in patients with Waldenström macroglobulinemia in Italy.

PubMed

Aiello, Andrea; D'Ausilio, Anna; Lo Muto, Roberta; Randon, Francesca; Laurenti, Luca

2017-01-01

Background and Objective: Ibrutinib has recently been approved in Europe for Waldenström Macroglobulinemia (WM) in symptomatic patients who have received at least one prior therapy, or in first-line treatment for patients unsuitable for chemo-immunotherapy. The aim of the study is to estimate the incremental cost-effectiveness ratio (ICER) of ibrutinib in relapse/refractory WM, compared with the Italian current therapeutic pathways (CTP). Methods: A Markov model was adapted for Italy considering the National Health System perspective. Input data from literature as well as global trials were used. The percentage use of therapies, and healthcare resources consumption were estimated according to expert panel advice. Drugs ex-factory prices and national tariffs were used for estimating costs. The model had a 15-year time horizon, with a 3.0% discount rate for both clinical and economic data. Deterministic and probabilistic sensitivity analyses were performed to test the results strength. Results: Ibrutinib resulted in increased Life Years Gained (LYGs) and increased costs compared to CTP, with an ICER of €52,698/LYG. Sensitivity analyses confirmed the results of the BaseCase. Specifically, in the probabilistic analysis, at a willingness to pay threshold of €60,000/LYG ibrutinib was cost-effective in 84% of simulations. Conclusions: Ibrutinib has demonstrated a positive cost-effectiveness profile in Italy.

Intrinsic Remediation Engineering Evaluation/Cost Analysis for Site SS27/XYZ Dover AFB, Dover, DE

DTIC Science & Technology

1996-01-01

and Output Files APPENDIX F Analytical Models APPENDIX G Costing Worksheets and Present Worth Calculations TABLES No. Title Page 2.1 CPT Activity and...8217 ............................................................... 4-38 _ 4.19 Redox Potential Map for Groundwater ......................................... 4-42 4.20 Vertical Profile of Redox Isopleths for...Groundwater Cross-Section C-C ’. ............................................................... 4-43 4.21 Vertical Profile of Redox Isopleths for

Separation of the principal HDL subclasses by iodixanol ultracentrifugation

PubMed Central

Harman, Nicola L.; Griffin, Bruce A.; Davies, Ian G.

2013-01-01

HDL subclasses detection, in cardiovascular risk, has been limited due to the time-consuming nature of current techniques. We have developed a time-saving and reliable separation of the principal HDL subclasses employing iodixanol density gradient ultracentrifugation (IxDGUC) combined with digital photography. HDL subclasses were separated in 2.5 h from prestained plasma on a three-step iodixanol gradient. HDL subclass profiles were generated by digital photography and gel scan software. Plasma samples (n = 46) were used to optimize the gradient for the resolution of HDL heterogeneity and to compare profiles generated by IxDGUC with gradient gel electrophoresis (GGE); further characterization from participants (n = 548) with a range of lipid profiles was also performed. HDL subclass profiles generated by IxDGUC were comparable to those separated by GGE as indicated by a significant association between areas under the curve for both HDL2 and HDL3 (HDL2, r = 0.896, P < 0.01; HDL3, r = 0.894, P < 0.01). The method was highly reproducible, with intra- and interassay coefficient of variation percentage < 5 for percentage area under the curve HDL2 and HDL3, and < 1% for peak Rf and peak density. The method provides time-saving and cost-effective detection and preparation of the principal HDL subclasses. PMID:23690506

In vitro steroid profiling system for the evaluation of endocrine disruptors.

PubMed

Nakano, Yosuke; Yamashita, Toshiyuki; Okuno, Masashi; Fukusaki, Eiichiro; Bamba, Takeshi

2016-09-01

Endocrine disruptors (ED) are chemicals that affect various aspects of the endocrine system, often leading to the inhibition of steroidogenesis. Current chemical safety policies that restrict human exposure to such chemicals describe often time-consuming and costly methods for the evaluation of ED effects. We aimed to develop an effective tool for accurate phenotypic chemical toxicology studies. We developed an in vitro ED evaluation system using gas chromatography/mass spectrometry (GC/MS/MS) methods for metabolomic analysis of multi-marker profiles. Accounting for sample preparation and GC/MS/MS conditions, we established a screening method that allowed the simultaneous analysis of 17 steroids with good reproducibility and a linear calibration curve. Moreover, we applied the developed system to H295R human adrenocortical cells exposed to forskolin and prochloraz in accordance with the Organization for Economic Cooperation and Development (OECD) guidelines and observed dose-dependent variations in steroid profiles. While the OECD guidelines include only testosterone and 17β-estradiol, our system enabled a comprehensive and highly sensitive analysis of steroid profile alteration due to ED exposure. The application of our ED evaluation screen could be economical and provide novel insights into the hazards of ED exposure to the endocrine system. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

Measuring the Electronic Properties of DNA-Specific Schottky Diodes Towards Detecting and Identifying Basidiomycetes DNA

PubMed Central

Periasamy, Vengadesh; Rizan, Nastaran; Al-Ta’ii, Hassan Maktuff Jaber; Tan, Yee Shin; Tajuddin, Hairul Annuar; Iwamoto, Mitsumasa

2016-01-01

The discovery of semiconducting behavior of deoxyribonucleic acid (DNA) has resulted in a large number of literatures in the study of DNA electronics. Sequence-specific electronic response provides a platform towards understanding charge transfer mechanism and therefore the electronic properties of DNA. It is possible to utilize these characteristic properties to identify/detect DNA. In this current work, we demonstrate a novel method of DNA-based identification of basidiomycetes using current-voltage (I-V) profiles obtained from DNA-specific Schottky barrier diodes. Electronic properties such as ideality factor, barrier height, shunt resistance, series resistance, turn-on voltage, knee-voltage, breakdown voltage and breakdown current were calculated and used to quantify the identification process as compared to morphological and molecular characterization techniques. The use of these techniques is necessary in order to study biodiversity, but sometimes it can be misleading and unreliable and is not sufficiently useful for the identification of fungi genera. Many of these methods have failed when it comes to identification of closely related species of certain genus like Pleurotus. Our electronics profiles, both in the negative and positive bias regions were however found to be highly characteristic according to the base-pair sequences. We believe that this simple, low-cost and practical method could be useful towards identifying and detecting DNA in biotechnology and pathology. PMID:27435636

Measuring the Electronic Properties of DNA-Specific Schottky Diodes Towards Detecting and Identifying Basidiomycetes DNA

NASA Astrophysics Data System (ADS)

Periasamy, Vengadesh; Rizan, Nastaran; Al-Ta'Ii, Hassan Maktuff Jaber; Tan, Yee Shin; Tajuddin, Hairul Annuar; Iwamoto, Mitsumasa

2016-07-01

The discovery of semiconducting behavior of deoxyribonucleic acid (DNA) has resulted in a large number of literatures in the study of DNA electronics. Sequence-specific electronic response provides a platform towards understanding charge transfer mechanism and therefore the electronic properties of DNA. It is possible to utilize these characteristic properties to identify/detect DNA. In this current work, we demonstrate a novel method of DNA-based identification of basidiomycetes using current-voltage (I-V) profiles obtained from DNA-specific Schottky barrier diodes. Electronic properties such as ideality factor, barrier height, shunt resistance, series resistance, turn-on voltage, knee-voltage, breakdown voltage and breakdown current were calculated and used to quantify the identification process as compared to morphological and molecular characterization techniques. The use of these techniques is necessary in order to study biodiversity, but sometimes it can be misleading and unreliable and is not sufficiently useful for the identification of fungi genera. Many of these methods have failed when it comes to identification of closely related species of certain genus like Pleurotus. Our electronics profiles, both in the negative and positive bias regions were however found to be highly characteristic according to the base-pair sequences. We believe that this simple, low-cost and practical method could be useful towards identifying and detecting DNA in biotechnology and pathology.

Peregrine

PubMed Central

Langevin, Stanley A.; Bent, Zachary W.; Solberg, Owen D.; Curtis, Deanna J.; Lane, Pamela D.; Williams, Kelly P.; Schoeniger, Joseph S.; Sinha, Anupama; Lane, Todd W.; Branda, Steven S.

2013-01-01

Use of second generation sequencing (SGS) technologies for transcriptional profiling (RNA-Seq) has revolutionized transcriptomics, enabling measurement of RNA abundances with unprecedented specificity and sensitivity and the discovery of novel RNA species. Preparation of RNA-Seq libraries requires conversion of the RNA starting material into cDNA flanked by platform-specific adaptor sequences. Each of the published methods and commercial kits currently available for RNA-Seq library preparation suffers from at least one major drawback, including long processing times, large starting material requirements, uneven coverage, loss of strand information and high cost. We report the development of a new RNA-Seq library preparation technique that produces representative, strand-specific RNA-Seq libraries from small amounts of starting material in a fast, simple and cost-effective manner. Additionally, we have developed a new quantitative PCR-based assay for precisely determining the number of PCR cycles to perform for optimal enrichment of the final library, a key step in all SGS library preparation workflows. PMID:23558773

Review of Variable Generation Integration Charges

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

Porter, K.; Fink, S.; Buckley, M.

2013-03-01

The growth of wind and solar generation in the United States, and the expectation of continued growth of these technologies, dictates that the future power system will be operated in a somewhat different manner because of increased variability and uncertainty. A small number of balancing authorities have attempted to determine an 'integration cost' to account for these changes to their current operating practices. Some balancing authorities directly charge wind and solar generators for integration charges, whereas others add integration charges to projected costs of wind and solar in integrated resource plans or in competitive solicitations for generation. This report reviewsmore » the balancing authorities that have calculated variable generation integration charges and broadly compares and contrasts the methodologies they used to determine their specific integration charges. The report also profiles each balancing authority and how they derived wind and solar integration charges.« less

Design of a Low Power, Fast-Spectrum, Liquid-Metal Cooled Surface Reactor System

NASA Astrophysics Data System (ADS)

Marcille, T. F.; Dixon, D. D.; Fischer, G. A.; Doherty, S. P.; Poston, D. I.; Kapernick, R. J.

2006-01-01

In the current 2005 US budget environment, competition for fiscal resources make funding for comprehensive space reactor development programs difficult to justify and accommodate. Simultaneously, the need to develop these systems to provide planetary and deep space-enabling power systems is increasing. Given that environment, designs intended to satisfy reasonable near-term surface missions, using affordable technology-ready materials and processes warrant serious consideration. An initial lunar application design incorporating a stainless structure, 880 K pumped NaK coolant system and a stainless/UO2 fuel system can be designed, fabricated and tested for a fraction of the cost of recent high-profile reactor programs (JIMO, SP-100). Along with the cost reductions associated with the use of qualified materials and processes, this design offers a low-risk, high-reliability implementation associated with mission specific low temperature, low burnup, five year operating lifetime requirements.

Use of automated rendezvous trajectory planning to improve spacecraft operations efficiency

NASA Technical Reports Server (NTRS)

Mulder, Tom A.

1991-01-01

The current planning process for space shuttle rendezvous with a second Earth-orbiting vehicle is time consuming and costly. It is a labor-intensive, manual process performed pre-mission with the aid of specialized maneuver processing tools. Real-time execution of a rendezvous plan must closely follow a predicted trajectory, and targeted solutions leading up to the terminal phase are computed on the ground. Despite over 25 years of Gemini, Apollo, Skylab, and shuttle vehicle-to-vehicle rendezvous missions flown to date, rendezvous in Earth orbit still requires careful monitoring and cannot be taken for granted. For example, a significant trajectory offset was experienced during terminal phase rendezvous of the STS-32 Long Duration Exposure Facility retrieval mission. Several improvements can be introduced to the present rendezvous planning process to reduce costs, produce more fuel-efficient profiles, and increase the probability of mission success.

Improved cost-effective fabrication of arbitrarily shaped μIPMC transducers

NASA Astrophysics Data System (ADS)

Feng, Guo-Hua; Chen, Ri-Hong

2008-01-01

Conventional ionic polymer-metal composite (IPMC) production cuts individual transducers from bulk IPMC sheets. This paper presents a novel photolithographic technique that grows a large array of identical devices on a thin (~µm range) parylene diaphragm supported on a perforated substrate of material that is immune to the subsequent processing liquids. In particular, the new technique relies on a unique wax fill-up and removal concept that can produce arbitrarily shaped Nafion films with micron feature size. The developed process is cheap and results in devices of high uniformity and reliability, with greater design flexibility. Microtensile testing characterizes the fracture profiles of the non-electroded Nafion film and IPMC. Young's modulus is characterized, as well as maximum displacement and current consumption under various loading, driving voltages, waveforms and frequencies. High product quality and low process costs make this process of interest for mass production of micromachined IPMC transducers.

Recovery of polyhydroxyalkanoates from municipal secondary wastewater sludge.

PubMed

Kumar, Manish; Ghosh, Pooja; Khosla, Khushboo; Thakur, Indu Shekhar

2018-05-01

In the current study, the feasibility of utilizing municipal secondary wastewater sludge for Polyhydroxyalkanoate (PHA) extraction was improved by optimization of various parameters (temperature, duration and concentration of sludge solids). Optimized process parameters resulted in PHA recovery of 0.605 g, significantly higher than un-optimized conditions. The characterization of PHA was carried out by GC-MS, FT-IR and NMR ( 1 H and 13 C) spectroscopy. The PHA profile was found to be dominated by mcl PHA (58%) along with other diverse PHA. The results of the present study show rich diversity of PHA extracted from a raw material which is readily available at minimal cost. In conclusion, exploring the potential of wastes for production of bioplastics not only reduces the cost of bioplastic production, but also provides a sustainable means for waste management. Copyright © 2018 Elsevier Ltd. All rights reserved.

RF current profile control studies in the alcator C-mod tokamak

NASA Astrophysics Data System (ADS)

Bonoli, P. T.; Porkolab, M.; Wukitch, S. J.; Bernabei, S.; Kaita, R.; Mikkelsen, D.; Phillips, C. K.; Schilling, G.

1999-09-01

Time dependent calculations of lower hybrid (LH) current profile control in Alcator C-Mod have been done using the TRANSP [1], FPPRF [2], and LSC [3] codes. Up to 3 MW of LH current drive power was applied in plasmas with high power ICRF minority heating (PICH=1.8-3 MW) and fast current ramp up. Using the experimentally measured temperature profiles, off-axis current generation resulted in nonmonotonic q-profiles with qmin~=1.6. Self-consistent effects of off-axis electron heating by the LH power were also included in the analysis and significant broadening of the electron temperature profile was found with qmin>~2 and a larger shear reversal radius.

Combining select neuropsychological assessment with blood-based biomarkers to detect mild Alzheimer's disease: a molecular neuropsychology approach.

PubMed

Edwards, Melissa; Balldin, Valerie Hobson; Hall, James; O'Bryant, Sid

2014-01-01

Current work has sought to establish a rapid and cost effective means of screening for Alzheimer's disease (AD) with the most recent findings showing utility of integrating blood-based biomarkers with cognitive measures. The current project sought to create a combined biomarker-cognitive profile to detect mild AD. Data was analyzed from 266 participants (129 AD cases [Early AD n = 93; Very Early AD n = 36]; 137 controls) enrolled in the Texas Alzheimer's Research and Care Consortium (TARCC). Non-fasting serum samples were collected from each participant and assayed via a multi-plex biomarker assay platform using electrochemiluminescence. Logistic Regression was utilized to detect early AD using two serum biomarkers (TNFα and IL7), demographic information (age), and one neuropsychological measure (Clock 4-point) as predictor variable. Disease severity was determined via Clinical Dementia Rating (CDR) scale global scores. In the total sample (all levels of CDR scores), the combination of biomarkers, cognitive test score, and demographics yielded the obtained sensitivity (SN) of 0.94, specificity (SP) of 0.90, and an overall accuracy of 0.92. When examining early AD cases (i.e.m CDR = 0.5-1), the biomarker-cognitive profile yielded SN of 0.94, SP of 0.85, and an overall accuracy of 0.91. When restricted to very early AD cases (i.e., CDR = 0.5), the biomarker-cognitive profile yielded SN of 0.97 and SP of 0.72, with an overall accuracy of 0.91. The combination of demographics, two biomarkers, and one cognitive test created a biomarker-cognitive profile that was highly accurate in detecting the presence of AD, even in the very early stages.

Economic evaluation of Avonex (interferon beta-Ia) in patients following a single demyelinating event.

PubMed

Iskedjian, Michael; Walker, John H; Gray, Trevor; Vicente, Colin; Einarson, Thomas R; Gehshan, Adel

2005-10-01

Interferon beta-Ia (Avonex) 30 microg, intramuscular (i.m.), once weekly is efficacious in delaying clinically definite multiple sclerosis (CDMS) following a single demyelinating event (SDE). This study determined the cost effectiveness of Avonex compared to current treatment in delaying the onset of CDMS. A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) were performed from Ministry of Health (MoH) and societal perspectives. For CEA, the outcome of interest was time spent in the pre-CDMS state, termed monosymptomatic life years (MLY) gained. For CUA, the outcome was quality-adjusted monosymptomatic life years (QAMLY) gained. A Markov model was developed with transitional probabilities and utilities derived from the literature. Costs were reported in 2002 Canadian dollars. Costs and outcomes were discounted at 5%. The time horizon was 12 years for the CEA, and 15 years for the CUA. All uncertainties were tested via univariate and multivariate sensitivity analyses. In the CEA, the incremental cost of Avonex per ILYgained was $53110 and $44789 from MoH and societal perspectives, respectively. In the CUA, the incremental cost of Avonex per QAMLY gained was $227586 and $189286 from MoH and societal perspectives, respectively. Both models were sensitive to the probability of progressing to CDMS and the analytical time horizon. The CUA was sensitive to the utilities value. Avonex may be considered as a reasonably cost-effective approach to treatment of patients experiencing an SDE In addition, the overall incremental cost-effectiveness profile of Avonex improves if treatment is initiated in pre-CDMS rather than waiting until CDMS.

Compact, low profile antennas for MSAT and mini-M and Std-M land mobile satellite communications

NASA Technical Reports Server (NTRS)

Strickland, P. C.

1995-01-01

CAL Corporation has developed a new class of low profile radiating elements for use in planar phased array antennas. These new elements have been used in the design of a low cost, compact, low profile antenna unit for MSAT and INMARSAT Mini-M land mobile satellite communications. The antenna unit which measures roughly 32 cm in diameter by 5 cm deep incorporates a compact LNA and diplexer unit as well as a complete, low cost, beam steering system. CAL has also developed a low profile antenna unit for INMARSAT-M land mobile satellite communications. A number of these units, which utilize a microstrip patch array design, were put into service in 1994.

Performance of diagnosis-based risk adjustment measures in a population of sick Australians.

PubMed

Duckett, S J; Agius, P A

2002-12-01

Australia is beginning to explore 'managed competition' as an organising framework for the health care system. This requires setting fair capitation rates, i.e. rates that adjust for the risk profile of covered lives. This paper tests two US-developed risk adjustment approaches using Australian data. Data from the 'co-ordinated care' dataset (which incorporates all service costs of 16,538 participants in a large health service research project conducted in 1996-99) were grouped into homogenous risk categories using risk adjustment 'grouper software'. The grouper products yielded three sets of homogenous categories: Diagnostic Groups and Diagnostic cost Groups. A two-stage analysis of predictive power was used: probability of any service use in the concurrent year, next year and the year after (logistic regression) and, for service users, a regression of logged cost of service use. The independent variables were diagnosis gender, a SES variable and the Age, gender and diagnosis-based risk adjustment measures explain around 40-45% of variation in costs of service use in the current year for untrimmed data (compared with around 15% for age and gender alone). Prediction of subsequent use is much poorer (around 20%). Using more information to assign people to risk categories generally improves prediction. Predictive power of diagnosis-base risk adjusters on this Australian dataset is similar to that found in Low predictive power carries policy risks of cream skimming rather than managing population health and care. Competitive funding models with risk adjustment on prior year experience could reduce system efficiency if implemented with current risk adjustment technology.

Liposomal bupivacaine for regional anesthesia.

PubMed

Uskova, Anna; O'Connor, Jessica E

2015-10-01

Using a regional block in a multimodal approach to postoperative analgesia management involves addressing, which local anesthetic and how much should be used to ensure adequate pain relief to reduce related morbidity and mortality. This article will review literature surrounding the recently approved formulation of slow release liposomal bupivacaine, define its proven benefits, and identify ongoing studies to further examine the utility of this novel formulation by various routes. Recent Phase II and III clinical trials have demonstrated the ability of liposomal bupivacaine to provide prolonged analgesia, maintain a high safety profile in therapeutic doses, and decrease opioid requirements when compared with placebo in local infiltration applications for up to 24 h. Between 24 and 72 h after study drug administration, there was minimal to no difference between EXPAREL and placebo treatments on mean pain intensity. Conventional bupivacaine or ropivacaine groups (current standard practice in many hospitals in the USA) were not compared. In addition, the analgesic efficacy, cost-effectiveness, and safety profile of liposomal bupivacaine has not thoroughly been studied in various standard clinical settings such as perineural, intrathecal, and epidural administration. Current published data do not provide superior clinical results for EXPAREL over conventional bupivacaine based upon the lack of adequately powered multicentered clinical trials with comparison groups. Further investigation is necessary to identify the analgesic efficacy and safety profile of liposomal bupivacaine versus standard local anesthetics and to define the optimal clinical indication for liposomal bupivacaine administration in regional anesthesia.

Modifications to the edge current profile with auxiliary edge current drive and improved confinement in a reversed-field pinch

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

Chapman, B.E.; Biewer, T.M.; Chattopadhyay, P.K.

2000-09-01

Auxiliary edge current drive is routinely applied in the Madison Symmetric Torus [R.N. Dexter, D. W. Kerst, T.W. Lovell et.al., Fusion Technol. 19, 131 (1991)] with the goal of modifying the parallel current profile to reduce current- driven magnetic fluctuations and the associated particle and energy transport. Provided by an inductive electric field, the current drive successfully reduces energy transport. First-time measurements of the modified edge current profile reveal that, relative to discharges without auxiliary current drive, the edge current density decreases. This decrease is explicable in terms of newly measured reductions in the dynamo (fluctuation-based) electric field and themore » electrical conductivity. Induced by the current drive, these two changes to the edge plasma play as much of a role in determining the resultant edge current profile as does the current drive itself.« less

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

none,

This Building America Top Innovations profile describes Building America research showing how some energy-efficiency measure cost increases can balance against measures that reduce up-front costs: Advanced framing cuts lumber costs, right sizing can mean downsizing the HVAC, moving HVAC into conditioned space cuts installation costs, designing on a 2-foot grid reduces materials waste, etc.

Anti-TNF-α therapies for the treatment of Crohn's disease: the past, present and future.

PubMed

Berns, Marc; Hommes, Daniel W

2016-01-01

Anti-TNF-α therapy is a novel approach that has transformed the way moderate-to-severe Crohn's disease (CD) is treated and has significantly improved clinical outcomes of patients with enhanced remission induction and maintenance efficacies. As a result, anti-TNF-α agents have become the primary cost driver in the treatment of CD, as the frequency of hospitalizations and surgical interventions have been drastically reduced. In the review, the authors cover current anti-TNF-α treatments for CD including efficacy, mechanisms of action, pharmacokinetics and safety. In addition, the authors discuss future anti-TNF-α agents currently in the development pipeline including biosimilars, golimumab, oral AVX-470, TNF-α-kinoid vaccine, and non-biologic HMPL-004. While new therapeutics are in the pipeline like anti-integrin and anti-interleukin therapeutics, anti-TNF-α therapy remains at the forefront of CD treatment due to its long-term efficacy and safety profiles. The next horizon for new anti-TNF-α agents is biosimilars, which offer comparable safety and effectiveness to the originator molecules. Biosimilars promise to expand accessibility to anti-TNF-α therapy while significantly reducing the cost burden to patients and healthcare systems.

Exploring the effects of population change on the costs of physician services.

PubMed

Denton, Frank T; Gafni, Amiram; Spencer, Byron G

2002-09-01

The effects of population aging on future health care costs are an important public policy concern in many countries. We focus in this paper on physician services and investigate how changes in the size and age distribution of a population can affect the aggregate and per capita costs of such services. The principal data set (unpublished, for Ontario) provides information about payments to physicians, by age and sex of patients. Using it, we derive age/cost profiles for 19 categories of physicians. Adopting an index-theoretic framework, we then use the profiles to analyse the "pure" effects of population change (historical and projected) on physician costs, and to decompose the effects into population growth effects and population aging effects. We present calculations for Ontario, for the population of 15 industrialized countries, and for four theoretical populations.

Performance Assessment of Model-Based Optimal Feedforward and Feedback Current Profile Control in NSTX-U using the TRANSP Code

NASA Astrophysics Data System (ADS)

Ilhan, Z.; Wehner, W. P.; Schuster, E.; Boyer, M. D.; Gates, D. A.; Gerhardt, S.; Menard, J.

2015-11-01

Active control of the toroidal current density profile is crucial to achieve and maintain high-performance, MHD-stable plasma operation in NSTX-U. A first-principles-driven, control-oriented model describing the temporal evolution of the current profile has been proposed earlier by combining the magnetic diffusion equation with empirical correlations obtained at NSTX-U for the electron density, electron temperature, and non-inductive current drives. A feedforward + feedback control scheme for the requlation of the current profile is constructed by embedding the proposed nonlinear, physics-based model into the control design process. Firstly, nonlinear optimization techniques are used to design feedforward actuator trajectories that steer the plasma to a desired operating state with the objective of supporting the traditional trial-and-error experimental process of advanced scenario planning. Secondly, a feedback control algorithm to track a desired current profile evolution is developed with the goal of adding robustness to the overall control scheme. The effectiveness of the combined feedforward + feedback control algorithm for current profile regulation is tested in predictive simulations carried out in TRANSP. Supported by PPPL.

Correlation of ion and beam current densities in Kaufman thrusters.

NASA Technical Reports Server (NTRS)

Wilbur, P. J.

1973-01-01

In the absence of direct impingement erosion, electrostatic thruster accelerator grid lifetime is defined by the charge exchange erosion that occurs at peak values of the ion beam current density. In order to maximize the thrust from an engine with a specified grid lifetime, the ion beam current density profile should therefore be as flat as possible. Knauer (1970) has suggested this can be achieved by establishing a radial plasma uniformity within the thruster discharge chamber; his tests with the radial field thruster provide an example of uniform plasma properties within the chamber and a flat ion beam profile occurring together. It is shown that, in particular, the ion density profile within the chamber determines the beam current density profile, and that a uniform ion density profile at the screen grid end of the discharge chamber should lead to a flat beam current density profile.

Tracking hospital costs in the last year of life - The Shanghai experience.

PubMed

Zhu, Bifan; Li, Fen; Wang, Changying; Wang, Linan; He, Zhimin; Zhang, Xiaoxi; Song, Peipei; Ding, Lingling; Jin, Chunlin

2018-01-01

One aim of the current study was to track end-of-life care using individual data in Shanghai, China to profile hospital costs for decedents and those for the entire population. A second aim of this study was to clarify the effect of proximity to death. Data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) were examined. For decedents who died in medical facilities in 2015, inpatient care was tracked for 1 year before death. A total of 43,765 decedents were included in the study, accounting for 35% of total deaths in 2015 in Shanghai. Hospital costs were higher for people who died before the age of 45 (14,228.62 USD) than for those aged 90 or older (8,696.34 USD). The ratio of costs for decedents to the entire population declined significantly with age. Women received less care than men in the last year of life (t = -15.1244, p < 0.05). Average tertiary hospital costs per decedent declined significantly with age, whereas average secondary hospital costs increased slightly with age. Among the top 14 causes of death classified using the ICD-10, rectal cancer incurred the greatest costs (13,973 USD per decedent). Over 43% of hospital costs were incurred during the month before death. Declining costs in the last year of life with age as well as with distance to death demonstrate the existence of a proximity to death phenomenon in health care expenses. Disease-specific studies should be conducted and attention should be paid to gender equity when examining end-of-life medical costs in the future.

Neural network evaluation of tokamak current profiles for real time control

NASA Astrophysics Data System (ADS)

Wróblewski, Dariusz

1997-02-01

Active feedback control of the current profile, requiring real-time determination of the current profile parameters, is envisioned for tokamaks operating in enhanced confinement regimes. The distribution of toroidal current in a tokamak is now routinely evaluated based on external (magnetic probes, flux loops) and internal (motional Stark effect) measurements of the poloidal magnetic field. However, the analysis involves reconstruction of magnetohydrodynamic equilibrium and is too intensive computationally to be performed in real time. In the present study, a neural network is used to provide a mapping from the magnetic measurements (internal and external) to selected parameters of the safety factor profile. The single-pass, feedforward calculation of output of a trained neural network is very fast, making this approach particularly suitable for real-time applications. The network was trained on a large set of simulated equilibrium data for the DIII-D tokamak. The database encompasses a large variety of current profiles including the hollow current profiles important for reversed central shear operation. The parameters of safety factor profile (a quantity related to the current profile through the magnetic field tilt angle) estimated by the neural network include central safety factor, q0, minimum value of q, qmin, and the location of qmin. Very good performance of the trained neural network both for simulated test data and for experimental datais demonstrated.

Neural network evaluation of tokamak current profiles for real time control (abstract)

NASA Astrophysics Data System (ADS)

Wróblewski, Dariusz

1997-01-01

Active feedback control of the current profile, requiring real-time determination of the current profile parameters, is envisioned for tokamaks operating in enhanced confinement regimes. The distribution of toroidal current in a tokamak is now routinely evaluated based on external (magnetic probes, flux loops) and internal (motional Stark effect) measurements of the poloidal magnetic field. However, the analysis involves reconstruction of magnetohydrodynamic equilibrium and is too intensive computationally to be performed in real time. In the present study, a neural network is used to provide a mapping from the magnetic measurements (internal and external) to selected parameters of the safety factor profile. The single-pass, feedforward calculation of output of a trained neural network is very fast, making this approach particularly suitable for real-time applications. The network was trained on a large set of simulated equilibrium data for the DIII-D tokamak. The database encompasses a large variety of current profiles including the hollow current profiles important for reversed central shear operation. The parameters of safety factor profile (a quantity related to the current profile through the magnetic field tilt angle) estimated by the neural network include central safety factor, q0, minimum value of q, qmin, and the location of qmin. Very good performance of the trained neural network both for simulated test data and for experimental data is demonstrated.

Observation of instability-induced current redistribution in a spherical-torus plasma.

PubMed

Menard, J E; Bell, R E; Gates, D A; Kaye, S M; LeBlanc, B P; Levinton, F M; Medley, S S; Sabbagh, S A; Stutman, D; Tritz, K; Yuh, H

2006-09-01

A motional Stark effect diagnostic has been utilized to reconstruct the parallel current density profile in a spherical-torus plasma for the first time. The measured current profile compares favorably with neoclassical theory when no large-scale magnetohydrodynamic instabilities are present in the plasma. However, a current profile anomaly is observed during saturated interchange-type instability activity. This apparent anomaly can be explained by redistribution of neutral beam injection current drive and represents the first observation of interchange-type instabilities causing such redistribution. The associated current profile modifications contribute to sustaining the central safety factor above unity for over five resistive diffusion times, and similar processes may contribute to improved operational scenarios proposed for ITER.

Computational-experimental approach to drug-target interaction mapping: A case study on kinase inhibitors

PubMed Central

Ravikumar, Balaguru; Parri, Elina; Timonen, Sanna; Airola, Antti; Wennerberg, Krister

2017-01-01

Due to relatively high costs and labor required for experimental profiling of the full target space of chemical compounds, various machine learning models have been proposed as cost-effective means to advance this process in terms of predicting the most potent compound-target interactions for subsequent verification. However, most of the model predictions lack direct experimental validation in the laboratory, making their practical benefits for drug discovery or repurposing applications largely unknown. Here, we therefore introduce and carefully test a systematic computational-experimental framework for the prediction and pre-clinical verification of drug-target interactions using a well-established kernel-based regression algorithm as the prediction model. To evaluate its performance, we first predicted unmeasured binding affinities in a large-scale kinase inhibitor profiling study, and then experimentally tested 100 compound-kinase pairs. The relatively high correlation of 0.77 (p < 0.0001) between the predicted and measured bioactivities supports the potential of the model for filling the experimental gaps in existing compound-target interaction maps. Further, we subjected the model to a more challenging task of predicting target interactions for such a new candidate drug compound that lacks prior binding profile information. As a specific case study, we used tivozanib, an investigational VEGF receptor inhibitor with currently unknown off-target profile. Among 7 kinases with high predicted affinity, we experimentally validated 4 new off-targets of tivozanib, namely the Src-family kinases FRK and FYN A, the non-receptor tyrosine kinase ABL1, and the serine/threonine kinase SLK. Our sub-sequent experimental validation protocol effectively avoids any possible information leakage between the training and validation data, and therefore enables rigorous model validation for practical applications. These results demonstrate that the kernel-based modeling approach offers practical benefits for probing novel insights into the mode of action of investigational compounds, and for the identification of new target selectivities for drug repurposing applications. PMID:28787438

Evidence base and future research directions in the management of low back pain

PubMed Central

Abbott, Allan

2016-01-01

Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care. PMID:27004162

End-threaded intramedullary positive profile screw ended self-tapping pin (Admit pin) - A cost-effective novel implant for fixing canine long bone fractures.

PubMed

Chanana, Mitin; Kumar, Adarsh; Tyagi, Som Prakash; Singla, Amit Kumar; Sharma, Arvind; Farooq, Uiase Bin

2018-02-01

The current study was undertaken to evaluate the clinical efficacy of end-threaded intramedullary pinning for management of various long bone fractures in canines. This study was conducted in two phases, managing 25 client-owned dogs presented with different fractures. The technique of application of end-threaded intramedullary pinning in long bone fractures was initially standardized in 6 clinical patients presented with long bone fractures. In this phase, end-threaded pins of different profiles, i.e., positive and negative, were used as the internal fixation technique. On the basis of results obtained from standardization phase, 19 client-owned dogs clinically presented with different fractures were implanted with end-threaded intramedullary positive profile screw ended self-tapping pin in the clinical application phase. The patients, allocated randomly in two groups, when evaluated postoperatively revealed slight pin migration in Group-I (negative profile), which resulted in disruption of callus site causing delayed union in one case and large callus formation in other two cases whereas no pin migration was observed in Group-II (positive profile). Other observations in Group-I was reduced muscle girth and delayed healing time as compared to Group-II. In clinical application, phase 21 st and 42 nd day post-operative radiographic follow-up revealed no pin migration in any of the cases, and there was no bone shortening or fragment collapse in end-threaded intramedullary positive profile screw ended self-tapping pin. The end-threaded intramedullary positive profile screw ended self-tapping pin used for fixation of long bone fractures in canines can resist pin migration, pin breakage, and all loads acting on the bone, i.e., compression, tension, bending, rotation, and shearing to an extent with no post-operative complications.

Demonstrating the Alaska Ocean Observing System in Prince William Sound

NASA Astrophysics Data System (ADS)

Schoch, G. Carl; McCammon, Molly

2013-07-01

The Alaska Ocean Observing System and the Oil Spill Recovery Institute developed a demonstration project over a 5 year period in Prince William Sound. The primary goal was to develop a quasi-operational system that delivers weather and ocean information in near real time to diverse user communities. This observing system now consists of atmospheric and oceanic sensors, and a new generation of computer models to numerically simulate and forecast weather, waves, and ocean circulation. A state of the art data management system provides access to these products from one internet portal at http://www.aoos.org. The project culminated in a 2009 field experiment that evaluated the observing system and performance of the model forecasts. Observations from terrestrial weather stations and weather buoys validated atmospheric circulation forecasts. Observations from wave gages on weather buoys validated forecasts of significant wave heights and periods. There was an emphasis on validation of surface currents forecasted by the ocean circulation model for oil spill response and search and rescue applications. During the 18 day field experiment a radar array mapped surface currents and drifting buoys were deployed. Hydrographic profiles at fixed stations, and by autonomous vehicles along transects, were made to acquire measurements through the water column. Terrestrial weather stations were the most reliable and least costly to operate, and in situ ocean sensors were more costly and considerably less reliable. The radar surface current mappers were the least reliable and most costly but provided the assimilation and validation data that most improved ocean circulation forecasts. We describe the setting of Prince William Sound and the various observational platforms and forecast models of the observing system, and discuss recommendations for future development.

Bootstrap current in a tokamak

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

Kessel, C.E.

1994-03-01

The bootstrap current in a tokamak is examined by implementing the Hirshman-Sigmar model and comparing the predicted current profiles with those from two popular approximations. The dependences of the bootstrap current profile on the plasma properties are illustrated. The implications for steady state tokamaks are presented through two constraints; the pressure profile must be peaked and {beta}{sub p} must be kept below a critical value.

Modifications to the edge current profile with auxiliary edge current drive and improved confinement in a reversed-field pinch

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

Chapman, B. E.; Biewer, T. M.; Chattopadhyay, P. K.

2000-09-01

Auxiliary edge current drive is routinely applied in the Madison Symmetric Torus [R. N. Dexter, D. W. Kerst, T. W. Lovell et al., Fusion Technol. 19, 131 (1991)] with the goal of modifying the parallel current profile to reduce current-driven magnetic fluctuations and the associated particle and energy transport. Provided by an inductive electric field, the current drive successfully reduces fluctuations and transport. First-time measurements of the modified edge current profile reveal that, relative to discharges without auxiliary current drive, the edge current density decreases. This decrease is explicable in terms of newly measured reductions in the dynamo (fluctuation-based) electricmore » field and the electrical conductivity. Induced by the current drive, these two changes to the edge plasma play as much of a role in determining the resultant edge current profile as does the current drive itself. (c) 2000 American Institute of Physics.« less

Surface currents associated with external kink modes in tokamak plasmas during a major disruption

NASA Astrophysics Data System (ADS)

Ng, C. S.; Bhattacharjee, A.

2017-10-01

The surface current on the plasma-vacuum interface during a disruption event involving kink instability can play an important role in driving current into the vacuum vessel. However, there have been disagreements over the nature or even the sign of the surface current in recent theoretical calculations based on idealized step-function background plasma profiles. We revisit such calculations by replacing step-function profiles with more realistic profiles characterized by a strong but finite gradient along the radial direction. It is shown that the resulting surface current is no longer a delta-function current density, but a finite and smooth current density profile with an internal structure, concentrated within the region with a strong plasma pressure gradient. Moreover, this current density profile has peaks of both signs, unlike the delta-function case with a sign opposite to, or the same as the plasma current. We show analytically and numerically that such current density can be separated into two parts, with one of them, called the convective current density, describing the transport of the background plasma density by the displacement, and the other part that remains, called the residual current density. It is argued that consideration of both types of current density is important and can resolve past controversies.

Modeling of the control of the driven current profile in ICRF MCCD on EAST plasma

NASA Astrophysics Data System (ADS)

Yin, L.; Yang, C.; Gong, X. Y.; Lu, X. Q.; Cao, J. J.; Wu, Z. Y.; Chen, Y.; Du, D.

2018-05-01

Control of the current profile is a crucial issue for improved confinement and the inhibition of instability in advanced tokamak operation. Using typical discharge data for the Experimental Advanced Superconducting Tokamak, numerical simulations of driven-current profile control in mode conversion current drive (MCCD) in the ion cyclotron range of frequencies were performed employing a full-wave method and Ehst-Karney efficiency formula. Results indicate that the driven current profile in MCCD can be effectively modified by shifting the mode conversion layer. The peak of the driven current can be located at an aimed position in the normalized minor radius range (-0.60 ≤r/a≤0) by changing the radiofrequency and the minority-ion concentration. The efficiency of the off-axis MCCD can reach 233 kA/MW through optimization, and the mode converted ion cyclotron wave plays an important role in such scenarios. The effects of electron temperature and plasma density on the driven current profile are also investigated.

Estimating the dim light melatonin onset of adolescents within a 6-h sampling window: the impact of sampling rate and threshold method

PubMed Central

Crowley, Stephanie J.; Suh, Christina; Molina, Thomas A.; Fogg, Louis F.; Sharkey, Katherine M.; Carskadon, Mary A.

2016-01-01

Objective/Background Circadian rhythm sleep-wake disorders often manifest during the adolescent years. Measurement of circadian phase such as the Dim Light Melatonin Onset (DLMO) improves diagnosis and treatment of these disorders, but financial and time costs limit the use of DLMO phase assessments in clinic. The current analysis aims to inform a cost-effective and efficient protocol to measure the DLMO in older adolescents by reducing the number of samples and total sampling duration. Patients/Methods A total of 66 healthy adolescents (26 males) aged 14.8 to 17.8 years participated in a study in which sleep was fixed for one week before they came to the laboratory for saliva collection in dim light (<20 lux). Two partial 6-h salivary melatonin profiles were derived for each participant. Both profiles began 5 h before bedtime and ended 1 h after bedtime, but one profile was derived from samples taken every 30 mins (13 samples) and the other from samples taken every 60 mins (7 samples). Three standard thresholds (first 3 melatonin values mean + 2 SDs, 3 pg/mL, and 4 pg/mL) were used to compute the DLMO. Agreement between DLMOs derived from 30-min and 60-min sampling rates was determined using a Bland-Altman analysis; agreement between sampling rate DLMOs was defined as ± 1 h. Results and Conclusions Within a 6-h sampling window, 60-min sampling provided DLMO estimates that were within ± 1 h of DLMO from 30-min sampling, but only when an absolute threshold (3 pg/mL or 4 pg/mL) was used to compute the DLMO. Future analyses should be extended to include adolescents with circadian rhythm sleep-wake disorders. PMID:27318227

Venus entry probe technology reference mission

NASA Astrophysics Data System (ADS)

van den Berg, M. L.; Falkner, P.; Atzei, A. C.; Phipps, A.; Mieremet, A.; Kraft, S.; Peacock, A.

The Venus Entry Probe is one of ESA's Technology Reference Missions (TRM). TRMs are model science-driven missions that are, although not part of the ESA science programme, able to provide focus to future technology requirements. This is accomplished through the study of several technologically demanding and scientifically meaningful mission concepts, which are strategically chosen to address diverse technological issues. The TRMs complement ESA's current mission specific development programme and allow the ESA Science Directorate to strategically plan the development of technologies that will enable potential future scientific missions. Key technological objectives for future planetary exploration include the use of small orbiters and in-situ probes with highly miniaturized and highly integrated payload suites. The low resource, and therefore low cost, spacecraft allow for a phased strategic approach to planetary exploration. The aim of the Venus Entry Probe TRM (VEP) is to study approaches for low cost in-situ exploration of the Venusian atmosphere. The mission profile consists of two minisats. The first satellite enters low Venus orbit. This satellite contains a highly integrated remote sensing payload suite primarily dedicated to support the in-situ atmospheric measurements of the aerobot. The second minisat enters deep elliptical orbit, deploys the aerobot, and subsequently operates as a data relay, data processing and overall resource allocation satellite. The micro-aerobot consists of a long-duration balloon that will analyze the Venusian middle cloud layer at an altitude of ˜ 55 km, where the environment is relatively benign (T = 20 C and p = 0.45 bars). The balloon will deploy a swarm of active ballast probes, which determine vertical profiles of selected properties of the lower atmosphere. In this presentation, the mission objectives and profile of the Venus Entry Probe TRM will be given as well as the key technological challenges.

After thalidomide - do we have the right balance between public health and intellectual property.

PubMed

Feldschreiber, Peter; Breckenridge, Alasdair

2015-01-01

The current European regulatory and consumer protection legal framework is the legacy of Thalidomide. The disaster led to the introduction of systematic biological and clinical data to endorse the safety and efficacy of new medicines. The European Medicines Directive outlined the pre-clinical, clinical data and product information to evaluate an appropriate benefit. Risk profile of new medicines and also allowed innovative companies to extend patent protection and data/marketing exclusivity periods to compensate for the cost for research and development. However in recent years it has become apparent that the costs and time for research and development are becoming increasingly burdensome, particularly for new drugs with recently discovered mechanisms of action for cancers and neurodegenerative disorders. The costs of development and the commercial uncertainty of such products is reducing commercialisation of these medicines. There is now considerable debate in the regulatory community as to how this regulatory burden may be eased by making earlier review of benefit risk and hence earlier access to authorised medicines. The Courts are moving away from the wide definition of medicinal product to a more nuanced view of the biological and clinical therapeutic mechanisms to satisfy the 'functional' limb definition in the Directive. This may be a move away from the rigorous scientific methodology generated after thalidomide. We discuss the ethical and public health implications of this shift in policy and the implications for intellectual property mechanisms currently available to protect the commercial needs of companies.

Performance of a small annular turbojet combustor designed for low cost

NASA Technical Reports Server (NTRS)

Fear, J. S.

1972-01-01

Performance investigations were conducted on a combustor utilizing several cost-reducing innovations and designed for use in a low-cost 4448-N thrust turbojet engine for commercial light aircraft. Low-cost features included simple, air-atomizing fuel injectors; combustor liners of perforated sheet; and the use of inexpensive type 304 stainless-steel material. Combustion efficiencies at the cruise and sea-level-takeoff design points were approximately 97 and 98 percent, respectively. The combustor isothermal pressure loss was 6.3 percent at the cruise-condition diffuser inlet Mach number of 0.34. The combustor exit temperature pattern factor was less than 0.24 at both the cruise and sea-level-takeoff design points. The combustor exit average radial temperature profiles at all conditions were in very good agreement with the design profile.

Investigating the chemical profile of regenerated scorpion (Parabuthus transvaalicus) venom in relation to metabolic cost and toxicity.

PubMed

Nisani, Zia; Boskovic, Danilo S; Dunbar, Stephen G; Kelln, Wayne; Hayes, William K

2012-09-01

We investigated the biochemical profile of regenerated venom of the scorpion Parabuthus transvaalicus in relation to its metabolic cost and toxicity. Using a closed-system respirometer, we compared oxygen consumption between milked and unmilked scorpions to determine the metabolic costs associated with the first 192 h of subsequent venom synthesis. Milked scorpions had a substantially (21%) higher mean metabolic rate than unmilked scorpions, with the largest increases in oxygen consumption occurring at approximately 120 h, 162 h, and 186 h post-milking. Lethality tests in crickets indicated that toxicity of the regenerated venom returned to normal levels within 4 d after milking. However, the chemical profile of the regenerated venom, as evaluated by FPLC and MALDI-TOF mass spectrometry, suggested that regeneration of different venom components was asynchronous. Some peptides regenerated quickly, particularly those associated with the scorpion's "prevenom," whereas others required much or all of this time period for regeneration. This asynchrony could explain the different spikes detected in oxygen consumption of milked scorpions as various peptides and other venom components were resynthesized. These observations confirm the relatively high metabolic cost of venom regeneration and suggest that greater venom complexity can be associated with higher costs of venom production. Copyright © 2012 Elsevier Ltd. All rights reserved.

A genetics-based approach confirms immune associations with life history across multiple populations of an aquatic vertebrate (Gasterosteus aculeatus).

PubMed

Whiting, James R; Magalhaes, Isabel S; Singkam, Abdul R; Robertson, Shaun; D'Agostino, Daniele; Bradley, Janette E; MacColl, Andrew D C

2018-06-20

Understanding how wild immune variation covaries with other traits can reveal how costs and trade-offs shape immune evolution in the wild. Divergent life history strategies may increase or alleviate immune costs, helping shape immune variation in a consistent, testable way. Contrasting hypotheses suggest that shorter life histories may alleviate costs by offsetting them against increased mortality; or increase the effect of costs if immune responses are traded off against development or reproduction. We investigated the evolutionary relationship between life history and immune responses within an island radiation of three-spined stickleback, with discrete populations of varying life histories and parasitism. We sampled two short-lived, two long-lived and an anadromous population using qPCR to quantify current immune profile and RAD-seq data to study the distribution of immune variants within our assay genes and across the genome. Short-lived populations exhibited significantly increased expression of all assay genes, which was accompanied by a strong association with population-level variation in local alleles and divergence in a gene that may be involved in complement pathways. In addition, divergence around the eda gene in anadromous fish is likely associated with increased inflammation. A wider analysis of 15 populations across the island revealed that immune genes across the genome show evidence of having diverged alongside life history strategies. Parasitism and reproductive investment were also important sources of variation for expression, highlighting the caution required when assaying immune responses in the wild. These results provide strong, gene-based support for current hypotheses linking life history and immune variation across multiple populations of a vertebrate model. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Boundary Layer Observations of Water Vapor and Aerosol Profiles with an Eye-Safe Micro-Pulse Differential Absorption Lidar (DIAL)

NASA Astrophysics Data System (ADS)

Nehrir, A. R.; Repasky, K. S.; Carlsten, J.; Ismail, S.

2011-12-01

Measurements of real-time high spatial and temporal resolution profiles of combined water vapor and aerosols in the boundary layer have been a long standing observational challenge to the meteorological, weather forecasting, and climate science communities. To overcome the high reoccurring costs associated with radiosondes as well as the lack of sufficient water vapor measurements over the continental united states, a compact and low cost eye-safe all semiconductor-based micro-pulse differential absorption lidar (DIAL) has been developed for water vapor and aerosol profiling in the lower troposphere. The laser transmitter utilizes two continuous wave external cavity diode lasers operating in the 830 nm absorption band as the online and offline seed laser sources. An optical switch is used to sequentially injection seed a tapered semiconductor optical amplifier (TSOA) with the two seed laser sources in a master oscillator power amplifier (MOPA) configuration. The TSOA is actively current pulsed to produce up to 7 μJ of output energy over a 1 μs pulse duration (150 m vertical resolution) at a 10 kHz pulse repetition frequency. The measured laser transmitter spectral linewidth is less than 500 kHz while the long term frequency stability of the stabilized on-line wavelength is ± 55 MHz. The laser transmitter spectral purity was measured to be greater than 0.9996, allowing for simultaneous measurements of water vapor in the lower and upper troposphere. The DIAL receiver utilizes a commercially available full sky-scanning capable 35 cm Schmidt-Cassegrain telescope to collect the scattered light from the laser transmitter. Light collected by the telescope is spectrally filtered to suppress background noise and is coupled into a fiber optic cable which acts as the system field stop and limits the full angle field of view to 140 μrad. The light is sampled by a fiber coupled APD operated in a Geiger mode. The DIAL instrument is operated autonomously where water vapor and aerosol profiles are displayed in real-time. The transmitter is capable of operating at any spectral position along the selected water vapor absorption line allowing for year round operation at various geographical locations using a single line. Water vapor and aerosol profiles have been recorded up to 6 km and 15 km with 10 m and 1 m temporal averaging, respectively, allowing for mesoscale monitoring of boundary layer dynamics during both daytime and nighttime operation. A brief description of the current status of the water vapor DIAL instrument will be presented. Nighttime and daytime water vapor and aerosol profiles/inversions from the DIAL instrument will also be presented and favorable comparisons against collocated radiosonde, in situ, and column averaged data from SUOMINET and AERONET will also be discussed. A future outlook towards instrument enhancements that will allow the diode-laser-based DIAL technique/technology to become a viable candidate for deployment in multi-point sensor networks will also be discussed.

Foods and Dietary Patterns That Are Healthy, Low-Cost, and Environmentally Sustainable: A Case Study of Optimization Modeling for New Zealand

PubMed Central

Wilson, Nick; Nghiem, Nhung; Ni Mhurchu, Cliona; Eyles, Helen; Baker, Michael G.; Blakely, Tony

2013-01-01

Objective Global health challenges include non-communicable disease burdens, ensuring food security in the context of rising food prices, and environmental constraints around food production, e.g., greenhouse gas [GHG] emissions. We therefore aimed to consider optimized solutions to the mix of food items in daily diets for a developed country population: New Zealand (NZ). Methods We conducted scenario development and linear programming to model 16 diets (some with uncertainty). Data inputs included nutrients in foods, food prices, food wastage and food-specific GHG emissions. Findings This study identified daily dietary patterns that met key nutrient requirements for as little as a median of NZ$ 3.17 per day (US$ 2.41/d) (95% simulation interval [SI] = NZ$ 2.86 to 3.50/d). Diets that included “more familiar meals” for New Zealanders, increased the cost. The optimized diets also had low GHG emission profiles compared with the estimate for the ‘typical NZ diet’ e.g., 1.62 kg CO2e/d for one scenario (95%SI = 1.39 to 1.85 kg CO2e) compared with 10.1 kg CO2e/d, respectively. All of the optimized low-cost and low-GHG dietary patterns had likely health advantages over the current NZ dietary pattern, i.e., lower cardiovascular disease and cancer risk. Conclusions We identified optimal foods and dietary patterns that would lower the risk of non-communicable diseases at low cost and with low greenhouse gas emission profiles. These results could help guide central and local government decisions around which foods to focus policies on. That is which foods are most suitable for: food taxes (additions and exemptions); healthy food vouchers and subsidies; and for increased use by public institutions involved in food preparation. PMID:23544082

A rapid nuclear staining test using cationic dyes contributes to efficient STR analysis of telogen hair roots.

PubMed

Lee, So-Yeon; Ha, Eun-Ju; Woo, Seung-Kyun; Lee, So-Min; Lim, Kyung-Hee; Eom, Yong-Bin

2017-07-01

Telogen hairs presented in the crime scene are commonly encountered as trace evidence. However, short tandem repeat (STR) profiling of the hairs currently have low and limited use due to poor success rate. To increase the success rate of STR profiling of telogen hairs, we developed a rapid and cost-effective method to estimate the number of nuclei in the hair roots. Five cationic dyes, Methyl green (MG), Harris hematoxylin (HH), Methylene blue (MB), Toluidine blue (TB), and Safranin O (SO) were evaluated in this study. We conducted a screening test based on microscopy and the percentage of loss with nuclear DNA, in order to select the best dye. MG was selected based on its specific nuclei staining and low adverse effect on the hair-associated nuclear DNA. We examined 330 scalp and 100 pubic telogen hairs with MG. Stained hairs were classified into five groups and analyzed by STR. The fast staining method revealed 70% (head hair) and 33.4% (pubic hair) of full (30 alleles) and high partial (18-29 alleles) STR profiling proportion from the lowest nuclei count group (one to ten nuclei). The results of this study demonstrated a rapid, specific, nondestructive, and high yield DNA profiling method applicable for screening telogen hairs. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Low-cost Beam Profiler Based On Cerium-doped Silica Fibers

NASA Astrophysics Data System (ADS)

Potkins, David Edward; Braccini, Saverio; Nesteruk, Konrad Pawel; Carzaniga, Tommaso Stefano; Vedda, Anna; Chiodini, Norberto; Timmermans, Jacob; Melanson, Stephane; Dehnel, Morgan Patrick

A beam profiler called the Universal Beam Monitor (UniBEaM) has been developed by D-Pace Inc. (Canada) and the Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics, University of Bern (Switzerland). The device is based on passing 100 to 600 micron cerium-doped optical fibers through a particle beam. Visible scintillation light from the sensor fibers is transmitted over distances of tens of meters to the light sensors with minimal signal loss and no susceptibility to electromagnetic fields. The probe has an insertion length of only 70 mm. The software plots the beam intensity distribution in the horizontal and vertical planes, and calculates the beam location and integrated profile area, which correlates well with total beam current. UniBEaM has a large dynamic range, operating with beam currents of ∼pA to mA, and a large range of particle kinetic energies of ∼keV to GeV, depending on the absorbed power density. Test data are presented for H- beams at 25keV for 500 μA, and H+ beams at 18MeV for 50pA to 10 μA. Maximum absorbed power density of the optical fiber before thermal damage is discussed in relation to dE/dx energy deposition as a function of particle type and kinetic energy. UniBEaM is well suited for a wide variety of beamlines including discovery science applications, radio-pharmaceutical production, hadron therapy, industrial ion beam applications including ion implantation, industrial electron beams, and ion source testing.

Drug formulary review process for sargramostim and filgrastim: focus on analysis of adverse drug reactions.

PubMed

Kellihan, M J

1993-01-01

Selection of a drug for formulary inclusion involves evaluation of safety, efficacy, and cost. The colony-stimulating factors (CSFs) sargramostim and filgrastim have a broad range of potential indications and represent a costly formulary addition when acquisition price alone is considered; their comparative safety is unclear. These factors suggest that the CSFs should be closely scrutinized prior to formulary addition. In the absence of direct comparative studies, an assessment of the safety of CSFs involves evaluation of information provided in the product circular, official drug compendia, adverse biologic reports submitted to the United States Food and Drug Administration, and data from key clinical trials. Data in the product circulars report on adverse events in small numbers of patients treated for chemotherapy-induced neutropenia (filgrastim) or neutropenia subsequent to bone marrow transplantation (sargramostim). The official compendia and clinical trials include experience with CSFs produced in a variety of expression systems; these data are not limited to sargramostim and filgrastim. Importantly, there was a similar incidence of adverse events in patients who received sargramostim or filgrastim and in those who took placebo reported in the product circulars and the pivotal trials, suggesting that the underlying disease may have an important role in determining the side-effect profile of these agents. Adverse biologic reports represent experience with sargramostim and filgrastim obtained under actual clinical conditions and suggest that the same types of adverse events are seen with sargramostim as with filgrastim. This analysis suggests that a decision to select filgrastim over sargramostim for formulary inclusion based on the safety profile is not appropriate because currently available data are equivocal and that such decisions would more appropriately be based on efficacy and cost.

Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

PubMed Central

Linder, Regina

2012-01-01

Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stake-holders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships. PMID:23653802

Weighted minimum-norm source estimation of magnetoencephalography utilizing the temporal information of the measured data

NASA Astrophysics Data System (ADS)

Iwaki, Sunao; Ueno, Shoogo

1998-06-01

The weighted minimum-norm estimation (wMNE) is a popular method to obtain the source distribution in the human brain from magneto- and electro- encephalograpic measurements when detailed information about the generator profile is not available. We propose a method to reconstruct current distributions in the human brain based on the wMNE technique with the weighting factors defined by a simplified multiple signal classification (MUSIC) prescanning. In this method, in addition to the conventional depth normalization technique, weighting factors of the wMNE were determined by the cost values previously calculated by a simplified MUSIC scanning which contains the temporal information of the measured data. We performed computer simulations of this method and compared it with the conventional wMNE method. The results show that the proposed method is effective for the reconstruction of the current distributions from noisy data.

Smart electric vehicle (EV) charging and grid integration apparatus and methods

DOEpatents

Gadh, Rajit; Mal, Siddhartha; Prabhu, Shivanand; Chu, Chi-Cheng; Sheikh, Omar; Chung, Ching-Yen; He, Lei; Xiao, Bingjun; Shi, Yiyu

2015-05-05

An expert system manages a power grid wherein charging stations are connected to the power grid, with electric vehicles connected to the charging stations, whereby the expert system selectively backfills power from connected electric vehicles to the power grid through a grid tie inverter (if present) within the charging stations. In more traditional usage, the expert system allows for electric vehicle charging, coupled with user preferences as to charge time, charge cost, and charging station capabilities, without exceeding the power grid capacity at any point. A robust yet accurate state of charge (SOC) calculation method is also presented, whereby initially an open circuit voltage (OCV) based on sampled battery voltages and currents is calculated, and then the SOC is obtained based on a mapping between a previously measured reference OCV (ROCV) and SOC. The OCV-SOC calculation method accommodates likely any battery type with any current profile.

The cost-effectiveness of disease-modifying therapies for the treatment of relapsing-remitting multiple sclerosis.

PubMed

Bozkaya, Duygu; Livingston, Terrie; Migliaccio-Walle, Kristen; Odom, Tanner

2017-03-01

The safety and efficacy of disease-modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS) has been established; however, it is not clear which provides optimal value, given benefit-risk profiles and costs. To compare the cost-effectiveness of current DMTs for patients with RRMS in the US. A Markov model predicting RRMS course following initiation of a DMT was created comparing outcomes (e.g. relapses, disease progression) and costs of natalizumab (NTZ), dimethyl fumarate (DMF), and peginterferon beta-1a (PEG) with fingolimod (FIN), glatiramer acetate (GA, 20 mg daily), and subcutaneous interferon beta-1a (IFN, 44 mcg), respectively, over 10 years. RRMS and secondary-progressive MS (SPMS) EDSS state transitions were predicted in 3-month cycles in which patients were at risk of death, relapse, or discontinuation. Upon DMT discontinuation, natural history progression and relapse rates were applied. Incremental cost-effectiveness ratios (ICERs) were estimated for the cost per relapse avoided, relapse-free years gained, progression avoided, and progression-free years gained. The impact of model parameters on outcomes was evaluated via one-way sensitivity analyses. Costs ranged from $561,177 (NTZ) to $616,251 (GA). NTZ, DMF, and PEG were dominant (less costly and more effective) compared to FIN, GA, and IFN, respectively, for all ICERs. Variability in drug costs and parameters that affected drug cost accrual (e.g. discontinuation rates and the decision to drop out after SPMS conversion) had a considerable impact on ICERs. Several simplifying assumptions were made that may represent potential limitations of this analysis (e.g. a constant treatment effect over time was assumed). The results from this analysis suggest that the NTZ, DMF, and PEG are cost-effective DMT choices compared to FIN, GA, and IFN, respectively. The actual impact on a particular plan will vary based on drug pricing and other factors affecting drug cost accrual.

Near-Inertial and Tidal Currents Detected with a Vessel Mounted Acoustic Doppler Current Profiler in the Western Mediterranean Sea

NASA Technical Reports Server (NTRS)

Garcia-Gorriz, E.; Candela, J.; Font, J.

1998-01-01

The Acoustic Doppler Current Profiler (ADCP) combined with accurate navigation provides absolute current velocities which include information from all the frequencies which have a dynamical presence in the ocean.

Evaluation of a Magnetically-Filtered Faraday Probe for Measuring the ion Current Density Profile of a Hall Thruster

DTIC Science & Technology

2004-07-01

The ability of a magnetically-filtered Faraday probe (MFFP) to obtain the ion current density profile of a Hall thruster is investigated. The MFFP is...MFFP, boxed Faraday probe (BFP), and nude Faraday probe are used to measure the ion current density profile of a 5 kW Hall thruster operated over the

Test of electical resistivity and current diffusion modelling on MAST and JET

NASA Astrophysics Data System (ADS)

Keeling, D. L.; Challis, C. D.; Jenkins, I.; Hawkes, N. C.; Lupelli, I.; Michael, C.; de Bock, M. F. M.; the MAST Team; contributors, JET

2018-01-01

Experiments have been carried out on the MAST and JET tokamaks intended to compare the electrical resistivity of the plasma with theoretical formulations. The tests consist of obtaining motional stark effect (MSE) measurements in MHD-free plasmas during plasma current ramp-up (JET and MAST), ramp-down (MAST) and in stationary state (JET and MAST). Simulations of these plasmas are then performed in which the current profile evolution is calculated according to the poloidal field diffusion equation (PFDE) with classical or neoclassical resistivity. Synthetic MSE data are produced in the simulations for direct comparison with the experimental data. It is found that the toroidal current profile evolution modelled using neoclassical resistivity did not match the experimental observations on either device during current ramp-up or ramp-down as concluded from comparison of experimental and synthetic MSE profiles. In these phases, use of neoclassical resistivity in the modelling systematically overestimates the rate of current profile evolution. During the stationary state however, the modelled toroidal current profile matched experimental observations to a high degree of accuracy on both devices using neoclassical resistivity. Whilst no solution to the mismatch in the dynamic phases of the plasma is proposed, it is suggested that some physical process other than MHD which is not captured by the simple diffusive model of current profile evolution is responsible.

Considerations for Assessing the Appropriateness of High-Cost Pediatric Care in Low-Income Regions

PubMed Central

Argent, Andrew C.

2018-01-01

It may be difficult to predict the consequences of provision of high-cost pediatric care (HCC) in low- and middle-income countries (LMICs), and these consequences may be different to those experienced in high-income countries. An evaluation of the implications of HCC in LMICs must incorporate considerations of the specific context in that country (population age profile, profile of disease, resources available), likely costs of the HCC, likely benefits that can be gained versus the costs that will be incurred. Ideally, the process that is followed in decision making around HCC should be transparent and should involve the communities that will be most affected by those decisions. It is essential that the impacts of provision of HCC are carefully monitored so that informed decisions can be made about future provision medical interventions. PMID:29637061

Gene expression profiling and expanded immunohistochemistry tests to guide the use of adjuvant chemotherapy in breast cancer management: a systematic review and cost-effectiveness analysis.

PubMed

Ward, S; Scope, A; Rafia, R; Pandor, A; Harnan, S; Evans, P; Wyld, L

2013-10-01

Gene expression profiling (GEP) and expanded immunohistochemistry (IHC) tests aim to improve decision-making relating to adjuvant chemotherapy for women with early breast cancer. The aim of this report is to assess the clinical effectiveness and cost-effectiveness of nine GEP and expanded IHC tests compared with current prognostic tools in guiding the use of adjuvant chemotherapy in patients with early breast cancer in England and Wales. The nine tests are BluePrint, Breast Cancer Index (BCI), IHC4, MammaPrint, Mammostrat, NPI plus (NPI+), OncotypeDX, PAM50 and Randox Breast Cancer Array. Databases searched included MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE and The Cochrane Library. Databases were searched from January 2009 to May 2011 for the OncotypeDX and MammaPrint tests and from January 2002 to May 2011 for the other tests. A systematic review of the evidence on clinical effectiveness (analytical validity, clinical validity and clinical utility) and cost-effectiveness was conducted. An economic model was developed to evaluate the cost-effectiveness of adjuvant chemotherapy treatment guided by four of the nine test (OncotypeDX, IHC4, MammaPrint and Mammostrat) compared with current clinical practice in England and Wales, using clinicopathological parameters, in women with oestrogen receptor-positive (ER+), lymph node-negative (LN-), human epidermal growth factor receptor type 2-negative (HER2-) early breast cancer. The literature searches for clinical effectiveness identified 5993 citations, of which 32 full-text papers or abstracts (30 studies) satisfied the criteria for the effectiveness review. A narrative synthesis was performed. Evidence for OncotypeDX supported the prognostic capability of the test. There was some evidence on the impact of the test on decision-making and to support the case that OncotypeDX predicts chemotherapy benefit; however, few studies were UK based and limitations in relation to study design were identified. Evidence for MammaPrint demonstrated that the test score was a strong independent prognostic factor, but the evidence is non-UK based and is based on small sample sizes. Evidence on the Mammostrat test showed that the test was an independent prognostic tool for women with ER+, tamoxifen-treated breast cancer. The three studies appeared to be of reasonable quality and provided data from a UK setting (one study). One large study reported on clinical validity of the IHC4 test, with IHC4 score a highly significant predictor of distant recurrence. This study included data from a UK setting and appeared to be of reasonable quality. Evidence for the remaining five tests (PAM50, NPI+, BCI, BluePrint and Randox) was limited. The economic analysis suggests that treatment guided using IHC4 has the greatest potential to be cost-effective at a £20,000 threshold, given the low cost of the test; however, further research is needed on the analytical validity and clinical utility of IHC4, and the exact cost of the test needs to be confirmed. Current limitations in the evidence base produce significant uncertainty in the results. OncotypeDX has a more robust evidence base, but further evidence on its impact on decision-making in the UK and the predictive ability of the test in an ER+, LN-, HER- population receiving current drug regimens is needed. For MammaPrint and Mammostrat there were significant gaps in the available evidence and the estimates of cost-effectiveness produced were not considered to be robust by the External Assessment Group. Methodological weaknesses in the clinical evidence base relate to heterogeneity of patient cohorts and issues arising from the retrospective nature of the evidence. Further evidence is required on the clinical utility of all of the tests and on UK-based populations. A key area of uncertainty relates to whether the tests provide prognostic or predictive ability. The clinical evidence base for OncotypeDX is considered to be the most robust. The economic analysis suggested that treatment guided using IHC4 has the most potential to be cost-effective at a threshold of £20,000; however, the evidence base to support IHC4 needs significant further research. PROSPERO 2011:CRD42011001361, available from www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42011001361.

Pricing the Services in Dynamic Environment: Agent Pricing Model

NASA Astrophysics Data System (ADS)

Žagar, Drago; Rupčić, Slavko; Rimac-Drlje, Snježana

New Internet applications and services as well as new user demands open many new issues concerning dynamic management of quality of service and price for received service, respectively. The main goals of Internet service providers are to maximize profit and maintain a negotiated quality of service. From the users' perspective the main goal is to maximize ratio of received QoS and costs of service. However, achieving these objectives could become very complex if we know that Internet service users might during the session become highly dynamic and proactive. This connotes changes in user profile or network provider/s profile caused by high level of user mobility or variable level of user demands. This paper proposes a new agent based pricing architecture for serving the highly dynamic customers in context of dynamic user/network environment. The proposed architecture comprises main aspects and basic parameters that will enable objective and transparent assessment of the costs for the service those Internet users receive while dynamically change QoS demands and cost profile.

[Evolution in the use and the expenditures of a healthcare provider].

PubMed

Duarte, André Luís de Castro Moura; Oliveira, Felippe de Medeiros; Santos, Anderson de Andrade; Santos, Bento Fortunato Cardoso Dos

2017-08-01

Brazil's aging population and the rising number of people reliant upon the country's supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil.

Impact and cost-effectiveness of current and future tuberculosis diagnostics: the contribution of modelling

PubMed Central

Houben, R.; Cohen, T.; Pai, M.; Cobelens, F.; Vassall, A.; Menzies, N. A.; Gomez, G. B.; Langley, I.; Squire, S. B.; White, R.

2014-01-01

SUMMARY The landscape of diagnostic testing for tuberculosis (TB) is changing rapidly, and stakeholders need urgent guidance on how to develop, deploy and optimize TB diagnostics in a way that maximizes impact and makes best use of available resources. When decisions must be made with only incomplete or preliminary data available, modelling is a useful tool for providing such guidance. Following a meeting of modelers and other key stakeholders organized by the TB Modelling and Analysis Consortium, we propose a conceptual framework for positioning models of TB diagnostics. We use that framework to describe modelling priorities in four key areas: Xpert® MTB/RIF scale-up, target product profiles for novel assays, drug susceptibility testing to support new drug regimens, and the improvement of future TB diagnostic models. If we are to maximize the impact and cost-effectiveness of TB diagnostics, these modelling priorities should figure prominently as targets for future research. PMID:25189546

Heat, mass and force flows in supersonic shockwave interaction

NASA Astrophysics Data System (ADS)

Dixon, John Michael

There is no cost effective way to deliver a payload to space and, with rising fuel prices, currently the price to travel commercially is also becoming more prohibitive to the public. During supersonic flight, compressive shock waves form around the craft which could be harnessed to deliver an additional lift on the craft. Using a series of hanging plates below a lifting wing design, the total lift generated can be increased above conventional values, while still maintaining a similar lift-to-drag ratio. Here, we study some of the flows involved in supersonic shockwave interaction. This analysis uses ANSYS Fluent Computational Fluid Dynamics package as the modeler. Our findings conclude an increase of up to 30% lift on the modeled craft while maintaining the lift-to-drag profile of the unmodified lifting wing. The increase in lift when utilizing the shockwave interaction could increase transport weight and reduce fuel cost for space and commercial flight, as well as mitigating negative effects associated with supersonic travel.

Human Transportation System (HTS) study: Executive summary

NASA Technical Reports Server (NTRS)

Lance, N.; Geyer, M. S.; Gaunce, M. T.

1993-01-01

Work completed under the Human Transportation System Study is summarized. This study was conducted by the New Initiatives Office at JSC with the technical support of Boeing, General Dynamics, Lockheed, McDonnell-Douglas, Martin Marietta, and Rockwell. The study was designed to generate information on determining the appropriate path to follow for new system development to meet the Nation's space transportation needs. The study evaluates 18 transportation architecture options using a parametric set of mission requirements. These options include use of current systems as well as proposed systems to assess the impact of various considerations, such as the cost of alternate access, or the benefit of separating people and cargo. The architecture options are compared to each other with six measurable evaluation criteria or attributes. They are the following: funding profile, human safety, probability of mission success, architecture cost risk, launch schedule confidence, and environmental impact. Values for these attributes are presented for the architecture options, with pertinent conclusions and recommendations.

Peregrine: A rapid and unbiased method to produce strand-specific RNA-Seq libraries from small quantities of starting material.

PubMed

Langevin, Stanley A; Bent, Zachary W; Solberg, Owen D; Curtis, Deanna J; Lane, Pamela D; Williams, Kelly P; Schoeniger, Joseph S; Sinha, Anupama; Lane, Todd W; Branda, Steven S

2013-04-01

Use of second generation sequencing (SGS) technologies for transcriptional profiling (RNA-Seq) has revolutionized transcriptomics, enabling measurement of RNA abundances with unprecedented specificity and sensitivity and the discovery of novel RNA species. Preparation of RNA-Seq libraries requires conversion of the RNA starting material into cDNA flanked by platform-specific adaptor sequences. Each of the published methods and commercial kits currently available for RNA-Seq library preparation suffers from at least one major drawback, including long processing times, large starting material requirements, uneven coverage, loss of strand information and high cost. We report the development of a new RNA-Seq library preparation technique that produces representative, strand-specific RNA-Seq libraries from small amounts of starting material in a fast, simple and cost-effective manner. Additionally, we have developed a new quantitative PCR-based assay for precisely determining the number of PCR cycles to perform for optimal enrichment of the final library, a key step in all SGS library preparation workflows.

Human Transportation System (HTS) study, volume 2

NASA Technical Reports Server (NTRS)

Lance, N.; Geyer, M. S.; Gaunce, M. T.

1993-01-01

This report summarizes work completed under the Human Transportation System Study. This study was conducted by the New Initiatives Office at JSC with the technical support of Boeing, General Dynamics, Lockheed, McDonnell-Douglas, Martin Marietta, and Rockwell. The study was designed to generate information on determining the appropriate path to follow for new system development to meet the Nation's space transportation needs. The study evaluates 18 transportation architecture options using a parametric set of mission requirements. These options include use of current systems (e.g., Shuttle, Titan, etc. ) as well as proposed systems (e.g., PLS, Single-Stage-to-Orbit, etc.) to assess the impact of various considerations, such as the cost of alternate access, or the benefit of separating people and cargo. The architecture options are compared to each other with six measurable evaluation criteria or attributes. They are: funding profile, human safety, probability of mission success, architecture cost risk, launch schedule confidence, and environmental impact. Values for these attributes are presented for the architecture options, with pertinent conclusions and recommendations.

Human Transportation System (HTS) study, volume 1

NASA Technical Reports Server (NTRS)

Lance, N.; Geyer, M. S.; Gaunce, M. T.

1993-01-01

Work completed under the Human Transportation System Study is summarized. This study was conducted by the New Initiatives Office at JSC with the technical support of Boeing, General Dynamics, Lockheed, McDonnell-Douglas, Martin Marietta, and Rockwell. The study was designed to generate information on determining the appropriate path to follow for new system development to meet the Nation's space transportation needs. The study evaluates 18 transportation architecture options using a parametric set of mission requirements. These options include use of current systems as well as proposed systems to assess the impact of various considerations, such as the cost of alternate access, or the benefit of separating people and cargo. The architecture options are compared to each other with six measurable evaluation criteria or attributes. They are the following: funding profile, human safety, probability of mission success, architecture cost risk, launch schedule confidence, and environmental impact. Values for these attributes are presented for the architecture options, with pertinent conclusions and recommendations.

Demand Response Availability Profiles for California in the Year 2020

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

Olsen, Daniel; Sohn, Michael; Piette, Mary Ann

2014-11-01

Demand response (DR) is being considered as a valuable resource for keeping the electrical grid stable and efficient, and deferring upgrades to generation, transmission, and distribution systems. However, simulations to determine how much infrastructure upgrades can be deferred are necessary in order to plan optimally. Production cost modeling is a technique, which simulates the dispatch of generators to meet demand and reserves in each hour of the year, at minimal cost. By integrating demand response resources into a production cost model (PCM), their value to the grid can be estimated and used to inform operations and infrastructure planning. DR availabilitymore » profiles and constraints for 13 end-uses in California for the year 2020 were developed by Lawrence Berkeley National Laboratory (LBNL), and integrated into a production cost model by Lawrence Livermore National Laboratory (LLNL), for the California Energy Commission’s Value of Energy Storage and Demand Response for Renewable Integration in California Study. This report summarizes the process for developing the DR availability profiles for California, and their aggregate capabilities. While LBNL provided potential DR hourly profiles for regulation product in the ancillary services market and five-minute load following product in the energy market for LLNL’s study, additional results in contingency reserves and an assumed flexible product are also defined. These additional products are included in the analysis for managing high ramps associated with renewable generation and capacity products and they are also presented in this report.« less

DOE/NASA SIMS Prototype Solar System, no. 4. Part 1: Market analysis. Part 2: Modular manufacturing cost estimate

NASA Technical Reports Server (NTRS)

1979-01-01

The findings of the IIT Research Institute (IITRI) market study of the SIMS Prototype System 4, a hot water (DHW) system are documented. The feasibility of prepackaging currently available solar heating components into modular subsystems for site assembly is addressed. A documented design and installation procedure and a performance test report were prepared. The potential markets and applications for this particular system in the nonfederal market are profiled by assessing the needs and requirements of potential users and specifiers, by characterizing the nature of the market and the competitive environment, by identifying the barriers to commercial acceptance, and by estimating the size of the potential market.

Off-axis current drive and real-time control of current profile in JT-60U

NASA Astrophysics Data System (ADS)

Suzuki, T.; Ide, S.; Oikawa, T.; Fujita, T.; Ishikawa, M.; Seki, M.; Matsunaga, G.; Hatae, T.; Naito, O.; Hamamatsu, K.; Sueoka, M.; Hosoyama, H.; Nakazato, M.; JT-60 Team

2008-04-01

Aiming at optimization of current profile in high-β plasmas for higher confinement and stability, a real-time control system of the minimum of the safety factor (qmin) using the off-axis current drive has been developed. The off-axis current drive can raise the safety factor in the centre and help to avoid instability that limits the performance of the plasma. The system controls the injection power of lower-hybrid waves, and hence its off-axis driven current in order to control qmin. The real-time control of qmin is demonstrated in a high-β plasma, where qmin follows the temporally changing reference qmin,ref from 1.3 to 1.7. Applying the control to another high-β discharge (βN = 1.7, βp = 1.5) with m/n = 2/1 neo-classical tearing mode (NTM), qmin was raised above 2 and the NTM was suppressed. The stored energy increased by 16% with the NTM suppressed, since the resonant rational surface was eliminated. For the future use for current profile control, current density profile for off-axis neutral beam current drive (NBCD) is for the first time measured, using the motional Stark effect diagnostic. Spatially localized NBCD profile was clearly observed at the normalized minor radius ρ of about 0.6-0.8. The location was also confirmed by multi-chordal neutron emission profile measurement. The total amount of the measured beam driven current was consistent with the theoretical calculation using the ACCOME code. The CD location in the calculation was inward shifted than the measurement.

Approximate Stokes Drift Profiles in Deep Water

NASA Astrophysics Data System (ADS)

Breivik, Øyvind; Janssen, Peter A. E. M.; Bidlot, Jean-Raymond

2014-09-01

A deep-water approximation to the Stokes drift velocity profile is explored as an alternative to the monochromatic profile. The alternative profile investigated relies on the same two quantities required for the monochromatic profile, viz the Stokes transport and the surface Stokes drift velocity. Comparisons with parametric spectra and profiles under wave spectra from the ERA-Interim reanalysis and buoy observations reveal much better agreement than the monochromatic profile even for complex sea states. That the profile gives a closer match and a more correct shear has implications for ocean circulation models since the Coriolis-Stokes force depends on the magnitude and direction of the Stokes drift profile and Langmuir turbulence parameterizations depend sensitively on the shear of the profile. The alternative profile comes at no added numerical cost compared to the monochromatic profile.

ECRH System For ITER

NASA Astrophysics Data System (ADS)

Darbos, C.; Henderson, M.; Albajar, F.; Bigelow, T.; Bomcelli, T.; Chavan, R.; Denisov, G.; Farina, D.; Gandini, F.; Heidinger, R.; Goodman, T.; Hogge, J. P.; Kajiwara, K.; Kasugai, A.; Kern, S.; Kobayashi, N.; Oda, Y.; Ramponi, G.; Rao, S. L.; Rasmussen, D.; Rzesnicki, T.; Saibene, G.; Sakamoto, K.; Sauter, O.; Scherer, T.; Strauss, D.; Takahashi, K.; Zohm, H.

2009-11-01

A 26 MW Electron Cyclotron Heating and Current Drive (EC H&CD) system is to be installed for ITER. The main objectives are to provide, start-up assist, central H&CD and control of MHD activity. These are achieved by a combination of two types of launchers, one located in an equatorial port and the second type in four upper ports. The physics applications are partitioned between the two launchers, based on the deposition location and driven current profiles. The equatorial launcher (EL) will access from the plasma axis to mid radius with a relatively broad profile useful for central heating and current drive applications, while the upper launchers (ULs) will access roughly the outer half of the plasma radius with a very narrow peaked profile for the control of the Neoclassical Tearing Modes (NTM) and sawtooth oscillations. The EC power can be switched between launchers on a time scale as needed by the immediate physics requirements. A revision of all injection angles of all launchers is under consideration for increased EC physics capabilities while relaxing the engineering constraints of both the EL and ULs. A series of design reviews are being planned with the five parties (EU, IN, JA, RF, US) procuring the EC system, the EC community and ITER Organization (IO). The review meetings qualify the design and provide an environment for enhancing performances while reducing costs, simplifying interfaces, predicting technology upgrades and commercial availability. In parallel, the test programs for critical components are being supported by IO and performed by the Domestic Agencies (DAs) for minimizing risks. The wide participation of the DAs provides a broad representation from the EC community, with the aim of collecting all expertise in guiding the EC system optimization. Still a strong relationship between IO and the DA is essential for optimizing the design of the EC system and for the installation and commissioning of all ex-vessel components when several teams from several DAs will be involved together in the tests on the ITER site.

GRASP/Ada 95: Reverse Engineering Tools for Ada

NASA Technical Reports Server (NTRS)

Cross, James H., II

1996-01-01

The GRASP/Ada project (Graphical Representations of Algorithms, Structures, and Processes for Ada) has successfully created and prototyped an algorithmic level graphical representation for Ada software, the Control Structure Diagram (CSD), and a new visualization for a fine-grained complexity metric called the Complexity Profile Graph (CPG). By synchronizing the CSD and the CPG, the CSD view of control structure, nesting, and source code is directly linked to the corresponding visualization of statement level complexity in the CPG. GRASP has been integrated with GNAT, the GNU Ada 95 Translator to provide a comprehensive graphical user interface and development environment for Ada 95. The user may view, edit, print, and compile source code as a CSD with no discernible addition to storage or computational overhead. The primary impetus for creation of the CSD was to improve the comprehension efficiency of Ada software and, as a result, improve reliability and reduce costs. The emphasis has been on the automatic generation of the CSD from Ada 95 source code to support reverse engineering and maintenance. The CSD has the potential to replace traditional prettyprinted Ada source code. The current update has focused on the design and implementation of a new Motif compliant user interface, and a new CSD generator consisting of a tagger and renderer. The Complexity Profile Graph (CPG) is based on a set of functions that describes the context, content, and the scaling for complexity on a statement by statement basis. When combined graphicafly, the result is a composite profile of complexity for the program unit. Ongoing research includes the development and refinement of the associated functions, and the development of the CPG generator prototype. The current Version 5.0 prototype provides the capability for the user to generate CSDs and CPGs from Ada 95 source code in a reverse engineering as well as forward engineering mode with a level of flexibility suitable for practical application. This report provides an overview of the GRASP/Ada project with an emphasis on the current update.

Impact of socioeconomic adjustment on physicians' relative cost of care.

PubMed

Timbie, Justin W; Hussey, Peter S; Adams, John L; Ruder, Teague W; Mehrotra, Ateev

2013-05-01

Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES). The importance of SES adjustment has not been explored in cost-profiling applications that measure costs using an episode of care framework. We assessed the relationship between SES and episode costs and the impact of adjusting for SES on physicians' relative cost rankings. We analyzed claims submitted to 3 Massachusetts commercial health plans during calendar years 2004 and 2005. We grouped patients' care into episodes, attributed episodes to individual physicians, and standardized costs for price differences across plans. We accounted for differences in physicians' case mix using indicators for episode type and a patient's severity of illness. A patient's SES was measured using an index of 6 indicators based on the zip code in which the patient lived. We estimated each physician's case mix-adjusted average episode cost and percentile rankings with and without adjustment for SES. Patients in the lowest SES quintile had $80 higher unadjusted episode costs, on average, than patients in the highest quintile. Nearly 70% of the variation in a physician's average episode cost was explained by case mix of their patients, whereas the contribution of SES was negligible. After adjustment for SES, only 1.1% of physicians changed relative cost rankings >2 percentiles. Accounting for patients' SES has little impact on physicians' relative cost rankings within an episode cost framework.

Metabolically healthy and unhealthy weight statuses, health issues and related costs: Findings from the 2013-2015 European Health Examination Survey in Luxembourg.

PubMed

Samouda, H; Ruiz-Castell, M; Karimi, M; Bocquet, V; Kuemmerle, A; Chioti, A; Dadoun, F; Stranges, S

2017-12-01

To investigate the relationship between metabolically healthy and unhealthy weight statuses and a wide range of related health issues, and healthcare and loss-of-productivity costs. A total of 693 men and 729 women, aged 25-64 years, took part in the European Health Examination Survey conducted in Luxembourg between 2013 and 2015. Metabolically unhealthy normal-weight profiles were defined as having two or more cardiometabolic abnormalities (high blood pressure, high fasting glucose or triglycerides, low HDL cholesterol and/or previously diagnosed hypertension or diabetes) in people with normal weight. Metabolically healthy overweight/obesity was defined as having fewer than two of the above-mentioned abnormalities in people with overweight or obesity. For the present report, the participants' anthropometric, clinical, biological, sociodemographic, lifestyle and health-related data were analyzed. Of the participants with normal weight, 20% had a metabolically unhealthy profile, whereas 60% with overweight and 30% with obesity had a metabolically healthy profile. Comparisons between metabolically healthy and unhealthy normal weight, overweight and/or obesity status revealed that participants presented with a metabolically unhealthy profile independently of weight status (P<0.0001). People with a metabolically healthy profile were more likely to perceive their health as good (66%; P<0.0001), and to report no physical pain (64%; P=0.03), no limitations in daily activities (66%; P=0.0008), no difficulties getting in or out of a bed or chair (63%; P=0.02) or dressing and undressing (63%; P=0.003), going shopping (63%; P=0.053) or doing occasional heavy housework (64%; P=0.007); they also displayed fewer gastrointestinal (63%; P=0.02), arthrosis (64%; P=0.001) and sleep apnoea issues (63%; P=0.002) compared with those with a metabolically unhealthy profile. Healthcare- and loss-of-productivity-related costs were higher with a metabolically unhealthy profile, with differences of up to € 3000 (P=0.02). The present work has highlighted that, independently of weight status, people may develop a metabolically unhealthy profile associated with several health issues as well as higher healthcare and loss-of-productivity costs. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Comparative Costs and Staffing Report for College and University Facilities, 1993-94.

ERIC Educational Resources Information Center

Silberman, Gil, Ed.; Glazner, Steve, Ed.

This report presents comparative data on facility management costs and staffing based on responses from 516 U.S. postsecondary educational facilities during 1993-94. It lists statistics from both private and public institutions, beginning with statistical reductions presenting the survey response tally, institutional profiles, and mean costs per…

Cost and fuel consumption per nautical mile for two engine jet transports using OPTIM and TRAGEN

NASA Technical Reports Server (NTRS)

Wiggs, J. F.

1982-01-01

The cost and fuel consumption per nautical mile for two engine jet transports are computed using OPTIM and TRAGEN. The savings in fuel and direct operating costs per nautical mile for each of the different types of optimal trajectories over a standard profile are shown.

Theory and discretization of ideal magnetohydrodynamic equilibria with fractal pressure profiles

NASA Astrophysics Data System (ADS)

Kraus, B. F.; Hudson, S. R.

2017-09-01

In three-dimensional ideal magnetohydrodynamics, closed flux surfaces cannot maintain both rational rotational-transform and pressure gradients, as these features together produce unphysical, infinite currents. A proposed set of equilibria nullifies these currents by flattening the pressure on sufficiently wide intervals around each rational surface. Such rational surfaces exist at every scale, which characterizes the pressure profile as self-similar and thus fractal. The pressure profile is approximated numerically by considering a finite number of rational regions and analyzed mathematically by classifying the irrational numbers that support gradients into subsets. Applying these results to a given rotational-transform profile in cylindrical geometry, we find magnetic field and current density profiles compatible with the fractal pressure.

Using Cell Phones From Satellites

NASA Technical Reports Server (NTRS)

Horan, Stephen

2000-01-01

During the past several years, an interest has grown in using commercial telecommunications techniques to supply Telemetry and Command (T&C) services. Recently, the National Aeronautics and Space Administration (NASA) Space Operations Management Office (SOMO) has outlined plans to utilize satellite-based telecommunications services to support space operations in space missions over the next several decades. NASA currently obtains the bulk of its telecommunications services for earth-orbiting satellites via the existing government-owned and controlled Space Network (SN) system. This system consists of the constellation of Tracking and Data Relay Satellites (TDRS) in Geostationary Earth Orbit (GEO) and the associated ground terminals and communications intrastructure. This system is valuable and effective for scientific satellites costing over one million dollars. However, for smaller satellites, this system becomes problematic due to the cost of transponders and support infrastructure. The nominal transponders for using the TDRS cannot be obtained for a cost in dollars, and size, weight, or power that the 3 Corner Satellite project can afford. For these types of nanosatellite missions, alternatives that fit the mission cost and satellite profiles are needed. In particular, low-cost access using existing commercial infrastructure would be useful to mission planners. In particular, the ability to obtain low data rate T&C services would be especially valuable. The nanosatellites generally have low T&C requirements and therefore would benefit from using commercial services that could operate in the 2400 bps - 9600 bps range, especially if contact times longer than the 5 - 10 minute ground station passes could be found.

Development of cost-effective media to increase the economic potential for larger-scale bioproduction of natural food additives by Lactobacillus rhamnosus , Debaryomyces hansenii , and Aspergillus niger.

PubMed

Salgado, José Manuel; Rodríguez, Noelia; Cortés, Sandra; Domínguez, José Manuel

2009-11-11

Yeast extract (YE) is the most common nitrogen source in a variety of bioprocesses in spite of the high cost. Therefore, the use of YE in culture media is one of the major technical hurdles to be overcome for the development of low-cost fermentation routes, making the search for alternative-cheaper nitrogen sources particularly desired. The aim of the current study is to develop cost-effective media based on corn steep liquor (CSL) and locally available vinasses in order to increase the economic potential for larger-scale bioproduction. Three microorganisms were evaluated: Lactobacillus rhamnosus , Debaryomyces hansenii , and Aspergillus niger . The amino acid profile and protein concentration was relevant for the xylitol and citric acid production by D. hansenii and A. niger , respectively. Metals also played an important role for citric acid production, meanwhile, D. hansenii showed a strong dependence with the initial amount of Mg(2+). Under the best conditions, 28.8 g lactic acid/L (Q(LA) = 0.800 g/L.h, Y(LA/S) = 0.95 g/g), 35.3 g xylitol/L (Q(xylitol) = 0.380 g/L.h, Y(xylitol/S) = 0.69 g/g), and 13.9 g citric acid/L (Q(CA) = 0.146 g/L.h, Y(CA/S) = 0.63 g/g) were obtained. The economic efficiency (E(p/euro)) parameter identify vinasses as a lower cost and more effective nutrient source in comparison to CSL.

1975 Manual of Freshman Profiles. Four-year Colleges and University Centers, State University of New York. 1976 Profile Supplement.

ERIC Educational Resources Information Center

State Univ. of New York, Albany. Office of Admissions and Financial Aid Affairs.

The State University of New York compiles an information manual about freshman admission to the baccalaureate programs throughout the state. A profile summary for the four-year colleges and university centers is charted. An outline of costs and financial assistance available is provided to help the prospective student understand and prepare for…

Upper ocean moored current and density profiler applied to winter conditions near Bermuda

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

Eriksen, C.C.; Dahlen, J.M.; Shillingford, J.T. Jr.

1982-09-20

A new moored instrument which makes repeated high vertical resolution profiles of current, temperature, and salinity in the upper ocean over extended periods was used to observe midwinter conditions near Bermuda. The operation and performance of the instrument, called the profiling current meter (PCM), in the surface wave environment of winter storms is reported here. The PCM profiles along the upper portion of a slightly subsurface mooring by adjusting its buoyancy under computer control. This design decouples the instrument from vertical motions of the mooring induced by surface waves, so that its electromagnetic current sensor operates in a favorable mean-to-fluctuatingmore » flow regime. Current, temperature, and electrical conductivity are (vector) averaged into contiguous preselected bins several meters wide over the possible profile range of 20- to 250-m depth. The PCM is capable of collecting 1000--4000 profiles in a 6- to 12-month period, depending on depth range and ambient currents. A variety of baroclinic motions are evident in the Bermuda observations. Upper ocean manifestations of both Kelvin and superinertial island-trapped waves dominate longshore currents. Vertical coherence of onshore current and temperature suggest that internal wave vertical wave number energy distribution is independent of frequency but modified by island bathymetry. Kinetic energy in shear integrated over a 115.6-m-thick layer in the upper ocean is limited to values less than or equal to the potential energy required to mix the existing stratification. Mixing events occur when kinetic energy associated with shear drives the bulk Richardson number (defined by the ratio of energy integrals over the range profiles) to unity, where it remains while shear and stratification disappear together.« less

Single-cell RNA-seq of rheumatoid arthritis synovial tissue using low-cost microfluidic instrumentation.

PubMed

Stephenson, William; Donlin, Laura T; Butler, Andrew; Rozo, Cristina; Bracken, Bernadette; Rashidfarrokhi, Ali; Goodman, Susan M; Ivashkiv, Lionel B; Bykerk, Vivian P; Orange, Dana E; Darnell, Robert B; Swerdlow, Harold P; Satija, Rahul

2018-02-23

Droplet-based single-cell RNA-seq has emerged as a powerful technique for massively parallel cellular profiling. While this approach offers the exciting promise to deconvolute cellular heterogeneity in diseased tissues, the lack of cost-effective and user-friendly instrumentation has hindered widespread adoption of droplet microfluidic techniques. To address this, we developed a 3D-printed, low-cost droplet microfluidic control instrument and deploy it in a clinical environment to perform single-cell transcriptome profiling of disaggregated synovial tissue from five rheumatoid arthritis patients. We sequence 20,387 single cells revealing 13 transcriptomically distinct clusters. These encompass an unsupervised draft atlas of the autoimmune infiltrate that contribute to disease biology. Additionally, we identify previously uncharacterized fibroblast subpopulations and discern their spatial location within the synovium. We envision that this instrument will have broad utility in both research and clinical settings, enabling low-cost and routine application of microfluidic techniques.

Voltage Profiles for the Lead-Acid Cell: Experiment and Theory

NASA Astrophysics Data System (ADS)

Haaser, Robert; Ross, Joseph H.; Saslow, Wayne M.

1999-10-01

Using platinum electrodes we have measured the voltage profile in space across a lead-acid cell, for slow, steady processes. Once in the slow, steady charge or discharge regime, the experimental voltage profile is quadratic, as predicted by recent theory.^1 However, even without current flow, in the slow, steady regime the voltage profile also is quadratic, rather than a straight line with zero slope. This other quadratic voltage profile is due to nonfaradaic chemical reactions at the working electrodes, which slowly discharge the cell without drawing any current. Such a quadratic voltage profile follows from theory. The voltage jump profiles (change in voltage profile on sudden change in current) on starting or ending a charge or discharge, are linear in space, with slope consistent with the measured resistivity of battery acid. This is as expected if charge on the electrodes, but not in the electrolyte, has time to move. 1. W.M.Saslow, Phys.Rev.Lett.76, 4849 (1996).

A simple and reliable sensor for accurate measurement of angular speed for low speed rotating machinery

NASA Astrophysics Data System (ADS)

Kuosheng, Jiang; Guanghua, Xu; Tangfei, Tao; Lin, Liang; Yi, Wang; Sicong, Zhang; Ailing, Luo

2014-01-01

This paper presents the theory and implementation of a novel sensor system for measuring the angular speed (AS) of a shaft rotating at a very low speed range, nearly zero speed. The sensor system consists mainly of an eccentric sleeve rotating with the shaft on which the angular speed to be measured, and an eddy current displacement sensor to obtain the profile of the sleeve for AS calculation. When the shaft rotates at constant speed the profile will be a pure sinusoidal trace. However, the profile will be a phase modulated signal when the shaft speed is varied. By applying a demodulating procedure, the AS can be obtained in a straightforward manner. The sensor system was validated experimentally based on a gearbox test rig and the result shows that the AS obtained are consistent with that obtained by a conventional encoder. However, the new sensor gives very smooth and stable traces of the AS, demonstrating its higher accuracy and reliability in obtaining the AS of the low speed operations with speed-up and down transients. In addition, the experiment also shows that it is easy and cost-effective to be realised in different applications such as condition monitoring and process control.

Characterization of Unimorph-Membrane Microactuators and Error-Analysis of the Characterization Process

NASA Technical Reports Server (NTRS)

Wright, Matthew W.

2005-01-01

Microactuators are versatile, low-cost, low-mass electrical-mechanical devices that can be used in many applications. Microactuators consist of two electrodes sandwiching a PZT (piezo-electric) film between them. The centers of the microactuators deflect when a voltage is applied across the electrodes. In order to correctly apply this technology for use, it is important to fully characterize the actuation behavior. Measuring the deflection profile as a function of the voltage of various microactuators is crucial. This measurement process has errors associated with it, so it is being studied to determine the accuracy of the data. In certain applications, microactuators may undergo many cycles of deflection; testing various microactuators through many cycles of deflection simulates these circumstances. However, due to an unknown issue, many of the microactuators exhibit defects that cause them to fail when voltage is applied to their electrodes. These defects do not allow for the acquisition of significant deflection profiles. Vibrations are the largest cause of error in deflection measurements, and the microactuators withstand continuous cycles of deflection, yet the cause of damage is still to be determined. Future projects will be needed to characterize the deflection profiles of various microactuators and to overcome the defects in the microactuators that are currently present.

Blinatumomab: Enlisting serial killer T cells in the war against hematologic malignanciess

PubMed Central

Rogala, Britny; Freyer, Craig W.; Ontiveros, Evelena P.; Griffiths, Elizabeth A.; Wang, Eunice S.; Wetzler, Meir

2016-01-01

Introduction The approval of blinatumomab signals the long awaited arrival of immunotherapy for acute lymphoblastic leukemia (ALL). Previous options for relapsed or refractory disease were restricted to combination cytotoxic chemotherapy with limited efficacy and significant toxicity. Through an innovative mechanism of action, blinatumomab stimulates a polyclonal antitumor T cell response, yielding unprecedented single agent efficacy in the relapsed/refractory setting. Success comes at the cost of immunological toxicities rarely encountered with previous therapies and challenging administration logistics requiring clinical expertise. Areas covered All published clinical and preclinical studies using blinatumomab were reviewed in addition to all registered ongoing clinical trials and data published in abstract form. The search was limited to the English language. The pharmacology, clinical efficacy, toxicity profile, and logistical considerations for drug administration are discussed. Expert Opinion Blinatumomab is an exciting addition to the treatment armamentarium for relapsed/refractory ALL, yet several questions remain regarding optimal implementation into the current treatment paradigm. A unique toxicity profile should be weighed against promising benefits in a poor prognosis population. Other emerging therapies, such as chimeric antigen receptor-modified T cells and inotuzumab ozogamicin, with different side effect profiles and administration schedules, may prove to be more beneficial for specific patient populations. PMID:25985814

Overcoming Cost Implications of Mutational Analysis in Patients with Gastrointestinal Stromal Tumors: A Pragmatic Approach.

PubMed

Schöffski, Patrick; Wozniak, Agnieszka; Schöffski, Oliver; van Eycken, Liesbet; Debiec-Rychter, Maria

2016-01-01

Genetic analysis of tissue derived from patients with advanced gastrointestinal stromal tumors (GISTs) is not uniformly applied on a national and international level, even though mutational data can provide clinically relevant prognostic and predictive information, especially in patients qualifying for treatment with expensive targeted agents. The current article describes the rationale for genetic testing of GIST tissue, looks at financial implications associated with such analysis and speculates on potential cost savings introduced by routine mutational testing and tailored use of tyrosine kinase inhibitors based on genotyping. This work is based on a hypothetical analysis of epidemiological data, drug costs, reimbursement criteria and market research figures. The cost burden for routine genotyping of important genes in GISTs, especially in patients at high risk for relapse after primary surgery and in advanced, inoperable metastatic disease, is relatively low. The early identification of GISTs with primary resistance mutations should be the basis for personalized GIST treatment and reimbursement of drugs. As illustrated by Belgian figures, the exclusive use of a drug such as imatinib in patients who are likely to benefit from the agent based on genetic information can lead to significant cost savings, which outweigh the costs for testing. Mutational analysis of GIST should be considered early in all patients at risk for relapse after curative surgery and in the case of advanced, inoperable, metastatic disease. The costs for the actual genotyping should not be used as an argument against profiling of the tumor. The adjuvant and palliative systemic treatment of GISTs should be personalized based on the genotype and other known prognostic and predictive factors. Reimbursement criteria for essential agents such as imatinib should be adapted accordingly. © 2016 S. Karger GmbH, Freiburg.

Medicare long-term CPAP coverage policy: a cost-utility analysis.

PubMed

Billings, Martha E; Kapur, Vishesh K

2013-10-15

CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Cost-utility and cost-effectiveness analysis. U.S. Medicare Population. N/A. N/A. We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change.

The role of lipid composition for insertion and stabilization of amino acids in membranes

NASA Astrophysics Data System (ADS)

Johansson, Anna C. V.; Lindahl, Erik

2009-05-01

While most membrane protein helices are clearly hydrophobic, recent experiments have indicated that it is possible to insert marginally hydrophobic helices into bilayers and have suggested apparent in vivo free energies of insertion for charged residues that are low, e.g., a few kcals for arginine. In contrast, a number of biophysical simulation studies have predicted that the bilayer interior is close to a pure hydrophobic environment with large penalties for hydrophilic amino acids—and yet the experimental scales do significantly better at predicting actual membrane proteins from sequence. Here, we have systematically studied the dependence of the free energy profiles on lipid properties, including tail length, saturation, headgroup hydrogen bond strength, and charge, both to see to whether the in vivo insertion can be explained in whole or part from lipid composition of the endoplasmic reticulum (ER) membranes, and if the solvation properties can help interpret how protein function depends on the lipids. We find that lipid charge is important to stabilize charged amino acids inside the bilayer (with implications, e.g., for ion channels), that thicker bilayers have higher solvation costs for hydrophilic side chains, and that headgroup hydrogen bond strength determines how adaptive the lipids are as a hydrophobic/hydrophilic solvent. None of the different free energy profiles are even close to the low apparent in vivo insertion cost, which suggests that regardless of the specific ER membrane composition the current experimental results cannot be explained by normal lipid-type variation.

CYGNSS: Lessons We are Learning from a Class D Mission

NASA Technical Reports Server (NTRS)

Tumlinson, Jessica

2015-01-01

CYGNSS: Lessons Learned from NASA Class D Mission and how they selected their parts for the program to include balance between cost, risk, schedule and technology available as well as balancing cost restraints with mission risk profile.

Random sampling technique for ultra-fast computations of molecular opacities for exoplanet atmospheres

NASA Astrophysics Data System (ADS)

Min, M.

2017-10-01

Context. Opacities of molecules in exoplanet atmospheres rely on increasingly detailed line-lists for these molecules. The line lists available today contain for many species up to several billions of lines. Computation of the spectral line profile created by pressure and temperature broadening, the Voigt profile, of all of these lines is becoming a computational challenge. Aims: We aim to create a method to compute the Voigt profile in a way that automatically focusses the computation time into the strongest lines, while still maintaining the continuum contribution of the high number of weaker lines. Methods: Here, we outline a statistical line sampling technique that samples the Voigt profile quickly and with high accuracy. The number of samples is adjusted to the strength of the line and the local spectral line density. This automatically provides high accuracy line shapes for strong lines or lines that are spectrally isolated. The line sampling technique automatically preserves the integrated line opacity for all lines, thereby also providing the continuum opacity created by the large number of weak lines at very low computational cost. Results: The line sampling technique is tested for accuracy when computing line spectra and correlated-k tables. Extremely fast computations ( 3.5 × 105 lines per second per core on a standard current day desktop computer) with high accuracy (≤1% almost everywhere) are obtained. A detailed recipe on how to perform the computations is given.

Recovery of human DNA profiles from poached deer remains part 2: improved recovery protocol without the need for LCN analysis.

PubMed

Tobe, Shanan S; Bailey, Stuart; Govan, James; Welch, Lindsey A

2013-03-01

Although poaching is a common wildlife crime, the high and prohibitive cost of specialised animal testing means that many cases are left un-investigated. We previously described a novel approach to wildlife crime investigation that looked at the identification of human DNA on poached animal remains (Tobe, Govan and Welch, 2011). Human DNA was successfully isolated and amplified from simulated poaching incidents, however a low template protocol was required which made this method unsuitable for use in many laboratories. We now report on an optimised recovery and amplification protocol which removes the need for low template analysis. Samples from 10 deer (40 samples total - one from each leg) analysed in the original study were re-analysed in the current study with an additional 11 deer samples. Four samples analysed using Chelex did not show any results and a new method was devised whereby the available DNA was concentrated. By combining the DNA extracts from all tapings of the same deer remains followed by concentration, the recovered quantity of human DNA was found to be 29.5pg±43.2pg, 31× greater than the previous study. The use of the Investigator Decaplex SE (QIAGEN) STR kit provided better results in the form of more complete profiles than did the AmpFℓSTR® SGM Plus® kit at 30cycles (Applied Biosystems). Re-analysis of the samples from the initial study using the new, optimised protocol resulted in an average increase of 18% of recovered alleles. Over 17 samples, 71% of the samples analysed using the optimised protocol showed sufficient amplification for comparison to a reference profile and gave match probabilities ranging from 7.7690×10(-05) to 2.2706×10(-14). The removal of low template analysis means this optimised method provides evidence of high probative value and is suitable for immediate use in forensic laboratories. All methods and techniques used are standard and are compatible with current SOPs. As no high cost non-human DNA analysis is required the overall process is no more expensive than the investigation of other volume crime samples. The technique is suitable for immediate use in poaching incidents. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

[Options for a future risc structure compensation in Germany].

PubMed

Greiner, W

2006-07-01

AIM OF THE ARTICLE: The risc structure compensation scheme within the German compulsory health insurance system is intended to enforce the principle of solidarity all over the statutory health insurance and not only within the different sickness funds. Differences in the contribution rates should not reflect different risc profiles, but the differences of the efficiency in social care. The criticism against the current adjustment system in Germany is multifarious and points e. g. on the missing orientation to morbidity. This article follows the question, whether this criticism is valid. The variables and methods, which are currently used to calculate the risc structure adjustment are discussed and compared to an alternative proposal for the future form of the risc structure adjustment, which includes both a higher orientation to riscs and incentives for social health insurance funds to decline the costs for the social care system on long-term. Currently, for the calculation of the risc structure adjustment the following variables are used: age, sex, income, number of family members who are exempted from contributions and persons who get occupational disability pension, and number of insured persons who are registered to an accredited Disease-Management-Program (DMP). Especially the last variable includes a high control effort, because the higher co-payments of the adjustment system are aligned to the voluntariness of participation and active collaboration of the patients in DMP. The argument, a further development to a morbidity-oriented risc structure adjustment leads to less cost management of the sickness funds is not totally correct, because not actual, but standardised costs are the basis for compensation. On the other hand the morbidity determined cost components should not totally be adjusted, as a proper distribution of savings to the risc structure adjustment and the single funds would still be an incentive for cost management and prevention. An ongoing refining of the risc structure adjustment might cause new incentive problems. Instead a morbidity orientated risc structure compensation scheme should leave a part of the savings due to better social care structures in the sickness funds and should include outpatient care parameters. The change to a new honorarium system could create a better data basis for this improved form of risc structure adjustment in the future.

Theory and discretization of ideal magnetohydrodynamic equilibria with fractal pressure profiles

DOE PAGES

Kraus, B. F.; Hudson, S. R.

2017-09-29

In three-dimensional ideal magnetohydrodynamics, closed flux surfaces cannot maintain both rational rotational-transform and pressure gradients, as these features together produce unphysical, infinite currents. A proposed set of equilibria nullifies these currents by flattening the pressure on sufficiently wide intervals around each rational surface. Such rational surfaces exist at every scale, which characterizes the pressure profile as self-similar and thus fractal. The pressure profile is approximated numerically by considering a finite number of rational regions and analyzed mathematically by classifying the irrational numbers that support gradients into subsets. As a result, applying these results to a given rotational-transform profile in cylindricalmore » geometry, we find magnetic field and current density profiles compatible with the fractal pressure.« less

Theory and discretization of ideal magnetohydrodynamic equilibria with fractal pressure profiles

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

Kraus, B. F.; Hudson, S. R.

In three-dimensional ideal magnetohydrodynamics, closed flux surfaces cannot maintain both rational rotational-transform and pressure gradients, as these features together produce unphysical, infinite currents. A proposed set of equilibria nullifies these currents by flattening the pressure on sufficiently wide intervals around each rational surface. Such rational surfaces exist at every scale, which characterizes the pressure profile as self-similar and thus fractal. The pressure profile is approximated numerically by considering a finite number of rational regions and analyzed mathematically by classifying the irrational numbers that support gradients into subsets. As a result, applying these results to a given rotational-transform profile in cylindricalmore » geometry, we find magnetic field and current density profiles compatible with the fractal pressure.« less

Observations of Near-Bottom Currents with Low-Cost SeaHorse Tilt Current Meters

DTIC Science & Technology

2010-09-30

DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Observations of Near-Bottom Currents with Low-Cost SeaHorse Tilt...sheremet/ SeaHorse LONG-TERM GOALS The SeaHorse TCM is a low-cost, easy to use, robust current meter based on the drag principle. Use of a large...2010 2. REPORT TYPE 3. DATES COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Observations of Near-Bottom Currents with Low-Cost SeaHorse

Profiles of Childhood Trauma in Patients with Alcohol Dependence and Their Associations with Addiction-Related Problems.

PubMed

Lotzin, Annett; Haupt, Lena; von Schönfels, Julia; Wingenfeld, Katja; Schäfer, Ingo

2016-03-01

The high occurrence of childhood trauma in individuals with alcohol dependence is well-recognized. Nevertheless, researchers have rarely studied which types of childhood trauma often co-occur and how these combinations of different types and severities of childhood trauma are related to the patients' current addiction-related problems. We aimed to identify childhood trauma profiles in patients with alcohol dependence and examined relations of these trauma profiles with the patients' current addiction-related problems. In 347 alcohol-dependent patients, 5 types of childhood trauma (sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) were measured using the Childhood Trauma Questionnaire. Childhood trauma profiles were identified using cluster analysis. The patients' current severity of addiction-related problems was assessed using the European Addiction Severity Index. We identified 6 profiles that comprised different types and severities of childhood trauma. The patients' trauma profiles predicted the severity of addiction-related problems in the domains of psychiatric symptoms, family relationships, social relationships, and drug use. Childhood trauma profiles may provide more useful information about the patient's risk of current addiction-related problems than the common distinction between traumatized versus nontraumatized patients. Copyright © 2016 by the Research Society on Alcoholism.

Current source density analysis of the hippocampal theta rhythm: associated sustained potentials and candidate synaptic generators.

PubMed

Brankack, J; Stewart, M; Fox, S E

1993-07-02

Single-electrode depth profiles of the hippocampal EEG were made in urethane-anesthetized rats and rats trained in an alternating running/drinking task. Current source density (CSD) was computed from the voltage as a function of depth. A problem inherent to AC-coupled profiles was eliminated by incorporating sustained potential components of the EEG. 'AC' profiles force phasic current sinks to alternate with current sources at each lamina, changing the magnitude and even the sign of the computed membrane current. It was possible to include DC potentials in the profiles from anesthetized rats by using glass micropipettes for recording. A method of 'subtracting' profiles of the non-theta EEG from theta profiles was developed as an approach to including sustained potentials in recordings from freely-moving animals implanted with platinum electrodes. 'DC' profiles are superior to 'AC' profiles for analysis of EEG activity because 'DC'-CSD values can be considered correct in sign and more closely represent the actual membrane current magnitudes. Since hippocampal inputs are laminated, CSD analysis leads to straightforward predictions of the afferents involved. Theta-related activity in afferents from entorhinal neurons, hippocampal interneurons and ipsi- and contralateral hippocampal pyramids all appear to contribute to sources and sinks in CA1 and the dentate area. The largest theta-related generator was a sink at the fissure, having both phasic and tonic components. This sink may reflect activity in afferents from the lateral entorhinal cortex. The phase of the dentate mid-molecular sink suggests that medial entorhinal afferents drive the theta-related granule and pyramidal cell firing. The sustained components may be simply due to different average rates of firing during theta rhythm than during non-theta EEG in afferents whose firing rates are also phasically modulated.

Modeling and Simulation of - and Silicon Germanium-Base Bipolar Transistors Operating at a Wide Range of Temperatures.

NASA Astrophysics Data System (ADS)

Shaheed, M. Reaz

1995-01-01

Higher speed at lower cost and at low power consumption is a driving force for today's semiconductor technology. Despite a substantial effort toward achieving this goal via alternative technologies such as III-V compounds, silicon technology still dominates mainstream electronics. Progress in silicon technology will continue for some time with continual scaling of device geometry. However, there are foreseeable limits on achievable device performance, reliability and scaling for room temperature technologies. Thus, reduced temperature operation is commonly viewed as a means for continuing the progress towards higher performance. Although silicon CMOS will be the first candidate for low temperature applications, bipolar devices will be used in a hybrid fashion, as line drivers or in limited critical path elements. Silicon -germanium-base bipolar transistors look especially attractive for low-temperature bipolar applications. At low temperatures, various new physical phenomena become important in determining device behavior. Carrier freeze-out effects which are negligible at room temperature, become of crucial importance for analyzing the low temperature device characteristics. The conventional Pearson-Bardeen model of activation energy, used for calculation of carrier freeze-out, is based on an incomplete picture of the physics that takes place and hence, leads to inaccurate results at low temperatures. Plasma -induced bandgap narrowing becomes more pronounced in device characteristics at low temperatures. Even with modern numerical simulators, this effect is not well modeled or simulated. In this dissertation, improved models for such physical phenomena are presented. For accurate simulation of carrier freeze-out, the Pearson-Bardeen model has been extended to include the temperature dependence of the activation energy. The extraction of the model is based on the rigorous, first-principle theoretical calculations available in the literature. The new model is shown to provide consistently accurate values for base sheet resistance for both Si- and SiGe-base transistors over a wide range of temperatures. A model for plasma-induced bandgap narrowing suitable for implementation in a numerical simulator has been developed. The appropriate method of incorporating this model in a drift -diffusion solver is described. The importance of including this model for low temperature simulation is demonstrated. With these models in place, the enhanced simulator has been used for evaluating and designing the Si- and SiGe-base bipolar transistors. Silicon-germanium heterojunction bipolar transistors offer significant performance and cost advantages over conventional technologies in the production of integrated circuits for communications, computer and transportation applications. Their high frequency performance at low cost, will find widespread use in the currently exploding wireless communication market. However, the high performance SiGe-base transistors are prone to have a low common-emitter breakdown voltage. In this dissertation, a modification in the collector design is proposed for improving the breakdown voltage without sacrificing the high frequency performance. A comprehensive simulation study of p-n-p SiGe-base transistors has been performed. Different figures of merit such as drive current, current gain, cut -off frequency and Early voltage were compared between a graded germanium profile and an abrupt germanium profile. The differences in the performance level between the two profiles diminishes as the base width is scaled down.

Comparison of sequencing-based methods to profile DNA methylation and identification of monoallelic epigenetic modifications

PubMed Central

Harris, R. Alan; Wang, Ting; Coarfa, Cristian; Nagarajan, Raman P.; Hong, Chibo; Downey, Sara L.; Johnson, Brett E.; Fouse, Shaun D.; Delaney, Allen; Zhao, Yongjun; Olshen, Adam; Ballinger, Tracy; Zhou, Xin; Forsberg, Kevin J.; Gu, Junchen; Echipare, Lorigail; O’Geen, Henriette; Lister, Ryan; Pelizzola, Mattia; Xi, Yuanxin; Epstein, Charles B.; Bernstein, Bradley E.; Hawkins, R. David; Ren, Bing; Chung, Wen-Yu; Gu, Hongcang; Bock, Christoph; Gnirke, Andreas; Zhang, Michael Q.; Haussler, David; Ecker, Joseph; Li, Wei; Farnham, Peggy J.; Waterland, Robert A.; Meissner, Alexander; Marra, Marco A.; Hirst, Martin; Milosavljevic, Aleksandar; Costello, Joseph F.

2010-01-01

Sequencing-based DNA methylation profiling methods are comprehensive and, as accuracy and affordability improve, will increasingly supplant microarrays for genome-scale analyses. Here, four sequencing-based methodologies were applied to biological replicates of human embryonic stem cells to compare their CpG coverage genome-wide and in transposons, resolution, cost, concordance and its relationship with CpG density and genomic context. The two bisulfite methods reached concordance of 82% for CpG methylation levels and 99% for non-CpG cytosine methylation levels. Using binary methylation calls, two enrichment methods were 99% concordant, while regions assessed by all four methods were 97% concordant. To achieve comprehensive methylome coverage while reducing cost, an approach integrating two complementary methods was examined. The integrative methylome profile along with histone methylation, RNA, and SNP profiles derived from the sequence reads allowed genome-wide assessment of allele-specific epigenetic states, identifying most known imprinted regions and new loci with monoallelic epigenetic marks and monoallelic expression. PMID:20852635

The Impact of Patient Profiles and Procedures on Hospitalization Costs through Length of Stay in Community-Acquired Pneumonia Patients Based on a Japanese Administrative Database

PubMed Central

Uematsu, Hironori; Kunisawa, Susumu; Yamashita, Kazuto; Imanaka, Yuichi

2015-01-01

Background Community-acquired pneumonia is a common cause of patient hospitalization, and its burden on health care systems is increasing in aging societies. In this study, we aimed to investigate the factors that affect hospitalization costs in community-acquired pneumonia patients while considering the intermediate influence of patient length of stay. Methods Using a multi-institutional administrative claims database, we analyzed 30,041 patients hospitalized for community-acquired pneumonia who had been discharged between April 1, 2012 and September 30, 2013 from 289 acute care hospitals in Japan. Possible factors associated with hospitalization costs were investigated using structural equation modeling with length of stay as an intermediate variable. We calculated the direct, indirect (through length of stay), and total effects of the candidate factors on hospitalization costs in the model. Lastly, we calculated the ratio of indirect effects to direct effects for each factor. Results The structural equation model showed that higher disease severities (using A-DROP, Barthel Index, and Charlson Comorbidity Index scores), use of mechanical ventilation, and tube feeding were associated with higher hospitalization costs, regardless of the intermediate influence of length of stay. The severity factors were also associated with longer length of stay durations. The ratio of indirect effects to direct effects on total hospitalization costs showed that the former was greater than the latter in the factors, except in the use of mechanical ventilation. Conclusions Our structural equation modeling analysis indicated that patient profiles and procedures impacted on hospitalization costs both directly and indirectly. Furthermore, the profiles were generally shown to have greater indirect effects (through length of stay) on hospitalization costs than direct effects. These findings may be useful in supporting the more appropriate distribution of health care resources. PMID:25923785

River Inflows into Lakes: Basin Temperature Profiles Driven By Peeling Detrainment from Dense Underflows

NASA Astrophysics Data System (ADS)

Hogg, C. A. R.; Huppert, H. E.; Imberger, J.; Dalziel, S. B.

2014-12-01

Dense gravity currents from river inflows feed fluid into confined basins in lakes. Large inflows can influence temperature profiles in the basins. Existing parameterisations of the circulation and mixing of such inflows are often based on the entrainment of ambient fluid into the underflowing gravity currents. However, recent observations have suggested that uni-directional entrainment into a gravity current does not fully describe the transfer between such gravity currents and the ambient water. Laboratory experiments visualised peeling detrainment from the gravity current occurring when the ambient fluid was stratified. A theoretical model of the observed peeling detrainment was developed to predict the temperature profile in the basin. This new model gives a better approximation of the temperature profile observed in the experiments than the pre-existing entraining model. The model can now be developed such that it integrates into operational models of lake basins.

The Biobank Economic Modeling Tool (BEMT): Online Financial Planning to Facilitate Biobank Sustainability

PubMed Central

Odeh, Hana; Miranda, Lisa; Rao, Abhi; Vaught, Jim; Greenman, Howard; McLean, Jeffrey; Reed, Daniel; Memon, Sarfraz; Fombonne, Benjamin; Guan, Ping

2015-01-01

Background: Biospecimens are essential resources for advancing basic and translational research. However, there are little data available regarding the costs associated with operating a biobank, and few resources to enable their long-term sustainability. To support the research community in this effort, the National Institutes of Health, National Cancer Institute's Biorepositories and Biospecimen Research Branch has developed the Biobank Economic Modeling Tool (BEMT). The tool is accessible at http://biospecimens.cancer.gov/resources/bemt.asp. Methods: To obtain market-based cost information and to inform the development of the tool, a survey was designed and sent to 423 biobank managers and directors across the world. The survey contained questions regarding infrastructure investments, salary costs, funding options, types of biospecimen resources and services offered, as well as biospecimen pricing and service-related costs. Results: A total of 106 responses were received. The data were anonymized, aggregated, and used to create a comprehensive database of cost and pricing information that was integrated into the web-based tool, the BEMT. The BEMT was built to allow the user to input cost and pricing data through a seven-step process to build a cost profile for their biobank, define direct and indirect costs, determine cost recovery fees, perform financial forecasting, and query the anonymized survey data from comparable biobanks. Conclusion: A survey was conducted to obtain a greater understanding of the costs involved in operating a biobank. The anonymized survey data was then used to develop the BEMT, a cost modeling tool for biobanks. Users of the tool will be able to create a cost profile for their biobanks' specimens, products and services, establish pricing, and allocate costs for biospecimens based on percent cost recovered, and perform project-specific cost analyses and financial forecasting. PMID:26697911

The Biobank Economic Modeling Tool (BEMT): Online Financial Planning to Facilitate Biobank Sustainability.

PubMed

Odeh, Hana; Miranda, Lisa; Rao, Abhi; Vaught, Jim; Greenman, Howard; McLean, Jeffrey; Reed, Daniel; Memon, Sarfraz; Fombonne, Benjamin; Guan, Ping; Moore, Helen M

2015-12-01

Biospecimens are essential resources for advancing basic and translational research. However, there are little data available regarding the costs associated with operating a biobank, and few resources to enable their long-term sustainability. To support the research community in this effort, the National Institutes of Health, National Cancer Institute's Biorepositories and Biospecimen Research Branch has developed the Biobank Economic Modeling Tool (BEMT). The tool is accessible at http://biospecimens.cancer.gov/resources/bemt.asp. To obtain market-based cost information and to inform the development of the tool, a survey was designed and sent to 423 biobank managers and directors across the world. The survey contained questions regarding infrastructure investments, salary costs, funding options, types of biospecimen resources and services offered, as well as biospecimen pricing and service-related costs. A total of 106 responses were received. The data were anonymized, aggregated, and used to create a comprehensive database of cost and pricing information that was integrated into the web-based tool, the BEMT. The BEMT was built to allow the user to input cost and pricing data through a seven-step process to build a cost profile for their biobank, define direct and indirect costs, determine cost recovery fees, perform financial forecasting, and query the anonymized survey data from comparable biobanks. A survey was conducted to obtain a greater understanding of the costs involved in operating a biobank. The anonymized survey data was then used to develop the BEMT, a cost modeling tool for biobanks. Users of the tool will be able to create a cost profile for their biobanks' specimens, products and services, establish pricing, and allocate costs for biospecimens based on percent cost recovered, and perform project-specific cost analyses and financial forecasting.

Safety Profile and Costs of Related Adverse Events of Trastuzumab Emtansine for the Treatment of HER2-Positive Locally Advanced or Metastatic Breast Cancer Compared to Capecitabine Plus Lapatinib from the Perspective of the Canadian Health-Care System.

PubMed

Piwko, Charles; Prady, Catherine; Yunger, Simon; Pollex, Erika; Moser, Aurelie

2015-08-01

Trastuzumab emtansine (T-DM1, KADCYLA(®)) is an antibody-drug conjugate comprised of the cytotoxic agent DM1 and trastuzumab (HERCEPTIN(®)). The safety profile of T-DM1 in human epidermal growth factor receptor 2 (HER2)-positive locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane was investigated in the phase III EMILIA trial. The trial demonstrated clinically and statistically meaningful differences in the safety profile between T-DM1 and capecitabine plus lapatinib (CAP + LAP). The objective of this study was to estimate the costs of managing treatment-related grade ≥ 3 adverse events (AEs) that occurred in ≥ 2% of patients and grade 2 AEs that occurred in ≥ 5% of patients taking T-DM1 compared with patients taking CAP + LAP based on the EMILIA trial, from the perspective of Canadian public payers. An Excel-based model was utilized to estimate the relevant costs. Clinical data were obtained from the EMILIA trial. Cost information was obtained from the literature, clinical experts, and standard cost sources. The analysis was conducted from the Canadian public-payer perspective and reported in 2014 Canadian dollars (CAD). The management of included treatment-related AEs resulted in higher estimated per-patient costs of CAD6901 for CAP + LAP versus CAD3380 for T-DM1, resulting in savings of CAD3521. From a Canadian perspective, this analysis demonstrated that utilizing T-DM1 for the management of HER2-positive metastatic breast cancer results in substantial savings to the public health-care system when considering the costs of treatment-related AEs, due to fewer amount of toxicities compared with CAP + LAP. Results of various sensitivity analyses investigating changes in number and costs of AEs confirmed the findings; however, the magnitude of cost savings varied. Further analyses are necessary to determine whether these cost savings would occur in other countries and health-care systems.

Medicare Long-Term CPAP Coverage Policy: A Cost-Utility Analysis

PubMed Central

Billings, Martha E.; Kapur, Vishesh K.

2013-01-01

Study Objectives: CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Design: Cost-utility and cost-effectiveness analysis. Setting: U.S. Medicare Population. Patients or Participants: N/A. Interventions: N/A. Measurements and Results: We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Conclusions: Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change. Citation: Billings ME; Kapur VK. Medicare long-term CPAP coverage policy: a cost-utility analysis. J Clin Sleep Med 2013;9(10):1023-1029. PMID:24127146

Endocrine therapy for breast cancer prevention in high-risk women: clinical and economic considerations.

PubMed

Groom, Amy G; Younis, Tallal

2016-01-01

The global burden of breast cancer highlights the need for primary prevention strategies that demonstrate both favorable clinical benefit/risk profile and good value for money. Endocrine therapy with selective estrogen-receptor modulators (SERMs) or aromatase inhibitors (AIs) has been associated with a favorable clinical benefit/risk profile in the prevention of breast cancer in women at high risk of developing the disease. The available endocrine therapy strategies differ in terms of their relative reductions of breast cancer risk, potential side effects, and upfront drug acquisition costs, among others. This review highlights the clinical trials of SERMs and AIs for the primary prevention of breast cancer, and the cost-effectiveness /cost-utility studies that have examined their "value for money" in various health care jurisdictions.

Structural Health and Prognostics Management for Offshore Wind Turbines: Sensitivity Analysis of Rotor Fault and Blade Damage with O&M Cost Modeling

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

Myrent, Noah J.; Barrett, Natalie C.; Adams, Douglas E.

2014-07-01

Operations and maintenance costs for offshore wind plants are significantly higher than the current costs for land-based (onshore) wind plants. One way to reduce these costs would be to implement a structural health and prognostic management (SHPM) system as part of a condition based maintenance paradigm with smart load management and utilize a state-based cost model to assess the economics associated with use of the SHPM system. To facilitate the development of such a system a multi-scale modeling and simulation approach developed in prior work is used to identify how the underlying physics of the system are affected by themore » presence of damage and faults, and how these changes manifest themselves in the operational response of a full turbine. This methodology was used to investigate two case studies: (1) the effects of rotor imbalance due to pitch error (aerodynamic imbalance) and mass imbalance and (2) disbond of the shear web; both on a 5-MW offshore wind turbine in the present report. Sensitivity analyses were carried out for the detection strategies of rotor imbalance and shear web disbond developed in prior work by evaluating the robustness of key measurement parameters in the presence of varying wind speeds, horizontal shear, and turbulence. Detection strategies were refined for these fault mechanisms and probabilities of detection were calculated. For all three fault mechanisms, the probability of detection was 96% or higher for the optimized wind speed ranges of the laminar, 30% horizontal shear, and 60% horizontal shear wind profiles. The revised cost model provided insight into the estimated savings in operations and maintenance costs as they relate to the characteristics of the SHPM system. The integration of the health monitoring information and O&M cost versus damage/fault severity information provides the initial steps to identify processes to reduce operations and maintenance costs for an offshore wind farm while increasing turbine availability, revenue, and overall profit.« less

Shaking Up the Debate: Ensuring the Ethical Use of DBS Intervention Criteria for Mid-Stage Parkinson's Patients.

PubMed

Eijkholt, Marleen; Cabrera, Laura Y; Ramirez-Zamora, Adolfo; Pilitsis, Julie G

2017-07-01

Deep brain stimulation (DBS) is a well-established treatment for the management of severe motor fluctuations in advanced Parkinson's disease (PD). Until recently, device regulation, medical, and insurance practices limited DBS to patients with advanced stages of PD. In February 2016 this changed, however, when the US Food and Drug Administration (FDA) granted formal approval for the use of brain stimulator in mid-stage PD patients. In this article, we examine whether DBS in mid-stage PD can be ethically justified beyond the FDA approval. We scrutinize the current risk-benefit profile, the costs-benefit profile, and the capacity for informed consent requirement, to ask if use of subthalamic nucleus (STN) in mid-stage DBS is ethically appropriate. We propose that mid-stage DBS decisions could be appropriate under a shared decision-making model, which embraces a broad quality of life perspective. Although it might be too premature to know how the FDA decision will affect medical and insurance practices, we conclude by arguing that revisions to persisting guidelines seems justified both on scientific and ethical grounds. © 2017 International Neuromodulation Society.

Novel approaches to the pharmacotherapy of obesity.

PubMed

Gouni-Berthold, Ioanna; Brüning, Jens C; Berthold, Heiner K

2013-01-01

Although the obesity epidemic is constantly expanding at very high costs for health care systems, the currently available options for the pharmacotherapy of obesity are very limited. This is not due to lack of interest or research on the subject but rather to the poor efficacy and/or safety profile of the majority of the antiobesity drugs developed up to now. Since the late fifties, various medications were brought to advanced states of clinical development but either never made it to the market or were initially approved only to be withdrawn some years later because of safety issues. However, our understanding of the pathophysiology of obesity has been steadily increasing and new, promising drugs targeting various selected obesity-associated and energy-homeostasis-related pathways are now under development. Nonetheless, obesity remains a disease mainly caused by an excess of caloric intake in relation to energy expenditure and on that basis, its treatment should be a healthy diet and physical activity. When these options alone are not sufficient, then additional pharmacotherapy with an acceptable efficacy and safety profile could provide a useful option.

PCT Databank: A Tool for Planning, Implementation and Monitoring of Integrated Preventive Chemotherapy for Control of Neglected Tropical Diseases (NTD)

PubMed Central

Mikhailov, Alexei; Yajima, Aya; Mbabazi, PS; Gabrielli, Albis F.; Montresor, Antonio; Engels, Dirk

2017-01-01

The integration of vertical control programmes of neglected tropical diseases (NTDs) aims at containing operational cost, simplifies the application of the control measures and extends the intervention coverage. The Preventive Chemotherapy and Transmission Control (PCT) Databank was established by the World Health Organization to facilitate the sharing of data among the different partners involved in control activities and collects and compiles historical and current information on disease-specific epidemiological situation, the geographical overlapping of NTDs and the progress of control activities in all the NTD-endemic countries. The summary of country-specific epidemiological maps and the progress of control activities is available online as the online PCT Databank and Country Profiles. The annual progress of preventive chemotherapy (PC) interventions targeting at specific NTDs is also annually reported in the Weekly Epidemiological Record (WER). In this paper, we elucidated the methodology of data collection, compilation and mapping to establish the PCT Databank and presented the key features of the associated three online outputs, i.e. the online PCT Databank, the Country Profile and the WER. PMID:22357399

Development & experimental validation of a SINDA/FLUINT thermal/fluid/electrical model of a multi-tube AMTEC cell

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

Hendricks, T.J.; Borkowski, C.A.; Huang, C.

1998-01-01

AMTEC (Alkali Metal Thermal-to-Electric Conversion) cell development has received increased attention and funding in the space power community because of several desirable performance characteristics compared to current radioisotope thermoelectric generation and solar photovoltaic (PV) power generation. AMTEC cell development is critically dependent upon the ability to predict thermal, fluid dynamic and electrical performance of an AMTEC cell which has many complex thermal, fluid dynamic and electrical processes and interactions occurring simultaneously. Development of predictive capability is critical to understanding the complex processes and interactions within the AMTEC cell, and thereby creating the ability to design high-performance, cost-effective AMTEC cells. Amore » flexible, sophisticated thermal/fluid/electrical model of an operating AMTEC cell has been developed using the SINDA/FLUINT analysis software. This model can accurately simulate AMTEC cell performance at any hot side and cold side temperature combination desired, for any voltage and current conditions, and for a broad range of cell design parameters involving the cell dimensions, current collector and electrode design, electrode performance parameters, and cell wall and thermal shield emissivity. The model simulates the thermal radiation network within the AMTEC cell using RadCAD thermal radiation analysis; hot side, cold side and cell wall conductive and radiative coupling; BASE (Beta Alumina Solid Electrode) tube electrochemistry, including electrode over-potentials; the fluid dynamics of the low-pressure sodium vapor flow to the condenser and liquid sodium flow in the wick; sodium condensation at the condenser; and high-temperature sodium evaporation in the wick. The model predicts the temperature profiles within the AMTEC cell walls, the BASE tube temperature profiles, the sodium temperature profile in the artery return, temperature profiles in the evaporator, thermal energy flows throughout the AMTEC cell, all sodium pressure drops from hot BASE tubes to the condenser, the current, voltage, and power output from the cell, and the cell efficiency. This AMTEC cell model is so powerful and flexible that it is used in radioisotope AMTEC power system design, solar AMTEC power system design, and combustion-driven power system design on several projects at Advanced Modular Power Systems, Inc. (AMPS). The model has been successfully validated against actual cell experimental data and its performance predictions agree very well with experimental data on PX-5B cells and other test cells at AMPS. {copyright} {ital 1998 American Institute of Physics.}« less

Design of a Low-cost Oil Spill Tracking Buoy

NASA Astrophysics Data System (ADS)

Zhao, Y.; Hu, X.; Yu, F.; Dong, S.; Chen, G.

2017-12-01

As the rapid development of oil exploitation and transportation, oil spill accidents, such as Prestige oil spill, Gulf of Mexico oil spill accident and so on, happened frequently in recent years which would result in long-term damage to the environment and human life. It would be helpful for rescue operation if we can locate the oil slick diffusion area in real time. Equipped with GNSS system, current tracking buoys(CTB), such as Lagrangian drifting buoy, Surface Velocity Program (SVP) drifter, iSLDMB (Iridium self locating datum marker buoy) and Argosphere buoy, have been used as oil tracking buoy in oil slick observation and as validation tools for oil spill simulation. However, surface wind could affect the movement of oil slick, which couldn't be reflected by CTB, thus the oil spill tracking performance is limited. Here, we proposed an novel oil spill tracking buoy (OSTB) which has a low cost of less than $140 and is equipped with Beidou positioning module and sails to track oil slick. Based on hydrodynamic equilibrium model and ocean dynamic analysis, the wind sails and water sails are designed to be adjustable according to different marine conditions to improve tracking efficiency. Quick release device is designed to assure easy deployment from air or ship. Sea experiment was carried out in Jiaozhou Bay, Northern China. OSTB, SVP, iSLDMB, Argosphere buoy and a piece of oil-simulated rubber sheet were deployed at the same time. Meanwhile, oil spill simulation model GNOME (general NOAA operational modeling environment) was configured with the wind and current field, which were collected by an unmanned surface vehicle (USV) mounted with acoustic Doppler current profilers (ADCP) and wind speed and direction sensors. Experimental results show that the OSTB has better relevance with rubber sheet and GNOME simulation results, which validate the oil tracking ability of OSTB. With low cost and easy deployment, OSTB provides an effective way for oil spill numerical modeling validation and quick response to oil spill accidents.

Preventing and Treating Peri-Implantitis: A Cost-Effectiveness Analysis.

PubMed

Schwendicke, Falk; Tu, Yu-Kang; Stolpe, Michael

2015-09-01

A large number of treatments for peri-implantitis are available, but their cost-effectiveness remains uncertain. This study evaluates the cost-effectiveness of preventing and treating peri-implantitis. A Markov model was constructed that followed each implant over 20 years. Supportive implant therapy (SIT) for managing peri-implant mucositis and preventing development of peri-implantitis was either provided or not. Risk of peri-implantitis was assumed to be affected by SIT and the patient's risk profile. If peri-implantitis occurred, 11 treatment strategies (non-surgical or surgical debridement alone or combined with adjunct therapies) were compared. Treatments and risk profiles determined disease progression. Modeling was performed based on systematically collected data. Primary outcomes were costs and proportion of lost implants, as assessed via Monte Carlo microsimulations. Not providing SIT and performing only non-surgical debridement was both least costly and least effective. The next best (more costly and effective) option was to provide SIT and perform surgical debridement (additional 0.89 euros per 1% fewer implants lost). The most effective option included bone grafts, membranes, and laser treatment (56 euros per 1%). For patients at high risk, the cost-effectiveness of SIT increased, whereas in low-risk groups, a cost-optimized strategy was cost-effective. Although clinical decision-making will be guided mainly by clinical condition, cost-effectiveness analyses might add another perspective. Based on these findings, an unambiguous comparative effectiveness ranking was not established. However, cost-effectiveness was predominantly determined by provision of SIT and initial treatment costs. Transferability of these findings to other healthcare systems needs further confirmation.

Uncertainty propagation in q and current profiles derived from motional Stark effect polarimetry on TFTR (abstract)a)

NASA Astrophysics Data System (ADS)

Batha, S. H.; Levinton, F. M.; Bell, M. G.; Wieland, R. M.; Hirschman, S. P.

1995-01-01

The magnetic-field pitch-angle profile, γp(R)≡arctan(Bpol/Btor), is measured on the TFTR tokamak using a motional Stark effect (MSE) polarimeter. Measured profiles are converted to q profiles with the equilibrium code vmec. Uncertainties in the q profile due to uncertainties in the γp(R), magnetics, and kinetic measurements are quantified. Subsequent uncertainties in the vmec-calculated profiles of current density and shear, both of which are important for stability and transport analyses, are also quantified. Examples of circular plasmas under various confinement modes, including the supershot and L mode, will be given.

Energy density, nutrient adequacy, and cost per serving can provide insight into food choices in the lower Mississippi Delta.

PubMed

Connell, Carol L; Zoellner, Jamie M; Yadrick, M Kathleen; Chekuri, Srinivasa C; Crook, Lashaundrea B; Bogle, Margaret L

2012-01-01

To compare differences across food groups for food cost, energy, and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in 18 counties across the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. Energy, nutrient, and cost profiles for food items were calculated by using Naturally Nutrient Rich methodology and converting price per 100 g edible portion to price per serving. Foods were grouped into 6 food groups. Mean differences were compared with ANOVA. Significant differences existed by food group for each measure. Energy density was highest for fats/oils/sweets, whereas nutrient density was highest for vegetables. Price per serving was lowest for fats/oils/sweets and highest for meats. Educational messages focusing on a complete diet should consider the role of food costs and provide specific recommendations for increasing nutrient-dense foods by replacing a portion of the meat serving at meals with culturally acceptable lower-cost nutrient-dense foods. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Use of ground-penetrating radar techniques in archaeological investigations

NASA Technical Reports Server (NTRS)

Doolittle, James A.; Miller, W. Frank

1991-01-01

Ground-penetrating radar (GPR) techniques are increasingly being used to aid reconnaissance and pre-excavation surveys at many archaeological sites. As a 'remote sensing' tool, GPR provides a high resolution graphic profile of the subsurface. Radar profiles are used to detect, identify, and locate buried artifacts. Ground-penetrating radar provides a rapid, cost effective, and nondestructive method for identification and location analyses. The GPR can be used to facilitate excavation strategies, provide greater areal coverage per unit time and cost, minimize the number of unsuccessful exploratory excavations, and reduce unnecessary or unproductive expenditures of time and effort.

Cervical pessaries for prevention of spontaneous preterm birth: past, present and future

PubMed Central

Arabin, B; Alfirevic, Z

2013-01-01

This Review describes the rationale for the use of cervical pessaries to prevent spontaneous preterm birth and their gradual introduction into clinical practice, discusses technical aspects of the more commonly used designs and provides guidance for their use and future evaluation. Possible advantages of cervical pessaries include the easy, ‘one-off’ application, good side-effect profile, good patient tolerance and relatively low cost compared with current alternatives. Use of transvaginal sonography to assess cervical length in the second trimester allows much better selection of patients who may benefit from the use of a cervical pessary, but future clinical trials are needed to establish clearly the role of pessaries as a preterm birth prevention strategy worldwide. PMID:23775862

Combined use of isotopic fingerprint and metabolomics analysis for the authentication of saw palmetto (Serenoa repens) extracts.

PubMed

Perini, Matteo; Paolini, Mauro; Camin, Federica; Appendino, Giovanni; Vitulo, Francesca; De Combarieu, Eric; Sardone, Nicola; Martinelli, Ernesto Marco; Pace, Roberto

2018-04-22

Saw palmetto (Serenoa repens, SP) is the most expensive oil source of the pharmaceutical and healthfood market, and its high cost and recurrent shortages have spurred the development of designer blends of fatty acids to mimic its phytochemical profile and fraudulently comply with the current authentication assays. To detect this adulteration, the combined use of isotopic fingerprint and omic analysis has been investigated, using Principal Component Analysis (PCA) to handle the complex databases generated by these techniques and to identify the possible source of the adulterants. Surprisingly, the presence of fatty acids of animal origin turned out to be widespread in commercial samples of saw palmetto oil. Copyright © 2018 Elsevier B.V. All rights reserved.

UQlust: combining profile hashing with linear-time ranking for efficient clustering and analysis of big macromolecular data.

PubMed

Adamczak, Rafal; Meller, Jarek

2016-12-28

Advances in computing have enabled current protein and RNA structure prediction and molecular simulation methods to dramatically increase their sampling of conformational spaces. The quickly growing number of experimentally resolved structures, and databases such as the Protein Data Bank, also implies large scale structural similarity analyses to retrieve and classify macromolecular data. Consequently, the computational cost of structure comparison and clustering for large sets of macromolecular structures has become a bottleneck that necessitates further algorithmic improvements and development of efficient software solutions. uQlust is a versatile and easy-to-use tool for ultrafast ranking and clustering of macromolecular structures. uQlust makes use of structural profiles of proteins and nucleic acids, while combining a linear-time algorithm for implicit comparison of all pairs of models with profile hashing to enable efficient clustering of large data sets with a low memory footprint. In addition to ranking and clustering of large sets of models of the same protein or RNA molecule, uQlust can also be used in conjunction with fragment-based profiles in order to cluster structures of arbitrary length. For example, hierarchical clustering of the entire PDB using profile hashing can be performed on a typical laptop, thus opening an avenue for structural explorations previously limited to dedicated resources. The uQlust package is freely available under the GNU General Public License at https://github.com/uQlust . uQlust represents a drastic reduction in the computational complexity and memory requirements with respect to existing clustering and model quality assessment methods for macromolecular structure analysis, while yielding results on par with traditional approaches for both proteins and RNAs.

Cost-effectiveness of precision medicine in the fourth-line treatment of metastatic lung adenocarcinoma: An early decision analytic model of multiplex targeted sequencing.

PubMed

Doble, Brett; John, Thomas; Thomas, David; Fellowes, Andrew; Fox, Stephen; Lorgelly, Paula

2017-05-01

To identify parameters that drive the cost-effectiveness of precision medicine by comparing the use of multiplex targeted sequencing (MTS) to select targeted therapy based on tumour genomic profiles to either no further testing with chemotherapy or no further testing with best supportive care in the fourth-line treatment of metastatic lung adenocarcinoma. A combined decision tree and Markov model to compare costs, life-years, and quality-adjusted life-years over a ten-year time horizon from an Australian healthcare payer perspective. Data sources included the published literature and a population-based molecular cohort study (Cancer 2015). Uncertainty was assessed using deterministic sensitivity analyses and quantified by estimating expected value of perfect/partial perfect information. Uncertainty due to technological/scientific advancement was assessed through a number of plausible future scenario analyses. Point estimate incremental cost-effective ratios indicate that MTS is not cost-effective for selecting fourth-line treatment of metastatic lung adenocarcinoma. Lower mortality rates during testing and for true positive patients, lower health state utility values for progressive disease, and targeted therapy resulting in reductions in inpatient visits, however, all resulted in more favourable cost-effectiveness estimates for MTS. The expected value to decision makers of removing all current decision uncertainty was estimated to be between AUD 5,962,843 and AUD 13,196,451, indicating that additional research to reduce uncertainty may be a worthwhile investment. Plausible future scenarios analyses revealed limited improvements in cost-effectiveness under scenarios of improved test performance, decreased costs of testing/interpretation, and no biopsy costs/adverse events. Reductions in off-label targeted therapy costs, when considered together with the other scenarios did, however, indicate more favourable cost-effectiveness of MTS. As more clinical evidence is generated for MTS, the model developed should be revisited and cost-effectiveness re-estimated under different testing scenarios to further understand the value of precision medicine and its potential impact on the overall health budget. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Using Computational Approaches to Improve Risk-Stratified Patient Management: Rationale and Methods

PubMed Central

Stone, Bryan L; Sakaguchi, Farrant; Sheng, Xiaoming; Murtaugh, Maureen A

2015-01-01

Background Chronic diseases affect 52% of Americans and consume 86% of health care costs. A small portion of patients consume most health care resources and costs. More intensive patient management strategies, such as case management, are usually more effective at improving health outcomes, but are also more expensive. To use limited resources efficiently, risk stratification is commonly used in managing patients with chronic diseases, such as asthma, chronic obstructive pulmonary disease, diabetes, and heart disease. Patients are stratified based on predicted risk with patients at higher risk given more intensive care. The current risk-stratified patient management approach has 3 limitations resulting in many patients not receiving the most appropriate care, unnecessarily increased costs, and suboptimal health outcomes. First, using predictive models for health outcomes and costs is currently the best method for forecasting individual patient’s risk. Yet, accuracy of predictive models remains poor causing many patients to be misstratified. If an existing model were used to identify candidate patients for case management, enrollment would miss more than half of those who would benefit most, but include others unlikely to benefit, wasting limited resources. Existing models have been developed under the assumption that patient characteristics primarily influence outcomes and costs, leaving physician characteristics out of the models. In reality, both characteristics have an impact. Second, existing models usually give neither an explanation why a particular patient is predicted to be at high risk nor suggestions on interventions tailored to the patient’s specific case. As a result, many high-risk patients miss some suitable interventions. Third, thresholds for risk strata are suboptimal and determined heuristically with no quality guarantee. Objective The purpose of this study is to improve risk-stratified patient management so that more patients will receive the most appropriate care. Methods This study will (1) combine patient, physician profile, and environmental variable features to improve prediction accuracy of individual patient health outcomes and costs; (2) develop the first algorithm to explain prediction results and suggest tailored interventions; (3) develop the first algorithm to compute optimal thresholds for risk strata; and (4) conduct simulations to estimate outcomes of risk-stratified patient management for various configurations. The proposed techniques will be demonstrated on a test case of asthma patients. Results We are currently in the process of extracting clinical and administrative data from an integrated health care system’s enterprise data warehouse. We plan to complete this study in approximately 5 years. Conclusions Methods developed in this study will help transform risk-stratified patient management for better clinical outcomes, higher patient satisfaction and quality of life, reduced health care use, and lower costs. PMID:26503357

How phenobarbital revolutionized epilepsy therapy: the story of phenobarbital therapy in epilepsy in the last 100 years.

PubMed

Yasiry, Zeid; Shorvon, Simon D

2012-12-01

Phenobarbital (phenobarbitone) was first used as an antiepileptic drug 100 years ago, in 1912. This article tells the story of the discovery of its antiepileptic action, its early development, and the subsequent course of its clinical use over the 100-year period. The side effects, pharmacokinetics, and misuse of barbiturates are considered, along with the more recent clinical trials and the drug's current clinical utilization. The introduction of controlled drug regulations, the comparative cost of phenobarbital, and its inclusion on the World Health Organization (WHO) essential drug list are discussed. It is one of the few drugs on the formulary in 1912 that is still listed today, and remarkably its efficacy in epilepsy has not been significantly bettered. The current recommendation by the WHO is that phenobarbital should be offered as the first option for therapy for convulsive epilepsy in adults and children if availability can be ensured. This is rated as a strong recommendation because of the proven efficacy and low cost of phenobarbital, and despite its perceived side-effect profile and the practical problems of access. Whether this recommendation puts "a hierarchy on the brain," as has been suggested, is arguable. Much still needs to be learned about the drug's effects, and the issues raised by phenobarbital have lessons for all antiepileptic drug therapy. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

The Economic Impact of the Introduction of Biosimilars in Inflammatory Bowel Disease.

PubMed

Severs, M; Oldenburg, B; van Bodegraven, A A; Siersema, P D; Mangen, M-J J

2017-03-01

Inflammatory bowel disease [IBD] entails a high economic burden to society. We aimed to estimate the current and future impact of the introduction of biosimilars for infliximab on IBD-related health care costs. We designed a stochastic economic model to simulate the introduction of biosimilars in IBD, using a 5-year time horizon, based on the Dutch situation. Prevalence data on ulcerative colitis [UC] and Crohn's disease [CD] and IBD-related health care costs data were used as input. Assumptions were made on price reductions of anti-tumour necrosis factor [TNF] therapy, increase of anti-TNF prescription rate, and development of hospitalization costs. The base case scenario included a gradual decrease in prices of biosimilars up to 60%, a gradual decrease in prices of original anti-TNF compounds up to 50%, and an annual increase of anti-TNF prescription rate of 1%, and this was compared with no introduction of biosimilars. Sensitivity analyses were performed. For the base case, cost savings over the total of 5 years were on average €9,850 per CD patient and €2,250 per UC patient, yielding in €493 million total cost savings [a reduction of 28%] for The Netherlands. Results were predominantly determined by price reduction of anti-TNF therapy, threshold price reduction at which physicians switch patients towards biosimilars and the extent to which switching will take place. The introduction of biosimilars for infliximab can be expected to have a major impact on the cost profile of IBD. The economic impact will depend on local pricing, procurement policies and the physician's willingness to switch patients to biosimilars. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Gauging the feasibility of cost-sharing and medical student interest groups to reduce interview costs.

PubMed

Lieber, Bryan A; Wilson, Taylor A; Bell, Randy S; Ashley, William W; Barrow, Daniel L; Wolfe, Stacey Quintero

2014-11-01

Indirect costs of the interview tour can be prohibitive. The authors sought to assess the desire of interviewees to mitigate these costs through ideas such as sharing hotel rooms and transportation, willingness to stay with local students, and the preferred modality to coordinate this collaboration. A survey link was posted on the Uncle Harvey website and the Facebook profile page of fourth-year medical students from 6 different medical schools shortly after the 2014 match day. There were a total of 156 respondents to the survey. The majority of the respondents were postinterview medical students (65.4%), but preinterview medical students (28.2%) and current residents (6.4%) also responded to the survey. Most respondents were pursuing a field other than neurosurgery (75.0%) and expressed a desire to share a hotel room and/or transportation (77.4%) as well as stay in the dorm room of a medical student at the program in which they are interviewing (70.0%). Students going into neurosurgery were significantly more likely to be interested in sharing hotel/transportation (89.2% neurosurgery vs 72.8% nonneurosurgery; p = 0.040) and in staying in the dorm room of a local student when on interviews (85.0% neurosurgery vs 57.1% nonneurosurgery; p = 0.040) than those going into other specialties. Among postinterview students, communication was preferred to be by private, email identification-only chat room. Given neurosurgery resident candidates' interest in collaborating to reduce interview costs, consideration should be given to creating a system that could allow students to coordinate cost sharing between interviewees. Moreover, interviewees should be connected to local students from neurosurgery interest groups as a resource.

Use of the Zebrafish Larvae as a Model to Study Cigarette Smoke Condensate Toxicity

PubMed Central

Ellis, Lee D.; Soo, Evelyn C.; Achenbach, John C.; Morash, Michael G.; Soanes, Kelly H.

2014-01-01

The smoking of tobacco continues to be the leading cause of premature death worldwide and is linked to the development of a number of serious illnesses including heart disease, respiratory diseases, stroke and cancer. Currently, cell line based toxicity assays are typically used to gain information on the general toxicity of cigarettes and other tobacco products. However, they provide little information regarding the complex disease-related changes that have been linked to smoking. The ethical concerns and high cost associated with mammalian studies have limited their widespread use for in vivo toxicological studies of tobacco. The zebrafish has emerged as a low-cost, high-throughput, in vivo model in the study of toxicology. In this study, smoke condensates from 2 reference cigarettes and 6 Canadian brands of cigarettes with different design features were assessed for acute, developmental, cardiac, and behavioural toxicity (neurotoxicity) in zebrafish larvae. By making use of this multifaceted approach we have developed an in vivo model with which to compare the toxicity profiles of smoke condensates from cigarettes with different design features. This model system may provide insights into the development of smoking related disease and could provide a cost-effective, high-throughput platform for the future evaluation of tobacco products. PMID:25526262

Use of the zebrafish larvae as a model to study cigarette smoke condensate toxicity.

PubMed

Ellis, Lee D; Soo, Evelyn C; Achenbach, John C; Morash, Michael G; Soanes, Kelly H

2014-01-01

The smoking of tobacco continues to be the leading cause of premature death worldwide and is linked to the development of a number of serious illnesses including heart disease, respiratory diseases, stroke and cancer. Currently, cell line based toxicity assays are typically used to gain information on the general toxicity of cigarettes and other tobacco products. However, they provide little information regarding the complex disease-related changes that have been linked to smoking. The ethical concerns and high cost associated with mammalian studies have limited their widespread use for in vivo toxicological studies of tobacco. The zebrafish has emerged as a low-cost, high-throughput, in vivo model in the study of toxicology. In this study, smoke condensates from 2 reference cigarettes and 6 Canadian brands of cigarettes with different design features were assessed for acute, developmental, cardiac, and behavioural toxicity (neurotoxicity) in zebrafish larvae. By making use of this multifaceted approach we have developed an in vivo model with which to compare the toxicity profiles of smoke condensates from cigarettes with different design features. This model system may provide insights into the development of smoking related disease and could provide a cost-effective, high-throughput platform for the future evaluation of tobacco products.

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed

Mendes, Romeu; Sousa, Nelson; Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-09-13

The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Participants ( n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program ( n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group ( n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. A significant time * group interaction effect ( p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

Estimating the dim light melatonin onset of adolescents within a 6-h sampling window: the impact of sampling rate and threshold method.

PubMed

Crowley, Stephanie J; Suh, Christina; Molina, Thomas A; Fogg, Louis F; Sharkey, Katherine M; Carskadon, Mary A

2016-04-01

Circadian rhythm sleep-wake disorders (CRSWDs) often manifest during the adolescent years. Measurement of circadian phase such as the dim light melatonin onset (DLMO) improves diagnosis and treatment of these disorders, but financial and time costs limit the use of DLMO phase assessments in clinic. The current analysis aims to inform a cost-effective and efficient protocol to measure the DLMO in older adolescents by reducing the number of samples and total sampling duration. A total of 66 healthy adolescents (26 males) aged 14.8-17.8 years participated in a study; they were required to sleep on a fixed baseline schedule for a week before which they visited the laboratory for saliva collection in dim light (<20 lux). Two partial 6-h salivary melatonin profiles were derived for each participant. Both profiles began 5 h before bedtime and ended 1 h after bedtime, but one profile was derived from samples taken every 30 min (13 samples) and the other from samples taken every 60 min (seven samples). Three standard thresholds (first three melatonin values mean + 2 SDs, 3 pg/mL, and 4 pg/mL) were used to compute the DLMO. An agreement between DLMOs derived from 30-min and 60-min sampling rates was determined using Bland-Altman analysis; agreement between the sampling rate DLMOs was defined as ± 1 h. Within a 6-h sampling window, 60-min sampling provided DLMO estimates within ± 1 h of DLMO from 30-min sampling, but only when an absolute threshold (3 or 4 pg/mL) was used to compute the DLMO. Future analyses should be extended to include adolescents with CRSWDs. Copyright © 2016 Elsevier B.V. All rights reserved.

Hypertension: management perspectives.

PubMed

Borghi, Claudio; Cicero, Arrigo F G

2012-10-01

The increasing worldwide prevalence of hypertension and the related increase in cost due to diagnosis, management and negative outcomes forces public health institutions and clinical researchers to find new strategies to improve blood pressure (BP) control. So what are the possible future perspectives for high BP management? Three main points are briefly discussed in this article: individualized therapy, the known genetic contribution to hypertension development and control, and the improvement of disease management, including perspectives on new antihypertensive drug development. It is likely that the integration of the best available current knowledge with recent diagnostic and therapeutic achievements for the management of hypertension prevention and treatment will lead to the early detection of at-risk conditions, early diagnosis, and individualized and efficacious treatment. The most promising antihypertensive drugs currently in development are innovative renin-angiotensin-aldosterone system modulators. Further drugs have potentially interesting mechanisms of action, but renalase analogs are in the very early phases of development, and available endothelin antagonists have a poor safety profile.

Diagnosis and Treatment of the Cardiovascular Consequences of Fabry Disease.

PubMed

Baig, S; Vijapurapu, R; Alharbi, F; Nordin, S; Kozor, R; Moon, J; Bembi, B; Geberhiwot, T; Steeds, R P

2018-06-06

Fabry Disease (FD) has been a diagnostic challenge since it was first recognised in 1898, with patients traditionally suffering from considerable delay before a diagnosis is made. Cardiac involvement is the current leading cause of death in FD. A combination of improved enzyme assays, availability of genetic profiling, together with more organised clinical services for rare diseases, has led to a rapid growth in the prevalence of FD. The earlier and more frequent diagnosis of asymptomatic individuals before development of the phenotype has focussed attention on early detection of organ involvement and closer monitoring of disease progression. The high cost of enzyme replacement therapy at a time of constraint within many health economies moreover, has challenged clinicians to target treatment effectively. This article provides an outline of FD for the general physician and summarises the aetiology and pathology of FD, the cardiovascular (CV) consequences thereof, modalities used in diagnosis, and then discusses current indications for treatment, including pharmacotherapy and device implantation.

Cost-comparison of different management policies for tuberculosis patients in Italy. AIPO TB Study Group.

PubMed Central

Migliori, G. B.; Ambrosetti, M.; Besozzi, G.; Farris, B.; Nutini, S.; Saini, L.; Casali, L.; Nardini, S.; Bugiani, M.; Neri, M.; Raviglione, M. C.

1999-01-01

Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$186.90, whereas that of a single outpatient visit ranged, according to the different options, from US$2.50 to US$11. Scenario 2 was consistently less costly than scenario 1. The cost per case cured for smear-positive cases was US$16,703 in scenario 1 and US$5946 in scenario 2. The difference in cost between the cheapest option (no DOT) and the more expensive option (DOT, additional staff, incentives) ranged from US$1407 (scenario 1, smear-negative and extrapulmonary cases) to US$1814 (scenario 2, smear-positive cases). The additional cost to society including indirect costs ranged from US$1800 to US$4200. The possible savings at the national level were in the order of US$50 million per year. In conclusion, cost-comparison analysis showed that a relatively minor change in policy can result in significant savings and that the adoption of DOT will represent a relatively modest economic burden, although the real gain in effectiveness resulting from DOT in Italy requires further evaluation. PMID:10427931

Electric/Hybrid Vehicle Simulation

NASA Technical Reports Server (NTRS)

Slusser, R. A.; Chapman, C. P.; Brennand, J. P.

1985-01-01

ELVEC computer program provides vehicle designer with simulation tool for detailed studies of electric and hybrid vehicle performance and cost. ELVEC simulates performance of user-specified electric or hybrid vehicle under user specified driving schedule profile or operating schedule. ELVEC performs vehicle design and life cycle cost analysis.

[Care costs and activity in the last three months of life of cancer patients who died in the Basque Country (Spain)].

PubMed

Nuño-Solinís, Roberto; Herrera Molina, Emilio; Librada Flores, Silvia; Orueta Mendía, Juan F; Cabrera-León, Andrés

To analyse the use of health resources and its budget in the last months of life of the population who died from malignant neoplasm in the Basque Autonomous Country (Spain). Retrospective observational study of a population with a diagnosis of malignancy deceased in the Basque Country (2010 and 2011). MDS and Mortality Register. gender, age, place of death, tumour location, clinical activity data and costs in the last three months of life. We performed a descriptive analysis of clinical activity and costs, and lineal multivariate regressions to obtain the adjusted mean costs by gender, age and place of death. 9,333 deaths from malignancy were identified in 2010 and 2011. 65.4% were men, 61.5% aged 70 or over, mean age 72.9 years, 71.1% died in hospital. People who died in the hospital had an average cost of about double that of the people who died at home (€14,794 and €7,491, respectively; p <0.001) and 31.3% higher than in the nursing home (€11,269; p <0.001). Greater interventions at the end of life at the community level are necessary, strengthening the care capacity of primary health care, both from training and support from expert teams in order to change the current care profile to a more outpatient care that allows a lower consumption of resources and greater care at home. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

[The impact on costs and care of two approaches to reduce employees' dental plan expenses in a private company].

PubMed

Costa Filho, Luiz Cesar da; Duncan, Bruce Bartholow; Polanczyk, Carisi Anne; Sória, Marina Lara; Habekost, Ana Paula; Costa, Carolina Covolo da

2008-05-01

The present study evaluated the dental care plan offered to 4,000 employees of a private hospital and their respective families. The analysis covered three stages: (1) baseline (control), when dental care was provided by an outsourced company with a network of dentists paid for services, (2) a renegotiation of costs with the original dental care provider, and (3) provision of dental care by the hospital itself, through directly hired dentists on regular salaries. Monthly economic and clinical data were collected for this research. The dental plan renegotiation reduced costs by 37% in relation to baseline, and the hospital's own dental service reduced costs by 50%. Renegotiation led to a 31% reduction in clinical procedures, without altering the dental care profile; the hospital's own dental service did not reduce the total number of clinical procedures, but modified the profile of dental care, since procedures related to the causes of diseases increased and surgical/restorative procedures decreased.

Construction of new profiler certification tracks.

DOT National Transportation Integrated Search

2014-04-01

The existing smoothness specifications of the Texas Department of Transportation (TxDOT) require : certification of inertial profilers for ride quality assurance testing. Currently, inertial profilers are certified : based on profile measurements col...

Long-term healthcare use and costs in patients with stable coronary artery disease: a population-based cohort using linked health records (CALIBER)

PubMed Central

Walker, Simon; Asaria, Miqdad; Manca, Andrea; Palmer, Stephen; Gale, Chris P.; Shah, Anoop Dinesh; Abrams, Keith R.; Crowther, Michael; Timmis, Adam; Hemingway, Harry; Sculpher, Mark

2016-01-01

Abstract Aims To examine long-term healthcare utilization and costs of patients with stable coronary artery disease (SCAD). Methods and results Linked cohort study of 94 966 patients with SCAD in England, 1 January 2001 to 31 March 2010, identified from primary care, secondary care, disease, and death registries. Resource use and costs, and cost predictors by time and 5-year cardiovascular disease (CVD) risk profile were estimated using generalized linear models. Coronary heart disease hospitalizations were 20.5% in the first year and 66% in the year following a non-fatal (myocardial infarction, ischaemic or haemorrhagic stroke) event. Mean healthcare costs were £3133 per patient in the first year and £10 377 in the year following a non-fatal event. First-year predictors of cost included sex (mean cost £549 lower in females), SCAD diagnosis (non-ST-elevation myocardial infarction cost £656 more than stable angina), and co-morbidities (heart failure cost £657 more per patient). Compared with lower risk patients (5-year CVD risk 3.5%), those of higher risk (5-year CVD risk 44.2%) had higher 5-year costs (£23 393 vs. £9335) and lower lifetime costs (£43 020 vs. £116 888). Conclusion Patients with SCAD incur substantial healthcare utilization and costs, which varies and may be predicted by 5-year CVD risk profile. Higher risk patients have higher initial but lower lifetime costs than lower risk patients as a result of shorter life expectancy. Improved cardiovascular survivorship among an ageing CVD population is likely to require stratified care in anticipation of the burgeoning demand. PMID:27042338

Study of a Low Profile School: Riverheights School, Brandon, Manitoba.

ERIC Educational Resources Information Center

Manitoba Dept. of Education, Winnipeg. Research Branch.

The new Riverheights School, constructed by the Brandon (Manitoba) School Board for kindergarten through ninth grade students, was built as a "low-profile" school with an "earthberm" in order to save on heating, vandalism, and insurance costs and to integrate the building into a neighborhood park setting.…

Aircraft Route Optimization using the A-Star Algorithm

DTIC Science & Technology

2014-03-27

Map Cost array allows a search for a route that not only seeks to minimize the distance travelled, but also considers other factors that may impact ...Rules (VFR) flight profile requires aviators to plan a 20-minute fuel reserve into the flight while an Instrument Flight Rules ( IFR ) flight profile

Community College League of California Pocket Profile, 2002. 3rd Edition.

ERIC Educational Resources Information Center

Community Coll. League of California, Sacramento.

This document is a pocket profile from the Community College League of California (CCLC), which represents 72 community college districts and 108 community colleges. The report offers information on general governance and institutional missions, enrollment figures, community college student demographics, and student educational costs. (1) the Los…

Radar Cuts Subsoil Survey Costs

NASA Technical Reports Server (NTRS)

Johnson, R.; Glaccum, R.

1984-01-01

Soil features located with minimum time and labor. Ground-penetrating radar (GPR) system supplements manual and mechanical methods in performing subsurface soil survey. Mobile system obtains graphic profile of soil discontinuities and interfaces as function of depth. One or two test borings necessary to substantiate soil profile. GPR proves useful as reconnaissance tool.

Application of a range of turbulence energy models to the determination of M4 tidal current profiles

NASA Astrophysics Data System (ADS)

Xing, Jiuxing; Davies, Alan M.

1996-04-01

A fully nonlinear, three-dimensional hydrodynamic model of the Irish Sea, using a range of turbulence energy sub-models, is used to examine the influence of the turbulence closure method upon the vertical variation of the current profile of the fundamental and higher harmonics of the tide in the region. Computed tidal current profiles are compared with previous calculations using a spectral model with eddy viscosity related to the flow field. The model has a sufficiently fine grid to resolve the advection terms, in particular the advection of turbulence and momentum. Calculations show that the advection of turbulence energy does not have a significant influence upon the current profile of either the fundamental or higher harmonic of the tide, although the advection of momentum is important in the region of headlands. The simplification of the advective terms by only including them in their vertically integrated form does not appear to make a significant difference to current profiles, but does reduce the computational effort by a significant amount. Computed current profiles both for the fundamental and the higher harmonic determined with a prognostic equation for turbulence and an algebraic mixing length formula, are as accurate as those determined with a two prognostic equation model (the so called q2- q2l model), provided the mixing length is specified correctly. A simple, flow-dependent eddy viscosity with a parabolic variation of viscosity also performs equally well.

Low cost solar silicon production

NASA Astrophysics Data System (ADS)

Mede, Matt

2009-08-01

The worldwide demand for solar grade silicon reached an all time high between 2007 and 2008. Although growth in the solar industry is slowing due to the current economic downturn, demand is expected to rebound in 2011 based on current cost models. However, demand will increase even more than currently anticipated if costs are reduced. This situation creates an opportunity for new and innovative approaches to the production of photovoltaic grade silicon, especially methods which can demonstrate cost reductions over currently utilized processes.

Mass spectrometry based proteomics profiling as diagnostic tool in oncology: current status and future perspective.

PubMed

Findeisen, Peter; Neumaier, Michael

2009-01-01

Proteomics analysis has been heralded as a novel tool for identifying new and specific biomarkers that may improve diagnosis and monitoring of various disease states. Recent years have brought a number of proteomics profiling technologies. Although proteomics profiling has resulted in the detection of disease-associated differences and modification of proteins, current proteomics technologies display certain limitations that are hampering the introduction of these new technologies into clinical laboratory diagnostics and routine applications. In this review, we summarize current advances in mass spectrometry based biomarker discovery. The promises and challenges of this new technology are discussed with particular emphasis on diagnostic perspectives of mass-spectrometry based proteomics profiling for malignant diseases.

New method of 2-dimensional metrology using mask contouring

NASA Astrophysics Data System (ADS)

Matsuoka, Ryoichi; Yamagata, Yoshikazu; Sugiyama, Akiyuki; Toyoda, Yasutaka

2008-10-01

We have developed a new method of accurately profiling and measuring of a mask shape by utilizing a Mask CD-SEM. The method is intended to realize high accuracy, stability and reproducibility of the Mask CD-SEM adopting an edge detection algorithm as the key technology used in CD-SEM for high accuracy CD measurement. In comparison with a conventional image processing method for contour profiling, this edge detection method is possible to create the profiles with much higher accuracy which is comparable with CD-SEM for semiconductor device CD measurement. This method realizes two-dimensional metrology for refined pattern that had been difficult to measure conventionally by utilizing high precision contour profile. In this report, we will introduce the algorithm in general, the experimental results and the application in practice. As shrinkage of design rule for semiconductor device has further advanced, an aggressive OPC (Optical Proximity Correction) is indispensable in RET (Resolution Enhancement Technology). From the view point of DFM (Design for Manufacturability), a dramatic increase of data processing cost for advanced MDP (Mask Data Preparation) for instance and surge of mask making cost have become a big concern to the device manufacturers. This is to say, demands for quality is becoming strenuous because of enormous quantity of data growth with increasing of refined pattern on photo mask manufacture. In the result, massive amount of simulated error occurs on mask inspection that causes lengthening of mask production and inspection period, cost increasing, and long delivery time. In a sense, it is a trade-off between the high accuracy RET and the mask production cost, while it gives a significant impact on the semiconductor market centered around the mask business. To cope with the problem, we propose the best method of a DFM solution using two-dimensional metrology for refined pattern.

Kinetic simulations of the stability of a plasma confined by the magnetic field of a current rod

NASA Astrophysics Data System (ADS)

Tonge, J.; Leboeuf, J. N.; Huang, C.; Dawson, J. M.

2003-09-01

The kinetic stability of a plasma in the magnetic field of a current rod is investigated for various temperature and density profiles using three-dimensional particle-in-cell simulations. Such a plasma obeys similar physics to a plasma in a dipole magnetic field, while it is easier to perform computer simulations, and do theoretical analysis, of a plasma in the field of a current rod. Simple energy principle calculations and simulations with a variety of temperature and density profiles show that the plasma is stable to interchange for pressure profiles proportional to r-10/3. As predicted by theory the simulations also show that the density profile will be stationary as long as density is proportional to r-2 even though the temperature profile may not be stable.

Lower hybrid current drive in experiments for transport barriers at high βN of JET (Joint European Torus)

NASA Astrophysics Data System (ADS)

Cesario, R. C.; Castaldo, C.; Fonseca, A.; De Angelis, R.; Parail, V.; Smeulders, P.; Beurskens, M.; Brix, M.; Calabrò, G.; De Vries, P.; Mailloux, J.; Pericoli, V.; Ravera, G.; Zagorski, R.

2007-09-01

LHCD has been used in JET experiments aimed at producing internal transport barriers (ITBs) in highly triangular plasmas (δ≈0.4) at high βN (up to 3) for steady-state application. The LHCD is a potentially valuable tool for (i) modifying the target q-profile, which can help avoid deleterious MHD modes and favour the formation of ITBs, and (ii) contributing to the non-inductive current drive required to prolong such plasma regimes. The q-profile evolution has been simulated during the current ramp-up phase for such a discharge (B0 = 2.3 T, IP = 1.5 MA) where 2 MW of LHCD has been coupled. The JETTO code was used taking measured plasma profiles, and the LHCD profile modeled by the LHstar code. The results are in agreement with MSE measurements and indicate the importance of the elevated electron temperature due to LHCD, as well as the driven current. During main heating with 18 MW of NBI and 3 MW of ICRH the bootstrap current density at the edge also becomes large, consistently with the observed reduction of the local turbulence and of the MHD activity. JETTO modelling suggests that the bootstrap current can reduce the magnetic shear (sh) at large radius, potentially affecting the MHD stability and turbulence behaviour in this region. Keywords: lower hybrid current drive (LHCD), bootstrap current, q (safety factor) and shear (sh) profile evolutions.

Fibromyalgia: Prevalence, epidemiologic profiles and economic costs.

PubMed

Cabo-Meseguer, Asensi; Cerdá-Olmedo, Germán; Trillo-Mata, José Luis

2017-11-22

Fibromyalgia is an idiopathic chronic condition that causes widespread musculoskeletal pain, hyperalgesia and allodynia. This review aims to approach the general epidemiology of fibromyalgia according to the most recent published studies, identifying the general worldwide prevalence of the disease, its basic epidemiological profiles and its economic costs, with specific interest in the Spanish and Comunidad Valenciana cases. Fibromyalgia affects, on average, 2.10% of the world's population; 2.31% of the European population; 2.40% of the Spanish population; and 3.69% of the population in the Comunidad Valenciana. It supposes a painful loss of the quality of life of the people who suffer it and the economic costs are enormous: in Spain is has been estimated at more than 12,993 million euros annually. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Addressing the computational cost of large EIT solutions.

PubMed

Boyle, Alistair; Borsic, Andrea; Adler, Andy

2012-05-01

Electrical impedance tomography (EIT) is a soft field tomography modality based on the application of electric current to a body and measurement of voltages through electrodes at the boundary. The interior conductivity is reconstructed on a discrete representation of the domain using a finite-element method (FEM) mesh and a parametrization of that domain. The reconstruction requires a sequence of numerically intensive calculations. There is strong interest in reducing the cost of these calculations. An improvement in the compute time for current problems would encourage further exploration of computationally challenging problems such as the incorporation of time series data, wide-spread adoption of three-dimensional simulations and correlation of other modalities such as CT and ultrasound. Multicore processors offer an opportunity to reduce EIT computation times but may require some restructuring of the underlying algorithms to maximize the use of available resources. This work profiles two EIT software packages (EIDORS and NDRM) to experimentally determine where the computational costs arise in EIT as problems scale. Sparse matrix solvers, a key component for the FEM forward problem and sensitivity estimates in the inverse problem, are shown to take a considerable portion of the total compute time in these packages. A sparse matrix solver performance measurement tool, Meagre-Crowd, is developed to interface with a variety of solvers and compare their performance over a range of two- and three-dimensional problems of increasing node density. Results show that distributed sparse matrix solvers that operate on multiple cores are advantageous up to a limit that increases as the node density increases. We recommend a selection procedure to find a solver and hardware arrangement matched to the problem and provide guidance and tools to perform that selection.

High-throughput screening and small animal models, where are we?

PubMed Central

Giacomotto, Jean; Ségalat, Laurent

2010-01-01

Current high-throughput screening methods for drug discovery rely on the existence of targets. Moreover, most of the hits generated during screenings turn out to be invalid after further testing in animal models. To by-pass these limitations, efforts are now being made to screen chemical libraries on whole animals. One of the most commonly used animal model in biology is the murine model Mus musculus. However, its cost limit its use in large-scale therapeutic screening. In contrast, the nematode Caenorhabditis elegans, the fruit fly Drosophila melanogaster, and the fish Danio rerio are gaining momentum as screening tools. These organisms combine genetic amenability, low cost and culture conditions that are compatible with large-scale screens. Their main advantage is to allow high-throughput screening in a whole-animal context. Moreover, their use is not dependent on the prior identification of a target and permits the selection of compounds with an improved safety profile. This review surveys the versatility of these animal models for drug discovery and discuss the options available at this day. PMID:20423335

Fosphenytoin: Current Place in Therapy

PubMed Central

Mueller, Eric W.; Boucher, Bradley A.

2004-01-01

Fosphenytoin is a parenteral phosphate ester prodrug of phenytoin developed to overcome the limitations associated with parenteral administration of phenytoin. Despite potential clinical advantages, pharmacoeconomic concerns have prevented widespread substitution of parenteral phenytoin with fosphenytoin. The purposes of this descriptive review are to (1) highlight recent clinical and pharmacoeconomic data regarding the therapeutic decision to use phenytoin or fosphenytoin for the parenteral management of acute seizures, and (2) discuss the implications of fosphenytoin use in neonatal and pediatric patients. Supporting recent, multidisciplinary, consensus guidelines, it is our opinion that each patient should be evaluated individually to identify those who will benefit most from fosphenytoin. Such patients may include those without intravenous or enteral access, those requiring parenteral therapy with tenuous peripheral intravenous access, and pediatric and neonatal patients. Additionally, institution-specific cost analyses should be done to assure the most appropriate agent is being used, while being sensitive to the potential disparate risk profiles between patient populations. Until the issues of safety relative to cost are objectively ameliorated, individual clinicians will likely use their own experience to dictate the place of fosphenytoin in their respective practices. PMID:23118706

The emerging role for robotics in cholecystectomy: the dawn of a new era?

PubMed Central

Zaman, Jessica A.

2018-01-01

Though laparoscopic cholecystectomy (LC) was highly criticized in its early stages, it quickly grew to become a new standard of care and has revolutionized the field of general surgery. Now emerging robotic technology is making its way into the minimally invasive arena. Robotic cholecystectomy (RC) is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC. However, this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure. RC can be performed in a cost-effective manner as the volume of robotic procedures increases. In addition, improved visualization and capability to perform fluorescence cholangiography can improve the safety profile of cholecystectomy to a level that has not yet been achieved with conventional laparoscopy. Advanced simulation technology for robotic surgery, and newer single-site robotic platforms have the potential to further revolutionize this technology and lead to improved patient satisfaction. In this review, we will present current data, trends, and controversies in robotic-assisted cholecystectomy. PMID:29531940

Coil-current effect in Kibble balances: analysis, measurement, and optimization

NASA Astrophysics Data System (ADS)

Li, S.; Bielsa, F.; Stock, M.; Kiss, A.; Fang, H.

2018-02-01

The Kibble balance is expected to become an important instrument in the near future for realizing the unit of mass, the kilogram, in the revised international system of units (SI). The Kibble balance assumes an equality of two magnetic profiles measured in the weighing and velocity phases. A recent study conducted in the Kibble balance group at the Bureau International des Poids et Mesures (BIPM) showed that the coil current could significantly affect the magnetic profile, which should be carefully taken into account in the Kibble balance experiment. This paper gives a deeper understanding and investigation of the effect, and discusses the magnetic profile change due to the coil current, for both the classical two-mode and the one-mode Kibble balances. The coil current effect has been theoretically and experimentally investigated based on a typical magnet design with an air gap. One important conclusion found in the one-mode Kibble balance is that the magnetic profile change measured in the velocity phase is twice the change in the weighing phase. A compensation suggestion, to minimize the profile change due to the coil current in a BIPM-type magnet, is presented.

Data Quality Control for Vessel Mounted Acoustic Doppler Current Profiler. Application for the Western Mediterranean Sea

NASA Technical Reports Server (NTRS)

Garcia-Gorriz, E.; Front, J.; Candela, J.

1997-01-01

A systematic Data Quality Checking Protocol for vessel Mounted Acoustic Doppler Current Profiler observations is proposed. Previous-to-acquisition conditions are considered along with simultaneous ones.

Method and system employing finite state machine modeling to identify one of a plurality of different electric load types

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

Du, Liang; Yang, Yi; Harley, Ronald Gordon

A system is for a plurality of different electric load types. The system includes a plurality of sensors structured to sense a voltage signal and a current signal for each of the different electric loads; and a processor. The processor acquires a voltage and current waveform from the sensors for a corresponding one of the different electric load types; calculates a power or current RMS profile of the waveform; quantizes the power or current RMS profile into a set of quantized state-values; evaluates a state-duration for each of the quantized state-values; evaluates a plurality of state-types based on the powermore » or current RMS profile and the quantized state-values; generates a state-sequence that describes a corresponding finite state machine model of a generalized load start-up or transient profile for the corresponding electric load type; and identifies the corresponding electric load type.« less

Large fluctuations of the macroscopic current in diffusive systems: a numerical test of the additivity principle.

PubMed

Hurtado, Pablo I; Garrido, Pedro L

2010-04-01

Most systems, when pushed out of equilibrium, respond by building up currents of locally conserved observables. Understanding how microscopic dynamics determines the averages and fluctuations of these currents is one of the main open problems in nonequilibrium statistical physics. The additivity principle is a theoretical proposal that allows to compute the current distribution in many one-dimensional nonequilibrium systems. Using simulations, we validate this conjecture in a simple and general model of energy transport, both in the presence of a temperature gradient and in canonical equilibrium. In particular, we show that the current distribution displays a Gaussian regime for small current fluctuations, as prescribed by the central limit theorem, and non-Gaussian (exponential) tails for large current deviations, obeying in all cases the Gallavotti-Cohen fluctuation theorem. In order to facilitate a given current fluctuation, the system adopts a well-defined temperature profile different from that of the steady state and in accordance with the additivity hypothesis predictions. System statistics during a large current fluctuation is independent of the sign of the current, which implies that the optimal profile (as well as higher-order profiles and spatial correlations) are invariant upon current inversion. We also demonstrate that finite-time joint fluctuations of the current and the profile are well described by the additivity functional. These results suggest the additivity hypothesis as a general and powerful tool to compute current distributions in many nonequilibrium systems.

How to calculate the annual costs of NGO-implemented programmes to support orphans and vulnerable children: a six-step approach

PubMed Central

2011-01-01

Background Information on the costs of implementing programmes designed to provide support of orphans and vulnerable children (OVC) in sub-Saharan Africa and elsewhere is increasingly being requested by donors for programme evaluation purposes. To date, little information exists to document the costs and structure of costs of OVC programmes as actually implemented "on the ground" by local non-governmental organizations (NGOs). This analysis provides a practical, six-step approach that NGOs can incorporate into routine operations to evaluate their costs of implementing their OVC programmes annually. This approach is applied to the Community-Based Care for Orphans and Vulnerable Children (CBCO) Program implemented by BIDII (a Kenyan NGO) in Eastern Province of Kenya. Methods and results The costing methodology involves the following six steps: accessing and organizing the NGO's annual financial report into logical sub-categories; reorganizing the sub-categories into input cost categories to create a financial cost profile; estimating the annual equivalent payment for programme equipment; documenting donations to the NGO for programme implementation; including a portion of NGO organizational costs not attributed to specific programmes; and including the results of Steps 3-5 into an expanded cost profile. Detailed results are provided for the CBCO programme. Conclusions This paper shows through a concrete example how NGOs implementing OVC programmes (and other public health programmes) can organize themselves for data collection and documentation prospectively during the implementation of their OVC programmes so that costing analyses become routine practice to inform programme implementation rather than a painful and flawed retrospective activity. Such information is required if the costs and outcomes achieved by OVC programmes will ever be clearly documented and compared across OVC programmes and other types of programmes (prevention, treatment, etc.). PMID:22182588

How to calculate the annual costs of NGO-implemented programmes to support orphans and vulnerable children: a six-step approach.

PubMed

Larson, Bruce A; Wambua, Nancy

2011-12-19

Information on the costs of implementing programmes designed to provide support of orphans and vulnerable children (OVC) in sub-Saharan Africa and elsewhere is increasingly being requested by donors for programme evaluation purposes. To date, little information exists to document the costs and structure of costs of OVC programmes as actually implemented "on the ground" by local non-governmental organizations (NGOs). This analysis provides a practical, six-step approach that NGOs can incorporate into routine operations to evaluate their costs of implementing their OVC programmes annually. This approach is applied to the Community-Based Care for Orphans and Vulnerable Children (CBCO) Program implemented by BIDII (a Kenyan NGO) in Eastern Province of Kenya. The costing methodology involves the following six steps: accessing and organizing the NGO's annual financial report into logical sub-categories; reorganizing the sub-categories into input cost categories to create a financial cost profile; estimating the annual equivalent payment for programme equipment; documenting donations to the NGO for programme implementation; including a portion of NGO organizational costs not attributed to specific programmes; and including the results of Steps 3-5 into an expanded cost profile. Detailed results are provided for the CBCO programme. This paper shows through a concrete example how NGOs implementing OVC programmes (and other public health programmes) can organize themselves for data collection and documentation prospectively during the implementation of their OVC programmes so that costing analyses become routine practice to inform programme implementation rather than a painful and flawed retrospective activity. Such information is required if the costs and outcomes achieved by OVC programmes will ever be clearly documented and compared across OVC programmes and other types of programmes (prevention, treatment, etc.).

Decisions on Further Research for Predictive Biomarkers of High-Dose Alkylating Chemotherapy in Triple-Negative Breast Cancer: A Value of Information Analysis.

PubMed

Miquel-Cases, Anna; Retèl, Valesca P; van Harten, Wim H; Steuten, Lotte M G

2016-06-01

To inform decisions about the design and priority of further studies of emerging predictive biomarkers of high-dose alkylating chemotherapy (HDAC) in triple-negative breast cancer (TNBC) using value-of-information analysis. A state transition model compared treating women with TNBC with current clinical practice and four biomarker strategies to personalize HDAC: 1) BRCA1-like profile by array comparative genomic hybridization (aCGH) testing; 2) BRCA1-like profile by multiplex ligation-dependent probe amplification (MLPA) testing; 3) strategy 1 followed by X-inactive specific transcript gene (XIST) and tumor suppressor p53 binding protein (53BP1) testing; and 4) strategy 2 followed by XIST and 53BP1 testing, from a Dutch societal perspective and a 20-year time horizon. Input data came from literature and expert opinions. We assessed the expected value of partial perfect information, the expected value of sample information, and the expected net benefit of sampling for potential ancillary studies of an ongoing randomized controlled trial (RCT; NCT01057069). The expected value of partial perfect information indicated that further research should be prioritized to the parameter group including "biomarkers' prevalence, positive predictive value (PPV), and treatment response rates (TRRs) in biomarker-negative patients and patients with TNBC" (€639 million), followed by utilities (€48 million), costs (€40 million), and transition probabilities (TPs) (€30 million). By setting up four ancillary studies to the ongoing RCT, data on 1) TP and MLPA prevalence, PPV, and TRR; 2) aCGH and aCGH/MLPA plus XIST and 53BP1 prevalence, PPV, and TRR; 3) utilities; and 4) costs could be simultaneously collected (optimal size = 3000). Further research on predictive biomarkers for HDAC should focus on gathering data on TPs, prevalence, PPV, TRRs, utilities, and costs from the four ancillary studies to the ongoing RCT. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

MHD Equilibrium with Reversed Current Density and Magnetic Islands Revisited: the Vacuum Vector Potential Calculus

NASA Astrophysics Data System (ADS)

L. Braga, F.

2013-10-01

The solution of Grad-Shafranov equation determines the stationary behavior of fusion plasma inside a tokamak. To solve the equation it is necessary to know the toroidal current density profile. Recent works show that it is possible to determine a magnetohydrodynamic (MHD) equilibrium with reversed current density (RCD) profiles that presents magnetic islands. In this work we show analytical MHD equilibrium with a RCD profile and analyze the structure of the vacuum vector potential associated with these equilibria using the virtual casing principle.

2013 Cost of Wind Energy Review

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

Mone, C.; Smith, A.; Maples, B.

2015-02-01

This report uses representative project types to estimate the levelized cost of wind energy (LCOE) in the United States for 2013. Scheduled to be published on an annual basis, it relies on both market and modeled data to maintain a current understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed from this analysis are used to inform wind technology cost projections, goals, and improvement opportunities.

Gravitational circulation in a tidal strait

USGS Publications Warehouse

Smith, P.E.; Cheng, R.T.; Burau, J.R.; Simpson, M.R.; ,

1991-01-01

Eight months of continuous measurements of tidal current profiles with an acoustic Doppler current profiler (ADCP) were made in Carquinez Strait, California, during 1988 for the purpose of estimating long-term variations in vertical profiles of Eulerian residual currents. Salinity stratification near the ADCP deployment site also was analyzed. The strength of density-driven gravitational circulation and the amount of salinity stratification in the strait varied significantly over the spring-neap tidal cycle. Density currents and stratification were greater during neap tides when vertical mixing from the tide is at a minimum. Landward residual currents along the bottom were observed only during neap tides. Simulations made with a three-dimensional model to supplement the field measurements show a significant, tidally induced lateral variation in residual currents across the strait. The Stokes drift of 1-2 cm/s in the strait is small relative to the speed of gravitational currents.

Changing trends in US injury profiles: revisiting non-fatal occupational injury statistics.

PubMed

Subramanian, A; Desai, A; Prakash, L; Mital, A; Mital, Anil

2006-03-01

The purpose of this paper is to review the current trends in non-fatal injury profiles of workers in the United States. It is generally accepted that occupational injury and illness rates are affected by many factors, such as the amount and quality of training, employee turnover rates, work experience, extent of mechanization and automation, job-related parameters, and worker gender. In the last decade, not only have the technologies used in the workplace changed significantly, there has been a greater awareness among employers and employees as to the importance of containing work injuries. Additionally, the extent of outsourcing for labor-intensive jobs has increased dramatically owing to cheaper labor costs in places such as China and Mexico. These changes have affected the manufacturing sector of US industry more than any other sector. How these changes have influenced the injury and illness profiles of the American worker is of considerable interest given the increased attention paid to work-workplace design, injury hazard control, and ergonomics in general. In this paper, we compare the injury and illness profiles of US workers separated by nearly a decade. The trends from early 1990s are compared to those from early 2000s. Data from the Bureau of Labor Statistics were used to compile the injury statistics. The results of our comparison show that while the absolute numbers of work-related injuries and illnesses have declined over the last 10 years, the basic trends associated with different factors remain almost unchanged. The reasons for this decline are discussed in this paper.

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 novel optical investigation technique for railroad track inspection and assessment

NASA Astrophysics Data System (ADS)

Sabato, Alessandro; Beale, Christopher H.; Niezrecki, Christopher

2017-04-01

Track failures due to cross tie degradation or loss in ballast support may result in a number of problems ranging from simple service interruptions to derailments. Structural Health Monitoring (SHM) of railway track is important for safety reasons and to reduce downtime and maintenance costs. For this reason, novel and cost-effective track inspection technologies for assessing tracks' health are currently insufficient and needed. Advancements achieved in recent years in cameras technology, optical sensors, and image-processing algorithms have made machine vision, Structure from Motion (SfM), and three-dimensional (3D) Digital Image Correlation (DIC) systems extremely appealing techniques for extracting structural deformations and geometry profiles. Therefore, optically based, non-contact measurement techniques may be used for assessing surface defects, rail and tie deflection profiles, and ballast condition. In this study, the design of two camera-based measurement systems is proposed for crossties-ballast condition assessment and track examination purposes. The first one consists of four pairs of cameras installed on the underside of a rail car to detect the induced deformation and displacement on the whole length of the track's cross tie using 3D DIC measurement techniques. The second consists of another set of cameras using SfM techniques for obtaining a 3D rendering of the infrastructure from a series of two-dimensional (2D) images to evaluate the state of the track qualitatively. The feasibility of the proposed optical systems is evaluated through extensive laboratory tests, demonstrating their ability to measure parameters of interest (e.g. crosstie's full-field displacement, vertical deflection, shape, etc.) for assessment and SHM of railroad track.

Identification of fecal input sites in spring water by selection and genotyping of multiresistant Escherichia coli.

PubMed

Wicki, Melanie; Karabulut, Fatma; Auckenthaler, Adrian; Felleisen, Richard; Tanner, Marcel; Baumgartner, Andreas

2011-12-01

The localization of fecal input sites is important for water quality management. For this purpose, we have developed a new approach based on a three-step procedure, including a preparatory phase, the screening of multiresistant bacteria using selective agar plates, and a typing phase where selected Escherichia coli isolates are characterized by antibiotic resistance profiles and molecular fingerprinting techniques (pulsed-field gel electrophoresis [PFGE]). These two well-known source tracking methods were combined in order to reduce cost and effort. This approach was successfully applied under field conditions in a study area located in the north-western part of Switzerland. E. coli isolates from spring water and surface water samples collected in this area were screened with selective agar plates. In this way, 21 different groups, each consisting of strains with the same pattern of antibiotic resistance, were found. Of these, four groups were further analyzed using PFGE. Strains with identical PFGE profiles were detected repeatedly, demonstrating the suitability of this method for the localization of fecal input sites over an extended period of time. Identical PFGE patterns of strains detected in water from two different springs were also found in the stream flowing through the study area. These results demonstrated the applicability of the new approach for the examination of incidents of fecal contamination in drinking water. The advantages of the described approach over genotyping methods currently being used to identify sources of fecal contaminants are a reduction in time, costs, and the effort required. Identical isolates could be identified without the construction of large libraries.

Nutrient profiling can help identify foods of good nutritional quality for their price: a validation study with linear programming.

PubMed

Maillot, Matthieu; Ferguson, Elaine L; Drewnowski, Adam; Darmon, Nicole

2008-06-01

Nutrient profiling ranks foods based on their nutrient content. They may help identify foods with a good nutritional quality for their price. This hypothesis was tested using diet modeling with linear programming. Analyses were undertaken using food intake data from the nationally representative French INCA (enquête Individuelle et Nationale sur les Consommations Alimentaires) survey and its associated food composition and price database. For each food, a nutrient profile score was defined as the ratio between the previously published nutrient density score (NDS) and the limited nutrient score (LIM); a nutritional quality for price indicator was developed and calculated from the relationship between its NDS:LIM and energy cost (in euro/100 kcal). We developed linear programming models to design diets that fulfilled increasing levels of nutritional constraints at a minimal cost. The median NDS:LIM values of foods selected in modeled diets increased as the levels of nutritional constraints increased (P = 0.005). In addition, the proportion of foods with a good nutritional quality for price indicator was higher (P < 0.0001) among foods selected (81%) than among foods not selected (39%) in modeled diets. This agreement between the linear programming and the nutrient profiling approaches indicates that nutrient profiling can help identify foods of good nutritional quality for their price. Linear programming is a useful tool for testing nutrient profiling systems and validating the concept of nutrient profiling.

Integrated modeling of plasma ramp-up in DIII-D ITER-like and high bootstrap current scenario discharges

NASA Astrophysics Data System (ADS)

Wu, M. Q.; Pan, C. K.; Chan, V. S.; Li, G. Q.; Garofalo, A. M.; Jian, X.; Liu, L.; Ren, Q. L.; Chen, J. L.; Gao, X.; Gong, X. Z.; Ding, S. Y.; Qian, J. P.; Cfetr Physics Team

2018-04-01

Time-dependent integrated modeling of DIII-D ITER-like and high bootstrap current plasma ramp-up discharges has been performed with the equilibrium code EFIT, and the transport codes TGYRO and ONETWO. Electron and ion temperature profiles are simulated by TGYRO with the TGLF (SAT0 or VX model) turbulent and NEO neoclassical transport models. The VX model is a new empirical extension of the TGLF turbulent model [Jian et al., Nucl. Fusion 58, 016011 (2018)], which captures the physics of multi-scale interaction between low-k and high-k turbulence from nonlinear gyro-kinetic simulation. This model is demonstrated to accurately model low Ip discharges from the EAST tokamak. Time evolution of the plasma current density profile is simulated by ONETWO with the experimental current ramp-up rate. The general trend of the predicted evolution of the current density profile is consistent with that obtained from the equilibrium reconstruction with Motional Stark effect constraints. The predicted evolution of βN , li , and βP also agrees well with the experiments. For the ITER-like cases, the predicted electron and ion temperature profiles using TGLF_Sat0 agree closely with the experimental measured profiles, and are demonstrably better than other proposed transport models. For the high bootstrap current case, the predicted electron and ion temperature profiles perform better in the VX model. It is found that the SAT0 model works well at high IP (>0.76 MA) while the VX model covers a wider range of plasma current ( IP > 0.6 MA). The results reported in this paper suggest that the developed integrated modeling could be a candidate for ITER and CFETR ramp-up engineering design modeling.

Innovative real-time and non-destructive method of beam profile measurement under large beam current irradiation for BNCT

NASA Astrophysics Data System (ADS)

Takada, M.; Kamada, S.; Suda, M.; Fujii, R.; Nakamura, M.; Hoshi, M.; Sato, H.; Endo, S.; Hamano, T.; Arai, S.; Higashimata, A.

2012-10-01

We developed a real-time and non-destructive method of beam profile measurement on a target under large beam current irradiation, and without any complex radiation detectors or electrical circuits. We measured the beam profiles on a target by observing the target temperature using an infrared-radiation thermometer camera. The target temperatures were increased and decreased quickly by starting and stopping the beam irradiation within 1 s in response speed. Our method could trace beam movements rapidly. The beam size and position were calibrated by measuring O-ring heat on the target. Our method has the potential to measure beam profiles at beam current over 1 mA for proton and deuteron with the energy around 3 MeV and allows accelerator operators to adjust the beam location during beam irradiation experiments without decreasing the beam current.

Target validation: linking target and chemical properties to desired product profile.

PubMed

Wyatt, Paul G; Gilbert, Ian H; Read, Kevin D; Fairlamb, Alan H

2011-01-01

The discovery of drugs is a lengthy, high-risk and expensive business taking at least 12 years and is estimated to cost upwards of US$800 million for each drug to be successfully approved for clinical use. Much of this cost is driven by the late phase clinical trials and therefore the ability to terminate early those projects destined to fail is paramount to prevent unwanted costs and wasted effort. Although neglected diseases drug discovery is driven more by unmet medical need rather than financial considerations, the need to minimise wasted money and resources is even more vital in this under-funded area. To ensure any drug discovery project is addressing the requirements of the patients and health care providers and delivering a benefit over existing therapies, the ideal attributes of a novel drug needs to be pre-defined by a set of criteria called a target product profile. Using a target product profile the drug discovery process, clinical study design, and compound characteristics can be defined all the way back through to the suitability or druggability of the intended biochemical target. Assessment and prioritisation of the most promising targets for entry into screening programmes is crucial for maximising chances of success.

S. U. N. Y. Profiles of the Two-Year Colleges.

ERIC Educational Resources Information Center

State Univ. of New York, Albany. Office of Access Services.

Profiles of each of the six agricultural and technical colleges, 29 community colleges, and three other colleges offering two-year programs within the State University of New York (SUNY) system are presented. Tuition and other costs as well as availability of financial assistance are outlined. A description of the Educational Opportunity Program…

Low-Cost Structural Thermoelectric Materials: Processing and Consolidation

DTIC Science & Technology

2015-01-01

12 Fig. 8 Hardness from X - ray 2θ profiles for the Fe–Al–V and Ti–Ni–Sn... Hardness from X - ray 2θ profiles for the Fe–Al–V and Ti–Ni–Sn TE materials as a function of annealing temperature 3.3 Consolidated Thermoelectric...9 3. Results 10 3.1 X - ray

The Evolution of Methods of Air Traffic Control.

DTIC Science & Technology

1984-01-01

Constraints: The fundemental presupposition of this method is that it is only the aircraft which can make the choice of the most cost-efficient profile...the direct operating costs but the return on investment in the ground equipment. Similarly in operational terms, improving the day-to-day quality of

Evaluation of the Veterans' Cost-of-Instruction Program. Final Report.

ERIC Educational Resources Information Center

French, Arthur M.; And Others

Objectives of the Veterans' Cost-of-Instruction Program (VCIP) evaluation were: (1) to develop profiles describing institutional services for veterans, the Office of Veterans' Affairs (OVA), and demographic characteristics; (2) to identify differences and similarities in institutions' veteran assistance programs; (3) to describe the degree to…

Comparison of L1000 and Affymetrix Microarray for In Vitro Concentration-Response Gene Expression Profiling (SOT)

EPA Science Inventory

Advances in high-throughput screening technologies and in vitro systems have opened doors for cost-efficient evaluation of chemical effects on a diversity of biological endpoints. However, toxicogenomics platforms remain too costly to evaluate large libraries of chemicals in conc...

Nutrition advocacy and national development: the PROFILES programme and its application.

PubMed

Burkhalter, B R; Abel, E; Aguayo, V; Diene, S M; Parlato, M B; Ross, J S

1999-01-01

Investment in nutritional programmes can contribute to economic growth and is cost-effective in improving child survival and development. In order to communicate this to decision-makers, the PROFILES nutrition advocacy and policy development programme was applied in certain developing countries. Effective advocacy is necessary to generate financial and political support for scaling up from small pilot projects and maintaining successful national programmes. The programme uses scientific knowledge to estimate development indicators such as mortality, morbidity, fertility, school performance and labour productivity from the size and nutritional condition of populations. Changes in nutritional condition are estimated from the costs, coverage and effectiveness of proposed programmes. In Bangladesh this approach helped to gain approval and funding for a major nutrition programme. PROFILES helped to promote the nutrition component of an early childhood development programme in the Philippines, and to make nutrition a top priority in Ghana's new national child survival strategy. The application of PROFILES in these and other countries has been supported by the United States Agency for International Development, the United Nations Children's Fund, the World Bank, the Asian Development Bank, the Micronutrient Initiative and other bodies.

Age and the economics of an emergency medical admission-what factors determine costs?

PubMed

McCabe, J J; Cournane, S; Byrne, D; Conway, R; O'Riordan, D; Silke, B

2017-02-01

The ageing of the population may be anticipated to increase demand on hospital resources. We have investigated the relationship between hospital episode costs and age profile in a single centre. All Emergency Medical admissions (33 732 episodes) to an Irish hospital over a 6-year period, categorized into three age groups, were evaluated against total hospital episode costs. Univariate and adjusted incidence rate ratios (IRRs) were calculated using zero truncated Poisson regression. The total hospital episode cost increased with age ( P < 0.001). The multi-variable Poisson regression model demonstrated that the most important drivers of overall costs were Acute Illness Severity-IRR 1.36 (95% CI: 1.30, 1.41), Sepsis Status -1.46 (95% CI: 1.42, 1.51) and Chronic Disabling Disease Score -1.25 (95% CI: 1.22, 1.27) and the Age Group as exemplified for those 85 years IRR 1.23 (95% CI: 1.15, 1.32). Total hospital episode costs are a product of clinical complexity with contributions from the Acute Illness Severity, Co-Morbidity, Chronic Disabling Disease Score and Sepsis Status. However age is also an important contributor and an increasing patient age profile will have a predictable impact on total hospital episode costs. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Wing kinematics and flexibility for optimal manoeuvring and escape

NASA Astrophysics Data System (ADS)

Wong, Jaime Gustav

Understanding how animals control the dynamic stall vortices in their wake is critical to developing micro-aerial vehicles and autonomous underwater vehicles, not to mention wind turbines, delta wings, and rotor craft that undergo similar dynamic stall processes. Applying this knowledge to biomimetic engineering problems requires progress in three areas: (i) understanding the flow physics of natural swimmers and flyers; (ii) developing flow measurement techniques to resolve this physics; and (iii) deriving low-cost models suitable for studying the vast parameter space observed in nature. This body of work, which consists of five research chapters, focuses on the leading-edge vortex (LEV) that forms on profiles undergoing rapid manoeuvres, delta wings, and similar devices. Lagrangian particle tracking is used throughout this thesis to track the mass and circulation transport in the LEV on manoeuvring profiles. The growth and development of the LEV is studied in relation to: flapping and plunging profile kinematics; spanwise flow from profile sweep and spanwise profile bending; and varying the angle-of-attack gradient along the profile span. Finally, scaling relationships derived from the observations above are used to develop a low-cost model for LEV growth, that is validated on a flat-plate delta wing. Together these results contribute to each of the three topics identified above, as a step towards developing robust, agile biomimetic swimmers and flyers.

Comprehensive Characterization a Tidal Energy Site (Invited)

NASA Astrophysics Data System (ADS)

Polagye, B. L.; Thomson, J. M.; Bassett, C. S.; Epler, J.; Northwest National Marine Renewable Energy Center

2010-12-01

Northern Admiralty Inlet, Puget Sound, Washington is the proposed location of a pilot tidal energy project. Site-specific characterization of the physical and biological environment is required for device engineering and environmental analysis. However, the deep water and strong currents which make the site attractive for tidal energy development also pose unique challenges to collecting comprehensive information. This talk focuses on efforts to optimally site hydrokinetic turbines and estimate their acoustic impact, based on 18 months of field data collected to date. Additional characterization efforts being undertaken by the University of Washington branch of the Northwest National Marine Renewable Energy Center and its partners include marine mammal presence and behavior, water quality, seabed geology, and biofouling potential. Because kinetic power density varies with the cube of horizontal current velocity, an accurate map of spatial current variations is required to optimally site hydrokinetic turbines. Acoustic Doppler profilers deployed on the seabed show operationally meaningful variations in flow characteristics (e.g., power density, directionality, vertical shear) and tidal harmonic constituents over length scales of less than 100m. This is, in part, attributed to the proximity of this site to a headland. Because of these variations, interpolation between stationary measurement locations introduces potentially high uncertainty. The use of shipboard acoustic Doppler profilers is shown to be an effective tool for mapping peak currents and, combined with information from seabed profilers, may be able to resolve power density variations in the project area. Because noise levels from operating turbines are expected to exceed regulatory thresholds for incidental harassment of marine mammals known to be present in the project area, an estimate of the acoustic footprint is required to permit the pilot project. This requires site-specific descriptions of pre-existing ambient noise levels and the transmission loss (or practical spreading) at frequencies of interest. Recording hydrophones deployed on the seabed are used to quantify ambient noise, but are contaminated by self-noise during periods of strong currents. An empirical estimate of transmission loss is obtained from a source of opportunity - a passenger ferry which operates for more than twelve hours each day. By comparing recorded sound pressure levels against the location of the passenger ferry and other vessels (logged by an AIS receiver), the empirical transmission loss and source level for the ferry are obtained. Measurements of current velocity and underwater noise can apply routine oceanographic instruments and techniques. More unique measurements will be more challenging, such as high resolution sampling of current structure upstream and downstream of an operating device tens of meters off the seabed. Innovative approaches are required for cost effective characterization of tidal energy sites and monitoring of operating projects.

A Case Study of Pharmaceutical Pricing in China: Setting the Price for Off-Patent Originators.

PubMed

Hu, Shanlian; Zhang, Yabing; He, Jiangjiang; Du, Lixia; Xu, Mingfei; Xie, Chunyan; Peng, Ying; Wang, Linan

2015-08-01

This article aims to define a value-based approach to pricing and reimbursement for off-patent originators using a multiple criteria decision analysis (MCDA) approach centered on a systematic analysis of current pricing and reimbursement policies in China. A drug price policy review was combined with a quantitative analysis of China's drug purchasing database. Policy preferences were identified through a MCDA performed by interviewing well-known academic experts and industry stakeholders. The study findings indicate that the current Chinese price policy includes cost-based pricing and the establishment of maximum retail prices and premiums for off-patent originators, whereas reference pricing may be adopted in the future. The literature review revealed significant differences in the dissolution profiles between originators and generics; therefore, dissolution profiles need to be improved. Market data analysis showed that the overall price ratio of generics and off-patent originators was around 0.54-0.59 in 2002-2011, with a 40% price difference, on average. Ten differentiating value attributes were identified and MCDA was applied to test the impact of three pricing policy scenarios. With the condition of implementing quality consistency regulations and controls, a reduction in the price gap between high-quality off-patent products (including originator and generics) seemed to be the preferred policy. Patents of many drugs will expire within the next 10 years; thus, pricing will be an issue of importance for off-patent originators and generic alternatives.

Cost analysis and sociocultural profile of kidney patients. Impact of the treatment method.

PubMed

Lorenzo-Sellares, Víctor; Pedrosa, M Inmaculada; Santana-Expósito, Balbina; García-González, Zoraida; Barroso-Montesinos, Mónica

2014-01-01

The cost analysis of chronic kidney disease based on individual data for treatment methods and components has not been published in Spain. a) To study the health costs of a year of treatment with haemodialysis (HD), deceased donor renal transplantation (RTx), renal-pancreas transplantation (RPTx), and S4 and S5 advanced chronic kidney disease (ACKD) b) Assess the potential relationship between sociocultural diversity, costs and treatment method. Observational study of: 1) 81 patients with ACKD (53 S4 and 28 S5) 2) 162 with more than 3 months on HD and 3) 173 with a Tx for more than 6 months (140 RTx and 33 RPTx). The costs were assessed in five categories: 1) HD sessions, 2) drug intake, 3) hospitalisation, 4) outpatient care and 5) transportation. We carried out a survey with socio-demographic parameters. The financial impact of HD was €47,714±18,360 (mean±SD), that of Tx €13,988±9970, and that of ACKD €9654±9412. The cost of HD was the highest in all financial items. The costs were similar between RTx and RPTx. In ACKD, the greater the renal deterioration, the greater the cost is (S4 €7846±8901 versus S5 €13,300±9820, P<.01). Tx patients had the best sociocultural status, while HD patients had the worst profile. We did not find differences in costs between the three sociocultural groups. HD has the greatest financial impact in all items, five times higher than the ACKD patient cost and three times than the Tx patient cost. Optimising early prevention and Tx, if appropriate, must be priority strategies. This analysis invites us to think about whether sociocultural status can have an influence on opportunities for Tx.

A Study of the Implementation of Current Cost Accounting in the Republic of Korea Army Procurement Systems.

DTIC Science & Technology

1986-06-01

financial reporting in Republic of Korea Army (ROKA) procurement. A discussion of the nature of the ROKA procurement system and two alternatives to historical cost financial statements are presented. The concepts, methods and procedures of the historical cost/constant dollars financial statements are described. The proposal for current cost/constant dollars financial statements is presented and emphasis is given to the description of four problems in existing ROKA procurement due to using inadequate accounting information. Keywords: Cost accounting, Procurement, Current

The prevalence and costs of obesity in the EU.

PubMed

Fry, James; Finley, Willa

2005-08-01

The present paper reports on results obtained as part of the economics module of the LIPGENE project. It reviews recent trends in obesity in the fifteen member states of the EU (the member states before enlargement in 2004) and concludes that in 2002 for both adult men and women at least half the fifteen member states of the EU had obesity levels of >20%. In the same year the total direct and indirect annual costs of obesity in the fifteen member states of the EU were 32,800 euro x 10(6). The provision of 'healthy' foods with an adapted lipid profile provides one means of mitigating the impact of obesity. However, there are extra costs associated with the supply of such foods, via additional costs of food ingredients, identity preservation costs for premium-value food products and the penalties caused by the inability to exploit economies of scale. The limited scale of the markets for healthy foods is caused by their high selling prices. Also presented is an analysis of the costs of subsidising, throughout the EU, ingredients that improve the fatty acid profile of beef, eggs, poultry meat and low-fat spreads, so that healthier versions of these products sell at the same price as traditional alternatives. The total costs of such subsidies for these four food products would have been 10 euro x 10(9)/year in 2002, which was 30% of the direct and indirect costs of obesity.

The cost-effectiveness of the RSI QuickScan intervention programme for computer workers: Results of an economic evaluation alongside a randomised controlled trial.

PubMed

Speklé, Erwin M; Heinrich, Judith; Hoozemans, Marco J M; Blatter, Birgitte M; van der Beek, Allard J; van Dieën, Jaap H; van Tulder, Maurits W

2010-11-11

The costs of arm, shoulder and neck symptoms are high. In order to decrease these costs employers implement interventions aimed at reducing these symptoms. One frequently used intervention is the RSI QuickScan intervention programme. It establishes a risk profile of the target population and subsequently advises interventions following a decision tree based on that risk profile. The purpose of this study was to perform an economic evaluation, from both the societal and companies' perspective, of the RSI QuickScan intervention programme for computer workers. In this study, effectiveness was defined at three levels: exposure to risk factors, prevalence of arm, shoulder and neck symptoms, and days of sick leave. The economic evaluation was conducted alongside a randomised controlled trial (RCT). Participating computer workers from 7 companies (N = 638) were assigned to either the intervention group (N = 320) or the usual care group (N = 318) by means of cluster randomisation (N = 50). The intervention consisted of a tailor-made programme, based on a previously established risk profile. At baseline, 6 and 12 month follow-up, the participants completed the RSI QuickScan questionnaire. Analyses to estimate the effect of the intervention were done according to the intention-to-treat principle. To compare costs between groups, confidence intervals for cost differences were computed by bias-corrected and accelerated bootstrapping. The mean intervention costs, paid by the employer, were 59 euro per participant in the intervention and 28 euro in the usual care group. Mean total health care and non-health care costs per participant were 108 euro in both groups. As to the cost-effectiveness, improvement in received information on healthy computer use as well as in their work posture and movement was observed at higher costs. With regard to the other risk factors, symptoms and sick leave, only small and non-significant effects were found. In this study, the RSI QuickScan intervention programme did not prove to be cost-effective from the both the societal and companies' perspective and, therefore, this study does not provide a financial reason for implementing this intervention. However, with a relatively small investment, the programme did increase the number of workers who received information on healthy computer use and improved their work posture and movement. NTR1117.

Generation and Characterization of Electron Bunches with Ramped Current Profiles in a Dual-Frequency Superconducting Linear Accelerator

DOE PAGES

Piot, P.; Behrens, C.; Gerth, C.; ...

2011-09-07

We report on the successful experimental generation of electron bunches with ramped current profiles. The technique relies on impressing nonlinear correlations in the longitudinal phase space using a superconducing radiofrequency linear accelerator operating at two frequencies and a current-enhancing dispersive section. The produced {approx} 700-MeV bunches have peak currents of the order of a kilo-Ampere. Data taken for various accelerator settings demonstrate the versatility of the method and in particular its ability to produce current profiles that have a quasi-linear dependency on the longitudinal (temporal) coordinate. The measured bunch parameters are shown, via numerical simulations, to produce gigavolt-per-meter peak acceleratingmore » electric fields with transformer ratios larger than 2 in dielectric-lined waveguides.« less

Generation and characterization of electron bunches with ramped current profiles in a dual-frequency superconducting linear accelerator.

PubMed

Piot, P; Behrens, C; Gerth, C; Dohlus, M; Lemery, F; Mihalcea, D; Stoltz, P; Vogt, M

2012-01-20

We report on the successful experimental generation of electron bunches with ramped current profiles. The technique relies on impressing nonlinear correlations in the longitudinal phase space using a superconducing radio frequency linear accelerator operating at two frequencies and a current-enhancing dispersive section. The produced ~700-MeV bunches have peak currents of the order of a kilo-Ampère. Data taken for various accelerator settings demonstrate the versatility of the method and, in particular, its ability to produce current profiles that have a quasilinear dependency on the longitudinal (temporal) coordinate. The measured bunch parameters are shown, via numerical simulations, to produce gigavolt-per-meter peak accelerating electric fields with transformer ratios larger than 2 in dielectric-lined waveguides. © 2012 American Physical Society

Same-day genomic and epigenomic diagnosis of brain tumors using real-time nanopore sequencing.

PubMed

Euskirchen, Philipp; Bielle, Franck; Labreche, Karim; Kloosterman, Wigard P; Rosenberg, Shai; Daniau, Mailys; Schmitt, Charlotte; Masliah-Planchon, Julien; Bourdeaut, Franck; Dehais, Caroline; Marie, Yannick; Delattre, Jean-Yves; Idbaih, Ahmed

2017-11-01

Molecular classification of cancer has entered clinical routine to inform diagnosis, prognosis, and treatment decisions. At the same time, new tumor entities have been identified that cannot be defined histologically. For central nervous system tumors, the current World Health Organization classification explicitly demands molecular testing, e.g., for 1p/19q-codeletion or IDH mutations, to make an integrated histomolecular diagnosis. However, a plethora of sophisticated technologies is currently needed to assess different genomic and epigenomic alterations and turnaround times are in the range of weeks, which makes standardized and widespread implementation difficult and hinders timely decision making. Here, we explored the potential of a pocket-size nanopore sequencing device for multimodal and rapid molecular diagnostics of cancer. Low-pass whole genome sequencing was used to simultaneously generate copy number (CN) and methylation profiles from native tumor DNA in the same sequencing run. Single nucleotide variants in IDH1, IDH2, TP53, H3F3A, and the TERT promoter region were identified using deep amplicon sequencing. Nanopore sequencing yielded ~0.1X genome coverage within 6 h and resulting CN and epigenetic profiles correlated well with matched microarray data. Diagnostically relevant alterations, such as 1p/19q codeletion, and focal amplifications could be recapitulated. Using ad hoc random forests, we could perform supervised pan-cancer classification to distinguish gliomas, medulloblastomas, and brain metastases of different primary sites. Single nucleotide variants in IDH1, IDH2, and H3F3A were identified using deep amplicon sequencing within minutes of sequencing. Detection of TP53 and TERT promoter mutations shows that sequencing of entire genes and GC-rich regions is feasible. Nanopore sequencing allows same-day detection of structural variants, point mutations, and methylation profiling using a single device with negligible capital cost. It outperforms hybridization-based and current sequencing technologies with respect to time to diagnosis and required laboratory equipment and expertise, aiming to make precision medicine possible for every cancer patient, even in resource-restricted settings.

Scenario drafting to anticipate future developments in technology assessment.

PubMed

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

2012-08-16

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

Scenario drafting to anticipate future developments in technology assessment

PubMed Central

2012-01-01

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

Cost-Effectiveness Analysis of Using Loss of Heterozygosity to Manage Premalignant Oral Dysplasia in British Columbia, Canada.

PubMed

Cromwell, Ian; Regier, Dean A; Peacock, Stuart J; Poh, Catherine F

2016-09-01

Management of low-grade oral dysplasias (LGDs) is complicated, as only a small percentage of lesions will progress to invasive disease. The current standard of care requires patients to undergo regular monitoring of their lesions, with intervention occurring as a response to meaningful clinical changes. Recent improvements in molecular technologies and understanding of the biology of LGDs may allow clinicians to manage lesions based on their genome-guided risk. We used a decision-analytic Markov model to estimate the cost-effectiveness of risk-stratified care using a genomic assay. In the experimental arm, patients with LGDs were managed according to their risk profile using the assay, with low- and intermediate-risk patients given longer screening intervals and high-risk patients immediately treated with surgery. Patients in the comparator arm had standard care (biannual follow-up appointments at an oral cancer clinic). Incremental costs and outcomes in life-years gained (LYG) and quality-adjusted life-years (QALY) were calculated based on the results in each arm. The mean cost of assay-guided management was $8,123 (95% confidence interval [CI] $2,973 to $23,062 in 2013 Canadian dollars) less than the cost of standard care. This difference was driven largely by reductions in resource use among people who did not develop cancer. Mean incremental effectiveness was 0.18 LYG (95% CI 0.08 to 0.39) or 0.64 QALY (95% CI 0.46 to 0.89). Sensitivity analysis suggests that these findings are robust to both expected and extreme variation in all parameter values. Use of the assay-guided management strategy costs less and is more effective than standard management of LGDs. The findings of this study strongly suggest that the use of a risk-stratification method such as a genomic assay can result in improved quality-adjusted survival outcomes for patients with low-grade oral dysplasia (LGD). The use of such an assay in this study provides "precision medicine," allowing for a change in follow-up frequency or early intervention as compared with current standard care. As genomic technologies become more common in cancer care, it is hoped that such an assay, once validated, will become part of a new model for the standard management of LGDs in similar health systems. ©AlphaMed Press.

Using a 1200 kHz workhorse ADCP with mode 12 to measure near bottom mean currents

USGS Publications Warehouse

Martini, M.; ,

2003-01-01

Using high frequency Acoustic Doppler Current (ADCP) profiling technology, it is possible to make high-resolution measurements of mean current profiles within a few meters of the seabed. In coastal applications, mean current speeds may be 10 cm/s or less, and oscillatory wave currents may exceed 100 cm/s during storm events. To resolve mean flows of 10 cm/s or less under these conditions, accuracies of 1 cm/s or better are desirable.

Paclitaxel: a pharmacoeconomic review of its use in non-small cell lung cancer.

PubMed

Plosker, G L; Hurst, M

2001-01-01

A number of first-line chemotherapy options for patients with advanced non-small cell lung cancer (NSCLC) are advocated in treatment guidelines and/or by various clinical investigators. Platinum-based chemotherapy has clearly demonstrated efficacy in patients with advanced NSCLC and is generally recommended as first-line therapy, although there is increasing interest in the use of non-platinum chemotherapy regimens. Among the platinum-based combinations currently used in clinical practice are regimens such as cisplatin or carboplatin combined with paclitaxel, vinorelbine, gemcitabine, docetaxel or irinotecan. The particular combinations employed may vary between institutions and geographical regions. Several pharmacoeconomic analyses have been conducted on paclitaxel in NSCLC and most have focused on its use in combination with cisplatin. In terms of clinical efficacy, paclitaxel-cisplatin combinations achieved significantly higher response rates than teniposide plus cisplatin or etoposide plus cisplatin (previously thought to be among the more effective regimens available) in two large randomised trials. One of these studies showed a survival advantage for paclitaxel plus cisplatin [with or without a granulocyte colony-stimulating factor (G-CSF)] compared with etoposide plus cisplatin. A Canadian cost-effectiveness analysis incorporated data from one of the large randomised comparative trials and showed that the incremental cost per life-year saved for outpatient administration of paclitaxel plus cisplatin versus etoposide plus cisplatin was $US 22181 (30619 Canadian dollars; $Can) [1997 costs]. A European analysis incorporated data from the other large randomised study and showed slightly higher costs per responder for paclitaxel plus cisplatin than for teniposide plus cisplatin in The Netherlands ($US 30769 vs $US 29592) and Spain ($US 19 923 vs $US 19724) but lower costs per responder in Belgium ($US 22852 vs $US 25000) and France ($US28 080 vs $US 34747) [1995/96 costs]. In other cost-effectiveness analyses, paclitaxel plus cisplatin was associated with a cost per life-year saved relative to best supportive care of approximately $US 10000 in a US study (year of costing not reported) or $US 11200 in a Canadian analysis ($Can 15400; 1995 costs). Results were less favourable when combining paclitaxel with carboplatin instead of cisplatin and particularly when G-CSF was added to paclitaxel plus cisplatin. The Canadian study incorporated the concept of extended dominance in a threshold analysis and ranked paclitaxel plus cisplatin first among several comparator regimens (including vinorelbine plus cisplatin) when the threshold level was $Can 75000 ($US 54526) per life-year saved or per quality-adjusted life-year gained (1995 values). Current treatment guidelines for advanced NSCLC recognise paclitaxel-platinum combinations as one of the first-line chemotherapy treatment options. In two large head-to-head comparative clinical trials, paclitaxel plus cisplatin was associated with significantly greater response rates than cisplatin in combination with either teniposide or etoposide, and a survival advantage was shown for paclitaxel plus cisplatin (with or without G-CSF) over etoposide plus cisplatin. There are limitations to the currently available pharmacoeconomic data and further economic analyses of paclitaxel-carboplatin regimens are warranted, as this combination is widely used in NSCLC and appears to have some clinical advantages over paclitaxel plus cisplatin in terms of ease of administration and tolerability profile. Nevertheless, results of various cost-effectiveness studies support the use of paclitaxel-platinum combinations, particularly paclitaxel plus cisplatin, as a first-line chemotherapy treatment option in patients with advanced NSCLC.

A transistor based on 2D material and silicon junction

NASA Astrophysics Data System (ADS)

Kim, Sanghoek; Lee, Seunghyun

2017-07-01

A new type of graphene-silicon junction transistor based on bipolar charge-carrier injection was designed and investigated. In contrast to many recent studies on graphene field-effect transistor (FET), this device is a new type of bipolar junction transistor (BJT). The transistor fully utilizes the Fermi level tunability of graphene under bias to increase the minority-carrier injection efficiency of the base-emitter junction in the BJT. Single-layer graphene was used to form the emitter and the collector, and a p-type silicon was used as the base. The output of this transistor was compared with a metal-silicon junction transistor ( i.e. surface-barrier transistor) to understand the difference between a graphene-silicon junction and metal-silicon Schottky junction. A significantly higher current gain was observed in the graphene-silicon junction transistor as the base current was increased. The graphene-semiconductor heterojunction transistor offers several unique advantages, such as an extremely thin device profile, a low-temperature (< 110 °C) fabrication process, low cost (no furnace process), and high-temperature tolerance due to graphene's stability. A transistor current gain ( β) of 33.7 and a common-emitter amplifier voltage gain of 24.9 were achieved.

Proper nozzle location, bit profile, and cutter arrangement affect PDC-bit performance significantly

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

Garcia-Gavito, D.; Azar, J.J.

1994-09-01

During the past 20 years, the drilling industry has looked to new technology to halt the exponentially increasing costs of drilling oil, gas, and geothermal wells. This technology includes bit design innovations to improve overall drilling performance and reduce drilling costs. These innovations include development of drag bits that use PDC cutters, also called PDC bits, to drill long, continuous intervals of soft to medium-hard formations more economically than conventional three-cone roller-cone bits. The cost advantage is the result of higher rates of penetration (ROP's) and longer bit life obtained with the PDC bits. An experimental study comparing the effectsmore » of polycrystalline-diamond-compact (PDC)-bit design features on the dynamic pressure distribution at the bit/rock interface was conducted on a full-scale drilling rig. Results showed that nozzle location, bit profile, and cutter arrangement are significant factors in PDC-bit performance.« less

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed Central

Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-01-01

Background: The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Methods: Participants (n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program (n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group (n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. Results: A significant time * group interaction effect (p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. Conclusions: A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628. PMID:28902144

Technological advances for interrogating the human kinome.

PubMed

Baharani, Akanksha; Trost, Brett; Kusalik, Anthony; Napper, Scott

2017-02-08

There is increasing appreciation among researchers and clinicians of the value of investigating biology and pathobiology at the level of cellular kinase (kinome) activity. Kinome analysis provides valuable opportunity to gain insights into complex biology (including disease pathology), identify biomarkers of critical phenotypes (including disease prognosis and evaluation of therapeutic efficacy), and identify targets for therapeutic intervention through kinase inhibitors. The growing interest in kinome analysis has fueled efforts to develop and optimize technologies that enable characterization of phosphorylation-mediated signaling events in a cost-effective, high-throughput manner. In this review, we highlight recent advances to the central technologies currently available for kinome profiling and offer our perspectives on the key challenges remaining to be addressed. © 2017 The Author(s); published by Portland Press Limited on behalf of the Biochemical Society.

A Horizontal Take-off and Landing satellite launcher or aerospace plane (HOTOL)

NASA Astrophysics Data System (ADS)

Conchie, P. J.

1985-09-01

An assessment is made of the technology readiness and typical mission profile of a Horizontal Takeoof and Landing (HOTOL) single-stage satellite launch vehicle for 1990s deployment. HOTOL would employ H2-fueled air-breathing propulsion for the first stage of its ascent to low earth orbit through the lower portions of the atmosphere; it would then switch to H2-fueled rocket engines using liquid oxygen from internal tanks for exoatmospheric flight and orbit insertion. Mission cost comparisons are made with alternative launch vehicle design options. HOTOL is approximately the same size as the Concorde SST, and will weigh so much less than the current Space Shuttle as to significantly reduce reentry speeds and temperatures, obviating ceramic insulation systems for the primary structure.

[Metformin and kidney].

PubMed

Sessa, Concetto; Blanco, Julien; Granata, Antonio; Fatuzzo, Pasquale; Castellino, Pietro; Zanoli, Luca

2016-01-01

Metformin is the first choice among drugs used for the treatment of type II diabetes mellitus mainly because of several advantages: proven hypoglycemic effect, good safety profile, virtually no risk of hypoglycemia, body weight reduction, lipid-lowering effect, efficacy in preventing micro- and macrovascular complications as well as adverse cardiac and cerebrovascular events and reduced cost. Previous reports had shown an increased risk of lactic acidosis in patients receiving metformin. However, the current Guidelines have greatly limited this risk to certain categories of patients, such as those with severe chronic renal failure, particularly when predisposing risk factors such as administration of iodinated contrast are present. In this review, we reported the main data of the literature on the use of metformin in patients with chronic renal failure and both highly expected benefits and high potential risks.

Evaluating the Invariance of Cognitive Profile Patterns Derived from Profile Analysis via Multidimensional Scaling (PAMS): A Bootstrapping Approach

ERIC Educational Resources Information Center

Kim, Se-Kang

2010-01-01

The aim of the current study is to validate the invariance of major profile patterns derived from multidimensional scaling (MDS) by bootstrapping. Profile Analysis via Multidimensional Scaling (PAMS) was employed to obtain profiles and bootstrapping was used to construct the sampling distributions of the profile coordinates and the empirical…

Advanced nickel-hydrogen spacecraft battery development

NASA Technical Reports Server (NTRS)

Coates, Dwaine K.; Fox, Chris L.; Standlee, D. J.; Grindstaff, B. K.

1994-01-01

Eagle-Picher currently has several advanced nickel-hydrogen (NiH2) cell component and battery designs under development including common pressure vessel (CPV), single pressure vessel (SPV), and dependent pressure vessel (DPV) designs. A CPV NiH2 battery, utilizing low-cost 64 mm (2.5 in.) cell diameter technology, has been designed and built for multiple smallsat programs, including the TUBSAT B spacecraft which is currently scheduled (24 Nov. 93) for launch aboard a Russian Proton rocket. An advanced 90 mm (3.5 in.) NiH2 cell design is currently being manufactured for the Space Station Freedom program. Prototype 254 mm (10 in.) diameter SPV batteries are currently under construction and initial boilerplate testing has shown excellent results. NiH2 cycle life testing is being continued at Eagle-Picher and IPV cells have currently completed more than 89,000 accelerated LEO cycles at 15% DOD, 49,000 real-time LEO cycles at 30 percent DOD, 37,800 cycles under a real-time LEO profile, 30 eclipse seasons in accelerated GEO, and 6 eclipse seasons in real-time GEO testing at 75 percent DOD maximum. Nickel-metal hydride battery development is continuing for both aerospace and electric vehicle applications. Eagle-Picher has also developed an extensive range of battery evaluation, test, and analysis (BETA) measurement and control equipment and software, based on Hewlett-Packard computerized data acquisition/control hardware.

An Analysis of Rocket Propulsion Testing Costs

NASA Technical Reports Server (NTRS)

Ramirez-Pagan, Carmen P.; Rahman, Shamim A.

2009-01-01

The primary mission at NASA Stennis Space Center (SSC) is rocket propulsion testing. Such testing is generally performed within two arenas: (1) Production testing for certification and acceptance, and (2) Developmental testing for prototype or experimental purposes. The customer base consists of NASA programs, DOD programs, and commercial programs. Resources in place to perform on-site testing include both civil servants and contractor personnel, hardware and software including data acquisition and control, and 6 test stands with a total of 14 test positions/cells. For several business reasons there is the need to augment understanding of the test costs for all the various types of test campaigns. Historical propulsion test data was evaluated and analyzed in many different ways with the intent to find any correlation or statistics that could help produce more reliable and accurate cost estimates and projections. The analytical efforts included timeline trends, statistical curve fitting, average cost per test, cost per test second, test cost timeline, and test cost envelopes. Further, the analytical effort includes examining the test cost from the perspective of thrust level and test article characteristics. Some of the analytical approaches did not produce evidence strong enough for further analysis. Some other analytical approaches yield promising results and are candidates for further development and focused study. Information was organized for into its elements: a Project Profile, Test Cost Timeline, and Cost Envelope. The Project Profile is a snap shot of the project life cycle on a timeline fashion, which includes various statistical analyses. The Test Cost Timeline shows the cumulative average test cost, for each project, at each month where there was test activity. The Test Cost Envelope shows a range of cost for a given number of test(s). The supporting information upon which this study was performed came from diverse sources and thus it was necessary to build several intermediate databases in order to understand, validate, and manipulate data. These intermediate databases (validated historical account of schedule, test activity, and cost) by themselves are of great value and utility. For example, for the Project Profile, we were able to merged schedule, cost, and test activity. This kind of historical account conveys important information about sequence of events, lead time, and opportunities for improvement in future propulsion test projects. The Product Requirement Document (PRD) file is a collection of data extracted from each project PRD (technical characteristics, test requirements, and projection of cost, schedule, and test activity). This information could help expedite the development of future PRD (or equivalent document) on similar projects, and could also, when compared to the actual results, help improve projections around cost and schedule. Also, this file can be sorted by the parameter of interest to perform a visual review of potential common themes or trends. The process of searching, collecting, and validating propulsion test data encountered a lot of difficulties which then led to a set of recommendations for improvement in order to facilitate future data gathering and analysis.

Predicting hospital accounting costs

PubMed Central

Newhouse, Joseph P.; Cretin, Shan; Witsberger, Christina J.

1989-01-01

Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40 percent of hospitals had predicted costs within plus or minus 5 percent of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated. PMID:10313352

Fivefold confinement time increase in the Madison Symmetric Torus using inductive poloidal current drive

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

Stoneking, M.R.; Lanier, N.E.; Prager, S.C.

1996-12-01

Current profile control is employed in the Madison Symmetric Torus reversed field pinch to reduce the magnetic fluctuations responsible for anomalous transport. An inductive poloidal electric field pulse is applied in the sense to flatten the parallel current profile, reducing the dynamo fluctuation amplitude required to sustain the equilibrium. This technique demonstrates a substantial reduction in fluctuation amplitude (as much as 50%), and improvement in energy confinement (from 1 ms to 5 ms); a record low fluctuation (0.8%) and record high temperature (615 eV) for this device were observed simultaneously during current drive experiments. Plasma beta increases by 50% andmore » the Ohmic input power is three times lower. Particle confinement improves and plasma impurity contamination is reduced. The results of the transient current drive experiments provide motivation for continuing development of steady-state current profile control strategies for the reversed field pinch.« less

Recent RF Experiments and Application of RF Waves to Real-Time Control of Safety Factor Profile in JT-60U

NASA Astrophysics Data System (ADS)

Suzuki, T.; Isayama, A.; Ide, S.; Fujita, T.; Oikawa, T.; Sakata, S.; Sueoka, M.; Hosoyama, H.; JT-60 Team

2005-09-01

Two topics of applications of RF waves to current profile control in JT-60U are presented; application of lower-hybrid (LH) waves to safety factor profile control and electron cyclotron (EC) waves to neo-classical tearing mode (NTM) control. A real-time control system of safety factor (q) profile was developed. This system, for the first time, enables 1) real time evaluation of q profile using local magnetic pitch angle measurement by motional Stark effect (MSE) diagnostic and 2) control of current drive (CD) location (ρCD) by controlling the parallel refractive index N∥ of LH waves through control of phase difference (Δφ) of LH waves between multi-junction launcher modules. The method for real-time q profile evaluation was newly developed, without time-consuming reconstruction of equilibrium, so that the method requires less computational time. Safety factor profile by the real-time calculation agrees well with that by equilibrium reconstruction with MSE. The control system controls ρCD through Δφ in such a way to decrease the largest residual between the real-time evaluated q profile q(r) and its reference profile qref(r). The real-time control system was applied to a positive shear plasma (q(0)˜1). The reference q profile was set to monotonic positive shear profile having qref(0)=1.3. The real-time q profile approached to the qref(r) during application of real-time control, and was sustained for 3s, which was limited by the duration of the injected LH power. Temporal evolution of current profile was consistent with relaxation of inductive electric field induced by theoretical LH driven current. An m/n=3/2 NTM that appeared at βN˜3 was completely stabilized by ECCD applied to a fully-developed NTM. Precise ECCD at NTM island was essential for the stabilization. ECCD that was applied to resonant rational surface (q=3/2) before an NTM onset suppressed appearance of NTM. In order to keep NTM intensity below a level, ECCD before the mode onset was more effective than that after mode saturation.

Optimal shutdown management

NASA Astrophysics Data System (ADS)

Bottasso, C. L.; Croce, A.; Riboldi, C. E. D.

2014-06-01

The paper presents a novel approach for the synthesis of the open-loop pitch profile during emergency shutdowns. The problem is of interest in the design of wind turbines, as such maneuvers often generate design driving loads on some of the machine components. The pitch profile synthesis is formulated as a constrained optimal control problem, solved numerically using a direct single shooting approach. A cost function expressing a compromise between load reduction and rotor overspeed is minimized with respect to the unknown blade pitch profile. Constraints may include a load reduction not-to-exceed the next dominating loads, a not-to-be-exceeded maximum rotor speed, and a maximum achievable blade pitch rate. Cost function and constraints are computed over a possibly large number of operating conditions, defined so as to cover as well as possible the operating situations encountered in the lifetime of the machine. All such conditions are simulated by using a high-fidelity aeroservoelastic model of the wind turbine, ensuring the accuracy of the evaluation of all relevant parameters. The paper demonstrates the capabilities of the novel proposed formulation, by optimizing the pitch profile of a multi-MW wind turbine. Results show that the procedure can reliably identify optimal pitch profiles that reduce design-driving loads, in a fully automated way.

The current total economic burden of diabetes mellitus in the Netherlands.

PubMed

Peters, M L; Huisman, E L; Schoonen, M; Wolffenbuttel, B H R

2017-09-01

Insight into the total economic burden of diabetes mellitus (DM) is essential for decision makers and payers. Currently available estimates for the Netherlands only include part of the total burden or are no longer up-to-date. Therefore, this study aimed to determine the current total economic burden of DM and its complications in the Netherlands, by including all the relevant cost components. The study combined a systematic literature review to identify all relevant published information and a targeted review to identify relevant information in the grey literature. The identified evidence was then combined to estimate the current total economic burden. In 2016, there were an estimated 1.1 million DM patients in the Netherlands, of whom approximately 10% had type 1 and 90% had type 2 DM. The estimated current total economic burden of DM was € 6.8 billion in 2016. Healthcare costs (excluding costs of complications) were € 1.6 billion, direct costs of complications were € 1.3 billion and indirect costs due to productivity losses, welfare payments and complications were € 4.0 billion. DM and its complications pose a substantial economic burden to the Netherlands, which is expected to rise due to changing demographics and lifestyle. Indirect costs, such as welfare payments, accounted for a large portion of the current total economic burden of DM, while these cost components are often not included in cost estimations. Publicly available data for key cost drivers such as complications were scarce.

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

Generation of optimum vertical profiles for an advanced flight management system

NASA Technical Reports Server (NTRS)

Sorensen, J. A.; Waters, M. H.

1981-01-01

Algorithms for generating minimum fuel or minimum cost vertical profiles are derived and examined. The option for fixing the time of flight is included in the concepts developed. These algorithms form the basis for the design of an advanced on-board flight management system. The variations in the optimum vertical profiles (resulting from these concepts) due to variations in wind, takeoff mass, and range-to-destination are presented. Fuel savings due to optimum climb, free cruise altitude, and absorbing delays enroute are examined.

Determination of current and rotational transform profiles in a current-carrying stellarator using soft x-ray emissivity measurements

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

Ma, X.; Cianciosa, M. R.; Ennis, D. A.

In this research, collimated soft X-ray (SXR) emissivity measurements from multi-channel cameras on the Compact Toroidal Hybrid (CTH) tokamak/torsatron device are incorporated in the 3D equilibrium reconstruction code V3FIT to reconstruct the shape of flux surfaces and infer the current distribution within the plasma. Equilibrium reconstructions of sawtoothing plasmas that use data from both SXR and external magnetic diagnostics show the central safety factor to be near unity under the assumption that SXR iso-emissivity contours lie on magnetic flux surfaces. The reconstruction results are consistent with those using the external magnetic data and a constraint on the location of qmore » = 1 surfaces determined from the sawtooth inversion surface extracted from SXR brightness profiles. The agreement justifies the use of approximating SXR emission as a flux function in CTH, at least within the core of the plasma, subject to the spatial resolution of the SXR diagnostics. Lastly, this improved reconstruction of the central current density indicates that the current profile peakedness decreases with increasing external transform and that the internal inductance is not a relevant measure of how peaked the current profile is in hybrid discharges.« less

Determination of current and rotational transform profiles in a current-carrying stellarator using soft x-ray emissivity measurements

NASA Astrophysics Data System (ADS)

Ma, X.; Cianciosa, M. R.; Ennis, D. A.; Hanson, J. D.; Hartwell, G. J.; Herfindal, J. L.; Howell, E. C.; Knowlton, S. F.; Maurer, D. A.; Traverso, P. J.

2018-01-01

Collimated soft X-ray (SXR) emissivity measurements from multi-channel cameras on the Compact Toroidal Hybrid (CTH) tokamak/torsatron device are incorporated in the 3D equilibrium reconstruction code V3FIT to reconstruct the shape of flux surfaces and infer the current distribution within the plasma. Equilibrium reconstructions of sawtoothing plasmas that use data from both SXR and external magnetic diagnostics show the central safety factor to be near unity under the assumption that SXR iso-emissivity contours lie on magnetic flux surfaces. The reconstruction results are consistent with those using the external magnetic data and a constraint on the location of q = 1 surfaces determined from the sawtooth inversion surface extracted from SXR brightness profiles. The agreement justifies the use of approximating SXR emission as a flux function in CTH, at least within the core of the plasma, subject to the spatial resolution of the SXR diagnostics. This improved reconstruction of the central current density indicates that the current profile peakedness decreases with increasing external transform and that the internal inductance is not a relevant measure of how peaked the current profile is in hybrid discharges.

Determination of current and rotational transform profiles in a current-carrying stellarator using soft x-ray emissivity measurements

DOE PAGES

Ma, X.; Cianciosa, M. R.; Ennis, D. A.; ...

2018-01-31

In this research, collimated soft X-ray (SXR) emissivity measurements from multi-channel cameras on the Compact Toroidal Hybrid (CTH) tokamak/torsatron device are incorporated in the 3D equilibrium reconstruction code V3FIT to reconstruct the shape of flux surfaces and infer the current distribution within the plasma. Equilibrium reconstructions of sawtoothing plasmas that use data from both SXR and external magnetic diagnostics show the central safety factor to be near unity under the assumption that SXR iso-emissivity contours lie on magnetic flux surfaces. The reconstruction results are consistent with those using the external magnetic data and a constraint on the location of qmore » = 1 surfaces determined from the sawtooth inversion surface extracted from SXR brightness profiles. The agreement justifies the use of approximating SXR emission as a flux function in CTH, at least within the core of the plasma, subject to the spatial resolution of the SXR diagnostics. Lastly, this improved reconstruction of the central current density indicates that the current profile peakedness decreases with increasing external transform and that the internal inductance is not a relevant measure of how peaked the current profile is in hybrid discharges.« less

Calculation of the non-inductive current profile in high-performance NSTX plasmas

NASA Astrophysics Data System (ADS)

Gerhardt, S. P.; Fredrickson, E.; Gates, D.; Kaye, S.; Menard, J.; Bell, M. G.; Bell, R. E.; Le Blanc, B. P.; Kugel, H.; Sabbagh, S. A.; Yuh, H.

2011-03-01

The constituents of the current profile have been computed for a wide range of high-performance plasmas in NSTX (Ono et al 2000 Nucl. Fusion 40 557); these include cases designed to maximize the non-inductive fraction, pulse length, toroidal-β or stored energy. In the absence of low-frequency MHD activity, good agreement is found between the reconstructed current profile and that predicted by summing the independently calculated inductive, pressure-driven and neutral beam currents, without the need to invoke any anomalous beam ion diffusion. Exceptions occur, for instance, when there are toroidal Alfvén eigenmode avalanches or coupled m/n = 1/1 + 2/1 kink-tearing modes. In these cases, the addition of a spatially and temporally dependent fast-ion diffusivity can reduce the core beam current drive, restoring agreement between the reconstructed profile and the summed constituents, as well as bringing better agreement between the simulated and measured neutron emission rate. An upper bound on the fast-ion diffusivity of ~0.5-1 m2 s-1 is found in 'MHD-free' discharges, based on the neutron emission, the time rate of change in the neutron signal when a neutral beam is stepped and reconstructed on-axis current density.

Investigating the origin of efficiency droop by profiling the voltage across the multi-quantum well of an operating light-emitting diode

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

Kim, Taewoong; Seong, Tae-Yeon; School of Materials Science and Engineering, Korea University, Seoul 136-713

Efficiency droop is a phenomenon in which the efficiency of a light-emitting diode (LED) decreases with the increase in current density. To analyze efficiency droop, direct experimental observations on the energy conversion occurring inside the LED is required. Here, we present the measured voltage profiles on the cross section of an operating LED and analyze them with the cross-sectional temperature profiles obtained in a previous study under the same operation conditions. The measured voltage profiles suggest that with increases in the injection current density, electron depletion shifts from the multi-quantum well through an electron blocking layer to the p-GaN region.more » This is because electron leakage increases with increases in current density.« less

The role of satisfaction and switching costs in Medicare Part D choices.

PubMed

Han, Jayoung; Ko, Dong Woo; Urmie, Julie M

2014-01-01

Most U.S. states had over 50 Medicare Prescription Drug Plans (PDPs) in 2007. Medicare beneficiaries are expected to switch Part D plans based on their health and financial needs; however, the switching rate has been low. Such consumer inertia potentially has negative effects on both beneficiaries and the insurance market, resulting in a critical need to investigate its cause. To 1) describe how Medicare beneficiaries who were satisfied with their current Part D plan differed from those who were not satisfied; 2) examine the effect of switching costs on consideration of switching among Medicare beneficiaries who were dissatisfied with their current Part D plan. Data from the 2007 Prescription Drug Study supplement to the Health and Retirement Study (HRS) survey were used in this study. The satisfied and dissatisfied groups were compared in terms of cost variables, switching costs, and perception of Part D complexity. Structural equation modeling was used to examine relationships among switching costs, Part D complexity, cost variables, and consideration of switching for beneficiaries who were dissatisfied with their current Part D coverage. Out of 467 participants, a total of 255 (54.6%) were satisfied with their current Part D plan. The satisfied group paid lower out-of-pocket costs ($50.63 vs. $114.60) and premiums ($30.88 vs. $40.77) than the dissatisfied group. They also had lower switching costs. Only 11.3% of the dissatisfied beneficiaries switched plans. Among respondents who were dissatisfied with their current plan, those who perceived Part D as complex had high switching costs and were less likely to consider switching plans. Out-of-pocket cost did not have a statistically significant association with consideration of switching. Medicare beneficiaries who were satisfied with their current Part D plans had lower out-of-pocket costs and premiums as well as higher switching costs. Among beneficiaries who were dissatisfied with their current Part D plan, those who had higher switching costs were less likely to consider switching Part D plans. Copyright © 2014 Elsevier Inc. All rights reserved.

Model-based analysis of costs and outcomes of non-invasive prenatal testing for Down's syndrome using cell free fetal DNA in the UK National Health Service.

PubMed

Morris, Stephen; Karlsen, Saffron; Chung, Nancy; Hill, Melissa; Chitty, Lyn S

2014-01-01

Non-invasive prenatal testing (NIPT) for Down's syndrome (DS) using cell free fetal DNA in maternal blood has the potential to dramatically alter the way prenatal screening and diagnosis is delivered. Before NIPT can be implemented into routine practice, information is required on its costs and benefits. We investigated the costs and outcomes of NIPT for DS as contingent testing and as first-line testing compared with the current DS screening programme in the UK National Health Service. We used a pre-existing model to evaluate the costs and outcomes associated with NIPT compared with the current DS screening programme. The analysis was based on a hypothetical screening population of 10,000 pregnant women. Model inputs were taken from published sources. The main outcome measures were number of DS cases detected, number of procedure-related miscarriages and total cost. At a screening risk cut-off of 1∶150 NIPT as contingent testing detects slightly fewer DS cases, has fewer procedure-related miscarriages, and costs the same as current DS screening (around UK£280,000) at a cost of £500 per NIPT. As first-line testing NIPT detects more DS cases, has fewer procedure-related miscarriages, and is more expensive than current screening at a cost of £50 per NIPT. When NIPT uptake increases, NIPT detects more DS cases with a small increase in procedure-related miscarriages and costs. NIPT is currently available in the private sector in the UK at a price of £400-£900. If the NHS cost was at the lower end of this range then at a screening risk cut-off of 1∶150 NIPT as contingent testing would be cost neutral or cost saving compared with current DS screening. As first-line testing NIPT is likely to produce more favourable outcomes but at greater cost. Further research is needed to evaluate NIPT under real world conditions.

A novel feedback algorithm for simulating controlled dynamics and confinement in the advanced reversed-field pinch

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

Dahlin, J.-E.; Scheffel, J.

2005-06-15

In the advanced reversed-field pinch (RFP), the current density profile is externally controlled to diminish tearing instabilities. Thus the scaling of energy confinement time with plasma current and density is improved substantially as compared to the conventional RFP. This may be numerically simulated by introducing an ad hoc electric field, adjusted to generate a tearing mode stable parallel current density profile. In the present work a current profile control algorithm, based on feedback of the fluctuating electric field in Ohm's law, is introduced into the resistive magnetohydrodynamic code DEBSP [D. D. Schnack and D. C. Baxter, J. Comput. Phys. 55,more » 485 (1984); D. D. Schnack, D. C. Barnes, Z. Mikic, D. S. Marneal, E. J. Caramana, and R. A. Nebel, Comput. Phys. Commun. 43, 17 (1986)]. The resulting radial magnetic field is decreased considerably, causing an increase in energy confinement time and poloidal {beta}. It is found that the parallel current density profile spontaneously becomes hollow, and that a formation, being related to persisting resistive g modes, appears close to the reversal surface.« less

Discharge measurements at gaging stations

USGS Publications Warehouse

Turnipseed, D. Phil; Sauer, Vernon B.

2010-01-01

The techniques and standards for making discharge measurements at streamflow gaging stations are described in this publication. The vertical axis rotating-element current meter, principally the Price current meter, has been traditionally used for most measurements of discharge; however, advancements in acoustic technology have led to important developments in the use of acoustic Doppler current profilers, acoustic Doppler velocimeters, and other emerging technologies for the measurement of discharge. These new instruments, based on acoustic Doppler theory, have the advantage of no moving parts, and in the case of the acoustic Doppler current profiler, quickly and easily provide three-dimensional stream-velocity profile data through much of the vertical water column. For much of the discussion of acoustic Doppler current profiler moving-boat methodology, the reader is referred to U.S. Geological Survey Techniques and Methods 3-A22 (Mueller and Wagner, 2009). Personal digital assistants (PDAs), electronic field notebooks, and other personal computers provide fast and efficient data-collection methods that are more error-free than traditional hand methods. The use of portable weirs and flumes, floats, volumetric tanks, indirect methods, and tracers in measuring discharge are briefly described.

The Practice Profile: An All Purpose Tool for Program Communication, Staff Development, Evaluation and Improvement.

ERIC Educational Resources Information Center

Loucks, Susan F.; Crandall, David P.

The practice profile is a standardized, systematic, cost-effective tool for summarizing the components and requirements of a program in a manner that permits comparison with other programs or selection of discrete components from various programs. It provides a component checklist, a precise list of implementation requirements, and a system for…

Single element laser beam shaper

DOEpatents

Zhang, Shukui [Yorktown, VA; Shinn, Michelle D [Newport News, VA

2005-09-13

A single lens laser beam shaper for converting laser beams from any spatial profile to a flat-top or uniform spatial profile. The laser beam shaper includes a lens having two aspheric surfaces. The beam shaper significantly simplifies the overall structure in comparison with conventional 2-element systems and therefore provides great ease in alignment and reduction of cost.

The Protective Influence of Spiritual-Religious Lifestyle Profiles on Tobacco Use, Alcohol Use, and Gambling

ERIC Educational Resources Information Center

Hodge, David R.; Andereck, Kathleen; Montoya, Harry

2007-01-01

The costs associated with the use of addictive substances and practices underscore the need for research on protective factors that inhibit use. In this study, the protective influences of various spiritual-religious lifestyle profiles on tobacco smoking, alcohol use, and gambling frequency and expenditures are examined. Among the predominantly…

Determinants of Employment Success Among Ex-Offenders

ERIC Educational Resources Information Center

Knox, George W.; Stacey, William A.

1978-01-01

Use of cost-benefit analysis in evaluation of seven manpower service programs for ex-offenders in Illinois shows these programs have benefit-cost ratios ranging from 4.24 to 16.88. Demographic profiles for the client flows differ somewhat, with Operation DARE's population being somewhat of a more "hard-core" group based on previous law…

Comparative Costs and Staffing Report for Educational Facilities, 1997-1998.

ERIC Educational Resources Information Center

Glazner, Steve, Ed.

This report presents comparative data on facility management costs and staffing based on responses from 193 U.S. postsecondary educational facilities and K-12 institutions during 1997-98. It also lists data from both private and public institutions. Section 1 contains general data on the survey response tally and institutional profiles listed by…

Design and cost analysis for an ammonia-based solar thermochemical cavity absorber

NASA Astrophysics Data System (ADS)

Williams, O. M.

1980-01-01

A design and cost analysis is introduced for a solar thermochemical cavity absorber operated at the focus of a tracking paraboloidal concentrator and based on the ammonia dissociation reaction. The absorber design consists of a catalyst-filled nickel alloy tube wound into a spiral forming the inner cavity wall and shaped to match the incident power density profile to the reactor heat requirements. The reactor tube is welded to a coaxial counterflow heat exchanger. The relationships among the power density profile, the reaction thermodynamics and kinetics, and the heat transfer characteristics are examined in detail and it is shown that an installed cost goal of typically 10 U.S. dollars per square meter of solar collector area can be achieved through use of high activity ammonia dissociation catalyst. The optimum absorber size for a given paraboloidal dish area is calculated for a system pressure of 20 MPa and it is shown that a cost effective absorber suitable for 100,000-hr operation would operate at 90% efficiency at 750 C wall temperature.

10 CFR Appendix D to Part 30 - Criteria Relating to Use of Financial Tests and Self-Guarantee for Providing Reasonable Assurance...

Code of Federal Regulations, 2012 CFR

2012-01-01

... will be available for decommissioning costs and on a demonstration that the company passes the... total current decommissioning cost estimate (or the current amount required if certification is used... percent of total assets or at least 10 times the total current decommissioning cost estimate (or the...

Economic issues involved in integrating genomic testing into clinical care: the case of genomic testing to guide decision-making about chemotherapy for breast cancer patients.

PubMed

Marino, Patricia; Siani, Carole; Bertucci, François; Roche, Henri; Martin, Anne-Laure; Viens, Patrice; Seror, Valérie

2011-09-01

The use of taxanes to treat node-positive (N+) breast cancer patients is associated with heterogeneous benefits as well as with morbidity and financial costs. This study aimed to assess the economic impact of using gene expression profiling to guide decision-making about chemotherapy, and to discuss the coverage/reimbursement issues involved. Retrospective data on 246 patients included in a randomised trial (PACS01) were analyzed. Tumours were genotyped using DNA microarrays (189-gene signature), and patients were classified depending on whether or not they were likely to benefit from chemotherapy regimens without taxanes. Standard anthracyclines plus taxane chemotherapy (strategy AT) was compared with the innovative strategy based on genomic testing (GEN). Statistical analyses involved bootstrap methods and sensitivity analyses. The AT and GEN strategies yielded similar 5-year metastasis-free survival rates. In comparison with AT, GEN was cost-effective when genomic testing costs were less than 2,090€. With genomic testing costs higher than 2,919€, AT was cost-effective. Considering a 30% decrease in the price of docetaxel (the patent rights being about to expire), GEN was cost-effective if the cost of genomic testing was in the 0€-1,139€, range; whereas AT was cost-effective if genomic testing costs were higher than 1,891€. The use of gene expression profiling to guide decision-making about chemotherapy for N+ breast cancer patients is potentially cost-effective. Since genomic testing and the drugs targeted in these tests yield greater well-being than the sum of those resulting from separate use, questions arise about how to deal with extra well-being in decision-making about coverage/reimbursement.

Herbal remedies: issues in licensing and economic evaluation.

PubMed

Ashcroft, D M; Po, A L

1999-10-01

In recent years, the use of alternative therapies has become widespread. In particular, there has been a resurgence in the public's demand for herbal remedies, despite a lack of high-quality evidence to support the use of many of them. Given the increasing pressures to control healthcare spending in most countries, it is not surprising that attention is being focused on the cost effectiveness of herbal remedies. We address the question of whether there is sufficient information to enable the assessment of the cost effectiveness of herbal remedies. In so doing, we discuss the current state of play with several of the more high-profile alternative herbal remedies [Chinese medicinal herbs for atopic eczema, evening primrose oil, ginkgo biloba, hypericum (St John's wort)] and some which have made the transition from being alternative to being orthodox remedies. We use historical context to discuss, on the one hand, the increasing commodification of herbal remedies and on the other, the trend towards greater regulatory control and licensing of alternative herbal remedies. We argue that unless great care is exercised, these changes are not necessarily in the best interests of patients. In order to identify cost-effective care, we need reliable information about the costs as well as the efficacy and safety of the treatments being assessed. For most alternative therapies, such data are not available. We believe that studies to gather such data are long overdue. Whilst we argue strongly in favour of control of some herbal remedies, we urge caution with the trend towards licensing of all herbal remedies. We argue that the licensing of those herbal remedies with equivocal benefits and few risks, as evidenced by a long history of safe use, increases barriers to entry and increases societal healthcare costs.

Favorable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs and Resource Utilization: The 2012 Medical Expenditure Panel Survey.

PubMed

Valero-Elizondo, Javier; Salami, Joseph A; Ogunmoroti, Oluseye; Osondu, Chukwuemeka U; Aneni, Ehimen C; Malik, Rehan; Spatz, Erica S; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Blaha, Michael J; Veledar, Emir; Nasir, Khurram

2016-03-01

The American Heart Association's 2020 Strategic Goals emphasize the value of optimizing risk factor status to reduce the burden of morbidity and mortality. In this study, we aimed to quantify the overall and marginal impact of favorable cardiovascular risk factor (CRF) profile on healthcare expenditure and resource utilization in the United States among those with and without cardiovascular disease (CVD). The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS). Direct and indirect costs were calculated for all-cause healthcare resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias, or heart failure), ascertained by International Classification of Diseases, Ninth Edition, Clinical Modification codes, and CRF profile (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity, and obesity). Two-part econometric models were used to study expenditure data. The final study sample consisted of 15 651 MEPS participants (58.5±12 years, 54% female). Overall, 5921 (37.8%) had optimal, 7002 (44.7%) had average, and 2728 (17.4%) had poor CRF profile, translating to 54.2, 64.1, and 24.9 million adults in United States, respectively. Significantly lower health expenditures were noted with favorable CRF profile across CVD status. Among study participants with established CVD, overall healthcare expenditures with optimal and average CRF profile were $5946 and $3731 less compared with those with poor CRF profile. The respective differences were $4031 and $2560 in those without CVD. Favorable CRF profile is associated with significantly lower medical expenditure and healthcare utilization among individuals with and without established CVD. © 2016 American Heart Association, Inc.

Linear MHD stability analysis of post-disruption plasmas in ITER

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

Aleynikova, K., E-mail: ksenia.aleynikova@gmail.com; Huijsmans, G. T. A.; Aleynikov, P.

2016-05-15

Most of the plasma current can be replaced by a runaway electron (RE) current during plasma disruptions in ITER. In this case the post-disruption plasma current profile is likely to be more peaked than the pre-disruption profile. The MHD activity of such plasma will affect the runaway electron generation and confinement and the dynamics of the plasma position evolution (Vertical Displacement Event), limiting the timeframe for runaway electrons and disruption mitigation. In the present paper, we evaluate the influence of the possible RE seed current parameters on the onset of the MHD instabilities. By varying the RE seed current profile,more » we search for subsequent plasma evolutions with the highest and the lowest MHD activity. This information can be applied to a development of desirable ITER disruption scenario.« less

Measurements of slope currents and internal tides on the Continental Shelf and slope off Newport Beach, California

USGS Publications Warehouse

Rosenberger, Kurt J.; Noble, Marlene A.; Norris, Benjamin

2014-01-01

An array of seven moorings housing current meters and oceanographic sensors was deployed for 6 months at 5 sites on the Continental Shelf and slope off Newport Beach, California, from July 2011 to January 2012. Full water-column profiles of currents were acquired at all five sites, and a profile of water-column temperature was also acquired at two of the five sites for the duration of the deployment. In conjunction with this deployment, the Orange County Sanitation District deployed four bottom platforms with current meters on the San Pedro Shelf, and these meters provided water-column profiles of currents. The data from this program will provide the basis for an investigation of the interaction between the deep water flow over the slope and the internal tide on the Continental Shelf.

Profile modification computations for LHCD experiments on PBX-M using the TSC/LSC model

NASA Astrophysics Data System (ADS)

Kaita, R.; Ignat, D. W.; Jardin, S. C.; Okabayashi, M.; Sun, Y. C.

1996-02-01

The TSC-LSC computational model of the dynamics of lower hybrid current drive has been exercised extensively in comparison with data from a Princeton Beta Experiment-Modification (PBX-M) discharge where the measured q(0) attained values slightly above unity. Several significant, but plausible, assumptions had to be introduced to keep the computation from behaving pathologically over time, producing singular profiles of plasma current density and q. Addition of a heuristic current diffusion estimate, or more exactly, a smoothing of the rf-driven current with a diffusion-like equation, greatly improved the behavior of the computation, and brought theory and measurement into reasonable agreement. The model was then extended to longer pulse lengths and higher powers to investigate performance to be expected in future PBX-M current profile modification experiments.

Analysis of tidal currents in the North Sea from shipboard acoustic Doppler current profiler data

NASA Astrophysics Data System (ADS)

Vindenes, Håvard; Orvik, Kjell Arild; Søiland, Henrik; Wehde, Henning

2018-06-01

North Sea tidal currents are determined by applying harmonic analysis to ship-borne acoustic Doppler current profiler data recorded from 1999 to 2016, covering large areas of the northern North Sea. Direct current measurement data sets of this magnitude are rare in the otherwise well investigated North Sea, and thus it is a valuable asset in studying and expanding our understanding of its tidal currents and circulation in general. The harmonic analysis is applied to a least squares fit of the current observations at a set of knot points. Results from the harmonic analysis compare favorably to tidal parameters estimated from observations from moored instruments. The analysis shows that the tides are characterized by strong semi-diurnal component, with amplitudes of the principal Lunar constituent ranging from 1.6 cm/s in the Skagerrak to 67 cm/s in the Fair Isle Channel. Diurnal tides are found to be approximately one fifth the strength of the predominant semi-diurnal constituent. Output from a regional barotropic tide model compares well to tidal current determined from the harmonic analysis of the Acoustic Doppler Current Profiler data.

A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.

PubMed

Ayres, Alice C; Whitty, Jennifer A; Ellwood, David A

2014-10-01

Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Gender profiling: a gendered race perspective on person-position fit.

PubMed

Hall, Erika V; Galinsky, Adam D; Phillips, Katherine W

2015-06-01

The current research integrates perspectives on gendered race and person-position fit to introduce the concept of a gender profile. We propose that both the "gender" of a person's biological sex and the "gender" of a person's race (Asians are perceived as feminine and Blacks as masculine) help comprise an individual's gender profile-the overall femininity or masculinity associated with their demographic characteristics. We also propose that occupational positions have gender profiles. Finally, we argue that the overall gender profile of one's demographics, rather than just one's biological sex, determines one's fit and hirability for feminine or masculine occupational roles. The current five studies establish the gender profiles of different races and sexes, and then demonstrate that individuals with feminine-typed and masculine-typed gender profiles are selected for feminine and masculine positions, respectively. These studies provide new insights on who gets ahead in different environments. © 2015 by the Society for Personality and Social Psychology, Inc.

Silicon microneedle array for minimally invasive human health monitoring

NASA Astrophysics Data System (ADS)

Smith, Rosemary L.; Collins, Scott D.; Duy, Janice; Minogue, Timothy D.

2018-02-01

A silicon microneedle array with integrated microfluidic channels is presented, which is designed to extract dermal interstitial fluid (ISF) for biochemical analysis. ISF is a cell-free biofluid that is known to contain many of the same constituents as blood plasma, but the scope and dynamics of biomarker similarities are known for only a few components, most notably glucose. Dermal ISF is accessible just below the outer skin layer (epidermis), which can be reached and extracted with minimal sensation and tissue trauma by using a microneedle array. The microneedle arrays presented here are being developed to extract dermal ISF for off-chip profiling of nucleic acid constituents in order to identify potential biomarkers of disease. In order to assess sample volume requirements, preliminary RNA profiling was performed with suction blister ISF. The microneedles are batch fabricated using established silicon technology (low cost), are small in size, and can be integrated with sensors for on-chip analysis. This approach portends a more rapid, less expensive, self-administered assessment of human health than is currently achievable with blood sampling, especially in non-clinical and austere settings. Ultimately, a wearable device for monitoring a person's health in any setting is envisioned.

Mask industry assessment: 2008

NASA Astrophysics Data System (ADS)

Hughes, Greg; Yun, Henry

2008-10-01

Microelectronics industry leaders routinely name the cost and cycle time of mask technology and mask supply as top critical issues. A survey was created with support from SEMATECH and administered by David Powell Consulting to gather information about the mask industry as an objective assessment of its overall condition. The survey is designed with the input of semiconductor company mask technologists, merchant mask suppliers, and industry equipment makers. This year's assessment is the seventh in the current series of annual reports. With ongoing industry support, the report can be used as a baseline to gain perspective on the technical and business status of the mask and microelectronics industries. The report will continue to serve as a valuable reference to identify the strengths and opportunities of the mask industry. The results will be used to guide future investments pertaining to critical path issues. This year's survey is basically the same as the 2005 through 2007 surveys. Questions are grouped into categories: General Business Profile Information, Data Processing, Yields and Yield Loss Mechanisms, Delivery Times, Returns, and Services. Within each category is a multitude of questions that create a detailed profile of both the business and technical status of the critical mask industry.

Mask industry assessment trend analysis: 2010

NASA Astrophysics Data System (ADS)

Hughes, Greg; Yun, Henry

2010-05-01

Microelectronics industry leaders consistently cite the cost and cycle time of mask technology and mask supply as top critical issues. A survey was designed with input from semiconductor company mask technologists and merchant mask suppliers and support from SEMATECH to gather information about the mask industry as an objective assessment of its overall condition. This year's assessment was the eighth in the current series of annual reports. Its data were presented in detail at BACUS, and the detailed trend analysis is presented at EMLC. With continued industry support, the report can be used as a baseline to gain perspective on the technical and business status of the mask and microelectronics industries. The report will continue to serve as a valuable reference to identify the strengths and opportunities of the mask industry. Its results will be used to guide future investments on critical path issues. This year's survey is basically the same as the surveys in 2005 through 2009. Questions are grouped into six categories: General Business Profile Information, Data Processing, Yields and Yield Loss Mechanisms, Delivery Times, Returns, and Services. Within each category is a multitude of questions that creates a detailed profile of both the business and technical status of the critical mask industry.

The 2002 to 2010 mask survey trend analysis

NASA Astrophysics Data System (ADS)

Hughes, Greg; Chan, David

2011-03-01

Microelectronics industry leaders consistently cite the cost and cycle time of mask technology and mask supply as top critical issues. A survey was designed with input from semiconductor company mask technologists and merchant mask suppliers and support from SEMATECH to gather information about the mask industry as an objective assessment of its overall condition. This year's assessment was the ninth in the current series of annual reports. Its data were presented in detail at BACUS, and the detailed trend analysis is presented at EMLC. With continued industry support, the report can be used as a baseline to gain perspective on the technical and business status of the mask and microelectronics industries. The report will continue to serve as a valuable reference to identify the strengths and opportunities of the mask industry. Results will be used to guide future investments in critical path issues. This year's survey is basically the same as the 2005 through 2010 surveys. Questions are grouped into six categories: General Business Profile Information, Data Processing, Yields and Yield Loss Mechanisms, Delivery Times, Returns, and Services. Within each category are multiple questions that ultimately create a detailed profile of both the business and technical status of the critical mask industry.

Precomputing Process Noise Covariance for Onboard Sequential Filters

NASA Technical Reports Server (NTRS)

Olson, Corwin G.; Russell, Ryan P.; Carpenter, J. Russell

2017-01-01

Process noise is often used in estimation filters to account for unmodeled and mismodeled accelerations in the dynamics. The process noise covariance acts to inflate the state covariance over propagation intervals, increasing the uncertainty in the state. In scenarios where the acceleration errors change significantly over time, the standard process noise covariance approach can fail to provide effective representation of the state and its uncertainty. Consider covariance analysis techniques provide a method to precompute a process noise covariance profile along a reference trajectory using known model parameter uncertainties. The process noise covariance profile allows significantly improved state estimation and uncertainty representation over the traditional formulation. As a result, estimation performance on par with the consider filter is achieved for trajectories near the reference trajectory without the additional computational cost of the consider filter. The new formulation also has the potential to significantly reduce the trial-and-error tuning currently required of navigation analysts. A linear estimation problem as described in several previous consider covariance analysis studies is used to demonstrate the effectiveness of the precomputed process noise covariance, as well as a nonlinear descent scenario at the asteroid Bennu with optical navigation.

Precomputing Process Noise Covariance for Onboard Sequential Filters

NASA Technical Reports Server (NTRS)

Olson, Corwin G.; Russell, Ryan P.; Carpenter, J. Russell

2017-01-01

Process noise is often used in estimation filters to account for unmodeled and mismodeled accelerations in the dynamics. The process noise covariance acts to inflate the state covariance over propagation intervals, increasing the uncertainty in the state. In scenarios where the acceleration errors change significantly over time, the standard process noise covariance approach can fail to provide effective representation of the state and its uncertainty. Consider covariance analysis techniques provide a method to precompute a process noise covariance profile along a reference trajectory, using known model parameter uncertainties. The process noise covariance profile allows significantly improved state estimation and uncertainty representation over the traditional formulation. As a result, estimation performance on par with the consider filter is achieved for trajectories near the reference trajectory without the additional computational cost of the consider filter. The new formulation also has the potential to significantly reduce the trial-and-error tuning currently required of navigation analysts. A linear estimation problem as described in several previous consider covariance analysis publications is used to demonstrate the effectiveness of the precomputed process noise covariance, as well as a nonlinear descent scenario at the asteroid Bennu with optical navigation.

Bluetooth wireless database for scoliosis clinics.

PubMed

Lou, E; Fedorak, M V; Hill, D L; Raso, J V; Moreau, M J; Mahood, J K

2003-05-01

A database system with Bluetooth wireless connectivity has been developed so that scoliosis clinics can be run more efficiently and data can be mined for research studies without significant increases in equipment cost. The wireless database system consists of a Bluetooth-enabled laptop or PC and a Bluetooth-enabled handheld personal data assistant (PDA). Each patient has a profile in the database, which has all of his or her clinical history. Immediately prior to the examination, the orthopaedic surgeon selects a patient's profile from the database and uploads that data to the PDA over a Bluetooth wireless connection. The surgeon can view the entire clinical history of the patient while in the examination room and, at the same time, enter in any new measurements and comments from the current examination. After seeing the patient, the surgeon synchronises the newly entered information with the database wirelessly and prints a record for the chart. This combination of the database and the PDA both improves efficiency and accuracy and can save significant time, as there is less duplication of work, and no dictation is required. The equipment required to implement this solution is a Bluetooth-enabled PDA and a Bluetooth wireless transceiver for the PC or laptop.

Trends in dermatology practices and the implications for the workforce.

PubMed

Ehrlich, Alison; Kostecki, James; Olkaba, Helen

2017-10-01

The American Academy of Dermatology (AAD) practice profile surveys have been conducted for more than a decade to gauge trends in our workforce supply and demand. To update the trends and current workforce issues for the field of dermatology. The AAD Practice Profile Survey is sent by both e-mail and postal mail to a random sample of practicing dermatologists who are AAD members. Shifts are noted in the primary practice setting; fewer dermatologists are in solo practice and more are in group practices than in previous years. Teledermatology use trended upward from 7% to 11% between 2012 and 2014. The implementation of electronic health records increased from 51% in 2011 to 70% in 2014. There is potential for response bias and inaccurate self-reporting. Survey responses collected may not be representative of all geographic areas. The demand for dermatology services remains strong. Shifts in the practice setting may be related to increases in overhead costs that are partially associated with the implementation of technology-based medical records. Integration of electronic health records and utilization of telemedicine are increasing. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Alouette and ISIS topside sounder measurements -A data source for improvements of the IRI model in the topside ionosphere

NASA Astrophysics Data System (ADS)

Bilitza, Dieter; Benson, Robert; Reinisch, Bodo; Huang, Xueqin

The Alouette and ISIS topside sounder satellites recorded a great wealth of information about the topside ionosphere during their long period of operations (from 1962 to 1990). So much though that only a small percentage was analyzed during the mission life time. The soundings were stored on more than 100,000 seven-track analog telemetry tapes. In the mid-nineties space limitations and storage costs threatened an imminent loss of these tapes. Only a last minute intervention spear-headed by NASA's Ionosphere, Thermosphere, Mesosphere (ITM) Data Evaluation Panel saved a significant portion of these tapes and with funding from the AISRP program these data were first digitized and then converted into electron density profiles. This data restoration effort more than tripled the Alouette/ISIS topside sounder data base and has led to significant improvements of models for the topside ionosphere, e.g., about a factor of 2 improvement in the case of the IRI-2007 topside electron density profile. We will present a brief history of this successful data restoration effort and its current status. The homepage for the ISIS project is at http://nssdc.gsfc.nasa.gov/space/isis/isis-status.html.

A Comparison of Four Different Beach Profiling Techniques at St Leonards, Victoria - An Example of a Collaborative Stakeholder Research Project

NASA Astrophysics Data System (ADS)

Cox, N. L.; Miner, A. S.; Wynn, N.; Turner, D.

2015-12-01

Many beaches in Australia are under attack from shoreline erosion due rising sea levels and the action of waves. St Leonard's beach, a tourist town on the Victorian coastline, is of concern from this destructive erosion and the threat to the economic stability of the town. The major cause of erosion in this area is related to waves created from strong to gale force north to north-easterly winds. This in turn produces a northerly longshore current along with sediment suspension leading to a negative sediment budget. Ongoing and systematic monitoring of the shoreline movement is important to ensure the coast is understood and effectively managed now and into the future. Coastal land managers and agencies are required to find 'cost-effective' and 'fit-for-purpose' coastal monitoring methodologies which are affordable and efficient. This project forges a collaboration of stakeholders from academia, public sector land manager, local government and the private sector to compare four different methods of obtaining beach profiles. The four methods of obtaining beach profiles used for comparison are: 1. traditional survey method along transects using a total station theodolite, 2. traditional survey method along transects using a builder's grade laser level, 3. a small multi-rotor unmanned aerial vehicle (UAV) to produce a full 3D digital surface model of the study area, and 4. an experimental stationary device to produce a limited 3D model along a designated transect using terrestrial photogrammetric approach via a small GPS enabled camera. Assessment is made by comparing the method's precision, spatial coverage, expertise and equipment requirements/costs, preparation time, field acquisition time, number of people required in the field, post-acquisition processing time, and applicability for community use. Whilst is must be very clearly stated that all methods proved to be successful, the preliminary results of the "workflow and resourcing" assessment ranked the methods in the following order from highest ranking: 1. Laser levelling, 2. Terrestrial Photogrammetry, 3. Total Station, and 4. UAV aerial survey. The outcomes of this collaboration will be of great use to coastal management organisations grappling with the effectiveness of the different types of methods which are available for measuring beach profiles.

Smoking Cessation Is Associated With Lower Indirect Costs.

PubMed

Baker, Christine L; Bruno, Marianna; Emir, Birol; Li, Vicky W; Goren, Amir

2018-06-01

This study quantified differences in indirect costs due to decreased work productivity between current and former smokers. Former smokers were further categorized by number of years since quitting to assess corresponding differences. Data on employed individuals were obtained from the 2013 US National Health and Wellness Survey (NHWS; N = 75,000). Indirect costs were calculated for current smokers and former smokers from weekly wages based on age and sex. The annual total indirect costs for current smokers were $1327.53, $1560.18, and $1839.87 higher than for those who quit 0 to 4 years, 5 to 10 years, and more than or equal to 11 years prior, respectively. There were no significant differences in mean total indirect costs between the former smoker groups. Current smokers showed significantly higher total annual indirect costs compared with former smokers, independently of the number of years since quitting smoking.

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

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

Saifee, T.; Konnerth, A. III

1991-11-01

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

The role of cross-shore tidal dynamics in controlling intertidal sediment exchange in mangroves in Cù Lao Dung, Vietnam

NASA Astrophysics Data System (ADS)

Bryan, Karin R.; Nardin, William; Mullarney, Julia C.; Fagherazzi, Sergio

2017-09-01

Mangroves are halophytic plants common in tropical and sub-tropical environments. Their roots and pneumatophores strongly affect intertidal hydrodynamics and related sediment transport. Here, we investigate the role tree and root structures may play in altering tidal currents and the effect of these currents on the development of intertidal landscapes in mangrove-dominated environments. We use a one-dimensional Delft3D model, forced using typical intertidal slopes and vegetation characteristics from two sites with contrasting slope on Cù Lao Dung within the Mekong Delta in Vietnam, to examine the vegetation controls on tidal currents and suspended sediment transport as the tides propagate into the forest. Model results show that vegetation characteristics at the seaward fringe determine the shape of the cross-shore bottom profile, with sparse vegetation leading to profiles that are close to linear, whereas with dense vegetation resulting in a convex intertidal topography. Examples showing different profile developments are provided from a variety of published studies, ranging from linear profiles in sandier sites, and distinctive convex profiles in muddier sites. As expected, profile differences in the model are caused by increased dissipation due to enhanced drag caused by vegetation; however, the reduction of flow shoreward in sparsely vegetated or non-vegetated cases was similar, indicating that shallowing of the profile and slope effects play a dominant role in dissipation. Here, tidal velocities are measured in the field using transects of Acoustic Doppler Current Profilers, and confirm that cross-shore tidal currents diminish quickly as they move over the fringe of the forest; they then stay fairly consistent within the outer few 100 m of the forest, indicating that the fringing environment is likely a region of deposition. An understanding of how vegetation controls the development of topography is critical to predicting the resilience of these sensitive intertidal areas to changes in inundation caused by sea-level rise.

Breakeven Prices for Photovoltaics on Supermarkets in the United States

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

Ong, S.; Clark, N.; Denholm, P.

The photovoltaic (PV) breakeven price is the PV system price at which the cost of PV-generated electricity equals the cost of electricity purchased from the grid. This point is also called 'grid parity' and can be expressed as dollars per watt ($/W) of installed PV system capacity. Achieving the PV breakeven price depends on many factors, including the solar resource, local electricity prices, customer load profile, PV incentives, and financing. In the United States, where these factors vary substantially across regions, breakeven prices vary substantially across regions as well. In this study, we estimate current and future breakeven prices formore » PV systems installed on supermarkets in the United States. We also evaluate key drivers of current and future commercial PV breakeven prices by region. The results suggest that breakeven prices for PV systems installed on supermarkets vary significantly across the United States. Non-technical factors -- including electricity rates, rate structures, incentives, and the availability of system financing -- drive break-even prices more than technical factors like solar resource or system orientation. In 2020 (where we assume higher electricity prices and lower PV incentives), under base-case assumptions, we estimate that about 17% of supermarkets will be in utility territories where breakeven conditions exist at a PV system price of $3/W; this increases to 79% at $1.25/W (the DOE SunShot Initiative's commercial PV price target for 2020). These percentages increase to 26% and 91%, respectively, when rate structures favorable to PV are used.« less

Impact of Capital and Current Costs Changes of the Incineration Process of the Medical Waste on System Management Cost

NASA Astrophysics Data System (ADS)

Jolanta Walery, Maria

2017-12-01

The article describes optimization studies aimed at analysing the impact of capital and current costs changes of medical waste incineration on the cost of the system management and its structure. The study was conducted on the example of an analysis of the system of medical waste management in the Podlaskie Province, in north-eastern Poland. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. capital and current costs of medical waste incineration on economic efficiency index (E) and the spatial structure of the system was determined. Optimization studies were conducted for the following cases: with a 25% increase in capital and current costs of incineration process, followed by 50%, 75% and 100% increase. As a result of the calculations, the highest cost of system operation was achieved at the level of 3143.70 PLN/t with the assumption of 100% increase in capital and current costs of incineration process. There was an increase in the economic efficiency index (E) by about 97% in relation to run 1.

EAST kinetic equilibrium reconstruction combining with Polarimeter-Interferometer internal measurement constraints

NASA Astrophysics Data System (ADS)

Lian, H.; Liu, H. Q.; Li, K.; Zou, Z. Y.; Qian, J. P.; Wu, M. Q.; Li, G. Q.; Zeng, L.; Zang, Q.; Lv, B.; Jie, Y. X.; EAST Team

2017-12-01

Plasma equilibrium reconstruction plays an important role in the tokamak plasma research. With a high temporal and spatial resolution, the POlarimeter-INTerferometer (POINT) system on EAST has provided effective measurements for 102s H-mode operation. Based on internal Faraday rotation measurements provided by the POINT system, the equilibrium reconstruction with a more accurate core current profile constraint has been demonstrated successfully on EAST. Combining other experimental diagnostics and external magnetic fields measurement, the kinetic equilibrium has also been reconstructed on EAST. Take the pressure and edge current information from kinetic EFIT into the equilibrium reconstruction with Faraday rotation constraint, the new equilibrium reconstruction not only provides a more accurate internal current profile but also contains edge current and pressure information. One time slice result using new kinetic equilibrium reconstruction with POINT data constraints is demonstrated in this paper and the result shows there is a reversed shear of q profile and the pressure profile is also contained. The new improved equilibrium reconstruction is greatly helpful to the future theoretical analysis.

Mass, momentum and energy flow from an MPD accelerator. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Cory, J. S.

1971-01-01

The mass, momentum, and energy flows are measured over a current range of 8 to 50 kA and inlet mass flows of 2 to 36q/sec of argon. The momentum flux profile indicates that the accelerator produces a uniform, 2-inch diameter axial jet at the anode which expands into a Gaussian profile at an axial station 11 inches from the anode. The electromagnetic component of the thrust is found to follow the familiar quadratic dependence on arc current, while a more complex empirical relation is needed to correlate the gasdynamic contribution with the current and mass flow rate. Using available time-of-flight velocity profiles at a current of 16 kA and a mass flow of 5.9 g/sec, calculated flux profiles of mass and kinetic energy exhibit a tendency for some fraction of the inlet mass flow to leak out at a low velocity around the central high velocity core.

QRev—Software for computation and quality assurance of acoustic doppler current profiler moving-boat streamflow measurements—User’s manual for version 2.8

USGS Publications Warehouse

Mueller, David S.

2016-05-12

The software program, QRev computes the discharge from moving-boat acoustic Doppler current profiler measurements using data collected with any of the Teledyne RD Instrument or SonTek bottom tracking acoustic Doppler current profilers. The computation of discharge is independent of the manufacturer of the acoustic Doppler current profiler because QRev applies consistent algorithms independent of the data source. In addition, QRev automates filtering and quality checking of the collected data and provides feedback to the user of potential quality issues with the measurement. Various statistics and characteristics of the measurement, in addition to a simple uncertainty assessment are provided to the user to assist them in properly rating the measurement. QRev saves an extensible markup language file that can be imported into databases or electronic field notes software. The user interacts with QRev through a tablet-friendly graphical user interface. This report is the manual for version 2.8 of QRev.

Detection of an electron beam in a high density plasma via an electrostatic probe

NASA Astrophysics Data System (ADS)

Majeski, Stephen; Yoo, Jongsoo; Zweben, Stewart; Yamada, Masaaki

2018-07-01

An electron beam is detected by a 1D floating potential probe array in a relatively high density (1012–1013 cm‑3) and low temperature (∼5 eV) plasma of the Magnetic Reconnection Experiment. Clear perturbations in the floating potential profile by the electron beam are observed. Based on the floating potential profile and a current balance equation to the probe array tips, the effective width of the electron beam is determined, from which we determine the radial and toroidal beam current density profiles. After the profile of the electron beam is specified from the measured beam current, we demonstrate the consistency of the current balance equation and the location of the perturbation is also in agreement with field line mapping. No significant broadening of the electron beam is observed after the beam propagates for tens of centimeters through the high density plasma. These results prove that the field line mapping is, in principle, possible in high density plasmas.

Vertical Position and Current Profile Measurements by Faraday-effect Polarimetry On EAST tokamak

NASA Astrophysics Data System (ADS)

Ding, Weixing; Liu, H. Q.; Jie, Y. X.; Brower, D. L.; Qian, J. P.; Zou, Z. Y.; Lian, H.; Wang, S. X.; Luo, Z. P.; Xiao, B. J.; Ucla Team; Asipp Team

2017-10-01

A primary goal for ITER and prospective fusion power reactors is to achieve controlled long-pulse/steady-state burning plasmas. For elongated divertor plasmas, both the vertical position and current profile have to be precisely controlled to optimize performance and prevent disruptions. An eleven-channel laser-based POlarimeter-INTerferometer (POINT) system has been developed for measuring the internal magnetic field in the EAST tokamak and can be used to obtain the plasma current profile and vertical position. Current profiles are determined from equilibrium reconstruction including internal magnetic field measurements as internal constraints. Horizontally-viewing chords at/near the mid-plane allow us to determine plasma vertical position non-inductively with subcentimeter spatial resolution and time response up to 1 s. The polarimeter-based position measurement, which does not require equilibrium reconstruction, is benchmarked against conventional flux loop measurements and can be exploited for feedback control. Work supported by US DOE through Grants No. DE-FG02-01ER54615 and No. DC-SC0010469.

Detection of an electron beam in a high density plasma via an electrostatic probe

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

Majeski, Stephen; Yoo, Jongsoo; Zweben, Stewart

Here, an electron beam is detected by a 1D floating potential probe array in a relatively high density (10 12–10 13 cm -3) and low temperature (~5 eV) plasma of the Magnetic Reconnection Experiment. Clear perturbations in the floating potential profile by the electron beam are observed. Based on the floating potential profile and a current balance equation to the probe array tips, the effective width of the electron beam is determined, from which we determine the radial and toroidal beam current density profiles. After the profile of the electron beam is specified from the measured beam current, we demonstratemore » the consistency of the current balance equation and the location of the perturbation is also in agreement with field line mapping. No significant broadening of the electron beam is observed after the beam propagates for tens of centimeters through the high density plasma. These results prove that the field line mapping is, in principle, possible in high density plasmas.« less

Detection of an electron beam in a high density plasma via an electrostatic probe

DOE PAGES

Majeski, Stephen; Yoo, Jongsoo; Zweben, Stewart; ...

2018-05-08

Here, an electron beam is detected by a 1D floating potential probe array in a relatively high density (10 12–10 13 cm -3) and low temperature (~5 eV) plasma of the Magnetic Reconnection Experiment. Clear perturbations in the floating potential profile by the electron beam are observed. Based on the floating potential profile and a current balance equation to the probe array tips, the effective width of the electron beam is determined, from which we determine the radial and toroidal beam current density profiles. After the profile of the electron beam is specified from the measured beam current, we demonstratemore » the consistency of the current balance equation and the location of the perturbation is also in agreement with field line mapping. No significant broadening of the electron beam is observed after the beam propagates for tens of centimeters through the high density plasma. These results prove that the field line mapping is, in principle, possible in high density plasmas.« less

Current/Pressure Profile Effects on Tearing Mode Stability in DIII-D Hybrid Discharges

NASA Astrophysics Data System (ADS)

Kim, K.; Park, J. M.; Murakami, M.; La Haye, R. J.; Na, Yong-Su

2015-11-01

It is important to understand the onset threshold and the evolution of tearing modes (TMs) for developing a high-performance steady state fusion reactor. As initial and basic comparisons to determine TM onset, the measured plasma profiles (such as temperature, density, rotation) were compared with the calculated current profiles between a pair of discharges with/without n=1 mode based on the database for DIII-D hybrid plasmas. The profiles were not much different, but the details were analyzed to determine their characteristics, especially near the rational surface. The tearing stability index calculated from PEST3, Δ' tends to increase rapidly just before the n=1 mode onset for these cases. The modeled equilibrium with varying pressure or current profiles parametrically based on the reference discharge is reconstructed for checking the onset dependency on Δ' or neoclassical effects such as bootstrap current. Simulations of TMs with the modeled equilibrium using resistive MHD codes will also be presented and compared with experiments to determine the sensibility for predicting TM onset. Work supported by US DOE under DE-FC02-04ER54698 and DE-AC52-07NA27344.

Valuing Non-CO2 GHG Emission Changes in Benefit-Cost ...

EPA Pesticide Factsheets

The climate impacts of greenhouse gas (GHG) emissions impose social costs on society. To date, EPA has not had an approach to estimate the economic benefits of reducing emissions of non-CO2 GHGs (or the costs of increasing them) that is consistent with the methodology underlying the U.S. Government’s current estimates of the social cost of carbon (SCC). A recently published paper presents estimates of the social cost of methane that are consistent with the SCC estimates. The Agency is seeking review of the potential application of these new benefit estimates to benefit cost analysis in relation to current practice in this area. The goal of this project is to improve upon the current treatment of non-CO2 GHG emission impacts in benefit-cost analysis.

Stable Spheromaks with Profile Control

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

Fowler, T K; Jayakumar, R

A spheromak equilibrium with zero edge current is shown to be stable to both ideal MHD and tearing modes that normally produce Taylor relaxation in gun-injected spheromaks. This stable equilibrium differs from the stable Taylor state in that the current density j falls to zero at the wall. Estimates indicate that this current profile could be sustained by non-inductive current drive at acceptable power levels. Stability is determined using the NIMROD code for linear stability analysis. Non-linear NIMROD calculations with non-inductive current drive could point the way to improved fusion reactors.

10 CFR Appendix E to Part 30 - Criteria Relating to Use of Financial Tests and Self-Guarantee For Providing Reasonable Assurance...

Code of Federal Regulations, 2012 CFR

2012-01-01

... for decommissioning costs and on a demonstration that the applicant or licensee passes the financial... of at least $50 million, or at least 30 times the total current decommissioning cost estimate (or the... least 100 times the total current decommissioning cost estimate (or the current amount required if...

10 CFR Appendix E to Part 30 - Criteria Relating to Use of Financial Tests and Self-Guarantee For Providing Reasonable Assurance...

Code of Federal Regulations, 2013 CFR

2013-01-01

... guarantee that funds will be available for decommissioning costs and on a demonstration that the applicant... United States of at least $50 million, or at least 30 times the total current decommissioning cost... current decommissioning cost estimate (or the current amount required if certification is used) for all...

10 CFR Appendix E to Part 30 - Criteria Relating to Use of Financial Tests and Self-Guarantee For Providing Reasonable Assurance...

Code of Federal Regulations, 2014 CFR

2014-01-01

... guarantee that funds will be available for decommissioning costs and on a demonstration that the applicant... United States of at least $50 million, or at least 30 times the total current decommissioning cost... current decommissioning cost estimate (or the current amount required if certification is used) for all...

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.

Validating the use of Hospital Episode Statistics data and comparison of costing methodologies for economic evaluation: an end-of-life case study from the Cluster randomised triAl of PSA testing for Prostate cancer (CAP)

PubMed Central

Thorn, Joanna C; Turner, Emma L; Hounsome, Luke; Walsh, Eleanor; Down, Liz; Verne, Julia; Donovan, Jenny L; Neal, David E; Hamdy, Freddie C; Martin, Richard M; Noble, Sian M

2016-01-01

Objectives To evaluate the accuracy of routine data for costing inpatient resource use in a large clinical trial and to investigate costing methodologies. Design Final-year inpatient cost profiles were derived using (1) data extracted from medical records mapped to the National Health Service (NHS) reference costs via service codes and (2) Hospital Episode Statistics (HES) data using NHS reference costs. Trust finance departments were consulted to obtain costs for comparison purposes. Setting 7 UK secondary care centres. Population A subsample of 292 men identified as having died at least a year after being diagnosed with prostate cancer in Cluster randomised triAl of PSA testing for Prostate cancer (CAP), a long-running trial to evaluate the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing. Results Both inpatient cost profiles showed a rise in costs in the months leading up to death, and were broadly similar. The difference in mean inpatient costs was £899, with HES data yielding ∼8% lower costs than medical record data (differences compatible with chance, p=0.3). Events were missing from both data sets. 11 men (3.8%) had events identified in HES that were all missing from medical record review, while 7 men (2.4%) had events identified in medical record review that were all missing from HES. The response from finance departments to requests for cost data was poor: only 3 of 7 departments returned adequate data sets within 6 months. Conclusions Using HES routine data coupled with NHS reference costs resulted in mean annual inpatient costs that were very similar to those derived via medical record review; therefore, routinely available data can be used as the primary method of costing resource use in large clinical trials. Neither HES nor medical record review represent gold standards of data collection. Requesting cost data from finance departments is impractical for large clinical trials. Trial registration number ISRCTN92187251; Pre-results. PMID:27130167

Active Learning Strategies for Phenotypic Profiling of High-Content Screens.

PubMed

Smith, Kevin; Horvath, Peter

2014-06-01

High-content screening is a powerful method to discover new drugs and carry out basic biological research. Increasingly, high-content screens have come to rely on supervised machine learning (SML) to perform automatic phenotypic classification as an essential step of the analysis. However, this comes at a cost, namely, the labeled examples required to train the predictive model. Classification performance increases with the number of labeled examples, and because labeling examples demands time from an expert, the training process represents a significant time investment. Active learning strategies attempt to overcome this bottleneck by presenting the most relevant examples to the annotator, thereby achieving high accuracy while minimizing the cost of obtaining labeled data. In this article, we investigate the impact of active learning on single-cell-based phenotype recognition, using data from three large-scale RNA interference high-content screens representing diverse phenotypic profiling problems. We consider several combinations of active learning strategies and popular SML methods. Our results show that active learning significantly reduces the time cost and can be used to reveal the same phenotypic targets identified using SML. We also identify combinations of active learning strategies and SML methods which perform better than others on the phenotypic profiling problems we studied. © 2014 Society for Laboratory Automation and Screening.

Profiling a multiplex short tandem repeat loci from human urine with use of low cost on-site technology for verification of sample authenticity.

PubMed

Pires, Nuno M M; Tao Dong; Berntzen, Lasse; Lonningdal, Torill

2017-07-01

This work focuses on the development of a sophisticated technique via STR typing to unequivocally verify the authenticity of urine samples before sent to laboratories. STR profiling was conducted with the CSF1PO, TPOX, TH01 Multiplex System coupled with a smartphone-based detection method. The promising capability of the method to identify distinct STR profiles from urine of different persons opens the possibility to conduct sample authenticity tests. On-site STR profiling could be realized with a self-contained autonomous device with an integrated PCR microchip shown hereby.

Hospital costs associated with smoking in veterans undergoing general surgery.

PubMed

Kamath, Aparna S; Vaughan Sarrazin, Mary; Vander Weg, Mark W; Cai, Xueya; Cullen, Joseph; Katz, David A

2012-06-01

Approximately 30% of patients undergoing elective general surgery smoke cigarettes. The association between smoking status and hospital costs in general surgery patients is unknown. The objectives of this study were to compare total inpatient costs in current smokers, former smokers, and never smokers undergoing general surgical procedures in Veterans Affairs (VA) hospitals; and to determine whether the relationship between smoking and cost is mediated by postoperative complications. Patients undergoing general surgery during the period of October 1, 2005 to September 30, 2006 were identified in the VA Surgical Quality Improvement Program (VASQIP) data set. Inpatient costs were extracted from the VA Decision Support System (DSS). Relative surgical costs (incurred during index hospitalization and within 30 days of operation) for current and former smokers relative to never smokers, and possible mediators of the association between smoking status and cost were estimated using generalized linear regression models. Models were adjusted for preoperative and operative variables, accounting for clustering of costs at the hospital level. Of the 14,853 general surgical patients, 34% were current smokers, 39% were former smokers, and 27% were never smokers. After controlling for patient covariates, current smokers had significantly higher costs compared with never smokers: relative cost was 1.04 (95% Cl 1.00 to 1.07; p = 0.04); relative costs for former smokers did not differ significantly from those of never smokers: 1.02 (95% Cl 0.99 to 1.06; p = 0.14). The relationship between smoking and hospital costs for current smokers was partially mediated by postoperative respiratory complications. These findings complement emerging evidence recommending effective smoking cessation programs in general surgical patients and provide an estimate of the potential savings that could be accrued during the preoperative period. Published by Elsevier Inc.

The U.S. Department of Energy's Reference Facility for Offshore Renewable Energy (RFORE): A New Platform for Research and Development (Invited)

NASA Astrophysics Data System (ADS)

Shaw, W. J.

2013-12-01

Offshore renewable energy represents a significant but essentially untapped electricity resource for the U.S. Offshore wind energy is attractive for a number of reasons, including the feasibility of using much larger and more efficient wind turbines than is possible on land. In many offshore regions near large population centers, the diurnal maximum in wind energy production is also closely matched to the diurnal maximum in electricity demand, easing the balancing of generation and load. Currently, however, the cost of offshore wind energy is not competitive with other energy sources, including terrestrial wind. Two significant contributing reasons for this are the cost of offshore wind resource assessment and fundamental gaps in knowledge of the behavior of winds and turbulence in the layer of the atmosphere spanned by the sweep of the turbine rotor. Resource assessment, a necessary step in securing financing for a wind project, is conventionally carried out on land using meteorological towers erected for a year or more. Comparable towers offshore are an order of magnitude more expensive to install. New technologies that promise to reduce these costs, such as Doppler lidars mounted on buoys, are being developed, but these need to be validated in the environment in which they will be used. There is currently no facility in the U.S. that can carry out such validations offshore. Research needs include evaluation and improvement of hub-height wind forecasts from regional forecast models in the marine boundary layer, understanding of turbulence characteristics that affect turbine loads and wind plant efficiency, and development of accurate representations of sea surface roughness and atmospheric thermodynamic stability on hub height winds. In response to these needs for validation and research, the U.S. Department of Energy is developing the Reference Facility for Offshore Renewable Energy (RFORE). The RFORE will feature a meteorological tower with wind, temperature, humidity, and turbulence sensors at nominally eight levels to a maximum measurement height of at least 100 m. In addition, remote sensing systems for atmospheric dynamic and thermodynamic profiles, sea state measurements including wave spectra, and subsurface measurements of current, temperature, and salinity profiles will be measured. Eventually, measurements from the platform are anticipated to include monitoring of marine and avian life as well as bats. All data collected at the RFORE will be archived and made available to all interested users. The RFORE is currently planned to be built on the structure of the Chesapeake Light Tower, approximately 25 km east of Virginia Beach, Virginia. This development is an active collaboration among U.S. DOE headquarters staff, the National Renewable Energy Laboratory (NREL), and Pacific Northwest National Laboratory (PNNL). NREL will design, construct, and operate the facility. PNNL will develop the research agenda, including the data archive. This presentation emphasizes the measurement capabilities of the facility in the context of research applications, user access to the data through the archive, and plans for user engagement and research management of the facility.

Direct and rapid mass spectral fingerprinting of maternal urine for the detection of Down syndrome pregnancy.

PubMed

Iles, Ray K; Shahpari, Maryam E; Cuckle, Howard; Butler, Stephen A

2015-01-01

The established methods of antenatal screening for Down syndrome are based on immunoassay for a panel of maternal serum biomarkers together with ultrasound measures. Recently, genetic analysis of maternal plasma cell free (cf) DNA has begun to be used but has a number of limitations including excessive turn-around time and cost. We aimed to develop an alternative method based on urinalysis that is simple, affordable and accurate. 101 maternal urine samples sampled at 12-17 weeks gestation were taken from an archival collection of 2567 spot urines collected from women attending a prenatal screening clinic. 18 pregnancies in this set subsequently proved to be Down pregnancies. Samples were either neat urine or diluted between 10 to 1000 fold in dH2O and subjected to matrix assisted laser desorption ionization (MALDI), time of flight (ToF) mass spectrometry (MS). Data profiles were examined in the region 6,000 to 14,000 m/z. Spectral data was normalised and quantitative characteristics of the profile were compared between Down and controls. In Down cases there were additional spectral profile peaks at 11,000-12,000 m/z and a corresponding reduction in intensity at 6,000-8,000 m/z. The ratio of the normalised values at these two ranges completely separated the 8 Down syndrome from the 39 controls at 12-14 weeks. Discrimination was poorer at 15-17 weeks where 3 of the 10 Down syndrome cases had values within the normal range. Direct MALDI ToF mass spectral profiling of maternal urinary has the potential for an affordable, simple, accurate and rapid alternative to current Down syndrome screening protocols.

Enhanced genetic analysis of single human bioparticles recovered by simplified micromanipulation from forensic 'touch DNA' evidence.

PubMed

Farash, Katherine; Hanson, Erin K; Ballantyne, Jack

2015-03-09

DNA profiles can be obtained from 'touch DNA' evidence, which comprises microscopic traces of human biological material. Current methods for the recovery of trace DNA employ cotton swabs or adhesive tape to sample an area of interest. However, such a 'blind-swabbing' approach will co-sample cellular material from the different individuals, even if the individuals' cells are located in geographically distinct locations on the item. Thus, some of the DNA mixtures encountered in touch DNA samples are artificially created by the swabbing itself. In some instances, a victim's DNA may be found in significant excess thus masking any potential perpetrator's DNA. In order to circumvent the challenges with standard recovery and analysis methods, we have developed a lower cost, 'smart analysis' method that results in enhanced genetic analysis of touch DNA evidence. We describe an optimized and efficient micromanipulation recovery strategy for the collection of bio-particles present in touch DNA samples, as well as an enhanced amplification strategy involving a one-step 5 µl microvolume lysis/STR amplification to permit the recovery of STR profiles from the bio-particle donor(s). The use of individual or few (i.e., "clumps") bioparticles results in the ability to obtain single source profiles. These procedures represent alternative enhanced techniques for the isolation and analysis of single bioparticles from forensic touch DNA evidence. While not necessary in every forensic investigation, the method could be highly beneficial for the recovery of a single source perpetrator DNA profile in cases involving physical assault (e.g., strangulation) that may not be possible using standard analysis techniques. Additionally, the strategies developed here offer an opportunity to obtain genetic information at the single cell level from a variety of other non-forensic trace biological material.

Lifetime risks for aneurysmal subarachnoid haemorrhage: multivariable risk stratification.

PubMed

Vlak, Monique H M; Rinkel, Gabriel J E; Greebe, Paut; Greving, Jacoba P; Algra, Ale

2013-06-01

The overall incidence of aneurysmal subarachnoid haemorrhage (aSAH) in western populations is around 9 per 100 000 person-years, which confers to a lifetime risk of around half per cent. Risk factors for aSAH are usually expressed as relative risks and suggest that absolute risks vary considerably according to risk factor profiles, but such estimates are lacking. We aimed to estimate incidence and lifetime risks of aSAH according to risk factor profiles. We used data from 250 patients admitted with aSAH and 574 sex-matched and age-matched controls, who were randomly retrieved from general practitioners files. We determined independent prognostic factors with multivariable logistic regression analyses and assessed discriminatory performance using the area under the receiver operating characteristic curve. Based on the prognostic model we predicted incidences and lifetime risks of aSAH for different risk factor profiles. The four strongest independent predictors for aSAH, namely current smoking (OR 6.0; 95% CI 4.1 to 8.6), a positive family history for aSAH (4.0; 95% CI 2.3 to 7.0), hypertension (2.4; 95% CI 1.5 to 3.8) and hypercholesterolaemia (0.2; 95% CI 0.1 to 0.4), were used in the final prediction model. This model had an area under the receiver operating characteristic curve of 0.73 (95% CI 0.69 to 0.76). Depending on sex, age and the four predictors, the incidence of aSAH ranged from 0.4/100 000 to 298/100 000 person-years and lifetime risk between 0.02% and 7.2%. The incidence and lifetime risk of aSAH in the general population varies widely according to risk factor profiles. Whether persons with high risks benefit from screening should be assessed in cost-effectiveness studies.

Oxy-acetylene driven laboratory scale shock tubes for studying blast wave effects

NASA Astrophysics Data System (ADS)

Courtney, Amy C.; Andrusiv, Lubov P.; Courtney, Michael W.

2012-04-01

This paper describes the development and characterization of modular, oxy-acetylene driven laboratory scale shock tubes. Such tools are needed to produce realistic blast waves in a laboratory setting. The pressure-time profiles measured at 1 MHz using high-speed piezoelectric pressure sensors have relevant durations and show a true shock front and exponential decay characteristic of free-field blast waves. Descriptions are included for shock tube diameters of 27-79 mm. A range of peak pressures from 204 kPa to 1187 kPa (with 0.5-5.6% standard error of the mean) were produced by selection of the driver section diameter and distance from the shock tube opening. The peak pressures varied predictably with distance from the shock tube opening while maintaining both a true blast wave profile and relevant pulse duration for distances up to about one diameter from the shock tube opening. This shock tube design provides a more realistic blast profile than current compression-driven shock tubes, and it does not have a large jet effect. In addition, operation does not require specialized personnel or facilities like most blast-driven shock tubes, which reduces operating costs and effort and permits greater throughput and accessibility. It is expected to be useful in assessing the response of various sensors to shock wave loading; assessing the reflection, transmission, and absorption properties of candidate armor materials; assessing material properties at high rates of loading; assessing the response of biological materials to shock wave exposure; and providing a means to validate numerical models of the interaction of shock waves with structures. All of these activities have been difficult to pursue in a laboratory setting due in part to lack of appropriate means to produce a realistic blast loading profile.

Vertical Mixing In Western Lake Constance Due To Long Internal Waves

NASA Astrophysics Data System (ADS)

Boehrer, B.

Current profiles in the pelagic waters of western Lake Constance have been broken up into modes of the internal wave equation [1,2]. All current profiles can be well represented by a combination of the first and second mode wave. The temporal vari- ation of the modal composition with the interaction of the first and second mode im- plies current shear at varying depths. From current and density profiles, the gradient Richardson number can be evaluated in its spatial and temporal pattern with occa- tional occurence of supercritical values at all depths, also in the deep hypolimnion. An empiric connection between gradient Richardson number and diapycnical mixing [3] is applied to yield a profile of vertical transport coefficients, which can be com- pared with transport coefficients from gradient flux calculations of temperature and electrical conductivity profiles [4]. [1] B. Boehrer, J. Ilmberger and K.O. Münnich (2000): Vertical Structure of Current in Western Lake Constance, JGR-Oceans, 105 (12), 28823-28835 [2] B. Boehrer (2000): Modal Response of a Deep Stratified Lake: Western Lake Con- stance, JGR-Oceans, 105 (12), 28837-28845 [3] H. Peeters, M.C. Gregg and J.M. Toole (1988): On the parameterization of equa- torial turbulence, JGR, 93, 1199-1218 [4] G. Heinz, J. Ilmberger and M. Schimmele (1990): Vertical Mixing in Überlinger See, western part of Lake Constance, Aquat. Sci., 52(3), 256-268

To Whom Do They Belong? "A Profile of America's Runaway and Homeless Youth and the Programs That Help Them."

ERIC Educational Resources Information Center

National Network of Runaway and Youth Services, Inc., Washington, DC.

A profile and needs assessment of runaway and homeless children was produced using survey data gathered from 210 youth services agencies throughout the United States. The National Network of Runaway and Youth Services conducted this survey to provide policymakers and the media with information about successful, cost-effective crisis intervention…

Nutrition advocacy and national development: the PROFILES programme and its application.

PubMed Central

Burkhalter, B. R.; Abel, E.; Aguayo, V.; Diene, S. M.; Parlato, M. B.; Ross, J. S.

1999-01-01

Investment in nutritional programmes can contribute to economic growth and is cost-effective in improving child survival and development. In order to communicate this to decision-makers, the PROFILES nutrition advocacy and policy development programme was applied in certain developing countries. Effective advocacy is necessary to generate financial and political support for scaling up from small pilot projects and maintaining successful national programmes. The programme uses scientific knowledge to estimate development indicators such as mortality, morbidity, fertility, school performance and labour productivity from the size and nutritional condition of populations. Changes in nutritional condition are estimated from the costs, coverage and effectiveness of proposed programmes. In Bangladesh this approach helped to gain approval and funding for a major nutrition programme. PROFILES helped to promote the nutrition component of an early childhood development programme in the Philippines, and to make nutrition a top priority in Ghana's new national child survival strategy. The application of PROFILES in these and other countries has been supported by the United States Agency for International Development, the United Nations Children's Fund, the World Bank, the Asian Development Bank, the Micronutrient Initiative and other bodies. PMID:10361758

A simple and inexpensive method for muddy shore profiling

NASA Astrophysics Data System (ADS)

Chowdhury, Sayedur Rahman; Hossain, M. Shahadat; Sharifuzzaman, S. M.

2014-11-01

There are several well-established methods for obtaining beach profiles, and more accurate and precise high-tech methods are emerging. Traditional low-cost methods requiring minimal user skill or training are still popular among professionals, scientists, and coastal zone management practitioners. Simple methods are being developed with a primary focus on sand and gravel beaches. This paper describes a simple, low-cost, manual field method for measuring profiles of beaches, which is particularly suitable for muddy shores. The equipment is a type of flexible U-tube manometer that uses liquid columns in vertical tubes to measure differences in elevation; the supporting frame is constructed from wooden poles with base disks, which hold measuring scales and a PVC tube. The structure was trialed on a mudflat characterized by a 20-40-cm-thick surface layer of silt and clay, located at the Kutubdia Island, Bangladesh. The study results are discussed with notes on the method's applicability, advantages and limitations, and several optional modifications for different scenarios for routine profiling of muddy shores. The equipment can be used by one person or two people, and the accuracy of the method is comparable to those in other methods. The equipment can also be used on sandy or gravel beaches.

Hydrography and bottom boundary layer dynamics: Influence on inner shelf sediment mobility, Long Bay, North Carolina

USGS Publications Warehouse

Davis, L.A.; Leonard, L.A.; Snedden, G.A.

2008-01-01

This study examined the hydrography and bottom boundary-layer dynamics of two typical storm events affecting coastal North Carolina (NC); a hurricane and the passages of two small consecutive extratropical storms during November 2005. Two upward-looking 1200-kHz Acoustic Doppler Current Profilers (ADCP) were deployed on the inner shelf in northern Long Bay, NC at water depths of less than 15 m. Both instruments profiled the overlying water column in 0.35 in bins beginning at a height of 1.35 in above the bottom (mab). Simultaneous measurements of wind speed and direction, wave and current parameters, and acoustic backscatter were coupled with output from a bottom boundary layer (bbl) model to describe the hydrography and boundary layer conditions during each event. The bbl model also was used to quantify sediment transport in the boundary layer during each storm. Both study sites exhibited similar temporal variations in wave and current magnitude, however, wave heights during the November event were higher than waves associated with the hurricane. Near-bottom mean and subtidal currents, however, were of greater magnitude during the hurricane. Peak depth-integrated suspended sediment transport during the November event exceeded transport associated with the hurricane by 25-70%. Substantial spatial variations in sediment transport existed throughout both events. During both events, along-shelf sediment transport exceeded across-shelf transport and was related to the magnitude and direction of subtidal currents. Given the variations in sediment type across the bay, complex shoreline configuration, and local bathymetry, the sediment transport rates reported here are very site specific. However, the general hydrography associated with the two storms is representative of conditions across northern Long Bay. Since the beaches in the study area undergo frequent renourishment to counter the effects of beach erosion, the results of this study also are relevant to coastal management decision-making. Specifically, these issues include 1) identification of municipalities that should share the cost for renourishment given the likelihood for significant along-shelf sand movement and 2) appropriate timing of sand placement with respect to local climatology and sea-turtle nesting restrictions.

Description and evaluation of the Acoustic Profiling of Ocean Currents (APOC) system used on R. V. Oceanus cruise 96 on 11-22 May 1981

NASA Technical Reports Server (NTRS)

Joyce, T. M.; Rintoul, S. R., Jr.; Barbour, R. L.

1982-01-01

The underway current profiling system which consists of a microprocessor controlled data logger that collects and formats data from a four beam Ametek-Straza 300 kHz acoustic Doppler current profiler, heading from the ship's gyrocompass, and navigation information from a Loran-C receiver and a satellite navigation unit is discussed. Data are recorded on magnetic tape and real time is calculated. Time averaging is required to remove effects of ship motion. An intercomparison is made with a moored vector measuring current meter (VMCM). The mean difference in hourly averaged APOC and VMCM currents over the four hour intercomparison is a few mm s minus including: two Gulf Stream crossings, a warm core ring survey, and shallow water in a frontal zone to the east of Nantucket Shoals.

Health Services Use and Costs for Americans with Intellectual and Developmental Disabilities: A National Analysis

ERIC Educational Resources Information Center

Fujiura, Glenn T.; Li, Henan; Magaña, Sandy

2018-01-01

Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed…

Low Cost Coherent Doppler Lidar Data Acquisition and Processing

NASA Technical Reports Server (NTRS)

Barnes, Bruce W.; Koch, Grady J.

2003-01-01

The work described in this paper details the development of a low-cost, short-development time data acquisition and processing system for a coherent Doppler lidar. This was done using common laboratory equipment and a small software investment. This system provides near real-time wind profile measurements. Coding flexibility created a very useful test bed for new techniques.

Energy and greenhouse gas life cycle assessment and cost analysis of aerobic and anaerobic membrane bioreactor systems: Influence of scale, population density, climate, and methane recovery

EPA Science Inventory

This study calculated the energy and greenhouse gas life cycle and cost profiles of transitional aerobic membrane bioreactors (AeMBR) and anaerobic membrane bioreactors (AnMBR). Membrane bioreactors (MBR) represent a promising technology for decentralized wastewater treatment and...

Economic Impact of Gene Expression Profiling in Patients with Early-Stage Breast Cancer in France.

PubMed

Katz, Gregory; Romano, Olivier; Foa, Cyril; Vataire, Anne-Lise; Chantelard, Jean-Victor; Hervé, Robert; Barletta, Hugues; Durieux, Axel; Martin, Jean-Pierre; Salmon, Rémy

2015-01-01

The heterogeneous nature of breast cancer can make decisions on adjuvant chemotherapy following surgical resection challenging. Oncotype DX is a validated gene expression profiling test that predicts the likelihood of adjuvant chemotherapy benefit in early-stage breast cancer. The aim of this study is to determine the costs of chemotherapy in private hospitals in France, and evaluate the cost-effectiveness of Oncotype DX from national insurance and societal perspectives. A multicenter study was conducted in seven French private hospitals, capturing retrospective data from 106 patient files. Cost estimates were used in conjunction with a published Markov model to assess the cost-effectiveness of using Oncotype DX to inform chemotherapy decision making versus standard care. Sensitivity analyses were performed. The cost of adjuvant chemotherapy in private hospitals was estimated at EUR 8,218 per patient from a national insurance perspective and EUR 10,305 from a societal perspective. Cost-effectiveness analysis indicated that introducing Oncotype DX improved life expectancy (+0.18 years) and quality-adjusted life expectancy (+0.17 QALYs) versus standard care. Oncotype DX was found cost-effective from a national insurance perspective (EUR 2,134 per QALY gained) and cost saving from a societal perspective versus standard care. Inclusion of lost productivity costs in the modeling analysis meant that costs for eligible patients undergoing Oncotype DX testing were on average EUR 602 lower than costs for those receiving standard care. As Oncotype DX was found both cost and life-saving from a societal perspective, the test was considered to be dominant to standard care. However, the delay in coverage has the potential to erode the quality of the French healthcare system, thus depriving patients of technologies that could improve clinical outcomes and allow healthcare professionals to better allocate hospital resources to improve the standard of care for all patients.

Preparing a cost analysis for the section of medical physics-guidelines and methods.

PubMed

Mills, M D; Spanos, W J; Jose, B O; Kelly, B A; Brill, J P

2000-01-01

Radiation oncology is a highly complex medical specialty, involving many varied routine and special procedures. To assure cost-effectiveness and maintain support for the medical physics program, managers are obligated to analyze and defend all aspects of an institutional billing and cost-reporting program. Present standards of practice require that each patient's radiation treatments be customized to fit his/her particular condition. Since the use of personnel time and other resources is highly variable among patients, graduated levels of charges have been established to allow for more precise billing. Some radiation oncology special procedures have no specific code descriptors; so existing codes are modified or additional information attached in order to avoid payment denial. Recent publications have explored the manpower needs, salaries, and other resources required to perform radiation oncology "physics" procedures. This information is used to construct a model cost-based resource use profile for a radiation oncology center. This profile can be used to help the financial officer prepare a cost report for the institution. Both civil and criminal penalties for Medicare fraud and abuse (intentional or unintentional) are included in the False Claims Act and other statutes. Compliance guidelines require managers to train all personnel in correct billing procedures and to review continually billing performance.

Rhea: a transparent and modular R pipeline for microbial profiling based on 16S rRNA gene amplicons

PubMed Central

Fischer, Sandra; Kumar, Neeraj

2017-01-01

The importance of 16S rRNA gene amplicon profiles for understanding the influence of microbes in a variety of environments coupled with the steep reduction in sequencing costs led to a surge of microbial sequencing projects. The expanding crowd of scientists and clinicians wanting to make use of sequencing datasets can choose among a range of multipurpose software platforms, the use of which can be intimidating for non-expert users. Among available pipeline options for high-throughput 16S rRNA gene analysis, the R programming language and software environment for statistical computing stands out for its power and increased flexibility, and the possibility to adhere to most recent best practices and to adjust to individual project needs. Here we present the Rhea pipeline, a set of R scripts that encode a series of well-documented choices for the downstream analysis of Operational Taxonomic Units (OTUs) tables, including normalization steps, alpha- and beta-diversity analysis, taxonomic composition, statistical comparisons, and calculation of correlations. Rhea is primarily a straightforward starting point for beginners, but can also be a framework for advanced users who can modify and expand the tool. As the community standards evolve, Rhea will adapt to always represent the current state-of-the-art in microbial profiles analysis in the clear and comprehensive way allowed by the R language. Rhea scripts and documentation are freely available at https://lagkouvardos.github.io/Rhea. PMID:28097056

Rhea: a transparent and modular R pipeline for microbial profiling based on 16S rRNA gene amplicons.

PubMed

Lagkouvardos, Ilias; Fischer, Sandra; Kumar, Neeraj; Clavel, Thomas

2017-01-01

The importance of 16S rRNA gene amplicon profiles for understanding the influence of microbes in a variety of environments coupled with the steep reduction in sequencing costs led to a surge of microbial sequencing projects. The expanding crowd of scientists and clinicians wanting to make use of sequencing datasets can choose among a range of multipurpose software platforms, the use of which can be intimidating for non-expert users. Among available pipeline options for high-throughput 16S rRNA gene analysis, the R programming language and software environment for statistical computing stands out for its power and increased flexibility, and the possibility to adhere to most recent best practices and to adjust to individual project needs. Here we present the Rhea pipeline, a set of R scripts that encode a series of well-documented choices for the downstream analysis of Operational Taxonomic Units (OTUs) tables, including normalization steps, alpha - and beta -diversity analysis, taxonomic composition, statistical comparisons, and calculation of correlations. Rhea is primarily a straightforward starting point for beginners, but can also be a framework for advanced users who can modify and expand the tool. As the community standards evolve, Rhea will adapt to always represent the current state-of-the-art in microbial profiles analysis in the clear and comprehensive way allowed by the R language. Rhea scripts and documentation are freely available at https://lagkouvardos.github.io/Rhea.

The 3D scanner prototype utilize object profile imaging using line laser and octave software

NASA Astrophysics Data System (ADS)

Nurdini, Mugi; Manunggal, Trikarsa Tirtadwipa; Samsi, Agus

2016-11-01

Three-dimensional scanner or 3D Scanner is a device to reconstruct the real object into digital form on a computer. 3D Scanner is a technology that is being developed, especially in developed countries, where the current 3D Scanner devices is the advanced version with a very expensive prices. This study is basically a simple prototype of 3D Scanner with a very low investment costs. 3D Scanner prototype device consists of a webcam, a rotating desk system controlled by a stepper motor and Arduino UNO, and a line laser. Objects that limit the research is the object with same radius from its center point (object pivot). Scanning is performed by using object profile imaging by line laser which is then captured by the camera and processed by a computer (image processing) using Octave software. On each image acquisition, the scanned object on a rotating desk rotated by a certain degree, so for one full turn multiple images of a number of existing side are finally obtained. Then, the profile of the entire images is extracted in order to obtain digital object dimension. Digital dimension is calibrated by length standard, called gage block. Overall dimensions are then digitally reconstructed into a three-dimensional object. Validation of the scanned object reconstruction of the original object dimensions expressed as a percentage error. Based on the results of data validation, horizontal dimension error is about 5% to 23% and vertical dimension error is about +/- 3%.

Physician access to drug profiles to reduce adverse reactions

NASA Astrophysics Data System (ADS)

Yasnoff, William A.; Tomkins, Edward L.; Dunn, Louise M.

1995-10-01

Adverse drug reactions (ADRs) are a major source of preventable morbidity and mortality, especially among the elderly, who use more drugs and are more sensitive to them. The insurance industry has recently addressed this problem through the implementation of drug interaction alerts to pharmacists in conjunction with immediate online claims adjudication for almost 60% of prescriptions (expected to reach 90% within 5 years). These alerts are based on stored patient drug profiles maintained by pharmacy benefit managers (PBMs) which are updated whenever prescriptions are filled. While these alerts are very helpful, the pharmacist does not prescribe, resulting in time-consuming and costly delays to contact the physician and remedy potential interactions. We have developed and demonstrated the feasibility of the PINPOINT (Pharmaceutical Information Network for prevention of interactions) system for making the drug profile and interaction information easily available to the physician before the prescription is written. We plan to test the cost-effectiveness of the system in a prospective controlled clinical trial.

A cost-effective strategy for nonoscillatory convection without clipping

NASA Technical Reports Server (NTRS)

Leonard, B. P.; Niknafs, H. S.

1990-01-01

Clipping of narrow extrema and distortion of smooth profiles is a well known problem associated with so-called high resolution nonoscillatory convection schemes. A strategy is presented for accurately simulating highly convective flows containing discontinuities such as density fronts or shock waves, without distorting smooth profiles or clipping narrow local extrema. The convection algorithm is based on non-artificially diffusive third-order upwinding in smooth regions, with automatic adaptive stencil expansion to (in principle, arbitrarily) higher order upwinding locally, in regions of rapidly changing gradients. This is highly cost effective because the wider stencil is used only where needed-in isolated narrow regions. A recently developed universal limiter assures sharp monotonic resolution of discontinuities without introducing artificial diffusion or numerical compression. An adaptive discriminator is constructed to distinguish between spurious overshoots and physical peaks; this automatically relaxes the limiter near local turning points, thereby avoiding loss of resolution in narrow extrema. Examples are given for one-dimensional pure convection of scalar profiles at constant velocity.

Real-time metabolome profiling of the metabolic switch between starvation and growth.

PubMed

Link, Hannes; Fuhrer, Tobias; Gerosa, Luca; Zamboni, Nicola; Sauer, Uwe

2015-11-01

Metabolic systems are often the first networks to respond to environmental changes, and the ability to monitor metabolite dynamics is key for understanding these cellular responses. Because monitoring metabolome changes is experimentally tedious and demanding, dynamic data on time scales from seconds to hours are scarce. Here we describe real-time metabolome profiling by direct injection of living bacteria, yeast or mammalian cells into a high-resolution mass spectrometer, which enables automated monitoring of about 300 compounds in 15-30-s cycles over several hours. We observed accumulation of energetically costly biomass metabolites in Escherichia coli in carbon starvation-induced stationary phase, as well as the rapid use of these metabolites upon growth resumption. By combining real-time metabolome profiling with modeling and inhibitor experiments, we obtained evidence for switch-like feedback inhibition in amino acid biosynthesis and for control of substrate availability through the preferential use of the metabolically cheaper one-step salvaging pathway over costly ten-step de novo purine biosynthesis during growth resumption.

High-throughput STR analysis for DNA database using direct PCR.

PubMed

Sim, Jeong Eun; Park, Su Jeong; Lee, Han Chul; Kim, Se-Yong; Kim, Jong Yeol; Lee, Seung Hwan

2013-07-01

Since the Korean criminal DNA database was launched in 2010, we have focused on establishing an automated DNA database profiling system that analyzes short tandem repeat loci in a high-throughput and cost-effective manner. We established a DNA database profiling system without DNA purification using a direct PCR buffer system. The quality of direct PCR procedures was compared with that of conventional PCR system under their respective optimized conditions. The results revealed not only perfect concordance but also an excellent PCR success rate, good electropherogram quality, and an optimal intra/inter-loci peak height ratio. In particular, the proportion of DNA extraction required due to direct PCR failure could be minimized to <3%. In conclusion, the newly developed direct PCR system can be adopted for automated DNA database profiling systems to replace or supplement conventional PCR system in a time- and cost-saving manner. © 2013 American Academy of Forensic Sciences Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.

MISTiC Winds, a Micro-Satellite Constellation Approach to High Resolution Observations of the Atmosphere Using Infrared Sounding and 3D Winds Measurements

NASA Technical Reports Server (NTRS)

Maschhoff, K. R.; Polizotti, J. J.; Aumann, H. H.; Susskind, J.

2016-01-01

MISTiC(TM) Winds is an approach to improve short-term weather forecasting based on a miniature high resolution, wide field, thermal emission spectrometry instrument that will provide global tropospheric vertical profiles of atmospheric temperature and humidity at high (3-4 km) horizontal and vertical ( 1 km) spatial resolution. MISTiCs extraordinarily small size, payload mass of less than 15 kg, and minimal cooling requirements can be accommodated aboard a 27U-class CubeSat or an ESPA-Class micro-satellite. Low fabrication and launch costs enable a LEO sunsynchronous sounding constellation that would collectively provide frequent IR vertical profiles and vertically resolved atmospheric motion vector wind observations in the troposphere. These observations are highly complementary to present and emerging environmental observing systems, and would provide a combination of high vertical and horizontal resolution not provided by any other environmental observing system currently in operation. The spectral measurements that would be provided by MISTiC Winds are similar to those of NASA's AIRS that was built by BAE Systems and operates aboard the AQUA satellite. These new observations, when assimilated into high resolution numerical weather models, would revolutionize short-term and severe weather forecasting, save lives, and support key economic decisions in the energy, air transport, and agriculture arenasat much lower cost than providing these observations from geostationary orbit. In addition, this observation capability would be a critical tool for the study of transport processes for water vapor, clouds, pollution, and aerosols. Key remaining technical risks are being reduced through laboratory and airborne testing under NASA's Instrument Incubator Program.

How to reform western care payment systems according to physicians, policy makers, healthcare executives and researchers: a discrete choice experiment.

PubMed

Kessels, Roselinde; Van Herck, Pieter; Dancet, Eline; Annemans, Lieven; Sermeus, Walter

2015-05-06

Many developed countries are reforming healthcare payment systems in order to limit costs and improve clinical outcomes. Knowledge on how different groups of professional stakeholders trade off the merits and downsides of healthcare payment systems is limited. Using a discrete choice experiment we asked a sample of physicians, policy makers, healthcare executives and researchers from Canada, Europe, Oceania, and the United States to choose between profiles of hypothetical outcomes on eleven healthcare performance objectives which may arise from a healthcare payment system reform. We used a Bayesian D-optimal design with partial profiles, which enables studying a large number of attributes, i.e. the eleven performance objectives, in the experiment. Our findings suggest that (a) moving from current payment systems to a value-based system is supported by physicians, despite an income trade-off, if effectiveness and long term cost containment improve. (b) Physicians would gain in terms of overall objective fulfillment in Eastern Europe and the US, but not in Canada, Oceania and Western Europe. Finally, (c) such payment reform more closely aligns the overall fulfillment of objectives between stakeholders such as physicians versus healthcare executives. Although the findings should be interpreted with caution due to the potential selection effects of participants, it seems that the value driven nature of newly proposed and/or introduced care payment reforms is more closely aligned with what stakeholders favor in some health systems, but not in others. Future studies, including the use of random samples, should examine the contextual factors that explain such differences in values and buy-in. C90, C99, E61, I11, I18, O57.

MISTiC Winds, a Micro-Satellite Constellation Approach to High Resolution Observations of the Atmosphere using Infrared Sounding and 3D Winds Measurements

NASA Astrophysics Data System (ADS)

Maschhoff, K. R.; Polizotti, J. J.; Susskind, J.; Aumann, H. H.

2015-12-01

MISTiCTM Winds is an approach to improve short-term weather forecasting based on a miniature high resolution, wide field, thermal emission spectrometry instrument that will provide global tropospheric vertical profiles of atmospheric temperature and humidity at high (3-4 km) horizontal and vertical ( 1 km) spatial resolution. MISTiC's extraordinarily small size, payload mass of less than 15 kg, and minimal cooling requirements can be accommodated aboard a 27U-class CubeSat or an ESPA-Class micro-satellite. Low fabrication and launch costs enable a LEO sun-synchronous sounding constellation that would collectively provide frequent IR vertical profiles and vertically resolved atmospheric motion vector wind observations in the troposphere. These observations are highly complementary to present and emerging environmental observing systems, and would provide a combination of high vertical and horizontal resolution not provided by any other environmental observing system currently in operation. The spectral measurements that would be provided by MISTiC Winds are similar to those of NASA's Atmospheric Infrared Sounder that was built by BAE Systems and operates aboard the AQUA satellite. These new observations, when assimilated into high resolution numerical weather models, would revolutionize short-term and severe weather forecasting, save lives, and support key economic decisions in the energy, air transport, and agriculture arenas-at much lower cost than providing these observations from geostationary orbit. In addition, this observation capability would be a critical tool for the study of transport processes for water vapor, clouds, pollution, and aerosols. Key technical risks are being reduced through laboratory and airborne testing under NASA's Instrument Incubator Program.

MISTiC Winds: A micro-satellite constellation approach to high resolution observations of the atmosphere using infrared sounding and 3D winds measurements

NASA Astrophysics Data System (ADS)

Maschhoff, K. R.; Polizotti, J. J.; Aumann, H. H.; Susskind, J.

2016-09-01

MISTiCTM Winds is an approach to improve short-term weather forecasting based on a miniature high resolution, wide field, thermal emission spectrometry instrument that will provide global tropospheric vertical profiles of atmospheric temperature and humidity at high (3-4 km) horizontal and vertical ( 1 km) spatial resolution. MISTiC's extraordinarily small size, payload mass of less than 15 kg, and minimal cooling requirements can be accommodated aboard a 27U-class CubeSat or an ESPA-Class micro-satellite. Low fabrication and launch costs enable a LEO sunsynchronous sounding constellation that would collectively provide frequent IR vertical profiles and vertically resolved atmospheric motion vector wind observations in the troposphere. These observations are highly complementary to present and emerging environmental observing systems, and would provide a combination of high vertical and horizontal resolution not provided by any other environmental observing system currently in operation. The spectral measurements that would be provided by MISTiC Winds are similar to those of NASA's AIRS that was built by BAE Systems and operates aboard the AQUA satellite. These new observations, when assimilated into high resolution numerical weather models, would revolutionize short-term and severe weather forecasting, save lives, and support key economic decisions in the energy, air transport, and agriculture arenas-at much lower cost than providing these observations from geostationary orbit. In addition, this observation capability would be a critical tool for the study of transport processes for water vapor, clouds, pollution, and aerosols. Key remaining technical risks are being reduced through laboratory and airborne testing under NASA's Instrument Incubator Program.

Mistic winds, a microsatellite constellation approach to high-resolution observations of the atmosphere using infrared sounding and 3d winds measurements

NASA Astrophysics Data System (ADS)

Maschhoff, K. R.; Polizotti, J. J.; Aumann, H. H.; Susskind, J.

2016-10-01

MISTiC Winds is an approach to improve short-term weather forecasting based on a miniature high resolution, wide field, thermal emission spectrometry instrument that will provide global tropospheric vertical profiles of atmospheric temperature and humidity at high (3-4 km) horizontal and vertical ( 1 km) spatial resolution. MISTiC's extraordinarily small size, payload mass of less than 15 kg, and minimal cooling requirements can be accommodated aboard a 27U-class CubeSat or an ESPA-Class micro-satellite. Low fabrication and launch costs enable a LEO sunsynchronous sounding constellation that would collectively provide frequent IR vertical profiles and vertically resolved atmospheric motion vector wind observations in the troposphere. These observations are highly complementary to present and emerging environmental observing systems, and would provide a combination of high vertical and horizontal resolution not provided by any other environmental observing system currently in operation. The spectral measurements that would be provided by MISTiC Winds are similar to those of NASA's AIRS that was built by BAE Systems and operates aboard the AQUA satellite. These new observations, when assimilated into high resolution numerical weather models, would revolutionize short-term and severe weather forecasting, save lives, and support key economic decisions in the energy, air transport, and agriculture arenas-at much lower cost than providing these observations from geostationary orbit. In addition, this observation capability would be a critical tool for the study of transport processes for water vapor, clouds, pollution, and aerosols. Key remaining technical risks are being reduced through laboratory and airborne testing under NASA's Instrument Incubator Program.

Green Thermosetting Factory: Novel Star-Shaped Biobased Systems and Their Thermosetting Resins; Synthesis and Characterization

NASA Astrophysics Data System (ADS)

Jahandideh, Arash

Increasing attentions toward sustainable development, economic and environmental issues have led to many attempts at replacing the petroleum-based materials with renewables. Substitution of petroleum-based platforms with green alternative technologies is beneficiary in different ways. Using bio-renewables reduces the dependency of the national plastic industry to the petroleum resources and substantially promotes the environmental profile and sustainability of the product. It is expected that the emergence of the corn-based thermosetting industry generates substantial profits for the corn production sector. Developments in the emerging biobased thermosets are spectacular from a technological point of view. However, there are still several disadvantages associated with the current biobased thermosetting resins, e.g. low processability, environmental issues, expensive sources and poor thermomechanical properties. Use of natural fibers not only contributes to the production of a more environmentally friendly product, but also has advantages such as low-weight product and low manufacturing costs. The results of this study show a possibility of production of biocomposites made from natural fibers and star-shaped resin, synthesized from corn-based materials (lactic acid and itaconic acid) and different multihydroxyl core molecules. These resins were synthesized via two-steps strategy: polycondensation of the monomers with the core molecules followed by end-functionalization of the branches by methacrylic anhydride or itaconic acid. The results have shown that these resin are capable of competing with or even surpassing fossil fuel based resins in terms of cost and eco-friendliness aspect. Inexpensive biobased raw material, better environmental profile, low viscosity, and better processability of the matrix along with better thermomechanical properties of the produced biocomposites are of advantages expected for these systems.

A pragmatic, multicentre, randomised controlled trial comparing stapled haemorrhoidopexy to traditional excisional surgery for haemorrhoidal disease (eTHoS): study protocol for a randomised controlled trial.

PubMed

Watson, Angus J M; Bruhn, Hanne; MacLeod, Kathleen; McDonald, Alison; McPherson, Gladys; Kilonzo, Mary; Norrie, John; Loudon, Malcolm A; McCormack, Kirsty; Buckley, Brian; Brown, Steven; Curran, Finlay; Jayne, David; Rajagopal, Ramesh; Cook, Jonathan A

2014-11-11

Current interventions for haemorrhoidal disease include traditional haemorrhoidectomy (TH) and stapled haemorrhoidopexy (SH) surgery. However, uncertainty remains as to how they compare from a clinical, quality of life (QoL) and economic perspective. The study is therefore designed to determine whether SH is more effective and more cost-effective, compared with TH. eTHoS (either Traditional Haemorrhoidectomy or Stapled Haemorrhoidopexy for Haemorrhoidal Disease) is a pragmatic, multicentre, randomised controlled trial. Currently, 29 secondary care centres are open to recruitment. Patients, aged 18 year or older, with circumferential haemorrhoids grade II to IV, are eligible to take part. The primary clinical and economic outcomes are QoL profile (area under the curve derived from the EuroQol Group's 5 Dimension Health Status Questionnaire (EQ-5D) at all assessment points) and incremental cost per quality adjusted life year (QALY) based on the responses to the EQ-5D at 24 months. The secondary outcomes include a comparison of the SF-36 scores, pain and symptoms sub-domains, disease recurrence, complication rates and direct and indirect costs to the National Health Service (NHS). A sample size of n =338 per group has been calculated to provide 90% power to detect a difference in the mean area under the curve (AUC) of 0.25 standard deviations derived from EQ-5D score measurements, with a two-sided significance level of 5%. Allowing for non-response, 400 participants will be randomised per group. Randomisation will utilise a minimisation algorithm that incorporates centre, grade of haemorrhoidal disease, baseline EQ-5D score and gender. Blinding of participants and outcome assessors is not attempted. This is one of the largest trials of its kind. In the United Kingdom alone, 29,000 operations for haemorrhoidal disease are done annually. The trial is therefore designed to give robust evidence on which clinicians and health service managers can base management decisions and, more importantly, patients can make informed choices. Current Controlled Trials ISRCTN80061723 (assigned 8 March 2010).

Current and Under Development Treatment Modalities of Psoriasis: A Review.

PubMed

Albaghdadi, Abdullah

2017-01-01

Psoriasis is a chronic and complex autoimmune inflammatory skin disease that affects over 125 million people worldwide. It can exhibit at any age, in spite of the fact that children are less normally influenced than adults. It is characterized by distinct erythematous plaques shielded with conspicuous silvery scales that shows up in different areas of the skin. Knowledge of pathophysiology, especially the pathogenesis of psoriasis, has significantly progressed in the recent decade. Advancement in molecular knowledge leads to better understanding of the disease, thus influencing the development of efficient treatment modalities. However, even with the availability of various options of treatment most of the efficient treatment modalities are costly. Expenses of health care bring about major financial weight to the patients as well as to health care systems. Thus, it was important to review the available current treatment options and those which are under development, in terms of efficacy, safety and cost to assist in selecting the most appropriate treatment for psoriasis patients. Literatures were searched by using key words psoriasis, topical treatment, systemic treatment, biologics and phototherapies, on Embase, Medline, Jstor, Cochrane and Merck Index databases. Life-style choices such as smoking, alcohol consumption, obesity and stress are recognised as risk factors and triggers associated with psoriasis. Psoriasis poses psycho-social and economic burden on affected patients that sometimes leads to depression, reduced social interaction and suicidal tendencies in patients. Depending on the type, severity and extent of the disease, comorbidities, patient preference, efficacy and safety profile, numerous treatment modalities and therapeutic agents are available such as topical, systemic, biologic and phototherapeutic treatments. However, it was found that among all the current available treatments for psoriasis, biologic agents and phototherapeutic modalities are the most commonly employed treatment modalities for moderate to severe psoriasis. Evaluation of present-day available treatment alternatives will surely help physician to select a suitable module for each patient while keeping in mind the financial status of the patient. Future research should aim to develop therapies which are efficient, safe and cost-effective. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Combustion Sensors: Gas Turbine Applications

NASA Technical Reports Server (NTRS)

Human, Mel

2002-01-01

This report documents efforts to survey the current research directions in sensor technology for gas turbine systems. The work is driven by the current and future requirements on system performance and optimization. Accurate real time measurements of velocities, pressure, temperatures, and species concentrations will be required for objectives such as combustion instability attenuation, pollutant reduction, engine health management, exhaust profile control via active control, etc. Changing combustor conditions - engine aging, flow path slagging, or rapid maneuvering - will require adaptive responses; the effectiveness of such will be only as good as the dynamic information available for processing. All of these issues point toward the importance of continued sensor development. For adequate control of the combustion process, sensor data must include information about the above mentioned quantities along with equivalence ratios and radical concentrations, and also include both temporal and spatial velocity resolution. Ultimately these devices must transfer from the laboratory to field installations, and thus must become low weight and cost, reliable and maintainable. A primary conclusion from this study is that the optics-based sensor science will be the primary diagnostic in future gas turbine technologies.

Potential role of dermatologists and dermatological services in developing and sustaining the leprosy control referral system in resource constrained settings.

PubMed

Kawuma, Herman Joseph S

2007-03-01

General Health Services that pay due attention to the management of skin conditions are opportune for suspecting and diagnosing early leprosy. In many developing countries, patients with dermatological conditions can only access specialist services in the larger cities and university hospitals; unaffordable costs make the services even less accessible if they can only be provided in the private sector. The high profile of dermatologists in the health services, gives them the opportunity to facilitate the development and implementation of a referral system that includes leprosy. This potential benefit for leprosy control must be initiated by current National Leprosy Programme Managers through establishing formal relationships with the dermatologists and involving them and other partners in the re-designing of leprosy control strategies to keep them in tandem with changing epidemiological patterns, national policies and on -going health sector reforms. The same health service managers should avail of the opportunities from the dermatologists (both in public and private sectors) about the current knowledge on the management and control of leprosy.

Transcranial direct current stimulation in psychiatric disorders

PubMed Central

Tortella, Gabriel; Casati, Roberta; Aparicio, Luana V M; Mantovani, Antonio; Senço, Natasha; D’Urso, Giordano; Brunelin, Jerome; Guarienti, Fabiana; Selingardi, Priscila Mara Lorencini; Muszkat, Débora; Junior, Bernardo de Sampaio Pereira; Valiengo, Leandro; Moffa, Adriano H; Simis, Marcel; Borrione, Lucas; Brunoni, André R

2015-01-01

The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation (tDCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally, we provide an overview of tDCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding tDCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding tDCS efficacy in psychiatry. PMID:25815258

Cost minimisation analysis of provision of oxygen at home: are the Drug Tariff guidelines cost effective?

PubMed Central

Heaney, Liam G; McAllister, Denise; MacMahon, Joseph

1999-01-01

Objectives To determine the level of oxygen cylinder use at which it becomes more cost effective to provide oxygen by concentrator at home in Northern Ireland, and to examine potential cost savings if cylinder use above this level had been replaced by concentrator in 1996. Design Cost minimisation analysis. Setting Area health boards in Northern Ireland. Main outcome measures Cost effective cut off point for switch to provision of oxygen from cylinder to concentrator. Potential maximum and minimum savings in Northern Ireland (sensitivity analysis) owing to switch to more cost effective strategy on the basis of provision of cylinders in 1996. Results In Northern Ireland it is currently cost effective to provide oxygen by concentrator when the patient is using three or more cylinders per month independent of the duration of the prescription. More widespread use of concentrators at this level of provision is likely to lead to a cost saving. Conclusions The Drug Tariff prescribing guidelines, advocating that provision of oxygen by concentrator becomes cheaper when 21 cylinders are being used per month—are currently inaccurate in Northern Ireland. Regional health authorities should review their current arrangements for provision of oxygen at home and perform a cost analysis to determine at what level it becomes more cost effective to provide oxygen by concentrator. Key messagesThe current Drug Tariff prescribing guidelines are not cost effective for provision of oxygen at home in Northern IrelandIndividual prescriptions detailing frequency of usage and delivery costs should be recordedA switch to a more cost effective strategy is likely to result in a cost savingRegional health authorities should examinecurrent arrangements for provision of oxygen at home and should perform cost analyses PMID:10390453

Normalized velocity profiles of field-measured turbidity currents

USGS Publications Warehouse

Xu, Jingping

2010-01-01

Multiple turbidity currents were recorded in two submarine canyons with maximum speed as high as 280 cm/s. For each individual turbidity current measured at a fixed station, its depth-averaged velocity typically decreased over time while its thickness increased. Some turbidity currents gained in speed as they traveled downcanyon, suggesting a possible self-accelerating process. The measured velocity profiles, first in this high resolution, allowed normalizations with various schemes. Empirical functions, obtained from laboratory experiments whose spatial and time scales are two to three orders of magnitude smaller, were found to represent the field data fairly well. The best similarity collapse of the velocity profiles was achieved when the streamwise velocity and the elevation were normalized respectively by the depth-averaged velocity and the turbidity current thickness. This normalization scheme can be generalized to an empirical function Y = exp(–αXβ) for the jet region above the velocity maximum. Confirming theoretical arguments and laboratory results of other studies, the field turbidity currents are Froude-supercritical.

Modal Profiles for the WISC-III.

ERIC Educational Resources Information Center

Pritchard, David A.; Livingston, Ronald B.; Reynolds, Cecil R.; Moses, James A., Jr.

2000-01-01

Presents a normative typology for classifying the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) factor index profiles according to profile shape. Current analyses indicate that overall profile level accounted for a majority of the variance in WISC-III index scores, but a considerable proportion of the variance was because of…

The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis and surveillance.

PubMed

Fitzpatrick, Christopher; Asiedu, Kingsley; Sands, Anita; Gonzalez Pena, Tita; Marks, Michael; Mitja, Oriol; Meheus, Filip; Van der Stuyft, Patrick

2017-10-01

Yaws is a non-venereal treponemal infection caused by Treponema pallidum subspecies pertenue. The disease is targeted by WHO for eradication by 2020. Rapid diagnostic tests (RDTs) are envisaged for confirmation of clinical cases during treatment campaigns and for certification of the interruption of transmission. Yaws testing requires both treponemal (trep) and non-treponemal (non-trep) assays for diagnosis of current infection. We evaluate a sequential testing strategy (using a treponemal RDT before a trep/non-trep RDT) in terms of cost and cost-effectiveness, relative to a single-assay combined testing strategy (using the trep/non-trep RDT alone), for two use cases: individual diagnosis and community surveillance. We use cohort decision analysis to examine the diagnostic and cost outcomes. We estimate cost and cost-effectiveness of the alternative testing strategies at different levels of prevalence of past/current infection and current infection under each use case. We take the perspective of the global yaws eradication programme. We calculate the total number of correct diagnoses for each strategy over a range of plausible prevalences. We employ probabilistic sensitivity analysis (PSA) to account for uncertainty and report 95% intervals. At current prices of the treponemal and trep/non-trep RDTs, the sequential strategy is cost-saving for individual diagnosis at prevalence of past/current infection less than 85% (81-90); it is cost-saving for surveillance at less than 100%. The threshold price of the trep/non-trep RDT (below which the sequential strategy would no longer be cost-saving) is US$ 1.08 (1.02-1.14) for individual diagnosis at high prevalence of past/current infection (51%) and US$ 0.54 (0.52-0.56) for community surveillance at low prevalence (15%). We find that the sequential strategy is cost-saving for both diagnosis and surveillance in most relevant settings. In the absence of evidence assessing relative performance (sensitivity and specificity), cost-effectiveness is uncertain. However, the conditions under which the combined test only strategy might be more cost-effective than the sequential strategy are limited. A cheaper trep/non-trep RDT is needed, costing no more than US$ 0.50-1.00, depending on the use case. Our results will help enhance the cost-effectiveness of yaws programmes in the 13 countries known to be currently endemic. It will also inform efforts in the much larger group of 71 countries with a history of yaws, many of which will have to undertake surveillance to confirm the interruption of transmission.

Development of a wear model for the wheel profile optimisation on railway vehicles

NASA Astrophysics Data System (ADS)

Ignesti, M.; Innocenti, A.; Marini, L.; Meli, E.; Rindi, A.

2013-09-01

The modelling and the reduction of wear due to wheel-rail interaction is a fundamental aspect in the railway field, mainly correlated to safety, maintenance interventions and costs. In this work, the authors present two innovative wheel profiles, specifically designed with the aim of improving the wear and stability behaviour of the standard ORE S1002 wheel profile matched with the UIC60 rail profile canted at 1/20 rad, which represents the wheel-rail combination adopted in the Italian railway line. The two wheel profiles, conventionally named CD1 and DR2, have been developed by the authors in collaboration with Trenitalia S.p.A. The CD1 profile has been designed with the purpose of spreading the contact points in the flange zone on a larger area in order to reduce wear phenomena and having a constant equivalent conicity for small lateral displacements of the wheelset with respect to the centred position in the track. The DR2 wheel profile is instead designed to guarantee the same kinematic characteristics of the matching formed by ORE S1002 wheel profile and UIC60 rail profile with laying angle α p equal to 1/40 rad, widely common in European railways and characterised by good performances in both wear and kinematic behaviour. The evolution of wheel profiles due to wear has been evaluated through a wear model developed and validated by the authors in previous works. The wear model comprises two mutually interactive units: a vehicle model for the dynamic simulations and a model for the wear assessment. The whole model is based on a discrete process: each discrete step consists in one dynamic simulation and one profile update by means of the wear model while, within the discrete step, the profiles are supposed to be constant. The choice of an appropriate step is crucial in terms of precision and computational effort: the particular strategy adopted in the current work has been chosen for its capacity in representing the nonlinear wear evolution and for the low computational time required. In the present research, the investigated trainset is the passenger vehicle ALSTOM ALn 501 'Minuetto', which is usually equipped with the standard ORE S1002 wheel profile in Italian railways. The entire model has been simulated on a virtual track specifically developed to represent a statistical description of the whole Italian line. The data necessary to build the virtual track and the vehicle model were provided by Trenitalia S.p.A. and Rete Ferroviaria Italiana. The CD1 and DR2 wheel profiles, matched to the UIC60 rail with cant 1/20 rad, have shown a good behaviour in terms of wear resistance if compared with the old ORE S1002 wheel profile, consequently assuring a more uniform distribution of the removed material and a prolongation of the mean time between two subsequent re-profiling interventions.

Performance of the K+ ion diode in the 2 MV injector for heavy ion fusion

NASA Astrophysics Data System (ADS)

Bieniosek, F. M.; Henestroza, E.; Kwan, J. W.

2002-02-01

Heavy ion beam inertial fusion driver concepts depend on the availability and performance of high-brightness high-current ion sources. Surface ionization sources have relatively low current density but high brightness because of the low temperature of the emitted ions. We have measured the beam profiles at the exit of the injector diode, and compared the measured profiles with EGUN and WARP-3D predictions. Spherical aberrations are significant in this large aspect ratio diode. We discuss the measured and calculated beam size and beam profiles, the effect of aberrations, quality of vacuum, and secondary electron distributions on the beam profile.

Development of high poloidal beta, steady-state scenario with ITER-like tungsten divertor on EAST

NASA Astrophysics Data System (ADS)

Garofalo, A. M.; Gong, X. Z.; Qian, J.; Chen, J.; Li, G.; Li, K.; Li, M. H.; Zhai, X.; Bonoli, P.; Brower, D.; Cao, L.; Cui, L.; Ding, S.; Ding, W. X.; Guo, W.; Holcomb, C.; Huang, J.; Hyatt, A.; Lanctot, M.; Lao, L. L.; Liu, H.; Lyu, B.; McClenaghan, J.; Peysson, Y.; Ren, Q.; Shiraiwa, S.; Solomon, W.; Zang, Q.; Wan, B.

2017-07-01

Recent experiments on EAST have achieved the first long pulse H-mode (61 s) with zero loop voltage and an ITER-like tungsten divertor, and have demonstrated access to broad plasma current profiles by increasing the density in fully-noninductive lower hybrid current-driven discharges. These long pulse discharges reach wall thermal and particle balance, exhibit stationary good confinement (H 98y2 ~ 1.1) with low core electron transport, and are only possible with optimal active cooling of the tungsten armors. In separate experiments, the electron density was systematically varied in order to study its effect on the deposition profile of the external lower hybrid current drive (LHCD), while keeping the plasma in fully-noninductive conditions and with divertor strike points on the tungsten divertor. A broadening of the current profile is found, as indicated by lower values of the internal inductance at higher density. A broad current profile is attractive because, among other reasons, it enables internal transport barriers at large minor radius, leading to improved confinement as shown in companion DIII-D experiments. These experiments strengthen the physics basis for achieving high performance, steady state discharges in future burning plasmas.

Development of high poloidal beta, steady-state scenario with ITER-like tungsten divertor on EAST

DOE PAGES

Garofalo, Andrea M.; Gong, X. Z.; Qian, J.; ...

2017-06-07

Recent experiments on EAST have achieved the first long pulse H-mode (61 s) with zero loop voltage and an ITER-like tungsten divertor, and have demonstrated access to broad plasma current profiles by increasing the density in fully-noninductive lower hybrid current-driven discharges. These long pulse discharges reach wall thermal and particle balance, exhibit stationary good confinement (H 98y2~1.1) with low core electron transport, and are only possible with optimal active cooling of the tungsten armors. In separate experiments, the electron density was systematically varied in order to study its effect on the deposition profile of the external lower hybrid current drivemore » (LHCD), while keeping the plasma in fully-noninductive conditions and with divertor strike points on the tungsten divertor. A broadening of the current profile is found, as indicated by lower values of the internal inductance at higher density. A broad current profile is attractive because, among other reasons, it enables internal transport barriers at large minor radius, leading to improved confinement as shown in companion DIII-D experiments. These experiments strengthen the physics basis for achieving high performance, steady state discharges in future burning plasmas.« less

Assessment of the risk due to release of carbon fiber in civil aircraft accidents, phase 2

NASA Technical Reports Server (NTRS)

Pocinki, L.; Cornell, M. E.; Kaplan, L.

1980-01-01

The risk associated with the potential use of carbon fiber composite material in commercial jet aircraft is investigated. A simulation model developed to generate risk profiles for several airports is described. The risk profiles show the probability that the cost due to accidents in any year exceeds a given amount. The computer model simulates aircraft accidents with fire, release of fibers, their downwind transport and infiltration of buildings, equipment failures, and resulting ecomomic impact. The individual airport results were combined to yield the national risk profile.

Impact of Te and ne on edge current density profiles in ELM mitigated regimes on ASDEX Upgrade

NASA Astrophysics Data System (ADS)

Dunne, M. G.; Rathgeber, S.; Burckhart, A.; Fischer, R.; Giannone, L.; McCarthy, P. J.; Schneider, P. A.; Wolfrum, E.; the ASDEX Upgrade Team

2015-01-01

ELM resolved edge current density profiles are reconstructed using the CLISTE equilibrium code. As input, highly spatially and temporally resolved edge electron temperature and density profiles are used in addition to data from the extensive set of external poloidal field measurements available at ASDEX Upgrade, flux loop difference measurements, and current measurements in the scrape-off layer. Both the local and flux surface averaged current density profiles are analysed for several ELM mitigation regimes. The focus throughout is on the impact of altered temperature and density profiles on the current density. In particular, many ELM mitigation regimes rely on operation at high density. Two reference plasmas with type-I ELMs are analysed, one with a deuterium gas puff and one without, in order to provide a reference for the behaviour in type-II ELMy regimes and high density ELM mitigation with external magnetic perturbations at ASDEX Upgrade. For type-II ELMs it is found that while a similar pedestal top pressure is sustained at the higher density, the temperature gradient decreases in the pedestal. This results in lower local and flux surface averaged current densities in these phases, which reduces the drive for the peeling mode. No significant differences between the current density measured in the type-I phase and ELM mitigated phase is seen when external perturbations are applied, though the pedestal top density was increased. Finally, ELMs during the nitrogen seeded phase of a high performance discharge are analysed and compared to ELMs in the reference phase. An increased pedestal pressure gradient, which is the source of confinement improvement in impurity seeded discharges, causes a local current density increase. However, the increased Zeff in the pedestal acts to reduce the flux surface averaged current density. This dichotomy, which is not observed in other mitigation regimes, could act to stabilize both the ballooning mode and the peeling mode at the same time.

Current Measurements and Overwash Monitoring Using Tilt Current Meters in Three Coastal Environments

NASA Astrophysics Data System (ADS)

Lowell, N. S.; Sherwood, C. R.; Decarlo, T. M.; Grant, J. R.

2014-12-01

Tilt Current Meters (TCMs) provide accurate, cost effective measurements of near-bottom current velocities. Many studies in coastal environments require current measurements, which are frequently made with Acoustic Doppler Profilers (ADPs). ADPs are expensive, however, and may not be suitable for locations where there is significant risk of damage, loss, or theft or where a large spatial array of measurements is required. TCMs, by contrast, are smaller, less expensive, and easier to deploy. This study tested TCMs in three sites to determine their suitability for use in research applications. TCMs are based on the drag-tilt principle, where the instrument tilts in response to current. The meter consists of a buoyant float with an onboard accelerometer, three-axis tilt sensor, three-axis magnetometer (compass), and a data logger. Current measurements are derived by post processing the tilt and compass values and converting them to velocity using empirical calibration data. Large data-storage capacity (4 GB) and low power requirements allow long deployments (many months) at high sample rates (16 Hz). We demonstrate the utility of TCM current measurements on a reef at Dongsha Atoll in the South China Sea, and in Vineyard Sound off Cape Cod, where the TCM performance was evaluated against ADP measurements. We have also used the TCM to record waves during an overwash event on a Cape Cod barrier beach during a winter storm. The TCM recorded waves as they came through the overwash channel, and the data were in agreement with the water-level record used as a reference. These tests demonstrate that TCMs may be used in a variety of near shore environments and have the potential to significantly increase the density of meters in future studies were current measurements are required.

Corn and sorghum phenotyping using a fixed-wing UAV-based remote sensing system

NASA Astrophysics Data System (ADS)

Shi, Yeyin; Murray, Seth C.; Rooney, William L.; Valasek, John; Olsenholler, Jeff; Pugh, N. Ace; Henrickson, James; Bowden, Ezekiel; Zhang, Dongyan; Thomasson, J. Alex

2016-05-01

Recent development of unmanned aerial systems has created opportunities in automation of field-based high-throughput phenotyping by lowering flight operational cost and complexity and allowing flexible re-visit time and higher image resolution than satellite or manned airborne remote sensing. In this study, flights were conducted over corn and sorghum breeding trials in College Station, Texas, with a fixed-wing unmanned aerial vehicle (UAV) carrying two multispectral cameras and a high-resolution digital camera. The objectives were to establish the workflow and investigate the ability of UAV-based remote sensing for automating data collection of plant traits to develop genetic and physiological models. Most important among these traits were plant height and number of plants which are currently manually collected with high labor costs. Vegetation indices were calculated for each breeding cultivar from mosaicked and radiometrically calibrated multi-band imagery in order to be correlated with ground-measured plant heights, populations and yield across high genetic-diversity breeding cultivars. Growth curves were profiled with the aerial measured time-series height and vegetation index data. The next step of this study will be to investigate the correlations between aerial measurements and ground truth measured manually in field and from lab tests.

Sustainability of Endovenous Iron Deficiency Anaemia Treatment: Hospital-Based Health Technology Assessment in IBD Patients.

PubMed

Poscia, A; Stojanovic, J; Kheiraoui, F; Proli, E M; Scaldaferri, F; Volpe, M; Di Pietro, M L; Gasbarrini, A; Fabrizio, L; Boccia, S; Favaretti, C

2017-01-01

Iron deficiency anaemia (IDA) is the main extraintestinal manifestation affecting patients with inflammatory bowel disease (IBD). The Health Technology Assessment approach was applied to evaluate the sustainability of intravenous (IV) iron formulations in the Italian hospital setting, with particular focus on ferric carboxymaltose. Data on the epidemiology of IBD and associated IDA, in addition to the efficacy and safety of IV iron formulations currently used in Italy, were retrieved from scientific literature. A hospital-based cost-analysis of the outpatient delivery of IV iron treatments was performed. Organizational and ethical implications were discussed. IDA prevalence in IBD patients varies markedly from 9 to 73%. IV iron preparations were proven to have good efficacy and safety profiles, and ferric carboxymaltose provided a fast correction of haemoglobin and serum ferritin levels in iron-deficient patients. Despite a higher price, ferric carboxymaltose would confer a beneficial effect to the hospital, in terms of reduced cost related to individual patient management and additionally to the patient by reducing the number of infusions and admissions to healthcare facilities. Ethically, the evaluation is appropriate due to its efficacy and compliance. This assessment supports the introduction of ferric carboxymaltose in the Italian outpatient setting.

Kinematic parameter estimation using close range photogrammetry for sport applications

NASA Astrophysics Data System (ADS)

Magre Colorado, Luz Alejandra; Martínez Santos, Juan Carlos

2015-12-01

In this article, we show the development of a low-cost hardware/software system based on close range photogrammetry to track the movement of a person performing weightlifting. The goal is to reduce the costs to the trainers and athletes dedicated to this sport when it comes to analyze the performance of the sportsman and avoid injuries or accidents. We used a web-cam as the data acquisition hardware and develop the software stack in Processing using the OpenCV library. Our algorithm extracts size, position, velocity, and acceleration measurements of the bar along the course of the exercise. We present detailed characteristics of the system with their results in a controlled setting. The current work improves the detection and tracking capabilities from a previous version of this system by using HSV color model instead of RGB. Preliminary results show that the system is able to profile the movement of the bar as well as determine the size, position, velocity, and acceleration values of a marker/target in scene. The average error finding the size of object at four meters of distance is less than 4%, and the error of the acceleration value is 1.01% in average.

Using science and psychology to improve the dissemination and evaluation of scientific work.

PubMed

Buttliere, Brett T

2014-01-01

Here I outline some of what science can tell us about the problems in psychological publishing and how to best address those problems. First, the motivation behind questionable research practices is examined (the desire to get ahead or, at least, not fall behind). Next, behavior modification strategies are discussed, pointing out that reward works better than punishment. Humans are utility seekers and the implementation of current change initiatives is hindered by high initial buy-in costs and insufficient expected utility. Open science tools interested in improving science should team up, to increase utility while lowering the cost and risk associated with engagement. The best way to realign individual and group motives will probably be to create one, centralized, easy to use, platform, with a profile, a feed of targeted science stories based upon previous system interaction, a sophisticated (public) discussion section, and impact metrics which use the associated data. These measures encourage high quality review and other prosocial activities while inhibiting self-serving behavior. Some advantages of centrally digitizing communications are outlined, including ways the data could be used to improve the peer review process. Most generally, it seems that decisions about change design and implementation should be theory and data driven.

How can activity-based costing methodology be performed as a powerful tool to calculate costs and secure appropriate patient care?

PubMed

Lin, Blossom Yen-Ju; Chao, Te-Hsin; Yao, Yuh; Tu, Shu-Min; Wu, Chun-Ching; Chern, Jin-Yuan; Chao, Shiu-Hsiung; Shaw, Keh-Yuong

2007-04-01

Previous studies have shown the advantages of using activity-based costing (ABC) methodology in the health care industry. The potential values of ABC methodology in health care are derived from the more accurate cost calculation compared to the traditional step-down costing, and the potentials to evaluate quality or effectiveness of health care based on health care activities. This project used ABC methodology to profile the cost structure of inpatients with surgical procedures at the Department of Colorectal Surgery in a public teaching hospital, and to identify the missing or inappropriate clinical procedures. We found that ABC methodology was able to accurately calculate costs and to identify several missing pre- and post-surgical nursing education activities in the course of treatment.

Environmental issues and economic performance of the coal industry in Brazil

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

Santana, E.A.; Seabra, F.; Wendhausen, J.

1996-12-31

The purpose of this study is to investigate the main sources of inefficiency of the Brazilian coal industry. In addition, the authors examine the current and the future competitiveness of the Brazilian coal industry taking into account the effects of globalization, the modernization of the mining techniques and, most important, the environmental costs regarded under the concept of sustainable development. This paper examines some of the causes behind the alleged inefficiency of coal production and coal-electric generation, with special emphasis to environmental issues. The rest of the paper is organized as follows. Section 2 outlines a profile of the energeticmore » potential of coal reserves in Brazil. In section 3, the authors discuss environmental restrictions and other features that can be related to the performance of the coal industry in Brazil.« less

A new model for predicting moisture uptake by packaged solid pharmaceuticals.

PubMed

Chen, Y; Li, Y

2003-04-14

A novel mathematical model has been developed for predicting moisture uptake by packaged solid pharmaceutical products during storage. High density polyethylene (HDPE) bottles containing the tablet products of two new chemical entities and desiccants are investigated. Permeability of the bottles is determined at different temperatures using steady-state data. Moisture sorption isotherms of the two model drug products and desiccants at the same temperatures are determined and expressed in polynomial equations. The isotherms are used for modeling the time-humidity profile in the container, which enables the prediction of the moisture content of individual component during storage. Predicted moisture contents agree well with real time stability data. The current model could serve as a guide during packaging selection for moisture protection, so as to reduce the cost and cycle time of screening study.

Genital Warts

PubMed Central

Yanofsky, Valerie R.; Patel, Rita V.

2012-01-01

External genital warts, also known as condylomata acuminata, are extremely common, with between 500,000 to one million new cases diagnosed each year in the United States alone. To date, more than 120 distinct subtypes of human papillomavirus have been identified. Human papillomavirus types 6 and 11 rarely give rise to cervical cancers, but are responsible for 90 percent of the cases of genital warts. The current treatment options are largely centered upon removal of the warts rather than elimination of the underlying viral infection. A wide range of therapies are presently in use, which are highly variable and can differ dramatically with respect to cost, side-effect profiles, dosing schedules, duration of treatment, and overall effectiveness. As of yet, no definitive therapy has emerged as the ideal standard of care in the treatment of genital warts, and therapy selection generally occurs in a patient-specific manner. PMID:22768354

Evaluation of vertical profiles to design continuous descent approach procedure

NASA Astrophysics Data System (ADS)

Pradeep, Priyank

The current research focuses on predictability, variability and operational feasibility aspect of Continuous Descent Approach (CDA), which is among the key concepts of the Next Generation Air Transportation System (NextGen). The idle-thrust CDA is a fuel economical, noise and emission abatement procedure, but requires increased separation to accommodate for variability and uncertainties in vertical and speed profiles of arriving aircraft. Although a considerable amount of researches have been devoted to the estimation of potential benefits of the CDA, only few have attempted to explain the predictability, variability and operational feasibility aspect of CDA. The analytical equations derived using flight dynamics and Base of Aircraft and Data (BADA) Total Energy Model (TEM) in this research gives insight into dependency of vertical profile of CDA on various factors like wind speed and gradient, weight, aircraft type and configuration, thrust settings, atmospheric factors (deviation from ISA (DISA), pressure and density of the air) and descent speed profile. Application of the derived equations to idle-thrust CDA gives an insight into sensitivity of its vertical profile to multiple factors. This suggests fixed geometric flight path angle (FPA) CDA has higher degree of predictability and lesser variability at the cost of non-idle and low thrust engine settings. However, with optimized design this impact can be overall minimized. The CDA simulations were performed using Future ATM Concept Evaluation Tool (FACET) based on radar-track and aircraft type data (BADA) of the real air-traffic to some of the busiest airports in the USA (ATL, SFO and New York Metroplex (JFK, EWR and LGA)). The statistical analysis of the vertical profiles of CDA shows 1) mean geometric FPAs derived from various simulated vertical profiles are consistently shallower than 3° glideslope angle and 2) high level of variability in vertical profiles of idle-thrust CDA even in absence of uncertainties in external factors. Analysis from operational feasibility perspective suggests that two key features of the performance based Flight Management System (FMS) i.e. required time of arrival (RTA) and geometric descent path would help in reduction of unpredictability associated with arrival time and vertical profile of aircraft guided by the FMS coupled with auto-pilot (AP) and auto-throttle (AT). The statistical analysis of the vertical profiles of CDA also suggests that for procedure design window type, 'AT or above' and 'AT or below' altitude and FPA constraints are more realistic and useful compared to obsolete 'AT' type altitude constraint.

The social costs of dangerous products: an empirical investigation.

PubMed

Shapiro, Sidney; Ruttenberg, Ruth; Leigh, Paul

2009-01-01

Defective consumer products impose significant costs on consumers and third parties when they cause fatalities and injuries. This Article develops a novel approach to measuring the true extent of such costs, which may not be accurately captured under current methods of estimating the cost of dangerous products. Current analysis rests on a narrowly defined set of costs, excluding certain types of costs. The cost-of-injury estimates utilized in this Article address this omission by quantifying and incorporating these costs to provide a more complete picture of the true impact of defective consumer products. The new estimates help to gauge the true value of the civil liability system.

[Cost of mother-child care in Morelos State].

PubMed

Cahuana-Hurtado, Lucero; Sosa-Rubí, Sandra; Bertozzi, Stefano

2004-01-01

To compare the cost of maternal and child health care (current model) to that of the WHO Mother-Baby Package if it were implemented. A pilot cross-sectional case study was conducted in September 2001 in Sanitary District No. III, Morelos State, Mexico. Two rural health centers, an urban health center, and a general hospital, all managed by the Ministry of Health, were selected for the study. The Mother-Baby Package Costing Spreadsheet was used to estimate the total cost and cost per intervention for the current model and for the Mother-Baby Package model. The total cost of the Mother-Baby Package was twice the cost of the current model. Of the 18 interventions evaluated, the highest proportion of total costs corresponded to antenatal care and normal delivery. Personnel costs represented more than half of the total costs. The Mother-Baby Package Costing Spreadsheet is a practical tool to estimate and compare costs and is useful to guide the distribution of financial resources allocated to maternal and child healthcare. However, this model has limited application unless it is adapted to the structure of each healthcare system. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Improved cardiac management with a disease management program incorporating comprehensive lipid profiling.

PubMed

McAna, John F; Goldfarb, Neil I; Couto, Joseph; Henry, Michelle A; Piefer, Gary; Rapier, George M

2012-02-01

The objective of this study was to evaluate the improved effectiveness of a disease management treatment protocol incorporating comprehensive lipid profiling and targeted lipid care based on lipid profile findings in patients with ischemic heart disease (IHD) or congestive heart failure (CHF) enrolled in a managed care plan. This retrospective cohort study, conducted over a 2-year period, compared outcomes between patients with a standard lipid profile to those evaluated with a comprehensive lipid profile. All adult members of the WellMed Medical Management, Inc. managed care health plan diagnosed with IHD or CHF, and continuously enrolled between July 1, 2006 and June 30, 2008, were included in the study. Cases were defined as those who had at least 1 comprehensive lipid test (the VAP [vertical auto profile] ultracentrifuge test) during this period (n=1767); they were compared to those who had no lipid testing or traditional standard lipid testing only (controls, n=289). Univariate statistics were analyzed to describe the groups, and bivariate t tests or chi-squares examined differences between the 2 cohorts. Multivariate regression analyses were performed to control for potential confounders. The results show that the case group had lower total costs ($4852.62 vs. $7413.18; P=0.0255), fewer inpatient stays (13.1% vs. 18.3% of controls; P=0.0175) and emergency department visits (11.9% vs. 15.6% of controls; P=0.0832). Prescription use and frequency of lipid measurement suggested improved control resulting from a targeted approach to managing specific dyslipidemias. A treatment protocol incorporating a comprehensive lipid profile appears to improve care and reduce utilization and costs in a disease management program for cardiac patients.

Assessing community exposure to hazardous air pollutants by combining optical remote sensing and "low-cost" sensor technologies

NASA Astrophysics Data System (ADS)

Pikelnaya, O.; Polidori, A.; Wimmer, R.; Mellqvist, J.; Samuelsson, J.; Marianne, E.; Andersson, P.; Brohede, S.; Izos, O.

2017-12-01

Industrial facilities such as refineries and oil processing facilities can be sources of chemicals adversely affecting human health, for example aromatic hydrocarbons and formaldehyde. In an urban setting, such as the South Coast Air Basin (SCAB), exposure to harmful air pollutants (HAP's) for residents of communities neighboring such facilities is of serious concern. Traditionally, exposure assessments are performed by modeling a community exposure using emission inventories and data collected at fixed air monitoring sites. However, recent field measurements found that emission inventories may underestimate HAP emissions from refineries; and HAP measurements data from fixed sites is lacking spatial resolution; as a result, the impact of HAP emissions on communities is highly uncertain. The next generation air monitoring technologies can help address these challenges. For example, dense "low-cost" sensors allow continuous monitoring of concentrations of pollutants within communities with high temporal- and spatial- resolution, and optical remote sensing (ORS) technologies offer measurements of emission fluxes and real-time ground-concentration mapping of HAPs. South Coast Air Quality Management District (SCAQMD) is currently conducting a multi-year study using ORS methods and "low-cost" Volatile Organic Compounds (VOCs) sensors to monitor HAP emissions from selected industrial facilities in the SCAB and their ambient concentrations in neighboring communities. For this purpose, quarterly mobile ORS surveys are conducted to quantify facility-wide emissions for VOCs, aromatic hydrocarbons and HCHO, and to collect ground-concentration profiles of these pollutants inside neighboring communities. Additionally, "low-cost" sensor nodes for deployment in neighborhood(s) downwind of the facilities have been developed in order to obtain long-term, granular data on neighborhood VOC concentrations, During this presentation we will discuss initial results of quarterly ORS surveys and pilot "low-cost" sensor deployments. We will also outline benefits of using a combination of mobile ORS surveys and "low-cost" sensor networks for community exposure monitoring.

Consensus conference on the management of tumor lysis syndrome.

PubMed

Tosi, Patrizia; Barosi, Giovanni; Lazzaro, Carlo; Liso, Vincenzo; Marchetti, Monia; Morra, Enrica; Pession, Andrea; Rosti, Giovanni; Santoro, Antonio; Zinzani, Pier Luigi; Tura, Sante

2008-12-01

Tumor lysis syndrome is a potentially life threatening complication of massive cellular lysis in cancers. Identification of high-risk patients and early recognition of the syndrome is crucial in the institution of appropriate treatments. Drugs that act on the metabolic pathway of uric acid to allantoin, like allopurinol or rasburicase, are effective for prophylaxis and treatment of tumor lysis syndrome. Sound recommendations should regulate diagnosis and drug application in the clinical setting. The current article reports the recommendations on the management of tumor lysis syndrome that were issued during a Consensus Conference project, and which were endorsed by the Italian Society of Hematology (SIE), the Italian Association of Pediatric Oncologists (AIEOP) and the Italian Society of Medical Oncology (AIOM). Current concepts on the pathophysiology, clinical features, and therapy of tumor lysis syndrome were evaluated by a Panel of 8 experts. A consensus was then developed for statements regarding key questions on tumor lysis syndrome management selected according to the criterion of relevance by group discussion. Hydration and rasburicase should be administered to adult cancer patients who are candidates for tumor-specific therapy and who carry a high risk of tumor lysis syndrome. Cancer patients with a low-risk of tumor lysis syndrome should instead receive hydration along with oral allopurinol. Hydration and rasburicase should also be administered to patients with clinical tumor lysis syndrome and to adults and high-risk children who develop laboratory tumor lysis syndrome. In conclusion, the Panel recommended rasburicase for tumor lysis syndrome prophylaxis in selected patients based on the drug efficacy profile. Methodologically rigorous studies are needed to clarify its cost-effectiveness profile.

Application of IRI-Plas in Ionospheric Tomography and HF Communication Studies with Assimilation of GPS-TEC

NASA Astrophysics Data System (ADS)

Arikan, Feza; Gulyaeva, Tamara; Sezen, Umut; Arikan, Orhan; Toker, Cenk; Hakan Tuna, MR.; Erdem, Esra

2016-07-01

International Reference Ionosphere is the most acknowledged climatic model of ionosphere that provides electron density profile and hourly, monthly median values of critical layer parameters of the ionosphere for a desired location, date and time between 60 to 2,000 km altitude. IRI is also accepted as the International Standard Ionosphere model. Recently, the IRI model is extended to the Global Positioning System (GPS) satellite orbital range of 20,000 km. The new version is called IRI-Plas and it can be obtained from http://ftp.izmiran.ru/pub/izmiran /SPIM/. A user-friendly online version is also provided at www.ionolab.org as a space weather service. Total Electron Content (TEC), which is defined as the line integral of electron density on a given ray path, is an observable parameter that can be estimated from earth based GPS receivers in a cost-effective manner as GPS-TEC. One of the most important advantages of IRI-Plas is the possible input of GPS-TEC to update the background deterministic ionospheric model to the current ionospheric state. This option is highly useful in regional and global tomography studies and HF link assessments. IONOLAB group currently implements IRI-Plas as a background model and updates the ionospheric state using GPS-TEC in IONOLAB-CIT and IONOLAB-RAY algorithms. The improved state of ionosphere allows the most reliable 4-D imaging of electron density profiles and HF and satellite communication link simulations.This study is supported by TUBITAK 115E915 and joint TUBITAK 114E092 and AS CR 14/001.

ACCEPT 2: A public library of cluster properties

NASA Astrophysics Data System (ADS)

Donahue, Megan

2012-09-01

The current public ACCEPT database of cluster properties includes radial profiles of Tx, n_elec, entropy, and cooling time. We propose to more than double the current number of clusters in ACCEPT and to expand the current suite of properties to include uniformly measured profiles of gas mass and hydrostatic equilibrium mass along with signatures of dynamical relaxation (centroid shift, power ratios, surface brightness concentration, temperature ratios) and global quantities such as core-excised Tx, Lx, and metallicities. We will explore the relationship between cool cores and dynamical relaxation, the reliability of hydrostatic mass profiles, and the dependence of the gas mass fraction on halo mass, redshift, and the degree of relaxation. ACCEPT2 will enable further community science.

Adenosine-stress cardiac magnetic resonance imaging in suspected coronary artery disease: a net cost analysis and reimbursement implications.

PubMed

Pilz, Guenter; Patel, Pankaj A; Fell, Ulrich; Ladapo, Joseph A; Rizzo, John A; Fang, Hai; Gunnarsson, Candace; Heer, Tobias; Hoefling, Berthold

2011-01-01

The health and economic implications of new imaging technologies are increasingly relevant policy issues. Cardiac magnetic resonance imaging (CMR) is currently not or not sufficiently reimbursed in a number of countries including Germany, presumably because of a limited evidence base. It is unknown, however, whether it can be effectively used to facilitate medical decision-making and reduce costs by serving as a gatekeeper to invasive coronary angiography. We investigated whether the application of CMR in patients suspected of having coronary artery disease (CAD) reduces costs by averting referrals to cardiac catheterization. We used propensity score methods to match 218 patients from a CMR registry to a previously studied cohort in which CMR was demonstrated to reliably identify patients who were low-risk for major cardiac events. Covariates over which patients were matched included comorbidity profiles, demographics, CAD-related symptoms, and CAD risk as measured by Morise scores. We determined the proportion of patients for whom cardiac catheterization was deferred based upon CMR findings. We then calculated the economic effects of practice pattern changes using data on cardiac catheterization and CMR costs. CMR reduced the utilization of cardiac catheterization by 62.4%. Based on estimated catheterization costs of € 619, the utilization of CMR as a gatekeeper reduced per-patient costs by a mean of € 90. Savings were realized until CMR costs exceeded € 386. Cost savings were greatest for patients at low-risk for CAD, as measured by baseline Morise scores, but were present for all Morise subgroups with the exception of patients at the highest risk of CAD. CMR significantly reduces the utilization of cardiac catheterization in patients suspected of having CAD. Per-patient savings range from € 323 in patients at lowest risk of CAD to € 58 in patients at high-risk but not in the highest risk stratum. Because a negative CMR evaluation has high negative predictive value, its application as a gatekeeper to cardiac catheterization should be further explored as a treatment option.

Cost-effectiveness of pazopanib versus sunitinib for metastatic renal cell carcinoma in the United Kingdom

PubMed Central

Amdahl, Jordan; Diaz, Jose; Sharma, Arati; Park, Jinhee; Chandiwana, David

2017-01-01

Background Sunitinib and pazopanib are the only two targeted therapies for the first-line treatment of locally advanced or metastatic renal cell carcinoma (mRCC) recommended by the United Kingdom’s National Institute for Health and Care Excellence. Pazopanib demonstrated non-inferior efficacy and a differentiated safety profile versus sunitinib in the phase III COMPARZ trial. The current analysis provides a direct comparison of the cost-effectiveness of pazopanib versus sunitinib from the perspective of the United Kingdom’s National Health Service based on data from COMPARZ and other sources. Methods A partitioned-survival analysis model with three health states (alive with no progression, alive with progression, or dead) was used to estimate the incremental cost per quality-adjusted life-year (QALY) gained for pazopanib versus sunitinib over five years (duration of follow-up for final survival analysis in COMPARZ). The proportion of patients in each health state over time was based on Kaplan–Meier distributions for progression-free and overall survival from COMPARZ. Utility values were based on EQ-5D data from the pivotal study of pazopanib versus placebo. Costs were based on medical resource utilisation data from COMPARZ and unit costs from secondary sources. Probabilistic and deterministic sensitivity analyses were conducted to assess uncertainty of model results. Results In the base case, pazopanib was estimated to provide more QALYs (0.0565, 95% credible interval [CrI]: −0.0920 to 0.2126) at a lower cost (−£1,061, 95% CrI: −£4,328 to £2,067) versus sunitinib. The probability that pazopanib yields more QALYs than sunitinib was estimated to be 76%. For a threshold value of £30,000 per QALY gained, the probability that pazopanib is cost-effective versus sunitinib was estimated to be 95%. Pazopanib was dominant in most scenarios examined in deterministic sensitivity analyses. Conclusions Pazopanib is likely to be a cost-effective treatment option compared with sunitinib as first-line treatment of mRCC in the United Kingdom. PMID:28636648

Adenosine-stress cardiac magnetic resonance imaging in suspected coronary artery disease: a net cost analysis and reimbursement implications

PubMed Central

Patel, Pankaj A.; Fell, Ulrich; Ladapo, Joseph A.; Rizzo, John A.; Fang, Hai; Gunnarsson, Candace; Heer, Tobias; Hoefling, Berthold

2010-01-01

The health and economic implications of new imaging technologies are increasingly relevant policy issues. Cardiac magnetic resonance imaging (CMR) is currently not or not sufficiently reimbursed in a number of countries including Germany, presumably because of a limited evidence base. It is unknown, however, whether it can be effectively used to facilitate medical decision-making and reduce costs by serving as a gatekeeper to invasive coronary angiography. We investigated whether the application of CMR in patients suspected of having coronary artery disease (CAD) reduces costs by averting referrals to cardiac catheterization. We used propensity score methods to match 218 patients from a CMR registry to a previously studied cohort in which CMR was demonstrated to reliably identify patients who were low-risk for major cardiac events. Covariates over which patients were matched included comorbidity profiles, demographics, CAD-related symptoms, and CAD risk as measured by Morise scores. We determined the proportion of patients for whom cardiac catheterization was deferred based upon CMR findings. We then calculated the economic effects of practice pattern changes using data on cardiac catheterization and CMR costs. CMR reduced the utilization of cardiac catheterization by 62.4%. Based on estimated catheterization costs of € 619, the utilization of CMR as a gatekeeper reduced per-patient costs by a mean of € 90. Savings were realized until CMR costs exceeded € 386. Cost savings were greatest for patients at low-risk for CAD, as measured by baseline Morise scores, but were present for all Morise subgroups with the exception of patients at the highest risk of CAD. CMR significantly reduces the utilization of cardiac catheterization in patients suspected of having CAD. Per-patient savings range from € 323 in patients at lowest risk of CAD to € 58 in patients at high-risk but not in the highest risk stratum. Because a negative CMR evaluation has high negative predictive value, its application as a gatekeeper to cardiac catheterization should be further explored as a treatment option. PMID:20524070

German EstSmoke: estimating adult smoking-related costs and consequences of smoking cessation for Germany.

PubMed

Sonntag, Diana; Gilbody, Simon; Winkler, Volker; Ali, Shehzad

2018-01-01

We compared predicted life-time health-care costs for current, never and ex-smokers in Germany under the current set of tobacco control polices. We compared these economic consequences of the current situation with an alternative in which Germany were to implement more comprehensive tobacco control policies consistent with the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) guidelines. German EstSmoke, an adapted version of the UK EstSmoke simulation model, applies the Markov modelling approach. Transition probabilities for (re-)currence of smoking-related diseases were calculated from large German disease-specific registries and the German Health Update (GEDA 2010). Estimations of both health-care costs and effect sizes of smoking cessation policies were taken from recent German studies and discounted at 3.5%/year. Germany. German population of prevalent current, never and ex-smokers in 2009. Life-time cost and outcomes in current, never and ex-smokers. If tobacco control policies are not strengthened, the German smoking population will incur €41.56 billion life-time excess costs compared with never smokers. Implementing tobacco control policies consistent with WHO FCTC guidelines would reduce the difference of life-time costs between current smokers and ex-smokers by at least €1.7 billion. Modelling suggests that the life-time healthcare costs of people in Germany who smoke are substantially greater than those of people who have never smoked. However, more comprehensive tobacco control policies could reduce health-care expenditures for current smokers by at least 4%. © 2017 Society for the Study of Addiction.

Integrative prescreening in analysis of multiple cancer genomic studies

PubMed Central

2012-01-01

Background In high throughput cancer genomic studies, results from the analysis of single datasets often suffer from a lack of reproducibility because of small sample sizes. Integrative analysis can effectively pool and analyze multiple datasets and provides a cost effective way to improve reproducibility. In integrative analysis, simultaneously analyzing all genes profiled may incur high computational cost. A computationally affordable remedy is prescreening, which fits marginal models, can be conducted in a parallel manner, and has low computational cost. Results An integrative prescreening approach is developed for the analysis of multiple cancer genomic datasets. Simulation shows that the proposed integrative prescreening has better performance than alternatives, particularly including prescreening with individual datasets, an intensity approach and meta-analysis. We also analyze multiple microarray gene profiling studies on liver and pancreatic cancers using the proposed approach. Conclusions The proposed integrative prescreening provides an effective way to reduce the dimensionality in cancer genomic studies. It can be coupled with existing analysis methods to identify cancer markers. PMID:22799431

Shifting orders among suppliers considering risk, price and transportation cost

NASA Astrophysics Data System (ADS)

Revitasari, C.; Pujawan, I. N.

2018-04-01

Supplier order allocation is an important supply chain decision for an enterprise. It is related to the supplier’s function as a raw material provider and other supporting materials that will be used in production process. Most of works on order allocation has been based on costs and other supply chain performance, but very limited of them taking risks into consideration. In this paper we address the problem of order allocation of a single commodity sourced from multiple suppliers considering supply risks in addition to the attempt of minimizing transportation costs. The supply chain risk was investigated and a procedure was proposed in the risk mitigation phase as a form of risk profile. The objective including risk profile in order allocation is to maximize the product flow from a risky supplier to a relatively less risky supplier. The proposed procedure is applied to a sugar company. The result suggests that order allocations should be maximized to suppliers that have a relatively low risk and minimized to suppliers that have a relatively larger risks.

Engineering and Design: Civil Works Cost Engineering

DTIC Science & Technology

1994-03-31

labor cost requirements are broken into tasks of work. Each task is usually performd by a labor crew. Crews may vary in size and mix of skills. The...requested in advance of the expected purchase date. Suppliers are reluctant to guarantee future pricw and ofien will only quote current prices. It may be...unit cost is the overhead cost for the item. g. Sources for Pricing. The Cost Engineer must rely on judgement, historical data, and current labor market

Design of Launch Abort System Thrust Profile and Concept of Operations

NASA Technical Reports Server (NTRS)

Litton, Daniel; O'Keefe, Stephen A.; Winski, Richard G.; Davidson, John B.

2008-01-01

This paper describes how the Abort Motor thrust profile has been tailored and how optimizing the Concept of Operations on the Launch Abort System (LAS) of the Orion Crew Exploration Vehicle (CEV) aides in getting the crew safely away from a failed Crew Launch Vehicle (CLV). Unlike the passive nature of the Apollo system, the Orion Launch Abort Vehicle will be actively controlled, giving the program a more robust abort system with a higher probability of crew survival for an abort at all points throughout the CLV trajectory. By optimizing the concept of operations and thrust profile the Orion program will be able to take full advantage of the active Orion LAS. Discussion will involve an overview of the development of the abort motor thrust profile and the current abort concept of operations as well as their effects on the performance of LAS aborts. Pad Abort (for performance) and Maximum Drag (for separation from the Launch Vehicle) are the two points that dictate the required thrust and shape of the thrust profile. The results in this paper show that 95% success of all performance requirements is not currently met for Pad Abort. Future improvements to the current parachute sequence and other potential changes will mitigate the current problems, and meet abort performance requirements.

Influence of field dependent critical current density on flux profiles in high Tc superconductors

NASA Technical Reports Server (NTRS)

Takacs, S.

1990-01-01

The field distribution for superconducting cylinders and slabs with field dependent critical current densities in combined DC and AC magnetic fields and the corresponding magnetic fluxes are calculated. It is shown that all features of experimental magnetic-field profile measurements can be explained in the framework of field dependent critical current density. Even the quantitative agreement between the experimental and theoretical results using Kim's model is very good.

Effectiveness of the population-based Check your health preventive programme conducted in primary care with 4 years follow-up [the CORE trial]: study protocol for a randomised controlled trial.

PubMed

Maindal, Helle Terkildsen; Støvring, Henrik; Sandbaek, Annelli

2014-08-29

The periodic health check-up has been a fundamental part of routine medical practice for decades, despite a lack of consensus regarding its value in health promotion and disease prevention. A large-scale Danish population-based preventive programme 'Check your health' was developed based on available evidence of screening and successive accepted treatment, prevention for diseases and health promotion, and is closely aligned with the current health care system.The objective of the 'Check your health' [CORE] trial is to investigate effectiveness on health outcomes of a preventive health check offered at a population-level to all individuals aged 30-49 years, and to establish the cost-effectiveness. The trial will be conducted as a pragmatic household-cluster randomised controlled trial involving 10,505 individuals. All individuals within a well-defined geographical area in the Central Denmark Region, Denmark (DK) were randomised to be offered a preventive health check (Intervention group, n = 5250) or to maintain routine access to healthcare until a delayed intervention (Comparison group, n = 5255). The programme consists of a health examination which yields an individual risk profile, and according to this participants are assigned to one of the following interventions: (a) referral to a health promoting consultation in general practice, (b) behavioural programmes at the local Health Centre, or (c) no need for follow-up.The primary outcomes at 4 years follow-up are: ten-year-risk of fatal cardiovascular event (Heart-SCORE model), physical activity level (self-report and cardiorespiratory fitness), quality of life (SF12), sick leave and labour market attachment. Cost-effectiveness will be evaluated according to life years gained, direct costs and total health costs. Intention to treat analysis will be performed. Results from the largest Danish health check programme conducted within the current healthcare system, spanning the sectors which share responsibility for the individual, will provide a scientific basis to be used in the development of systems to optimise population health in the 21st century. The trial has registered at ClinicalTrials.gov with an ID: NCT02028195 (7. March 2014).

Development of a solar array drive mechanism for micro-satellite platforms

NASA Astrophysics Data System (ADS)

Galatis, Giorgos; Guo, Jian; Buursink, Jeroen

2017-10-01

Photovoltaic solar array (PVSA) systems are the most widely used method for spacecraft power generation. However, in many satellite missions, the optimum orientation of the PVSA system is not always compatible with that of the payload orientation. Many methods, have been examined in the past to overcome this problem. Up to date, the most widely used active method for large costly satellites is the Solar Array Drive Mechanism (SADM). The SADM serves as the interface between the satellite body and the PVSA subsystem, enabling the decoupling of their spatial orientation. Nonetheless, there exists a research and development gap for such systems regarding low cost micro-satellites. During the literature study of this paper, individual orbital parameters of various micro-satellites have been extracted and compared to the rotational freedom of the corresponding SADMs used. The findings demonstrated that the implemented SADMs are over designed. It is therefore concluded that these components are not tailored made for each spacecraft mission individually, but rather, exhibit a generic design to full fill a majority of mission profiles and requirements. Motivated by the above analysis, the cardinal objective of the current research is to develop a low cost mechanism that will be precisely tailored for the use of a low Earth orbit (LEO) micro-satellite platform orbiting in altitudes of 500 - 1000km . The design of the mechanism may vary from the existing miniaturized SADMs. For example, the preliminary analysis of the current research suggests, that the conventional use of the slip ring system as the electronic transfer unit can be replaced by a seMI Orientation Unit (MIOU). Systems engineering tools for concept generation and selection have been used. In addition, simulation and mathematical modelling have been implemented on component and system level, to accurately predict the behaviour of the system under various modes of operation. The production and system testing of the prototype has taken place and it has verified that the development of such a system, will aid the power generation of the solar arrays, while having a positive impact on the cost reduction of such satellites.

The influence of current speed and vegetation density on flow structure in two macrotidal eelgrass canopies

USGS Publications Warehouse

Lacy, Jessica R.; Wyllie-Echeverria, Sandy

2011-01-01

The influence of eelgrass (Zostera marina) on near-bed currents, turbulence, and drag was investigated at three sites in two eelgrass canopies of differing density and at one unvegetated site in the San Juan archipelago of Puget Sound, Washington, USA. Eelgrass blade length exceeded 1 m. Velocity profiles up to 1.5 m above the sea floor were collected over a spring-neap tidal cycle with a downward-looking pulse-coherent acoustic Doppler profiler above the canopies and two acoustic Doppler velocimeters within the canopies. The eelgrass attenuated currents by a minimum of 40%, and by more than 70% at the most densely vegetated site. Attenuation decreased with increasing current speed. The data were compared to the shear-layer model of vegetated flows and the displaced logarithmic model. Velocity profiles outside the meadows were logarithmic. Within the canopies, most profiles were consistent with the shear-layer model, with a logarithmic layer above the canopy. However, at the less-dense sites, when currents were strong, shear at the sea floor and above the canopy was significant relative to shear at the top of the canopy, and the velocity profiles more closely resembled those in a rough-wall boundary layer. Turbulence was strong at the canopy top and decreased with height. Friction velocity at the canopy top was 1.5–2 times greater than at the unvegetated, sandy site. The coefficient of drag CD on the overlying flow derived from the logarithmic velocity profile above the canopy, was 3–8 times greater than at the unvegetated site (0.01–0.023 vs. 2.9 × 10−3).

Impact and cost-effectiveness of chlamydia testing in Scotland: a mathematical modelling study.

PubMed

Looker, Katharine J; Wallace, Lesley A; Turner, Katherine M E

2015-01-15

Chlamydia is the most common sexually transmitted bacterial infection in Scotland, and is associated with potentially serious reproductive outcomes, including pelvic inflammatory disease (PID) and tubal factor infertility (TFI) in women. Chlamydia testing in Scotland is currently targeted towards symptomatic individuals, individuals at high risk of existing undetected infection, and young people. The cost-effectiveness of testing and treatment to prevent PID and TFI in Scotland is uncertain. A compartmental deterministic dynamic model of chlamydia infection in 15-24 year olds in Scotland was developed. The model was used to estimate the impact of a change in testing strategy from baseline (16.8% overall testing coverage; 0.4 partners notified and tested/treated per treated positive index) on PID and TFI cases. Cost-effectiveness calculations informed by best-available estimates of the quality-adjusted life years (QALYs) lost due to PID and TFI were also performed. Increasing overall testing coverage by 50% from baseline to 25.2% is estimated to result in 21% fewer cases in young women each year (PID: 703 fewer; TFI: 88 fewer). A 50% decrease to 8.4% would result in 20% more PID (669 additional) and TFI (84 additional) cases occurring annually. The cost per QALY gained of current testing activities compared to no testing is £40,034, which is above the £20,000-£30,000 cost-effectiveness threshold. However, calculations are hampered by lack of reliable data. Any increase in partner notification from baseline would be cost-effective (incremental cost per QALY gained for a partner notification efficacy of 1 compared to baseline: £5,119), and would increase the cost-effectiveness of current testing strategy compared to no testing, with threshold cost-effectiveness reached at a partner notification efficacy of 1.5. However, there is uncertainty in the extent to which partner notification is currently done, and hence the amount by which it could potentially be increased. Current chlamydia testing strategy in Scotland is not cost-effective under the conservative model assumptions applied. However, with better data enabling some of these assumptions to be relaxed, current coverage could be cost-effective. Meanwhile, increasing partner notification efficacy on its own would be a cost-effective way of preventing PID and TFI from current strategy.

B-2 Extremely High Frequency SATCOM and Computer Increment 1 (B-2 EHF Inc 1)

DTIC Science & Technology

2015-12-01

Confidence Level Confidence Level of cost estimate for current APB: 55% This APB reflects cost and funding data based on the B-2 EHF Increment I SCP...This cost estimate was quantified at the Mean (~55%) confidence level . Total Quantity Quantity SAR Baseline Production Estimate Current APB...Production Estimate Econ Qty Sch Eng Est Oth Spt Total 33.624 -0.350 1.381 0.375 0.000 -6.075 0.000 -0.620 -5.289 28.335 Current SAR Baseline to Current

48 CFR 1652.244-70 - Subcontracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... price analysis; (5) The subcontractor's current, complete, and accurate cost or pricing data and a Certificate of Current Cost or Pricing Data must be submitted to the Contracting officer if required by law... controlling establishment of initial or revised prices; (iii) An explanation of the reason cost or pricing...

Deleterious effects of increased body weight associated with intensive insulin therapy for type 1 diabetes: increased blood pressure and worsened lipid profile partially negate improvements in life expectancy.

PubMed

Palmer, Andrew J; Roze, Stéphane; Valentine, William J; Minshall, Michael E; Lammert, Morten; Nicklasson, Lars; Spinas, Giatgen A

2004-08-01

Weight gain is an unwanted side effect of improved glycaemic control in type 1 diabetes, associated with increased blood pressure (BP) and worsening lipid profiles. While improved glycaemic control per se should improve long-term patient outcomes, increases in BP and worsening lipid profiles may counteract these benefits. The aim of this modelling study was to assess whether the increased body weight and associated worsening of lipid profile and blood pressure would negate the improvements in glycaemic control seen with intensive therapy in patients with type 1 diabetes. A validated diabetes model projected life expectancy (LE), quality-adjusted LE (QALE) and total lifetime costs of complications in type 1 diabetes cohorts with the characteristics of patients from the Diabetes Control and Complications Trial (DCCT). The following four cohorts (A-D) were created based on increased body weight under either conventional or intensive therapy: A) conventional glycaemic control in the subgroup with lowest weight-gain quartile after 6.5 years (HbA1c increased by 11% from baseline); B) conventional control in the highest weight-gain quartile (no change in HbA1c from baseline); C) intensive control in the lowest quartile of weight gain (with 16.1% decrease in HbA1c, but no increase in weight or associated BP, and improved lipid profile); D) intensive control in the highest quartile of weight gain (with 21% decrease in HbA1c, increased systolic BP of 6 mmHg, and worsened lipid profile). Data were derived from DCCT and other published sources. Intensive control, even with weight gain, led to major improvements in LE and QALE, and reduction in costs of complications versus conventional therapy. Intensive therapy with no weight increase led to a higher LE (increased by 0.57 years) and higher QALE (increased by 0.28 years) and lower costs of complications (reduced by 523 dollars/patient), compared to intensive therapy with the highest quartile of weight gain. Concerns about weight gain should not deter intensive insulin therapy. However, the value of improving glycaemic control without increasing body weight (and associated increased BP and worsening of lipid profile) has been confirmed.

Driver behavior profiling: An investigation with different smartphone sensors and machine learning

PubMed Central

Ferreira, Jair; Carvalho, Eduardo; Ferreira, Bruno V.; de Souza, Cleidson; Suhara, Yoshihiko; Pentland, Alex

2017-01-01

Driver behavior impacts traffic safety, fuel/energy consumption and gas emissions. Driver behavior profiling tries to understand and positively impact driver behavior. Usually driver behavior profiling tasks involve automated collection of driving data and application of computer models to generate a classification that characterizes the driver aggressiveness profile. Different sensors and classification methods have been employed in this task, however, low-cost solutions and high performance are still research targets. This paper presents an investigation with different Android smartphone sensors, and classification algorithms in order to assess which sensor/method assembly enables classification with higher performance. The results show that specific combinations of sensors and intelligent methods allow classification performance improvement. PMID:28394925