Sample records for evaluation cost update

  1. 1999 update of the Arizona highway cost allocation study

    DOT National Transportation Integrated Search

    1999-08-01

    The purpose of this report was to update the Arizona highway cost allocation study and to evaluate the alternative of using the new FHWA cost allocation model as a replacement The update revealed that the repeal of Arizona's weight-distance tas has l...

  2. Opportunities for Success: Cost Effective Programs for Children Update, 1988. A Report of the Select Committee on Children, Youth and Families, U.S. House of Representatives, One Hundredth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

    Based on findings of the most current and highly regarded evaluations and research reviews available, this committee print provides an update of a prior committee report (August, 1985) on eight cost-effective federal programs for children. Described in terms of program participation, characteristics, benefits for children, cost effectiveness, and…

  3. The economic costs of illness: A replication and update

    PubMed Central

    Rice, Dorothy P.; Hodgson, Thomas A.; Kopstein, Andrea N.

    1985-01-01

    The economic burden resulting from illness, disability, and premature death is of major importance in the allocation of health care resources and in the evaluation of health research and programs. This article updates the 1963 and 1972 studies of the costs of illness. In 1980, the estimated total economic costs of illness were $455 billion: $211 billion for direct costs, $68 billion for morbidity, and $176 billion for mortality. Diseases of the circulatory system and injuries and poisonings were the most costly, with variations in the diagnostic distributions among the three types of costs and by age and sex. PMID:10311399

  4. The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation

    PubMed Central

    French, Michael T.; Fang, Hai

    2010-01-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than ten years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost of society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. PMID:20071107

  5. The cost of crime to society: new crime-specific estimates for policy and program evaluation.

    PubMed

    McCollister, Kathryn E; French, Michael T; Fang, Hai

    2010-04-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Hydrogen Pathways: Updated Cost, Well-to-Wheels Energy Use, and Emissions for the Current Technology Status of Ten Hydrogen Production, Delivery, and Distribution Scenarios

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

    Ramsden, T.; Ruth, M.; Diakov, V.

    2013-03-01

    This report describes a life-cycle assessment conducted by the National Renewable Energy Laboratory (NREL) of 10 hydrogen production, delivery, dispensing, and use pathways that were evaluated for cost, energy use, and greenhouse gas (GHG) emissions. This evaluation updates and expands on a previous assessment of seven pathways conducted in 2009. This study summarizes key results, parameters, and sensitivities to those parameters for the 10 hydrogen pathways, reporting on the levelized cost of hydrogen in 2007 U.S. dollars as well as life-cycle well-to-wheels energy use and GHG emissions associated with the pathways.

  7. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... updating fees. Each fee shall be updated by updating the cost components comprising the fee. Cost... direct labor costs are direct labor costs determined by the cost study set forth in Revision of Fees For... by total office costs for the Offices directly associated with user fee activity. Actual updating of...

  8. A knowledge management platform for infrastructure performance modeling

    DOT National Transportation Integrated Search

    2011-05-10

    The ITS/JPO Evaluation Program is requesting ITS costs information in order to update the ITS Costs database with current data and account for new/emerging services and technologies. If you have ITS Costs on recent ITS projects, or if you have ITS co...

  9. A process control system for the John F. Kennedy Memorial Bridge

    DOT National Transportation Integrated Search

    2011-05-10

    The ITS/JPO Evaluation Program is requesting ITS costs information in order to update the ITS Costs database with current data and account for new/emerging services and technologies. If you have ITS Costs on recent ITS projects, or if you have ITS co...

  10. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... updating the cost components comprising the fee. Cost components shall be updated as follows: (1) Direct... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... by total office costs for the office directly associated with user fee activity. Actual updating of...

  11. Conducting systematic reviews of economic evaluations.

    PubMed

    Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

    2015-09-01

    In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other types of evidence. The updated JBI guidance will be useful for researchers wanting to synthesize evidence about economic questions, either as stand-alone reviews or part of comprehensive or mixed method evidence reviews. Although the updated methodology produced by the work of the working group has improved the JBI guidance for systematic reviews of economic evaluations, there are areas where further work is required. These include adjusting the critical appraisal tool to separate out questions addressing intervention cost and effectiveness measurement; providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.

  12. Delayed Slater determinant update algorithms for high efficiency quantum Monte Carlo

    DOE PAGES

    McDaniel, Tyler; D’Azevedo, Ed F.; Li, Ying Wai; ...

    2017-11-07

    Within ab initio Quantum Monte Carlo simulations, the leading numerical cost for large systems is the computation of the values of the Slater determinants in the trial wavefunction. Each Monte Carlo step requires finding the determinant of a dense matrix. This is most commonly iteratively evaluated using a rank-1 Sherman-Morrison updating scheme to avoid repeated explicit calculation of the inverse. The overall computational cost is therefore formally cubic in the number of electrons or matrix size. To improve the numerical efficiency of this procedure, we propose a novel multiple rank delayed update scheme. This strategy enables probability evaluation with applicationmore » of accepted moves to the matrices delayed until after a predetermined number of moves, K. The accepted events are then applied to the matrices en bloc with enhanced arithmetic intensity and computational efficiency via matrix-matrix operations instead of matrix-vector operations. Here this procedure does not change the underlying Monte Carlo sampling or its statistical efficiency. For calculations on large systems and algorithms such as diffusion Monte Carlo where the acceptance ratio is high, order of magnitude improvements in the update time can be obtained on both multi- core CPUs and GPUs.« less

  13. Delayed Slater determinant update algorithms for high efficiency quantum Monte Carlo

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

    McDaniel, Tyler; D’Azevedo, Ed F.; Li, Ying Wai

    Within ab initio Quantum Monte Carlo simulations, the leading numerical cost for large systems is the computation of the values of the Slater determinants in the trial wavefunction. Each Monte Carlo step requires finding the determinant of a dense matrix. This is most commonly iteratively evaluated using a rank-1 Sherman-Morrison updating scheme to avoid repeated explicit calculation of the inverse. The overall computational cost is therefore formally cubic in the number of electrons or matrix size. To improve the numerical efficiency of this procedure, we propose a novel multiple rank delayed update scheme. This strategy enables probability evaluation with applicationmore » of accepted moves to the matrices delayed until after a predetermined number of moves, K. The accepted events are then applied to the matrices en bloc with enhanced arithmetic intensity and computational efficiency via matrix-matrix operations instead of matrix-vector operations. Here this procedure does not change the underlying Monte Carlo sampling or its statistical efficiency. For calculations on large systems and algorithms such as diffusion Monte Carlo where the acceptance ratio is high, order of magnitude improvements in the update time can be obtained on both multi- core CPUs and GPUs.« less

  14. Delayed Slater determinant update algorithms for high efficiency quantum Monte Carlo.

    PubMed

    McDaniel, T; D'Azevedo, E F; Li, Y W; Wong, K; Kent, P R C

    2017-11-07

    Within ab initio Quantum Monte Carlo simulations, the leading numerical cost for large systems is the computation of the values of the Slater determinants in the trial wavefunction. Each Monte Carlo step requires finding the determinant of a dense matrix. This is most commonly iteratively evaluated using a rank-1 Sherman-Morrison updating scheme to avoid repeated explicit calculation of the inverse. The overall computational cost is, therefore, formally cubic in the number of electrons or matrix size. To improve the numerical efficiency of this procedure, we propose a novel multiple rank delayed update scheme. This strategy enables probability evaluation with an application of accepted moves to the matrices delayed until after a predetermined number of moves, K. The accepted events are then applied to the matrices en bloc with enhanced arithmetic intensity and computational efficiency via matrix-matrix operations instead of matrix-vector operations. This procedure does not change the underlying Monte Carlo sampling or its statistical efficiency. For calculations on large systems and algorithms such as diffusion Monte Carlo, where the acceptance ratio is high, order of magnitude improvements in the update time can be obtained on both multi-core central processing units and graphical processing units.

  15. Delayed Slater determinant update algorithms for high efficiency quantum Monte Carlo

    NASA Astrophysics Data System (ADS)

    McDaniel, T.; D'Azevedo, E. F.; Li, Y. W.; Wong, K.; Kent, P. R. C.

    2017-11-01

    Within ab initio Quantum Monte Carlo simulations, the leading numerical cost for large systems is the computation of the values of the Slater determinants in the trial wavefunction. Each Monte Carlo step requires finding the determinant of a dense matrix. This is most commonly iteratively evaluated using a rank-1 Sherman-Morrison updating scheme to avoid repeated explicit calculation of the inverse. The overall computational cost is, therefore, formally cubic in the number of electrons or matrix size. To improve the numerical efficiency of this procedure, we propose a novel multiple rank delayed update scheme. This strategy enables probability evaluation with an application of accepted moves to the matrices delayed until after a predetermined number of moves, K. The accepted events are then applied to the matrices en bloc with enhanced arithmetic intensity and computational efficiency via matrix-matrix operations instead of matrix-vector operations. This procedure does not change the underlying Monte Carlo sampling or its statistical efficiency. For calculations on large systems and algorithms such as diffusion Monte Carlo, where the acceptance ratio is high, order of magnitude improvements in the update time can be obtained on both multi-core central processing units and graphical processing units.

  16. Automotive Manufacturers' Cost/Revenue, Financial and Risk Analysis : Projected Impact of Automobile Manufacturing on the Plastics Industry

    DOT National Transportation Integrated Search

    1979-08-01

    The report is part of a study to update the historical and projected cost/revenue analysis of the U.S. domestic automobile manufacturers. It includes the evaluation of the historical and projected financial data to assess the corporate financial posi...

  17. Evaluation of School-Based Dental Sealant Programs: An Updated Community Guide Systematic Economic Review.

    PubMed

    Griffin, Susan O; Naavaal, Shillpa; Scherrer, Christina; Patel, Mona; Chattopadhyay, Sajal

    2017-03-01

    A recently updated Community Guide systematic review of the effectiveness of school sealant programs (SSPs) still found strong evidence that SSPs reduced dental caries among schoolchildren. This follow-up systematic review updates SSP cost and benefit information from the original 2002 review. Using Community Guide economic review methods, the authors searched the literature from January 2000 to November 20, 2014. The final body of evidence included 14 studies-ten from the current search and four with cost information from the 2002 review. Nine studies had information on SSP costs; six on sealant benefit (averted treatment costs and productivity losses); four on SSP net cost (cost minus benefit); and three on net cost to Medicaid of clinically delivered sealants. The authors imputed productivity losses and discounted costs/outcomes when this information was missing. The analysis, conducted in 2015, reported all values in 2014 U.S. dollars. The median one-time SSP cost per tooth sealed was $11.64. Labor accounted for two thirds of costs, and time to provide sealants was a major cost driver. The median annual economic benefit was $6.29, suggesting that over 4 years the SSP benefit ($23.37 at a 3% discount rate) would exceed costs by $11.73 per sealed tooth. In addition, two of four economic models and all three analyses of Medicaid claims data found that SSP benefit to society exceeded SSP cost. Recent evidence indicates the benefits of SSPs exceed their costs when SSPs target schools attended by a large number of high-risk children. Published by Elsevier Inc.

  18. Cost-Effectiveness of Social Work Services in Aging: An Updated Systematic Review

    ERIC Educational Resources Information Center

    Rizzo, Victoria M.; Rowe, Jeannine M.

    2016-01-01

    Objectives: This study examines the impact of social work interventions in aging on quality of life (QOL) and cost outcomes in four categories (health, mental health, geriatric evaluation and management, and caregiving). Methods: Systematic review methods are employed. Databases were searched for articles published in English between 2004 and 2012…

  19. The impact of organizational structure on flight software cost risk

    NASA Technical Reports Server (NTRS)

    Hihn, Jairus; Lum, Karen; Monson, Erik

    2004-01-01

    This paper summarizes the final results of the follow-up study updating the estimated software effort growth for those projects that were still under development and including an evaluation of the roles versus observed cost risk for the missions included in the original study which expands the data set to thirteen missions.

  20. The Race to Refinance Debt: Market Offers Opportunities to Reduce Interest Costs.

    ERIC Educational Resources Information Center

    DuPont, Lorrie A.

    1992-01-01

    In this interest market, colleges and universities could benefit from careful evaluation of debt portfolios. Refinancing debt is an opportunity to lower debt service costs, ease cash flow, change security pledges, eliminate debt service reserves, update bond documents. Timing is important. Existing and new bonds can also be combined…

  1. NREL Updates Baseline Cost and Performance Data for Electricity Generation

    Science.gov Websites

    Technologies | News | NREL Updates Baseline Cost and Performance Data for Electricity Generation Technologies News Release: NREL Updates Baseline Cost and Performance Data for Electricity generation technology cost and performance data used to support and inform electric sector analysis in the

  2. International ITS Program Assessment

    DOT National Transportation Integrated Search

    1995-08-01

    THIS PAPER ATTEMPTS TO MAKE AN UPDATED COMPARISON OF WORLDWIDE ACTIVITIES IN INTELLIGENT TRANSPORTATION SYSTEMS (ITS) AND TO RECOMMEND A STRATEGY FOR CONTINUING INTERNATIONAL PROGRAM ASSESSMENT FOR DISCUSSION AT THE BENEFITS, EVALUATION AND COSTS (BE...

  3. Herpes zoster vaccine: A health economic evaluation for Switzerland.

    PubMed

    Blank, Patricia R; Ademi, Zanfina; Lu, Xiaoyan; Szucs, Thomas D; Schwenkglenks, Matthias

    2017-07-03

    Herpes zoster (HZ) or "shingles" results from a reactivation of the varicella zoster virus (VZV) acquired during primary infection (chickenpox) and surviving in the dorsal root ganglia. In about 20% of cases, a complication occurs, known as post-herpetic neuralgia (PHN). A live attenuated vaccine against VZV is available for the prevention of HZ and subsequent PHN. The present study aims to update an earlier evaluation estimating the cost-effectiveness of the HZ vaccine from a Swiss third party payer perspective. It takes into account updated vaccine prices, a different age cohort, latest clinical data and burden of illness data. A Markov model was developed to simulate the lifetime consequences of vaccinating 15% of the Swiss population aged 65-79 y. Information from sentinel data, official statistics and published literature were used. Endpoints assessed were number of HZ and PHN cases, quality-adjusted life years (QALYs), costs of hospitalizations, consultations and prescriptions. Based on a vaccine price of CHF 162, the vaccination strategy accrued additional costs of CHF 17,720,087 and gained 594 QALYs. The incremental cost-effectiveness ratio (ICER) was CHF 29,814 per QALY gained. Sensitivity analyses showed that the results were most sensitive to epidemiological inputs, utility values, discount rates, duration of vaccine efficacy, and vaccine price. Probabilistic sensitivity analyses indicated a more than 99% chance that the ICER was below 40,000 CHF per QALY. Findings were in line with existing cost-effectiveness analyses of HZ vaccination. This updated study supports the value of an HZ vaccination strategy targeting the Swiss population aged 65-79 y.

  4. Herpes zoster vaccine: A health economic evaluation for Switzerland

    PubMed Central

    Blank, Patricia R.; Ademi, Zanfina; Lu, Xiaoyan; Szucs, Thomas D.; Schwenkglenks, Matthias

    2017-01-01

    ABSTRACT Herpes zoster (HZ) or “shingles” results from a reactivation of the varicella zoster virus (VZV) acquired during primary infection (chickenpox) and surviving in the dorsal root ganglia. In about 20% of cases, a complication occurs, known as post-herpetic neuralgia (PHN). A live attenuated vaccine against VZV is available for the prevention of HZ and subsequent PHN. The present study aims to update an earlier evaluation estimating the cost-effectiveness of the HZ vaccine from a Swiss third party payer perspective. It takes into account updated vaccine prices, a different age cohort, latest clinical data and burden of illness data. A Markov model was developed to simulate the lifetime consequences of vaccinating 15% of the Swiss population aged 65–79 y. Information from sentinel data, official statistics and published literature were used. Endpoints assessed were number of HZ and PHN cases, quality-adjusted life years (QALYs), costs of hospitalizations, consultations and prescriptions. Based on a vaccine price of CHF 162, the vaccination strategy accrued additional costs of CHF 17,720,087 and gained 594 QALYs. The incremental cost-effectiveness ratio (ICER) was CHF 29,814 per QALY gained. Sensitivity analyses showed that the results were most sensitive to epidemiological inputs, utility values, discount rates, duration of vaccine efficacy, and vaccine price. Probabilistic sensitivity analyses indicated a more than 99% chance that the ICER was below 40,000 CHF per QALY. Findings were in line with existing cost-effectiveness analyses of HZ vaccination. This updated study supports the value of an HZ vaccination strategy targeting the Swiss population aged 65–79 y. PMID:28481678

  5. 19 CFR 10.21 - Updating cost data and other information.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

  6. 19 CFR 10.21 - Updating cost data and other information.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

  7. 19 CFR 10.21 - Updating cost data and other information.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

  8. 19 CFR 10.21 - Updating cost data and other information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

  9. Working paper : national costs of the metropolitan ITS infrastructure : updated with 2004 deployment data

    DOT National Transportation Integrated Search

    The purpose of this report, "Working Paper National Costs of the Metropolitan ITS infrastructure: Updated with 2004 Deployment Data," is to update the estimates of the costs remaining to deploy Intelligent Transportation Systems (ITS) infrastructure ...

  10. Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature

    PubMed Central

    Wilffert, Bob; Boersma, Cornelis; Annemans, Lieven; Vegter, Stefan; van Boven, Job F. M.; Postma, Maarten J.

    2016-01-01

    Objective Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature. Methods A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies’ overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument. Results We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing. Conclusions Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests’ efficacy remains of utmost importance. PMID:26752539

  11. Working paper : national costs of the metropolitan ITS infrastructure : updated with 2005 deployment data

    DOT National Transportation Integrated Search

    2006-07-01

    The purpose of this report, "Working Paper National Costs of the Metropolitan ITS Infrastructure: Updated with 2005 Deployment Data," is to update the estimates of the costs remaining to fully deploy Intelligent Transportation Systems (ITS) infrastru...

  12. A Comparison of Various Estimators for Updating Forest Area Coverage Using AVHRR and Forest Inventory Data

    Treesearch

    Francis A. Roesch; Paul C. van Deusen; Zhiliang Zhu

    1995-01-01

    Various methods of adjusting low-cost and possibly biased estimates of percent forest coverage from AVHRR data with a subsample of higher-cost estimates from the USDA Forest Service's Forest Inventory and Analysis plots were investigated. Two ratio and two regression estimators were evaluated. Previous work (Zhu and Teuber, 1991) finding that the estimates from...

  13. [Calculation of standardised unit costs from a societal perspective for health economic evaluation].

    PubMed

    Bock, J-O; Brettschneider, C; Seidl, H; Bowles, D; Holle, R; Greiner, W; König, H H

    2015-01-01

    Due to demographic aging, economic evaluation of health care technologies for the elderly becomes more important. A standardised questionnaire to measure the health-related resource utilisation has been designed. The monetary valuation of the resource use documented by the questionnaire is a central step towards the determination of the corresponding costs. The aim of this paper is to provide unit costs for the resources in the questionnaire from a societal perspective. The unit costs are calculated pragmatically based on regularly published sources. Thus, an easy update is possible. This paper presents the calculated unit costs for outpatient medical care, inpatient care, informal and formal nursing care and pharmaceuticals from a societal perspective. The calculated unit costs can serve as a reference case in health economic evaluations and hence help to increase their comparability. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Updated Health Effects Assessment for Chloroform

    EPA Science Inventory

    This report summarizes and evaluates infornation relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analys...

  15. Updated Health Effects Assessment for Acetone

    EPA Science Inventory

    This report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analys...

  16. Mental health economics, health service provision, and the practice of geriatric psychiatry.

    PubMed

    Suh, Guk-Hee; Han, Changsu

    2008-11-01

    Economic evaluation is becoming more and more important as a means to assist policy makers in choosing the best intervention or treatment against a pervasive scarcity of resources relative to the demands. Health service provision and the practice of geriatric psychiatry are closely associated with costs and outcomes of health economics. Recently published literature raising unanswered questions in these areas is reviewed. Some studies on the costs, outcomes, and cost-effectiveness of certain interventions or treatments (e.g. respite care, home-visiting community service) compared with usual strategies show that these are not optimal in terms of health economics. The updated guidance by the National Institute for Health and Clinical Excellence that cholinesterase inhibitors should be used only for moderate severity dementia on the grounds of cost-effectiveness has been heavily criticized. Mental health provision for older people varies across 'developed' and 'developing' countries. Updated findings provide better understanding of recent progress and issues on mental health economics, health service provision, and the practice of geriatric psychiatry. The application of health economics to the field of mental health should make complicated issues simple and explicit. Constructive criticisms and scientific debates will hasten the development of better tools or methodologies to evaluate the cost-effectiveness of current and new interventions or treatments.

  17. 47 CFR 64.903 - Cost allocation manuals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... Annual cost allocation manual updates shall be filed on or before the last working day of each calendar... update their cost allocation manuals at least annually, except that changes to the cost apportionment...

  18. 47 CFR 64.903 - Cost allocation manuals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... Annual cost allocation manual updates shall be filed on or before the last working day of each calendar... update their cost allocation manuals at least annually, except that changes to the cost apportionment...

  19. 47 CFR 64.903 - Cost allocation manuals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... Annual cost allocation manual updates shall be filed on or before the last working day of each calendar... update their cost allocation manuals at least annually, except that changes to the cost apportionment...

  20. 47 CFR 64.903 - Cost allocation manuals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... Annual cost allocation manual updates shall be filed on or before the last working day of each calendar... update their cost allocation manuals at least annually, except that changes to the cost apportionment...

  1. State Energy Efficiency Program Evaluation Inventory

    EIA Publications

    2013-01-01

    The focus of this inventory, some of which has been placed into a searchable spreadsheet, is to support the National Energy Modeling System (NEMS) and to research cost information in state-mandated energy efficiency program evaluations – e.g., for use in updating analytic and modeling assumptions used by the U.S. Energy Information Administration (EIA).

  2. 77 FR 10650 - Annual Update of Filing Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... updating is to adjust the fees on the basis of the Commission's costs for Fiscal Year 2011. DATES... establishing updated fees on the basis of the Commission's Fiscal Year 2011 costs. The adjusted fees announced...] Annual Update of Filing Fees AGENCY: Federal Energy Regulatory Commission, DOE. ACTION: Final rule...

  3. 78 FR 2880 - Annual Update of Filing Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-15

    ... updating is to adjust the fees on the basis of the Commission's costs for Fiscal Year 2012. DATES... establishing updated fees on the basis of the Commission's Fiscal Year 2012 costs. The adjusted fees announced...] Annual Update of Filing Fees AGENCY: Federal Energy Regulatory Commission, DOE. ACTION: Final rule...

  4. 42 CFR 412.328 - Determining and updating the hospital-specific rate.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-year cost reporting period—(1) Last 12 month cost reporting period ending on or before December 31... intermediary updates the case-mix adjusted base period costs per discharge to FY 1992 based on the national... determined under paragraph (d) of this section by the following factors: (1) Update factor. After FY 1992...

  5. 42 CFR 412.328 - Determining and updating the hospital-specific rate.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-year cost reporting period—(1) Last 12 month cost reporting period ending on or before December 31... intermediary updates the case-mix adjusted base period costs per discharge to FY 1992 based on the national... determined under paragraph (d) of this section by the following factors: (1) Update factor. After FY 1992...

  6. 42 CFR 412.328 - Determining and updating the hospital-specific rate.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-year cost reporting period—(1) Last 12 month cost reporting period ending on or before December 31... intermediary updates the case-mix adjusted base period costs per discharge to FY 1992 based on the national... determined under paragraph (d) of this section by the following factors: (1) Update factor. After FY 1992...

  7. 42 CFR 412.328 - Determining and updating the hospital-specific rate.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-year cost reporting period—(1) Last 12 month cost reporting period ending on or before December 31... intermediary updates the case-mix adjusted base period costs per discharge to FY 1992 based on the national... determined under paragraph (d) of this section by the following factors: (1) Update factor. After FY 1992...

  8. Health Effects Assessment for Carbon Tetrachloride (Updated 1989)

    EPA Science Inventory

    This report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analys...

  9. Road weather management performance measures : 2012 update.

    DOT National Transportation Integrated Search

    1997-01-01

    The goal of the cost analysis of the ITS National Architecture program is twofold. First, the evaluation is to produce a high-level estimate of the expenditures associated with implementing the physical elements and the functional capabilities of ITS...

  10. Cost-effectiveness analysis of quadrivalent influenza vaccination in at-risk adults and the elderly: an updated analysis in the U.K.

    PubMed

    Meier, G; Gregg, M; Poulsen Nautrup, B

    2015-01-01

    To update an earlier evaluation estimating the cost-effectiveness of quadrivalent influenza vaccination (QIV) compared with trivalent influenza vaccination (TIV) in the adult population currently recommended for influenza vaccination in the UK (all people aged ≥65 years and people aged 18-64 years with clinical risk conditions). This analysis takes into account updated vaccine prices, reference costs, influenza strain circulation, and burden of illness data. A lifetime, multi-cohort, static Markov model was constructed with seven age groups. The model was run in 1-year cycles for a lifetime, i.e., until the youngest patients at entry reached the age of 100 years. The base-case analysis was from the perspective of the UK National Health Service, with a secondary analysis from the societal perspective. Costs and benefits were discounted at 3.5%. Herd effects were not included. Inputs were derived from systematic reviews, peer-reviewed articles, and government publications and databases. One-way and probabilistic sensitivity analyses were performed. In the base-case, QIV would be expected to avoid 1,413,392 influenza cases, 41,780 hospitalizations, and 19,906 deaths over the lifetime horizon, compared with TIV. The estimated incremental cost-effectiveness ratio (ICER) was £14,645 per quality-adjusted life-year (QALY) gained. From the societal perspective, the estimated ICER was £13,497/QALY. A strategy of vaccinating only people aged ≥65 years had an estimated ICER of £11,998/QALY. Sensitivity analysis indicated that only two parameters, seasonal variation in influenza B matching and influenza A circulation, had a substantial effect on the ICER. QIV would be likely to be cost-effective compared with TIV in 68% of simulations with a willingness-to-pay threshold of <£20,000/QALY and 87% with a willingness-to-pay threshold of <£30,000/QALY. In this updated analysis, QIV was estimated to be cost-effective compared with TIV in the U.K.

  11. Belgian guidelines for economic evaluations: second edition.

    PubMed

    Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina

    2014-12-01

    The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.

  12. The Next Step: Managing Your District's Technology Operations.

    ERIC Educational Resources Information Center

    Pereus, Stephen C.

    2001-01-01

    Discusses benefits and especially risks involved with educational technology: unexpected costs; possible negative effects on student achievement; legal, ethical, and security issues; and resistance to change. Success ensues from providing leadership and vision, updating technology planning, evaluating alternatives, setting standards, involving…

  13. Update of the Dutch manual for costing studies in health care

    PubMed Central

    Kanters, Tim A.; Bouwmans, Clazien A. M.; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

    2017-01-01

    Objectives Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. Methods An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. Results The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. Conclusions The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines. PMID:29121647

  14. Update of the Dutch manual for costing studies in health care.

    PubMed

    Kanters, Tim A; Bouwmans, Clazien A M; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

    2017-01-01

    Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines.

  15. Capital update factor: a new era approaches.

    PubMed

    Grimaldi, P L

    1993-02-01

    The Health Care Financing Administration (HCFA) has constructed a preliminary model of a new capital update method which is consistent with the framework being developed to refine the update method for PPS operating costs. HCFA's eventual goal is to develop a single update framework for operating and capital costs. Initial results suggest that adopting the new capital update method would reduce capital payments substantially, which might intensify creditor's concerns about extending loans to hospitals.

  16. Useful Life | Energy Analysis | NREL

    Science.gov Websites

    Useful Life Useful Life Transparent Cost Database Button The table below gives ranges on useful seeking utility-scale technology cost and performance estimates, please visit the Transparent Cost Cost (February 2016 Update) Operations & Maintenance (February 2016 Update) Utility-Scale Capacity

  17. Re-examination of sea lamprey control policies for the St. Marys River: Completion of an adaptive management cycle

    USGS Publications Warehouse

    Jones, Michael L.; Brenden, Travis O.; Irwin, Brian J.

    2015-01-01

    The St. Marys River (SMR) historically has been a major producer of sea lampreys (Petromyzon marinus) in the Laurentian Great Lakes. In the early 2000s, a decision analysis (DA) project was conducted to evaluate sea lamprey control policies for the SMR; this project suggested that an integrated policy of trapping, sterile male releases, and Bayluscide treatment was the most cost-effective policy. Further, it concluded that formal assessment of larval sea lamprey abundance and distribution in the SMR would be valuable for future evaluation of control strategies. We updated this earlier analysis, adding information from annual larval assessments conducted since 1999 and evaluating additional control policies. Bayluscide treatments continued to be critical for sea lamprey control, but high recruitment compensation minimized the effectiveness of trapping and sterile male release under current feasible ranges. Because Bayluscide control is costly, development of strategies to enhance trapping success remains a priority. This study illustrates benefits of an adaptive management cycle, wherein models inform decisions, are updated based on learning achieved from those decisions, and ultimately inform future decisions.

  18. Burden of disease and costs of exposure to endocrine disrupting chemicals in the European Union: an updated analysis.

    PubMed

    Trasande, L; Zoeller, R T; Hass, U; Kortenkamp, A; Grandjean, P; Myers, J P; DiGangi, J; Hunt, P M; Rudel, R; Sathyanarayana, S; Bellanger, M; Hauser, R; Legler, J; Skakkebaek, N E; Heindel, J J

    2016-07-01

    A previous report documented that endocrine disrupting chemicals contribute substantially to certain forms of disease and disability. In the present analysis, our main objective was to update a range of health and economic costs that can be reasonably attributed to endocrine disrupting chemical exposures in the European Union, leveraging new burden and disease cost estimates of female reproductive conditions from accompanying report. Expert panels evaluated the epidemiologic evidence, using adapted criteria from the WHO Grading of Recommendations Assessment, Development and Evaluation Working Group, and evaluated laboratory and animal evidence of endocrine disruption using definitions recently promulgated by the Danish Environmental Protection Agency. The Delphi method was used to make decisions on the strength of the data. Expert panels consensus was achieved for probable (>20%) endocrine disrupting chemical causation for IQ loss and associated intellectual disability; autism; attention deficit hyperactivity disorder; endometriosis; fibroids; childhood obesity; adult obesity; adult diabetes; cryptorchidism; male infertility, and mortality associated with reduced testosterone. Accounting for probability of causation, and using the midpoint of each range for probability of causation, Monte Carlo simulations produced a median annual cost of €163 billion (1.28% of EU Gross Domestic Product) across 1000 simulations. We conclude that endocrine disrupting chemical exposures in the EU are likely to contribute substantially to disease and dysfunction across the life course with costs in the hundreds of billions of Euros per year. These estimates represent only those endocrine disrupting chemicals with the highest probability of causation; a broader analysis would have produced greater estimates of burden of disease and costs. © 2016 American Society of Andrology and European Academy of Andrology.

  19. Online Videoconferencing Products: Update

    ERIC Educational Resources Information Center

    Burton, Douglas; Kitchen, Tim

    2011-01-01

    Software allowing real-time online video connectivity is rapidly evolving. The ability to connect students, staff, and guest speakers instantaneously carries great benefits for the online distance education classroom. This evaluation report compares four software applications at opposite ends of the cost spectrum: "DimDim", "Elluminate VCS",…

  20. 77 FR 2680 - Defense Federal Acquisition Regulation Supplement; Definition of Cost or Pricing Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-19

    ... Regulation Supplement; Definition of Cost or Pricing Data AGENCY: Defense Acquisition Regulations System... Acquisition Regulation Supplement (DFARS) to update text addressing the definition of cost or pricing data... update the DFARS for consistency with FAR changes addressing the definition of cost or pricing data...

  1. Economic Costs of Alcohol and Drug Abuse in Texas: 1997 Update.

    ERIC Educational Resources Information Center

    Liu, Liang Y.

    This report provides an update of the costs of alcohol and drug abuse for 1997. The 1997 costs were estimated by multiplying the percent changes in various socioeconomic factors from 1989 to 1997 by the cost estimates. The adverse health and social consequences of substance abuse extensively increased costs to the state. The total economic costs…

  2. 75 FR 3987 - Annual Update of Filing Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... updating is to adjust the fees on the basis of the Commission's costs for Fiscal Year 2009. DATES... fees on the basis of the Commission's Fiscal Year 2009 costs. The adjusted fees announced in this...] Annual Update of Filing Fees January 20, 2010. AGENCY: Federal Energy Regulatory Commission. ACTION...

  3. 76 FR 9641 - Annual Update of Filing Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... purpose of updating is to adjust the fees on the basis of the Commission's costs for Fiscal Year 2010... basis of the Commission's Fiscal Year 2010 costs. The adjusted fees announced in this notice are...] Annual Update of Filing Fees February 14, 2011. AGENCY: Federal Energy Regulatory Commission, Energy...

  4. Modifications of ORNL's computer programs MSF-21 and VTE-21 for the evaluation and rapid optimization of multistage flash and vertical tube evaporators

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

    Glueckstern, P.; Wilson, J.V.; Reed, S.A.

    1976-06-01

    Design and cost modifications were made to ORNL's Computer Programs MSF-21 and VTE-21 originally developed for the rapid calculation and design optimization of multistage flash (MSF) and multieffect vertical tube evaporator (VTE) desalination plants. The modifications include additional design options to make possible the evaluation of desalting plants based on current technology (the original programs were based on conceptual designs applying advanced and not yet proven technological developments and design features) and new materials and equipment costs updated to mid-1975.

  5. Communications systems technology assessment study. Volume 2: Results

    NASA Technical Reports Server (NTRS)

    Kelley, R. L.; Khatri, R. K.; Kiesling, J. D.; Weiss, J. A.

    1977-01-01

    The cost and technology characteristics are examined for providing special satellite services at UHF, 2.5 GHz, and 14/12 GHz. Considered are primarily health, educational, informational and emergency disaster type services. The total cost of each configuration including space segment, earth station, installation operation and maintenance was optimized to reduce the user's total annual cost and establish preferred equipment performance parameters. Technology expected to be available between now and 1985 is identified and comparisons made between selected alternatives. A key element of the study is a survey of earth station equipment updating past work in the field, providing new insight into technology, and evaluating production and test methods that can reduce costs in large production runs. Various satellite configurations were examined. The cost impact of rain attenuation at Ku-band was evaluated. The factors affecting the ultimate capacity achievable with the available orbital arc and available bandwidth were analyzed.

  6. [Reduce Energy Costs While Maintaining Healthy IAQ.] "Indoor Air Quality Tools for Schools" Update #17

    ERIC Educational Resources Information Center

    US Environmental Protection Agency, 2009

    2009-01-01

    This issue of "Indoor Air Quality Tools for Schools" Update ("IAQ TfS" Update) contains the following items: (1) News and Events; (2) Feature Article: Reduce Energy Costs while Maintaining Healthy IAQ; (3) Insight into Excellence: North East Independent School District ; (4) School Building Week 2009; and (5) Have Your Questions Answered!

  7. 77 FR 19425 - Prescription Drugs Not Administered During Treatment; Update to Administrative Cost for Calendar...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... that requires automobile accident reparations insurance. This updated administrative cost charge was... automobile accident reparations insurance, ``charges billed separately for such prescription drugs will...

  8. Introducing GEOPHIRES v2.0: Updated Geothermal Techno-Economic Simulation Tool: Preprint

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

    Beckers, Koenraad J; McCabe, Kevin

    This paper presents an updated version of the geothermal techno-economic simulation tool GEOPHIRES (GEOthermal Energy for Production of Heat and electricity (IR) Economically Simulated). GEOPHIRES combines reservoir, wellbore, surface plant and economic models to estimate the capital, and operation and maintenance costs, lifetime energy production, and overall levelized cost of energy of a geothermal plant. The available end-use options are electricity, direct-use heat and cogeneration. The main updates in the new version include conversion of the source code from FORTRAN to Python, the option to couple to an external reservoir simulator, updated cost correlations, and more flexibility in selecting themore » time step and number of injection and production wells. An overview of all the updates and two case-studies to illustrate the tool's new capabilities are provided in this paper.« less

  9. An updated comprehensive techno-economic analysis of algae biodiesel.

    PubMed

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

    2013-10-01

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

  10. 49 CFR 611.207 - Overall New Starts project ratings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... evaluation. (2) Ratings for individual projects will be developed upon entry into engineering and prior to an FFGA. Additionally, ratings may be updated while a project is in engineering if the project scope and cost have changed materially since the most recent rating was assigned. (c) These ratings will be used...

  11. 42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... October 1, 2002, is the percentage increase projected by the hospital market basket index. (4) Target... target amount for the previous cost reporting period, updated by the market basket percentage increase... each cost reporting period, the ceiling is determined by multiplying the updated target amount, as...

  12. Introducing GEOPHIRES v2.0: Updated Geothermal Techno-Economic Simulation Tool

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

    Beckers, Koenraad J; McCabe, Kevin

    This paper presents an updated version of the geothermal techno-economic simulation tool GEOPHIRES (GEOthermal energy for Production of Heat and electricity ('IR') Economically Simulated). GEOPHIRES combines engineering models of the reservoir, wellbores, and surface plant facilities of a geothermal plant with an economic model to estimate the capital and operation and maintenance costs, lifetime energy production, and overall levelized cost of energy. The available end-use options are electricity, direct-use heat, and cogeneration. The main updates in the new version include conversion of the source code from FORTRAN to Python, the option to import temperature data (e.g., measured or from stand-alonemore » reservoir simulator), updated cost correlations, and more flexibility in selecting the time step and number of injection and production wells. In this paper, we provide an overview of all the updates and two case studies to illustrate the tool's new capabilities.« less

  13. 78 FR 47336 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... provides an updated cost/benefit analysis providing an assessment of the benefits attained by HUD through... the scope of the existing computer matching program to now include the updated cost/ benefit analysis... change, and find a continued favorable examination of benefit/cost results; and (2) All parties certify...

  14. Impact of the proposed energy tax on nuclear electric generating technologies

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

    Edmunds, T.A.; Lamont, A.D.; Pasternak, A.D.

    1993-05-01

    The President`s new economic initiatives include an energy tax that will affect the costs of power from most electric generating technologies. The tax on nuclear power could be applied in a number of different ways at several different points in the fuel cycle. These different approaches could have different effects on the generation costs and benefits of advanced reactors. The Office of Nuclear Energy has developed models for assessing the costs and benefits of advanced reactor cycles which must be updated to take into account the impacts of the proposed tax. This report has been prepared to assess the spectrummore » of impacts of the energy tax on nuclear power and can be used in updating the Office`s economic models. This study was conducted in the following steps. First, the most authoritative statement of the proposed tax available at this time was obtained. Then the impacts of the proposed tax on the costs of nuclear and fossil fueled generation were compared. Finally several other possible approaches to taxing nuclear energy were evaluated. The cost impact on several advanced nuclear technologies and a current light water technology were computed. Finally, the rationale for the energy tax as applied to various electric generating methods was examined.« less

  15. Working Memory Updating Latency Reflects the Cost of Switching between Maintenance and Updating Modes of Operation

    ERIC Educational Resources Information Center

    Kessler, Yoav; Oberauer, Klaus

    2014-01-01

    Updating and maintenance of information are 2 conflicting demands on working memory (WM). We examined the time required to update WM (updating latency) as a function of the sequence of updated and not-updated items within a list. Participants held a list of items in WM and updated a variable subset of them in each trial. Four experiments that vary…

  16. Ensemble Kalman Filter versus Ensemble Smoother for Data Assimilation in Groundwater Modeling

    NASA Astrophysics Data System (ADS)

    Li, L.; Cao, Z.; Zhou, H.

    2017-12-01

    Groundwater modeling calls for an effective and robust integrating method to fill the gap between the model and data. The Ensemble Kalman Filter (EnKF), a real-time data assimilation method, has been increasingly applied in multiple disciplines such as petroleum engineering and hydrogeology. In this approach, the groundwater models are sequentially updated using measured data such as hydraulic head and concentration data. As an alternative to the EnKF, the Ensemble Smoother (ES) was proposed with updating models using all the data together, and therefore needs a much less computational cost. To further improve the performance of the ES, an iterative ES was proposed for continuously updating the models by assimilating measurements together. In this work, we compare the performance of the EnKF, the ES and the iterative ES using a synthetic example in groundwater modeling. The hydraulic head data modeled on the basis of the reference conductivity field are utilized to inversely estimate conductivities at un-sampled locations. Results are evaluated in terms of the characterization of conductivity and groundwater flow and solute transport predictions. It is concluded that: (1) the iterative ES could achieve a comparable result with the EnKF, but needs a less computational cost; (2) the iterative ES has the better performance than the ES through continuously updating. These findings suggest that the iterative ES should be paid much more attention for data assimilation in groundwater modeling.

  17. Spacecraft Complexity Subfactors and Implications on Future Cost Growth

    NASA Technical Reports Server (NTRS)

    Leising, Charles J.; Wessen, Randii; Ellyin, Ray; Rosenberg, Leigh; Leising, Adam

    2013-01-01

    During the last ten years the Jet Propulsion Laboratory has used a set of cost-risk subfactors to independently estimate the magnitude of development risks that may not be covered in the high level cost models employed during early concept development. Within the last several years the Laboratory has also developed a scale of Concept Maturity Levels with associated criteria to quantitatively assess a concept's maturity. This latter effort has been helpful in determining whether a concept is mature enough for accurate costing but it does not provide any quantitative estimate of cost risk. Unfortunately today's missions are significantly more complex than when the original cost-risk subfactors were first formulated. Risks associated with complex missions are not being adequately evaluated and future cost growth is being underestimated. The risk subfactor process needed to be updated.

  18. Alcoholism in the Navy: An Updated Cost Study.

    DTIC Science & Technology

    1987-09-01

    ivism ............................ 21 f. Psychodrama ........................... 22 g . O fficers .............................. 22 h . Women...are organized very similar to where the ARC’s and ARU’s were in 1972. However, today’s programs include psychodrama , couples group and physical...evaluation by the commanding officer, change in psychological test data, discharge, recidivism, psychodrama , officers, women, biofeedback/stress reduction

  19. Update on EPA’s ToxCast Program: Providing High Throughput Decision Support Tools for Chemical Risk Management

    EPA Science Inventory

    The field of toxicology is on the cusp of a major transformation in how the safety and hazard of chemicals are evaluated for potential effects on human health and the environment. Brought on by the recognition of the limitations of the current paradigm in terms of cost, time, and...

  20. Benefits from remote sensing data utilization in urban planning processes and system recommendations

    NASA Technical Reports Server (NTRS)

    Mallon, H. J.; Howard, J. Y.

    1972-01-01

    The benefits of utilizing remote sensor data in the urban planning process of the Metropolitan Washington Council of Governments are investigated. An evaluation of sensor requirements, a description/ comparison of costs, benefits, levels of accuracy, ease of attainment, and frequency of update possible using sensor versus traditional data acquisition techniques are discussed.

  1. High-efficiency wavefunction updates for large scale Quantum Monte Carlo

    NASA Astrophysics Data System (ADS)

    Kent, Paul; McDaniel, Tyler; Li, Ying Wai; D'Azevedo, Ed

    Within ab intio Quantum Monte Carlo (QMC) simulations, the leading numerical cost for large systems is the computation of the values of the Slater determinants in the trial wavefunctions. The evaluation of each Monte Carlo move requires finding the determinant of a dense matrix, which is traditionally iteratively evaluated using a rank-1 Sherman-Morrison updating scheme to avoid repeated explicit calculation of the inverse. For calculations with thousands of electrons, this operation dominates the execution profile. We propose a novel rank- k delayed update scheme. This strategy enables probability evaluation for multiple successive Monte Carlo moves, with application of accepted moves to the matrices delayed until after a predetermined number of moves, k. Accepted events grouped in this manner are then applied to the matrices en bloc with enhanced arithmetic intensity and computational efficiency. This procedure does not change the underlying Monte Carlo sampling or the sampling efficiency. For large systems and algorithms such as diffusion Monte Carlo where the acceptance ratio is high, order of magnitude speedups can be obtained on both multi-core CPU and on GPUs, making this algorithm highly advantageous for current petascale and future exascale computations.

  2. 40 CFR 600.314-01 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. 600.314-01 Section 600... Model Year Automobiles-Labeling § 600.314-01 Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. (a) The label values established in § 600.312...

  3. 40 CFR 600.314-86 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. 600.314-86 Section 600... Model Year Automobiles-Labeling § 600.314-86 Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. (a) The label values established in § 600.312...

  4. Lignocellulosic Biomass to Ethanol Process Design and Economics Utilizing Co-Current Dilute Acid Prehydrolysis and Enzymatic Hydrolysis for Corn Stover

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

    Aden, A.; Ruth, M.; Ibsen, K.

    This report is an update of NREL's ongoing process design and economic analyses of processes related to developing ethanol from lignocellulosic feedstocks. The U.S. Department of Energy (DOE) is promoting the development of ethanol from lignocellulosic feedstocks as an alternative to conventional petroleum-based transportation fuels. DOE funds both fundamental and applied research in this area and needs a method for predicting cost benefits of many research proposals. To that end, the National Renewable Energy Laboratory (NREL) has modeled many potential process designs and estimated the economics of each process during the last 20 years. This report is an update ofmore » the ongoing process design and economic analyses at NREL. We envision updating this process design report at regular intervals; the purpose being to ensure that the process design incorporates all new data from NREL research, DOE funded research and other sources, and that the equipment costs are reasonable and consistent with good engineering practice for plants of this type. For the non-research areas this means using equipment and process approaches as they are currently used in industrial applications. For the last report, published in 1999, NREL performed a complete review and update of the process design and economic model for the biomass-to-ethanol process utilizing co-current dilute acid prehydrolysis with simultaneous saccharification (enzymatic) and co-fermentation. The process design included the core technologies being researched by the DOE: prehydrolysis, simultaneous saccharification and co-fermentation, and cellulase enzyme production. In addition, all ancillary areas--feed handling, product recovery and purification, wastewater treatment (WWT), lignin combustor and boiler-turbogenerator, and utilities--were included. NREL engaged Delta-T Corporation (Delta-T) to assist in the process design evaluation, the process equipment costing, and overall plant integration. The process design and costing for the lignin combustor and boiler turbogenerator was reviewed by Reaction Engineering Inc. (REI) and Merrick & Company reviewed the wastewater treatment. Since then, NREL has engaged Harris Group (Harris) to perform vendor testing, process design, and costing of critical equipment identified during earlier work. This included solid/liquid separation and pretreatment reactor design and costing. Corn stover handling was also investigated to support DOE's decision to focus on corn stover as a feedstock for lignocellulosic ethanol. Working with Harris, process design and costing for these areas were improved through vendor designs, costing, and vendor testing in some cases. In addition to this work, enzyme costs were adjusted to reflect collaborative work between NREL and enzyme manufacturers (Genencor International and Novozymes Biotech) to provide a delivered enzyme for lignocellulosic feedstocks. This report is the culmination of our work and represents an updated process design and cost basis for the process using a corn stover feedstock. The process design and economic model are useful for predicting the cost benefits of proposed research. Proposed research results can be translated into modifications of the process design, and the economic impact can be assessed. This allows DOE, NREL, and other researchers to set priorities on future research with an understanding of potential reductions to the ethanol production cost. To be economically viable, ethanol production costs must be below market values for ethanol. DOE has chosen a target ethanol selling price of $1.07 per gallon as a goal for 2010. The conceptual design and costs presented here are based on a 2010 plant start-up date. The key research targets required to achieve this design and the $1.07 value are discussed in the report.« less

  5. 40 CFR 600.314-08 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. 600.314-08 Section 600.314... Model Year Automobiles-Labeling § 600.314-08 Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. (a) The label values established in § 600.312...

  6. Criterios Farmacoeconómicos Usados en México para la Evaluación de Tratamientos en Personas en Fases Terminales.

    PubMed

    Rizo Ríos, Pedro; González Rivera, Aurora; Campos Ramírez, Odette; Lifshitz Guinzberg, Alberto

    2012-12-01

    In Mexico, the primary aim of "Healthcare Supplies Catalog" (CBCISS) is guide the optimization of public resources to the attention of the health problems of the country, through the use of medicines, treatments, procedures and devices which have proven safety, efficacy and efficiency. Since May 2003, the Commission of CBCISS established as a requirement for updating submits a Health Economic Evaluation (EE) of the product. Therefore, in 2008, was a prepared and published methodological guideline for the conduct of studies of economic value (GCEEE). In 2011 was developed some strategies as updated the Internal Regulations and developed the Evaluation Guide Health Products (GEIS); both complement the GCEEE and oriented between other things, to increased the availability of technologies in different public institutions, decreased likelihood to commit injustices and inequities in access to supplies and standardize a transparent process. With the epidemiological transition, the cares of patients with chronic or terminal phase are contributing to the escalating costs of health care. The escalating costs are driven by the use of therapies that unfortunately have only marginal benefits, increasing the health and social costs, and upholding financial sustainability of healthcare systems. Therefore the stakeholders must decide the order of preference and establish an allocation methodology. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Economic burden of seasonal influenza in the United States.

    PubMed

    Putri, Wayan C W S; Muscatello, David J; Stockwell, Melissa S; Newall, Anthony T

    2018-05-22

    Seasonal influenza is responsible for a large disease and economic burden. Despite the expanding recommendation of influenza vaccination, influenza has continued to be a major public health concern in the United States (U.S.). To evaluate influenza prevention strategies it is important that policy makers have current estimates of the economic burden of influenza. To provide an updated estimate of the average annual economic burden of seasonal influenza in the U.S. population in the presence of vaccination efforts. We evaluated estimates of age-specific influenza-attributable outcomes (ill-non medically attended, office-based outpatient visit, emergency department visits, hospitalizations and death) and associated productivity loss. Health outcome rates were applied to the 2015 U.S. population and multiplied by the relevant estimated unit costs for each outcome. We evaluated both direct healthcare costs and indirect costs (absenteeism from paid employment) reporting results from both a healthcare system and societal perspective. Results were presented in five age groups (<5 years, 5-17 years, 18-49 years, 50-64 years and ≥65 years of age). The estimated average annual total economic burden of influenza to the healthcare system and society was $11.2 billion ($6.3-$25.3 billion). Direct medical costs were estimated to be $3.2 billion ($1.5-$11.7 billion) and indirect costs $8.0 billion ($4.8-$13.6 billion). These total costs were based on the estimated average numbers of (1) ill-non medically attended patients (21.6 million), (2) office-based outpatient visits (3.7 million), (3) emergency department visit (0.65 million) (4) hospitalizations (247.0 thousand), (5) deaths (36.3 thousand) and (6) days of productivity lost (20.1 million). This study provides an updated estimate of the total economic burden of influenza in the U.S. Although we found a lower total cost than previously estimated, our results confirm that influenza is responsible for a substantial economic burden in the U.S. Copyright © 2018. Published by Elsevier Ltd.

  8. Cost-effectiveness of superficial femoral artery endovascular interventions in the UK and Germany: a modelling study

    PubMed Central

    Kearns, Benjamin C; Thomas, Steven M

    2017-01-01

    Objectives To assess the lifetime costs and cost-effectiveness of 5 endovascular interventions to treat superficial femoral arterial disease. Design A model-based health economic evaluation. An existing decision analytical model was used, with updated effectiveness data taken from the literature, and updated costs based on purchasing prices. Setting UK and German healthcare perspectives were considered. Participants Patients with intermittent claudication of the femoropopliteal arteries eligible for endovascular treatment. Methods UK and German healthcare perspectives were considered, as were different strategies for re-intervention. Interventions Percutaneous transluminal angioplasty (PTA) with bail-out bare metal stenting (assumed to represent the existing standard of care, and 4 alternatives: primary bare metal stents, drug-eluting stents, drug-eluting balloons (DEBs) and biomimetic stents). Primary outcome measures The incremental cost-effectiveness ratio between 2 treatments, defined as the incremental costs divided by the incremental quality-adjusted life years (QALYs). Results Use of a biomimetic stent, BioMimics 3D, was always estimated to dominate the other interventions, having lower lifetime costs and greater effectiveness, as measured by QALYs. Of the remaining interventions, DEBs were always the most effective, and PTA the least effective. There was uncertainty in the cost-effectiveness results, with key drivers being the costs and effectiveness of the biomimetic stent along with the costs of DEBs. Conclusions All 4 of the alternatives to PTA were more effective, with the biomimetic stent being the most cost-effective. As there was uncertainty in the results, and all of the interventions have different mechanisms of action, all 4 may be considered to be alternatives to PTA. PMID:28087551

  9. The role of change data in a land use and land cover map updating program

    USGS Publications Warehouse

    Milazzo, Valerie A.

    1981-01-01

    An assessment of current land use and a process for identifying and measuring change are needed to evaluate trends and problems associated with the use of our Nation's land resources. The U. S. Geological Survey is designing a program to maintain the currency of its land use and land cover maps and digital data base and to provide data on changes in our Nation's land use and land cover. Ways to produce and use change data in a map updating program are being evaluated. A dual role for change data is suggested. For users whose applications require specific polygon data on land use change, showing the locations of all individual category changes and detailed statistical data on these changes can be provided as byproducts of the map-revision process. Such products can be produced quickly and inexpensively either by conventional mapmaking methods or as specialized output from a computerized geographic information system. Secondly, spatial data on land use change are used directly for updating existing maps and statistical data. By incorporating only selected change data, maps and digital data can be updated in an efficient and timely manner without the need for complete and costly detailed remapping and redigitization of polygon data.

  10. 48 CFR 52.216-7 - Allowable Cost and Payment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... last disclosure of internal audit reports to the Government. (J) Annual internal audit plan of...-contract cost allowability limitations, and billing limitations. (v) The Contractor shall update the billings on all contracts to reflect the final settled rates and update the schedule of cumulative direct...

  11. Systematic review, network meta-analysis and economic evaluation of biological therapy for the management of active psoriatic arthritis.

    PubMed

    Cawson, Matthew Richard; Mitchell, Stephen Andrew; Knight, Chris; Wildey, Henry; Spurden, Dean; Bird, Alex; Orme, Michelle Elaine

    2014-01-20

    An updated economic evaluation was conducted to compare the cost-effectiveness of the four tumour necrosis factor (TNF)-α inhibitors adalimumab, etanercept, golimumab and infliximab in active, progressive psoriatic arthritis (PsA) where response to standard treatment has been inadequate. A systematic review was conducted to identify relevant, recently published studies and the new trial data were synthesised, via a Bayesian network meta-analysis (NMA), to estimate the relative efficacy of the TNF-α inhibitors in terms of Psoriatic Arthritis Response Criteria (PsARC) response, Health Assessment Questionnaire (HAQ) scores and Psoriasis Area and Severity Index (PASI). A previously developed economic model was updated with the new meta-analysis results and current cost data. The model was adapted to delineate patients by PASI 50%, 75% and 90% response rates to differentiate between psoriasis outcomes. All four licensed TNF-α inhibitors were significantly more effective than placebo in achieving PsARC response in patients with active PsA. Adalimumab, etanercept and infliximab were significantly more effective than placebo in improving HAQ scores in patients who had achieved a PsARC response and in improving HAQ scores in PsARC non-responders. In an analysis using 1,000 model simulations, on average etanercept was the most cost-effective treatment and, at the National Institute for Health and Care Excellence willingness-to-pay threshold of between £20,000 to £30,000, etanercept is the preferred option. The economic analysis agrees with the conclusions from the previous models, in that biologics are shown to be cost-effective for treating patients with active PsA compared with the conventional management strategy. In particular, etanercept is cost-effective compared with the other biologic treatments.

  12. Review of USACE Institutional Information Related to Evaluation of Incremental Changes in Water Resources Planning

    DTIC Science & Technology

    2011-03-01

    The Corps will deliver a more holistic approach to solving water resources chal- lenges that effectively considers the broad variety of economic ...scales, and standards for a balanced evaluation of economic , social, and environmental factors, should be updated and expanded to a level of detail...comparable to cur- rent standards for traditional benefit-cost analysis of economic objec- tives of a project” (pp 5–6). • “The Corps should ensure that

  13. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

  14. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

  15. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

  16. A novel edge-preserving nonnegative matrix factorization method for spectral unmixing

    NASA Astrophysics Data System (ADS)

    Bao, Wenxing; Ma, Ruishi

    2015-12-01

    Spectral unmixing technique is one of the key techniques to identify and classify the material in the hyperspectral image processing. A novel robust spectral unmixing method based on nonnegative matrix factorization(NMF) is presented in this paper. This paper used an edge-preserving function as hypersurface cost function to minimize the nonnegative matrix factorization. To minimize the hypersurface cost function, we constructed the updating functions for signature matrix of end-members and abundance fraction respectively. The two functions are updated alternatively. For evaluation purpose, synthetic data and real data have been used in this paper. Synthetic data is used based on end-members from USGS digital spectral library. AVIRIS Cuprite dataset have been used as real data. The spectral angle distance (SAD) and abundance angle distance(AAD) have been used in this research for assessment the performance of proposed method. The experimental results show that this method can obtain more ideal results and good accuracy for spectral unmixing than present methods.

  17. 75 FR 59680 - El Dorado County Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... Rural Schools and Community Self-Determination Act (Pub. L. 110-343) and in compliance with the Federal..., administrative costs update and a report out on outreach for proposals. DATES: The meeting will be held on... following business will be conducted: Review of the October field trip; administrative costs update and a...

  18. 78 FR 21352 - Update on Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... DEPARTMENT OF ENERGY Update on Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites AGENCY: Department of Energy. ACTION: Notice of the Title X claims during fiscal... at active uranium and thorium processing sites to remediate byproduct material generated as an...

  19. 78 FR 70586 - Technical Support Document: Technical Update of the Social Cost of Carbon for Regulatory Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... OFFICE OF MANAGEMENT AND BUDGET Technical Support Document: Technical Update of the Social Cost of... Budget, Executive Office of the President. ACTION: Notice of availability and request for comments. SUMMARY: The Office of Management and Budget (OMB) requests comments on the Technical Support Document...

  20. Update on the Costs of Depakote and Depakene.

    ERIC Educational Resources Information Center

    Feldstein, Jerome H.; Curtis, Judy L.

    1995-01-01

    This update on the costs of two anticonvulsant drugs points out that a substantial price increase for Depakene makes it nearly twice as expensive as Depakote and, thus, now makes Depakote the preferred drug over Depakene. Implications of price increases for treatment of individuals with mental retardation who exhibit behavior or mental disorders…

  1. A simplified economic filter for open-pit mining and heap-leach recovery of copper in the United States

    USGS Publications Warehouse

    Long, Keith R.; Singer, Donald A.

    2001-01-01

    Determining the economic viability of mineral deposits of various sizes and grades is a critical task in all phases of mineral supply, from land-use management to mine development. This study evaluates two simple tools for estimating the economic viability of porphyry copper deposits mined by open-pit, heap-leach methods when only limited information on these deposits is available. These two methods are useful for evaluating deposits that either (1) are undiscovered deposits predicted by a mineral resource assessment, or (2) have been discovered but for which little data has been collected or released. The first tool uses ordinary least-squared regression analysis of cost and operating data from selected deposits to estimate a predictive relationship between mining rate, itself estimated from deposit size, and capital and operating costs. The second method uses cost models developed by the U.S. Bureau of Mines (Camm, 1991) updated using appropriate cost indices. We find that the cost model method works best for estimating capital costs and the empirical model works best for estimating operating costs for mines to be developed in the United States.

  2. Integrated use of spatial and semantic relationships for extracting road networks from floating car data

    NASA Astrophysics Data System (ADS)

    Li, Jun; Qin, Qiming; Xie, Chao; Zhao, Yue

    2012-10-01

    The update frequency of digital road maps influences the quality of road-dependent services. However, digital road maps surveyed by probe vehicles or extracted from remotely sensed images still have a long updating circle and their cost remain high. With GPS technology and wireless communication technology maturing and their cost decreasing, floating car technology has been used in traffic monitoring and management, and the dynamic positioning data from floating cars become a new data source for updating road maps. In this paper, we aim to update digital road maps using the floating car data from China's National Commercial Vehicle Monitoring Platform, and present an incremental road network extraction method suitable for the platform's GPS data whose sampling frequency is low and which cover a large area. Based on both spatial and semantic relationships between a trajectory point and its associated road segment, the method classifies each trajectory point, and then merges every trajectory point into the candidate road network through the adding or modifying process according to its type. The road network is gradually updated until all trajectories have been processed. Finally, this method is applied in the updating process of major roads in North China and the experimental results reveal that it can accurately derive geometric information of roads under various scenes. This paper provides a highly-efficient, low-cost approach to update digital road maps.

  3. The role of ERTS in the establishment and of a nationwide land cover information system

    NASA Technical Reports Server (NTRS)

    Abram, P.; Tullos, J.

    1974-01-01

    The economic potential of utilizing an ERTS type satellite in the development, updating, and maintenance of a nation-wide land cover information system in the post-1977 time frame was examined. Several alternative acquisition systems were evaluated for land cover data acquisition, processing, and interpretation costs in order to determine, on a total life cycle cost basis, under which conditions of user demand (i.e., area of coverage, frequency of coverage, timeliness of information, and level of information detail) an ERTS type satellite would be cost effective, and what the annual cost savings benefits would be. It was concluded that a three satellite system with high and low altitude aircraft and ground survey team utilizing automatic interpretation and classification techniques is an economically sound proposal.

  4. An Ensemble-Based Smoother with Retrospectively Updated Weights for Highly Nonlinear Systems

    NASA Technical Reports Server (NTRS)

    Chin, T. M.; Turmon, M. J.; Jewell, J. B.; Ghil, M.

    2006-01-01

    Monte Carlo computational methods have been introduced into data assimilation for nonlinear systems in order to alleviate the computational burden of updating and propagating the full probability distribution. By propagating an ensemble of representative states, algorithms like the ensemble Kalman filter (EnKF) and the resampled particle filter (RPF) rely on the existing modeling infrastructure to approximate the distribution based on the evolution of this ensemble. This work presents an ensemble-based smoother that is applicable to the Monte Carlo filtering schemes like EnKF and RPF. At the minor cost of retrospectively updating a set of weights for ensemble members, this smoother has demonstrated superior capabilities in state tracking for two highly nonlinear problems: the double-well potential and trivariate Lorenz systems. The algorithm does not require retrospective adaptation of the ensemble members themselves, and it is thus suited to a streaming operational mode. The accuracy of the proposed backward-update scheme in estimating non-Gaussian distributions is evaluated by comparison to the more accurate estimates provided by a Markov chain Monte Carlo algorithm.

  5. 76 FR 46628 - Regulations Governing Fees for Services Performed in Connection With Licensing and Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ... Services--2011 Update AGENCY: Surface Transportation Board. ACTION: Final rule. SUMMARY: The Board adopts... decreased costs, resulting from a freeze on wage and salary increases in 2011, coupled with changes to the... adopted here reflect a combination of the unchanged wage and salary costs from the 2010 User Fee Update...

  6. 76 FR 72912 - TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the data necessary to update the FY 2012 rates.

  7. 78 FR 65618 - TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios, and the data necessary to update the FY 2014 rates.

  8. 77 FR 71180 - TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-29

    ...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the data necessary to update the FY 2013 rates.

  9. Landfill Gas Energy Cost Model Version 3.0 (LFGcost-Web V3 ...

    EPA Pesticide Factsheets

    To help stakeholders estimate the costs of a landfill gas (LFG) energy project, in 2002, LMOP developed a cost tool (LFGcost). Since then, LMOP has routinely updated the tool to reflect changes in the LFG energy industry. Initially the model was designed for EPA to assist landfills in evaluating the economic and financial feasibility of LFG energy project development. In 2014, LMOP developed a public version of the model, LFGcost-Web (Version 3.0), to allow landfill and industry stakeholders to evaluate project feasibility on their own. LFGcost-Web can analyze costs for 12 energy recovery project types. These project costs can be estimated with or without the costs of a gas collection and control system (GCCS). The EPA used select equations from LFGcost-Web to estimate costs of the regulatory options in the 2015 proposed revisions to the MSW Landfills Standards of Performance (also known as New Source Performance Standards) and the Emission Guidelines (herein thereafter referred to collectively as the Landfill Rules). More specifically, equations derived from LFGcost-Web were applied to each landfill expected to be impacted by the Landfill Rules to estimate annualized installed capital costs and annual O&M costs of a gas collection and control system. In addition, after applying the LFGcost-Web equations to the list of landfills expected to require a GCCS in year 2025 as a result of the proposed Landfill Rules, the regulatory analysis evaluated whether electr

  10. Costing evidence for health care decision-making in Austria: A systematic review.

    PubMed

    Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata; Simon, Judit

    2017-01-01

    With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. A systematic literature review of English and German language peer-reviewed as well as grey literature (2004-2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods.

  11. Costing evidence for health care decision-making in Austria: A systematic review

    PubMed Central

    Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata

    2017-01-01

    Background With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. Methods A systematic literature review of English and German language peer-reviewed as well as grey literature (2004–2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. Results A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. Conclusion There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods. PMID:28806728

  12. Designing the Architecture of Hierachical Neural Networks Model Attention, Learning and Goal-Oriented Behavior

    DTIC Science & Technology

    1993-12-31

    19,23,25,26,27,28,32,33,35,41]) - A new cost function is postulated and an algorithm that employs this cost function is proposed for the learning of...updates the controller parameters from time to time [53]. The learning control algorithm consist of updating the parameter estimates as used in the...proposed cost function with the other learning type algorithms , such as based upon learning of iterative tasks [Kawamura-85], variable structure

  13. Making the Surface Fleet Green: The DOTMLPF, Policy, and Cost Implications of Using Biofuel in Surface Ships

    DTIC Science & Technology

    2012-12-01

    Navy’s Ships Renewable Fuels Evaluation, 2011) ..25 Table 4. Diesel Injector Component Testing (From U.S. Navy Biofuel Test and Qualification Update...components, including shipboard quality assurance instruments, fuel injector nozzles , fuel nozzle atomization, fuel nozzle fouling, carbon deposition...Leung, Turgeon, & Williams, 2011, p. 7). Table 4 lists the results from component testing conducted on various diesel engine fuel injectors using

  14. 75 FR 79348 - TRICARE; Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the data necessary to update the Fiscal Year 2011 rates.

  15. A Class of Manifold Regularized Multiplicative Update Algorithms for Image Clustering.

    PubMed

    Yang, Shangming; Yi, Zhang; He, Xiaofei; Li, Xuelong

    2015-12-01

    Multiplicative update algorithms are important tools for information retrieval, image processing, and pattern recognition. However, when the graph regularization is added to the cost function, different classes of sample data may be mapped to the same subspace, which leads to the increase of data clustering error rate. In this paper, an improved nonnegative matrix factorization (NMF) cost function is introduced. Based on the cost function, a class of novel graph regularized NMF algorithms is developed, which results in a class of extended multiplicative update algorithms with manifold structure regularization. Analysis shows that in the learning, the proposed algorithms can efficiently minimize the rank of the data representation matrix. Theoretical results presented in this paper are confirmed by simulations. For different initializations and data sets, variation curves of cost functions and decomposition data are presented to show the convergence features of the proposed update rules. Basis images, reconstructed images, and clustering results are utilized to present the efficiency of the new algorithms. Last, the clustering accuracies of different algorithms are also investigated, which shows that the proposed algorithms can achieve state-of-the-art performance in applications of image clustering.

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

    Ramuhalli, Pradeep; Hirt, Evelyn H.; Veeramany, Arun

    This research report summaries the development and evaluation of a prototypic enhanced risk monitor (ERM) methodology (framework) that includes alternative risk metrics and uncertainty analysis. This updated ERM methodology accounts for uncertainty in the equipment condition assessment (ECA), the prognostic result, and the probabilistic risk assessment (PRA) model. It is anticipated that the ability to characterize uncertainty in the estimated risk and update the risk estimates in real time based on equipment condition assessment (ECA) will provide a mechanism for optimizing plant performance while staying within specified safety margins. These results (based on impacting active component O&M using real-time equipmentmore » condition information) are a step towards ERMs that, if integrated with AR supervisory plant control systems, can help control O&M costs and improve affordability of advanced reactors.« less

  17. Update of GRASP/Ada reverse engineering tools for Ada

    NASA Technical Reports Server (NTRS)

    Cross, James H., II

    1993-01-01

    The GRASP/Ada project (Graphical Representations of Algorithms, Structures, and Processes for Ada) successfully created and prototyped a new algorithmic level graphical representation for Ada software, the Control Structure Diagram (CSD). 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 was on the automatic generation of the CSD from Ada PDL or source code to support reverse engineering and maintenance. The CSD has the potential to replace traditional pretty printed Ada source code. In Phase 1 of the GRASP/Ada project, the CSD graphical constructs were created and applied manually to several small Ada programs. A prototype CSD generator (Version 1) was designed and implemented using FLEX and BISON running under VMS on a VAX 11-780. In Phase 2, the prototype was improved and ported to the Sun 4 platform under UNIX. A user interface was designed and partially implemented using the HP widget toolkit and the X Windows System. In Phase 3, the user interface was extensively reworked using the Athena widget toolkit and X Windows. The prototype was applied successfully to numerous Ada programs ranging in size from several hundred to several thousand lines of source code. Following Phase 3,e two update phases were completed. Update'92 focused on the initial analysis of evaluation data collected from software engineering students at Auburn University and the addition of significant enhancements to the user interface. Update'93 (the current update) focused on the statistical analysis of the data collected in the previous update and preparation of Version 3.4 of the prototype for limited distribution to facilitate further evaluation. The current prototype provides the capability for the user to generate CSD's from Ada PDL or source code in a reverse engineering as well as forward engineering mode with a level of flexibility suitable for practical application. An overview of the GRASP/Ada project with an emphasis on the current update is provided.

  18. Mask cost of ownership for advanced lithography

    NASA Astrophysics Data System (ADS)

    Muzio, Edward G.; Seidel, Philip K.

    2000-07-01

    As technology advances, becoming more difficult and more expensive, the cost of ownership (CoO) metric becomes increasingly important in evaluating technical strategies. The International SEMATECH CoC analysis has steadily gained visibility over the past year, as it attempts to level the playing field between technology choices, and create a fair relative comparison. In order to predict mask cots for advanced lithography, mask process flows are modeled using bets-known processing strategies, equipment cost, and yields. Using a newly revised yield mode, and updated mask manufacture flows, representative mask flows can be built. These flows are then used to calculate mask costs for advanced lithography down to the 50 nm node. It is never the goal of this type of work to provide absolute cost estimates for business planning purposes. However, the combination of a quantifiable yield model with a clearly defined set of mask processing flows and a cost model based upon them serves as an excellent starting point for cost driver analysis and process flow discussion.

  19. An Update on Physician Practice Cost Shares

    PubMed Central

    Dayhoff, Debra A.; Cromwell, Jerry; Rosenbach, Margo L.

    1993-01-01

    The 1988 physicians' practice costs and income survey (PPCIS) collected detailed costs, revenues, and incomes data for a sample of 3,086 physicians. These data are utilized to update the Health Care Financing Administration (HCFA) cost shares used in calculating the medicare economic index (MEI) and the geographic practice cost index (GPCI). Cost shares were calculated for the national sample, for 16 specialty groupings, for urban and rural areas, and for 9 census divisions. Although statistical tests reveal that cost shares differ across specialties and geographic areas, sensitivity analysis shows that these differences are small enough to have trivial effects in computing the MEI and GPCI. These results may inform policymakers on one aspect of the larger issue of whether physician payments should vary by geographic location or specialty. PMID:10130573

  20. Cost of rotavirus diarrhea for programmatic evaluation of vaccination in Vietnam.

    PubMed

    Riewpaiboon, Arthorn; Shin, Sunheang; Le, Thi Phuong Mai; Vu, Dinh Thiem; Nguyen, Thi Hien Anh; Alexander, Neal; Dang, Duc Anh

    2016-08-11

    Rotavirus is the most common etiology of diarrhea-associated hospitalizations and clinic visits in Vietnamese children < 5 years old. To estimate the economic burden of rotavirus-associated formal healthcare encounters, an economic study was conducted. A cost-of-illness study was performed from a societal perspective. Data were collected from children below the age of five years who presented to a clinic or hospital with symptoms of acute gastroenteritis (AGE). Patient-specific information on resource use and cost was obtained through caregiver interviews and medical chart review. Costs are presented in 2014 US dollar ($). A total of 557 children with symptoms of AGE were enrolled from March through June 2009, with mean age of 16.5 months. Of the 340 outpatients and 217 admitted patients enrolled, 41 % tested rotavirus positive. It was found that, from a societal perspective, the mean total cost of AGE was $175. Costs of patients with and without rotavirus were $217 and $158, respectively. From multiple regression analysis, it was found that rotavirus infection, patient age and receiving oral rehydration solution before visiting health facility had significant effect on the costs. This study clearly demonstrated substantial economic burden of AGE including rotavirus disease. They were significantly greater than the previously reported cost estimates in Vietnam. These updated costs of illness result in more favorable vaccine cost-effectiveness than in previous economic evaluations.

  1. Costs of Fetal Alcohol Spectrum Disorder in the Canadian Criminal Justice System.

    PubMed

    Thanh, Nguyen Xuan; Jonsson, Egon

    2015-01-01

    We reviewed literature to estimate the costs of Fetal Alcohol Spectrum Disorder (FASD) in the Canadian Criminal Justice System (CJS), and to update the total costs of FASD in Canada. The results suggest FASD is costlier than previous estimates. The costs of FASD associated with the CJS are estimated at $3.9 billion a year, with $1.2 billion for police, $0.4 billion for court, $0.5 billion for correctional services, $1.6 billion for victims, and $0.2 billion for third-party. The updated total costs of FASD in Canada are $9.7 billion a year, of which CJS accounts for 40%, healthcare 21%, education 17%, social services 13%, and others 9%.

  2. Cost-effectiveness of supervised exercise therapy in heart failure patients.

    PubMed

    Kühr, Eduardo M; Ribeiro, Rodrigo A; Rohde, Luis Eduardo P; Polanczyk, Carisi A

    2011-01-01

    Exercise therapy in heart failure (HF) patients is considered safe and has demonstrated modest reduction in hospitalization rates and death in recent trials. Previous cost-effectiveness analysis described favorable results considering long-term supervised exercise intervention and significant effectiveness of exercise therapy; however, these evidences are now no longer supported. To evaluate the cost-effectiveness of supervised exercise therapy in HF patients under the perspective of the Brazilian Public Healthcare System. We developed a Markov model to evaluate the incremental cost-effectiveness ratio of supervised exercise therapy compared to standard treatment in patients with New York Heart Association HF class II and III. Effectiveness was evaluated in quality-adjusted life years in a 10-year time horizon. We searched PUBMED for published clinical trials to estimate effectiveness, mortality, hospitalization, and utilities data. Treatment costs were obtained from published cohort updated to 2008 values. Exercise therapy intervention costs were obtained from a rehabilitation center. Model robustness was assessed through Monte Carlo simulation and sensitivity analysis. Cost were expressed as international dollars, applying the purchasing-power-parity conversion rate. Exercise therapy showed small reduction in hospitalization and mortality at a low cost, an incremental cost-effectiveness ratio of Int$26,462/quality-adjusted life year. Results were more sensitive to exercise therapy costs, standard treatment total costs, exercise therapy effectiveness, and medications costs. Considering a willingness-to-pay of Int$27,500, 55% of the trials fell below this value in the Monte Carlo simulation. In a Brazilian scenario, exercise therapy shows reasonable cost-effectiveness ratio, despite current evidence of limited benefit of this intervention. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. 40 CFR 600.314-86 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. 600.314-86 Section 600.314-86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR...

  4. 40 CFR 600.314-01 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. 600.314-01 Section 600.314-01 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR...

  5. 40 CFR 600.314-08 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. 600.314-08 Section 600.314-08 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR...

  6. Food Irradiation Update and Cost Analysis

    DTIC Science & Technology

    1991-11-01

    Natick). Significant contributions were made by Dr. Irwin Taub and Mr. Christopher Rees of the Technology Acquisition Division, Food Engineering...stability. 5 Food Irradiation Update C-ost Analysis I. Introduction In the book The Physioloqy of Taste (1825), one of the pioneers of gastronomy ...review of the utility that radiation preserved foods might offer the military food service system. To date, this technology has seen limited use in the

  7. Revenues: Where Does the Money Come from? A Delta Data Update, 2000-2010

    ERIC Educational Resources Information Center

    Kirshstein, Rita J.; Hurlburt, Steven

    2012-01-01

    This is one in a series of data briefs developed by the Delta Cost Project at AIR using data from the "IPEDS Analytics: Delta Cost Project Database 1987-2010," which was released on August 14, 2012, by the U.S. Department of Education, National Center for Education Statistics. The intent of these briefs is to update key tables and figures from…

  8. Spending: Where Does the Money Go? A Delta Data Update, 2000-2010

    ERIC Educational Resources Information Center

    Hurlburt, Steven; Kirshstein, Rita J.

    2012-01-01

    This is one in a series of data briefs developed by the Delta Cost Project at AIR using data from the "IPEDS Analytics: Delta Cost Project Database 1987-2010," which was released on August 14, 2012, by the U.S. Department of Education, National Center for Education Statistics. The intent of these briefs is to update key tables and figures from…

  9. Benefit/cost framework for evaluating modular energy storage : a study for the DOE energy storage systems program.

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

    Eyer, James M.; Schoenung, Susan M.

    2008-02-01

    The work documented in this report represents another step in the ongoing investigation of innovative and potentially attractive value propositions for electricity storage by the United States Department of Energy (DOE) and Sandia National Laboratories (SNL) Energy Storage Systems (ESS) Program. This study uses updated cost and performance information for modular energy storage (MES) developed for this study to evaluate four prospective value propositions for MES. The four potentially attractive value propositions are defined by a combination of well-known benefits that are associated with electricity generation, delivery, and use. The value propositions evaluated are: (1) transportable MES for electric utilitymore » transmission and distribution (T&D) equipment upgrade deferral and for improving local power quality, each in alternating years, (2) improving local power quality only, in all years, (3) electric utility T&D deferral in year 1, followed by electricity price arbitrage in following years; plus a generation capacity credit in all years, and (4) electric utility end-user cost management during times when peak and critical peak pricing prevail.« less

  10. Prophylatic treatment of migraine and migraine clinical variants with topiramate: an update

    PubMed Central

    Carmona, Sergio; Bruera, Osvaldo

    2009-01-01

    Migraine and migraine variants are common, chronic and incapacitating neurovascular disorders with a high impact on health resources. There is an extensive evidence base provided by double-blind, placebo-controlled trials showing that topiramate is a safe, effective and well tolerated drug in the management of migraine and its variants, being especially promising in the management of migraine-vertigo syndrome. Models both in the US and the UK have also shown that it offers a cost benefit when direct and indirect costs are evaluated, by reducing work loss, improving quality of life and reducing the use of increasingly scarce health resources. PMID:19707282

  11. Site Partitioning for Redundant Arrays of Distributed Disks

    NASA Technical Reports Server (NTRS)

    Mourad, Antoine N.; Fuchs, W. Kent; Saab, Daniel G.

    1996-01-01

    Redundant arrays of distributed disks (RADD) can be used in a distributed computing system or database system to provide recovery in the presence of disk crashes and temporary and permanent failures of single sites. In this paper, we look at the problem of partitioning the sites of a distributed storage system into redundant arrays in such a way that the communication costs for maintaining the parity information are minimized. We show that the partitioning problem is NP-hard. We then propose and evaluate several heuristic algorithms for finding approximate solutions. Simulation results show that significant reduction in remote parity update costs can be achieved by optimizing the site partitioning scheme.

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

    Segev, A.; Fang, W.

    In currency-based updates, processing a query to a materialized view has to satisfy a currency constraint which specifies the maximum time lag of the view data with respect to a transaction database. Currency-based update policies are more general than periodical, deferred, and immediate updates; they provide additional opportunities for optimization and allow updating a materialized view from other materialized views. In this paper, we present algorithms to determine the source and timing of view updates and validate the resulting cost savings through simulation results. 20 refs.

  13. Health system costs of skin cancer and cost-effectiveness of skin cancer prevention and screening: a systematic review.

    PubMed

    Gordon, Louisa G; Rowell, David

    2015-03-01

    The objective of this study was to review the literature for malignant melanoma, basal and squamous cell carcinomas to understand: (a) national estimates of the direct health system costs of skin cancer and (b) the cost-effectiveness of interventions for skin cancer prevention or early detection. A systematic review was performed using Medline, Cochrane Library and the National Health Service Economic Evaluation Databases as well as a manual search of reference lists to identify relevant studies up to 31 August 2013. A narrative synthesis approach was used to summarize the data. National cost estimates were adjusted for country-specific inflation and presented in 2013 euros. The CHEERS statement was used to assess the quality of the economic evaluation studies. Sixteen studies reporting national estimates of skin cancer costs and 11 cost-effectiveness studies on skin cancer prevention or early detection were identified. Relative to the size of their respective populations, the annual direct health system costs for skin cancer were highest for Australia, New Zealand, Sweden and Denmark (2013 euros). Skin cancer prevention initiatives are highly cost-effective and may also be cost-saving. Melanoma early detection programmes aimed at high-risk individuals may also be cost-effective; however, updated analyses are needed. There is a significant cost burden of skin cancer for many countries and health expenditure for this disease will grow as incidence increases. Public investment in skin cancer prevention and early detection programmes show strong potential for health and economic benefits.

  14. Assessment and Optimization of Lidar Measurement Availability for Wind Turbine Control (Poster)

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

    Scholbrock, F. A.; Fleming, P.; Wright, A.

    2014-02-01

    Integrating Lidar to improve wind turbine controls is a potential breakthrough for reducing the cost of wind energy. By providing undisturbed wind measurements up to 400m in front of the rotor, Lidar may provide an accurate update of the turbine inflow with a preview time of several seconds. Focusing on loads, several studies have evaluated potential reductions using integrated Lidar, either by simulation or full scale field testing.

  15. A Systems Approach to Costing in the Blood Bank

    PubMed Central

    Delon, Gerald L.; Smalley, Harold E.

    1969-01-01

    A macroscopic approach to departmental cost finding is combined with a microscopic approach to the weighting of laboratory tests in a mathematical model which, when incorporated into a relative unit value format, yields unit costs for such tests under a wide variety of operational conditions. The task of updating such costs to reflect changing conditions can be facilitated by a computer program incorporating the capability of pricing the various tests to achieve any desired profit or loss or to break even. Among other potential uses of such a technique, the effects on unit cost per test caused by increasing or decreasing the number of technicians or the volume of tests can be systematically examined, and pricing can be updated each year as hospital costs change. PMID:5799486

  16. Catalyzed D-D stellarator reactor

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

    Sheffield, John; Spong, Donald A.

    The advantages of using the catalyzed deuterium-deuterium (D-D) approach for a fusion reactor—lower and less energetic neutron flux and no need for a tritium breeding blanket—have been evaluated in previous papers, giving examples of both tokamak and stellarator reactors. This paper presents an update for the stellarator example, taking account of more recent empirical transport scaling results and design studies of lower-aspect-ratio stellarators. We use a modified version of the Generic Magnetic Fusion Reactor model to cost a stellarator-type reactor. Recently, this model has been updated to reflect the improved science and technology base and costs in the magnetic fusionmore » program. Furthermore, it is shown that an interesting catalyzed D-D, stellarator power plant might be possible if the following parameters could be achieved: R/ ≈ 4, required improvement factor to ISS04 scaling, F R = 0.9 to 1.15, ≈ 8.0% to 11.5%, Z eff ≈ 1.45 plus a relativistic temperature correction, fraction of fast ions lost ≈ 0.07, B m ≈ 14 to 16 T, and R ≈ 18 to 24 m.« less

  17. Catalyzed D-D stellarator reactor

    DOE PAGES

    Sheffield, John; Spong, Donald A.

    2016-05-12

    The advantages of using the catalyzed deuterium-deuterium (D-D) approach for a fusion reactor—lower and less energetic neutron flux and no need for a tritium breeding blanket—have been evaluated in previous papers, giving examples of both tokamak and stellarator reactors. This paper presents an update for the stellarator example, taking account of more recent empirical transport scaling results and design studies of lower-aspect-ratio stellarators. We use a modified version of the Generic Magnetic Fusion Reactor model to cost a stellarator-type reactor. Recently, this model has been updated to reflect the improved science and technology base and costs in the magnetic fusionmore » program. Furthermore, it is shown that an interesting catalyzed D-D, stellarator power plant might be possible if the following parameters could be achieved: R/ ≈ 4, required improvement factor to ISS04 scaling, F R = 0.9 to 1.15, ≈ 8.0% to 11.5%, Z eff ≈ 1.45 plus a relativistic temperature correction, fraction of fast ions lost ≈ 0.07, B m ≈ 14 to 16 T, and R ≈ 18 to 24 m.« less

  18. PLANNING AND ASSESSMENT MEASURES TO UPDATING RESOURCES RECYCLING EQUIPMENTS IN COLLABORATION WITH SEWAGE TREATMENT PLANTS AND WASTE INCINERATION PLANTS

    NASA Astrophysics Data System (ADS)

    Nakakubo, Toyohiko; Tokai, Akihiro; Ohno, Koichi

    This study aims to assess two biomass utilization policies: the integration of food waste treatment in a sewerage treatment plant with an anaerobic digestion tank, and the pruned branch usage as heat source for drying sludge. We focused on two points in our analysis that the impact of the increase of dewatered sludge on sludge treatment processes after digestion and the improvement of the efficiency of waste power generation plants. A developed model was applied to the case study in Kobe city and evaluated the impact until 2030 by four indicators: energy consumption, greenhouse gas (GHG) emission, phosphorus-recovery, and cost. The results showed that case 3-C, which introducing the combined sludge and food waste digestion system, pyrolysis gasification with gas engine and wood-chip boiler, could supply additional 452 TJ/y of energy, recovery 93 t-P/y of phosphorus, and reduce 38 kt-CO2eq./y of GHG while shrinking the cost by 88 million yen/y compared to business as usual types-update case.

  19. The same-location cost is unrelated to attentional settings: an object-updating account.

    PubMed

    Carmel, Tomer; Lamy, Dominique

    2014-08-01

    What mechanisms allow us to ignore salient yet irrelevant visual information has been a matter of intense debate. According to the contingent-capture hypothesis, such information is filtered out, whereas according to the salience-based account, it captures attention automatically. Several recent studies have reported a same-location cost that appears to fit neither of these accounts. These showed that responses may actually be slower when the target appears at the location just occupied by an irrelevant singleton distractor. Here, we investigated the mechanisms underlying this same-location cost. Our findings show that the same-location cost is unrelated to automatic attentional capture or strategic setting of attentional priorities, and therefore invalidate the feature-based inhibition and fast attentional disengagement accounts of this effect. In addition, we show that the cost is wiped out when the cue and target are not perceived as parts of the same object. We interpret these findings as indicating that the same-location cost has been previously misinterpreted by both bottom-up and top-down theories of attentional capture. We propose that it is better understood as a consequence of object updating, namely, as the cost of updating the information stored about an object when this object changes across time.

  20. Cost analysis of the treatment of severe acute malnutrition in West Africa.

    PubMed

    Isanaka, Sheila; Menzies, Nicolas A; Sayyad, Jessica; Ayoola, Mudasiru; Grais, Rebecca F; Doyon, Stéphane

    2017-10-01

    We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support). For each category, total costs were calculated by multiplying input quantities expended in the Médecins Sans Frontières nutrition program in Niger during a 12-month study period by 2015 input prices. All children received outpatient treatment, with 43% also receiving inpatient treatment. In this large, well-established program, the average cost per child treated was €148.86, with outpatient and inpatient treatment costs of €75.50 and €134.57 per child, respectively. Therapeutic food (44%, €32.98 per child) and personnel (35%, €26.70 per child) dominated outpatient costs, while personnel (56%, €75.47 per child) dominated in the cost of inpatient care. Sensitivity analyses suggested lowering prices of medical treatments, and therapeutic food had limited effect on total costs per child, while increasing program size and decreasing use of expatriate staff support reduced total costs per child substantially. Updated estimates of severe acute malnutrition treatment cost are substantially lower than previously published values, and important cost savings may be possible with increases in coverage/program size and integration into national health programs. These updated estimates can be used to suggest approaches to improve efficiency and inform national-level resource allocation. © 2016 John Wiley & Sons Ltd.

  1. Trends in College Spending: 2001-2011. A Delta Data Update

    ERIC Educational Resources Information Center

    Desrochers, Donna M.; Hurlburt, Steven

    2014-01-01

    This "Trends in College Spending" update presents national-level estimates for the "Delta Cost Project" data metrics during the period 2001-11. To accelerate the release of more current trend data, however, this update includes only a brief summary of the financial patterns and trends observed during the decade 2001-11, with…

  2. The evolution of reputation-based partner-switching behaviors with a cost

    PubMed Central

    Li, Yixiao

    2014-01-01

    Humans constantly adjust their social relationships and choose new partners of good reputations, thereby promoting the evolution of cooperation. Individuals have to pay a cost to build a reputation, obtain others' information and then make partnership adjustments, yet the conditions under which such costly behaviors are able to evolve remain to be explored. In this model, I assume that individuals have to pay a cost to adjust their partnerships. Furthermore, whether an individual can adjust his partnership based on reputation is determined by his strategic preference, which is updated via coevolution. Using the metaphor of a public goods game where the collective benefit is shared among all members of a group, the coupling dynamics of cooperation and partnership adjustment were numerically simulated. Partner-switching behavior cannot evolve in a public goods game with a low amplification factor. However, such an effect can be exempted by raising the productivity of public goods or the frequency of partnership adjustment. Moreover, costly partner-switching behavior is remarkably promoted by the condition that the mechanism of reputation evaluation considers its prosociality. A mechanism of reputation evaluation that praises both cooperative and partner-switching behaviors allows them to coevolve. PMID:25091006

  3. The evolution of reputation-based partner-switching behaviors with a cost

    NASA Astrophysics Data System (ADS)

    Li, Yixiao

    2014-08-01

    Humans constantly adjust their social relationships and choose new partners of good reputations, thereby promoting the evolution of cooperation. Individuals have to pay a cost to build a reputation, obtain others' information and then make partnership adjustments, yet the conditions under which such costly behaviors are able to evolve remain to be explored. In this model, I assume that individuals have to pay a cost to adjust their partnerships. Furthermore, whether an individual can adjust his partnership based on reputation is determined by his strategic preference, which is updated via coevolution. Using the metaphor of a public goods game where the collective benefit is shared among all members of a group, the coupling dynamics of cooperation and partnership adjustment were numerically simulated. Partner-switching behavior cannot evolve in a public goods game with a low amplification factor. However, such an effect can be exempted by raising the productivity of public goods or the frequency of partnership adjustment. Moreover, costly partner-switching behavior is remarkably promoted by the condition that the mechanism of reputation evaluation considers its prosociality. A mechanism of reputation evaluation that praises both cooperative and partner-switching behaviors allows them to coevolve.

  4. Conversion of transuranic waste to low level waste by decontamination: a technical and economic evaluation

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

    Allen, R.P.; Hazelton, R.F.

    1984-12-01

    A study was conducted to evaluate the technical and economic feasibility of using in-situ decontamination techniques to convert glove boxes and other large TRU-contaminated components directly into LLW. The results of the technical evaluation indicate that in-situ decontamination of these types of components to non-TRU levels is technically feasible. Applicable decontamination techniques include electropolishing, hand scrubbing, chemical washes/sprays, strippable coatings and Freon spray-cleaning. The removal of contamination from crevices and other holdup areas remains a problem, but may be solved through further advances in decontamination technology. Also, the increase in the allowable maximum TRU level from 10 nCi/g to 100more » nCi/g as defined in DOE Order 5820.2 reduces the removal requirement and facilitates measurement of the remaining quantities. The major emphasis of the study was on a cost/benefit evaluation that included a review and update of previous analyses and evaluations of TRU-waste volume reduction and conversion options. The results of the economic evaluation show, for the assumptions used, that there is a definite cost incentive to size reduce large components, and that decontamination of sectioned material has become cost competitive with the size reduction options. In-situ decontamination appears to be the lowest cost option when based on routine-type operations conducted by well-trained and properly equipped personnel. 16 references, 1 figure, 7 tables.« less

  5. Multiparametric magnetic resonance imaging and prostate cancer: what's new?

    PubMed

    Catalá, V; Vilanova, J C; Gaya, J M; Algaba, F; Martí, T

    Prostatic multi-parametric magnetic resonance imaging (MP-MRI) has recently had a wide development becoming a key tool in the diagnostic and therapeutic decisions in prostate cancer (Pca). The fast development both in technology and in reading (PIRADS V2) requires a continuous updating of knowledge within this area. The aim of this article is to present an updated revision of technical aspects, reading patterns and prostatic MP-MRI in Pca, with a multidisciplinary approach. Currently guidelines establish the use of the MP-MRI when there is a high PSA and a negative prostatic biopsy; tumor staging; evaluation in candidates to active surveillance; focal treatments plans and tumoral recurrence evaluation. Although it is used in other indications in some centers, like its use in patients suspicious of Pca but with no previous biopsy, there is still the need of a cost/benefit assessment for its use to be wider. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Statistical methods of estimating mining costs

    USGS Publications Warehouse

    Long, K.R.

    2011-01-01

    Until it was defunded in 1995, the U.S. Bureau of Mines maintained a Cost Estimating System (CES) for prefeasibility-type economic evaluations of mineral deposits and estimating costs at producing and non-producing mines. This system had a significant role in mineral resource assessments to estimate costs of developing and operating known mineral deposits and predicted undiscovered deposits. For legal reasons, the U.S. Geological Survey cannot update and maintain CES. Instead, statistical tools are under development to estimate mining costs from basic properties of mineral deposits such as tonnage, grade, mineralogy, depth, strip ratio, distance from infrastructure, rock strength, and work index. The first step was to reestimate "Taylor's Rule" which relates operating rate to available ore tonnage. The second step was to estimate statistical models of capital and operating costs for open pit porphyry copper mines with flotation concentrators. For a sample of 27 proposed porphyry copper projects, capital costs can be estimated from three variables: mineral processing rate, strip ratio, and distance from nearest railroad before mine construction began. Of all the variables tested, operating costs were found to be significantly correlated only with strip ratio.

  7. Optimal regulation in systems with stochastic time sampling

    NASA Technical Reports Server (NTRS)

    Montgomery, R. C.; Lee, P. S.

    1980-01-01

    An optimal control theory that accounts for stochastic variable time sampling in a distributed microprocessor based flight control system is presented. The theory is developed by using a linear process model for the airplane dynamics and the information distribution process is modeled as a variable time increment process where, at the time that information is supplied to the control effectors, the control effectors know the time of the next information update only in a stochastic sense. An optimal control problem is formulated and solved for the control law that minimizes the expected value of a quadratic cost function. The optimal cost obtained with a variable time increment Markov information update process where the control effectors know only the past information update intervals and the Markov transition mechanism is almost identical to that obtained with a known and uniform information update interval.

  8. Airfoil Design and Optimization by the One-Shot Method

    NASA Technical Reports Server (NTRS)

    Kuruvila, G.; Taasan, Shlomo; Salas, M. D.

    1995-01-01

    An efficient numerical approach for the design of optimal aerodynamic shapes is presented in this paper. The objective of any optimization problem is to find the optimum of a cost function subject to a certain state equation (governing equation of the flow field) and certain side constraints. As in classical optimal control methods, the present approach introduces a costate variable (Lagrange multiplier) to evaluate the gradient of the cost function. High efficiency in reaching the optimum solution is achieved by using a multigrid technique and updating the shape in a hierarchical manner such that smooth (low-frequency) changes are done separately from high-frequency changes. Thus, the design variables are changed on a grid where their changes produce nonsmooth (high-frequency) perturbations that can be damped efficiently by the multigrid. The cost of solving the optimization problem is approximately two to three times the cost of the equivalent analysis problem.

  9. Airfoil optimization by the one-shot method

    NASA Technical Reports Server (NTRS)

    Kuruvila, G.; Taasan, Shlomo; Salas, M. D.

    1994-01-01

    An efficient numerical approach for the design of optimal aerodynamic shapes is presented in this paper. The objective of any optimization problem is to find the optimum of a cost function subject to a certain state equation (Governing equation of the flow field) and certain side constraints. As in classical optimal control methods, the present approach introduces a costate variable (Language multiplier) to evaluate the gradient of the cost function. High efficiency in reaching the optimum solution is achieved by using a multigrid technique and updating the shape in a hierarchical manner such that smooth (low-frequency) changes are done separately from high-frequency changes. Thus, the design variables are changed on a grid where their changes produce nonsmooth (high-frequency) perturbations that can be damped efficiently by the multigrid. The cost of solving the optimization problem is approximately two to three times the cost of the equivalent analysis problem.

  10. [Evaluation of financial status of public hospitals considering the updated costs of their services].

    PubMed

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

    In 2011 the Chilean National Health Fund (FONASA) commissioned a study to assess the costs of the 120 most relevant hospital care services with an established fee, in a large sample of public hospitals. We herein report the cost evaluation results of such study, considering the financial condition of those hospitals in the year of the study. Based on the premise that the expenses derived from the provision of institutional and appraised hospital services should be identical to the billing of hospitals to FONASA, the prices are undervalued, since they cover only 56% of billing, generating a gap between expenses and invoicing. This gap shows an important limitation of tariffs, since their prices do not cover the real costs. However not all hospitals behave in the same way. While the provision of services of some hospitals is even higher than their billing, most hospitals do not completely justify their invoicing. These assumptions would imply that, generally speaking, hospital debts are justified by the costs incurred. However, hospitals have heterogeneous financial situations that need to be analyzed carefully. In particular, nothing can be said about their relative efficiency if cost estimations are not adjusted by the complexity of patients attended and comparison groups are not defined.

  11. Quantitative critical thinking: Student activities using Bayesian updating

    NASA Astrophysics Data System (ADS)

    Warren, Aaron R.

    2018-05-01

    One of the central roles of physics education is the development of students' ability to evaluate proposed hypotheses and models. This ability is important not just for students' understanding of physics but also to prepare students for future learning beyond physics. In particular, it is often hoped that students will better understand the manner in which physicists leverage the availability of prior knowledge to guide and constrain the construction of new knowledge. Here, we discuss how the use of Bayes' Theorem to update the estimated likelihood of hypotheses and models can help achieve these educational goals through its integration with evaluative activities that use hypothetico-deductive reasoning. Several types of classroom and laboratory activities are presented that engage students in the practice of Bayesian likelihood updating on the basis of either consistency with experimental data or consistency with pre-established principles and models. This approach is sufficiently simple for introductory physics students while offering a robust mechanism to guide relatively sophisticated student reflection concerning models, hypotheses, and problem-solutions. A quasi-experimental study utilizing algebra-based introductory courses is presented to assess the impact of these activities on student epistemological development. The results indicate gains on the Epistemological Beliefs Assessment for Physical Science (EBAPS) at a minimal cost of class-time.

  12. 78 FR 41013 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...

  13. 77 FR 71179 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-29

    ... notice provides the updated regional per-diem rates for low-volume mental health providers; the update... beneficiary per-diem cost-share amount for low-volume providers; and, the updated per-diem rates for both full... with high TRICARE volume) and regional-specific rates for psychiatric hospitals and units with low...

  14. Health service use and costs associated with aggressiveness or agitation and containment in adult psychiatric care: a systematic review of the evidence.

    PubMed

    Rubio-Valera, Maria; Luciano, Juan V; Ortiz, José Miguel; Salvador-Carulla, Luis; Gracia, Alfredo; Serrano-Blanco, Antoni

    2015-03-04

    Agitation and containment are frequent in psychiatric care but little is known about their costs. The aim was to evaluate the use of services and costs related to agitation and containment of adult patients admitted to a psychiatric hospital or emergency service. Systematic searches of four electronic databases covering the period January 1998-January 2014 were conducted. Manual searches were also performed. Paper selection and data extraction were performed in duplicate. Cost data were converted to euros in 2014. Ten studies met inclusion criteria and were included in the analysis (retrospective cohorts, prospective cohorts and cost-of-illness studies). Evaluated in these studies were length of stay, readmission rates and medication. Eight studies assessed the impact of agitation on the length of stay and six showed that it was associated with longer stays. Four studies examined the impact of agitation on readmission and a statistically significant increase in the probability of readmission of agitated patients was observed. Two studies evaluated medication. One study showed that the mean medication dose was higher in agitated patients and the other found higher costs of treatment compared with non-agitated patients in the unadjusted analysis. One study estimated the costs of conflict and containment incurred in acute inpatient psychiatric care in the UK. The estimation for the year 2014 of total annual cost per ward for all conflict was €182,616 and €267,069 for containment based on updated costs from 2005. Agitation has an effect on healthcare use and costs in terms of longer length of stay, more readmissions and higher drug use. Evidence is scarce and further research is needed to estimate the burden of agitation and containment from the perspective of hospitals and the healthcare system.

  15. Costs And Savings Associated With Community Water Fluoridation In The United States.

    PubMed

    O'Connell, Joan; Rockell, Jennifer; Ouellet, Judith; Tomar, Scott L; Maas, William

    2016-12-01

    The most comprehensive study of US community water fluoridation program benefits and costs was published in 2001. This study provides updated estimates using an economic model that includes recent data on program costs, dental caries increments, and dental treatments. In 2013 more than 211 million people had access to fluoridated water through community water systems serving 1,000 or more people. Savings associated with dental caries averted in 2013 as a result of fluoridation were estimated to be $32.19 per capita for this population. Based on 2013 estimated costs ($324 million), net savings (savings minus costs) from fluoridation systems were estimated to be $6,469 million and the estimated return on investment, 20.0. While communities should assess their specific costs for continuing or implementing a fluoridation program, these updated findings indicate that program savings are likely to exceed costs. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Societal costs of traffic crashes and crime in Michigan : 2011 update.

    DOT National Transportation Integrated Search

    2011-06-01

    "Cost estimates, including both monetary and nonmonetary quality-of-life costs specific to Michigan, were : estimated for overall traffic crashes and index crimes by experts in the field of economics of traffic crashes : and crimes. These cost estima...

  17. Evaluation of global onshore wind energy potential and generation costs.

    PubMed

    Zhou, Yuyu; Luckow, Patrick; Smith, Steven J; Clarke, Leon

    2012-07-17

    In this study, we develop an updated global estimate of onshore wind energy potential using reanalysis wind speed data, along with updated wind turbine technology performance, land suitability factors, cost assumptions, and explicit consideration of transmission distance in the calculation of transmission costs. We find that wind has the potential to supply a significant portion of the world energy needs, although this potential varies substantially by region and with assumptions such as on what types of land can be used to site wind farms. Total global economic wind potential under central assumptions, that is, intermediate between optimistic and pessimistic, is estimated to be approximately 119.5 petawatt hours per year (13.6 TW) at less than 9 cents/kWh. A sensitivity analysis of eight key parameters is presented. Wind potential is sensitive to a number of input parameters, particularly wind speed (varying by -70% to +450% at less than 9 cents/kWh), land suitability (by -55% to +25%), turbine density (by -60% to +80%), and cost and financing options (by -20% to +200%), many of which have important policy implications. As a result of sensitivities studied here we suggest that further research intended to inform wind supply curve development focus not purely on physical science, such as better resolved wind maps, but also on these less well-defined factors, such as land-suitability, that will also have an impact on the long-term role of wind power.

  18. Systematic meta-review of supported self-management for asthma: a healthcare perspective.

    PubMed

    Pinnock, Hilary; Parke, Hannah L; Panagioti, Maria; Daines, Luke; Pearce, Gemma; Epiphaniou, Eleni; Bower, Peter; Sheikh, Aziz; Griffiths, Chris J; Taylor, Stephanie J C

    2017-03-17

    Supported self-management has been recommended by asthma guidelines for three decades; improving current suboptimal implementation will require commitment from professionals, patients and healthcare organisations. The Practical Systematic Review of Self-Management Support (PRISMS) meta-review and Reducing Care Utilisation through Self-management Interventions (RECURSIVE) health economic review were commissioned to provide a systematic overview of supported self-management to inform implementation. We sought to investigate if supported asthma self-management reduces use of healthcare resources and improves asthma control; for which target groups it works; and which components and contextual factors contribute to effectiveness. Finally, we investigated the costs to healthcare services of providing supported self-management. We undertook a meta-review (systematic overview) of systematic reviews updated with randomised controlled trials (RCTs) published since the review search dates, and health economic meta-analysis of RCTs. Twelve electronic databases were searched in 2012 (updated in 2015; pre-publication update January 2017) for systematic reviews reporting RCTs (and update RCTs) evaluating supported asthma self-management. We assessed the quality of included studies and undertook a meta-analysis and narrative synthesis. A total of 27 systematic reviews (n = 244 RCTs) and 13 update RCTs revealed that supported self-management can reduce hospitalisations, accident and emergency attendances and unscheduled consultations, and improve markers of control and quality of life for people with asthma across a range of cultural, demographic and healthcare settings. Core components are patient education, provision of an action plan and regular professional review. Self-management is most effective when delivered in the context of proactive long-term condition management. The total cost (n = 24 RCTs) of providing self-management support is offset by a reduction in hospitalisations and accident and emergency visits (standard mean difference 0.13, 95% confidence interval -0.09 to 0.34). Evidence from a total of 270 RCTs confirms that supported self-management for asthma can reduce unscheduled care and improve asthma control, can be delivered effectively for diverse demographic and cultural groups, is applicable in a broad range of clinical settings, and does not significantly increase total healthcare costs. Informed by this comprehensive synthesis of the literature, clinicians, patient-interest groups, policy-makers and providers of healthcare services should prioritise provision of supported self-management for people with asthma as a core component of routine care. RECURSIVE: PROSPERO CRD42012002694 ; PRISMS: PROSPERO does not register meta-reviews.

  19. Integrated tracking of components by engineering and logistics utilizing logistics asset tracking system

    NASA Technical Reports Server (NTRS)

    Renfroe, Michael B.; Mcdonald, Edward J.; Bradshaw, Kimberly

    1988-01-01

    The Logistics Asset Tracking System (LATS) devised by NASA contains data on Space Shuttle LRUs that are daily updated to reflect such LRU status changes as repair due to failure or modification due to changing engineering requirements. The implementation of LATS has substantially increased personnel responsiveness, preventing costly delays in Space Shuttle processing and obviating hardware cannibalization. An evaluation is presented of LATS achievements in the direction of an integrated logistical support posture.

  20. Process development

    NASA Technical Reports Server (NTRS)

    Bickler, D. B.

    1985-01-01

    An overview is given of seven process development activities which were presented at this session. Pulsed excimer laser processing of photovoltaic cells was presented. A different pulsed excimer laser annealing was described using a 50 w laser. Diffusion barrier research focused on lowering the chemical reactivity of amorphous thin film on silicon. In another effort adherent and conductive films were successfully achieved. Other efforts were aimed at achieving a simultaneous front and back junction. Microwave enhanced plasma deposition experiments were performed. An updated version of the Solar Array Manufacturing Industry Costing Standards (SAMICS) was presented, along with a life cycle cost analysis of high efficiency cells. The last presentation was on the evaluation of the ethyl vinyl acetate encapsulating system.

  1. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) All updated fees shall be rounded downward in the following manner...

  2. 76 FR 12074 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... notice provides the updated regional per-diem rates for low-volume mental health providers; the update... beneficiary per-diem cost-share amount for low-volume providers; and, the updated per-diem rates for both full... psychiatric hospitals and units with low TRICARE volume will have their TRICARE rates for Fiscal Year 2011...

  3. Distributed Common Ground System Army Increment 1 (DCGS-A Inc 1)

    DTIC Science & Technology

    2016-03-01

    Acquisition Executive DoD - Department of Defense DoDAF - DoD Architecture Framework FD - Full Deployment FDD - Full Deployment Decision FY - Fiscal...updated prior to the FDD ITAB in December 2012 and provided additional COA analysis/validation referenced in the FDD ADM (December 14, 2012) and FDD ...required by 10 U.S.C. 2334(a)(6). The Army Cost Review Board developed the FDD Army Cost Position (ACP), dated October 19, 2012, through the update of

  4. The Economic Costs of Substance Abuse Treatment: Updated Estimates and Cost Bands for Program Assessment and Reimbursement

    PubMed Central

    French, Michael T.; Popovici, Ioana; Tapsell, Lauren

    2008-01-01

    Federal, State, and local government agencies require current and accurate cost information for publicly funded substance abuse treatment programs to guide program assessments and reimbursement decisions. The Center for Substance Abuse Treatment (CSAT) published a list of modality-specific cost bands for this purpose in 2002. However, the upper and lower values in these ranges are so wide that they offer little practical guidance for funding agencies. Thus, the dual purpose of this investigation was to assemble the most current and comprehensive set of economic cost estimates from the readily-available literature and then use these estimates to develop updated modality-specific cost bands for more reasonable reimbursement policies. Although cost estimates were scant for some modalities, the recommended cost bands are based on the best available economic research, and we believe these new ranges will be more useful and pertinent for all stakeholders of publicly-funded substance abuse treatment. PMID:18294803

  5. Validation of the OpCost logging cost model using contractor surveys

    Treesearch

    Conor K. Bell; Robert F. Keefe; Jeremy S. Fried

    2017-01-01

    OpCost is a harvest and fuel treatment operations cost model developed to function as both a standalone tool and an integrated component of the Bioregional Inventory Originated Simulation Under Management (BioSum) analytical framework for landscape-level analysis of forest management alternatives. OpCost is an updated implementation of the Fuel Reduction Cost Simulator...

  6. Reducing Work Content in Early Stage Naval Ship Designs (Briefing Charts)

    DTIC Science & Technology

    2014-05-14

    criticizes US naval ships for: • early design decisions that lock in density • poor arrangements of piping and ventilation 8 An overly dense ship with...Thresholds Update Save As Exit T45 #1 T45 #2 T45 #3 HPC Enables Exhaustive Exploration by: and Visualization Exploring The Space Evaluating The Space From...design points such as traditional design spiral method 30 SHIP AVG Weighted Qty (Qty) by Cost 1980s Reagan Build-up 14 10% 1% 1990/2000s Low Rate

  7. A Method for Scheduling Air Traffic with Uncertain En Route Capacity Constraints

    NASA Technical Reports Server (NTRS)

    Arneson, Heather; Bloem, Michael

    2009-01-01

    A method for scheduling ground delay and airborne holding for flights scheduled to fly through airspace with uncertain capacity constraints is presented. The method iteratively solves linear programs for departure rates and airborne holding as new probabilistic information about future airspace constraints becomes available. The objective function is the expected value of the weighted sum of ground and airborne delay. In order to limit operationally costly changes to departure rates, they are updated only when such an update would lead to a significant cost reduction. Simulation results show a 13% cost reduction over a rough approximation of current practices. Comparison between the proposed as needed replanning method and a similar method that uses fixed frequency replanning shows a typical cost reduction of 1% to 2%, and even up to a 20% cost reduction in some cases.

  8. Development of Improved Composite Pressure Vessels for Hydrogen Storage

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

    Newhouse, Norman L.

    2016-04-29

    Hexagon Lincoln started this DOE project as part of the Hydrogen Storage Engineering Center of Excellence (HSECoE) contract on 1 February 2009. The purpose of the HSECoE was the research and development of viable material based hydrogen storage systems for on-board vehicular applications to meet DOE performance and cost targets. A baseline design was established in Phase 1. Studies were then conducted to evaluate potential improvements, such as alternate fiber, resin, and boss materials. The most promising concepts were selected such that potential improvements, compared with the baseline Hexagon Lincoln tank, resulted in a projected weight reduction of 11 percent,more » volume increase of 4 percent, and cost reduction of 10 percent. The baseline design was updated in Phase 2 to reflect design improvements and changes in operating conditions specified by HSECoE Partners. Evaluation of potential improvements continued during Phase 2. Subscale prototype cylinders were designed and fabricated for HSECoE Partners’ use in demonstrating their components and systems. Risk mitigation studies were conducted in Phase 3 that focused on damage tolerance of the composite reinforcement. Updated subscale prototype cylinders were designed and manufactured to better address the HSECoE Partners’ requirements for system demonstration. Subscale Type 1, Type 3, and Type 4 tanks were designed, fabricated and tested. Laboratory tests were conducted to evaluate vacuum insulated systems for cooling the tanks during fill, and maintaining low temperatures during service. Full scale designs were prepared based on results from the studies of this program. The operating conditions that developed during the program addressed adsorbent systems operating at cold temperatures. A Type 4 tank would provide the lowest cost and lightest weight, particularly at higher pressures, as long as issues with liner compatibility and damage tolerance could be resolved. A Type 1 tank might be the choice if the liner and damage tolerance issues were not resolved, particularly if the operating pressure was reduced.« less

  9. Cost-effectiveness analysis alongside clinical trials II-An ISPOR Good Research Practices Task Force report.

    PubMed

    Ramsey, Scott D; Willke, Richard J; Glick, Henry; Reed, Shelby D; Augustovski, Federico; Jonsson, Bengt; Briggs, Andrew; Sullivan, Sean D

    2015-03-01

    Clinical trials evaluating medicines, medical devices, and procedures now commonly assess the economic value of these interventions. The growing number of prospective clinical/economic trials reflects both widespread interest in economic information for new technologies and the regulatory and reimbursement requirements of many countries that now consider evidence of economic value along with clinical efficacy. As decision makers increasingly demand evidence of economic value for health care interventions, conducting high-quality economic analyses alongside clinical studies is desirable because they broaden the scope of information available on a particular intervention, and can efficiently provide timely information with high internal and, when designed and analyzed properly, reasonable external validity. In 2005, ISPOR published the Good Research Practices for Cost-Effectiveness Analysis Alongside Clinical Trials: The ISPOR RCT-CEA Task Force report. ISPOR initiated an update of the report in 2014 to include the methodological developments over the last 9 years. This report provides updated recommendations reflecting advances in several areas related to trial design, selecting data elements, database design and management, analysis, and reporting of results. Task force members note that trials should be designed to evaluate effectiveness (rather than efficacy) when possible, should include clinical outcome measures, and should obtain health resource use and health state utilities directly from study subjects. Collection of economic data should be fully integrated into the study. An incremental analysis should be conducted with an intention-to-treat approach, complemented by relevant subgroup analyses. Uncertainty should be characterized. Articles should adhere to established standards for reporting results of cost-effectiveness analyses. Economic studies alongside trials are complementary to other evaluations (e.g., modeling studies) as information for decision makers who consider evidence of economic value along with clinical efficacy when making resource allocation decisions. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. Highway User Benefit Analysis System Research Project #128

    DOT National Transportation Integrated Search

    2000-10-01

    In this research, a methodology for estimating road user costs of various competing alternatives was developed. Also, software was developed to calculate the road user cost, perform economic analysis and update cost tables. The methodology is based o...

  11. Updating the 2001 National Land Cover Database Impervious Surface Products to 2006 using Landsat imagery change detection methods

    USGS Publications Warehouse

    Xian, George; Homer, Collin G.

    2010-01-01

    A prototype method was developed to update the U.S. Geological Survey (USGS) National Land Cover Database (NLCD) 2001 to a nominal date of 2006. NLCD 2001 is widely used as a baseline for national land cover and impervious cover conditions. To enable the updating of this database in an optimal manner, methods are designed to be accomplished by individual Landsat scene. Using conservative change thresholds based on land cover classes, areas of change and no-change were segregated from change vectors calculated from normalized Landsat scenes from 2001 and 2006. By sampling from NLCD 2001 impervious surface in unchanged areas, impervious surface predictions were estimated for changed areas within an urban extent defined by a companion land cover classification. Methods were developed and tested for national application across six study sites containing a variety of urban impervious surface. Results show the vast majority of impervious surface change associated with urban development was captured, with overall RMSE from 6.86 to 13.12% for these areas. Changes of urban development density were also evaluated by characterizing the categories of change by percentile for impervious surface. This prototype method provides a relatively low cost, flexible approach to generate updated impervious surface using NLCD 2001 as the baseline.

  12. Opportunities for Success: Cost-Effective Programs for Children, Update, 1990. Report together with Additional Minority Views and Dissenting Views of the Select Committee on Children, Youth, and Families, One Hundred First Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

    This report on effective programs for children updates the 1988 report by providing new and stronger documentation of the programs' benefits and cost effectiveness. Eight programs and types of programs are discussed in Part I and four program areas that warrant attention are discussed in Part II. Part I reports on: (1) the Special Supplemental…

  13. ARTS. Accountability Reporting and Tracking System

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

    Jones, J.F.; Faccio, R.M.

    ARTS is a micro based prototype of the data elements, screens, and information processing rules that apply to the Accountability Reporting Program. The system focuses on the Accountability Event. The Accountability Event is an occurrence of incurring avoidable costs. The system must be able to CRUD (Create, Retrieve, Update, Delete) instances of the Accountability Event. Additionally, the system must provide for a review committee to update the `event record` with findings and determination information. Lastly, the system must provide for financial representatives to perform a cost reporting process.

  14. Lazy Updating of hubs can enable more realistic models by speeding up stochastic simulations

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

    Ehlert, Kurt; Loewe, Laurence, E-mail: loewe@wisc.edu; Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin 53715

    2014-11-28

    To respect the nature of discrete parts in a system, stochastic simulation algorithms (SSAs) must update for each action (i) all part counts and (ii) each action's probability of occurring next and its timing. This makes it expensive to simulate biological networks with well-connected “hubs” such as ATP that affect many actions. Temperature and volume also affect many actions and may be changed significantly in small steps by the network itself during fever and cell growth, respectively. Such trends matter for evolutionary questions, as cell volume determines doubling times and fever may affect survival, both key traits for biological evolution.more » Yet simulations often ignore such trends and assume constant environments to avoid many costly probability updates. Such computational convenience precludes analyses of important aspects of evolution. Here we present “Lazy Updating,” an add-on for SSAs designed to reduce the cost of simulating hubs. When a hub changes, Lazy Updating postpones all probability updates for reactions depending on this hub, until a threshold is crossed. Speedup is substantial if most computing time is spent on such updates. We implemented Lazy Updating for the Sorting Direct Method and it is easily integrated into other SSAs such as Gillespie's Direct Method or the Next Reaction Method. Testing on several toy models and a cellular metabolism model showed >10× faster simulations for its use-cases—with a small loss of accuracy. Thus we see Lazy Updating as a valuable tool for some special but important simulation problems that are difficult to address efficiently otherwise.« less

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

    PubMed

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

    2017-11-07

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

  16. 75 FR 2515 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ...: This notice provides the updated regional per diem rates for low volume mental health providers; the... beneficiary per-diem cost-share amount for low-volume providers; and the updated per- [[Page 2516

  17. Conversion of transuranic waste to low level waste by decontamination: a site specific update

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

    Allen, R.P.; Hazelton, R.F.

    1985-09-01

    As a followup to an FY-1984 cost/benefit study, a program was conducted in FY-1985 to transfer to the relevant DOE sites the information and technology for the direct conversion of transuranic (TRU) waste to low-level waste (LLW) by decontamination. As part of this work, the economic evaluation of the various TRUW volume reduction and conversion options was updated and expanded to include site-specific factors. The results show, for the assumptions used, that size reduction, size reduction followed by decontamination, or in situ decontamination are cost effective compared with the no-processing option. The technology transfer activities included site presentations and discussionsmore » with operations and waste management personnel to identify application opportunities and site-specific considerations and constraints that could affect the implementation of TRU waste conversion principles. These discussions disclosed definite potential for the beneficial application of these principles at most of the sites, but also confirmed the existence of site-specific factors ranging from space limitations to LLW disposal restrictions that could preclude particular applications or diminish expected benefits. 8 refs., 2 figs., 4 tabs.« less

  18. CHARACTERIZING COSTS, SAVINGS AND BENEFITS OF A SELECTION OF ENERGY EFFICIENT EMERGING TECHNOLOGIES IN THE UNITED STATES

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

    Xu, T.; Slaa, J.W.; Sathaye, J.

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing CO2 emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing themore » costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world. Successful implementation of emerging technologies not only can help advance productivities and competitiveness but also can play a significant role in mitigation efforts by saving energy. Providing evaluation and estimation of the costs and energy savings potential of emerging technologies is the focus of our work in this project. The overall goal of the project is to identify and select emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. This report contains the results from performing Task 2"Technology evaluation" for the project titled"Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies," which was sponsored by California Energy Commission and managed by CIEE. The project purpose is to analyze market status, market potential, and economic viability of selected technologies applicable to the U.S. In this report, LBNL first performed re-assessments of all of the 33 emerging energy-efficient industrial technologies, including re-evaluation of the 26 technologies that were previously identified by Martin et al. (2000) and their potential significance to energy use in the industries, and new evaluation of additional seven technologies. The re-assessments were essentially updated with recent information that we searched and collected from literature to the extent possible. The progress of selected technologies as they diffused into the marketplace from 2000 to 2010 was then discussed in this report. The report also includes updated detailed characterizations of 15 technologies studied in 2000, with comparisons noted.« less

  19. Vehicle operating costs, fuel consumption, and pavement type condition factors

    DOT National Transportation Integrated Search

    1982-06-01

    This report presents updated vehicle operating cost tables which may be used by a highway agency for estimation of vehicle operating costs as a function of operational and roadway variables. These results, partially based on fuel consumption tests on...

  20. ABEL model: Evaluates corporations` claims of inability to afford penalties and compliance costs (version 3.0.16). Model-simulation

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

    NONE

    1998-11-01

    The easy-to-use ABEL software evaluates for-profit company claims of inability to afford penalties, clean-up costs, or compliance costs. Violators raise the issue of inability to pay in most of EPA`s enforcement actions regardless of whether there is any hard evidence supporting those claims. The program enables Federal, State and local enforcement professionals to quickly determine if there was any validity to those claims. ABEL is a tool that promotes quick settlements by performing screening analyses of defendants and potentially responsible parties (PRP`s) to determine their financial capacity. After analyzing some basic financial ratios that reflect a company`s solvency, ABEL assessesmore » the firm`s ability to pay by focusing on projected cash flows. The model explicitly calculates the value of projected, internally generated cash flows from historical tax information, and compares these cash flows to the proposed environmental expenditure(s). The software is extremely easy to use. Version 3.0.16 updates the standard values for inflation and discount rate.« less

  1. Economic evaluation of Vacuum Assisted Closure® Therapy for the treatment of diabetic foot ulcers in France.

    PubMed

    Whitehead, Sarah J; Forest-Bendien, Véronique L; Richard, Jean-Louis; Halimi, Serge; Van, Georges Ha; Trueman, Paul

    2011-02-01

    The objective of the study was to assess the cost-effectiveness of Vacuum Assisted Closure® (V.A.C.®) Therapy compared with advanced wound care (AWC) for the treatment of diabetic foot ulcers (DFUs) in France. A cost-effectiveness model intended to reflect the management of DFUs was updated for the French setting. The Markov model follows the progression of 1000 hypothetical patients over a 1-year period. The model was populated with French-specific data, obtained from published sources and clinical experts. The analysis evaluated costs and health outcomes, in terms of quality-adjusted life-years (QALYs), wounds healed and amputations, from the perspective of the payer. The patients treated with V.A.C.® Therapy experienced more QALYs (0.787 versus 0.784) and improved healing rates (50.2% versus 48.5%) at a lower total cost of care (€24,881 versus €28,855 per patient per year) when compared with AWC. Sensitivity analyses conducted around key model parameters indicated that the results were affected by hospital resource use and costs. DFU treatment using V.A.C.® Therapy in France was associated with lower costs, additional QALYs, more healed ulcers and fewer amputations than treatment with AWC. V.A.C.® Therapy was therefore found to be the dominant treatment option. © 2010 The Authors. © 2010 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  2. Evaluating Cost-effectiveness of Interventions That Affect Fertility and Childbearing: How Health Effects Are Measured Matters.

    PubMed

    Goldhaber-Fiebert, Jeremy D; Brandeau, Margaret L

    2015-10-01

    Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Our objective was to characterize current practices for counting such health outcomes. We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on quality-adjusted life-years (QALYs) associated with fertility and childbearing. We reviewed 108 studies, identifying 7 themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies used multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations include that the review was targeted rather than systematic. Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased toward the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our study contributes to harmonizing methods in this respect. © The Author(s) 2015.

  3. Evaluating Cost-Effectiveness of Interventions that Affect Fertility and Childbearing: How Health Effects are Measured Matters

    PubMed Central

    Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

    2015-01-01

    Background Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Objective To characterize current practices for counting such health outcomes. Design We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on QALYs associated with fertility and childbearing. Results We reviewed 108 studies, identifying seven themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies employed multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations The review was targeted rather than systematic. Conclusions Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased towards the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our study contributes to harmonizing methods in this respect. PMID:25926281

  4. An update to the cost-effectiveness of posaconazole vs fluconazole or itraconazole in the prevention of invasive fungal disease among neutropenic patients in the United States.

    PubMed

    Sung, Anita H; Marcella, Stephen W; Xie, Yang

    2015-05-01

    Posaconazole has shown superior clinical efficacy in the prevention of invasive fungal disease (IFD) among neutropenic patients as well as cost-effectiveness in the US healthcare setting vs fluconazole or itraconazole (FLU/ITRA) based on oral suspension formulations of each therapy. This study aims to provide an update on the cost-effectiveness of posaconazole in the current US healthcare setting to reflect bioequivalent tablet formulations of posaconazole and fluconazole, as well as changes in healthcare and drug costs. An existing model was used to assess the cost-effectiveness of posaconazole vs FLU/ITRA in the prevention of IFD among patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) and chemotherapy-induced neutropenia. Drug efficacy, mortality related to IFD, and death from other causes were estimated for tablet formulations using data from a randomized clinical trial of oral suspensions based on bioequivalence. IFD treatment costs were updated using the average inflation rate over 8 years (2006-2014) and drug costs were based on 2014 Analysource data. Trial data show a lower IFD probability over 100 days of follow-up with posaconazole compared to standard azole therapy (0.05 vs 0.11). The treatment duration on posaconazole is 29 days compared to 24 days for FLU and 29 days for ITRA. The average cost of prophylaxis is higher in the posaconazole group compared to FLU/ITRA ($4673 vs $353); however, the costs associated with treating the IFD are lower in the posaconazole group compared to FLU/ITRA ($2205 vs $5303). The incremental cost effectiveness ratio of IFD avoided for posaconazole is $18,898 vs FLU/ITRA. In the current healthcare cost environment where both drug costs and overall IFD treatment costs have increased since 2007, posaconazole tablets are a cost-effective alternative to fluconazole or itraconazole in the prevention of IFD among neutropenic patients with AML and MDS in the US.

  5. Evaluation of a new eLearning platform for distance teaching of microsurgery.

    PubMed

    Messaoudi, T; Bodin, F; Hidalgo Diaz, J J; Ichihara, S; Fikry, T; Lacreuse, I; Liverneaux, P; Facca, S

    2015-06-01

    Online learning (or eLearning) is in constant evolution in medicine. An analytical survey of the websites of eight academic societies and medical schools was carried out. These sites were evaluated against parameters that define the quality of an eLearning website, as well as the shareable content object reference model (SCORM) technical standards. All studied platforms were maintained by a webmaster and regularly updated. Only two platforms had teleconference opportunities, five had courses in PDF format, and four allowed online testing. Based on SCORM standards, only four platforms allowed direct access without a password. The content of all platforms was adaptable, interoperable and reusable. But their sustainability was difficult to assess. In parallel, we developed the first eLearning platform to be used as part of a university diploma in microsurgery in France. The platform was evaluated by students enrolled this diploma program. A satisfaction survey and platform evaluation showed that students were generally satisfied and had used the platform for microsurgery education, especially the seven students living abroad. ELearning for microsurgery allows the content to be continuously updated, makes for fewer classroom visits, provides easy remote access, and especially better training time management and cost savings in terms of travel and accommodations. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Freight railroads : updated information on rates and other industry trends

    DOT National Transportation Integrated Search

    2007-08-15

    This report provides an update to the October 2006 GAO report using 2005 data. It includes changes in industry and commodity rates, other costs to shippers (such as railcar ownership and miscellaneous revenue), and data on traffic traveling at rates ...

  7. The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies.

    PubMed

    Dhaliwal, Rupinder; Cahill, Naomi; Lemieux, Margot; Heyland, Daren K

    2014-02-01

    Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners and patient decisions about appropriate healthcare for specific clinical circumstances, and are designed to minimize practice variation, improve costs, and improve clinical outcomes. The Canadian Critical Care Practice Guidelines (CCPGs) were first published in 2003 and most recently updated in 2013. A total of 68 new randomized controlled trials were identified since the last version in 2009, 50 of them published between 2009 and 2013. The remaining articles were trials published before 2009 but were not identified in previous iterations of the CCPGs. For clinical practice guidelines to be useful to practitioners, they need to be up-to-date and be reflective of the current body of evidence. Herein we describe the process by which the CCPGs were updated. This process resulted in 10 new sections or clinical topics. Of the old clinical topics, 3 recommendations were upgraded, 4 were downgraded, and 27 remained the same. To influence decision making at the bedside, these updated guidelines need to be accompanied by active guideline implementation strategies. Optimal implementation strategies should be guided by local contextual factors including barriers and facilitators to best practice recommendations. Moreover, evaluating and monitoring performance, such as participating in the International Nutrition Survey of practice, should be part of any intensive care unit's performance improvement strategy. The active implementation of the updated CCPGs may lead to better nutrition care and improved patient outcomes in the critical care setting.

  8. Heuristic reusable dynamic programming: efficient updates of local sequence alignment.

    PubMed

    Hong, Changjin; Tewfik, Ahmed H

    2009-01-01

    Recomputation of the previously evaluated similarity results between biological sequences becomes inevitable when researchers realize errors in their sequenced data or when the researchers have to compare nearly similar sequences, e.g., in a family of proteins. We present an efficient scheme for updating local sequence alignments with an affine gap model. In principle, using the previous matching result between two amino acid sequences, we perform a forward-backward alignment to generate heuristic searching bands which are bounded by a set of suboptimal paths. Given a correctly updated sequence, we initially predict a new score of the alignment path for each contour to select the best candidates among them. Then, we run the Smith-Waterman algorithm in this confined space. Furthermore, our heuristic alignment for an updated sequence shows that it can be further accelerated by using reusable dynamic programming (rDP), our prior work. In this study, we successfully validate "relative node tolerance bound" (RNTB) in the pruned searching space. Furthermore, we improve the computational performance by quantifying the successful RNTB tolerance probability and switch to rDP on perturbation-resilient columns only. In our searching space derived by a threshold value of 90 percent of the optimal alignment score, we find that 98.3 percent of contours contain correctly updated paths. We also find that our method consumes only 25.36 percent of the runtime cost of sparse dynamic programming (sDP) method, and to only 2.55 percent of that of a normal dynamic programming with the Smith-Waterman algorithm.

  9. A normative price for energy from an electricity generation system: An Owner-dependent Methodology for Energy Generation (system) Assessment (OMEGA). Volume 1: Summary

    NASA Technical Reports Server (NTRS)

    Chamberlain, R. G.; Mcmaster, K. M.

    1981-01-01

    The utility owned solar electric system methodology is generalized and updated. The net present value of the system is determined by consideration of all financial benefits and costs (including a specified return on investment). Life cycle costs, life cycle revenues, and residual system values are obtained. Break even values of system parameters are estimated by setting the net present value to zero. While the model was designed for photovoltaic generators with a possible thermal energy byproduct, it applicability is not limited to such systems. The resulting owner-dependent methodology for energy generation system assessment consists of a few equations that can be evaluated without the aid of a high-speed computer.

  10. Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years.

    PubMed

    Ashley, Paul F; Williams, Catherine E C S; Moles, David R; Parry, Jennifer

    2015-09-28

    A significant proportion of children have caries requiring restorations or extractions, and some of these children will not accept this treatment under local anaesthetic. Historically this has been managed by the use of a general anaesthetic in children; however, use of sedation may lead to reduced morbidity and cost. The aim of this review was to compare the efficiency of sedation versus general anaesthesia (GA) for provision of dental treatment to children and adolescents younger than 18 years. This review was originally published in 2009 and was updated in 2012 and again in 2015. We will evaluate morbidity and effectiveness of sedation versus GA for provision of dental treatment to patients younger than 18 years. If data become available, we will analyse the cost-effectiveness of different interventions. If data are not available, we will obtain crude estimates of cost.Morbidity can be defined as 'an undesired result or complication'. For the purposes of this review, 'postoperative morbidity' refers to undesired results or complications such as nausea following a procedure, once the patient had been restored to consciousness and could breathe unaided. 'Intraoperative morbidity' refers to any complications that occur during the procedure that may necessitate action by the anaesthetist or the sedationist, such as respiratory arrest. In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE Ovid SP (1950 to July 2015); EMBASE Ovid SP (1974 to July 2015); System for Information on Grey Literature in Europe (SIGLE) (1980 to October July 2012); Latin American & Caribbean Health Sciences Literature (LILACS) (1982 to July 2015); and Institute for Scientific Information (ISI) Web of Science (1945 to July 2015).We also carried out handsearching of relevant journals to July 2015. We imposed no language restriction. We planned to include randomized controlled clinical trials that compared sedative agents versus general anaesthesia in children and adolescents up to 18 years of age undergoing dental treatment. We excluded complex surgical procedures and pseudo-randomized trials. Two review authors assessed titles and abstracts for inclusion in the review. We recorded information relevant to objectives and outcome measures by using a specially designed 'data extraction form'. We will employ the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach to interpret findings. In our original review, we identified 16 studies for potential inclusion after searching available databases and screening titles and abstracts. After retrieving full-text studies, we found none to be eligible. We identified no additional studies in the updated search of July 2012. We identified two studies for possible inclusion in the updated search of July 2015; again we found these to be ineligible. Randomized controlled studies comparing use of dental general anaesthesia versus sedation are needed to quantify differences such as morbidity and cost.

  11. Competitive Electricity Prices: An Update

    EIA Publications

    1998-01-01

    Illustrates a third impact of the move to competitive generation pricing -- the narrowing of the range of prices across regions of the country. This feature article updates information in Electricity Prices in a Competitive Environment: Marginal Cost Pricing of Generation Services and Financial Status of Electric Utilities.

  12. What Do Traffic Crashes Cost? Total Cost to Employers by State and Industry

    DOT National Transportation Integrated Search

    1996-12-01

    This report shows that by preventing motor vehicle crashes, the potential health : care savings are large. Motor vehicle injury costs to employers are reported : on a nationwide, state-by-state, and industry basis. The report updates the : national e...

  13. Singapore Urological Association Clinical Guidelines for Male Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia

    PubMed Central

    2017-01-01

    The first clinical guidelines for male lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) were published in 2005. An update is urgently needed in view of BPH being recognised as one of ten chronic illnesses by the Ministry of Health, Singapore. This review summarises the definition of BPH and the epidemiology of male LUTS/BPH in Singapore. BPH can be phenotyped with noninvasive transabdominal ultrasonography, according to intravesical prostatic protrusion and prostate volume, and classified according to severity (staging) for individualised treatment. At the initial evaluation, the majority of patients (59%) can be managed with fluid adjustment, exercise and diet; 32% with medications, using alpha blockers and/or 5-alpha reductase inhibitors for prostates weighing more than 30 g; and 9% with surgical intervention for more advanced disease. The 2015 guidelines comprise updated evidence that will help family medicine practitioners and specialists manage this common ailment more cost-effectively. PMID:28848988

  14. Abu Dhabi Basemap Update Using the LiDAR Mobile Mapping Technology

    NASA Astrophysics Data System (ADS)

    Alshaiba, Omar; Amparo Núñez-Andrés, M.; Lantada, Nieves

    2016-04-01

    Mobile LiDAR system provides a new technology which can be used to update geospatial information by direct and rapid data collection. This technology is faster than the traditional survey ways and has lower cost. Abu Dhabi Municipal System aims to update its geospatial system frequently as the government entities have invested heavily in GIS technology and geospatial data to meet the repaid growth in the infrastructure and construction projects in recent years. The Emirate of Abu Dhabi has witnessed a huge growth in infrastructure and construction projects in recent years. Therefore, it is necessary to develop and update its basemap system frequently to meet their own organizational needs. Currently, the traditional ways are used to update basemap system such as human surveyors, GPS receivers and controller (GPS assigned computer). Then the surveyed data are downloaded, edited and reviewed manually before it is merged to the basemap system. Traditional surveying ways may not be applicable in some conditions such as; bad weather, difficult topographic area and boundary area. This paper presents a proposed methodology which uses the Mobile LiDAR system to update basemap in Abu Dhabi by using daily transactions services. It aims to use and integrate the mobile LiDAR technology into the municipality's daily workflow such that it becomes the new standard cost efficiency operating procedure for updating the base-map in Abu Dhabi Municipal System. On another note, the paper will demonstrate the results of the innovated workflow for the base-map update using the mobile LiDAR point cloud and few processing algorithms.

  15. Advanced Fuel Cycle Cost Basis – 2017 Edition

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

    Dixon, B. W.; Ganda, F.; Williams, K. A.

    This report, commissioned by the U.S. Department of Energy (DOE) Office of Nuclear Energy (NE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the DOE Nuclear Technology Research and Development (NTRD) Program (previously the Fuel Cycle Research and Development (FCRD) and the Advanced Fuel Cycle Initiative (AFCI)). The report describes the NTRD cost basis development process, reference information on NTRD cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This reportmore » contains reference cost data for numerous fuel cycle cost modules (modules A-O) as well as cost modules for a number of reactor types (R modules). The fuel cycle cost modules were developed in the areas of natural uranium mining and milling, thorium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, managed decay storage, recycled product storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste. Since its inception, this report has been periodically updated. The last such internal document was published in August 2015 while the last external edition was published in December of 2009 as INL/EXT-07-12107 and is available on the Web at URL: www.inl.gov/technicalpublications/Documents/4536700.pdf. This current report (Sept 2017) is planned to be reviewed for external release, at which time it will replace the 2009 report as an external publication. This information is used in the ongoing evaluation of nuclear fuel cycles by the NE NTRD program.« less

  16. An interval model updating strategy using interval response surface models

    NASA Astrophysics Data System (ADS)

    Fang, Sheng-En; Zhang, Qiu-Hu; Ren, Wei-Xin

    2015-08-01

    Stochastic model updating provides an effective way of handling uncertainties existing in real-world structures. In general, probabilistic theories, fuzzy mathematics or interval analyses are involved in the solution of inverse problems. However in practice, probability distributions or membership functions of structural parameters are often unavailable due to insufficient information of a structure. At this moment an interval model updating procedure shows its superiority in the aspect of problem simplification since only the upper and lower bounds of parameters and responses are sought. To this end, this study develops a new concept of interval response surface models for the purpose of efficiently implementing the interval model updating procedure. The frequent interval overestimation due to the use of interval arithmetic can be maximally avoided leading to accurate estimation of parameter intervals. Meanwhile, the establishment of an interval inverse problem is highly simplified, accompanied by a saving of computational costs. By this means a relatively simple and cost-efficient interval updating process can be achieved. Lastly, the feasibility and reliability of the developed method have been verified against a numerical mass-spring system and also against a set of experimentally tested steel plates.

  17. Updating flood maps efficiently using existing hydraulic models, very-high-accuracy elevation data, and a geographic information system; a pilot study on the Nisqually River, Washington

    USGS Publications Warehouse

    Jones, Joseph L.; Haluska, Tana L.; Kresch, David L.

    2001-01-01

    A method of updating flood inundation maps at a fraction of the expense of using traditional methods was piloted in Washington State as part of the U.S. Geological Survey Urban Geologic and Hydrologic Hazards Initiative. Large savings in expense may be achieved by building upon previous Flood Insurance Studies and automating the process of flood delineation with a Geographic Information System (GIS); increases in accuracy and detail result from the use of very-high-accuracy elevation data and automated delineation; and the resulting digital data sets contain valuable ancillary information such as flood depth, as well as greatly facilitating map storage and utility. The method consists of creating stage-discharge relations from the archived output of the existing hydraulic model, using these relations to create updated flood stages for recalculated flood discharges, and using a GIS to automate the map generation process. Many of the effective flood maps were created in the late 1970?s and early 1980?s, and suffer from a number of well recognized deficiencies such as out-of-date or inaccurate estimates of discharges for selected recurrence intervals, changes in basin characteristics, and relatively low quality elevation data used for flood delineation. FEMA estimates that 45 percent of effective maps are over 10 years old (FEMA, 1997). Consequently, Congress has mandated the updating and periodic review of existing maps, which have cost the Nation almost 3 billion (1997) dollars. The need to update maps and the cost of doing so were the primary motivations for piloting a more cost-effective and efficient updating method. New technologies such as Geographic Information Systems and LIDAR (Light Detection and Ranging) elevation mapping are key to improving the efficiency of flood map updating, but they also improve the accuracy, detail, and usefulness of the resulting digital flood maps. GISs produce digital maps without manual estimation of inundated areas between cross sections, and can generate working maps across a broad range of scales, for any selected area, and overlayed with easily updated cultural features. Local governments are aggressively collecting very-high-accuracy elevation data for numerous reasons; this not only lowers the cost and increases accuracy of flood maps, but also inherently boosts the level of community involvement in the mapping process. These elevation data are also ideal for hydraulic modeling, should an existing model be judged inadequate.

  18. The threshold rate of oral atypical anti-psychotic adherence at which paliperidone palmitate is cost saving.

    PubMed

    Edwards, Natalie C; Muser, Erik; Doshi, Dilesh; Fastenau, John

    2012-01-01

    To identify, estimate, and compare 'real world' costs and outcomes associated with paliperidone palmitate compared with branded oral atypical anti-psychotics, and to estimate the threshold rate of oral atypical adherence at which paliperidone palmitate is cost saving. Decision analytic modeling techniques developed by Glazer and Ereshefsky have previously been used to estimate the cost-effectiveness of depot haloperidol, LAI risperidone, and, more recently, LAI olanzapine. This study used those same techniques, along with updated comparative published clinical data, to evaluate paliperidone palmitate. Adherence rates were based on strict Medication Event Monitoring System (MEMS) criteria. The evaluation was conducted from the perspective of US healthcare payers. Paliperidone palmitate patients had fewer mean annual days of relapse (8.7 days; 6.0 requiring hospitalization, 2.7 not requiring hospitalization vs 17.8 days; 12.4 requiring hospitalization, 5.4 not requiring hospitalization), and lower annual total cost ($20,995) compared to oral atypicals (mean $22,481). Because paliperidone palmitate was both more effective and less costly, it is considered economically dominant. Paliperidone palmitate saved costs when the rate of adherence of oral atypical anti-psychotics was below 44.9% using strict MEMS criteria. Sensitivity analyses showed results were robust to changes in parameter values. For patients receiving 156 mg paliperidone palmitate, the annual incremental cost was $1216 per patient (ICER = $191 per day of relapse averted). Inclusion of generic risperidone (market share 18.6%) also resulted in net incremental cost for paliperidone palmitate ($120; ICER = $13). Limitations of this evaluation include use of simplifying assumptions, data from multiple sources, and generalizability of results. Although uptake of LAIs in the US has not been as rapid as elsewhere, many thought leaders emphasize their importance in optimizing outcomes in patients with adherence problems. The findings of this analysis support the cost-effectiveness of paliperidone palmitate in these patients.

  19. Updated (BP3) Technical and Economic Feasibility Study - Electrochemical Membrane for Carbon Dioxide Capture and Power Generation

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

    Ghezel-Ayagh, Hossein

    This topical report summarizes the results of an updated Technical & Economic Feasibility Study (T&EFS) which was conducted in Budget Period 3 of the project to evaluate the performance and cost of the Electrochemical Membrane (ECM)-based CO 2 capture system. The ECM technology is derived from commercially available inorganic membranes; the same used in FuelCell Energy’s commercial fuel cell power plants and sold under the trade name Direct FuelCell® (DFC®). The ECM stacks are utilized in the Combined Electric Power (generation) And Carbon dioxide Separation (CEPACS) systems which can be deployed as add-ons to conventional power plants (Pulverized Coal, Combinedmore » Cycle, etc.) or industrial facilities to simultaneously produce power while capturing >90% of the CO 2 from the flue gas. In this study, an ECM-based CEPACS plant was designed to capture and compress >90% of the CO 2 (for sequestration or beneficial use) from the flue gas of a reference 550 MW (nominal, net AC) Pulverized Coal (PC) Rankine Cycle (Subcritical steam) power plant. ECM performance was updated based on bench scale ECM stack test results. The system process simulations were performed to generate the CEPACS plant performance estimates. The performance assessment included estimation of the parasitic power consumption for CO 2 capture and compression, and the efficiency impact on the PC plant. While the ECM-based CEPACS system for the 550 MW PC plant captures 90% of CO 2 from the flue gas, it generates additional (net AC) power after compensating for the auxiliary power requirements of CO 2 capture and compression. An equipment list, ECM stacks packaging design, and CEPACS plant layout were developed to facilitate the economic analysis. Vendor quotes were also solicited. The economic feasibility study included estimation of CEPACS plant capital cost, cost of electricity (COE) analyses and estimation of cost per ton of CO 2 captured. The incremental COE for the ECM-based CO 2 capture is expected to meet U.S. DOE’s target of 35%. This study has indicated that CEPACS systems offer significant benefits with respect to cost, performance, water consumption and emissions to environment. The realization of these benefits will provide a single solution to carbon dioxide capture in addition to meeting the increasing demand for electricity.« less

  20. Updated (BP3) Technical and Economic Feasibility Study - Electrochemical Membrane for Carbon Dioxide Capture and Power Generation

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

    Ghezel-Ayagh, Hossein

    This topical report summarizes the results of an updated Technical & Economic Feasibility Study (T&EFS) which was conducted in Budget Period 3 of the project to evaluate the performance and cost of the Electrochemical Membrane (ECM)-based CO2 capture system. The ECM technology is derived from commercially available inorganic membranes; the same used in FuelCell Energy’s commercial fuel cell power plants and sold under the trade name Direct FuelCell® (DFC®). The ECM stacks are utilized in the Combined Electric Power (generation) And Carbon dioxide Separation (CEPACS) systems which can be deployed as add-ons to conventional power plants (Pulverized Coal, Combined Cycle,more » etc.) or industrial facilities to simultaneously produce power while capturing >90% of the CO2 from the flue gas. In this study, an ECM-based CEPACS plant was designed to capture and compress >90% of the CO2 (for sequestration or beneficial use) from the flue gas of a reference 550 MW (nominal, net AC) Pulverized Coal (PC) Rankine Cycle (Subcritical steam) power plant. ECM performance was updated based on bench scale ECM stack test results. The system process simulations were performed to generate the CEPACS plant performance estimates. The performance assessment included estimation of the parasitic power consumption for CO2 capture and compression, and the efficiency impact on the PC plant. While the ECM-based CEPACS system for the 550 MW PC plant captures 90% of CO2 from the flue gas, it generates additional (net AC) power after compensating for the auxiliary power requirements of CO2 capture and compression. An equipment list, ECM stacks packaging design, and CEPACS plant layout were developed to facilitate the economic analysis. Vendor quotes were also solicited. The economic feasibility study included estimation of CEPACS plant capital cost, cost of electricity (COE) analyses and estimation of cost per ton of CO2 captured. The incremental COE for the ECM-based CO2 capture is expected to meet U.S. DOE’s target of 35%. This study has indicated that CEPACS systems offer significant benefits with respect to cost, performance, water consumption and emissions to environment. The realization of these benefits will provide a single solution to carbon dioxide capture in addition to meeting the increasing demand for electricity.« less

  1. Updating the Psoriatic Arthritis (PsA) Core Domain Set: A Report from the PsA Workshop at OMERACT 2016.

    PubMed

    Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J; Callis Duffin, Kristina; Elmamoun, Musaab; Tillett, William; Campbell, Willemina; FitzGerald, Oliver; Gladman, Dafna D; Goel, Niti; Gossec, Laure; Hoejgaard, Pil; Leung, Ying Ying; Lindsay, Chris; Strand, Vibeke; van der Heijde, Désirée M; Shea, Bev; Christensen, Robin; Coates, Laura; Eder, Lihi; McHugh, Neil; Kalyoncu, Umut; Steinkoenig, Ingrid; Ogdie, Alexis

    2017-10-01

    To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). At OMERACT 2016, research conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted 24 focus groups with 130 patients from 7 countries representing 5 continents to identify patient domains. We achieved consensus through 2 rounds of separate surveys with 50 patients and 75 physicians, and a nominal group technique meeting with 12 patients and 12 physicians. We conducted a workshop and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health-related quality of life, and systemic inflammation, which were recommended for all RCT and LOS. These were important, but not required in all RCT and LOS: economic cost, emotional well-being, participation, and structural damage. Independence, sleep, stiffness, and treatment burden were on the research agenda. The updated PsA Core Domain Set was endorsed at OMERACT 2016. Next steps for the PsA working group include evaluation of PsA outcome measures and development of a PsA Core Outcome Measurement Set.

  2. Economic Evaluations in the Diagnosis and Management of Traumatic Brain Injury: A Systematic Review and Analysis of Quality.

    PubMed

    Alali, Aziz S; Burton, Kirsteen; Fowler, Robert A; Naimark, David M J; Scales, Damon C; Mainprize, Todd G; Nathens, Avery B

    2015-07-01

    Economic evaluations provide a unique opportunity to identify the optimal strategies for the diagnosis and management of traumatic brain injury (TBI), for which uncertainty is common and the economic burden is substantial. The objective of this study was to systematically review and examine the quality of contemporary economic evaluations in the diagnosis and management of TBI. Two reviewers independently searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, Health Technology Assessment Database, EconLit, and the Tufts CEA Registry for comparative economic evaluations published from 2000 onward (last updated on August 30, 2013). Data on methods, results, and quality were abstracted in duplicate. The results were summarized quantitatively and qualitatively. Of 3539 citations, 24 economic evaluations met our inclusion criteria. Nine were cost-utility, five were cost-effectiveness, three were cost-minimization, and seven were cost-consequences analyses. Only six studies were of high quality. Current evidence from high-quality studies suggests the economic attractiveness of the following strategies: a low medical threshold for computed tomography (CT) scanning of asymptomatic infants with possible inflicted TBI, selective CT scanning of adults with mild TBI as per the Canadian CT Head Rule, management of severe TBI according to the Brain Trauma Foundation guidelines, management of TBI in dedicated neurocritical care units, and early transfer of patients with TBI with nonsurgical lesions to neuroscience centers. Threshold-guided CT scanning, adherence to Brain Trauma Foundation guidelines, and care for patients with TBI, including those with nonsurgical lesions, in specialized settings appear to be economically attractive strategies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. Pharmacoeconomics of parenteral nutrition in surgical and critically ill patients receiving structured triglycerides in China.

    PubMed

    Wu, Guo Hao; Ehm, Alexandra; Bellone, Marco; Pradelli, Lorenzo

    2017-01-01

    A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015. Newly identified studies were pooled with the prior studies and an updated meta-analysis was performed. A deterministic simulation model was used to compare the effects of STGs and mixed MCT/LCT's on Chinese hospital costs. The literature search identified six new trials, resulting in a total of 27 studies in the updated meta-analysis. Statistically significant differences favoring STGs were observed for cumulative nitrogen balance, pre- albumin and albumin concentrations, plasma triglycerides, and liver enzymes. STGs were also associated with a significant reduction in the length of hospital stay (mean difference, -1.45 days; 95% confidence interval, -2.48 to -0.43; p=0.005) versus mixed MCT/LCTs. Cost analysis demonstrated a net cost benefit of ¥675 compared with mixed MCT/LCTs. STGs are associated with improvements in metabolic function and reduced length of hospitalization in surgical and critically ill patients compared with mixed MCT/LCT emulsions. Cost analysis using data from Chinese hospitals showed a corresponding cost benefit.

  4. 75 FR 59661 - Update of Overflight Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... existing Overflight Fees by using current FAA cost accounting data and air traffic activity data. This action is necessary because operational costs for providing air traffic control and related services for... would result in an increased level of cost recovery for the services being provided. DATES: Send your...

  5. Gambling on CD-ROM.

    ERIC Educational Resources Information Center

    Lowe, John B.

    1988-01-01

    If the CD-ROM revolution is likened to gambling, players are information providers and consumers; the stakes are development, production, distribution, hardware, and software costs; and betting is represented by the costs of updating disks and hardware and software maintenance, and by pricing. Strategy should take into account cost savings,…

  6. 76 FR 68040 - Federal Acquisition Regulation; Labor Relations Costs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... allowable and unallowable costs. Response: FAR 31.201-6 requires contractors to have an accounting system to... update their accounting systems to account for the costs made unallowable by this rule; that contractors demonstrate to contracting officers that their accounting systems can effectively account for these...

  7. EoC Study Update to Examine the Cost, Schedule and Technical Changes to NASA Projects

    NASA Technical Reports Server (NTRS)

    Bitten, Bob; Emmons, Debra; Shinn, Stephen; Scolese, Chris

    2018-01-01

    The original National Aeronautics and Space Administration (NASA) Explanation of Change (EoC) study was conducted in 2010 to understand the underlying causes of cost and schedule growth. The first study consisted of 25 missions launched from 2000 to 2010 and looked at the events that led to growth. These events were categorized into different bins that were rolled up to quantify whether the growth was due to internal planning, or internal execution, or from external forces and found that the growth was evenly distributed among those three categories. The result of the study presented nine considerations focused at reducing growth due to project external events and internal planning events. Although no one 'magic bullet' consideration was discovered in the previous work, the nine considerations taken as a whole were postulated to help reduce cost and schedule change in future NASA missions. A recent update was conducted that included investigating 8 missions developed since the previous study to determine if the results were different. Cost, schedule, and mass increases were analyzed from the start of Phase B through Preliminary Design Review and Critical Design Review to Launch. As shown in this paper, the results are better with overall cost and schedule growth being reduced. The paper will show a comparison of the previous results to the updated results to show specific reductions and provide an explanation of which recommendations were followed.

  8. Salivary immunoassays to investigate potential exposure to microbial contaminants from drinking water in rural Puerto Rico: an update

    EPA Science Inventory

    This presentation provides an update to an ongoing collaboration with Inter American University of Puerto Rico. The goal of this study is to investigate public health benefits that result from implementation of low cost, sustainable filtration technologies in remote, rural commu...

  9. A Markov model to evaluate cost-effectiveness of antiangiogenesis therapy using bevacizumab in advanced cervical cancer.

    PubMed

    Minion, Lindsey E; Bai, Jiaru; Monk, Bradley J; Robin Keller, L; Ramez, Eskander N; Forde, Gareth K; Chan, John K; Tewari, Krishnansu S

    2015-06-01

    To evaluate the cost-effectiveness of bevacizumab in recurrent/persistent and metastatic cervical cancer using recently reported updated survival and toxicology data. A Markov decision tree based on the Gynecologic Oncology Group 240 randomized trial was created. The 2013 MediCare Services Drug Payment Table and Physician Fee Schedule provided costs. In the 5-year model subjects transitioned through the following states: response, progression, minor complications, severe complications, and death. Patients experiencing a health utility per month according to treatment effectiveness were calculated. Because cervical cancer survival is measured in months rather than years, results were reported in both quality adjusted cervical cancer life months and years (QALmonth, QALY), adjusted from a baseline of having advanced cervical cancer during a month. The estimated total cost of therapy with bevacizumab is approximately 13.2 times that for chemotherapy alone, adding $73,791 per 3.5months (0.29year) of life gained, resulting in an incremental cost-effectiveness ratio (ICER) of $21.083 per month of added life. The ICER increased to $5775 per month of added life and $24,597/QALmonth ($295,164/QALY) due to the smaller difference in QALmonths. With 75% bevacizumab cost reduction, the ICER is $6737/QALmonth ($80,844/QALY), which translates to $23,580 for the 3.5month (0.29year) gain in OS. Increased costs are primarily related to the cost of drug and not the management of bevacizumab-induced complications. Cost reductions in bevacizumab result in dramatic declines in the ICER, suggesting that cost reconciliation in advanced cervical cancer may be possible through the availability of biosimilars, and/or less expensive, equally efficacious anti-angiogenesis agents. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Biomass fuels update. TVAs biomass fuels program

    NASA Astrophysics Data System (ADS)

    1982-02-01

    Equipment was installed and tests were conducted on the ethanol from hardwood project. Location of hardwoods, to improve forest management, and to reduce the cost of harvesting woody biomass was assessed. Substantial underutilized cropland exists in the Valley, and a questionnaire survey was administered to supplement available cropland data. The potential liquid fuel yields and production management practices for alternative starch, sugar, and vegetable oil crops were determined to obtain benchmark data and to evaluate alcohol production from alternative agricultural feedstocks. Workshops were conducted to provide information on production of alcohol.

  11. Experimental Evaluation of Processing Time for the Synchronization of XML-Based Business Objects

    NASA Astrophysics Data System (ADS)

    Ameling, Michael; Wolf, Bernhard; Springer, Thomas; Schill, Alexander

    Business objects (BOs) are data containers for complex data structures used in business applications such as Supply Chain Management and Customer Relationship Management. Due to the replication of application logic, multiple copies of BOs are created which have to be synchronized and updated. This is a complex and time consuming task because BOs rigorously vary in their structure according to the distribution, number and size of elements. Since BOs are internally represented as XML documents, the parsing of XML is one major cost factor which has to be considered for minimizing the processing time during synchronization. The prediction of the parsing time for BOs is an significant property for the selection of an efficient synchronization mechanism. In this paper, we present a method to evaluate the influence of the structure of BOs on their parsing time. The results of our experimental evaluation incorporating four different XML parsers examine the dependencies between the distribution of elements and the parsing time. Finally, a general cost model will be validated and simplified according to the results of the experimental setup.

  12. [Myocardial viability: update in nuclear cardiology].

    PubMed

    Vallejo, Enrique

    2007-01-01

    Evaluation of myocardial viability with the aid of radionuclides, is a technique that offers reliable, reproducible information, with an attractive cost-benefit relationship, in the study of the myocardial viability, integrating cardiac molecular, metabolic, and functional aspects. Nowadays, coronary risk stratification in post-myocardial infarction patients pretends to locate them as low-, intermediate, and high risk-subjects that can suffer cardiovascular complications in the very near future. Low-risk patients are characterized by a cardiac-related mortality below 1%, whereas high-risk mortality is greater than 3%. Because of clinical complications following a myocardial infarction are observed during the first month of evolution, clinical guidelines suggest to evaluate the cardiovascular risk before hospital discharge.

  13. Policy Makers Will Need A Way To Update Bundled Payments That Reflects Highly Skewed Spending Growth Of Various Care Episodes

    PubMed Central

    Rosen, Allison B.; Aizcorbe, Ana; Ryu, Alexander J.; Nestoriak, Nicole; Cutler, David M.; Chernew, Michael E.

    2015-01-01

    Bundled payment entails paying a single price for all services delivered as part of an episode of care for a specific condition. It is seen as a promising way to slow the growth of health care spending while maintaining or improving the quality of care. To implement bundled payment, policy makers must set base payment rates for episodes of care and update the rates over time to reflect changes in the costs of delivering care and the components of care. Adopting the fee-for-service paradigm of adjusting payments with uniform update rates would be fair and accurate if costs increased at a uniform rate across episodes. But our analysis of 2003 and 2007 US commercial claims data showed spending growth to be highly skewed across episodes: 10 percent of episodes accounted for 82.5 percent of spending growth, and within-episode spending growth ranged from a decline of 75 percent to an increase of 323 percent. Given that spending growth was much faster for some episodes than for others, a situation known as skewness, policy makers should not update episode payments using uniform update rates. Rather, they should explore ways to address variations in spending growth, such as updating episode payments one by one, at least at the outset. PMID:23650329

  14. To Your Health: NLM update transcript - U.S. health costs and care

    MedlinePlus

    ... well as insurance companies provide more leadership. Otherwise, comparative costs for hospital stays in the U.S. (from the Agency for Healthcare Research and Quality) is available within the 'statistics and ...

  15. Update on Parametric Cost Models for Space Telescopes

    NASA Technical Reports Server (NTRS)

    Stahl. H. Philip; Henrichs, Todd; Luedtke, Alexander; West, Miranda

    2011-01-01

    Since the June 2010 Astronomy Conference, an independent review of our cost data base discovered some inaccuracies and inconsistencies which can modify our previously reported results. This paper will review changes to the data base, our confidence in those changes and their effect on various parametric cost models

  16. 76 FR 296 - Periodic Reporting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-04

    ... part would update the mail processing portion of the Parcel Select/Parcel Return Service cost models...) processing cost model that was filed as Proposal Seven on September 8, 2010. Proposal Thirteen at 1. These... develop the Standard Mail/non-flat machinable (NFM) mail processing cost model. It also proposes to use...

  17. Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

    PubMed

    Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

    2018-03-01

    Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

  18. Estimating the implied cost of carbon in future scenarios using a CGE model: The Case of Colorado

    DOE PAGES

    Hannum, Christopher; Cutler, Harvey; Iverson, Terrence; ...

    2017-01-07

    We develop a state-level computable general equilibrium (CGE) model that reflects the roles of coal, natural gas, wind, solar, and hydroelectricity in supplying electricity, using Colorado as a case study. Also, we focus on the economic impact of implementing Colorado's existing Renewable Portfolio Standard, updated in 2013. This requires that 25% of state generation come from qualifying renewable sources by 2020. We evaluate the policy under a variety of assumptions regarding wind integration costs and assumptions on the persistence of federal subsidies for wind. Specifically, we estimate the implied price of carbon as the carbon price at which a state-levelmore » policy would pass a state-level cost-benefit analysis, taking account of estimated greenhouse gas emission reductions and ancillary benefits from corresponding reductions in criteria pollutants. Our findings suggest that without the Production Tax Credit (federal aid), the state policy of mandating renewable power generation (RPS) is costly to state actors, with an implied cost of carbon of about $17 per ton of CO 2 with a 3% discount rate. Federal aid makes the decision between natural gas and wind nearly cost neutral for Colorado.« less

  19. Estimating the implied cost of carbon in future scenarios using a CGE model: The Case of Colorado

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

    Hannum, Christopher; Cutler, Harvey; Iverson, Terrence

    We develop a state-level computable general equilibrium (CGE) model that reflects the roles of coal, natural gas, wind, solar, and hydroelectricity in supplying electricity, using Colorado as a case study. Also, we focus on the economic impact of implementing Colorado's existing Renewable Portfolio Standard, updated in 2013. This requires that 25% of state generation come from qualifying renewable sources by 2020. We evaluate the policy under a variety of assumptions regarding wind integration costs and assumptions on the persistence of federal subsidies for wind. Specifically, we estimate the implied price of carbon as the carbon price at which a state-levelmore » policy would pass a state-level cost-benefit analysis, taking account of estimated greenhouse gas emission reductions and ancillary benefits from corresponding reductions in criteria pollutants. Our findings suggest that without the Production Tax Credit (federal aid), the state policy of mandating renewable power generation (RPS) is costly to state actors, with an implied cost of carbon of about $17 per ton of CO 2 with a 3% discount rate. Federal aid makes the decision between natural gas and wind nearly cost neutral for Colorado.« less

  20. A comparison of costs associated with utility management options for dry active waste

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

    Hornibrook, C.

    1995-12-31

    The economics of low level waste management is receiving more attention today than ever before. This is due to four factors: (1) the increases in the cost of processing of these wastes; (2) increases in the cost of disposal; (3) the addition of storage costs for those without access to disposal; and (4) the increasing competitive nature of the electric generation industry. These pressures are forcing the industry to update it`s evaluation of the mix of processing that will afford it the best long term economics and minimize it`s risks for unforeseen costs. Whether disposal is available or not, allmore » utilities face the same challenge of minimizing the costs associated with the management of these wastes. There are a number of variables that will impact how a utility manages their wastes but the problem is the uncertainty of what will actually happen, i.e., will disposal be available, when and at what cost. Using the EPRI-developed WASTECOST: DAW code, this paper explores a variety of LLW management options available to utilities. Along with providing the costs and benefits, other technical considerations which play an important part in the management of these wastes are also addressed.« less

  1. Review of the cost of venous thromboembolism

    PubMed Central

    Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

    2015-01-01

    Background Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new treatment options such as the non-vitamin K antagonist oral anticoagulants on VTE treatment are warranted. PMID:26355805

  2. Review of the cost of venous thromboembolism.

    PubMed

    Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

    2015-01-01

    Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003-2014. Additional studies were identified through searching bibliographies of related publications. Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198-$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804-$16,644 during the 1998-2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new treatment options such as the non-vitamin K antagonist oral anticoagulants on VTE treatment are warranted.

  3. [Analysis of the cost-effectiveness of antiviral therapies in chronic hepatitis B patients in Korea].

    PubMed

    Kim, Byung Kook; Kwon, So Young; Lee, Chang Hong; Choe, Won Hyeok; Choi, Hong Mi; Koo, Hye Won

    2009-03-01

    The purpose of this study was to evaluate the cost-effectiveness of 1 year and up to 5 years of antiviral treatment for chronic hepatitis B (CHB). Two ten-health-state Markov models were developed for CHB patients. The proportion of patients remaining alive in each health state, and healthcare costs and quality-adjusted life years (QALYs) were determined during annual cycles of these Markov models. The total healthcare costs, life years, and QALYs over the 40-year time horizon of the model were calculated. The perspectives of the cost-effectiveness analysis were the Korean healthcare system and the healthcare needs of the CHB patient. Short-course therapy with alpha-interferon or 1-year treatment with pegylated interferon alpha-2a, lamivudine (LMV), or adefovir (ADV) had limited impact on disease progression. In contrast, either LMV-ADV or ADV-LMV as rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. The cost-effectiveness threshold in Korea was estimated to be approximately 25,000,000 South Korean won. LMV administered for 1 year is cost-effective in comparison with no treatment for both HBeAg-positive and HBeAg-negative CHB patients, but longer duration antiviral therapies administered for up to 5 years in CHB patients were found to be highly cost-effective by international standards. Antiviral treatment of CHB with LMV or ADV for up to 5 years using the alternative antiviral agent as rescue medication appears to be a cost-effective strategy for both HBeAg-positive and HBeAg-negative CHB patients in Korea. Economic evaluation of antiviral therapies should be studied further and updated, particularly for newer agents.

  4. Tree value conversion standards revisited

    Treesearch

    Paul S. DeBald; Martin E. Dale; Martin E. Dale

    1991-01-01

    Updated tree value conversion standards (TVCS) are presented for 12 important hardwood species of the oak-hickory forest. These updated standards-developed for each species by butt-log grade, merchantable height, and diameter at breast height-reflect the changes in lumber prices and in conversion costs which have occurred since 1976 when the original TVCS were...

  5. Using the Wilderness to Facilitate Adjustment to College: An Updated Description of Wilderness Orientation Programs.

    ERIC Educational Resources Information Center

    Davis-Berman, Jennifer; Berman, Dene

    1996-01-01

    Updated description of 38 wilderness orientation programs currently affiliated with U.S. colleges and universities includes program enrollment, length, cost, types of leaders, training, and sponsorship. Discusses program philosophies, goals, reasons for using the wilderness, and critical and emerging issues. Compares data to previous research.…

  6. 78 FR 63185 - Waste Management System; Testing and Monitoring Activities; Update V of SW-846

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... performance and cost effectiveness. Since the publication of the Methods Innovation Rule (MIR) (70 FR 34537... SW-846,'' which identifies the update history for each document in SW-846. The Agency strongly... Methods Innovation Rule (MIR) published on June 14, 2005 (70 FR 34538), reemphasized the flexible approach...

  7. 42 CFR 495.340 - As-needed HIT PAPD update and as-needed HIT IAPD update requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.340 As... document or the HIT implementation advance planning document. (d) A change in implementation concept or a change to the scope of the project. (e) A change to the approved cost allocation methodology. ...

  8. 42 CFR 495.340 - As-needed HIT PAPD update and as-needed HIT IAPD update requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.340 As... document or the HIT implementation advance planning document. (d) A change in implementation concept or a change to the scope of the project. (e) A change to the approved cost allocation methodology. ...

  9. The 1993 RPA timber assessment update

    Treesearch

    Richard W. Haynes; Darius M. Adams; John R. Mills

    1995-01-01

    This update reports changes in the Nation's timber resource since the 1989 RPA timber assessment. The timber resource situation is analyzed to provide projections for future cost and availability of timber products to meet demands. Prospective trends in demands for and supplies of timber, and the factors that affect these trends are examined. These include changes...

  10. REVISING/UPDATING EPA 625/1-79-011, PROCESS DESIGN MANUAL FOR SLUDGE TREATMENT AND DISPOSAL

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) wishes to revise/update its very large and comprehensive 1979 Process Design Manual for Sludge Treatment and Disposal, EPA 625/1-79-011. As you might imagine the task is not trivial, as already in 1979 the original manual cost more tha...

  11. 78 FR 12269 - Wireline Competition Bureau Seeks Updates and Corrections to TelcoMaster Table for Connect...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... Competition Bureau Seeks Updates and Corrections to TelcoMaster Table for Connect America Cost Model AGENCY... centers to particular holding companies for purposes of Connect America Phase II implementation. DATES... companies for purposes of Connect America Phase II implementation. 2. The USF/ICC Transformation Order, 76...

  12. Information distribution in distributed microprocessor based flight control systems

    NASA Technical Reports Server (NTRS)

    Montgomery, R. C.; Lee, P. S.

    1977-01-01

    This paper presents an optimal control theory that accounts for variable time intervals in the information distribution to control effectors in a distributed microprocessor based flight control system. The theory is developed using a linear process model for the aircraft dynamics and the information distribution process is modeled as a variable time increment process where, at the time that information is supplied to the control effectors, the control effectors know the time of the next information update only in a stochastic sense. An optimal control problem is formulated and solved that provides the control law that minimizes the expected value of a quadratic cost function. An example is presented where the theory is applied to the control of the longitudinal motions of the F8-DFBW aircraft. Theoretical and simulation results indicate that, for the example problem, the optimal cost obtained using a variable time increment Markov information update process where the control effectors know only the past information update intervals and the Markov transition mechanism is almost identical to that obtained using a known uniform information update interval.

  13. CoMET: Cost and Mass Evaluation Tool for Spacecraft and Mission Design

    NASA Technical Reports Server (NTRS)

    Bieber, Ben S.

    2005-01-01

    New technology in space exploration is often developed without a complete knowledge of its impact. While the immediate benefits of a new technology are obvious, it is harder to understand its indirect consequences, which ripple through the entire system. COMET is a technology evaluation tool designed to illuminate how specific technology choices affect a mission at each system level. COMET uses simplified models for mass, power, and cost to analyze performance parameters of technologies of interest. The sensitivity analysis that CoMET provides shows whether developing a certain technology will greatly benefit the project or not. CoMET is an ongoing project approaching a web-based implementation phase. This year, development focused on the models for planetary daughter craft, such as atmospheric probes, blimps and balloons, and landers. These models are developed through research into historical data, well established rules of thumb, and engineering judgment of experts at JPL. The model is validated by corroboration with JpL advanced mission studies. Other enhancements to COMET include adding launch vehicle analysis and integrating an updated cost model. When completed, COMET will allow technological development to be focused on areas that will most drastically improve spacecraft performance.

  14. Landfill Gas Energy Cost Model Version 3.0 (LFGcost-Web V3.0)

    EPA Science Inventory

    To help stakeholders estimate the costs of a landfill gas (LFG) energy project, in 2002, LMOP developed a cost tool (LFGcost). Since then, LMOP has routinely updated the tool to reflect changes in the LFG energy industry. Initially the model was designed for EPA to assist landfil...

  15. Update on the methodology for Amtrak cost accounting Amtrak performance tracking (APT) : volume 2, appendices A-F.

    DOT National Transportation Integrated Search

    2016-04-22

    Each table below represents the list of Cost Centers associated with each APT Subfamily at the time the data for this report was gathered from APT in April 2016. The #701 Capital Family is not included as it does not have Cost Centers in a traditiona...

  16. Revolution…Now The Future Arrives for Five Clean Energy Technologies – 2015 Update

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

    None

    In 2013, the U.S. Department of Energy (DOE) released the Revolution Now report, highlighting four transformational technologies: land-based wind power, silicon photovoltaic (PV) solar modules, light-emitting diodes (LEDs), and electric vehicles (EVs). That study and its 2014 update showed how dramatic reductions in cost are driving a surge in consumer, industrial, and commercial adoption for these clean energy technologies—as well as yearly progress. In addition to presenting the continued progress made over the last year in these areas, this year’s update goes further. Two separate sections now cover large, central, utility-scale PV plants and smaller, rooftop, distributed PV systems tomore » highlight how both have achieved significant deployment nationwide, and have done so through different innovations, such as easier access to capital for utility-scale PV and reductions of non-hardware costs and third-party ownership for distributed PV. Along with these core technologies« less

  17. A recursive Bayesian approach for fatigue damage prognosis: An experimental validation at the reliability component level

    NASA Astrophysics Data System (ADS)

    Gobbato, Maurizio; Kosmatka, John B.; Conte, Joel P.

    2014-04-01

    Fatigue-induced damage is one of the most uncertain and highly unpredictable failure mechanisms for a large variety of mechanical and structural systems subjected to cyclic and random loads during their service life. A health monitoring system capable of (i) monitoring the critical components of these systems through non-destructive evaluation (NDE) techniques, (ii) assessing their structural integrity, (iii) recursively predicting their remaining fatigue life (RFL), and (iv) providing a cost-efficient reliability-based inspection and maintenance plan (RBIM) is therefore ultimately needed. In contribution to these objectives, the first part of the paper provides an overview and extension of a comprehensive reliability-based fatigue damage prognosis methodology — previously developed by the authors — for recursively predicting and updating the RFL of critical structural components and/or sub-components in aerospace structures. In the second part of the paper, a set of experimental fatigue test data, available in the literature, is used to provide a numerical verification and an experimental validation of the proposed framework at the reliability component level (i.e., single damage mechanism evolving at a single damage location). The results obtained from this study demonstrate (i) the importance and the benefits of a nearly continuous NDE monitoring system, (ii) the efficiency of the recursive Bayesian updating scheme, and (iii) the robustness of the proposed framework in recursively updating and improving the RFL estimations. This study also demonstrates that the proposed methodology can lead to either an extent of the RFL (with a consequent economical gain without compromising the minimum safety requirements) or an increase of safety by detecting a premature fault and therefore avoiding a very costly catastrophic failure.

  18. Roads Data Conflation Using Update High Resolution Satellite Images

    NASA Astrophysics Data System (ADS)

    Abdollahi, A.; Riyahi Bakhtiari, H. R.

    2017-11-01

    Urbanization, industrialization and modernization are rapidly growing in developing countries. New industrial cities, with all the problems brought on by rapid population growth, need infrastructure to support the growth. This has led to the expansion and development of the road network. A great deal of road network data has made by using traditional methods in the past years. Over time, a large amount of descriptive information has assigned to these map data, but their geometric accuracy and precision is not appropriate to today's need. In this regard, the improvement of the geometric accuracy of road network data by preserving the descriptive data attributed to them and updating of the existing geo databases is necessary. Due to the size and extent of the country, updating the road network maps using traditional methods is time consuming and costly. Conversely, using remote sensing technology and geographic information systems can reduce costs, save time and increase accuracy and speed. With increasing the availability of high resolution satellite imagery and geospatial datasets there is an urgent need to combine geographic information from overlapping sources to retain accurate data, minimize redundancy, and reconcile data conflicts. In this research, an innovative method for a vector-to-imagery conflation by integrating several image-based and vector-based algorithms presented. The SVM method for image classification and Level Set method used to extract the road the different types of road intersections extracted from imagery using morphological operators. For matching the extracted points and to find the corresponding points, matching function which uses the nearest neighborhood method was applied. Finally, after identifying the matching points rubber-sheeting method used to align two datasets. Two residual and RMSE criteria used to evaluate accuracy. The results demonstrated excellent performance. The average root-mean-square error decreased from 11.8 to 4.1 m.

  19. Update on value-based medicine.

    PubMed

    Brown, Melissa M; Brown, Gary C

    2013-05-01

    To update concepts in Value-Based Medicine, especially in view of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act assures that some variant of Value-Based Medicine cost-utility analysis will play a key role in the healthcare system. It identifies the highest quality care, thereby maximizing the most efficacious use of healthcare resources and empowering patients and physicians.Standardization is critical for the creation and acceptance of a Value-Based Medicine, cost-utility analysis, information system, since 27 million different input variants can go into a cost-utility analysis. Key among such standards is the use of patient preferences (utilities), as patients best understand the quality of life associated with their health states. The inclusion of societal costs, versus direct medical costs alone, demonstrates that medical interventions are more cost effective and, in many instances, provide a net financial return-on-investment to society referent to the direct medical costs expended. Value-Based Medicine provides a standardized methodology, integrating critical, patient, quality-of-life preferences, and societal costs, to allow the highest quality, most cost-effective care. Central to Value-Based Medicine is the concept that all patients deserve the interventions that provide the greatest patient value (improvement in quality of life and/or length of life).

  20. Production of Hydrogen by Superadiabatic Decomposition of Hydrogen Sulfide - Final Technical Report for the Period June 1, 1999 - September 30, 2000

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

    Rachid B. Slimane; Francis S. Lau; Javad Abbasian

    2000-10-01

    The objective of this program is to develop an economical process for hydrogen production, with no additional carbon dioxide emission, through the thermal decomposition of hydrogen sulfide (H{sub 2}S) in H{sub 2}S-rich waste streams to high-purity hydrogen and elemental sulfur. The novel feature of the process being developed is the superadiabatic combustion (SAC) of part of the H{sub 2}S in the waste stream to provide the thermal energy required for the decomposition reaction such that no additional energy is required. The program is divided into two phases. In Phase 1, detailed thermochemical and kinetic modeling of the SAC reactor withmore » H{sub 2}S-rich fuel gas and air/enriched air feeds is undertaken to evaluate the effects of operating conditions on exit gas products and conversion efficiency, and to identify key process parameters. Preliminary modeling results are used as a basis to conduct a thorough evaluation of SAC process design options, including reactor configuration, operating conditions, and productivity-product separation schemes, with respect to potential product yields, thermal efficiency, capital and operating costs, and reliability, ultimately leading to the preparation of a design package and cost estimate for a bench-scale reactor testing system to be assembled and tested in Phase 2 of the program. A detailed parametric testing plan was also developed for process design optimization and model verification in Phase 2. During Phase 2 of this program, IGT, UIC, and industry advisors UOP and BP Amoco will validate the SAC concept through construction of the bench-scale unit and parametric testing. The computer model developed in Phase 1 will be updated with the experimental data and used in future scale-up efforts. The process design will be refined and the cost estimate updated. Market survey and assessment will continue so that a commercial demonstration project can be identified.« less

  1. Quantity and Quality of Economic Evaluations in U.S. Nursing Research, 1997-2015: A Systematic Review.

    PubMed

    Cook, Wendy A; Morrison, Megan L; Eaton, Linda H; Theodore, Brian R; Doorenbos, Ardith Z

    The United States has a complex healthcare system that is undergoing substantial reformations. There is a need for high-quality, economic evaluations of nursing practice. An updated review of completed economic evaluations relevant to the field of nursing within the U.S. healthcare system is timely and needed. The purpose of this study was to evaluate and describe the quantity and quality of economic evaluations in nursing-relevant research performed in the United States between 1997 and 2015. Four databases were searched. Titles, abstracts, and full-text content were reviewed to identify studies that analyzed both costs and outcomes, relevant to nursing, performed in the United States, and used the quality-adjusted life year to measure effectiveness. For included studies, data were extracted from full-text articles using criteria from U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. Twenty-eight studies met the inclusion criteria. Most (n = 25, 89%) were published in the last decade of the analysis, from 2006 to 2015. Assessment of quality, based on selected items from the panel guidelines, found that the evaluations did not consistently use the recommended societal perspective, use multiple resource utilization categories, use constant dollars, discount future costs and outcomes, use a lifetime horizon, or include an indication of uncertainty in results. The only resource utilization category consistently included across studies was healthcare resources. Only 28 nursing-related studies meeting the inclusion criteria were identified as meeting robust health economic evaluation methodological criteria, and most did not include all important guideline items. Despite increases in absolute numbers of published studies over the past decade, economic evaluation has been underutilized in U.S. nursing-relevant research in the past two decades.

  2. Which interventions are cost-effective for the management of whiplash-associated and neck pain-associated disorders? A systematic review of the health economic literature by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

    PubMed

    van der Velde, Gabrielle; Yu, Hainan; Paulden, Mike; Côté, Pierre; Varatharajan, Sharanya; Shearer, Heather M; Wong, Jessica J; Randhawa, Kristi; Southerst, Danielle; Mior, Silvano; Sutton, Deborah; Jacobs, Craig; Taylor-Vaisey, Anne

    2016-12-01

    Whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD) are prevalent conditions that impact society and impose a significant economic burden on health-care systems. Health economic evidence on WAD and NAD interventions has been sparse: only three economic evaluations of interventions for NAD were identified by the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (NPTF). An updated overview is needed to inform health-care policy and guidelines. This study aimed to determine the cost-effectiveness of interventions for grades I-III WAD and NAD in children and adults. Systematic review of health economic literature, best-evidence synthesis. We systematically searched CINAHL, the Cochrane economic databases (Health Technology Assessment, NHS Economic Evaluation Database), EconLit, EMBASE, MEDLINE, PsycINFO, and Tufts CEA Registry from 2000 to 2015 for economic evaluations of WAD and NAD interventions. We appraised relevant evaluations using the Scottish Intercollegiate Guidelines Network Methodology Criteria for Economic Evaluations. We extracted data, including mean costs (standardized to 2013 Canadian dollars [CAD]) and quality-adjusted life years (QALYs), from studies with adequate methodological quality. We recalculated cost-effectiveness statistics based on the standardized currency using a willingness-to-pay of CAD $50,000 per additional QALY. Funding was provided by the Ministry of Finance. Our search identified 1,616 citations. Six studies fulfilled our selection criteria, including three studies previously reviewed by the NPTF. Structured education appears cost-effective for adults with WAD. For adults with NAD, acupuncture added to routine medical care; manual therapy; multimodal care that includes manual therapy; advice and exercise; and psychological care using cognitive-behavioral therapy appear cost-effective. In contrast, adding manual therapy or diathermy to advice and exercise; multimodal care by a physiotherapist or physician; and behavioral-graded activity do not appear cost-effective for adults with NAD. Our review adds to the findings of the NPTF. Recent evidence suggests that structured education is cost-effective for WAD, whereas advice and exercise and multimodal care that include manual therapy are cost-effective for NAD. Obtaining more robust health economic evidence for non-invasive interventions for WAD and NAD in children and adults remains an essential research priority. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Updating Sensory "versus" Task Representations during Task-Switching: Insights from Cognitive Brain Potentials in Humans

    ERIC Educational Resources Information Center

    Perianez, Jose A.; Barcelo, Francisco

    2009-01-01

    Task-cueing studies suggest that the updating of sensory and task representations both contribute to behavioral task-switch costs [Forstmann, B. U., Brass, M., & Koch, I. (2007). "Methodological and empirical issues when dissociating cue-related from task-related processes in the explicit task-cuing procedure." "Psychological Research, 71"(4),…

  4. 75 FR 14076 - Express Mail Open and Distribute and Priority Mail Open and Distribute Changes and Updates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-24

    ... POSTAL SERVICE 39 CFR Part 111 Express Mail Open and Distribute and Priority Mail Open and... to reflect changes and updates for Express Mail[supreg] Open and Distribute and Priority Mail[supreg] Open and Distribute to improve efficiencies in processing and to control costs. DATES: Effective Date...

  5. Updating the Economic Impacts of the High/Scope Perry Preschool Program

    ERIC Educational Resources Information Center

    Nores, Milagros; Belfield, Clive R.; Barnett, W. Steven; Schweinhart, Lawrence

    2005-01-01

    This article derives an updated cost-benefit ratio for the High/Scope Perry Preschool Program, an intensive preschool intervention delivered during the 1960s to at-risk children in Ypsilanti, Michigan. Because children were randomly assigned to the program or a control group, differences in outcomes are probably attributable to program status.…

  6. Performance, Agility and Cost of Cloud Computing Services for NASA GES DISC Giovanni Application

    NASA Astrophysics Data System (ADS)

    Pham, L.; Chen, A.; Wharton, S.; Winter, E. L.; Lynnes, C.

    2013-12-01

    The NASA Goddard Earth Science Data and Information Services Center (GES DISC) is investigating the performance, agility and cost of Cloud computing for GES DISC applications. Giovanni (Geospatial Interactive Online Visualization ANd aNalysis Infrastructure), one of the core applications at the GES DISC for online climate-related Earth science data access, subsetting, analysis, visualization, and downloading, was used to evaluate the feasibility and effort of porting an application to the Amazon Cloud Services platform. The performance and the cost of running Giovanni on the Amazon Cloud were compared to similar parameters for the GES DISC local operational system. A Giovanni Time-Series analysis of aerosol absorption optical depth (388nm) from OMI (Ozone Monitoring Instrument)/Aura was selected for these comparisons. All required data were pre-cached in both the Cloud and local system to avoid data transfer delays. The 3-, 6-, 12-, and 24-month data were used for analysis on the Cloud and local system respectively, and the processing times for the analysis were used to evaluate system performance. To investigate application agility, Giovanni was installed and tested on multiple Cloud platforms. The cost of using a Cloud computing platform mainly consists of: computing, storage, data requests, and data transfer in/out. The Cloud computing cost is calculated based on the hourly rate, and the storage cost is calculated based on the rate of Gigabytes per month. Cost for incoming data transfer is free, and for data transfer out, the cost is based on the rate in Gigabytes. The costs for a local server system consist of buying hardware/software, system maintenance/updating, and operating cost. The results showed that the Cloud platform had a 38% better performance and cost 36% less than the local system. This investigation shows the potential of cloud computing to increase system performance and lower the overall cost of system management.

  7. Update on the evaluation of repeated stone formers.

    PubMed

    Kadlec, Adam O; Turk, Thomas M

    2013-12-01

    Office management of stone disease is an important component of a urologist's practice. Evaluation should include analysis of stone composition, 24-hour urine studies, identification of modifiable risk factors, and targeted dietary, lifestyle, and/or medical therapy. A sizeable portion of investigated etiologies and risk factors for stone disease have centered on the complex interplay between obesity, diabetes, and other disease states that comprise the metabolic syndrome. Alternatives to traditional preventive therapy, such as probiotics and various fruit juices, are still being studied but may prove useful adjuncts to traditional preventive therapy, where the mainstays remain increased fluid intake, dietary modification, and pharmacologic therapy. Future studies on preventive therapy of urolithiasis are likely to focus on strategies to increase compliance, cost-effectiveness, and systems-based implementation.

  8. 75 FR 42835 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... estimated cost of the case exceeds the adjusted outlier threshold. We calculate the adjusted outlier... to 80 percent of the difference between the estimated cost of the case and the outlier threshold. In... Federal Prospective Payment Rates VI. Update to Payments for High-Cost Outliers under the IRF PPS A...

  9. Lower Costs, Higher Returns: UNCF HBCUs in a High-Priced College Environment. Financing African American College Aspirations Series

    ERIC Educational Resources Information Center

    Richards, David A. R.

    2014-01-01

    While research consistently shows the earning power of college degrees, those returns are best weighed against the cost of attending post-secondary institutions, historically black colleges and universities (HBCUs) included. This study is an update of "Affordability of UNCF-Member Institutions" (2009), and compares the average costs at…

  10. Technical Services Cost Studies in ARL Libraries. SPEC Kit 125.

    ERIC Educational Resources Information Center

    Hoerman, Heidi Lee

    Based on a survey of Association of Research Libraries (ARL) member libraries in February 1986, this kit is designed to illustrate a wide range of alternative approaches to analyzing the costs of technical services. The kit consists of the following unedited primary-source documents: (1) SPEC Technical Services Costs Survey (Three-Year Update)…

  11. 78 FR 53055 - Regulations Governing Fees for Services Performed in Connection With Licensing and Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... the unchanged salary costs from the 2012 User Fee Update decision; no change in the publication cost levels of that decision; plus increase changes to two of the three Board overhead cost factors (the other overhead factor remains unchanged from its 2012 level), resulting from the mechanical application of the...

  12. The High/Scope Perry Preschool Program: Cost-Benefit Analysis Using Data from the Age-40 Followup

    ERIC Educational Resources Information Center

    Belfield, Clive R.; Nores, Milagros; Barnett, Steve; Schweinhart, Lawrence

    2006-01-01

    This paper presents an updated cost-benefit analysis of the High/Scope Perry preschool Program, using data on individuals aged 40. Children were randomly assigned to a treatment or control group. Program costs are compared against treatment impacts on educational resources, earnings, criminal activity, and welfare receipt. Net present values are…

  13. service line analytics in the new era.

    PubMed

    Spence, Jay; Seargeant, Dan

    2015-08-01

    To succeed under the value-based business model, hospitals and health systems require effective service line analytics that combine inpatient and outpatient data and that incorporate quality metrics for evaluating clinical operations. When developing a framework for collection, analysis, and dissemination of service line data, healthcare organizations should focus on five key aspects of effective service line analytics: Updated service line definitions. Ability to analyze and trend service line net patient revenues by payment source. Access to accurate service line cost information across multiple dimensions with drill-through capabilities. Ability to redesign key reports based on changing requirements. Clear assignment of accountability.

  14. Development of satellite remote sensing techniques as an economic tool for forestry industry

    NASA Technical Reports Server (NTRS)

    Sader, Steven A.; Jadkowski, Mark A.

    1989-01-01

    A cooperative commercial development project designed to focus on cost-effective and practical applications of satellite remote sensing in forest management is discussed. The project, initiated in September, 1988 is being executed in three phases: (1) development of a forest resource inventory and geographic information system (GIS) updating systems; (2) testing and evaluation of remote-sensing products against forest industry specifications; and (3) integration of remote-sensing services and products in an operational setting. An advisory group represented by eleven major forest-product companies will provide direct involvement of the target market. The advisory group will focus on the following questions: Does the technology work for them? How can it be packaged to provide the needed forest-management information? Can the products and information be provided in a cost-effective manner?

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

    PubMed

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

    2010-07-01

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

  16. A review of the Virginia Department of Transportation's maintenance cost index.

    DOT National Transportation Integrated Search

    1999-01-01

    This report details research done to review and update the Virginia Department of Transportation's Maintenance Cost Index (MCI), the first such review since its development in 1986. The study re-examined the composition of items within the MCI, provi...

  17. Psoriasis treatment and management - a systematic review of full economic evaluations.

    PubMed

    Hamilton, M P; Ntais, D; Griffiths, C E M; Davies, L M

    2015-03-01

    Psoriasis frequently requires lifetime control and current therapies vary significantly in price. High-quality economic evaluations are necessary to determine if higher-cost treatments are value for money. This review aims to identify the cost-effectiveness of psoriasis care (whether more expensive interventions are associated with savings in health care and psoriasis management and/or improve patients' health); assess the level of uncertainty and transferability of this evidence to policy and practice; and, identify future research needs. Searches of electronic databases Embase, MEDLINE and NHS EED for full economic evaluations were conducted in January 2012 (updated April 2014). Included articles were screened, selected and critically appraised using predefined inclusion criteria and data extraction forms: 1355 articles were identified; 37 papers reporting 71 comparisons met the inclusion criteria. Treatments evaluated were systemic (n = 45), topical (n = 22), phototherapies (n = 14) and combination (n = 4). Despite a significant number of recent economic evaluations, the cost-effectiveness of all therapies remains unclear. This uncertainty arises from a diversity in settings, perspective and design. Economic evaluations were constrained by limited availability of high-quality short- and long-term head-to-head comparisons of the effectiveness, safety and adherence of different interventions. The economic evidence is dominated by comparisons of interventions to placebo, with implicit comparisons of different therapies. There is a lack of evaluations of service model innovations to deliver complex packages of care for psoriasis. Primary and secondary integrated clinical and economic research is needed to address the limitations and to identify patient preferences and barriers/facilitators to treatment. © 2014 British Association of Dermatologists.

  18. Trends in childhood vaccine purchase costs in the US public sector: 1996-2014.

    PubMed

    Chen, Weiwei; Messonnier, Mark; Zhou, Fangjun

    2016-09-07

    While vaccination remains as one of the most cost-effective preventive strategies, the cost of fully immunizing a child has grown considerably over the last few decades. This study examines trends in non-influenza childhood vaccine purchase costs in the public sector from 1996 to 2014. Non-influenza vaccine purchase cost per child for children aged 0 through 18years was calculated based on public-sector purchase prices. Purchase cost changes were then decomposed into changes attributable to recommendation updates and changes attributable to price variation. The study analyzed the growth rate of combination vaccine prices separately and compared these prices with the sum of prices of component vaccines. It is found that the average annual growth rate of non-influenza vaccine purchase cost per child during 1996-2014 was 12.6%. The growth rate attributable to price changes was 1.0% on average. Combination vaccine prices showed greater variation. The study concludes that vaccine price variation was one but a minor reason for purchase cost changes. Recommendation updates, particularly the introduction of new vaccines, played a much larger role in raising the purchase costs. If the 12.6% annual growth rate found during 1996-2014 in the study continues to apply, the purchase costs of childhood vaccines may more than double by 2020. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Applications of Clocks to Space Navigation & "Planetary GPS"

    NASA Technical Reports Server (NTRS)

    Lichten, Stephen M.

    2004-01-01

    The ability to fly atomic clocks on GPS satellites has profoundly defined the capabilities and limitations of GPS in near-Earth applications. It is likely that future infrastructure for Lunar and Mars applications will be constrained by financial factors. The development of a low cost, small, high performance space clock -- or ultrahigh performance space clocks -- could revolutionize and drive the entire approach to GPS-like systems at the Moon (or Mars), and possibly even change the future of GPS at Earth. Many system trade studies are required. The performance of future GPS-like tracking systems at the Moon or Mars will depend critically on clock performance, availability of inertial sensors, and constellation coverage. Example: present-day GPS carry 10(exp -13) clocks and require several updates per day. With 10(exp -15) clocks, a constellation at Mars could operate autonomously with updates just once per month. Use of GPS tracking at the Moon should be evaluated in a technical study.

  20. Singapore Urological Association Clinical Guidelines for Male Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia.

    PubMed

    2017-08-01

    The first clinical guidelines for male lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) were published in 2005. An update is urgently needed in view of BPH being recognised as one of ten chronic illnesses by the Ministry of Health, Singapore. This review summarises the definition of BPH and the epidemiology of male LUTS/BPH in Singapore. BPH can be phenotyped with noninvasive transabdominal ultrasonography, according to intravesical prostatic protrusion and prostate volume, and classified according to severity (staging) for individualised treatment. At the initial evaluation, the majority of patients (59%) can be managed with fluid adjustment, exercise and diet; 32% with medications, using alpha blockers and/or 5-alpha reductase inhibitors for prostates weighing more than 30 g; and 9% with surgical intervention for more advanced disease. The 2015 guidelines comprise updated evidence that will help family medicine practitioners and specialists manage this common ailment more cost-effectively. Copyright: © Singapore Medical Association.

  1. Global cost of child survival: estimates from country-level validation

    PubMed Central

    van Ekdom, Liselore; Scherpbier, Robert W; Niessen, Louis W

    2011-01-01

    Abstract Objective To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4) as estimated by the World Health Organization (WHO) in 2007 by using the latest country-provided data and new assumptions. Methods After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV). Findings Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53% increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$]) for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15%). New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16%). Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80%) for 2010–2015. Conclusion Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12% increase in total health expenditure) would be needed between 2010 and 2015. Given resource constraints, countries will need to prioritize health activities within their national resource envelope. PMID:21479091

  2. Reducing Contingency through Sampling at the Luckey FUSRAP Site - 13186

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

    Frothingham, David; Barker, Michelle; Buechi, Steve

    2013-07-01

    Typically, the greatest risk in developing accurate cost estimates for the remediation of hazardous, toxic, and radioactive waste sites is the uncertainty in the estimated volume of contaminated media requiring remediation. Efforts to address this risk in the remediation cost estimate can result in large cost contingencies that are often considered unacceptable when budgeting for site cleanups. Such was the case for the Luckey Formerly Utilized Sites Remedial Action Program (FUSRAP) site near Luckey, Ohio, which had significant uncertainty surrounding the estimated volume of site soils contaminated with radium, uranium, thorium, beryllium, and lead. Funding provided by the American Recoverymore » and Reinvestment Act (ARRA) allowed the U.S. Army Corps of Engineers (USACE) to conduct additional environmental sampling and analysis at the Luckey Site between November 2009 and April 2010, with the objective to further delineate the horizontal and vertical extent of contaminated soils in order to reduce the uncertainty in the soil volume estimate. Investigative work included radiological, geophysical, and topographic field surveys, subsurface borings, and soil sampling. Results from the investigative sampling were used in conjunction with Argonne National Laboratory's Bayesian Approaches for Adaptive Spatial Sampling (BAASS) software to update the contaminated soil volume estimate for the site. This updated volume estimate was then used to update the project cost-to-complete estimate using the USACE Cost and Schedule Risk Analysis process, which develops cost contingencies based on project risks. An investment of $1.1 M of ARRA funds for additional investigative work resulted in a reduction of 135,000 in-situ cubic meters (177,000 in-situ cubic yards) in the estimated base volume estimate. This refinement of the estimated soil volume resulted in a $64.3 M reduction in the estimated project cost-to-complete, through a reduction in the uncertainty in the contaminated soil volume estimate and the associated contingency costs. (authors)« less

  3. Evaluation of the ASCO Value Framework for Anticancer Drugs at an Academic Medical Center.

    PubMed

    Wilson, Leslie; Lin, Tracy; Wang, Ling; Patel, Tanuja; Tran, Denise; Kim, Sarah; Dacey, Katie; Yuen, Courtney; Kroon, Lisa; Brodowy, Bret; Rodondi, Kevin

    2017-02-01

    Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center. The High Cost Oncology Drug Initiative at the MOC aims to assess and adopt tools for the critical assessment and amelioration of high-cost cancer drugs. The American Society of Clinical Oncology (ASCO) Value Framework (2016 update) and a cost-effectiveness analysis (CEA) framework were identified as potential tools for adoption. To assess 1 prominent value framework, the study investigators (a) asked 8 clinicians to complete the ASCO Value Framework for 11 anticancer medications selected by the MOC; (b) reviewed CEAs assessing the drugs; (c) generated descriptive statistics; and (d) analyzed inter-rater reliability, convergence validity, and ranking consistency. On the scale of -20 to 180, the mean ASCO net health benefit (NHB) total score across 11 drugs ranged from 7.6 (SD = 7.8) to 53 (SD = 9.8). The Kappa coefficient (κ) for NHB scores across raters was 0.11, which is categorized as "slightly reliable." The combined κ score was 0.22, which is interpreted as low to fair inter-rater reliability. Convergent validity indicates that the correlation between NHB scores and CEA-based incremental cost-effectiveness ratios (ICERs) was low (-0.215). Ranking of ICERs, ASCO scores, and wholesale acquisition costs indicated different results between frameworks. The ASCO Value Framework requires further specificity before use in a clinical setting, since it currently results in low inter-rater reliability and validity. Furthermore, ASCO scores were unable to discriminate between drugs providing the most and least value. The evaluation provides specific areas of weakness that can be addressed in future updates of the ASCO framework to improve usability. Meanwhile, the UCSF Medical Center should rely on CEAs, which are highly accessible for the highlighted cancer drugs. The MOC role can include summarizing and disseminating available CEA studies for interpretation by clinicians and financial counselors around drug value. Funding for this research was contributed by the University of California, San Francisco, Medical Center Campus Strategic Initiative Program. The authors have no conflicts of interest to disclose. Study concept and design were contributed primarily by Wilson, along with Wang and Patel. Kim, Dacey, and Yuen collected the data, and data interpretation was performed by Wilson and Lin. The manuscript was written by Wilson, Lin, Wang, and Tran and revised by Lin, Redondi, Brodowy, and Kroon.

  4. Comparison of anaesthetic cost in open and laparoscopic appendectomy.

    PubMed

    Demirel, I; Ozer, A B; Kilinc, M; Bayar, M K; Erhan, O L

    2014-01-01

    Appendectomy is generally conducted as open or by laparoscopic surgical techniques under general anesthesia. This study aims to compare the anesthetic costs of the patients, who underwent open or laparoscopic appendectomy under general anesthesia. The design is retrospective and records of 379 patients who underwent open or laparoscopic appendectomy under general anesthesia, falling under the category of I-III risk group according to the American Society of Anesthesiologists (ASA) classification between the years 2011 and 2013, and aged 18-77. Open (Group I) or laparoscopic (Group II) appendectomy operation under general anesthesia were evaluated retrospectively by utilizing hospital automation and anesthesia observation records. This study evaluated the anesthesia time of the patients and total costs (Turkish Lira ₺, US dollar $) of anesthetic agents used (induction, maintenance), necessary medical materials (connecting line, endotracheal tube, airway, humidifier, branule, aspiration probe), and intravenously administered fluids were evaluated. We used Statistical Package for the Social Sciences software (SPSS version 17.0) for statistical analysis. Of the patients, 237 were males (62.53%) and 142 were females (37.47%). Anesthesia time limits were established as 70.30 ± 30.23 minute in Group I and 74.92 ± 31.83 minute in Group II. Mean anesthesia administration cost per patient was found to be 78.79 ± 30.01₺ (39.16 ± 14.15$) in Group I and 83.09 ± 26.85₺ (41.29 ± 13.34$) in Group II (P > 0.05). A correlation was observed between cost and operation times (P = 0.002, r = 0.158). Although a statistical difference was not established in this study in terms of time and costs in appendectomy operations conducted as open and laparoscopically, changes may occur in time in market conditions of drugs, patent rights, legal regulations, and prices. Therefore, we believe that it would be beneficial to update and revise cost analyses from time to time.

  5. The costs of nurse turnover, part 2: application of the Nursing Turnover Cost Calculation Methodology.

    PubMed

    Jones, Cheryl Bland

    2005-01-01

    This is the second article in a 2-part series focusing on nurse turnover and its costs. Part 1 (December 2004) described nurse turnover costs within the context of human capital theory, and using human resource accounting methods, presented the updated Nursing Turnover Cost Calculation Methodology. Part 2 presents an application of this method in an acute care setting and the estimated costs of nurse turnover that were derived. Administrators and researchers can use these methods and cost information to build a business case for nurse retention.

  6. Pharmaceutical policies: effects of cap and co-payment on rational use of medicines.

    PubMed

    Luiza, Vera Lucia; Chaves, Luisa A; Silva, Rondineli M; Emmerick, Isabel Cristina M; Chaves, Gabriela C; Fonseca de Araújo, Silvia Cristina; Moraes, Elaine L; Oxman, Andrew D

    2015-05-08

    Growing expenditures on prescription medicines represent a major challenge to many health systems. Cap and co-payment policies are intended as an incentive to deter unnecessary or marginal utilisation, and to reduce third-party payer expenditures by shifting parts of the financial burden from insurers to patients, thus increasing their financial responsibility for prescription medicines. Direct patient payment policies include caps (maximum numbers of prescriptions or medicines that are reimbursed), fixed co-payments (patients pay a fixed amount per prescription or medicine), co-insurance (patients pay a percentage of the price), ceilings (patients pay the full price or part of the cost up to a ceiling, after which medicines are free or are available at reduced cost) and tier co-payments (differential co-payments usually assigned to generic and brand medicines). This is the first update of the original review. To determine the effects of cap and co-payment (cost-sharing) policies on use of medicines, healthcare utilisation, health outcomes and costs (expenditures). For this update, we searched the following databases and websites: The Cochrane Central Register of Controlled Trials (CENTRAL) (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, Cochrane Library; MEDLINE, Ovid; EMBASE, Ovid; IPSA, EBSCO; EconLit, ProQuest; Worldwide Political Science Abstracts, ProQuest; PAIS International, ProQuest; INRUD Bibliography; WHOLIS, WHO; LILACS), VHL; Global Health Library WHO; PubMed, NHL; SCOPUS; SciELO, BIREME; OpenGrey; JOLIS Library Network; OECD Library; World Bank e-Library; World Health Organization, WHO; World Bank Documents & Reports; International Clinical Trials Registry Platform (ICTRP), WHO; ClinicalTrials.gov, NIH. We searched all databases during January and February 2013, apart from SciELO, which we searched in January 2012, and ICTRP and ClinicalTrials.gov, which we searched in March 2014. We defined policies in this review as laws, rules or financial or administrative orders made by governments, non-government organisations or private insurers. We included randomised controlled trials, non-randomised controlled trials, interrupted time series studies, repeated measures studies and controlled before-after studies of cap or co-payment policies for a large jurisdiction or system of care. To be included, a study had to include an objective measure of at least one of the following outcomes: medicine use, healthcare utilisation, health outcomes or costs (expenditures). Two review authors independently extracted data and assessed study limitations. We reanalysed time series data for studies with sufficient data, if appropriate analyses were not reported. We included 32 full-text articles (17 new) reporting evaluations of 39 different interventions (one study - Newhouse 1993 - comprises five papers). We excluded from this update eight controlled before-after studies included in the previous version of this review, because they included only one site in their intervention or control groups. Five papers evaluated caps, and six evaluated a cap with co-insurance and a ceiling. Six evaluated fixed co-payment, two evaluated tiered fixed co-payment, 10 evaluated a ceiling with fixed co-payment and 10 evaluated a ceiling with co-insurance. Only one evaluation was a randomised trial. The certainty of the evidence was found to be generally low to very low.Increasing the amount of money that people pay for medicines may reduce insurers' medicine expenditures and may reduce patients' medicine use. This may include reductions in the use of life-sustaining medicines as well as medicines that are important in treating chronic conditions and medicines for asymptomatic conditions. These types of interventions may lead to small decreases in or uncertain effects on healthcare utilisation. We found no studies that reliably reported the effects of these types of interventions on health outcomes. The diversity of interventions and outcomes addressed across studies and differences in settings, populations and comparisons made it difficult to summarise results across studies. Cap and co-payment polices may reduce the use of medicines and reduce medicine expenditures for health insurers. However, they may also reduce the use of life-sustaining medicines or medicines that are important in treating chronic, including symptomatic, conditions and, consequently, could increase the use of healthcare services. Fixed co-payment with a ceiling and tiered fixed co-payment may be less likely to reduce the use of essential medicines or to increase the use of healthcare services.

  7. 78 FR 48233 - Medicare Program; FY 2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... Contents I. Executive Summary A. Purpose B. Summary of the Major Provisions C. Summary of Costs, Benefits, and Transfers II. Background A. Hospice Care B. History of the Medicare Hospice Benefit C. Services... IV.C.3. We also update the FY 2014 hospice wage index with more current wage data, and the BNAF will...

  8. 2006 Update of Business Downtime Costs

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

    Hinrichs, Mr. Doug; Goggin, Mr. Michael

    2007-01-01

    The objective of this paper is to assess the downtime cost of power outages to businesses in the commercial and industrial sectors, updating and improving upon studies that have already been published on this subject. The goal is to produce a study that, relative to existing studies, (1) applies to a wider set of business types (2) reflects more current downtime costs, (3) accounts for the time duration factor of power outages, and (4) includes data on the costs imposed by real outages in a well-defined market. This study examines power outage costs in 11 commercial subsectors and 5 industrialmore » subsectors, using data on downtime costs that was collected in the 1990's. This study also assesses power outage costs for power outages of 20 minutes, 1 hour, and 4 hours duration. Finally, this study incorporates data on the costs of real power outages for two business subsectors. However, the current limited state of data availability on the topic of downtime costs means there is room to improve upon this study. Useful next steps would be to generate more recent data on downtime costs, data that covers outages shorter than 20 minutes duration and longer than 4 hours duration, and more data that is based on the costs caused by real-world outages. Nevertheless, with the limited data that is currently available, this study is able to generate a clear and detailed picture of the downtime costs that are faced by different types of businesses.« less

  9. Working paper : national costs of the metropolitan ITS infrastructure : update to the FHWA 1995 report

    DOT National Transportation Integrated Search

    2001-07-01

    This working paper has been prepared to provide new estimates of the costs to deploy Intelligent Transportation System (ITS) infrastructure elements in the largest metropolitan areas in the United States. It builds upon estimates that were distribute...

  10. Working Paper : national costs of the metropolitan ITS infrastructure : update to the FHWA 1995 report

    DOT National Transportation Integrated Search

    2000-08-01

    This working paper has been prepared to provide new estimates of the costs to deploy Intelligent Transportation System (ITS) infrastructure elements in the largest metropolitan areas in the United States. It builds upon estimates that were distribute...

  11. Mobility and the costs of congestion in New Jersey : 2001 update

    DOT National Transportation Integrated Search

    2001-07-01

    The objective of the Mobility and the Costs of Congestion study is to measure quantifiable and qualitative impacts of roadway congestion in New Jersey. The study addresses the impacts of congestion on an average traveler or affected person, as well a...

  12. Evaluating Non-In-Place Update Techniques for Flash-Based Transaction Processing Systems

    NASA Astrophysics Data System (ADS)

    Wang, Yongkun; Goda, Kazuo; Kitsuregawa, Masaru

    Recently, flash memory is emerging as the storage device. With price sliding fast, the cost per capacity is approaching to that of SATA disk drives. So far flash memory has been widely deployed in consumer electronics even partly in mobile computing environments. For enterprise systems, the deployment has been studied by many researchers and developers. In terms of the access performance characteristics, flash memory is quite different from disk drives. Without the mechanical components, flash memory has very high random read performance, whereas it has a limited random write performance because of the erase-before-write design. The random write performance of flash memory is comparable with or even worse than that of disk drives. Due to such a performance asymmetry, naive deployment to enterprise systems may not exploit the potential performance of flash memory at full blast. This paper studies the effectiveness of using non-in-place-update (NIPU) techniques through the IO path of flash-based transaction processing systems. Our deliberate experiments using both open-source DBMS and commercial DBMS validated the potential benefits; x3.0 to x6.6 performance improvement was confirmed by incorporating non-in-place-update techniques into file system without any modification of applications or storage devices.

  13. A model for estimating the cost impact of schedule perturbations on aerospace research and development programs

    NASA Technical Reports Server (NTRS)

    Bishop, D. F.

    1972-01-01

    The problem of determining the cost impact attributable to perturbations in an aerospace R and D program schedule is discussed in terms of the diminishing availability of funds. The methodology from which a model is presented for updating R and D cost estimates as a function of perturbations in program time is presented.

  14. 40 CFR 600.314-08 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. 600.314-08 Section 600.314... label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles... economies of comparable automobiles based upon all label data supplied to the Administrator. (e) The...

  15. 40 CFR 600.314-08 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. 600.314-08 Section 600.314... label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles... economies of comparable automobiles based upon all label data supplied to the Administrator. (e) The...

  16. 40 CFR 600.314-08 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. 600.314-08 Section 600.314... label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles... economies of comparable automobiles based upon all label data supplied to the Administrator. (e) The...

  17. Recommendations for Methicillin-Resistant Staphylococcus aureus Prevention in Adult ICUs: A Cost-Effectiveness Analysis.

    PubMed

    Whittington, Melanie D; Atherly, Adam J; Curtis, Donna J; Lindrooth, Richard C; Bradley, Cathy J; Campbell, Jonathan D

    2017-08-01

    Patients in the ICU are at the greatest risk of contracting healthcare-associated infections like methicillin-resistant Staphylococcus aureus. This study calculates the cost-effectiveness of methicillin-resistant S aureus prevention strategies and recommends specific strategies based on screening test implementation. A cost-effectiveness analysis using a Markov model from the hospital perspective was conducted to determine if the implementation costs of methicillin-resistant S aureus prevention strategies are justified by associated reductions in methicillin-resistant S aureus infections and improvements in quality-adjusted life years. Univariate and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness. ICU. Hypothetical cohort of adults admitted to the ICU. Three prevention strategies were evaluated, including universal decolonization, targeted decolonization, and screening and isolation. Because prevention strategies have a screening component, the screening test in the model was varied to reflect commonly used screening test categories, including conventional culture, chromogenic agar, and polymerase chain reaction. Universal and targeted decolonization are less costly and more effective than screening and isolation. This is consistent for all screening tests. When compared with targeted decolonization, universal decolonization is cost-saving to cost-effective, with maximum cost savings occurring when a hospital uses more expensive screening tests like polymerase chain reaction. Results were robust to sensitivity analyses. As compared with screening and isolation, the current standard practice in ICUs, targeted decolonization, and universal decolonization are less costly and more effective. This supports updating the standard practice to a decolonization approach.

  18. Evaluation of the North Stanley Polymer Demonstration Project. [Tertiary oil recovery; polymer-enhanced waterflooding; Oklahoma

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

    Harpole, K.J.; Hill, C.J.

    1983-02-01

    A review of the performance of the North Stanley Polymer Demonstration Project has been completed. The objective of the cost-project was to evaluate the technical efficiency and economic feasibility of polymer-enhanced waterflooding as a tertiary recovery process in a highly heterogeneous and vertically fractured sandstone reservoir that has been successfully waterflooded and is approaching the economic limits of conventional waterflooding recovery. The ultimate incremental oil recovery from the project is estimated to be about 570,000 barrels (or approximately 1.4% of the original oil-in-place). This is significantly less than the original recovery predictions but does demonstrate that the project was technicallymore » successful. The lower-than-anticipated recovery is attributed principally to the extremely heterogeneous nature of the reservoir. One of the major objectives of this evaluation is to present an updated economic anlaysis of the North Stanley Polymer Demonstration Project. The updated economic analysis under current (mid-1982) economic conditions indicates that the North Stanley project would be commercially feasible if polymer injection had begun in 1982, rather than in 1976. Overall project operations were conducted efficiently, with a minimum of operational problems. The North Stanley polymer project provides a well-documented example of an actual field-scale tertiary application of polymer-augmented waterflooding in a highly heterogeneous reservoir.« less

  19. Pharmacoeconomic Considerations in Treating Actinic Keratosis: An Update.

    PubMed

    Vale, Spencer M; Hill, Dane; Feldman, Steven R

    2017-02-01

    Actinic keratosis is one of the most common dermatological diagnoses worldwide, especially among the elderly, fair-skinned, and immunocompromised, and is associated with a risk of transformation to skin cancer. With actinic keratosis and skin cancer prevalence increasing as the aged population expands in the US, optimizing treatment strategies may produce cost savings for the healthcare system. Since the time of our last review in 2008, investigation of the economic considerations in treating actinic keratosis has advanced. To provide an update of treatment cost effectiveness and to review factors relating to the costs of care, we conducted a systematic review of pharmacoeconomic publications since December 2008. We identified 11 pharmacoeconomic studies, with one cost-of-treatment, five cost-effectiveness, and five cost-utility analyses. Photodynamic therapy (PDT) was well tolerated and produced a favorable cosmetic outcome in most studies. Ingenol mebutate, the newest but most expensive topical field therapy, 5-fluorouracil, and PDT were the most cost-effective treatments in our review. Patient adherence to therapy and the management of adverse effects were significant contributors to treatment costs. In the US, treatment guidelines and formalized cost-effectiveness analyses for actinic keratosis are absent from the recent literature. Future pharmacoeconomic investigation will depend on up-to-date comparative efficacy data, as well as clarification of rates of, and management strategies for, adverse effects, therapeutic non-adherence, and lesion recurrence.

  20. Systematic review of economic evaluations of the 23-valent pneumococcal polysaccharide vaccine (PPV23) in individuals 60 years of age or older.

    PubMed

    Nishikawa, Alvaro Mitsunori; Sartori, Ana Marli Christovam; Mainardi, Giulia Marcelino; Freitas, Angela Carvalho; Itria, Alexander; Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho

    2018-05-03

    To systematically review the economic evaluations of 23-valent pneumococcal polysaccharide vaccine (PPV23) in adults aged ≥60 years to inform the development of local studies through the discussion of parameters and assumptions that influence the results of the analyses. We searched the MEDLINE, Excerpta Medica, Cochrane Library, Latin-American and Caribbean Health Sciences Literature (LILACS), Brazilian Regional Library of Medicine, National Health Service Economic Evaluation, and Centre for Reviews and Dissemination-as well as the Scopus citation index and the Web of Science for full economic evaluations of PPV23 published up to March 2016. Two independent reviewers screened the articles for relevance and extracted the data. Main study characteristics and methods (clinical and epidemiological data, cost and incremental cost-effectiveness ratios (ICERs) were extracted and compared. Costs were updated to 2016 international dollars. Twenty-seven studies published from 1980 to 2016 were reviewed. Most studies were conducted in Europe and the USA; three studies were conducted in Latin America (Brazil, 2; Colombia, 1). In addition to the scenario comparing the vaccination with the PPV23 to non-vaccination, three studies also compared PPV23 to pneumococcal conjugate 13-valent vaccine (PCV13). All studies used static models. Most used a lifetime (44.4%) or 5-6 year's time horizon (33.3%). Only three studies considered herd protection from children immunization with PCV13 in the model. Most studies considered PPV23 cost-effective (less than US$50,000 per LYG or QALY) and sometimes cost-saving (results ranging from cost-saving to US$84,636/QALY). The estimates of disease burden, the efficacy/effectiveness of PPV23, and the effects of herd protection from childhood immunization had most influence on the results. Well-designed cost-effectiveness studies of PPV23 that represent the current epidemiological scenario and reduce uncertainty related to efficacy/effectiveness are extremely relevant to informing the decision-making process. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds.

    PubMed

    Ashley, Paul F; Williams, Catherine E C S; Moles, David R; Parry, Jennifer

    2012-11-14

    A significant proportion of children have caries requiring restorations or extractions, and some of these children will not accept this treatment under local anaesthetic. Historically this has been managed in children by the use of a general anaesthetic, however use of sedation may lead to reduced morbidity and cost. The aim of this review is to compare the efficiency of sedation versus general anaesthesia for the provision of dental treatment for children and adolescents aged under 18 years.This review was originally published in 2009 and updated in 2012. We evaluated the intra- and postoperative morbidity, effectiveness and cost effectiveness of sedation versus general anaesthesia for the provision of dental treatment for under 18 year olds. In this updated review we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7); MEDLINE (Ovid) (1950 to July 2012); EMBASE (Ovid) (1974 to July 2012); System for information on Grey Literature in Europe (SIGLE) (1980 to October 2008), Latin American & Caribbean Health Sciences Literature (LILACS) (1982 to July 2012), and ISI Web of Science (1945 to October 2008). The searches were updated to July 2012. The original search was performed in October 2008.We also carried out handsearching of relevant journals to July 2012. We imposed no language restriction. We planned to include randomized controlled clinical trials of sedative agents compared to general anaesthesia in children and adolescents aged up to 18 years having dental treatment. We excluded complex surgical procedures and pseudo-randomized trials. Two authors assessed titles and abstracts for inclusion in the review. We recorded information relevant to the objectives and outcome measures in a specially designed 'data extraction form'. We identified 15 studies for potential inclusion after searching the available databases and screening the titles and abstracts. We identified a further study through personal contacts. Following full text retrieval of the studies, we found none to be eligible for inclusion in this review. Randomized controlled studies are required comparing the use of dental general anaesthesia with sedation to quantify differences such as morbidity and cost.

  2. TRU Waste Management Program. Cost/schedule optimization analysis

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

    Detamore, J.A.; Raudenbush, M.H.; Wolaver, R.W.

    This Current Year Work Plan presents in detail a description of the activities to be performed by the Joint Integration Office Rockwell International (JIO/RI) during FY86. It breaks down the activities into two major work areas: Program Management and Program Analysis. Program Management is performed by the JIO/RI by providing technical planning and guidance for the development of advanced TRU waste management capabilities. This includes equipment/facility design, engineering, construction, and operations. These functions are integrated to allow transition from interim storage to final disposition. JIO/RI tasks include program requirements identification, long-range technical planning, budget development, program planning document preparation, taskmore » guidance development, task monitoring, task progress information gathering and reporting to DOE, interfacing with other agencies and DOE lead programs, integrating public involvement with program efforts, and preparation of reports for DOE detailing program status. Program Analysis is performed by the JIO/RI to support identification and assessment of alternatives, and development of long-term TRU waste program capabilities. These analyses include short-term analyses in response to DOE information requests, along with performing an RH Cost/Schedule Optimization report. Systems models will be developed, updated, and upgraded as needed to enhance JIO/RI's capability to evaluate the adequacy of program efforts in various fields. A TRU program data base will be maintained and updated to provide DOE with timely responses to inventory related questions.« less

  3. Model-based impact and cost-effectiveness of cervical cancer prevention in the Extended Middle East and North Africa (EMENA).

    PubMed

    Kim, Jane J; Sharma, Monisha; O'Shea, Meredith; Sweet, Steven; Diaz, Mireia; Sancho-Garnier, Hélène; Seoud, Muhieddine

    2013-12-30

    To date, no studies have evaluated the cost-effectiveness of human papillomavirus (HPV) vaccination in countries in the Extended Middle East and North Africa (EMENA) region. We synthesized population and epidemiologic data for 20 EMENA countries using a model-based approach to estimate averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and cost-effectiveness ratios (I$ [international dollars] per DALY averted) associated with HPV vaccination of pre-adolescent girls. We utilized additional epidemiologic data from Algeria, Lebanon, and Turkey to evaluate select cervical cancer screening strategies either alone or in combination with vaccination. Results showed that pre-adolescent vaccination of five consecutive birth cohorts at 70% coverage has the potential to prevent over 180,000 cervical cancer cases. Cases averted varied by country, largely due to differences in cancer burden and population size; 69% of cases averted occurred in the three GAVI-eligible countries in EMENA. Despite the low cervical cancer incidence in EMENA, we found that HPV vaccination was cost-effective using a threshold of each country's gross domestic product per capita (a common metric for evaluating cost-effectiveness) in all but five countries at a cost per vaccinated girl of I$25 ($5 per dose). However, cost-effectiveness diminished with increasing vaccine cost; at a cost of I$200 per vaccinated girl, HPV vaccination was cost-effective in only five countries. When the cost per vaccinated girl exceeded I$50 in Lebanon and Turkey and I$150 in Algeria, screening alone was most attractive. We identified opportunities to improve upon current national screening guidelines, involving less frequent screening every 3-5 years. While pre-adolescent HPV vaccination promises to be a cost-effective strategy in most EMENA countries at low costs, decision makers will need to consider many other factors, such as affordability, acceptability, feasibility, and competing health priorities, when making decisions about cervical cancer prevention. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Extended Middle East and North Africa Region" Vaccine Volume 31, Supplement 6, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. The value of psychological treatment for borderline personality disorder: Systematic review and cost offset analysis of economic evaluations.

    PubMed

    Meuldijk, Denise; McCarthy, Alexandra; Bourke, Marianne E; Grenyer, Brin F S

    2017-01-01

    Borderline Personality Disorder (BPD) is a common mental health condition with high patterns of service utilisation of inpatient and community treatment. Over the past five years there has been significant growth in research with economic data, making this systematic review a timely update. Empirical studies written in English or German, published up to December 2015, and cited in major electronic databases were examined using the PRISMA systematic review method. Papers were included that had one of the following: data related to cost of BPD to society, the individual, the carer or families; cost benefits of interventions. Reported cost data were inflated to the year 2015 and converted into US- dollars (USD $) using purchasing power parities. We identified 30 economic evaluations providing cost data related to interventions for BPD across 134,136 patients. The methodological quality was good, almost all studies fulfilled ≥ 50% of the quality criteria. The mean cost saving for treating BPD with evidence-based psychotherapy across studies was USD $2,987.82 per patient per year. A further mean weighted reduction of USD $1,551 per patient per year (range $83 - $29,392) was found compared to treatment as usual. Evidence-based psychological treatment was both less expensive as well as more effective, despite considerable differences in health cost arrangements between individual studies and countries. Where it was able to be calculated, a significant difference in cost-savings between different types of evidence-based psychotherapies was found. Individuals with BPD consistently demonstrate high patterns of service utilization and therefore high costs. The findings of this review present a strong argument in favour of prioritizing BPD treatments in reimbursement decisions, both for the affected individual and the family. The provision of evidence based treatment, irrespective of the type of psychological treatment, may lead to widespread reductions in healthcare costs.

  5. The value of psychological treatment for borderline personality disorder: Systematic review and cost offset analysis of economic evaluations

    PubMed Central

    Meuldijk, Denise; McCarthy, Alexandra; Bourke, Marianne E.; Grenyer, Brin F. S.

    2017-01-01

    Aim Borderline Personality Disorder (BPD) is a common mental health condition with high patterns of service utilisation of inpatient and community treatment. Over the past five years there has been significant growth in research with economic data, making this systematic review a timely update. Methods Empirical studies written in English or German, published up to December 2015, and cited in major electronic databases were examined using the PRISMA systematic review method. Papers were included that had one of the following: data related to cost of BPD to society, the individual, the carer or families; cost benefits of interventions. Reported cost data were inflated to the year 2015 and converted into US- dollars (USD $) using purchasing power parities. Results We identified 30 economic evaluations providing cost data related to interventions for BPD across 134,136 patients. The methodological quality was good, almost all studies fulfilled ≥ 50% of the quality criteria. The mean cost saving for treating BPD with evidence-based psychotherapy across studies was USD $2,987.82 per patient per year. A further mean weighted reduction of USD $1,551 per patient per year (range $83 - $29,392) was found compared to treatment as usual. Evidence-based psychological treatment was both less expensive as well as more effective, despite considerable differences in health cost arrangements between individual studies and countries. Where it was able to be calculated, a significant difference in cost-savings between different types of evidence-based psychotherapies was found. Discussion Individuals with BPD consistently demonstrate high patterns of service utilization and therefore high costs. The findings of this review present a strong argument in favour of prioritizing BPD treatments in reimbursement decisions, both for the affected individual and the family. The provision of evidence based treatment, irrespective of the type of psychological treatment, may lead to widespread reductions in healthcare costs. PMID:28249032

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

    DOT National Transportation Integrated Search

    1980-12-01

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

  7. A Comparison of Three Commercial Online Vendors.

    ERIC Educational Resources Information Center

    Hoover, Ryan E.

    1979-01-01

    Compares database update currency, number of hits, elapsed time, number of offline prints or online types, offline print turnaround time, vendor rates, total search cost, and discounted search cost based on vendor discount rates for five simple searches run on three major commercial vendors' online systems. (CWM)

  8. Cost-value analysis of health interventions: introduction and update on methods and preference data.

    PubMed

    Nord, Erik

    2015-02-01

    According to the consensus statement from the International Society for Pharmacoeconomics and Outcomes Research Quality-Adjusted Life-Year (QALY) workshop in Philadelphia in 2007 "concerns for fairness may cause social resource allocation preferences to deviate considerably from the ranking that consideration of costs per QALY would suggest." Salient concerns for fairness include the view that priority should be given to the severely ill over the less severely ill, that people have a right to realize their potential for health even if their capacity to benefit from treatment is moderate, and that everybody has the same right to treatment that averts premature death, even if their health and functional level is less than perfect. Cost-value analysis incorporates these concerns in formal economic evaluation of health interventions and programs and thus has a potential for ranking interventions and programs in a way that is more consistent with societal values. Data on the strength of public concerns for fairness are now sufficient to be useful in formal economic evaluation. The data may, within a context of fair and open deliberations, help societal decision makers to roughly indicate the societal value of a QALY in different circumstances and thus determine a tentative grading of willingness to pay for a QALY.

  9. A Global Model for Effective Use and Evaluation of e-Learning in Health

    PubMed Central

    Farrington, Conor; Brayne, Carol

    2013-01-01

    Abstract Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of “information overload” have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and “digital literacy” and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning. PMID:23472702

  10. A global model for effective use and evaluation of e-learning in health.

    PubMed

    Ruggeri, Kai; Farrington, Conor; Brayne, Carol

    2013-04-01

    Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

  11. Self-learning Monte Carlo method and cumulative update in fermion systems

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

    Liu, Junwei; Shen, Huitao; Qi, Yang

    2017-06-07

    In this study, we develop the self-learning Monte Carlo (SLMC) method, a general-purpose numerical method recently introduced to simulate many-body systems, for studying interacting fermion systems. Our method uses a highly efficient update algorithm, which we design and dub “cumulative update”, to generate new candidate configurations in the Markov chain based on a self-learned bosonic effective model. From a general analysis and a numerical study of the double exchange model as an example, we find that the SLMC with cumulative update drastically reduces the computational cost of the simulation, while remaining statistically exact. Remarkably, its computational complexity is far lessmore » than the conventional algorithm with local updates.« less

  12. Clinical and cost-effectiveness analysis of early detection of patients at nutrition risk during their hospital stay through the new screening method CIPA: a study protocol.

    PubMed

    Suárez-Llanos, José Pablo; Benítez-Brito, Néstor; Vallejo-Torres, Laura; Delgado-Brito, Irina; Rosat-Rodrigo, Adriá; Hernández-Carballo, Carolina; Ramallo-Fariña, Yolanda; Pereyra-García-Castro, Francisca; Carlos-Romero, Juan; Felipe-Pérez, Nieves; García-Niebla, Jennifer; Calderón-Ledezma, Eduardo Mauricio; González-Melián, Teresa de Jesús; Llorente-Gómez de Segura, Ignacio; Barrera-Gómez, Manuel Ángel

    2017-04-20

    Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient's recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system. The present study is carried out as an open, controlled, randomized study on patients that were admitted to the Internal Medicine and the General and Digestive Surgery ward; the patients were randomized to either a control or an intervention group (n = 824, thereof 412 patients in each of the two study arms). The control group underwent usual inpatient clinical care, while the intervention group was evaluated with the CIPA screening tool for early detection of malnutrition and treated accordingly. CIPA nutrition screening was performed upon hospital admission and classified positive when at least one of the following parameters was met: 72 h food intake control < 50%, serum albumin < 3 g/dL, body mass index < 18.5 kg/m 2 (or mid-upper arm circumference ≤ 22.5 cm). In this case, the doctor decided on whether or not providing nutrition support. The following variables will be evaluated: hospital length of stay (primary endpoint), mortality, 3-month readmission, and in-hospital complications. Likewise, the quality of life questionnaires EQ-5D-5 L are being collected for all patients at hospital admission, discharge, and 3 months post-discharge. Analysis of cost-effectiveness will be performed by measuring effectiveness in terms of quality-adjusted life years (QALYs). The cost per patient will be established by identifying health care resource utilization; cost-effectiveness will be determined through the incremental cost-effectiveness ratio (ICER). We will calculate the incremental cost per QALY gained with respect to the intervention. This ongoing trial aims to evaluate the cost-effectiveness of implementing the malnutrition screening tool CIPA in a tertiary hospital. Clinical Trial.gov ( NCT02721706 ). First receivevd: March 1, 2016 Last updated: April 8, 2017 Last verified: April 2017.

  13. Improving Safety on the International Space Station: Transitioning to Electronic Emergency Procedure Books on the International Space Station

    NASA Technical Reports Server (NTRS)

    Carter-Journet, Katrina; Clahoun, Jessica; Morrow, Jason; Duncan, Gary

    2012-01-01

    The National Aeronautics and Space Administration (NASA) originally designed the International Space Station (ISS) to operate until 2015, but have extended operations until at least 2020. As part of this very dynamic Program, there is an effort underway to simplify the certification of Commercial ]of ]the ]Shelf (COTS) hardware. This change in paradigm allows the ISS Program to take advantage of technologically savvy and commercially available hardware, such as the iPad. The iPad, a line of tablet computers designed and marketed by Apple Inc., was chosen to support this endeavor. The iPad is functional, portable, and could be easily accessed in an emergency situation. The iPad Electronic Flight Bag (EFB), currently approved for use in flight by the Federal Aviation Administration (FAA), is a fraction of the cost of a traditional Class 2 EFB. In addition, the iPad fs ability to use electronic aeronautical data in lieu of paper in route charts and approach plates can cut the annual cost of paper data in half for commercial airlines. ISS may be able to benefit from this type of trade since one of the most important factors considered is information management. Emergency procedures onboard the ISS are currently available to the crew in paper form. Updates to the emergency books can either be launched on an upcoming visiting vehicle such as a Russian Soyuz flight or printed using the onboard ISS printer. In both cases, it is costly to update hardcopy procedures. A new operations concept was proposed to allow for the use of a tablet system that would provide a flexible platform to support space station crew operations. The purpose of the system would be to provide the crew the ability to view and maintain operational data, such as emergency procedures while also allowing Mission Control Houston to update the procedures. The ISS Program is currently evaluating the safety risks associated with the use of iPads versus paper. Paper products can contribute to the flammability risk and require manual updates that take time away from research tasks. The ISS program has recently purchased three iPads for the astronauts and the certification has been approved. The crew is currently using the iPads onboard. The results of this analysis could be used to discern whether the iPad is a viable option for use in emergencies by assessing the risk posture through the development of a quantitative probabilistic risk assessment (PRA).

  14. A divide and conquer approach to the nonsymmetric eigenvalue problem

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

    Jessup, E.R.

    1991-01-01

    Serial computation combined with high communication costs on distributed-memory multiprocessors make parallel implementations of the QR method for the nonsymmetric eigenvalue problem inefficient. This paper introduces an alternative algorithm for the nonsymmetric tridiagonal eigenvalue problem based on rank two tearing and updating of the matrix. The parallelism of this divide and conquer approach stems from independent solution of the updating problems. 11 refs.

  15. An integrated approach for updating cadastral maps in Pakistan using satellite remote sensing data

    NASA Astrophysics Data System (ADS)

    Ali, Zahir; Tuladhar, Arbind; Zevenbergen, Jaap

    2012-08-01

    Updating cadastral information is crucial for recording land ownership and property division changes in a timely fashioned manner. In most cases, the existing cadastral maps do not provide up-to-date information on land parcel boundaries. Such a situation demands that all the cadastral data and parcel boundaries information in these maps to be updated in a timely fashion. The existing techniques for acquiring cadastral information are discipline-oriented based on different disciplines such as geodesy, surveying, and photogrammetry. All these techniques require a large number of manpower, time, and cost when they are carried out separately. There is a need to integrate these techniques for acquiring cadastral information to update the existing cadastral data and (re)produce cadastral maps in an efficient manner. To reduce the time and cost involved in cadastral data acquisition, this study develops an integrated approach by integrating global position system (GPS) data, remote sensing (RS) imagery, and existing cadastral maps. For this purpose, the panchromatic image with 0.6 m spatial resolution and the corresponding multi-spectral image with 2.4 m spatial resolution and 3 spectral bands from QuickBird satellite were used. A digital elevation model (DEM) was extracted from SPOT-5 stereopairs and some ground control points (GCPs) were also used for ortho-rectifying the QuickBird images. After ortho-rectifying these images and registering the multi-spectral image to the panchromatic image, fusion between them was attained to get good quality multi-spectral images of these two study areas with 0.6 m spatial resolution. Cadastral parcel boundaries were then identified on QuickBird images of the two study areas via visual interpretation using participatory-GIS (PGIS) technique. The regions of study are the urban and rural areas of Peshawar and Swabi districts in the Khyber Pakhtunkhwa province of Pakistan. The results are the creation of updated cadastral maps with a lot of cadastral information which can be used in updating the existing cadastral data with less time and cost.

  16. The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature.

    PubMed

    Edwards, Katherine; Jones, Natasha; Newton, Julia; Foster, Charlie; Judge, Andrew; Jackson, Kate; Arden, Nigel K; Pinedo-Villanueva, Rafael

    2017-10-19

    This descriptive review aimed to assess the characteristics and methodological quality of economic evaluations of cardiac rehabilitation (CR) programs according to updated economic guidelines for healthcare interventions. Recommendations will be made to inform future research addressing the impact of a physical exercise component on cost-effectiveness. Electronic databases were searched for economic evaluations of exercise-based CR programs published in English between 2000 and 2014. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to review the methodological quality of included economic evaluations. Fifteen economic evaluations met the review inclusion criteria. Assessed study characteristics exhibited wide variability, particularly in their economic perspective, time horizon, setting, comparators and included costs, with significant heterogeneity in exercise dose across interventions. Ten evaluations were based on randomised controlled trials (RCTs) spanning 6-24 months but often with weak or inconclusive results; two were modelling studies; and the final three utilised longer time horizons of 3.5-5 years from which findings suggest that long-term exercise-based CR results in lower costs, reduced hospitalisations and a longer cumulative patient lifetime. None of the 15 articles met all the CHEERS quality criteria, with the majority either fully or partially meeting a selection of the assessed variables. Evidence exists supporting the cost-effectiveness of exercise-based CR for cardiovascular disease patients. However, variability in CR program delivery and weak consistency between study perspective and design limits study comparability and therefore the accumulation of evidence in support of a particular exercise regime. The generalisability of study findings was limited due to the exclusion of patients with comorbidities as would typically be found in a real-world setting. The use of longer time-horizons would be more comparable with a chronic condition and enable economic assessments of the long-term effects of CR. As none of the articles met recent reporting standards for the economic assessment of healthcare interventions, it is recommended that future studies adhere to such guidelines.

  17. Retrospective Assessment of Cost Savings From Prevention

    PubMed Central

    Grosse, Scott D.; Berry, Robert J.; Tilford, J. Mick; Kucik, James E.; Waitzman, Norman J.

    2016-01-01

    Introduction Although fortification of food with folic acid has been calculated to be cost saving in the U.S., updated estimates are needed. This analysis calculates new estimates from the societal perspective of net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S. that was implemented during 1997–1998. Methods Estimates of annual numbers of live-born spina bifida cases in 1995–1996 relative to 1999–2011 based on birth defects surveillance data were combined during 2015 with published estimates of the present value of lifetime direct costs updated in 2014 U.S. dollars for a live-born infant with spina bifida to estimate avoided direct costs and net cost savings. Results The fortification mandate is estimated to have reduced the annual number of U.S. live-born spina bifida cases by 767, with a lower-bound estimate of 614. The present value of mean direct lifetime cost per infant with spina bifida is estimated to be $791,900, or $577,000 excluding caregiving costs. Using a best estimate of numbers of avoided live-born spina bifida cases, fortification is estimated to reduce the present value of total direct costs for each year's birth cohort by $603 million more than the cost of fortification. A lower-bound estimate of cost savings using conservative assumptions, including the upper-bound estimate of fortification cost, is $299 million. Conclusions The estimates of cost savings are larger than previously reported, even using conservative assumptions. The analysis can also inform assessments of folic acid fortification in other countries. PMID:26790341

  18. Efficient fuzzy C-means architecture for image segmentation.

    PubMed

    Li, Hui-Ya; Hwang, Wen-Jyi; Chang, Chia-Yen

    2011-01-01

    This paper presents a novel VLSI architecture for image segmentation. The architecture is based on the fuzzy c-means algorithm with spatial constraint for reducing the misclassification rate. In the architecture, the usual iterative operations for updating the membership matrix and cluster centroid are merged into one single updating process to evade the large storage requirement. In addition, an efficient pipelined circuit is used for the updating process for accelerating the computational speed. Experimental results show that the the proposed circuit is an effective alternative for real-time image segmentation with low area cost and low misclassification rate.

  19. Medicare program; inpatient psychiatric facilities prospective payment system--update for fiscal year beginning October 1, 2014 (FY 2015). Final rule.

    PubMed

    2014-08-06

    This final rule will update the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes will be applicable to IPF discharges occurring during the fiscal year (FY) beginning October 1, 2014 through September 30, 2015. This final rule will also address implementation of ICD-10-CM and ICD-10-PCS codes; finalize a new methodology for updating the cost of living adjustment (COLA), and finalize new quality measures and reporting requirements under the IPF quality reporting program.

  20. Polycrystalline silicon material availability and market pricing outlook study for 1980 to 88: January 1983 update

    NASA Technical Reports Server (NTRS)

    Costogue, E.; Pellin, R.

    1983-01-01

    Photovoltaic solar cell arrays which convert solar energy into electrical energy can become a cost effective, alternative energy source provided that an adequate supply of low priced materials and automated fabrication techniques are available. Presently, silicon is the most promising cell material for achieving the near term cost goals of the Photovoltaics Program. Electronic grade silicon is produced primarily for the semiconductor industry with the photovoltaic industry using, in most cases, the production rejects of slightly lower grade material. Therefore, the future availability of adequate supplies of low cost silicon is one of the major concerns of the Photovoltaic Program. The supply outlook for silicon with emphasis on pricing is updated and is based primarily on an industry survey conducted by a JPL consultant. This survey included interviews with polycrystalline silicon manufacturers, a large cross section of silicon users and silicon solar cell manufacturers.

  1. Cost Analysis Sources and Documents Data Base Reference Manual (Update)

    DTIC Science & Technology

    1989-06-01

    M: Refcrence Manual PRICE H: Training Course Workbook 11. Use in Cost Analysis. Important source of cost estimates for electronic and mechanical...Nature of Data. Contains many microeconomic time series by month or quarter. 5. Level of Detail. Very detailed. 6. Normalization Processes Required...Reference Manual. Moorestown, N.J,: GE Corporation, September 1986. 64. PRICE Training Course Workbook . Moorestown, N.J.: GE Corporation, February 1986

  2. University Research: Policies for the Reimbursement of Indirect Costs Need to Be Updated. Report to Congressional Committees. GAO-10-937

    ERIC Educational Resources Information Center

    Needham, John K.

    2010-01-01

    In fiscal year 2007, the majority of the Department of Defense's (DOD) basic research obligations were provided to higher education institutions. DOD reimburses these institutions for both direct and indirect costs for research. Two federal agencies, DOD and the Department of Health and Human Services (HHS), negotiate indirect cost rates used to…

  3. Evaluating the effects of the Dietary Guidelines for Americans on consumer behavior and health: methodological challenges.

    PubMed

    Guthrie, Joanne F; Smallwood, David M

    2003-12-01

    The Dietary Guidelines for Americans is the official nutrition policy statement for the United States. Government involvement in providing information on private behavior, such as food choice, is justified by the high cost of poor diets, as measured in medical expenses and lost productivity. The Guidelines are intended to provide an up-to-date, consistent information base for federal nutrition education and information efforts and food assistance program regulations. Through these policy mechanisms, the Guidelines are assumed to improve dietary behavior, and, ultimately, health. By law, the Dietary Guidelines for Americans must be updated every five years; however, there is no mandate for evaluation. Evaluation could provide useful information to assess the extent to which the Guidelines positively influence health and provide insights into reasons for their successes and limitations. However, evaluation would also present considerable challenges. This paper discusses the critical data and methodological needs for improving evaluation of the Dietary Guidelines for Americans.

  4. Alaska School District Cost Study Update

    ERIC Educational Resources Information Center

    Tuck, Bradford H.; Berman, Matthew; Hill, Alexandra

    2005-01-01

    The Legislative Budget and Audit Committee of the Alaska Legislature has asked The Institute of Social and Economic Research (ISER) at the University of Alaska Anchorage to make certain changes and adjustments to the Geographic Cost of Education Index (GCEI) that the American Institutes for Research (AIR) constructed and reported on in Alaska…

  5. PRELIMINARY ESTIMATES OF PERFORMANCE AND COST OF MERCURY EMISSION CONTROL TECHNOLOGY APPLICATIONS ON ELECTRIC UTILITY BOILERS: AN UPDATE

    EPA Science Inventory

    The paper presents estimates of performance levels and related costs associated with controlling mercury (Hg) emissions from coal-fired power plants using either powdered activated carbon (PAC) injection or multipollutant control in which Hg capture is enhanced in existing and ne...

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

    DOT National Transportation Integrated Search

    1980-12-01

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

  7. 44 CFR 334.5 - GMR system description.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... departments and agencies may need to gather additional data on selected resources or increase their preparedness activities. Costed Option Packages may need to be updated or new ones prepared for the response..., but the Costed Option Packages may also require new funding. (3) If the crisis worsens, and prior to...

  8. 44 CFR 334.5 - GMR system description.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... departments and agencies may need to gather additional data on selected resources or increase their preparedness activities. Costed Option Packages may need to be updated or new ones prepared for the response..., but the Costed Option Packages may also require new funding. (3) If the crisis worsens, and prior to...

  9. 44 CFR 334.5 - GMR system description.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... departments and agencies may need to gather additional data on selected resources or increase their preparedness activities. Costed Option Packages may need to be updated or new ones prepared for the response..., but the Costed Option Packages may also require new funding. (3) If the crisis worsens, and prior to...

  10. 77 FR 15004 - Updating of Employer Identification Numbers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ... the IRS, including whether the information will have practical utility; The accuracy of the estimated... techniques or other forms of information technology; and Estimates of capital or start-up costs and costs of... respondents are persons that have an EIN. Estimated total annual reporting burden: 403,177 hours. Estimated...

  11. Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

    PubMed

    Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

    2014-01-01

    A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

  12. Large area sheet task: Advanced dendritic web growth development

    NASA Technical Reports Server (NTRS)

    Duncan, C. S.; Seidensticker, R. G.; Mchugh, J. P.; Hopkins, R. H.; Meier, D.; Schruben, J.

    1981-01-01

    The growth of silicon dendritic web for photovoltaic applications was investigated. The application of a thermal model for calculating buckling stresses as a function of temperature profile in the web is discussed. Lid and shield concepts were evaluated to provide the data base for enhancing growth velocity. An experimental web growth machine which embodies in one unit the mechanical and electronic features developed in previous work was developed. In addition, evaluation of a melt level control system was begun, along with preliminary tests of an elongated crucible design. The economic analysis was also updated to incorporate some minor cost changes. The initial applications of the thermal model to a specific configuration gave results consistent with experimental observation in terms of the initiation of buckling vs. width for a given crystal thickness.

  13. Evaluation of Teachers and Leaders. State Implementation of College- and Career-Readiness Standards

    ERIC Educational Resources Information Center

    Anderson, Kimberly; Mira, Mary Elizabeth

    2015-01-01

    By 2012, all of the states in this study had started implementing new or revised teacher and leader evaluation systems. The systems include many and varying updates. In some cases, the updates were designed to meet conditions for a state's "Race to the Top" grant. In others, the updates were made to meet conditions for a state's waiver…

  14. Updated System-Availability and Resource-Allocation Program

    NASA Technical Reports Server (NTRS)

    Viterna, Larry

    2004-01-01

    A second version of the Availability, Cost and Resource Allocation (ACARA) computer program has become available. The first version was reported in an earlier tech brief. To recapitulate: ACARA analyzes the availability, mean-time-between-failures of components, life-cycle costs, and scheduling of resources of a complex system of equipment. ACARA uses a statistical Monte Carlo method to simulate the failure and repair of components while complying with user-specified constraints on spare parts and resources. ACARA evaluates the performance of the system on the basis of a mathematical model developed from a block-diagram representation. The previous version utilized the MS-DOS operating system and could not be run by use of the most recent versions of the Windows operating system. The current version incorporates the algorithms of the previous version but is compatible with Windows and utilizes menus and a file-management approach typical of Windows-based software.

  15. Influence of generic reference pricing on medicine cost in Slovenia: a retrospective study

    PubMed Central

    Marđetko, Nika; Kos, Mitja

    2018-01-01

    Aim To assess the impact of the generic reference pricing (GRP) system on the prices and cost of medicines in Slovenia approximately 8 years after its introduction in 2003 and before the implementation of the therapeutic reference pricing system. Methods A retrospective study of all medicines (N = 789) included in the GRP system on January 31, 2012 was performed. Medicine prices and cost were analyzed between January 31, 2012 and December 31, 2013 after every update (N = 11) of the maximum reimbursable price (MRP) and were compared to the price and cost on January 31, 2012 (index date). Time trends of different types of medicine prices (maximum allowed price, MRP, and actual wholesale price) were graphically analyzed, and actual wholesale price adjustments to the MRP changes and the budget impact of the GRP were assessed. Results In the 2-year study period, the long-term performance of the GRP system was associated with an approximate 45% decrease in the average MRP or an approximate 20% cost reduction. For each MRP update period, the GRP reduced the cost based on the maximum allowed price for approximately 30%. The wholesale price adjustments were mostly made for medicines priced above the MRP and reduced patients’ out-of-pocket cost. Conclusions In the long term, the GRP system effectively reduced medicine prices and the cost of reimbursed products. PMID:29740992

  16. The distance effect in numerical memory-updating tasks.

    PubMed

    Lendínez, Cristina; Pelegrina, Santiago; Lechuga, Teresa

    2011-05-01

    Two experiments examined the role of numerical distance in updating numerical information in working memory. In the first experiment, participants had to memorize a new number only when it was smaller than a previously memorized number. In the second experiment, updating was based on an external signal, which removed the need to perform any numerical comparison. In both experiments, distance between the memorized number and the new one was manipulated. The results showed that smaller distances between the new and the old information led to shorter updating times. This graded facilitation suggests that the process by which information is substituted in the focus of attention involves maintaining the shared features between the new and the old number activated and selecting other new features to be activated. Thus, the updating cost may be related to amount of new features to be activated in the focus of attention.

  17. A Cost-Effectiveness Tool for Informing Policies on Zika Virus Control.

    PubMed

    Alfaro-Murillo, Jorge A; Parpia, Alyssa S; Fitzpatrick, Meagan C; Tamagnan, Jules A; Medlock, Jan; Ndeffo-Mbah, Martial L; Fish, Durland; Ávila-Agüero, María L; Marín, Rodrigo; Ko, Albert I; Galvani, Alison P

    2016-05-01

    As Zika virus continues to spread, decisions regarding resource allocations to control the outbreak underscore the need for a tool to weigh policies according to their cost and the health burden they could avert. For example, to combat the current Zika outbreak the US President requested the allocation of $1.8 billion from Congress in February 2016. Illustrated through an interactive tool, we evaluated how the number of Zika cases averted, the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an intervention is cost-effective. From Northeast Brazilian microcephaly incidence data, we estimated the probability of microcephaly in infants born to Zika-infected women (0.49% to 2.10%). We also estimated the probability of GBS arising from Zika infections in Brazil (0.02% to 0.06%) and Colombia (0.08%). We calculated that each microcephaly and GBS case incurs the loss of 29.95 DALYs and 1.25 DALYs per case, as well as direct medical costs for Latin America and the Caribbean of $91,102 and $28,818, respectively. We demonstrated the utility of our cost-effectiveness tool with examples evaluating funding commitments by Costa Rica and Brazil, the US presidential proposal, and the novel approach of genetically modified mosquitoes. Our analyses indicate that the commitments and the proposal are likely to be cost-effective, whereas the cost-effectiveness of genetically modified mosquitoes depends on the country of implementation. Current estimates from our tool suggest that the health burden from microcephaly and GBS warrants substantial expenditures focused on Zika virus control. Our results justify the funding committed in Costa Rica and Brazil and many aspects of the budget outlined in the US president's proposal. As data continue to be collected, new parameter estimates can be customized in real-time within our user-friendly tool to provide updated estimates on cost-effectiveness of interventions and inform policy decisions in country-specific settings.

  18. 76 FR 42750 - National Science Board: Sunshine Act Meetings; Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ...) Update NSB Information Item: Network for Earthquake Engineering Simulation (NEES) Update NSB Information... Teleconference Discussion on the Timeline, Process and Procedures for Evaluating Nominees Update on Committee...

  19. An algorithm for the solution of dynamic linear programs

    NASA Technical Reports Server (NTRS)

    Psiaki, Mark L.

    1989-01-01

    The algorithm's objective is to efficiently solve Dynamic Linear Programs (DLP) by taking advantage of their special staircase structure. This algorithm constitutes a stepping stone to an improved algorithm for solving Dynamic Quadratic Programs, which, in turn, would make the nonlinear programming method of Successive Quadratic Programs more practical for solving trajectory optimization problems. The ultimate goal is to being trajectory optimization solution speeds into the realm of real-time control. The algorithm exploits the staircase nature of the large constraint matrix of the equality-constrained DLPs encountered when solving inequality-constrained DLPs by an active set approach. A numerically-stable, staircase QL factorization of the staircase constraint matrix is carried out starting from its last rows and columns. The resulting recursion is like the time-varying Riccati equation from multi-stage LQR theory. The resulting factorization increases the efficiency of all of the typical LP solution operations over that of a dense matrix LP code. At the same time numerical stability is ensured. The algorithm also takes advantage of dynamic programming ideas about the cost-to-go by relaxing active pseudo constraints in a backwards sweeping process. This further decreases the cost per update of the LP rank-1 updating procedure, although it may result in more changes of the active set that if pseudo constraints were relaxed in a non-stagewise fashion. The usual stability of closed-loop Linear/Quadratic optimally-controlled systems, if it carries over to strictly linear cost functions, implies that the saving due to reduced factor update effort may outweigh the cost of an increased number of updates. An aerospace example is presented in which a ground-to-ground rocket's distance is maximized. This example demonstrates the applicability of this class of algorithms to aerospace guidance. It also sheds light on the efficacy of the proposed pseudo constraint relaxation scheme.

  20. Fractional exhaled nitric oxide-measuring devices: technology update

    PubMed Central

    Maniscalco, Mauro; Vitale, Carolina; Vatrella, Alessandro; Molino, Antonio; Bianco, Andrea; Mazzarella, Gennaro

    2016-01-01

    The measurement of exhaled nitric oxide (NO) has been employed in the diagnosis of specific types of airway inflammation, guiding treatment monitoring by predicting and assessing response to anti-inflammatory therapy and monitoring for compliance and detecting relapse. Various techniques are currently used to analyze exhaled NO concentrations under a range of conditions for both health and disease. These include chemiluminescence and electrochemical sensor devices. The cost effectiveness and ability to achieve adequate flexibility in sensitivity and selectivity of NO measurement for these methods are evaluated alongside the potential for use of laser-based technology. This review explores the technologies involved in the measurement of exhaled NO. PMID:27382340

  1. Facility Management as Part of an Integrated Design of Civil Engineering Structures

    NASA Astrophysics Data System (ADS)

    Hyben, Ivan; Podmanický, Peter

    2014-11-01

    The present article deals about facility management, as still relatively young component of an integrated planning and design of buildings. Attention is focused on the area of the proposal, which can greatly affect to amount of future operating costs. Operational efficiency has been divided into individual components and satisfaction with the solution of buildings already constructed was assessed by workers, who are actually dedicated facility management in these organizations. The results were then assessed and evaluated through regression analysis. The aim of this paper is to determine to what extent is desired update project documentation of new buildings from the perspective of facility management.

  2. The costs of nurse turnover: part 1: an economic perspective.

    PubMed

    Jones, Cheryl Bland

    2004-12-01

    Nurse turnover is costly for healthcare organizations. Administrators and nurse executives need a reliable estimate of nurse turnover costs and the origins of those costs if they are to develop effective measures of reducing nurse turnover and its costs. However, determining how to best capture and quantify nurse turnover costs can be challenging. Part 1 of this series conceptualizes nurse turnover via human capital theory and presents an update of a previously developed method for determining the costs of nurse turnover, the Nursing Turnover Cost Calculation Method. Part 2 (January 2005) presents a recent application of the methodology in an acute care hospital.

  3. Defense Management: DOD’s Conference Policy Is Generally Consistent with OMB’s Requirements

    DTIC Science & Technology

    2014-01-01

    of conference costs and updated it in November 2013, citing lessons learned from implementing the September 2012 policy, among other things. The...memorandum accompanying the November 2013 policy, updates were based upon lessons learned from implementation of the September 2012 policy, the budget...higher learning or professional licensure or certification, or other training entities. However, events are not exempt simply because they offer

  4. Effects of Title IV of the Clean Air Act Amendments of 1990 on Electric Utilities: An Update, The

    EIA Publications

    1997-01-01

    Describes the strategies used to comply with the Acid Rain Program in 1995, the effect of compliance on SO2 emissions levels, the cost of compliance, and the effects of the program on coal supply and demand. It updates and expands the EIA report, Electric Utility Phase I Acid Rain Compliance Strategies for the Clean Air Act Amendments of 1990.

  5. Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

    PubMed Central

    Linertová, Renata; Abreu-González, Rodrigo; García-Pérez, Lidia; Alonso-Plasencia, Marta; Cordovés-Dorta, Luis Mateo; Abreu-Reyes, José Augusto; Serrano-Aguilar, Pedro

    2014-01-01

    Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens. PMID:25152613

  6. The benefits of health information exchange: an updated systematic review.

    PubMed

    Menachemi, Nir; Rahurkar, Saurabh; Harle, Christopher A; Vest, Joshua R

    2018-04-28

    Widespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Our search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects. The current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.

  7. The Post-Award Costs of Contracting Out: The U.S. Navy’s Implementation of OMB Circular A-76

    DTIC Science & Technology

    1988-06-01

    Commercial Activities (CA) Program Update, 6 April 1987. 4. Horngren , C.T. and Foster, G., Cost Accounting : A Managerial Emphasis, 6th Ed., Prentice-Hall... COSTS OF CONTRACTING OUT: THE U.S. NAVY’S IMPLEMENTATION OF OMB CIRCULAR A-76 12 PERSONAL AUTHOR( S ) Cole. Nancy S . and Cnlp Charla P 13a TYPE OF...of contracting out and identifies those costs that are either underestimated or not accounted for in the cost comparison process. Research was

  8. Coordinating plug-in electric vehicle charging with electric grid: Valley filling and target load following

    NASA Astrophysics Data System (ADS)

    Zhang, Li; Jabbari, Faryar; Brown, Tim; Samuelsen, Scott

    2014-12-01

    Plug-in electric vehicles (PEVs) shift energy consumption from petroleum to electricity for the personal transportation sector. This work proposes a decentralized charging protocol for PEVs with grid operators updating the cost signal. Each PEV calculates its own optimal charging profile only once based on the cost signal, after it is plugged in, and sends the result back to the grid operators. Grid operators only need to aggregate charging profiles and update the load and cost. The existing PEV characteristics, national household travel survey (NHTS), California Independent System Operator (CAISO) demand, and estimates for future renewable generation in California are used to simulate PEV operation, PEV charging profiles, grid demand, and grid net load (demand minus renewable). Results show the proposed protocol has good performance for overnight net load valley filling if the costs to be minimized are proportional to the net load. Annual results are shown in terms of overnight load variation and comparisons are made with grid level valley filling results. Further, a target load can be approached in the same manner by using the gap between current load and the target load as the cost. The communication effort involved is quite modest.

  9. Updating the reference population to achieve constant genomic prediction reliability across generations.

    PubMed

    Pszczola, M; Calus, M P L

    2016-06-01

    The reliability of genomic breeding values (DGV) decays over generations. To keep the DGV reliability at a constant level, the reference population (RP) has to be continuously updated with animals from new generations. Updating RP may be challenging due to economic reasons, especially for novel traits involving expensive phenotyping. Therefore, the goal of this study was to investigate a minimal RP update size to keep the reliability at a constant level across generations. We used a simulated dataset resembling a dairy cattle population. The trait of interest was not included itself in the selection index, but it was affected by selection pressure by being correlated with an index trait that represented the overall breeding goal. The heritability of the index trait was assumed to be 0.25 and for the novel trait the heritability equalled 0.2. The genetic correlation between the two traits was 0.25. The initial RP (n=2000) was composed of cows only with a single observation per animal. Reliability of DGV using the initial RP was computed by evaluating contemporary animals. Thereafter, the RP was used to evaluate animals which were one generation younger from the reference individuals. The drop in the reliability when evaluating younger animals was then assessed and the RP was updated to re-gain the initial reliability. The update animals were contemporaries of evaluated animals (EVA). The RP was updated in batches of 100 animals/update. First, the animals most closely related to the EVA were chosen to update RP. The results showed that, approximately, 600 animals were needed every generation to maintain the DGV reliability at a constant level across generations. The sum of squared relationships between RP and EVA and the sum of off-diagonal coefficients of the inverse of the genomic relationship matrix for RP, separately explained 31% and 34%, respectively, of the variation in the reliability across generations. Combined, these parameters explained 53% of the variation in the reliability across generations. Thus, for an optimal RP update an algorithm considering both relationships between reference and evaluated animals, as well as relationships among reference animals, is required.

  10. The Update of the Mexican Health Care Formulary and Supply Catalog in the Context of the Health Technology Assessment.

    PubMed

    Ríos, Pedro Rizo; Rivera, Aurora González; Oropeza, Itzel Rivas; Ramírez, Odette Campos

    2014-12-01

    One of the instruments Mexico has available for the optimization of resources specifically allocated to health technologies is the Health Care Formulary and Supply Catalog (Cuadro Básico y Catálogo de Insumos del Sector Salud [CBCISS]). The aim of the CBCISS is to collaborate in the optimization of public resources through the use of technologies (supplies) that have proven their safety, therapeutic efficacy, and efficiency. The importance of the CBCISS lies in the fact that all public institutions within the National Health System must use only the established technologies it contains. The implementation of strategies that strengthen the CBCISS update process allows it to be thought of as an essential regulatory tool for the introduction of health technologies, with relevant contributions to the proper selection of cost-effective interventions. It ensures that each supply included on the list meets the criteria sufficient and necessary to ensure efficacy, safety, effectiveness, and, of course, efficiency, as evidence supporting the selection of suitable technologies. The General Health Council (Consejo de Salubridad General [CSG]) is a collegial body of constitutional origin that-in accordance with its authority-prepares, updates, publishes, and distributes the CBCISS. To perform these activities, the CSG has the CBCISS Inter-institutional Commission. The CBCISS update is performed through the processes of inclusion, modification, and exclusion of supplies approved by the Interior Commission. The CBCISS update process consists of three stages: the first stage involves a test that leads to the acceptance or inadmissibility of the requests, and the other two focus on an in-depth evaluation for the ruling. This article describes the experience of health technology assessment in Mexico, presents the achievements and outlines the improvements in the process of submission of new health technologies, and presents a preliminary analysis of the submissions evaluated until December 2012. During the analysis period, 394 submissions were received. After confirming compliance with the requirements, 59.9% of the submissions passed to the next stage of the process, technology assessment. In the third stage, the committee approved 44.9% of the submissions evaluated. The improvements established in the country in terms of health technology assessment allowed choosing the technologies that give more value for money in a context of public health institutions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Assessing prescribing practices of clozapine before and after the implementation of an updated risk evaluation and mitigation strategy

    PubMed Central

    2018-01-01

    Introduction: Clozapine is an atypical antipsychotic medication approved for treatment-resistant schizophrenia and suicidal behavior in schizophrenia or schizoaffective disorders. Despite its therapeutic efficacy, clozapine is associated with several adverse effects, including agranulocytosis. In late 2015, the Food and Drug Administration updated the risk evaluation and mitigation strategy (REMS) for clozapine with new requirements for monitoring, prescribing, and dispensing. The purpose of this study was to evaluate clozapine prescribing practices at a Kentucky state psychiatric hospital before and after the implementation of the updated REMS program. Methods: The primary outcome of this study was to evaluate clozapine prescribing practices by identifying the number of patients on clozapine therapy in the 6 months pre and post updated REMS implementation. Included in the study were patients at a Kentucky state psychiatric hospital on clozapine therapy for the 24 months before the updated REMS implementation and in the 6-month study period after the implementation. The secondary objective of this study examined psychiatrist comfort level of prescribing clozapine. Results: Since the implementation of the updated REMS program, there has been an increased percentage of patients that were prescribed clozapine at a Kentucky state psychiatric hospital. This increase was not statistically significant (P = .2610). Discussion: The prescribing practices of clozapine within this facility did not differ significantly comparing pre- and post-REMS change in terms of number of patients prescribed clozapine, patient's dose, and therapy duration. Data from this study contributes to the body of knowledge evaluating this new standard of practice under the updated REMS.

  12. Optimize Resources and Help Reduce Cost of Ownership with Dell[TM] Systems Management

    ERIC Educational Resources Information Center

    Technology & Learning, 2008

    2008-01-01

    Maintaining secure, convenient administration of the PC system environment can be a significant drain on resources. Deskside visits can greatly increase the cost of supporting a large number of computers. Even simple tasks, such as tracking inventory or updating software, quickly become expensive when they require physically visiting every…

  13. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent...

  14. 2012 NASA Cost Estimating Handbook Highlights

    NASA Technical Reports Server (NTRS)

    Rosenberg, Leigh; Stukes, Sherry

    2012-01-01

    The major goal is to ensure that appropriate policy is adopted and that best practices are being developed, communicated, and used across the Agency. -- Accomplished by engaging the NASA Cost Estimating Community representatives in the update. Scheduled to be complete by the end of FY 2012. Document has been through 3 detailed reviews across NASA.

  15. 47 CFR 36.622 - National and study area average unseparated loop costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2011-10-01 2011-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

  16. 47 CFR 36.622 - National and study area average unseparated loop costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2010-10-01 2010-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

  17. Influence of affective valence on working memory processes.

    PubMed

    Gotoh, Fumiko

    2008-02-01

    Recent research has revealed widespread effects of emotion on cognitive function and memory. However, the influence of affective valence on working or short-term memory remains largely unexplored. In two experiments, the present study examined the predictions that negative words would capture attention, that attention would be difficult to disengage from such negative words, and that the cost of attention switching would increase the time required to update information in working memory. Participants switched between two concurrent working memory tasks: word recognition and a working memory digit updating task. Experiment 1 showed substantial switching cost for negative words, relative to neutral words. Experiment 2 replicated the first experiment, using a self-report measure of anxiety to examine if switching cost is a function of an anxiety-related attention bias. Results did not support this hypothesis. In addition, Experiment 2 revealed switch costs for positive words without the effect of the attention bias from anxiety. The present study demonstrates the effect of affective valence on a specific component of working memory. Moreover, findings suggest why affective valence effects on working memory have not been found in previous research.

  18. Cost-effective handoff scheme based on mobility-aware dual pointer forwarding in proxy mobile IPv6 networks.

    PubMed

    Son, Seungsik; Jeong, Jongpil

    2014-01-01

    In this paper, a mobility-aware Dual Pointer Forwarding scheme (mDPF) is applied in Proxy Mobile IPv6 (PMIPv6) networks. The movement of a Mobile Node (MN) is classified as intra-domain and inter-domain handoff. When the MN moves, this scheme can reduce the high signaling overhead for intra-handoff/inter-handoff, because the Local Mobility Anchor (LMA) and Mobile Access Gateway (MAG) are connected by pointer chains. In other words, a handoff is aware of low mobility between the previously attached MAG (pMAG) and newly attached MAG (nMAG), and another handoff between the previously attached LMA (pLMA) and newly attached LMA (nLMA) is aware of high mobility. Based on these mobility-aware binding updates, the overhead of the packet delivery can be reduced. Also, we analyse the binding update cost and packet delivery cost for route optimization, based on the mathematical analytic model. Analytical results show that our mDPF outperforms the PMIPv6 and the other pointer forwarding schemes, in terms of reducing the total cost of signaling.

  19. Economics of Malignant Gliomas: A Critical Review

    PubMed Central

    Raizer, Jeffrey J.; Fitzner, Karen A.; Jacobs, Daniel I.; Bennett, Charles L.; Liebling, Dustin B.; Luu, Thanh Ha; Trifilio, Steven M.; Grimm, Sean A.; Fisher, Matthew J.; Haleem, Meraaj S.; Ray, Paul S.; McKoy, Judith M.; DeBoer, Rebecca; Tulas, Katrina-Marie E.; Deeb, Mohammed; McKoy, June M.

    2015-01-01

    Purpose: Approximately 18,500 persons are diagnosed with malignant glioma in the United States annually. Few studies have investigated the comprehensive economic costs. We reviewed the literature to examine costs to patients with malignant glioma and their families, payers, and society. Methods: A total of 18 fully extracted studies were included. Data were collected on direct and indirect costs, and cost estimates were converted to US dollars using the conversion rate calculated from the study's publication date, and updated to 2011 values after adjustment for inflation. A standardized data abstraction form was used. Data were extracted by one reviewer and checked by another. Results: Before approval of effective chemotherapeutic agents for malignant gliomas, estimated total direct medical costs in the United States for surgery and radiation therapy per patient ranged from $50,600 to $92,700. The addition of temozolomide (TMZ) and bevacizumab to glioblastoma treatment regimens has resulted in increased overall costs for glioma care. Although health care costs are now less front-loaded, they have increased over the course of illness. Analysis using a willingness-to-pay threshold of $50,000 per quality-adjusted life-year suggests that the benefits of TMZ fall on the edge of acceptable therapies. Furthermore, indirect medical costs, such as productivity losses, are not trivial. Conclusion: With increased chemotherapy use for malignant glioma, the paradigm for treatment and associated out-of-pocket and total medical costs continue to evolve. Larger out-of-pocket costs may influence the choice of chemotherapeutic agents, the economic implications of which should be evaluated prospectively. PMID:25466707

  20. Economics of Malignant Gliomas: A Critical Review.

    PubMed

    Raizer, Jeffrey J; Fitzner, Karen A; Jacobs, Daniel I; Bennett, Charles L; Liebling, Dustin B; Luu, Thanh Ha; Trifilio, Steven M; Grimm, Sean A; Fisher, Matthew J; Haleem, Meraaj S; Ray, Paul S; McKoy, Judith M; DeBoer, Rebecca; Tulas, Katrina-Marie E; Deeb, Mohammed; McKoy, June M

    2015-01-01

    Approximately 18,500 persons are diagnosed with malignant glioma in the United States annually. Few studies have investigated the comprehensive economic costs. We reviewed the literature to examine costs to patients with malignant glioma and their families, payers, and society. A total of 18 fully extracted studies were included. Data were collected on direct and indirect costs, and cost estimates were converted to US dollars using the conversion rate calculated from the study's publication date, and updated to 2011 values after adjustment for inflation. A standardized data abstraction form was used. Data were extracted by one reviewer and checked by another. Before approval of effective chemotherapeutic agents for malignant gliomas, estimated total direct medical costs in the United States for surgery and radiation therapy per patient ranged from $50,600 to $92,700. The addition of temozolomide (TMZ) and bevacizumab to glioblastoma treatment regimens has resulted in increased overall costs for glioma care. Although health care costs are now less front-loaded, they have increased over the course of illness. Analysis using a willingness-to-pay threshold of $50,000 per quality-adjusted life-year suggests that the benefits of TMZ fall on the edge of acceptable therapies. Furthermore, indirect medical costs, such as productivity losses, are not trivial. With increased chemotherapy use for malignant glioma, the paradigm for treatment and associated out-of-pocket and total medical costs continue to evolve. Larger out-of-pocket costs may influence the choice of chemotherapeutic agents, the economic implications of which should be evaluated prospectively. Copyright © 2015 by American Society of Clinical Oncology.

  1. Understanding evidence-based diagnosis.

    PubMed

    Kohn, Michael A

    2014-01-01

    The real meaning of the word "diagnosis" is naming the disease that is causing a patient's illness. The cognitive process of assigning this name is a mysterious combination of pattern recognition and the hypothetico-deductive approach that is only remotely related to the mathematical process of using test results to update the probability of a disease. What I refer to as "evidence-based diagnosis" is really evidence-based use of medical tests to guide treatment decisions. Understanding how to use test results to update the probability of disease can help us interpret test results more rationally. Also, evidence-based diagnosis reminds us to consider the costs and risks of testing and the dangers of over-diagnosis and over-treatment, in addition to the costs and risks of missing serious disease.

  2. Parabolic Trough Collector Cost Update for the System Advisor Model (SAM)

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

    Kurup, Parthiv; Turchi, Craig S.

    2015-11-01

    This report updates the baseline cost for parabolic trough solar fields in the United States within NREL's System Advisor Model (SAM). SAM, available at no cost at https://sam.nrel.gov/, is a performance and financial model designed to facilitate decision making for people involved in the renewable energy industry. SAM is the primary tool used by NREL and the U.S. Department of Energy (DOE) for estimating the performance and cost of concentrating solar power (CSP) technologies and projects. The study performed a bottom-up build and cost estimate for two state-of-the-art parabolic trough designs -- the SkyTrough and the Ultimate Trough. The SkyTroughmore » analysis estimated the potential installed cost for a solar field of 1500 SCAs as $170/m 2 +/- $6/m 2. The investigation found that SkyTrough installed costs were sensitive to factors such as raw aluminum alloy cost and production volume. For example, in the case of the SkyTrough, the installed cost would rise to nearly $210/m 2 if the aluminum alloy cost was $1.70/lb instead of $1.03/lb. Accordingly, one must be aware of fluctuations in the relevant commodities markets to track system cost over time. The estimated installed cost for the Ultimate Trough was only slightly higher at $178/m 2, which includes an assembly facility of $11.6 million amortized over the required production volume. Considering the size and overall cost of a 700 SCA Ultimate Trough solar field, two parallel production lines in a fully covered assembly facility, each with the specific torque box, module and mirror jigs, would be justified for a full CSP plant.« less

  3. Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S.

    PubMed

    Grosse, Scott D; Berry, Robert J; Mick Tilford, J; Kucik, James E; Waitzman, Norman J

    2016-05-01

    Although fortification of food with folic acid has been calculated to be cost saving in the U.S., updated estimates are needed. This analysis calculates new estimates from the societal perspective of net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S. that was implemented during 1997-1998. Estimates of annual numbers of live-born spina bifida cases in 1995-1996 relative to 1999-2011 based on birth defects surveillance data were combined during 2015 with published estimates of the present value of lifetime direct costs updated in 2014 U.S. dollars for a live-born infant with spina bifida to estimate avoided direct costs and net cost savings. The fortification mandate is estimated to have reduced the annual number of U.S. live-born spina bifida cases by 767, with a lower-bound estimate of 614. The present value of mean direct lifetime cost per infant with spina bifida is estimated to be $791,900, or $577,000 excluding caregiving costs. Using a best estimate of numbers of avoided live-born spina bifida cases, fortification is estimated to reduce the present value of total direct costs for each year's birth cohort by $603 million more than the cost of fortification. A lower-bound estimate of cost savings using conservative assumptions, including the upper-bound estimate of fortification cost, is $299 million. The estimates of cost savings are larger than previously reported, even using conservative assumptions. The analysis can also inform assessments of folic acid fortification in other countries. Published by Elsevier Inc.

  4. Economic appraisal of the public control and prevention strategy against the 2010 West Nile Virus outbreak in Central Macedonia, Greece.

    PubMed

    Kolimenakis, A; Bithas, K; Richardson, C; Latinopoulos, D; Baka, A; Vakali, A; Hadjichristodoulou, C; Mourelatos, S; Kalaitzopoulou, S; Gewehr, S; Michaelakis, A; Koliopoulos, G

    2016-02-01

    The aim of the present paper is to evaluate the economic efficiency of the public control and prevention strategies to tackle the 2010 West Nile Virus (WNV) outbreak in the Region of Central Macedonia, Greece. Efficiency is examined on the basis of the public prevention costs incurred and their potential in justifying the costs arising from health and nuisance impacts in the succeeding years. Economic appraisal of public health management interventions. Prevention and control cost categories including control programmes, contingency planning and blood safety testing, are analyzed based on market prices. A separate cost of illness approach is conducted for the estimation of medical costs and productivity losses from 2010 to 2013 and for the calculation of averted health impacts. The averted mosquito nuisance costs to households are estimated on the basis of a contingent valuation study. Based on these findings, a limited cost-benefit analysis is employed in order to evaluate the economic efficiency of these strategies in 2010-2013. Results indicate that cost of illness and prevention costs fell significantly in the years following the 2010 outbreak, also as a result of the epidemic coming under control. According to the contingent valuation survey, the annual average willingness to pay to eliminate the mosquito problem in the study area ranged between 22 and 27 € per household. Cost-benefit analysis indicates that the aggregate benefit of implementing the previous 3-year strategy creates a net socio-economic benefit in 2013. However the spread of the WNV epidemic and the overall socio-economic consequences, had the various costs not been employed, remain unpredictable and extremely difficult to calculate. The application of a post epidemic strategy appears to be of utmost importance for public health safety. An updated well designed survey is needed for a more precise definition of the optimum prevention policies and levels and for the establishment of the various cost/benefit parameters. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Federal employees health benefits acquisition regulation: large provider agreements, subcontracts, and miscellaneous changes. Final rule.

    PubMed

    2005-06-01

    The Office of Personnel Management (OPM) is issuing this final regulation to amend the Federal Employees Health Benefits Acquisition Regulation (FEHBAR). It establishes requirements, including audit, for Federal Employees Health Benefits Program (FEHB) experience-rated carriers' Large Provider Agreements. It also modifies the dollar threshold for review of carriers' subcontract agreements; revises the definitions of Cost or Pricing Data and Experience-rate to reflect mental health parity requirements; updates the contract records retention requirement; updates the FEHB Clause Matrix; and conforms subpart and paragraph references to Federal Acquisition Regulation (FAR) revisions made since we last updated the FEHBAR.

  6. What is the clinical effectiveness and cost-effectiveness of conservative interventions for tendinopathy? An overview of systematic reviews of clinical effectiveness and systematic review of economic evaluations.

    PubMed

    Long, Linda; Briscoe, Simon; Cooper, Chris; Hyde, Chris; Crathorne, Louise

    2015-01-01

    Lateral elbow tendinopathy (LET) is a common complaint causing characteristic pain in the lateral elbow and upper forearm, and tenderness of the forearm extensor muscles. It is thought to be an overuse injury and can have a major impact on the patient's social and professional life. The condition is challenging to treat and prone to recurrent episodes. The average duration of a typical episode ranges from 6 to 24 months, with most (89%) reporting recovery by 1 year. This systematic review aims to summarise the evidence concerning the clinical effectiveness and cost-effectiveness of conservative interventions for LET. A comprehensive search was conducted from database inception to 2012 in a range of databases including MEDLINE, EMBASE and Cochrane Databases. We conducted an overview of systematic reviews to summarise the current evidence concerning the clinical effectiveness and a systematic review for the cost-effectiveness of conservative interventions for LET. We identified additional randomised controlled trials (RCTs) that could contribute further evidence to existing systematic reviews. We searched MEDLINE, EMBASE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science, The Cochrane Library and other important databases from inception to January 2013. A total of 29 systematic reviews published since 2003 matched our inclusion criteria. These were quality appraised using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist; five were considered high quality and evaluated using a Grading of Recommendations, Assessment, Development and Evaluation approach. A total of 36 RCTs were identified that were not included in a systematic review and 29 RCTs were identified that had only been evaluated in an included systematic review of intermediate/low quality. These were then mapped to existing systematic reviews where further evidence could provide updates. Two economic evaluations were identified. The summary of findings from the review was based only on high-quality evidence (scoring of > 5 AMSTAR). Other limitations were that identified RCTs were not quality appraised and dichotomous outcomes were also not considered. Economic evaluations took effectiveness estimates from trials that had small sample sizes leading to uncertainty surrounding the effect sizes reported. This, in turn, led to uncertainty of the reported cost-effectiveness and, as such, no robust recommendations could be made in this respect. Clinical effectiveness evidence from the high-quality systematic reviews identified in this overview continues to suggest uncertainty as to the effectiveness of many conservative interventions for the treatment of LET. Although new RCT evidence has been identified with either placebo or active controls, there is uncertainty as to the size of effects reported within them because of the small sample size. Conclusions regarding cost-effectiveness are also unclear. We consider that, although updated or new systematic reviews may also be of value, the primary focus of future work should be on conducting large-scale, good-quality clinical trials using a core set of outcome measures (for defined time points) and appropriate follow-up. Subgroup analysis of existing RCT data may be beneficial to ascertain whether or not certain patient groups are more likely to respond to treatments. This study is registered as PROSPERO CRD42013003593. The National Institute for Health Research Health Technology Assessment programme.

  7. Automated analysis of electronic medical record data reflects the pathophysiology of operative complications.

    PubMed

    Tepas, Joseph J; Rimar, Joan M; Hsiao, Allen L; Nussbaum, Michael S

    2013-10-01

    We hypothesized that a novel algorithm that uses data from the electronic medical record (EMR) from multiple clinical and biometric sources could provide early warning of organ dysfunction in patients with high risk for postoperative complications and sepsis. Operative patients undergoing colorectal procedures were evaluated. The Rothman Index (RI) is a predictive model based on heuristic equations derived from 26 variables related to inpatient care. The RI integrates clinical nursing observations, bedside biometrics, and laboratory data into a continuously updated, numeric physiologic assessment, ranging from 100 (unimpaired) to -91. The RI can be displayed within the EMR as a graphic trend, with a decreasing trend reflecting physiologic dysfunction. Patients undergoing colorectal procedures between June and October 2011 were evaluated to determine correlation of initial RI, average inpatient RI, and lowest RI to incidence of complications and/or postoperative sepsis. Patients were stratified by color-coded RI risk group (100-65, blue; 64-40, yellow; <40 red). One-way or repeated-measures analysis of variance was used to compare groups by age, number of complications, and presence of sepsis defined by discharge International Classification of Diseases, 9(th) Revision, codes. Mean direct cost of care and duration of stay also was calculated for each group. The overall incidence of perioperative complications in the 124 patient cohort was 51% (n = 64 patients). The 261 complications sustained by this group represented 82 distinct diagnoses. The 10 patients with sepsis (8%) experienced a 40% mortality. Analysis of initial RI for the population stratified by number of complications and/or sepsis demonstrated a risk-related difference. With progressive onset of complications, the RI decreased, suggesting worsening physiologic dysfunction and linear increase in direct cost of care. These findings demonstrate that EMR data can be automatically compiled into an objective metric that reflects patient risk and changing physiologic state. The automated process of continuous update reflects a physiologic trajectory associated with evolving organ system dysfunction indicative of postoperative complications. Early intervention based on these trends may guide preoperative counseling, enhance pre-emptive management of adverse occurrences, and improve cost-efficiency of care. Copyright © 2013 Mosby, Inc. All rights reserved.

  8. Salivary immunoassays to investigate potential exposure to ...

    EPA Pesticide Factsheets

    This presentation provides an update to an ongoing collaboration with Inter American University of Puerto Rico. The goal of this study is to investigate public health benefits that result from implementation of low cost, sustainable filtration technologies in remote, rural communities in Puerto Rico. To present an update to an ongoing collaborative project with Inter American University of Puerto Rico which investigates the health benefits that may result from installation of community level water filtration systems.

  9. Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.

    PubMed

    Barreix, Maria; Tunçalp, Özge; Mutombo, Namuunda; Adegboyega, Ayotunde A; Say, Lale

    2017-05-01

    Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations. © 2017 World Health Organization; licensed by Wiley on behalf of International Federation of Gynecology and Obstetrics.

  10. Constraint-based modeling of carbon fixation and the energetics of electron transfer in Geobacter metallireducens.

    PubMed

    Feist, Adam M; Nagarajan, Harish; Rotaru, Amelia-Elena; Tremblay, Pier-Luc; Zhang, Tian; Nevin, Kelly P; Lovley, Derek R; Zengler, Karsten

    2014-04-01

    Geobacter species are of great interest for environmental and biotechnology applications as they can carry out direct electron transfer to insoluble metals or other microorganisms and have the ability to assimilate inorganic carbon. Here, we report on the capability and key enabling metabolic machinery of Geobacter metallireducens GS-15 to carry out CO2 fixation and direct electron transfer to iron. An updated metabolic reconstruction was generated, growth screens on targeted conditions of interest were performed, and constraint-based analysis was utilized to characterize and evaluate critical pathways and reactions in G. metallireducens. The novel capability of G. metallireducens to grow autotrophically with formate and Fe(III) was predicted and subsequently validated in vivo. Additionally, the energetic cost of transferring electrons to an external electron acceptor was determined through analysis of growth experiments carried out using three different electron acceptors (Fe(III), nitrate, and fumarate) by systematically isolating and examining different parts of the electron transport chain. The updated reconstruction will serve as a knowledgebase for understanding and engineering Geobacter and similar species.

  11. An update of preliminary perspectives gained from Individual Plant Examination of External Events (IPEEE) submittal reviews

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

    Rubin, A.M.; Chen, J.T.; Chokshi, N.

    1998-03-01

    As a result of the US Nuclear Regulatory Commission (USNRC) initiated Individual Plant Examination of External Events (IPEEE) program, virtually every operating commercial nuclear power reactor in the US has performed an assessment of severe accident risk due to external events. To date, the USNRC staff has received 63 IPEEE submittals and will receive an additional 11 by mid 1998. Currently, 49 IPEEE submittals are under various stages ore view. This paper is based on the information available for those 41 plants for which at least preliminary Technical Evaluation Reports have been prepared by the review teams. The goal ofmore » the review is to ascertain whether the licensee`s IPEEE process is capable of identifying external events-induced severe accident vulnerabilities and cost-effective safety improvements to either eliminate or reduce the impact of these vulnerabilities. The review does not, however, attempt to validate or verify the results of the licensee`s IPEEE. The primary objective of this paper is to provide an update on the preliminary perspectives and insights gained from the IPEEE process.« less

  12. Systematic Approach to Better Understanding Integration Costs

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

    Stark, Gregory B.

    2015-09-01

    This research presents a systematic approach to evaluating the costs of integrating new generation and operational procedures into an existing power system, and the methodology is independent of the type of change or nature of the generation. The work was commissioned by the U.S. Department of Energy and performed by the National Renewable Energy Laboratory to investigate three integration cost-related questions: (1) How does the addition of new generation affect a system's operational costs, (2) How do generation mix and operating parameters and procedures affect costs, and (3) How does the amount of variable generation (non-dispatchable wind and solar) impactmore » the accuracy of natural gas orders? A detailed operational analysis was performed for seven sets of experiments: variable generation, large conventional generation, generation mix, gas prices, fast-start generation, self-scheduling, and gas supply constraints. For each experiment, four components of integration costs were examined: cycling costs, non-cycling VO&M costs, fuel costs, and reserves provisioning costs. The investigation was conducted with PLEXOS production cost modeling software utilizing an updated version of the Institute of Electrical and Electronics Engineers 118-bus test system overlaid with projected operating loads from the Western Electricity Coordinating Council for the Sacramento Municipal Utility District, Puget Sound Energy, and Public Service Colorado in the year 2020. The test system was selected in consultation with an industry-based technical review committee to be a reasonable approximation of an interconnection yet small enough to allow the research team to investigate a large number of scenarios and sensitivity combinations. The research should prove useful to market designers, regulators, utilities, and others who want to better understand how system changes can affect production costs.« less

  13. Maintenance Management Update.

    ERIC Educational Resources Information Center

    Sternloff, Robert E.

    1987-01-01

    Current trends in park maintenance are overviewed, including maintenance impact statements, avoidance of cost through efficient use and national resource conservation, horticultural accomplishments that influence maintenance management, and vandalism prevention. (CB)

  14. Physician and patient willingness to pay for electronic cardiovascular disease management.

    PubMed

    Deal, Ken; Keshavjee, Karim; Troyan, Sue; Kyba, Robert; Holbrook, Anne Marie

    2014-07-01

    Cardiovascular disease (CVD) is an important target for electronic decision support. We examined the potential sustainability of an electronic CVD management program using a discrete choice experiment (DCE). Our objective was to estimate physician and patient willingness-to-pay (WTP) for the current and enhanced programs. Focus groups, expert input and literature searches decided the attributes to be evaluated for the physician and patient DCEs, which were carried out using a Web-based program. Hierarchical Bayes analysis estimated preference coefficients for each respondent and latent class analysis segmented each sample. Simulations were used to estimate WTP for each of the attributes individually and for an enhanced vascular management system. 144 participants (70 physicians, 74 patients) completed the DCE. Overall, access speed to updated records and monthly payments for a nurse coordinator were the main determinants of physician choices. Two distinctly different segments of physicians were identified - one very sensitive to monthly subscription fee and speed of updating the tracker with new patient data and the other very sensitive to the monthly cost of the nurse coordinator and government billing incentives. Patient choices were most significantly influenced by the yearly subscription cost. The estimated physician WTP was slightly above the estimated threshold for sustainability while the patient WTP was below. Current willingness to pay for electronic cardiovascular disease management should encourage innovation to provide economies of scale in program development, delivery and maintenance to meet sustainability thresholds. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. How Many Objects are You Worth? Quantification of the Self-Motion Load on Multiple Object Tracking

    PubMed Central

    Thomas, Laura E.; Seiffert, Adriane E.

    2011-01-01

    Perhaps walking and chewing gum is effortless, but walking and tracking moving objects is not. Multiple object tracking is impaired by walking from one location to another, suggesting that updating location of the self puts demands on object tracking processes. Here, we quantified the cost of self-motion in terms of the tracking load. Participants in a virtual environment tracked a variable number of targets (1–5) among distractors while either staying in one place or moving along a path that was similar to the objects’ motion. At the end of each trial, participants decided whether a probed dot was a target or distractor. As in our previous work, self-motion significantly impaired performance in tracking multiple targets. Quantifying tracking capacity for each individual under move versus stay conditions further revealed that self-motion during tracking produced a cost to capacity of about 0.8 (±0.2) objects. Tracking your own motion is worth about one object, suggesting that updating the location of the self is similar, but perhaps slightly easier, than updating locations of objects. PMID:21991259

  16. Application of LANDSAT and Skylab data for land use mapping in Italy. [emphasizing the Alps Mountains

    NASA Technical Reports Server (NTRS)

    Bodechtel, J.; Nithack, J.; Dibernardo, G.; Hiller, K.; Jaskolla, F.; Smolka, A.

    1975-01-01

    Utilizing LANDSAT and Skylab multispectral imagery of 1972 and 1973, a land use map of the mountainous regions of Italy was evaluated at a scale of 1:250,000. Seven level I categories were identified by conventional methods of photointerpretation. Images of multispectral scanner (MSS) bands 5 and 7, or equivalents were mainly used. Areas of less than 200 by 200 m were classified and standard procedures were established for interpretation of multispectral satellite imagery. Land use maps were produced for central and southern Europe indicating that the existing land use maps could be updated and optimized. The complexity of European land use patterns, the intensive morphology of young mountain ranges, and time-cost calculations are the reasons that the applied conventional techniques are superior to automatic evaluation.

  17. Life sciences payload definition and integration study. Volume 4: Appendix, costs, and data management requirements of the dedicated 30-day laboratory. [carry-on laboratory for Spacelab

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The results of the updated 30-day life sciences dedicated laboratory scheduling and costing activities are documented, and the 'low cost' methodology used to establish individual equipment item costs is explained in terms of its allowances for equipment that is commerical off-the-shelf, modified commercial, and laboratory prototype; a method which significantly lowers program costs. The costs generated include estimates for non-recurring development, recurring production, and recurring operations costs. A cost for a biomedical emphasis laboratory and a Delta cost to provide a bioscience and technology laboratory were also generated. All cost reported are commensurate with the design and schedule definitions available.

  18. Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

    PubMed Central

    Hex, Nick; Setters, Jo; Little, Stuart

    2016-01-01

    “Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers. Educational aims Provide update for oxygen prescribers on options for home oxygen provision. Provide update on the evidence base for available self-fill oxygen technologies. Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems. PMID:27408629

  19. a Bottom-Up Geosptial Data Update Mechanism for Spatial Data Infrastructure Updating

    NASA Astrophysics Data System (ADS)

    Tian, W.; Zhu, X.; Liu, Y.

    2012-08-01

    Currently, the top-down spatial data update mechanism has made a big progress and it is wildly applied in many SDI (spatial data infrastructure). However, this mechanism still has some issues. For example, the update schedule is limited by the professional department's project, usually which is too long for the end-user; the data form collection to public cost too much time and energy for professional department; the details of geospatial information does not provide sufficient attribute, etc. Thus, how to deal with the problems has become the effective shortcut. Emerging Internet technology, 3S technique and geographic information knowledge which is popular in the public promote the booming development of geoscience in volunteered geospatial information. Volunteered geospatial information is the current "hotspot", which attracts many researchers to study its data quality and credibility, accuracy, sustainability, social benefit, application and so on. In addition to this, a few scholars also pay attention to the value of VGI to support the SDI updating. And on that basis, this paper presents a bottom-up update mechanism form VGI to SDI, which includes the processes of match homonymous elements between VGI and SDI vector data , change data detection, SDI spatial database update and new data product publication to end-users. Then, the proposed updating cycle is deeply discussed about the feasibility of which can detect the changed elements in time and shorten the update period, provide more accurate geometry and attribute data for spatial data infrastructure and support update propagation.

  20. Navy Virginia (SSN-774) Class Attack Submarine Procurement: Background and Issues for Congress

    DTIC Science & Technology

    2015-12-17

    Engineers Journal, No. 4, 2009: 79-94; and John D. Butler, “The Sweet Smell of Acquisition Success,” U.S. Naval Institute Proceedings, June 2011: 22...update cost estimates soon based on the final concept design, but so far the program has been successful in sticking to its cost goals. The program

  1. 39 CFR 3050.22 - Documentation supporting attributable cost estimates in the Postal Service's section 3652 report.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the updated factors and input data sets from the supporting data systems used, including: (1) The In... Determination. (b) The CRA report, including relevant data on international mail services; (c) The Cost Segments and Components (CSC) report; (d) All input data and processing programs used to produce the CRA report...

  2. 39 CFR 3050.22 - Documentation supporting attributable cost estimates in the Postal Service's section 3652 report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the updated factors and input data sets from the supporting data systems used, including: (1) The In... Determination. (b) The CRA report, including relevant data on international mail services; (c) The Cost Segments and Components (CSC) report; (d) All input data and processing programs used to produce the CRA report...

  3. 39 CFR 3050.22 - Documentation supporting attributable cost estimates in the Postal Service's section 3652 report.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the updated factors and input data sets from the supporting data systems used, including: (1) The In... Determination. (b) The CRA report, including relevant data on international mail services; (c) The Cost Segments and Components (CSC) report; (d) All input data and processing programs used to produce the CRA report...

  4. 39 CFR 3050.22 - Documentation supporting attributable cost estimates in the Postal Service's section 3652 report.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the updated factors and input data sets from the supporting data systems used, including: (1) The In... Determination. (b) The CRA report, including relevant data on international mail services; (c) The Cost Segments and Components (CSC) report; (d) All input data and processing programs used to produce the CRA report...

  5. Users' Guide to USDA Estimates of the Cost of Raising a Child.

    ERIC Educational Resources Information Center

    Edwards, Carolyn S.

    In this article, estimates of the cost of raising a child, that are available from the U.S. Department of Agriculture, are described; the most widely requested estimates updated to current price levels are provided; and the most frequently asked questions about the use and interpretation of these estimates are answered. Information on additional…

  6. The Energy Imperative: Report Update

    DTIC Science & Technology

    2008-11-01

    projections for 2030.2 • Renewable power generation from solar , wind, biomass, and geothermal resources is growing rapidly, but these sources still...consistent policy approach to address cost, regulatory, and transmission infrastructure challenges. For solar photovoltaic (PV) technology, basic...research is particularly important to make the needed improvements in cost and performance. • Solar power can help meet peak load electricity demand

  7. 77 FR 44158 - Fees for Services Performed in Connection With Licensing and Related Services-2012 Update

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-27

    ... AGENCY: Surface Transportation Board, DOT. ACTION: Final rules. SUMMARY: The Board adopts its 2012 user... result of no wage & salary increases given in January 2012, no change to publication costs from their... 1002.3(d). The fee changes adopted here, reflect a combination of the unchanged wage and salary costs...

  8. Who will have health insurance in the future? An updated projection.

    PubMed

    Young, Richard A; DeVoe, Jennifer E

    2012-01-01

    The passage of the 2010 Patient Protection and Affordable Care Act (PPACA) in the United States put the issues of health care reform and health care costs back in the national spotlight. DeVoe and colleagues previously estimated that the cost of a family health insurance premium would equal the median household income by the year 2025. A slowdown in health care spending tied to the recent economic downturn and the passage of the PPACA occurred after this model was published. In this updated model, we estimate that this threshold will be crossed in 2033, and under favorable assumptions the PPACA may extend this date only to 2037. Continuing to make incremental changes in US health policy will likely not bend the cost curve, which has eluded policy makers for the past 50 years. Private health insurance will become increasingly unaffordable to low-to-middle-income Americans unless major changes are made in the US health care system.

  9. Attitude Determination Algorithm based on Relative Quaternion Geometry of Velocity Incremental Vectors for Cost Efficient AHRS Design

    NASA Astrophysics Data System (ADS)

    Lee, Byungjin; Lee, Young Jae; Sung, Sangkyung

    2018-05-01

    A novel attitude determination method is investigated that is computationally efficient and implementable in low cost sensor and embedded platform. Recent result on attitude reference system design is adapted to further develop a three-dimensional attitude determination algorithm through the relative velocity incremental measurements. For this, velocity incremental vectors, computed respectively from INS and GPS with different update rate, are compared to generate filter measurement for attitude estimation. In the quaternion-based Kalman filter configuration, an Euler-like attitude perturbation angle is uniquely introduced for reducing filter states and simplifying propagation processes. Furthermore, assuming a small angle approximation between attitude update periods, it is shown that the reduced order filter greatly simplifies the propagation processes. For performance verification, both simulation and experimental studies are completed. A low cost MEMS IMU and GPS receiver are employed for system integration, and comparison with the true trajectory or a high-grade navigation system demonstrates the performance of the proposed algorithm.

  10. Development of Advanced Life Cycle Costing Methods for Technology Benefit/Cost/Risk Assessment

    NASA Technical Reports Server (NTRS)

    Yackovetsky, Robert (Technical Monitor)

    2002-01-01

    The overall objective of this three-year grant is to provide NASA Langley's System Analysis Branch with improved affordability tools and methods based on probabilistic cost assessment techniques. In order to accomplish this objective, the Aerospace Systems Design Laboratory (ASDL) needs to pursue more detailed affordability, technology impact, and risk prediction methods and to demonstrate them on variety of advanced commercial transports. The affordability assessment, which is a cornerstone of ASDL methods, relies on the Aircraft Life Cycle Cost Analysis (ALCCA) program originally developed by NASA Ames Research Center and enhanced by ASDL. This grant proposed to improve ALCCA in support of the project objective by updating the research, design, test, and evaluation cost module, as well as the engine development cost module. Investigations into enhancements to ALCCA include improved engine development cost, process based costing, supportability cost, and system reliability with airline loss of revenue for system downtime. A probabilistic, stand-alone version of ALCCA/FLOPS will also be developed under this grant in order to capture the uncertainty involved in technology assessments. FLOPS (FLight Optimization System program) is an aircraft synthesis and sizing code developed by NASA Langley Research Center. This probabilistic version of the coupled program will be used within a Technology Impact Forecasting (TIF) method to determine what types of technologies would have to be infused in a system in order to meet customer requirements. A probabilistic analysis of the CER's (cost estimating relationships) within ALCCA will also be carried out under this contract in order to gain some insight as to the most influential costs and the impact that code fidelity could have on future RDS (Robust Design Simulation) studies.

  11. Cost-effectiveness of vaccination against pneumococcal bacteremia among elderly people.

    PubMed

    Sisk, J E; Moskowitz, A J; Whang, W; Lin, J D; Fedson, D S; McBean, A M; Plouffe, J F; Cetron, M S; Butler, J C

    Clinical, epidemiologic, and policy considerations support updating the cost-effectiveness of pneumococcal vaccination for elderly people and targeting the evaluation only to prevention of pneumococcal bacteremia. To assess the implications for medical costs and health effects of vaccination against pneumococcal bacteremia in elderly people. Cost-effectiveness analysis of pneumococcal vaccination compared with no vaccination, from a societal perspective. The elderly population aged 65 years and older in the United States in 3 geographic areas: metropolitan Atlanta, Ga; Franklin County, Ohio; and Monroe County, New York. Incremental medical costs and health effects, expressed in quality-adjusted life-years per person vaccinated. Vaccination was cost saving, ie, it both reduced medical expenses and improved health, for all age groups and geographic areas analyzed in the base case. For people aged 65 years and older, vaccination saved $8.27 and gained 1.21 quality-adjusted days of life per person vaccinated. Vaccination of the 23 million elderly people unvaccinated in 1993 would have gained about 78000 years of healthy life and saved $194 million. In univariate sensitivity analysis, the results remained cost saving except for doubling vaccination costs, including future medical costs of survivors, and lowering vaccination effectiveness. With assumptions most unfavorable to vaccination, cost per quality-adjusted life-year ranged from $35 822 for ages 65 to 74 years to $598 487 for ages 85 years and older. In probabilistic sensitivity analysis, probability intervals were more narrow, with less than 5% probability that the ratio for ages 85 years and older would exceed $100000. Pneumococcal vaccination saves costs in the prevention of bacteremia alone and is greatly underused among the elderly population, on both health and economic grounds. These results support recent recommendations of the Advisory Committee on Immunization Practices and public and private efforts under way to improve vaccination rates.

  12. Dynamic model updating based on strain mode shape and natural frequency using hybrid pattern search technique

    NASA Astrophysics Data System (ADS)

    Guo, Ning; Yang, Zhichun; Wang, Le; Ouyang, Yan; Zhang, Xinping

    2018-05-01

    Aiming at providing a precise dynamic structural finite element (FE) model for dynamic strength evaluation in addition to dynamic analysis. A dynamic FE model updating method is presented to correct the uncertain parameters of the FE model of a structure using strain mode shapes and natural frequencies. The strain mode shape, which is sensitive to local changes in structure, is used instead of the displacement mode for enhancing model updating. The coordinate strain modal assurance criterion is developed to evaluate the correlation level at each coordinate over the experimental and the analytical strain mode shapes. Moreover, the natural frequencies which provide the global information of the structure are used to guarantee the accuracy of modal properties of the global model. Then, the weighted summation of the natural frequency residual and the coordinate strain modal assurance criterion residual is used as the objective function in the proposed dynamic FE model updating procedure. The hybrid genetic/pattern-search optimization algorithm is adopted to perform the dynamic FE model updating procedure. Numerical simulation and model updating experiment for a clamped-clamped beam are performed to validate the feasibility and effectiveness of the present method. The results show that the proposed method can be used to update the uncertain parameters with good robustness. And the updated dynamic FE model of the beam structure, which can correctly predict both the natural frequencies and the local dynamic strains, is reliable for the following dynamic analysis and dynamic strength evaluation.

  13. What have we learned on costs and financing of routine immunization from the comprehensive multi-year plans in GAVI eligible countries?

    PubMed

    Brenzel, Logan

    2015-05-07

    Immunization is one of the most cost-effective health interventions, but as countries introduce new vaccines and scale-up immunization coverage, costs will likely increase. This paper updates estimates of immunization costs and financing based on information from comprehensive multi-year plans (cMYPs) from GAVI-eligible countries during a period when countries planned to introduce a range of new vaccines (2008-2016). The analysis database included information from baseline and 5-year projection years for each country cMYP, resulting in a total sample size of 243 observations. Two-thirds were from African countries. Cost data included personnel, vaccine, injection, transport, training, maintenance, cold chain and other capital investments. Financing from government and external sources was evaluated. All estimates were converted to 2010 US Dollars. Statistical analysis was performed using STATA, and results were population-weighted. Results pertain to country planning estimates. Average annual routine immunization cost was $62 million. Vaccines continued to be the major cost driver (51%) followed by immunization-specific personnel costs (22%). Non-vaccine delivery costs accounted for almost half of routine program costs (44%). Routine delivery cost per dose averaged $0.61 and the delivery cost per infant was $10. The cost per DTP3 vaccinated child was $27. Routine program costs increased with each new vaccine introduced. Costs accounted for 5% of government health expenditures. Governments accounted for 67% of financing. Total and average costs of routine immunization programs are rising as coverage rates increase and new vaccines are introduced. The cost of delivering vaccines is nearly equivalent to the cost of vaccines. Governments are financing greater proportions of the immunization program but there may be limits in resource scarce countries. Price reductions for new vaccines will help reduce costs and the burden of financing. Strategies to improve efficiency in service delivery should be pursued. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Supply of genetic information--amount, format, and frequency.

    PubMed

    Misztal, I; Lawlor, T J

    1999-05-01

    The volume and complexity of genetic information is increasing because of new traits and better models. New traits may include reproduction, health, and carcass. More comprehensive models include the test day model in dairy cattle or a growth model in beef cattle. More complex models, which may include nonadditive effects such as inbreeding and dominance, also provide additional information. The amount of information per animal may increase drastically if DNA marker typing becomes routine and quantitative trait loci information is utilized. In many industries, evaluations are run more frequently. They result in faster genetic progress and improved management and marketing opportunities but also in extra costs and information overload. Adopting new technology and making some organizational changes can help realize all the added benefits of the improvements to the genetic evaluation systems at an acceptable cost. Continuous genetic evaluation, in which new records are accepted and breeding values are updated continuously, will relieve time pressures. An online mating system with access to both genetic and marketing information can result in mating recommendations customized for each user. Such a system could utilize inbreeding and dominance information that cannot efficiently be accommodated in the current sire summaries or off-line mating programs. The new systems will require a new organizational approach in which the task of scientists and technicians will not be simply running the evaluations but also providing the research, design, supervision, and maintenance required in the entire system of evaluation, decision making, and distribution.

  15. Selection in spatial working memory is independent of perceptual selective attention, but they interact in a shared spatial priority map.

    PubMed

    Hedge, Craig; Oberauer, Klaus; Leonards, Ute

    2015-11-01

    We examined the relationship between the attentional selection of perceptual information and of information in working memory (WM) through four experiments, using a spatial WM-updating task. Participants remembered the locations of two objects in a matrix and worked through a sequence of updating operations, each mentally shifting one dot to a new location according to an arrow cue. Repeatedly updating the same object in two successive steps is typically faster than switching to the other object; this object switch cost reflects the shifting of attention in WM. In Experiment 1, the arrows were presented in random peripheral locations, drawing perceptual attention away from the selected object in WM. This manipulation did not eliminate the object switch cost, indicating that the mechanisms of perceptual selection do not underlie selection in WM. Experiments 2a and 2b corroborated the independence of selection observed in Experiment 1, but showed a benefit to reaction times when the placement of the arrow cue was aligned with the locations of relevant objects in WM. Experiment 2c showed that the same benefit also occurs when participants are not able to mark an updating location through eye fixations. Together, these data can be accounted for by a framework in which perceptual selection and selection in WM are separate mechanisms that interact through a shared spatial priority map.

  16. FPGA Implementation of Generalized Hebbian Algorithm for Texture Classification

    PubMed Central

    Lin, Shiow-Jyu; Hwang, Wen-Jyi; Lee, Wei-Hao

    2012-01-01

    This paper presents a novel hardware architecture for principal component analysis. The architecture is based on the Generalized Hebbian Algorithm (GHA) because of its simplicity and effectiveness. The architecture is separated into three portions: the weight vector updating unit, the principal computation unit and the memory unit. In the weight vector updating unit, the computation of different synaptic weight vectors shares the same circuit for reducing the area costs. To show the effectiveness of the circuit, a texture classification system based on the proposed architecture is physically implemented by Field Programmable Gate Array (FPGA). It is embedded in a System-On-Programmable-Chip (SOPC) platform for performance measurement. Experimental results show that the proposed architecture is an efficient design for attaining both high speed performance and low area costs. PMID:22778640

  17. An adaptive Gaussian process-based iterative ensemble smoother for data assimilation

    NASA Astrophysics Data System (ADS)

    Ju, Lei; Zhang, Jiangjiang; Meng, Long; Wu, Laosheng; Zeng, Lingzao

    2018-05-01

    Accurate characterization of subsurface hydraulic conductivity is vital for modeling of subsurface flow and transport. The iterative ensemble smoother (IES) has been proposed to estimate the heterogeneous parameter field. As a Monte Carlo-based method, IES requires a relatively large ensemble size to guarantee its performance. To improve the computational efficiency, we propose an adaptive Gaussian process (GP)-based iterative ensemble smoother (GPIES) in this study. At each iteration, the GP surrogate is adaptively refined by adding a few new base points chosen from the updated parameter realizations. Then the sensitivity information between model parameters and measurements is calculated from a large number of realizations generated by the GP surrogate with virtually no computational cost. Since the original model evaluations are only required for base points, whose number is much smaller than the ensemble size, the computational cost is significantly reduced. The applicability of GPIES in estimating heterogeneous conductivity is evaluated by the saturated and unsaturated flow problems, respectively. Without sacrificing estimation accuracy, GPIES achieves about an order of magnitude of speed-up compared with the standard IES. Although subsurface flow problems are considered in this study, the proposed method can be equally applied to other hydrological models.

  18. A systematic approach for the location of hand sanitizer dispensers in hospitals.

    PubMed

    Cure, Laila; Van Enk, Richard; Tiong, Ewing

    2014-09-01

    Compliance with hand hygiene practices is directly affected by the accessibility and availability of cleaning agents. Nevertheless, the decision of where to locate these dispensers is often not explicitly or fully addressed in the literature. In this paper, we study the problem of selecting the locations to install alcohol-based hand sanitizer dispensers throughout a hospital unit as an indirect approach to maximize compliance with hand hygiene practices. We investigate the relevant criteria in selecting dispenser locations that promote hand hygiene compliance, propose metrics for the evaluation of various location configurations, and formulate a dispenser location optimization model that systematically incorporates such criteria. A complete methodology to collect data and obtain the model parameters is described. We illustrate the proposed approach using data from a general care unit at a collaborating hospital. A cost analysis was performed to study the trade-offs between usability and cost. The proposed methodology can help in evaluating the current location configuration, determining the need for change, and establishing the best possible configuration. It can be adapted to incorporate alternative metrics, tailored to different institutions and updated as needed with new internal policies or safety regulation.

  19. Economic Impact of Dengue: Multicenter Study across Four Brazilian Regions.

    PubMed

    Martelli, Celina Maria Turchi; Siqueira, Joao Bosco; Parente, Mirian Perpetua Palha Dias; Zara, Ana Laura de Sene Amancio; Oliveira, Consuelo Silva; Braga, Cynthia; Pimenta, Fabiano Geraldo; Cortes, Fanny; Lopez, Juan Guillermo; Bahia, Luciana Ribeiro; Mendes, Marcia Costa Ooteman; da Rosa, Michelle Quarti Machado; de Siqueira Filha, Noemia Teixeira; Constenla, Dagna; de Souza, Wayner Vieira

    2015-01-01

    Dengue is an increasing public health concern in Brazil. There is a need for an updated evaluation of the economic impact of dengue within the country. We undertook this multicenter study to evaluate the economic burden of dengue in Brazil. We estimated the economic burden of dengue in Brazil for the years 2009 to 2013 and for the epidemic season of August 2012- September 2013. We conducted a multicenter cohort study across four endemic regions: Midwest, Goiania; Southeast, Belo Horizonte and Rio de Janeiro; Northeast: Teresina and Recife; and the North, Belem. Ambulatory or hospitalized cases with suspected or laboratory-confirmed dengue treated in both the private and public sectors were recruited. Interviews were scheduled for the convalescent period to ascertain characteristics of the dengue episode, date of first symptoms/signs and recovery, use of medical services, work/school absence, household spending (out-of-pocket expense) and income lost using a questionnaire developed for a previous cost study. We also extracted data from the patients' medical records for hospitalized cases. Overall costs per case and cumulative costs were calculated from the public payer and societal perspectives. National cost estimations took into account cases reported in the official notification system (SINAN) with adjustment for underreporting of cases. We applied a probabilistic sensitivity analysis using Monte Carlo simulations with 90% certainty levels (CL). We screened 2,223 cases, of which 2,035 (91.5%) symptomatic dengue cases were included in our study. The estimated cost for dengue for the epidemic season (2012-2013) in the societal perspective was US$ 468 million (90% CL: 349-590) or US$ 1,212 million (90% CL: 904-1,526) after adjusting for under-reporting. Considering the time series of dengue (2009-2013) the estimated cost of dengue varied from US$ 371 million (2009) to US$ 1,228 million (2013). The economic burden associated with dengue in Brazil is substantial with large variations in reported cases and consequently costs reflecting the dynamic of dengue transmission.

  20. Do Health Care Delivery System Reforms Improve Value? The Jury Is Still Out.

    PubMed

    Korenstein, Deborah; Duan, Kevin; Diaz, Manuel J; Ahn, Rosa; Keyhani, Salomeh

    2016-01-01

    Widespread restructuring of health delivery systems is underway in the United States to reduce costs and improve the quality of health care. To describe studies evaluating the impact of system-level interventions (incentives and delivery structures) on the value of US health care, defined as the balance between quality and cost. We identified articles in PubMed (2003 to July 2014) using keywords identified through an iterative process, with reference and author tracking. We searched tables of contents of relevant journals from August 2014 through 11 August 2015 to update our sample. We included prospective or retrospective studies of system-level changes, with a control, reporting both quality and either cost or utilization of resources. Data about study design, study quality, and outcomes was extracted by one reviewer and checked by a second. Thirty reports of 28 interventions were included. Interventions included patient-centered medical home implementations (n=12), pay-for-performance programs (n=10), and mixed interventions (n=6); no other intervention types were identified. Most reports (n=19) described both cost and utilization outcomes. Quality, cost, and utilization outcomes varied widely; many improvements were small and process outcomes predominated. Improved value (improved quality with stable or lower cost/utilization or stable quality with lower cost/utilization) was seen in 23 reports; 1 showed decreased value, and 6 showed unchanged, unclear, or mixed results.Study limitations included variability among specific endpoints reported, inconsistent methodologies, and lack of full adjustment in some observational trials. Lack of standardized MeSH terms was also a challenge in the search. On balance, the literature suggests that health system reforms can improve value. However, this finding is tempered by the varying outcomes evaluated across studies with little documented improvement in outcome quality measures. Standardized measures of value would facilitate assessment of the impact of interventions across studies and better estimates of the broad impact of system change.

  1. A data management system for weight control and design-to-cost

    NASA Technical Reports Server (NTRS)

    Bryant, J. C.

    1978-01-01

    The definition of the mass properties data of aircraft changed on a daily basis as do design details of the aircraft. This dynamic nature of the definition has generally encouraged those responsible for the data to update the data on a weekly or monthly basis. The by-product of these infrequent updates was the requirement of manual records to maintain daily activity. The development of WAVES changed the approach to management of mass properties data. WAVES has given the ability to update the data on a daily basis thereby eliminating the need for manual records. WAVES has demonstrated that a software product can support a data management system for engineering data.

  2. Introducing Value-Based Purchasing into TRICARE Reform

    PubMed Central

    Hosek, Susan D.; Sorbero, Melony E.; Martsolf, Grant; Kandrack, Ryan

    2017-01-01

    Abstract TRICARE, the health benefits program created for beneficiaries of the U.S. Department of Defense, covers health care provided in military treatment facilities and by civilian providers. Congress is now considering how to update TRICARE, which was first developed in the 1980s drawing on managed care concepts from civilian health plans. This article places TRICARE's current managed care strategy in historical context and describes recent innovations by private insurers and Medicare intended to enhance the value---cost and quality---of the care they purchase for their members. With this movement toward value-based purchasing as background, the authors evaluate two existing proposals for reform and describe an alternative approach that blends the existing proposals. PMID:28845347

  3. Statistical, economic and other tools for assessing natural aggregate

    USGS Publications Warehouse

    Bliss, J.D.; Moyle, P.R.; Bolm, K.S.

    2003-01-01

    Quantitative aggregate resource assessment provides resource estimates useful for explorationists, land managers and those who make decisions about land allocation, which may have long-term implications concerning cost and the availability of aggregate resources. Aggregate assessment needs to be systematic and consistent, yet flexible enough to allow updating without invalidating other parts of the assessment. Evaluators need to use standard or consistent aggregate classification and statistic distributions or, in other words, models with geological, geotechnical and economic variables or interrelationships between these variables. These models can be used with subjective estimates, if needed, to estimate how much aggregate may be present in a region or country using distributions generated by Monte Carlo computer simulations.

  4. An economic evaluation of the costs and benefits of heparin rationalisation in a hospital pharmacy.

    PubMed

    Reeves, Penny; Cooke, Jonathan; Lloyd, Adam; Hutchings, Adam

    2004-06-01

    To estimate the costs and benefits for a UK hospital pharmacy of stocking a single low molecular weight heparin (LMWH), enoxaparin, compared to stocking unfractionated heparin (UFH) and stocking both UFH and multiple different LMWHs. A decision-tree model was developed which considered the use of heparins for five indications: prophylaxis against venous thromboembolism (VTE) in major orthopaedic surgery; VTE prophylaxis in major general surgery; VTE prophylaxis in acute medical inpatients; treatment of diagnosed VTE; and anticoagulation for patients with unstable angina and non-ST-elevation myocardial infarction (UA/NSTEMI). Previously published cost-effectiveness analyses for each indication were combined into a single model and updated to 2002 prices. The number of patients given heparin in each indication was estimated from the pharmacy records of a large UK teaching hospital. The model estimated the use of drugs, staff time, clinical events and resource use resulting from anti-coagulation. Costs were estimated from the perspective of the hospital and the UK National Health Service. Total annual cost was estimated to be pounds sterling 3.2 m (single LMWH), pounds sterling 4.4 m (UFH only) and pounds sterling 3.7 m (multiple heparins). The largest expected cost savings from using a single LMWH compared to UFH only resulted from reduced hospital stay for DVT treatment, reduced revascularisation in UA/NSTEMI and fewer VTE events in orthopaedic surgery. Expected cost savings from using a single LMWH compared to multiple heparins were more modest Sub-optimal choice of anticoagulants may result in substantial excess costs elsewhere in the hospital.

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

    PubMed

    Yeung, Christina; Dinh, Tuan; Lee, Joseph

    2014-11-01

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

  6. Resolving the "Cost-Effective but Unaffordable" Paradox: Estimating the Health Opportunity Costs of Nonmarginal Budget Impacts.

    PubMed

    Lomas, James; Claxton, Karl; Martin, Stephen; Soares, Marta

    2018-03-01

    Considering whether or not a proposed investment (an intervention, technology, or program of care) is affordable is really asking whether the benefits it offers are greater than its opportunity cost. To say that an investment is cost-effective but not affordable must mean that the (implicit or explicit) "threshold" used to judge cost-effectiveness does not reflect the scale and value of the opportunity costs. Existing empirical estimates of health opportunity costs are based on cross-sectional variation in expenditure and mortality outcomes by program budget categories (PBCs) and do not reflect the likely effect of nonmarginal budget impacts on health opportunity costs. The UK Department of Health regularly updates the needs-based target allocation of resources to local areas of the National Health Service (NHS), creating two subgroups of local areas (those under target allocation and those over). These data provide the opportunity to explore how the effects of changes in health care expenditure differ with available resources. We use 2008-2009 data to evaluate two econometric approaches to estimation and explore a range of criteria for accepting subgroup specific effects for differences in expenditure and outcome elasticities across the 23 PBCs. Our results indicate that health opportunity costs arising from an investment imposing net increases in expenditure are underestimated unless account is taken of likely nonmarginal effects. They also indicate the benefits (reduced health opportunity costs or increased value-based price of a technology) of being able to "smooth" these nonmarginal budget impacts by health care systems borrowing against future budgets or from manufacturers offering "mortgage" type arrangements. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Enhancing LoRaWAN Security through a Lightweight and Authenticated Key Management Approach.

    PubMed

    Sanchez-Iborra, Ramon; Sánchez-Gómez, Jesús; Pérez, Salvador; Fernández, Pedro J; Santa, José; Hernández-Ramos, José L; Skarmeta, Antonio F

    2018-06-05

    Luckily, new communication technologies and protocols are nowadays designed considering security issues. A clear example of this can be found in the Internet of Things (IoT) field, a quite recent area where communication technologies such as ZigBee or IPv6 over Low power Wireless Personal Area Networks (6LoWPAN) already include security features to guarantee authentication, confidentiality and integrity. More recent technologies are Low-Power Wide-Area Networks (LP-WAN), which also consider security, but present initial approaches that can be further improved. An example of this can be found in Long Range (LoRa) and its layer-two supporter LoRa Wide Area Network (LoRaWAN), which include a security scheme based on pre-shared cryptographic material lacking flexibility when a key update is necessary. Because of this, in this work, we evaluate the security vulnerabilities of LoRaWAN in the area of key management and propose different alternative schemes. Concretely, the application of an approach based on the recently specified Ephemeral Diffie⁻Hellman Over COSE (EDHOC) is found as a convenient solution, given its flexibility in the update of session keys, its low computational cost and the limited message exchanges needed. A comparative conceptual analysis considering the overhead of different security schemes for LoRaWAN is carried out in order to evaluate their benefits in the challenging area of LP-WAN.

  8. Performance Analysis of Low-Cost Single-Frequency GPS Receivers in Hydrographic Surveying

    NASA Astrophysics Data System (ADS)

    Elsobeiey, M.

    2017-10-01

    The International Hydrographic Organization (IHO) has issued standards that provide the minimum requirements for different types of hydrographic surveys execution to collect data to be used to compile navigational charts. Such standards are usually updated from time to time to reflect new survey techniques and practices and must be achieved to assure both surface navigation safety and marine environment protection. Hydrographic surveys can be classified to four orders namely, special order, order 1a, order 1b, and order 2. The order of hydrographic surveys to use should be determined in accordance with the importance to the safety of navigation in the surveyed area. Typically, geodetic-grade dual-frequency GPS receivers are utilized for position determination during data collection in hydrographic surveys. However, with the evolution of high-sensitivity low-cost single-frequency receivers, it is very important to evaluate the performance of such receivers. This paper investigates the performance of low-cost single-frequency GPS receivers in hydrographic surveying applications. The main objective is to examine whether low-cost single-frequency receivers fulfil the IHO standards for hydrographic surveys. It is shown that the low-cost single-frequency receivers meet the IHO horizontal accuracy for all hydrographic surveys orders at any depth. However, the single-frequency receivers meet only order 2 requirements for vertical accuracy at depth more than or equal 100 m.

  9. Mobile phone messaging reminders for attendance at healthcare appointments.

    PubMed

    Gurol-Urganci, Ipek; de Jongh, Thyra; Vodopivec-Jamsek, Vlasta; Atun, Rifat; Car, Josip

    2013-12-05

    This review is an update of the original Cochrane review published in July 2012. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs for the health system, leading to delays in diagnosis and appropriate treatment. Patients' forgetfulness is one of the main reasons for missed appointments. Patient reminders may help reduce missed appointments. Modes of communicating reminders for appointments to patients include face-to-face communication, postal messages, calls to landlines or mobile phones, and mobile phone messaging. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), could provide an important, inexpensive delivery medium for reminders for healthcare appointments. To update our review assessing the effects of mobile phone messaging reminders for attendance at healthcare appointments. Secondary objectives include assessment of costs; health outcomes; patients' and healthcare providers' evaluation of the intervention and perceptions of safety; and possible harms and adverse effects associated with the intervention. Original searches were run in June 2009. For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2012, Issue 8), MEDLINE (OvidSP) (January 1993 to August 2012), EMBASE (OvidSP) (January 1993 to August 2012), PsycINFO (OvidSP) (January 1993 to August 2012) and CINAHL (EbscoHOST) (January 1993 to August 2012). We also reviewed grey literature (including trial registers) and reference lists of articles. Randomised controlled trials (RCTs) assessing mobile phone messaging as reminders for healthcare appointments. We only included studies in which it was possible to assess effects of mobile phone messaging independent of other technologies or interventions.   Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third author. Two authors assessed the risk of bias of the included studies. As the intervention characteristics and outcome measures were similar across included studies, we conducted a meta-analysis to estimate an overall effect size. We included eight randomised controlled trials involving 6615 participants. Four of these studies were newly identified during this update.We found moderate quality evidence from seven studies (5841 participants) that mobile text message reminders improved the rate of attendance at healthcare appointments compared to no reminders (risk ratio (RR) 1.14 (95% confidence interval (CI) 1.03 to 1.26)). There was also moderate quality evidence from three studies (2509 participants) that mobile text message reminders had a similar impact to phone call reminders (RR 0.99 (95% CI 0.95 to 1.02). Low quality evidence from one study (291 participants) suggests that mobile text message reminders combined with postal reminders improved the rate of attendance at healthcare appointments compared to postal reminders alone (RR 1.10 (95% CI 1.02 to 1.19)). Overall, the attendance to appointment rates were 67.8% for the no reminders group, 78.6% for the mobile phone messaging reminders group and 80.3% for the phone call reminders group. One study reported generally that there were no adverse effects during the study period; none of the studies reported in detail on specific adverse events such as loss of privacy, data misinterpretation, or message delivery failure. Two studies reported that the costs per text message per attendance were respectively 55% and 65% lower than costs per phone call reminder. The studies included in the review did not report on health outcomes or people's perceptions of safety related to receiving reminders by text message. Low to moderate quality evidence included in this review shows that mobile phone text messaging reminders increase attendance at healthcare appointments compared to no reminders, or postal reminders.Text messaging reminders were similar to telephone reminders in terms of their effect on attendance rates, and cost less than telephone reminders. However, the included studies were heterogeneous and the quality of the evidence therein is low to moderate. Further, there is a lack of information about health effects, adverse effects and harms, user evaluation of the intervention and user perceptions of its safety. The current evidence therefore still remains insufficient to conclusively inform policy decisions.There is a need for more high-quality randomised trials of mobile phone messaging reminders, that measure not only patients' attendance rates, but also focus on the cost-effectiveness of these interventions. Health outcomes, patients' and healthcare providers' evaluation and perceptions of the safety of the interventions, potential harms, and adverse effects of mobile phone messaging reminders should be assessed. Studies should report message content and timing in relation to the appointment.

  10. Efficiency of U.S. Dialysis Centers: An Updated Examination of Facility Characteristics That Influence Production of Dialysis Treatments

    PubMed Central

    Shreay, Sanatan; Ma, Martin; McCluskey, Jill; Mittelhammer, Ron C; Gitlin, Matthew; Stephens, J Mark

    2014-01-01

    Objective To explore the relative efficiency of dialysis facilities in the United States and identify factors that are associated with efficiency in the production of dialysis treatments. Data Sources/Study Setting Medicare cost report data from 4,343 free-standing dialysis facilities in the United States that offered in-center hemodialysis in 2010. Study Design A cross-sectional, facility-level retrospective database analysis, utilizing data envelopment analysis (DEA) to estimate facility efficiency. Data Collection/Extraction Methods Treatment data and cost and labor inputs of dialysis treatments were obtained from 2010 Medicare Renal Cost Reports. Demographic data were obtained from the 2010 U.S. Census. Principal Findings Only 26.6 percent of facilities were technically efficient. Neither the intensity of market competition nor the profit status of the facility had a significant effect on efficiency. Facilities that were members of large chains were less likely to be efficient. Cost and labor savings due to changes in drug protocols had little effect on overall dialysis center efficiency. Conclusions The majority of free-standing dialysis facilities in the United States were functioning in a technically inefficient manner. As payment systems increasingly employ capitation and bundling provisions, these institutions will need to evaluate their efficiency to remain competitive. PMID:24237043

  11. Budget impact and cost-utility analysis of universal infant rotavirus vaccination in Spain.

    PubMed

    Imaz, Iñaki; Rubio, Beltrán; Cornejo, Ana M; González-Enríquez, Jesús

    2014-04-01

    Rotavirus is not included in the Spanish mass infant vaccination schedule but has also not been economically evaluated for its inclusion. We analysed cost-utility of the universal infant rotavirus vaccination using RotaTeq® versus no vaccination in Spain. We also carried out a budget impact analysis and determined the effect on results of different variables introduced in the model. A deterministic Markov model was built considering loss of quality of life for children and their parents, and introducing direct and indirect costs updated to 2011. The introduction of the vaccination using RotaTeq® as a universal infant vaccination would increase the annual health care budget in 10.43 million euro and would result in a gain of an additional Quality Adjusted Life Year at a cost of 280,338€ from the healthcare system perspective and 210,167€ from the societal perspective. The model was stable to variable modifications. To sum up, according to our model and estimates, the introduction of a universal infant rotavirus vaccination with RotaTeq® in Spain would cause a large impact on the health care budget and would not be efficient unless significant variations in vaccine price, vaccine efficacy and/or utilities took place. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. An Update: Changes Abound in Forestry Cost-Share Assistance Programs

    Treesearch

    Robert J. Moulton

    1999-01-01

    There have been some major changes in the line-up and funding for federal incentive programs that provide technical and financial assistance to non-industrial private forest (NIPF) landowners since I last reported on this subject ("Sorting Through Cost-Share Assistance Programs," Nov./Dec. 1994 Tree Farmer). The purpose of this article is to bring you up to...

  13. Rural Health Information Hub

    MedlinePlus

    ... Impact Analysis Tool Rural Health IT Curriculum Resources Sustainability Planning Tools Testing New Approaches RHIhub Publications & Updates ... Urban Adults Source: CDC Morbidity and Mortality Weekly Report Diabetes and Forgone Medical Care Due to Cost ...

  14. 24 CFR 50.36 - Updating of environmental reviews.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Updating of environmental reviews... Urban Development PROTECTION AND ENHANCEMENT OF ENVIRONMENTAL QUALITY Environmental Assessments and Related Reviews § 50.36 Updating of environmental reviews. The environmental review must be re-evaluated...

  15. 24 CFR 50.36 - Updating of environmental reviews.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Updating of environmental reviews... Urban Development PROTECTION AND ENHANCEMENT OF ENVIRONMENTAL QUALITY Environmental Assessments and Related Reviews § 50.36 Updating of environmental reviews. The environmental review must be re-evaluated...

  16. Updated cost-effectiveness analysis of supplemental glutamine for parenteral nutrition of intensive-care patients

    PubMed Central

    Pradelli, L; Povero, M; Muscaritoli, M; Eandi, M

    2015-01-01

    Background/Objectives: Intravenous (i.v.) glutamine supplementation of parenteral nutrition (PN) can improve clinical outcomes, reduce mortality and infection rates and shorten the length of hospital and/or intensive care unit (ICU) stays compared with standard PN. This study is a pharmacoeconomic analysis to determine whether i.v. glutamine supplementation of PN remains both a highly favourable and cost-effective option for Italian ICU patients. Subjects/Methods: A previously published discrete event simulation model was updated by incorporating the most up-to-date and clinically relevant efficacy data (a clinically realistic subgroup analysis from a published meta-analysis), recent cost data from the Italian health-care system and the latest epidemiology data from a large Italian ICU database (covering 230 Italian ICUs and more than 77 000 patients). Sensitivity analyses were performed to test the robustness of the results. Results: Parenteral glutamine supplementation can significantly improve ICU efficiency in Italy, as the additional cost of supplemented treatment is more than completely offset by cost savings in hospital care. Supplementation was more cost-effective (cost-effectiveness ratio (CER)=€35 165 per patient discharged alive) than standard, non-supplemented PN (CER=€40 156 per patient discharged alive), and it resulted in mean cost savings of €4991 per patient discharged alive or €1047 per patient admitted to the hospital. Sensitivity analyses confirmed the robustness of these results. Conclusions: Alanyl-glutamine supplementation of PN is a clinically and economically attractive strategy for ICU patients in Italy and may be applicable to selected ICU patient populations in other countries. PMID:25469466

  17. Updated cost-effectiveness analysis of supplemental glutamine for parenteral nutrition of intensive-care patients.

    PubMed

    Pradelli, L; Povero, M; Muscaritoli, M; Eandi, M

    2015-05-01

    Intravenous (i.v.) glutamine supplementation of parenteral nutrition (PN) can improve clinical outcomes, reduce mortality and infection rates and shorten the length of hospital and/or intensive care unit (ICU) stays compared with standard PN. This study is a pharmacoeconomic analysis to determine whether i.v. glutamine supplementation of PN remains both a highly favourable and cost-effective option for Italian ICU patients. A previously published discrete event simulation model was updated by incorporating the most up-to-date and clinically relevant efficacy data (a clinically realistic subgroup analysis from a published meta-analysis), recent cost data from the Italian health-care system and the latest epidemiology data from a large Italian ICU database (covering 230 Italian ICUs and more than 77,000 patients). Sensitivity analyses were performed to test the robustness of the results. Parenteral glutamine supplementation can significantly improve ICU efficiency in Italy, as the additional cost of supplemented treatment is more than completely offset by cost savings in hospital care. Supplementation was more cost-effective (cost-effectiveness ratio (CER)=[euro ]35,165 per patient discharged alive) than standard, non-supplemented PN (CER=[euro ]40,156 per patient discharged alive), and it resulted in mean cost savings of [euro ]4991 per patient discharged alive or [euro ]1047 per patient admitted to the hospital. Sensitivity analyses confirmed the robustness of these results. Alanyl-glutamine supplementation of PN is a clinically and economically attractive strategy for ICU patients in Italy and may be applicable to selected ICU patient populations in other countries.

  18. Reliability-based management of buried pipelines considering external corrosion defects

    NASA Astrophysics Data System (ADS)

    Miran, Seyedeh Azadeh

    Corrosion is one of the main deteriorating mechanisms that degrade the energy pipeline integrity, due to transferring corrosive fluid or gas and interacting with corrosive environment. Corrosion defects are usually detected by periodical inspections using in-line inspection (ILI) methods. In order to ensure pipeline safety, this study develops a cost-effective maintenance strategy that consists of three aspects: corrosion growth model development using ILI data, time-dependent performance evaluation, and optimal inspection interval determination. In particular, the proposed study is applied to a cathodic protected buried steel pipeline located in Mexico. First, time-dependent power-law formulation is adopted to probabilistically characterize growth of the maximum depth and length of the external corrosion defects. Dependency between defect depth and length are considered in the model development and generation of the corrosion defects over time is characterized by the homogenous Poisson process. The growth models unknown parameters are evaluated based on the ILI data through the Bayesian updating method with Markov Chain Monte Carlo (MCMC) simulation technique. The proposed corrosion growth models can be used when either matched or non-matched defects are available, and have ability to consider newly generated defects since last inspection. Results of this part of study show that both depth and length growth models can predict damage quantities reasonably well and a strong correlation between defect depth and length is found. Next, time-dependent system failure probabilities are evaluated using developed corrosion growth models considering prevailing uncertainties where three failure modes, namely small leak, large leak and rupture are considered. Performance of the pipeline is evaluated through failure probability per km (or called a sub-system) where each subsystem is considered as a series system of detected and newly generated defects within that sub-system. Sensitivity analysis is also performed to determine to which incorporated parameter(s) in the growth models reliability of the studied pipeline is most sensitive. The reliability analysis results suggest that newly generated defects should be considered in calculating failure probability, especially for prediction of long-term performance of the pipeline and also, impact of the statistical uncertainty in the model parameters is significant that should be considered in the reliability analysis. Finally, with the evaluated time-dependent failure probabilities, a life cycle-cost analysis is conducted to determine optimal inspection interval of studied pipeline. The expected total life-cycle costs consists construction cost and expected costs of inspections, repair, and failure. The repair is conducted when failure probability from any described failure mode exceeds pre-defined probability threshold after each inspection. Moreover, this study also investigates impact of repair threshold values and unit costs of inspection and failure on the expected total life-cycle cost and optimal inspection interval through a parametric study. The analysis suggests that a smaller inspection interval leads to higher inspection costs, but can lower failure cost and also repair cost is less significant compared to inspection and failure costs.

  19. Update on ɛK with lattice QCD inputs

    NASA Astrophysics Data System (ADS)

    Jang, Yong-Chull; Lee, Weonjong; Lee, Sunkyu; Leem, Jaehoon

    2018-03-01

    We report updated results for ɛK, the indirect CP violation parameter in neutral kaons, which is evaluated directly from the standard model with lattice QCD inputs. We use lattice QCD inputs to fix B\\hatk,|Vcb|,ξ0,ξ2,|Vus|, and mc(mc). Since Lattice 2016, the UTfit group has updated the Wolfenstein parameters in the angle-only-fit method, and the HFLAV group has also updated |Vcb|. Our results show that the evaluation of ɛK with exclusive |Vcb| (lattice QCD inputs) has 4.0σ tension with the experimental value, while that with inclusive |Vcb| (heavy quark expansion based on OPE and QCD sum rules) shows no tension.

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

    Gilbride, Theresa L.

    This short article was prepared for the U.S. Department of Energy's Building America Update newsletter. The article identifies energy and cost-saving benefits of using advanced framing techniques in new construction identified by research teams working with the DOE's Building America program. The article also provides links to guides in the Building America Solution Center that give how-to instructions for builders who want to implement advanced framing construction. The newsletter is issued monthly and can be accessed at http://energy.gov/eere/buildings/building-america-update-newsletter

  1. Nuclear Decay Data for the International Reactor Dosimetry Library for Fission and Fusion (IRDFF): Updated Evaluations of the Half-Lives and Gamma Ray Intensities

    NASA Astrophysics Data System (ADS)

    Chechev, Valery P.; Kuzmenko, Nikolay K.

    2016-02-01

    Updated evaluations of the half-lives and prominent gamma ray intensities have been presented for 20 radionuclides - dosimetry reaction residuals. The new values of these decay characteristics recommended for the IRDFF library were obtained using the approaches and methodology adopted by the working group of the Decay Data Evaluation Project (DDEP) cooperation. The experimental data published up to 2014 were taken into account in updated evaluations. The list of radionuclides includes 3H, 18F, 22Na, 24Na, 46Sc, 51Cr, 54Mn, 59Fe, 57Co, 60Co, 57Ni, 64Cu, 88Y, 132Te, 131I, 140Ba, 140La, 141Ce, 182Ta, 198Au.

  2. Test and analysis procedures for updating math models of Space Shuttle payloads

    NASA Technical Reports Server (NTRS)

    Craig, Roy R., Jr.

    1991-01-01

    Over the next decade or more, the Space Shuttle will continue to be the primary transportation system for delivering payloads to Earth orbit. Although a number of payloads have already been successfully carried by the Space Shuttle in the payload bay of the Orbiter vehicle, there continues to be a need for evaluation of the procedures used for verifying and updating the math models of the payloads. The verified payload math models is combined with an Orbiter math model for the coupled-loads analysis, which is required before any payload can fly. Several test procedures were employed for obtaining data for use in verifying payload math models and for carrying out the updating of the payload math models. Research was directed at the evaluation of test/update procedures for use in the verification of Space Shuttle payload math models. The following research tasks are summarized: (1) a study of free-interface test procedures; (2) a literature survey and evaluation of model update procedures; and (3) the design and construction of a laboratory payload simulator.

  3. Caregiver Statistics: Demographics

    MedlinePlus

    ... 20 Arno, P. S., Well Being of Caregivers: The Economic Issues of Caregivers, in T. McRae (Chair), New ... Institute (2011) Valuing the Invaluable: 2011 Update, The Economic Value of Family Caregiving 45 Doty, P. Cost- ...

  4. A parallel simulated annealing algorithm for standard cell placement on a hypercube computer

    NASA Technical Reports Server (NTRS)

    Jones, Mark Howard

    1987-01-01

    A parallel version of a simulated annealing algorithm is presented which is targeted to run on a hypercube computer. A strategy for mapping the cells in a two dimensional area of a chip onto processors in an n-dimensional hypercube is proposed such that both small and large distance moves can be applied. Two types of moves are allowed: cell exchanges and cell displacements. The computation of the cost function in parallel among all the processors in the hypercube is described along with a distributed data structure that needs to be stored in the hypercube to support parallel cost evaluation. A novel tree broadcasting strategy is used extensively in the algorithm for updating cell locations in the parallel environment. Studies on the performance of the algorithm on example industrial circuits show that it is faster and gives better final placement results than the uniprocessor simulated annealing algorithms. An improved uniprocessor algorithm is proposed which is based on the improved results obtained from parallelization of the simulated annealing algorithm.

  5. Efficient Geometry Minimization and Transition Structure Optimization Using Interpolated Potential Energy Surfaces and Iteratively Updated Hessians.

    PubMed

    Zheng, Jingjing; Frisch, Michael J

    2017-12-12

    An efficient geometry optimization algorithm based on interpolated potential energy surfaces with iteratively updated Hessians is presented in this work. At each step of geometry optimization (including both minimization and transition structure search), an interpolated potential energy surface is properly constructed by using the previously calculated information (energies, gradients, and Hessians/updated Hessians), and Hessians of the two latest geometries are updated in an iterative manner. The optimized minimum or transition structure on the interpolated surface is used for the starting geometry of the next geometry optimization step. The cost of searching the minimum or transition structure on the interpolated surface and iteratively updating Hessians is usually negligible compared with most electronic structure single gradient calculations. These interpolated potential energy surfaces are often better representations of the true potential energy surface in a broader range than a local quadratic approximation that is usually used in most geometry optimization algorithms. Tests on a series of large and floppy molecules and transition structures both in gas phase and in solutions show that the new algorithm can significantly improve the optimization efficiency by using the iteratively updated Hessians and optimizations on interpolated surfaces.

  6. Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care.

    PubMed

    Oksman, Erja; Linna, Miika; Hörhammer, Iiris; Lammintakanen, Johanna; Talja, Martti

    2017-02-15

    The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF). A total of 1570 patients were blindly randomized to intervention (n = 970) and control (n = 470) groups. The intervention group received monthly individual health coaching by telephone from a specially trained nurse for 12-months in addition to routine social and healthcare. Patients in the control group received routine social and health care. Quality of life was assessed at the beginning of the intervention and follow-up measurements were made after 12 months health coaching. The cost included all direct health-care costs supplemented with home care and nursing home-care costs in social care. Utility was based on a Health Related Quality of Life (HRQoL) measurement (15D instrument), and cost effectiveness was assessed using incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of health coaching was highest in the T2D group (ICER €20,000 per Quality-Adjusted Life Years [QALY]). The ICER for the CAD group was more modest (€40,278 per QALY), and in the CHF group, costs increased with no marked effect on QoL. Probabilistic sensitivity analysis indicated that at the societal willingness to pay threshold of €50,000 per QALY, the probability of health coaching being cost effective was 55% in the whole study group. The cost effectiveness of health coaching may vary substantially across patient groups, and thus interventions should be targeted at selected subgroups of chronically ill. Based on the results of this study, health coaching improved the QoL of T2D and CAD patients with moderate costs. However, the results are grounded on a short follow-up period, and more evidence is needed to evaluate the long-term outcomes of health-coaching programs. NCT00552903 [Prospectively registered, registration date 1 st November 2007, last updated 3 rd February 2009].

  7. Updating expected action outcome in the medial frontal cortex involves an evaluation of error type.

    PubMed

    Maier, Martin E; Steinhauser, Marco

    2013-10-02

    Forming expectations about the outcome of an action is an important prerequisite for action control and reinforcement learning in the human brain. The medial frontal cortex (MFC) has been shown to play an important role in the representation of outcome expectations, particularly when an update of expected outcome becomes necessary because an error is detected. However, error detection alone is not always sufficient to compute expected outcome because errors can occur in various ways and different types of errors may be associated with different outcomes. In the present study, we therefore investigate whether updating expected outcome in the human MFC is based on an evaluation of error type. Our approach was to consider an electrophysiological correlate of MFC activity on errors, the error-related negativity (Ne/ERN), in a task in which two types of errors could occur. Because the two error types were associated with different amounts of monetary loss, updating expected outcomes on error trials required an evaluation of error type. Our data revealed a pattern of Ne/ERN amplitudes that closely mirrored the amount of monetary loss associated with each error type, suggesting that outcome expectations are updated based on an evaluation of error type. We propose that this is achieved by a proactive evaluation process that anticipates error types by continuously monitoring error sources or by dynamically representing possible response-outcome relations.

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

    PubMed Central

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

    2015-01-01

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

  9. Final Report: Mass Production Cost Estimation of Direct H2 PEM Fuel Cell Systems for Transportation Applications (2012-2016)

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

    James, Brian David; Huya-Kouadio, Jennie Moton; Houchins, Cassidy

    This report summarizes project activities for Strategic Analysis, Inc. (SA) Contract Number DE-EE0005236 to the U.S. Department of Energy titled “Transportation Fuel Cell System Cost Assessment”. The project defined and projected the mass production costs of direct hydrogen Proton Exchange Membrane fuel cell power systems for light-duty vehicles (automobiles) and 40-foot transit buses. In each year of the five-year contract, the fuel cell power system designs and cost projections were updated to reflect technology advances. System schematics, design assumptions, manufacturing assumptions, and cost results are presented.

  10. An accurate and efficient reliability-based design optimization using the second order reliability method and improved stability transformation method

    NASA Astrophysics Data System (ADS)

    Meng, Zeng; Yang, Dixiong; Zhou, Huanlin; Yu, Bo

    2018-05-01

    The first order reliability method has been extensively adopted for reliability-based design optimization (RBDO), but it shows inaccuracy in calculating the failure probability with highly nonlinear performance functions. Thus, the second order reliability method is required to evaluate the reliability accurately. However, its application for RBDO is quite challenge owing to the expensive computational cost incurred by the repeated reliability evaluation and Hessian calculation of probabilistic constraints. In this article, a new improved stability transformation method is proposed to search the most probable point efficiently, and the Hessian matrix is calculated by the symmetric rank-one update. The computational capability of the proposed method is illustrated and compared to the existing RBDO approaches through three mathematical and two engineering examples. The comparison results indicate that the proposed method is very efficient and accurate, providing an alternative tool for RBDO of engineering structures.

  11. EPA Superfund Records of Decision (RODs) for Region 7: Iowa, Kansas, Missouri, and Nebraska

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

    NONE

    1999-03-01

    The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

  12. EPA Superfund Records of Decision (RODs) for Region 10: Alaska, Idaho, Oregon, and Washington

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

    NONE

    1999-03-01

    The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

  13. New medicines in primary care: a review of influences on general practitioner prescribing.

    PubMed

    Mason, A

    2008-02-01

    The uptake of new medicines is slower in the UK than in many other countries. Previous research found that cost and price have little influence on general practitioner (GP) behaviour, but recent UK government policy may have heightened cost-consciousness. Focussing on new medicines, this review aimed to explore the determinants of uptake, the causes of geographical variations, and the influence of price, cost and financial incentives on prescribing behaviour. Two separate searches were conducted on nine electronic databases. Strategy 1, an update of a previous review, used key terms for primary care physicians, uptake, medicines and 'new'. Strategy 2 focussed on terms relating to incentives and prescribing. Records were screened for eligibility and data from relevant papers were extracted using Bonair and Persson's typology for determinants of the diffusion of innovation, which classified influences into three groups: actors, structural/environmental characteristics and product characteristics. The searches identified 550 records and 28 studies were included in the updated review. Prescribing of new medicines needs to be understood in the context of individual patient-centred care, which is characterized by stability and continuity. Hospital doctors, pharmaceutical representatives and prescribing advisers are all influential, but GP attitudes towards these actors vary and there are notable differences between high and low prescribers of new pharmaceuticals. Support systems can help provide appropriate guidance and increase the uptake of new medicines by identifying patients who may benefit from pharmaceutical therapy. There is evidence of a shift in GP attitudes towards central policy initiatives, with doctors slowly accepting the need for external scrutiny and national standards. Although cost does appear to inform prescribing decisions, it is typically of lower importance than both safety and efficacy concerns and does not represent a significant barrier to uptake of new medicines. The impact of financial incentives on prescribing behaviour remains unclear, but is unlikely to be straightforward. No evidence exploring the reasons for geographical variations in GP uptake of new medicines was found. General practitioner care has historically been patient-centred, and it is unclear whether and how GPs consider the impact of their decisions upon the wider patient population. Incorporating cost considerations into GP decision making is one way to reflect the broader impact of individual treatment decisions. Current UK government policies use incentives to improve quality and encourage financial responsibility. Although these initiatives may help foster cost-consciousness, there is a risk that unintended consequences may ensue. Therefore, future policy evaluations should assess benefits, harms and costs so that the overall impact is transparent.

  14. Cost-effectiveness of pharmacist-participated warfarin therapy management in Thailand.

    PubMed

    Saokaew, Surasak; Permsuwan, Unchalee; Chaiyakunapruk, Nathorn; Nathisuwan, Surakit; Sukonthasarn, Apichard; Jeanpeerapong, Napawan

    2013-10-01

    Although pharmacist-participated warfarin therapy management (PWTM) is well established, the economic evaluation of PWTM is still lacking particularly in Asia-Pacific region. The objective of this study was to estimate the cost-effectiveness of PWTM in Thailand using local data where available. A Markov model was used to compare lifetime costs and quality-adjusted life years (QALYs) accrued to patients receiving warfarin therapy through PWTM or usual care (UC). The model was populated with relevant information from both health care system and societal perspectives. Input data were obtained from literatures and database analyses. Incremental cost-effectiveness ratios (ICERs) were presented as year 2012 values. A base-case analysis was performed for patients at age 45 years old. Sensitivity analyses including one-way and probabilistic sensitivity analyses were constructed to determine the robustness of the findings. From societal perspective, PWTM and UC results in 39.5 and 38.7 QALY, respectively. Thus, PWTM increase QALY by 0.79, and increase costs by 92,491 THB (3,083 USD) compared with UC (ICER 116,468 THB [3,882.3 USD] per QALY gained). While, from health care system perspective, PWTM also results in 0.79 QALY, and increase costs by 92,788 THB (3,093 USD) compared with UC (ICER 116,842 THB [3,894.7 USD] per QALY gained). Thus, PWTM was cost-effective compared with usual care, assuming willingness-to-pay (WTP) of 150,000 THB/QALY. Results were sensitive to the discount rate and cost of clinic set-up. Our finding suggests that PWTM is a cost-effective intervention. Policy-makers may consider our finding as part of information in their decision-making for implementing this strategy into healthcare benefit package. Further updates when additional data available are needed. © 2013.

  15. Intelligent transportation systems benefits, costs, and lessons learned : 2014 update report.

    DOT National Transportation Integrated Search

    2014-06-01

    Intelligent transportation systems (ITS) provide a proven set of strategies for advancing transportation safety, mobility, and environmental sustainability by integrating communication and information technology applications into the management and o...

  16. Update and enhancement of ODOT's crash reduction factors.

    DOT National Transportation Integrated Search

    2006-06-01

    Appropriate selection of cost-effective countermeasures for highway safety improvement projects requires an : estimate of the safety effects of alternative designs. The Oregon Department of Transportation (ODOT), like many : agencies, makes these est...

  17. UPDATE ON PEC ACTIVITIES INCLUDING NEW EVALUATION CRITERIA, THE APPLICATION COMPLETENESS CHECKLIST, AND STATUS OF THE WEBSITE DEVELOPMENT

    EPA Science Inventory

    US EPA's Pathogen Equivalency Committee (PEC) has updated the evaluation criteria it uses to make recommendations of equivalency (to processes acceptable under 40CFR503) on innovative or alternative sludge pathogen reduction processes. These criteria will be presented along with ...

  18. Gypcheck environmentally safe viral insecticide for gypsy moth control

    Treesearch

    Richard Reardon; John Podgwaite; Roger Zerillo

    2012-01-01

    This handbook is an update of handbook FHTET-2009-01, Gypchek - Bioinsecticide for the Gypsy Moth, printed in July, 2009. This update contains information on virus production, safety evaluations, results of efficacy and deposition evaluations, commercial production, and a copy of the revised registration label, material safety data sheet, and...

  19. Reporting Items for Updated Clinical Guidelines: Checklist for the Reporting of Updated Guidelines (CheckUp)

    PubMed Central

    Vernooij, Robin W. M.; Alonso-Coello, Pablo; Brouwers, Melissa

    2017-01-01

    Background Scientific knowledge is in constant development. Consequently, regular review to assure the trustworthiness of clinical guidelines is required. However, there is still a lack of preferred reporting items of the updating process in updated clinical guidelines. The present article describes the development process of the Checklist for the Reporting of Updated Guidelines (CheckUp). Methods and Findings We developed an initial list of items based on an overview of research evidence on clinical guideline updating, the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument, and the advice of the CheckUp panel (n = 33 professionals). A multistep process was used to refine this list, including an assessment of ten existing updated clinical guidelines, interviews with key informants (response rate: 54.2%; 13/24), a three-round Delphi consensus survey with the CheckUp panel (33 participants), and an external review with clinical guideline methodologists (response rate: 90%; 53/59) and users (response rate: 55.6%; 10/18). CheckUp includes 16 items that address (1) the presentation of an updated guideline, (2) editorial independence, and (3) the methodology of the updating process. In this article, we present the methodology to develop CheckUp and include as a supplementary file an explanation and elaboration document. Conclusions CheckUp can be used to evaluate the completeness of reporting in updated guidelines and as a tool to inform guideline developers about reporting requirements. Editors may request its completion from guideline authors when submitting updated guidelines for publication. Adherence to CheckUp will likely enhance the comprehensiveness and transparency of clinical guideline updating for the benefit of patients and the public, health care professionals, and other relevant stakeholders. PMID:28072838

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

    Michael Ebert

    This is the final report for the DOE-NETL grant entitled 'Creating New Incentives for Risk Identification & Insurance Processes for the Electric Utility Industry' and later, 'Energy & Risk Transfer Assessment'. It reflects work done on projects from 15 August 2004 to 29 February 2008. Projects were on a variety of topics, including commercial insurance for electrical utilities, the Electrical Reliability Organization, cost recovery by Gulf State electrical utilities after major hurricanes, and review of state energy emergency plans. This Final Technical Report documents and summarizes all work performed during the award period, which in this case is from 15more » August 2004 (date of notification of original award) through 29 February 2008. This report presents this information in a comprehensive, integrated fashion that clearly shows a logical and synergistic research trajectory, and is augmented with findings and conclusions drawn from the research as a whole. Four major research projects were undertaken and completed during the 42 month period of activities conducted and funded by the award; these are: (1) Creating New Incentives for Risk Identification and Insurance Process for the Electric Utility Industry (also referred to as the 'commercial insurance' research). Three major deliverables were produced: a pre-conference white paper, a two-day facilitated stakeholders workshop conducted at George Mason University, and a post-workshop report with findings and recommendations. All deliverables from this work are published on the CIP website at http://cipp.gmu.edu/projects/DoE-NETL-2005.php. (2) The New Electric Reliability Organization (ERO): an examination of critical issues associated with governance, standards development and implementation, and jurisdiction (also referred to as the 'ERO study'). Four major deliverables were produced: a series of preliminary memoranda for the staff of the Office of Electricity Delivery and Energy Reliability ('OE'), an ERO interview protocol and stakeholder/experts interviews, a formal research paper, and a data quality and availability study of North American Electric Reliability Corporation/ERO's disturbances and outages working group ('DAWG') databases. (3) Critical Electric Power Infrastructure Recovery and Reconstruction: Issues & New Policy Initiatives in Four Gulf Coast States After 2005's Catastrophic Hurricanes (also referred to as the 'Gulf Coast cost recovery study'). Four deliverables were produced: the original research paper providing preliminary findings and recommendations (29 September 2006), a formal presentation of that report to officials, staff and invited guests at OE's Washington, DC headquarters, a series of update memoranda and quarterly activity updates (1 November 2006 through Q3-2007), and a final cumulative update of the original research report (February 2008). Documentation and information on these research activities can be found on the CIP website at http://cipp.gmu.edu/projects/DoE-NETL-2006.php. (4) Evaluation of State Energy Emergency Response Plans (also referred to as the 'SEERP project'). Two major deliverables were produced: an evaluation of 47 SEERPs with findings, statistical analyses, geospatial renderings (mappings of the States whose plans were evaluated with statistical analysis underpinnings) and recommendations (17 September 2007), and a major revision to the original deliverable to include one additional plan (Missouri), with fully updated findings, statistical analyses, geospatial renderings, and recommendations (Revision 1, 29 February 2008).« less

  1. Investigating the Impact on Modeled Ozone Concentrations Using Meteorological Fields From WRF With and Updated Four-Dimensional Data Assimilation Approach”

    EPA Science Inventory

    The four-dimensional data assimilation (FDDA) technique in the Weather Research and Forecasting (WRF) meteorological model has recently undergone an important update from the original version. Previous evaluation results have demonstrated that the updated FDDA approach in WRF pr...

  2. On-line Bayesian model updating for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Rocchetta, Roberto; Broggi, Matteo; Huchet, Quentin; Patelli, Edoardo

    2018-03-01

    Fatigue induced cracks is a dangerous failure mechanism which affects mechanical components subject to alternating load cycles. System health monitoring should be adopted to identify cracks which can jeopardise the structure. Real-time damage detection may fail in the identification of the cracks due to different sources of uncertainty which have been poorly assessed or even fully neglected. In this paper, a novel efficient and robust procedure is used for the detection of cracks locations and lengths in mechanical components. A Bayesian model updating framework is employed, which allows accounting for relevant sources of uncertainty. The idea underpinning the approach is to identify the most probable crack consistent with the experimental measurements. To tackle the computational cost of the Bayesian approach an emulator is adopted for replacing the computationally costly Finite Element model. To improve the overall robustness of the procedure, different numerical likelihoods, measurement noises and imprecision in the value of model parameters are analysed and their effects quantified. The accuracy of the stochastic updating and the efficiency of the numerical procedure are discussed. An experimental aluminium frame and on a numerical model of a typical car suspension arm are used to demonstrate the applicability of the approach.

  3. Treatment 2.0: catalyzing the next phase of treatment, care and support.

    PubMed

    Duncombe, Chris; Ball, Andrew; Passarelli, Carlos; Hirnschall, Gottfried

    2013-01-01

    This review provides an update on the WHO/UNAIDS Treatment 2.0 strategy by reviewing the documents and technical updates issued under the initiative. Launched in 2010, this global initiative provides a framework for the continued scale-up of access to HIV care and treatment. WHO has prioritized once daily fixed-dose combination as the preferred antiretroviral (ARV) regimen to initiate HIV treatment, paving the way for programmatic simplification, with reduced toxicity and improved adherence. WHO also recommends the use of point-of-care diagnostics, with CD4 cell count technologies being implemented in the field and progress towards improving access to simplified viral load testing. The strategy also seeks mechanisms that can contribute to reducing treatment costs, such as pooled commodity procurement and public health-oriented licensing approaches. Improved service delivery, specifically through decentralization, task shifting, integration and community mobilization also has the potential to reduce costs and improve access. Support to countries has been provided through the timely release of a series of programmatic and technical updates on specific treatment-related topics. The Treatment 2.0 strategy articulates how innovation and greater efficiency can make HIV care and treatment more accessible and affordable, and guide treatment and prevention scale-up.

  4. Imitate or innovate: Competition of strategy updating attitudes in spatial social dilemma games

    NASA Astrophysics Data System (ADS)

    Danku, Zsuzsa; Wang, Zhen; Szolnoki, Attila

    2018-01-01

    Evolution is based on the assumption that competing players update their strategies to increase their individual payoffs. However, while the applied updating method can be different, most of previous works proposed uniform models where players use identical way to revise their strategies. In this work we explore how imitation-based or learning attitude and innovation-based or myopic best-response attitude compete for space in a complex model where both attitudes are available. In the absence of additional cost the best response trait practically dominates the whole snow-drift game parameter space which is in agreement with the average payoff difference of basic models. When additional cost is involved then the imitation attitude can gradually invade the whole parameter space but this transition happens in a highly nontrivial way. However, the role of competing attitudes is reversed in the stag-hunt parameter space where imitation is more successful in general. Interestingly, a four-state solution can be observed for the latter game which is a consequence of an emerging cyclic dominance between possible states. These phenomena can be understood by analyzing the microscopic invasion processes, which reveals the unequal propagation velocities of strategies and attitudes.

  5. Advanced manufacturing development of a composite empennage component for L-1011 aircraft

    NASA Technical Reports Server (NTRS)

    Alva, T.; Henkel, J.; Johnson, R.; Carll, B.; Jackson, A.; Mosesian, B.; Brozovic, R.; Obrien, R.; Eudaily, R.

    1982-01-01

    This is the final report of technical work conducted during the fourth phase of a multiphase program having the objective of the design, development and flight evaluation of an advanced composite empennage component manufactured in a production environment at a cost competitive with those of its metal counterpart, and at a weight savings of at least 20 percent. The empennage component selected for this program is the vertical fin box of the L-1011 aircraft. The box structure extends from the fuselage production joint to the tip rib and includes front and rear spars. During Phase 4 of the program, production quality tooling was designed and manufactured to produce three sets of covers, ribs, spars, miscellaneous parts, and subassemblies to assemble three complete ACVF units. Recurring and nonrecurring cost data were compiled and documented in the updated producibility/design to cost plan. Nondestruct inspections, quality control tests, and quality acceptance tests were performed in accordance with the quality assurance plan and the structural integrity control plan. Records were maintained to provide traceability of material and parts throughout the manufacturing development phase. It was also determined that additional tooling would not be required to support the current and projected L-1011 production rate.

  6. Chronic comorbidities associated with inflammatory bowel disease: prevalence and impact on healthcare costs in Switzerland.

    PubMed

    Bähler, Caroline; Schoepfer, Alain M; Vavricka, Stephan R; Brüngger, Beat; Reich, Oliver

    2017-08-01

    Inflammatory bowel disease (IBD) was shown to be associated with a variety of chronic comorbidities. We aimed to evaluate the frequency of 21 chronic conditions and compared frequencies in IBD and non-IBD populations. Further, healthcare costs of those (additional) chronic conditions were calculated. A total of 4791 IBD patients, who were insured at Helsana Insurance Group in 2014, were compared with 1 114 638 individuals without IBD. Entropy balancing was performed to create balanced samples. Chronic conditions were identified by means of the updated Pharmacy-based Cost Group model. Multivariate log-transformed linear regression modeling was performed to estimate the effect of the morbidity status (non-IBD +none, +1, +2, and +3 or more chronic conditions) on the healthcare costs. Overall, 78% of IBD patients had at least one comorbidity, with a median of three comorbidities. Largest differences between individuals with and without IBD were found for rheumatologic conditions, acid-related disorders, pain, bone diseases, migraines, cancer, and iron-deficiency anemia, whereas no significant differences between the two groups were found for diabetes, dementia, hyperlipidemia, glaucoma, gout, HIV, psychoses, and Parkinson's disease after adjustments for a variety of covariates. Each increase in the morbidity status led to increased healthcare costs; rheumatologic conditions, acid-related disorders, and pain as the most frequent comorbidities more than doubled total costs in IBD patients. We found a considerably high prevalence of concomitant chronic diseases in IBD patients. This was associated with considerably higher healthcare costs, especially in the outpatient setting.

  7. Low cost management of replicated data in fault-tolerant distributed systems

    NASA Technical Reports Server (NTRS)

    Joseph, Thomas A.; Birman, Kenneth P.

    1990-01-01

    Many distributed systems replicate data for fault tolerance or availability. In such systems, a logical update on a data item results in a physical update on a number of copies. The synchronization and communication required to keep the copies of replicated data consistent introduce a delay when operations are performed. A technique is described that relaxes the usual degree of synchronization, permitting replicated data items to be updated concurrently with other operations, while at the same time ensuring that correctness is not violated. The additional concurrency thus obtained results in better response time when performing operations on replicated data. How this technique performs in conjunction with a roll-back and a roll-forward failure recovery mechanism is also discussed.

  8. A brief review of the estimated economic burden of sexually transmitted diseases in the United States: inflation-adjusted updates of previously published cost studies.

    PubMed

    Chesson, Harrell W; Gift, Thomas L; Owusu-Edusei, Kwame; Tao, Guoyu; Johnson, Ana P; Kent, Charlotte K

    2011-10-01

    We conducted a literature review of studies of the economic burden of sexually transmitted diseases in the United States. The annual direct medical cost of sexually transmitted diseases (including human immunodeficiency virus) has been estimated to be $16.9 billion (range: $13.9-$23.0 billion) in 2010 US dollars.

  9. Updated Buildings Sector Appliance and Equipment Costs and Efficiency

    EIA Publications

    2016-01-01

    EIA works with technology experts to project the cost and efficiency of future HVAC, lighting, and other major end-use equipment rather than developing residential and commercial technology projections in-house. These reports have always been available by request. By providing the reports online, EIA is increasing transparency for some of the most important assumptions used for our AEO projections of buildings energy demand.

  10. Numerical modeling and model updating for smart laminated structures with viscoelastic damping

    NASA Astrophysics Data System (ADS)

    Lu, Jun; Zhan, Zhenfei; Liu, Xu; Wang, Pan

    2018-07-01

    This paper presents a numerical modeling method combined with model updating techniques for the analysis of smart laminated structures with viscoelastic damping. Starting with finite element formulation, the dynamics model with piezoelectric actuators is derived based on the constitutive law of the multilayer plate structure. The frequency-dependent characteristics of the viscoelastic core are represented utilizing the anelastic displacement fields (ADF) parametric model in the time domain. The analytical model is validated experimentally and used to analyze the influencing factors of kinetic parameters under parametric variations. Emphasis is placed upon model updating for smart laminated structures to improve the accuracy of the numerical model. Key design variables are selected through the smoothing spline ANOVA statistical technique to mitigate the computational cost. This updating strategy not only corrects the natural frequencies but also improves the accuracy of damping prediction. The effectiveness of the approach is examined through an application problem of a smart laminated plate. It is shown that a good consistency can be achieved between updated results and measurements. The proposed method is computationally efficient.

  11. Modulation of working memory updating: Does long-term memory lexical association matter?

    PubMed

    Artuso, Caterina; Palladino, Paola

    2016-02-01

    The aim of the present study was to investigate how working memory updating for verbal material is modulated by enduring properties of long-term memory. Two coexisting perspectives that account for the relation between long-term representation and short-term performance were addressed. First, evidence suggests that performance is more closely linked to lexical properties, that is, co-occurrences within the language. Conversely, other evidence suggests that performance is linked more to long-term representations which do not entail lexical/linguistic representations. Our aim was to investigate how these two kinds of long-term memory associations (i.e., lexical or nonlexical) modulate ongoing working memory activity. Therefore, we manipulated (between participants) the strength of the association in letters based on either frequency of co-occurrences (lexical) or contiguity along the sequence of the alphabet (nonlexical). Results showed a cost in working memory updating for strongly lexically associated stimuli only. Our findings advance knowledge of how lexical long-term memory associations between consonants affect working memory updating and, in turn, contribute to the study of factors which impact the updating process across memory systems.

  12. Citation Discovery Tools for Conducting Adaptive Meta-analyses to Update Systematic Reviews.

    PubMed

    Bae, Jong-Myon; Kim, Eun Hee

    2016-03-01

    The systematic review (SR) is a research methodology that aims to synthesize related evidence. Updating previously conducted SRs is necessary when new evidence has been produced, but no consensus has yet emerged on the appropriate update methodology. The authors have developed a new SR update method called 'adaptive meta-analysis' (AMA) using the 'cited by', 'similar articles', and 'related articles' citation discovery tools in the PubMed and Scopus databases. This study evaluates the usefulness of these citation discovery tools for updating SRs. Lists were constructed by applying the citation discovery tools in the two databases to the articles analyzed by a published SR. The degree of overlap between the lists and distribution of excluded results were evaluated. The articles ultimately selected for the SR update meta-analysis were found in the lists obtained from the 'cited by' and 'similar' tools in PubMed. Most of the selected articles appeared in both the 'cited by' lists in Scopus and PubMed. The Scopus 'related' tool did not identify the appropriate articles. The AMA, which involves using both citation discovery tools in PubMed, and optionally, the 'related' tool in Scopus, was found to be useful for updating an SR.

  13. Osteopathic Manipulative Treatment in Pediatric and Neonatal Patients and Disorders: Clinical Considerations and Updated Review of the Existing Literature.

    PubMed

    Bagagiolo, Donatella; Didio, Alessia; Sbarbaro, Marco; Priolo, Claudio Giuseppe; Borro, Tiziana; Farina, Daniele

    2016-09-01

    Osteopathic medicine is a form of complementary and alternative medicine. Osteopathic practitioners treat patients of all ages: according to the Osteopathic International Alliance's 2012 survey, about one-third of all treated patients are aged between 31 and 50 years and nearly a quarter (23.4%) are pediatric patients, with 8.7% of them being younger than 2 years. In 2013 a systematic review evaluated the effectiveness of osteopathic manipulative treatment (OMT) in pediatric patients with different underlying disorders, but due to the paucity and low methodological quality of the primary studies the results were inconclusive. The aim of this review is therefore to update the evidence concerning OMT in perinatal and pediatric disorders and to assess its clinical impact. Most published studies favor OMT, but the generally small sample sizes in these studies cannot support ultimate conclusions about the efficacy of osteopathic therapy in pediatric age. In turn, clinical trials of OMT in premature infants might represent an important step in the osteopathic research because they can address both cost-effectiveness issues, and an innovative, multidisciplinary approach to the management of specific pediatric diseases cared for by the same, common health care system. The available studies in neonatal settings provide evidence that OMT is effective in reducing the hospital length of stay of the treated infants, therefore, suggesting that robust cost-effectiveness analyses should be included in the future clinical trials' design to establish new possible OMT-shared strategies within the health care services provided to newborns. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Application of enhanced recovery after gastric cancer surgery: An updated meta-analysis

    PubMed Central

    Wang, Liu-Hua; Zhu, Ren-Fei; Gao, Cheng; Wang, Shou-Lin; Shen, Li-Zong

    2018-01-01

    AIM To provide an updated assessment of the safety and efficacy of enhanced recovery after surgery (ERAS) protocols in elective gastric cancer (GC) surgery. METHODS PubMed, Medline, EMBASE, World Health Organization International Trial Register, and Cochrane Library were searched up to June 2017 for all available randomized controlled trials (RCTs) comparing ERAS protocols and standard care (SC) in GC surgery. Thirteen RCTs, with a total of 1092 participants, were analyzed in this study, of whom 545 underwent ERAS protocols and 547 received SC treatment. RESULTS No significant difference was observed between ERAS and control groups regarding total complications (P = 0.88), mortality (P = 0.50) and reoperation (P = 0.49). The incidence of pulmonary infection was significantly reduced (P = 0.03) following gastrectomy. However, the readmission rate after GC surgery nearly tripled under ERAS (P = 0.009). ERAS protocols significantly decreased the length of postoperative hospital stay (P < 0.00001) and medical costs (P < 0.00001), and accelerated bowel function recovery, as measured by earlier time to the first flatus (P = 0.0004) and the first defecation (P < 0.0001). Moreover, ERAS protocols were associated with a lower level of serum inflammatory response, higher serum albumin, and superior short-term quality of life (QOL). CONCLUSION Collectively, ERAS results in accelerated convalescence, reduction of surgical stress and medical costs, improved nutritional status, and better QOL for GC patients. However, high-quality multicenter RCTs with large samples and long-term follow-up are needed to more precisely evaluate ERAS in radical gastrectomy. PMID:29662294

  15. Effect of display update interval, update type, and background on perception of aircraft separation on a cockpit display on traffic information

    NASA Technical Reports Server (NTRS)

    Jago, S.; Baty, D.; Oconnor, S.; Palmer, E.

    1981-01-01

    The concept of a cockpit display of traffic information (CDTI) includes the integration of air traffic, navigation, and other pertinent information in a single electronic display in the cockpit. Concise display symbology was developed for use in later full-mission simulator evaluations of the CDTI concept. Experimental variables used included the update interval motion of the aircraft, the update type, (that is, whether the two aircraft were updated at the same update interval or not), the background (grid pattern or no background), and encounter type (straight or curved). Only the type of encounter affected performance.

  16. Evaluation of Lower East Fork Poplar Creek Mercury Sources - Model Update

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

    Ketelle, Richard; Brandt, Craig C.; Peterson, Mark J.

    The purpose of this report is to assess new data that has become available and provide an update to the evaluations and modeling presented in the Oak Ridge National Laboratory (ORNL) Technical Manuscript Evaluation of lower East Fork Poplar Creek (LEFPC) Mercury Sources (Watson et al., 2016). Primary sources of field and laboratory data for this update include multiple US Department of Energy (DOE) programs including Environmental Management (EM; e.g., Biological Monitoring and Abatement Program, Mercury Remediation Technology Development [TD], and Applied Field Research Initiative), Office of Science (Mercury Science Focus Areas [SFA] project), and the Y-12 National Security Complexmore » (Y-12) Compliance Department.« less

  17. 75 FR 3901 - Board of Visitors, United States Military Academy (USMA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... Organizational Meeting of the USMA Board of Visitors (BoV). Members of the Board will be provided updates on..., Technology, Engineering & Math (STEM) Center of Excellence, Energy Costs and Initiatives, Wastewater...

  18. 39 CFR 3050.21 - Content of the Postal Service's section 3652 report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... speed of delivery and the reliability of delivery; (e) For each market dominant workshare discount... unit costs and price elasticities, shall be updated using fiscal year values; and (5) Analyze the...

  19. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

  20. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

  1. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

  2. [Preoperative evaluation of adult patients before elective, noncardiothoracic surgery : Joint recommendation of the German Society of Anesthesiology and Intensive Care Medicine, the German Society of Surgery, and the German Society of Internal Medicine].

    PubMed

    Zwissler, B

    2017-06-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate recommendations on the preoperative evaluation of adult patients prior to elective, noncardiothoracic surgery, which were initially published in 2010. These recommendations have now been updated based on the current literature and existing international guidelines. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

  3. Nutritional update for physicians: plant-based diets.

    PubMed

    Tuso, Philip J; Ismail, Mohamed H; Ha, Benjamin P; Bartolotto, Carole

    2013-01-01

    The objective of this article is to present to physicians an update on plant-based diets. Concerns about the rising cost of health care are being voiced nationwide, even as unhealthy lifestyles are contributing to the spread of obesity, diabetes, and cardiovascular disease. For these reasons, physicians looking for cost-effective interventions to improve health outcomes are becoming more involved in helping their patients adopt healthier lifestyles. Healthy eating may be best achieved with a plant-based diet, which we define as a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs as well as all refined and processed foods. We present a case study as an example of the potential health benefits of such a diet. Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, HbA1C, and cholesterol levels. They may also reduce the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates. Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.

  4. A Novel Unsupervised Adaptive Learning Method for Long-Term Electromyography (EMG) Pattern Recognition

    PubMed Central

    Huang, Qi; Yang, Dapeng; Jiang, Li; Zhang, Huajie; Liu, Hong; Kotani, Kiyoshi

    2017-01-01

    Performance degradation will be caused by a variety of interfering factors for pattern recognition-based myoelectric control methods in the long term. This paper proposes an adaptive learning method with low computational cost to mitigate the effect in unsupervised adaptive learning scenarios. We presents a particle adaptive classifier (PAC), by constructing a particle adaptive learning strategy and universal incremental least square support vector classifier (LS-SVC). We compared PAC performance with incremental support vector classifier (ISVC) and non-adapting SVC (NSVC) in a long-term pattern recognition task in both unsupervised and supervised adaptive learning scenarios. Retraining time cost and recognition accuracy were compared by validating the classification performance on both simulated and realistic long-term EMG data. The classification results of realistic long-term EMG data showed that the PAC significantly decreased the performance degradation in unsupervised adaptive learning scenarios compared with NSVC (9.03% ± 2.23%, p < 0.05) and ISVC (13.38% ± 2.62%, p = 0.001), and reduced the retraining time cost compared with ISVC (2 ms per updating cycle vs. 50 ms per updating cycle). PMID:28608824

  5. A Novel Unsupervised Adaptive Learning Method for Long-Term Electromyography (EMG) Pattern Recognition.

    PubMed

    Huang, Qi; Yang, Dapeng; Jiang, Li; Zhang, Huajie; Liu, Hong; Kotani, Kiyoshi

    2017-06-13

    Performance degradation will be caused by a variety of interfering factors for pattern recognition-based myoelectric control methods in the long term. This paper proposes an adaptive learning method with low computational cost to mitigate the effect in unsupervised adaptive learning scenarios. We presents a particle adaptive classifier (PAC), by constructing a particle adaptive learning strategy and universal incremental least square support vector classifier (LS-SVC). We compared PAC performance with incremental support vector classifier (ISVC) and non-adapting SVC (NSVC) in a long-term pattern recognition task in both unsupervised and supervised adaptive learning scenarios. Retraining time cost and recognition accuracy were compared by validating the classification performance on both simulated and realistic long-term EMG data. The classification results of realistic long-term EMG data showed that the PAC significantly decreased the performance degradation in unsupervised adaptive learning scenarios compared with NSVC (9.03% ± 2.23%, p < 0.05) and ISVC (13.38% ± 2.62%, p = 0.001), and reduced the retraining time cost compared with ISVC (2 ms per updating cycle vs. 50 ms per updating cycle).

  6. Economic burden of follicular non-Hodgkin's lymphoma.

    PubMed

    Foster, Talia; Miller, Jeffrey D; Boye, Mark E; Russell, Mason W

    2009-01-01

    Follicular non-Hodgkin's lymphoma (FNHL), a slow-growing cancer of the immune system, constitutes about 15-30% of all incident non-Hodgkin's lymphoma in developed countries. Its incidence is rising worldwide. Patients can live many years, but FNHL is considered incurable. We systematically reviewed the English-language MEDLINE-indexed and non-indexed economic literature published in the past 10 years on FNHL, identifying 23 primary economic studies. The economic burden of FNHL is significant, but available data are generally limited to retrospective considerations of hospital-based direct treatment costs, with little information available regarding societal cost of illness. Most direct cost information originates from the US, with one estimate of $US36 000 for the per-patient incremental cost of FNHL care during the first year following diagnosis. The most studied treatment is rituximab, which may offer similar overall costs to fludarabine considering higher resource use with fludarabine complications. Nearly all cost-effectiveness models identified by this review evaluated rituximab for relapsed/refractory FNHL responding to chemotherapy induction. Rituximab is supported as a cost-effective addition to standard chemotherapy by two models in the UK and one in the US, as maintenance therapy instead of stem-cell transplant by one UK model, and as maintenance therapy instead of observation alone by one model each in France, Spain and Canada. The UK National Institute for Health and Clinical Excellence updated guidance on rituximab in February 2008, concluding that it is cost effective when added to induction chemotherapy, and when used as maintenance therapy. No studies of per-patient or national indirect costs of illness were identified, with the only study of indirect costs a Canadian survey documenting lost work productivity. Across all study types identified by our review, the most common focus was on the direct costs of rituximab. As new treatments for FNHL come to market, more real-life cost data are imperative to calculate their relative cost effectiveness.

  7. Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts

    PubMed Central

    2014-01-01

    Background To achieve globally or regionally defined accelerated disease control, elimination and eradication (ADC/E/E) goals against vaccine-preventable diseases requires complementing national routine immunization programs with intensive, time-limited, and targeted Supplementary Immunization Activities (SIAs). Many global and country-level SIA costing efforts have historically relied on what are now outdated benchmark figures. Mobilizing adequate resources for successful implementation of SIAs requires updated estimates of non-vaccine costs per target population. Methods This assessment updates the evidence base on the SIA operational costs through a review of literature between 1992 and 2012, and an analysis of actual expenditures from 142 SIAs conducted between 2004 and 2011 and documented in country immunization plans. These are complemented with an analysis of budgets from 31 SIAs conducted between 2006 and 2011 in order to assess the proportion of total SIA costs per person associated with various cost components. All results are presented in 2010 US dollars. Results Existing evidence indicate that average SIA operational costs were usually less than US$0.50 per person in 2010 dollars. However, the evidence is sparse, non-standardized, and largely out of date. Average operational costs per person generated from our analysis of country immunization plans are consistently higher than published estimates, approaching US$1.00 for injectable vaccines. The results illustrate that the benchmarks often used to project needs underestimate the true costs of SIAs and the analysis suggests that SIA operational costs have been increasing over time in real terms. Our assessment also illustrates that operational costs vary across several dimensions. Variations in the actual costs of SIAs likely to reflect the extents to which economies of scale associated with campaign-based delivery can be attained, the underlying strength of the immunization program, sensitivities to the relative ease of vaccine administration (i.e. orally, or by injection), and differences in disease-specific programmatic approaches. The assessment of SIA budgets by cost component illustrates that four cost drivers make up the largest proportion of costs across all vaccines: human resources, program management, social mobilization, and vehicles and transportation. These findings suggest that SIAs leverage existing health system infrastructure, reinforcing the fact that strong routine immunization programs are an important pre-requisite for achieving ADC/E/E goals. Conclusions The results presented here will be useful for national and global-level actors involved in planning, budgeting, resource mobilization, and financing of SIAs in order to create more realistic assessments of resource requirements for both existing ADC/E/E efforts as well as for new vaccines that may deploy a catch-up campaign-based delivery component. However, limitations of our analysis suggest a need to conduct further research into operational costs of SIAs. Understanding the changing face of delivery costs and cost structures for SIAs will continue to be critical to avoid funding gaps and in order to improve vaccination coverage, reduce health inequities, and achieve the ADC/E/E goals many of which have been endorsed by the World Health Assembly and are included in the Decade of Vaccines Global Vaccine Action Plan. PMID:24450832

  8. Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts.

    PubMed

    Gandhi, Gian; Lydon, Patrick

    2014-01-22

    To achieve globally or regionally defined accelerated disease control, elimination and eradication (ADC/E/E) goals against vaccine-preventable diseases requires complementing national routine immunization programs with intensive, time-limited, and targeted Supplementary Immunization Activities (SIAs). Many global and country-level SIA costing efforts have historically relied on what are now outdated benchmark figures. Mobilizing adequate resources for successful implementation of SIAs requires updated estimates of non-vaccine costs per target population. This assessment updates the evidence base on the SIA operational costs through a review of literature between 1992 and 2012, and an analysis of actual expenditures from 142 SIAs conducted between 2004 and 2011 and documented in country immunization plans. These are complemented with an analysis of budgets from 31 SIAs conducted between 2006 and 2011 in order to assess the proportion of total SIA costs per person associated with various cost components. All results are presented in 2010 US dollars. Existing evidence indicate that average SIA operational costs were usually less than US$0.50 per person in 2010 dollars. However, the evidence is sparse, non-standardized, and largely out of date. Average operational costs per person generated from our analysis of country immunization plans are consistently higher than published estimates, approaching US$1.00 for injectable vaccines. The results illustrate that the benchmarks often used to project needs underestimate the true costs of SIAs and the analysis suggests that SIA operational costs have been increasing over time in real terms. Our assessment also illustrates that operational costs vary across several dimensions. Variations in the actual costs of SIAs likely to reflect the extents to which economies of scale associated with campaign-based delivery can be attained, the underlying strength of the immunization program, sensitivities to the relative ease of vaccine administration (i.e. orally, or by injection), and differences in disease-specific programmatic approaches. The assessment of SIA budgets by cost component illustrates that four cost drivers make up the largest proportion of costs across all vaccines: human resources, program management, social mobilization, and vehicles and transportation. These findings suggest that SIAs leverage existing health system infrastructure, reinforcing the fact that strong routine immunization programs are an important pre-requisite for achieving ADC/E/E goals. The results presented here will be useful for national and global-level actors involved in planning, budgeting, resource mobilization, and financing of SIAs in order to create more realistic assessments of resource requirements for both existing ADC/E/E efforts as well as for new vaccines that may deploy a catch-up campaign-based delivery component. However, limitations of our analysis suggest a need to conduct further research into operational costs of SIAs. Understanding the changing face of delivery costs and cost structures for SIAs will continue to be critical to avoid funding gaps and in order to improve vaccination coverage, reduce health inequities, and achieve the ADC/E/E goals many of which have been endorsed by the World Health Assembly and are included in the Decade of Vaccines Global Vaccine Action Plan.

  9. Remote Infrared Thermal Sensing of Sewer Voids, Four-Year Update

    NASA Astrophysics Data System (ADS)

    Weil, Gary J.

    1988-01-01

    When a sewer caves in, it often takes the street, sidewalks, and surrounding buildings along for the ride. These collapses endanger public health and safety. Repairing a sewer before such a cave-in is obviously the preferred method. Emergency repairs cost far more than prevention measures - often millions of dollars more. Many combined sewers in the St. Louis area, as in many of America's cities, are more than 125 years old and are subject to structural failure. In 1981 alone, St. Louis had 4,000 sewer collapses and an astronomical repair bill. These and similar problems have been described as "a crisis of national proportions. The question addressed by this paper is how to detect unseen problem areas in sewer systems before they give way. At the present, progressive sewer administrations may use crawl crews to inspect sewers when problems are suspected. This can be extremely costly and dangerous, and a void around the outside of the sewer is often invisible from within. Thus, even a crawl crew can fail to detect most voids. Infrared Thermography has been found by sewer districts and independent evaluation engineering firms to be an extremely accurate method of finding sewer voids, before they can cause expensive and dangerous problems. This technique uses a non-contact, remote sensing method, with the potential for surveying large areas quickly and efficiently. This paper reviews our initial paper presented to The International Society for Optical Engineering in October of 1983 and presents an update of our experience, both successes and failures, in several large-scale void detection projects. Infrared Thermographic techniques of non-destructive testing will have major implications for cities and for the engineering profession because it promises to make the crisis of infrastructure repair and rehabilitation more manageable. Intelligent, systematic use of this relatively low cost void detection method, Infrared Thermography, may revolutionize the way sewer problems are handled in the future.

  10. Updates to the CMAQ Post Processing and Evaluation Tools for 2016

    EPA Science Inventory

    In the spring of 2016, the evaluation tools distributed with the CMAQ model code were updated and new tools were added to the existing set of tools. Observation data files, compatible with the AMET software, were also made available on the CMAS website for the first time with the...

  11. Flood design recipes vs. reality: can predictions for ungauged basins be trusted?

    NASA Astrophysics Data System (ADS)

    Efstratiadis, A.; Koussis, A. D.; Koutsoyiannis, D.; Mamassis, N.

    2014-06-01

    Despite the great scientific and technological advances in flood hydrology, everyday engineering practices still follow simplistic approaches that are easy to formally implement in ungauged areas. In general, these "recipes" have been developed many decades ago, based on field data from typically few experimental catchments. However, many of them have been neither updated nor validated across all hydroclimatic and geomorphological conditions. This has an obvious impact on the quality and reliability of hydrological studies, and, consequently, on the safety and cost of the related flood protection works. Preliminary results, based on historical flood data from Cyprus and Greece, indicate that a substantial revision of many aspects of flood engineering procedures is required, including the regionalization formulas as well as the modelling concepts themselves. In order to provide a consistent design framework and to ensure realistic predictions of the flood risk (a key issue of the 2007/60/EU Directive) in ungauged basins, it is necessary to rethink the current engineering practices. In this vein, the collection of reliable hydrological data would be essential for re-evaluating the existing "recipes", taking into account local peculiarities, and for updating the modelling methodologies as needed.

  12. 75 FR 51982 - Fisheries of the Gulf of Mexico; Southeast Data, Assessment, and Review (SEDAR) Update; Greater...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-24

    ... evaluates potential datasets and recommends which datasets are appropriate for assessment analyses. The... points to datasets incorporated in the original SEDAR benchmark assessment and run the benchmark... Webinar II November 22, 2010; 10 a.m. - 1 p.m.; SEDAR Update Assessment Webinar III Using updated datasets...

  13. Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes

    PubMed Central

    Grey, Margaret; Liberti, Lauren; Whittemore, Robin

    2015-01-01

    Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths’ many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5–1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense. PMID:26213677

  14. Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes.

    PubMed

    Grey, Margaret; Liberti, Lauren; Whittemore, Robin

    2015-07-01

    Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths' many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE ™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5-1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense.

  15. Evaluating an approach to improving the adoption rate of wireless drug library updates for smart pumps.

    PubMed

    Poppe, Lindsey B; Eckel, Stephen F

    2011-01-15

    An academic medical center's approach to improving the adoption rate of wireless drug library updates for smart pumps was evaluated. A multidisciplinary team composed of pharmacy, nursing, medical engineering, materials management, and patient equipment personnel at an academic medical center collaborated to update the drug libraries of more than 1800 smart pumps via a wireless control system. Two pilot tests were completed to identify and resolve issues before the live wireless update was attempted. The second pilot test, a passive approach, produced an adoption rate of 42% of 1804 pumps at the end of one week and a rate of 56% on day 10. The goal of 80% was not achieved until day 22. The change to an active multidisciplinary process three months later produced an adoption rate of 80% for 1869 pumps on day 10, resulting in a 45.4% increase in the adoption rate between the two trials on day 10 (p < 0.001). Communication regarding the updates was disseminated via e-mail to the entire organization, with fliers posted on all patient care units, and verbally during staff meetings. Patient equipment personnel manually tagged each pump with a blue zip tie after verifying the update to easily identify which pumps had been updated. Areas for improvement include increasing communication to the staff detailing when the update will occur and changing the day of the week the update is performed. A multidisciplinary team actively engaged in the updating of wireless i.v. smart pump drug libraries reduced the amount of time required to reach a goal adoption rate of 80%.

  16. Effect of present technology on airship capabilities

    NASA Technical Reports Server (NTRS)

    Madden, R. T.

    1975-01-01

    The effect is presented of updating past airship designs using current materials and propulsion systems to determine new airship performance and productivity capabilities. New materials and power plants permit reductions in the empty weights and increases in the useful load capabilities of past airship designs. The increased useful load capability results in increased productivity for a given range, i.e., either increased payload at the same operating speed or increased operating speed for the same payload weight or combinations of both. Estimated investment costs and operating costs are presented to indicate the significant cost parameters in estimating transportation costs of payloads in cents per ton mile. Investment costs are presented considering production lots of 1, 10 and 100 units. Operating costs are presented considering flight speeds and ranges.

  17. Costs of illness analysis in Italian patients with chronic obstructive pulmonary disease (COPD): an update.

    PubMed

    Dal Negro, Roberto W; Bonadiman, Luca; Turco, Paola; Tognella, Silvia; Iannazzo, Sergio

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide, and its epidemiological, clinical, and socioeconomic impact is progressively increasing. A first estimate of the economic burden of COPD in Italy was conducted in 2008 (the SIRIO [Social Impact of Respiratory Integrated Outcomes] study). The aim of the present study is to provide an updated picture of the COPD economic burden in Italy. Sequential patients presenting at the specialist center for the first time during the period 2008-2012 and with record file complete (demographic, clinical, lung function, and therapeutic data; health care resources consumed in the 12 months before the enrollment and for the 3 subsequent years) were selected from the institutional database. Two hundred and seventy-five COPD patients fitting the inclusion criteria were selected (226 males; mean age: 70.9 years [standard deviation: ±8.4 years]; 45.8% were from the north, 25.1% from central Italy, and 29.1% from south Italy). COPD-related average costs per patient in the 12 months before enrollment were as follows: hospitalization: €1,970; outpatient care: €463; pharmaceutical: €499; and indirect costs: €358. Average direct costs and total societal costs were €2,932 and €3,291, respectively. Direct cost was €2,461 (hospitalization: €1,570; outpatient: €344; and pharmaceutical: €547) in the first year of follow-up, while total societal cost was €2,707. No significant difference was reported in any cost category between sexes. The therapeutic approach followed in a specialist center, based on the application of clinical guidelines, has been shown to be a highly effective investment for the long-term management of COPD. A small increase of pharmaceutical costs per year allowed a substantial saving in terms of hospitalizations, costs related to outpatient services, and indirect costs.

  18. The effectiveness and cost-effectiveness of donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease (review of Technology Appraisal No. 111): a systematic review and economic model.

    PubMed

    Bond, M; Rogers, G; Peters, J; Anderson, R; Hoyle, M; Miners, A; Moxham, T; Davis, S; Thokala, P; Wailoo, A; Jeffreys, M; Hyde, C

    2012-01-01

    Alzheimer’s disease (AD) is the most commonly occurring form of dementia. It is predominantly a disease of later life, affecting 5% of those over 65 in the UK. Review and update guidance to the NHS in England and Wales on the clinical effectiveness and cost-effectiveness of donepezil, galantamine, rivastigmine [acetylcholinesterase inhibitors (AChEIs)] and memantine within their licensed indications for the treatment of AD, which was issued in November 2006 (amended September 2007 and August 2009). Electronic databases were searched for systematic reviews and/or metaanalyses, randomised controlled trials (RCTs) and ongoing research in November 2009 and updated in March 2010; this updated search revealed no new includable studies. The databases searched included The Cochrane Library (2009 Issue 4, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials), MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, PsycINFO, EconLit, ISI Web of Science Databases--Science Citation Index, Conference Proceedings Citation Index, and BIOSIS; the Centre for Reviews and Dissemination (CRD) databases--NHS Economic Evaluation Database, Health Technology Assessment, and Database of Abstracts of Reviews of Effects. The clinical effectiveness systematic review was undertaken following the principles published by the NHS CRD. We included RCTs whose population was people with AD. The intervention and comparators depended on disease severity, measured by the Mini Mental State Examination (MMSE). mild AD (MMSE 21-26)--donepezil, galantamine and rivastigmine; moderate AD (MMSE 10-20)--donepezil, galantamine, rivastigmine and memantine; severe AD (MMSE < 10)--memantine. Comparators: mild AD (MMSE 21-26)--placebo or best supportive care (BSC); moderate AD (MMSE 10-20)--donepezil, galantamine, rivastigmine, memantine, placebo or BSC; severe AD (MMSE < 10)--placebo or BSC. The outcomes were clinical, global, functional, behavioural, quality of life, adverse events, costs and cost-effectiveness. Where appropriate, data were pooled using pair-wise meta-analysis, multiple outcome measures, metaregression and mixedtreatment comparisons. The decision model was based broadly on the structure of the three-state Markov model described in the previous technology assessment report, based upon time to institutionalisation, parameterised with updated estimates of effectiveness, costs and utilities. Notwithstanding the uncertainty of our results, we found in the base case that the AChEIs are probably cost saving at a willingness-to-pay (WTP) of £’30,000 per qualityadjusted life-year (QALY) for people with mild-to-moderate AD. For this class of drugs, there is a > 99% probability that the AChEIs are more cost-effective than BSC. These analyses assume that the AChEIs have no effect on survival. For the AChEIs, in people with mild to moderate AD, the probabilistic sensitivity analyses suggested that donepezil is the most cost-effective, with a 28% probability of being the most cost-effective option at a WTP of £’30,000 per QALY (27% at a WTP of £’20,000 per QALY). In the deterministic results, donepezil dominates the other drugs and BSC, which, along with rivastigmine patches, are associated with greater costs and fewer QALYs. Thus, although galantamine has a slightly cheaper total cost than donepezil (£’69,592 vs £’69,624), the slightly greater QALY gains from donepezil (1.616 vs 1.617) are enough for donepezil to dominate galantamine.The probability that memantine is cost-effective in a moderate to severe cohort compared with BSC at a WTP of £’30,000 per QALY is 38% (and 28% at a WTP of £’20,000 per QALY). The deterministic ICER for memantine is £’32,100 per/QALY and the probabilistic ICER is £’36,700 per/QALY. Trials were of 6 months maximum follow-up, lacked reporting of key outcomes, provided no subgroup analyses and used insensitive measures. Searches were limited to English language, The model does not include behavioural symptoms and there is uncertainty about the model structure and parameters. The additional clinical effectiveness evidence identified continues to suggest clinical benefit from the AChEIs in alleviating AD symptoms, although there is debate about the magnitude of the effect. Although there is also new evidence on the effectiveness of memantine, it remains less supportive of this drug’s use than the evidence for AChEIs. The conclusions concerning cost-effectiveness are quite different from the previous assessment. This is because both the changes in effectiveness and costs between drug use and non-drug use underlying the ICERs are very small. This leads to highly uncertain results, which are very sensitive to change. RESEARCH PRIORITIES: RCTs to include mortality, time to institutionalisation and quality of life, powered for subgroup analysis. The National Institute for Health Research Health Technology Assessment programme.

  19. Summary and Comparison of the 2016 Billion-Ton Report with the 2011 U.S. Billion-Ton Update

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

    None

    2016-06-01

    In terms of the magnitude of the resource potential, the results of the 2016 Billion-Ton Report (BT16) are consistent with the original 2005 Billion-Ton Study (BTS) and the 2011 report, U.S. Billion-Ton Update: Biomass Supply for a Bioenergy and Bioproducts Industry (BT2. An effort was made to reevaluate the potential forestland, agricultural, and waste resources at the roadside, then extend the analysis by adding transportation costs to a biorefinery under specified logistics assumptions to major resource fractions.

  20. Digital images in the map revision process

    NASA Astrophysics Data System (ADS)

    Newby, P. R. T.

    Progress towards the adoption of digital (or softcopy) photogrammetric techniques for database and map revision is reviewed. Particular attention is given to the Ordnance Survey of Great Britain, the author's former employer, where digital processes are under investigation but have not yet been introduced for routine production. Developments which may lead to increasing automation of database update processes appear promising, but because of the cost and practical problems associated with managing as well as updating large digital databases, caution is advised when considering the transition to softcopy photogrammetry for revision tasks.

  1. Symptom management in the older adult: 2015 update.

    PubMed

    Smith, Thomas J

    2015-05-01

    This article updates the 2002 Jamie von Roenn article about "the palliation of commonly observed symptoms in older patients, including pain, neuropsychiatric, gastrointestinal, and respiratory symptoms." When palliative care was last covered in Clinics in Geriatric Medicine, President George W. Bush had just signed the No Child Left Behind Act, Homeland Security was being established, Michael Jackson won the Artist of the Century Award at the American Music Awards, and gas cost $1.61 a gallon. What has changed in the last decade and a half? Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Higher Education in the Digital Age. Updated Edition. The William G. Bowen Memorial Series in Higher Education

    ERIC Educational Resources Information Center

    Bowen, William G.

    2015-01-01

    Two of the most visible and important trends in higher education today are its exploding costs and the rapid expansion of online learning. Could the growth in online courses slow the rising cost of college and help solve the crisis of affordability? In this short and incisive book, William G. Bowen, one of the foremost experts on the intersection…

  3. Spent nuclear fuel canister storage building conceptual design report

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

    Swenson, C.E.

    This Conceptual Design Report provides the technical basis for the Spent Nuclear Fuels Project, Canister Storage Building, and as amended by letter (correspondence number 9555700, M.E. Witherspoon to E.B. Sellers, ``Technical Baseline and Updated Cost Estimate for the Canister Storage Building``, dated October 24, 1995), includes the project cost baseline and Criteria to be used as the basis for starting detailed design in fiscal year 1995.

  4. 76 FR 2081 - El Dorado County Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... Rural Schools and Community Self-Determination Act (Pub. L. 110-343) and in compliance with the Federal..., administrative costs update and a report out on outreach for proposals. DATES: The meeting will be held on...

  5. FTA low-speed urban Maglev research program : updated lessons learned.

    DOT National Transportation Integrated Search

    2012-11-01

    In 1999, the Federal Transit Administration (FTA) initiated the Low-Speed Urban Magnetic Levitation (Urban Maglev) Program to develop magnetic levitation technology that offers a cost-effective, reliable, and environmentally-sound transit option for ...

  6. Intelligent transportation systems benefits, costs, and lessons learned : 2005 update

    DOT National Transportation Integrated Search

    2005-05-01

    Intelligent Transportation Systems (ITS) technologies offer a clear opportunity to improve transportation safety, relieve congestion, and enhance productivity. This report is a continuation of a series of reports providing a synthesis of the informat...

  7. Iowa Department of Transportation strategic plan

    DOT National Transportation Integrated Search

    1999-08-01

    This report presents the Iowa Department of Transportation's updated strategic plan - an action guide for today's decisions that will help the DOT carry out its objectives in the future and serve its customers with cost effectiveness and quality. The...

  8. Sources and Nature of Cost Analysis Data Base Reference Manual.

    DTIC Science & Technology

    1983-07-01

    COVERED Sources and Nature of Cost Analysis Data Base Interim Report (Update) Reference Manual 6 . PERFORMING ORG. REPORT NUMBER USAAVRADCOM TM 83-F-3 7 ...SECTION 6 - DATA FOR MULTIPLE APPLICATIONS 6.0.0 7.0.0 SECTION 7 - GLOSSARY OF COST ANALYSIS TERMS SECTION 8 - REFERENCES 8.0.0 SECTION 9 - BIBLIOGRAPHY...Relationsh-;ips Manual for the Army 1.14. 1 Yateri ci Command, TP-449, Mla; 1912 ( 7 21 RACKFORS JiR 1CO(PTER, INC. xlB.Aii- 6 -4A 1.15. 1 Z FNE>:THj MUNSON

  9. Regulatory, policy and quality update for venous thromboembolism and stroke in United States hospitals.

    PubMed

    Mahan, Charles E

    2012-10-01

    Stroke and venous thromboembolism (VTE) have a large impact on the United States (US) healthcare system. It is estimated that up to 1.7million new and recurrent stroke and VTE events are occurring in the US on an annual basis with the combined cost approaching over $200billion per year. A significant amount of stroke and VTE are preventable from appropriate antithrombotic use in at-risk patients and the Center for Medicaid and Medicare Services, the Joint Commission, the National Quality Forum and other key quality and regulatory entities have prioritized minimizing the impact of morbidity, mortality and avoidable costs related to these diseases. This review provides a brief history, overview, and update for the development of quality measures, quality systems, and regulatory and policy changes as related to stroke and VTE within the US healthcare system. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Bioresearch Module Design Definition and Space Shuttle Vehicle Integration Study. Volume 1: Basic Report

    NASA Technical Reports Server (NTRS)

    Lang, A. L., Jr.

    1971-01-01

    Preliminary designs of the Bioexplorer spacecraft, developed in an earlier study program, are analyzed and updated to conform to a new specification which includes use of both the Scout and the space shuttle vehicle for launch. The updated spacecraft is referred to as bioresearch module. It is capable of supporting a variety of small biological experiments in near-earth and highly elliptical earth orbits. The baseline spacecraft design is compatible with the Scout launch vehicle. Inboard profile drawings, weight statements, interface drawings, and spacecraft parts and aerospace ground equipment lists are provided to document the design. The baseline design was analyzed to determine the design and cost impact of a set of optional features. These include reduced experiment power and thermal load, addition of an experiment television monitor, and replacement of VHF with S-band communications. The impact of these options on power required, weight change and cost is defined.

  11. Updating categorical soil maps using limited survey data by Bayesian Markov chain cosimulation.

    PubMed

    Li, Weidong; Zhang, Chuanrong; Dey, Dipak K; Willig, Michael R

    2013-01-01

    Updating categorical soil maps is necessary for providing current, higher-quality soil data to agricultural and environmental management but may not require a costly thorough field survey because latest legacy maps may only need limited corrections. This study suggests a Markov chain random field (MCRF) sequential cosimulation (Co-MCSS) method for updating categorical soil maps using limited survey data provided that qualified legacy maps are available. A case study using synthetic data demonstrates that Co-MCSS can appreciably improve simulation accuracy of soil types with both contributions from a legacy map and limited sample data. The method indicates the following characteristics: (1) if a soil type indicates no change in an update survey or it has been reclassified into another type that similarly evinces no change, it will be simply reproduced in the updated map; (2) if a soil type has changes in some places, it will be simulated with uncertainty quantified by occurrence probability maps; (3) if a soil type has no change in an area but evinces changes in other distant areas, it still can be captured in the area with unobvious uncertainty. We concluded that Co-MCSS might be a practical method for updating categorical soil maps with limited survey data.

  12. Updating Categorical Soil Maps Using Limited Survey Data by Bayesian Markov Chain Cosimulation

    PubMed Central

    Dey, Dipak K.; Willig, Michael R.

    2013-01-01

    Updating categorical soil maps is necessary for providing current, higher-quality soil data to agricultural and environmental management but may not require a costly thorough field survey because latest legacy maps may only need limited corrections. This study suggests a Markov chain random field (MCRF) sequential cosimulation (Co-MCSS) method for updating categorical soil maps using limited survey data provided that qualified legacy maps are available. A case study using synthetic data demonstrates that Co-MCSS can appreciably improve simulation accuracy of soil types with both contributions from a legacy map and limited sample data. The method indicates the following characteristics: (1) if a soil type indicates no change in an update survey or it has been reclassified into another type that similarly evinces no change, it will be simply reproduced in the updated map; (2) if a soil type has changes in some places, it will be simulated with uncertainty quantified by occurrence probability maps; (3) if a soil type has no change in an area but evinces changes in other distant areas, it still can be captured in the area with unobvious uncertainty. We concluded that Co-MCSS might be a practical method for updating categorical soil maps with limited survey data. PMID:24027447

  13. A keyword searchable attribute-based encryption scheme with attribute update for cloud storage.

    PubMed

    Wang, Shangping; Ye, Jian; Zhang, Yaling

    2018-01-01

    Ciphertext-policy attribute-based encryption (CP-ABE) scheme is a new type of data encryption primitive, which is very suitable for data cloud storage for its fine-grained access control. Keyword-based searchable encryption scheme enables users to quickly find interesting data stored in the cloud server without revealing any information of the searched keywords. In this work, we provide a keyword searchable attribute-based encryption scheme with attribute update for cloud storage, which is a combination of attribute-based encryption scheme and keyword searchable encryption scheme. The new scheme supports the user's attribute update, especially in our new scheme when a user's attribute need to be updated, only the user's secret key related with the attribute need to be updated, while other user's secret key and the ciphertexts related with this attribute need not to be updated with the help of the cloud server. In addition, we outsource the operation with high computation cost to cloud server to reduce the user's computational burden. Moreover, our scheme is proven to be semantic security against chosen ciphertext-policy and chosen plaintext attack in the general bilinear group model. And our scheme is also proven to be semantic security against chosen keyword attack under bilinear Diffie-Hellman (BDH) assumption.

  14. A keyword searchable attribute-based encryption scheme with attribute update for cloud storage

    PubMed Central

    Wang, Shangping; Zhang, Yaling

    2018-01-01

    Ciphertext-policy attribute-based encryption (CP-ABE) scheme is a new type of data encryption primitive, which is very suitable for data cloud storage for its fine-grained access control. Keyword-based searchable encryption scheme enables users to quickly find interesting data stored in the cloud server without revealing any information of the searched keywords. In this work, we provide a keyword searchable attribute-based encryption scheme with attribute update for cloud storage, which is a combination of attribute-based encryption scheme and keyword searchable encryption scheme. The new scheme supports the user's attribute update, especially in our new scheme when a user's attribute need to be updated, only the user's secret key related with the attribute need to be updated, while other user's secret key and the ciphertexts related with this attribute need not to be updated with the help of the cloud server. In addition, we outsource the operation with high computation cost to cloud server to reduce the user's computational burden. Moreover, our scheme is proven to be semantic security against chosen ciphertext-policy and chosen plaintext attack in the general bilinear group model. And our scheme is also proven to be semantic security against chosen keyword attack under bilinear Diffie-Hellman (BDH) assumption. PMID:29795577

  15. Using Third Party Data to Update a Reference Dataset in a Quality Evaluation Service

    NASA Astrophysics Data System (ADS)

    Xavier, E. M. A.; Ariza-López, F. J.; Ureña-Cámara, M. A.

    2016-06-01

    Nowadays it is easy to find many data sources for various regions around the globe. In this 'data overload' scenario there are few, if any, information available about the quality of these data sources. In order to easily provide these data quality information we presented the architecture of a web service for the automation of quality control of spatial datasets running over a Web Processing Service (WPS). For quality procedures that require an external reference dataset, like positional accuracy or completeness, the architecture permits using a reference dataset. However, this reference dataset is not ageless, since it suffers the natural time degradation inherent to geospatial features. In order to mitigate this problem we propose the Time Degradation & Updating Module which intends to apply assessed data as a tool to maintain the reference database updated. The main idea is to utilize datasets sent to the quality evaluation service as a source of 'candidate data elements' for the updating of the reference database. After the evaluation, if some elements of a candidate dataset reach a determined quality level, they can be used as input data to improve the current reference database. In this work we present the first design of the Time Degradation & Updating Module. We believe that the outcomes can be applied in the search of a full-automatic on-line quality evaluation platform.

  16. Tamper-Resistant Mobile Health Using Blockchain Technology

    PubMed Central

    2017-01-01

    Background Digital health technologies, including telemedicine, mobile health (mHealth), and remote monitoring, are playing a greater role in medical practice. Safe and accurate management of medical information leads to the advancement of digital health, which in turn results in a number of beneficial effects. Furthermore, mHealth can help lower costs by facilitating the delivery of care and connecting people to their health care providers. Mobile apps help empower patients and health care providers to proactively address medical conditions through near real-time monitoring and treatment, regardless of the location of the patient or the health care provider. Additionally, mHealth data are stored in servers, and consequently, data management that prevents all forms of manipulation is crucial for both medical practice and clinical trials. Objective The aim of this study was to develop and evaluate a tamper-resistant mHealth system using blockchain technology, which enables trusted and auditable computing using a decentralized network. Methods We developed an mHealth system for cognitive behavioral therapy for insomnia using a smartphone app. The volunteer data collected with the app were stored in JavaScript Object Notation format and sent to the blockchain network. Thereafter, we evaluated the tamper resistance of the data against the inconsistencies caused by artificial faults. Results Electronic medical records collected using smartphones were successfully sent to a private Hyperledger Fabric blockchain network. We verified the data update process under conditions where all the validating peers were running normally. The mHealth data were successfully updated under network faults. We further ensured that any electronic health record registered to the blockchain network was resistant to tampering and revision. The mHealth data update was compatible with tamper resistance in the blockchain network. Conclusions Blockchain serves as a tamperproof system for mHealth. Combining mHealth with blockchain technology may provide a novel solution that enables both accessibility and data transparency without a third party such as a contract research organization. PMID:28747296

  17. Fast model updating coupling Bayesian inference and PGD model reduction

    NASA Astrophysics Data System (ADS)

    Rubio, Paul-Baptiste; Louf, François; Chamoin, Ludovic

    2018-04-01

    The paper focuses on a coupled Bayesian-Proper Generalized Decomposition (PGD) approach for the real-time identification and updating of numerical models. The purpose is to use the most general case of Bayesian inference theory in order to address inverse problems and to deal with different sources of uncertainties (measurement and model errors, stochastic parameters). In order to do so with a reasonable CPU cost, the idea is to replace the direct model called for Monte-Carlo sampling by a PGD reduced model, and in some cases directly compute the probability density functions from the obtained analytical formulation. This procedure is first applied to a welding control example with the updating of a deterministic parameter. In the second application, the identification of a stochastic parameter is studied through a glued assembly example.

  18. Vitamin K to prevent fractures in older women: systematic review and economic evaluation.

    PubMed

    Stevenson, M; Lloyd-Jones, M; Papaioannou, D

    2009-09-01

    To determine the clinical and cost-effectiveness of vitamin K in preventing osteoporotic fractures in postmenopausal women. Searches were conducted in May 2007 in MEDLINE, MEDLINE In-Process, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, BIOSIS, CINAHL, DARE, NHS EED and HTA databases, AMED, NRR, Science Citation Index and Current Controlled Trials. The MEDLINE search was updated in March 2009. Selected studies were assessed and subjected to data extraction and quality assessment using standard methods. Where appropriate, meta-analysis was carried out. A mathematical model was constructed to estimate the cost-effectiveness of vitamin K1. The electronic literature searches identified 1078 potentially relevant articles. Of these, 14 articles relating to five trials that compared vitamin K with a relevant comparator in postmenopausal women with osteoporosis or osteopenia met the review inclusion criteria. The double-blind ECKO trial compared 5 mg of phylloquinone (vitamin K1) with placebo in Canadian women with osteopenia but without osteoporosis. Four open-label trials used 45 mg of menatetrenone (vitamin K2) in Japanese women with osteoporosis; the comparators were no treatment, etidronate or calcium. The methodological quality of the ECKO trial was good; however, all four menatetrenone trials were poorly reported and three were very small (n < 100 in each group). Phylloquinone was associated with a statistically significant reduction in the risk of clinical fractures relative to placebo [relative risk 0.46, 95% confidence interval (CI) 0.22 to 0.99]; morphometric vertebral fractures were not reported. The smaller menatetrenone trials found that menatetrenone was associated with a reduced risk of morphometric vertebral fractures relative to no treatment or calcium; however, the larger Osteoporosis Fracture (OF) study found no evidence of a reduction in vertebral fracture risk. The three smaller trials found no significant difference between treatment groups in non-vertebral fracture incidence. In the ECKO trial, phylloquinone was not associated with an increase in adverse events. In the menatetrenone trials, adverse event reporting was generally poor; however, in the OF study, menatetrenone was associated with a significantly higher incidence of skin and skin appendage lesions. No published economic evaluations of vitamin K were found and a mathematical model was thus constructed to estimate the cost-effectiveness of vitamin K1. Comparators were alendronate, risedronate and strontium ranelate. Vitamin K1 and alendronate were markedly more cost-effective than either risedronate or strontium ranelate. The base-case results favoured vitamin K1, but this relied on many assumptions, particularly on the efficacy of preventing hip and vertebral fractures. Calculation of the expected value of sampled information was conducted assuming a randomised controlled trial of 5 years' duration comparing alendronate with vitamin K1. The costs incurred in obtaining updated efficacy data from a trial with 2000 women per arm were estimated to be a cost-effective use of resources. There is currently large uncertainty over whether vitamin K1 is more cost-effective than alendronate; further research is required. It is unlikely that the present prescribing policy (i.e. alendronate as first-line treatment) would be altered.

  19. The Evaluation and Systems Analysis of the SYSTRAN Machine Translation System

    DTIC Science & Technology

    1977-01-01

    DiFondi (IRDT) I. KIY *0*01 (Cu.wMu. .~ .‘~~.. lid. it a....Wp .11 id.iiSiIp Op e4.Sk s~~S.,) Machine Traca lation Evaluation scan Dictionary Update S...ntic Expression Dictionary Update *55? **Ct fCMi~ uw * lid. It -- p Sdsffl~~ Sr Sidsi ,~~~Siv) This report is the product of contractual effort to...translated end then corrected by a b ilingu.ai. exper t in each field. two types of corrections were considered iaplweatabi e, stan dictionary update and

  20. External costs of risky health behaviors associated with leading actual causes of death in the U.S.: a review of the evidence and implications for future research.

    PubMed

    Zohrabian, Armineh; Philipson, Tomas J

    2010-06-01

    This paper reviews the evidence on external costs of risky behaviors in the U.S. and provides a framework for estimating them. External costs arise when a person does not bear all the costs of his or her behavior. They provide one of the strongest rationales for government interventions. Although the earlier estimates of external costs no longer have policy relevance, they demonstrated that the existence of external costs was an empirical question. We recommend that the estimates of external costs be updated as insurance structures, environments, and knowledge about these behaviors change. The general aspects of external costs may apply to countries other than the U.S. after taking into account differences in institutional, policy and epidemiological characteristics.

  1. Advances in the Diagnosis and Management of Inflammatory Bowel Disease: Challenges and Uncertainties

    PubMed Central

    Mosli, Mahmoud; Al Beshir, Mohammad; Al-Judaibi, Bandar; Al-Ameel, Turki; Saleem, Abdulaziz; Bessissow, Talat; Ghosh, Subrata; Almadi, Majid

    2014-01-01

    Over the past two decades, several advances have been made in the management of patients with inflammatory bowel disease (IBD) from both evaluative and therapeutic perspectives. This review discusses the medical advancements that have recently been made as the standard of care for managing patients with ulcerative colitis (UC) and Crohn's Disease (CD) and to identify the challenges associated with implementing their use in clinical practice. A comprehensive literature search of the major databases (PubMed and Embase) was conducted for all recent scientific papers (1990–2013) giving the recent updates on the management of IBD and the data were extracted. The reported advancements in managing IBD range from diagnostic and evaluative tools, such as genetic tests, biochemical surrogate markers of activity, endoscopic techniques, and radiological modalities, to therapeutic advances, which encompass medical, endoscopic, and surgical interventions. There are limited studies addressing the cost-effectiveness and the impact that these advances have had on medical practice. The majority of the advances developed for managing IBD, while considered instrumental by some IBD experts in improving patient care, have questionable applications due to constraints of cost, lack of availability, and most importantly, insufficient evidence that supports their role in improving important long-term health-related outcomes. PMID:24705146

  2. Risk-Informed Margin Management (RIMM) Industry Applications IA1 - Integrated Cladding ECCS/LOCA Performance Analysis - Problem Statement

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

    Szilard, Ronaldo Henriques; Youngblood, Robert; Frepoli, Cesare

    2015-04-01

    The U. S. NRC is currently proposing rulemaking designated as “10 CFR 50.46c” to revise the LOCA/ECCS acceptance criteria to include the effects of higher burnup on cladding performance as well as to address some other issues. The NRC is also currently resolving the public comments with the final rule expected to be issued in the summer of 2016. The impact of the final 50.46c rule on the industry will involve updating of fuel vendor LOCA evaluation models, NRC review and approval, and licensee submittal of new LOCA evaluations or reanalyses and associated technical specification revisions for NRC review andmore » approval. The rule implementation process, both industry and NRC activities, is expected to take 5-10 years following the rule effective date. The need to use advanced cladding designs is expected. A loss of operational margin will result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee cost as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. Consequently there will be an increased focus on licensee decision making related to LOCA analysis to minimize cost and impact, and to manage margin.« less

  3. A rapid learning and dynamic stepwise updating algorithm for flat neural networks and the application to time-series prediction.

    PubMed

    Chen, C P; Wan, J Z

    1999-01-01

    A fast learning algorithm is proposed to find an optimal weights of the flat neural networks (especially, the functional-link network). Although the flat networks are used for nonlinear function approximation, they can be formulated as linear systems. Thus, the weights of the networks can be solved easily using a linear least-square method. This formulation makes it easier to update the weights instantly for both a new added pattern and a new added enhancement node. A dynamic stepwise updating algorithm is proposed to update the weights of the system on-the-fly. The model is tested on several time-series data including an infrared laser data set, a chaotic time-series, a monthly flour price data set, and a nonlinear system identification problem. The simulation results are compared to existing models in which more complex architectures and more costly training are needed. The results indicate that the proposed model is very attractive to real-time processes.

  4. Considerations for the Next Revision of STRS

    NASA Technical Reports Server (NTRS)

    Johnson, Sandra K.; Handler, Louis M.; Briones, Janette C.

    2016-01-01

    Development of NASAs Software Defined Radio architecture, the Space Telecommunication Radio System (STRS), was initiated in 2004 with a goal of reducing the cost, risk and schedule when implementing Software Defined Radios (SDR) for NASA space missions. Since STRS was first flown in 2012 on three Software Defined Radios on the Space Communication and Navigation (SCaN) Testbed, only minor changes have been made to the architecture. Multiple entities have since implemented the architecture and have provided significant feedback for consideration for the next revision of the standard. The focus for the first set of updates to the architecture is items that enhance application portability. Items that require modifications to existing applications before migrating to the updated architecture will only be considered if there is compelling reasons to make the change. The significant suggestions that were further evaluated for consideration include expanding and clarifying the timing Application Programming Interfaces (APIs), improving handle name and identification (ID) definitions and use, and multiple items related to implementation of STRS Devices. In addition to ideas suggested while implementing STRS, SDR technology has evolved significantly and this impact to the architecture needs to be considered. These include incorporating cognitive concepts - learning from past decisions and making new decisions that the radio can act upon. SDRs are also being developed that do not contain a General Purpose Module which is currently required for the platform to be STRS compliant. The purpose of this paper is to discuss the comments received, provide a summary of the evaluation considerations, and examine planned dispositions

  5. A cost analysis of approved antiretroviral strategies in persons with advanced human immunodeficiency virus disease and zidovudine intolerance.

    PubMed

    Bozzette, S A; Parker, R; Hay, J

    1994-04-01

    Treatment with zidovudine has been standard therapy for patients with advanced HIV infection, but intolerance is common. Previously, management of intolerance has consisted of symptomatic therapy, dose interruption/discontinuation, and, when appropriate, transfusion. The availability of new antiretroviral agents such as didanosine as well as adjunctive recombinant hematopoietic growth factors makes additional strategies possible for the zidovudine-intolerant patient. Because all of these agents are costly, we evaluated the cost implications of these various strategies for the management of zidovudine-intolerant individuals within a population of persons with advanced HIV disease. We performed a decision analysis using iterative algorithmic models of 1 year of antiretroviral care under various strategies. The real costs providing antiretroviral therapy were estimated by deflating medical center charges by specific Medi-Cal (Medicaid) charge-to-payment ratios. Clinical data were extracted from the medical literature, product package inserts, investigator updates, and personal communications. Sensitivity analysis was used to test the effect of error in the estimation of parameters. The models predict that a strategy of dose interruption and transfusion for zidovudine intolerance will provide an average of 46 weeks of therapy per year to the average patient at a cost of $5,555/year of therapy provided (1991 U.S. dollars). The models predict that a strategy of adding hematopoietic growth factors to the regimen of appropriate patients would increase the average amount of therapy provided to the average patient by 3 weeks (6%) and the costs attributable to therapy by 77% to $9,805/year of therapy provided.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Tightly coupled low cost 3D RISS/GPS integration using a mixture particle filter for vehicular navigation.

    PubMed

    Georgy, Jacques; Noureldin, Aboelmagd

    2011-01-01

    Satellite navigation systems such as the global positioning system (GPS) are currently the most common technique used for land vehicle positioning. However, in GPS-denied environments, there is an interruption in the positioning information. Low-cost micro-electro mechanical system (MEMS)-based inertial sensors can be integrated with GPS and enhance the performance in denied GPS environments. The traditional technique for this integration problem is Kalman filtering (KF). Due to the inherent errors of low-cost MEMS inertial sensors and their large stochastic drifts, KF, with its linearized models, has limited capabilities in providing accurate positioning. Particle filtering (PF) was recently suggested as a nonlinear filtering technique to accommodate for arbitrary inertial sensor characteristics, motion dynamics and noise distributions. An enhanced version of PF called the Mixture PF is utilized in this study to perform tightly coupled integration of a three dimensional (3D) reduced inertial sensors system (RISS) with GPS. In this work, the RISS consists of one single-axis gyroscope and a two-axis accelerometer used together with the vehicle's odometer to obtain 3D navigation states. These sensors are then integrated with GPS in a tightly coupled scheme. In loosely-coupled integration, at least four satellites are needed to provide acceptable GPS position and velocity updates for the integration filter. The advantage of the tightly-coupled integration is that it can provide GPS measurement update(s) even when the number of visible satellites is three or lower, thereby improving the operation of the navigation system in environments with partial blockages by providing continuous aiding to the inertial sensors even during limited GPS satellite availability. To effectively exploit the capabilities of PF, advanced modeling for the stochastic drift of the vertically aligned gyroscope is used. In order to benefit from measurement updates for such drift, which are loosely-coupled updates, a hybrid loosely/tightly coupled solution is proposed. This solution is suitable for downtown environments because of the long natural outages or degradation of GPS. The performance of the proposed 3D Navigation solution using Mixture PF for 3D RISS/GPS integration is examined by road test trajectories in a land vehicle and compared to the KF counterpart.

  7. Tightly Coupled Low Cost 3D RISS/GPS Integration Using a Mixture Particle Filter for Vehicular Navigation

    PubMed Central

    Georgy, Jacques; Noureldin, Aboelmagd

    2011-01-01

    Satellite navigation systems such as the global positioning system (GPS) are currently the most common technique used for land vehicle positioning. However, in GPS-denied environments, there is an interruption in the positioning information. Low-cost micro-electro mechanical system (MEMS)-based inertial sensors can be integrated with GPS and enhance the performance in denied GPS environments. The traditional technique for this integration problem is Kalman filtering (KF). Due to the inherent errors of low-cost MEMS inertial sensors and their large stochastic drifts, KF, with its linearized models, has limited capabilities in providing accurate positioning. Particle filtering (PF) was recently suggested as a nonlinear filtering technique to accommodate for arbitrary inertial sensor characteristics, motion dynamics and noise distributions. An enhanced version of PF called the Mixture PF is utilized in this study to perform tightly coupled integration of a three dimensional (3D) reduced inertial sensors system (RISS) with GPS. In this work, the RISS consists of one single-axis gyroscope and a two-axis accelerometer used together with the vehicle’s odometer to obtain 3D navigation states. These sensors are then integrated with GPS in a tightly coupled scheme. In loosely-coupled integration, at least four satellites are needed to provide acceptable GPS position and velocity updates for the integration filter. The advantage of the tightly-coupled integration is that it can provide GPS measurement update(s) even when the number of visible satellites is three or lower, thereby improving the operation of the navigation system in environments with partial blockages by providing continuous aiding to the inertial sensors even during limited GPS satellite availability. To effectively exploit the capabilities of PF, advanced modeling for the stochastic drift of the vertically aligned gyroscope is used. In order to benefit from measurement updates for such drift, which are loosely-coupled updates, a hybrid loosely/tightly coupled solution is proposed. This solution is suitable for downtown environments because of the long natural outages or degradation of GPS. The performance of the proposed 3D Navigation solution using Mixture PF for 3D RISS/GPS integration is examined by road test trajectories in a land vehicle and compared to the KF counterpart. PMID:22163846

  8. Benefits to the Simulation Training Community of a New ANSI Standard for the Exchange of Aero Simulation Models

    NASA Technical Reports Server (NTRS)

    Hildreth, Bruce L.; Jackson, E. Bruce

    2009-01-01

    The American Institute of Aeronautics Astronautics (AIAA) Modeling and Simulation Technical Committee is in final preparation of a new standard for the exchange of flight dynamics models. The standard will become an ANSI standard and is under consideration for submission to ISO for acceptance by the international community. The standard has some a spects that should provide benefits to the simulation training community. Use of the new standard by the training simulation community will reduce development, maintenance and technical refresh investment on each device. Furthermore, it will significantly lower the cost of performing model updates to improve fidelity or expand the envelope of the training device. Higher flight fidelity should result in better transfer of training, a direct benefit to the pilots under instruction. Costs of adopting the standard are minimal and should be paid back within the cost of the first use for that training device. The standard achie ves these advantages by making it easier to update the aerodynamic model. It provides a standard format for the model in a custom eXtensible Markup Language (XML) grammar, the Dynamic Aerospace Vehicle Exchange Markup Language (DAVE-ML). It employs an existing XML grammar, MathML, to describe the aerodynamic model in an input data file, eliminating the requirement for actual software compilation. The major components of the aero model become simply an input data file, and updates are simply new XML input files. It includes naming and axis system conventions to further simplify the exchange of information.

  9. Updated Priorities Among Effective Clinical Preventive Services

    PubMed Central

    Maciosek, Michael V.; LaFrance, Amy B.; Dehmer, Steven P.; McGree, Dana A.; Flottemesch, Thomas J.; Xu, Zack; Solberg, Leif I.

    2017-01-01

    PURPOSE The Patient Protection and Affordable Care Act’s provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services. METHODS We assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures—cost-effectiveness and clinically preventable burden—for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally. RESULTS The 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesity-related behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations. CONCLUSIONS This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives. PMID:28376457

  10. Economic evaluation of second generation pneumococcal conjugate vaccines in Norway.

    PubMed

    Robberstad, Bjarne; Frostad, Carl R; Akselsen, Per E; Kværner, Kari J; Berstad, Aud K H

    2011-11-03

    A seven valent pneumococcal conjugate vaccine (PCV7) was introduced in the Norwegian childhood immunization programme in 2006, and since then the incidence of invasive pneumococcal disease has declined substantially. Recently, two new second generation pneumococcal conjugate vaccines have become available, and an update of the economic evidence is needed. The aim of this study was to estimate incremental costs, health effects and cost-effectiveness of the pneumococcal conjugate vaccines PCV7, PCV13 and PHiD-CV in Norway. We used a Markov model to estimate costs and epidemiological burden of pneumococcal- and NTHi-related diseases (invasive pneumococcal disease (IPD), Community Acquired Pneumonia (CAP) and acute otitis media (AOM)) for a specific birth cohort. Using the most relevant evidence and assumptions for a Norwegian setting, we calculated incremental costs, health effects and cost-effectiveness for different vaccination strategies. In addition we performed sensitivity analyses for key parameters, tested key assumptions in scenario analyses and explored overall model uncertainty using probabilistic sensitivity analysis. The model predicts that both PCV13 and PHiD-CV provide more health gains at a lower cost than PCV7. Differences in health gains between the two second generation vaccines are small for invasive pneumococcal disease but larger for acute otitis media and myringotomy procedures. Consequently, PHiD-CV saves more disease treatment costs and indirect costs than PCV13. This study predicts that, compared to PVC13, PHiD-CV entails lower costs and greater benefits if the latter is measured in terms of quality adjusted life years. PVC13 entails more life years gained than PHiD-CV, but those come at a cost of NOK 3.1 million (∼€0.4 million) per life year. The results indicate that PHiD-CV is cost-effective compared to PCV13 in the Norwegian setting. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Low Cost Aerial and Spatial Data, Transportation Research Synthesis

    DOT National Transportation Integrated Search

    2018-03-31

    MnDOT Office of Transportation System Management (OTSM) desires to reduce the cycle time for collecting road data updates from county sources and, opportunistically, capture additional data about road and ancillary uses, e.g. bicycle access. Specific...

  12. The Microcomputer and School Transportation.

    ERIC Educational Resources Information Center

    Dembowski, Frederick L.

    1984-01-01

    Microcomputers have many cost- and time-saving uses in school transportation management. Applications include routing and scheduling, demographic analysis, fleet maintenance, and personnel and contract management. Word processing is especially promising for storing and updating documents like specifications. Enrollment forecasting and inventory…

  13. Intelligent transportation systems benefits and costs : 2003 update

    DOT National Transportation Integrated Search

    2003-03-01

    The increasing demand for travel by highway and public transit in the United States is causing the transportation system to reach the limits of its existing capacity. Intelligent Transportation Systems (ITS) can help ease this strain through the appl...

  14. Updating RoadHAT : collision diagram builder and HSM elements.

    DOT National Transportation Integrated Search

    2016-01-01

    In order to minimize the losses resulting from traffic crashes, Indiana developed its road safety management methods before the Highway Safety Manual : and the SafetyAnalyst became available. The considerable cost of replacing the Indiana current pra...

  15. Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project.

    PubMed

    Lord, J; Willis, S; Eatock, J; Tappenden, P; Trapero-Bertran, M; Miners, A; Crossan, C; Westby, M; Anagnostou, A; Taylor, S; Mavranezouli, I; Wonderling, D; Alderson, P; Ruiz, F

    2013-12-01

    National Institute for Health and Care Excellence (NICE) clinical guidelines (CGs) make recommendations across large, complex care pathways for broad groups of patients. They rely on cost-effectiveness evidence from the literature and from new analyses for selected high-priority topics. An alternative approach would be to build a model of the full care pathway and to use this as a platform to evaluate the cost-effectiveness of multiple topics across the guideline recommendations. In this project we aimed to test the feasibility of building full guideline models for NICE guidelines and to assess if, and how, such models can be used as a basis for cost-effectiveness analysis (CEA). A 'best evidence' approach was used to inform the model parameters. Data were drawn from the guideline documentation, advice from clinical experts and rapid literature reviews on selected topics. Where possible we relied on good-quality, recent UK systematic reviews and meta-analyses. Two published NICE guidelines were used as case studies: prostate cancer and atrial fibrillation (AF). Discrete event simulation (DES) was used to model the recommended care pathways and to estimate consequent costs and outcomes. For each guideline, researchers not involved in model development collated a shortlist of topics suggested for updating. The modelling teams then attempted to evaluate options related to these topics. Cost-effectiveness results were compared with opinions about the importance of the topics elicited in a survey of stakeholders. The modelling teams developed simulations of the guideline pathways and disease processes. Development took longer and required more analytical time than anticipated. Estimates of cost-effectiveness were produced for six of the nine prostate cancer topics considered, and for five of eight AF topics. The other topics were not evaluated owing to lack of data or time constraints. The modelled results suggested 'economic priorities' for an update that differed from priorities expressed in the stakeholder survey. We did not conduct systematic reviews to inform the model parameters, and so the results might not reflect all current evidence. Data limitations and time constraints restricted the number of analyses that we could conduct. We were also unable to obtain feedback from guideline stakeholders about the usefulness of the models within project time scales. Discrete event simulation can be used to model full guideline pathways for CEA, although this requires a substantial investment of clinical and analytic time and expertise. For some topics lack of data may limit the potential for modelling. There are also uncertainties over the accessibility and adaptability of full guideline models. However, full guideline modelling offers the potential to strengthen and extend the analytical basis of NICE's CGs. Further work is needed to extend the analysis of our case study models to estimate population-level budget and health impacts. The practical usefulness of our models to guideline developers and users should also be investigated, as should the feasibility and usefulness of whole guideline modelling alongside development of a new CG. This project was funded by the Medical Research Council and the National Institute for Health Research through the Methodology Research Programme [grant number G0901504] and will be published in full in Health Technology Assessment; Vol. 17, No. 58. See the NIHR Journals Library website for further project information.

  16. Long-Term Memory and the Control of Attentional Control

    PubMed Central

    Mayr, Ulrich; Kuhns, David; Hubbard, Jason

    2014-01-01

    Task-switch costs and in particular the switch-cost asymmetry (i.e., the larger costs of switching to a dominant than a non-dominant task) are usually explained in terms of trial-to-trial carry-over of task-specific control settings. Here we argue that task switches are just one example of situations that trigger a transition from working-memory maintenance to updating, thereby opening working memory to interference from long-term memory. We used a new paradigm that requires selecting a spatial location either on the basis of a central cue (i.e., endogenous control of attention) or a peripheral, sudden onset (i.e., exogenous control of attention). We found a strong cost asymmetry that occurred even after short interruptions of otherwise single-task blocks (Exp. 1-3), but that was much stronger when participants had experienced the competing task under conditions of conflict (Exp. 1-2). Experiment 3 showed that the asymmetric costs were due to interruptions per se, rather than to associative interference tied to specific interruption activities. Experiment 4 generalized the basic pattern across interruptions varying in length or control demands and Experiment 5 across primary tasks with response-selection conflict rather than attentional conflict. Combined, the results support a model in which costs of selecting control settings arise when (a) potentially interfering memory traces have been encoded in long-term memory and (b) working-memory is forced from a maintenance mode into an updating mode (e.g., through task interruptions), thereby allowing unwanted retrieval of the encoded memory traces. PMID:24650696

  17. A Clinical Update and Global Economic Burden of Rheumatoid Arthritis.

    PubMed

    Fazal, Syed Ali; Khan, Mohammad; Nishi, Shamima E; Alam, Fahmida; Zarin, Nowshin; Bari, Mohammad T; Ashraf, Ghulam Md

    2018-02-13

    Rheumatoid arthritis (RA) is a predominant inflammatory autoimmune disorder. The incidence and prevalence of RA is increasing with considerable morbidity and mortality worldwide. The pathophysiology of RA has become clearer due to many significant research outputs during the last two decades. Many inflammatory cytokines involved in RA pathophysiology and the presence of autoantibodies are being used as potential biomarkers via the use of effective diagnostic techniques for the early diagnosis of RA. Currently, several disease-modifying anti-rheumatic drugs are being prescribed targeting RA pathophysiology, which have shown significant contributions in improving the disease outcomes. Even though innovations in treatment strategies and monitoring are helping the patients to achieve early and sustained clinical and radiographic remission, the high cost of drugs and limited health care budgets are restricting the easy access of RA treatment. Both direct and indirect high cost of treatment are creating economic burden for the patients and affecting their quality of life. The aim of this review is to describe the updated concept of RA pathophysiology and highlight current diagnostic tools used for the early detection as well as prognosis - targeting several biomarkers of RA. Additionally, we explored the updated treatment options with side effects besides discussing the global economic burden. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  18. Influenza vaccination health impact and cost effectiveness among adults aged 50 to 64 and 65 and older.

    PubMed

    Maciosek, Michael V; Solberg, Leif I; Coffield, Ashley B; Edwards, Nichol M; Goodman, Michael J

    2006-07-01

    Influenza causes approximately 36,000 deaths per year in the United States despite the presence of an effective vaccine. This assessment of the value of influenza vaccination to the U.S. population is part of an update to the 2001 ranking of clinical preventive services recommended by the U.S. Preventive Services Task Force. The forthcoming ranking will include the new recommendation of the Advisory Committee on Immunization Practices to extend influenza vaccination to adults aged 50 to 64 years. This service is evaluated on the two most important dimensions: burden of disease prevented and cost effectiveness. Study methods, described in a companion article, are designed to ensure consistency across many services. Over the lifetime of a birth cohort of 4 million, it is estimated that about 275,000 quality-adjusted life years (QALYs) would be saved if influenza vaccination were offered annually to all people after age 50. Eighty percent of the QALYs saved (220,000) would be achieved by offering the vaccine only to persons aged 65 and older. In year 2000 dollars, the cost effectiveness of influenza vaccination is $980 per QALY saved in persons aged 65 and older, and $28,000 per QALY saved in persons aged 50 to 64. When the costs of patient time and travel are excluded, the cost effectiveness ratio of vaccinating 50- to 64-year-olds decreases to $7200 per QALY saved, and vaccinating those aged 65 and older saves $17 per person vaccinated. Influenza vaccination is a high-impact, cost-effective service for persons aged 65 and older. Vaccinations are also cost effective for persons aged 50 to 64.

  19. Hydrography change detection: the usefulness of surface channels derived From LiDAR DEMs for updating mapped hydrography

    USGS Publications Warehouse

    Poppenga, Sandra K.; Gesch, Dean B.; Worstell, Bruce B.

    2013-01-01

    The 1:24,000-scale high-resolution National Hydrography Dataset (NHD) mapped hydrography flow lines require regular updating because land surface conditions that affect surface channel drainage change over time. Historically, NHD flow lines were created by digitizing surface water information from aerial photography and paper maps. Using these same methods to update nationwide NHD flow lines is costly and inefficient; furthermore, these methods result in hydrography that lacks the horizontal and vertical accuracy needed for fully integrated datasets useful for mapping and scientific investigations. Effective methods for improving mapped hydrography employ change detection analysis of surface channels derived from light detection and ranging (LiDAR) digital elevation models (DEMs) and NHD flow lines. In this article, we describe the usefulness of surface channels derived from LiDAR DEMs for hydrography change detection to derive spatially accurate and time-relevant mapped hydrography. The methods employ analyses of horizontal and vertical differences between LiDAR-derived surface channels and NHD flow lines to define candidate locations of hydrography change. These methods alleviate the need to analyze and update the nationwide NHD for time relevant hydrography, and provide an avenue for updating the dataset where change has occurred.

  20. Revolution...Now The Future Arrives for Five Clean Energy Technologies – 2016 Update

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

    Donohoo-Vallett, Paul

    Decades of investments by the federal government and industry in five key clean energy technologies are making an impact today. The cost of land-based wind power, utility and distributed photovoltaic (PV) solar power, light emitting diodes (LEDs), and electric vehicles (EVs) has fallen by 41% to as high as 94% since 2008. These cost reductions have enabled widespread adoption of these technologies with deployment increasing across the board.

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