Intelligent Engine Systems

NASA Technical Reports Server (NTRS)

Xie, Ming

2008-01-01

A high bypass jet engine fan case represents one of the largest, heaviest single components in an engine. In addition to supporting the inlet and providing the fan flowpath, the most critical function is the containment of a failed fan blade. In this development program, a lightweight, low-cost composite containment case with diagnostic capabilities was developed, fabricated, and tested. The fan case design, containment methods, and diagnostic concepts evaluated in the initial Propulsion 21 program were improved and scaled up to a full case design.

Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in Iran

PubMed Central

Javanbakht, Mehdi; Baradaran, Hamid R.; Mashayekhi, Atefeh; Haghdoost, Ali Akbar; Khamseh, Mohammad E.; Kharazmi, Erfan; Sadeghi, Aboozar

2011-01-01

Introduction Diabetes is a worldwide high prevalence chronic progressive disease that poses a significant challenge to healthcare systems. The aim of this study is to provide a detailed economic burden of diagnosed type 2 diabetes mellitus (T2DM) and its complications in Iran in 2009 year. Methods This is a prevalence-based cost-of-illness study focusing on quantifying direct health care costs by bottom-up approach. Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, laboratory test, education and non-medical cost were collected from two national registries. The human capital approach was used to calculate indirect costs separately in male and female and also among different age groups. Results The total national cost of diagnosed T2DM in 2009 is estimated at 3.78 billion USA dollars (USD) including 2.04±0.28 billion direct (medical and non-medical) costs and indirect costs of 1.73 million. Average direct and indirect cost per capita was 842.6±102 and 864.8 USD respectively. Complications (48.9%) and drugs (23.8%) were main components of direct cost. The largest components of medical expenditures attributed to diabetes's complications are cardiovascular disease (42.3% of total Complications cost), nephropathy (23%) and ophthalmic complications (14%). Indirect costs include temporarily disability (335.7 million), permanent disability (452.4 million) and reduced productivity due to premature mortality (950.3 million). Conclusions T2DM is a costly disease in the Iran healthcare system and consume more than 8.69% of total health expenditure. In addition to these quantified costs, T2DM imposes high intangible costs on society in terms of reduced quality of life. Identification of effective new strategies for the control of diabetes and its complications is a public health priority. PMID:22066013

Reliability and Productivity Modeling for the Optimization of Separated Spacecraft Interferometers

NASA Technical Reports Server (NTRS)

Kenny, Sean (Technical Monitor); Wertz, Julie

2002-01-01

As technological systems grow in capability, they also grow in complexity. Due to this complexity, it is no longer possible for a designer to use engineering judgement to identify the components that have the largest impact on system life cycle metrics, such as reliability, productivity, cost, and cost effectiveness. One way of identifying these key components is to build quantitative models and analysis tools that can be used to aid the designer in making high level architecture decisions. Once these key components have been identified, two main approaches to improving a system using these components exist: add redundancy or improve the reliability of the component. In reality, the most effective approach to almost any system will be some combination of these two approaches, in varying orders of magnitude for each component. Therefore, this research tries to answer the question of how to divide funds, between adding redundancy and improving the reliability of components, to most cost effectively improve the life cycle metrics of a system. While this question is relevant to any complex system, this research focuses on one type of system in particular: Separate Spacecraft Interferometers (SSI). Quantitative models are developed to analyze the key life cycle metrics of different SSI system architectures. Next, tools are developed to compare a given set of architectures in terms of total performance, by coupling different life cycle metrics together into one performance metric. Optimization tools, such as simulated annealing and genetic algorithms, are then used to search the entire design space to find the "optimal" architecture design. Sensitivity analysis tools have been developed to determine how sensitive the results of these analyses are to uncertain user defined parameters. Finally, several possibilities for the future work that could be done in this area of research are presented.

Analysis of the production and transaction costs of forest carbon offset projects in the USA.

PubMed

Galik, Christopher S; Cooley, David M; Baker, Justin S

2012-12-15

Forest carbon offset project implementation costs, comprised of both production and transaction costs, could present an important barrier to private landowner participation in carbon offset markets. These costs likewise represent a largely undocumented component of forest carbon offset potential. Using a custom spreadsheet model and accounting tool, this study examines the implementation costs of different forest offset project types operating in different forest types under different accounting and sampling methodologies. Sensitivity results are summarized concisely through response surface regression analysis to illustrate the relative effect of project-specific variables on total implementation costs. Results suggest that transaction costs may represent a relatively small percentage of total project implementation costs - generally less than 25% of the total. Results also show that carbon accounting methods, specifically the method used to establish project baseline, may be among the most important factors in driving implementation costs on a per-ton-of-carbon-sequestered basis, dramatically increasing variability in both transaction and production costs. This suggests that accounting could be a large driver in the financial viability of forest offset projects, with transaction costs likely being of largest concern to those projects at the margin. Copyright © 2012 Elsevier Ltd. All rights reserved.

Modelling the costs of care of hypertension in patients with metabolic syndrome and its consequences, in Germany, Spain and Italy.

PubMed

Wille, Eberhard; Scholze, Jürgen; Alegria, Eduardo; Ferri, Claudio; Langham, Sue; Stevens, Warren; Jeffries, David; Uhl-Hochgraeber, Kerstin

2011-06-01

The presence of metabolic syndrome in patients with hypertension significantly increases the risk of cardiovascular disease, type 2 diabetes and mortality. Our aim is to estimate the economic burden to the health service of metabolic syndrome (MetS) in patients with hypertension and its consequences, in three European countries in 2008, and to forecast future economic burden in 2020 using projected demographic estimates and assumptions around the growth of MetS. An age-, sex- and risk group-structured prevalence-based cost of illness model was developed using the United States Adult Treatment Panel III of the National Cholesterol Education Program criteria to define MetS. Data sources included published information and public use databases on disease prevalence, incidence of cardiovascular events, prevalence of type 2 diabetes, treatment patterns and cost of management in Germany, Spain and Italy. The economic burden to the health service of MetS in patients with hypertension has been estimated at 24,427 euro, 1,900 euro and 4,877 euro million in Germany, Spain and Italy, and is forecast to rise by 59, 179 and 157%, respectively, by 2020. The largest components of costs included the management of prevalent type 2 diabetes and incident cardiovascular events. Mean annual costs per hypertensive patient were around three-fold higher in subjects with MetS compared to those without and rose incrementally with the additional number of MetS components present. In conclusion, the presence of MetS in patients with hypertension significantly inflates economic burden, and costs are likely to increase in the future due to an aging population and an increase in the prevalence of components of MetS.

Delivery Unit Costs for Antiretroviral Treatment and Prevention of Mother-to-Child-Transmission of HIV

PubMed Central

Galárraga, Omar; Wirtz, Veronika J.; Figueroa-Lara, Alejandro; Santa-Ana-Tellez, Yared; Coulibaly, Ibrahima; Viisainen, Kirsi; Medina-Lara, Antonieta; Korenromp, Eline L.

2013-01-01

Background As antiretroviral treatment (ART) for HIV/AIDS is scaled-up globally, information on per-person costs is critical to improve efficiency in service delivery and maximize coverage and health impact. Objective To review studies on delivery unit costs for adult and pediatric ART provision per-patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in low- and middle-income countries. Methods Systematic review of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analyzed by country income level and cost component. All costs were standardized to 2009 US dollars. Results Analyses covered 29 eligible, comprehensive costing studies. In the base case, in low-income countries (LIC), median, ART cost per patient-year was $792 (mean: $839, range: $682-$1089); for lower-middle-income countries (LMIC), the median was $932 (mean: $1246, range: $156-$3904); and for upper-middle-income countries (UMIC) the median was $1454 (mean: $2783, range: $1230-$5667). ARV drugs were largest component of overall ART cost in all settings (62%, 50% and 47% in LIC, LMIC and UMIC respectively). Out of 26 ART studies, 14 report which drug regimes were used, and only one study explicitly reported second line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 19.5%) whereas it was personnel costs in UMIC (26%). Two studies specified the types of laboratory tests costed, and three studies specifically included above-facility-level personnel costs. Three studies reported detailed PMTCT costs, and two studies reported on pediatric ART. Conclusions There is a paucity of data on the full ART and PMTCT delivery unit costs, in particular for low-and middle-income countries. Heterogeneity in activities costed and insufficient detail regarding components included in the costing hampers standardization of unit cost measures. Evaluation of program-level unit costs would benefit from international guidance on standardized costing methods, and expenditure categories and definitions. Future work should help elucidate the sources for the large variations in delivery unit costs across settings with similar income and epidemiological characteristics. PMID:21671687

Developing Cost-Effective Field Assessments of Carbon Stocks in Human-Modified Tropical Forests.

PubMed

Berenguer, Erika; Gardner, Toby A; Ferreira, Joice; Aragão, Luiz E O C; Camargo, Plínio B; Cerri, Carlos E; Durigan, Mariana; Oliveira Junior, Raimundo C; Vieira, Ima C G; Barlow, Jos

2015-01-01

Across the tropics, there is a growing financial investment in activities that aim to reduce emissions from deforestation and forest degradation, such as REDD+. However, most tropical countries lack on-the-ground capacity to conduct reliable and replicable assessments of forest carbon stocks, undermining their ability to secure long-term carbon finance for forest conservation programs. Clear guidance on how to reduce the monetary and time costs of field assessments of forest carbon can help tropical countries to overcome this capacity gap. Here we provide such guidance for cost-effective one-off field assessments of forest carbon stocks. We sampled a total of eight components from four different carbon pools (i.e. aboveground, dead wood, litter and soil) in 224 study plots distributed across two regions of eastern Amazon. For each component we estimated survey costs, contribution to total forest carbon stocks and sensitivity to disturbance. Sampling costs varied thirty-one-fold between the most expensive component, soil, and the least, leaf litter. Large live stems (≥10 cm DBH), which represented only 15% of the overall sampling costs, was by far the most important component to be assessed, as it stores the largest amount of carbon and is highly sensitive to disturbance. If large stems are not taxonomically identified, costs can be reduced by a further 51%, while incurring an error in aboveground carbon estimates of only 5% in primary forests, but 31% in secondary forests. For rapid assessments, necessary to help prioritize locations for carbon- conservation activities, sampling of stems ≥20cm DBH without taxonomic identification can predict with confidence (R2 = 0.85) whether an area is relatively carbon-rich or carbon-poor-an approach that is 74% cheaper than sampling and identifying all the stems ≥10cm DBH. We use these results to evaluate the reliability of forest carbon stock estimates provided by the IPCC and FAO when applied to human-modified forests, and to highlight areas where cost savings in carbon stock assessments could be most easily made.

Developing Cost-Effective Field Assessments of Carbon Stocks in Human-Modified Tropical Forests

PubMed Central

Berenguer, Erika; Gardner, Toby A.; Ferreira, Joice; Aragão, Luiz E. O. C.; Camargo, Plínio B.; Cerri, Carlos E.; Durigan, Mariana; Oliveira Junior, Raimundo C.; Vieira, Ima C. G.; Barlow, Jos

2015-01-01

Across the tropics, there is a growing financial investment in activities that aim to reduce emissions from deforestation and forest degradation, such as REDD+. However, most tropical countries lack on-the-ground capacity to conduct reliable and replicable assessments of forest carbon stocks, undermining their ability to secure long-term carbon finance for forest conservation programs. Clear guidance on how to reduce the monetary and time costs of field assessments of forest carbon can help tropical countries to overcome this capacity gap. Here we provide such guidance for cost-effective one-off field assessments of forest carbon stocks. We sampled a total of eight components from four different carbon pools (i.e. aboveground, dead wood, litter and soil) in 224 study plots distributed across two regions of eastern Amazon. For each component we estimated survey costs, contribution to total forest carbon stocks and sensitivity to disturbance. Sampling costs varied thirty-one-fold between the most expensive component, soil, and the least, leaf litter. Large live stems (≥10 cm DBH), which represented only 15% of the overall sampling costs, was by far the most important component to be assessed, as it stores the largest amount of carbon and is highly sensitive to disturbance. If large stems are not taxonomically identified, costs can be reduced by a further 51%, while incurring an error in aboveground carbon estimates of only 5% in primary forests, but 31% in secondary forests. For rapid assessments, necessary to help prioritize locations for carbon- conservation activities, sampling of stems ≥20cm DBH without taxonomic identification can predict with confidence (R2 = 0.85) whether an area is relatively carbon-rich or carbon-poor—an approach that is 74% cheaper than sampling and identifying all the stems ≥10cm DBH. We use these results to evaluate the reliability of forest carbon stock estimates provided by the IPCC and FAO when applied to human-modified forests, and to highlight areas where cost savings in carbon stock assessments could be most easily made. PMID:26308074

Pricing and components analysis of some key essential pediatric medicine in Odisha state

PubMed Central

Samal, Satyajit; Swain, Trupti Rekha

2017-01-01

Objective: Study highlighting prices, i.e., the patients actually pay at ground level is important for interventions such as alternate procurement schemes or to expedite regulatory assessment of essential medicines for children. The present study was undertaken to study pricing and component analysis of few key essential medicines in Odisha state. Methodology: Six child-specific medicines of different formulations were selected based on use in different disease condition and having widest pricing variation. Data were collected, entered, and analyzed in the price components data collection form of the World Health Organization-Health Action International (WHO-HAI) 2007 Workbook version 5 – Part II provided as part of the WHO/HAI methodology. The analysis includes the cumulative percent markup, total cumulative percent markup, and percent contribution of individual components to the final medicine price in both public and private sector of Odisha state. Results: Add-on costs such as taxes, wholesale, and retail markups contribute substantially to the final price of medicines in private sector, particularly for branded-generic products. The largest contributor to add-on costs is at the level of retailer shop. Conclusion: Policy should be framed to achieve a greater transparency and uniformity of the pricing of medicines at different health sectors of Odisha. PMID:28458429

Does topological information matter for power grid vulnerability?

PubMed

Ouyang, Min; Yang, Kun

2014-12-01

Power grids, which are playing an important role in supporting the economy of a region as well as the life of its citizens, could be attacked by terrorists or enemies to damage the region. Depending on different levels of power grid information collected by the terrorists, their attack strategies might be different. This paper groups power grid information into four levels: no information, purely topological information (PTI), topological information with generator and load nodes (GLNI), and full information (including component physical properties and flow parameters information), and then identifies possible attack strategies for each information level. Analyzing and comparing power grid vulnerability under these attack strategies from both terrorists' and utility companies' point of view give rise to an approach to quantify the relative values of these three types of information, including PTI, GLNI, and component parameter information (CPI). This approach can provide information regarding the extent to which topological information matters for power system vulnerability decisions. Taking several test systems as examples, results show that for small attacks with p ≤ 0.1, CPI matters the most; when taking attack cost into consideration and assuming that the terrorists take the optimum cost-efficient attack intensity, then CPI has the largest cost-based information value.

Does topological information matter for power grid vulnerability?

NASA Astrophysics Data System (ADS)

Ouyang, Min; Yang, Kun

2014-12-01

Power grids, which are playing an important role in supporting the economy of a region as well as the life of its citizens, could be attacked by terrorists or enemies to damage the region. Depending on different levels of power grid information collected by the terrorists, their attack strategies might be different. This paper groups power grid information into four levels: no information, purely topological information (PTI), topological information with generator and load nodes (GLNI), and full information (including component physical properties and flow parameters information), and then identifies possible attack strategies for each information level. Analyzing and comparing power grid vulnerability under these attack strategies from both terrorists' and utility companies' point of view give rise to an approach to quantify the relative values of these three types of information, including PTI, GLNI, and component parameter information (CPI). This approach can provide information regarding the extent to which topological information matters for power system vulnerability decisions. Taking several test systems as examples, results show that for small attacks with p ≤ 0.1, CPI matters the most; when taking attack cost into consideration and assuming that the terrorists take the optimum cost-efficient attack intensity, then CPI has the largest cost-based information value.

Construction and startup performance of the Miamisburg salt-gradient solar pond

NASA Astrophysics Data System (ADS)

Wittenberg, L. J.; Harris, M. J.

1981-02-01

An account is given of the construction and 1.5 years of operation of the Miamisburg, Ohio salt-gradient solar pond which, with 2020 sq m, is the largest solar collector in the U.S. The 18% sodium chloride solution pond has reached storage temperatures of 64 C in July and 28 C in February. Under steady-state conditions, conservative heat-yield estimates on the order of 962 million Btu have been made. The heat is used to warm-up a summer outdoor swimming pool and in winter a recreational building. Installation costs were only $35/sq m, and heat costs based on a 15-year depreciation of installation costs is below that of fuel oil heating, at $9.45 per million Btu. Further study is recommended for maintenance of water clarity, metallic component corrosion and assurance of pond water containment.

The redesign of consumer cost sharing for specialty drugs at the California Health Insurance Exchange.

PubMed

Robinson, James; Price, Anne; Goldman, Zahary

2016-03-01

This paper describes the redesign of health benefits at Covered California-the nation's largest health insurance exchange, which covers 1.3 million individuals, and its benefit designs extending to hundreds of thousands more enrollees through insurance products sold outside the exchange-with respect to specialty drugs for the 2016 enrollment year. The catalyst for benefit redesign came from advocacy organizations representing patients suffering from HIV, multiple sclerosis, epilepsy, hepatitis C, and other chronic conditions. The first component of the benefit redesign creates a separate deductible for pharmaceutical expenditures, with a commensurate reduction in the deductible for other (medical) expenditures. The second component requires health plans to assign at least 1 specialty drug for each therapeutic class to a nonspecialty tier, offering patients a treatment option for which they are not exposed to coinsurance. The third component imposes a monthly payment limit of $250 for each specialty drug prescription, thereby buffering patients using these drugs against the $6250 individual, or $13,500 family, annual medical payment limit. The pharmacy deductible and monthly out-of-pocket payment limit are substantially lower for low-income enrollees in the subsidized silver-tier products. The Covered California redesign indicates that patients can be shielded from the most onerous cost-sharing burdens while keeping premiums affordable for the entire enrolled population; however, sustainable access to care requires reductions in the underlying cost of new clinical technologies.

Thermospheric mass density model error variance as a function of time scale

NASA Astrophysics Data System (ADS)

Emmert, J. T.; Sutton, E. K.

2017-12-01

In the increasingly crowded low-Earth orbit environment, accurate estimation of orbit prediction uncertainties is essential for collision avoidance. Poor characterization of such uncertainty can result in unnecessary and costly avoidance maneuvers (false positives) or disregard of a collision risk (false negatives). Atmospheric drag is a major source of orbit prediction uncertainty, and is particularly challenging to account for because it exerts a cumulative influence on orbital trajectories and is therefore not amenable to representation by a single uncertainty parameter. To address this challenge, we examine the variance of measured accelerometer-derived and orbit-derived mass densities with respect to predictions by thermospheric empirical models, using the data-minus-model variance as a proxy for model uncertainty. Our analysis focuses mainly on the power spectrum of the residuals, and we construct an empirical model of the variance as a function of time scale (from 1 hour to 10 years), altitude, and solar activity. We find that the power spectral density approximately follows a power-law process but with an enhancement near the 27-day solar rotation period. The residual variance increases monotonically with altitude between 250 and 550 km. There are two components to the variance dependence on solar activity: one component is 180 degrees out of phase (largest variance at solar minimum), and the other component lags 2 years behind solar maximum (largest variance in the descending phase of the solar cycle).

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

PubMed

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

2013-04-01

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

Cost accounting in a surgical unit in a teaching hospital--a pilot study.

PubMed

Malalasekera, A P; Ariyaratne, M H; Fernando, R; Perera, D; Deen, K I

2003-09-01

Economic constraints remain one of the major limitations on the quality of health care even in industrialised countries. Improvement of quality will require optimising facilities within available resources. Our objective was to determine costs of surgery and to identify areas where cost reduction is possible. 80 patients undergoing routine major and intermediate surgery during a period of 6 months were selected at random. All consumables used and procedures carried out were documented. A unit cost was assigned to each of these. Costing was based on 3 main categories: preoperative (investigations, blood product related costs), operative (anaesthetic charges, consumables and theatre charges) and post-operative (investigations, consumables, hospital stay). Theatre charges included two components: fixed (consumables) and variable (dependent on time per operation). The indirect costs (e.g. administration costs, 'hotel' costs), accounted for 30%, of the total and were lower than similar costs in industrialised nations. The largest contributory factors (median, range) towards total cost were, basic hospital charges (30%; 15 to 63%); theatre charges fixed (23%; 6 to 35%) and variable (14%; 8 to 27%); and anaesthetic charges (15%; 1 to 36%). Cost reduction in patients undergoing surgery should focus on decreasing hospital stay, operating theatre time and anaesthetic expenditure. Although definite measures can be suggested from the study, further studies on these variables are necessary to optimise cost effectiveness of surgical units.

A tool to determine financial impact of adverse events in health care: healthcare quality calculator.

PubMed

Yarbrough, Wendell G; Sewell, Andrew; Tickle, Erin; Rhinehardt, Eric; Harkleroad, Rod; Bennett, Marc; Johnson, Deborah; Wen, Li; Pfeiffer, Matthew; Benegas, Manny; Morath, Julie

2014-12-01

Hospital leaders lack tools to determine the financial impact of poor patient outcomes and adverse events. To provide health-care leaders with decision support for investments to improve care, we created a tool, the Healthcare Quality Calculator (HQCal), which uses institution-specific financial data to calculate impact of poor patient outcomes or quality improvement on present and future margin. Excel and Web-based versions of the HQCal were based on a cohort study framework and created with modular components including major drivers of cost and reimbursement. The Healthcare Quality Calculator (HQCal) compares payment, cost, and profit/loss for patients with and without poor outcomes or quality issues. Cost and payment information for groups with and without quality issues are used by the HQCal to calculate profit or loss. Importantly, institution-specific payment and cost data are used to calculate financial impact and attributable cost associated with poor patient outcomes, adverse events, or quality issues. Because future cost and reimbursement changes can be forecast, the HQCal incorporates a forward-looking component. The flexibility of the HQCal was demonstrated using surgical site infections after abdominal surgery and postoperative surgical airway complications. The Healthcare Quality Calculator determines financial impact of poor patient outcomes and the benefit of initiatives to improve quality. The calculator can identify quality issues that would provide the largest financial benefit if improved; however, it cannot identify specific interventions. The calculator provides a tool to improve transparency regarding both short- and long-term financial consequences of funding, or failing to fund, initiatives to close gaps in quality or improve patient outcomes.

Lightweight custom composite prosthetic components using an additive manufacturing-based molding technique.

PubMed

Leddy, Michael T; Belter, Joseph T; Gemmell, Kevin D; Dollar, Aaron M

2015-01-01

Additive manufacturing techniques are becoming more prominent and cost-effective as 3D printing becomes higher quality and more inexpensive. The idea of 3D printed prosthetics components promises affordable, customizable devices, but these systems currently have major shortcomings in durability and function. In this paper, we propose a fabrication method for custom composite prostheses utilizing additive manufacturing, allowing for customizability, as well the durability of professional prosthetics. The manufacturing process is completed using 3D printed molds in a multi-stage molding system, which creates a custom finger or palm with a lightweight epoxy foam core, a durable composite outer shell, and soft urethane gripping surfaces. The composite material was compared to 3D printed and aluminum materials using a three-point bending test to compare stiffness, as well as gravimetric measurements to compare weight. The composite finger demonstrates the largest stiffness with the lowest weight compared to other tested fingers, as well as having customizability and lower cost, proving to potentially be a substantial benefit to the development of upper-limb prostheses.

High-resolution wavefront control of high-power laser systems

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

Brase, J; Brown, C; Carrano, C

1999-07-08

Nearly every new large-scale laser system application at LLNL has requirements for beam control which exceed the current level of available technology. For applications such as inertial confinement fusion, laser isotope separation, laser machining, and laser the ability to transport significant power to a target while maintaining good beam quality is critical. There are many ways that laser wavefront quality can be degraded. Thermal effects due to the interaction of high-power laser or pump light with the internal optical components or with the ambient gas are common causes of wavefront degradation. For many years, adaptive optics based on thing deformablemore » glass mirrors with piezoelectric or electrostrictive actuators have be used to remove the low-order wavefront errors from high-power laser systems. These adaptive optics systems have successfully improved laser beam quality, but have also generally revealed additional high-spatial-frequency errors, both because the low-order errors have been reduced and because deformable mirrors have often introduced some high-spatial-frequency components due to manufacturing errors. Many current and emerging laser applications fall into the high-resolution category where there is an increased need for the correction of high spatial frequency aberrations which requires correctors with thousands of degrees of freedom. The largest Deformable Mirrors currently available have less than one thousand degrees of freedom at a cost of approximately $1M. A deformable mirror capable of meeting these high spatial resolution requirements would be cost prohibitive. Therefore a new approach using a different wavefront control technology is needed. One new wavefront control approach is the use of liquid-crystal (LC) spatial light modulator (SLM) technology for the controlling the phase of linearly polarized light. Current LC SLM technology provides high-spatial-resolution wavefront control, with hundreds of thousands of degrees of freedom, more than two orders of magnitude greater than the best Deformable Mirrors currently made. Even with the increased spatial resolution, the cost of these devices is nearly two orders of magnitude less than the cost of the largest deformable mirror.« less

[Cost Analysis of Cochlear Implantation in Adults].

PubMed

Raths, S; Lenarz, T; Lesinski-Schiedat, A; Flessa, S

2016-04-01

The number of implantation of cochlear implants has steadily risen in recent years. Reasons for this are an extension of indication criteria, demographic change, increased quality of life needs and greater acceptance. The consequences are rising expenditure for statutory health insurance (SHI) for cochlear implantation. A detailed calculation of lifetime costs from SHI's perspective for postlingually deafened adolescents and adults is essential in estimating future cost developments. Calculations are based on accounting data from the Hannover Medical School. With regard to further life expectancy, average costs of preoperative diagnosis, surgery, rehabilitation, follow-ups, processor upgrades and electrical maintenance were discounted to their present value at age of implantation. There is an inverse relation between cost of unilateral cochlear implantation and age of initial implantation. From SHI's perspective, the intervention costs between 36,001 and 68,970 € ($ 42,504-$ 81,429). The largest cost components are initial implantation and processor upgrades. Compared to the UK the cost of cochlear implantation in Germany seems to be significantly lower. In particular the costs of, rehabilitation and maintenance in Germany cause only a small percentage of total costs. Also, the costs during the first year of treatment seem comparatively low. With regard to future spending of SHI due to implant innovations and associated extension of indication, increasing cost may be suspected. © Georg Thieme Verlag KG Stuttgart · New York.

Use of corn steep liquor as an economical nitrogen source for biosuccinic acid production by Actinobacillus succinogenes

NASA Astrophysics Data System (ADS)

Tan, J. P.; Jahim, J. M.; Wu, T. Y.; Harun, S.; Mumtaz, T.

2016-06-01

Expensive raw materials are the driving force that leads to the shifting of the petroleum-based succinic acid production into bio-based succinic acid production by microorganisms. Cost of fermentation medium is among the main factors contributing to the total production cost of bio-succinic acid. After carbon source, nitrogen source is the second largest component of the fermentation medium, the cost of which has been overlooked for the past years. The current study aimed at replacing yeast extract- a costly nitrogen source with corn steep liquor for economical production of bio-succinic acid by Actinobacillus succinogenes 130Z. In this study, a final succinic acid concentration of 20.6 g/L was obtained from the use of corn steep liquor as the nitrogen source, which was comparable with the use of yeast extract as the nitrogen source that had a final succinate concentration of 21.4 g/l. In terms of economical wise, corn steep liquor was priced at 200 /ton, which was one fifth of the cost of yeast extract at 1000 /ton. Therefore, corn steep liquor can be considered as a potential nitrogen source in biochemical industries instead of the costly yeast extract.

Three-camera stereo vision for intelligent transportation systems

NASA Astrophysics Data System (ADS)

Bergendahl, Jason; Masaki, Ichiro; Horn, Berthold K. P.

1997-02-01

A major obstacle in the application of stereo vision to intelligent transportation system is high computational cost. In this paper, a PC based three-camera stereo vision system constructed with off-the-shelf components is described. The system serves as a tool for developing and testing robust algorithms which approach real-time performance. We present an edge based, subpixel stereo algorithm which is adapted to permit accurate distance measurements to objects in the field of view using a compact camera assembly. Once computed, the 3D scene information may be directly applied to a number of in-vehicle applications, such as adaptive cruise control, obstacle detection, and lane tracking. Moreover, since the largest computational costs is incurred in generating the 3D scene information, multiple applications that leverage this information can be implemented in a single system with minimal cost. On-road applications, such as vehicle counting and incident detection, are also possible. Preliminary in-vehicle road trial results are presented.

Low-Cost and Durable Bipolar Plates for Proton Exchange Membrane Electrolyzers

NASA Astrophysics Data System (ADS)

Lettenmeier, P.; Wang, R.; Abouatallah, R.; Saruhan, B.; Freitag, O.; Gazdzicki, P.; Morawietz, T.; Hiesgen, R.; Gago, A. S.; Friedrich, K. A.

2017-03-01

Cost reduction and high efficiency are the mayor challenges for sustainable H2 production via proton exchange membrane (PEM) electrolysis. Titanium-based components such as bipolar plates (BPP) have the largest contribution to the capital cost. This work proposes the use of stainless steel BPPs coated with Nb and Ti by magnetron sputtering physical vapor deposition (PVD) and vacuum plasma spraying (VPS), respectively. The physical properties of the coatings are thoroughly characterized by scanning electron, atomic force microscopies (SEM, AFM); and X-ray diffraction, photoelectron spectroscopies (XRD, XPS). The Ti coating (50 μm) protects the stainless steel substrate against corrosion, while a 50-fold thinner layer of Nb decreases the contact resistance by almost one order of magnitude. The Nb/Ti-coated stainless steel bipolar BPPs endure the harsh environment of the anode for more than 1000 h of operation under nominal conditions, showing a potential use in PEM electrolyzers for large-scale H2 production from renewables.

Low-Cost and Durable Bipolar Plates for Proton Exchange Membrane Electrolyzers

PubMed Central

Lettenmeier, P.; Wang, R.; Abouatallah, R.; Saruhan, B.; Freitag, O.; Gazdzicki, P.; Morawietz, T.; Hiesgen, R.; Gago, A. S.; Friedrich, K. A.

2017-01-01

Cost reduction and high efficiency are the mayor challenges for sustainable H2 production via proton exchange membrane (PEM) electrolysis. Titanium-based components such as bipolar plates (BPP) have the largest contribution to the capital cost. This work proposes the use of stainless steel BPPs coated with Nb and Ti by magnetron sputtering physical vapor deposition (PVD) and vacuum plasma spraying (VPS), respectively. The physical properties of the coatings are thoroughly characterized by scanning electron, atomic force microscopies (SEM, AFM); and X-ray diffraction, photoelectron spectroscopies (XRD, XPS). The Ti coating (50 μm) protects the stainless steel substrate against corrosion, while a 50-fold thinner layer of Nb decreases the contact resistance by almost one order of magnitude. The Nb/Ti-coated stainless steel bipolar BPPs endure the harsh environment of the anode for more than 1000 h of operation under nominal conditions, showing a potential use in PEM electrolyzers for large-scale H2 production from renewables. PMID:28294119

Costs and Effects of a Telephonic Diabetes Self-Management Support Intervention Using Health Educators

PubMed Central

Schechter, Clyde B.; Walker, Elizabeth A.; Ortega, Felix M.; Chamany, Shadi; Silver, Lynn D.

2015-01-01

Background Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Methods Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. Oneway sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. Results The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Conclusions Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. PMID:26750743

Costs and effects of a telephonic diabetes self-management support intervention using health educators.

PubMed

Schechter, Clyde B; Walker, Elizabeth A; Ortega, Felix M; Chamany, Shadi; Silver, Lynn D

2016-03-01

Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. One-way sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. Copyright © 2016 Elsevier Inc. All rights reserved.

Organic solvent pretreatment of lignocellulosic biomass for biofuels and biochemicals: A review.

PubMed

Zhang, Ke; Pei, Zhijian; Wang, Donghai

2016-01-01

Lignocellulosic biomass represents the largest potential volume and lowest cost for biofuel and biochemical production. Pretreatment is an essential component of biomass conversion process, affecting a majority of downstream processes, including enzymatic hydrolysis, fermentation, and final product separation. Organic solvent pretreatment is recognized as an emerging way ahead because of its inherent advantages, such as the ability to fractionate lignocellulosic biomass into cellulose, lignin, and hemicellulose components with high purity, as well as easy solvent recovery and solvent reuse. Objectives of this review were to update and extend previous works on pretreatment of lignocellulosic biomass for biofuels and biochemicals using organic solvents, especially on ethanol, methanol, ethylene glycol, glycerol, acetic acid, and formic acid. Perspectives and recommendations were given to fully describe implementation of proper organic solvent pretreatment for future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Estimating Power Outage Cost based on a Survey for Industrial Customers

NASA Astrophysics Data System (ADS)

Yoshida, Yoshikuni; Matsuhashi, Ryuji

A survey was conducted on power outage cost for industrial customers. 5139 factories, which are designated energy management factories in Japan, answered their power consumption and the loss of production value due to the power outage in an hour in summer weekday. The median of unit cost of power outage of whole sectors is estimated as 672 yen/kWh. The sector of services for amusement and hobbies and the sector of manufacture of information and communication electronics equipment relatively have higher unit cost of power outage. Direct damage cost from power outage in whole sectors reaches 77 billion yen. Then utilizing input-output analysis, we estimated indirect damage cost that is caused by the repercussion of production halt. Indirect damage cost in whole sectors reaches 91 billion yen. The sector of wholesale and retail trade has the largest direct damage cost. The sector of manufacture of transportation equipment has the largest indirect damage cost.

Healthcare resource utilization and costs of outpatient follow-up after liver transplantation in a university hospital in São Paulo, Brazil: cost description study.

PubMed

Soárez, Patricia Coelho de; Lara, Amanda Nazareth; Sartori, Ana Marli Christovam; Abdala, Edson; Haddad, Luciana Bertocco de Paiva; D'Albuquerque, Luiz Augusto Carneiro; Novaes, Hillegonda Maria Dutilh

2015-01-01

Data on the costs of outpatient follow-up after liver transplantation are scarce in Brazil. The purpose of the present study was to estimate the direct medical costs of the outpatient follow-up after liver transplantation, from the first outpatient visit after transplantation to five years after transplantation. Cost description study conducted in a university hospital in São Paulo, Brazil. Cost data were available for 20 adults who underwent liver transplantation due to acute liver failure (ALF) from 2005 to 2009. The data were retrospectively retrieved from medical records and the hospital accounting information system from December 2010 to January 2011. Mean cost per patient/year was R$ 13,569 (US$ 5,824). The first year of follow-up was the most expensive (R$ 32,546 or US$ 13,968), and medication was the main driver of total costs, accounting for 85% of the total costs over the five-year period and 71.9% of the first-year total costs. In the second year after transplantation, the mean total costs were about half of the amount of the first-year costs (R$ 15,165 or US$ 6,509). Medication was the largest contributor to the costs followed by hospitalization, over the five-year period. In the fourth year, the costs of diagnostic tests exceeded the hospitalization costs. This analysis provides significant insight into the costs of outpatient follow-up after liver transplantation due to ALF and the participation of each cost component in the Brazilian setting.

State High-Risk Pools: An Update on the Minnesota Comprehensive Health Association

PubMed Central

Spencer, Donna; Burke, Courtney E.

2011-01-01

State health insurance high-risk pools are a key component of the US health care system's safety net, because they provide health insurance to the “uninsurable.” In 2007, 34 states had individual high-risk pools, which covered more than 200 000 people at a total cost of $1.8 billion. We examine the experience of the largest and oldest pool in the nation, the Minnesota Comprehensive Health Association, to document key issues facing state high-risk pools in enrollment and financing. We also considered the role and future of high-risk pools in light of national health care finance reform. PMID:21228286

Health care: economic impact of caring for geriatric patients.

PubMed

Rich, Preston B; Adams, Sasha D

2015-02-01

National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. Copyright © 2015 Elsevier Inc. All rights reserved.

Additive Manufacturing for Affordable Rocket Engines

NASA Technical Reports Server (NTRS)

West, Brian; Robertson, Elizabeth; Osborne, Robin; Calvert, Marty

2016-01-01

Additive manufacturing (also known as 3D printing) technology has the potential to drastically reduce costs and lead times associated with the development of complex liquid rocket engine systems. NASA is using 3D printing to manufacture rocket engine components including augmented spark igniters, injectors, turbopumps, and valves. NASA is advancing the process to certify these components for flight. Success Story: MSFC has been developing rocket 3D-printing technology using the Selective Laser Melting (SLM) process. Over the last several years, NASA has built and tested several injectors and combustion chambers. Recently, MSFC has 3D printed an augmented spark igniter for potential use the RS-25 engines that will be used on the Space Launch System. The new design is expected to reduce the cost of the igniter by a factor of four. MSFC has also 3D printed and tested a liquid hydrogen turbopump for potential use on an Upper Stage Engine. Additive manufacturing of the turbopump resulted in a 45% part count reduction. To understanding how the 3D printed parts perform and to certify them for flight, MSFC built a breadboard liquid rocket engine using additive manufactured components including injectors, turbomachinery, and valves. The liquid rocket engine was tested seven times in 2016 using liquid oxygen and liquid hydrogen. In addition to exposing the hardware to harsh environments, engineers learned to design for the new manufacturing technique, taking advantage of its capabilities and gaining awareness of its limitations. Benefit: The 3D-printing technology promises reduced cost and schedule for rocket engines. Cost is a function of complexity, and the most complicated features provide the largest opportunities for cost reductions. This is especially true where brazes or welds can be eliminated. The drastic reduction in part count achievable with 3D printing creates a waterfall effect that reduces the number of processes and drawings, decreases the amount of touch labor required, and increases reliability. When certification is achieved, NASA missions will be able to realize these benefits.

Health insurance premium increases for the 5 largest school districts in the United States, 2004-2008.

PubMed

Cantillo, John R

2010-03-01

Local school districts are often one of the largest, if not the largest, employers in their respective communities. Like many large employers, school districts offer health insurance to their employees. There is a lack of information about the rate of health insurance premiums in US school districts relative to other employers. To assess the change in the costs of healthcare insurance in the 5 largest public school districts in the United States, between 2004 and 2008, as representative of large public employers in the country. Data for this study were drawn exclusively from a survey sent to the 5 largest public school districts in the United States. The survey requested responses on 3 data elements for each benefit plan offered from 2004 through 2008; these included enrollment, employee costs, and employer costs. The premium growth for the 5 largest school districts has slowed down and is consistent with other purchasers-Kaiser/Health Research & Educational Trust and the Federal Employee Health Benefit Program. The average increase in health insurance premium for the schools was 5.9% in 2008, and the average annual growth rate over the study period was 7.5%. For family coverage, these schools provide the most generous employer contribution (80.8%) compared with the employer contribution reported by other employers (73.5%) for 2008. Often the largest employers in their communities, school districts demonstrate a commitment to provide choice of benefits and affordability for employees and their families. Despite constraints typical of public employers, the 5 largest school districts in the United States have decelerated in premium growth consistent with other purchasers, albeit at a slower pace.

Health Insurance Premium Increases for the 5 Largest School Districts in the United States, 2004–2008

PubMed Central

Cantillo, John R.

2010-01-01

Background Local school districts are often one of the largest, if not the largest, employers in their respective communities. Like many large employers, school districts offer health insurance to their employees. There is a lack of information about the rate of health insurance premiums in US school districts relative to other employers. Objective To assess the change in the costs of healthcare insurance in the 5 largest public school districts in the United States, between 2004 and 2008, as representative of large public employers in the country. Methods Data for this study were drawn exclusively from a survey sent to the 5 largest public school districts in the United States. The survey requested responses on 3 data elements for each benefit plan offered from 2004 through 2008; these included enrollment, employee costs, and employer costs. Results The premium growth for the 5 largest school districts has slowed down and is consistent with other purchasers—Kaiser/Health Research & Educational Trust and the Federal Employee Health Benefit Program. The average increase in health insurance premium for the schools was 5.9% in 2008, and the average annual growth rate over the study period was 7.5%. For family coverage, these schools provide the most generous employer contribution (80.8%) compared with the employer contribution reported by other employers (73.5%) for 2008. Conclusions Often the largest employers in their communities, school districts demonstrate a commitment to provide choice of benefits and affordability for employees and their families. Despite constraints typical of public employers, the 5 largest school districts in the United States have decelerated in premium growth consistent with other purchasers, albeit at a slower pace. PMID:25126311

Process development and exergy cost sensitivity analysis of a hybrid molten carbonate fuel cell power plant and carbon dioxide capturing process

NASA Astrophysics Data System (ADS)

Mehrpooya, Mehdi; Ansarinasab, Hojat; Moftakhari Sharifzadeh, Mohammad Mehdi; Rosen, Marc A.

2017-10-01

An integrated power plant with a net electrical power output of 3.71 × 105 kW is developed and investigated. The electrical efficiency of the process is found to be 60.1%. The process includes three main sub-systems: molten carbonate fuel cell system, heat recovery section and cryogenic carbon dioxide capturing process. Conventional and advanced exergoeconomic methods are used for analyzing the process. Advanced exergoeconomic analysis is a comprehensive evaluation tool which combines an exergetic approach with economic analysis procedures. With this method, investment and exergy destruction costs of the process components are divided into endogenous/exogenous and avoidable/unavoidable parts. Results of the conventional exergoeconomic analyses demonstrate that the combustion chamber has the largest exergy destruction rate (182 MW) and cost rate (13,100 /h). Also, the total process cost rate can be decreased by reducing the cost rate of the fuel cell and improving the efficiency of the combustion chamber and heat recovery steam generator. Based on the total avoidable endogenous cost rate, the priority for modification is the heat recovery steam generator, a compressor and a turbine of the power plant, in rank order. A sensitivity analysis is done to investigate the exergoeconomic factor parameters through changing the effective parameter variations.

Costs of cervical cancer treatment: population-based estimates from Ontario

PubMed Central

Pendrith, C.; Thind, A.; Zaric, G.S.; Sarma, S.

2016-01-01

Objectives The objectives of the present study were to estimate the overall and specific medical care costs associated with cervical cancer in the first 5 years after diagnosis in Ontario. Methods Incident cases of invasive cervical cancer during 2007–2010 were identified from the Ontario Cancer Registry and linked to administrative databases held at the Institute for Clinical Evaluative Sciences. Mean costs in 2010 Canadian dollars were estimated using the arithmetic mean and estimators that adjust for censored data. Results Mean age of the patients in the study cohort (779 cases) was 49.3 years. The mean overall medical care cost was $39,187 [standard error (se): $1,327] in the 1st year after diagnosis. Costs in year 1 ranged from $34,648 (se: $1,275) for those who survived at least 1 year to $69,142 (se: $4,818) for those who died from cervical cancer within 1 year. At 5 years after diagnosis, the mean overall unadjusted cost was $63,131 (se: $3,131), and the cost adjusted for censoring was $68,745 (se: $2,963). Inpatient hospitalizations and cancer-related care were the two largest components of cancer treatment costs. Conclusions We found that the estimated mean costs that did not account for censoring were consistently undervalued, highlighting the importance of estimates based on censoring-adjusted costs in cervical cancer. Our results are reliable for estimating the economic burden of cervical cancer and the cost-effectiveness of cervical cancer prevention strategies. PMID:27122978

Neurological Diseases, Disorders and Injuries in Canada: Highlights of a National Study.

PubMed

Bray, Garth M; Huggett, Deanna L

2016-01-01

The National Population Health Study of Neurological Conditions, a partnership between Neurological Health Charities Canada and the Government of Canada, was the largest study of neurological diseases, disorders, and injuries ever conducted in Canada. Undertaken between 2009 and 2013, the expansive program of research addressed the epidemiology, impacts, health services, and risk factors of 18 neurological conditions and estimated the health outcomes and costs of these conditions in Canada through 2031. This review summarizes highlights from the component projects of the study as presented in the synthesis report, Mapping Connections: An Understanding of Neurological Conditions in Canada. The key findings included new prevalence and incidence estimates, documentation of the diverse and often debilitating effects of neurological conditions, and identification of the utilization, economic costs, and current limitations of related health services. The study findings will support health charities, governments, and other stakeholders to reduce the impact of neurological conditions in Canada.

A novel method for producing low cost dynamometric wheels based on harmonic elimination techniques

NASA Astrophysics Data System (ADS)

Gutiérrez-López, María D.; García de Jalón, Javier; Cubillo, Adrián

2015-02-01

A method for producing low cost dynamometric wheels is presented in this paper. For carrying out this method, the metallic part of a commercial wheel is instrumented with strain gauges, which must be grouped in at least three circumferences and in equidistant radial lines. The strain signals of the same circumference are linearly combined to obtain at least two new signals that only depend on the tyre/road contact forces and moments. The influence of factors like the angle rotated by the wheel, the temperature or the centrifugal forces is eliminated in them by removing the continuous component and the largest possible number of harmonics, except the first or the second one, of the strain signals. The contact forces and moments are obtained from these new signals by solving two systems of linear equations with three unknowns each. This method is validated with some theoretical and experimental examples.

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

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

PubMed

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

2018-03-20

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

Affordability of programmes to prevent spontaneous preterm birth in Austria: a budget impact analysis.

PubMed

Zechmeister-Koss, Ingrid; Piso, Brigitte

2014-02-01

Preterm birth is a rising health problem in Europe generally, and in Austria specifically. Decision makers require objective information on the effects and costs of measures to prevent preterm birth. We undertook a budget impact analysis from a public payer perspective and for a 1-year and 5-year time horizon for five prevention approaches to reduce preterm birth. These were cervix screening + progesterone application, progesterone injection, smoking cessation, fish oil supplementation and infection screening. We analysed affordability in terms of programme costs and potential cost savings. Programme costs range from below €50 000 (cervix screening in high-risk pregnancy) to €500 000 (universal infection screening). The lowest health effects have been shown for smoking cessation programmes (-10 preterm births per year), whereas infection screening demonstrated the largest effect (-230 preterm births per year). In the base-case analysis, all programmes are potentially cost saving (-€500 000 to -€13 million per year). In the sensitivity analyses, preterm birth costs, target group size and (partly) unit costs of programme components have an influence on potential cost savings. However, except for two programmes, the results are robust concerning an overall economic net benefit of the programmes analysed compared with no programme. The study is mainly limited by the quality of some cost data and choice of the reference scenario. When considering potential cost savings, the five prevention programmes analysed seem affordable, with cervix screening and infection screening likely being the most promising in Austria.

Average annual cost of Parkinson’s disease in São Paulo, Brazil, with a focus on disease-related motor symptoms

PubMed Central

Bovolenta, Tânia M; de Azevedo Silva, Sônia Maria Cesar; Saba, Roberta Arb; Borges, Vanderci; Ferraz, Henrique Ballalai; Felicio, Andre C

2017-01-01

Background Although Parkinson’s disease is the second most prevalent neurodegenerative disease worldwide, its cost in Brazil – South America’s largest country – is unknown. Objective The goal of this study was to calculate the average annual cost of Parkinson’s disease in the city of São Paulo (Brazil), with a focus on disease-related motor symptoms. Subjects and methods This was a retrospective, cross-sectional analysis using a bottom-up approach (ie, from the society’s perspective). Patients (N=260) at two tertiary public health centers, who were residents of the São Paulo metropolitan area, completed standardized questionnaires regarding their disease-related expenses. We used simple and multiple generalized linear models to assess the correlations between total cost and patient-related, as well as disease-related variables. Results The total average annual cost of Parkinson’s disease was estimated at US$5,853.50 per person, including US$3,172.00 in direct costs (medical and nonmedical) and US$2,681.50 in indirect costs. Costs were directly correlated with disease severity (including the degree of motor symptoms), patients’ age, and time since disease onset. Conclusion In this study, we determined the cost of Parkinson’s disease in Brazil and observed that disease-related motor symptoms are a significant component of the costs incurred on the public health system, patients, and society in general. PMID:29276379

Activity-based costing evaluation of a [(18)F]-fludeoxyglucose positron emission tomography study.

PubMed

Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Borght, Thierry Vander

2009-10-01

The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes. The cost data were obtained from the hospital administration, personnel and vendor interviews as well as from structured questionnaires. A process map separates the process in 16 patient- and non-patient-related activities, to which the detailed cost data are related. One-way sensitivity analyses shows to which degree of uncertainty the different parameters affect the individual cost and evaluate the impact of possible resource or practice changes like the acquisition of a hybrid PET/CT device, the patient throughput or the sales price of a 370MBq (18)F-FDG patient dose. The PET centre spends 73% of time in clinical activities and the resting time after injection of the tracer (42%) is the single largest departmental cost element. The tracer cost and the operational time have the most influence on cost per procedure. The analysis shows a total cost per FDG-PET ranging from 859 Euro for a BGO PET camera to 1142 Euro for a 16 slices PET-CT system, with a distribution of the resource costs in decreasing order: materials (44%), equipment (24%), wage (16%), space (6%) and hospital overhead (10%). The cost of FDG-PET is mainly influenced by the cost of the radiopharmaceutical. Therefore, the latter rather than the operational time should be reduced in order to improve its cost-effectiveness.

Cost of individual peer counselling for the promotion of exclusive breastfeeding in Uganda

PubMed Central

2011-01-01

Background Exclusive breastfeeding (EBF) for 6 months is the recommended form of infant feeding. Support of mothers through individual peer counselling has been proved to be effective in increasing exclusive breastfeeding prevalence. We present a costing study of an individual peer support intervention in Uganda, whose objective was to raise exclusive breastfeeding rates at 3 months of age. Methods We costed the peer support intervention, which was offered to 406 breastfeeding mothers in Uganda. The average number of counselling visits was about 6 per woman. Annual financial and economic costs were collected in 2005-2008. Estimates were made of total project costs, average costs per mother counselled and average costs per peer counselling visit. Alternative intervention packages were explored in the sensitivity analysis. We also estimated the resources required to fund the scale up to district level, of a breastfeeding intervention programme within a public health sector model. Results Annual project costs were estimated to be US$56,308. The largest cost component was peer supporter supervision, which accounted for over 50% of total project costs. The cost per mother counselled was US$139 and the cost per visit was US$26. The cost per week of EBF was estimated to be US$15 at 12 weeks post partum. We estimated that implementing an alternative package modelled on routine public health sector programmes can potentially reduce costs by over 60%. Based on the calculated average costs and annual births, scaling up modelled costs to district level would cost the public sector an additional US$1,813,000. Conclusion Exclusive breastfeeding promotion in sub-Saharan Africa is feasible and can be implemented at a sustainable cost. The results of this study can be incorporated in cost effectiveness analyses of exclusive breastfeeding promotion programmes in sub-Saharan Africa. PMID:21714877

Random matrix theory and cross-correlations in global financial indices and local stock market indices

NASA Astrophysics Data System (ADS)

Nobi, Ashadun; Maeng, Seong Eun; Ha, Gyeong Gyun; Lee, Jae Woo

2013-02-01

We analyzed cross-correlations between price fluctuations of global financial indices (20 daily stock indices over the world) and local indices (daily indices of 200 companies in the Korean stock market) by using random matrix theory (RMT). We compared eigenvalues and components of the largest and the second largest eigenvectors of the cross-correlation matrix before, during, and after the global financial the crisis in the year 2008. We find that the majority of its eigenvalues fall within the RMT bounds [ λ -, λ +], where λ - and λ + are the lower and the upper bounds of the eigenvalues of random correlation matrices. The components of the eigenvectors for the largest positive eigenvalues indicate the identical financial market mode dominating the global and local indices. On the other hand, the components of the eigenvector corresponding to the second largest eigenvalue are positive and negative values alternatively. The components before the crisis change sign during the crisis, and those during the crisis change sign after the crisis. The largest inverse participation ratio (IPR) corresponding to the smallest eigenvector is higher after the crisis than during any other periods in the global and local indices. During the global financial the crisis, the correlations among the global indices and among the local stock indices are perturbed significantly. However, the correlations between indices quickly recover the trends before the crisis.

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2014-08-01

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

Health services costs and their determinants in women with fibromyalgia.

PubMed

Penrod, John R; Bernatsky, Sasha; Adam, Viviane; Baron, Murray; Dayan, Natalie; Dobkin, Patricia L

2004-07-01

Patients with fibromyalgia (FM) use health services extensively. Knowledge about costs of FM is limited because of non-inclusiveness in assessing direct costs, because attempts to assess indirect costs are largely absent, and because determinants of costs have yet to be identified. We investigated the 6-month costs (direct and indirect) in women with primary FM, and we identified determinants of direct costs. Subjects (n = 180 women) completed a health resource questionnaire as well as measures of pain, psychological distress, comorbidity, and disability. Unit costs for resources were obtained from government, hospital, laboratory, and professional association sources. Regression modeling for 6-month direct cost included age, disability, comorbidity, pain intensity, psychological distress, education, and work status. The average 6-month direct cost was $CDN 2298 (SD 2303). The largest components were medications ($CDN 758; SD 654), complementary and alternative medicine (CAM; $CDN 398; SD 776), and diagnostic tests ($CDN 356; SD 580). Our most conservative estimate of average 6-month indirect cost was $CDN 5035 (SD 7439). Comorbidity and FM disability were statistically significant contributors to direct costs in the multivariate analysis. Costs increased by approximately 20% with each additional comorbid condition. Women with FM are high consumers of both conventional and CAM services. Our estimates of costs exceed those from most other studies; this may be due to our inclusion of a broader set of health services, medications, and indirect costs. Although in univariate analyses the number of comorbidities and indices of the effect of FM, psychological distress, and pain intensity were associated with higher direct cost, in a multiple regression analysis, only the measure of FM disability and the number of comorbidities were significant direct-cost determinants. FM also imposes important indirect costs, which were nearly 70% of the economic burden.

Preventing Obesity in the USA: Impact on Health Service Utilization and Costs.

PubMed

Cecchini, Michele; Sassi, Franco

2015-07-01

With more than two-thirds of the US population overweight or obese, the obesity epidemic is a major threat for population health and the financial sustainability of the healthcare service. Whether, and to what extent, effective prevention interventions may offer the opportunity to 'bend the curve' of rising healthcare costs is still an object of debate. This study evaluates the potential economic impact of a set of prevention programmes, including education, counselling, long-term drug treatment, regulation (e.g. of advertising or labelling) and fiscal measures, on national healthcare expenditure and use of healthcare services in the USA. The study was carried out as a retrospective evaluation of alternative scenarios compared with a 'business as usual' scenario. An advanced econometric approach involving the use of logistic regression and generalized linear models was used to calculate the number of contacts with key healthcare services (inpatient, outpatient, drug prescriptions) and the associated cost. Analyses were carried out on the Medical Expenditure Panel Survey (1997-2010). In 2010, prevention interventions had the potential to decrease total healthcare expenditure by up to $US2 billion. This estimate does not include the implementation costs. The largest share of savings is produced by reduced use and costs of inpatient care, followed by reduced use of drugs. Reduction in expenditure for outpatient care would be more limited. Private insurance schemes benefit from the largest savings in absolute terms; however, public insurance schemes benefit from the largest cost reduction per patient. People in the lowest income groups show the largest economic benefits. Prevention interventions aimed at tackling obesity and associated risk factors may produce a significant decrease in the use of healthcare services and expenditure. Savings become substantial when a long-term perspective is taken.

Cost-effective conservation planning: lessons from economics.

PubMed

Duke, Joshua M; Dundas, Steven J; Messer, Kent D

2013-08-15

Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Cost of Psoriasis and Psoriatic Arthritis in 5 European Countries: A Systematic Review.

PubMed

Burgos-Pol, R; Martínez-Sesmero, J M; Ventura-Cerdá, J M; Elías, I; Caloto, M T; Casado, M Á

2016-09-01

While the introduction of biologics has improved the quality of life of patients with psoriasis and psoriatic arthritis, it may have increased the economic burden of these diseases. To perform a systematic review of studies on the costs associated with managing and treating psoriasis and psoriatic arthritis in 5 European countries: Germany, Spain, France, Italy, and the United Kingdom. We undertook a systematic review of the literature (up to May 2015) using the MEDLINE and EMBASE databases. The methodological quality of the studies identified was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. We considered both direct costs (medical and nonmedical) and indirect costs, adjusted for country-specific inflation and converted to international dollars using purchasing power parity exchange rates for 2015 ($US PPP). The search retrieved 775 studies; 68.3% analyzed psoriasis and 31.7% analyzed psoriatic arthritis. The total annual cost per patient ranged from US $2,077 to US $13,132 PPP for psoriasis and from US $10,924 to US $17,050 PPP for psoriatic arthritis. Direct costs were the largest component of total expenditure in both diseases. The severity of these diseases was associated with higher costs. The introduction of biologics led to a 3-fold to 5-fold increase in direct costs, and consequently to an increase in total costs. We have analyzed the economic burden of psoriasis and psoriatic arthritis and shown that costs increase with the treatment and management of more severe disease and the use of biologics. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

The costs of traumatic brain injury due to motorcycle accidents in Hanoi, Vietnam

PubMed Central

Hoang, Hanh TM; Pham, Tran L; Vo, Thuy TN; Nguyen, Phuong K; Doran, Christopher M; Hill, Peter S

2008-01-01

Background Road traffic accidents are the leading cause of fatal and non-fatal injuries in Vietnam. The purpose of this study is to estimate the costs, in the first year post-injury, of non-fatal traumatic brain injury (TBI) in motorcycle users not wearing helmets in Hanoi, Vietnam. The costs are calculated from the perspective of the injured patients and their families, and include quantification of direct, indirect and intangible costs, using years lost due to disability as a proxy. Methods The study was a retrospective cross-sectional study. Data on treatment and rehabilitation costs, employment and support were obtained from patients and their families using a structured questionnaire and The European Quality of Life instrument (EQ6D). Results Thirty-five patients and their families were interviewed. On average, patients with severe, moderate and minor TBI incurred direct costs at USD 2,365, USD 1,390 and USD 849, with time lost for normal activities averaging 54 weeks, 26 weeks and 17 weeks and years lived with disability (YLD) of 0.46, 0.25 and 0.15 year, respectively. Conclusion All three component costs of TBI were high; the direct cost accounted for the largest proportion, with costs rising with the severity of TBI. The results suggest that the burden of TBI can be catastrophic for families because of high direct costs, significant time off work for patients and caregivers, and impact on health-related quality of life. Further research is warranted to explore the actual social and economic benefits of mandatory helmet use. PMID:18718026

The cost of obesity for nonbariatric inpatient operative procedures in the United States: national cost estimates obese versus nonobese patients.

PubMed

Mason, Rodney J; Moroney, Jolene R; Berne, Thomas V

2013-10-01

To evaluate the economic impact of obesity on hospital costs associated with the commonest nonbariatric, nonobstetrical surgical procedures. Health care costs and obesity are both rising. Nonsurgical costs associated with obesity are well documented but surgical costs are not. National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2009, for the highest volume nonbariatric nonobstetric procedures. Obesity was identified from the HCUP-NIS severity data file comorbidity index. Costs for obese patients were compared with those for nonobese patients. To control for medical complexity, each obese patient was matched one-to-one with a nonobese patient using age, sex, race, and 28 comorbid defined elements. Of 2,309,699 procedures, 439,8129 (19%) were successfully matched into 2 medically equal groups (obese vs nonobese). Adjusted total hospital costs incurred by obese patients were 3.7% higher with a significantly (P < 0.0001) higher per capita cost of $648 (95% confidence interval [CI]: $556-$736) compared with nonobese patients. Of the 2 major components of hospital costs, length of stay was significantly increased in obese patients (mean difference = 0.0253 days, 95% CI: 0.0225-0.0282) and resource utilization determined by costs per day were greater in obese patients due to an increased number of diagnostic and therapeutic procedures needed postoperatively (odds ratio [OR] = 0.94, 95% CI: 0.93-0.96). Postoperative complications were equivalent in both groups (OR = 0.97, 95% CI: 0.93-1.02). Annual national hospital expenditures for the largest volume surgical procedures is an estimated $160 million higher in obese than in a comparative group of nonobese patients.

Cost analysis of the development and implementation of a spatial decision support system for malaria elimination in Solomon Islands.

PubMed

Marston, Luke; Kelly, Gerard C; Hale, Erick; Clements, Archie C A; Hodge, Andrew; Jimenez-Soto, Eliana

2014-08-18

The goal of malaria elimination faces numerous challenges. New tools are required to support the scale up of interventions and improve national malaria programme capacity to conduct detailed surveillance. This study investigates the cost factors influencing the development and implementation of a spatial decision support system (SDSS) for malaria elimination in the two elimination provinces of Isabel and Temotu, Solomon Islands. Financial and economic costs to develop and implement a SDSS were estimated using the Solomon Islands programme's financial records. Using an ingredients approach, verified by stakeholders and operational reports, total costs for each province were quantified. A budget impact sensitivity analysis was conducted to investigate the influence of variations in standard budgetary components on the costs and to identify potential cost savings. A total investment of US$ 96,046 (2012 constant dollars) was required to develop and implement the SDSS in two provinces (Temotu Province US$ 49,806 and Isabel Province US$ 46,240). The single largest expense category was for computerized equipment totalling approximately US$ 30,085. Geographical reconnaissance was the most expensive phase of development and implementation, accounting for approximately 62% of total costs. Sensitivity analysis identified different cost factors between the provinces. Reduced equipment costs would deliver a budget saving of approximately 10% in Isabel Province. Combined travel costs represented the greatest influence on the total budget in the more remote Temotu Province. This study provides the first cost analysis of an operational surveillance tool used specifically for malaria elimination in the South-West Pacific. It is demonstrated that the costs of such a decision support system are driven by specialized equipment and travel expenses. Such factors should be closely scrutinized in future programme budgets to ensure maximum efficiencies are gained and available resources are allocated effectively.

An optimal staggered harvesting strategy for herbaceous biomass energy crops

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

Bhat, M.G.; English, B.C.

1993-12-31

Biofuel research over the past two decades indicates lignocellulosic crops are a reliable source of feedstock for alternative energy. However, under the current technology of producing, harvesting and converting biomass crops, the cost of biofuel is not competitive with conventional biofuel. Cost of harvesting biomass feedstock is a single largest component of feedstock cost so there is a cost advantage in designing a biomass harvesting system. Traditional farmer-initiated harvesting operation causes over investment. This study develops a least-cost, time-distributed (staggered) harvesting system for example switch grass, that calls for an effective coordination between farmers, processing plant and a single third-partymore » custom harvester. A linear programming model explicitly accounts for the trade-off between yield loss and benefit of reduced machinery overhead cost, associated with the staggered harvesting system. Total cost of producing and harvesting switch grass will decline by 17.94 percent from conventional non-staggered to proposed staggered harvesting strategy. Harvesting machinery cost alone experiences a significant reduction of 39.68 percent from moving from former to latter. The net return to farmers is estimated to increase by 160.40 percent. Per tonne and per hectare costs of feedstock production will decline by 17.94 percent and 24.78 percent, respectively. These results clearly lend support to the view that the traditional system of single period harvesting calls for over investment on agricultural machinery which escalates the feedstock cost. This social loss to the society in the form of escalated harvesting cost can be avoided if there is a proper coordination among farmers, processing plant and custom harvesters as to when and how biomass crop needs to be planted and harvested. Such an institutional arrangement benefits producers, processing plant and, in turn, end users of biofuels.« less

Mask strategy at International SEMATECH

NASA Astrophysics Data System (ADS)

Kimmel, Kurt R.

2002-08-01

International SEMATECH (ISMT) is a consortium consisting of 13 leading semiconductor manufacturers from around the globe. Its objective is to develop the infrastructure necessary for its member companies to realize the International Technology Roadmap for Semiconductors (ITRS) through efficiencies of shared development resources and knowledge. The largest area of effort is lithography, recognized as a crucial enabler for microelectronics technology progress. Within the Lithography Division, most of the efforts center on mask-related issues. The development strategy at International SEMATCH will be presented and the interlock of lithography projects clarified. Because of the limited size of the mask production equipment market, the business case is weak for aggressive investment commensurate with the pace of the International Technology Roadmap for Semiconductors. With masks becoming the overwhelming component of lithography cost, new ways of reducing or eliminating mask costs are being explored. Will mask technology survive without a strong business case? Will the mask industry limit the growth of the semiconductor industry? Are advanced masks worth their escalating cost? An analysis of mask cost from the perspective of mask value imparted to the user is presented with examples and generic formulas for the reader to apply independently. A key part to the success for both International SEMATECH and the industry globally will be partnerships on both the local level between mask-maker and mask-user, and the macro level where global collaborations will be necessary to resolve technology development cost challenges.

National Maglev initiative: California line electric utility power system requirements

NASA Technical Reports Server (NTRS)

Save, Phil

1994-01-01

The electrical utility power system requirements were determined for a Maglev line from San Diego to San Francisco and Sacramento with a maximum capacity of 12,000 passengers an hour in each direction at a speed of 300 miles per hour, or one train every 30 seconds in each direction. Basically the Maglev line requires one 50-MVA substation every 12.5 miles. The need for new power lines to serve these substations and their voltage levels are based not only on equipment loading criteria but also on limitations due to voltage flicker and harmonics created by the Maglev system. The resulting power system requirements and their costs depend mostly on the geographical area, urban or suburban with 'strong' power systems, or mountains and rural areas with 'weak' power systems. A reliability evaluation indicated that emergency power sources, such as a 10-MW battery at each substation, were not justified if sufficient redundancy is provided in the design of the substations and the power lines serving them. With a cost of $5.6 M per mile, the power system requirements, including the 12-kV DC cables and the inverters along the Maglev line, were found to be the second largest cost component of the Maglev system, after the cost of the guideway system ($9.1 M per mile), out of a total cost of $23 M per mile.

Energy monitoring in gins

USDA-ARS?s Scientific Manuscript database

Energy costs are the second largest source of variable costs for cotton gins, accounting for 27% of variable costs. Energy use has typically not been a major consideration in gin design, and previous studies of energy use have utilized instantaneous readings or aggregated season-long values. In this...

Energy Monitoring in Gins - 2011

USDA-ARS?s Scientific Manuscript database

Energy costs are the second largest source of variable costs for gins, accounting for 27% of variable costs. Energy use has typically not been a major consideration in gin design and previous studies of energy use have utilized instantaneous readings or aggregated season-long values. Electricity u...

Electricity use patterns in cotton gins

USDA-ARS?s Scientific Manuscript database

Energy costs are the second largest source of variable costs for cotton gins, with electricity accounting for 18% of variable costs. Energy use has typically not been a major consideration in gin design and previous studies of energy use have utilized instantaneous readings or aggregated season-lon...

Building Earth's Largest Library: Driving into the Future.

ERIC Educational Resources Information Center

Coffman, Steve

1999-01-01

Examines the Amazon.com online bookstore as a blueprint for designing the world's largest library. Topics include selection; accessibility and convenience; quality of Web sites and search tools; personalized service; library collection development, including interlibrary loan; library catalogs and catalog records; a circulation system; costs;…

Model reduction by weighted Component Cost Analysis

NASA Technical Reports Server (NTRS)

Kim, Jae H.; Skelton, Robert E.

1990-01-01

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

An urban metabolism and ecological footprint assessment of Metro Vancouver.

PubMed

Moore, Jennie; Kissinger, Meidad; Rees, William E

2013-07-30

As the world urbanizes, the role of cities in determining sustainability outcomes grows in importance. Cities are the dominant form of human habitat, and most of the world's resources are either directly or indirectly consumed in cities. Sustainable city analysis and management requires understanding the demands a city places on a wider geographical area and its ecological resource base. We present a detailed, integrated urban metabolism of residential consumption and ecological footprint analysis of the Vancouver metropolitan region for the year 2006. Our overall goal is to demonstrate the application of a bottom-up ecological footprint analysis using an urban metabolism framework at a metropolitan, regional scale. Our specific objectives are: a) to quantify energy and material consumption using locally generated data and b) to relate these data to global ecological carrying capacity. Although water is the largest material flow through Metro Vancouver (424,860,000 m(3)), it has the smallest ecological footprint (23,100 gha). Food (2,636,850 tonnes) contributes the largest component to the ecological footprint (4,514,400 gha) which includes crop and grazing land as well as carbon sinks required to sequester emissions from food production and distribution. Transportation fuels (3,339,000 m(3)) associated with motor vehicle operation and passenger air travel comprises the second largest material flow through the region and the largest source of carbon dioxide emissions (7,577,000 tonnes). Transportation also accounts for the second largest component of the EF (2,323,200 gha). Buildings account for the largest electricity flow (17,515,150 MWh) and constitute the third largest component of the EF (1,779,240 gha). Consumables (2,400,000 tonnes) comprise the fourth largest component of the EF (1,414,440 gha). Metro Vancouver's total Ecological Footprint in 2006 was 10,071,670 gha, an area approximately 36 times larger than the region itself. The EFA reveals that cropland and carbon sinks (forested land required to sequester carbon dioxide emissions) account for 90% of Metro Vancouver's overall demand for biocapacity. The per capita ecological footprint is 4.76 gha, nearly three times the per capita global supply of biocapacity. Note that this value excludes national government services that operate outside the region and could account for up to an additional 2 gha/ca. Copyright © 2013 Elsevier Ltd. All rights reserved.

Development of an Enhanced Payback Function for the Superior Energy Performance Program

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

Therkelsen, Peter; Rao, Prakash; McKane, Aimee

2015-08-03

The U.S. DOE Superior Energy Performance (SEP) program provides recognition to industrial and commercial facilities that achieve certification to the ISO 50001 energy management system standard and third party verification of energy performance improvements. Over 50 industrial facilities are participating and 28 facilities have been certified in the SEP program. These facilities find value in the robust, data driven energy performance improvement result that the SEP program delivers. Previous analysis of SEP certified facility data demonstrated the cost effectiveness of SEP and identified internal staff time to be the largest cost component related to SEP implementation and certification. This papermore » analyzes previously reported and newly collected data of costs and benefits associated with the implementation of an ISO 50001 and SEP certification. By disaggregating “sunk energy management system (EnMS) labor costs”, this analysis results in a more accurate and detailed understanding of the costs and benefits of SEP participation. SEP is shown to significantly improve and sustain energy performance and energy cost savings, resulting in a highly attractive return on investment. To illustrate these results, a payback function has been developed and is presented. On average facilities with annual energy spend greater than $2M can expect to implement SEP with a payback of less than 1.5 years. Finally, this paper also observes and details decreasing facility costs associated with implementing ISO 50001 and certifying to the SEP program, as the program has improved from pilot, to demonstration, to full launch.« less

Current costs & projected financial needs of India's Universal Immunization Programme.

PubMed

Chatterjee, Susmita; Pant, Manish; Haldar, Pradeep; Aggarwal, Mahesh Kumar; Laxminarayan, Ramanan

2016-06-01

India's Universal Immunization Programme (UIP) is one of the largest programmes in the world in terms of quantities of vaccines administered, number of beneficiaries, number of immunization sessions, and geographical extent and diversity of areas covered. Strategic planning for the Programme requires credible information on the cost of achieving the objectives and the financial resources needed at national, State, and district levels. We present here expenditures on immunization services in India in 2012 (baseline) and projected costs for five years (2013-2017). Data were collected from the Immunization Division of the Ministry of Health and Family Welfare, Government of India, and immunization partners, such as the World Health Organization and UNICEF. The cost components were immunization personnel, vaccines and injection supplies, transportation, trainings, social mobilization, advocacy and communication activities, disease surveillance, Programme management, maintenance of cold chain and other equipment, and capital costs. Total baseline expenditure was ₹ 3,446 crore [1 crore = 10 million] (US$718 million), including shared personnel costs. In 2012, the government paid for 90 per cent of the Programme. Total resource requirements for 2013-2017 are ₹ 34,336 crore (US$ 5, 282 million). Allocations for vaccines increase from ₹ 511 crore in 2013 to ₹ 3,587 crore in 2017 as new vaccines are assumed to be introduced in the Programme. The projections show that the government immunization budget will be double in 2017 as compared to 2013. It will increase from ₹ 4,570 crore in 2013 to ₹ 9,451 crore in 2017.

Production of Energy Efficient Preform Structures (PEEPS)

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

Dr. John A. Baumann

2012-06-08

Due to its low density, good structural characteristics, excellent fabrication properties, and attractive appearance, aluminum metal and its alloys continue to be widely utilized. The transportation industry continues to be the largest consumer of aluminum products, with aerospace as the principal driver for this use. Boeing has long been the largest single company consumer of heat-treated aluminum in the U.S. The extensive use of aluminum to build aircraft and launch vehicles has been sustained, despite the growing reliance on more structurally efficient carbon fiber reinforced composite materials. The trend in the aerospace industry over the past several decades has beenmore » to rely extensively on large, complex, thin-walled, monolithic machined structural components, which are fabricated from heavy billets and thick plate using high speed machining. The use of these high buy-to-fly ratio starting product forms, while currently cost effective, is energy inefficient, with a high environmental impact. The widespread implementation of Solid State Joining (SSJ) technologies, to produce lower buy-to-fly ratio starting forms, tailored to each specific application, offers the potential for a more sustainable manufacturing strategy, which would consume less energy, require less material, and reduce material and manufacturing costs. One objective of this project was to project the energy benefits of using SSJ techniques to produce high-performance aluminum structures if implemented in the production of the world fleet of commercial aircraft. A further objective was to produce an energy consumption prediction model, capable of calculating the total energy consumption, solid waste burden, acidification potential, and CO2 burden in producing a starting product form - whether by conventional or SSJ processes - and machining that to a final part configuration. The model needed to be capable of computing and comparing, on an individual part/geometry basis, multiple possible manufacturing pathways, to identify the best balance of energy consumption and environmental impact. This model has been created and populated with energy consumption data for individual SSJ processes and process platforms. Technology feasibility cases studies were executed, to validate the model, and confirm the ability to create lower buy-to-fly ratio performs and machine these to final configuration aircraft components. This model can now be used as a tool to select manufacturing pathways that offer significant energy savings and, when coupled with a cost model, drive implementation of the SSJ processes.« less

Battery Ownership | Transportation Research | NREL

Science.gov Websites

Ownership Battery Ownership The high cost of lithium-ion (Li-ion) batteries may be the largest (including fast charging), and vehicle-to-grid revenue generation strategies. Calculating the true cost of Model (BOM) takes the guesswork out of determining EV cost and comparing it to that of conventional

40 CFR 258.71 - Financial assurance for closure.

Code of Federal Regulations, 2011 CFR

2011-07-01

....71 Section 258.71 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES... closure. (a) The owner or operator must have a detailed written estimate, in current dollars, of the cost.... (1) The cost estimate must equal the cost of closing the largest area of all MSWLF unit ever...

40 CFR 258.71 - Financial assurance for closure.

Code of Federal Regulations, 2010 CFR

2010-07-01

....71 Section 258.71 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES... closure. (a) The owner or operator must have a detailed written estimate, in current dollars, of the cost.... (1) The cost estimate must equal the cost of closing the largest area of all MSWLF unit ever...

Understanding the reductions in US corn ethanol production costs: an experience curve approach

USDA-ARS?s Scientific Manuscript database

The US is currently the world's largest ethanol producer. An increasing percentage is used as transportation fuel, but debates continue on its cost competitiveness and energy balance. In this study, technological development of ethanol production and resulting cost reductions are investigated by usi...

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

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.

The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa.

PubMed

Lince-Deroche, Naomi; Fetters, Tamara; Sinanovic, Edina; Devjee, Jaymala; Moodley, Jack; Blanchard, Kelly

2017-01-01

Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32-75.51). The total average cost per MVA was higher at $69.60 (52.62-86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs.

User fee exemptions are not enough: out-of-pocket payments for 'free' delivery services in rural Tanzania.

PubMed

Kruk, Margaret E; Mbaruku, Godfrey; Rockers, Peter C; Galea, Sandro

2008-12-01

To identify the main drivers of costs of facility delivery and the financial consequences for households among rural women in Tanzania, a country with a policy of delivery fee exemptions. We selected a representative sample of households in a rural district in western Tanzania. Women who given birth within 5 years were asked about payments for doctor's/nurse's fees, drugs, non-medical supplies, medical tests, maternity waiting home, transport and other expenses. Wealth was assessed using a household asset index. We estimated the proportion of women who cut down on spending or borrowed money/sold household items to pay for delivery in each wealth group. In all, 73.3% of women with facility delivery reported having made out-of-pocket payments for delivery-related costs. The average cost was 6272 Tanzanian shillings (TZS), [95% Confidence Interval (CI): 4916, 7628] or 5.0 United States dollars. Transport costs (53.6%) and provider fees (26.6%) were the largest cost components in government facilities. Deliveries in mission facilities were twice as expensive as those in government facilities. Nearly half (48.3%) of women reported cutting down on spending or borrowing money/selling household assets to pay for delivery, with the poor reporting this most frequently. Out-of-pocket payments for facility delivery were substantial and were driven by high transport costs, unofficial provider payments, and preference for mission facilities, which levy user charges. Novel approaches to financing maternal health services, such as subsidies for transport and care from private providers, are required to reduce the cost barriers to attended delivery.

Cost of illness for cholera in a high risk urban area in Bangladesh: an analysis from household perspective

PubMed Central

2013-01-01

Background Cholera poses a substantial health burden to developing countries such as Bangladesh. In this study, the objective is to estimate the economic burden of cholera treatments incurred by households. The study was carried out in the context of a large vaccine trial in an urban area of Bangladesh. Methods The study used a combination of prospective and retrospective incidence-based cost analyses of cholera illness per episode per household. A total of 394 confirmed cholera hospitalized cases were identified and treated in the study area during June–October 2011. Households with cholera patients were interviewed within 15 days after discharge from hospitals or clinics. To estimate the total cost of cholera illness a structured questionnaire was used, which included questions on direct medical costs, non-medical costs, and the indirect costs of patients and caregivers. Results The average total household cost of treatment for an episode of cholera was US$30.40. Total direct and indirect costs constituted 24.6% (US$7.40) and 75.4% (US$23.00) of the average total cost, respectively. The cost for children under 5 years of age (US$21.50) was higher than that of children aged 5–14 years (US$17.50). The direct cost of treatment was similar for male and female patients, but the indirect cost was higher for males. Conclusion Our study suggests that by preventing one cholera episode (3 days on an average), we can avert a total cost of 2,278.50 BDT (US$30.40) per household. Among medical components, medicines are the largest cost driver. No clear socioeconomic gradient emerged from our study, but limited demographic patterns were observed in the cost of illness. By preventing cholera cases, large production losses can be reduced. PMID:24188717

Encouraging Low-Income Households to Make Location-Efficient Housing Choices

DOT National Transportation Integrated Search

2016-01-01

Transportation costs are typically a households second-largest expense after housing and, on average, account for about one-fifth of household spending. Low-income households are especially burdened by transportation costs, with low-income househo...

Cooled Ceramic Matrix Composite Propulsion Structures Demonstrated

NASA Technical Reports Server (NTRS)

Jaskowiak, Martha H.; Dickens, Kevin W.

2005-01-01

NASA's Next Generation Launch Technology (NGLT) Program has successfully demonstrated cooled ceramic matrix composite (CMC) technology in a scramjet engine test. This demonstration represented the world s largest cooled nonmetallic matrix composite panel fabricated for a scramjet engine and the first cooled nonmetallic composite to be tested in a scramjet facility. Lightweight, high-temperature, actively cooled structures have been identified as a key technology for enabling reliable and low-cost space access. Tradeoff studies have shown this to be the case for a variety of launch platforms, including rockets and hypersonic cruise vehicles. Actively cooled carbon and CMC structures may meet high-performance goals at significantly lower weight, while improving safety by operating with a higher margin between the design temperature and material upper-use temperature. Studies have shown that using actively cooled CMCs can reduce the weight of the cooled flow-path component from 4.5 to 1.6 lb/sq ft and the weight of the propulsion system s cooled surface area by more than 50 percent. This weight savings enables advanced concepts, increased payload, and increased range. The ability of the cooled CMC flow-path components to operate over 1000 F hotter than the state-of-the-art metallic concept adds system design flexibility to space-access vehicle concepts. Other potential system-level benefits include smaller fuel pumps, lower part count, lower cost, and increased operating margin.

Haven't We Been Here Before? Some Comments on Steve Coffman's Proposal for "Earth's Largest Library".

ERIC Educational Resources Information Center

McGervey, Teresa

2000-01-01

Discusses the concept of Earth's Largest Library (ELL), a mega-virtual library based on the Amazon.com model. Topics include who will be included; privacy; censorship; scope of the collection; costs; legal aspects; collection development; personnel management; access; the concept of community; public service; lending policies; technical…

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

PubMed

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

2011-10-01

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

Some regional costs of a synthetic fuel industry: The case of illinois

USGS Publications Warehouse

Attanasi, E.D.; Green, E.K.

1981-01-01

The Federal Government's efforts to induce development of a coal-based synthetic fuel industry include direct subsidies, tax concessions, and assurances that it will purchase the industry's output, even if above the market price. In this note it is argued that these subsidies will enable this industry to secure a region's largest and lowest-cost coal deposits and that the costs imposed on other coal users will be substantial. Moreover, because the lowest-cost coal deposits will be committed to synthetic fuels production regardless of the industry's commercial viability, distortions in regional coal markets will develop. If economic efficiency requires that the price of the resource reflect its replacement value, then a State government is justified in imposing a tax on coal destined for subsidized synthetic fuel plants. Amounts of such a tax, based on the higher costs of coal that must be accepted by other users as the result of the subsidized synthetic fuel plants' preempting the largest and lowest-cost deposits, are estimated for the case of Illinois strippable coal. ?? 1981 Annals of Regional Science.

Direct and indirect costs for adverse drug events identified in medical records across care levels, and their distribution among payers.

PubMed

Natanaelsson, Jennie; Hakkarainen, Katja M; Hägg, Staffan; Andersson Sundell, Karolina; Petzold, Max; Rehnberg, Clas; Jönsson, Anna K; Gyllensten, Hanna

2017-11-01

Adverse drug events (ADEs) cause considerable costs in hospitals. However, little is known about costs caused by ADEs outside hospitals, effects on productivity, and how the costs are distributed among payers. To describe the direct and indirect costs caused by ADEs, and their distribution among payers. Furthermore, to describe the distribution of patient out-of-pocket costs and lost productivity caused by ADEs according to socio-economic characteristics. In a random sample of 5025 adults in a Swedish county, prevalence-based costs for ADEs were calculated. Two different methods were used: 1) based on resource use judged to be caused by ADEs, and 2) as costs attributable to ADEs by comparing costs among individuals with ADEs to costs among matched controls. Payers of costs caused by ADEs were identified in medical records among those with ADEs (n = 596), and costs caused to individual patients were described by socio-economic characteristics. Costs for resource use caused by ADEs were €505 per patient with ADEs (95% confidence interval €345-665), of which 38% were indirect costs. Compared to matched controls, the costs attributable to ADEs were €1631, of which €410 were indirect costs. The local health authorities paid 58% of the costs caused by ADEs. Women had higher productivity loss than men (€426 vs. €109, p = 0.018). Out-of-pocket costs displaced a larger proportion of the disposable income among low-income earners than higher income earners (0.7% vs. 0.2%-0.3%). We used two methods to identify costs for ADEs, both identifying indirect costs as an important component of the overall costs for ADEs. Although the largest payers of costs caused by ADEs were the local health authorities responsible for direct costs, employers and patients costs for lost productivity contributed substantially. Our results indicate inequalities in costs caused by ADEs, by sex and income. Copyright © 2016 Elsevier Inc. All rights reserved.

The magnitude, share and determinants of unpaid care costs for home-based palliative care service provision in Toronto, Canada.

PubMed

Chai, Huamin; Guerriere, Denise N; Zagorski, Brandon; Coyte, Peter C

2014-01-01

With increasing emphasis on the provision of home-based palliative care in Canada, economic evaluation is warranted, given its tremendous demands on family caregivers. Despite this, very little is known about the economic outcomes associated with home-based unpaid care-giving at the end of life. The aims of this study were to (i) assess the magnitude and share of unpaid care costs in total healthcare costs for home-based palliative care patients, from a societal perspective and (ii) examine the sociodemographic and clinical factors that account for variations in this share. One hundred and sixty-nine caregivers of patients with a malignant neoplasm were interviewed from time of referral to a home-based palliative care programme provided by the Temmy Latner Centre for Palliative Care at Mount Sinai Hospital, Toronto, Canada, until death. Information regarding palliative care resource utilisation and costs, time devoted to care-giving and sociodemographic and clinical characteristics was collected between July 2005 and September 2007. Over the last 12 months of life, the average monthly cost was $14 924 (2011 CDN$) per patient. Unpaid care-giving costs were the largest component - $11 334, accounting for 77% of total palliative care expenses, followed by public costs ($3211; 21%) and out-of-pocket expenditures ($379; 2%). In all cost categories, monthly costs increased exponentially with proximity to death. Seemingly unrelated regression estimation suggested that the share of unpaid care costs of total costs was driven by patients' and caregivers' sociodemographic characteristics. Results suggest that overwhelming the proportion of palliative care costs is unpaid care-giving. This share of costs requires urgent attention to identify interventions aimed at alleviating the heavy financial burden and to ultimately ensure the viability of home-based palliative care in future. © 2013 John Wiley & Sons Ltd.

The structural robustness of geographical networks against regional failure and their pre-optimization

NASA Astrophysics Data System (ADS)

Li, Yixiao; Zhang, Lin; Huang, Chaogeng; Shen, Bin

2016-06-01

Failures of real-world infrastructure networks due to natural disasters often originate in a certain region, but this feature has seldom been considered in theoretical models. In this article, we introduce a possible failure pattern of geographical networks-;regional failure;-by which nodes and edges within a region malfunction. Based on a previous spatial network model (Louf et al., 2013), we study the robustness of geographical networks against regional failure, which is measured by the fraction of nodes that remain in the largest connected component, via simulations. A small-area failure results in a large reduction of their robustness measure. Furthermore, we investigate two pre-deployed mechanisms to enhance their robustness: One is to extend the cost-benefit growth mechanism of the original network model by adding more than one link in a growth step, and the other is to strengthen the interconnection of hubs in generated networks. We measure the robustness-enhancing effects of both mechanisms on the basis of their costs, i.e., the amount of excessive links and the induced geographical length. The latter mechanism is better than the former one if a normal level of costs is considered. When costs exceed a certain level, the former has an advantage. Because the costs of excessive links affect the investment decision of real-world infrastructure networks, it is practical to enhance their robustness by adding more links between hubs. These results might help design robust geographical networks economically.

Economic Impacts of Non-Native Forest Insects in the Continental United States

PubMed Central

Aukema, Juliann E.; Leung, Brian; Kovacs, Kent; Chivers, Corey; Britton, Kerry O.; Englin, Jeffrey; Frankel, Susan J.; Haight, Robert G.; Holmes, Thomas P.; Liebhold, Andrew M.; McCullough, Deborah G.; Von Holle, Betsy

2011-01-01

Reliable estimates of the impacts and costs of biological invasions are critical to developing credible management, trade and regulatory policies. Worldwide, forests and urban trees provide important ecosystem services as well as economic and social benefits, but are threatened by non-native insects. More than 450 non-native forest insects are established in the United States but estimates of broad-scale economic impacts associated with these species are largely unavailable. We developed a novel modeling approach that maximizes the use of available data, accounts for multiple sources of uncertainty, and provides cost estimates for three major feeding guilds of non-native forest insects. For each guild, we calculated the economic damages for five cost categories and we estimated the probability of future introductions of damaging pests. We found that costs are largely borne by homeowners and municipal governments. Wood- and phloem-boring insects are anticipated to cause the largest economic impacts by annually inducing nearly $1.7 billion in local government expenditures and approximately $830 million in lost residential property values. Given observations of new species, there is a 32% chance that another highly destructive borer species will invade the U.S. in the next 10 years. Our damage estimates provide a crucial but previously missing component of cost-benefit analyses to evaluate policies and management options intended to reduce species introductions. The modeling approach we developed is highly flexible and could be similarly employed to estimate damages in other countries or natural resource sectors. PMID:21931766

Assessing the Social and Environmental Costs of Institutional ...

EPA Pesticide Factsheets

We estimate the damage costs associated with the institutional nitrogen (N) footprint and explore how this information could be used to create more sustainable institutions. Potential damages associated with the release of NOx and N2O to air and release of N to water were estimated using a cost per unit N approach. Annual potential damage costs to human health, agriculture and natural ecosystems associated with the N footprint of institutions were $10.5 million USD (2014) at the University of Virginia (UVA) and $3.04 million at the University of New Hampshire (UNH). Costs associated with the release of nitrogen oxides (NOx) to human health, in particular the use of coal-derived energy, were the largest component of damage at UVA. At UNH the energy N footprint is much lower because of a co-generation source, and thus the majority of damages were associated with food production. Annual damages associated with release of N from food production were very similar at the two universities ($1.37 vs. $1.66 million at UVA and UNH respectively). These damages also have implications for the extent and scale at which the damages are felt. For example, impacts to human health from energy and transportation are generally larger near the power plants and roads, while impacts from food production can be distant from the campus. Making this information available to institutions can improve their understanding of the damages associated with the different N forms and sourc

Assessing the Social and Environmental Costs of Institutional ...

EPA Pesticide Factsheets

Background/Question/Methods: Release of N to air, land and water has a host of effects on human health, ecosystems and the economy, many of which scientists and economists are just beginning to develop methods to quantify. In order to understand the broader connections to sustainability, more effort is needed to connect N release to the environment with the impacts on social and economic systems. We estimate the damage costs associated with the institutional nitrogen (N) footprint and explore how this information could be used to create more sustainable institutions. Potential damages associated with the release of NOx and N2O to air and release of N to water were estimated using a cost per unit N approach. Results/Conclusions: Annual potential damage costs to human health, agriculture and natural ecosystems associated with the N footprint of institutions were $10.5 million USD (2014) at the University of Virginia (UVA) and $3.0 million USD at the University of New Hampshire (UNH). Costs associated with the release of nitrogen oxides (NOx) to human health, in particular the use of coal-derived energy, were the largest component of damage at UVA. At UNH the energy N footprint is much lower because of a co-generation source, and thus the majority of damages were associated with food production. Annual damages associated with release of N from food production were very similar at the two universities ($1.37 vs. $1.66 million at UVA and UNH respectively). T

Electric and hybrid electric vehicles: A technology assessment based on a two-stage Delphi study

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

Vyas, A.D.; Ng, H.K.; Santini, D.J.

1997-12-01

To address the uncertainty regarding future costs and operating attributes of electric and hybrid electric vehicles, a two stage, worldwide Delphi study was conducted. Expert opinions on vehicle attributes, current state of the technology, possible advancements, costs, and market penetration potential were sought for the years 2000, 2010, and 2020. Opinions related to such critical components as batteries, electric drive systems, and hybrid vehicle engines, as well as their respective technical and economic viabilities, were also obtained. This report contains descriptions of the survey methodology, analytical approach, and results of the analysis of survey data, together with a summary ofmore » other factors that will influence the degree of market success of electric and hybrid electric vehicle technologies. Responses by industry participants, the largest fraction among all the participating groups, are compared with the overall responses. An evaluation of changes between the two Delphi stages is also summarized. An analysis of battery replacement costs for various types is summarized, and variable operating costs for electric and hybrid vehicles are compared with those of conventional vehicles. A market penetration analysis is summarized, in which projected market shares from the survey are compared with predictions of shares on the basis of two market share projection models that use the cost and physical attributes provided by the survey. Finally, projections of market shares beyond the year 2020 are developed by use of constrained logit models of market shares, statistically fitted to the survey data.« less

Inexpensive health care reform: the mathematics of medicine.

PubMed

Forsyth, Roger A

2010-02-01

There is data to support the hypothesis that US healthcare reform will require systemic changes in their delivery system rather than a segment-by-segment approach to improving individual components such as administrative or pharmaceutical costs or illness-by-illness programs such as comparative effectiveness or disease management. Mathematically, personnel costs provide the largest potential for savings. These costs are reflected in utilization rates. However, when governments or insurers try to control utilization, shortages or dissatisfaction ensue. Therefore, reform should be structured to encourage individually initiated reductions in utilization. This can be facilitated by changing from employer-paid comprehensive group policies of variable coverage to a three-part, standardized, individually purchased, group policy with a targeted deductible and co-pays that provide disincentives to over-utilization and incentives (refunds on unused contributions) to reduce utilization. There will be a public health policy (maternal, infant, and immunizations) that will be very inexpensive and not subject to any disincentives, a catastrophic policy with a deductible and enhanced but diminishing co-pays, and a Health Savings Account that pre-positions funds to cover the deductible and co-pays. These changes will lead to a reduction in administrative costs. The excess capacity created will provide care for the currently uninsured. Savings will be refunded to individuals thereby generating taxes that can pay for needed subsidies. Reform can be inexpensive if it puts the mathematics before the politics.

Are renewables portfolio standards cost-effective emission abatement policy?

PubMed

Dobesova, Katerina; Apt, Jay; Lave, Lester B

2005-11-15

Renewables portfolio standards (RPS) could be an important policy instrument for 3P and 4P control. We examine the costs of renewable power, accounting for the federal production tax credit, the market value of a renewable credit, and the value of producing electricity without emissions of SO2, NOx, mercury, and CO2. We focus on Texas, which has a large RPS and is the largest U.S. electricity producer and one of the largest emitters of pollutants and CO2. We estimate the private and social costs of wind generation in an RPS compared with the current cost of fossil generation, accounting for the pollution and CO2 emissions. We find that society paid about 5.7 cent/kWh more for wind power, counting the additional generation, transmission, intermittency, and other costs. The higher cost includes credits amounting to 1.1 cent/kWh in reduced SO2, NOx, and Hg emissions. These pollution reductions and lower CO2 emissions could be attained at about the same cost using pulverized coal (PC) or natural gas combined cycle (NGCC) plants with carbon capture and sequestration (CCS); the reductions could be obtained more cheaply with an integrated coal gasification combined cycle (IGCC) plant with CCS.

Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

PubMed Central

Temperley, Matilda; Mueller, Dirk H; Njagi, J Kiambo; Akhwale, Willis; Clarke, Siân E; Jukes, Matthew CH; Estambale, Benson BA; Brooker, Simon

2008-01-01

Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT) as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly). Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child) whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year). The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This study provides the first evidence that IPT administered by teachers is a cost-effective school-based malaria intervention and merits investigation in other settings. PMID:18826594

Thermal System Upgrade of the Space Environment Simulation Test Chamber

NASA Technical Reports Server (NTRS)

Desai, Ashok B.

1997-01-01

The paper deals with the refurbishing and upgrade of the thermal system for the existing thermal vacuum test facility, the Space Environment Simulator, at NASA's Goddard Space Flight Center. The chamber is the largest such facility at the center. This upgrade is the third phase of the long range upgrade of the chamber that has been underway for last few years. The first phase dealt with its vacuum system, the second phase involved the GHe subsystem. The paper describes the considerations of design philosophy options for the thermal system; approaches taken and methodology applied, in the evaluation of the remaining "life" in the chamber shrouds and related equipment by conducting special tests and studies; feasibility and extent of automation, using computer interfaces and Programmable Logic Controllers in the control system and finally, matching the old components to the new ones into an integrated, highly reliable and cost effective thermal system for the facility. This is a multi-year project just started and the paper deals mainly with the plans and approaches to implement the project successfully within schedule and costs.

An Introduction to Cost-of-Living Adjustments in Public Retirement Plans: Details Matter

ERIC Educational Resources Information Center

Jennings, Penelope R.; Jennings, William P.; Phillips, G. Michael

2016-01-01

While financial planning students are expected to be able to understand client retirement plans, subtle differences in cost-of-living adjustments can have major impact on the success of client retirement plans. This teaching note compares the cost-of-living adjustments in the largest government sponsored retirement systems and a hypothetical…

An attachment-based description of the medial collateral and spring ligament complexes.

PubMed

Cromeens, Barrett P; Kirchhoff, Claire A; Patterson, Rita M; Motley, Travis; Stewart, Donald; Fisher, Cara; Reeves, Rustin E

2015-06-01

Anatomy of the medial collateral and spring ligament complexes has been the cause of confusion. The anatomic description is highly dependent on the source studied and little agreement exists between texts. In addition, inconsistent nomenclature has been used to describe the components. This study attempted to clarify confusion through the creation of a 3D ligament map using attachment-based dissection. Nine fresh foot and ankle specimens were observed. The medial collateral ligament and spring ligament complexes were dissected using their attachment sites as a guide to define individual components. Each component's perimeter and thickness was measured and each bony attachment was mapped using a microscribe 3D digitizer. Five components were identified contributing to the ligament complexes of interest: the tibiocalcaneonavicular, superficial posterior tibiotalar, deep posterior tibiotalar, deep anterior tibiotalar, and inferoplantar longitudinal ligaments. The largest component by total attachment area was the tibiocalcaneonavicular ligament followed by the deep posterior tibiotalar ligament. The largest ligament surface area of attachment to the tibia and talus was the deep posterior tibiotalar ligament. The largest attachment to the navicular and calcaneus was the tibiocalcaneonavicular ligament, which appeared to function in holding these bones in proximity while supporting the head of the talus. By defining complex components by their attachment sites, a novel, more functional and reproducible description of the medial collateral and spring ligament complexes was created. The linear measurements and 3D maps may prove useful when attempting more anatomically accurate reconstructions. © The Author(s) 2015.

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

PubMed

Kempers, Jari; Ketting, Evert; Lesco, Galina

2014-07-21

Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH components (STI, early pregnancy and contraception, and HIV) are potentially cost saving. High cost savings resulting from averted lifetime treatment cost of HIV infected persons are likely to off-set the costs of STIs and unwanted pregnancies.

Innovative High-Performance Deposition Technology for Low-Cost Manufacturing of OLED Lighting

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

Hamer, John; Scott, David

In this project, OLEDWorks developed and demonstrated the innovative high-performance deposition technology required to deliver dramatic reductions in the cost of manufacturing OLED lighting in production equipment. The current high manufacturing cost of OLED lighting is the most urgent barrier to its market acceptance. The new deposition technology delivers solutions to the two largest parts of the manufacturing cost problem – the expense per area of good product for organic materials and for the capital cost and depreciation of the equipment. Organic materials cost is the largest expense item in the bill of materials and is predicted to remain somore » through 2020. The high-performance deposition technology developed in this project, also known as the next generation source (NGS), increases material usage efficiency from 25% found in current Gen2 deposition technology to 60%. This improvement alone results in a reduction of approximately 25 USD/m 2 of good product in organic materials costs, independent of production volumes. Additionally, this innovative deposition technology reduces the total depreciation cost from the estimated value of approximately 780 USD/m 2 of good product for state-of-the-art G2 lines (at capacity, 5-year straight line depreciation) to 170 USD/m 2 of good product from the OLEDWorks production line.« less

Cost per remission and cost per response with infliximab, adalimumab, and golimumab for the treatment of moderately-to-severely active ulcerative colitis.

PubMed

Toor, Kabirraaj; Druyts, Eric; Jansen, Jeroen P; Thorlund, Kristian

2015-06-01

To determine the short-term costs per sustained remission and sustained response of three tumor necrosis factor inhibitors (infliximab, adalimumab, and golimumab) in comparison to conventional therapy for the treatment of moderately-to-severely active ulcerative colitis. A probabilistic Markov model was developed. This included an 8-week induction period, and 22 subsequent 2-week cycles (up to 1 year). The model included three disease states: remission, response, and relapse. Costs were from a Canadian public payer perspective. Estimates for the additional cost per 1 year of sustained remission and sustained response were obtained. Golimumab 100 mg provided the lowest cost per additional remission ($935) and cost per additional response ($701) compared with conventional therapy. Golimumab 50 mg yielded slightly higher costs than golimumab 100 mg. Infliximab was associated with the largest additional number of estimated remissions and responses, but also higher cost at $1975 per remission and $1311 per response. Adalimumab was associated with the largest cost per remission ($7430) and cost per response ($2361). The cost per additional remission and cost per additional response associated with infliximab vs golimumab 100 mg was $14,659 and $4753, respectively. The results suggest that the additional cost of 1 full year of remission and response are lowest with golimumab 100 mg, followed by golimumab 50 mg. Although infliximab has the highest efficacy, it did not exhibit the lowest cost per additional remission or response. Adalimumab produced the highest cost per additional remission and response.

Self-Assembled Carbon-Polyoxometalate Composites for Electrochemical Capacitors

NASA Astrophysics Data System (ADS)

Genovese, Matthew

The development of high performance yet cost effective energy storage devices is critical for enabling the growth of important emerging sectors from the internet of things to grid integration of renewable energy. Material costs are by far the largest contributor to the overall cost of energy storage devices and thus research into cost effective energy storage materials will play an important role in developing technology to meet real world storage demands. In this thesis, low cost high performance composite electrode materials for supercapacitors (SCs) have been developed through the surface modification of electrochemically double layer capacitive (EDLC) carbon substrates with pseudocapacitive Polyoxometalates (POMs). Significant fundamental contributions have been made to the understanding of all components of the composite electrode including the POM active layer, cation linker, and carbon substrate. The interaction of different POM chemistries in solution has been studied to elucidate the novel ways in which these molecules combine and the mechanism underlying this combination. A more thorough understanding regarding the cation linker's role in electrode fabrication has been developed through examining the linker properties which most strongly affect electrode performance. The development of porosity in biomass derived carbon materials has also been examined leading to important insights regarding the effect of substrate porosity on POM modification and electrochemical properties. These fundamental contributions enabled the design and performance optimization of POM-carbon composite SC electrodes. Understanding how POMs combine in solution, allowed for the development of mixed POM molecular coatings with tunable electrochemical properties. These molecular coatings were used to modify low cost biomass derived carbon substrates that had been structurally optimized to accommodate POM molecules. The resulting electrode composites utilizing low cost materials fabricated through simple scalable techniques demonstrated (i) high capacitance (361 F g-1), (ii) close to ideal pseudocapacitive behavior, (iii) stable cycling, and (iv) good rate performance.

The 30/20 GHz mixed user architecture development study: Executive summary

NASA Technical Reports Server (NTRS)

1979-01-01

The baseline 30/30 GHz satellite communication system, designed for cost-effective communications in the years 1990 to 2000, incorporates on-board satellite demodulation and routing of individual 64 kbps digital voice-grade circuits. This level of routing flexibility is necessary to provide efficient communications to the large number of direct-to-user terminals (DTU) projected. The circuit interfacing hardware is distributed among all the DTU and master control stations. The switching circuitry which provides full interconnectivity between 30 to 45 thousand circuits is in the satellite. The DTU terminal cost, perhaps the largest element in the system cost, represents the largest economic value element of the system because it avoids using terrestrial signal distribution and routing and the charges associated with these functions. Satellite baseline design and power requirements for the system are examined.

Examining the production costs of antiretroviral drugs.

PubMed

Pinheiro, Eloan; Vasan, Ashwin; Kim, Jim Yong; Lee, Evan; Guimier, Jean Marc; Perriens, Joseph

2006-08-22

To present direct manufacturing costs and price calculations of individual antiretroviral drugs, enabling those responsible for their procurement to have a better understanding of the cost structure of their production, and to indicate the prices at which these antiretroviral drugs could be offered in developing country markets. Direct manufacturing costs and factory prices for selected first and second-line antiretroviral drugs were calculated based on cost structure data from a state-owned company in Brazil. Prices for the active pharmaceutical ingredients (API) were taken from a recent survey by the World Health Organization (WHO). The calculated prices for antiretroviral drugs are compared with quoted prices offered by privately-owned, for-profit manufacturers. The API represents the largest component of direct manufacturing costs (55-99%), while other inputs, such as salaries, equipment costs, and scale of production, have a minimal impact. The calculated prices for most of the antiretroviral drugs studied fall within the lower quartile of the range of quoted prices in developing country markets. The exceptions are those drugs, primarily for second-line therapy, for which the API is either under patent, in short supply, or in limited use in developing countries (e.g. abacavir, lopinavir/ritonavir, nelfinavir, saquinavir). The availability of data on the cost of antiretroviral drug production and calculation of factory prices under a sustainable business model provide benchmarks that bulk purchasers of antiretroviral drugs could use to negotiate lower prices. While truly significant price decreases for antiretroviral drugs will depend largely on the future evolution of API prices, the present study demonstrates that for several antiretroviral drugs price reduction is currently possible. Whether or not these reductions materialize will depend on the magnitude of indirect cost and profit added by each supplier over the direct production costs. The ability to achieve price reductions in line with production costs will have critical implications for sustainable treatment for HIV/AIDS in the developing world.

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...

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...

HEALTH ASPECTS OF BROMINATED FLAME RETARDANTS (BFRS)

EPA Science Inventory

In order to reduce the societal costs of fires, flammability standards have been set for consumer products and equipment. Flame retardants containing bromine have constituted the largest share of this market due both to their efficiency and cost. While there are at least 75 dif...

Technoeconomic analysis of wheat straw densification in the Canadian Prairie Province of Manitoba.

PubMed

Mupondwa, Edmund; Li, Xue; Tabil, Lope; Phani, Adapa; Sokhansanj, Shahab; Stumborg, Mark; Gruber, Margie; Laberge, Serge

2012-04-01

This study presents a technoeconomic analysis of wheat straw densification in Canada's prairie province of Manitoba as an integral part of biomass-to-cellulosic-ethanol infrastructure. Costs of wheat straw bale and pellet transportation and densification are analysed, including densification plant profitability. Wheat straw collection radius increases nonlinearly with pellet plant capacity, from 9.2 to 37km for a 2-35tonnesh(-1) plant. Bales are cheaper under 250km, beyond which the cheapest feedstocks are pellets from the largest pellet plant that can be built to exploit economies of scale. Feedstocks account for the largest percentage of variable costs. Marginal and average cost curves suggest Manitoba could support a pellet plant up to 35tonnesh(-1). Operating below capacity (75-50%) significantly erodes a plant's net present value (NPV). Smaller plants require higher NPV break-even prices. Very large plants have considerable risk under low pellet prices and increased processing costs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

The Evolution of Virginia Public School Finance: From the Beginnings to Today's Difficulties

ERIC Educational Resources Information Center

Salmon, Richard G.

2010-01-01

Public elementary and secondary education, a vast, uneven and complex system, is the most significant cost to local government and one of the largest costs to state government in Virginia. Meeting this cost has become even more difficult as the state and nation continue to struggle with the most severe economic downturn since the Great Depression.…

Using Machine Learning as a fast emulator of physical processes within the Met Office's Unified Model

NASA Astrophysics Data System (ADS)

Prudden, R.; Arribas, A.; Tomlinson, J.; Robinson, N.

2017-12-01

The Unified Model is a numerical model of the atmosphere used at the UK Met Office (and numerous partner organisations including Korean Meteorological Agency, Australian Bureau of Meteorology and US Air Force) for both weather and climate applications.Especifically, dynamical models such as the Unified Model are now a central part of weather forecasting. Starting from basic physical laws, these models make it possible to predict events such as storms before they have even begun to form. The Unified Model can be simply described as having two components: one component solves the navier-stokes equations (usually referred to as the "dynamics"); the other solves relevant sub-grid physical processes (usually referred to as the "physics"). Running weather forecasts requires substantial computing resources - for example, the UK Met Office operates the largest operational High Performance Computer in Europe - and the cost of a typical simulation is spent roughly 50% in the "dynamics" and 50% in the "physics". Therefore there is a high incentive to reduce cost of weather forecasts and Machine Learning is a possible option because, once a machine learning model has been trained, it is often much faster to run than a full simulation. This is the motivation for a technique called model emulation, the idea being to build a fast statistical model which closely approximates a far more expensive simulation. In this paper we discuss the use of Machine Learning as an emulator to replace the "physics" component of the Unified Model. Various approaches and options will be presented and the implications for further model development, operational running of forecasting systems, development of data assimilation schemes, and development of ensemble prediction techniques will be discussed.

Evolution and Influence of Military Adult Education

ERIC Educational Resources Information Center

Persyn, John M.; Polson, Cheryl J.

2012-01-01

Military education programs encompass almost every adult education component from basic skills training through graduate-level higher education. As the country's largest employer, the U.S. Department of Defense (DoD) is also the largest provider of adult education, offering training and education for a workforce of more than 3.2 million members…

The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti.

PubMed

Zuraik, Christopher; Sampalis, John; Brierre, Alexa

2018-06-01

The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2 , 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach. A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries. Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.

Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

PubMed

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

Aero-Thermo-Structural Analysis of Inlet for Rocket Based Combined Cycle Engines

NASA Technical Reports Server (NTRS)

Shivakumar, K. N.; Challa, Preeti; Sree, Dave; Reddy, Dhanireddy R. (Technical Monitor)

2000-01-01

NASA has been developing advanced space transportation concepts and technologies to make access to space less costly. One such concept is the reusable vehicles with short turn-around times. The NASA Glenn Research Center's concept vehicle is the Trailblazer powered by a rocket-based combined cycle (RBCC) engine. Inlet is one of the most important components of the RBCC engine. This paper presents fluid flow, thermal, and structural analysis of the inlet for Mach 6 free stream velocity for fully supersonic and supercritical with backpressure conditions. The results concluded that the fully supersonic condition was the most severe case and the largest stresses occur in the ceramic matrix composite layer of the inlet cowl. The maximum tensile and the compressive stresses were at least 3.8 and 3.4, respectively, times less than the associated material strength.

Cost decomposition of linear systems with application to model reduction

NASA Technical Reports Server (NTRS)

Skelton, R. E.

1980-01-01

A means is provided to assess the value or 'cst' of each component of a large scale system, when the total cost is a quadratic function. Such a 'cost decomposition' of the system has several important uses. When the components represent physical subsystems which can fail, the 'component cost' is useful in failure mode analysis. When the components represent mathematical equations which may be truncated, the 'component cost' becomes a criterion for model truncation. In this latter event component costs provide a mechanism by which the specific control objectives dictate which components should be retained in the model reduction process. This information can be valuable in model reduction and decentralized control problems.

Health Care Costs and the Socioeconomic Consequences of Work Injuries in Brazil: A Longitudinal Study

PubMed Central

SANTANA, Vilma Sousa; FERNANDES DE SOUZA, Luis Eugênio Portela; PINTO, Isabela Cardoso de Matos

2013-01-01

Work injuries are a worldwide public health problem but little is known about their socioeconomic impact. This prospective longitudinal study estimates the direct health care costs and socioeconomic consequences of work injuries for 406 workers identified in the emergency departments of the two largest public hospitals in Salvador, Brazil, from June through September 2005. After hospital discharge workers were followed up monthly until their return to work. Most insured workers were unaware of their rights or of how to obtain insurance benefits (81.6%). Approximately half the cases suffered loss of earnings, and women were more frequently dismissed than men. The most frequently reported family consequences were: need for a family member to act as a caregiver and difficulties with daily expenses. Total costs were US$40,077.00 but individual costs varied widely, according to injury severity. Out-of-pocket costs accounted for the highest proportion of total costs (50.5%) and increased with severity (57.6%). Most out-of-pocket costs were related to transport and purchasing medicines and other wound care products. The second largest contribution (40.6%) came from the public National Health System − SUS. Employer participation was negligible. Health care funding must be discussed to alleviate the economic burden of work injuries on workers. PMID:23803496

The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa

PubMed Central

Devjee, Jaymala; Moodley, Jack

2017-01-01

Background Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. Methods We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. Results A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32–75.51). The total average cost per MVA was higher at $69.60 (52.62–86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. Conclusion This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs. PMID:28369061

Spoken Word Recognition and Serial Recall of Words from Components in the Phonological Network

ERIC Educational Resources Information Center

Siew, Cynthia S. Q.; Vitevitch, Michael S.

2016-01-01

Network science uses mathematical techniques to study complex systems such as the phonological lexicon (Vitevitch, 2008). The phonological network consists of a "giant component" (the largest connected component of the network) and "lexical islands" (smaller groups of words that are connected to each other, but not to the giant…

Surface enlargement factor of rumen papillae and expression of genes involved in dermatological diseases and their relationships with feed intake in beef steers

USDA-ARS?s Scientific Manuscript database

Feed costs make up the largest portion of the total cost to produce beef. One way to reduce this cost, thereby increasing profitability of beef production, is to improve feed efficiency. The rumen is responsible for digestion and absorption of nutrients and microbial by-products and may play a sig...

Cost-Efficacy Analysis of Out-of-District Special Education Placements: An Evaluative Measure of Behavior Support Intervention in Public Schools.

ERIC Educational Resources Information Center

Putnam, Robert F.; Luiselli, James K.; Sennett, Kenneth; Malonson, Joanne

2002-01-01

Evaluation of out-of-district special education placement costs in the 15 largest Massachusetts public school districts found the criterion school district (which had developed a system-wide approach to behavioral intervention) had the lowest per capita cost, lowest percentage of total school budget consumed by out-of-district placements, and the…

Evaluating variable rate fungicide applications for control of Sclerotinia

USDA-ARS?s Scientific Manuscript database

Oklahoma peanut growers continue to try to increase yields and reduce input costs. Perhaps the largest input in a peanut crop is fungicide applications. This is especially true for areas in the state that have high disease pressure from Sclerotinia. On average, a single fungicide application cost...

Health Care Analysis for the MCRMC Insurance Cost Model

DTIC Science & Technology

2015-06-01

demographically matched beneficiaries in civilian health care plans today in a PPO style plan 522 May 2015 FEHB  Largest employer-sponsored health benefit...Cost of treating Active Duty personnel  Implications of family earnings for plan choice  Availability of regional PPOs  Treatment of pharmacy

Experts Debate Cost Savings of Virtual Education

ERIC Educational Resources Information Center

Ash, Katie

2009-01-01

This article reports that a group of superintendents and secondary school educators in Massachusetts gathered to discuss how online courses might help offset budget cuts. Maryland state officials say their virtual Advanced Placement classes are a cost-effective way to get high-quality coursework to more students. And the largest state-sponsored…

Iraq Country Analysis Brief

EIA Publications

2016-01-01

Iraq is the second-largest crude oil producer in the Organization of the Petroleum Exporting Countries (OPEC) after Saudi Arabia, and it holds the world's fifth-largest proved crude oil reserves after Venezuela, Saudi Arabia, Canada, and Iran. Most of Iraq's major known fields are producing or in development, although much of its known hydrocarbon resources have not been fully exploited. All of Iraq's known oil fields are onshore. The largest fields in the south have relatively low extraction costs owing to uncomplicated geology, multiple supergiant fields, fields located in relatively unpopulated areas with flat terrain, and the close proximity of fields to coastal ports.

Adhesive bonding of wood materials

Treesearch

Charles B. Vick

1999-01-01

Adhesive bonding of wood components has played an essential role in the development and growth of the forest products industry and has been a key factor in the efficient utilization of our timber resource. The largest use of adhesives is in the construction industry. By far, the largest amounts of adhesives are used to manufacture building materials, such as plywood,...

Carbon Cycling in Wetland Forest Soils

Treesearch

Carl C. Trettin; Martin F. Jurgensen

2003-01-01

Wetlands comprise a small proportion (i.e., 2 to 3%) of earth's terrestrial surface, yet they contain a significant proportion of the terrestrial carbon (C) pool. Soils comprise the largest terrestrial C pool (ca. 1550 Pg C in upper 100 cm; Eswaran et al., 1993; Batjes, 1996), and wetlands contain the single largest component, with estimates ranging between 18...

Core discrete event simulation model for the evaluation of health care technologies in major depressive disorder.

PubMed

Vataire, Anne-Lise; Aballéa, Samuel; Antonanzas, Fernando; Roijen, Leona Hakkaart-van; Lam, Raymond W; McCrone, Paul; Persson, Ulf; Toumi, Mondher

2014-03-01

A review of existing economic models in major depressive disorder (MDD) highlighted the need for models with longer time horizons that also account for heterogeneity in treatment pathways between patients. A core discrete event simulation model was developed to estimate health and cost outcomes associated with alternative treatment strategies. This model simulated short- and long-term clinical events (partial response, remission, relapse, recovery, and recurrence), adverse events, and treatment changes (titration, switch, addition, and discontinuation) over up to 5 years. Several treatment pathways were defined on the basis of fictitious antidepressants with three levels of efficacy, tolerability, and price (low, medium, and high) from first line to third line. The model was populated with input data from the literature for the UK setting. Model outputs include time in different health states, quality-adjusted life-years (QALYs), and costs from National Health Service and societal perspectives. The codes are open source. Predicted costs and QALYs from this model are within the range of results from previous economic evaluations. The largest cost components from the payer perspective were physician visits and hospitalizations. Key parameters driving the predicted costs and QALYs were utility values, effectiveness, and frequency of physician visits. Differences in QALYs and costs between two strategies with different effectiveness increased approximately twofold when the time horizon increased from 1 to 5 years. The discrete event simulation model can provide a more comprehensive evaluation of different therapeutic options in MDD, compared with existing Markov models, and can be used to compare a wide range of health care technologies in various groups of patients with MDD. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessing the Social and Environmental Costs of Institution Nitrogen Footprints

PubMed Central

Leach, Allison M.; Castner, Elizabeth A.; Galloway, James N.

2017-01-01

Abstract This article estimates the damage costs associated with the institutional nitrogen (N) footprint and explores how this information could be used to create more sustainable institutions. Potential damages associated with the release of nitrogen oxides (NOx), ammonia (NH3), and nitrous oxide (N2O) to air and release of nitrogen to water were estimated using existing values and a cost per unit of nitrogen approach. These damage cost values were then applied to two universities. Annual potential damage costs to human health, agriculture, and natural ecosystems associated with the N footprint of institutions were $11.0 million (2014) at the University of Virginia (UVA) and $3.04 million at the University of New Hampshire (UNH). Costs associated with the release of nitrogen oxides to human health, in particular the use of coal-derived energy, were the largest component of damage at UVA. At UNH the energy N footprint is much lower because of a landfill cogeneration source, and thus the majority of damages were associated with food production. Annual damages associated with release of nitrogen from food production were very similar at the two universities ($1.80 million vs. $1.66 million at UVA and UNH, respectively). These damages also have implications for the extent and scale at which the damages are felt. For example, impacts to human health from energy and transportation are generally larger near the power plants and roads, while impacts from food production can be distant from the campus. Making this information available to institutions and communities can improve their understanding of the damages associated with the different nitrogen forms and sources, and inform decisions about nitrogen reduction strategies. PMID:29350221

Assessing the Social and Environmental Costs of Institution Nitrogen Footprints.

PubMed

Compton, Jana E; Leach, Allison M; Castner, Elizabeth A; Galloway, James N

2017-04-01

This article estimates the damage costs associated with the institutional nitrogen (N) footprint and explores how this information could be used to create more sustainable institutions. Potential damages associated with the release of nitrogen oxides (NOx), ammonia (NH 3 ), and nitrous oxide (N 2 O) to air and release of nitrogen to water were estimated using existing values and a cost per unit of nitrogen approach. These damage cost values were then applied to two universities. Annual potential damage costs to human health, agriculture, and natural ecosystems associated with the N footprint of institutions were $11.0 million (2014) at the University of Virginia (UVA) and $3.04 million at the University of New Hampshire (UNH). Costs associated with the release of nitrogen oxides to human health, in particular the use of coal-derived energy, were the largest component of damage at UVA. At UNH the energy N footprint is much lower because of a landfill cogeneration source, and thus the majority of damages were associated with food production. Annual damages associated with release of nitrogen from food production were very similar at the two universities ($1.80 million vs. $1.66 million at UVA and UNH, respectively). These damages also have implications for the extent and scale at which the damages are felt. For example, impacts to human health from energy and transportation are generally larger near the power plants and roads, while impacts from food production can be distant from the campus. Making this information available to institutions and communities can improve their understanding of the damages associated with the different nitrogen forms and sources, and inform decisions about nitrogen reduction strategies.

Influence of Power Delivery Timing on the Energetics and Biomechanics of Humans Wearing a Hip Exoskeleton

PubMed Central

Young, Aaron J.; Foss, Jessica; Gannon, Hannah; Ferris, Daniel P.

2017-01-01

A broad goal in the field of powered lower limb exoskeletons is to reduce the metabolic cost of walking. Ankle exoskeletons have successfully achieved this goal by correctly timing a plantarflexor torque during late stance phase. Hip exoskeletons have the potential to assist with both flexion and extension during walking gait, but the optimal timing for maximally reducing metabolic cost is unknown. The focus of our study was to determine the best assistance timing for applying hip assistance through a pneumatic exoskeleton on human subjects. Ten non-impaired subjects walked with a powered hip exoskeleton, and both hip flexion and extension assistance were separately provided at different actuation timings using a simple burst controller. The largest average across-subject reduction in metabolic cost for hip extension was at 90% of the gait cycle (just prior to heel contact) and for hip flexion was at 50% of the gait cycle; this resulted in an 8.4 and 6.1% metabolic reduction, respectively, compared to walking with the unpowered exoskeleton. However, the ideal timing for both flexion and extension assistance varied across subjects. When selecting the assistance timing that maximally reduced metabolic cost for each subject, average metabolic cost for hip extension was 10.3% lower and hip flexion was 9.7% lower than the unpowered condition. When taking into account user preference, we found that subject preference did not correlate with metabolic cost. This indicated that user feedback was a poor method of determining the most metabolically efficient assistance power timing. The findings of this study are relevant to developers of exoskeletons that have a powered hip component to assist during human walking gait. PMID:28337434

Influence of Power Delivery Timing on the Energetics and Biomechanics of Humans Wearing a Hip Exoskeleton.

PubMed

Young, Aaron J; Foss, Jessica; Gannon, Hannah; Ferris, Daniel P

2017-01-01

A broad goal in the field of powered lower limb exoskeletons is to reduce the metabolic cost of walking. Ankle exoskeletons have successfully achieved this goal by correctly timing a plantarflexor torque during late stance phase. Hip exoskeletons have the potential to assist with both flexion and extension during walking gait, but the optimal timing for maximally reducing metabolic cost is unknown. The focus of our study was to determine the best assistance timing for applying hip assistance through a pneumatic exoskeleton on human subjects. Ten non-impaired subjects walked with a powered hip exoskeleton, and both hip flexion and extension assistance were separately provided at different actuation timings using a simple burst controller. The largest average across-subject reduction in metabolic cost for hip extension was at 90% of the gait cycle (just prior to heel contact) and for hip flexion was at 50% of the gait cycle; this resulted in an 8.4 and 6.1% metabolic reduction, respectively, compared to walking with the unpowered exoskeleton. However, the ideal timing for both flexion and extension assistance varied across subjects. When selecting the assistance timing that maximally reduced metabolic cost for each subject, average metabolic cost for hip extension was 10.3% lower and hip flexion was 9.7% lower than the unpowered condition. When taking into account user preference, we found that subject preference did not correlate with metabolic cost. This indicated that user feedback was a poor method of determining the most metabolically efficient assistance power timing. The findings of this study are relevant to developers of exoskeletons that have a powered hip component to assist during human walking gait.

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

PubMed

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

2017-12-01

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

Collective action problem in heterogeneous groups

PubMed Central

Gavrilets, Sergey

2015-01-01

I review the theoretical and experimental literature on the collective action problem in groups whose members differ in various characteristics affecting individual costs, benefits and preferences in collective actions. I focus on evolutionary models that predict how individual efforts and fitnesses, group efforts and the amount of produced collective goods depend on the group's size and heterogeneity, as well as on the benefit and cost functions and parameters. I consider collective actions that aim to overcome the challenges from nature or win competition with neighbouring groups of co-specifics. I show that the largest contributors towards production of collective goods will typically be group members with the highest stake in it or for whom the effort is least costly, or those who have the largest capability or initial endowment. Under some conditions, such group members end up with smaller net pay-offs than the rest of the group. That is, they effectively behave as altruists. With weak nonlinearity in benefit and cost functions, the group effort typically decreases with group size and increases with within-group heterogeneity. With strong nonlinearity in benefit and cost functions, these patterns are reversed. I discuss the implications of theoretical results for animal behaviour, human origins and psychology. PMID:26503689

Influence of geomagnetic activity and atmospheric pressure in hypertensive adults.

PubMed

Azcárate, T; Mendoza, B

2017-09-01

We performed a study of the systolic and diastolic arterial blood pressure behavior under natural variables such as the atmospheric pressure and the horizontal geomagnetic field component. We worked with a group of eight adult hypertensive volunteers, four men and four women, with ages between 18 and 27 years in Mexico City during a geomagnetic storm in 2014. The data was divided by gender, age, and day/night cycle. We studied the time series using three methods: correlations, bivariate analysis, and superposed epoch (within a window of 2 days around the day of occurrence of a geomagnetic storm) analysis, between the systolic and diastolic blood pressure and the natural variables. The correlation analysis indicated a correlation between the systolic and diastolic blood pressure and the atmospheric pressure and the horizontal geomagnetic field component, being the largest during the night. Furthermore, the correlation and bivariate analyses showed that the largest correlations are between the systolic and diastolic blood pressure and the horizontal geomagnetic field component. Finally, the superposed epoch analysis showed that the largest number of significant changes in the blood pressure under the influence of geomagnetic field occurred in the systolic blood pressure for men.

Influence of geomagnetic activity and atmospheric pressure in hypertensive adults

NASA Astrophysics Data System (ADS)

Azcárate, T.; Mendoza, B.

2017-09-01

We performed a study of the systolic and diastolic arterial blood pressure behavior under natural variables such as the atmospheric pressure and the horizontal geomagnetic field component. We worked with a group of eight adult hypertensive volunteers, four men and four women, with ages between 18 and 27 years in Mexico City during a geomagnetic storm in 2014. The data was divided by gender, age, and day/night cycle. We studied the time series using three methods: correlations, bivariate analysis, and superposed epoch (within a window of 2 days around the day of occurrence of a geomagnetic storm) analysis, between the systolic and diastolic blood pressure and the natural variables. The correlation analysis indicated a correlation between the systolic and diastolic blood pressure and the atmospheric pressure and the horizontal geomagnetic field component, being the largest during the night. Furthermore, the correlation and bivariate analyses showed that the largest correlations are between the systolic and diastolic blood pressure and the horizontal geomagnetic field component. Finally, the superposed epoch analysis showed that the largest number of significant changes in the blood pressure under the influence of geomagnetic field occurred in the systolic blood pressure for men.

Weapon Acquisition Program Outcomes and Efforts to Reform DOD’s Acquisition Process

DTIC Science & Technology

2016-05-09

portfolio’s total estimated acquisition cost. 11. The equity prices of contractors delivering the ten costliest programs performed well relative to broad...cost growth. • In a constrained funding environment, unforeseen cost increases limit investment choices. The equity prices of the contractors ...remain profitable well into the future • Five publicly-traded defense contractors are developing and delivering the ten largest DOD programs in the 2015

How Do Students Meet the Cost of Attending a State University? Information Brief. Volume 4, Issue 2

ERIC Educational Resources Information Center

Florida Board of Governors, State University System, 2007

2007-01-01

Students and their families must cover, on average, 83% of the roughly $16,000 cost of attendance for a full-time, in-state undergraduate at a state university in Florida. On average, 75% of the cost of attendance in Florida's public universities is from expenses other than tuition and fees and books. The largest expense is room and board,…

Behavior of Machine Learning Algorithms in Adversarial Environments

DTIC Science & Technology

2010-11-23

handwriting recog- nition [cf., Plamondon and Srihari, 2000], they also have potentially far-reaching utility for many applications in security, networking...cost of the largest ℓp cost ball that fits entirely within their convex hull; let’s say this cost is C† ≤ C+0 . To achieve ǫ-multiplicative optimality...optimal on Fconvex,’+’ for ℓ2 costs. The proof of this result is in Appendix C.4. This result says that there is no algorithm can generally achieve ǫ

Highway Funding: It's Time to Think Seriously About Operations. A Policy Framework

DOT National Transportation Integrated Search

1998-09-01

This report describes the results of a major data gathering effort aimed at tracking deployment of nine infrastructure components of the metropolitan ITS infrastructure in 78 of the largest metropolitan areas in the nation. The nine components are: F...

Collaborating to Cut Costs in Higher Education

ERIC Educational Resources Information Center

Hassett, Tracy

2017-01-01

Tuition prices at colleges and universities are high. It is also true that salaries and benefits are the single biggest chunk of every higher education institution's (HEI) budget. And one of the largest and most difficult costs to contain is group employee health insurance. The situation is particularly difficult for smaller New England HEIs…

Comprehensive investigation into historical pipeline construction costs and engineering economic analysis of Alaska in-state gas pipeline

NASA Astrophysics Data System (ADS)

Rui, Zhenhua

This study analyzes historical cost data of 412 pipelines and 220 compressor stations. On the basis of this analysis, the study also evaluates the feasibility of an Alaska in-state gas pipeline using Monte Carlo simulation techniques. Analysis of pipeline construction costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary by diameter, length, volume, year, and location. Overall average learning rates for pipeline material and labor costs are 6.1% and 12.4%, respectively. Overall average cost shares for pipeline material, labor, miscellaneous, and right of way (ROW) are 31%, 40%, 23%, and 7%, respectively. Regression models are developed to estimate pipeline component costs for different lengths, cross-sectional areas, and locations. An analysis of inaccuracy in pipeline cost estimation demonstrates that the cost estimation of pipeline cost components is biased except for in the case of total costs. Overall overrun rates for pipeline material, labor, miscellaneous, ROW, and total costs are 4.9%, 22.4%, -0.9%, 9.1%, and 6.5%, respectively, and project size, capacity, diameter, location, and year of completion have different degrees of impacts on cost overruns of pipeline cost components. Analysis of compressor station costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary in terms of capacity, year, and location. Average learning rates for compressor station material and labor costs are 12.1% and 7.48%, respectively. Overall average cost shares of material, labor, miscellaneous, and ROW are 50.6%, 27.2%, 21.5%, and 0.8%, respectively. Regression models are developed to estimate compressor station component costs in different capacities and locations. An investigation into inaccuracies in compressor station cost estimation demonstrates that the cost estimation for compressor stations is biased except for in the case of material costs. Overall average overrun rates for compressor station material, labor, miscellaneous, land, and total costs are 3%, 60%, 2%, -14%, and 11%, respectively, and cost overruns for cost components are influenced by location and year of completion to different degrees. Monte Carlo models are developed and simulated to evaluate the feasibility of an Alaska in-state gas pipeline by assigning triangular distribution of the values of economic parameters. Simulated results show that the construction of an Alaska in-state natural gas pipeline is feasible at three scenarios: 500 million cubic feet per day (mmcfd), 750 mmcfd, and 1000 mmcfd.

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

PubMed Central

2014-01-01

Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH components (STI, early pregnancy and contraception, and HIV) are potentially cost saving. High cost savings resulting from averted lifetime treatment cost of HIV infected persons are likely to off-set the costs of STIs and unwanted pregnancies. PMID:25047074

Progress and outlook of inorganic nanoparticles for delivery of nucleic acid sequences related to orthopedic pathologies: a review.

PubMed

Wagner, Darcy E; Bhaduri, Sarit B

2012-02-01

The anticipated growth in the aging population will drastically increase medical needs of society; of which, one of the largest components will undoubtedly be from orthopedic-related pathologies. There are several proposed solutions being investigated to cost-effectively prepare for the future--pharmaceuticals, implant devices, cell and gene therapies, or some combination thereof. Gene therapy is one of the more promising possibilities because it seeks to correct the root of the problem, thereby minimizing treatment duration and cost. Currently, viral vectors have shown the highest efficacies, but immunological concerns remain. Nonviral methods show reduced immune responses but are regarded as less efficient. The nonviral paradigms consist of mechanical and chemical approaches. While organic-based materials have been used more frequently in particle-based methods, inorganic materials capable of delivery have distinct advantages, especially advantageous in orthopedic applications. The inorganic gene therapy field is highly interdisciplinary in nature, and requires assimilation of knowledge across the broad fields of cell biology, biochemistry, molecular genetics, materials science, and clinical medicine. This review provides an overview of the role each area plays in orthopedic gene therapy as well as possible future directions for the field.

An Overview of the MaRIE X-FEL and Electron Radiography LINAC RF Systems

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

Bradley, Joseph Thomas III; Rees, Daniel Earl; Scheinker, Alexander

The purpose of the Matter-Radiation Interactions in Extremes (MaRIE) facility at Los Alamos National Laboratory is to investigate the performance limits of materials in extreme environments. The MaRIE facility will utilize a 12 GeV linac to drive an X-ray Free-Electron Laser (FEL). Most of the same linac will also be used to perform electron radiography. The main linac is driven by two shorter linacs; one short linac optimized for X-FEL pulses and one for electron radiography. The RF systems have historically been the one of the largest single component costs of a linac. We will describe the details of themore » different types of RF systems required by each part of the linacs. Starting with the High Power RF system, we will present our methodology for the choice of RF system peak power and pulselength with respect to klystron parameters, modulator parameters, performance requirements and relative costs. We will also present an overview of the Low Level RF systems that are proposed for MaRIE and briefly describe their use with some proposed control schemes.« less

Premium growth and its effect on employer-sponsored insurance.

PubMed

Vistnes, Jessica; Selden, Thomas

2011-03-01

We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers' health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia

PubMed Central

Nguyen, Kim-Huong; Smith, Anthony C.; Armfield, Nigel R.; Bensink, Mark; Scuffham, Paul A.

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013–14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia’s health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited. PMID:26406592

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia.

PubMed

Nguyen, Kim-Huong; Smith, Anthony C; Armfield, Nigel R; Bensink, Mark; Scuffham, Paul A

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013-14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia's health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited.

The financial burden from non-communicable diseases in low- and middle-income countries: a literature review.

PubMed

Kankeu, Hyacinthe Tchewonpi; Saksena, Priyanka; Xu, Ke; Evans, David B

2013-08-16

Non-communicable diseases (NCDs) were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both mortality and morbidity in low- and middle-income countries (LMICs), although little is known about the impact these diseases have on households in these countries. In this paper, we present a literature review on the costs imposed by NCDs on households in LMICs. We examine both the costs of obtaining medical care and the costs associated with being unable to work, while discussing the methodological issues of particular studies. The results suggest that NCDs pose a heavy financial burden on many affected households; poor households are the most financially affected when they seek care. Medicines are usually the largest component of costs and the use of originator brand medicines leads to higher than necessary expenses. In particular, in the treatment of diabetes, insulin--when required--represents an important source of spending for patients and their families. These financial costs deter many people suffering from NCDs from seeking the care they need. The limited health insurance coverage for NCDs is reflected in the low proportions of patients claiming reimbursement and the low reimbursement rates in existing insurance schemes. The costs associated with lost income-earning opportunities are also significant for many households. Therefore, NCDs impose a substantial financial burden on many households, including the poor in low-income countries. The financial costs of obtaining care also impose insurmountable barriers to access for some people, which illustrates the urgency of improving financial risk protection in health in LMIC settings and ensuring that NCDs are taken into account in these systems. In this paper, we identify areas where further research is needed to have a better view of the costs incurred by households because of NCDs; namely, the extension of the geographical scope, the inclusion of certain diseases hitherto little studied, the introduction of a time dimension, and more comparisons with acute illnesses.

Identifying efficient dairy heifer producers using production costs and data envelopment analysis.

PubMed

Heinrichs, A J; Jones, C M; Gray, S M; Heinrichs, P A; Cornelisse, S A; Goodling, R C

2013-01-01

During November and December 2011, data were collected from 44 dairy operations in 13 Pennsylvania counties. Researchers visited each farm to collect information regarding management practices and feeding, and costs for labor, health, bedding, and reproduction for replacement heifers from birth until first calving. Costs per heifer were broken up into 4 time periods: birth until weaning, weaning until 6 mo of age, 6 mo of age until breeding age, and heifers from breeding to calving. Milk production records for each herd were obtained from Dairy Herd Improvement. The average number of milking cows on farms in this study was 197.8 ± 280.1, with a range from 38 to 1,708. Total cost averaged $1,808.23 ± $338.62 from birth until freshening. Raising calves from birth to weaning cost $217.49 ± 86.21; raising heifers from weaning age through 6 mo of age cost $247.38 ± 78.89; raising heifers from 6 mo of age until breeding cost $607.02 ± 192.28; and total cost for bred heifers was $736.33 ± 162.86. Feed costs were the largest component of the cost to raise heifers from birth to calving, accounting for nearly 73% of the total. Data envelopment analysis determined that 9 of the 44 farms had no inefficiencies in inputs or outputs. These farms best combined feed and labor investments, spending, on average, $1,137.40 and $140.62/heifer for feed and labor. These heifers calved at 23.7 mo of age and produced 88.42% of the milk produced by older cows. In contrast, the 35 inefficient farms spent $227 more on feed and $78 more on labor per heifer for animals that calved 1.6 mo later and produced only 82% of the milk made by their mature herdmates. Efficiency was attained by herds with the lowest input costs, but herds with higher input costs were also able to be efficient if age at calving was low and milk production was high for heifers compared with the rest of the herd. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

ERIC Educational Resources Information Center

Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

2007-01-01

The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

PubMed

Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

2016-12-01

Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic costs of different acute hand and wrist injuries varied greatly depending on the study methodology, however, by any standards, these injuries should be considered a substantial burden on the individual and society. Further research using standardised methodologies could provide guidance to relevant policy makers on how to best distribute limited resources by identifying the major disorders and exposures resulting in the largest burden. Copyright © 2016 Elsevier Ltd. All rights reserved.

Component Cost Analysis of Large Scale Systems

NASA Technical Reports Server (NTRS)

Skelton, R. E.; Yousuff, A.

1982-01-01

The ideas of cost decomposition is summarized to aid in the determination of the relative cost (or 'price') of each component of a linear dynamic system using quadratic performance criteria. In addition to the insights into system behavior that are afforded by such a component cost analysis CCA, these CCA ideas naturally lead to a theory for cost-equivalent realizations.

Common Cents? The Role of Pennies in the U.S. Economy

DTIC Science & Technology

2006-12-01

economy. This debate stems from political and economical sources with ties to historical references. This paper explores the various reasons for...roughly $.50. Today, that same pound of zinc costs nearly $1.50.14 Additionally, China is currently experiencing an economic whirlwind. The... economic growth in China has turned it from one of the world’s largest zinc exporters to one of the largest zinc importers.15 As a result, many items

Herd-Level Mastitis-Associated Costs on Canadian Dairy Farms

PubMed Central

Aghamohammadi, Mahjoob; Haine, Denis; Kelton, David F.; Barkema, Herman W.; Hogeveen, Henk; Keefe, Gregory P.; Dufour, Simon

2018-01-01

Mastitis imposes considerable and recurring economic losses on the dairy industry worldwide. The main objective of this study was to estimate herd-level costs incurred by expenditures and production losses associated with mastitis on Canadian dairy farms in 2015, based on producer reports. Previously, published mastitis economic frameworks were used to develop an economic model with the most important cost components. Components investigated were divided between clinical mastitis (CM), subclinical mastitis (SCM), and other costs components (i.e., preventive measures and product quality). A questionnaire was mailed to 374 dairy producers randomly selected from the (Canadian National Dairy Study 2015) to collect data on these costs components, and 145 dairy producers returned a completed questionnaire. For each herd, costs due to the different mastitis-related components were computed by applying the values reported by the dairy producer to the developed economic model. Then, for each herd, a proportion of the costs attributable to a specific component was computed by dividing absolute costs for this component by total herd mastitis-related costs. Median self-reported CM incidence was 19 cases/100 cow-year and mean self-reported bulk milk somatic cell count was 184,000 cells/mL. Most producers reported using post-milking teat disinfection (97%) and dry cow therapy (93%), and a substantial proportion of producers reported using pre-milking teat disinfection (79%) and wearing gloves during milking (77%). Mastitis costs were substantial (662 CAD per milking cow per year for a typical Canadian dairy farm), with a large portion of the costs (48%) being attributed to SCM, and 34 and 15% due to CM and implementation of preventive measures, respectively. For SCM, the two most important cost components were the subsequent milk yield reduction and culling (72 and 25% of SCM costs, respectively). For CM, first, second, and third most important cost components were culling (48% of CM costs), milk yield reduction following the CM events (34%), and discarded milk (11%), respectively. This study is the first since 1990 to investigate costs of mastitis in Canada. The model developed in the current study can be used to compute mastitis costs at the herd and national level in Canada. PMID:29868620

Network-Centric Interventions to Contain the Syphilis Epidemic in San Francisco.

PubMed

Juher, David; Saldaña, Joan; Kohn, Robert; Bernstein, Kyle; Scoglio, Caterina

2017-07-25

The number of reported early syphilis cases in San Francisco has increased steadily since 2005. It is not yet clear what factors are responsible for such an increase. A recent analysis of the sexual contact network of men who have sex with men with syphilis in San Francisco has discovered a large connected component, members of which have a significantly higher chance of syphilis and HIV compared to non-member individuals. This study investigates whether it is possible to exploit the existence of the largest connected component to design new notification strategies that can potentially contribute to reducing the number of cases. We develop a model capable of incorporating multiple types of notification strategies and compare the corresponding incidence of syphilis. Through extensive simulations, we show that notifying the community of the infection state of few central nodes appears to be the most effective approach, balancing the cost of notification and the reduction of syphilis incidence. Additionally, among the different measures of centrality, the eigenvector centrality reveals to be the best to reduce the incidence in the long term as long as the number of missing links (non-disclosed contacts) is not very large.

Component costs of foodborne illness: a scoping review

PubMed Central

2014-01-01

Background Governments require high-quality scientific evidence to prioritize resource allocation and the cost-of-illness (COI) methodology is one technique used to estimate the economic burden of a disease. However, variable cost inventories make it difficult to interpret and compare costs across multiple studies. Methods A scoping review was conducted to identify the component costs and the respective data sources used for estimating the cost of foodborne illnesses in a population. This review was accomplished by: (1) identifying the research question and relevant literature, (2) selecting the literature, (3) charting, collating, and summarizing the results. All pertinent data were extracted at the level of detail reported in a study, and the component cost and source data were subsequently grouped into themes. Results Eighty-four studies were identified that described the cost of foodborne illness in humans. Most studies (80%) were published in the last two decades (1992–2012) in North America and Europe. The 10 most frequently estimated costs were due to illnesses caused by bacterial foodborne pathogens, with non-typhoidal Salmonella spp. being the most commonly studied. Forty studies described both individual (direct and indirect) and societal level costs. The direct individual level component costs most often included were hospital services, physician personnel, and drug costs. The most commonly reported indirect individual level component cost was productivity losses due to sick leave from work. Prior estimates published in the literature were the most commonly used source of component cost data. Data sources were not provided or specifically linked to component costs in several studies. Conclusions The results illustrated a highly variable depth and breadth of individual and societal level component costs, and a wide range of data sources being used. This scoping review can be used as evidence that there is a lack of standardization in cost inventories in the cost of foodborne illness literature, and to promote greater transparency and detail of data source reporting. By conforming to a more standardized cost inventory, and by reporting data sources in more detail, there will be an increase in cost of foodborne illness research that can be interpreted and compared in a meaningful way. PMID:24885154

Tracking the deployment of the integrated metropolitan ITS infrastructure in the USA : FY99 results

DOT National Transportation Integrated Search

2000-05-01

This report describes the results of a major data gathering effort aimed at tracking deployment of nine infrastructure components of the metropolitan ITS infrastructure in 78 of the largest metropolitan areas in the nation. The nine components are: F...

Improving the Targeting of Treatment: Evidence from College Remediation. NBER Working Paper No. 18457

ERIC Educational Resources Information Center

Scott-Clayton, Judith; Crosta, Peter M.; Belfield, Clive R.

2012-01-01

At an annual cost of roughly $7 billion nationally, remedial coursework is one of the single largest interventions intended to improve outcomes for underprepared college students. But like a costly medical treatment with non-trivial side effects, the value of remediation overall depends upon whether those most likely to benefit can be identified…

Go Green, Save Green with ENERGY STAR[R

ERIC Educational Resources Information Center

Hatcher, Caterina

2010-01-01

Did you know that the nation's 17,450 K-12 school districts spend more on energy than on computers and textbooks combined? Energy costs represent a typical school district's second largest operating expense after salaries. Schools that have earned the ENERGY STAR--EPA's mark of superior energy performance--cost 40 cents per square foot less to…

Costs and Policy Options for Federal Student Loan Programs. A CBO Study

ERIC Educational Resources Information Center

Lucas, Deborah; Moore, Damien

2010-01-01

The Department of Education oversees various programs to help students pay for the costs of postsecondary education. This Congressional Budget Office (CBO) study focuses on the two largest student loan programs created under the authority of the Higher Education Act of 1965 (as amended): (1) The Federal Family Education Loan (FFEL) program, which…

An Analysis of Staff Development Programs and Their Costs in Three Urban School Districts.

ERIC Educational Resources Information Center

Moore, Donald R.; Hyde, Arthur A.

This report analyzes teacher staff development programs and their costs in three large urban school districts, and discusses research and policy implications of the research results. The districts were selected through a survey of school districts serving the 75 largest U.S. cities, and were chosen because of their respectively high, medium, and…

Polymorphisms in POMC are not associated with dry matter intake and average daily gain phenotypes in beef cattle

USDA-ARS?s Scientific Manuscript database

The cost of feed for beef cattle is the largest expense incurred by cattle producers. The ability to genetically select for more efficient animals that require less feed while still achieving acceptable levels of production will result in a substantial cost savings. The purpose of this study was to ...

Exergo-Economic Analysis of an Experimental Aircraft Turboprop Engine Under Low Torque Condition

NASA Astrophysics Data System (ADS)

Atilgan, Ramazan; Turan, Onder; Aydin, Hakan

Exergo-economic analysis is an unique combination of exergy analysis and cost analysis conducted at the component level. In exergo-economic analysis, cost of each exergy stream is determined. Inlet and outlet exergy streams of the each component are associated to a monetary cost. This is essential to detect cost-ineffective processes and identify technical options which could improve the cost effectiveness of the overall energy system. In this study, exergo-economic analysis is applied to an aircraft turboprop engine. Analysis is based on experimental values at low torque condition (240 N m). Main components of investigated turboprop engine are the compressor, the combustor, the gas generator turbine, the free power turbine and the exhaust. Cost balance equations have been formed for all components individually and exergo-economic parameters including cost rates and unit exergy costs have been calculated for each component.

Social impacts of the work loss in cancer survivors.

PubMed

Yamauchi, Hideko; Nakagawa, Chizuko; Fukuda, Takashi

2017-09-01

As cancer frequently occurs during the most productive years of life, our purpose was to estimate the cost of work loss of cancer survivors and develop interventions to minimize the loss. We estimated the cost of the work loss from all cancers resulting from patients' inpatient, outpatient, and non-treatment days. This was calculated with a new method, the product of the "employment rate coefficient × productivity coefficient," making use of data published by the Japanese Ministries. The estimate of work loss on treatment days for all cancers was $1820.21 million in men and $939.38 million in women. In terms of disease classification, lung cancer was the largest cause in men, whereas breast cancer was the largest in women. On non-treatment days, the work losses because of gastric, colon, and lung cancers were large in men, while breast cancer was the largest in women and in total. The estimated loss for all cancers was $3685.506 million in men and $2502.565 million in women, when the product was assumed 0.5. In Japan, breast cancer was considered the leading cause for cost of work loss, and the most influential cause when the product of the "employment rate coefficient × productivity coefficient" for breast cancer was assumed the same as the product for all other types of cancers. It is necessary to establish support systems for working cancer survivors.

Cost of hospitalised patients due to complicated urinary tract infections: a retrospective observational study in countries with high prevalence of multidrug-resistant Gram-negative bacteria: the COMBACTE-MAGNET, RESCUING study.

PubMed

Vallejo-Torres, Laura; Pujol, Miquel; Shaw, Evelyn; Wiegand, Irith; Vigo, Joan Miquel; Stoddart, Margaret; Grier, Sally; Gibbs, Julie; Vank, Christiane; Cuperus, Nienke; van den Heuvel, Leo; Eliakim-Raz, Noa; Carratala, Jordi; Vuong, Cuong; MacGowan, Alasdair; Babich, Tanya; Leibovici, Leonard; Addy, Ibironke; Morris, Stephen

2018-04-12

Complicated urinary tract infections (cUTIs) impose a high burden on healthcare systems and are a frequent cause of hospitalisation. The aims of this paper are to estimate the cost per episode of patients hospitalised due to cUTI and to explore the factors associated with cUTI-related healthcare costs in eight countries with high prevalence of multidrug resistance (MDR). This is a multinational observational, retrospective study. The mean cost per episode was computed by multiplying the volume of healthcare use for each patient by the unit cost of each item of care and summing across all components. Costs were measured from the hospital perspective. Patient-level regression analyses were used to identify the factors explaining variation in cUTI-related costs. The study was conducted in 20 hospitals in eight countries with high prevalence of multidrug resistant Gram-negative bacteria (Bulgaria, Greece, Hungary, Israel, Italy, Romania, Spain and Turkey). Data were obtained from 644 episodes of patients hospitalised due to cUTI. The mean cost per case was €5700, with considerable variation between countries (largest value €7740 in Turkey; lowest value €4028 in Israel), mainly due to differences in length of hospital stay. Factors associated with higher costs per patient were: type of admission, infection source, infection severity, the Charlson comorbidity index and presence of MDR. The mean cost per hospitalised case of cUTI was substantial and varied significantly between countries. A better knowledge of the reasons for variations in length of stays could facilitate a better standardised quality of care for patients with cUTI and allow a more efficient allocation of healthcare resources. Urgent admissions, infections due to an indwelling urinary catheterisation, resulting in septic shock or severe sepsis, in patients with comorbidities and presenting MDR were related to a higher cost. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Geographic Variations in Incremental Costs of Heart Disease Among Medicare Beneficiaries, by Type of Service, 2012.

PubMed

Wakim, Rita; Ritchey, Matthew; Hockenberry, Jason; Casper, Michele

2016-12-29

Using 2012 data on fee-for-service Medicare claims, we documented regional and county variation in incremental standardized costs of heart disease (ie, comparing costs between beneficiaries with heart disease and beneficiaries without heart disease) by type of service (eg, inpatient, outpatient, post-acute care). Absolute incremental total costs varied by region. Although the largest absolute incremental total costs of heart disease were concentrated in southern and Appalachian counties, geographic patterns of costs varied by type of service. These data can be used to inform development of policies and payment models that address the observed geographic disparities.

Evaluation of a Voluntary Worksite Weight Loss Program on Metabolic Syndrome.

PubMed

Earnest, Conrad P; Church, Timothy S

2015-11-01

Health care costs increase with the presence of metabolic syndrome and present a significant burden to companies throughout the world. Identifying effective behavioral programs within the workplace can reduce health care costs. We examined the effect of a voluntary worksite program on weight loss and metabolic syndrome. Participants (N = 3880, from 93 companies) volunteered within their workplaces to participate in a 10-week weight loss program (Naturally Slim) focused on self-monitoring, eating behaviors, understanding hunger signals, reducing refined carbohydrate and sugar intake, and increasing protein intake to 25%-30%. Primary outcomes included weight loss and metabolic syndrome prevalence. Secondary analyses examined the individual components of metabolic syndrome and a categorical analysis within each World Health Organization body mass index category. Overall, women and men lost 9.4 (-4.8%) and 13.2 pounds (-5.8%), respectively. Each metabolic risk factor for both genders had a significant improvement but men exhibited the largest relative improvement for each risk factor. At baseline, 43% of women and 52% of men presented with metabolic syndrome, which was reduced to 30% in women and 26% in men (P < 0.001 for each) at the conclusion of the program. Secondary analysis demonstrated that individuals with greater baseline levels of metabolic dysfunction had larger metabolic improvements, similar benefits to risk factors across baseline body mass index categories, and the greater the weight loss, the greater the metabolic benefit. Our results demonstrate that a worksite program targeting core behavioral skills associated with weight loss is an effective strategy to reduce weight and improve the components of metabolic syndrome amongst at-risk employees.

Antecedents to the adoption of ASPS in healthcare.

PubMed

Randeree, Ebrahim; Judd, Susan P; Kishore, Rajiv; Rao, H Raghav

2003-01-01

The objective of this exploratory study was to identify drivers of adoption for a new form of information technology outsourcing--the ASP model--in the healthcare industry. Primary data were collected in January 2002 from a nationwide survey of senior-level healthcare information technology executives. Cost management (supplier presence, asset specificity, production costs, transaction costs, resource availability) and relative advantage (reliability, customizability, strategic alignment, and magnitude of potential loss) were found to have the largest influences on adoption behavior.

Millimeter-wave automotive radars: the markets, technologies, and production costs

NASA Astrophysics Data System (ADS)

Raffaelli, Lamberto; Stewart, Earle

1995-01-01

This paper examines markets, competing technologies, and required production costs of 77 GHz automotive radars. These products will be offered to the market a few years from now and represent the largest opportunity ever offered to the millimeter-wave (MMW) industry. To succeed in this business, an entire industry, primarily focused in the past on expensive small volume military applications, has to be re-engineered to successfully design and manufacture low cost, large volume parts.

CRUSER News. Issue 23, January 2013

DTIC Science & Technology

2013-01-01

Ricardo Martins, José Pinto, Laboratório de Sistemas e Tecnologias Subaquáticas, Engineering Faculty, Porto University Portugal has one of the largest...Total Ownership Cost ( TOC ) by Dr. Dan Nussbaum, Professor in the Operations Research Dept at NPS, danussba@nps.edu According to the methodology section of...paradigm shift in UAV cost estimation The purpose in this part of the project is to provide a TOC that reflects the end-to-end costs associated with ISR

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

Perdue, J.M.

Phillips Petroleum Co., one of the largest international oil companies and the largest producer of natural gas liquids in the US, recently reported that first half 1996 net income was $916 million, up from $224 million for the same period the year before. During the past 5 years, reserves have increased 11% and production by 8%. Exploration expenses are down 32% and production costs per boe are down 24%. Compared to other majors involved in worldwide E and P, Phillips has the second highest 5-year percentage of reserves replacement--117%--and the second lowest finding and development cost/boe--$3.46--in the industry. How didmore » the company do this while decreasing headcount by 5,300? The paper discusses focused growth, paring down assets, E and P projects, research and development, and electronic document management.« less

Performance Models of Testability.

DTIC Science & Technology

1984-08-01

4.1.17 Cost of Isolating Component/Part (CPI) 5J Cost of isolating components or parts at the depot is at CPI - n1 (HDC)(TPI)(NPI) where TPI = average...testing component N Deec N a aiur Yes(PFD D)S Cos ofi oaig op nn -- Cost ofcmpnn rmva n relaemn Exece Cost of omponn reatmovae anda

Health economics perspective of the components of the cardiometabolic syndrome.

PubMed

Tamariz, Leonardo; Palacio, Ana; Yang, Yadong; Parris, Donald; Ben-Joseph, Rami; Florez, Hermes

2010-07-01

The components of the cardiometabolic syndrome (CMS) increase the risk of coronary artery disease (CAD). The authors compared 12-month costs of subjects with different number of components of the CMS. In claims data from a large health benefits company, 383,420 individuals with the first International Classification of Diseases, Ninth Revision codes for hypertension, diabetes, lipid abnormalities, and obesity were identified. Patients were stratified according to presence of CAD and the number of components of the CMS. Twelve-month costs were added after the identification of the risk factor. Mean annual costs increased with the number of components of CMS both in those with and without CAD, even after adjusting for age, sex, and comorbidities (P<.01). Similar trends were seen for medical and pharmacy costs. The adjusted total annual health care cost in those with an isolated component of the CMS was $5564 (95% confidence interval: $5491-$5631) while in those with 4 components was $12,287 (95% confidence interval: $11,987-$12,587). Individuals with accumulating components of the CMS have higher health care costs regardless of age, sex, and other comorbidities.

Dairy farm cost efficiency.

PubMed

Tauer, L W; Mishra, A K

2006-12-01

A stochastic cost equation was estimated for US dairy farms using national data from the production year 2000 to determine how farmers might reduce their cost of production. Cost of producing a unit of milk was estimated into separate frontier (efficient) and inefficiency components, with both components estimated as a function of management and causation variables. Variables were entered as impacting the frontier component as well as the efficiency component of the stochastic curve because a priori both components could be impacted. A factor that has an impact on the cost frontier was the number of hours per day the milking facility is used. Using the milking facility for more hours per day decreased frontier costs; however, inefficiency increased with increased hours of milking facility use. Thus, farmers can decrease costs with increased utilization of the milking facility, but only if they are efficient in this strategy. Parlors compared with stanchions used for milking did not decrease frontier costs, but decreased costs because of increased efficiency, as did the use of a nutritionist. Use of rotational grazing decreased frontier costs but also increased inefficiency. Older farmers were less efficient.

The Affordability of MyPlate: An Analysis of SNAP Benefits and the Actual Cost of Eating According to the Dietary Guidelines.

PubMed

Mulik, Kranti; Haynes-Maslow, Lindsey

2017-09-01

To estimate the funds required to support a MyPlate diet and to estimate the additional costs needed for Supplemental Nutrition Assistance Program recipients to adhere to the MyPlate diet. Using the US Department of Agriculture's (USDA's) MyPlate dietary guidelines that specify recommendations for individuals based on age and gender and retail price data from the USDA, the cost of following USDA's MyPlate guidelines for consuming 3 meals daily was estimated for the following individuals: children, adolescents, female adults, male adults, female seniors, male seniors, and a 4-person family. Cost of consuming a MyPlate diet, including canned, frozen, and fresh produce as part of the diet. Descriptive analysis of the cost of consuming a MyPlate diet. Consuming a MyPlate diet consisting of only fresh fruits and vegetables is the most expensive diet. The monthly additional costs on an individual basis is the largest for boys aged 12-17 years ($75/mo) because they have the largest quantity of food consumed compared with all other gender and age groups. The monthly cost for a family of 4 ranged from $1,109 to $1,249/mo. The monetary amount of Supplemental Nutrition Assistance Program benefits may be insufficient to support a healthy diet recommended by federal nutrition guidelines. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Affordability of Meteorology Graduate Programs in the United States and Canada.

NASA Astrophysics Data System (ADS)

Gilmore, Matthew S.; Toracinta, E. Richard

1998-06-01

The authors surveyed 55 university departments in the United States and Canada that grant doctor of philosophy and/or master of science degrees in meteorology or the atmospheric sciences. Two-thirds of university departments responded. Survey topics included graduate student income (stipends and health insurance benefits) and mandatory costs (tuition, fees, and health insurance costs) incurred for fall 1996.Results show that most graduate students do have funding but only one-quarter of departments indicate that health insurance benefits are provided to graduate assistants. The largest mandatory cost is typically housing, which was estimated (except for Canadian schools) with 1996 Fair Market Rent data from the U.S. Department of Housing and Urban Development. For schools not providing it, the second largest cost is typically health insurance. The smallest costs are typically tuition (waived for graduate assistants in most cases) and fees.The difference between income and mandatory costs over a nine-month period gives an "effective income." Evidence was found associating greater effective income with larger departments and with locations where housing costs are larger. No significant evidence was found to associate differences in effective income with city size or geographic region. The broad range in effective income between the departments suggests that some graduate programs may be much more affordable than others.This information can aid university departments in planning budgets that keep them competitive with one another. This paper will also help prospective graduate students by raising awareness about important issues of graduate program affordability.

Cost trend analysis of initial cancer treatment in Taiwan.

PubMed

Li, Tsai-Yun; Hsieh, Jan-Sing; Lee, King-Teh; Hou, Ming-Feng; Wu, Chia-Ling; Kao, Hao-Yun; Shi, Hon-Yi

2014-01-01

Despite the high cost of initial cancer care, that is, care in the first year after diagnosis, limited information is available for specific categories of cancer-related costs, especially costs for specific services. This study purposed to identify causes of change in cancer treatment costs over time and to perform trend analyses of the percentage of cancer patients who had received a specific treatment type and the mean cost of care for patients who had received that treatment. The analysis of trends in initial treatment costs focused on cancer-related surgery, chemotherapy, radiation therapy, and treatments other than active treatments. For each cancer-specific trend, slopes were calculated for regression models with 95% confidence intervals. Analyses of patients diagnosed in 2007 showed that the National Health Insurance (NHI) system paid, on average, $10,780 for initial care of a gastric cancer patient and $10,681 for initial care of a lung cancer patient, which were inflation-adjusted increases of $6,234 and $5,522, respectively, over the 1996 care costs. During the same interval, the mean NHI payment for initial care for the five specific cancers increased significantly (p<0.05). Hospitalization costs comprised the largest portion of payments for all cancers. During 1996-2007, the use of chemotherapy and radiation therapy significantly increased in all cancer types (p<0.05). In 2007, NHI payments for initial care for these five cancers exceeded $12 billion, and gastric and lung cancers accounted for the largest share. In addition to the growing number of NHI beneficiaries with cancer, treatment costs and the percentage of patients who undergo treatment are growing. Therefore, the NHI must accurately predict the economic burden of new chemotherapy agents and radiation therapies and may need to develop programs for stratifying patients according to their potential benefit from these expensive treatments.

1400200

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400198

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400199

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400202

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400203

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400201

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400204

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400205

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400207

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

1400206

NASA Image and Video Library

2014-03-28

NASA AND BOEING ENGINEERS INSPECT AND PREPARE ONE OF THE LARGEST COMPSITE ROCKET PROPELLANT TANKS EVER MANUFACTURED. THE COMPOSITE CRYOTANK PROMISES A 30% WEIGHT REDUCTION AND A 25 % COST REDUCTION OVER THE PREVIOUSLY USED METAL TANKS.

Anticipating and controlling mask costs within EDA physical design

NASA Astrophysics Data System (ADS)

Rieger, Michael L.; Mayhew, Jeffrey P.; Melvin, Lawrence S.; Lugg, Robert M.; Beale, Daniel F.

2003-08-01

For low k1 lithography, more aggressive OPC is being applied to critical layers, and the number of mask layers with OPC treatments is growing rapidly. The 130 nm, process node required, on average, 8 layers containing rules- or model-based OPC. The 90 nm node will have 16 OPC layers, of which 14 layers contain aggressive model-based OPC. This escalation of mask pattern complexity, coupled with the predominant use of vector-scan e-beam (VSB) mask writers contributes to the rising costs of advanced mask sets. Writing times for OPC layouts are several times longer than for traditional layouts, making mask exposure the single largest cost component for OPC masks. Lower mask yields, another key factor in higher mask costs, is also aggravated by OPC. Historical mask set costs are plotted below. The initial cost of a 90 nm-node mask set will exceed one million dollars. The relative impact of mask cost on chip depends on how many total wafers are printed with each mask set. For many foundry chips, where unit production is often well below 1000 wafers, mask costs are larger than wafer processing costs. Further increases in NRE may begin to discourage these suppliers' adoption to 90 nm and smaller nodes. In this paper we will outline several alternatives for reducing mask costs by strategically leveraging dimensional margins. Dimensional specifications for a particular masking layer usually are applied uniformly to all features on that layer. As a practical matter, accuracy requirements on different features in the design may vary widely. Take a polysilicon layer, for example: global tolerance specifications for that layer are driven by the transistor-gate requirements; but these parameters over-specify interconnect feature requirements. By identifying features where dimensional accuracy requirements can be reduced, additional margin can be leveraged to reduce OPC complexity. Mask writing time on VSB tools will drop in nearly direct proportion to reduce shot count. By inspecting masks with reference to feature-dependent margins, instead of uniform specifications, mask yield can be effectively increased further reducing delivered mask expense.

Capital Requirements for the Air Transport Industry

NASA Technical Reports Server (NTRS)

James, G. W.

1972-01-01

In recent years the U.S. scheduled airline industry has been involved in the largest re-equipment program that involves the addition of hundreds of new aircraft to the airline fleet. The costs associated with the purchase of this new equipment, along with the other costs involving such matters as the environment and security, are presenting the carriers with significant financial challenges.

Southwest Oregon Biscuit Fire: an analysis of forest resources and fire severity

Treesearch

David L. Azuma; Joseph Donnegan; Donald Gedney

2004-01-01

The Biscuit Fire in southwestern Oregon was one of the largest and most costly in recent history, burning over 499,000 acres and costing over 150 million dollars in suppression efforts. This study uses prefire resource information in conjunction with postfire burn severity to generate statistically reliable prefire resource estimates for the land within the Biscuit...

Residential energy consumption and conservation programs: A systematic approach to identify inefficient households, provide meaningful feedback, and prioritize homes for conservation intervention

NASA Astrophysics Data System (ADS)

Macsleyne, Amelia Chadbourne Carus

There are three main objectives for residential energy conservation policies: to reduce the use of fossil fuels, reduce greenhouse gas emissions, and reduce the energy costs seen by the consumer (U.S. Department of Energy: Strategic Objectives, 2006). A prominent difficulty currently facing conservation policy makers and program managers is how to identify and communicate with households that would be good candidates for conservation intervention, in such a way that affects a change in consumption patterns and is cost-effective. This research addresses this issue by separating the problem into three components: how to identify houses that are significantly more inefficient than comparable households; how to find the maximum financially-feasible investment in energy efficiency for a household in order to reduce annual energy costs and/or improve indoor comfort; and how to prioritize low-income households for a subsidized weatherization program. Each component of the problem is presented as a paper prepared for publication. Household consumption related to physical house efficiency, thermostat settings, and daily appliance usage is studied in the first and second paper by analyzing natural gas utility meter readings associated with over 10,000 households from 2001-2006. A rich description of a house's architectural characteristics and household demographics is attained by integrating publicly available databases based on the house address. This combination of information allows for the largest number of individual households studied at this level of detail to date. The third paper uses conservation program data from two natural gas utilities that administer and sponsor the program; over 1,000 weatherized households are included in this sample. This research focuses on natural gas-related household conservation. However, the same principles and methods could be applied for electricity-related conservation programs. We find positive policy implications from each of these three papers.

Design of preventive maintenance system using the reliability engineering and maintenance value stream mapping methods in PT. XYZ

NASA Astrophysics Data System (ADS)

Sembiring, N.; Panjaitan, N.; Angelita, S.

2018-02-01

PT. XYZ is a company owned by non-governmental organizations engaged in the field of production of rubber processing becoming crumb rubber. Part of the production is supported by some of machines and interacting equipment to achieve optimal productivity. Types of the machine that are used in the production process are Conveyor Breaker, Breaker, Rolling Pin, Hammer Mill, Mill Roll, Conveyor, Shredder Crumb, and Dryer. Maintenance system in PT. XYZ is corrective maintenance i.e. repairing or replacing the engine components after the crash on the machine. Replacement of engine components on corrective maintenance causes the machine to stop operating during the production process is in progress. The result is in the loss of production time due to the operator must replace the damaged engine components. The loss of production time can impact on the production targets which were not reached and lead to high loss costs. The cost for all components is Rp. 4.088.514.505. This cost is really high just for maintaining a Mill Roll Machine. Therefore PT. XYZ is needed to do preventive maintenance i.e. scheduling engine components and improving maintenance efficiency. The used methods are Reliability Engineering and Maintenance Value Stream Mapping (MVSM). The needed data in this research are the interval of time damage to engine components, opportunity cost, labor cost, component cost, corrective repair time, preventive repair time, Mean Time To Opportunity (MTTO), Mean Time To Repair (MTTR), and Mean Time To Yield (MTTY). In this research, the critical components of Mill Roll machine are Spier, Bushing, Bearing, Coupling and Roll. Determination of damage distribution, reliability, MTTF, cost of failure, cost of preventive, current state map, and future state map are done so that the replacement time for each critical component with the lowest maintenance cost and preparation of Standard Operation Procedure (SOP) are developed. For the critical component that has been determined, the Spier component replacement time interval is 228 days with a reliability value of 0,503171, Bushing component is 240 days with reliability value of 0.36861, Bearing component is 202 days with reliability value of 0,503058, Coupling component is 247 days with reliability value of 0,50108 and Roll component is 301 days with reliability value of 0,373525. The results show that the cost decreases from Rp 300,688,114 to Rp 244,384,371 obtained from corrective maintenance to preventive maintenance. While maintenance efficiency increases with the application of preventive maintenance i.e. for Spier component from 54,0540541% to 74,07407%, Bushing component from 52,3809524% to 68,75%, Bearing component from 40% to 52,63158%, Coupling component from 60.9756098% to 71.42857%, and Roll components from 64.516129% to 74.7663551%.

How are the costs of care for medical falls distributed? The costs of medical falls by component of cost, timing, and injury severity.

PubMed

Bohl, Alex A; Phelan, Elizabeth A; Fishman, Paul A; Harris, Jeffrey R

2012-10-01

To examine the components of cost that drive increased total costs after a medical fall over time, stratified by injury severity. We used 2004-2007 cost and utilization data for persons enrolled in an integrated care delivery system. We used a longitudinal cohort study design, where each individual provides 2-3 years of administrative data grouped into 3-month intervals relative to an index date. We identified 8,969 medical fallers through International Classification of Diseases, 9th Revision, codes and E-Codes and used 8,956 nonfaller controls, identified through age and gender frequency matching. Total costs were partitioned into 7 components: inpatient, outpatient, emergency, radiology, pharmacy, postacute care, and "other." The large increase in costs after a hospitalized fall is mainly associated with inpatient and postacute care components. The spike in costs after a nonhospitalized fall is attributable to outpatient and "other" (e.g., ambulatory surgery or community health services) components. Hospitalized fallers' inpatient, emergency, postacute care, outpatient, and radiology costs are not always greater than those for nonhospitalized fallers. Components associated with increased costs after a medical fall vary over time and by injury severity. Future studies should compare if delivering certain acute and postacute health services improve health and reduce cost trajectories after a medical fall more than others. Additionally, since the older adult population and the problem of falls are growing, health care delivery systems should develop standardized methodology to monitor medical fall rates.

Cost Study of Educational Media Systems and Their Equipment Components. Volume III, A Supplementary Report: Computer Assisted Instruction. Final Report.

ERIC Educational Resources Information Center

General Learning Corp., Washington, DC.

The COST-ED model (Costs of Schools, Training, and Education) of the instructional process encourages the recognition of management alternatives and potential cost-savings. It is used to calculate the minimum cost of performing specified instructional tasks. COST-ED components are presented as cost modules in a flowchart format for manpower,…

What does it cost to prevent on-duty firefighter cardiac events? A content valid method for calculating costs.

PubMed

Patterson, P Daniel; Suyama, Joe; Reis, Steven E; Weaver, Matthew D; Hostler, David

2013-01-01

Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries. The interviews produced a draft cost model with 6 components and 26 subcomponents. In 2013, we randomly sampled 100 fire chiefs out of >7,400 affiliated with the International Association of Fire Chiefs. We used the Content Validity Index (CVI) to identify the content valid components of the draft cost model. This was accomplished by having fire chiefs rate the relevancy of cost components using a 4-point Likert scale (highly relevant to not relevant). We received complete survey data from 65 fire chiefs (65% response rate). We retained 5 components and 21 subcomponents based on CVI scores ≥0.70. The five main components include, (1) investment costs, (2) orientation and training costs, (3) medical and pharmaceutical costs, (4) education and continuing education costs, and (5) maintenance costs. Data from a diverse sample of fire chiefs has produced a content valid method for calculating the cost of a prevention program among firefighters.

What Does It Cost to Prevent On-Duty Firefighter Cardiac Events? A Content Valid Method for Calculating Costs

PubMed Central

Patterson, P. Daniel; Suyama, Joe; Reis, Steven E.; Weaver, Matthew D.; Hostler, David

2013-01-01

Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries. The interviews produced a draft cost model with 6 components and 26 subcomponents. In 2013, we randomly sampled 100 fire chiefs out of >7,400 affiliated with the International Association of Fire Chiefs. We used the Content Validity Index (CVI) to identify the content valid components of the draft cost model. This was accomplished by having fire chiefs rate the relevancy of cost components using a 4-point Likert scale (highly relevant to not relevant). We received complete survey data from 65 fire chiefs (65% response rate). We retained 5 components and 21 subcomponents based on CVI scores ≥0.70. The five main components include, (1) investment costs, (2) orientation and training costs, (3) medical and pharmaceutical costs, (4) education and continuing education costs, and (5) maintenance costs. Data from a diverse sample of fire chiefs has produced a content valid method for calculating the cost of a prevention program among firefighters. PMID:24455288

Deploying and operating integrated intelligent transportation systems : twenty questions and answers : guidance from the evaluation of the Metropolitan Model Deployment Initiative sites

DOT National Transportation Integrated Search

2000-01-01

This report describes the results of a major data gathering effort aimed at tracking deployment of nine infrastructure components of the metropolitan ITS infrastructure in 78 of the largest metropolitan areas in the nation. The nine components are: F...

Experimental dissection of oxygen transport resistance in the components of a polymer electrolyte membrane fuel cell

NASA Astrophysics Data System (ADS)

Oh, Hwanyeong; Lee, Yoo il; Lee, Guesang; Min, Kyoungdoug; Yi, Jung S.

2017-03-01

Oxygen transport resistance is a major obstacle for obtaining high performance in a polymer electrolyte membrane fuel cell (PEMFC). To distinguish the major components that inhibit oxygen transport, an experimental method is established to dissect the oxygen transport resistance of the components of the PEMFC, such as the substrate, micro-porous layer (MPL), catalyst layer, and ionomer film. The Knudsen numbers are calculated to determine the types of diffusion mechanisms at each layer by measuring the pore sizes with either mercury porosimetry or BET analysis. At the under-saturated condition where condensation is mostly absent, the molecular diffusion resistance is dissected by changing the type of inert gas, and ionomer film permeation is separated by varying the inlet gas humidity. Moreover, the presence of the MPL and the variability of the substrate thickness allow the oxygen transport resistance at each component of a PEMFC to be dissected. At a low relative humidity of 50% and lower, an ionomer film had the largest resistance, while the contribution of the MPL was largest for the other humidification conditions.

Incidence and Costs of Clostridium difficile Infections in Canada.

PubMed

Levy, Adrian R; Szabo, Shelagh M; Lozano-Ortega, Greta; Lloyd-Smith, Elisa; Leung, Victor; Lawrence, Robin; Romney, Marc G

2015-09-01

Background.  Limited data are available on direct medical costs and lost productivity due to Clostridium difficile infection (CDI) in Canada. Methods.  We developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with CDI in Canada. The number of episodes was projected based on publicly available national rates of hospital-associated CDI and the estimate that 64% of all CDI is hospital-associated. Clostridium difficile infection recurrences were classified as relapses or reinfections. Resource utilization data came from published literature, clinician interviews, and Canadian CDI surveillance programs, and this included the following: hospital length of stay, contact with healthcare providers, pharmacotherapy, laboratory testing, and in-hospital procedures. Lost productivity was considered for those under 65 years of age, and the economic impact was quantified using publicly available labor statistics. Unit costs were obtained from published sources and presented in 2012 Canadian dollars. Results.  There were an estimated 37 900 CDI episodes in Canada in 2012; 7980 (21%) of these were relapses, out of a total of 10 900 (27%) episodes of recurrence. The total cost to society of CDI was estimated at $281 million; 92% ($260 million) was in-hospital costs, 4% ($12 million) was direct medical costs in the community, and 4% ($10 million) was due to lost productivity. Management of CDI relapses alone accounted for $65.1 million (23%). Conclusions.  The largest proportion of costs due to CDI in Canada arise from extra days of hospitalization. Interventions reducing the severity of infection and/or relapses leading to rehospitalizations are likely to have the largest absolute effect on direct medical costs.

Incidence and Costs of Clostridium difficile Infections in Canada

PubMed Central

Levy, Adrian R.; Szabo, Shelagh M.; Lozano-Ortega, Greta; Lloyd-Smith, Elisa; Leung, Victor; Lawrence, Robin; Romney, Marc G.

2015-01-01

Background. Limited data are available on direct medical costs and lost productivity due to Clostridium difficile infection (CDI) in Canada. Methods. We developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with CDI in Canada. The number of episodes was projected based on publicly available national rates of hospital-associated CDI and the estimate that 64% of all CDI is hospital-associated. Clostridium difficile infection recurrences were classified as relapses or reinfections. Resource utilization data came from published literature, clinician interviews, and Canadian CDI surveillance programs, and this included the following: hospital length of stay, contact with healthcare providers, pharmacotherapy, laboratory testing, and in-hospital procedures. Lost productivity was considered for those under 65 years of age, and the economic impact was quantified using publicly available labor statistics. Unit costs were obtained from published sources and presented in 2012 Canadian dollars. Results. There were an estimated 37 900 CDI episodes in Canada in 2012; 7980 (21%) of these were relapses, out of a total of 10 900 (27%) episodes of recurrence. The total cost to society of CDI was estimated at $281 million; 92% ($260 million) was in-hospital costs, 4% ($12 million) was direct medical costs in the community, and 4% ($10 million) was due to lost productivity. Management of CDI relapses alone accounted for $65.1 million (23%). Conclusions. The largest proportion of costs due to CDI in Canada arise from extra days of hospitalization. Interventions reducing the severity of infection and/or relapses leading to rehospitalizations are likely to have the largest absolute effect on direct medical costs. PMID:26191534

HUMAN RESPONDING ON RANDOM-INTERVAL SCHEDULES OF RESPONSE-COST PUNISHMENT: THE ROLE OF REDUCED REINFORCEMENT DENSITY

PubMed Central

Pietras, Cynthia J; Brandt, Andrew E; Searcy, Gabriel D

2010-01-01

An experiment with adult humans investigated the effects of response-contingent money loss (response-cost punishment) on monetary-reinforced responding. A yoked-control procedure was used to separate the effects on responding of the response-cost contingency from the effects of reduced reinforcement density. Eight adults pressed buttons for money on a three-component multiple reinforcement schedule. During baseline, responding in all components produced money gains according to a random-interval 20-s schedule. During punishment conditions, responding during the punishment component conjointly produced money losses according to a random-interval schedule. The value of the response-cost schedule was manipulated across conditions to systematically evaluate the effects on responding of response-cost frequency. Participants were assigned to one of two yoked-control conditions. For participants in the Yoked Punishment group, during punishment conditions money losses were delivered in the yoked component response independently at the same intervals that money losses were produced in the punishment component. For participants in the Yoked Reinforcement group, responding in the yoked component produced the same net earnings as produced in the punishment component. In 6 of 8 participants, contingent response cost selectively decreased response rates in the punishment component and the magnitude of the decrease was directly related to the punishment schedule value. Under punishment conditions, for participants in the Yoked Punishment group response rates in the yoked component also decreased, but the decrease was less than that observed in the punishment component, whereas for participants in the Yoked Reinforcement group response rates in the yoked component remained similar to rates in the no-punishment component. These results provide further evidence that contingent response cost functions similarly to noxious punishers in that it appears to suppress responding apart from its effects on reinforcement density. PMID:20676265

Cost and schedule management on the quiet short-haul research aircraft project

NASA Technical Reports Server (NTRS)

Wilcox, D. E.; Patterakis, P.

1979-01-01

The Quiet Short-Haul Research Aircraft (QSRA) Project, one of the largest aeronautical programs undertaken by NASA to date, achieved a significant cost underrun. This is attributed to numerous factors, not the least of which were the contractual arrangement and the system of cost and schedule management employed by the contractor. This paper summarizes that system and the methods used for cost/performance measurement by the contractor and by the NASA project management. Recommendations are made for the use of some of these concepts in particular for future programs of a similar nature.

Utility-Scale Lithium-Ion Storage Cost Projections for Use in Capacity Expansion Models

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

Cole, Wesley J.; Marcy, Cara; Krishnan, Venkat K.

2016-11-21

This work presents U.S. utility-scale battery storage cost projections for use in capacity expansion models. We create battery cost projections based on a survey of literature cost projections of battery packs and balance of system costs, with a focus on lithium-ion batteries. Low, mid, and high cost trajectories are created for the overnight capital costs and the operating and maintenance costs. We then demonstrate the impact of these cost projections in the Regional Energy Deployment System (ReEDS) capacity expansion model. We find that under reference scenario conditions, lower battery costs can lead to increased penetration of variable renewable energy, withmore » solar photovoltaics (PV) seeing the largest increase. We also find that additional storage can reduce renewable energy curtailment, although that comes at the expense of additional storage losses.« less

Conductors for commercial MRI magnets beyond NbTi: requirements and challenges.

PubMed

Parizh, Michael; Lvovsky, Yuri; Sumption, Michael

2017-01-01

Magnetic Resonance Imaging (MRI), a powerful medical diagnostic tool, is the largest commercial application of superconductivity. The superconducting magnet is the largest and most expensive component of an MRI system. The magnet configuration is determined by competing requirements including optimized functional performance, patient comfort, ease of siting in a hospital environment, minimum acquisition and lifecycle cost including service. In this paper, we analyze conductor requirements for commercial MRI magnets beyond traditional NbTi conductors, while avoiding links to a particular magnet configuration or design decisions. Potential conductor candidates include MgB 2 , ReBCO and BSCCO options. The analysis shows that no MRI-ready non-NbTi conductor is commercially available at the moment. For some conductors, MRI specifications will be difficult to achieve in principle. For others, cost is a key barrier. In some cases, the prospects for developing an MRI-ready conductor are more favorable, but significant developments are still needed. The key needs include the development of, or significant improvements in: (a) conductors specifically designed for MRI applications, with form-fit-and-function readily integratable into the present MRI magnet technology with minimum modifications. Preferably, similar conductors should be available from multiple vendors; (b) conductors with improved quench characteristics, i.e. the ability to carry significant current without damage while in the resistive state; (c) insulation which is compatible with manufacturing and refrigeration technologies; (d) dramatic increases in production and long-length quality control, including large-volume conductor manufacturing technology. In-situ MgB 2 is, perhaps, the closest to meeting commercial and technical requirements to become suitable for commercial MRI. Conductor technology is an important, but not the only, issue in introduction of HTS / MgB 2 conductor into commercial MRI magnets. These new conductors, even when they meet the above requirements, will likely require numerous modifications and developments in the associated magnet technology.

Conductors for commercial MRI magnets beyond NbTi: requirements and challenges

NASA Astrophysics Data System (ADS)

Parizh, Michael; Lvovsky, Yuri; Sumption, Michael

2017-01-01

Magnetic resonance imaging (MRI), a powerful medical diagnostic tool, is the largest commercial application of superconductivity. The superconducting magnet is the largest and most expensive component of an MRI system. The magnet configuration is determined by competing requirements including optimized functional performance, patient comfort, ease of siting in a hospital environment, minimum acquisition and lifecycle cost including service. In this paper, we analyze conductor requirements for commercial MRI magnets beyond traditional NbTi conductors, while avoiding links to a particular magnet configuration or design decisions. Potential conductor candidates include MgB2, ReBCO and BSCCO options. The analysis shows that no MRI-ready non-NbTi conductor is commercially available at the moment. For some conductors, MRI specifications will be difficult to achieve in principle. For others, cost is a key barrier. In some cases, the prospects for developing an MRI-ready conductor are more favorable, but significant developments are still needed. The key needs include the development of, or significant improvements in: (a) conductors specifically designed for MRI applications, with form-fit-and-function readily integratable into the present MRI magnet technology with minimum modifications. Preferably, similar conductors should be available from multiple vendors; (b) conductors with improved quench characteristics, i.e. the ability to carry significant current without damage while in the resistive state; (c) insulation which is compatible with manufacturing and refrigeration technologies; (d) dramatic increases in production and long-length quality control, including large-volume conductor manufacturing technology. In-situ MgB2 is, perhaps, the closest to meeting commercial and technical requirements to become suitable for commercial MRI. Conductor technology is an important, but not the only, issue in introduction of HTS/MgB2 conductor into commercial MRI magnets. These new conductors, even when they meet the above requirements, will likely require numerous modifications and developments in the associated magnet technology.

Optimal Stomatal Behaviour Around the World: Synthesis of a Global Stomatal Conductance Database and Scaling from Leaf to Ecosystem

NASA Astrophysics Data System (ADS)

Lin, Y. S.; Medlyn, B. E.; Duursma, R.; Prentice, I. C.; Wang, H.

2014-12-01

Stomatal conductance (gs) is a key land surface attribute as it links transpiration, the dominant component of global land evapotranspiration and a key element of the global water cycle, and photosynthesis, the driving force of the global carbon cycle. Despite the pivotal role of gs in predictions of global water and carbon cycles, a global scale database and an associated globally applicable model of gs that allow predictions of stomatal behaviour are lacking. We present a unique database of globally distributed gs obtained in the field for a wide range of plant functional types (PFTs) and biomes. We employed a model of optimal stomatal conductance to assess differences in stomatal behaviour, and estimated the model slope coefficient, g1, which is directly related to the marginal carbon cost of water, for each dataset. We found that g1 varies considerably among PFTs, with evergreen savanna trees having the largest g1 (least conservative water use), followed by C3 grasses and crops, angiosperm trees, gymnosperm trees, and C4 grasses. Amongst angiosperm trees, species with higher wood density had a higher marginal carbon cost of water, as predicted by the theory underpinning the optimal stomatal model. There was an interactive effect between temperature and moisture availability on g1: for wet environments, g1 was largest in high temperature environments, indicated by high mean annual temperature during the period when temperature above 0oC (Tm), but it did not vary with Tm across dry environments. We examine whether these differences in leaf-scale behaviour are reflected in ecosystem-scale differences in water-use efficiency. These findings provide a robust theoretical framework for understanding and predicting the behaviour of stomatal conductance across biomes and across PFTs that can be applied to regional, continental and global-scale modelling of productivity and ecohydrological processes in a future changing climate.

Conductors for commercial MRI magnets beyond NbTi: requirements and challenges

PubMed Central

Parizh, Michael; Lvovsky, Yuri; Sumption, Michael

2016-01-01

Magnetic Resonance Imaging (MRI), a powerful medical diagnostic tool, is the largest commercial application of superconductivity. The superconducting magnet is the largest and most expensive component of an MRI system. The magnet configuration is determined by competing requirements including optimized functional performance, patient comfort, ease of siting in a hospital environment, minimum acquisition and lifecycle cost including service. In this paper, we analyze conductor requirements for commercial MRI magnets beyond traditional NbTi conductors, while avoiding links to a particular magnet configuration or design decisions. Potential conductor candidates include MgB2, ReBCO and BSCCO options. The analysis shows that no MRI-ready non-NbTi conductor is commercially available at the moment. For some conductors, MRI specifications will be difficult to achieve in principle. For others, cost is a key barrier. In some cases, the prospects for developing an MRI-ready conductor are more favorable, but significant developments are still needed. The key needs include the development of, or significant improvements in: (a) conductors specifically designed for MRI applications, with form-fit-and-function readily integratable into the present MRI magnet technology with minimum modifications. Preferably, similar conductors should be available from multiple vendors; (b) conductors with improved quench characteristics, i.e. the ability to carry significant current without damage while in the resistive state; (c) insulation which is compatible with manufacturing and refrigeration technologies; (d) dramatic increases in production and long-length quality control, including large-volume conductor manufacturing technology. In-situ MgB2 is, perhaps, the closest to meeting commercial and technical requirements to become suitable for commercial MRI. Conductor technology is an important, but not the only, issue in introduction of HTS / MgB2 conductor into commercial MRI magnets. These new conductors, even when they meet the above requirements, will likely require numerous modifications and developments in the associated magnet technology. PMID:28626340

The National School Lunch Program: Background, Trends, and Issues. Economic Research Report Number 61

ERIC Educational Resources Information Center

Ralston, Katherine; Newman, Constance; Clauson, Annette; Guthrie, Joanne; Buzby, Jean

2008-01-01

The National School Lunch Program (NSLP) is the Nation's second largest food and nutrition assistance program. In 2006, it operated in over 101,000 public and nonprofit private schools and provided over 28 million low-cost or free lunches to children on a typical school day at a Federal cost of $8 billion for the year. This report provides…

The hidden cost of wildfires: Economic valuation of health effects of wildfire smoke exposure in southern California

Treesearch

Leslie A. Richardson; Patricia A. Champ; John B. Loomis

2012-01-01

There is a growing concern that human health impacts from exposure to wildfire smoke are ignored in estimates of monetized damages from wildfires. Current research highlights the need for better data collection and analysis of these impacts. Using unique primary data, this paper quantifies the economic cost of health effects from the largest wildfire in Los Angeles...

A region on BTA14 that includes the positional candidate genes LYPLA1, XKR4 and TMEM68 is associated with feed intake and growth phenotypes in cattle

USDA-ARS?s Scientific Manuscript database

The cost of feed for beef cattle is the largest expense incurred by cattle producers. Development of genetic markers to enhance selection of more efficient animals that require less feed while still achieving acceptable levels of production has the potential to substantially reduce production costs....

Analysis on Inpatient Health Expenditures of Renal Cell Carcinoma in a Grade-A Tertiary Hospital in Beijing.

PubMed

Liu, Xin; Mao, Yong-Hui; He, Xue-Mei; Zhang, Yan-Jing; Sun, Ying

2017-10-20

Renal cell carcinoma (RCC) is the most common type of malignant renal tumors with a growing incidence in the recent years. This study aimed to investigate the influencing factors and variation trend of hospitalization expenditures among RCC patients in a single-centered hospital in Beijing during 5 consecutive years and to find the major cost items and fluctuation tendency of inpatient medical expenditures. The information of medical expenditures among RCC patients in a Grade-A tertiary hospital during the years 2012-2016 was investigated to find the main cost items and changes affecting the medical cost structure. Gray correlation method was adopted in quantitative analysis to analyze the composition of medical expenditures, and the variation of hospitalization expense structure during the five years was studied by analyzing the degree of structural variation. The cost item constitution of the hospitalization expenditures among RCC patients was relatively stable in the sample hospital during the past five years. To be specific, drug costs accounted for the largest proportion of medical expenditures each year, with the highest of 37.81% in 2012, and showed a slowly declining tendency in the coming years. The cost item with the highest correlation degree was drug costs, with the value of 1.0000; followed by the costs of surgeries, 0.8423. Furthermore, drug costs shared the largest proportion (40.95%) of structural variation, followed by the costs of surgeries (18.35%). Drug costs are the major influencing factors of the hospitalization expenditures among RCC patients. Thus, reasonable control on excessive drugs as well as the standardization of the diagnosis and treatment behaviors is conducive in reducing medical expenditures as well as easing patients' economic burdens. Besides, the positive growth on surgery costs suggests that the labor value of medical staffs has been gradually recognized.

Evaluating and planning the radioactive waste options for dismantling the Tokamak Fusion Test Reactor

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

Rule, K.; Scott, J.; Larson, S.

1995-12-31

The Tokamak Fusion Test Reactor (TFTR) is a one-of-a kind tritium fusion research reactor, and is planned to be decommissioned within the next several years. This is the largest fusion reactor in the world and as a result of deuterium-tritum reactions is tritium contaminated and activated from 14 Mev neutrons. This presents many unusual challenges when dismantling, packaging and disposing its components and ancillary systems. Special containers are being designed to accommodate the vacuum vessel, neutral beams, and tritium delivery and processing systems. A team of experienced professionals performed a detailed field study to evaluate the requirements and appropriate methodsmore » for packaging the radioactive materials. This team focused on several current and innovative methods for waste minimization that provides the oppurtunmost cost effective manner to package and dispose of the waste. This study also produces a functional time-phased schedule which conjoins the waste volume, weight, costs and container requirements with the detailed project activity schedule for the entire project scope. This study and project will be the first demonstration of the decommissioning of a tritium fusion test reactor. The radioactive waste disposal aspects of this project are instrumental in demonstrating the viability of a fusion power reactor with regard to its environmental impact and ultimate success.« less

Intelligent Bioreactor Management Information System (IBM-IS) for Mitigation of Greenhouse Gas Emissions

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

Paul Imhoff; Ramin Yazdani; Don Augenstein

Methane is an important contributor to global warming with a total climate forcing estimated to be close to 20% that of carbon dioxide (CO2) over the past two decades. The largest anthropogenic source of methane in the US is 'conventional' landfills, which account for over 30% of anthropogenic emissions. While controlling greenhouse gas emissions must necessarily focus on large CO2 sources, attention to reducing CH4 emissions from landfills can result in significant reductions in greenhouse gas emissions at low cost. For example, the use of 'controlled' or bioreactor landfilling has been estimated to reduce annual US greenhouse emissions by aboutmore » 15-30 million tons of CO2 carbon (equivalent) at costs between $3-13/ton carbon. In this project we developed or advanced new management approaches, landfill designs, and landfill operating procedures for bioreactor landfills. These advances are needed to address lingering concerns about bioreactor landfills (e.g., efficient collection of increased CH4 generation) in the waste management industry, concerns that hamper bioreactor implementation and the consequent reductions in CH4 emissions. Collectively, the advances described in this report should result in better control of bioreactor landfills and reductions in CH4 emissions. Several advances are important components of an Intelligent Bioreactor Management Information System (IBM-IS).« less

Space Station Furnace Facility. Volume 3: Program cost estimate

NASA Technical Reports Server (NTRS)

1992-01-01

The approach used to estimate costs for the Space Station Furnace Facility (SSFF) is based on a computer program developed internally at Teledyne Brown Engineering (TBE). The program produces time-phased estimates of cost elements for each hardware component, based on experience with similar components. Engineering estimates of the degree of similarity or difference between the current project and the historical data is then used to adjust the computer-produced cost estimate and to fit it to the current project Work Breakdown Structure (WBS). The SSFF Concept as presented at the Requirements Definition Review (RDR) was used as the base configuration for the cost estimate. This program incorporates data on costs of previous projects and the allocation of those costs to the components of one of three, time-phased, generic WBS's. Input consists of a list of similar components for which cost data exist, number of interfaces with their type and complexity, identification of the extent to which previous designs are applicable, and programmatic data concerning schedules and miscellaneous data (travel, off-site assignments). Output is program cost in labor hours and material dollars, for each component, broken down by generic WBS task and program schedule phase.

Knee point search using cascading top-k sorting with minimized time complexity.

PubMed

Wang, Zheng; Tseng, Shian-Shyong

2013-01-01

Anomaly detection systems and many other applications are frequently confronted with the problem of finding the largest knee point in the sorted curve for a set of unsorted points. This paper proposes an efficient knee point search algorithm with minimized time complexity using the cascading top-k sorting when a priori probability distribution of the knee point is known. First, a top-k sort algorithm is proposed based on a quicksort variation. We divide the knee point search problem into multiple steps. And in each step an optimization problem of the selection number k is solved, where the objective function is defined as the expected time cost. Because the expected time cost in one step is dependent on that of the afterwards steps, we simplify the optimization problem by minimizing the maximum expected time cost. The posterior probability of the largest knee point distribution and the other parameters are updated before solving the optimization problem in each step. An example of source detection of DNS DoS flooding attacks is provided to illustrate the applications of the proposed algorithm.

Advanced Supersonic Technology concept AST-100 characteristics developed in a baseline-update study

NASA Technical Reports Server (NTRS)

Baber, H. T., Jr.; Swanson, E. E.

1976-01-01

The advanced supersonic technology configuration, AST-100, is described. The combination of wing thickness reduction, nacelle recontouring for minimum drag at cruise, and the use of the horizontal tail to produce lift during climb and cruise resulted in an increase in maximum lift-to-drag ratio. Lighter engines and lower fuel weight associated with this resizing result in a six percent reduction in takeoff gross weight. The AST-100 takeoff maximum effective perceived noise at the runway centerline and sideline measurement stations was 114.4 decibels. Since 1.5-decibels tradeoff is available from the approach noise, the required engine noise supression is 4.9 decibels. The AST-100 largest maximum overpressure would occur during transonic climb acceleration when the aircraft was at relatively low altitude. Calculated standard +8 C day range of the AST-100, with a 292 passenger payload, is 7348 km (3968 n.mi). Fuel price is the largest contributor to direct operating cost. However, if the AST-100 were flown subsonically (M = 0.9), direct operating costs would increase approximately 50 percent because of time related costs.

Investigate plow blade optimization : executive summary.

DOT National Transportation Integrated Search

2015-08-01

Snow and ice management is the single largest expenditure in the maintenance budget for the Ohio : Department of Transportation (ODOT), with an annual cost including labor, equipment, and materials : reaching approximately $86 million. Given the curr...

Millimeter wave radar for automobile crash avoidance systems

NASA Astrophysics Data System (ADS)

Huguenin, G. Richard

1994-08-01

Low cost, millimeter wave, forward looking radar sensors for applications in Autonomous Collision Warning and Autonomous Intelligent Cruise Control systems will be described. These safety related systems promise the largest payoff in preventing highway crashes.

Managing manifest diseases, but not health risks, saved PepsiCo money over seven years.

PubMed

Caloyeras, John P; Liu, Hangsheng; Exum, Ellen; Broderick, Megan; Mattke, Soeren

2014-01-01

Workplace wellness programs are increasingly popular. Employers expect them to improve employee health and well-being, lower medical costs, increase productivity, and reduce absenteeism. To test whether such expectations are warranted, we evaluated the cost impact of the lifestyle and disease management components of PepsiCo's wellness program, Healthy Living. We found that seven years of continuous participation in one or both components was associated with an average reduction of $30 in health care cost per member per month. When we looked at each component individually, we found that the disease management component was associated with lower costs and that the lifestyle management component was not. We estimate disease management to reduce health care costs by $136 per member per month, driven by a 29 percent reduction in hospital admissions. Workplace wellness programs may reduce health risks, delay or avoid the onset of chronic diseases, and lower health care costs for employees with manifest chronic disease. But employers and policy makers should not take for granted that the lifestyle management component of such programs can reduce health care costs or even lead to net savings.

Audiovisual integration for speech during mid-childhood: electrophysiological evidence.

PubMed

Kaganovich, Natalya; Schumaker, Jennifer

2014-12-01

Previous studies have demonstrated that the presence of visual speech cues reduces the amplitude and latency of the N1 and P2 event-related potential (ERP) components elicited by speech stimuli. However, the developmental trajectory of this effect is not yet fully mapped. We examined ERP responses to auditory, visual, and audiovisual speech in two groups of school-age children (7-8-year-olds and 10-11-year-olds) and in adults. Audiovisual speech led to the attenuation of the N1 and P2 components in all groups of participants, suggesting that the neural mechanisms underlying these effects are functional by early school years. Additionally, while the reduction in N1 was largest over the right scalp, the P2 attenuation was largest over the left and midline scalp. The difference in the hemispheric distribution of the N1 and P2 attenuation supports the idea that these components index at least somewhat disparate neural processes within the context of audiovisual speech perception. Copyright © 2014 Elsevier Inc. All rights reserved.

Audiovisual integration for speech during mid-childhood: Electrophysiological evidence

PubMed Central

Kaganovich, Natalya; Schumaker, Jennifer

2014-01-01

Previous studies have demonstrated that the presence of visual speech cues reduces the amplitude and latency of the N1 and P2 event-related potential (ERP) components elicited by speech stimuli. However, the developmental trajectory of this effect is not yet fully mapped. We examined ERP responses to auditory, visual, and audiovisual speech in two groups of school-age children (7–8-year-olds and 10–11-year-olds) and in adults. Audiovisual speech led to the attenuation of the N1 and P2 components in all groups of participants, suggesting that the neural mechanisms underlying these effects are functional by early school years. Additionally, while the reduction in N1 was largest over the right scalp, the P2 attenuation was largest over the left and midline scalp. The difference in the hemispheric distribution of the N1 and P2 attenuation supports the idea that these components index at least somewhat disparate neural processes within the context of audiovisual speech perception. PMID:25463815

Strong motion observations and recordings from the great Wenchuan Earthquake

USGS Publications Warehouse

Li, X.; Zhou, Z.; Yu, H.; Wen, R.; Lu, D.; Huang, M.; Zhou, Y.; Cu, J.

2008-01-01

The National Strong Motion Observation Network System (NSMONS) of China is briefly introduced in this paper. The NSMONS consists of permanent free-field stations, special observation arrays, mobile observatories and a network management system. During the Wenchuan Earthquake, over 1,400 components of acceleration records were obtained from 460 permanent free-field stations and three arrays for topographical effect and structural response observation in the network system from the main shock, and over 20,000 components of acceleration records from strong aftershocks occurred before August 1, 2008 were also obtained by permanent free-field stations of the NSMONS and 59 mobile instruments quickly deployed after the main shock. The strong motion recordings from the main shock and strong aftershocks are summarized in this paper. In the ground motion recordings, there are over 560 components with peak ground acceleration (PGA) over 10 Gal, the largest being 957.7 Gal. The largest PGA recorded during the aftershock exceeds 300 Gal. ?? 2008 Institute of Engineering Mechanics, China Earthquake Administration and Springer-Verlag GmbH.

Multibrid technology - a significant step to multi-megawatt wind turbines

NASA Astrophysics Data System (ADS)

Siegfriedsen, S.; Böhmeke, G.

1998-12-01

To fulfil the significant economic potential for offshore wind energy, it is essential that the largest possible installations must be allowed to come into use. Infrastructure investments for foundations and energy transport are only slightly dependent on the size of the installation, so these costs become proportionally smaller as the installed power output increases. This article puts forward a technologically novel type of development for a drive train design, specifically introduced for a 5 MW installation. The concept is especially suited for offshore application and the components are designed for this purpose. The usual way of modifying onshore plants partially and using them in the sea has been left with the present proposals. The design comprises a single-stage planetary gear, into which the rotor bearing is integrated, and a generator rotating at slow speed. Both components are assembled into a compact unit and are characterized by low wear and complete enclosure. New solutions are also proposed for the cooling of the machinery and the yaw system, offering particular advantages in offshore application. The advantages of the new technology are brought out from system comparisons with both a conventional plant configuration with a multi-stage gear and a high-speed generator, and also a combination with a direct drive generator in the 1·5 MW class. A particular design solution, worked through for a 5 MW installation, is presented and described in detail. At 31 kg kW-1, the specific tower head mass achieves a value that has not previously been realized in this power output class. As a result of the advantages that are brought together by this technology, both investment and operating costs are lowered, particularly for offshore applications. Implementation of this technology can thus provide a further stimulus for progress in wind energy utilization. Copyright

Computerised Analysis of Telemonitored Respiratory Sounds for Predicting Acute Exacerbations of COPD.

PubMed

Fernandez-Granero, Miguel Angel; Sanchez-Morillo, Daniel; Leon-Jimenez, Antonio

2015-10-23

Chronic obstructive pulmonary disease (COPD) is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients' quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD). The evidence that might support the effectiveness of the telemonitoring interventions in COPD is limited partially due to the lack of useful predictors for the early detection of AECOPD. Electronic stethoscopes and computerised analyses of respiratory sounds (CARS) techniques provide an opportunity for substantial improvement in the management of respiratory diseases. This exploratory study aimed to evaluate the feasibility of using: (a) a respiratory sensor embedded in a self-tailored housing for ageing users; (b) a telehealth framework; (c) CARS and (d) machine learning techniques for the remote early detection of the AECOPD. In a 6-month pilot study, 16 patients with COPD were equipped with a home base-station and a sensor to daily record their respiratory sounds. Principal component analysis (PCA) and a support vector machine (SVM) classifier was designed to predict AECOPD. 75.8% exacerbations were early detected with an average of 5 ± 1.9 days in advance at medical attention. The proposed method could provide support to patients, physicians and healthcare systems.

Lightweighting Impacts on Fuel Economy, Cost, and Component Losses

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

Brooker, A. D.; Ward, J.; Wang, L.

2013-01-01

The Future Automotive Systems Technology Simulator (FASTSim) is the U.S. Department of Energy's high-level vehicle powertrain model developed at the National Renewable Energy Laboratory. It uses a time versus speed drive cycle to estimate the powertrain forces required to meet the cycle. It simulates the major vehicle powertrain components and their losses. It includes a cost model based on component sizing and fuel prices. FASTSim simulated different levels of lightweighting for four different powertrains: a conventional gasoline engine vehicle, a hybrid electric vehicle (HEV), a plug-in hybrid electric vehicle (PHEV), and a battery electric vehicle (EV). Weight reductions impacted themore » conventional vehicle's efficiency more than the HEV, PHEV and EV. Although lightweighting impacted the advanced vehicles' efficiency less, it reduced component cost and overall costs more. The PHEV and EV are less cost effective than the conventional vehicle and HEV using current battery costs. Assuming the DOE's battery cost target of $100/kWh, however, the PHEV attained similar cost and lightweighting benefits. Generally, lightweighting was cost effective when it costs less than $6/kg of mass eliminated.« less

The financial burden from non-communicable diseases in low- and middle-income countries: a literature review

PubMed Central

2013-01-01

Non-communicable diseases (NCDs) were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both mortality and morbidity in low- and middle-income countries (LMICs), although little is known about the impact these diseases have on households in these countries. In this paper, we present a literature review on the costs imposed by NCDs on households in LMICs. We examine both the costs of obtaining medical care and the costs associated with being unable to work, while discussing the methodological issues of particular studies. The results suggest that NCDs pose a heavy financial burden on many affected households; poor households are the most financially affected when they seek care. Medicines are usually the largest component of costs and the use of originator brand medicines leads to higher than necessary expenses. In particular, in the treatment of diabetes, insulin – when required – represents an important source of spending for patients and their families. These financial costs deter many people suffering from NCDs from seeking the care they need. The limited health insurance coverage for NCDs is reflected in the low proportions of patients claiming reimbursement and the low reimbursement rates in existing insurance schemes. The costs associated with lost income-earning opportunities are also significant for many households. Therefore, NCDs impose a substantial financial burden on many households, including the poor in low-income countries. The financial costs of obtaining care also impose insurmountable barriers to access for some people, which illustrates the urgency of improving financial risk protection in health in LMIC settings and ensuring that NCDs are taken into account in these systems. In this paper, we identify areas where further research is needed to have a better view of the costs incurred by households because of NCDs; namely, the extension of the geographical scope, the inclusion of certain diseases hitherto little studied, the introduction of a time dimension, and more comparisons with acute illnesses. PMID:23947294

Advanced General Aviation Turbine Engine (GATE) concepts

NASA Technical Reports Server (NTRS)

Lays, E. J.; Murray, G. L.

1979-01-01

Concepts are discussed that project turbine engine cost savings through use of geometrically constrained components designed for low rotational speeds and low stress to permit manufacturing economies. Aerodynamic development of geometrically constrained components is recommended to maximize component efficiency. Conceptual engines, airplane applications, airplane performance, engine cost, and engine-related life cycle costs are presented. The powerplants proposed offer encouragement with respect to fuel efficiency and life cycle costs, and make possible remarkable airplane performance gains.

How Students Use Federal, State and Institutional Aid to Pay for College: A Primer for State Policymakers. Special Report

ERIC Educational Resources Information Center

Sarubbi, Molly; Pingel, Sarah

2018-01-01

Postsecondary education is one of the largest investments that students and their families make, with average yearly cost of attendance--including tuition, fees, room and board--of just under $17,000 to attend a public institution in the 2015-16 academic year. In the context of increasing college costs, aid dollars have failed to keep pace with…

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

PubMed

Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

Estimated cost of overactive bladder in Thailand.

PubMed

Prasopsanti, Kriangsak; Santi-Ngamkun, Apirak; Pornprasit, Kanokwan

2007-11-01

To estimate the annual direct and indirect costs of overactive bladder (OAB) in indigenous Thai people aged 18 years and over in the year 2005. Economically based models using diagnostic and treatment algorithms from clinical practice guidelines and current disease prevalence data were used to estimate direct and indirect costs of OAB. Prevalence and event probability estimates were obtained from the literature, national data sets, and expert opinion. Costs were estimated from a small survey using a cost questionnaire and from unit costs of King Chulalongkorn Memorial Hospital. The annual cost of OAB in Thailand is estimated as 1.9 billion USD. It is estimated to consume 1.14% of national GDP The cost includes 0.33 billion USD for direct medical costs, 1.3 billion USD for direct, nonmedical costs and 0.29 billion USD for indirect costs of lost productivity. The largest costs category was direct treatment costs of comorbidities associated with OAB. Costs of OAB medication accountedfor 14% of the total costs ofOAB.

Ultrahigh-rate supercapacitors based on eletrochemically reduced graphene oxide for ac line-filtering.

PubMed

Sheng, Kaixuan; Sun, Yiqing; Li, Chun; Yuan, Wenjing; Shi, Gaoquan

2012-01-01

The recent boom in multifunction portable electronic equipments requires the development of compact and miniaturized electronic circuits with high efficiencies, low costs and long lasting time. For the operation of most line-powered electronics, alternating current (ac) line-filters are used to attenuate the leftover ac ripples on direct current (dc) voltage busses. Today, aluminum electrolytic capacitors (AECs) are widely applied for this purpose. However, they are usually the largest components in electronic circuits. Replacing AECs by more compact capacitors will have an immense impact on future electronic devices. Here, we report a double-layer capacitor based on three-dimensional (3D) interpenetrating graphene electrodes fabricated by electrochemical reduction of graphene oxide (ErGO-DLC). At 120-hertz, the ErGO-DLC exhibited a phase angle of -84 degrees, a specific capacitance of 283 microfaradays per centimeter square and a resistor-capacitor (RC) time constant of 1.35 milliseconds, making it capable of replacing AECs for the application of 120-hertz filtering.

Ultrahigh-rate supercapacitors based on eletrochemically reduced graphene oxide for ac line-filtering

NASA Astrophysics Data System (ADS)

Sheng, Kaixuan; Sun, Yiqing; Li, Chun; Yuan, Wenjing; Shi, Gaoquan

2012-02-01

The recent boom in multifunction portable electronic equipments requires the development of compact and miniaturized electronic circuits with high efficiencies, low costs and long lasting time. For the operation of most line-powered electronics, alternating current (ac) line-filters are used to attenuate the leftover ac ripples on direct current (dc) voltage busses. Today, aluminum electrolytic capacitors (AECs) are widely applied for this purpose. However, they are usually the largest components in electronic circuits. Replacing AECs by more compact capacitors will have an immense impact on future electronic devices. Here, we report a double-layer capacitor based on three-dimensional (3D) interpenetrating graphene electrodes fabricated by electrochemical reduction of graphene oxide (ErGO-DLC). At 120-hertz, the ErGO-DLC exhibited a phase angle of -84 degrees, a specific capacitance of 283 microfaradays per centimeter square and a resistor-capacitor (RC) time constant of 1.35 milliseconds, making it capable of replacing AECs for the application of 120-hertz filtering.

Ultrahigh-rate supercapacitors based on eletrochemically reduced graphene oxide for ac line-filtering

PubMed Central

Sheng, Kaixuan; Sun, Yiqing; Li, Chun; Yuan, Wenjing; Shi, Gaoquan

2012-01-01

The recent boom in multifunction portable electronic equipments requires the development of compact and miniaturized electronic circuits with high efficiencies, low costs and long lasting time. For the operation of most line-powered electronics, alternating current (ac) line-filters are used to attenuate the leftover ac ripples on direct current (dc) voltage busses. Today, aluminum electrolytic capacitors (AECs) are widely applied for this purpose. However, they are usually the largest components in electronic circuits. Replacing AECs by more compact capacitors will have an immense impact on future electronic devices. Here, we report a double-layer capacitor based on three-dimensional (3D) interpenetrating graphene electrodes fabricated by electrochemical reduction of graphene oxide (ErGO-DLC). At 120-hertz, the ErGO-DLC exhibited a phase angle of −84 degrees, a specific capacitance of 283 microfaradays per centimeter square and a resistor-capacitor (RC) time constant of 1.35 milliseconds, making it capable of replacing AECs for the application of 120-hertz filtering. PMID:22355759

A Comparison of Six Repair Scheduling Policies for the P3 Aircraft.

DTIC Science & Technology

1988-03-01

each type component i: RHO(i) = LAMBDA(i) / SRATE(i) LINEUPti) - RHO(i) x COUNT(i) Step 14c: Sort components by LINEUP (i), reorder position in line in...favor of the largest LINEUP (i). Return to step 7. Dynamic 3 Model Modifications: Step 14a: Count the number of operating parts of each component i...STOCK(i)). Step 14b: Assign a priority to each component type based on the count of current stock in step 14a: LINEUP (i) < LINEUP (J) iff STOCK(i

Consolidation and the transformation of competition in health insurance.

PubMed

Robinson, James C

2004-01-01

This paper presents data on fifty state and substate insurance markets, in terms of the 2003 relative shares of the largest health plans and the antitrust index of concentration. It presents 2000-03 data on rates of growth in premiums, costs, operating earnings, returns on equity, and share prices for the nation's largest health plans (Well-Point, Anthem, Aetna, and CIGNA). Private insurers face renewed price and profit pressures in the short term, but long-term prospects depend on the emergence of new products and new competitors in an increasingly consolidated industry.

Taking action to close the nursing-finance gap: learning from success.

PubMed

Douglas, Kathy

2010-01-01

Nurse leaders control the largest part of a hospital labor budget, in some cases the largest part of the overall budget. The effectiveness of overseeing this responsibility can mean the difference between an organization's financial stability and financial turmoil. The nursing department at Northwestern Memorial Hospital took ownership of its financial performance. Over the past 2 years, their financial performance saved $4.9 million in productivity while reducing nurses turnover costs by $7.6 million. Valuable lessons from their experience are offered for improving health care's financial and operational outlook.

Percolation under noise: Detecting explosive percolation using the second-largest component

NASA Astrophysics Data System (ADS)

Viles, Wes; Ginestet, Cedric E.; Tang, Ariana; Kramer, Mark A.; Kolaczyk, Eric D.

2016-05-01

We consider the problem of distinguishing between different rates of percolation under noise. A statistical model of percolation is constructed allowing for the birth and death of edges as well as the presence of noise in the observations. This graph-valued stochastic process is composed of a latent and an observed nonstationary process, where the observed graph process is corrupted by type-I and type-II errors. This produces a hidden Markov graph model. We show that for certain choices of parameters controlling the noise, the classical (Erdős-Rényi) percolation is visually indistinguishable from a more rapid form of percolation. In this setting, we compare two different criteria for discriminating between these two percolation models, based on the interquartile range (IQR) of the first component's size, and on the maximal size of the second-largest component. We show through data simulations that this second criterion outperforms the IQR of the first component's size, in terms of discriminatory power. The maximal size of the second component therefore provides a useful statistic for distinguishing between different rates of percolation, under physically motivated conditions for the birth and death of edges, and under noise. The potential application of the proposed criteria for the detection of clinically relevant percolation in the context of applied neuroscience is also discussed.

EVALUATING AND DESIGNING ULTRA-LOW-COST SOLAR WATER HEATING SYSTEMS

EPA Science Inventory

This project will have three key outputs:

1. an evaluation of the thermal performance of ultra-low-cost solar components, with components being characterized by their absorbed solar energy per cost;
2. a built demonstration prototype of...

3. Healthcare costs in chronic kidney disease and renal replacement therapy: a population-based cohort study in Sweden.

   PubMed

   Eriksson, Jonas K; Neovius, Martin; Jacobson, Stefan H; Elinder, Carl-Gustaf; Hylander, Britta

   2016-10-07

   To compare healthcare costs in chronic kidney disease (CKD) stage 4 or 5 not on dialysis (estimated glomerular filtration rate <30 mL/min/1.73m 2 ), peritoneal dialysis, haemodialysis and in transplanted patients with matched general population comparators. Population-based cohort study. Swedish national healthcare system. Prevalent adult patients with CKD 4 or 5 (n=1046, mean age 68 years), on peritoneal dialysis (n=101; 64 years), on haemodialysis (n=460; 65 years) and with renal transplants (n=825; 52 years) were identified in Stockholm County clinical quality registers for renal disease on 1 January 2010. 5 general population comparators from the same county were matched to each patient by age, sex and index year. Annual healthcare costs in 2009 incurred through inpatient and hospital-based outpatient care and dispensed prescription drugs ascertained from nationwide healthcare registers. Secondary outcomes were annual number of hospital days and outpatient care visits. Patients on haemodialysis had the highest mean annual cost (€87 600), which was 1.49 (95% CI 1.38 to 1.60) times that observed in peritoneal dialysis (€58 600). The mean annual cost was considerably lower in transplanted patients (€15 500) and in the CKD group (€9600). In patients on haemodialysis, outpatient care costs made up more than two-thirds (€62 500) of the total, while costs related to fluids ($29 900) was the largest cost component in patients on peritoneal dialysis (51%). Compared with their matched general population comparators, the mean annual cost (95% CI) in patients on haemodialysis, peritoneal dialysis, transplanted patients and patients with CKD was 45 (39 to 51), 29 (22 to 37), 11 (10 to 13) and 4.0 (3.6 to 4.5) times higher, respectively. The mean annual costs were ∼50% higher in patients on haemodialysis than in those on peritoneal dialysis. Compared with the general population, costs were substantially elevated in all groups, from 4-fold in patients with CKD to 11, 29 and 45 times higher in transplanted patients and patients on peritoneal dialysis and haemodialysis, respectively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

4. The economic burden of schizophrenia in Canada in 2004.

   PubMed

   Goeree, R; Farahati, F; Burke, N; Blackhouse, G; O'Reilly, D; Pyne, J; Tarride, J-E

   2005-12-01

   To estimate the financial burden of schizophrenia in Canada in 2004. A prevalence-based cost-of-illness (COI) approach was used. The primary sources of information for the study included a review of the published literature, a review of published reports and documents, secondary analysis of administrative datasets, and information collected directly from various federal and provincial government programs and services. The literature review included publications up to April 2005 reported in MedLine, EMBASE and PsychINFO. Where specific information from a province was not available, the method of mean substitution from other provinces was used. Costs incurred by various levels/departments of government were separated into healthcare and non-healthcare costs. Also included in the analysis was the value of lost productivity for premature mortality and morbidity associated with schizophrenia. Sensitivity analysis was used to test major cost assumptions used in the analysis. Where possible, all resource utilization estimates for the financial burden of schizophrenia were obtained for 2004 and are expressed in 2004 Canadian dollars (CAN dollars). The estimated number of persons with schizophrenia in Canada in 2004 was 234 305 (95% CI, 136 201-333 402). The direct healthcare and non-healthcare costs were estimated to be 2.02 billion CAN dollars in 2004. There were 374 deaths attributed to schizophrenia. This combined with the high unemployment rate due to schizophrenia resulted in an additional productivity morbidity and mortality loss estimate of 4.83 billion CAN dollars, for a total cost estimate in 2004 of 6.85 billion CAN dollars. By far the largest component of the total cost estimate was for productivity losses associated with morbidity in schizophrenia (70% of total costs) and the results showed that total cost estimates were most sensitive to alternative assumptions regarding the additional unemployment due to schizophrenia in Canada. Despite significant improvements in the past decade in pharmacotherapy, programs and services available for patients with schizophrenia, the economic burden of schizophrenia in Canada remains high. The most significant factor affecting the cost of schizophrenia in Canada is lost productivity due to morbidity. Programs targeted at improving patient symptoms and functioning to increase workforce participation has the potential to make a significant contribution in reducing the cost of this severe mental illness in Canada.

5. Social costs of road crashes: An international analysis.

   PubMed

   Wijnen, Wim; Stipdonk, Henk

   2016-09-01

   This paper provides an international overview of the most recent estimates of the social costs of road crashes: total costs, value per casualty and breakdown in cost components. The analysis is based on publications about the national costs of road crashes of 17 countries, of which ten high income countries (HICs) and seven low and middle income countries (LMICs). Costs are expressed as a proportion of the gross domestic product (GDP). Differences between countries are described and explained. These are partly a consequence of differences in the road safety level, but there are also methodological explanations. Countries may or may not correct for underreporting of road crashes, they may or may not use the internationally recommended willingness to pay (WTP)-method for estimating human costs, and there are methodological differences regarding the calculation of some other cost components. The analysis shows that the social costs of road crashes in HICs range from 0.5% to 6.0% of the GDP with an average of 2.7%. Excluding countries that do not use a WTP- method for estimating human costs and countries that do not correct for underreporting, results in average costs of 3.3% of GDP. For LMICs that do correct for underreporting the share in GDP ranges from 1.1% to 2.9%. However, none of the LMICs included has performed a WTP study of the human costs. A major part of the costs is related to injuries: an average share of 50% for both HICs and LMICs. The average share of fatalities in the costs is 23% and 30% respectively. Prevention of injuries is thus important to bring down the socio-economic burden of road crashes. The paper shows that there are methodological differences between countries regarding cost components that are taken into account and regarding the methods used to estimate specific cost components. In order to be able to make sound comparisons of the costs of road crashes across countries, (further) harmonization of cost studies is recommended. This can be achieved by updating and improving international guidelines and applying them in future cost studies. The information regarding some cost components, particularly human costs and property damage, is poor and more research into these cost components is recommended. Copyright © 2016 Elsevier Ltd. All rights reserved.

6. Brominated Flame Retardants

   EPA Science Inventory

   Brominated flame retardants (BFRs) belong to a large class of compounds known as organohalogens. BFRs are currently the largest marketed flame retardant group due to their high performance efficiency and low cost. In the commercial market, more than 75 different BFRs are recogniz...

7. 78 FR 21950 - Bosley, Inc., a Corporation, and Aderans America Holdings, Inc., a Corporation, and Aderans Co...

   Federal Register 2010, 2011, 2012, 2013, 2014

   2013-04-12

   ... information such as costs, sales statistics, inventories, formulas, patterns, devices, manufacturing processes... recognition. Bosley is the largest such manager in the United States. For at least four years, the chief...

8. How Are the Costs of Care for Medical Falls Distributed? The Costs of Medical Falls by Component of Cost, Timing, and Injury Severity

   ERIC Educational Resources Information Center

   Bohl, Alex A.; Phelan, Elizabeth A.; Fishman, Paul A.; Harris, Jeffrey R.

   2012-01-01

   Purpose of the Study: To examine the components of cost that drive increased total costs after a medical fall over time, stratified by injury severity. Design and Methods: We used 2004-2007 cost and utilization data for persons enrolled in an integrated care delivery system. We used a longitudinal cohort study design, where each individual…

9. Shuttle payload vibroacoustic test plan evaluation

   NASA Technical Reports Server (NTRS)

   Stahle, C. V.; Gongloff, H. R.; Young, J. P.; Keegan, W. B.

   1977-01-01

   Statistical decision theory is used to evaluate seven alternate vibro-acoustic test plans for Space Shuttle payloads; test plans include component, subassembly and payload testing and combinations of component and assembly testing. The optimum test levels and the expected cost are determined for each test plan. By including all of the direct cost associated with each test plan and the probabilistic costs due to ground test and flight failures, the test plans which minimize project cost are determined. The lowest cost approach eliminates component testing and maintains flight vibration reliability by performing subassembly tests at a relatively high acoustic level.

Standardization and program effect analysis (Study 2.4). Volume 2: Equipment commonality analysis. [cost savings of using flight-proven components in designing spacecraft

NASA Technical Reports Server (NTRS)

Shiokari, T.

1975-01-01

The feasibility and cost savings of using flight-proven components in designing spacecraft were investigated. The components analyzed were (1) large space telescope, (2) stratospheric aerosol and gas equipment, (3) mapping mission, (4) solar maximum mission, and (5) Tiros-N. It is concluded that flight-proven hardware can be used with not-too-extensive modification, and significant savings can be realized. The cost savings for each component are presented.

Dynamic Exergy Method for Evaluating the Control and Operation of Oxy-Combustion Boiler Island Systems.

PubMed

Jin, Bo; Zhao, Haibo; Zheng, Chuguang; Liang, Zhiwu

2017-01-03

Exergy-based methods are widely applied to assess the performance of energy conversion systems; however, these methods mainly focus on a certain steady-state and have limited applications for evaluating the control impacts on system operation. To dynamically obtain the thermodynamic behavior and reveal the influences of control structures, layers and loops, on system energy performance, a dynamic exergy method is developed, improved, and applied to a complex oxy-combustion boiler island system for the first time. The three most common operating scenarios are studied, and the results show that the flow rate change process leads to less energy consumption than oxygen purity and air in-leakage change processes. The variation of oxygen purity produces the largest impact on system operation, and the operating parameter sensitivity is not affected by the presence of process control. The control system saves energy during flow rate and oxygen purity change processes, while it consumes energy during the air in-leakage change process. More attention should be paid to the oxygen purity change because it requires the largest control cost. In the control system, the supervisory control layer requires the greatest energy consumption and the largest control cost to maintain operating targets, while the steam control loops cause the main energy consumption.

Highlights of recent balance of system research and evaluation

NASA Astrophysics Data System (ADS)

Thomas, M. G.; Stevens, J. W.

The cost of most photovoltaic (PV) systems is more a function of the balance of system (BOS) components than the collectors. The exception to this rule is the grid-tied system whose cost is related more directly to the collectors, and secondarily to the inverter/controls. In fact, recent procurements throughout the country document that collector costs for roof-mounted, utility-tied systems (Russell, PV Systems Workshop, 7/94) represent 60% to 70% of the system cost. This contrasts with the current market for packaged stand-alone all PV or PV-hybrid systems where collectors represent only 25% to 35% of the total. Not only are the BOS components the cost drivers in the current cost-effective PV system market place, they are also the least reliable components. This paper discusses the impact that BOS issues have on component performance, system performance, and system cost and reliability. We will also look at recent recommended changes in system design based upon performance evaluations of fielded PV systems.

Shuttle payload minimum cost vibroacoustic tests

NASA Technical Reports Server (NTRS)

Stahle, C. V.; Gongloff, H. R.; Young, J. P.; Keegan, W. B.

1977-01-01

This paper is directed toward the development of the methodology needed to evaluate cost effective vibroacoustic test plans for Shuttle Spacelab payloads. Statistical decision theory is used to quantitatively evaluate seven alternate test plans by deriving optimum test levels and the expected cost for each multiple mission payload considered. The results indicate that minimum costs can vary by as much as $6 million for the various test plans. The lowest cost approach eliminates component testing and maintains flight vibration reliability by performing subassembly tests at a relatively high acoustic level. Test plans using system testing or combinations of component and assembly level testing are attractive alternatives. Component testing alone is shown not to be cost effective.

A Cost-Utility Model of Care for Peristomal Skin Complications

PubMed Central

Inglese, Gary; Manson, Andrea; Townshend, Arden

2016-01-01

PURPOSE: The aim of this study was to evaluate the economic and humanistic implications of using ostomy components to prevent subsequent peristomal skin complications (PSCs) in individuals who experience an initial, leakage-related PSC event. DESIGN: Cost-utility analysis. METHODS: We developed a simple decision model to consider, from a payer's perspective, PSCs managed with and without the use of ostomy components over 1 year. The model evaluated the extent to which outcomes associated with the use of ostomy components (PSC events avoided; quality-adjusted life days gained) offset the costs associated with their use. RESULTS: Our base case analysis of 1000 hypothetical individuals over 1 year assumes that using ostomy components following a first PSC reduces recurrent events versus PSC management without components. In this analysis, component acquisition costs were largely offset by lower resource use for ostomy supplies (barriers; pouches) and lower clinical utilization to manage PSCs. The overall annual average resource use for individuals using components was about 6.3% ($139) higher versus individuals not using components. Each PSC event avoided yielded, on average, 8 additional quality-adjusted life days over 1 year. CONCLUSIONS: In our analysis, (1) acquisition costs for ostomy components were offset in whole or in part by the use of fewer ostomy supplies to manage PSCs and (2) use of ostomy components to prevent PSCs produced better outcomes (fewer repeat PSC events; more health-related quality-adjusted life days) over 1 year compared to not using components. PMID:26633166

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India.

PubMed

Masters, William A; Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush

2018-05-01

Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes.

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India

PubMed Central

Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush; Bhattacharjee, Lalita; Chandrasekhar, S; Christensen, Cheryl; Desai, Sonalde; Kazi-Hutchins, Nabeeha; Levin, Carol; Paarlberg, Robert; Vosti, Steven; Adekugbe, Olayinka; Atomsa, Gudina Egata; Badham, Jane; Baye, Kaleab; Beyero, Mesfin; Covic, Namukolo; Dalton, Babukiika; Dufour, Charlotte; Fracassi, Patrizia; Getahun, Zewditu; Haidar, Jemal; Hailu, Tesfaye; Kebede, Aweke; Kinabo, Joyce; Kussaga, Jamal Bakari; Mavrotas, George; Mwanja, Wilson Waiswa; Oguntona, Babatunde; Oladipo, Abiodun; Oniang’o, Ruth; Sibanda, Simbarashe; Sodjinou, Roger; Tom, Carol; Wamani, Henry; Wendelin, Akwilina; Adhikari, Ramesh Kant; Amatya, Archana; Bhattarai, Manav; Brahmbhatt, Viral; Chandyo, Ram Krishna; Gulati, Seema; Kapil, Umesh; Mehta, Ranju; Mohan, Sailesh; Prabhakaran, D; Prakash, V; Puri, Seema; Roy, S K; Sharma, Rekha; Shivakoti, Sabnam; Thorne-Lyman, Andrew; Rana, Pooja Pandey; Trilok-Kumar, Geeta

2018-01-01

Abstract Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes. PMID:29522103

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...

77 FR 59348 - Revisions to Page 700 of FERC Form No. 6

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

.... The components of an oil pipeline's rate base are governed by the Trended Original Cost Methodology... ratemaking methodology to the Trended Original Cost methodology as adopted in Opinion 154-B. The SRB was to... trended original cost methodology divides the nominal return on equity component of the cost of service...

High direct costs of medical care in patients with Type 1 diabetes attending a referral clinic in a government-funded hospital in Northern India.

PubMed

Katam, Kishore K; Bhatia, Vijayalakshmi; Dabadghao, Preeti; Bhatia, Eesh

2016-01-01

There is little information regarding costs of managing type 1 diabetes mellitus (T1DM) from low- and middle-income countries. We estimated direct costs of T1DM in patients attending a referral diabetes clinic in a governmentfunded hospital in northern India. We prospectively enrolled 88 consecutive T1DM patients (mean [SD] age 15.3 [8] years) with age at onset <18 years presenting to the endocrine clinic of our institution. Data on direct costs were collected for a 12 months-6 months retrospectively followed by 6 months prospectively. Patients belonged predominantly (77%) to the middle socioeconomic strata (SES); 81% had no access to government subsidy or health insurance. The mean direct cost per patient-year of T1DM was `27 915 (inter-quartile range [IQR] `19 852-32 856), which was 18.6% (7.1%-30.1%) of the total family income. A greater proportion of income was spent by families of lower compared to middle SES (32.6% v. 6.6%, p<0.001). The mean out-of-pocket payment for diabetes care ranged from 2% to 100% (mean 87%) of the total costs. The largest expenditure was on home blood glucose monitoring (40%) and insulin (39.5%). On multivariate analysis, total direct cost was associated with annual family income (β=0.223, p=0.033), frequency of home blood glucose monitoring (β=0.249, p=0.016) and use of analogue insulin (β=0.225, p=0.016). Direct costs of T1DM were high; in proportion to their income the costs were greater in the lower SES. The largest expenditure was on home blood glucose monitoring and insulin. Support for insulin and glucose testing strips for T1DM care is urgently required.

IMPROVE EMISSION INVENTORIES THROUGH ADVANCES IN METHODS AND MODELS

EPA Science Inventory

Emission inventories are the foundation of cost-effective air quality management strategies. The emission inventory must be complete, accurate, timely, transparent, and affordable. The general approach is to identify the largest uncertainties that can impact model outputs and a...

Analyzing asset management data using data and text mining.

DOT National Transportation Integrated Search

2014-07-01

Predictive models using text from a sample competitively bid California highway projects have been used to predict a construction : projects likely level of cost overrun. A text description of the project and the text of the five largest project line...

Transportation Infrastructure: Central Artery/Tunnel Project Faces Continued Financial Uncertainties

DOT National Transportation Integrated Search

1996-05-01

At a cost of over $1 billion a mile, the Central Artery/Tunnel project - an Interstate Highway System project in Boston, Massachusetts - is one of the largest, most complex, and most expensive highway construction projects ever undertaken. In respons...

Highway safety research : a national agenda : executive summary.

DOT National Transportation Integrated Search

2001-01-01

Motor vehicle-related injury and death is the nations largest public health problem. The economic costs to society : will approach $2 trillion and an even greater intangible human loss will occur to family and friends of the 33 million : victims. :...

Trends in health care expenditure among US adults with heart failure: The Medical Expenditure Panel Survey 2002-2011.

PubMed

Echouffo-Tcheugui, Justin B; Bishu, Kinfe G; Fonarow, Gregg C; Egede, Leonard E

2017-04-01

Population-based national data on the trends in expenditures related to heart failure (HF) are scarce. Assessing the time trends in health care expenditures for HF in the United States can help to better define the burden of this condition. Using 10-year data (2002-2011) from the national Medical Expenditure Panel Survey (weighted sample of 188,708,194US adults aged ≥18years) and a 2-part model (adjusting for demographics, comorbidities, and time); we estimated adjusted mean and incremental medical expenditures by HF status. The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency department, inpatient hospital, pharmacy, home health care, and other medical expenditures). Compared with expenditures for individuals without HF ($5511 [95% CI 5405-5617]), individuals with HF had a 4-fold higher mean expenditures of ($23,854 [95% CI 21,733-25,975]). Individuals with HF had $3446 (95% CI 2592-4299) higher direct incremental expenditures compared with those without HF, after adjusting for demographics and comorbidities. Among those with HF, costs continuously increased by $5836 (28% relative increase), from $21,316 (95% CI 18,359-24,272) in 2002/2003 to $27,152 (95% CI 20,066-34,237) in 2010/2011, and inpatient costs ($11,318 over the whole period) were the single largest component of total medical expenditure. The estimated unadjusted total direct medical expenditures for US adults with HF were $30 billion/y and the adjusted total incremental expenditure was $5.8 billion/y. Heart failure is costly and over a recent 10-year period, and direct expenditure related to HF increased markedly, mainly driven by inpatient costs. Copyright © 2017 Elsevier Inc. All rights reserved.

Trends in Health Care Expenditure among U.S. Adults with Heart Failure - The Medical Expenditure Panel Survey 2002–2011

PubMed Central

Echouffo-Tcheugui, Justin B.; Bishu, Kinfe G.; Fonarow, Gregg C; Egede, Leonard E.

2017-01-01

Background Population-based national data on the trends in expenditures related to heart failure (HF) is scarce. Assessing the time trends in health care expenditures for HF in the United States can help to better define the burden of this condition. Methods Using 10-year data (2002–2011) from the national Medical Expenditure Panel Survey (weighted sample of 188,708,194 U.S adults aged ≥18 years) and a two-part model (adjusting for demographics, comorbidities and time); we estimated adjusted mean and incremental medical expenditures by HF status. The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency room, inpatient hospital, pharmacy, home health care, and other medical expenditures). Results Compared to expenditures for individuals without HF ($5,511 [95% confidence interval (CI): 5,405–5,617]), individuals with HF had a four-fold higher mean expenditures of ($23,854 [95%CI: 21,733–25,975]). Individuals with HF had $3,446 (95%CI: 2,592–4,299) higher direct incremental expenditures compared with those without HF, after adjusting for demographics and comorbidities. Among those with HF, costs continuously increased by $5836 (28% relative increase), from $21,316 (95%CI: 18,359–24,272) in 2002/2003 to $27,152 (95%CI: 20,066–34,237) in 2010/2011; and inpatient costs ($11,318 over the whole period) were the single largest component of total medical expenditure. The estimated unadjusted total direct medical expenditures for US adults with HF were $30 billion/year and the adjusted total incremental expenditure $5.8 billion/year. Conclusions Heart failure is costly and over a recent 10-year period, direct expenditure related to HF increased markedly, mainly driven by inpatient costs. PMID:28454834

Longitudinal Associations between Triglycerides and Metabolic Syndrome Components in a Beijing Adult Population, 2007-2012.

PubMed

Tao, Li-Xin; Yang, Kun; Liu, Xiang-Tong; Cao, Kai; Zhu, Hui-Ping; Luo, Yan-Xia; Guo, Jin; Wu, Li-Juan; Li, Xia; Guo, Xiu-Hua

2016-01-01

Longitudinal associations between triglycerides (TG) and other metabolic syndrome (MetS) components have rarely been reported. The purpose was to investigate the longitudinal association between TG and other MetS components with time. The longitudinal study was established in 2007 on individuals who attended health check-ups at Beijing Tongren Hospital and Beijing Xiaotangshan Hospital. Data used in this study was based on 7489 participants who had at least three health check-ups over a period of 5-year follow up. Joint model was used to explore longitudinal associations between TG and other MetS components after adjusted for age. There were positive correlations between TG and other MetS components except for high density lipoprotein (HDL), and the correlations increased with time. A negative correlation was displayed between TG and HDL, and the correlation also increased with time. Among all five pairs of TG and other MetS components, the marginal correlation between TG and body mass index (BMI) was the largest for both men and women. The marginal correlation between TG and fasting plasma glucose was the smallest for men, while the marginal correlation between TG and diastolic blood pressure was the smallest for women. The longitudinal association between TG and other MetS components increased with time. Among five pairs of TG and other MetS components, the longitudinal correlation between TG and BMI was the largest. It is important to closely monitor subjects with high levels of TG and BMI in health check-up population especially for women, because these two components are closely associated with development of hypertension, diabetes, cardiovascular disease and other metabolic diseases.

Practice patterns, case mix, Medicare payment policy, and dialysis facility costs.

PubMed Central

Hirth, R A; Held, P J; Orzol, S M; Dor, A

1999-01-01

OBJECTIVE: To evaluate the effects of case mix, practice patterns, features of the payment system, and facility characteristics on the cost of dialysis. DATA SOURCES/STUDY SETTING: The nationally representative sample of dialysis units in the 1991 U.S. Renal Data System's Case Mix Adequacy (CMA) Study. The CMA data were merged with data from Medicare Cost Reports, HCFA facility surveys, and HCFA's end-stage renal disease patient registry. STUDY DESIGN: We estimated a statistical cost function to examine the determinants of costs at the dialysis unit level. PRINCIPAL FINDINGS: The relationship between case mix and costs was generally weak. However, dialysis practices (type of dialysis membrane, membrane reuse policy, and treatment duration) did have a significant effect on costs. Further, facilities whose payment was constrained by HCFA's ceiling on the adjustment for area wage rates incurred higher costs than unconstrained facilities. The costs of hospital-based units were considerably higher than those of freestanding units. Among chain units, only members of one of the largest national chains exhibited significant cost savings relative to independent facilities. CONCLUSIONS: Little evidence showed that adjusting dialysis payment to account for differences in case mix across facilities would be necessary to ensure access to care for high-cost patients or to reimburse facilities equitably for their costs. However, current efforts to increase dose of dialysis may require higher payments. Longer treatments appear to be the most economical method of increasing the dose of dialysis. Switching to more expensive types of dialysis membranes was a more costly means of increasing dose and hence must be justified by benefits beyond those of higher dose. Reusing membranes saved money, but the savings were insufficient to offset the costs associated with using more expensive membranes. Most, but not all, of the higher costs observed in hospital-based units appear to reflect overhead cost allocation rather than a difference in real resources devoted to treatment. The economies experienced by the largest chains may provide an explanation for their recent growth in market share. The heterogeneity of results by chain size implies that characterizing units using a simple chain status indicator variable is inadequate. Cost differences by facility type and the effects of the ongoing growth of large chains are worthy of continued monitoring to inform both payment policy and antitrust enforcement. PMID:10029498

Practice patterns, case mix, Medicare payment policy, and dialysis facility costs.

PubMed

Hirth, R A; Held, P J; Orzol, S M; Dor, A

1999-02-01

To evaluate the effects of case mix, practice patterns, features of the payment system, and facility characteristics on the cost of dialysis. The nationally representative sample of dialysis units in the 1991 U.S. Renal Data System's Case Mix Adequacy (CMA) Study. The CMA data were merged with data from Medicare Cost Reports, HCFA facility surveys, and HCFA's end-stage renal disease patient registry. We estimated a statistical cost function to examine the determinants of costs at the dialysis unit level. The relationship between case mix and costs was generally weak. However, dialysis practices (type of dialysis membrane, membrane reuse policy, and treatment duration) did have a significant effect on costs. Further, facilities whose payment was constrained by HCFA's ceiling on the adjustment for area wage rates incurred higher costs than unconstrained facilities. The costs of hospital-based units were considerably higher than those of freestanding units. Among chain units, only members of one of the largest national chains exhibited significant cost savings relative to independent facilities. Little evidence showed that adjusting dialysis payment to account for differences in case mix across facilities would be necessary to ensure access to care for high-cost patients or to reimburse facilities equitably for their costs. However, current efforts to increase dose of dialysis may require higher payments. Longer treatments appear to be the most economical method of increasing the dose of dialysis. Switching to more expensive types of dialysis membranes was a more costly means of increasing dose and hence must be justified by benefits beyond those of higher dose. Reusing membranes saved money, but the savings were insufficient to offset the costs associated with using more expensive membranes. Most, but not all, of the higher costs observed in hospital-based units appear to reflect overhead cost allocation rather than a difference in real resources devoted to treatment. The economies experienced by the largest chains may provide an explanation for their recent growth in market share. The heterogeneity of results by chain size implies that characterizing units using a simple chain status indicator variable is inadequate. Cost differences by facility type and the effects of the ongoing growth of large chains are worthy of continued monitoring to inform both payment policy and antitrust enforcement.

Public Expenditures for Mental Health Services in Canadian Provinces: Dépenses publiques pour les services de santé mentale dans les provinces canadiennes.

PubMed

Wang, Jian; Jacobs, Philip; Ohinmaa, Arto; Dezetter, Anne; Lesage, Alain

2018-04-01

The purpose of this study is to measure provincial spending for mental health services in fiscal year (FY) 2013 and to compare these cost estimates to those of FY 2003. This study estimated the costs of publicly funded provincial mental health services in FY 2013 and compared them to the estimates for FY 2003 from a previously published report. Our data were obtained from publicly accessible databases. The cross-year cost comparisons for provincial mental health services were restricted to general and psychiatric hospital inpatients, clinical payments to physicians and psychologists, and prescribed psychotropic medications. Total public expenditures were inflation adjusted and expressed per capita and as a percentage of the total provincial health spending. Total public spending for mental health and addiction programs/services was estimated to be $6.75 billion for FY 2013. The largest component of the expenditures was hospital inpatient services ($4.02 billion, 59.6%), followed by clinical payments to physicians or psychologists ($1.69 billion, 25%), and then publicly funded prescribed psychotherapeutic medications ($1.04 billion, 15.4%). Nationally, the portion of total public spending on health that was spent on mental health decreased from FY 2003 to FY 2013 from 5.4% to 4.9%. Our results reveal that mental health spending, as a proportion of public health care expenditures, decreased in the decade from FY 2003 to FY 2013. Due to large differences in how the provinces report community mental health services, we still lack a comprehensive picture of the mental health system.

The cost of care homes for people with dementia in England: a modelling approach.

PubMed

Romeo, Renee; Knapp, Martin; Salverda, Suzanne; Orrell, Martin; Fossey, Jane; Ballard, Clive

2017-12-01

To examine the cost of care for people with dementia in institutional care settings, to understand the major cost drivers and to highlight opportunities for service development. Data on 277 residents with dementia in 16 UK residential or nursing homes were collected. We estimated care and support costs and fitted models to the data. Sensitivity analyses were also conducted. Care home residents cost £792 weekly: 95% of the costs accounted for by direct fees. Hospital contacts contributed the largest proportion of the additional costs. Having an established diagnosis of dementia (b = 0.070; p < 0.05) was associated with higher costs. No association was found between cost and needs (b = -0.002; p = 0.818). The absence of an association between cost and needs emphasizes the importance of a more needs-based costing system which could result in clinical and economic advantages. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Estimated Annual Cost of Uterine Leiomyomata in the United States

PubMed Central

CARDOZO, Eden R.; CLARK, Andrew D.; BANKS, Nicole K.; HENNE, Melinda B.; STEGMANN, Barbara J.; SEGARS, James H.

2011-01-01

Objective To estimate the total annual societal cost of uterine fibroids in the United States, based on direct and indirect costs, including associated obstetric complications. Study Design A systematic review of the literature was conducted to estimate the number of women seeking treatment for symptomatic fibroids annually, the costs of medical and surgical treatment, work lost and obstetric complications attributable to fibroids. Total annual costs were converted to 2010 U.S. dollars. A sensitivity analysis was performed. Results The estimated annual direct costs (surgery, hospital admissions, outpatient visits, medications) were $4.1 to $9.4 billion. Estimated lost work costs ranged from $1.55 to $17.2 billion annually. Obstetric outcomes attributed to fibroids resulted in a cost of $238 million to $7.76 billion annually. Uterine fibroids were estimated to cost the US $5.9 to $34.4 billion annually. Conclusions Obstetric complications associated with fibroids contributed significantly to their economic burden. Lost work costs may account for the largest proportion of societal costs due to fibroids. PMID:22244472

Global Economic Burden of Norovirus Gastroenteritis

PubMed Central

Bartsch, Sarah M.; Lopman, Benjamin A.; Ozawa, Sachiko; Hall, Aron J.; Lee, Bruce Y.

2016-01-01

Background Despite accounting for approximately one fifth of all acute gastroenteritis illnesses, norovirus has received comparatively less attention than other infectious pathogens. With several candidate vaccines under development, characterizing the global economic burden of norovirus could help funders, policy makers, public health officials, and product developers determine how much attention and resources to allocate to advancing these technologies to prevent and control norovirus. Methods We developed a computational simulation model to estimate the economic burden of norovirus in every country/area (233 total) stratified by WHO region and globally, from the health system and societal perspectives. We considered direct costs of illness (e.g., clinic visits and hospitalization) and productivity losses. Results Globally, norovirus resulted in a total of $4.2 billion (95% UI: $3.2–5.7 billion) in direct health system costs and $60.3 billion (95% UI: $44.4–83.4 billion) in societal costs per year. Disease amongst children <5 years cost society $39.8 billion, compared to $20.4 billion for all other age groups combined. Costs per norovirus illness varied by both region and age and was highest among adults ≥55 years. Productivity losses represented 84–99% of total costs varying by region. While low and middle income countries and high income countries had similar disease incidence (10,148 vs. 9,935 illness per 100,000 persons), high income countries generated 62% of global health system costs. In sensitivity analysis, the probability of hospitalization had the largest impact on health system cost estimates ($2.8 billion globally, assuming no hospitalization costs), while the probability of missing productive days had the largest impact on societal cost estimates ($35.9 billion globally, with a 25% probability of missing productive days). Conclusions The total economic burden is greatest in young children but the highest cost per illness is among older age groups in some regions. These large costs overwhelmingly are from productivity losses resulting from acute illness. Low, middle, and high income countries all have a considerable economic burden, suggesting that norovirus gastroenteritis is a truly global economic problem. Our findings can help identify which age group(s) and/or geographic regions may benefit the most from interventions. PMID:27115736

Global Economic Burden of Norovirus Gastroenteritis.

PubMed

Bartsch, Sarah M; Lopman, Benjamin A; Ozawa, Sachiko; Hall, Aron J; Lee, Bruce Y

2016-01-01

Despite accounting for approximately one fifth of all acute gastroenteritis illnesses, norovirus has received comparatively less attention than other infectious pathogens. With several candidate vaccines under development, characterizing the global economic burden of norovirus could help funders, policy makers, public health officials, and product developers determine how much attention and resources to allocate to advancing these technologies to prevent and control norovirus. We developed a computational simulation model to estimate the economic burden of norovirus in every country/area (233 total) stratified by WHO region and globally, from the health system and societal perspectives. We considered direct costs of illness (e.g., clinic visits and hospitalization) and productivity losses. Globally, norovirus resulted in a total of $4.2 billion (95% UI: $3.2-5.7 billion) in direct health system costs and $60.3 billion (95% UI: $44.4-83.4 billion) in societal costs per year. Disease amongst children <5 years cost society $39.8 billion, compared to $20.4 billion for all other age groups combined. Costs per norovirus illness varied by both region and age and was highest among adults ≥55 years. Productivity losses represented 84-99% of total costs varying by region. While low and middle income countries and high income countries had similar disease incidence (10,148 vs. 9,935 illness per 100,000 persons), high income countries generated 62% of global health system costs. In sensitivity analysis, the probability of hospitalization had the largest impact on health system cost estimates ($2.8 billion globally, assuming no hospitalization costs), while the probability of missing productive days had the largest impact on societal cost estimates ($35.9 billion globally, with a 25% probability of missing productive days). The total economic burden is greatest in young children but the highest cost per illness is among older age groups in some regions. These large costs overwhelmingly are from productivity losses resulting from acute illness. Low, middle, and high income countries all have a considerable economic burden, suggesting that norovirus gastroenteritis is a truly global economic problem. Our findings can help identify which age group(s) and/or geographic regions may benefit the most from interventions.

[Exploration of influencing factors of price of herbal based on VAR model].

PubMed

Wang, Nuo; Liu, Shu-Zhen; Yang, Guang

2014-10-01

Based on vector auto-regression (VAR) model, this paper takes advantage of Granger causality test, variance decomposition and impulse response analysis techniques to carry out a comprehensive study of the factors influencing the price of Chinese herbal, including herbal cultivation costs, acreage, natural disasters, the residents' needs and inflation. The study found that there is Granger causality relationship between inflation and herbal prices, cultivation costs and herbal prices. And in the total variance analysis of Chinese herbal and medicine price index, the largest contribution to it is from its own fluctuations, followed by the cultivation costs and inflation.

Energy and life-cycle cost analysis of a six-story office building

NASA Astrophysics Data System (ADS)

Turiel, I.

1981-10-01

An energy analysis computer program, DOE-2, was used to compute annual energy use for a typical office building as originally designed and with several energy conserving design modifications. The largest energy use reductions were obtained with the incorporation of daylighting techniques, the use of double pane windows, night temperature setback, and the reduction of artificial lighting levels. A life-cycle cost model was developed to assess the cost-effectiveness of the design modifications discussed. The model incorporates such features as inclusion of taxes, depreciation, and financing of conservation investments. The energy conserving strategies are ranked according to economic criteria such as net present benefit, discounted payback period, and benefit to cost ratio.

Time Lapse of World’s Largest 3-D Printed Object

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

None

2016-08-29

Researchers at the MDF have 3D-printed a large-scale trim tool for a Boeing 777X, the world’s largest twin-engine jet airliner. The additively manufactured tool was printed on the Big Area Additive Manufacturing, or BAAM machine over a 30-hour period. The team used a thermoplastic pellet comprised of 80% ABS plastic and 20% carbon fiber from local material supplier. The tool has proven to decrease time, labor, cost and errors associated with traditional manufacturing techniques and increased energy savings in preliminary testing and will undergo further, long term testing.

Infrared Time Lapse of World’s Largest 3D-Printed Object

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

None

Researchers at Oak Ridge National Laboratory have 3D-printed a large-scale trim tool for a Boeing 777X, the world’s largest twin-engine jet airliner. The additively manufactured tool was printed on the Big Area Additive Manufacturing, or BAAM machine over a 30-hour period. The team used a thermoplastic pellet comprised of 80% ABS plastic and 20% carbon fiber from local material supplier. The tool has proven to decrease time, labor, cost and errors associated with traditional manufacturing techniques and increased energy savings in preliminary testing and will undergo further, long term testing.

Vibroacoustic test plan evaluation: Parameter variation study

NASA Technical Reports Server (NTRS)

Stahle, C. V.; Gongloef, H. R.

1976-01-01

Statistical decision models are shown to provide a viable method of evaluating the cost effectiveness of alternate vibroacoustic test plans and the associated test levels. The methodology developed provides a major step toward the development of a realistic tool to quantitatively tailor test programs to specific payloads. Testing is considered at the no test, component, subassembly, or system level of assembly. Component redundancy and partial loss of flight data are considered. Most and probabilistic costs are considered, and incipient failures resulting from ground tests are treated. Optimums defining both component and assembly test levels are indicated for the modified test plans considered. modeling simplifications must be considered in interpreting the results relative to a particular payload. New parameters introduced were a no test option, flight by flight failure probabilities, and a cost to design components for higher vibration requirements. Parameters varied were the shuttle payload bay internal acoustic environment, the STS launch cost, the component retest/repair cost, and the amount of redundancy in the housekeeping section of the payload reliability model.

The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies.

PubMed

Menzies, Nicolas A; Suharlim, Christian; Geng, Fangli; Ward, Zachary J; Brenzel, Logan; Resch, Stephen C

2017-10-06

Evidence on immunization costs is a critical input for cost-effectiveness analysis and budgeting, and can describe variation in site-level efficiency. The Expanded Program on Immunization Costing and Financing (EPIC) Project represents the largest investigation of immunization delivery costs, collecting empirical data on routine infant immunization in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. We developed a pooled dataset from individual EPIC country studies (316 sites). We regressed log total costs against explanatory variables describing service volume, quality, access, other site characteristics, and income level. We used Bayesian hierarchical regression models to combine data from different countries and account for the multi-stage sample design. We calculated output elasticity as the percentage increase in outputs (service volume) for a 1% increase in inputs (total costs), averaged across the sample in each country, and reported first differences to describe the impact of other predictors. We estimated average and total cost curves for each country as a function of service volume. Across countries, average costs per dose ranged from $2.75 to $13.63. Average costs per child receiving diphtheria, tetanus, and pertussis ranged from $27 to $139. Within countries costs per dose varied widely-on average, sites in the highest quintile were 440% more expensive than those in the lowest quintile. In each country, higher service volume was strongly associated with lower average costs. A doubling of service volume was associated with a 19% (95% interval, 4.0-32) reduction in costs per dose delivered, (range 13% to 32% across countries), and the largest 20% of sites in each country realized costs per dose that were on average 61% lower than those for the smallest 20% of sites, controlling for other factors. Other factors associated with higher costs included hospital status, provision of outreach services, share of effort to management, level of staff training/seniority, distance to vaccine collection, additional days open per week, greater vaccination schedule completion, and per capita gross domestic product. We identified multiple features of sites and their operating environment that were associated with differences in average unit costs, with service volume being the most influential. These findings can inform efforts to improve the efficiency of service delivery and better understand resource needs.

Multibody model reduction by component mode synthesis and component cost analysis

NASA Technical Reports Server (NTRS)

Spanos, J. T.; Mingori, D. L.

1990-01-01

The classical assumed-modes method is widely used in modeling the dynamics of flexible multibody systems. According to the method, the elastic deformation of each component in the system is expanded in a series of spatial and temporal functions known as modes and modal coordinates, respectively. This paper focuses on the selection of component modes used in the assumed-modes expansion. A two-stage component modal reduction method is proposed combining Component Mode Synthesis (CMS) with Component Cost Analysis (CCA). First, each component model is truncated such that the contribution of the high frequency subsystem to the static response is preserved. Second, a new CMS procedure is employed to assemble the system model and CCA is used to further truncate component modes in accordance with their contribution to a quadratic cost function of the system output. The proposed method is demonstrated with a simple example of a flexible two-body system.

Medical Total Force Management: Assessing Readiness and Cost

DTIC Science & Technology

The military medical force is an essential element of Department of Defense (DoD) warfighting capability, saving life and limb on the battlefield and...and retirees. The medical force is also one of the largest and most costly forces to maintain in DoD. The Under Secretary of Defense for Personnel... Defense Authorization Act (NDAA). The office of Total Force Manpower and Resources (TFM and RS), within USD(P and R), is responsible for force mix

The Profitability of a Birthing Center a Cost Finding Analysis of a Not-for-Profit Hospital.

DTIC Science & Technology

1997-03-01

bed-days in each DRG. The supply, equipment and dietary cost pools were distributed using this methodology. Supplies and drugs made-up the largest...Large Freestanding Birth Center of Low-Income Women. Journal of Nurse Midwifery 39 (2) (March-April): 112-8. Duboff, Robert S. 1992. Marketing to...Spitzer, Matthew C. 1995. Birth Centers - Economy, Safety, and Empowerment. Journal of Nurse Midwifery 40 (4) (July-August): 371-5. Stone, Patricia W

Status and opportunities associated with product costing strategies in wood component manufacturing

Treesearch

Adrienn Andersch; Urs Buehlmann; Jan Wiedenbeck; Steve Lawser

2013-01-01

Product costing systems are critically important for businesses because they help reduce costs, price products at competitive prices, and enable strategic decisionmaking. This article reports the results of a survey designed to collect information about practices used by the North American hardwood dimension and components industry to calculate the cost of their...

Noise Costs from Road Transport

NASA Astrophysics Data System (ADS)

Margorínová, Martina; Trojanová, Mária; Decký, Martin; Remišová, Eva

2018-06-01

Building and improving road infrastructure in Slovakia is currently influenced by the amount of state funding. Therefore, it is necessary to determine the effectiveness of each proposed solution of road project, which is based on life-cycle costs. Besides capital costs, social costs are also important, which valued the negative impacts due to road construction and operation on road users, the environment, and the population living in the affected area. Some components of social costs have shortcomings in quantifying and valuating, which need to be resolved. The one of important components which affects human health and the value of an area, and have some shortcomings are noise costs. Improvement of this component will lead to more accurate valuation of economic efficiency of roads.

Make-up wells drilling cost in financial model for a geothermal project

NASA Astrophysics Data System (ADS)

Oktaviani Purwaningsih, Fitri; Husnie, Ruly; Afuar, Waldy; Abdurrahman, Gugun

2017-12-01

After commissioning of a power plant, geothermal reservoir will encounter pressure decline, which will affect wells productivity. Therefore, further drilling is carried out to enhance steam production. Make-up wells are production wells drilled inside an already confirmed reservoir to maintain steam production in a certain level. Based on Sanyal (2004), geothermal power cost consists of three components, those are capital cost, O&M cost and make-up drilling cost. The make-up drilling cost component is a major part of power cost which will give big influence in a whole economical value of the project. The objective of this paper it to analyse the make-up wells drilling cost component in financial model of a geothermal power project. The research will calculate make-up wells requirements, drilling costs as a function of time and how they influence the financial model and affect the power cost. The best scenario in determining make-up wells strategy in relation with the project financial model would be the result of this research.

Transportation Infrastructure: Progress on and Challenges to Central Artery/Tunnel Project's Cost and Financing

DOT National Transportation Integrated Search

1997-07-01

The Central Artery/Tunnel project in Boston, Massachusetts--one of the largest, most complex, and most expensive highway construction projects ever undertaken--is well under way, with contracts worth nearly $8 billion either completed or awarded. Con...

Estimating costs and benefits of emissions reduction strategies for transit by extending the TRIMMS model : [summary].

DOT National Transportation Integrated Search

2012-01-01

Floridas remarkable transportation infrastructure is a key to its economic vitality, but transportation is also the single largest contributor to air pollution. Pollutants such as greenhouse gases (GHG) degrade air quality and contribute to climat...

Evaluation of the GPS/AVL systems for snow and ice operations resource management.

DOT National Transportation Integrated Search

2017-09-01

Snow and ice management is the single largest expenditure in the maintenance budget for the Ohio Department of Transportation (ODOT) with an annual cost including labor, equipment, and materials reaching approximately $86 million (ODOT, 2013). One me...

Commercial truck platooning - level 2 automation : project summary.

DOT National Transportation Integrated Search

2016-08-31

Besides driver compensation, the largest : operating expense for a line-haul truck is the : cost of fuel. At 65 mph, each truck expends about : 65 percent of its fuel consumption to overcome : the effects of aerodynamic drag. Many of the : large and ...

Interdisciplinary Coordination Reviews: A Process to Reduce Construction Costs.

ERIC Educational Resources Information Center

Fewell, Dennis A.

1998-01-01

Interdisciplinary Coordination design review is instrumental in detecting coordination errors and omissions in construction documents. Cleansing construction documents of interdisciplinary coordination errors reduces time extensions, the largest source of change orders, and limits exposure to liability claims. Improving the quality of design…

What Are the Real Procedural Costs of Bariatric Surgery? A Systematic Literature Review of Published Cost Analyses.

PubMed

Doble, Brett; Wordsworth, Sarah; Rogers, Chris A; Welbourn, Richard; Byrne, James; Blazeby, Jane M

2017-08-01

This review aims to evaluate the current literature on the procedural costs of bariatric surgery for the treatment of severe obesity. Using a published framework for the conduct of micro-costing studies for surgical interventions, existing cost estimates from the literature are assessed for their accuracy, reliability and comprehensiveness based on their consideration of seven 'important' cost components. MEDLINE, PubMed, key journals and reference lists of included studies were searched up to January 2017. Eligible studies had to report per-case, total procedural costs for any type of bariatric surgery broken down into two or more individual cost components. A total of 998 citations were screened, of which 13 studies were included for analysis. Included studies were mainly conducted from a US hospital perspective, assessed either gastric bypass or adjustable gastric banding procedures and considered a range of different cost components. The mean total procedural costs for all included studies was US$14,389 (range, US$7423 to US$33,541). No study considered all of the recommended 'important' cost components and estimation methods were poorly reported. The accuracy, reliability and comprehensiveness of the existing cost estimates are, therefore, questionable. There is a need for a comparative cost analysis of the different approaches to bariatric surgery, with the most appropriate costing approach identified to be micro-costing methods. Such an analysis will not only be useful in estimating the relative cost-effectiveness of different surgeries but will also ensure appropriate reimbursement and budgeting by healthcare payers to ensure barriers to access this effective treatment by severely obese patients are minimised.

Grid-Level Application of Electrical Energy Storage: Example Use Cases in the United States and China

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

Zhang, Yingchen; Gevorgian, Vahan; Wang, Caixia

Electrical energy storage (EES) systems are expected to play an increasing role in helping the United States and China-the world's largest economies with the two largest power systems-meet the challenges of integrating more variable renewable resources and enhancing the reliability of power systems by improving the operating capabilities of the electric grid. EES systems are becoming integral components of a resilient and efficient grid through a diverse set of applications that include energy management, load shifting, frequency regulation, grid stabilization, and voltage support.

Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis.

PubMed

Mansfield, Haley E; Canar, W Jeffrey; Gerard, Carter S; O'Toole, John E

2014-11-01

Patients suffering from cervical radiculopathy in whom a course of nonoperative treatment has failed are often candidates for a single-level anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). The objective of this analysis was to identify any significant cost differences between these surgical methods by comparing direct costs to the hospital. Furthermore, patient-specific characteristics were also considered for their effect on component costs. After obtaining approval from the medical center institutional review board, the authors conducted a retrospective cross-sectional comparative cohort study, with a sample of 101 patients diagnosed with cervical radiculopathy and who underwent an initial single-level ACDF or minimally invasive PCF during a 3-year period. Using these data, bivariate analyses were conducted to determine significant differences in direct total procedure and component costs between surgical techniques. Factorial ANOVAs were also conducted to determine any relationship between patient sex and smoking status to the component costs per surgery. The mean total direct cost for an ACDF was $8192, and the mean total direct cost for a PCF was $4320. There were significant differences in the cost components for direct costs and operating room supply costs. It was found that there was no statistically significant difference in component costs with regard to patient sex or smoking status. In the management of single-level cervical radiculopathy, the present analysis has revealed that the average cost of an ACDF is 89% more than a PCF. This increased cost is largely due to the cost of surgical implants. These results do not appear to be dependent on patient sex or smoking status. When combined with results from previous studies highlighting the comparable patient outcomes for either procedure, the authors' findings suggest that from a health care economics standpoint, physicians should consider a minimally invasive PCF in the treatment of cervical radiculopathy.

Nursing cost by DRG: nursing intensity weights.

PubMed

Knauf, Robert A; Ballard, Karen; Mossman, Philip N; Lichtig, Leo K

2006-11-01

Although diagnosis-related group (DRG) reimbursement is used for Medicare and many other payors, nursing--the largest portion of hospital costs--is not specifically identified and quantified in deriving payments in any of the DRG reimbursement systems except that of New York State. In New York, nursing costs are allocated to each DRG in payment rate formulation by means of nursing intensity weights (NIWs)--relative values reflecting the quantity and types of nursing services provided to patients in each DRG. In the absence of charges for nursing services, these NIWs are derived from scores for each DRG provided by a representative panel of nurses through a modified Delphi technique. NIWs have been shown to correlate with hospitals' nursing costs per day. They are used to set cost-based payment weights, thereby avoiding compression caused by using flat cost-to-charge or cost-per-day averages for all acute and intensive care patients.

Life-History and Spatial Determinants of Somatic Growth Dynamics in Komodo Dragon Populations

PubMed Central

Laver, Rebecca J.; Purwandana, Deni; Ariefiandy, Achmad; Imansyah, Jeri; Forsyth, David; Ciofi, Claudio; Jessop, Tim S.

2012-01-01

Somatic growth patterns represent a major component of organismal fitness and may vary among sexes and populations due to genetic and environmental processes leading to profound differences in life-history and demography. This study considered the ontogenic, sex-specific and spatial dynamics of somatic growth patterns in ten populations of the world’s largest lizard the Komodo dragon (Varanus komodoensis). The growth of 400 individual Komodo dragons was measured in a capture-mark-recapture study at ten sites on four islands in eastern Indonesia, from 2002 to 2010. Generalized Additive Mixed Models (GAMMs) and information-theoretic methods were used to examine how growth rates varied with size, age and sex, and across and within islands in relation to site-specific prey availability, lizard population density and inbreeding coefficients. Growth trajectories differed significantly with size and between sexes, indicating different energy allocation tactics and overall costs associated with reproduction. This leads to disparities in maximum body sizes and longevity. Spatial variation in growth was strongly supported by a curvilinear density-dependent growth model with highest growth rates occurring at intermediate population densities. Sex-specific trade-offs in growth underpin key differences in Komodo dragon life-history including evidence for high costs of reproduction in females. Further, inverse density-dependent growth may have profound effects on individual and population level processes that influence the demography of this species. PMID:23028983

An Essential Pathology Package for Low- and Middle-Income Countries.

PubMed

Fleming, Kenneth A; Naidoo, Mahendra; Wilson, Michael; Flanigan, John; Horton, Susan; Kuti, Modupe; Looi, Lai Meng; Price, Chris; Ru, Kun; Ghafur, Abdul; Wang, Jianxiang; Lago, Nestor

2017-01-01

We review the current status of pathology services in low- and middle-income countries and propose an “essential pathology package” along with estimated costs. The purpose is to provide guidance to policy makers as countries move toward universal health care systems. Five key themes were reviewed using existing literature (role of leadership; education, training, and continuing professional development; technology; accreditation, management, and quality standards; and reimbursement systems). A tiered system is described, building on existing proposals. The economic analysis draws on the very limited published studies, combined with expert opinion. Countries have underinvested in pathology services, with detrimental effects on health care. The equipment needs for a tier 1 laboratory in a primary health facility are modest ($2-$5,000), compared with $150,000 to $200,000 in a district hospital, and higher in a referral hospital (depending on tests undertaken). Access to a national (or regional) specialized laboratory undertaking disease surveillance and registry is important. Recurrent costs of appropriate laboratories in district and referral hospitals are around 6% of the hospital budget in midsized hospitals and likely decline in the largest hospitals. Primary health facilities rely largely on single-use tests. Pathology is an essential component of good universal health care. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Bringing together integration technologies in GaAs, InP and Si to deliver low-cost high performance DWDM optoelectronic components and solutions

NASA Astrophysics Data System (ADS)

Carter, Andrew C.; Wale, Michael J.; Simmons, T.; Whitbread, Neil; Asghari, M.

2003-06-01

A key attribute emerging in the optoelectronic component supply industry is the ability to deliver 'solution level' products rather than discrete optical components to equipment manufacturers. This approach is primarily aimed at reducing cost for the equipment manufacturer both in engineering and assembly. Such 'solutions' must be designed to be cost effective - offering costs substantially below discrete components - and must be compatible with subcontract board manufacture without the traditional and expensive skills of fibre handling, splicing and management. Examples of 'solutions' in this context may be the core of a multifunctional OADM or a DWDM laser transmitter subsystem, with modulation, wavelength and power management all included in a simple to use module. Essential to the cost effective production of such solutions is a high degree of optical/optoelectronic integration. Co-packaging of discrete components and electronics into modules will not deliver the cost reduction demanded. At Bookham Technology we have brought together what we believe to be the three key integration technologies - InP for monolithic tunable sources, GaAs for high performance integrated modulation and ASOC for smart passives and hybrid platforms - which can deliver this cost reduction, together with performance enhancement, over a wide range of applications. In the paper we will demonstrate and compare our above integration approaches with the competing alternatives and seek to show how the power of integration is finally being harnessed in optoelectronics, delivering radical cost reduction as well as enabling system concepts virtually impossible to achieve with discrete components. In the paper we will demonstrate and compare our above integration approaches with the competing alternatives and seek to show how the power of integration is finally being harnessed in optoelectronics, delivering radical cost reduction as well as enabling system concepts virtually impossible to achieve with discrete components.

Association between component costs, study methodologies, and foodborne illness-related factors with the cost of nontyphoidal Salmonella illness.

PubMed

McLinden, Taylor; Sargeant, Jan M; Thomas, M Kate; Papadopoulos, Andrew; Fazil, Aamir

2014-09-01

Nontyphoidal Salmonella spp. are one of the most common causes of bacterial foodborne illness. Variability in cost inventories and study methodologies limits the possibility of meaningfully interpreting and comparing cost-of-illness (COI) estimates, reducing their usefulness. However, little is known about the relative effect these factors have on a cost-of-illness estimate. This is important for comparing existing estimates and when designing new cost-of-illness studies. Cost-of-illness estimates, identified through a scoping review, were used to investigate the association between descriptive, component cost, methodological, and foodborne illness-related factors such as chronic sequelae and under-reporting with the cost of nontyphoidal Salmonella spp. illness. The standardized cost of nontyphoidal Salmonella spp. illness from 30 estimates reported in 29 studies ranged from $0.01568 to $41.22 United States dollars (USD)/person/year (2012). The mean cost of nontyphoidal Salmonella spp. illness was $10.37 USD/person/year (2012). The following factors were found to be significant in multiple linear regression (p≤0.05): the number of direct component cost categories included in an estimate (0-4, particularly long-term care costs) and chronic sequelae costs (inclusion/exclusion), which had positive associations with the cost of nontyphoidal Salmonella spp. illness. Factors related to study methodology were not significant. Our findings indicated that study methodology may not be as influential as other factors, such as the number of direct component cost categories included in an estimate and costs incurred due to chronic sequelae. Therefore, these may be the most important factors to consider when designing, interpreting, and comparing cost of foodborne illness studies.

Silicon solar photovoltaic power stations

NASA Technical Reports Server (NTRS)

Chowaniec, C. R.; Ferber, R. R.; Pittman, P. F.; Marshall, B. W.

1977-01-01

Modular design of components and arrays, cost estimates for modules and support structures, and cost/performance analysis of a central solar photovoltaic power plant are discussed. Costs of collector/reflector arrays are judged the dominant element in the total capital investment. High-concentration solar tracking arrays are recommended as the most economic means for producing solar photovoltaic energy when solar cells costs are high ($500 per kW generated). Capital costs for power conditioning subsystem components are itemized and system busbar energy costs are discussed at length.

A managerial accounting analysis of hospital costs.

PubMed Central

Frank, W G

1976-01-01

Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed. PMID:965233

A managerial accounting analysis of hospital costs.

PubMed

Frank, W G

1976-01-01

Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed.

Productivity-based approach to valuation of transportation infrastructure.

DOT National Transportation Integrated Search

2014-10-01

Transportation infrastructure, a vital component to sustain economic prosperity, represents the largest public-owned : infrastructure asset in the U.S. With over a trillion invested dollars invested into long-lived physical assets such as : roads and...

Earthquake forecasting during the complex Amatrice-Norcia seismic sequence

PubMed Central

Marzocchi, Warner; Taroni, Matteo; Falcone, Giuseppe

2017-01-01

Earthquake forecasting is the ultimate challenge for seismologists, because it condenses the scientific knowledge about the earthquake occurrence process, and it is an essential component of any sound risk mitigation planning. It is commonly assumed that, in the short term, trustworthy earthquake forecasts are possible only for typical aftershock sequences, where the largest shock is followed by many smaller earthquakes that decay with time according to the Omori power law. We show that the current Italian operational earthquake forecasting system issued statistically reliable and skillful space-time-magnitude forecasts of the largest earthquakes during the complex 2016–2017 Amatrice-Norcia sequence, which is characterized by several bursts of seismicity and a significant deviation from the Omori law. This capability to deliver statistically reliable forecasts is an essential component of any program to assist public decision-makers and citizens in the challenging risk management of complex seismic sequences. PMID:28924610

Earthquake forecasting during the complex Amatrice-Norcia seismic sequence.

PubMed

Marzocchi, Warner; Taroni, Matteo; Falcone, Giuseppe

2017-09-01

Earthquake forecasting is the ultimate challenge for seismologists, because it condenses the scientific knowledge about the earthquake occurrence process, and it is an essential component of any sound risk mitigation planning. It is commonly assumed that, in the short term, trustworthy earthquake forecasts are possible only for typical aftershock sequences, where the largest shock is followed by many smaller earthquakes that decay with time according to the Omori power law. We show that the current Italian operational earthquake forecasting system issued statistically reliable and skillful space-time-magnitude forecasts of the largest earthquakes during the complex 2016-2017 Amatrice-Norcia sequence, which is characterized by several bursts of seismicity and a significant deviation from the Omori law. This capability to deliver statistically reliable forecasts is an essential component of any program to assist public decision-makers and citizens in the challenging risk management of complex seismic sequences.

Logging costs for management planning for young-growth coast Douglas-fir.

Treesearch

.Roger D. Fight; Chris B. LeDoux; Tom L. Ortman

1984-01-01

Logging cost equations are provided that can be used for analyses of silvicultural regimes. These equations include costs for all phases of logging from felling to loading onto a truck. They are presented by various components so that the user can substitute other values if some components do not seem applicable. Where appropriate these costs vary by size of trees...

Footprinting analysis of interactions between the largest eukaryotic RNase P/MRP protein Pop1 and RNase P/MRP RNA components

PubMed Central

Fagerlund, Robert D.; Perederina, Anna; Berezin, Igor; Krasilnikov, Andrey S.

2015-01-01

Ribonuclease (RNase) P and RNase MRP are closely related catalytic ribonucleoproteins involved in the metabolism of a wide range of RNA molecules, including tRNA, rRNA, and some mRNAs. The catalytic RNA component of eukaryotic RNase P retains the core elements of the bacterial RNase P ribozyme; however, the peripheral RNA elements responsible for the stabilization of the global architecture are largely absent in the eukaryotic enzyme. At the same time, the protein makeup of eukaryotic RNase P is considerably more complex than that of the bacterial RNase P. RNase MRP, an essential and ubiquitous eukaryotic enzyme, has a structural organization resembling that of eukaryotic RNase P, and the two enzymes share most of their protein components. Here, we present the results of the analysis of interactions between the largest protein component of yeast RNases P/MRP, Pop1, and the RNA moieties of the enzymes, discuss structural implications of the results, and suggest that Pop1 plays the role of a scaffold for the stabilization of the global architecture of eukaryotic RNase P RNA, substituting for the network of RNA–RNA tertiary interactions that maintain the global RNA structure in bacterial RNase P. PMID:26135751

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

PubMed

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

2013-07-01

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

Energy Monitoring in Gins - 2013 Update

USDA-ARS?s Scientific Manuscript database

Energy, comprised of electricity and fuel, is the second largest source of variable costs for cotton gins, after labor. Few studies of gin energy use have been conducted recently and none have monitored energy use continuously throughout the ginning season. More detailed information is needed to ide...

Energy Monitoring in Gins - 2012 Preliminary Results

USDA-ARS?s Scientific Manuscript database

Electricity and fuel are the second largest source of variable costs for cotton gins, after labor. Few studies of gin energy use have been conducted recently and none have monitored energy use continuously throughout the ginning season. More detailed information is needed to identify management st...

Workplace Incivility: Worker and Organizational Antecedents and Outcomes

ERIC Educational Resources Information Center

Bartlett, James E., II; Bartlett, Michelle E.; Reio, Thomas G., Jr.

2008-01-01

Unresolved workplace conflicts represent the largest reducible costs to an organization (Keenan & Newton, 1985). As incivility increases (Buhler, 2003; Pearson, Andersson, & Wegner, 2001; Pearson & Porath, 2005) more research is being conducted (Tepper, Duffy, Henle, & Lambert, 2006; Vickers, 2006). This review examined antecedents (variables that…

75 FR 71643 - Periodic Reporting Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... on one-time studies. 2. Mail processing is the largest source of volume-variable costs in the postal... a strategic rulemaking, identifies several potential areas for study, and seeks suggestions for... data collection programs that need to be established. It might list existing analytical studies that...

Construction Cost Growth for New Department of Energy Nuclear Facilities

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

Kubic, Jr., William L.

Cost growth and construction delays are problems that plague many large construction projects including the construction of new Department of Energy (DOE) nuclear facilities. A study was conducted to evaluate cost growth of large DOE construction projects. The purpose of the study was to compile relevant data, consider the possible causes of cost growth, and recommend measures that could be used to avoid extreme cost growth in the future. Both large DOE and non-DOE construction projects were considered in this study. With the exception of Chemical and Metallurgical Research Building Replacement Project (CMRR) and the Mixed Oxide Fuel Fabrication Facilitymore » (MFFF), cost growth for DOE Nuclear facilities is comparable to the growth experienced in other mega construction projects. The largest increase in estimated cost was found to occur between early cost estimates and establishing the project baseline during detailed design. Once the project baseline was established, cost growth for DOE nuclear facilities was modest compared to non-DOE mega projects.« less

Low-Cost Resin Transfer Molding Process Developed for High-Temperature Polyimide Matrix Composites

NASA Technical Reports Server (NTRS)

1996-01-01

The use of high-temperature polymer matrix composites (PMC's) in aircraft engine applications can significantly reduce engine weight and improve performance and fuel efficiency. High-temperature PMC's, such as those based on the PMR-15 polyimide matrix resin developed by the NASA Lewis Research Center, have been used extensively in military applications where performance improvements have justified their use regardless of the cost involved in producing the component. However, in commercial engines cost is a primary driver, and PMC components must be produced at costs comparable to those of the metal components that they will replace.

Metabolic constraint imposes tradeoff between body size and number of brain neurons in human evolution

PubMed Central

Fonseca-Azevedo, Karina; Herculano-Houzel, Suzana

2012-01-01

Despite a general trend for larger mammals to have larger brains, humans are the primates with the largest brain and number of neurons, but not the largest body mass. Why are great apes, the largest primates, not also those endowed with the largest brains? Recently, we showed that the energetic cost of the brain is a linear function of its numbers of neurons. Here we show that metabolic limitations that result from the number of hours available for feeding and the low caloric yield of raw foods impose a tradeoff between body size and number of brain neurons, which explains the small brain size of great apes compared with their large body size. This limitation was probably overcome in Homo erectus with the shift to a cooked diet. Absent the requirement to spend most available hours of the day feeding, the combination of newly freed time and a large number of brain neurons affordable on a cooked diet may thus have been a major positive driving force to the rapid increased in brain size in human evolution. PMID:23090991

Metabolic constraint imposes tradeoff between body size and number of brain neurons in human evolution.

PubMed

Fonseca-Azevedo, Karina; Herculano-Houzel, Suzana

2012-11-06

Despite a general trend for larger mammals to have larger brains, humans are the primates with the largest brain and number of neurons, but not the largest body mass. Why are great apes, the largest primates, not also those endowed with the largest brains? Recently, we showed that the energetic cost of the brain is a linear function of its numbers of neurons. Here we show that metabolic limitations that result from the number of hours available for feeding and the low caloric yield of raw foods impose a tradeoff between body size and number of brain neurons, which explains the small brain size of great apes compared with their large body size. This limitation was probably overcome in Homo erectus with the shift to a cooked diet. Absent the requirement to spend most available hours of the day feeding, the combination of newly freed time and a large number of brain neurons affordable on a cooked diet may thus have been a major positive driving force to the rapid increased in brain size in human evolution.

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

PubMed Central

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

2016-01-01

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

Development of a universally applicable household food insecurity measurement tool: process, current status, and outstanding issues.

PubMed

Swindale, Anne; Bilinsky, Paula

2006-05-01

The United States Public Law 480 Title II food aid program is the largest U.S. government program directed at reducing hunger, malnutrition, and food insecurity in the developing world. USAID and Title II implementing partners face challenges in measuring the success of Title II programs in reducing household food insecurity because of the technical difficulty and cost of collecting and analyzing data on traditional food security indicators, such as per capita income and caloric adequacy. The Household Food Insecurity Access Scale (HFIAS) holds promise as an easier and more user-friendly approach for measuring the access component of household food security. To support the consistent and comparable collection of the HFIAS, efforts are under way to develop a guide with a standardized questionnaire and data collection and analysis instructions. A set of domains have been identified that is deemed to capture the universal experience of the access component of household food insecurity across countries and cultures. Based on these domains, a set of questions has been developed with wording that is deemed to be universally appropriate, with minor adaptation to local contexts. These underlying suppositions, based on research in multiple countries, are being verified by potential users of the guide. The key remaining issue relates to the process for creating a categorical indicator of food insecurity status from the HFIAS.

On the contribution of reconstruction labor wages and material prices to demand surge

USGS Publications Warehouse

Olsen, Anna H.; Porter, Keith A.

2011-01-01

Demand surge is understood to be a socio-economic phenomenon of large-scale natural disasters, most commonly explained by higher repair costs (after a large- versus small-scale disaster) resulting from higher material prices and labor wages. This study tests this explanation by developing quantitative models for the cost change of sets, or "baskets," of repairs to damage caused by Atlantic hurricanes making landfall on the mainland United States. We define six such baskets, representing the total repair cost, and material and labor components, each for a typical residential or commercial property. We collect cost data from the leading provider of these data to insurance claims adjusters in the United States, and we calculate the cost changes from July to January for nine Atlantic hurricane seasons at fifty-two cities on the Atlantic and Gulf Coasts. The data show that: changes in labor costs drive the changes in total repair costs; cost changes can vary significantly by geographic region and year; and cost changes for the residential basket of repairs are more volatile than the cost changes for the commercial basket. We then propose a series of multilevel regression models to predict the cost changes by considering several combinations of the following explanatory variables: the largest gradient wind speed at a city in a hurricane season; the number of tropical storms in a hurricane season whose center passes within 200 km of a city; and cost changes in the first two quarters of the year. We also allow the coefficients of the regression model to be stochastic, varying across groups defined by region of the Southeastern United States and year. Our best models predict that, for any city on the Gulf or Atlantic Coasts in any hurricane season, the residential total repair cost changes vary from 0.01 to 0.25, depending on the wind speed and number of storms, with an uncertainty of 0.1 (two standard errors of prediction) given the wind speed and number of storms. The commercial total repair cost changes vary from 0.005 to 0.15 with an uncertainty of 0.08. Our models including wind speed, the number of storms affecting a city, and cost changes in the first half of the year explain roughly half of the observed variability in cost changes. Additional explanatory variables that we have not considered may account for the remaining variability. Given these models, however, there is still considerable uncertainty in their predictions. This uncertainty arises from variations between groups defined by region and year, not from variations within a given region and year.

Cost/benefit analysis of advanced material technologies for small aircraft turbine engines

NASA Technical Reports Server (NTRS)

Comey, D. H.

1977-01-01

Cost/benefit studies were conducted on ten advanced material technologies applicable to small aircraft gas turbine engines to be produced in the 1985 time frame. The cost/benefit studies were applied to a two engine, business-type jet aircraft in the 6800- to 9100-Kg (15,000- to 20,000-lb) gross weight class. The new material technologies are intended to provide improvements in the areas of high-pressure turbine rotor components, high-pressure turbine rotor components, high-pressure turbine stator airfoils, and static structural components. The cost/benefit of each technology is presented in terms of relative value, which is defined as a change in life cycle cost times probability of success divided by development cost. Technologies showing the most promising cost/benefits based on relative value are uncooled single crystal MAR-M 247 turbine blades, cooled DS MAR-M 247 turbine blades, and cooled ODS 'M'CrAl laminate turbine stator vanes.

Materials in use in U.S. interstate highways

DOT National Transportation Integrated Search

2006-10-01

Natural aggregates (construction sand and gravel and crushed stone) make up the largest component of nonfuel mineral materials consumed in the United States. Most of these materials are used in construction activities, such as in buildings and roads....

Cut Costs with Thin Client Computing.

ERIC Educational Resources Information Center

Hartley, Patrick H.

2001-01-01

Discusses how school districts can considerably increase the number of administrative computers in their districts without a corresponding increase in costs by using the "Thin Client" component of the Total Cost of Ownership (TCC) model. TCC and Thin Client are described, including its software and hardware components. An example of a…

76 FR 21393 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition.... Capital and startup costs include, among other items, computers and software you purchase to prepare for...

76 FR 25367 - Agency Information Collection Activities: Proposed Collection, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition.... Capital and startup costs include, among other items, computers and software you purchase to prepare for...

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

PubMed

Stiles, R A; Mick, S S

1997-01-01

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

Near-Net Shape Fabrication Using Low-Cost Titanium Alloy Powders

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

Dr. David M. Bowden; Dr. William H. Peter

2012-03-31

The use of titanium in commercial aircraft production has risen steadily over the last half century. The aerospace industry currently accounts for 58% of the domestic titanium market. The Kroll process, which has been used for over 50 years to produce titanium metal from its mineral form, consumes large quantities of energy. And, methods used to convert the titanium sponge output of the Kroll process into useful mill products also require significant energy resources. These traditional approaches result in product forms that are very expensive, have long lead times of up to a year or more, and require costly operationsmore » to fabricate finished parts. Given the increasing role of titanium in commercial aircraft, new titanium technologies are needed to create a more sustainable manufacturing strategy that consumes less energy, requires less material, and significantly reduces material and fabrication costs. A number of emerging processes are under development which could lead to a breakthrough in extraction technology. Several of these processes produce titanium alloy powder as a product. The availability of low-cost titanium powders may in turn enable a more efficient approach to the manufacture of titanium components using powder metallurgical processing. The objective of this project was to define energy-efficient strategies for manufacturing large-scale titanium structures using these low-cost powders as the starting material. Strategies include approaches to powder consolidation to achieve fully dense mill products, and joining technologies such as friction and laser welding to combine those mill products into near net shape (NNS) preforms for machining. The near net shape approach reduces material and machining requirements providing for improved affordability of titanium structures. Energy and cost modeling was used to define those approaches that offer the largest energy savings together with the economic benefits needed to drive implementation. Technical feasibility studies were performed to identify the most viable approaches to NNS preform fabrication using basic powder metallurgy mill product forms as the building blocks and advanced joining techniques including fusion and solid state joining to assemble these building blocks into efficient machining performs.« less

CO Component Estimation Based on the Independent Component Analysis

NASA Astrophysics Data System (ADS)

Ichiki, Kiyotomo; Kaji, Ryohei; Yamamoto, Hiroaki; Takeuchi, Tsutomu T.; Fukui, Yasuo

2014-01-01

Fast Independent Component Analysis (FastICA) is a component separation algorithm based on the levels of non-Gaussianity. Here we apply FastICA to the component separation problem of the microwave background, including carbon monoxide (CO) line emissions that are found to contaminate the PLANCK High Frequency Instrument (HFI) data. Specifically, we prepare 100 GHz, 143 GHz, and 217 GHz mock microwave sky maps, which include galactic thermal dust, NANTEN CO line, and the cosmic microwave background (CMB) emissions, and then estimate the independent components based on the kurtosis. We find that FastICA can successfully estimate the CO component as the first independent component in our deflection algorithm because its distribution has the largest degree of non-Gaussianity among the components. Thus, FastICA can be a promising technique to extract CO-like components without prior assumptions about their distributions and frequency dependences.

CO component estimation based on the independent component analysis

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

Ichiki, Kiyotomo; Kaji, Ryohei; Yamamoto, Hiroaki

2014-01-01

Fast Independent Component Analysis (FastICA) is a component separation algorithm based on the levels of non-Gaussianity. Here we apply FastICA to the component separation problem of the microwave background, including carbon monoxide (CO) line emissions that are found to contaminate the PLANCK High Frequency Instrument (HFI) data. Specifically, we prepare 100 GHz, 143 GHz, and 217 GHz mock microwave sky maps, which include galactic thermal dust, NANTEN CO line, and the cosmic microwave background (CMB) emissions, and then estimate the independent components based on the kurtosis. We find that FastICA can successfully estimate the CO component as the first independentmore » component in our deflection algorithm because its distribution has the largest degree of non-Gaussianity among the components. Thus, FastICA can be a promising technique to extract CO-like components without prior assumptions about their distributions and frequency dependences.« less

Is Technological Change in Medicine Always Worth It? The Case of Acute Myocardial Infarction

PubMed Central

Staiger, Douglas; Fisher, Elliott

2007-01-01

We examine Medicare costs and survival gains for Acute Myocardial Infarction (AMI) during 1986–2002. Like Cutler and McClellan, we find overall gains in post-AMI survival more than justified the increases in costs during this period. Since 1996, however, survival gains have stagnated, while expenditures have continued to increase. We also consider changes in expenditures and outcomes at the regional level. Regions experiencing the largest expenditure gains were not those realizing the greatest improvements in survival. Factors yielding the greatest benefits to health (aspirin, beta blockers, and reperfusion) were not the factors that drove up costs (multiple physicians), and conversely. PMID:16464904

Valuing Climate Change Impacts on Human Health: Empirical Evidence from the Literature

PubMed Central

Markandya, Anil; Chiabai, Aline

2009-01-01

There is a broad consensus that climate change will increase the costs arising from diseases such as malaria and diarrhea and, furthermore, that the largest increases will be in developing countries. One of the problems is the lack of studies measuring these costs systematically and in detail. This paper critically reviews a number of studies about the costs of planned adaptation in the health context, and compares current health expenditures with MDGs which are felt to be inadequate when considering climate change impacts. The analysis serves also as a critical investigation of the methodologies used and aims at identifying research weaknesses and gaps. PMID:19440414

Reliability enhancement through optimal burn-in

NASA Astrophysics Data System (ADS)

Kuo, W.

1984-06-01

A numerical reliability and cost model is defined for production line burn-in tests of electronic components. The necessity of burn-in is governed by upper and lower bounds: burn-in is mandatory for operation-critical or nonreparable component; no burn-in is needed when failure effects are insignificant or easily repairable. The model considers electronic systems in terms of a series of components connected by a single black box. The infant mortality rate is described with a Weibull distribution. Performance reaches a steady state after burn-in, and the cost of burn-in is a linear function for each component. A minimum cost is calculated among the costs and total time of burn-in, shop repair, and field repair, with attention given to possible losses in future sales from inadequate burn-in testing.

Military Transformation: Intelligence, Surveillance and Reconnaissance

DTIC Science & Technology

2003-01-17

http:// ww2 .pstripes.osd.mil/01/research1.html]. The Air Force is the largest military provider of surveillance and reconnaissance as it operates most... Infrared System both had funding requests reduced. The cuts were due primarily to seriously escalating costs and program management issues.101 The DOD

Emboldened, the FTC Seems Ready to Fight More Mergers.

PubMed

Kirkner, Richard Mark

2016-11-01

Because hospital spending makes up the largest piece of U.S. health care spending-32%, according to data from CMS-any judicial rulings or legislative move to curb a hospital's market dominance are key to controlling overall health care costs. The FTC is stepping in.

Seeing Red Over Those Black Marks on Your Floors?

ERIC Educational Resources Information Center

Rittner-Heir, Robbin

1999-01-01

Describes one custodian's cost-effective approach for resolving black scuff marks on flooring and staving off their return. An eight-step cleaning program is detailed. Cautions that the largest obstacle to proper handling of floor problems lies in the lack of a proper maintenance schedule. (GR)

Retention in care, resource utilization, and costs for adults receiving antiretroviral therapy in Zambia: a retrospective cohort study

PubMed Central

2014-01-01

Background Of the estimated 800,000 adults living with HIV in Zambia in 2011, roughly half were receiving antiretroviral therapy (ART). As treatment scale up continues, information on the care provided to patients after initiating ART can help guide decision-making. We estimated retention in care, the quantity of resources utilized, and costs for a retrospective cohort of adults initiating ART under routine clinical conditions in Zambia. Methods Data on resource utilization (antiretroviral [ARV] and non-ARV drugs, laboratory tests, outpatient clinic visits, and fixed resources) and retention in care were extracted from medical records for 846 patients who initiated ART at ≥15 years of age at six treatment sites between July 2007 and October 2008. Unit costs were estimated from the provider’s perspective using site- and country-level data and are reported in 2011 USD. Results Patients initiated ART at a median CD4 cell count of 145 cells/μL. Fifty-nine percent of patients initiated on a tenofovir-containing regimen, ranging from 15% to 86% depending on site. One year after ART initiation, 75% of patients were retained in care. The average cost per patient retained in care one year after ART initiation was $243 (95% CI, $194-$293), ranging from $184 (95% CI, $172-$195) to $304 (95% CI, $290-$319) depending on site. Patients retained in care one year after ART initiation received, on average, 11.4 months’ worth of ARV drugs, 1.5 CD4 tests, 1.3 blood chemistry tests, 1.4 full blood count tests, and 6.5 clinic visits with a doctor or clinical officer. At all sites, ARV drugs were the largest cost component, ranging from 38% to 84% of total costs, depending on site. Conclusions Patients initiate ART late in the course of disease progression and a large proportion drop out of care after initiation. The quantity of resources utilized and costs vary widely by site, and patients utilize a different mix of resources under routine clinical conditions than if they were receiving fully guideline-concordant care. Improving retention in care and guideline concordance, including increasing the use of tenofovir in first-line ART regimens, may lead to increases in overall treatment costs. PMID:24684772

Economic impact of lumpy skin disease and cost effectiveness of vaccination for the control of outbreaks in Ethiopia.

PubMed

Molla, Wassie; de Jong, Mart C M; Gari, Getachew; Frankena, Klaas

2017-11-01

Lumpy skin disease (LSD), an infectious viral disease of cattle, causes considerable financial losses in livestock industry of affected countries. A questionnaire survey with the objectives of determining direct economic losses of LSD (mortality loss, milk loss, draft loss) and treatment costs (medication and labour cost) per affected herd, and assessing the cost effectiveness of vaccination as a means for LSD control was carried out in the central and north-western parts of Ethiopia. From a total of 4430 cattle (in 243 herds) surveyed, 941 animals (in 200 herds) were reported to be infected. The overall morbidity and mortality at animal level were 21.2% and 4.5%, and at herd level these were 82.3% and 24.3%. There was a significant difference in animal level morbidity and mortality between categories of animals. Over 94% of the herd owners ranked LSD as a big or very big problem for cattle production. A large proportion (92.2%) of the herd owners indicated that LSD affects cattle marketing. A median loss of USD 375 (USD 325 in local Zebu and USD 1250 in Holstein-Friesian local Zebu cross cattle) was estimated per dead animal. Median losses per affected lactating cow were USD 141 (USD 63 in local Zebu cows and USD 216 in Holstein-Friesian local Zebu cross cows) and, USD 36 per affected ox. Diagnosis and medication cost per affected animal were estimated at USD 5. The median total economic loss of an LSD outbreak at herd level was USD 1176 (USD 489 in subsistence farm and USD 2735 in commercial farm). At herd level, the largest component of the economic loss was due to mortality (USD 1000) followed by milk loss (USD 120). LSD control costs were the least contributor to herd level losses. The total herd level economic losses in the commercial farm type were significantly higher than in the subsistence farm type. The financial analysis showed a positive net profit of USD 136 (USD 56 for subsistence farm herds and USD 283 for commercial herds) per herd due to LSD vaccine investment. It should be noted that only the noticeable direct costs and treatment costs associated with the disease were considered in the study. Generally, vaccination is economically effective and should be encouraged. Copyright © 2017 Elsevier B.V. All rights reserved.

Cost-Reduction Roadmap for Residential Solar Photovoltaics (PV), 2017-2030

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

Cook, Jeffrey J.; Ardani, Kristen B.; Margolis, Robert M.

The installed cost of solar photovoltaics (PV) has fallen rapidly in recent years and is expected to continue declining in the future. In this report, we focus on the potential for continued PV cost reductions in the residential market. From 2010 to 2017, the levelized cost of energy (LCOE) for residential PV declined from 52 cents per kilowatt-hour (cents/kWh) to 16 cents/kWh (Fu et al. 2017). The U.S. Department of Energy's (DOE's) Solar Energy Technologies Office (SETO) recently set new LCOE targets for 2030, including a target of 5 cents/kWh for residential PV. We present a roadmap for achieving themore » SETO 2030 residential PV target. Because the 2030 target likely will not be achieved under business-as-usual trends (NREL 2017), we examine two key market segments that demonstrate significant opportunities for cost savings and market growth: installing PV at the time of roof replacement and installing PV as part of the new home construction process. Within both market segments, we identify four key cost-reduction opportunities: market maturation, business model integration, product innovation, and economies of scale. To assess the potential impact of these cost reductions, we compare modeled residential PV system prices in 2030 to the National Renewable Energy Laboratory's (NREL's) quarter one 2017 (Q1 2017) residential PV system price benchmark (Fu et al. 2017). We use a bottom-up accounting framework to model all component and project-development costs incurred when installing a PV system. The result is a granular accounting for 11 direct and indirect costs associated with installing a residential PV system in 2030. All four modeled pathways demonstrate significant installed-system price savings over the Q1 2017 benchmark, with the visionary pathways yielding the greatest price benefits. The largest modeled cost savings are in the supply chain, sales and marketing, overhead, and installation labor cost categories. When we translate these installed-system costs into LCOE, we find that the less-aggressive pathways achieve significant cost reductions, but may not achieve the 2030 LCOE target. On the other hand, both visionary pathways could get very close to (for roof replacement) or achieve (for new construction) the 2030 target. Our analysis has two key implications. First, because installed-system soft cost reductions account for about 65 percent of the LCOE reductions in 2030 for both visionary pathways, residential PV stakeholders may need to emphasize these soft cost reductions to achieve the 2030 target. Second, capturing these savings will likely require considerable innovation in the technologies and business practices employed by the PV industry.« less

The influence of various test plans on mission reliability. [for Shuttle Spacelab payloads

NASA Technical Reports Server (NTRS)

Stahle, C. V.; Gongloff, H. R.; Young, J. P.; Keegan, W. B.

1977-01-01

Methods have been developed for the evaluation of cost effective vibroacoustic test plans for Shuttle Spacelab payloads. The shock and vibration environments of components have been statistically represented, and statistical decision theory has been used to evaluate the cost effectiveness of five basic test plans with structural test options for two of the plans. Component, subassembly, and payload testing have been performed for each plan along with calculations of optimum test levels and expected costs. The tests have been ranked according to both minimizing expected project costs and vibroacoustic reliability. It was found that optimum costs may vary up to $6 million with the lowest plan eliminating component testing and maintaining flight vibration reliability via subassembly tests at high acoustic levels.

Joint Spatio-Temporal Shared Component Model with an Application in Iran Cancer Data

PubMed

Mahaki, Behzad; Mehrabi, Yadollah; Kavousi, Amir; Schmid, Volker J

2018-06-25

Background: Among the proposals for joint disease mapping, the shared component model has become more popular. Another advance to strengthen inference of disease data is the extension of purely spatial models to include time aspect. We aim to combine the idea of multivariate shared components with spatio-temporal modelling in a joint disease mapping model and apply it for incidence rates of seven prevalent cancers in Iran which together account for approximately 50% of all cancers. Methods: In the proposed model, each component is shared by different subsets of diseases, spatial and temporal trends are considered for each component, and the relative weight of these trends for each component for each relevant disease can be estimated. Results: For esophagus and stomach cancers the Northern provinces was the area of high risk. For colorectal cancer Gilan, Semnan, Fars, Isfahan, Yazd and East-Azerbaijan were the highest risk provinces. For bladder and lung cancer, the northwest were the highest risk area. For prostate and breast cancers, Isfahan, Yazd, Fars, Tehran, Semnan, Mazandaran and Khorasane-Razavi were the highest risk part. The smoking component, shared by esophagus, stomach, bladder and lung, had more effect in Gilan, Mazandaran, Chaharmahal and Bakhtiari, Kohgilouyeh and Boyerahmad, Ardebil and Tehran provinces, in turn. For overweight and obesity component, shared by esophagus, colorectal, prostate and breast cancers the largest effect was found for Tehran, Khorasane-Razavi, Semnan, Yazd, Isfahan, Fars, Mazandaran and Gilan, in turn. For low physical activity component, shared by colorectal and breast cancers North-Khorasan, Ardebil, Golestan, Ilam, Khorasane-Razavi and South-Khorasan had the largest effects, in turn. The smoking component is significantly more important for stomach than for esophagus, bladder and lung. The overweight and obesity had significantly more effect for colorectal than of esophagus cancer. Conclusions: The presented model is a valuable model to model geographical and temporal variation among diseases and has some interesting potential features and benefits over other joint models. Creative Commons Attribution License

How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016?

PubMed

Collins, Sara R; Gunja, Munira; Beutel, Sophie

2016-03-01

Health insurers selling plans in the Affordable Care Act's market­places are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal pov­erty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.

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

PubMed

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

2016-12-01

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

Present and Future Energy Scenario in India

NASA Astrophysics Data System (ADS)

Kumar, S.; Bhattacharyya, B.; Gupta, V. K.

2014-09-01

India's energy sector is one of the most critical components of an infrastructure that affects India's economic growth and therefore is also one of the largest industries in India. India has the 5th largest electricity generating capacity and is the 6th largest energy consumer amounting for around 3.4 % of global energy consumption. India's energy demand has grown at 3.6 % pa over the past 30 years. The consumption of the energy is directly proportional to the progress of manpower with ever growing population, improvement in the living standard of the humanity and industrialization of the developing countries. Very recently smart grid technology can attribute important role in energy scenario. Smart grid refers to electric power system that enhances grid reliability and efficiency by automatically responding to system disturbances. This paper discusses the new communication infrastructure and scheme designed to integrate data.

Overview of SDCM - The Spacecraft Design and Cost Model

NASA Technical Reports Server (NTRS)

Ferebee, Melvin J.; Farmer, Jeffery T.; Andersen, Gregory C.; Flamm, Jeffery D.; Badi, Deborah M.

1988-01-01

The Spacecraft Design and Cost Model (SDCM) is a computer-aided design and analysis tool for synthesizing spacecraft configurations, integrating their subsystems, and generating information concerning on-orbit servicing and costs. SDCM uses a bottom-up method in which the cost and performance parameters for subsystem components are first calculated; the model then sums the contributions from individual components in order to obtain an estimate of sizes and costs for each candidate configuration within a selected spacecraft system. An optimum spacraft configuration can then be selected.

Additive Manufacture of Plasma Diagnostic Components Final Report Phase II

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

Woodruff, Simon; Romero-Talamas, Carlos; You, Setthivoine

There is now a well-established set of plasma diagnostics (see e.g. [3]), but these remain some of the mostexpensive assemblies in fusion systems since for every system they have to be custom built, and time fordiagnostic development can pace the project. Additive manufacturing (AM) has the potential to decreaseproduction cost and significantly lower design time of fusion diagnostic subsystems, which would realizesignificant cost reduction for standard diagnostics. In some cases, these basic components can be additivelymanufactured for less than 1/100th costs of conventional manufacturing.In our DOE Phase II SBIR, we examined the impact that AM can have on plasma diagnosticmore » cost bytaking 15 separate diagnostics through an engineering design using Conventional Manufacturing (CM) tech-niques, then optimizing the design to exploit the benefits of AM. The impact of AM techniques on cost isfound to be in several areas. First, the cost of materials falls because AM parts can be manufactured withlittle to no waste, and engineered to use less material than CM. Next, the cost of fabrication falls for AMparts relative to CM since the fabrication time can be computed exactly, and often no post-processing isrequired for the part to be functional. We find that AM techniques are well suited for plasma diagnosticssince typical diagnostic complexity comes at no additional cost. Cooling channels, for example, can be builtin to plasma-facing components at no extra cost. Fabrication costs associated with assembly are lower forAM parts because many components can be combined and printed as monoliths, thereby mitigating the needfor alignment or calibration. Finally, the cost of engineering is impacted by exploiting AM design tools thatallow standard components to be customized through web-interfaces. Furthermore, we find that conceptdesign costs can be impacted by scripting interfaces for online engineering design tools.« less

New plastic recycling technology

EPA Science Inventory

Greater than 60% of the total plastic content of municipal solid waste is comprised of polyolefins (high-density, low-density, and linear polyethylene and polypropylene. Polyethylene (PE) is the largest-volume component but presents a challenge due to the absence of low-energy de...

Parkinson's Disease Glossary

MedlinePlus

... Epidemiology The study of the patterns, causes, and control of disease in groups of people. Epidemiological studies can be used to ... largest component of the basal ganglia, the striatum controls movement, balance, and walking. It is ... groups Many people find that support groups are tremendously ...

Comparative cost-effectiveness of the components of a behavior change communication campaign on HIV/AIDS in North India.

PubMed

Sood, Suruchi; Nambiar, Devaki

2006-01-01

Numerous studies show that exposure to entertainment-education-based mass media campaigns is associated with reduction in risk behaviors. Concurrently, there is a growing interest in comparing the cost-effectiveness of HIV prevention interventions taking into account infrastructural and programmatic costs. In such analyses, though few in number, mass media campaigns have fared well. Using data from a mass media communication campaign in the low HIV prevalence states of Uttar Pradesh, Rajasthan, and Delhi in Northern India, in this article we examine the following: (1) factors that mediate behavior change in different components of the campaign, comprising a TV drama, reality show for youth audiences, and TV spots; (2) the relative impact of campaign components on the behavioral outcome: condom use; and (3) the cost-effectiveness calculations arising from this analysis. Results suggest that recall of the TV spots and the TV drama influences behavior change and is strongly associated with interpersonal communication and positive gender attitudes. The TV drama, in spite of being the costliest, emerges as the most cost-effective component when considering the behavioral outcome of interest. The analysis of the comparative cost-effectiveness of individual campaign components provides insights into the planning of resources for communication interventions globally.

Reliability Methods for Shield Design Process

NASA Technical Reports Server (NTRS)

Tripathi, R. K.; Wilson, J. W.

2002-01-01

Providing protection against the hazards of space radiation is a major challenge to the exploration and development of space. The great cost of added radiation shielding is a potential limiting factor in deep space operations. In this enabling technology, we have developed methods for optimized shield design over multi-segmented missions involving multiple work and living areas in the transport and duty phase of space missions. The total shield mass over all pieces of equipment and habitats is optimized subject to career dose and dose rate constraints. An important component of this technology is the estimation of two most commonly identified uncertainties in radiation shield design, the shielding properties of materials used and the understanding of the biological response of the astronaut to the radiation leaking through the materials into the living space. The largest uncertainty, of course, is in the biological response to especially high charge and energy (HZE) ions of the galactic cosmic rays. These uncertainties are blended with the optimization design procedure to formulate reliability-based methods for shield design processes. The details of the methods will be discussed.

Public housing into private assets: wealth creation in urban China.

PubMed

Walder, Andrew G; He, Xiaobin

2014-07-01

State socialist economies provided public housing to urban citizens at nominal cost, while allocating larger and better quality apartments to individuals in elite occupations. In transitions to a market economy, ownership is typically transferred to existing occupants at deeply discounted prices, making home equity the largest component of household wealth. Housing privatization is therefore a potentially important avenue for the conversion of bureaucratic privilege into private wealth. We estimate the resulting inequalities with data from successive waves of a Chinese national income survey that details household assets and participation in housing programs. Access to privatization programs was relatively equal across urban residents in state sector occupations. Elite occupations had substantially greater wealth in the form of home equity shortly after privatization, due primarily to their prior allocations of newer and higher quality apartments. The resulting gaps in private wealth were nonetheless small by the standards of established market economies, and despite the inherent biases in the process, housing privatization distributed home equity widely across those who were resident in public housing immediately prior to privatization. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Kelly, K.; Singer, M.

The largest source of funding for alternative fuel vehicle and infrastructure projects in the U.S. Department of Energy's Clean Cities program's history came from the American Recovery and Reinvestment Act (Recovery Act). In 2009, the 25 cost-share projects totaled nearly $300 million in federal government investment. This effort included the involvement of 50 Clean Cities coalitions and their nearly 700 stakeholder partners who provided an additional $500 million in matching funds to support projects in their local communities. In total, those 25 projects established 1,380 alternative fueling stations and put more than 9,000 alternative fuel and advanced technology vehicles onmore » the road. Together, these projects displaced 154 million gasoline gallon equivalents (GGE) of petroleum and averted 254,000 tons of greenhouse gas (GHG) emissions, while supporting U.S. energy independence and contributing to regional economic development. During post-project interviews, project leaders consistently cited a number of key components - ranging from technical and logistical factors, to administrative capabilities - for accomplishing an effective and impactful project. This report summarizes the high-level project design and administrative considerations for conducting a successful transportation project.« less

Advancing Women in STEM at Florida International University

NASA Astrophysics Data System (ADS)

Simpson, Caroline E.

2015-01-01

Florida International University (FIU) was awarded an NSF ADVANCE grant in 2011 to fund a partnership with the University of Michigan (UM) in order to improve the advancement of women faculty in STEM fields at FIU. FIU is a Carnegie "High Research Activity" doctoral granting institution, and is the fifth largest university in the country with over 54,000 students and 1,100 full-time faculty. The project at FIU was designed to adapt and implement some of the tools and practices shown to have increased the participation and advancement of women in the sciences at UM. The FIU ADVANCE program was funded from 2011-2014, and resulted in increased awareness of the issues facing women faculty in STEM fields, increased hiring of women into STEM faculty positions at FIU, and improved satisfaction for women in terms of some gender equity issues, pay, and recognition at FIU. I will give an overview of the program structure and components, provide examples and evidence of change, and discuss no-cost changes that can be implemented at other institutions.

What makes up plant genomes: The vanishing line between transposable elements and genes.

PubMed

Zhao, Dongyan; Ferguson, Ann A; Jiang, Ning

2016-02-01

The ultimate source of evolution is mutation. As the largest component in plant genomes, transposable elements (TEs) create numerous types of mutations that cannot be mimicked by other genetic mechanisms. When TEs insert into genomic sequences, they influence the expression of nearby genes as well as genes unlinked to the insertion. TEs can duplicate, mobilize, and recombine normal genes or gene fragments, with the potential to generate new genes or modify the structure of existing genes. TEs also donate their transposase coding regions for cellular functions in a process called TE domestication. Despite the host defense against TE activity, a subset of TEs survived and thrived through discreet selection of transposition activity, target site, element size, and the internal sequence. Finally, TEs have established strategies to reduce the efficacy of host defense system by increasing the cost of silencing TEs. This review discusses the recent progress in the area of plant TEs with a focus on the interaction between TEs and genes. Copyright © 2015 Elsevier B.V. All rights reserved.

Material selection and assembly method of battery pack for compact electric vehicle

NASA Astrophysics Data System (ADS)

Lewchalermwong, N.; Masomtob, M.; Lailuck, V.; Charoenphonphanich, C.

2018-01-01

Battery packs become the key component in electric vehicles (EVs). The main costs of which are battery cells and assembling processes. The battery cell is indeed priced from battery manufacturers while the assembling cost is dependent on battery pack designs. Battery pack designers need overall cost as cheap as possible, but it still requires high performance and more safety. Material selection and assembly method as well as component design are very important to determine the cost-effectiveness of battery modules and battery packs. Therefore, this work presents Decision Matrix, which can aid in the decision-making process of component materials and assembly methods for a battery module design and a battery pack design. The aim of this study is to take the advantage of incorporating Architecture Analysis method into decision matrix methods by capturing best practices for conducting design architecture analysis in full account of key design components critical to ensure efficient and effective development of the designs. The methodology also considers the impacts of choice-alternatives along multiple dimensions. Various alternatives for materials and assembly techniques of battery pack are evaluated, and some sample costs are presented. Due to many components in the battery pack, only seven components which are positive busbar and Z busbar are represented in this paper for using decision matrix methods.

Beryllium and titanium cost-adjustment report

NASA Astrophysics Data System (ADS)

Owen, John; Ulph, Eric, Sr.

1991-09-01

This report summarizes cost adjustment factors for beryllium (Be, S200) and titanium (Ti, 6Al-4V) that were derived relative to aluminum (Al, 7075-T6). Aluminum is traditionally the material upon which many of the Cost Analysis Office, Missile Division cost estimating relationships (CERs) are based. The adjustment factors address both research and development and production (Q > 100) quantities. In addition, the factors derived include optical elements, normal structure, and structure with special requirements for minimal microcreep, such as sensor assembly parts and supporting components. Since booster cost per payload pound is an even larger factor in total missile launch costs than was initially presumed, the primary cost driver for all materials compared was the missiles' booster cost per payload pound for both R&D and production quantities. Al and Ti are 1.5 and 2.4 times more dense, respectively, than Be, and the cost to lift the heavier materials results in greater booster expense. In addition, Al and Ti must be 2.1 and 2.8, respectively, times the weight of a Be component to provide equivalent stiffness, based on the example component addressed in the report. These factors also increase booster costs. After review of the relative factors cited above, especially the lower costs for Be when stiffness and booster costs are taken into consideration, affordability becomes an important issue. When this study was initiated, both government and contractor engineers said that Be was the material to be used as a last resort because of its prohibitive cost and extreme toxicity. Although the initial price of Be may lead one to believe that any Be product would be extremely expensive, the total cost of Be used for space applications is actually competitive with or less costly than either Al or Ti. Also, the Be toxicity problem has turned out to be a non-issue for purchasers of finished Be components since no machining or grinding operations are required on the finished components. Several new costing techniques are developed which provide quantitative measures of the cost of material stiffness, costs related to payload weight, and costs associated with the relative temperature stability of different materials. In addition, use is made of the Design/Cost Trade Model developed by Applied Research, Inc., to determine the booster cost differential relative to changes in payload weight, and a mirror fabrication cost model, developed by OCA Applied Optics, was used for mirror costing. This report is a summary of an extensive study done by the U.S. Army Strategic Defense Command, Huntsville, Alabama.

Associative Networks on a Massively Parallel Computer.

DTIC Science & Technology

1985-10-01

lgbt (as a group of numbers, in this case), but this only leads to sensible queries when a statistical function is applied: "What is the largest salary...34.*"* . •.,. 64 the siW~pe operations being used during ascend, each movement step costs the same as executing an operation

Varietal Variability for Cotton Ginning Efficiency

USDA-ARS?s Scientific Manuscript database

Energy consumption is one of the largest expenses of a cotton gin. In light of the rising cost of energy, all avenues should be exploited to optimize energy use in modern cotton gins. One option is to study genetic variability within the available germplasm to look for varieties that gin faster and ...

48 CFR 942.705-5 - Nonprofit organizations other than educational and state and local governments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations System DEPARTMENT OF ENERGY CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Nonprofit organizations... approval of indirect cost rates. The Federal agency with the largest dollar value of awards (contracts plus...

DISINTEGRATING ASTEROID P/2013 R3

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

Jewitt, David; Li, Jing; Agarwal, Jessica

Splitting of the nuclei of comets into multiple components has been frequently observed but, to date, no main-belt asteroid has been observed to break up. Using the Hubble Space Telescope, we find that main-belt asteroid P/2013 R3 consists of 10 or more distinct components, the largest up to 200 m in radius (assumed geometric albedo of 0.05) each of which produces a coma and comet-like dust tail. A diffuse debris cloud with total mass ∼2 × 10{sup 8} kg further envelopes the entire system. The velocity dispersion among the components, ΔV ∼ 0.2-0.5 m s{sup –1}, is comparable to the gravitational escape speeds ofmore » the largest members, while their extrapolated plane-of-sky motions suggest a break up between 2013 February and September. The broadband optical colors are those of a C-type asteroid. We find no spectral evidence for gaseous emission, placing model-dependent upper limits to the water production rate ≤1 kg s{sup –1}. Breakup may be due to a rotationally induced structural failure of the precursor body.« less

Medicare and Medicaid; payment for the cost of malpractice insurance--HCFA. Interim final rule with comment period.

PubMed

1986-04-01

In this final rule we are adopting an apportionment methodology for determining reasonable cost reimbursement for hospital malpractice insurance costs. The new apportionment policy for hospitals will divide total malpractice insurance premium cost into two components. The "administrative component," which accounts for 8.5 percent of total premium cost, will be included in the General and Administrative cost center and will be apportioned on the basis of the individual hospital's Medicare utilization rate. The "risk component," which comprises 91.5 percent of total cost, will be apportioned on the basis of a formula that takes into account the individual hospital's utilization as well as the national Medicare patient utilization rate and the national Medicare malpractice loss ratio (as adjusted to account for associated claims handling costs). Effectively, the "scaling factor formula" will relate the national utilization rate to the adjusted national loss ratio. As a hospital's own utilization rate exceeds or falls below the national utilization rate, the risk component will be reimbursed on the basis of a "scaling factor" that is more or less than the national Medicare malpractice loss ratio. Different apportionment policies are being adopted for Medicare skilled nursing facilities and for providers of services under the Medicaid and Maternal and Child Health programs. This final rule replaces our current apportionment policy for reimbursement of malpractice insurance costs and is applicable, subject to the rules of reopening and administrative finality, to cost reporting periods beginning on or after July 1, 1979.

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

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

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

2012-08-31

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

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

PubMed

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

2011-05-17

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

Low-cost manufacturing of the point focus concentrating module and its key component, the Fresnel lens. Final subcontract report, 31 January 1991--6 May 1991

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

Saifee, T.; Konnerth, A. III

1991-11-01

Solar Kinetics, Inc. (SKI) has been developing point-focus concentrating PV modules since 1986. SKI is currently in position to manufacture between 200 to 600 kilowatts annually of the current design by a combination of manual and semi-automated methods. This report reviews the current status of module manufacture and specifies the required approach to achieve a high-volume manufacturing capability and low cost. The approach taken will include process development concurrent with module design for automated manufacturing. The current effort reviews the major manufacturing costs and identifies components and processes whose improvements would produce the greatest effect on manufacturability and cost reduction.more » The Fresnel lens is one such key component. Investigating specific alternative manufacturing methods and sources has substantially reduced the lens costs and has exceeded the DOE cost-reduction goals. 15 refs.« less

2013 Cost of Wind Energy Review

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

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

2015-02-01

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

Estimating the Global Burden of Endemic Canine Rabies

PubMed Central

Hampson, Katie; Coudeville, Laurent; Lembo, Tiziana; Sambo, Maganga; Kieffer, Alexia; Attlan, Michaël; Barrat, Jacques; Blanton, Jesse D.; Briggs, Deborah J.; Cleaveland, Sarah; Costa, Peter; Freuling, Conrad M.; Hiby, Elly; Knopf, Lea; Leanes, Fernando; Meslin, François-Xavier; Metlin, Artem; Miranda, Mary Elizabeth; Müller, Thomas; Nel, Louis H.; Recuenco, Sergio; Rupprecht, Charles E.; Schumacher, Carolin; Taylor, Louise; Vigilato, Marco Antonio Natal; Zinsstag, Jakob; Dushoff, Jonathan

2015-01-01

Background Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. Methodology/Principal Findings We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). Conclusions/Significance This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts. PMID:25881058

Variation in Bariatric Surgery Episode Costs in the Commercially Insured: Implications for Bundled Payments in the Private Sector.

PubMed

Kelsall, Alexander C; Cassidy, Ruth; Ghaferi, Amir A

2017-08-01

To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in the Medicare population found that the index hospitalization is responsible for the majority of payment variation among hospitals. However, this research largely excluded SG, now the most commonly performed bariatric surgery procedure nationally. We used data from a state-wide quality collaborative to calculate the average risk and price-adjusted 30-day episode payment for patients undergoing RYGB and SG procedures at Michigan hospitals between January 2009 and October 2014. We organized hospitals into quintiles and compared the variation in payments between highest and lowest-cost quintiles, and also the payment categories that drove this variation. We identified 9035 patients undergoing RYGB (n = 4194) or SG (n = 4841) procedures at 31 hospitals. The average price and risk-adjusted episode payment ranged from $11,874 in the lowest hospital quintile to $13,394 in the highest quintile, representing a difference of $1519 (12.8%). Payments for the index hospitalization accounted for the largest share of total episode costs for both procedure types. Despite representing 2.7% to 6.0% of payments across quintiles, postdischarge payments explained 22.6% of hospital variation in SG. Similarly, readmissions explained 24.5% of payment variation for SG episodes, despite representing between 1.2% and 4.4% of payments. Collectively, our findings suggest that there are previously underappreciated differences in episode payment variation between bariatric surgery procedures. SG may be more amenable to cost containment under bundled payment initiatives by virtue of the greater share of variation explained by readmission and postdischarge payments, components of episode payment more likely to be influenced by provider discretion.

Local, national, and service component cost variations in the management of low back pain: Considerations for the clinician.

PubMed

Babu, Ashwin N; McCormick, Zachary; Kennedy, David J; Press, Joel

2016-11-21

In the past two decades, the cost associated with managing low back pain has increased significantly. Improved consciousness of how clinicians utilize resources when managing low back pain is necessary in the current economic climate. The goal of this review is to examine the component costs associated with managing low back pain and provide practical solutions for reducing healthcare costs. This is accomplished by utilizing examples from a major metropolitan area with several major academic institutions and private health care centers. It is clear that there is considerable local and national variation in the component costs of managing low back pain, including physician visits, imaging studies, medications, and therapy services. By being well informed about these variations in one's environment, clinicians and patients alike can make strides towards reducing the financial impact of low back pain. Investigation of the cost discrepancies for services within one's community of practice is important. Improved public access to both cost and outcomes data is needed.

Engineering and fabrication cost considerations for cryogenic wind tunnel models

NASA Technical Reports Server (NTRS)

Boykin, R. M., Jr.; Davenport, J. B., Jr.

1983-01-01

Design and fabrication cost drivers for cryogenic transonic wind tunnel models are defined. The major cost factors for wind tunnel models are model complexity, tolerances, surface finishes, materials, material validation, and model inspection. The cryogenic temperatures require the use of materials with relatively high fracture toughness but at the same time high strength. Some of these materials are very difficult to machine, requiring extensive machine hours which can add significantly to the manufacturing costs. Some additional engineering costs are incurred to certify the materials through mechanical tests and nondestructive evaluation techniques, which are not normally required with conventional models. When instrumentation such as accelerometers and electronically scanned pressure modules is required, temperature control of these devices needs to be incorporated into the design, which requires added effort. Additional thermal analyses and subsystem tests may be necessary, which also adds to the design costs. The largest driver to the design costs is potentially the additional static and dynamic analyses required to insure structural integrity of the model and support system.

Free tuberculosis diagnosis and treatment are not enough: patient cost evidence from three continents.

PubMed

Mauch, V; Bonsu, F; Gyapong, M; Awini, E; Suarez, P; Marcelino, B; Melgen, R E; Lönnroth, K; Nhung, N V; Hoa, N B; Klinkenberg, E

2013-03-01

The National Tuberculosis Programs of Ghana, Viet Nam and the Dominican Republic. To assess the direct and indirect costs of tuberculosis (TB) diagnosis and treatment for patients and households. Each country translated and adapted a structured questionnaire, the Tool to Estimate Patients' Costs. A random sample of new adult patients treated for at least 1 month was interviewed in all three countries. Across the countries, 27-70% of patients stopped working and experienced reduced income, 5-37% sold property and 17-47% borrowed money due to TB. Hospitalisation costs (US$42-118) and additional food items formed the largest part of direct costs during treatment. Average total patient costs (US$538-1268) were equivalent to approximately 1 year of individual income. We observed similar patterns and challenges of TB-related costs for patients across the three countries. We advocate for global, united action for TB patients to be included under social protection schemes and for national TB programmes to improve equitable access to care.

48 CFR 225.7007-1 - Restrictions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., quality control, testing, and welding (both forging and shot blasting process); and (2) The cost of the components manufactured in the United States exceeds 50 percent of the total cost of components. (b) 10 U.S.C...

Defining quality of nursing work life.

PubMed

Brooks, Beth A; Anderson, Mary Ann

2005-01-01

As the largest single employee component of hospitals, nurses are critical to the functioning of the organization, and improving employee productivity continues to be a common theme in the health care literature. However, any increased productivity will be transitory if achieved at the expense of the quality of nurses' work life (QNWL), since improvement in the QNWL is prerequisite to improved productivity. The conceptual components of the concept of QNWL that differentiate QNWL from the concept job satisfaction are explored.

Defense Suppliers: Factors Affecting U.S. Titanium Aircraft Component Manufacturers’ Market Share of DOD Business

DTIC Science & Technology

2013-07-01

countries” currently are exempt from the specialty metals domestic source restriction and are permitted to use non-domestic produced titanium to...industry is the largest consumer of titanium metals in the world. DOD estimates that the aerospace industry accounts for 60 to 75 percent of the U.S...DOD, the specialty metals domestic source restriction limits the U.S. prime contractors’ and aircraft component manufacturers’ purchase of titanium

Electronics Reliability Fracture Mechanics, Volume 1. Causes of Failures of Shop Replaceable Units and Hybrid Microcircuits

DTIC Science & Technology

1992-05-01

Plate Figure H-1. Temperature Coefficient Test Circuit The forward voltage was measured at 3 different termperatures. The average TC was calculated to be...AT, rather than the average figure given by the large area Isolation diffusion. The peak temperature , rather than the average temperature , is the...components would cause the temperatures of the components to be nearer the average , particularly those near the minimum and maximum. X-I The largest

Footprinting analysis of interactions between the largest eukaryotic RNase P/MRP protein Pop1 and RNase P/MRP RNA components.

PubMed

Fagerlund, Robert D; Perederina, Anna; Berezin, Igor; Krasilnikov, Andrey S

2015-09-01

Ribonuclease (RNase) P and RNase MRP are closely related catalytic ribonucleoproteins involved in the metabolism of a wide range of RNA molecules, including tRNA, rRNA, and some mRNAs. The catalytic RNA component of eukaryotic RNase P retains the core elements of the bacterial RNase P ribozyme; however, the peripheral RNA elements responsible for the stabilization of the global architecture are largely absent in the eukaryotic enzyme. At the same time, the protein makeup of eukaryotic RNase P is considerably more complex than that of the bacterial RNase P. RNase MRP, an essential and ubiquitous eukaryotic enzyme, has a structural organization resembling that of eukaryotic RNase P, and the two enzymes share most of their protein components. Here, we present the results of the analysis of interactions between the largest protein component of yeast RNases P/MRP, Pop1, and the RNA moieties of the enzymes, discuss structural implications of the results, and suggest that Pop1 plays the role of a scaffold for the stabilization of the global architecture of eukaryotic RNase P RNA, substituting for the network of RNA-RNA tertiary interactions that maintain the global RNA structure in bacterial RNase P. © 2015 Fagerlund et al.; Published by Cold Spring Harbor Laboratory Press for the RNA Society.

Development and Deployment of a Short Rotation Woody Crops Harvesting System Based on a Case New Holland Forage Harvester and SRC Woody Crop Header

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

Eisenbies, Mark; Volk, Timothy; Abrahamson, Lawrence

Biomass for biofuels, bioproducts and bioenergy can be sourced from forests, agricultural crops, various residue streams, and dedicated woody or herbaceous crops. Short rotation woody crops (SRWC), like willow and hybrid poplar, are perennial cropping systems that produce a number of environmental and economic development benefits in addition to being a renewable source of biomass that can be produced on marginal land. Both hybrid poplar and willow have several characteristics that make them an ideal feedstock for biofuels, bioproducts, and bioenergy; these include high yields that can be obtained in three to four years, ease of cultivar propagation from dormantmore » cuttings, a broad underutilized genetic base, ease of breeding, ability to resprout after multiple harvests, and feedstock composition similar to other sources of woody biomass. Despite the range of benefits associated with SRWC systems, their deployment has been restricted by high costs, low market acceptance associated with inconsistent chip quality (see below for further explanation), and misperceptions about other feedstock characteristics (see below for further explanation). Harvesting of SRWC is the largest single cost factor (~1/3 of the final delivered cost) in the feedstock supply system. Harvesting is also the second largest input of primary fossil energy in the system after commercial N fertilizer, accounting for about one third of the input. Therefore, improving the efficiency of the harvesting system has the potential to reduce both cost and environmental impact. At the start of this project, we projected that improving the overall efficiency of the harvesting system by 25% would reduce the delivered cost of SRWC by approximately $0.50/MMBtu (or about $7.50/dry ton). This goal was exceeded over the duration of this project, as noted below.« less

Market Correlation Structure Changes Around the Great Crash: A Random Matrix Theory Analysis of the Chinese Stock Market

NASA Astrophysics Data System (ADS)

Han, Rui-Qi; Xie, Wen-Jie; Xiong, Xiong; Zhang, Wei; Zhou, Wei-Xing

The correlation structure of a stock market contains important financial contents, which may change remarkably due to the occurrence of financial crisis. We perform a comparative analysis of the Chinese stock market around the occurrence of the 2008 crisis based on the random matrix analysis of high-frequency stock returns of 1228 Chinese stocks. Both raw correlation matrix and partial correlation matrix with respect to the market index in two time periods of one year are investigated. We find that the Chinese stocks have stronger average correlation and partial correlation in 2008 than in 2007 and the average partial correlation is significantly weaker than the average correlation in each period. Accordingly, the largest eigenvalue of the correlation matrix is remarkably greater than that of the partial correlation matrix in each period. Moreover, each largest eigenvalue and its eigenvector reflect an evident market effect, while other deviating eigenvalues do not. We find no evidence that deviating eigenvalues contain industrial sectorial information. Surprisingly, the eigenvectors of the second largest eigenvalues in 2007 and of the third largest eigenvalues in 2008 are able to distinguish the stocks from the two exchanges. We also find that the component magnitudes of the some largest eigenvectors are proportional to the stocks’ capitalizations.

Stability of a giant connected component in a complex network

NASA Astrophysics Data System (ADS)

Kitsak, Maksim; Ganin, Alexander A.; Eisenberg, Daniel A.; Krapivsky, Pavel L.; Krioukov, Dmitri; Alderson, David L.; Linkov, Igor

2018-01-01

We analyze the stability of the network's giant connected component under impact of adverse events, which we model through the link percolation. Specifically, we quantify the extent to which the largest connected component of a network consists of the same nodes, regardless of the specific set of deactivated links. Our results are intuitive in the case of single-layered systems: the presence of large degree nodes in a single-layered network ensures both its robustness and stability. In contrast, we find that interdependent networks that are robust to adverse events have unstable connected components. Our results bring novel insights to the design of resilient network topologies and the reinforcement of existing networked systems.

Fairness in optimizing bus-crew scheduling process.

PubMed

Ma, Jihui; Song, Cuiying; Ceder, Avishai Avi; Liu, Tao; Guan, Wei

2017-01-01

This work proposes a model considering fairness in the problem of crew scheduling for bus drivers (CSP-BD) using a hybrid ant-colony optimization (HACO) algorithm to solve it. The main contributions of this work are the following: (a) a valid approach for cases with a special cost structure and constraints considering the fairness of working time and idle time; (b) an improved algorithm incorporating Gamma heuristic function and selecting rules. The relationships of each cost are examined with ten bus lines collected from the Beijing Public Transport Holdings (Group) Co., Ltd., one of the largest bus transit companies in the world. It shows that unfair cost is indirectly related to common cost, fixed cost and extra cost and also the unfair cost approaches to common and fixed cost when its coefficient is twice of common cost coefficient. Furthermore, the longest time for the tested bus line with 1108 pieces, 74 blocks is less than 30 minutes. The results indicate that the HACO-based algorithm can be a feasible and efficient optimization technique for CSP-BD, especially with large scale problems.

Rumble over jailhouse healthcare. As states broaden outsourcing to private vendors, critics question quality of care and cost savings.

PubMed

Kutscher, Beth; Meyer, Harris

2013-09-02

The trend for states to outsource prison healthcare has met opposition from inmate advocates and legal aid groups. They fear quality of care will suffer, while others debate whether outsourcing care saves any money. Corizon, the largest U.S. private prison healthcare provider, says it definitely delivers savings. "We are the model because we've been doing capitated rates since we've been in business. Our cost per individual is significantly less than in the 'free world,' "says Corizon CEO Rich Hallworth.

Research requirements for development of advanced-technology helicopter transmissions. [reduction of maintenance costs

NASA Technical Reports Server (NTRS)

Lemanski, A. J.

1976-01-01

Helicopter drive-system technology which would result in the largest benefit in direct maintenance cost when applied to civil helicopters in the 1980 timeframe was developed. A prototype baseline drive system based on 1975 technology provided the basis for comparison against the proposed advanced technology in order to determine the potential for each area recommended for improvement. A specific design example of an advanced-technology main transmission is presented to define improvements for maintainability, weight, producibility, reliability, noise, vibration, and diagnostics. Projections of the technology achievable in the 1980 timeframe are presented. Based on this data, the technologies with the highest payoff (lowest direct maintenance cost) for civil-helicopter drive systems are identified.

Make or buy decision model with multi-stage manufacturing process and supplier imperfect quality

NASA Astrophysics Data System (ADS)

Pratama, Mega Aria; Rosyidi, Cucuk Nur

2017-11-01

This research develops an make or buy decision model considering supplier imperfect quality. This model can be used to help companies make the right decision in case of make or buy component with the best quality and the least cost in multistage manufacturing process. The imperfect quality is one of the cost component that must be minimizing in this model. Component with imperfect quality, not necessarily defective. It still can be rework and used for assembly. This research also provide a numerical example and sensitivity analysis to show how the model work. We use simulation and help by crystal ball to solve the numerical problem. The sensitivity analysis result show that percentage of imperfect generally not affect to the model significantly, and the model is not sensitive to changes in these parameters. This is because the imperfect cost are smaller than overall total cost components.

Development of automated endoscopes for dimensional micro-measurements

NASA Astrophysics Data System (ADS)

Hrebabetzky, Frank

2013-04-01

Increasing demands for product quality and outsourcing of production in the automobile industry lead to in­ creasingly tight tolerances for the components. In the area of metal-mechanics these are largely dimensional and require frequently uncertainties in the micron region. For optical instruments this means microscopical resolu­ tion. Dimensional measurement with uncertainties of some microns is nothing new, state of the art equipment in fact goes far below. The task becomes difficult if the measurements have to be carried out in an industrial production environment - and deep inside a bore hole. This paper describes the development of an automatic measurement system for internal dimensions of brake master cylinders, specifically the development of endoscopes, illuminations for edge detection, and integration with other sensors, actuators and controllers. The most demanding part was the endoscope development, because, surprisingly, no commercial product for microscopic view and precision measurements was found on the market. As the market for such measurement machines is very small, and as the requirements were different for each endoscope, the budget allowed only the development of prototypes, using readily available optical components. Borders between faces with different orientation of metallic structures can be difficult do detect. A satisfactory metrological performance can be achieved only with carefully shaped illumination, even if the source is a simple LED (light emitting diode). The automation was responsible for the largest part of the overall cost, coming from the desire for a high throughput of the measurement machine, even when operated by not highly qualified personnel. With the safety requirements satisfied, such a device ends up as a pretty complex equipment. Nevertheless, these aspects will be mentioned only for completeness, because standard components and methods were applied.

Starch plastics packaging and agriculture applications

USDA-ARS?s Scientific Manuscript database

The environmental impact of petroleum-based plastics is a growing concern throughout the world. Containers and packaging comprise the largest sector of municipal solid waste and are a major component of pollution on both land and sea. Although the benefits of plastics in many consumer and industrial...

Modeling Dissolved Organic Carbon (DOC) Dynamics in Flooded Wetlands

EPA Science Inventory

Wetlands play an important role in the global carbon cycle and are recognized for their considerable potential to sequester carbon. Wetlands contain the largest component (18-30%) of the terrestrial carbon pool and are responsible for about a quarter of the global methane emissi...

76 FR 39470 - Integrated Resource Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-06

... region's natural resources. One component of this mission is the generation, transmission, and sale of reliable and affordable electric energy. TVA operates the nation's largest public power system, producing 4... 56 directly served large industrial and Federal customers. The TVA Act requires the TVA power system...

Multiscale analyses of solar-induced florescence and gross primary production

USDA-ARS?s Scientific Manuscript database

Remotely sensed solar induced fluorescence (SIF) has shown great promise for probing spatiotemporal variations in terrestrial gross primary production (GPP), the largest component flux of the global carbon cycle. However, scale mismatches between SIF and ground-based GPP have posed challenges toward...

EVALUATING THE ECONOMICS AND ENVIRONMENTAL FRIENDLINESS OF NEWLY DESIGNED OR RETROFITTED CHEMICAL PROCESSES

EPA Science Inventory

This work describes a method for using spreadsheet analyses of process designs and retrofits to provide simple and quick economic and environmental evaluations simultaneously. The method focuses attention onto those streams and components that have the largest monetary values and...

Normal modes from the 2013 Sea of Okhotsk earthquake, the largest deep event ever recorded

NASA Astrophysics Data System (ADS)

Okal, E. A.

2013-12-01

With a moment of 4.1 10**28 dyn*cm, the Sea of Okhotsk earthquake of 24 May 2013 is the largest deep event ever recorded. This provides a unique opportunity to study the excitation of low-frequency normal modes, including overtone and radial ones. The principal questions addressed will be the possible existence of a slow component to the source, which is not warranted by preliminary results; and the possible presence of an isotropic component to the moment tensor of its source. The latter was strongly debated in the case of the 1970 Colombian event (Gilbert and Dziewonski, 1973; Okal and Geller, 1979), and clearly found absent from the source of the 1994 Bolivian one (Kikuchi and Kanamori, 1994; Okal, 1996). Critical in this respect will be the investigation of the relative excitation of the the radial modes, and in particular, the fundamental 0s0, for which a sufficiently long (90 days) time series was not available by the submission deadline.

Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.

PubMed

Elbuluk, Ameer M; Old, Andrew B; Bosco, Joseph A; Schwarzkopf, Ran; Iorio, Richard

2017-12-01

Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone. Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.

Practice expenses in the MFS (Medicare fee schedule): the service-class approach.

PubMed

Latimer, E A; Kane, N M

1995-01-01

The practice expense component of the Medicare fee schedule (MFS), which is currently based on historical charges and rewards physician procedures at the expense of cognitive services, is due to be changed by January 1, 1998. The Physician Payment Review Commission (PPRC) and others have proposed microcosting direct costs and allocating all indirect costs on a common basis, such as physician time or work plus direct costs. Without altering the treatment of direct costs, the service-class approach disaggregates indirect costs into six practice function costs. The practice function costs are then allocated to classes of services using cost-accounting and statistical methods. This approach would make the practice expense component more resource-based than other proposed alternatives.

Homeless Veterans' Use of Peer Mentors and Effects on Costs and Utilization in VA Clinics.

PubMed

Yoon, Jean; Lo, Jeanie; Gehlert, Elizabeth; Johnson, Erin E; O'Toole, Thomas P

2017-06-01

The study compared health care utilization and costs among homeless veterans randomly assigned to peer mentors or usual care and described contacts with peer mentors. Homeless patients at four Department of Veterans Affairs clinics were randomly assigned to a peer mentor (N=195) or to usual care (N=180). Administrative data on utilization and costs over a six-month follow-up were combined with peer mentors' reports of patient contacts. Most patients (87%) in the peer mentor group had at least one peer contact. Patients in this group spent the largest proportions of time discussing housing and health issues with peer mentors and had more outpatient encounters than those in usual care, although differences were not significant. No other between-group differences were found in utilization or costs. Although significant impacts of peer mentors on health care patterns or costs were not detected, some patients had frequent contact with peer mentors.

Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China

PubMed Central

Zhao, Yinjun; Kang, Bowei; Liu, Yawen; Li, Yichong; Shi, Guoqing; Shen, Tao; Jiang, Yong; Zhang, Mei; Zhou, Maigeng; Wang, Limin

2014-01-01

Background China has the world's largest floating (migrant) population, which has characteristics largely different from the rest of the population. Our goal is to study health insurance coverage and its impact on medical cost for this population. Methods A telephone survey was conducted in 2012. 644 subjects were surveyed. Univariate and multivariate analysis were conducted on insurance coverage and medical cost. Results 82.2% of the surveyed subjects were covered by basic insurance at hometowns with hukou or at residences. Subjects' characteristics including age, education, occupation, and presence of chronic diseases were associated with insurance coverage. After controlling for confounders, insurance coverage was not significantly associated with gross or out-of-pocket medical cost. Conclusion For the floating population, health insurance coverage needs to be improved. Policy interventions are needed so that health insurance can have a more effective protective effect on cost. PMID:25386914

Musculoskeletal disorder costs and medical claim filing in the US retail trade sector.

PubMed

Bhattacharya, Anasua; Leigh, J Paul

2011-01-01

The average costs of Musculoskeletal Disorder (MSD) and odds ratios for filing medical claims related to MSD were examined. The medical claims were identified by ICD 9 codes for four US Census regions within retail trade. Large private firms' medical claims data from Thomson Reuters Inc. MarketScan databases for the years 2003 through 2006 were used. Average costs were highest for claims related to lumbar region (ICD 9 Code: 724.02) and number of claims were largest for low back syndrome (ICD 9 Code: 724.2). Whereas the odds of filing an MSD claim did not vary greatly over time, average costs declined over time. The odds of filing claims rose with age and were higher for females and southerners than men and non-southerners. Total estimated national medical costs for MSDs within retail trade were $389 million (2007 USD).

The hidden cost of wildfires: Economic valuation of health effects of wildfire smoke exposure in Southern California

USGS Publications Warehouse

Richardson, L.A.; Champ, P.A.; Loomis, J.B.

2012-01-01

There is a growing concern that human health impacts from exposure to wildfire smoke are ignored in estimates of monetized damages from wildfires. Current research highlights the need for better data collection and analysis of these impacts. Using unique primary data, this paper quantifies the economic cost of health effects from the largest wildfire in Los Angeles County's modern history. A cost of illness estimate is $9.50 per exposed person per day. However, theory and empirical research consistently find that this measure largely underestimates the true economic cost of health effects from exposure to a pollutant in that it ignores the cost of defensive actions taken as well as disutility. For the first time, the defensive behavior method is applied to calculate the willingness to pay for a reduction in one wildfire smoke induced symptom day, which is estimated to be $84.42 per exposed person per day. ?? 2011.

Health-related economic costs of the Three-Mile Island accident.

PubMed

Hu, T W; Slaysman, K S

1984-01-01

On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

Fitness consequences of polymorphic inversions in the zebra finch genome.

PubMed

Knief, Ulrich; Hemmrich-Stanisak, Georg; Wittig, Michael; Franke, Andre; Griffith, Simon C; Kempenaers, Bart; Forstmeier, Wolfgang

2016-09-29

Inversion polymorphisms constitute an evolutionary puzzle: they should increase embryo mortality in heterokaryotypic individuals but still they are widespread in some taxa. Some insect species have evolved mechanisms to reduce the cost of embryo mortality but humans have not. In birds, a detailed analysis is missing although intraspecific inversion polymorphisms are regarded as common. In Australian zebra finches (Taeniopygia guttata), two polymorphic inversions are known cytogenetically and we set out to detect these two and potentially additional inversions using genomic tools and study their effects on embryo mortality and other fitness-related and morphological traits. Using whole-genome SNP data, we screened 948 wild zebra finches for polymorphic inversions and describe four large (12-63 Mb) intraspecific inversion polymorphisms with allele frequencies close to 50 %. Using additional data from 5229 birds and 9764 eggs from wild and three captive zebra finch populations, we show that only the largest inversions increase embryo mortality in heterokaryotypic males, with surprisingly small effect sizes. We test for a heterozygote advantage on other fitness components but find no evidence for heterosis for any of the inversions. Yet, we find strong additive effects on several morphological traits. The mechanism that has carried the derived inversion haplotypes to such high allele frequencies remains elusive. It appears that selection has effectively minimized the costs associated with inversions in zebra finches. The highly skewed distribution of recombination events towards the chromosome ends in zebra finches and other estrildid species may function to minimize crossovers in the inverted regions.

The benefits divide: health care purchasing in retail versus other sectors.

PubMed

Maxwell, James; Temin, Peter; Zaman, Saminaz

2002-01-01

This paper is the first to compare health care purchasing in the retail versus other sectors of the Fortune 500. Employing millions of low-wage workers, the retail sector is the largest employer of uninsured workers in the economy. We found that retail companies are using the same competitive bidding process that other companies use to obtain a given level of coverage for the lowest possible cost. However, they are more price oriented than other Fortune 500 companies are. The most striking disparity lies in the nearly fivefold difference in offer rates for health care coverage. This shows that the economy's bifurcation in health benefits extends even to the nation's largest companies.

Winning with Green Remediation Practices at the Former McClellan AFB, Sacramento CA

DTIC Science & Technology

2011-05-12

PCE)  Metals (lead, cadmium, chromium)  Fuels (gas and diesel )  Radiological (Radium 226)  Largest cleanup effort in the Air Force  318 sites...Existing pump and treat system replaced with sustainable in-situ bioremediation (passive vegetable oil injection)  Cost to complete reduced by $15,000,000

Electronics

DTIC Science & Technology

2001-01-01

International Acer Incorporated, Hsin Chu, Taiwan Aerospace Industrial Development Corporation, Taichung, Taiwan American Institute of Taiwan, Taipei, Taiwan...Singapore and Malaysia .5 - 4 - The largest market for semiconductor products is the high technology consumer electronics industry that consumes up...Singapore, and Malaysia . A new semiconductor facility costs around $3 billion to build and takes about two years to become operational

Corporation for National and Community Service: Cost-Effective Solutions for Our Communities and Nation

ERIC Educational Resources Information Center

Corporation for National and Community Service, 2017

2017-01-01

The Corporation for National and Community Service (CNCS), a federal agency and the nation's largest grantmaker in support of service and volunteering, manages AmeriCorps, Senior Corps, and Volunteer Generation Fund. This brief report provides an overview of the Corporation for National and Community Service (CNCS).

The Effect of Study Group Participation on Student Naval Aviator Persistence

ERIC Educational Resources Information Center

Sheppard, Thomas H.

2010-01-01

Training naval combat pilots is expensive and time consuming, it follows that attrition from flight training is costly to the government and traumatic for the individual. Flight training is considered high-risk training, and therefore strictly voluntary. Voluntary withdrawal from naval flight training is the largest unexplained reason for Student…

Pell Grants: Where Does All the Money Go

ERIC Educational Resources Information Center

Robinson, Jenna Ashley; Cheston, Duke

2012-01-01

The Federal Pell Grant Program, which provides need-based grants to millions of college students, is the federal government's largest education expenditure. It consumes over half the Department of Education's annual budget and in 2010-2011 cost taxpayers about $36 billion per year. Although the program started out as a way to provide college…

Education System Benefits of U.S. Metric Conversion.

ERIC Educational Resources Information Center

Phelps, Richard P.

1996-01-01

U.S. metric conversion efforts are reviewed as they have affected education. Education system benefits and costs are estimated for three possible system conversion plans. The soft-conversion-to-metric plan, which drops all inch-pound instruction, appears to provide the largest net benefits. The primary benefit is in class time saved. (SLD)

Immunological dysfunction in periparturient cows: evidence, causes and ramifications

USDA-ARS?s Scientific Manuscript database

With a $35.7 billion Gross Domestic Value for milk produced in the U.S. during 2007, the dairy industry was the largest commodity group of the 2007 U.S. animal agriculture economic engine. The economic value of controlling mastitis pathogens is immense. Most economic analyses of the cost of mastit...

Neighbourhood Socio-Economic Factors in Relation to Student Drug Use and Programs.

ERIC Educational Resources Information Center

Smart, Reginald G.; And Others

1994-01-01

Examines relationships between drug use problems and socioeconomic status of neighborhoods where students in grades 11 and 13 reside. Found largest number of alcohol and drug problems in areas with lowest socioeconomic characteristics, characterized by low-cost substandard housing, social and racial problems, and delinquency. Includes 13…

Logging Work Injuries in Appalachia

Treesearch

Charles H. Wolf; Gilbert P. Dempsey

1978-01-01

Logging accidents are costly. They may bring pain to injured workers, hardship to their families, and higher insurance premiums and lower productivity to their employers. Our analysis of 1,172 injuries in central Appalachia reveals that nearly half of all time lost-and almost all fatalities-resulted from accidents during felling and unloading. The largest proportion of...

Why Waste a Second Chance? A Small Town Guide to Recycling.

ERIC Educational Resources Information Center

National Association of Towns and Townships, Washington, DC.

In many communities, garbage disposal--solid waste management--is the third largest municipal expenditure and a fast growing budget item. Many small local governments have controlled the growth of these costs by recycling up to 40% of the total solid waste they produce. This guidebook can help communities identify and develop opportunities…

Faculty Teaching Loads in the UNC System

ERIC Educational Resources Information Center

Schalin, Jay

2014-01-01

This paper explores the teaching loads of faculty in the University of North Carolina (UNC) system. Salaries for faculty members are the single largest cost of higher education in the UNC system, accounting for approximately half of expenditures. The system's funding formula for its 16 college campuses is largely dependent upon the number of…

India's Trade in Higher Education

ERIC Educational Resources Information Center

Kumar, Shailendra

2015-01-01

India has had an extremely adverse balance of trade in education. Though only a minor education exporter through Mode 2, India is the world's second largest student-sending country. Nevertheless, given English as the medium of instruction especially in apex institutions, low tuition and cost of living, quite a few world-class institutions, and a…

Defense Industry Consolidation and Weapon Systems Cost Growth

DTIC Science & Technology

2008-06-01

consolidation in the industry. Year Buyer Target Price ($Billions) 1988 Kohlberg Kravis RJR Nabisco 25.1 1984 Chevron Gulf Oil 13.3 1988 Philip Morris Kraft...Steel Marathon Oil 6.6 1988 Campeau Federated Stores 6.5 1986 Kohlberg Kravis Beatrice 6.2 Table 7. Ten Largest Acquisitions 1981 – 1989 (Aftrer54

A prototype yarn evaluation tester to rapidly assess comparative weavability of warp yarns without weaving

USDA-ARS?s Scientific Manuscript database

The art of weaving continues to be the most predominantly used method of converting textile fibers into fabrics for various end-use applications, including apparel. In fact, the weaving is by far the largest textile manufacturing sector, worldwide. However, the weaving process is complex and costly....

Invasive urodynamic testing prior to surgical treatment for stress urinary incontinence in women: cost-effectiveness and value of information analyses in the context of a mixed methods feasibility study.

PubMed

Homer, Tara; Shen, Jing; Vale, Luke; McColl, Elaine; Tincello, Douglas G; Hilton, Paul

2018-01-01

INVESTIGATE-I (INVasive Evaluation before Surgical Treatment of Incontinence Gives Added Therapeutic Effect?) was a mixed methods study to assess the feasibility of a future randomised controlled trial of invasive urodynamic testing (IUT) prior to surgery for stress urinary incontinence (SUI) in women. Here we report one of the study's five components, with the specific objectives of (i) exploring the cost-effectiveness of IUT compared with clinical assessment plus non-invasive tests (henceforth described as 'IUT' and 'no IUT' respectively) in women with SUI or stress-predominant mixed urinary incontinence (MUI) prior to surgery, and (ii) determining the expected net gain (ENG) from additional research. Study participants were women with SUI or stress-predominant MUI who had failed to respond to conservative treatments recruited from seven UK urogynaecology and female urology units. They were randomised to receive either 'IUT' or 'no IUT' before undergoing further treatment. Data from 218 women were used in the economic analysis. Cost utility, net benefit and value of information (VoI) analyses were performed within a randomised controlled pilot trial. Costs and quality-adjusted life years (QALYs) were estimated over 6 months to determine the incremental cost per QALY of 'IUT' compared to 'no IUT'. Net monetary benefit informed the VoI analysis. The VoI estimated the ENG and optimal sample size for a future definitive trial. At 6 months, the mean difference in total average cost was £138 ( p  = 0.071) in favour of 'IUT'; there was no difference in QALYs estimated from the SF-12 (difference 0.004; p  = 0.425) and EQ-5D-3L (difference - 0.004; p  = 0.725); therefore, the probability of IUT being cost-effective remains uncertain. The estimated ENG was positive for further research to address this uncertainty with an optimal sample size of 404 women. This is the largest economic evaluation of IUT. On average, up to 6 months after treatment, 'IUT' may be cost-saving compared to 'no IUT' because of the reduction in surgery following invasive investigation. However, uncertainty remains over the probability of 'IUT' being considered cost-effective, especially in the longer term. The VoI analysis indicated that further research would be of value. ISRCTN. ISRCTN71327395. Registered 7 June 2010.

HIV-1 and HCV viral load cost models for bDNA: 440 Molecular System versus real-time PCR AmpliPrep/TaqMan test.

PubMed

Elbeik, Tarek; Dalessandro, Ralph; Loftus, Richard A; Beringer, Scott

2007-11-01

Comparative cost models were developed to assess cost-per-reportable result and annual costs for HIV-1 and HCV bDNA and AmpliPrep/TaqMan Test (PCR). Model cost components included kit, disposables, platform and related equipment, equipment service plan, equipment maintenance, equipment footprint, waste and labor. Model assessment was most cost-effective when run by bDNA with 36 or more clinical samples and PCR with 30 or fewer clinical samples. Lower costs are attained with maximum samples (84-168) run daily. Highest cost contributors include kit, platform and PCR proprietary disposables. Understanding component costs and the most economic use of HIV-1 and HCV viral load will aid in attaining lowest costs through selection of the appropriate assay and effective negotiations.

Third-party reimbursement for generic prescription drugs: The prevalence of below-cost reimbursement in an environment of maximum allowable cost-based reimbursement.

PubMed

Murry, Logan; Gerleman, Brandon; Urick, Benjamin; Urmie, Julie

2018-05-31

To examine average prescription gross margin (GM) for prescriptions and to evaluate the prevalence of below-cost reimbursement for generic prescriptions across different third-party payers and therapeutic categories. A retrospective descriptive study using 2015 dispensing data from a single independently owned pharmacy in Iowa. To calculate GM, the pharmacy's actual acquisition cost was subtracted from the third-party reimbursement rate for each generic prescription. The frequency of negative GMs was calculated for the top 6 plans and the top 10 therapeutic categories by prescription volume. A single, independently owned community pharmacy in Iowa. Prescription dispensing records for the pharmacy's largest private and public payers by prescription volume. Gross margins were calculated on a payer and United States Pharmacopeia (USP) medication category level. GM for generic prescriptions reimbursed under cost for specific payers and USP medication categories. The 2015 prescription volume for the study pharmacy was 70,866 prescriptions, of which 88% were generic. For all prescriptions, the mean GM was $6.63 per prescription, and the median GM was $3.49 per prescription. Generic medications had a mean GM of $4.66 (median, $2.86), and brand name medications had a mean GM of $21.83 (median, $16.15). The percentage of generic prescriptions paid below acquisition cost was 15.1% overall and ranged from 4.1% for Iowa Medicaid to 25.9% for one of the private payers. The most common USP medication category by prescription volume was cardiovascular agents, representing 25.2% of generic prescriptions. For the 10.9% of these prescriptions reimbursed below cost, the mean GM was -$6.80. The 2 USP medication categories with the largest negative mean GM for generic prescriptions were analgesics and anticonvulsants, with mean GMs of -$10.10 and -$11.30, respectively. The current maximum allowable cost-based reimbursement system often results in inadequate payment for generic prescription drugs. The amount of underpayment varies substantially by payer and therapeutic class. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Impact of a hospitalist system on length of stay and cost for children with common conditions.

PubMed

Srivastava, Rajendu; Landrigan, Christopher P; Ross-Degnan, Dennis; Soumerai, Stephen B; Homer, Charles J; Goldmann, Donald A; Muret-Wagstaff, Sharon

2007-08-01

This study examined mechanisms of efficiency in a managed care hospitalist system on length of stay and total costs for common pediatric conditions. We conducted a retrospective cohort study (October 1993 to July 1998) of patients in a not-for-profit staff model (HMO 1) and a non-staff-model (HMO 2) managed care organization at a freestanding children's hospital. HMO 1 introduced a hospitalist system for patients in October 1996. Patients were included if they had 1 of 3 common diagnoses: asthma, dehydration, or viral illness. Linear regression models examining length-of-stay-specific costs for prehospitalist and posthospitalist systems were built. Distribution of length of stay for each diagnosis before and after the system change in both study groups was calculated. Interrupted time series analysis tested whether changes in the trends of length of stay and total costs occurred after implementation of the hospitalist system by HMO1 (HMO 2 as comparison group) for all 3 diagnoses combined. A total of 1970 patients with 1 of the 3 study conditions were cared for in HMO 1, and 1001 in HMO 2. After the hospitalist system was introduced in HMO 1, length of stay was reduced by 0.23 days (13%) for asthma and 0.19 days (11%) for dehydration; there was no difference for patients with viral illness. The largest relative reduction in length of stay occurred in patients with a shorter length of stay whose hospitalizations were reduced from 2 days to 1 day. This shift resulted in an average cost-per-case reduction of $105.51 (9.3%) for patients with asthma and $86.22 (7.8%) for patients with dehydration. During the same period, length of stay and total cost rose in HMO 2. Introduction of a hospitalist system in one health maintenance organization resulted in earlier discharges and reduced costs for children with asthma and dehydration compared with another one, with the largest reductions occurring in reducing some 2-day hospitalizations to 1 day. These findings suggest that hospitalists can increase efficiency and reduce costs for children with common pediatric conditions.

Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy.

PubMed

Gao, Lan; Xia, Li; Pan, Song-Qing; Xiong, Tao; Li, Shu-Chuen

2015-02-01

We aimed to gauge the burden of epilepsy in China from a societal perspective by estimating the direct, indirect and intangible costs. Patients with epilepsy and controls were enrolled from two tertiary hospitals in China. Patients were asked to complete a Cost-of-Illness (COI), Willingness-to-Pay (WTP) questionnaires, two utility elicitation instruments and Mini Mental State Examination (MMSE). Healthy controls only completed WTP questionnaire, and utility instruments. Univariate analyses were performed to investigate the differences in cost on the basis of different variables, while multivariate analysis was undertaken to explore the predictors of cost/cost component. In total, 141 epilepsy patients and 323 healthy controls were recruited. The median total cost, direct cost and indirect cost due to epilepsy were US$949.29, 501.34 and 276.72, respectively. Particularly, cost of anti-epileptic drugs (AEDs) (US$394.53) followed by cost of investigations (US$59.34), cost of inpatient and outpatient care (US$9.62) accounted for the majority of the direct medical costs. While patients' (US$103.77) and caregivers' productivity costs (US$103.77) constituted the major component of indirect cost. The intangible costs in terms of WTP value (US$266.07 vs. 88.22) and utility (EQ-5D, 0.828 vs. 0.923; QWB-SA, 0.657 vs. 0.802) were both substantially higher compared to the healthy subjects. Epilepsy is a cost intensive disease in China. According to the prognostic groups, drug-resistant epilepsy generated the highest total cost whereas patients in seizure remission had the lowest cost. AED is the most costly component of direct medical cost probably due to 83% of patients being treated by new generation of AEDs. Copyright © 2014 Elsevier B.V. All rights reserved.

Altair Lander Life Support: Design Analysis Cycles 1, 2, and 3

NASA Technical Reports Server (NTRS)

Anderson, Molly; Rotter, Hank; Stambaugh, Imelda; Curley, Su

2009-01-01

NASA is working to develop a new lunar lander to support lunar exploration. The development process that the Altair project is using for this vehicle is unlike most others. In Lander Design Analysis Cycle 1 (LDAC-1), a single-string, minimum functionality design concept was developed, including life support systems for different vehicle configuration concepts, first for a combination of an ascent vehicle and a habitat with integral airlocks, and then for a combined ascent vehicle-habitat with a detachable airlock. In LDAC-2, the Altair team took the ascent vehicle-habitat with detachable airlock and analyzed the design for the components that were the largest contributors to the risk of loss of crew (LOC). For life support, the largest drivers were related to oxygen supply and carbon dioxide control. Integrated abort options were developed at the vehicle level. Many life support failures were not considered to result in LOC because they had a long enough time to effect that abort was considered a feasible option to safely end the mission before the situation became life threatening. These failures were then classified as loss of mission (LOM) failures. Many options to reduce LOC risk were considered, and mass efficient solutions to the LOC problems were added to the vehicle design at the end of LDAC-2. In LDAC-3, the new design was analyzed for large contributors to the risk of LOM. To avoid ending the mission early or being unable to accomplish goals like performing all planned extravehicular activities (EVAs), various options were assessed for their combination of risk reduction and mass cost. This paper outlines the major assumptions, design features, and decisions related to the development of the life support system for the Altair project through LDAC-3.

Effects of the Fuel Price Increase on the Operating Cost of Freight Transport Vehicles

NASA Astrophysics Data System (ADS)

Gohari, Adel; Matori, Nasir; Yusof, Khamaruzaman Wan; Toloue, Iraj; Myint, Kin Cho

2018-03-01

One of the most important criteria in freight modal choices is the transport operating cost in which fuel price changes has a significant effect on it. This paper presents the impact of fuel price increases on the operating cost of the different transport modes for the containerized freight transportation. In this study, an operating cost equation was applied to compare the operating cost of different freight transport vehicles as well as evaluation of the operating cost changes across a range of fuel prices between the current price and one-hundred percent increase. The equation consists of influential parameters such as fuel cost, driver wage and maintenance cost of a vehicle. It has been concluded that the effect of the fuel price increase on the operating cost of different freight transportation modes is not in the same rate. According to equation and effective parameters considered, comparing the results showed that truck has the highest cost, train has the largest increase in price. Finally, the ship is the most influenced vehicle in terms of operating cost percentage increase when the rate of fuel price increase, followed by train and truck.

Impact of Friedreich’s Ataxia on health-care resource utilization in the United Kingdom and Germany

PubMed Central

2013-01-01

Background Friedreich’s Ataxia (FRDA) is a neurodegenerative disorder that causes progressive damage to the central and peripheral nervous systems having a significant impact upon quality of life. With little information in the literature, cross-sectional observational studies were conducted in the UK and Germany to collect data on resource use and the burden of the disease on individuals and their caregivers. Methods Cross-sectional observational studies were conducted in the UK and Germany to estimate the burden of FRDA on individuals and on the respective healthcare systems. A total of 75 individuals in the UK and 28 in Germany were recruited to the study. Participants in both countries were asked to complete a Patient and Caregiver Information Form (PCIF), regarding access to, and use of, healthcare resources, and the impact FRDA has on their lifestyle. In Germany, doctors were asked to complete a Patient Record Form (PRF). Analyses of annual direct and indirect resource utilization were conducted for both countries while costs were calculated for the UK only. These figures were compared to the costs associated with Parkinson’s disease; one of the most common neurodegenerative conditions and the one most similar in terms of disease progression. Results The results showed that the annual burden of FRDA is significant and falls on the health and social care sectors, on society, on caregivers and on the individuals themselves. In the UK FRDA had a total annual cost per person of between £11,818 and £18,774 depending on whether the cost of long-term unemployment was included. Typically the largest component of direct costs is associated with professional care. Given the high proportion of children and young adults recruited and the long disease duration, (typically 40-50 years for FRDA, compared with 20 years for Parkinson’s disease), these figures may underestimate the true burden of the disease. Conclusion It is hoped that these estimates of resource utilization, can help in understanding the previously unquantified burden of FRDA. Given the long disease duration, management strategies should seek to minimise the impact of the condition on individuals and their caregivers, while maximising quality of life. PMID:23448170

Low Cost Injection Mold Creation via Hybrid Additive and Conventional Manufacturing

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

Dehoff, Ryan R.; Watkins, Thomas R.; List, III, Frederick Alyious

2015-12-01

The purpose of the proposed project between Cummins and ORNL is to significantly reduce the cost of the tooling (machining and materials) required to create injection molds to make plastic components. Presently, the high cost of this tooling forces the design decision to make cast aluminum parts because Cummins typical production volumes are too low to allow injection molded plastic parts to be cost effective with the amortized cost of the injection molding tooling. In addition to reducing the weight of components, polymer injection molding allows the opportunity for the alternative cooling methods, via nitrogen gas. Nitrogen gas cooling offersmore » an environmentally and economically attractive cooling option, if the mold can be manufactured economically. In this project, a current injection molding design was optimized for cooling using nitrogen gas. The various components of the injection mold tooling were fabricated using the Renishaw powder bed laser additive manufacturing technology. Subsequent machining was performed on the as deposited components to form a working assembly. The injection mold is scheduled to be tested in a projection setting at a commercial vendor selected by Cummins.« less

MM&T: Testing of Electro-Optic Components.

DTIC Science & Technology

1981-02-01

electro - optic components with special emphasis on diamond-turned optics. The primary purpose of that study was to determine where new government initiatives could be most effective in moving this area forward. Besides an ordered list of recommended government actions, this study has resulted in+ an extensive survey of experts (the most extensive yet made), the largest annotated bibliography in the field, an improved form of Ronchi testing giving quantitative results, a general approach to nonconjugate interferometry, a high accuracy form of multiple-wavelength absolute

Inhibition of Radiation Induced Pro-Survival Genes by Curcumin in Prostate Cancer

DTIC Science & Technology

2005-04-01

diferuloylmethane) is a major chemical component of turmeric ( Curcuma longa ) and is used as a spice to give a specific flavor and yellow color in Asian...Curcumin [Diferuloylmethane] is a major chemical component of turmeric [ Curcuma longa ] and is used as a spice to give a specific flavor and yellow color...of turmeric ( curcuma longa ) and is used as a spice to give a specific flavor and yellow color in Prostate cancer is the cancer of second largest

Cloning and characterization of alpha-glucuronidase enzyme

USDA-ARS?s Scientific Manuscript database

Hemicellulose is the second largest source of biomass on Earth. Xylan, a polymer of beta-1,4-linked xylose residues, is a common component of hemicellulose. The enzymes xylanase and beta-xylosidase hydrolyze the xylan into xylose which can then be fermented into value-added products. However, the...

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis.

PubMed

Mills, Edward J; Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan

2011-11-23

To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Human capital cost analysis using publicly accessible data. Sub-Saharan African countries. Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. In the nine source countries the estimated government subsidised cost of a doctor's education ranged from $21,000 (£13,000; €15,000) in Uganda to $58,700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their health systems.

Advanced steam power plant concepts with optimized life-cycle costs: A new approach for maximum customer benefit

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

Seiter, C.

1998-07-01

The use of coal power generation applications is currently enjoying a renaissance. New highly efficient and cost-effective plant concepts together with environmental protection technologies are the main factors in this development. In addition, coal is available on the world market at attractive prices and in many places it is more readily available than gas. At the economical leading edge, standard power plant concepts have been developed to meet the requirements of emerging power markets. These concepts incorporate the high technological state-of-the-art and are designed to achieve lowest life-cycle costs. Low capital cost, fuel costs and operating costs in combination withmore » shortest lead times are the main assets that make these plants attractive especially for IPPs and Developers. Other aspects of these comprehensive concepts include turnkey construction and the willingness to participate in BOO/BOT projects. One of the various examples of such a concept, the 2 x 610-MW Paiton Private Power Project Phase II in Indonesia, is described in this paper. At the technological leading edge, Siemens has always made a major contribution and was pacemaker for new developments in steam power plant technology. Modern coal-fired steam power plants use computer-optimized process and plant design as well as advanced materials, and achieve efficiencies exceeding 45%. One excellent example of this high technology is the world's largest lignite-fired steam power plant Schwarze Pumpe in Germany, which is equipped with two 800 MW Siemens steam turbine generators with supercritical steam parameters. The world's largest 50-Hz single-shaft turbine generator with supercritical steam parameters rated at 1025 MW for the Niederaussem lignite-fired steam power plant in Germany is a further example of the sophisticated Siemens steam turbine technology and sets a new benchmark in this field.« less

Taxation of United States general aviation

NASA Astrophysics Data System (ADS)

Sobieralski, Joseph Bernard

General aviation in the United States has been an important part of the economy and American life. General aviation is defined as all flying excluding military and scheduled airline operations, and is utilized in many areas of our society. The majority of aircraft operations and airports in the United States are categorized as general aviation, and general aviation contributes more than one percent to the United States gross domestic product each year. Despite the many benefits of general aviation, the lead emissions from aviation gasoline consumption are of great concern. General aviation emits over half the lead emissions in the United States or over 630 tons in 2005. The other significant negative externality attributed to general aviation usage is aircraft accidents. General aviation accidents have caused over 8000 fatalities over the period 1994-2006. A recent Federal Aviation Administration proposed increase in the aviation gasoline tax from 19.4 to 70.1 cents per gallon has renewed interest in better understanding the implications of such a tax increase as well as the possible optimal rate of taxation. Few studies have examined aviation fuel elasticities and all have failed to study general aviation fuel elasticities. Chapter one fills that gap and examines the elasticity of aviation gasoline consumption in United States general aviation. Utilizing aggregate time series and dynamic panel data, the price and income elasticities of demand are estimated. The price elasticity of demand for aviation gasoline is estimated to range from -0.093 to -0.185 in the short-run and from -0.132 to -0.303 in the long-run. These results prove to be similar in magnitude to automobile gasoline elasticities and therefore tax policies could more closely mirror those of automobile tax policies. The second chapter examines the costs associated with general aviation accidents. Given the large number of general aviation operations as well as the large number of fatalities and injuries attributed to general aviation accidents in the United States, understanding the costs to society is of great importance. This chapter estimates the direct and indirect costs associated with general aviation accidents in the United States. The indirect costs are estimated via the human capital approach in addition to the willingness-to-pay approach. The average annual accident costs attributed to general aviation are found to be 2.32 billion and 3.81 billion (2006 US) utilizing the human capital approach and willingness-to-pay approach, respectively. These values appear to be fairly robust when subjected to a sensitivity analysis. These costs highlight the large societal benefits from accident and fatality reduction. The final chapter derives a second-best optimal aviation gasoline tax developed from previous general equilibrium frameworks. This optimal tax reflects both the lead pollution and accident externalities, as well as the balance between excise taxes and labor taxes to finance government spending. The calculated optimal tax rate is 4.07 per gallon, which is over 20 times greater than the current tax rate and 5 times greater than the Federal Aviation Administration proposed tax rate. The calculated optimal tax rate is also over 3 times greater than automobile gasoline optimal tax rates calculated by previous studies. The Pigovian component is 1.36, and we observe that the accident externality is taxed more severely than the pollution externality. The largest component of the optimal tax rate is the Ramsey component. At 2.70, the Ramsey component reflects the ability of the government to raise revenue aviation gasoline which is price inelastic. The calculated optimal tax is estimated to reduce lead emissions by over 10 percent and reduce accidents by 20 percent. Although unlikely to be adopted by policy makers, the optimal tax benefits are apparent and it sheds light on the need to reduce these negative externalities via policy changes.

Concept for a Differential Lock and Traction Control Model in Automobiles

NASA Astrophysics Data System (ADS)

Shukul, A. K.; Hansra, S. K.

2014-01-01

The automobile is a complex integration of electronics and mechanical components. One of the major components is the differential which is limited due to its shortcomings. The paper proposes a concept of a cost effective differential lock and traction for passenger cars to sports utility vehicles alike, employing a parallel braking mechanism coming into action based on the relative speeds of the wheels driven by the differential. The paper highlights the employment of minimum number of components unlike the already existing systems. The system was designed numerically for the traction control and differential lock for the world's cheapest car. The paper manages to come up with all the system parameters and component costing making it a cost effective system.

Cost: the missing outcome in simulation-based medical education research: a systematic review.

PubMed

Zendejas, Benjamin; Wang, Amy T; Brydges, Ryan; Hamstra, Stanley J; Cook, David A

2013-02-01

The costs involved with technology-enhanced simulation remain unknown. Appraising the value of simulation-based medical education (SBME) requires complete accounting and reporting of cost. We sought to summarize the quantity and quality of studies that contain an economic analysis of SBME for the training of health professions learners. We performed a systematic search of MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Articles reporting original research in any language evaluating the cost of simulation, in comparison with nonstimulation instruction or another simulation intervention, for training practicing and student physicians, nurses, and other health professionals were selected. Reviewers working in duplicate evaluated study quality and abstracted information on learners, instructional design, cost elements, and outcomes. From a pool of 10,903 articles we identified 967 comparative studies. Of these, 59 studies (6.1%) reported any cost elements and 15 (1.6%) provided information on cost compared with another instructional approach. We identified 11 cost components reported, most often the cost of the simulator (n = 42 studies; 71%) and training materials (n = 21; 36%). Ten potential cost components were never reported. The median number of cost components reported per study was 2 (range, 1-9). Only 12 studies (20%) reported cost in the Results section; most reported it in the Discussion (n = 34; 58%). Cost reporting in SBME research is infrequent and incomplete. We propose a comprehensive model for accounting and reporting costs in SBME. Copyright © 2013 Mosby, Inc. All rights reserved.

Optimal Inspection of Imports to Prevent Invasive Pest Introduction.

PubMed

Chen, Cuicui; Epanchin-Niell, Rebecca S; Haight, Robert G

2018-03-01

The United States imports more than 1 billion live plants annually-an important and growing pathway for introduction of damaging nonnative invertebrates and pathogens. Inspection of imports is one safeguard for reducing pest introductions, but capacity constraints limit inspection effort. We develop an optimal sampling strategy to minimize the costs of pest introductions from trade by posing inspection as an acceptance sampling problem that incorporates key features of the decision context, including (i) simultaneous inspection of many heterogeneous lots, (ii) a lot-specific sampling effort, (iii) a budget constraint that limits total inspection effort, (iv) inspection error, and (v) an objective of minimizing cost from accepted defective units. We derive a formula for expected number of accepted infested units (expected slippage) given lot size, sample size, infestation rate, and detection rate, and we formulate and analyze the inspector's optimization problem of allocating a sampling budget among incoming lots to minimize the cost of slippage. We conduct an empirical analysis of live plant inspection, including estimation of plant infestation rates from historical data, and find that inspections optimally target the largest lots with the highest plant infestation rates, leaving some lots unsampled. We also consider that USDA-APHIS, which administers inspections, may want to continue inspecting all lots at a baseline level; we find that allocating any additional capacity, beyond a comprehensive baseline inspection, to the largest lots with the highest infestation rates allows inspectors to meet the dual goals of minimizing the costs of slippage and maintaining baseline sampling without substantial compromise. © 2017 Society for Risk Analysis.

Time-varying value of electric energy efficiency

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

Mims, Natalie A.; Eckman, Tom; Goldman, Charles

Electric energy efficiency resources save energy and may reduce peak demand. Historically, quantification of energy efficiency benefits has largely focused on the economic value of energy savings during the first year and lifetime of the installed measures. Due in part to the lack of publicly available research on end-use load shapes (i.e., the hourly or seasonal timing of electricity savings) and energy savings shapes, consideration of the impact of energy efficiency on peak demand reduction (i.e., capacity savings) has been more limited. End-use load research and the hourly valuation of efficiency savings are used for a variety of electricity planningmore » functions, including load forecasting, demand-side management and evaluation, capacity and demand response planning, long-term resource planning, renewable energy integration, assessing potential grid modernization investments, establishing rates and pricing, and customer service. This study reviews existing literature on the time-varying value of energy efficiency savings, provides examples in four geographically diverse locations of how consideration of the time-varying value of efficiency savings impacts the calculation of power system benefits, and identifies future research needs to enhance the consideration of the time-varying value of energy efficiency in cost-effectiveness screening analysis. Findings from this study include: -The time-varying value of individual energy efficiency measures varies across the locations studied because of the physical and operational characteristics of the individual utility system (e.g., summer or winter peaking, load factor, reserve margin) as well as the time periods during which savings from measures occur. -Across the four locations studied, some of the largest capacity benefits from energy efficiency are derived from the deferral of transmission and distribution system infrastructure upgrades. However, the deferred cost of such upgrades also exhibited the greatest range in value of all the components of avoided costs across the locations studied. -Of the five energy efficiency measures studied, those targeting residential air conditioning in summer-peaking electric systems have the most significant added value when the total time-varying value is considered. -The increased use of rooftop solar systems, storage, and demand response, and the addition of electric vehicles and other major new electricity-consuming end uses are anticipated to significantly alter the load shape of many utility systems in the future. Data used to estimate the impact of energy efficiency measures on electric system peak demands will need to be updated periodically to accurately reflect the value of savings as system load shapes change. -Publicly available components of electric system costs avoided through energy efficiency are not uniform across states and utilities. Inclusion or exclusion of these components and differences in their value affect estimates of the time-varying value of energy efficiency. -Publicly available data on end-use load and energy savings shapes are limited, are concentrated regionally, and should be expanded.« less

Oil and gas pipeline construction cost analysis and developing regression models for cost estimation

NASA Astrophysics Data System (ADS)

Thaduri, Ravi Kiran

In this study, cost data for 180 pipelines and 136 compressor stations have been analyzed. On the basis of the distribution analysis, regression models have been developed. Material, Labor, ROW and miscellaneous costs make up the total cost of a pipeline construction. The pipelines are analyzed based on different pipeline lengths, diameter, location, pipeline volume and year of completion. In a pipeline construction, labor costs dominate the total costs with a share of about 40%. Multiple non-linear regression models are developed to estimate the component costs of pipelines for various cross-sectional areas, lengths and locations. The Compressor stations are analyzed based on the capacity, year of completion and location. Unlike the pipeline costs, material costs dominate the total costs in the construction of compressor station, with an average share of about 50.6%. Land costs have very little influence on the total costs. Similar regression models are developed to estimate the component costs of compressor station for various capacities and locations.

Costs of war: excess health care burdens during the wars in Afghanistan and Iraq (relative to the health care experience pre-war).

PubMed

2012-11-01

This report estimates the health care burden related to the wars in Iraq and Afghanistan by calculating the difference between the total health care delivered to U.S. military members during wartime (October 2001 to June 2012) and that which would have been delivered if pre-war (January 1998 to August 2001) rates of ambulatory visits, hospitalizations, and hospital bed days of active component members of the U.S. Armed Forces had persisted during the war. Overall, there were estimated excesses of 17,023,491 ambulatory visits, 66,768 hospitalizations, and 634,720 hospital bed days during the war period relative to that expected based on pre-war experience. Army and Marine Corps members and service members older than 30 accounted for the majority of excess medical care during the war period. The illness/injury-specific category of mental disorders was the single largest contributor to the total estimated excesses of ambulatory visits, hospitalizations, and bed days. The total health care burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection, and future health care associated with wartime injuries and illnesses.

Launch Vehicles

NASA Image and Video Library

2007-08-09

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, processes for upper stage barrel fabrication are talking place. Aluminum panels are manufacturing process demonstration articles that will undergo testing until perfected. The panels are built by AMRO Manufacturing located in El Monte, California. (Largest resolution available)

Least-cost control of agricultural nutrient contributions to the Gulf of Mexico hypoxic zone.

PubMed

Rabotyagov, Sergey; Campbell, Todd; Jha, Manoj; Gassman, Philip W; Arnold, Jeffrey; Kurkalova, Lyubov; Secchi, Silvia; Feng, Hongli; Kling, Catherine L

2010-09-01

In 2008, the hypoxic zone in the Gulf of Mexico, measuring 20 720 km2, was one of the two largest reported since measurement of the zone began in 1985. The extent of the hypoxic zone is related to nitrogen and phosphorous loadings originating on agricultural fields in the upper Midwest. This study combines the tools of evolutionary computation with a water quality model and cost data to develop a trade-off frontier for the Upper Mississippi River Basin specifying the least cost of achieving nutrient reductions and the location of the agricultural conservation practices needed. The frontier allows policymakers and stakeholders to explicitly see the trade-offs between cost and nutrient reductions. For example, the cost of reducing annual nitrate-N loadings by 30% is estimated to be US$1.4 billion/year, with a concomitant 36% reduction in P and the cost of reducing annual P loadings by 30% is estimated to be US$370 million/year, with a concomitant 9% reduction in nitrate-N.

Case-mix specialization in the market for hospital services.

PubMed Central

Farley, D E; Hogan, C

1990-01-01

Historically, cost-based reimbursement encouraged hospitals to compete on the basis of quality, leading to duplication of services and other inefficient behavior. More recently, prospective payment, selective contracting, and other innovations in reimbursement have strengthened incentives for more efficient hospital operations. In principle, hospitals may be able to reduce their costs by limiting the array of services they provide, but there has been little empirical evidence that U.S. hospitals are moving toward greater specialization or that specialization leads to cost savings. This article explores recent changes in case-mix specialization and the relationship of these changes to hospital costs. It first describes an index of specialization derived from Information Theory and shows that this index provides intuitively reasonable results in characterizing patterns of specialization across hospitals. The analysis then demonstrates that specialization, as measured by this index, in fact increased from 1980 through 1985; that specialization can indeed lower hospital costs; and that increases in specialization have been largest in those hospitals with the greatest incentives to reduce costs. PMID:2123838

Economic Assessment of Waterborne Outbreak of Cryptosporidiosis

PubMed Central

Chyzheuskaya, Aksana; Cormican, Martin; Srivinas, Raghavendra; O’Donovan, Diarmuid; Prendergast, Martina; O’Donoghue, Cathal

2017-01-01

In 2007, a waterborne outbreak of Cryptosporidium hominis infection occurred in western Ireland, resulting in 242 laboratory-confirmed cases and an uncertain number of unconfirmed cases. A boil water notice was in place for 158 days that affected 120,432 persons residing in the area, businesses, visitors, and commuters. This outbreak represented the largest outbreak of cryptosporidiosis in Ireland. The purpose of this study was to evaluate the cost of this outbreak. We adopted a societal perspective in estimating costs associated with the outbreak. Economic cost estimated was based on totaling direct and indirect costs incurred by public and private agencies. The cost of the outbreak was estimated based on 2007 figures. We estimate that the cost of the outbreak was >€19 million (≈€120,000/day of the outbreak). The US dollar equivalent based on today’s exchange rates would be $22.44 million (≈$142,000/day of the outbreak). This study highlights the economic need for a safe drinking water supply. PMID:28930007

[Costs and benefits of quality management].

PubMed

Schroeder-Printzen, I

2014-01-01

The establishment of quality management (QM) has been mandatory for health care providers of the national health insurance since 2004; however, certification is so far only compulsory for rehabilitation clinics. The costs have so far only been quantified in a few medical studies, while they are widely known in business administration with a basic distinction made between planning, steering, auditing, and declaration costs. Another business economics approach differentiates between prevention, appraisal, and non-conformance costs. The benefits of QM relates to customers, employees, external service providers, and health insurance providers. Also important in our consideration of the patient as a customer is that they should not be considered a customer in the usual business sense because the patient is in an emergency situation and can not freely decide. Improvements in treatment quality and in reducing the rate of adverse events make up the largest portion of the benefits of QM. Furthermore, QM can have a positive influence on motivation and employee recruitment. In addition, the cost savings that result despite costs for QM must not be forgotten.

Principal components analysis in clinical studies.

PubMed

Zhang, Zhongheng; Castelló, Adela

2017-09-01

In multivariate analysis, independent variables are usually correlated to each other which can introduce multicollinearity in the regression models. One approach to solve this problem is to apply principal components analysis (PCA) over these variables. This method uses orthogonal transformation to represent sets of potentially correlated variables with principal components (PC) that are linearly uncorrelated. PCs are ordered so that the first PC has the largest possible variance and only some components are selected to represent the correlated variables. As a result, the dimension of the variable space is reduced. This tutorial illustrates how to perform PCA in R environment, the example is a simulated dataset in which two PCs are responsible for the majority of the variance in the data. Furthermore, the visualization of PCA is highlighted.

[Productivity costs of rheumatoid arthritis in Germany. Cost composition and prediction of main cost components].

PubMed

Merkesdal, S; Huelsemann, J L; Mittendorf, T; Zeh, S; Zeidler, H; Ruof, J

2006-10-01

Identification of predictors for the productivity cost components: (1) sick leave, and (2) work disability in gainfully employed and (3) impaired household productivity in unemployed patients with rheumatoid arthritis (RA) from the societal perspective. Investigation of productivity costs was linked to a multicenter, randomized, controlled trial evaluating the effectiveness of clinical quality management in 338 patients with RA. The productivity losses were assessed according to the German Guidelines on Health Economic Evaluation. By means of multivariate logistic regression analyses, predictors of sick leave, work disability (employed patients, n=96), and for days confined to bed in unemployed patient (n=242) were determined. Mean annual costs of 970 EUR arose per person taking into consideration all patients (453 EUR sick leave, 63 EUR work disability, 454 EUR impaired productivity of unemployed patients). Disease activity, disease severity, and impaired physical function were global predictors for all of the cost components investigated. Sick leave costs were predicted by prior sick leave periods and the vocational status blue collar worker, work disability costs by sociodemographic variables (marital status, schooling), and the productivity costs of unemployed patients by impaired mental health and impaired physical functions. Interventions such as reduction in disease progression and control of disease activity, early vocational rehabilitation measures and vocational retraining in patients at risk of quitting working life, and self-management programs to learn coping strategies might decrease future RA-related productivity costs.

International Higher Education in Australia: Unplanned Future

ERIC Educational Resources Information Center

Shah, Mahsood; Nair, Chenicheri Sid

2011-01-01

International education is the third largest export industry in Australia and is worth almost A$20 billion. The last ten years have witnessed significant growth in both onshore and offshore enrolments of international students in Australian universities. The offshore component of all Australian universities has been subject to scrutiny by the…

Educational Resources: An Integral Component for Effective School Administration in Nigeria

ERIC Educational Resources Information Center

Usman, Yunusa Dangara

2016-01-01

Education as an investment constitutes the largest enterprise in Nigeria. It is the principal instrument for academic progress, social mobilization, political survival and effective national development of any country. Investment in education is a necessary condition for promotion of economic growth and national development. Educational…

Minnesota's aspen and its projected supply

Treesearch

Richard W. Groff

1966-01-01

Aspen, Minnesota's largest forest type, covers nearly one-third of the commercial forest land in the State. Its major components are bigtooth aspen, P. tremuloides, both fast-growing, generally short-lived, aggressive pioneer species that readily become established in burns and clear cuttings. They cannot be "stored on the stump," as they become...

Spatial variability in nitrous oxide and methane emissions from beef cattle feedyard pen surfaces

USDA-ARS?s Scientific Manuscript database

Greenhouse gas emissions from beef cattle feedlots include enteric carbon dioxide and methane, and manure-derived methane, nitrous oxide and carbon dioxide. Enteric methane comprises the largest portion of the greenhouse gas footprint of beef cattle feedyards. For the manure component, methane is th...

40 CFR 90.327 - Sampling system requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... each component (pump, sample line section, filters, and so forth) in the heated portion of the sampling... largest thermal mass and the oven temperature need be measured. (b) If water is removed by condensation, monitor the sample gas temperature or sample dew point either within the water trap or downstream. It may...

40 CFR 90.327 - Sampling system requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... each component (pump, sample line section, filters, and so forth) in the heated portion of the sampling... largest thermal mass and the oven temperature need be measured. (b) If water is removed by condensation, monitor the sample gas temperature or sample dew point either within the water trap or downstream. It may...

40 CFR 90.327 - Sampling system requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... each component (pump, sample line section, filters, and so forth) in the heated portion of the sampling... largest thermal mass and the oven temperature need be measured. (b) If water is removed by condensation, monitor the sample gas temperature or sample dew point either within the water trap or downstream. It may...

Impact-Resistant Ceramic Coating

NASA Technical Reports Server (NTRS)

Wheeler, W. H.; Creedon, J. F.; Izu, Y. D.

1986-01-01

Refractory fibers more than double strength of coating. Impact strengths of ceramic coatings increase with increasing whisker content. Silicon carbide whiskers clearly produce largest increase, and improvement grows even more with high-temperature sintering. Coating also improves thermal and mechanical properties of electromagnetic components, mirrors, furnace linings, and ceramic parts of advanced internal-combustion engines.

Effects of removal of different chemical components on moisture sorption property of Populus euramericana Cv. under dynamic hygrothermal conditions

NASA Astrophysics Data System (ADS)

Yang, Tiantian; Zhou, Haizhen; Ma, Erni; Wang, Jiamin

2018-09-01

Effects of chemical components on wood sorption property under dynamic condition were investigated for the first time. Hemicellulose, lignin and extractive (denoted as DHC, DL and DE, respectively) were removed from Populus euramericana Cv., 20 mm in radial (R) and tangential (T) directions with thickness of 4 mm along the grain, then the wood was subjected to cyclic tests where relative humidity (RH) varied from 45% to 75% sinusoidally at 25 °C. Based on measured data automatically, the results showed that, various chemical components had different effects on dynamic sorption behaviors of wood. The DL exhibited the largest moisture content and diffusion coefficient, followed by the DE, Control and DHC. This indicated lignin or extractive removal accelerated the dynamic sorption process and improved hygroscopicity of wood, while hemicellulose removal caused opposite effects. Theoretical sorption model was further applied and the modeled curves fitted satisfactorily with experimental data. Dynamic moisture gradient distribution inside the different treated wood was investigated and amplitude of moisture showed negative relation with wood element depth, while phase lag presented an opposite trend. Amplitude of DL was the largest while its phase lag was the least. Conditioning thickness for RH was greatest for DHC, about twice as much as the minimum of DL.

A measure for objects clustering in principal component analysis biplot: A case study in inter-city buses maintenance cost data

NASA Astrophysics Data System (ADS)

Ginanjar, Irlandia; Pasaribu, Udjianna S.; Indratno, Sapto W.

2017-03-01

This article presents the application of the principal component analysis (PCA) biplot for the needs of data mining. This article aims to simplify and objectify the methods for objects clustering in PCA biplot. The novelty of this paper is to get a measure that can be used to objectify the objects clustering in PCA biplot. Orthonormal eigenvectors, which are the coefficients of a principal component model representing an association between principal components and initial variables. The existence of the association is a valid ground to objects clustering based on principal axes value, thus if m principal axes used in the PCA, then the objects can be classified into 2m clusters. The inter-city buses are clustered based on maintenance costs data by using two principal axes PCA biplot. The buses are clustered into four groups. The first group is the buses with high maintenance costs, especially for lube, and brake canvass. The second group is the buses with high maintenance costs, especially for tire, and filter. The third group is the buses with low maintenance costs, especially for lube, and brake canvass. The fourth group is buses with low maintenance costs, especially for tire, and filter.

Health care costs and financing in world perspective.

PubMed Central

Roemer, M. I.

1991-01-01

Expenditures for health services, as a percentage of national wealth (gross national product, or GNP), have been rising throughout the world. Data to quantify this trend are available for many industrialized countries. The share of health spending derived from governmental sources has also been increasing. Mandatory or social insurance has developed to support health services in 70 nations. While widely used for paying doctors on a fee basis or by capitation, in Latin America doctors are organized in polyclinics and paid by salaries. General revenues are used to support Ministry of Health programs. Among health expenditures, the largest share goes to hospitalization. Cost sharing by patients is widely used to control rising costs. World trends have promoted equity in health care delivery. PMID:1814057

A Framework for Evaluating Economic Impacts of Rooftop PV Systems with or without Energy Storage on Thai Distribution Utilities and Ratepayers

NASA Astrophysics Data System (ADS)

Chaianong, A.; Bangviwat, A.; Menke, C.

2017-07-01

Driven by decreasing PV and energy storage prices, increasing electricity costs and policy supports from Thai government (self-consumption era), rooftop PV and energy storage systems are going to be deployed in the country rapidly that may disrupt existing business models structure of Thai distribution utilities due to revenue erosion and lost earnings opportunities. The retail rates that directly affect ratepayers (non-solar customers) are expected to increase. This paper focuses on a framework for evaluating impacts of PV with and without energy storage systems on Thai distribution utilities and ratepayers by using cost-benefit analysis (CBA). Prior to calculation of cost/benefit components, changes in energy sales need to be addressed. Government policies for the support of PV generation will also help in accelerating the rooftop PV installation. Benefit components include avoided costs due to transmission losses and deferring distribution capacity with appropriate PV penetration level, while cost components consist of losses in revenue, program costs, integration costs and unrecovered fixed costs. It is necessary for Thailand to compare total costs and total benefits of rooftop PV and energy storage systems in order to adopt policy supports and mitigation approaches, such as business model innovation and regulatory reform, effectively.

Cost per RN hired.

PubMed

Hoffman, F M

1985-02-01

Costs of recruiting, hiring, and training new staff members can be significant. This article demonstrates a method for analyzing the components of these costs to target areas where improved efficiency can lead to lower costs.

Ultrasonic Inspection of Wooden Pallet Parts Using Time of Flight

Treesearch

Daniel L. Schmoldt; Robert M. Nelson; Robert J. Ross; Kent A. McDonald

1997-01-01

Wooden pallets are the largest single use of sawn hardwood logs in the USA. Unfortunately, millions of wooden pallets are discarded annually due to damage or because their low cost makes them readily disposable. In general, pallets are constructed from stringers and deckboards of random quality. Higher quality wooden pallets, however, can be built from higher quality...

Using Side-scan Sonar to Characterize and Map Physical Habitat and Anthropogenic Underwater Features in the St. Louis River. (poster)

EPA Science Inventory

Characterizing underwater habitat and other features is difficult and costly, especially in large river systems. The St. Louis River is the largest US tributary to Lake Superior and the lower portion consists of a 48.5 km2 complex of wetlands, tributaries, and bays. We surveyed 8...

Least-cost control of agricultural nutrient contributions to the Gulf of Mexico hypoxic zone

USDA-ARS?s Scientific Manuscript database

In 2007, the hypoxic zone in the Gulf of Mexico, measuring 20,720 km**2, was one of the two largest reported since measurement of the zone began in 1985. The extent of the hypoxic zone is related to nitrogen and phosphorous loadings originating on agricultural fields in the upper Midwest. This stud...

High-severity wildfire effects on carbon stocks and emissions in fuels treated and untreated forest

Treesearch

Malcolm P. North; Matthew D. Hurteau

2011-01-01

Forests contain the world's largest terrestrial carbonstocks, but in seasonally dry environments stock stability can be compromised if burned by wildfire, emitting carbon back to the atmosphere. Treatments to reduce wildfireseverity can reduce emissions, but with an immediate cost of reducing carbonstocks. In this study we examine the tradeoffs in...

Global Norms and Local Politics: Uses and Abuses of Education Gender Quotas in Tajikistan

ERIC Educational Resources Information Center

Silova, Iveta; Abdushukurova, Tatiana

2009-01-01

In Central Asia, the post-Soviet transformation period has been accompanied by significant economic and social costs, including the widening of the gender gaps in politics, economy and the social sphere. Tajikistan, which receives the largest amount of international aid and has the worst record of gender inequity in Central Asia, has quickly…

Faculty Productivity and Costs at the University of Texas at Austin: A Preliminary Analysis

ERIC Educational Resources Information Center

Vedder, Richard; Matgouranis, Christopher; Robe, Jonathan

2011-01-01

In this report, the authors examine recently released preliminary data concerning faculty compensation, teaching loads and external research grant awards at one of the nation's largest college campuses, The University of Texas at Austin. The authors use these data to assess faculty productivity (in terms of both teaching and research), and their…

Pharmaceutical Use among Older Adults: Using Administrative Data to Examine Medication-Related Issues

ERIC Educational Resources Information Center

Metge, Colleen Jane; Grymonpre, Ruby; Yogendran, Marina

2005-01-01

Medication use is recognized as the least expensive, most cost-effective health care intervention. In older adults this is especially important, as they are the largest consumer of prescription medications. We describe the use of a linked data set including pharmaceutical, medical, and hospital claims to examine pharmaceutical use in the…

Student Loans: Are We Getting Our Money's Worth?

ERIC Educational Resources Information Center

Elliott, William

2014-01-01

Given the increasing expectation that students should bear most of the college-cost burden, loans have been the largest form of financial aid since 1982, a shift that has been particularly hard on needy students. Loan-aversion has contributed to the access problem for these students, while facilitating more privileged students' ability to…

The Relationship of Student Loan and Credit Card Debt on Financial Satisfaction of College Students

ERIC Educational Resources Information Center

Solis, Oscar; Ferguson, Ralph

2017-01-01

The cost of higher education at both public and private institutions is increasing and adversely affecting college students (College Board, 2009; Idemudia & Ferguson, 2014a, 2014b, 2015a, 2015b). Utilizing an institutional dataset called Financial Survey of Students 2006 compiled at one of the largest public universities in the southwestern…

Effort to test, evaluate and deploy technologies to automate the measurement of real-time border wait times at United States-Canada land border crossings.

DOT National Transportation Integrated Search

2011-09-01

The United States and Canada share the largest bi-national trading relationship in the world. An efficient and cost-effective border crossing system for both freight and passenger vehicle traffic is thus vital to the economic well-being and security ...

Health Insurance for Public School Teachers in Wisconsin: A Good Value for Taxpayers or a Case of Market Abuse?

ERIC Educational Resources Information Center

Browne, Mark; Leetch, Linda

2000-01-01

A study examined one state's suggestion for more cost-effective health insurance for teachers. Health insurance coverage for public school teachers in Wisconsin is determined through a collective-bargaining process. The Wisconsin Education Association (WEA) Insurance Corporation is affiliated with the states largest teachers' union and provides…

Using side-scan sonar to characterize and map physical habitat and anthropogenic underwater features in the St. Louis River

EPA Science Inventory

Characterizing underwater habitat and other features is difficult and costly, especially in large river systems. The St. Louis River is the largest US tributary to Lake Superior and the lower portion consists of a 48.5 km2 complex of wetlands, tributaries, and bays. We surveyed 8...

Diversity, Child Care Quality and Developmental Outcomes. FPG Snapshot, #21

ERIC Educational Resources Information Center

FPG Child Development Institute, University of North Carolina, 2004

2004-01-01

It is widely accepted that high quality child care enhances children's cognitive and social development, but some people question if what constitutes quality care depends on the child's ethnic and cultural background. To examine this issue, secondary analysis of the two largest U.S. studies of child care--the Cost, Quality, and Outcomes Study and…

The Impact of Child Care Subsidy Use on Child Care Quality

ERIC Educational Resources Information Center

Ryan, Rebecca M.; Johnson, Anna; Rigby, Elizabeth; Brooks-Gunn, Jeanne

2011-01-01

In 2008, the federal government allotted $7 billion in child care subsidies to low-income families through the state-administered Child Care and Development Fund (CCDF), now the government's largest child care program (US DHHS, 2008). Although subsidies reduce costs for families and facilitate parental employment, it is unclear how they impact the…

Recruitment strategy cost and impact on minority accrual to a breast cancer prevention trial.

PubMed

Dew, Alexander; Khan, Seema; Babinski, Christie; Michel, Nancy; Heffernan, Marie; Stephan, Stefanie; Jordan, Neil; Jovanovic, Borko; Carney, Paula; Bergan, Raymond

2013-04-01

Recruitment of minorities to cancer prevention trials is difficult and costly. Early-phase cancer prevention trials have fewer resources to promote recruitment. Identifying cost-effective strategies that can replace or supplement traditional recruitment methods and improve minority accrual to small, early-phase cancer prevention trials are of critical importance. To compare the costs of accrual strategies used in a small breast cancer prevention trial and assess their impact on recruitment and minority accrual. A total of 1196 potential subjects with a known recruitment source contacted study coordinators about the SOY study, a breast cancer prevention trial. Recruitment strategies for this study included recruitment from within the Northwestern University network (internal strategy), advertisements placed on public transportation (Chicago Transit Authority (CTA)), health-related events, media (print/radio/television), and direct mail. Total recruitment strategy cost included the cost of study personnel and material costs calculated from itemized receipts. Incremental cost-effectiveness ratios (ICERs) were calculated to compare the relative cost-effectiveness of each recruitment strategy. If a strategy was more costly and less effective than its comparator, then that strategy was considered dominated. Scenarios that were not dominated were compared. The primary effectiveness measure was the number of consents. Separate ICERs were calculated using the number of minority consents as the effectiveness measure. The total cost of SOY study recruitment was US$164,585, which included the cost of materials (US$26,133) and personnel (US$138,452). The internal referral strategy was the largest source of trial contacts (748/1196; 63%), consents (107/150; 71%), and minority consents (17/34; 50%) and was the most expensive strategy (US$139,033). CTA ads generated the second largest number of trial contacts (326/1196; 27%), the most minority contacts (184/321; 57%), and 16 minority consents (16/34; 47%), at a total cost of US$15,562. The other three strategies yielded many fewer contacts and consents. The methods of health events, CTA ads, and the internal strategy showed some evidence of cost-effectiveness (ICER: US$581, US$717, and US$1524, respectively). The CTA strategy was the most cost-effective strategy for minority accrual (ICER: US$908). Recall bias may have limited the accuracy of estimated time spent on recruitment by study personnel. Also, costs spent specifically on minority accrual were unobtainable; results may not be generalizable to other settings; and cost-effectiveness data for the methods of media, health events, and direct mail should be interpreted with caution since these methods generated few consents. Public transportation ads have the potential to generate numerous minority contacts and consents at a reasonable cost within an urban setting. Combined with traditional methods of recruitment, this method can lead to timelier study completion and increased minority accrual. Future research should prospectively track recruitment and costs in order to better assess the cost-effectiveness of recruitment methods used to target minority populations.

Reducing Life-Cycle Costs.

ERIC Educational Resources Information Center

Roodvoets, David L.

2003-01-01

Presents factors to consider when determining roofing life-cycle costs, explaining that costs do not tell the whole story; discussing components that should go into the decision (cost, maintenance, energy use, and environmental costs); and concluding that important elements in reducing life-cycle costs include energy savings through increased…

Resource Use and Medicare Costs During Lay Navigation for Geriatric Patients With Cancer.

PubMed

Rocque, Gabrielle B; Pisu, Maria; Jackson, Bradford E; Kvale, Elizabeth A; Demark-Wahnefried, Wendy; Martin, Michelle Y; Meneses, Karen; Li, Yufeng; Taylor, Richard A; Acemgil, Aras; Williams, Courtney P; Lisovicz, Nedra; Fouad, Mona; Kenzik, Kelly M; Partridge, Edward E

2017-06-01

Lay navigators in the Patient Care Connect Program support patients with cancer from diagnosis through survivorship to end of life. They empower patients to engage in their health care and navigate them through the increasingly complex health care system. Navigation programs can improve access to care, enhance coordination of care, and overcome barriers to timely, high-quality health care. However, few data exist regarding the financial implications of implementing a lay navigation program. To examine the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. This observational study from January 1, 2012, through December 31, 2015, used propensity score-matched regression analysis to compare quarterly changes in the mean total Medicare costs and resource use between navigated patients and nonnavigated, matched comparison patients. The setting was The University of Alabama at Birmingham Health System Cancer Community Network, which includes 2 academic and 10 community cancer centers across Alabama, Georgia, Florida, Mississippi, and Tennessee. Participants were Medicare beneficiaries with cancer who received care at participating institutions from 2012 through 2015. The primary exposure was contact with a patient navigator. Navigated patients were matched to nonnavigated patients on age, race, sex, cancer acuity (high vs low), comorbidity score, and preenrollment characteristics (costs, emergency department visits, hospitalizations, intensive care unit admissions, and chemotherapy in the preenrollment quarter). Total costs to Medicare, components of cost, and resource use (emergency department visits, hospitalizations, and intensive care unit admissions). In total, 12 428 patients (mean (SD) age at cancer diagnosis, 75 (7) years; 52.0% female) were propensity score matched, including 6214 patients in the navigated group and 6214 patients in the matched nonnavigated comparison group. Compared with the matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient (β = -781.29, SE = 45.77, P < .001), for an estimated $19 million decline per year across the network. Inpatient and outpatient costs had the largest between-group quarterly declines, at $294 and $275, respectively, per patient. Emergency department visits, hospitalizations, and intensive care unit admissions decreased by 6.0%, 7.9%, and 10.6%, respectively, per quarter in navigated patients compared with matched comparison patients (P < .001). Costs to Medicare and health care use from 2012 through 2015 declined significantly for navigated patients compared with matched comparison patients. Lay navigation programs should be expanded as health systems transition to value-based health care.

Medicare Part D: Are Insurers Gaming the Low Income Subsidy Design?

PubMed

Decarolis, Francesco

2015-04-01

This paper shows how in Medicare Part D insurers' gaming of the subsidy paid to low-income enrollees distorts premiums and raises the program cost. Using plan-level data from the first five years of the program, I find multiple instances of pricing strategy distortions for the largest insurers. Instrumental variable estimates indicate that the changes in a concentration index measuring the manipulability of the subsidy can explain a large share of the premium growth observed between 2006 and 2011. Removing this distortion could reduce the cost of the program without worsening consumer welfare.

Benefits of volcano monitoring far outweigh costs - the case of Mount Pinatubo

USGS Publications Warehouse

Newhall, Chris G.; Hendley, James W.; Stauffer, Peter H.

1997-01-01

The climactic June 1991 eruption of Mount Pinatubo, Philippines, was the largest volcanic eruption in this century to affect a heavily populated area. Because it was forecast by scientists from the Philippine Institute of Volcanology and Seismology and the U.S. Geological Survey, civil and military leaders were able to order massive evacuations and take measures to protect property before the eruption. Thousands of lives were saved and hundreds of millions of dollars in property losses averted. The savings in property alone were many times the total costs of the forecasting and evacuations.

Model-based Roentgen stereophotogrammetry of orthopaedic implants.

PubMed

Valstar, E R; de Jong, F W; Vrooman, H A; Rozing, P M; Reiber, J H

2001-06-01

Attaching tantalum markers to prostheses for Roentgen stereophotogrammetry (RSA) may be difficult and is sometimes even impossible. In this study, a model-based RSA method that avoids the attachment of markers to prostheses is presented and validated. This model-based RSA method uses a triangulated surface model of the implant. A projected contour of this model is calculated and this calculated model contour is matched onto the detected contour of the actual implant in the RSA radiograph. The difference between the two contours is minimized by variation of the position and orientation of the model. When a minimal difference between the contours is found, an optimal position and orientation of the model has been obtained. The method was validated by means of a phantom experiment. Three prosthesis components were used in this experiment: the femoral and tibial component of an Interax total knee prosthesis (Stryker Howmedica Osteonics Corp., Rutherfort, USA) and the femoral component of a Profix total knee prosthesis (Smith & Nephew, Memphis, USA). For the prosthesis components used in this study, the accuracy of the model-based method is lower than the accuracy of traditional RSA. For the Interax femoral and tibial components, significant dimensional tolerances were found that were probably caused by the casting process and manual polishing of the components surfaces. The largest standard deviation for any translation was 0.19mm and for any rotation it was 0.52 degrees. For the Profix femoral component that had no large dimensional tolerances, the largest standard deviation for any translation was 0.22mm and for any rotation it was 0.22 degrees. From this study we may conclude that the accuracy of the current model-based RSA method is sensitive to dimensional tolerances of the implant. Research is now being conducted to make model-based RSA less sensitive to dimensional tolerances and thereby improving its accuracy.

The social costs of uranium mining in the US Colorado Plateau cohort, 1960-2005.

PubMed

Jones, Benjamin A

2017-05-01

Long-term social costs associated with underground uranium mining are largely unknown. This study estimated health costs of Native American and white (Hispanic and non-Hispanic origin) uranium miners in the US Public Health Service Colorado Plateau cohort study. Elevated uranium miner person-years of life lost (PYLL) were calculated from the most recent study of the Colorado Plateau cohort over 1960-2005. Nine causes of death categories were included. Costs to society of miner PYLL were monetized using the value of a statistical life-year approach. Costs over 1960-2005 totaled $2 billion USD [95% CI: $1.8, $2.2], or $2.9 million per elevated miner death. This corresponds to $43.1 million [95%: $38.7, $48.7] in annual costs. Lung cancer was the most costly cause of death at $1.4 billion [95%: $1.3, $1.5]. Absolute health costs were largest for white miners, but Native Americans had larger costs per elevated death. Annual excess mortality over 1960-2005 averaged 366.4 per 100,000 miners; 404.6 (white) and 201.5 per 100,000 (Native American). This research advances our understanding of uranium extraction legacy impacts, particularly among indigenous populations.

The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty.

PubMed

Sabeh, Karim G; Rosas, Samuel; Buller, Leonard T; Roche, Martin W; Hernandez, Victor H

2017-10-01

Total joint arthroplasty (TJA) accounts for more Medicare expenditure than any other inpatient procedure. The Comprehensive Care for Joint Replacement model was introduced to decrease cost and improve quality in TJA. The largest portion of episode-of-care costs occurs after discharge. This study sought to quantify the cost variation of primary total hip arthroplasty (THA) according to discharge disposition. The Medicare and Humana claims databases were used to extract charges and reimbursements to compare day-of-surgery and 91-day postoperative costs simulating episode-of-care reimbursements. Of the patients who underwent primary THA, 257,120 were identified (204,912 from Medicare and 52,208 from Humana). Patients were stratified by discharge disposition: home with home health, skilled nursing facility, or inpatient rehabilitation facility. There is a significant difference in the episode-of-care costs according to discharge disposition, with discharge to an inpatient rehabilitation facility the most costly and discharge to home the least costly. Postdischarge costs represent a sizeable portion of the overall expense in THA, and optimizing patients to allow safe discharge to home may help reduce the cost of THA. Copyright © 2017 Elsevier Inc. All rights reserved.

MAPK-dependent JA and SA signalling in Nicotiana attenuata affects plant growth and fitness during competition with conspecifics

PubMed Central

2012-01-01

Background Induced defense responses to herbivores are generally believed to have evolved as cost-saving strategies that defer the fitness costs of defense metabolism until these defenses are needed. The fitness costs of jasmonate (JA)-mediated defenses have been well documented. Those of the early signaling units mediating induced resistance to herbivores have yet to be examined. Early signaling components that mediate herbivore-induced defense responses in Nicotiana attenuata, have been well characterized and here we examine their growth and fitness costs during competition with conspecifics. Two mitogen-activated protein kinases (MAPKs), salicylic acid (SA)-induced protein kinase (SIPK) and wound-induced protein kinase (WIPK) are rapidly activated after perception of herbivory and both kinases regulate herbivory-induced JA levels and JA-mediated defense metabolite accumulations. Since JA-induced defenses result in resource-based trade-offs that compromise plant productivity, we evaluated if silencing SIPK (irSIPK) and WIPK (irWIPK) benefits the growth and fitness of plants competiting with wild type (WT) plants, as has been shown for plants silenced in JA-signaling by the reduction of Lipoxygenase 3 (LOX3) levels. Results As expected, irWIPK and LOX3-silenced plants out-performed their competing WT plants. Surprisingly, irSIPK plants, which have the largest reductions in JA signaling, did not. Phytohormone profiling of leaves revealed that irSIPK plants accumulated higher levels of SA compared to WT. To test the hypothesis that these high levels of SA, and their presumed associated fitness costs of pathogen associated defenses in irSIPK plants had nullified the JA-deficiency-mediated growth benefits in these plants, we genetically reduced SA levels in irSIPK plants. Reducing SA levels partially recovered the biomass and fitness deficits of irSIPK plants. We also evaluated whether the increased fitness of plants with reduced SA or JA levels resulted from increased nitrogen or CO2 assimilation rates, and found no evidence that greater intake of these fitness-limiting resources were responsible. Conclusions Signaling mediated by WIPK, but not SIPK, is associated with large fitness costs in competing N. attenuata plants, demonstrating the contrasting roles that these two MAPKs play in regulating the plants’ growth-defense balance. We discuss the role of SIPK as an important regulator of plant fitness, possibly by modulating SA-JA crosstalk as mediated through ethylene signaling. PMID:23148462

Levelized cost-benefit analysis of proposed diagnostics for the Ammunition Transfer Arm of the US Army`s Future Armored Resupply Vehicle

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

Wilkinson, V.K.; Young, J.M.

1995-07-01

The US Army`s Project Manager, Advanced Field Artillery System/Future Armored Resupply Vehicle (PM-AFAS/FARV) is sponsoring the development of technologies that can be applied to the resupply vehicle for the Advanced Field Artillery System. The Engineering Technology Division of the Oak Ridge National Laboratory has proposed adding diagnostics/prognostics systems to four components of the Ammunition Transfer Arm of this vehicle, and a cost-benefit analysis was performed on the diagnostics/prognostics to show the potential savings that may be gained by incorporating these systems onto the vehicle. Possible savings could be in the form of reduced downtime, less unexpected or unnecessary maintenance, fewermore » regular maintenance checks. and/or tower collateral damage or loss. The diagnostics/prognostics systems are used to (1) help determine component problems, (2) determine the condition of the components, and (3) estimate the remaining life of the monitored components. The four components on the arm that are targeted for diagnostics/prognostics are (1) the electromechanical brakes, (2) the linear actuators, (3) the wheel/roller bearings, and (4) the conveyor drive system. These would be monitored using electrical signature analysis, vibration analysis, or a combination of both. Annual failure rates for the four components were obtained along with specifications for vehicle costs, crews, number of missions, etc. Accident scenarios based on component failures were postulated, and event trees for these scenarios were constructed to estimate the annual loss of the resupply vehicle, crew, arm. or mission aborts. A levelized cost-benefit analysis was then performed to examine the costs of such failures, both with and without some level of failure reduction due to the diagnostics/prognostics systems. Any savings resulting from using diagnostics/prognostics were calculated.« less

Process-Based Cost Modeling of Photonics Manufacture: The Cost Competitiveness of Monolithic Integration of a 1550-nm DFB Laser and an Electroabsorptive Modulator on an InP Platform

NASA Astrophysics Data System (ADS)

Fuchs, Erica R. H.; Bruce, E. J.; Ram, R. J.; Kirchain, Randolph E.

2006-08-01

The monolithic integration of components holds promise to increase network functionality and reduce packaging expense. Integration also drives down yield due to manufacturing complexity and the compounding of failures across devices. Consensus is lacking on the economically preferred extent of integration. Previous studies on the cost feasibility of integration have used high-level estimation methods. This study instead focuses on accurate-to-industry detail, basing a process-based cost model of device manufacture on data collected from 20 firms across the optoelectronics supply chain. The model presented allows for the definition of process organization, including testing, as well as processing conditions, operational characteristics, and level of automation at each step. This study focuses on the cost implications of integration of a 1550-nm DFB laser with an electroabsorptive modulator on an InP platform. Results show the monolithically integrated design to be more cost competitive over discrete component options regardless of production scale. Dominant cost drivers are packaging, testing, and assembly. Leveraging the technical detail underlying model projections, component alignment, bonding, and metal-organic chemical vapor deposition (MOCVD) are identified as processes where technical improvements are most critical to lowering costs. Such results should encourage exploration of the cost advantages of further integration and focus cost-driven technology development.

Microwave components for cellular portable radiotelephone

NASA Astrophysics Data System (ADS)

Muraguchi, Masahiro; Aikawa, Masayoshi

1995-09-01

Mobile and personal communication systems are expected to represent a huge market for microwave components in the coming years. A number of components in silicon bipolar, silicon Bi-CMOS, GaAs MESFET, HBT and HEMT are now becoming available for system application. There are tradeoffs among the competing technologies with regard to performance, cost, reliability and time-to-market. This paper describes process selection and requirements of cost and r.f. performances to microwave semiconductor components for digital cellular and cordless telephones. Furthermore, new circuit techniques which were developed by NTT are presented.

Selective inhibition of a multicomponent response can be achieved without cost

PubMed Central

Westrick, Zachary; Ivry, Richard B.

2014-01-01

Behavioral flexibility frequently requires the ability to modify an on-going action. In some situations, optimal performance requires modifying some components of an on-going action without interrupting other components of that action. This form of control has been studied with the selective stop-signal task, in which participants are instructed to abort only one movement of a multicomponent response. Previous studies have shown a transient disruption of the nonaborted component, suggesting limitations in our ability to use selective inhibition. This cost has been attributed to a structural limitation associated with the recruitment of a cortico-basal ganglia pathway that allows for the rapid inhibition of action but operates in a relatively generic manner. Using a model-based approach, we demonstrate that, with a modest amount of training and highly compatible stimulus-response mappings, people can perform a selective-stop task without any cost on the nonaborted component. Prior reports of behavioral costs in selective-stop tasks reflect, at least in part, a sampling bias in the method commonly used to estimate such costs. These results suggest that inhibition can be selectively controlled and present a challenge for models of inhibitory control that posit the operation of generic processes. PMID:25339712

Clinical care costing method for the Clinical Care Classification System.

PubMed

Saba, Virginia K; Arnold, Jean M

2004-01-01

To provide a means for calculating the cost of nursing care using the Clinical Care Classification System (CCCS). Three CCCS indicators of care components, actions, and outcomes in conjunction with Clinical Care Pathways (CCPs). The cost of patient care is based on the type of action time multiplied by care components and nursing costs. The CCCM for the CCCS makes it possible to measure and cost out clinical practice. The CCCM may be used with CCPs in the electronic patient medical record. The CCPs make it easy to track the clinical nursing care across time, settings, population groups, and geographical locations. Collected data may be used many times, allowing for improved documentation, analysis, and costing out of care.

Activity-based costing: a practical model for cost calculation in radiotherapy.

PubMed

Lievens, Yolande; van den Bogaert, Walter; Kesteloot, Katrien

2003-10-01

The activity-based costing method was used to compute radiotherapy costs. This report describes the model developed, the calculated costs, and possible applications for the Leuven radiotherapy department. Activity-based costing is an advanced cost calculation technique that allocates resource costs to products based on activity consumption. In the Leuven model, a complex allocation principle with a large diversity of cost drivers was avoided by introducing an extra allocation step between activity groups and activities. A straightforward principle of time consumption, weighed by some factors of treatment complexity, was used. The model was developed in an iterative way, progressively defining the constituting components (costs, activities, products, and cost drivers). Radiotherapy costs are predominantly determined by personnel and equipment cost. Treatment-related activities consume the greatest proportion of the resource costs, with treatment delivery the most important component. This translates into products that have a prolonged total or daily treatment time being the most costly. The model was also used to illustrate the impact of changes in resource costs and in practice patterns. The presented activity-based costing model is a practical tool to evaluate the actual cost structure of a radiotherapy department and to evaluate possible resource or practice changes.

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...

Additive manufacture (3d printing) of plasma diagnostic components and assemblies for fusion experiments

NASA Astrophysics Data System (ADS)

Sieck, Paul; Woodruff, Simon; Stuber, James; Romero-Talamas, Carlos; Rivera, William; You, Setthivoine; Card, Alexander

2015-11-01

Additive manufacturing (or 3D printing) is now becoming sufficiently accurate with a large range of materials for use in printing sensors needed universally in fusion energy research. Decreasing production cost and significantly lowering design time of energy subsystems would realize significant cost reduction for standard diagnostics commonly obtained through research grants. There is now a well-established set of plasma diagnostics, but these expensive since they are often highly complex and require customization, sometimes pace the project. Additive manufacturing (3D printing) is developing rapidly, including open source designs. Basic components can be printed for (in some cases) less than 1/100th costs of conventional manufacturing. We have examined the impact that AM can have on plasma diagnostic cost by taking 15 separate diagnostics through an engineering design using Conventional Manufacturing (CM) techniques to determine costs of components and labor costs associated with getting the diagnostic to work as intended. With that information in hand, we set about optimizing the design to exploit the benefits of AM. Work performed under DOE Contract DE-SC0011858.

Cost-effectiveness analysis of salt reduction policies to reduce coronary heart disease in Syria, 2010-2020.

PubMed

Wilcox, Meredith L; Mason, Helen; Fouad, Fouad M; Rastam, Samer; al Ali, Radwan; Page, Timothy F; Capewell, Simon; O'Flaherty, Martin; Maziak, Wasim

2015-01-01

This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria. Costs and benefits of a health promotion campaign about salt reduction (HP); labeling of salt content on packaged foods (L); reformulation of salt content within packaged foods (R); and combinations of the three were estimated over a 10-year time frame. Policies were deemed cost-effective if their cost-effectiveness ratios were below the region's established threshold of $38,997 purchasing power parity (PPP). Sensitivity analysis was conducted to account for the uncertainty in the reduction of salt intake. HP, L, and R+HP+L were cost-saving using the best estimates. The remaining policies were cost-effective (CERs: R=$5,453 PPP/LYG; R+HP=$2,201 PPP/LYG; R+L=$2,125 PPP/LYG). R+HP+L provided the largest benefit with net savings using the best and maximum estimates, while R+L was cost-effective with the lowest marginal cost using the minimum estimates. This study demonstrated that all policies were cost-saving or cost effective, with the combination of reformulation plus labeling and a comprehensive policy involving all three approaches being the most promising salt reduction strategies to reduce CHD mortality in Syria.

76 FR 57982 - Building Energy Codes Cost Analysis

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Docket No. EERE-2011-BT-BC-0046] Building Energy Codes Cost Analysis Correction In notice document 2011-23236 beginning on page... heading ``Table 1. Cash flow components'' should read ``Table 7. Cash flow components''. [FR Doc. C1-2011...

Frame of reference for electronic maps - The relevance of spatial cognition, mental rotation, and componential task analysis

NASA Technical Reports Server (NTRS)

Wickens, Christopher D.; Aretz, Anthony; Harwood, Kelly

1989-01-01

Three experiments are reported that examine the difference between north-up and track-up maps for airborne navigation. The results of the first two experiments, conducted in a basic laboratory setting, identified the cost associated with mental rotation, when a north-up map is used. However, the data suggest that these costs are neither large nor consistent. The third experiment examined a range of tasks in a higher fidelity helicopter flight simulation, and associated the costs of north-up maps with a cognitive component related to orientation, and the costs of track-up maps with a cognitive component related to inconsistent landmark location. Different tasks are associated with different dependence on these components. The results are discussed in terms of their implications for map design, and for cognitive models of navigational processes.

Novel cost controlled materials and processing for primary structures

NASA Technical Reports Server (NTRS)

Dastin, S. J.

1993-01-01

Textile laminates, developed a number of years ago, have recently been shown to be applicable to primary aircraft structures for both small and large components. Such structures have the potential to reduce acquisition costs but require advanced automated processing to keep costs controlled while verifying product reliability and assuring structural integrity, durability and affordable life-cycle costs. Recently, resin systems and graphite-reinforced woven shapes have been developed that have the potential for improved RTM processes for aircraft structures. Ciba-Geigy, Brochier Division has registered an RTM prepreg reinforcement called 'Injectex' that has shown effectivity for aircraft components. Other novel approaches discussed are thermotropic resins producing components by injection molding and ceramic polymers for long-duration hot structures. The potential of such materials and processing will be reviewed along with initial information/data available to date.

Farther on down the road: transport costs, trade and urban growth in sub-Saharan Africa

PubMed Central

2018-01-01

This paper investigates the role of inter-city transport costs in determining the income of sub-Saharan African cities. In particular, focusing on fifteen countries whose largest city is a port, I find that an oil price increase of the magnitude experienced between 2002 and 2008 induces the income of cities near that port to increase by 7 percent relative to otherwise identical cities 500 kilometers farther away. Combined with external estimates, this implies an elasticity of city economic activity with respect to transport costs of −0.28 at 500 kilometers from the port. Moreover, the effect differs by the surface of roads between cities. Cities connected to the port by paved roads are chiefly affected by transport costs to the port, while cities connected to the port by unpaved roads are more affected by connections to secondary centers. PMID:29743731

Hospital Supply Expenses: An Important Ingredient in Health Services Research.

PubMed

Abdulsalam, Yousef; Schneller, Eugene

2017-07-01

The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician-hospital arrangements, and value-based purchasing.

Cost - effectiveness analysis of the antiplatelet treatment administered on ischemic stroke patients using goal programming approach

NASA Astrophysics Data System (ADS)

Rajendran, Rasvini; Zainuddin, Zaitul Marlizawati; Idris, Badrisyah

2014-09-01

There are numerous ways to prevent or treat ischemic stroke and each of these competing alternatives is associated with a different effectiveness and a cost. In circumstances where health funds are budgeted and thus fixed, cost-effectiveness analysis (CEA) can provide information on how to comprehend the largest health gains with that limited fund as CEA is used to compare different strategies for preventing or treating a single disease. The most common medications for ischemic stroke are the anti-platelet drugs. While some drugs are more effective than others, they are also more expensive. This paper will thus assess the CEA of anti-platelet drug available for ischemic stroke patients using goal programming (GP) approach subject to in-patients days and patients' quality-of-life. GP presents a way of striving towards several objectives simultaneously whereby in this case we will consider minimizing the cost and maximizing the effectiveness.

Containing Health Care Costs

PubMed Central

Derzon, Robert A.

1980-01-01

As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551