[Cost-benefit analysis of the active screening of pulmonary tuberculosis in a recluse population entering prison].

PubMed

Martín, V; Domínguez, A; Alcaide, J

1997-01-01

In spanish prisons, tuberculosis is a serious problem of public health and health authorities don't take it seriously. To prove the efficiency of pulmonary tuberculosis case-finding on arrival at prison in order to get location resources in this activity. Cost-benefit analysis of a case-finding program compared with to wait for diagnostic to illness. The sensitivity of test was fixed in 80% and the specificity in 99.99%. The cost was based on market prices. Sensitivity analysis was done in every variables as well as tridimensional analysis in those one of more influence. The case-finding was efficient on prevalences of tuberculosis over 5 per mil. Its efficiency was hardly affected by discount social rates or the sensitivity of diagnostic tests. The prevalence of illness, the cost of diagnostic activities as well as the success of treatment and the specificity of diagnostic tests used had as influence on the efficiency model. The tridimensional analysis proved that the case-finding of pulmonary tuberculosis has efficiency on low prevalences (1 per thousand), provided the number of people cured is a 5% higher than the alternative one and the costs of case-finding less than 1,000 pesetas per subject. The case-finding pulmonary tuberculosis on arrival at prisons is of high efficiency. In a cost-opportunity situation (location of available resources, penitentiary and extrapenitentiary) the program is very efficacious taking into account the fact of higher prevalence of pulmonary tuberculosis in this people.

Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing.

PubMed

Thaker, Nikhil G; Pugh, Thomas J; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E; Martin, Neil E; Sio, Terence T; Kudchadker, Rajat J; Kaplan, Robert S; Kuban, Deborah A; Swanson, David A; Orio, Peter F; Zelefsky, Michael J; Cox, Brett W; Potters, Louis; Buchholz, Thomas A; Feeley, Thomas W; Frank, Steven J

2016-01-01

Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. Patients with low-risk PCa treated with low-dose-rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to 1 year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. A total of 238 men were eligible for analysis. Median age was 64 (range, 46-81). Median followup was 5 years (0.5-12.1). There were no acute Grade 3-5 complications. Expanded Prostate Cancer Index Composite 50 scores were favorable, with no clinically significant changes from baseline to last followup at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. We successfully created a visual framework to define the value of PBT using the International Consortium for Health Outcomes Measurement standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Low-Cost Charged-Coupled Device (CCD) Based Detectors for Shiga Toxins Activity Analysis.

PubMed

Rasooly, Reuven; Prickril, Ben; Bruck, Hugh A; Rasooly, Avraham

2017-01-01

To improve food safety there is a need to develop simple, low-cost sensitive devices for detection of food-borne pathogens and their toxins. We describe a simple, low-cost webcam-based detector which can be used for various optical detection modalities, including fluorescence, chemiluminescence, densitometry, and colorimetric assays. The portable battery-operated CCD-based detection system consists of four modules: (1) a webcam to measure and record light emission, (2) a sample plate to perform assays, (3) a light emitting diode (LED) for illumination, and (4) a portable computer to acquire and analyze images. To demonstrate the technology, we used a cell based assay for fluorescence detection of the activity of the food borne Shiga toxin type 2 (Stx2), differentiating between biologically active toxin and inactive toxin which is not a risk. The assay is based on Shiga toxin inhibition of cell protein synthesis measured through inhibition of the green fluorescent protein (GFP). In this assay, GFP emits light at 509 nm when excited with a blue LED equipped with a filter at 486 nm. The emitted light is then detected with a green filter at 535 nm. Toxin activity is measured through a reduction in the 509 nm emission. In this system the level of detection (LOD) for Stx2 was 0.1 pg/ml, similar to the LOD of commercial fluorometers. These results demonstrate the utility and potential of low cost detectors for toxin activity. This approach could be readily adapted to the detection of other food-borne toxins.

Removal performance of elemental mercury by low-cost adsorbents prepared through facile methods of carbonisation and activation of coconut husk.

PubMed

Johari, Khairiraihanna; Alias, Afidatul Shazwani; Saman, Norasikin; Song, Shiow Tien; Mat, Hanapi

2015-01-01

The preparation of chars and activated carbon as low-cost elemental mercury adsorbents was carried out through the carbonisation of coconut husk (pith and fibre) and the activation of chars with potassium hydroxide (KOH), respectively. The synthesised adsorbents were characterised by using scanning electron microscopy, Fourier transform infrared spectroscopy and nitrogen adsorption/desorption analysis. The elemental mercury removal performance was measured using a conventional flow type packed-bed adsorber. The physical and chemical properties of the adsorbents changed as a result of the carbonisation and activation process, hence affecting on the extent of elemental mercury adsorption. The highest elemental mercury (Hg°) adsorption capacity was obtained for the CP-CHAR (3142.57 µg g(-1)), which significantly outperformed the pristine and activated carbon adsorbents, as well as higher than some adsorbents reported in the literature. © The Author(s) 2014.

The cost to successfully apply for level 3 medical home recognition

PubMed Central

Mottus, Kathleen; Reiter, Kristin; Mitchell, C. Madeline; Donahue, Katrina E.; Gabbard, Wilson M.; Gush, Kimberly

2016-01-01

BACKGROUND The NCQA Patient Centered Medical Home (PCMH) recognition program provides practices an opportunity to implement Medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. METHODS Practice coaches identified 5 exemplar practices that received level 3 recognition (3 pediatric and 2 family medicine practices). This analysis focuses on 4 that received 2011 recognition. Clinical, informatics and administrative staff participated in 2–3 hour interviews. We collected the time required to develop, implement and maintain required activities. We categorized costs as: 1) non-personnel, 2) developmental 3) those to implement activities 4) those to maintain activities, 5) those to document the work and 6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent provider (pFTE) RESULTS Practice size ranged from 2.5 – 10.5 pFTE’s, payer mixes from 7–43 % Medicaid. There was variation in the distribution of costs by activity by practice; but the costs to apply were remarkably similar ($11,453–$15,977 pFTE). CONCLUSION The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low value activities could benefit practices. PMID:26769879

Application of Microchip Electrophoresis for Clinical Tests

NASA Astrophysics Data System (ADS)

Yatsushiro, Shouki; Kataoka, Masatoshi

Microchip electrophoresis has recently attracted much attention in the field of nuclear acid analysis due to its high efficiency, ease of operation, low consumption of samples and reagents, and relatively low costs. In addition, the analysis has expanded to an analytical field like not only the analysis of DNA but also the analysis of RNA, the protein, the sugar chain, and the cellular function, etc. In this report, we showed that high-performance monitoring systems for human blood glucose levels and α-amylase activity in human plasma using microchip electrophoresis.

Low Budget Biology. A Collection of Low Cost Labs and Activities.

ERIC Educational Resources Information Center

Wartski, Bert; Wartski, Lynn Marie

This document contains a collection of low cost labs and activities. The activities are organized into the following units: Chemistry; Microbiology; DNA to Chromosomes; Genetics; Evolution; Classification, Protist, and Fungus; Plant; Invertebrate; Human Biology; and Ecology and Miscellaneous. Some of the activities within these units include: (1)…

The cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer.

PubMed

Lao, Chunhuan; Edlin, Richard; Rouse, Paul; Brown, Charis; Holmes, Michael; Gilling, Peter; Lawrenson, Ross

2017-08-08

Radical prostatectomy is the most common treatment for localised prostate cancer in New Zealand. Active surveillance was introduced to prevent overtreatment and reduce costs while preserving the option of radical prostatectomy. This study aims to evaluate the cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy. Markov models were constructed to estimate the life-time cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer patients aged 45-70 years, using national datasets in New Zealand and published studies including the SPCG-4 study. This study was from the perspective of the Ministry of Health in New Zealand. Radical prostatectomy is less costly than active surveillance in men aged 45-55 years with low risk localised prostate cancer, but more costly for men aged 60-70 years. Scenario analyses demonstrated significant uncertainty as to the most cost-effective option in all age groups because of the unavailability of good quality of life data for men under active surveillance. Uncertainties around the likelihood of having radical prostatectomy when managed with active surveillance also affect the cost-effectiveness of active surveillance against radical prostatectomy. Active surveillance is less likely to be cost-effective compared to radical prostatectomy for younger men diagnosed with low risk localised prostate cancer. The cost-effectiveness of active surveillance compared to radical prostatectomy is critically dependent on the 'trigger' for radical prostatectomy and the quality of life in men on active surveillance. Research on the latter would be beneficial.

A Web-Based Physical Activity Intervention for Spanish-Speaking Latinas: A Costs and Cost-Effectiveness Analysis.

PubMed

Larsen, Britta; Marcus, Bess; Pekmezi, Dori; Hartman, Sheri; Gilmer, Todd

2017-02-22

Latinas report particularly low levels of physical activity and suffer from greater rates of lifestyle-related conditions such as obesity and diabetes. Interventions are needed that can increase physical activity in this growing population in a large-scale, cost-effective manner. Web-based interventions may have potential given the increase in Internet use among Latinas and the scalability of Web-based programs. To examine the costs and cost-effectiveness of a Web-based, Spanish-language physical activity intervention for Latinas compared to a wellness contact control. Healthy adult Latina women (N=205) were recruited from the community and randomly assigned to receive a Spanish-language, Web-based, individually tailored physical activity intervention (intervention group) or were given access to a website with content on wellness topics other than physical activity (control group). Physical activity was measured using the 7-Day Physical Activity Recall interview and ActiGraph accelerometers at baseline, 6 months (ie, postintervention), and 12 months (ie, maintenance phase). Costs were estimated from a payer perspective and included all features necessary to implement the intervention in a community setting, including staff time (ie, wages, benefits, and overhead), materials, hardware, website hosting, and routine website maintenance. At 6 months, the costs of running the intervention and control groups were US $17 and US $8 per person per month, respectively. These costs fell to US $12 and US $6 per person per month at 12 months, respectively. Linear interpolation showed that intervention participants increased their physical activity by 1362 total minutes at 6 months (523 minutes by accelerometer) compared to 715 minutes for control participants (186 minutes by accelerometer). At 6 months, each minute increase in physical activity for the intervention group cost US $0.08 (US $0.20 by accelerometer) compared to US $0.07 for control participants (US $0.26 by accelerometer). Incremental cost-per-minute increases associated with the intervention were US $0.08 at 6 months and US $0.04 at 12 months (US $0.16 and US $0.08 by accelerometer, respectively). Sensitivity analyses showed variations in staffing costs or intervention effectiveness yielded only modest changes in incremental costs. While the Web-based physical activity intervention was more expensive than the wellness control, both were quite low cost compared to face-to-face or mail-delivered interventions. Cost-effectiveness ranged markedly based on physical activity measure and was similar between the two conditions. Overall, the Web-based intervention was effective and low cost, suggesting a promising channel for increasing physical activity on a large scale in this at-risk population. Clinicaltrials.gov NCT01834287; https://clinicaltrials.gov/ct2/show/NCT01834287 (Archived by WebCite at http://www.webcitation.org/6nyjX9Jrh). ©Britta Larsen, Bess Marcus, Dori Pekmezi, Sheri Hartman, Todd Gilmer. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.02.2017.

A Web-Based Physical Activity Intervention for Spanish-Speaking Latinas: A Costs and Cost-Effectiveness Analysis

PubMed Central

Marcus, Bess; Pekmezi, Dori; Hartman, Sheri; Gilmer, Todd

2017-01-01

Background Latinas report particularly low levels of physical activity and suffer from greater rates of lifestyle-related conditions such as obesity and diabetes. Interventions are needed that can increase physical activity in this growing population in a large-scale, cost-effective manner. Web-based interventions may have potential given the increase in Internet use among Latinas and the scalability of Web-based programs. Objective To examine the costs and cost-effectiveness of a Web-based, Spanish-language physical activity intervention for Latinas compared to a wellness contact control. Methods Healthy adult Latina women (N=205) were recruited from the community and randomly assigned to receive a Spanish-language, Web-based, individually tailored physical activity intervention (intervention group) or were given access to a website with content on wellness topics other than physical activity (control group). Physical activity was measured using the 7-Day Physical Activity Recall interview and ActiGraph accelerometers at baseline, 6 months (ie, postintervention), and 12 months (ie, maintenance phase). Costs were estimated from a payer perspective and included all features necessary to implement the intervention in a community setting, including staff time (ie, wages, benefits, and overhead), materials, hardware, website hosting, and routine website maintenance. Results At 6 months, the costs of running the intervention and control groups were US $17 and US $8 per person per month, respectively. These costs fell to US $12 and US $6 per person per month at 12 months, respectively. Linear interpolation showed that intervention participants increased their physical activity by 1362 total minutes at 6 months (523 minutes by accelerometer) compared to 715 minutes for control participants (186 minutes by accelerometer). At 6 months, each minute increase in physical activity for the intervention group cost US $0.08 (US $0.20 by accelerometer) compared to US $0.07 for control participants (US $0.26 by accelerometer). Incremental cost-per-minute increases associated with the intervention were US $0.08 at 6 months and US $0.04 at 12 months (US $0.16 and US $0.08 by accelerometer, respectively). Sensitivity analyses showed variations in staffing costs or intervention effectiveness yielded only modest changes in incremental costs. Conclusions While the Web-based physical activity intervention was more expensive than the wellness control, both were quite low cost compared to face-to-face or mail-delivered interventions. Cost-effectiveness ranged markedly based on physical activity measure and was similar between the two conditions. Overall, the Web-based intervention was effective and low cost, suggesting a promising channel for increasing physical activity on a large scale in this at-risk population. ClinicalTrial Clinicaltrials.gov NCT01834287; https://clinicaltrials.gov/ct2/show/NCT01834287 (Archived by WebCite at http://www.webcitation.org/6nyjX9Jrh) PMID:28228368

Innovative approach for low-cost quick-access small payload missions

NASA Astrophysics Data System (ADS)

Friis, Jan W., Jr.

2000-11-01

A significant part of the burgeoning commercial space industry is placing an unprecedented number of satellites into low earth orbit for a variety of new applications and services. By some estimates the commercial space industry now exceeds that of government space activities. Yet the two markets remain largely separate, with each deploying dedicated satellites and infrastructure for their respective missions. One commercial space firm, Final Analysis, has created a new program wherein either government, scientific or new technology payloads can be integrated on a commercial spacecraft on commercial satellites for a variety of mission scenarios at a fraction of the cost of a dedicated mission. NASA has recognized the advantage of this approach, and has awarded the Quick Ride program to provide frequent, low cost flight opportunities for small independent payloads aboard the Final Analysis constellation, and investigators are rapidly developing science programs that conform to the proposed payload accommodations envelope. Missions that were not feasible using dedicated launches are now receiving approval under the lower cost Quick Ride approach. Final Analysis has dedicated ten out of its thirty-eight satellites in support of the Quick Ride efforts. The benefit of this type of space access extend beyond NASA science programs. Commercial space firms can now gain valuable flight heritage for new technology and satellite product offerings. Further, emerging international space programs can now place a payload in orbit enabling the country to allocate its resources against the payload and mission requirements rather htan increased launch costs of a dedicated spacecraft. Finally, the low cost nature provides University-based research educational opportunities previously out of the reach of most space-related budgets. This paper will describe the motivation, benefits, technical features, and program costs of the Final Analysis secondary payload program. Payloads can be accommodated on up to thirty-eight separate satellites. Since the secondary payloads will fly on satellites designed for global wireless data services, each user can utilize low cost communication system already in place for sending and retrieving digital information from its payload.

Economic Analysis of Classical Swine Fever Surveillance in the Netherlands.

PubMed

Guo, X; Claassen, G D H; Oude Lansink, A G J M; Loeffen, W; Saatkamp, H W

2016-06-01

Classical swine fever (CSF) is a highly contagious pig disease that causes economic losses and impaired animal welfare. Improving the surveillance system for CSF can help to ensure early detection of the virus, thereby providing a better initial situation for controlling the disease. Economic analysis is required to compare the benefits of improved surveillance with the costs of implementing a more intensive system. This study presents a comprehensive economic analysis of CSF surveillance in the Netherlands, taking into account the specialized structure of Dutch pig production, differences in virulence of CSF strains and a complete list of possible surveillance activities. The starting point of the analysis is the current Dutch surveillance system (i.e. the default surveillance-setup scenario), including the surveillance activities 'daily clinical observation by the farmer', 'veterinarian inspection after a call', 'routine veterinarian inspection', 'pathology in AHS', 'PCR on tonsil in AHS', 'PCR on grouped animals in CVI' and 'confirmatory PCR by NVWA'. Alternative surveillance-setup scenarios were proposed by adding 'routine serology in slaughterhouses', 'routine serology on sow farms' and 'PCR on rendered animals'. The costs and benefits for applying the alternative surveillance-setup scenarios were evaluated by comparing the annual mitigated economic losses because of intensified CSF surveillance with the annual additional surveillance costs. The results of the cost-effectiveness analysis show that the alternative surveillance-setup scenarios with 'PCR on rendered animals' are effective for the moderately virulent CSF strain, whereas the scenarios with 'routine serology in slaughterhouses' or 'routine serology on sow farms' are effective for the low virulent strain. Moreover, the current CSF surveillance system in the Netherlands is cost-effective for both moderately virulent and low virulent CSF strains. The results of the cost-benefit analysis for the moderately virulent CSF strain indicate that the current surveillance system in the Netherlands is adequate. From an economic perspective, there is little to be gained from intensifying surveillance. © 2014 Blackwell Verlag GmbH.

Empirical and Genealogical Analysis of Non-Vocational Adult Education in Europe

ERIC Educational Resources Information Center

Manninen, Jyri

2017-01-01

Non-formal, non-vocational adult education (NFNVAE) is a low-cost, low-threshold learning activity that generates many benefits for individuals and society, and it should play a more central role in educational policy. NFNVAE's challenge is that it lacks clear concepts and definitions and is, therefore, less systematically covered in statistics,…

Cost-effectiveness analysis of granisetron-based versus standard antiemetic regimens in low-emetogenic chemotherapy: a hospital-based perspective from Malaysia.

PubMed

Keat, Chan Huan; Ghani, Norazila Abdul

2013-01-01

In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

Performance and cost characteristics of multi-electron transfer, common ion exchange non-aqueous redox flow batteries

NASA Astrophysics Data System (ADS)

Laramie, Sydney M.; Milshtein, Jarrod D.; Breault, Tanya M.; Brushett, Fikile R.; Thompson, Levi T.

2016-09-01

Non-aqueous redox flow batteries (NAqRFBs) have recently received considerable attention as promising high energy density, low cost grid-level energy storage technologies. Despite these attractive features, NAqRFBs are still at an early stage of development and innovative design techniques are necessary to improve performance and decrease costs. In this work, we investigate multi-electron transfer, common ion exchange NAqRFBs. Common ion systems decrease the supporting electrolyte requirement, which subsequently improves active material solubility and decreases electrolyte cost. Voltammetric and electrolytic techniques are used to study the electrochemical performance and chemical compatibility of model redox active materials, iron (II) tris(2,2‧-bipyridine) tetrafluoroborate (Fe(bpy)3(BF4)2) and ferrocenylmethyl dimethyl ethyl ammonium tetrafluoroborate (Fc1N112-BF4). These results help disentangle complex cycling behavior observed in flow cell experiments. Further, a simple techno-economic model demonstrates the cost benefits of employing common ion exchange NAqRFBs, afforded by decreasing the salt and solvent contributions to total chemical cost. This study highlights two new concepts, common ion exchange and multi-electron transfer, for NAqRFBs through a demonstration flow cell employing model active species. In addition, the compatibility analysis developed for asymmetric chemistries can apply to other promising species, including organics, metal coordination complexes (MCCs) and mixed MCC/organic systems, enabling the design of low cost NAqRFBs.

A Cost-Effectiveness Analysis of Seminatural Wetlands and Activated Sludge Wastewater-Treatment Systems

NASA Astrophysics Data System (ADS)

Mannino, Ilda; Franco, Daniel; Piccioni, Enrico; Favero, Laura; Mattiuzzo, Erika; Zanetto, Gabriele

2008-01-01

A cost-effectiveness analysis was performed to evaluate the competitiveness of seminatural Free Water Surface (FWS) wetlands compared to traditional wastewater-treatment plants. Six scenarios of the service costs of three FWS wetlands and three different wastewater-treatment plants based on active sludge processes were compared. The six scenarios were all equally effective in their wastewater-treatment capacity. The service costs were estimated using real accounting data from an experimental wetland and by means of a market survey. Some assumptions had to be made to perform the analysis. A reference wastewater situation was established to solve the problem of the different levels of dilution that characterize the inflow water of the different systems; the land purchase cost was excluded from the analysis, considering the use of public land as shared social services, and an equal life span for both seminatural and traditional wastewater-treatment plants was set. The results suggest that seminatural systems are competitive with traditional biotechnological systems, with an average service cost improvement of 2.1-fold to 8-fold, according to the specific solution and discount rate. The main improvement factor was the lower maintenance cost of the seminatural systems, due to the self-regulating, low artificial energy inputs and the absence of waste to be disposed. In this work, only the waste-treatment capacity of wetlands was considered as a parameter for the economic competitiveness analysis. Other goods/services and environmental benefits provided by FWS wetlands were not considered.

A cost-effectiveness analysis of seminatural wetlands and activated sludge wastewater-treatment systems.

PubMed

Mannino, Ilda; Franco, Daniel; Piccioni, Enrico; Favero, Laura; Mattiuzzo, Erika; Zanetto, Gabriele

2008-01-01

A cost-effectiveness analysis was performed to evaluate the competitiveness of seminatural Free Water Surface (FWS) wetlands compared to traditional wastewater-treatment plants. Six scenarios of the service costs of three FWS wetlands and three different wastewater-treatment plants based on active sludge processes were compared. The six scenarios were all equally effective in their wastewater-treatment capacity. The service costs were estimated using real accounting data from an experimental wetland and by means of a market survey. Some assumptions had to be made to perform the analysis. A reference wastewater situation was established to solve the problem of the different levels of dilution that characterize the inflow water of the different systems; the land purchase cost was excluded from the analysis, considering the use of public land as shared social services, and an equal life span for both seminatural and traditional wastewater-treatment plants was set. The results suggest that seminatural systems are competitive with traditional biotechnological systems, with an average service cost improvement of 2.1-fold to 8-fold, according to the specific solution and discount rate. The main improvement factor was the lower maintenance cost of the seminatural systems, due to the self-regulating, low artificial energy inputs and the absence of waste to be disposed. In this work, only the waste-treatment capacity of wetlands was considered as a parameter for the economic competitiveness analysis. Other goods/services and environmental benefits provided by FWS wetlands were not considered.

Rethinking the cost of healthcare in low-resource settings: the value of time-driven activity-based costing

PubMed Central

McBain, Ryan K; Jerome, Gregory; Warsh, Jonathan; Browning, Micaela; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Rhatigan, Joseph; Leandre, Fernet; Kaplan, Robert

2016-01-01

Low-income and middle-income countries account for over 80% of the world's infectious disease burden, but <20% of global expenditures on health. In this context, judicious resource allocation can mean the difference between life and death, not just for individual patients, but entire patient populations. Understanding the cost of healthcare delivery is a prerequisite for allocating health resources, such as staff and medicines, in a way that is effective, efficient, just and fair. Nevertheless, health costs are often poorly understood, undermining effectiveness and efficiency of service delivery. We outline shortcomings, and consequences, of common approaches to estimating the cost of healthcare in low-resource settings, as well as advantages of a newly introduced approach in healthcare known as time-driven activity-based costing (TDABC). TDABC is a patient-centred approach to cost analysis, meaning that it begins by studying the flow of individual patients through the health system, and measuring the human, equipment and facility resources used to treat the patients. The benefits of this approach are numerous: fewer assumptions need to be made, heterogeneity in expenditures can be studied, service delivery can be modelled and streamlined and stronger linkages can be established between resource allocation and health outcomes. TDABC has demonstrated significant benefits for improving health service delivery in high-income countries but has yet to be adopted in resource-limited settings. We provide an illustrative case study of its application throughout a network of hospitals in Haiti, as well as a simplified framework for policymakers to apply this approach in low-resource settings around the world. PMID:28588971

Rethinking the cost of healthcare in low-resource settings: the value of time-driven activity-based costing.

PubMed

McBain, Ryan K; Jerome, Gregory; Warsh, Jonathan; Browning, Micaela; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Rhatigan, Joseph; Leandre, Fernet; Kaplan, Robert

2016-01-01

Low-income and middle-income countries account for over 80% of the world's infectious disease burden, but <20% of global expenditures on health. In this context, judicious resource allocation can mean the difference between life and death, not just for individual patients, but entire patient populations. Understanding the cost of healthcare delivery is a prerequisite for allocating health resources, such as staff and medicines, in a way that is effective, efficient, just and fair. Nevertheless, health costs are often poorly understood, undermining effectiveness and efficiency of service delivery. We outline shortcomings, and consequences, of common approaches to estimating the cost of healthcare in low-resource settings, as well as advantages of a newly introduced approach in healthcare known as time-driven activity-based costing (TDABC). TDABC is a patient-centred approach to cost analysis, meaning that it begins by studying the flow of individual patients through the health system, and measuring the human, equipment and facility resources used to treat the patients. The benefits of this approach are numerous: fewer assumptions need to be made, heterogeneity in expenditures can be studied, service delivery can be modelled and streamlined and stronger linkages can be established between resource allocation and health outcomes. TDABC has demonstrated significant benefits for improving health service delivery in high-income countries but has yet to be adopted in resource-limited settings. We provide an illustrative case study of its application throughout a network of hospitals in Haiti, as well as a simplified framework for policymakers to apply this approach in low-resource settings around the world.

Postoperative costs associated with outcomes after cardiac surgery with extracorporeal circulation: role of antithrombin levels.

PubMed

Muedra, Vicente; Llau, Juan V; Llagunes, José; Paniagua, Pilar; Veiras, Sonia; Fernández-López, Antonio R; Diago, Carmen; Hidalgo, Francisco; Gil, Jesús; Valiño, Cristina; Moret, Enric; Gómez, Laura; Pajares, Azucena; de Prada, Blanca

2013-04-01

To study the impact on postoperative costs of a patient's antithrombin levels associated with outcomes after cardiac surgery with extracorporeal circulation. An analytic decision model was designed to estimate costs and clinical outcomes after cardiac surgery in a typical patient with low antithrombin levels (<63.7%) compared with a patient with normal antithrombin levels (≥63.7%). The data used in the model were obtained from a literature review and subsequently validated by a panel of experts in cardiothoracic anesthesiology. Multi-institutional (14 Spanish hospitals). Consultant anesthesiologists. A sensitivity analysis of extreme scenarios was carried out to assess the impact of the major variables in the model results. The average cost per patient was €18,772 for a typical patient with low antithrombin levels and €13,881 for a typical patient with normal antithrombin levels. The difference in cost was due mainly to the longer hospital stay of a patient with low antithrombin levels compared with a patient with normal levels (13 v 10 days, respectively, representing a €4,596 higher cost) rather than to costs related to the management of postoperative complications (€215, mostly owing to transfusions). Sensitivity analysis showed a high variability range of approximately ±55% of the base case cost between the minimum and maximum scenarios, with the hospital stay contributing more significantly to the variation. Based on this analytic decision model, there could be a marked increase in the postoperative costs of patients with low antithrombin activity levels at the end of cardiac surgery, mainly ascribed to a longer hospitalization. Copyright © 2013 Elsevier Inc. All rights reserved.

Cost analysis of large-scale implementation of the 'Helping Babies Breathe' newborn resuscitation-training program in Tanzania.

PubMed

Chaudhury, Sumona; Arlington, Lauren; Brenan, Shelby; Kairuki, Allan Kaijunga; Meda, Amunga Robson; Isangula, Kahabi G; Mponzi, Victor; Bishanga, Dunstan; Thomas, Erica; Msemo, Georgina; Azayo, Mary; Molinier, Alice; Nelson, Brett D

2016-12-01

Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). Within Mbeya, 49 training sessions were undertaken, involving the training of 1,341 health providers from 336 health facilities in eight districts. To similarly expand the HBB program across the 25 regions of mainland Tanzania, the total economic cost is projected to be around $4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between $2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost $2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention.

Convoy Active Safety Technology - Environmental Understanding and Navigation With Use of Low Cost Sensors

DTIC Science & Technology

2012-08-01

ACTIVE SAFETY TECHNOLOGY – ENVIRONMENTAL UNDERSTANDING AND NAVIGATION WITH USE OF LOW COST SENSORS David Simon Lockheed Martin MFC, Grand Prairie, TX...Understanding and Navigation with use of low cost sensors 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) David Simon ; Bernard

The Cost to Successfully Apply for Level 3 Medical Home Recognition.

PubMed

Halladay, Jacqueline R; Mottus, Kathleen; Reiter, Kristin; Mitchell, C Madeline; Donahue, Katrina E; Gabbard, Wilson M; Gush, Kimberly

2016-01-01

The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. Practice coaches identified 5 exemplar practices (3 pediatric and 2 family medicine practices) that received level 3 recognition. This analysis focuses on 4 that received recognition in 2011. Clinical, informatics, and administrative staff participated in 2- to 3-hour interviews. We determined the time required to develop, implement, and maintain required activities. We categorized costs as (1) nonpersonnel, (2) developmental, (3) those used to implement activities, (4) those used to maintain activities, (5) those to document the work, and (6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent (pFTE) provider. Practice size ranged from 2.5 to 10.5 pFTE providers, and payer mixes ranged from 7% to 43% Medicaid. There was variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar ($11,453-15,977 pFTE provider). The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low-value activities could benefit practices. © Copyright 2016 by the American Board of Family Medicine.

Costs and effects in lumbar spinal fusion. A follow-up study in 136 consecutive patients with chronic low back pain

PubMed Central

Christensen, Finn Bjarke; Christiansen, Terkel; Bünger, Cody

2006-01-01

Although cost-effectiveness is becoming the foremost evaluative criterion within health service management of spine surgery, scientific knowledge about cost-patterns and cost-effectiveness is limited. The aims of this study were (1) to establish an activity-based method for costing at the patient-level, (2) to investigate the correlation between costs and effects, (3) to investigate the influence of selected patient characteristics on cost-effectiveness and, (4) to investigate the incremental cost-effectiveness ratio of (a) posterior instrumentation and (b) intervertebral anterior support in lumbar spinal fusion. We hypothesized a positive correlation between costs and effects, that determinants of effects would also determine cost-effectiveness, and that posterolateral instrumentation and anterior intervertebral support are cost-effective adjuncts in posterolateral lumbar fusion. A cohort of 136 consecutive patients with chronic low back pain, who were surgically treated from January 2001 through January 2003, was followed until 2 years postoperatively. Operations took place at University Hospital of Aarhus and all patients had either (1) non-instrumented posterolateral lumbar spinal fusion, (2) instrumented posterolateral lumbar spinal fusion, or (3) instrumented posterolateral lumbar spinal fusion + anterior intervertebral support. Analysis of costs was performed at the patient-level, from an administrator’s perspective, by means of Activity-Based-Costing. Clinical effects were measured by means of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted analysis (for non-random allocation of patients) was performed in order to reveal the incremental cost-effectiveness ratios of (a) posterior instrumentation and (b) anterior support. The costs of non-instrumented posterolateral spinal fusion were estimated at DKK 88,285(95% CI 81,369;95,546), instrumented posterolateral spinal fusion at DKK 94,396(95% CI 89,865;99,574) and instrumented posterolateral lumbar spinal fusion + anterior intervertebral support at DKK 120,759(95% CI 111,981;133,738). The net-benefit of the regimens was significantly affected by smoking and functional disability in psychosocial life areas. Multi-level fusion and surgical technique significantly affected the net-benefit as well. Surprisingly, no correlation was found between treatment costs and treatment effects. Incremental analysis suggested that the probability of posterior instrumentation being cost-effective was limited, whereas the probability of anterior intervertebral support being cost-effective escalates as willingness-to-pay per effect unit increases. This study reveals useful and hitherto unknown information both about cost-patterns at the patient-level and determinants of cost-effectiveness. The overall conclusion of the present investigation is a recommendation to focus further on determinants of cost-effectiveness. For example, patient characteristics that are modifiable at a relatively low expense may have greater influence on cost-effectiveness than the surgical technique itself—at least from an administrator’s perspective. PMID:16871387

Evaluation of the Effects of Physical Activity, Cardiorespiratory Condition, and Neuromuscular Fitness on Direct Healthcare Costs and Sickness-Related Absence Among Nursing Personnel With Recurrent Nonspecific Low Back Pain.

PubMed

Kolu, Päivi; Tokola, Kari; Kankaanpää, Markku; Suni, Jaana

2017-06-01

A cross-sectional study, part of a randomized controlled trial. To evaluate the association of physical activity, cardiorespiratory fitness, and neuromuscular fitness with direct healthcare costs and sickness-related absence among nursing personnel with nonspecific low back pain. Low back pain creates a huge economic burden due to increased sick leave and use of healthcare services. Female nursing personnel with nonspecific low back pain were included (n = 219). Physical activity was assessed with accelerometry and a questionnaire. In addition, measurements of cardiorespiratory and muscular fitness were conducted. Direct costs and sickness-related absence for a 6-month period were collected retrospectively by questionnaire. Health care utilization and absence from work were analyzed with a general linear model. The mean total costs were 80.5% lower among women who met physical activity recommendations than inactive women. Those with a higher mean daily intensity level of 10-minute activity sessions showed lower total costs than women in the lowest tertile (middle: 64.0% of the lowest; highest: 54.3% of the lowest). Women with good cardiorespiratory fitness (the highest tertile) as measured with the 6-minute-walk test (based on walking distance) had 77.0% lower total costs when compared with the lowest tertile. Women in the highest third for the modified push-up test had 84.0% lower total costs than those with the poorest results (the bottom tertile). High cardiorespiratory and muscular fitness and meeting physical activity recommendations for aerobic and muscular fitness were strongly associated with lower total costs among nursing personnel with pain-related disorders of recurrent nonspecific low back pain. Actions to increase physical activity and muscle conditioning may significantly save on healthcare costs and decrease sick-leave costs due to low back pain.

Risk assessment and management of brucellosis in the southern greater Yellowstone area (II): Cost-benefit analysis of reducing elk brucellosis prevalence.

PubMed

Boroff, Kari; Kauffman, Mandy; Peck, Dannele; Maichak, Eric; Scurlock, Brandon; Schumaker, Brant

2016-11-01

Recent cases of bovine brucellosis (Brucella abortus) in cattle (Bos taurus) and domestic bison (Bison bison) of the southern Greater Yellowstone Area (SGYA) have been traced back to free-ranging elk (Cervus elaphus). Several management activities have been implemented to reduce brucellosis seroprevalence in elk, including test-and-slaughter, low-density feeding at elk winter feedgrounds, and elk vaccination. It is unclear which of these activities are most cost-effective at reducing the risk of elk transmitting brucellosis to cattle. In a companion paper, a stochastic risk model was used to translate a reduction in elk seroprevalence to a reduction in the risk of transmission to cattle. Here, we use those results to estimate the expected economic benefits and costs of reducing seroprevalence in elk using three different management activities: vaccination of elk with Brucella strain 19 (S19), low-density feeding of elk, and elk test-and-slaughter. Results indicate that the three elk management activities yield negative expected net benefits, ranging from -$2983 per year for low-density feeding to -$595,471 per year for test-and-slaughter. Society's risk preferences will determine whether strategies that generate small negative net benefit, such as low-density feeding, are worth implementing. However, activities with large negative net benefits, such as test-and-slaughter and S19 vaccination, are unlikely to be economically worthwhile. Given uncertainty about various model parameters, we identify some circumstances in which individual management activities might generate positive expected net benefit. Copyright © 2016 Elsevier B.V. All rights reserved.

Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

PubMed

Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Low-cost bioanalysis on paper-based and its hybrid microfluidic platforms.

PubMed

Dou, Maowei; Sanjay, Sharma Timilsina; Benhabib, Merwan; Xu, Feng; Li, XiuJun

2015-12-01

Low-cost assays have broad applications ranging from human health diagnostics and food safety inspection to environmental analysis. Hence, low-cost assays are especially attractive for rural areas and developing countries, where financial resources are limited. Recently, paper-based microfluidic devices have emerged as a low-cost platform which greatly accelerates the point of care (POC) analysis in low-resource settings. This paper reviews recent advances of low-cost bioanalysis on paper-based microfluidic platforms, including fully paper-based and paper hybrid microfluidic platforms. In this review paper, we first summarized the fabrication techniques of fully paper-based microfluidic platforms, followed with their applications in human health diagnostics and food safety analysis. Then we highlighted paper hybrid microfluidic platforms and their applications, because hybrid platforms could draw benefits from multiple device substrates. Finally, we discussed the current limitations and perspective trends of paper-based microfluidic platforms for low-cost assays. Copyright © 2015 Elsevier B.V. All rights reserved.

Fourier analysis of a vibrating string through a low-cost experimental setup and a smartphone

NASA Astrophysics Data System (ADS)

Pereyra, C. J.; Osorio, M.; Laguarda, A.; Gau, D. L.

2018-07-01

In this work we present a simple and low-cost setup to illustrate the dependence of the behaviour of a standing wave in a guitar string with the initial conditions. To do so, we impose two kinds of initial conditions; in the first instance, the initial shape of the string is varied. Secondly, different nodes are imposed on the string. This dependence was studied using the Fourier analysis of the sound produced by the vibration of the string with a smartphone. The simplicity of the proposed activity makes it suitable to be implemented in any classroom to illustrate the concept of normal modes and as an example of Fourier series in a real system that is also familiar for the students.

Activity-based costing of health-care delivery, Haiti.

PubMed

McBain, Ryan K; Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient's medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated.

Activity-based costing of health-care delivery, Haiti

PubMed Central

Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

Abstract Objective To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Methods Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient’s medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Findings Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Conclusion Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated. PMID:29403096

Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome.

PubMed

Manchikanti, Laxmaiah; Falco, Frank J E; Pampati, Vidyasagar; Cash, Kimberly A; Benyamin, Ramsin M; Hirsch, Joshua A

2013-01-01

In this era of escalating health care costs and the questionable effectiveness of multiple interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine, and has an influence coverage decisions. Even though multiple cost effectiveness analysis studies have been performed over the years, extensive literature is lacking for interventional techniques. Cost utility analysis studies of epidural injections for managing chronic low back pain demonstrated highly variable results including a lack of cost utility in randomized trials and contrasting results in observational studies. There has not been any cost utility analysis studies of epidural injections in large randomized trials performed in interventional pain management settings. To assess the cost utility of caudal epidural injections in managing chronic low back pain secondary to lumbar disc herniation, axial or discogenic low back pain, lumbar central spinal stenosis, and lumbar post surgery syndrome. This analysis is based on 4 previously published randomized trials. A private, specialty referral interventional pain management center in the United States. Four randomized trials were conducted assessing the clinical effectiveness of caudal epidural injections with or without steroids for lumbar disc herniation, lumbar discogenic or axial low back pain, lumbar central spinal stenosis, and post surgery syndrome. A cost utility analysis was performed with direct payment data for a total of 480 patients over a period of 2 years from these 4 trials. Outcome included various measures with significant improvement defined as at least a 50% improvement in pain reduction and disability status. The results of 4 randomized controlled trials of low back pain with 480 patients with a 2 year follow-up with the actual reimbursement data showed cost utility for one year of quality-adjusted life year (QALY) of $2,206 for disc herniation, $2,136 for axial or discogenic pain without disc herniation, $2,155 for central spinal stenosis, and $2,191 for post surgery syndrome. All patients showed significant improvement clinically and showed positive results in the cost utility analysis with an average cost per one year QALY of $2,172.50 for all patients and $1,966.03 for patients judged to be successful. The results of this assessment show a better cost utility or lower cost of managing chronic, intractable low back pain with caudal epidural injections at a QALY that is similar or lower in price than medical therapy only, physical therapy, manipulation, and surgery in most cases. The limitations of this cost utility analysis include that it is a single center evaluation, even though 480 patients were included in the analysis. Further, only the costs of interventional procedures and physician visits were included. The benefits of returning to work were not assessed.   This cost utility analysis of caudal epidural injections in the treatment of disc herniation, axial or discogenic low back pain, central spinal stenosis, and post surgery syndrome in the lumbar spine shows the clinical effectiveness and cost utility of these injections at less than $2,200 per one year of QALY.

A Benefit Analysis of Using a Low-Cost Flight Simulator for the MH-60R

DTIC Science & Technology

2016-09-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. A BENEFIT ...2016 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE A BENEFIT ANALYSIS OF USING A LOW- COST FLIGHT SIMULATOR FOR THE MH... BENEFIT ANALYSIS OF USING A LOW- COST FLIGHT SIMULATOR FOR THE MH-60R J. Gregory Zilai Lieutenant, United States Navy B.S., United States Naval

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

PubMed

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

2007-02-15

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

A comparison of the cost-effectiveness of two pedometer-based telephone coaching programs for people with cardiac disease.

PubMed

Sangster, Janice; Church, Jody; Haas, Marion; Furber, Susan; Bauman, Adrian

2015-05-01

Following a cardiac event it is recommended that cardiac patients participate in cardiac rehabilitation (CR) programs. However, little is known about the relative cost-effectiveness of lifestyle-related interventions for cardiac patients. This study aimed to compare the cost-effectiveness of a telephone-delivered Healthy Weight intervention to a telephone-delivered Physical Activity intervention for patients referred to CR in urban and rural Australia. A cost-utility analysis was conducted alongside a randomised controlled trial of the two interventions. Outcomes were measured as Quality Adjusted Life Years (QALYs) gained. The estimated cost of delivering the interventions was $201.48 per Healthy Weight participant and $138.00 per Physical Activity participant. The average total cost (cost of health care utilisation plus patient costs) was $1,260 per Healthy Weight participant and $2,112 per Physical Activity participant, a difference of $852 in favour of the Healthy Weight intervention. Healthy Weight participants gained an average of 0.007 additional QALYs than did Physical Activity participants. Thus, overall the Healthy Weight intervention dominated the Physical Activity intervention (Healthy Weight intervention was less costly and more effective than the Physical Activity intervention). Subgroup analyses showed the Healthy Weight intervention also dominated the Physical Activity intervention for rural participants and for participants who did not attend CR. The low-contact pedometer-based telephone coaching Healthy Weight intervention is overall both less costly and more effective compared to the Physical Activity intervention, including for rural cardiac patients and patients that do not attend CR. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Observation Versus Initial Treatment for Men With Localized, Low-Risk Prostate Cancer A Cost-Effectiveness Analysis

PubMed Central

Hayes, Julia H.; Ollendorf, Daniel A.; Pearson, Steven D.; Barry, Michael J.; Kantoff, Philip W.; Lee, Pablo A.; McMahon, Pamela M.

2015-01-01

Background Observation is underused among men with localized, low-risk prostate cancer. Objective To assess the costs and benefits of observation versus initial treatment. Design Decision analysis simulating treatment or observation. Data Sources Medicare schedules, published literature. Target Population Men ages 65 and 75 years with newly diagnosed low-risk prostate cancer (prostate-specific antigen level <10 μg/L, stage ≤T2a, Gleason score ≤3+3). Time Horizon Lifetime. Perspective Societal. Intervention Treatment (brachytherapy, intensity-modulated radiation therapy, or radical prostatectomy) or observation (active surveillance [AS] or watchful waiting [WW]). Outcome Measures Quality-adjusted life expectancy, costs. Results of Base-Case Analysis Observation was more effective and less costly than initial treatment. Compared with AS, WW provided 2 additional months of quality-adjusted life expectancy (9.02 vs. 8.85 years) at a savings of $15 374 ($24 520 vs. $39 894) in men aged 65 years and 2 additional months (6.14 vs. 5.98 years) at a savings of $11 746 ($18 302 vs. $30 048) in men aged 75 years. Brachytherapy was the most effective and least expensive initial treatment. Results of Sensitivity Analysis Treatment became more effective than observation when it led to more dramatic reductions in prostate cancer death (hazard ratio, 0.47 vs. WW and 0.64 vs. AS). Active surveillance became as effective as WW in men aged 65 years when the probability of progressing to treatment on AS decreased below 63% or when the quality of life with AS versus WW was 4% higher in men aged 65 years or 1% higher in men aged 75 years. Watchful waiting remained least expensive in all analyses. Limitation Results depend on outcomes reported in the published literature, which is limited. Conclusion Among these men, observation is more effective and costs less than initial treatment, and WW is most effective and least expensive under a wide range of clinical scenarios. Primary Funding Source National Cancer Institute, U.S. Department of Defense, Prostate Cancer Foundation, and Blue Shield of California Foundation. PMID:23778902

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.

Impact of low cost refurbishable and standard spacecraft upon future NASA space programs. Payload effects follow-on study, appendix

NASA Technical Reports Server (NTRS)

1972-01-01

Mission analysis is discussed, including the consolidation and expansion of mission equipment and experiment characteristics, and determination of simplified shuttle flight schedule. Parametric analysis of standard space hardware and preliminary shuttle/payload constraints analysis are evaluated, along with the cost impact of low cost standard hardware.

Resource requirements for cancer registration in areas with limited resources: Analysis of cost data from four low- and middle-income countries☆

PubMed Central

Tangka, Florence K.L.; Subramanian, Sujha; Edwards, Patrick; Cole-Beebe, Maggie; Parkin, D. Maxwell; Bray, Freddie; Joseph, Rachael; Mery, Les; Saraiya, Mona

2018-01-01

Background The key aims of this study were to identify sources of support for cancer registry activities, to quantify resource use and estimate costs to operate registries in low- and middle-income countries (LMIC) at different stages of development across three continents. Methods Using the Centers for Disease Control and Prevention’s (CDC’s) International Registry Costing Tool (IntRegCosting Tool), cost and resource use data were collected from eight population-based cancer registries, including one in a low-income country (Uganda [Kampala)]), two in lower to middle-income countries (Kenya [Nairobi] and India [Mumbai]), and five in an upper to middle-income country (Colombia [Pasto, Barranquilla, Bucaramanga, Manizales and Cali cancer registries]). Results Host institution contributions accounted for 30%–70% of total investment in cancer registry activities. Cancer registration involves substantial fixed cost and labor. Labor accounts for more than 50% of all expenditures across all registries. The cost per cancer case registered in low-income and lower-middle-income countries ranged from US $3.77 to US $15.62 (United States dollars). In Colombia, an upper to middle-income country, the cost per case registered ranged from US $41.28 to US $113.39. Registries serving large populations (over 15 million inhabitants) had a lower cost per inhabitant (less than US $0.01 in Mumbai, India) than registries serving small populations (under 500,000 inhabitants) [US $0.22] in Pasto, Colombia. Conclusion This study estimates the total cost and resources used for cancer registration across several countries in the limited-resource setting, and provides cancer registration stakeholders and registries-with opportunities to identify cost savings and efficiency improvements. Our results suggest that cancer registration involve substantial fixed costs and labor, and that partnership with other institutions is critical for the operation and sustainability of cancer registries in limited resource settings. Although we included registries from a variety of limited-resource areas, information from eight registries in four countries may not be large enough to capture all the potential differences among the registries in limited-resource settings. PMID:27793574

Resource requirements for cancer registration in areas with limited resources: Analysis of cost data from four low- and middle-income countries.

PubMed

Tangka, Florence K L; Subramanian, Sujha; Edwards, Patrick; Cole-Beebe, Maggie; Parkin, D Maxwell; Bray, Freddie; Joseph, Rachael; Mery, Les; Saraiya, Mona

2016-12-01

The key aims of this study were to identify sources of support for cancer registry activities, to quantify resource use and estimate costs to operate registries in low- and middle-income countries (LMIC) at different stages of development across three continents. Using the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool (IntRegCosting Tool), cost and resource use data were collected from eight population-based cancer registries, including one in a low-income country (Uganda [Kampala)]), two in lower to middle-income countries (Kenya [Nairobi] and India [Mumbai]), and five in an upper to middle-income country (Colombia [Pasto, Barranquilla, Bucaramanga, Manizales and Cali cancer registries]). Host institution contributions accounted for 30%-70% of total investment in cancer registry activities. Cancer registration involves substantial fixed cost and labor. Labor accounts for more than 50% of all expenditures across all registries. The cost per cancer case registered in low-income and lower-middle-income countries ranged from US $3.77 to US $15.62 (United States dollars). In Colombia, an upper to middle-income country, the cost per case registered ranged from US $41.28 to US $113.39. Registries serving large populations (over 15 million inhabitants) had a lower cost per inhabitant (less than US $0.01 in Mumbai, India) than registries serving small populations (under 500,000 inhabitants) [US $0.22] in Pasto, Colombia. This study estimates the total cost and resources used for cancer registration across several countries in the limited-resource setting, and provides cancer registration stakeholders and registries with opportunities to identify cost savings and efficiency improvements. Our results suggest that cancer registration involve substantial fixed costs and labor, and that partnership with other institutions is critical for the operation and sustainability of cancer registries in limited resource settings. Although we included registries from a variety of limited-resource areas, information from eight registries in four countries may not be large enough to capture all the potential differences among the registries in limited-resource settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost-Benefit Analysis For Alternative Low-Emission Surface Preparation/ Depainting Technologies for Structural Steel

NASA Technical Reports Server (NTRS)

Lewis, Pattie

2007-01-01

Stennis Space Center (SSC), Kennedy Space Center (KSC) and Air Force Space Command (AFSPC) identified particulate emissions and waste generated from the depainting process of steel structures as hazardous materials to be eliminated or reduced. A Potential Alternatives Report, Potential Alternatives Report for Validation of Alternative Low Emission Surface Preparation/Depainting Technologies for Structural Steel, provided a technical analyses of identified alternatives to the current coating removal processes, criteria used to select alternatives for further analysis, and a list of those alternatives recommended for testing. The initial coating removal alternatives list was compiled using literature searches and stakeholder recommendations. The involved project participants initially considered approximately 13 alternatives. In late 2003, core project members selected the following depainting processes to be further evaluated: (1) Plastic Blast Media-Quickstrip(R)-A. (2) Hard Abrasive-Steel-Magic(R). (3) Sponge Blasting-Sponge-Jet(R). (4) Liquid Nitrogen-NItroJet(R). (5) Mechanical Removal with Vacuum Attachment-DESCO and OCM Clean-Air (6) Laser Coating Removal Alternatives were tested in accordance with the Joint Test Protocol for Validation of Alternative Low-Emission Surface Preparation/Depainting Technologies for Structural Steel, and the Field Evaluation Test Plan for Validation of Alternative Low-Emission Surface Preparation/Depainting Technologies for Structural Steel. Results of the testing are documented in the Joint Test Report. This Cost-Benefit Analysis (CBA) focuses on the three alternatives (Quickstrip(R)-A, SteelMagic (R), and Sponge-Jet(R)) that were considered viable alternatives for large area operations based on the results of the field demonstration and lab testing. This CBA was created to help participants determine if implementation of the candidate alternatives is economically justified. Each of the alternatives examined reduced Environmental Activity (EA) Costs-those costs associated with complying with environmental regulations. One alternative, Steel-Magic(R), also showed reduced Direct Costs and reduced total costs.

Comparison and cost analysis of drinking water quality monitoring requirements versus practice in seven developing countries.

PubMed

Crocker, Jonny; Bartram, Jamie

2014-07-18

Drinking water quality monitoring programs aim to support provision of safe drinking water by informing water quality management. Little evidence or guidance exists on best monitoring practices for low resource settings. Lack of financial, human, and technological resources reduce a country's ability to monitor water supply. Monitoring activities were characterized in Cambodia, Colombia, India (three states), Jordan, Peru, South Africa, and Uganda according to water sector responsibilities, monitoring approaches, and marginal cost. The seven study countries were selected to represent a range of low resource settings. The focus was on monitoring of microbiological parameters, such as E. coli, coliforms, and H2S-producing microorganisms. Data collection involved qualitative and quantitative methods. Across seven study countries, few distinct approaches to monitoring were observed, and in all but one country all monitoring relied on fixed laboratories for sample analysis. Compliance with monitoring requirements was highest for operational monitoring of large water supplies in urban areas. Sample transport and labor for sample collection and analysis together constitute approximately 75% of marginal costs, which exclude capital costs. There is potential for substantive optimization of monitoring programs by considering field-based testing and by fundamentally reconsidering monitoring approaches for non-piped supplies. This is the first study to look quantitatively at water quality monitoring practices in multiple developing countries.

Activity Analysis and Cost Analysis in Medical Schools.

ERIC Educational Resources Information Center

Koehler, John E.; Slighton, Robert L.

There is no unique answer to the question of what an ongoing program costs in medical schools. The estimates of program costs generated by classical methods of cost accounting are unsatisfactory because such accounting cannot deal with the joint production or joint cost problem. Activity analysis models aim at calculating the impact of alternative…

Decision Analysis of the Benefits and Costs of Screening for Prostate Cancer

DTIC Science & Technology

2014-08-01

waiting (WW) as experienced in the PIVOT study or active surveillance (AS), radical prostatectomy (RP), radiation therapy (IMRT), and brachytherapy...strategies for low-risk, clinically localized prostate cancer. In the initial iteration of this model, the strategies studied included active surveillance...with regard to modeling PSA kinetics. Task 1.4 Calibrate the model using data from published studies of the natural history of conservatively- treated

Comparative Effectiveness of After-School Programs to Increase Physical Activity

PubMed Central

Gesell, Sabina B.; Sommer, Evan C.; Lambert, E. Warren; Vides de Andrade, Ana Regina; Davis, Lauren; Beech, Bettina M.; Mitchell, Stephanie J.; Neloms, Stevon; Ryan, Colleen K.

2013-01-01

Background. We conducted a comparative effectiveness analysis to evaluate the difference in the amount of physical activity children engaged in when enrolled in a physical activity-enhanced after-school program based in a community recreation center versus a standard school-based after-school program. Methods. The study was a natural experiment with 54 elementary school children attending the community ASP and 37 attending the school-based ASP. Accelerometry was used to measure physical activity. Data were collected at baseline, 6 weeks, and 12 weeks, with 91% retention. Results. At baseline, 43% of the multiethnic sample was overweight/obese, and the mean age was 7.9 years (SD = 1.7). Linear latent growth models suggested that the average difference between the two groups of children at Week 12 was 14.7 percentage points in moderate-vigorous physical activity (P < .001). Cost analysis suggested that children attending traditional school-based ASPs—at an average cost of $17.67 per day—would need an additional daily investment of $1.59 per child for 12 weeks to increase their moderate-vigorous physical activity by a model-implied 14.7 percentage points. Conclusions. A low-cost, alternative after-school program featuring adult-led physical activities in a community recreation center was associated with increased physical activity compared to standard-of-care school-based after-school program. PMID:23984052

Fuel cells for automotive powertrains-A techno-economic assessment

NASA Astrophysics Data System (ADS)

Mock, Peter; Schmid, Stephan A.

With the objective of identifying the hurdles currently preventing a widespread application of fuel cell technology in passenger cars an assessment of technical and economic parameters is carried out. Patent and publication analysis is used to assess current status of fuel cell technology regarding its position on technology life cycle. S-curve methodology leads to the conclusion that further scientific activity is to be expected but for today's low-temperature PEM fuel cell technology might level by 2015. Technical analysis identifies power density and platinum loading as parameters for which further improvements are necessary in order to satisfy future customer needs. A detailed cost evaluation suggests that in future for high production volumes (approx. 1 million vehicles cumulative) significantly lower costs for fuel cell stacks (12-40 kW -1) and systems (35-83 kW -1) will be viable. Reducing costs to such a level will have to be the main focus for upcoming research activities in order to make fuel cell driven road vehicles a competitive alternative.

A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace

PubMed Central

2013-01-01

Background Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer’s perspective. Methods Employees used a 'loyalty card’ to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates. Results The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds. Conclusions The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer’s perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable “business model” which should become more cost-effective as it is delivered to more participants and can be adapted to suit other health behaviors and settings. This comes at a time when both UK and US governments are encouraging business involvement in tackling public health challenges. PMID:24112295

A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace.

PubMed

Dallat, Mary Anne T; Hunter, Ruth F; Tully, Mark A; Cairns, Karen J; Kee, Frank

2013-10-10

Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer's perspective. Employees used a 'loyalty card' to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates. The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds. The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer's perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable "business model" which should become more cost-effective as it is delivered to more participants and can be adapted to suit other health behaviors and settings. This comes at a time when both UK and US governments are encouraging business involvement in tackling public health challenges.

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

Designing informed game-based rehabilitation tasks leveraging advances in virtual reality.

PubMed

Lange, Belinda; Koenig, Sebastian; Chang, Chien-Yen; McConnell, Eric; Suma, Evan; Bolas, Mark; Rizzo, Albert

2012-01-01

This paper details a brief history and rationale for the use of virtual reality (VR) technology for clinical research and intervention, and then focuses on game-based VR applications in the area of rehabilitation. An analysis of the match between rehabilitation task requirements and the assets available with VR technology is presented. Low-cost camera-based systems capable of tracking user behavior at sufficient levels for game-based virtual rehabilitation activities are currently available for in-home use. Authoring software is now being developed that aims to provide clinicians with a usable toolkit for leveraging this technology. This will facilitate informed professional input on software design, development and application to ensure safe and effective use in the rehabilitation context. The field of rehabilitation generally stands to benefit from the continual advances in VR technology, concomitant system cost reductions and an expanding clinical research literature and knowledge base. Home-based activity within VR systems that are low-cost, easy to deploy and maintain, and meet the requirements for "good" interactive rehabilitation tasks could radically improve users' access to care, adherence to prescribed training and subsequently enhance functional activity in everyday life in clinical populations.

Peripheral vasomotor activity assessment using a continuous wavelet analysis on webcam photoplethysmographic signals.

PubMed

Bousefsaf, F; Maaoui, C; Pruski, A

2016-11-25

Vasoconstriction and vasodilation phenomena reflect the relative changes in the vascular bed. They induce particular modifications in the pulse wave magnitude. Webcams correspond to remote sensors that can be employed to measure the pulse wave in order to compute the pulse frequency. Record and analyze pulse wave signal with a low-cost webcam to extract the amplitude information and assess the vasomotor activity of the participant. Photoplethysmographic signals obtained from a webcam are analyzed through a continuous wavelet transform. The performance of the proposed filtering technique was evaluated using approved contact probes on a set of 12 healthy subjects after they perform a short but intense physical exercise. During the rest period, a cutaneous vasodilation is observable. High degrees of correlation between the webcam and a reference sensor were obtained. Webcams are low-cost and non-contact devices that can be used to reliably estimate both heart rate and peripheral vasomotor activity, notably during physical exertion.

A natural user interface to integrate citizen science and physical exercise.

PubMed

Palermo, Eduardo; Laut, Jeffrey; Nov, Oded; Cappa, Paolo; Porfiri, Maurizio

2017-01-01

Citizen science enables volunteers to contribute to scientific projects, where massive data collection and analysis are often required. Volunteers participate in citizen science activities online from their homes or in the field and are motivated by both intrinsic and extrinsic factors. Here, we investigated the possibility of integrating citizen science tasks within physical exercises envisaged as part of a potential rehabilitation therapy session. The citizen science activity entailed environmental mapping of a polluted body of water using a miniature instrumented boat, which was remotely controlled by the participants through their physical gesture tracked by a low-cost markerless motion capture system. Our findings demonstrate that the natural user interface offers an engaging and effective means for performing environmental monitoring tasks. At the same time, the citizen science activity increases the commitment of the participants, leading to a better motion performance, quantified through an array of objective indices. The study constitutes a first and necessary step toward rehabilitative treatments of the upper limb through citizen science and low-cost markerless optical systems.

The cost of cancer registry operations: Impact of volume on cost per case for core and enhanced registry activities

PubMed Central

Subramanian, Sujha; Tangka, Florence K.L.; Beebe, Maggie Cole; Trebino, Diana; Weir, Hannah K.; Babcock, Frances

2016-01-01

Background Cancer registration data is vital for creating evidence-based policies and interventions. Quantifying the resources needed for cancer registration activities and identifying potential efficiencies are critically important to ensure sustainability of cancer registry operations. Methods Using a previously validated web-based cost assessment tool, we collected activity-based cost data and report findings using 3 years of data from 40 National Program of Cancer Registry grantees. We stratified registries by volume: low-volume included fewer than 10,000 cases, medium-volume included 10,000–50,000 cases, and high-volume included >50,000 cases. Results Low-volume cancer registries incurred an average of $93.11 to report a case (without in-kind contributions) compared with $27.70 incurred by high-volume registries. Across all registries, the highest cost per case was incurred for data collection and abstraction ($8.33), management ($6.86), and administration ($4.99). Low- and medium-volume registries have higher costs than high-volume registries for all key activities. Conclusions Some cost differences by volume can be explained by the large fixed costs required for administering and performing registration activities, but other reasons may include the quality of the data initially submitted to the registries from reporting sources such as hospitals and pathology laboratories. Automation or efficiency improvements in data collection can potentially reduce overall costs. PMID:26702880

Comparative evaluation of low cost materials as constructed wetland filling media

NASA Astrophysics Data System (ADS)

Pinho, Henrique J. O.; Vaz, Mafalda M.; Mateus, Dina M. R.

2017-11-01

Three waste materials from civil construction activities were assessed as low cost alternative filling materials used in Constructed Wetlands (CW). CW are green processes for wastewater treatment, whose design includes an appropriate selection of vegetation and filling material. The sustainability of such processes may be incremented using recovered wastes as filling materials. The abilities of the materials to support plant growth and to contribute to pollutants removal from wastewater were assessed and compared to expanded clay, a filling usually used in CW design. Statistical analysis, using one-way ANOVA and Welch's ANOVA, demonstrate that limestone fragments are a better choice of filling material than brick fragments and basalt gravel.

Low-cost solar array project and Proceedings of the 14th Project Integration Meeting

NASA Technical Reports Server (NTRS)

Mcdonald, R. R.

1980-01-01

Activities are reported on the following areas: project analysis and integration; technology development in silicon material, large area sheet silicon, and encapsulation; production process and equipment development; and engineering and operations, and the steps taken to integrate these efforts. Visual materials presented at the project Integration Meeting are included.

An analysis of injury claims from low-seam coal mines

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

Gallagher, S.; Moore, S.; Dempsey, P.G.

2009-07-01

The restricted workspace present in low-seam coal mines forces workers to adopt awkward working postures (kneeling and stooping), which place high physical demands on the knee and lower back. This article provides an analysis of injury claims for eight mining companies operating low-seam coal mines during calendar years 1996-2008. All cost data were normalized using data on the cost of medical care (MPI) as provided by the U.S. Bureau of Labor Statistics. Results of the analysis indicate that the knee was the body part that led in terms of claim cost ($4.2 million), followed by injuries to the lower backmore » ($2.7 million). While the average cost per injury for these body parts was $13,100 and $14,400, respectively (close to the average cost of an injury overall), the high frequency of these injuries resulted in their pre-eminence in terms of cost. Analysis of data from individual mining companies suggest that knee and lower back injuries were a consistent problem across companies, as these injuries were each among the top five most costly part of body for seven out of eight companies studied. Results of this investigation suggest that efforts to reduce the frequency of knee and low back injuries in low-seam mines have the potential to create substantial cost savings.« less

Techno-economic analysis of the industrial production of a low-cost enzyme using E. coli: the case of recombinant β-glucosidase.

PubMed

Ferreira, Rafael da Gama; Azzoni, Adriano Rodrigues; Freitas, Sindelia

2018-01-01

The enzymatic conversion of lignocellulosic biomass into fermentable sugars is a promising approach for producing renewable fuels and chemicals. However, the cost and efficiency of the fungal enzyme cocktails that are normally employed in these processes remain a significant bottleneck. A potential route to increase hydrolysis yields and thereby reduce the hydrolysis costs would be to supplement the fungal enzymes with their lacking enzymatic activities, such as β-glucosidase. In this context, it is not clear from the literature whether recombinant E. coli could be a cost-effective platform for the production of some of these low-value enzymes, especially in the case of on-site production. Here, we present a conceptual design and techno-economic evaluation of the production of a low-cost industrial enzyme using recombinant E. coli . In a simulated baseline scenario for β-glucosidase demand in a hypothetical second-generation ethanol (2G) plant in Brazil, we found that the production cost (316 US$/kg) was higher than what is commonly assumed in the literature for fungal enzymes, owing especially to the facility-dependent costs (45%) and to consumables (23%) and raw materials (25%). Sensitivity analyses of process scale, inoculation volume, and volumetric productivity indicated that optimized conditions may promote a dramatic reduction in enzyme cost and also revealed the most relevant factors affecting production costs. Despite the considerable technical and economic uncertainties that surround 2G ethanol and the large-scale production of low-cost recombinant enzymes, this work sheds light on some relevant questions and supports future studies in this field. In particular, we conclude that process optimization, on many fronts, may strongly reduce the costs of E. coli recombinant enzymes, in the context of tailor-made enzymatic cocktails for 2G ethanol production.

Cost effectiveness of etanercept (Enbrel) in combination with methotrexate in the treatment of active rheumatoid arthritis based on the TEMPO trial.

PubMed

Kobelt, G; Lindgren, P; Singh, A; Klareskog, L

2005-08-01

To estimate the cost effectiveness of combination treatment with etanercept plus methotrexate in comparison with monotherapies in patients with active rheumatoid arthritis (RA) using a new model that incorporates both functional status and disease activity. Effectiveness data were based on a 2 year trial in 682 patients with active RA (TEMPO). Data on resource consumption and utility related to function and disease activity were obtained from a survey of 616 patients in Sweden. A Markov model was constructed with five states according to functional status (Health Assessment Questionnaire (HAQ)) subdivided into high and low disease activity. The cost for each quality adjusted life year (QALY) gained was estimated by Monte Carlo simulation. Disease activity had a highly significant effect on utilities, independently of HAQ. For resource consumption, only HAQ was a significant predictor, with the exception of sick leave. Compared with methotrexate alone, etanercept plus methotrexate over 2 years increased total costs by 14,221 euros and led to a QALY gain of 0.38. When treatment was continued for 10 years, incremental costs were 42,148 euros for a QALY gain of 0.91. The cost per QALY gained was 37,331 euros and 46,494 euros, respectively. The probability that the cost effectiveness ratio is below a threshold of 50,000 euros/QALY is 88%. Incorporating the influence of disease activity into this new model allows better assessment of the effects of anti-tumour necrosis factor treatment on patients' general wellbeing. In this analysis, the cost per QALY gained with combination treatment with etanercept plus methotrexate compared with methotrexate alone falls within the acceptable range.

Health Monitoring System Technology Assessments: Cost Benefits Analysis

NASA Technical Reports Server (NTRS)

Kent, Renee M.; Murphy, Dennis A.

2000-01-01

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

Economic analysis of cinacalcet in combination with low-dose vitamin D versus flexible-dose vitamin D in treating secondary hyperparathyroidism in hemodialysis patients.

PubMed

Shireman, Theresa I; Almehmi, Ammar; Wetmore, James B; Lu, John; Pregenzer, Mark; Quarles, L Darryl

2010-12-01

The ACHIEVE (Optimizing the Treatment of Secondary Hyperparathyroidism: A Comparison of Sensipar and Low Dose Vitamin D vs Escalating Doses of Vitamin D Alone) trial evaluated the efficacy of treatment with cinacalcet plus low-dose activated vitamin D analogues (Cinacalcet-D) compared with vitamin D analogues alone (Flex-D) in attaining KDOQI (Kidney Disease Outcomes Quality Initiative) targets for secondary hyperparathyroidism (SHPT). The economic implications of these treatment regimens have not been explored. Economic analysis of SHPT treatment in hemodialysis patients. This analysis used data from the ACHIEVE trial, in which patients received either Cinacalcet-D or Flex-D. We assessed the relative cost-effectiveness of these regimens in treating SHPT during the 27-week ACHIEVE trial, using a US payer perspective, with medication costs valued in 2006 US dollars. INTERVENTION & OUTCOMES: Relative cost-effectiveness was assessed using cost-minimization analysis or incremental cost-effectiveness ratios. Effectiveness was measured using biochemical markers. Mean medication costs per patient were $5,852 and $4,332 for the Cinacalcet-D and Flex-D treatment arms, respectively. There were no significant differences for the primary end point (parathyroid hormone level of 150-300 pg/mL and calcium-phosphorus product < 55 mg²/dL²) and several of the secondary end points, rendering Cinacalcet-D more costly than Flex-D. For secondary end points, for which Cinacalcet-D was more effective, incremental cost-effectiveness ratios ranged from $2,957 (calcium < 9.5 mg/dL) to $22,028 (all KDOQI targets) per patient reaching target. Switching to generic calcitriol would have increased the cost difference between treatment arms ($2,079), whereas switching sevelamer to lanthanum decreased the difference ($1,426). Costs and outcomes were derived from a short-term randomized controlled trial and were protocol driven. Clinical outcomes, such as mortality, were not available. Long-term economic conclusions cannot be drawn from these data. Cinacalcet combined with vitamin D analogues was no more effective than vitamin D analogues in achieving the primary ACHIEVE end point and incurred greater costs. This conclusion was not tempered substantially by the cost of vitamin D analogues or oral phosphate binders. Whether the additional costs of cinacalcet are warranted will require longer term models to determine whether changes in serum levels of mineral metabolic markers translate into lower morbidity, mortality, and downstream costs. Copyright © 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Costs of vaccine programs across 94 low- and middle-income countries.

PubMed

Portnoy, Allison; Ozawa, Sachiko; Grewal, Simrun; Norman, Bryan A; Rajgopal, Jayant; Gorham, Katrin M; Haidari, Leila A; Brown, Shawn T; Lee, Bruce Y

2015-05-07

While new mechanisms such as advance market commitments and co-financing policies of the GAVI Alliance are allowing low- and middle-income countries to gain access to vaccines faster than ever, understanding the full scope of vaccine program costs is essential to ensure adequate resource mobilization. This costing analysis examines the vaccine costs, supply chain costs, and service delivery costs of immunization programs for routine immunization and for supplemental immunization activities (SIAs) for vaccines related to 18 antigens in 94 countries across the decade, 2011-2020. Vaccine costs were calculated using GAVI price forecasts for GAVI-eligible countries, and assumptions from the PAHO Revolving Fund and UNICEF for middle-income countries not supported by the GAVI Alliance. Vaccine introductions and coverage levels were projected primarily based on GAVI's Adjusted Demand Forecast. Supply chain costs including costs of transportation, storage, and labor were estimated by developing a mechanistic model using data generated by the HERMES discrete event simulation models. Service delivery costs were abstracted from comprehensive multi-year plans for the majority of GAVI-eligible countries and regression analysis was conducted to extrapolate costs to additional countries. The analysis shows that the delivery of the full vaccination program across 94 countries would cost a total of $62 billion (95% uncertainty range: $43-$87 billion) over the decade, including $51 billion ($34-$73 billion) for routine immunization and $11 billion ($7-$17 billion) for SIAs. More than half of these costs stem from service delivery at $34 billion ($21-$51 billion)-with an additional $24 billion ($13-$41 billion) in vaccine costs and $4 billion ($3-$5 billion) in supply chain costs. The findings present the global costs to attain the goals envisioned during the Decade of Vaccines to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities. By projecting the full costs of immunization programs, our findings may aid to garner greater country and donor commitments toward adequate resource mobilization and efficient allocation. As service delivery costs have increasingly become the main driver of vaccination program costs, it is essential to pay additional consideration to health systems strengthening. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Low level alpha activity measurements with pulse shape discrimination--the analytical system and its characteristics].

PubMed

Noguchi, M; Satoh, K; Higuchi, H

1984-12-01

Pulse shape discrimination of alpha and beta rays with liquid scintillation counting was investigated for the purpose of low level alpha activity measurements. Various liquid scintillators for pulse shape discrimination were examined by means of pulse rise time analysis. A new scintillator of low cost and of superior characteristics was found. The figure of merits better than 3.5 in rise time spectrum and the energy resolution better than 9% were obtained for carefully prepared samples. The background counting rate for a sample of 10 ml was reduced to 0.013 cpm/MeV in the range of alpha ray energy 5 to 7 MeV.

Increasing value in plagiocephaly care: a time-driven activity-based costing pilot study.

PubMed

Inverso, Gino; Lappi, Michael D; Flath-Sporn, Susan J; Heald, Ronald; Kim, David C; Meara, John G

2015-06-01

Process management within a health care setting is poorly understood and often leads to an incomplete understanding of the true costs of patient care. Using time-driven activity-based costing methods, we evaluated the high-volume, low-complexity diagnosis of plagiocephaly to increase value within our clinic. A total of 59 plagiocephaly patients were evaluated in phase 1 (n = 31) and phase 2 (n = 28) of this study. During phase 1, a process map was created, encompassing each of the 5 clinicians and administrative personnel delivering 23 unique activities. After analysis of the phase 1 process maps, average times as well as costs of these activities were evaluated for potential modifications in workflow. These modifications were implemented in phase 2 to determine overall impact on visit-time and costs of care. Improvements in patient education, workflow coordination, and examination room allocation were implemented during phase 2, resulting in a reduced patient visit-time of 13:25 (19.9% improvement) and an increased cost of $8.22 per patient (7.7% increase) due to changes in physician process times. However, this increased cost was directly offset by the availability of 2 additional appointments per day, potentially generating $7904 of additional annual revenue. Quantifying the impact of a 19.9% reduction in patient visit-time at an increased cost of 7.7% resulted in an increased value ratio of 1.113. This pilot study effectively demonstrates the novel use of time-driven activity-based costing in combination with the value equation as a metric for continuous process improvement programs within the health care setting.

Performance and analysis of MAC protocols based on application

NASA Astrophysics Data System (ADS)

Yadav, Ravi; Daniel, A. K.

2018-04-01

Wireless Sensor Network is one of the rapid emerging technology in recent decades. It covers large application area as civilian and military. Wireless Sensor Network primary consists of sensor nodes having low-power, low cost and multifunctional activities to collaborates and communicates via wireless medium. The deployment of sensor nodes are adhoc in nature, so sensor nodes are auto organize themselves in such a way to communicate with each other. The characteristics make more challenging areas on WSNs. This paper gives overview about characteristics of WSNs, Architecture and Contention Based MAC protocol. The paper present analysis of various protocol based on performance.

A new ultrasonic method for measuring minute motion activities of rats.

PubMed

Young, C W; Young, M S; Li, Y C; Lin, M T

1996-12-01

A new ultrasonic method is presented for measuring the minute motion activities of rats. A pair of low-cost 40 kHz ultrasonic transducers are used to transmit ultrasound toward a rat and receive the ultrasound reflected from the rat. The relative motion of the rat modulates the phase difference between the transmitted and received ultrasound signals. An 8-bit digital phase meter was designed to record the phase difference signal which was used to reconstruct the relative motion waveform of the rat in an 8751 single-chip microcomputer. The reconstructed data are then sent to a PC-AT microcomputer for further processing. This method employs a spectrum analysis for the reconstructed data and can measure three minute motion activities including locomotor activity (LMA), tremor and myoclonia. Finally, the method has been tested with real animal experiments. The main advantages of this new method are that it is non-invasive, non-contact, low cost and high precision. This new method could also be profitably employed for other behavioral studies and offer potential for research in basic medicine.

An analysis of the costs of Uganda's Child Days Plus: do low costs reveal an efficient program or an underfinanced one?

PubMed

Fiedler, John L; Semakula, Richard

2014-03-01

Twice annually, Uganda implements Child Days Plus (CDP), a month-long outreach activity that distributes vitamin A capsules to preschool children and deworms children 6 months to 14 years old. Introduced initially as a temporary, interim strategy, CDP is now a decade old. To assess how well CDP is implemented using an activity-based cost analysis. In the absence of a cost-accounting system for CDP, we defined the six major CDP activities as cost centers and identified five important subactivities required to implement a round of CDP. Based on a purposive sample, we conducted a structured interview survey of 59 Ministry of Health facilities, 9 district offices, and national-level CDP staff. Only one-third of the facilities implemented all 11 CDP core activities. The survey revealed that Ministry of Health staff and volunteers are frequently paid substantially less in allowances than they are entitled to for their CDP outreach activities. Viewing these two practices--nonimplementation and less-than-full-reimbursement--as indicators of CDP's underfinancing, we estimate the program is underfinanced by the equivalent of 37% of its 'full implementation" costs. Two-thirds of underfinancing is manifested in nonimplementation and one-third as less-than full-reimbursement. CDP exploits economies of scale and scope and has an average cost per child served of US$0.22. We estimate that it annually saves 367,000 disability-adjusted life-years (DALYs) at an average cost of US$12.5, making it--despite its underfinancing--highly cost-effective. Increased CDP funding would enable its vitamin A coverage rate of 58% and its deworming coverage rate of 62% to be increased, thereby increasing its effectiveness and efficiency. CDP should be "relaunched," as part of an effort to improve the structure of the program, set expectations about it, and earmark a minimum of resources for CDP. The Ministry of Health should demonstrate its new, greater commitment to CDP by introducing a program-specific budget line item, increasing CDP's budget allocation, and developing and implementing a training program that identifies the minimum uniform activities required to implement CDP.

Evaluation of low-cost, objective instruments for assessing physical activity in 10-11-year-old children.

PubMed

Hart, Teresa L; Brusseau, Timothy; Kulinna, Pamela Hodges; McClain, James J; Tudor-Locke, Catrine

2011-12-01

This study compared step counts detected by four, low-cost, objective, physical-activity-assessment instruments and evaluated their ability to detect moderate-to-vigorous physical activity (MVPA) compared to the ActiGraph accelerometer (AG). Thirty-six 10-11-year-old children wore the NL-1000, Yamax Digiwalker SW 200, Omron HJ-151, and Walk4Life MVP concurrently with the AG during school hours on a single day. AG MVPA was derived from activity count data using previously validated cut points. Two of the evaluated instruments provided similar group mean MVPA and step counts compared to AG (dependent on cut point). Low-cost instruments may be useful for measurement of both MVPA and steps in children's physical activity interventions and program evaluation.

Low-cost three-dimensional gait analysis system for mice with an infrared depth sensor.

PubMed

Nakamura, Akihiro; Funaya, Hiroyuki; Uezono, Naohiro; Nakashima, Kinichi; Ishida, Yasumasa; Suzuki, Tomohiro; Wakana, Shigeharu; Shibata, Tomohiro

2015-11-01

Three-dimensional (3D) open-field gait analysis of mice is an essential procedure in genetic and nerve regeneration research. Existing gait analysis systems are generally expensive and may interfere with the natural behaviors of mice because of optical markers and transparent floors. In contrast, the proposed system captures the subjects shape from beneath using a low-cost infrared depth sensor (Microsoft Kinect) and an opaque infrared pass filter. This means that we can track footprints and 3D paw-tip positions without optical markers or a transparent floor, thereby preventing any behavioral changes. Our experimental results suggest with healthy mice that they are more active on opaque floors and spend more time in the center of the open-field, when compared with transparent floors. The proposed system detected footprints with a comparable performance to existing systems, and precisely tracked the 3D paw-tip positions in the depth image coordinates. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Using budget-friendly methods to analyze sport specific movements

NASA Astrophysics Data System (ADS)

Jackson, Lindsay; Williams, Sarah; Ferrara, Davon

2015-03-01

When breaking down the physics behind sport specific movements, athletes, usually professional, are often assessed in multimillion-dollar laboratories and facilities. Budget-friendly methods, such as video analysis using low-cost cameras, iPhone sensors, or inexpensive force sensors can make this process more accessible to amateur athletes, which in-turn can give insight into injury mechanisms. Here we present a comparison of two methods of determining the forces experienced by a cheerleader during co-education stunting and soccer goalies while side-diving. For the cheerleader, accelerometer measurements were taken by an iPhone 5 and compared to video analysis. The measurements done on the soccer players were taken using FlexiForce force sensors and again compared to video analysis. While these budget-friendly methods could use some refining, they show promise for producing usable measurements for possibly increasing our understanding of injury in amateur players. Furthermore, low-cost physics experiments with sports can foster an active learning environment for students with minimum physics and mathematical background.

Manned geosynchronous mission requirements and systems analysis study extension

NASA Technical Reports Server (NTRS)

1981-01-01

Turnaround requirements for the manned orbital transfer vehicle (MOTV) baseline and alternate concepts with and without a space operations center (SOC) are defined. Manned orbital transfer vehicle maintenance, refurbishment, resupply, and refueling are considered as well as the most effective combination of ground based and space based turnaround activities. Ground and flight operations requirements for abort are identified as well as low cost approaches to space and ground operations through maintenance and missions sensitivity studies. The recommended turnaround mix shows that space basing MOTV at SOC with periodic return to ground for overhaul results in minimum recurring costs. A pressurized hangar at SOC reduces labor costs by approximately 50%.

Low Life Cycle Cost Paratransit Vehicle Design Study

DOT National Transportation Integrated Search

1978-08-01

A preliminary design and cost study was performed for a low life cycle cost paratransit vehicle. The manufacturing technique and cost analysis were based on limited production of 5000 units per year for a ten year period. The vehicle configuration re...

Low Cost Solar Array Project: Composition Measurements by Analytical Photon Catalysis

NASA Technical Reports Server (NTRS)

Sutton, D. G.; Galvan, L.; Melzer, J.; Heidner, R. F., III

1979-01-01

The applicability of the photon catalysis technique for effecting composition analysis of silicon samples was assessed. Third quarter activities were devoted to the study of impurities in silicon matrices. The evaporation process was shown to be congruent; thus, the spectral analysis of the vapor yields the composition of the bulk sample. Qualitative analysis of metal impurities in silicon was demonstrated e part per million level. Only one atomic spectral interference was noted; however, it is imperative to maintain a leak tight system due to chemical and spectral interferences caused by the presence of even minute amounts of oxygen in the active nitrogen afterglow.

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

PubMed

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

2012-04-15

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

A strategy for low cost development of incremental oil in legacy reservoirs

USGS Publications Warehouse

Attanasi, E.D.

2016-01-01

The precipitous decline in oil prices during 2015 has forced operators to search for ways to develop low-cost and low-risk oil reserves. This study examines strategies to low cost development of legacy reservoirs, particularly those which have already implemented a carbon dioxide enhanced oil recovery (CO2 EOR) program. Initially the study examines the occurrence and nature of the distribution of the oil resources that are targets for miscible and near-miscible CO2 EOR programs. The analysis then examines determinants of technical recovery through the analysis of representative clastic and carbonate reservoirs. The economic analysis focusses on delineating the dominant components of investment and operational costs. The concluding sections describe options to maximize the value of assets that the operator of such a legacy reservoir may have that include incremental expansion within the same producing zone and to producing zones that are laterally or stratigraphically near main producing zones. The analysis identified the CO2 recycle plant as the dominant investment cost item and purchased CO2 and liquids management as a dominant operational cost items. Strategies to utilize recycle plants for processing CO2 from multiple producing zones and multiple reservoir units can significantly reduce costs. Industrial sources for CO2 should be investigated as a possibly less costly way of meeting EOR requirements. Implementation of tapered water alternating gas injection schemes can partially mitigate increases in fluid lifting costs.

A walking programme and a supervised exercise class versus usual physiotherapy for chronic low back pain: a single-blinded randomised controlled trial. (The Supervised Walking In comparison to Fitness Training for Back Pain (SWIFT) Trial)

PubMed Central

Hurley, Deirdre A; O'Donoghue, Grainne; Tully, Mark A; Moffett, Jennifer Klaber; van Mechelen, Willem; Daly, Leslie; Boreham, Colin AG; McDonough, Suzanne M

2009-01-01

Background Chronic low back pain (CLBP) is a persistent disabling condition with rising significant healthcare, social and economic costs. Current research supports the use of exercise-based treatment approaches that encourage people with CLBP to assume a physically active role in their recovery. While international clinical guidelines and systematic reviews for CLBP support supervised group exercise as an attractive first-line option for treating large numbers of CLBP patients at low cost, barriers to their delivery include space and time restrictions in healthcare settings and poor patient attendance. The European Clinical Guidelines have identified the need for research in the use of brief/minimal contact self-activation interventions that encourage participation in physical activity for CLBP. Walking may be an ideally suited form of individualized exercise prescription as it is easy to do, requires no special skills or facilities, and is achievable by virtually all ages with little risk of injury, but its effectiveness for LBP is unproven. Methods and design This study will be an assessor-blinded randomized controlled trial that will investigate the difference in clinical effectiveness and costs of an individualized walking programme and a supervised general exercise programme compared to usual physiotherapy, which will act as the control group, in people with chronic low back pain. A sample of 246 patients will be recruited in Dublin, Ireland through acute general hospital outpatient physiotherapy departments that provide treatment for people with CLBP. Patients will be randomly allocated to one of the three groups in a concealed manner. The main outcomes will be functional disability, pain, quality of life, fear avoidance, back beliefs, physical activity, satisfaction and costs, which will be evaluated at baseline, and 3, 6 and 12 months [follow-up by pre-paid postage]. Qualitative telephone interviews and focus groups will be embedded in the research design to obtain feedback about participants' experiences of the interventions and trial participation, and to inform interpretation of the quantitative data. Planned analysis will be by intention to treat (quantitative data) and thematic analysis (qualitative data) Discussion The trial will evaluate the effectiveness of a walking programme and a supervised general exercise programme compared to usual physiotherapy in people with CLBP. Trial registration Current controlled trial ISRCTN17592092 PMID:19573247

Clinical process analysis and activity-based costing at a heart center.

PubMed

Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

2002-08-01

Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

Using Ensemble Decisions and Active Selection to Improve Low-Cost Labeling for Multi-View Data

NASA Technical Reports Server (NTRS)

Rebbapragada, Umaa; Wagstaff, Kiri L.

2011-01-01

This paper seeks to improve low-cost labeling in terms of training set reliability (the fraction of correctly labeled training items) and test set performance for multi-view learning methods. Co-training is a popular multiview learning method that combines high-confidence example selection with low-cost (self) labeling. However, co-training with certain base learning algorithms significantly reduces training set reliability, causing an associated drop in prediction accuracy. We propose the use of ensemble labeling to improve reliability in such cases. We also discuss and show promising results on combining low-cost ensemble labeling with active (low-confidence) example selection. We unify these example selection and labeling strategies under collaborative learning, a family of techniques for multi-view learning that we are developing for distributed, sensor-network environments.

Commitment-Insurance: Compensating for the Autonomy Costs of Interdependence in Close Relationships

PubMed Central

Murray, Sandra L.; Holmes, John G.; Aloni, Maya; Pinkus, Rebecca T.; Derrick, Jaye L.; Leder, Sadie

2014-01-01

A model of the commitment-insurance system is proposed to examine how low and high self-esteem people cope with the costs interdependence imposes on autonomous goal pursuits. In this system, autonomy costs automatically activate compensatory cognitive processes that attach greater value to the partner. Greater partner-valuing compels greater responsiveness to the partner’s needs. Two experiments and a daily diary study of newlyweds supported the model. Autonomy costs automatically activate more positive implicit evaluations of the partner. On explicit measures of positive illusions, high self-esteem people continue to compensate for costs. However, cost-primed low self-esteem people correct and override their positive implicit sentiments when they have the opportunity to do so. Such corrections put the marriages of low self-esteem people at risk: Failing to compensate for costs predicted declines in satisfaction over a one year period. PMID:19634974

[Concept analysis of a participatory approach to occupational safety and health].

PubMed

Yoshikawa, Etsuko

2013-01-01

The purpose of this study was to analyze a participatory approach to occupational safety and health, and to examine the possibility of applying the concept to the practice and research of occupational safety and health. According to Rodger's method, descriptive data concerning antecedents, attributes and consequences were qualitatively analyzed. A total of 39 articles were selected for analysis. Attributes with a participatory approach were: "active involvement of both workers and employers", "focusing on action-oriented low-cost and multiple area improvements based on good practices", "the process of emphasis on consensus building", and "utilization of a local network". Antecedents of the participatory approach were classified as: "existing risks at the workplace", "difficulty of occupational safety and health activities", "characteristics of the workplace and workers", and "needs for the workplace". The derived consequences were: "promoting occupational safety and health activities", "emphasis of self-management", "creation of safety and healthy workplace", and "contributing to promotion of quality of life and productivity". A participatory approach in occupational safety and health is defined as, the process of emphasis on consensus building to promote occupational safety and health activities with emphasis on self-management, which focuses on action-oriented low-cost and multiple area improvements based on good practices with active involvement of both workers and employers through utilization of local networks. We recommend that the role of the occupational health professional be clarified and an evaluation framework be established for the participatory approach to promote occupational safety and health activities by involving both workers and employers.

Monolithically interconnected silicon-film™ module technology

NASA Astrophysics Data System (ADS)

DelleDonne, E. J.; Ford, D. H.; Hall, R. B.; Ingram, A. E.; Rand, J. A.; Barnett, A. M.

1999-03-01

AstroPower is developing an advanced thin-silicon-based, photovoltaic module product. A low-cost monolithic interconnected device is being integrated into a module that combines the design and process features of advanced light trapped, thin-silicon solar cells. This advanced product incorporates a low-cost substrate, a nominally 50-μm thick grown silicon layer with minority carrier diffusion lengths exceeding the active layer thickness, light trapping due to back-surface reflection, and back-surface passivation. The thin silicon layer enables high solar cell performance and can lead to a module conversion efficiency as high as 19%. These performance design features, combined with low-cost manufacturing using relatively low-cost capital equipment, continuous processing and a low-cost substrate, will lead to high-performance, low-cost photovoltaic panels.

Cost-effectiveness of a community-based physical activity programme for adults (Be Active) in the UK: an economic analysis within a natural experiment.

PubMed

Frew, Emma J; Bhatti, Mobeen; Win, Khine; Sitch, Alice; Lyon, Anna; Pallan, Miranda; Adab, Peymane

2014-02-01

To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK. Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using 'willingness-to-pay' as a measure of value. Under base-case assumptions-that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society. Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.

Low-cost carbon-silicon nanocomposite anodes for lithium ion batteries.

PubMed

Badi, Nacer; Erra, Abhinay Reddy; Hernandez, Francisco C Robles; Okonkwo, Anderson O; Hobosyan, Mkhitar; Martirosyan, Karen S

2014-01-01

The specific energy of the existing lithium ion battery cells is limited because intercalation electrodes made of activated carbon (AC) materials have limited lithium ion storage capacities. Carbon nanotubes, graphene, and carbon nanofibers are the most sought alternatives to replace AC materials but their synthesis cost makes them highly prohibitive. Silicon has recently emerged as a strong candidate to replace existing graphite anodes due to its inherently large specific capacity and low working potential. However, pure silicon electrodes have shown poor mechanical integrity due to the dramatic expansion of the material during battery operation. This results in high irreversible capacity and short cycle life. We report on the synthesis and use of carbon and hybrid carbon-silicon nanostructures made by a simplified thermo-mechanical milling process to produce low-cost high-energy lithium ion battery anodes. Our work is based on an abundant, cost-effective, and easy-to-launch source of carbon soot having amorphous nature in combination with scrap silicon with crystalline nature. The carbon soot is transformed in situ into graphene and graphitic carbon during mechanical milling leading to superior elastic properties. Micro-Raman mapping shows a well-dispersed microstructure for both carbon and silicon. The fabricated composites are used for battery anodes, and the results are compared with commercial anodes from MTI Corporation. The anodes are integrated in batteries and tested; the results are compared to those seen in commercial batteries. For quick laboratory assessment, all electrochemical cells were fabricated under available environment conditions and they were tested at room temperature. Initial electrochemical analysis results on specific capacity, efficiency, and cyclability in comparison to currently available AC counterpart are promising to advance cost-effective commercial lithium ion battery technology. The electrochemical performance observed for carbon soot material is very interesting given the fact that its production cost is away cheaper than activated carbon. The cost of activated carbon is about $15/kg whereas the cost to manufacture carbon soot as a by-product from large-scale milling of abundant graphite is about $1/kg. Additionally, here, we propose a method that is environmentally friendly with strong potential for industrialization.

Low-cost carbon-silicon nanocomposite anodes for lithium ion batteries

PubMed Central

2014-01-01

The specific energy of the existing lithium ion battery cells is limited because intercalation electrodes made of activated carbon (AC) materials have limited lithium ion storage capacities. Carbon nanotubes, graphene, and carbon nanofibers are the most sought alternatives to replace AC materials but their synthesis cost makes them highly prohibitive. Silicon has recently emerged as a strong candidate to replace existing graphite anodes due to its inherently large specific capacity and low working potential. However, pure silicon electrodes have shown poor mechanical integrity due to the dramatic expansion of the material during battery operation. This results in high irreversible capacity and short cycle life. We report on the synthesis and use of carbon and hybrid carbon-silicon nanostructures made by a simplified thermo-mechanical milling process to produce low-cost high-energy lithium ion battery anodes. Our work is based on an abundant, cost-effective, and easy-to-launch source of carbon soot having amorphous nature in combination with scrap silicon with crystalline nature. The carbon soot is transformed in situ into graphene and graphitic carbon during mechanical milling leading to superior elastic properties. Micro-Raman mapping shows a well-dispersed microstructure for both carbon and silicon. The fabricated composites are used for battery anodes, and the results are compared with commercial anodes from MTI Corporation. The anodes are integrated in batteries and tested; the results are compared to those seen in commercial batteries. For quick laboratory assessment, all electrochemical cells were fabricated under available environment conditions and they were tested at room temperature. Initial electrochemical analysis results on specific capacity, efficiency, and cyclability in comparison to currently available AC counterpart are promising to advance cost-effective commercial lithium ion battery technology. The electrochemical performance observed for carbon soot material is very interesting given the fact that its production cost is away cheaper than activated carbon. The cost of activated carbon is about $15/kg whereas the cost to manufacture carbon soot as a by-product from large-scale milling of abundant graphite is about $1/kg. Additionally, here, we propose a method that is environmentally friendly with strong potential for industrialization. PMID:25114651

Why some do but most don't. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study

PubMed Central

2011-01-01

Background The beneficial effect of physical activity for the prevention of a range of chronic diseases is widely acknowledged. These chronic conditions are most pronounced in economically disadvantaged groups where physical activity levels are consistently lower, yet this group is particularly difficult to recruit and retain in physical activity programmes. This study examined the perceptions of participants, non-participants, and exercise leaders in a low-income area regarding barriers, motives, and enabling factors for organised physical activity with a view to improving recruitment and retention. Methods A mixed methods research approach was adopted to guide data collection and analysis. A survey, incorporating the Motivation for Physical Activity Measure - Revised (MPAM-R), was used to assess the motivations of 152 physical activity session participants in a highly deprived suburban neighbourhood. The MPAM-R data were analysed using t tests, analyses of variance to estimate age, body mass index, and activity mode differences and Pearson's correlation coefficient to address associations. Semi-structured interviews were also conducted with 33 local residents who did not participate in activity sessions and with 14 activity session leaders. All interviews were audio-taped, transcribed verbatim and analyzed using an inductive thematic approach. Results Participants reported cost, childcare, lack of time and low awareness as barriers to joining activity classes. The need for support, confidence and competence in order to take up activity was widely expressed, particularly among women. Once people are active, high levels of social interaction, interest and enjoyment are associated with improved levels of retention, with different types of physical activity scoring differently on these factors. Conclusions This study suggests that some factors such as cost, the fear of 'walking in alone', accessibility of facilities, and appropriate communication strategies may be of particular importance to increasing recruitment of low income groups. Interventions targeting this group should consider low cost sessions and childcare; activities popular with the target group and associated with good recruitment and retention; sessions held at accessible times; a focus on fun and socialising; well-researched and designed communications strategies; targeting of friendship groups; clearly branded beginners' sessions, and the potential of social marketing as strategies. The evidence presented here suggests that the current UK government approach designed to 'enable and guide people's choices' may not be sufficient if low-income groups are to be effectively supported in changing their health behaviours. PMID:21711514

An Analysis of Port-Visit Costs of U.S. Navy Aircraft Carriers

DTIC Science & Technology

2008-06-01

Klang, Portsmouth, and Tarragona. Medium-cost ports are: Corfu, Freemantle, Limassol, Marseille, Naples, Palma, Rhodes, Souda Bay, and Valletta . Low...Split, Sydney Low Cost Manama Manama Corfu, Fremantle, Limassol, Marseille, Naples, Palma De Mallorca, Rhodes, Souda Bay, Valletta Medium Cost

Comparison and Cost Analysis of Drinking Water Quality Monitoring Requirements versus Practice in Seven Developing Countries

PubMed Central

Crocker, Jonny; Bartram, Jamie

2014-01-01

Drinking water quality monitoring programs aim to support provision of safe drinking water by informing water quality management. Little evidence or guidance exists on best monitoring practices for low resource settings. Lack of financial, human, and technological resources reduce a country’s ability to monitor water supply. Monitoring activities were characterized in Cambodia, Colombia, India (three states), Jordan, Peru, South Africa, and Uganda according to water sector responsibilities, monitoring approaches, and marginal cost. The seven study countries were selected to represent a range of low resource settings. The focus was on monitoring of microbiological parameters, such as E. coli, coliforms, and H2S-producing microorganisms. Data collection involved qualitative and quantitative methods. Across seven study countries, few distinct approaches to monitoring were observed, and in all but one country all monitoring relied on fixed laboratories for sample analysis. Compliance with monitoring requirements was highest for operational monitoring of large water supplies in urban areas. Sample transport and labor for sample collection and analysis together constitute approximately 75% of marginal costs, which exclude capital costs. There is potential for substantive optimization of monitoring programs by considering field-based testing and by fundamentally reconsidering monitoring approaches for non-piped supplies. This is the first study to look quantitatively at water quality monitoring practices in multiple developing countries. PMID:25046632

Evaluation of Low-Cost, Objective Instruments for Assessing Physical Activity in 10-11-Year-Old Children

ERIC Educational Resources Information Center

Hart, Teresa L.; Brusseau, Timothy; Kulinna, Pamela Hodges; McClain, James J.; Tudor-Locke, Catrine

2011-01-01

This study compared step counts detected by four, low-cost, objective, physical-activity-assessment instruments and evaluated their ability to detect moderate-to-vigorous physical activity (MVPA) compared to the ActiGraph accelerometer (AG). Thirty-six 10-11-year-old children wore the NL-1000, Yamax Digiwalker SW 200, Omron HJ-151, and Walk4Life…

Quantitative imaging assay for NF-κB nuclear translocation in primary human macrophages

PubMed Central

Noursadeghi, Mahdad; Tsang, Jhen; Haustein, Thomas; Miller, Robert F.; Chain, Benjamin M.; Katz, David R.

2008-01-01

Quantitative measurement of NF-κB nuclear translocation is an important research tool in cellular immunology. Established methodologies have a number of limitations, such as poor sensitivity, high cost or dependence on cell lines. Novel imaging methods to measure nuclear translocation of transcriptionally active components of NF-κB are being used but are also partly limited by the need for specialist imaging equipment or image analysis software. Herein we present a method for quantitative detection of NF-κB rel A nuclear translocation, using immunofluorescence microscopy and the public domain image analysis software ImageJ that can be easily adopted for cellular immunology research without the need for specialist image analysis expertise and at low cost. The method presented here is validated by demonstrating the time course and dose response of NF-κB nuclear translocation in primary human macrophages stimulated with LPS, and by comparison with a commercial NF-κB activation reporter cell line. PMID:18036607

Analysis of minimum target prices for production of entecavir to treat hepatitis B in high- and low-income countries.

PubMed

Hill, Andrew; Gotham, Dzintars; Cooke, Graham; Bhagani, Sanjay; Andrieux-Meyer, Isabelle; Cohn, Jennifer; Fortunak, Joseph

2015-04-01

In 2013, an estimated 686,000 people died from hepatitis B virus (HBV) infection worldwide. Mass treatment programmes for hepatitis B will require very low drug costs. International treatment guidelines recommend first-line monotherapy with either entecavir or tenofovir disoproxil fumarate (TDF). While the basic patent on TDF expires in 2017/8, entecavir is already generic in several countries, including the US. The chemical structure of entecavir is related to abacavir, which costs <$200 per person-year in low-income countries. The clinical efficacy, chemical structures, daily doses, routes of chemical synthesis, costs of raw materials and patent expiry dates were analysed for entecavir and TDF. Costs of sustainable, generic production were calculated for entecavir, and compared with published originator and generic prices in high- and low-income countries. With a daily dose of 0.5 mg, one year's supply of entecavir treatment requires <0.2 g of active pharmaceutical ingredient (API) per person, estimated to cost $4/year, based on quotations of API production from generic suppliers. With an additional $20 per year for formulation/packaging and a 50% profit margin, entecavir was estimated to cost a minimum of $36/person-year, substantially lower than current originator and generic prices. Entecavir is no longer under patent protection in the USA, China, Brazil and South Africa, with European expiry in 2017. Given differences in daily dosing, production volumes for entecavir would be 600 times lower than TDF (300 mg once daily) for treating the same numbers of patients. Mass treatment for hepatitis B with generic entecavir could be achieved at very low cost in all countries, provided that important projections can be met in terms of pricing for the API and finished dosage form.

A cost analysis of first-line chemotherapy for low-risk gestational trophoblastic neoplasia.

PubMed

Shah, Neel T; Barroilhet, Lisa; Berkowitz, Ross S; Goldstein, Donald P; Horowitz, Neil

2012-01-01

To determine the optimal approach to first-line treatment for low-risk gestational trophoblastic neoplasia (GTN) using a cost analysis of 3 commonly used regimens. A decision tree of the 3 most commonly used first-line low-risk GTN treatment strategies was created, accounting for toxicities, response rates and need for second- or third-line therapy. These strategies included 8-day methotrexate (MTX)/folinic acid, weekly MTX, and pulsed actinomycin-D (act-D). Response rates, average number of cycles needed for remission, and toxicities were determined by review of the literature. Costs of each strategy were examined from a societal perspective, including the direct total treatment costs as well as the indirect lost labor production costs from work absences. Sensitivity analysis on these costs was performed using both deterministic and probabilistic cost-minimization models with the aid of decision tree software (TreeAge Pro 2011, TreeAge Inc., Williamstown, Massachusetts). We found that 8-day MTX/folinic acid is the least expensive to society, followed by pulsed act-D ($4,867 vs. $6,111 average societal cost per cure, respectively), with act-D becoming more favorable only with act-D per-cycle cost <$231, or response rate to first-line therapy > 99%. Weekly MTX is the most expensive first-line treatment strategy to society ($9,089 average cost per cure), despite being least expensive to administer per cycle, based on lower first-line response rate. Absolute societal cost of each strategy is driven by the probability of needing expensive third-line multiagent chemotherapy, however relative cost differences are robust to sensitivity analysis over the reported range of cycle number and response rate for all therapies. Based on similar efficacy and lower societal cost, we recommend 8-day MTX/folinic acid for first-line treatment of low-risk GTN.

Controlling groundwater pumping online.

PubMed

Zekri, Slim

2009-08-01

Groundwater over-pumping is a major problem in several countries around the globe. Since controlling groundwater pumping through water flow meters is hardly feasible, the surrogate is to control electricity usage. This paper presents a framework to restrict groundwater pumping by implementing an annual individual electricity quota without interfering with the electricity pricing policy. The system could be monitored online through prepaid electricity meters. This provides low transaction costs of individual monitoring of users compared to the prohibitive costs of water flow metering and monitoring. The public groundwater managers' intervention is thus required to determine the water and electricity quota and watch the electricity use online. The proposed framework opens the door to the establishment of formal groundwater markets among users at very low transaction costs. A cost-benefit analysis over a 25-year period is used to evaluate the cost of non-action and compare it to the prepaid electricity quota framework in the Batinah coastal area of Oman. Results show that the damage cost to the community, if no active policy is implemented, amounts to (-$288) million. On the other hand, the implementation of a prepaid electricity quota with an online management system would result in a net present benefit of $199 million.

Incremental cost and cost-effectiveness of low-dose, high-frequency training in basic emergency obstetric and newborn care as compared to status quo: part of a cluster-randomized training intervention evaluation in Ghana.

PubMed

Willcox, Michelle; Harrison, Heather; Asiedu, Amos; Nelson, Allyson; Gomez, Patricia; LeFevre, Amnesty

2017-12-06

Low-dose, high-frequency (LDHF) training is a new approach best practices to improve clinical knowledge, build and retain competency, and transfer skills into practice after training. LDHF training in Ghana is an opportunity to build health workforce capacity in critical areas of maternal and newborn health and translate improved capacity into better health outcomes. This study examined the costs of an LDHF training approach for basic emergency obstetric and newborn care and calculates the incremental cost-effectiveness of the LDHF training program for health outcomes of newborn survival, compared to the status quo alternative of no training. The costs of LDHF were compared to costs of traditional workshop-based training per provider trained. Retrospective program cost analysis with activity-based costing was used to measure all resources of the LDHF training program over a 3-year analytic time horizon. Economic costs were estimated from financial records, informant interviews, and regional market prices. Health effects from the program's impact evaluation were used to model lives saved and disability-adjusted life years (DALYs) averted. Uncertainty analysis included one-way and probabilistic sensitivity analysis to explore incremental cost-effectiveness results when fluctuating key parameters. For the 40 health facilities included in the evaluation, the total LDHF training cost was $823,134. During the follow-up period after the first LDHF training-1 year at each participating facility-approximately 544 lives were saved. With deterministic calculation, these findings translate to $1497.77 per life saved or $53.07 per DALY averted. Probabilistic sensitivity analysis, with mean incremental cost-effectiveness ratio of $54.79 per DALY averted ($24.42-$107.01), suggests the LDHF training program as compared to no training has 100% probability of being cost-effective above a willingness to pay threshold of $1480, Ghana's gross national income per capita in 2015. This study provides insight into the investment of LDHF training and value for money of this approach to training in-service providers on basic emergency obstetric and newborn care. The LDHF training approach should be considered for expansion in Ghana and integrated into existing in-service training programs and health system organizational structures for lower cost and more efficiency at scale.

Time-driven activity-based cost comparison of prostate cancer brachytherapy and intensity-modulated radiation therapy.

PubMed

Dutta, Sunil W; Bauer-Nilsen, Kristine; Sanders, Jason C; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis. The capacity cost rate was determined for each resource and calculated for each treatment option from initial consultation to its completion. Treatment options included low-dose-rate brachytherapy (LDR-BT), combined high-dose-rate brachytherapy single fraction boost with 25-fraction intensity-modulated radiotherapy (HDR-BT-IMRT), moderately hypofractionated 28-fraction IMRT, conventionally fractionated 39-fraction IMRT, and conventionally fractionated (2 Gy/fraction) 23-fraction pelvis irradiation with 16-fraction prostate boost. The total cost to deliver LDR-BT, HDR-BT-IMRT, moderately hypofractionated 28-fraction IMRT, conventionally fractionated 39-fraction IMRT, conventionally fractionated 39-fraction IMRT, and conventionally fractionated (2 Gy/fraction) 23-fraction pelvis irradiation with 16-fraction prostate boost was $2719, $6517, $4173, $5507, and $5663, respectively. Total reimbursement for each course was $3123, $10,156, $7862, $9725, and $10,377, respectively. Radiation oncology attending time was 1.5-2 times higher for treatment courses incorporating BT. Attending radiation oncologist's time consumed per RVU was higher with BT (4.83 and 2.56 minutes per RVU generated for LDR-BT and HDR-BT-IMRT, respectively) compared to without BT (1.41-1.62 minutes per RVU). Time-driven activity-based costing analysis identified higher delivery costs associated with prostate BT compared with IMRT alone. In light of recent guidelines promoting BT for intermediate- to high-risk disease, re-evaluation of payment policies is warranted to encourage BT delivery. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Low-cost data analysis systems for processing multispectral scanner data

NASA Technical Reports Server (NTRS)

Whitely, S. L.

1976-01-01

The basic hardware and software requirements are described for four low cost analysis systems for computer generated land use maps. The data analysis systems consist of an image display system, a small digital computer, and an output recording device. Software is described together with some of the display and recording devices, and typical costs are cited. Computer requirements are given, and two approaches are described for converting black-white film and electrostatic printer output to inexpensive color output products. Examples of output products are shown.

A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance.

PubMed

Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik

2016-07-27

Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.

Making a Low Cost Candy Floss Kit Gets Students Excited about Learning Physics

ERIC Educational Resources Information Center

Amir, Nazir; Subramaniam, R.

2009-01-01

An activity to excite kinaesthetically inclined students about learning physics is described in this article. Using only commonly available materials, a low cost candy floss kit is fabricated by students. A number of physics concepts are embedded contextually in the activity so that students get to learn these concepts in a real world setting…

The role of the pharmacy technician in the skill-mixed district nursing team.

PubMed

McGraw, Caroline; Coleman, Bridget; Ashman, Lea; Hayes, Sarah

2012-09-01

Registered nurses in the district nursing service delegate a broad range of medication administration activities to healthcare assistants. Although healthcare assistants have provided extra capacity, not all activities are suitable for delegation to unregulated practitioners. At the same time, their competency assessment is often patient-specific and demands significant registered nursing input. The purpose of this 6-month pilot programme was to test the premise that the employment of a pharmacy technician in the district nursing service would enhance productivity levels and deliver cost savings. Activities delegated included the administration of oral tablets and subcutaneous insulin and low molecular weight heparin injections. The evaluation found that the introduction of the pharmacy technician was associated with neither enhanced productivity nor more than modest cost savings. However, role redesign is a long-term activity and their role could be built on with further competency analysis.

Low-Cost Large Aperture Telescopes for Optical Communications

NASA Technical Reports Server (NTRS)

Hemmati, Hamid

2006-01-01

Low-cost, 0.5-1 meter ground apertures are required for near-Earth laser communications. Low-cost ground apertures with equivalent diameters greater than 10 meters are desired for deep-space communications. This presentation focuses on identifying schemes to lower the cost of constructing networks of large apertures while continuing to meet the requirements for laser communications. The primary emphasis here is on the primary mirror. A slumped glass spherical mirror, along with passive secondary mirror corrector and active adaptive optic corrector show promise as a low-cost alternative to large diameter monolithic apertures. To verify the technical performance and cost estimate, development of a 1.5-meter telescope equipped with gimbal and dome is underway.

Economic Planning for Multicounty Rural Areas: Application of a Linear Programming Model in Northwest Arkansas. Technical Bulletin No. 1653.

ERIC Educational Resources Information Center

Williams, Daniel G.

Planners in multicounty rural areas can use the Rural Development, Activity Analysis Planning (RDAAP) model to try to influence the optimal growth of their areas among different general economic goals. The model implies that best industries for rural areas have: high proportion of imported inputs; low transportation costs; high value added/output…

Research and Development of Rapid Design Systems for Aerospace Structure

NASA Technical Reports Server (NTRS)

Schaeffer, Harry G.

1999-01-01

This report describes the results of research activities associated with the development of rapid design systems for aerospace structures in support of the Intelligent Synthesis Environment (ISE). The specific subsystems investigated were the interface between model assembly and analysis; and, the high performance NASA GPS equation solver software system in the Windows NT environment on low cost high-performance PCs.

A natural user interface to integrate citizen science and physical exercise

PubMed Central

Palermo, Eduardo; Laut, Jeffrey; Nov, Oded; Porfiri, Maurizio

2017-01-01

Citizen science enables volunteers to contribute to scientific projects, where massive data collection and analysis are often required. Volunteers participate in citizen science activities online from their homes or in the field and are motivated by both intrinsic and extrinsic factors. Here, we investigated the possibility of integrating citizen science tasks within physical exercises envisaged as part of a potential rehabilitation therapy session. The citizen science activity entailed environmental mapping of a polluted body of water using a miniature instrumented boat, which was remotely controlled by the participants through their physical gesture tracked by a low-cost markerless motion capture system. Our findings demonstrate that the natural user interface offers an engaging and effective means for performing environmental monitoring tasks. At the same time, the citizen science activity increases the commitment of the participants, leading to a better motion performance, quantified through an array of objective indices. The study constitutes a first and necessary step toward rehabilitative treatments of the upper limb through citizen science and low-cost markerless optical systems. PMID:28231261

Development of a low cost method to estimate the seismic signature of a geothermal field form ambient noise analysis.

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

Tibuleac, Ileana

2016-06-30

A new, cost effective and non-invasive exploration method using ambient seismic noise has been tested at Soda Lake, NV, with promising results. The material included in this report demonstrates that, with the advantage of initial S-velocity models estimated from ambient noise surface waves, the seismic reflection survey, although with lower resolution, reproduces the results of the active survey when the ambient seismic noise is not contaminated by strong cultural noise. Ambient noise resolution is less at depth (below 1000m) compared to the active survey. In general, the results are promising and useful information can be recovered from ambient seismic noise,more » including dipping features and fault locations.« less

Outreach at Washington State University: a case study in costs and attendance

NASA Astrophysics Data System (ADS)

Bernhardt, Elizabeth A.; Bollen, Viktor; Bersano, Thomas M.; Mossman, Sean M.

2016-09-01

Making effective and efficient use of outreach resources can be difficult for student groups in smaller rural communities. Washington State University's OSA/SPIE student chapter desires well attended yet cost-effective ways to educate and inform the public. We designed outreach activities focused on three different funding levels: low upfront cost, moderate continuing costs, and high upfront cost with low continuing costs. By featuring our activities at well attended events, such as a pre-football game event, or by advertising a headlining activity, such as a laser maze, we take advantage of large crowds to create a relaxed learning atmosphere. Moreover, participants enjoy casual learning while waiting for a main event. Choosing a particular funding level and associating with well-attended events makes outreach easier. While there are still many challenges to outreach, such as motivating volunteers or designing outreach programs, we hope overcoming two large obstacles will lead to future outreach success.

Activity-Based Costing in a Service Organization

DTIC Science & Technology

1993-06-01

environments, very little research has been done in service organizations. This thesis is a comparative analysis of a tradional cost accounting system with an...activity-based cost accounting system in a medium-sized mass transit system. The purpose of the analysis was to determine whether activity-based... accounting techniques can effectively be applied in a service industry. In addition, a goal for the thesis was to determine which costing system reports a

Cost-effectiveness of early interventions for non-specific low back pain: a randomized controlled study investigating medical yoga, exercise therapy and self-care advice.

PubMed

Aboagye, Emmanuel; Karlsson, Malin Lohela; Hagberg, Jan; Jensen, Irene

2015-02-01

To evaluate the cost-effectiveness of medical yoga as an early intervention compared with evidence-based exercise therapy and self-care advice for non-specific low back pain. Randomized controlled trial with a cost-effectiveness analysis. A total of 159 participants randomized into the medical yoga group (n = 52), the exercise therapy group (n = 52) and the self-care advice group (n = 55). The health outcome measure EQ-5D was applied to measure quality of life data combined with cost data collected from treatment groups from baseline to 12 months follow-up. Outcome measure was health-related quality of life (HRQL). Incremental cost per quality adjusted life year (QALY) was also calculated. Cost-effectiveness analysis was conducted primarily from the societal and employer perspectives. Medical yoga is cost-effective compared with self-care advice if an employer considers the significant improvement in the HRQL of an employee with low back pain justifies the additional cost of treatment (i.e. in this study EUR 150). From a societal perspective, medical yoga is a cost-effective treatment compared with exercise therapy and self-care advice if an additional QALY is worth EUR 11,500. Sensitivity analysis suggests that medical yoga is more cost-effective than its alternatives. Six weeks of uninterrupted medical yoga thera-py is a cost-effective early intervention for non-specific low back pain, when treatment recommendations are adhered to.

Patient casemix classification for medicare psychiatric prospective payment.

PubMed

Drozd, Edward M; Cromwell, Jerry; Gage, Barbara; Maier, Jan; Greenwald, Leslie M; Goldman, Howard H

2006-04-01

For a proposed Medicare prospective payment system for inpatient psychiatric facility treatment, the authors developed a casemix classification to capture differences in patients' real daily resource use. Primary data on patient characteristics and daily time spent in various activities were collected in a survey of 696 patients from 40 inpatient psychiatric facilities. Survey data were combined with Medicare claims data to estimate intensity-adjusted daily cost. Classification and Regression Trees (CART) analysis of average daily routine and ancillary costs yielded several hierarchical classification groupings. Regression analysis was used to control for facility and day-of-stay effects in order to compare hierarchical models with models based on the recently proposed payment system of the Centers for Medicare & Medicaid Services. CART analysis identified a small set of patient characteristics strongly associated with higher daily costs, including age, psychiatric diagnosis, deficits in daily living activities, and detox or ECT use. A parsimonious, 16-group, fully interactive model that used five major DSM-IV categories and stratified by age, illness severity, deficits in daily living activities, dangerousness, and use of ECT explained 40% (out of a possible 76%) of daily cost variation not attributable to idiosyncratic daily changes within patients. A noninteractive model based on diagnosis-related groups, age, and medical comorbidity had explanatory power of only 32%. A regression model with 16 casemix groups restricted to using "appropriate" payment variables (i.e., those with clinical face validity and low administrative burden that are easily validated and provide proper care incentives) produced more efficient and equitable payments than did a noninteractive system based on diagnosis-related groups.

Low cost 3D scanning process using digital image processing

NASA Astrophysics Data System (ADS)

Aguilar, David; Romero, Carlos; Martínez, Fernando

2017-02-01

This paper shows the design and building of a low cost 3D scanner, able to digitize solid objects through contactless data acquisition, using active object reflection. 3D scanners are used in different applications such as: science, engineering, entertainment, etc; these are classified in: contact scanners and contactless ones, where the last ones are often the most used but they are expensive. This low-cost prototype is done through a vertical scanning of the object using a fixed camera and a mobile horizontal laser light, which is deformed depending on the 3-dimensional surface of the solid. Using digital image processing an analysis of the deformation detected by the camera was done; it allows determining the 3D coordinates using triangulation. The obtained information is processed by a Matlab script, which gives to the user a point cloud corresponding to each horizontal scanning done. The obtained results show an acceptable quality and significant details of digitalized objects, making this prototype (built on LEGO Mindstorms NXT kit) a versatile and cheap tool, which can be used for many applications, mainly by engineering students.

Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis.

PubMed

Miyamoto, Gisela Cristiane; Lin, Chung-Wei Christine; Cabral, Cristina Maria Nunes; van Dongen, Johanna M; van Tulder, Maurits W

2018-04-20

To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain. Systematic review of economic evaluations. The search was performed in 5 clinical and 3 economic electronic databases. We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed. Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain. Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed. PROSPERO, CRD42017059025. © 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.

Activity-based cost analysis of hepatic tumor ablation using CT-guided high-dose rate brachytherapy or CT-guided radiofrequency ablation in hepatocellular carcinoma.

PubMed

Schnapauff, D; Collettini, F; Steffen, I; Wieners, G; Hamm, B; Gebauer, B; Maurer, M H

2016-02-25

To analyse and compare the costs of hepatic tumor ablation with computed tomography (CT)-guided high-dose rate brachytherapy (CT-HDRBT) and CT-guided radiofrequency ablation (CT-RFA) as two alternative minimally invasive treatment options of hepatocellular carcinoma (HCC). An activity based process model was created determining working steps and required staff of CT-RFA and CT-HDRBT. Prorated costs of equipment use (purchase, depreciation, and maintenance), costs of staff, and expenditure for disposables were identified in a sample of 20 patients (10 treated by CT-RFA and 10 by CT-HDRBT) and compared. A sensitivity and break even analysis was performed to analyse the dependence of costs on the number of patients treated annually with both methods. Costs of CT-RFA were nearly stable with mean overall costs of approximately 1909 €, 1847 €, 1816 € and 1801 € per patient when treating 25, 50, 100 or 200 patients annually, as the main factor influencing the costs of this procedure was the single-use RFA probe. Mean costs of CT-HDRBT decreased significantly per patient ablation with a rising number of patients treated annually, with prorated costs of 3442 €, 1962 €, 1222 € and 852 € when treating 25, 50, 100 or 200 patients, due to low costs of single-use disposables compared to high annual fix-costs which proportionally decreased per patient with a higher number of patients treated annually. A break-even between both methods was reached when treating at least 55 patients annually. Although CT-HDRBT is a more complex procedure with more staff involved, it can be performed at lower costs per patient from the perspective of the medical provider when treating more than 55 patients compared to CT-RFA, mainly due to lower costs for disposables and a decreasing percentage of fixed costs with an increasing number of treatments.

Phase 1 of the automated array assembly task of the low cost silicon solar array project

NASA Technical Reports Server (NTRS)

Pryor, R. A.; Grenon, L. A.; Coleman, M. G.

1978-01-01

The results of a study of process variables and solar cell variables are presented. Interactions between variables and their effects upon control ranges of the variables are identified. The results of a cost analysis for manufacturing solar cells are discussed. The cost analysis includes a sensitivity analysis of a number of cost factors.

Are iso-osmolar, as compared to low-osmolar, contrast media cost-effective in patients undergoing cardiac catheterization? An economic analysis.

PubMed

Hiremath, Swapnil; Akbari, Ayub; Wells, George A; Chow, Benjamin J W

2018-04-23

Contrast-induced acute kidney injury is a prominent complication following cardiac catheterization, though the risk has progressively decreased in recent times with appropriate risk stratification and use of safer contrast agents. Despite data supporting further lowering of risk with the iso-osmolar agent, iodixanol, uptake has lagged, perhaps due to increased upfront cost of this agent. We undertook an economic analysis to estimate the cost-effectiveness of a strategy utilizing iodixanol compared to using a low-osmolar contrast agent. We created a Markov model to evaluate the two strategies, and included a differential relative risk of contrast-induced acute kidney injury, based on a systematic review of the literature. Downstream clinical events, including need for dialysis and mortality, were modeled using data from existing published literature. A third-party payer perspective was utilized for the analysis and presentation of the primary economic analysis. The strategy of using iodixanol dominated in both the low-risk and high-risk base case analyses. However, the difference was quite small in the low-risk scenario (lifetime cost: C$678,034 vs. C$678,059 and life expectancy: 19.80 vs. 19.72 years). The difference was more marked (life expectancy 15.65 vs. 14.15 years and cost C$680,989 vs. C$682,023) in the high-risk case analysis. This was robust across most of the variables tested in sensitivity analyses. The use of iodixanol, compared with low-osmolar contrast agents, for cardiac catheterization, results in a small benefit clinical outcomes, and in a savings in direct healthcare costs. Overall, our analysis supports the use of iodixanol for cardiac catheterization, especially in patients at high risk of acute kidney injury.

Utilizing time-driven activity-based costing to understand the short- and long-term costs of treating localized, low-risk prostate cancer.

PubMed

Laviana, Aaron A; Ilg, Annette M; Veruttipong, Darlene; Tan, Hung-Jui; Burke, Michael A; Niedzwiecki, Douglas R; Kupelian, Patrick A; King, Chris R; Steinberg, Michael L; Kundavaram, Chandan R; Kamrava, Mitchell; Kaplan, Alan L; Moriarity, Andrew K; Hsu, William; Margolis, Daniel J A; Hu, Jim C; Saigal, Christopher S

2016-02-01

Given the costs of delivering care for men with prostate cancer remain poorly described, this article reports the results of time-driven activity-based costing (TDABC) for competing treatments of low-risk prostate cancer. Process maps were developed for each phase of care from the initial urologic visit through 12 years of follow-up for robotic-assisted laparoscopic prostatectomy (RALP), cryotherapy, high-dose rate (HDR) and low-dose rate (LDR) brachytherapy, intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and active surveillance (AS). The last modality incorporated both traditional transrectal ultrasound (TRUS) biopsy and multiparametric-MRI/TRUS fusion biopsy. The costs of materials, equipment, personnel, and space were calculated per unit of time and based on the relative proportion of capacity used. TDABC for each treatment was defined as the sum of its resources. Substantial cost variation was observed at 5 years, with costs ranging from $7,298 for AS to $23,565 for IMRT, and they remained consistent through 12 years of follow-up. LDR brachytherapy ($8,978) was notably cheaper than HDR brachytherapy ($11,448), and SBRT ($11,665) was notably cheaper than IMRT, with the cost savings attributable to shorter procedure times and fewer visits required for treatment. Both equipment costs and an inpatient stay ($2,306) contributed to the high cost of RALP ($16,946). Cryotherapy ($11,215) was more costly than LDR brachytherapy, largely because of increased single-use equipment costs ($6,292 vs $1,921). AS reached cost equivalence with LDR brachytherapy after 7 years of follow-up. The use of TDABC is feasible for analyzing cancer services and provides insights into cost-reduction tactics in an era focused on emphasizing value. By detailing all steps from diagnosis and treatment through 12 years of follow-up for low-risk prostate cancer, this study has demonstrated significant cost variation between competing treatments. © 2015 American Cancer Society.

Screening for tuberculosis among adults newly diagnosed with HIV in sub-Saharan Africa: a cost-effectiveness analysis

PubMed Central

Zwerling, Alice A.; Sahu, Maitreyi; Ngwira, Lucky G.; Khundi, McEwen; Harawa, Tina; Corbett, Elizabeth L.; Chaisson, Richard E.; Dowdy, David W.

2015-01-01

Objective New tools, including light emitting diode (LED) fluorescence microscopy and the molecular assay Xpert MTB/RIF® offer increased sensitivity for TB in persons with HIV but come with higher costs. Using operational data from rural Malawi we explored the potential cost-effectiveness of on-demand screening for TB in low-income countries of sub-Saharan Africa. Design & Methods Costs were empirically collected in four clinics and one hospital using a micro-costing approach, through direct interview and observation from the national TB program perspective. Using decision analysis newly diagnosed persons with HIV were modeled as being screened by one of three strategies: Xpert, LED or standard of care (i.e., at the discretion of the treating physician). Results Cost-effectiveness of TB screening among persons newly diagnosed with HIV was largely determined by two factors: prevalence of active TB among patients newly diagnosed with HIV and volume of testing. In facilities screening at least 50 people with a 6.5% prevalence of TB, or at least 500 people with a 2.5% TB prevalence, screening with Xpert is likely to be cost-effective. At lower prevalence – including that observed in Malawi – LED microscopy may be the preferred strategy, whereas in settings of lower TB prevalence or small numbers of eligible patients, no screening may be reasonable (such that resources can be deployed elsewhere). Conclusions TB screening at the point of HIV diagnosis may be cost-effective in low-income countries of sub-Saharan Africa, but only if a relatively large population with high prevalence of TB can be identified for screening. PMID:26049281

Cost-driven materials selection criteria for redox flow battery electrolytes

NASA Astrophysics Data System (ADS)

Dmello, Rylan; Milshtein, Jarrod D.; Brushett, Fikile R.; Smith, Kyle C.

2016-10-01

Redox flow batteries show promise for grid-scale energy storage applications but are presently too expensive for widespread adoption. Electrolyte material costs constitute a sizeable fraction of the redox flow battery price. As such, this work develops a techno-economic model for redox flow batteries that accounts for redox-active material, salt, and solvent contributions to the electrolyte cost. Benchmark values for electrolyte constituent costs guide identification of design constraints. Nonaqueous battery design is sensitive to all electrolyte component costs, cell voltage, and area-specific resistance. Design challenges for nonaqueous batteries include minimizing salt content and dropping redox-active species concentration requirements. Aqueous battery design is sensitive to only redox-active material cost and cell voltage, due to low area-specific resistance and supporting electrolyte costs. Increasing cell voltage and decreasing redox-active material cost present major materials selection challenges for aqueous batteries. This work minimizes cost-constraining variables by mapping the battery design space with the techno-economic model, through which we highlight pathways towards low price and moderate concentration. Furthermore, the techno-economic model calculates quantitative iterations of battery designs to achieve the Department of Energy battery price target of 100 per kWh and highlights cost cutting strategies to drive battery prices down further.

Cost Analysis of Selected Patient Categories within a Dermatology Department Using an ABC Approach

PubMed Central

Papadaki, Šárka; Popesko, Boris

2016-01-01

Background: Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. Methods: The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. Results: The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Conclusions: Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the hospital management. Based on the analysis results, it is possible to standardize activities and performance appraisal (Benchmarking), and provide all necessary information for hospital budgeting practices, especially Activity-Based Budgeting (ABB). PMID:26755477

Cost Analysis of Selected Patient Categories Within A Dermatology Department Using an ABC Approach.

PubMed

Papadaki, Šárka; Popesko, Boris

2015-11-17

Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the hospital management. Based on the analysis results, it is possible to standardize activities and performance appraisal (Benchmarking), and provide all necessary information for hospital budgeting practices, especially Activity-Based Budgeting (ABB).

Low-Cost Propellant Launch to LEO from a Tethered Balloon - Economic and Thermal Analysis

NASA Technical Reports Server (NTRS)

Wilcox, Brian H.; Schneider, Evan G.; Vaughan, David A.; Hall, Jeffrey L.

2010-01-01

This paper provides new analysis of the economics of low-cost propellant launch coupled with dry hardware re-use, and of the thermal control of the liquid hydrogen once on-orbit. One conclusion is that this approach enables an overall reduction in the cost-permission by as much as a factor of five as compared to current approaches for human exploration of the moon, Mars, and near-Earth asteroids.

Unsupervised Machine Learning for Developing Personalised Behaviour Models Using Activity Data.

PubMed

Fiorini, Laura; Cavallo, Filippo; Dario, Paolo; Eavis, Alexandra; Caleb-Solly, Praminda

2017-05-04

The goal of this study is to address two major issues that undermine the large scale deployment of smart home sensing solutions in people's homes. These include the costs associated with having to install and maintain a large number of sensors, and the pragmatics of annotating numerous sensor data streams for activity classification. Our aim was therefore to propose a method to describe individual users' behavioural patterns starting from unannotated data analysis of a minimal number of sensors and a "blind" approach for activity recognition. The methodology included processing and analysing sensor data from 17 older adults living in community-based housing to extract activity information at different times of the day. The findings illustrate that 55 days of sensor data from a sensor configuration comprising three sensors, and extracting appropriate features including a "busyness" measure, are adequate to build robust models which can be used for clustering individuals based on their behaviour patterns with a high degree of accuracy (>85%). The obtained clusters can be used to describe individual behaviour over different times of the day. This approach suggests a scalable solution to support optimising the personalisation of care by utilising low-cost sensing and analysis. This approach could be used to track a person's needs over time and fine-tune their care plan on an ongoing basis in a cost-effective manner.

Unsupervised Machine Learning for Developing Personalised Behaviour Models Using Activity Data

PubMed Central

Fiorini, Laura; Cavallo, Filippo; Dario, Paolo; Eavis, Alexandra; Caleb-Solly, Praminda

2017-01-01

The goal of this study is to address two major issues that undermine the large scale deployment of smart home sensing solutions in people’s homes. These include the costs associated with having to install and maintain a large number of sensors, and the pragmatics of annotating numerous sensor data streams for activity classification. Our aim was therefore to propose a method to describe individual users’ behavioural patterns starting from unannotated data analysis of a minimal number of sensors and a ”blind” approach for activity recognition. The methodology included processing and analysing sensor data from 17 older adults living in community-based housing to extract activity information at different times of the day. The findings illustrate that 55 days of sensor data from a sensor configuration comprising three sensors, and extracting appropriate features including a “busyness” measure, are adequate to build robust models which can be used for clustering individuals based on their behaviour patterns with a high degree of accuracy (>85%). The obtained clusters can be used to describe individual behaviour over different times of the day. This approach suggests a scalable solution to support optimising the personalisation of care by utilising low-cost sensing and analysis. This approach could be used to track a person’s needs over time and fine-tune their care plan on an ongoing basis in a cost-effective manner. PMID:28471405

Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project.

PubMed

Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper; Hansen, John; Nielsen, Gitte; Spindler, Helle; Dinesen, Birthe

2016-07-01

Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months. The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey. The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than €400,000 per QALY gained. Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself was not costly (less than €500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.

Design and validation of low-cost assistive glove for hand assessment and therapy during activity of daily living-focused robotic stroke therapy.

PubMed

Nathan, Dominic E; Johnson, Michelle J; McGuire, John R

2009-01-01

Hand and arm impairment is common after stroke. Robotic stroke therapy will be more effective if hand and upper-arm training is integrated to help users practice reaching and grasping tasks. This article presents the design, development, and validation of a low-cost, functional electrical stimulation grasp-assistive glove for use with task-oriented robotic stroke therapy. Our glove measures grasp aperture while a user completes simple-to-complex real-life activities, and when combined with an integrated functional electrical stimulator, it assists in hand opening and closing. A key function is a new grasp-aperture prediction model, which uses the position of the end-effectors of two planar robots to define the distance between the thumb and index finger. We validated the accuracy and repeatability of the glove and its capability to assist in grasping. Results from five nondisabled subjects indicated that the glove is accurate and repeatable for both static hand-open and -closed tasks when compared with goniometric measures and for dynamic reach-to-grasp tasks when compared with motion analysis measures. Results from five subjects with stroke showed that with the glove, they could open their hands but without it could not. We present a glove that is a low-cost solution for in vivo grasp measurement and assistance.

Oxygen transfer dynamics and activated sludge floc structure under different sludge retention times at low dissolved oxygen concentrations.

PubMed

Fan, Haitao; Liu, Xiuhong; Wang, Hao; Han, Yunping; Qi, Lu; Wang, Hongchen

2017-02-01

In activated sludge systems, the aeration process consumes the most energy. The energy cost can be dramatically reduced by decreasing the operating dissolved oxygen (DO) concentration. However, low DO may lead to incomplete nitrification and poor settling performance of activated sludge flocs (ASFs). This study investigates oxygen transfer dynamics and settling performances of activated sludge under different sludge retention times (SRTs) and DO conditions using microelectrodes and microscopic techniques. Our experimental results showed that with longer SRTs, treatment capacity and settling performances of activated sludge improved due to smaller floc size and less extracellular polymeric substances (EPS). Long-term low DO conditions produced larger flocs and more EPS per unit sludge, which produced a more extensive anoxic area and led to low oxygen diffusion performance in flocs. Long SRTs mitigated the adverse effects of low DO. According to the microelectrode analysis and fractal dimension determination, smaller floc size and less EPS in the long SRT system led to high oxygen diffusion property and more compact floc structure that caused a drop in the sludge volume index (SVI). In summary, our results suggested that long SRTs of activated sludge can improve the operating performance under low DO conditions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Payload analysis for space shuttle applications (study 2.2). Volume 3: Payload system operations analysis (task 2.2.1). [payload system operations analysis for shuttles and space tugs

NASA Technical Reports Server (NTRS)

1972-01-01

The technical and cost analysis that was performed for the payload system operations analysis is presented. The technical analysis consists of the operations for the payload/shuttle and payload/tug, and the spacecraft analysis which includes sortie, automated, and large observatory type payloads. The cost analysis includes the costing tradeoffs of the various payload design concepts and traffic models. The overall objectives of this effort were to identify payload design and operational concepts for the shuttle which will result in low cost design, and to examine the low cost design concepts to identify applicable design guidelines. The operations analysis examined several past and current NASA and DoD satellite programs to establish a shuttle operations model. From this model the analysis examined the payload/shuttle flow and determined facility concepts necessary for effective payload/shuttle ground operations. The study of the payload/tug operations was an examination of the various flight timelines for missions requiring the tug.

An activity-based methodology for operations cost analysis

NASA Technical Reports Server (NTRS)

Korsmeyer, David; Bilby, Curt; Frizzell, R. A.

1991-01-01

This report describes an activity-based cost estimation method, proposed for the Space Exploration Initiative (SEI), as an alternative to NASA's traditional mass-based cost estimation method. A case study demonstrates how the activity-based cost estimation technique can be used to identify the operations that have a significant impact on costs over the life cycle of the SEI. The case study yielded an operations cost of $101 billion for the 20-year span of the lunar surface operations for the Option 5a program architecture. In addition, the results indicated that the support and training costs for the missions were the greatest contributors to the annual cost estimates. A cost-sensitivity analysis of the cultural and architectural drivers determined that the length of training and the amount of support associated with the ground support personnel for mission activities are the most significant cost contributors.

The cost-effectiveness of 1% or less media campaigns promoting low-fat milk consumption.

PubMed

Wootan, Margo G; Reger-Nash, Bill; Booth-Butterfield, Steve; Cooper, Linda

2005-10-01

The purpose of our study was to compare the cost-effectiveness of four strategies using components of 1% Or Less to promote population-based behavior change. 1% Or Less is a mass-media campaign that encourages switching from high-fat (whole or 2%) to low-fat (1% or skim) milk. Using a quasi-experimental design, campaigns were previously conducted in four West Virginia communities using different combinations of 1) paid advertising, 2) media relations, and 3) community-based educational activities. Telephone surveys and supermarket milk sales data were used to measure the campaigns' effectiveness. Using data from the previously completed studies, we analyzed the cost of each campaign. We then calculated the cost per person exposed to the campaign and cost per person who switched from high- to low-fat milk. The combination of paid advertising and media relations was the most cost-effective campaign, with a cost of 0.57 dollars per person to elicit a switch from high- to low-fat milk, and the combination of media relations and community-based educational activities was the least cost-effective campaign, with a cost of 11.85 dollars per person to elicit a switch. Population-based campaigns using a combination of paid advertising and media relations strategies can be a cost-effective way to promote a behavior change in a community.

Finished Prokaryotic Genome Assemblies from a Low-cost Combination of Short and Long Reads (Seventh Annual Sequencing, Finishing, Analysis in the Future (SFAF) Meeting 2012)

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

Yin, Shuangye

2012-06-01

Shuangye Yin on "Finished prokaryotic genome assemblies from a low-cost combination of short and long reads"; at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

``Low-cost Electronic nose evaluated on Thai-herb of Northern-Thailand samples using multivariate analysis methods''

NASA Astrophysics Data System (ADS)

na ayudhaya, Paisarn Daungjak; Klinbumrung, Arrak; Jaroensutasinee, Krisanadej; Pratontep, Sirapat; Kerdcharoen, Teerakiat

2009-05-01

In case of species of natural and aromatic plant originated from the northern Thailand, sensory characteristics, especially odours, have unique identifiers of herbs. The instruments sensory analysis have performed by several of differential of sensing, so call `electronic nose', to be a significantly and rapidly for chemometrics. The signal responses of the low cost electronic nose were evaluated by principal component analysis (PCA). The aims of this paper evaluated various of Thai-herbs grown in Northern of Thailand as data preprocessing tools of the Low-cost electronic nose (enNU-PYO1). The essential oil groups of Thai herbs such as Garlic, Lemongrass, Shallot (potato onion), Onion, Zanthoxylum limonella (Dennst.) Alston (Thai name is Makaen), and Kaffir lime leaf were compared volatilized from selected fresh herbs. Principal component analysis of the original sensor responses did clearly distinguish either all samples. In all cases more than 97% for cross-validated group were classified correctly. The results demonstrated that it was possible to develop in a model to construct a low-cost electronic nose to provide measurement of odoriferous herbs.

A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

PubMed

Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for patients with poorly controlled asthma or who may be at risk for poor asthma control, to include services that address triggers in the home environment.

New lipopeptide produced by Corynebacterium aquaticum from a low-cost substrate.

PubMed

Martins, Paola Chaves; Bastos, Cibele Garcia; Granjeiro, Paulo Afonso; Martins, Vilásia Guimarães

2018-04-26

Conventional biosurfactants have high production costs. Therefore, the use of low-cost carbon sources for their production is attractive for industry. The ability to remain stable under various environmental conditions further extends industrial application. Here we aimed to evaluate the stability of a new lipopeptide produced by Corynebacterium aquaticum using fish residue as an unconventional energy source. The biosurfactant was produced using 3% fish residue, 2% of the microorganism, and mineral medium. Biosurfactant characterization was performed by thin layer chromatography (TLC), as well as by testing its infrared, surface tension, emulsifying activity, and ionic character. The stability of the biosurfactant was evaluated by testing its surface tension at a range of temperatures, pH, and saline concentrations, as well as after 6 months of storage. The biosurfactant was characterized as a lipopeptide due to its retention time, which was coincident with the amino acid and lipid chains obtained in the TLC analysis, being confirmed by some regions of absorption verified in the infrared analysis. The surface tension and emulsifying activity of the biosurfactant were 27.8 mN/m and 87.6%, respectively, and showed anionic character. The biosurfactant was stable at temperatures of 20 to 121 °C, in saline concentrations of 1 to 7%, and at pH close to neutrality. Based on our findings, it is possible to use unconventional sources of energy to produce a lipopeptide biosurfactant that can act under various environments.

Comparison of the costs of active surveillance and immediate surgery in the management of low-risk papillary microcarcinoma of the thyroid.

PubMed

Oda, Hitomi; Miyauchi, Akira; Ito, Yasuhiro; Sasai, Hisanori; Masuoka, Hiroo; Yabuta, Tomonori; Fukushima, Mitsuhiro; Higashiyama, Takuya; Kihara, Minoru; Kobayashi, Kaoru; Miya, Akihiro

2017-01-30

The incidence of thyroid cancer is increasing rapidly in many countries, resulting in rising societal costs of the care of thyroid cancer. We reported that the active surveillance of low-risk papillary microcarcinoma had less unfavorable events than immediate surgery, while the oncological outcomes of these managements were similarly excellent. Here we calculated the medical costs of these two managements. We created a model of the flow of these managements, based on our previous study. The flow and costs include the step of diagnosis, surgery, prescription of medicine, recurrence, salvage surgery for recurrence, and care for 10 years after the diagnosis. The costs were calculated according to the typical clinical practices at Kuma Hospital performed under the Japanese Health Care Insurance System. If conversion surgeries were not considered, the 'simple cost' of active surveillance for 10 years was 167,780 yen/patient. If there were no recurrences, the 'simple cost' of immediate surgery was calculated as 794,770 yen/patient to 1,086,070 yen/patient, depending on the type of surgery and postoperative medication. The 'simple cost' of surgery was 4.7 to 6.5 times the 'simple cost' of surveillance. When conversion surgeries and recurrence were considered, the 'total cost' of active surveillance for 10 years became 225,695 yen/patient. When recurrence were considered, the 'total cost' of immediate surgery was 928,094 yen/patient, which was 4.1 times the 'total cost' of the active surveillance. At Kuma Hospital in Japan, the 10-year total cost of immediate surgery was 4.1 times expensive than active surveillance.

Low energy stage study. Volume 4: Cost benefits analysis and recommendations. [orbital launching of space shuttle payloads

NASA Technical Reports Server (NTRS)

1978-01-01

The costs and benefits of existing/planned systems, new propulsion concepts, and adaptations of existing/planned systems (as supported by Orbiter interface requirements and operations requirements) were quantified. Scenarios of these propulsion approaches were established which accommodate the low energy regime as defined by the new low energy payload mission model. These scenarios were screened on a cost and then a benefits basis. A propulsion approach comprising existing/planned systems and a new propulsion concept were selected as the most cost effective approach to accommodate the model payloads and the low energy regime they represent. Key cost drivers and sensitivity trends were identified. All costs were derived in 1977 dollars.

[Are Interventions Promoting Physical Activity Cost-Effective? A Systematic Review of Reviews].

PubMed

Rütten, Alfred; Abu-Omar, Karim; Burlacu, Ionut; Schätzlein, Valentin; Suhrcke, Marc

2017-03-01

On the basis of international published reviews, this systematic review aims to determine the health economic benefits of interventions promoting physical activity.This review of reviews is based on a systematic literature research in 10 databases (e. g. PubMed, Scopus, SPORTDiscus) supplemented by hand searches from January 2000 to October 2015. Publications were considered in the English or German language only. Results of identified reviews were derived.In total, 18 reviews were identified that could be attributed to interventions promoting physical activity (2 reviews focusing on population-based physical activity interventions, 10 reviews on individual-based and 6 reviews on both population-based and individual-based physical activity interventions). Results showed that population-based physical activity interventions are of great health economic potential if reaching a wider population at comparably low costs. Outstanding are political and environmental strategies, as well as interventions supporting behavioural change through information. The most comprehensive documentation for interventions promoting physical activity could be found for individual-based strategies (i. e. exercise advice or exercise programs). However, such programs are comparatively less cost-effective due to limited reach and higher utilization of resources.The present study provides an extensive review and analysis of the current international state of research regarding the health economic evaluation of interventions promoting physical activity. Results show favourable cost-effectiveness for interventions promoting physical activity, though significant differences in the effectiveness between various interventions were noticed. The greatest potential for cost-effectiveness can be seen in population-based interventions. At the same time, there is a need to acknowledge the limitations of the economic evidence in this field which are attributable to methodological challenges and research deficits. © Georg Thieme Verlag KG Stuttgart · New York.

Thermal Analysis Study of Antihypertensive Drugs Telmisartan and Cilazapril

PubMed Central

Saber, Refaat Ahmed; Attia, Ali Kamal; Salem, Waheed Mohamed

2014-01-01

Purpose: The aim of the present work is to study the thermal analysis of telmisartan and cilazapril. Methods: Thermogravimetry (TGA), derivative thermogravimetry (DTG) and differential thermal analysis (DTA) were used through the work to achieve the thermal analysis study of some antihypertensive drugs, telmisartan and cilazapril. Results: The results led to thermal stability data and also to the interpretation concerning the thermal decomposition. Thermogravimetry data allowed determination of the kinetic parameters such as, activation energy and frequency factor. Conclusion: The simplicity, speed and low operational costs of thermal analysis justify its application in the quality control of pharmaceutical compounds for medications. PMID:24754013

Financial hardship, unmet medical need, and health self-efficacy among African American men.

PubMed

Tucker-Seeley, Reginald D; Mitchell, Jamie A; Shires, Deirdre A; Modlin, Charles S

2015-06-01

Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p < .05), more likely to report low health self-efficacy. When unmet medical need due to cost was added to the model, the association between financial hardship and low health self-efficacy was no longer statistically significant. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy. © 2014 Society for Public Health Education.

Low-cost Large Aperture Telescopes for Optical Communications

NASA Technical Reports Server (NTRS)

Hemmati, Hamid

2006-01-01

Low-cost, large-aperture optical receivers are required to form an affordable optical ground receiver network for laser communications. Among the ground receiver station's multiple subsystems, here, we only discuss the ongoing research activities aimed at reducing the cost of the large-size optics on the receiver. Experimental results of two different approaches for fabricating low-cost mirrors of wavefront quality on the order of 100-200X the diffraction limit are described. Laboratory-level effort are underway to improve the surface figure to better than 20X the diffraction limit.

EXPLORING PATENT ACTIVITY AND ITS POTENTIAL ASSOCIATION WITH HEALTHCARE OUTCOMES: A CASE STUDY OF OSTOMY PRODUCTS IN SWEDEN.

PubMed

Calara, Paul Samuel; Althin, Rikard; Inglese, Gary; Nichols, Thomas

2017-01-01

The aim of this study was to evaluate whether ostomy industry patent activity (PA) is associated with patient outcomes and healthcare costs. Two groups of ostomy pouch users based on manufacturer PA (low or high) were compared in terms of ostomy-related wear patterns, adverse events, and healthcare expenditure. Using Swedish registry data, all patients with newly formed stomas were divided between each group and were followed during a 2-year period (2011-12). Propensity score matching and parametric duration analysis were used to compare outcomes between patients of similar characteristics such as sex, age, and ostomy surgery type. In both one- and two-piece systems, the high PA group had significantly lower monthly ostomy-related expenditure than the low PA group (one-piece: 197.47 EUR versus 233.34 EUR; two-piece: 164.00 EUR versus 278.98 EUR). Fewer pouch and skin wafer purchases per month were an important driver of cost differences. Both groups had similar likelihood of purchasing dermatological products for skin complications over time. PA in the ostomy care industry was associated with reduced healthcare costs, but not necessarily with fewer skin complications. It suggests that there is a health economic benefit from products made by patent intensive companies which may differentiate them from generic comparators, but more research is needed to understand the impact of activities conducive to medical innovation on health outcomes.

Ultrasonic Methods for Human Motion Detection

DTIC Science & Technology

2006-10-01

contacts. The active method utilizes continuous wave ultrasonic Doppler sonar . Human motions have unique Doppler signatures and their combination...The present article reports results of human motion investigations with help of CW ultrasonic Doppler sonar . Low-cost, low-power ultrasonic motion...have been developed for operation in air [10]. Benefits of using ultrasonic CW Doppler sonar included the low-cost, low-electric noise, small size

Predicting the propagation of concentration and saturation fronts in fixed-bed filters.

PubMed

Callery, O; Healy, M G

2017-10-15

The phenomenon of adsorption is widely exploited across a range of industries to remove contaminants from gases and liquids. Much recent research has focused on identifying low-cost adsorbents which have the potential to be used as alternatives to expensive industry standards like activated carbons. Evaluating these emerging adsorbents entails a considerable amount of labor intensive and costly testing and analysis. This study proposes a simple, low-cost method to rapidly assess the potential of novel media for potential use in large-scale adsorption filters. The filter media investigated in this study were low-cost adsorbents which have been found to be capable of removing dissolved phosphorus from solution, namely: i) aluminum drinking water treatment residual, and ii) crushed concrete. Data collected from multiple small-scale column tests was used to construct a model capable of describing and predicting the progression of adsorbent saturation and the associated effluent concentration breakthrough curves. This model was used to predict the performance of long-term, large-scale filter columns packed with the same media. The approach proved highly successful, and just 24-36 h of experimental data from the small-scale column experiments were found to provide sufficient information to predict the performance of the large-scale filters for up to three months. Copyright © 2017 Elsevier Ltd. All rights reserved.

Allocating physicians' overhead costs to services: an econometric/accounting-activity based-approach.

PubMed

Peden, Al; Baker, Judith J

2002-01-01

Using the optimizing properties of econometric analysis, this study analyzes how physician overhead costs (OC) can be allocated to multiple activities to maximize precision in reimbursing the costs of services. Drawing on work by Leibenstein and Friedman, the analysis also shows that allocating OC to multiple activities unbiased by revenue requires controlling for revenue when making the estimates. Further econometric analysis shows that it is possible to save about 10 percent of OC by paying only for those that are necessary.

Electrochemical sensor for rutin detection based on Au nanoparticle-loaded helical carbon nanotubes

NASA Astrophysics Data System (ADS)

Yang, Haitang; Li, Bingyue; Cui, Rongjing; Xing, Ruimin; Liu, Shanhu

2017-10-01

The key step in the fabrication of highly active electrochemical sensors is seeking multifunctional nanocomposites as electrode modified materials. In this study, the gold nanoparticle-decorated helical carbon nanotube nanocomposites (AuNPs-HCNTs) were fabricated for rutin detection because of its superior sensitivity, the chemical stability of AuNPs, and the superior conductivity and unique 3D-helical structure of helical carbon nanotubes. Results showed the prepared nanocomposites exhibited superior electrocatalytic activity towards rutin due to the synergetic effects of AuNPs and HCNTs. Under the optimized conditions, the developed sensor exhibited a linear response range from 0.1 to 31 μmol/L for rutin with a low detectable limit of 81 nmol/L. The proposed method might offer a possibility for electrochemical analysis of rutin in Chinese medical analysis or serum monitoring owing to its low cost, simplicity, high sensitivity, good stability, and few interferences against common coexisting ions in real samples.

Meaningful Cost-Benefit Analysis for Service-Oriented Architecture Projects

DTIC Science & Technology

2010-05-01

SOA to identify these activities and shows how those costs come to be commingled with other development and maintenance activities. The paper argues...affected by SOA . To be consistent with the separation suggested above, this paper suggests the following new activities: • Enterprise architecture...Government or Federal Rights License 14. ABSTRACT This paper argues that proper cost-benefit analysis of service-oriented architecture projects is not

Usability evaluation of low-cost virtual reality hand and arm rehabilitation games.

PubMed

Seo, Na Jin; Arun Kumar, Jayashree; Hur, Pilwon; Crocher, Vincent; Motawar, Binal; Lakshminarayanan, Kishor

2016-01-01

The emergence of lower-cost motion tracking devices enables home-based virtual reality rehabilitation activities and increased accessibility to patients. Currently, little documentation on patients' expectations for virtual reality rehabilitation is available. This study surveyed 10 people with stroke for their expectations of virtual reality rehabilitation games. This study also evaluated the usability of three lower-cost virtual reality rehabilitation games using a survey and House of Quality analysis. The games (kitchen, archery, and puzzle) were developed in the laboratory to encourage coordinated finger and arm movements. Lower-cost motion tracking devices, the P5 Glove and Microsoft Kinect, were used to record the movements. People with stroke were found to desire motivating and easy-to-use games with clinical insights and encouragement from therapists. The House of Quality analysis revealed that the games should be improved by obtaining evidence for clinical effectiveness, including clinical feedback regarding improving functional abilities, adapting the games to the user's changing functional ability, and improving usability of the motion-tracking devices. This study reports the expectations of people with stroke for rehabilitation games and usability analysis that can help guide development of future games.

Advanced Imaging Adds Little Value in the Diagnosis of Femoroacetabular Impingement Syndrome.

PubMed

Cunningham, Daniel J; Paranjape, Chinmay S; Harris, Joshua D; Nho, Shane J; Olson, Steven A; Mather, Richard C

2017-12-20

Femoroacetabular impingement (FAI) syndrome is an increasingly recognized source of hip pain and disability in young active adults. In order to confirm the diagnosis, providers often supplement physical examination maneuvers and radiographs with intra-articular hip injection, magnetic resonance imaging (MRI), or magnetic resonance arthrography (MRA). Since diagnostic imaging represents the fastest rising cost segment in U.S. health care, there is a need for value-driven diagnostic algorithms. The purpose of this study was to identify cost-effective diagnostic strategies for symptomatic FAI, comparing history and physical examination (H&P) alone (utilizing only radiographic imaging) with supplementation with injection, MRI, or MRA. A simple-chain decision model run as a cost-utility analysis was constructed to assess the diagnostic value of the MRI, MRA, and injection that are added to the H&P and radiographs in diagnosing symptomatic FAI. Strategies were compared using the incremental cost-utility ratio (ICUR) with a willingness to pay (WTP) of $100,000/QALY (quality-adjusted life year). Direct costs were measured using the Humana database (PearlDiver). Diagnostic test accuracy, treatment outcome probabilities, and utilities were extracted from the literature. H&P with and without supplemental diagnostic injection was the most cost-effective. Adjunct injection was preferred in situations with a WTP of >$60,000/QALY, low examination sensitivity, and high FAI prevalence. With low disease prevalence and low examination sensitivity, as may occur in a general practitioner's office, H&P with injection was the most cost-effective strategy, whereas in the reciprocal scenario, H&P with injection was only favored at exceptionally high WTP (∼$990,000). H&P and radiographs with supplemental diagnostic injection are preferred over advanced imaging, even with reasonable deviations from published values of disease prevalence, test sensitivity, and test specificity. Providers with low examination sensitivity in situations with low disease prevalence may benefit most from including injection in their diagnostic strategy. Providers with high examination sensitivity in situations with high disease prevalence may not benefit from including injection in their diagnostic strategy. Providers should not routinely rely on advanced imaging to diagnose FAI syndrome, although advanced imaging may have a role in challenging clinical scenarios. Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.

"I got it on Ebay!": cost-effective approach to surgical skills laboratories.

PubMed

Schneider, Ethan; Schenarts, Paul J; Shostrom, Valerie; Schenarts, Kimberly D; Evans, Charity H

2017-01-01

Surgical education is witnessing a surge in the use of simulation. However, implementation of simulation is often cost-prohibitive. Online shopping offers a low budget alternative. The aim of this study was to implement cost-effective skills laboratories and analyze online versus manufacturers' prices to evaluate for savings. Four skills laboratories were designed for the surgery clerkship from July 2014 to June 2015. Skills laboratories were implemented using hand-built simulation and instruments purchased online. Trademarked simulation was priced online and instruments priced from a manufacturer. Costs were compiled, and a descriptive cost analysis of online and manufacturers' prices was performed. Learners rated their level of satisfaction for all educational activities, and levels of satisfaction were compared. A total of 119 third-year medical students participated. Supply lists and costs were compiled for each laboratory. A descriptive cost analysis of online and manufacturers' prices showed online prices were substantially lower than manufacturers, with a per laboratory savings of: $1779.26 (suturing), $1752.52 (chest tube), $2448.52 (anastomosis), and $1891.64 (laparoscopic), resulting in a year 1 savings of $47,285. Mean student satisfaction scores for the skills laboratories were 4.32, with statistical significance compared to live lectures at 2.96 (P < 0.05) and small group activities at 3.67 (P < 0.05). A cost-effective approach for implementation of skills laboratories showed substantial savings. By using hand-built simulation boxes and online resources to purchase surgical equipment, surgical educators overcome financial obstacles limiting the use of simulation and provide learning opportunities that medical students perceive as beneficial. Copyright © 2016 Elsevier Inc. All rights reserved.

Cost Effectiveness of Childhood Cochlear Implantation and Deaf Education in Nicaragua: A Disability Adjusted Life Year Model.

PubMed

Saunders, James E; Barrs, David M; Gong, Wenfeng; Wilson, Blake S; Mojica, Karen; Tucci, Debara L

2015-09-01

Cochlear implantation (CI) is a common intervention for severe-to-profound hearing loss in high-income countries, but is not commonly available to children in low resource environments. Owing in part to the device costs, CI has been assumed to be less economical than deaf education for low resource countries. The purpose of this study is to compare the cost effectiveness of the two interventions for children with severe-to-profound sensorineural hearing loss (SNHL) in a model using disability adjusted life years (DALYs). Cost estimates were derived from published data, expert opinion, and known costs of services in Nicaragua. Individual costs and lifetime DALY estimates with a 3% discounting rate were applied to both two interventions. Sensitivity analysis was implemented to evaluate the effect on the discounted cost of five key components: implant cost, audiology salary, speech therapy salary, number of children implanted per year, and device failure probability. The costs per DALY averted are $5,898 and $5,529 for CI and deaf education, respectively. Using standards set by the WHO, both interventions are cost effective. Sensitivity analysis shows that when all costs set to maximum estimates, CI is still cost effective. Using a conservative DALY analysis, both CI and deaf education are cost-effective treatment alternatives for severe-to-profound SNHL. CI intervention costs are not only influenced by the initial surgery and device costs but also by rehabilitation costs and the lifetime maintenance, device replacement, and battery costs. The major CI cost differences in this low resource setting were increased initial training and infrastructure costs, but lower medical personnel and surgery costs.

Cost analysis of centralized viral load testing for antiretroviral therapy monitoring in Nicaragua, a low-HIV prevalence, low-resource setting.

PubMed

Gerlach, Jay; Sequeira, Magda; Alvarado, Vivian; Cerpas, Christian; Balmaseda, Angel; Gonzalez, Alcides; de Los Santos, Tala; Levin, Carol E; Amador, Juan Jose; Domingo, Gonzalo J

2010-11-05

HIV viral load testing as a component of antiretroviral therapy monitoring is costly. Understanding the full costs and the major sources of inefficiency associated with viral load testing is critical for optimizing the systems and technologies that support the testing process. The objective of our study was to estimate the costs associated with viral load testing performed for antiretroviral therapy monitoring to both patients and the public healthcare system in a low-HIV prevalence, low-resource country. A detailed cost analysis was performed to understand the costs involved in each step of performing a viral load test in Nicaragua, from initial specimen collection to communication of the test results to each patient's healthcare provider. Data were compiled and cross referenced from multiple information sources: laboratory records, regional surveillance centre records, and scheduled interviews with the key healthcare providers responsible for HIV patient care in five regions of the country. The total average cost of performing a viral load test in Nicaragua varied by region, ranging from US$99.01 to US$124.58, the majority of which was at the laboratory level: $88.73 to $97.15 per specimen, depending on batch size. The average cost to clinics at which specimens were collected ranged from $3.31 to $20.92, depending on the region. The average cost per patient for transportation, food, lodging and lost income ranged from $3.70 to $14.93. The quantitative viral load test remains the single most expensive component of the process. For the patient, the distance of his or her residence from the specimen collection site is a large determinant of cost. Importantly, the efficiency of results reporting has a large impact on the cost per result delivered to the clinician and utility of the result for patient monitoring. Detailed cost analysis can identify opportunities for removing barriers to effective antiretroviral therapy monitoring programmes in limited-resource countries with low HIV prevalence.

Flux balance analysis indicates that methane is the lowest cost feedstock for microbial cell factories

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

Comer, Austin D.; Long, Matthew R.; Reed, Jennifer L.

The low cost of natural gas has driven significant interest in using C 1 carbon sources (e.g. methane, methanol, CO, syngas) as feedstocks for producing liquid transportation fuels and commodity chemicals. Given the large contribution of sugar and lignocellulosic feedstocks to biorefinery operating costs, natural gas and other C 1 sources may provide an economic advantage. To assess the relative costs of these feedstocks, we performed flux balance analysis on genome-scale metabolic models to calculate the maximum theoretical yields of chemical products from methane, methanol, acetate, and glucose. Yield calculations were performed for every metabolite (as a proxy for desiredmore » products) in the genome-scale metabolic models of three organisms: Escherichia coli (bacterium), Saccharomyces cerevisiae (yeast), and Synechococcus sp. PCC 7002 (cyanobacterium). The calculated theoretical yields and current feedstock prices provided inputs to create comparative feedstock cost surfaces. Our analysis shows that, at current market prices, methane feedstock costs are consistently lower than glucose when used as a carbon and energy source for microbial chemical production. Conversely, methanol is costlier than glucose under almost all price scenarios. Acetate feedstock costs could be less than glucose given efficient acetate production from low-cost syngas using nascent biological gas to liquids (BIO-GTL) technologies. Furthermore, our analysis suggests that research should focus on overcoming the technical challenges of methane assimilation and/or yield of acetate via BIO-GTL to take advantage of low-cost natural gas rather than using methanol as a feedstock.« less

Flux balance analysis indicates that methane is the lowest cost feedstock for microbial cell factories

DOE PAGES

Comer, Austin D.; Long, Matthew R.; Reed, Jennifer L.; ...

2017-07-10

The low cost of natural gas has driven significant interest in using C 1 carbon sources (e.g. methane, methanol, CO, syngas) as feedstocks for producing liquid transportation fuels and commodity chemicals. Given the large contribution of sugar and lignocellulosic feedstocks to biorefinery operating costs, natural gas and other C 1 sources may provide an economic advantage. To assess the relative costs of these feedstocks, we performed flux balance analysis on genome-scale metabolic models to calculate the maximum theoretical yields of chemical products from methane, methanol, acetate, and glucose. Yield calculations were performed for every metabolite (as a proxy for desiredmore » products) in the genome-scale metabolic models of three organisms: Escherichia coli (bacterium), Saccharomyces cerevisiae (yeast), and Synechococcus sp. PCC 7002 (cyanobacterium). The calculated theoretical yields and current feedstock prices provided inputs to create comparative feedstock cost surfaces. Our analysis shows that, at current market prices, methane feedstock costs are consistently lower than glucose when used as a carbon and energy source for microbial chemical production. Conversely, methanol is costlier than glucose under almost all price scenarios. Acetate feedstock costs could be less than glucose given efficient acetate production from low-cost syngas using nascent biological gas to liquids (BIO-GTL) technologies. Furthermore, our analysis suggests that research should focus on overcoming the technical challenges of methane assimilation and/or yield of acetate via BIO-GTL to take advantage of low-cost natural gas rather than using methanol as a feedstock.« less

Launch vehicle systems design analysis

NASA Technical Reports Server (NTRS)

Ryan, Robert; Verderaime, V.

1993-01-01

Current launch vehicle design emphasis is on low life-cycle cost. This paper applies total quality management (TQM) principles to a conventional systems design analysis process to provide low-cost, high-reliability designs. Suggested TQM techniques include Steward's systems information flow matrix method, quality leverage principle, quality through robustness and function deployment, Pareto's principle, Pugh's selection and enhancement criteria, and other design process procedures. TQM quality performance at least-cost can be realized through competent concurrent engineering teams and brilliance of their technical leadership.

Solid State Inflation Balloon Active Deorbiter: Scalable Low-Cost Deorbit System for Small Satellites

NASA Technical Reports Server (NTRS)

Huang, Adam

2016-01-01

The goal of the Solid State Inflation Balloon Active Deorbiter project is to develop and demonstrate a scalable, simple, reliable, and low-cost active deorbiting system capable of controlling the downrange point of impact for the full-range of small satellites from 1 kg to 180 kg. The key enabling technology being developed is the Solid State Gas Generator (SSGG) chip, generating pure nitrogen gas from sodium azide (NaN3) micro-crystals. Coupled with a metalized nonelastic drag balloon, the complete Solid State Inflation Balloon (SSIB) system is capable of repeated inflation/deflation cycles. The SSGG minimizes size, weight, electrical power, and cost when compared to the current state of the art.

Cost-effectiveness analysis of a statewide media campaign to promote adolescent physical activity.

PubMed

Peterson, Michael; Chandlee, Margaret; Abraham, Avron

2008-10-01

A cost-effectiveness analysis of a statewide social marketing campaign was performed using a statewide surveillance survey distributed to 6th through 12th graders, media production and placement costs, and 2000 census data. Exposure to all three advertisements had the highest impact on both intent and behavior with 65.6% of the respondents considering becoming more active and 58.3% reporting becoming more active. Average cost of the entire campaign was $4.01 per person to see an ad, $7.35 per person to consider being more active, and $8.87 per person to actually become more active, with billboards yielding the most positive cost-effectiveness. Findings highlight market research as an essential part of social marketing campaigns and the importance of using multiple marketing modalities to enhance cost-effectiveness and impact.

Studying colours with a smartphone

NASA Astrophysics Data System (ADS)

Rosi, T.; Malgieri, M.; Onorato, P.; De Ambrosis, , A.; Oss, S.

2017-03-01

We show how a low-cost spectrometer, based on the use of inexpensive diffraction transmission gratings coupled with a smartphone photo camera, can be assembled and employed to obtain quantitative measurements of spectra from different sources. The analysis of spectra emitted by different light sources (incandescent bulb, fluorescent lamp, gas lamps, LEDs) helps students understand the different physical mechanisms which govern the production of light. Measurements of emission and transmission spectra allow students to focus on the differences between additive and subtractive models of colour formation. For this purpose the spectra of RGB colours emitted from an LCD screen and the transmission spectra of CMY pigments of a laser printer have been studied, using our low-cost spectroscope. A sequence of experimental activities was designed, and proposed to undergraduate students and secondary school teachers in order to study the feasibility and educational potential.

Earth Observatory Satellite system definition study. Report 4: Low cost management approach and recommendations

NASA Technical Reports Server (NTRS)

1974-01-01

An analysis of low cost management approaches for the development of the Earth Observatory Satellite (EOS) is presented. The factors of the program which tend to increase costs are identified. The NASA/Industry interface is stressed to show how the interface can be improved to produce reduced program costs. Techniques and examples of cost reduction which can be applied to the EOS program are tabulated. Specific recommendations for actions to be taken to reduce costs in prescribed areas are submitted.

Effectiveness of demand generation interventions on use of modern contraceptives in low- and middle-income countries.

PubMed

Belaid, L; Dumont, A; Chaillet, N; Zertal, A; De Brouwere, V; Hounton, S; Ridde, V

2016-10-01

To synthesise evidence on the implementation, costs and cost-effectiveness of demand generation interventions and their effectiveness in improving uptake of modern contraception methods. A Cochrane systematic review was conducted. Searches were performed in electronic databases (MEDLINE, EMBASE) and the grey literature. Randomised controlled trials, cluster randomised trials and quasi-experimental studies, including controlled before-after studies (CBAs) and cost and cost-effectiveness studies that aimed to assess demand interventions (including community- and facility-based interventions, financial mechanisms and mass media campaigns) in low- and middle-income countries were considered. Meta-analyses and narrative synthesis were conducted. In total, 20 papers meeting the inclusion criteria were included in this review. Of those, 13 were used for meta-analysis. Few data were available on implementation and on the influence of context on demand interventions. Involving family members during counselling, providing education activities and increasing exposure to those activities could enhance the success of demand interventions. Demand generation interventions were positively associated with increases in current use (pooled OR 1.57; 95% CI: 1.46-1.69, P < 0.01). Financial mechanism interventions (vouchers) appeared effective to increase use of modern contraceptive methods (pooled OR 2.16; 95% CI: 1.91-2.45, P < 0.01; I 2 = 0%). Demand interventions improved knowledge (pooled OR 1.02; 95% CI 0.63-1.64, P = 0.93) and attitudes towards family planning and improved discussion with partners/husbands around modern contraceptive methods. However, given the limited number of studies included in each category of demand generation interventions, the dates of publication of the studies and their low quality, caution is advised in considering the results. Very limited evidence was available on costs; studies including data on costs were old and inconsistent. Demand generation interventions contribute to increases in modern contraceptive methods use. However, more studies with robust designs are needed to identify the most effective demand generation intervention to increase uptake of modern contraceptive methods. More evidence is also needed about implementation, costs and cost-effectiveness to inform decisions on sustainability and scaling-up. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post-lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis.

PubMed

Manchikanti, Laxmaiah; Helm, Standiford; Pampati, Vidyasagar; Racz, Gabor B

2015-06-01

The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost-effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high-quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome or lumbar central spinal stenosis. This analysis is based on 2 previously published controlled studies. To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post-lumbar surgery syndrome and lumbar central spinal stenosis. A private, specialty referral interventional pain management center in the United States. Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post-lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2-year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status. The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2-year follow-up with the actual reimbursement data showed cost utility for 1 year of quality-adjusted life year (QALY) of USD $2,652 for post-lumbar surgery syndrome and USD $2,649 for lumbar central spinal stenosis. The results of this assessment show that the cost utility of managing chronic, intractable low back pain with percutaneous adhesiolysis at a QALY that is similar or lower in price than medical therapy only, physical therapy, manipulation, spinal cord stimulation, and surgery. The limitations of this cost utility analysis are that it is a single-center evaluation, with the inclusion of costs of adhesiolysis procedures in an ambulatory surgery center and physician visits, rather than all related costs including drug therapy and costs of disability in multiple settings. This cost utility analysis of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome and lumbar central spinal stenosis shows the clinical effectiveness and cost utility of these procedures at USD $2,650 per one year of QALY when performed in an ambulatory surgery center. © 2014 World Institute of Pain.

The YMCA Healthy, Fit, and Strong Program: a community-based, family-centered, low-cost obesity prevention/treatment pilot study.

PubMed

Schwartz, Robert P; Vitolins, Mara Z; Case, L Douglas; Armstrong, Sarah C; Perrin, Eliana M; Cialone, Josephine; Bell, Ronny A

2012-12-01

Many resources are available for adults, but there are few community-based programs for overweight and obese children. Community engagement may be instrumental in overcoming barriers physicians experience in managing childhood obesity. Our objective was to design and test the feasibility of a community-based (YMCA), family-centered, low-cost intervention for overweight and obese children. Children 6-11 years over the 85th BMI percentile for age and sex were recruited to YMCA sites in four North Carolina communities. The children had physical activity sessions three times weekly for 3 months (one activity session weekly was family night). The parents received a once-weekly nutrition education class conducted by a registered dietitian using the NC Eat Smart Move More curriculum (10 sessions). Changes in BMI were measured at 3, 6, and 12 months and diet and activity behaviors at 3 and 12 months after baseline. Significant reductions were observed in BMI percentile for age and BMI z-scores at 3, 6, and 12 months. Improvements occurred in dietary and physical activity behaviors, including drinking fewer sugar-sweetened beverages, spending more time in physically active behaviors, and spending less time in sedentary behaviors. The program was low-cost, and qualitative comments suggest the parents and children benefited from the experience. This low-cost YMCA-based intervention was associated with BMI reductions and positive nutritional and activity behavior changes, providing an additional strategy for addressing childhood obesity in community settings.

Development of a low cost and low power consumption system for monitoring CO_{2} soil concentration in volcanic areas.

NASA Astrophysics Data System (ADS)

Awadallah Estévez, Shadia; Moure-García, David; Torres-González, Pedro; Acosta Sánchez, Leopoldo; Domínguez Cerdeña, Itahiza

2017-04-01

Volatiles dissolved in magma are released as gases when pressure or stress conditions change. H2O, CO2, SO2 and H2S are the most abundant gases involved in volcanic processes. Emission rates are related to changes in the volcanic activity. Therefore, in order to predict possible eruptive events, periodic measurements of CO2 concentrations from the soil should be carried out. In the last years, CO2 monitoring has been widespread for many reasons. A direct relationship between changes in volcanic activity and variations in concentration, diffuse flux and isotope ratios of this gas, have been observed prior to some eruptions or unrest processes. All these factors have pointed out the fact that CO2 emission data are crucial in volcanic monitoring programs. In addition, relevant instrumentation development has also taken place: improved accuracy, cost reduction and portability. Considering this, we propose a low cost and a low power consumption system for measuring CO2 concentration in the soil based on Arduino. Through a perforated pick-axe buried at a certain depth, gas samples are periodically taken with the aid of a piston. These samples are injected through a pneumatic circuit in the spectrometer, which measures the CO2 concentration. Simultaneously, the system records the following meteorological parameters: atmospheric pressure, precipitation, relative humidity and air and soil temperature. These parameters are used to correct their possible influence in the CO2 soil concentration. Data are locally stored (SD card) and transmitted via GPRS or WIFI to a data analysis center.

Cooling Duct Analysis for Transpiration/Film Cooled Liquid Propellant Rocket Engines

NASA Technical Reports Server (NTRS)

Micklow, Gerald J.

1996-01-01

The development of a low cost space transportation system requires that the propulsion system be reusable, have long life, with good performance and use low cost propellants. Improved performance can be achieved by operating the engine at higher pressure and temperature levels than previous designs. Increasing the chamber pressure and temperature, however, will increase wall heating rates. This necessitates the need for active cooling methods such as film cooling or transpiration cooling. But active cooling can reduce the net thrust of the engine and add considerably to the design complexity. Recently, a metal drawing process has been patented where it is possible to fabricate plates with very small holes with high uniformity with a closely specified porosity. Such a metal plate could be used for an inexpensive transpiration/film cooled liner to meet the demands of advanced reusable rocket engines, if coolant mass flow rates could be controlled to satisfy wall cooling requirements and performance. The present study investigates the possibility of controlling the coolant mass flow rate through the porous material by simple non-active fluid dynamic means. The coolant will be supplied to the porous material by series of constant geometry slots machined on the exterior of the engine.

CubeSat mechanical design: creating low mass and durable structures

NASA Astrophysics Data System (ADS)

Fiedler, Gilbert; Straub, Jeremy

2017-05-01

This paper considers the mechanical design of a low-mass, low-cost spacecraft for use in a multi-satellite sensing constellation. For a multi-spacecraft mission, aggregated small mass and cost reductions can have significant impact. One approach to mass reduction is to make cuts into the structure, removing material. Stress analysis is used to determine the level of material reduction possible. Focus areas for this paper include determining areas to make cuts to ensure that a strong shape remains, while considering the comparative cost and skill level of each type of cut. Real-world results for a CubeSat and universally applicable analysis are presented.

Process and assembly plans for low cost commercial fuselage structure

NASA Technical Reports Server (NTRS)

Willden, Kurtis; Metschan, Stephen; Starkey, Val

1991-01-01

Cost and weight reduction for a composite structure is a result of selecting design concepts that can be built using efficient low cost manufacturing and assembly processes. Since design and manufacturing are inherently cost dependent, concurrent engineering in the form of a Design-Build Team (DBT) is essential for low cost designs. Detailed cost analysis from DBT designs and hardware verification must be performed to identify the cost drivers and relationships between design and manufacturing processes. Results from the global evaluation are used to quantitatively rank design, identify cost centers for higher ranking design concepts, define and prioritize a list of technical/economic issues and barriers, and identify parameters that control concept response. These results are then used for final design optimization.

Cost minimization analysis of low back pain claims data for chiropractic vs medicine in a managed care organization.

PubMed

Grieves, Brian; Menke, J Michael; Pursel, Kevin J

2009-01-01

A managed care organization (MCO) examined differences in allowed cost for managing low back pain by medical providers vs chiropractors in an integrated care environment. The purpose of this study is to provide a retrospective cost analysis of administrative data of chiropractic vs medical management of low back pain in a managed care setting. All patients with a low back pain-related diagnosis presenting for health care from January 2004 to June 2004 who were insured by an MCO in northeast Wisconsin were tracked. The cumulative health care costs incurred by this MCO during the 2-year period from January 2004 to December 2005 related to these back pain diagnoses were collected. Allowed costs of chiropractic treatment were 12% greater than medical primary care and 60% less per case than other types of medical care combined, on a per-case basis: median cost of medical primary care was $365.00, chiropractic care was $417.00, and medical nonprimary care was $669.00. This study of an MCO's low back pain allowed costs may be better redirected to primary care or chiropractic, given equivalent levels of case complexity. This study suggests chiropractic management as less expensive compared with medical management of back pain when care extends beyond primary care. Primary care management alone is virtually indistinguishable from chiropractic management in terms of costs.

Radioactive Waste Characterization Strategies; Comparisons Between AK/PK, Dose to Curie Modeling, Gamma Spectroscopy, and Laboratory Analysis Methods- 12194

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

Singledecker, Steven J.; Jones, Scotty W.; Dorries, Alison M.

2012-07-01

In the coming fiscal years of potentially declining budgets, Department of Energy facilities such as the Los Alamos National Laboratory (LANL) will be looking to reduce the cost of radioactive waste characterization, management, and disposal processes. At the core of this cost reduction process will be choosing the most cost effective, efficient, and accurate methods of radioactive waste characterization. Central to every radioactive waste management program is an effective and accurate waste characterization program. Choosing between methods can determine what is classified as low level radioactive waste (LLRW), transuranic waste (TRU), waste that can be disposed of under an Authorizedmore » Release Limit (ARL), industrial waste, and waste that can be disposed of in municipal landfills. The cost benefits of an accurate radioactive waste characterization program cannot be overstated. In addition, inaccurate radioactive waste characterization of radioactive waste can result in the incorrect classification of radioactive waste leading to higher disposal costs, Department of Transportation (DOT) violations, Notice of Violations (NOVs) from Federal and State regulatory agencies, waste rejection from disposal facilities, loss of operational capabilities, and loss of disposal options. Any one of these events could result in the program that mischaracterized the waste losing its ability to perform it primary operational mission. Generators that produce radioactive waste have four characterization strategies at their disposal: - Acceptable Knowledge/Process Knowledge (AK/PK); - Indirect characterization using a software application or other dose to curie methodologies; - Non-Destructive Analysis (NDA) tools such as gamma spectroscopy; - Direct sampling (e.g. grab samples or Surface Contaminated Object smears) and laboratory analytical; Each method has specific advantages and disadvantages. This paper will evaluate each method detailing those advantages and disadvantages including; - Cost benefit analysis (basic materials costs, overall program operations costs, man-hours per sample analyzed, etc.); - Radiation Exposure As Low As Reasonably Achievable (ALARA) program considerations; - Industrial Health and Safety risks; - Overall Analytical Confidence Level. The concepts in this paper apply to any organization with significant radioactive waste characterization and management activities working to within budget constraints and seeking to optimize their waste characterization strategies while reducing analytical costs. (authors)« less

Cost analysis of the History, ECG, Age, Risk factors, and initial Troponin (HEART) Pathway randomized control trial.

PubMed

Riley, Robert F; Miller, Chadwick D; Russell, Gregory B; Harper, Erin N; Hiestand, Brian C; Hoekstra, James W; Lefebvre, Cedric W; Nicks, Bret A; Cline, David M; Askew, Kim L; Mahler, Simon A

2017-01-01

The HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported. We performed a cost analysis of patients enrolled in the HEART Pathway trial, which randomized participants to either usual care or the HEART Pathway protocol. For low-risk patients, the HEART Pathway recommended early discharge from the emergency department without further testing. We compared index visit cost, cost at 30 days, and cardiac-related health care cost at 30 days between the 2 treatment arms. Costs for each patient included facility and professional costs. Cost at 30 days included total inpatient and outpatient costs, including the index encounter, regardless of etiology. Cardiac-related health care cost at 30 days included the index encounter and costs adjudicated to be cardiac-related within that period. Two hundred seventy of the 282 patients enrolled in the trial had cost data available for analysis. There was a significant reduction in cost for the HEART Pathway group at 30 days (median cost savings of $216 per individual), which was most evident in low-risk (Thrombolysis In Myocardial Infarction score of 0-1) patients (median savings of $253 per patient) and driven primarily by lower cardiac diagnostic costs in the HEART Pathway group. Using the HEART Pathway as a decision aid for patients with undifferentiated chest pain resulted in significant cost savings. Copyright © 2016 Elsevier Inc. All rights reserved.

Cost-effective and robust mitigation of space debris in low earth orbit

NASA Astrophysics Data System (ADS)

Walker, R.; Martin, C.

It is predicted that the space debris population in low Earth orbit (LEO) will continue to grow and in an exponential manner in the long-term due to an increasing rate of collisions between large objects, unless internationally-accepted space debris mitigation measures are adopted soon. Such measures are aimed at avoiding the future generation of space debris objects and primarily need to be effective in preventing significant long-term growth in the debris population, even in the potential scenario of an increase in future space activity. It is also important that mitigation measures can limit future debris population levels, and therefore the underlying collision risk to space missions, to the lowest extent possible. However, for their wide acceptance, the cost of implementation associated with mitigation measures needs to be minimised as far as possible. Generally, a lower collision risk will cost more to achieve and vice versa, so it is necessary to strike a balance between cost and risk in order to find a cost-effective set of mitigation measures. In this paper, clear criteria are established in order to assess the cost-effectiveness of space debris mitigation measures. A full cost-risk-benefit trade-off analysis of numerous mitigation scenarios is presented. These scenarios consider explosion prevention and post-mission disposal of space systems, including de-orbiting to limited lifetime orbits and re-orbiting above the LEO region. The ESA DELTA model is used to provide long-term debris environment projections for these scenarios as input to the benefit and risk parts of the trade-off analysis. Manoeuvre requirements for the different post-mission disposal scenarios were also calculated in order to define the cost-related element. A 25-year post-mission lifetime de-orbit policy, combined with explosion prevention and mission-related object limitation, was found to be the most cost-effective solution to the space debris problem in LEO. This package would also remain effective after a significant increase in future launch traffic. It was found that the re-orbiting of space systems above the LEO region would not lead to significant collision activity there over the next century. However, above-LEO disposal should be used sparingly because the disposal region could become unstable after a limited number of explosions or collisions due to a lack of air drag to remove the resulting fragments.

Aquifer thermal-energy-storage costs with a seasonal-chill source

NASA Astrophysics Data System (ADS)

Brown, D. R.

1983-01-01

The cost of energy supplied by an aquifer thermal energy storage (ATES) ystem from a seasonal chill source was investigated. Costs were estimated for point demand and residential development ATES systems using the computer code AQUASTOR. AQUASTOR was developed at PNL specifically for the economic analysis of ATES systems. In this analysis the cost effect of varying a wide range of technical and economic parameters was examined. Those parameters exhibiting a substantial influence on the costs of ATES delivered chill were: system size; well flow rate; transmission distance; source temperature; well depth; and cost of capital. The effects of each parameter are discussed. Two primary constraints of ATES chill systems are the extremely low energy density of the storage fluid and the prohibitive costs of lengthly pipelines for delivering chill to residential users. This economic analysis concludes that ATES-delivered chill will not be competitive for residential cooling applications. The otherwise marginal attractiveness of ATES chill systems vanishes under the extremely low load factors characteristic of residential cooling systems. (LCL)

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

PubMed

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

2018-07-01

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

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

PubMed

Henchoz, Yves; Pinget, Christophe; Wasserfallen, Jean-Blaise; Paillex, Roland; de Goumoëns, Pierre; Norberg, Michael; Kai-Lik So, Alexander

2010-10-01

To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. Cost-utility analysis alongside a randomized controlled trial. A total of 105 patients with chronic low back pain. Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Cost analysis of prenatal care using the activity-based costing model: a pilot study.

PubMed

Gesse, T; Golembeski, S; Potter, J

1999-01-01

The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

Cost Analysis of Prenatal Care Using the Activity-Based Costing Model: A Pilot Study

PubMed Central

Gesse, Theresa; Golembeski, Susan; Potter, Jonell

1999-01-01

The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care. PMID:22945985

The predictive validity of the HERO Scorecard in determining future health care cost and risk trends.

PubMed

Goetzel, Ron Z; Henke, Rachel Mosher; Benevent, Richele; Tabrizi, Maryam J; Kent, Karen B; Smith, Kristyn J; Roemer, Enid Chung; Grossmeier, Jessica; Mason, Shawn T; Gold, Daniel B; Noeldner, Steven P; Anderson, David R

2014-02-01

To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

A global overview of health insurance administrative costs: what are the reasons for variations found?

PubMed

Mathauer, Inke; Nicolle, Emmanuelle

2011-10-01

Administrative costs are an important spending category in total health insurance expenditure. Yet, they have rarely been a topic outside the US and there is no cross-country comparison available. This paper provides a global overview and analysis of administrative costs for social security schemes (SSS) and private health insurance schemes (PHI). The analysis is based on data of the World Health Organization (WHO) National Health Accounts (NHA) and the Organisation for Economic Cooperation and Development (OECD) System of Health Accounts (SHA). These are the only worldwide databases on health expenditure data. Further data was retrieved from a literature search. Administrative costs are presented as a share of total health insurance costs. Data is available for 58 countries. In high-income OECD countries, the average SSS administrative costs are 4.2%. Average PHI administrative costs are about three times higher. The shares are much higher for low- and middle-income countries. However, considerable variations across and within countries over time are revealed. Seven explanatory factors are explored to explain the variations: health financing system aspects, administrative activities undertaken, insurance design aspects, context factors, reporting format, accounting methods, and management and administrative efficiency measures. More detailed reporting of administrative costs would enhance comparability and provide benchmarks. Improved administrative efficiency could free resources to expand coverage. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

Koen, A.D.

This paper reports that oil and gas companies in the US are curbing costs and redirecting spending to survive the worst decline of petroleum industry activity on record. Persistently weak US natural gas prices and shaky oil prices worldwide have put pressure on domestic companies to become low cost producers. Efforts to cut exploration and development costs have depressed activity in the US, one of the world's most mature oil and gas provinces. International E and D hot spots include the UK North Sea, Yemen, Thailand, Myanmar, Pakistan, and Latin America. Prospects in the Commonwealth of Independent States also continuemore » to generate considerable enthusiasm. Operators struggling to survive or searching for funds to spend on non-US prospects are trying to shuck noncore US assets. Other favored cost cutting strategies include reducing and restructuring debt, operating and administrative staffs, and internal organizations. Major integrated companies are able to add value by refocusing refining, petrochemical, or marketing operations. But independents must adapt operations close to the wellhead to become low cost producers. Whatever tactics are used to mitigate effects of low US activity, no domestic company --- from the largest integrated major to the smallest independent producer --- has proven to be immune from the downturn.« less

Costs and cost-effectiveness of pediatric inguinal hernia repair in Uganda.

PubMed

Eeson, Gareth; Birabwa-Male, Doreen; Pennington, Mark; Blair, Geoffrey K

2015-02-01

Surgically treatable diseases contribute approximately 11% of disability-adjusted life years (DALYs) worldwide yet they remain a neglected public health priority in low- and middle-income countries (LMICs). Pediatric inguinal hernia is the most common congenital abnormality in newborns and a major cause of morbidity and mortality yet elective repair remains largely unavailable in LMICs. This study is aimed to determine the costs and cost-effectiveness of pediatric inguinal hernia repair (PIHR) in a low-resource setting. Medical costs of consecutive elective PIHRs were recorded prospectively at two centers in Uganda. Decision modeling was used to compare two different treatment scenarios (adoption of PIHR and non-adoption) from a provider perspective. A Markov model was constructed to estimate health outcomes under each scenario. The robustness of the cost-effectiveness results in the base case analysis was tested in one-way and probabilistic sensitivity analysis. The primary outcome of interest was cost per DALY averted by the intervention. Sixty-nine PIHRs were performed in 65 children (mean age 3.6 years). Mean cost per procedure was $86.68 US (95% CI 83.1-90.2 USD) and averted an average of 5.7 DALYs each. Incremental cost-effectiveness ratio was $12.41 per DALY averted. The probability of cost-effectiveness was 95% at a cost-effectiveness threshold of $35 per averted DALY. Results were robust to sensitivity analysis under all considered scenarios. Elective PIHR is highly cost-effective for the treatment and prevention of complications of hernia disease even in low-resource settings. PIHR should be prioritized in LMICs alongside other cost-effective interventions.

Stakeholders' Perceptions Sought to Inform the Development of a Low-Cost Mobile Robot for Older Adults: A Qualitative Descriptive Study.

PubMed

Sefcik, Justine S; Johnson, Michelle J; Yim, Mark; Lau, Tessa; Vivio, Nicholas; Mucchiani, Caio; Cacchione, Pamela Z

2018-02-01

Creative solutions are needed to support community-dwelling older adults residing in a variety of settings including their house, apartment, or Supportive Apartment Living (SAL) to promote independence and reduce the risk of nursing home replacement. The objective of this study was to gain an understanding of older adults' needs for physical, mental, and social activities to support the design and functionality of a low-cost mobile assistive robot. A qualitative descriptive study was designed which included three stakeholder focus groups (caregivers, clinicians, and older adults). We held three focus groups with a total of 19 participants: one with paid caregivers ( n = 6), one with interdisciplinary clinicians ( n = 8), and one with older adults residing in SAL ( n = 5). Conventional content analysis was the analytical technique. Four themes emerged: (a) Accomplishing Everyday Tasks: activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were important from the perspectives of all three groups for the older adults to accomplish daily, as well as the "use it or lose it" attitude of the older adults; (b) Personal Connections and Meaningful Activities: for the older adults, it was important for them to engage in socialization and leisure activities, and for the caregivers and clinicians, they work to build personal relationships with the older adults; (c) Cognitive Interventions: the clinicians provided cognitive tools (including reminders, routine and designing interventions) to older adults so they can remain as safe and independent as possible in the SAL; and (d) Safety Measures: encompassed clinicians addressing safety and injury prevention and the caregivers checking in on the older adults in their SAL apartments. This work contributed to the design and functionality specifications for an autonomous low-cost mobile robot for deployment to increase the independence of older adults.

Stakeholders’ Perceptions Sought to Inform the Development of a Low-Cost Mobile Robot for Older Adults: A Qualitative Descriptive Study

PubMed Central

Sefcik, Justine S.; Johnson, Michelle J.; Yim, Mark; Lau, Tessa; Vivio, Nicholas; Mucchiani, Caio

2018-01-01

Creative solutions are needed to support community-dwelling older adults residing in a variety of settings including their house, apartment, or Supportive Apartment Living (SAL) to promote independence and reduce the risk of nursing home replacement. The objective of this study was to gain an understanding of older adults’ needs for physical, mental, and social activities to support the design and functionality of a low-cost mobile assistive robot. A qualitative descriptive study was designed which included three stakeholder focus groups (caregivers, clinicians, and older adults). We held three focus groups with a total of 19 participants: one with paid caregivers (n = 6), one with interdisciplinary clinicians (n = 8), and one with older adults residing in SAL (n = 5). Conventional content analysis was the analytical technique. Four themes emerged: (a) Accomplishing Everyday Tasks: activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were important from the perspectives of all three groups for the older adults to accomplish daily, as well as the “use it or lose it” attitude of the older adults; (b) Personal Connections and Meaningful Activities: for the older adults, it was important for them to engage in socialization and leisure activities, and for the caregivers and clinicians, they work to build personal relationships with the older adults; (c) Cognitive Interventions: the clinicians provided cognitive tools (including reminders, routine and designing interventions) to older adults so they can remain as safe and independent as possible in the SAL; and (d) Safety Measures: encompassed clinicians addressing safety and injury prevention and the caregivers checking in on the older adults in their SAL apartments. This work contributed to the design and functionality specifications for an autonomous low-cost mobile robot for deployment to increase the independence of older adults. PMID:28918654

The debt of nations and the distribution of ecological impacts from human activities

PubMed Central

Srinivasan, U. Thara; Carey, Susan P.; Hallstein, Eric; Higgins, Paul A. T.; Kerr, Amber C.; Koteen, Laura E.; Smith, Adam B.; Watson, Reg; Harte, John; Norgaard, Richard B.

2008-01-01

As human impacts to the environment accelerate, disparities in the distribution of damages between rich and poor nations mount. Globally, environmental change is dramatically affecting the flow of ecosystem services, but the distribution of ecological damages and their driving forces has not been estimated. Here, we conservatively estimate the environmental costs of human activities over 1961–2000 in six major categories (climate change, stratospheric ozone depletion, agricultural intensification and expansion, deforestation, overfishing, and mangrove conversion), quantitatively connecting costs borne by poor, middle-income, and rich nations to specific activities by each of these groups. Adjusting impact valuations for different standards of living across the groups as commonly practiced, we find striking imbalances. Climate change and ozone depletion impacts predicted for low-income nations have been overwhelmingly driven by emissions from the other two groups, a pattern also observed for overfishing damages indirectly driven by the consumption of fishery products. Indeed, through disproportionate emissions of greenhouse gases alone, the rich group may have imposed climate damages on the poor group greater than the latter's current foreign debt. Our analysis provides prima facie evidence for an uneven distribution pattern of damages across income groups. Moreover, our estimates of each group's share in various damaging activities are independent from controversies in environmental valuation methods. In a world increasingly connected ecologically and economically, our analysis is thus an early step toward reframing issues of environmental responsibility, development, and globalization in accordance with ecological costs. PMID:18212119

Summary of Results from the Risk Management Program for the Mars Microrover Flight Experiment

NASA Technical Reports Server (NTRS)

Shishko, Robert; Matijevic, Jacob R.

2000-01-01

On 4 July 1997, the Mars Pathfinder landed on the surface of Mars carrying the first planetary rover, known as the Sojourner. Formally known as the Microrover Flight Experiment (MFEX), the Sojourner was a low cost, high-risk technology demonstration, in which new risk management techniques were tried. This paper summarizes the activities and results of the effort to conduct a low-cost, yet meaningful risk management program for the MFEX. The specific activities focused on cost, performance, schedule, and operations risks. Just as the systems engineering process was iterative and produced successive refinements of requirements, designs, etc., so was the risk management process. Qualitative risk assessments were performed first to gain some insights for refining the microrover design and operations concept. These then evolved into more quantitative analyses. Risk management lessons from the manager's perspective is presented for other low-cost, high-risk space missions.

The costs and benefits of bone marrow transplantation.

PubMed

Beard, M E; Inder, A B; Allen, J R; Hart, D N; Heaton, D C; Spearing, R L

1991-07-24

The average direct costs of performing a bone marrow transplant (BMT), including the subsequent year, was found to be NZ$27,074 for 43 consecutive transplants. In 29 BMTs a full two year period of follow up was available and a quality of life analysis was carried out on these patients. It was calculated that 59 quality adjusted life years (QALYs) had been gained by the BMT procedure at the time of analysis. By combining these two analyses the cost of each QALY gained by BMT is NZ$13,272. The relatively low cost of BMT is partly due to the extremely low annual costs in second and subsequent years post BMT. In our patients this cost amounted to $195 per year. The costs and benefits of BMT compare very favourably with other complex medical procedures.

The Healthy LifeWorks Project: a pilot study of the economic analysis of a comprehensive workplace wellness program in a Canadian government department.

PubMed

Makrides, Lydia; Smith, Steven; Allt, Jane; Farquharson, Jane; Szpilfogel, Claudine; Curwin, Sandra; Veinot, Paula; Wang, Feifei; Edington, Dee

2011-07-01

To examine the relationship between health risks and absenteeism and drug costs vis-a-vis comprehensive workplace wellness. Eleven health risks, and change in drug claims, short-term and general illness calculated across four risk change groups. Wellness score examined using Wilcoxon test and regression model for cost change. The results showed 31% at risk; 9 of 11 risks associated with higher drug costs. Employees moving from low to high risk showed highest relative increase (81%) in drug costs; moving from high to low had lowest (24%). Low-high had highest increase in absenteeism costs (160%). With each risk increase, absenteeism costs increased by $CDN248 per year (P < 0.05) with average decrease of 0.07 risk factors and savings $CDN6979 per year. Both high-risk reduction and low-risk maintenance are important to contain drug costs. Only low-risk maintenance also avoids absenteeism costs associated with high risks.

Pathways for Disposal of Commercially-Generated Tritiated Waste

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

Halverson, Nancy V.

From a waste disposal standpoint, tritium is a major challenge. Because it behaves like hydrogen, tritium exchanges readily with hydrogen in the ground water and moves easily through the ground. Land disposal sites must control the tritium activity and mobility of incoming wastes to protect human health and the environment. Consequently, disposal of tritiated low-level wastes is highly regulated and disposal options are limited. The United States has had eight operating commercial facilities licensed for low-level radioactive waste disposal, only four of which are currently receiving waste. Each of these is licensed and regulated by its state. Only two ofmore » these sites accept waste from states outside of their specified regional compact. For waste streams that cannot be disposed directly at one of the four active commercial low-level waste disposal facilities, processing facilities offer various forms of tritiated low-level waste processing and treatment, and then transport and dispose of the residuals at a disposal facility. These processing facilities may remove and recycle tritium, reduce waste volume, solidify liquid waste, remove hazardous constituents, or perform a number of additional treatments. Waste brokers also offer many low-level and mixed waste management and transportation services. These services can be especially helpful for small-quantity tritiated-waste generators, such as universities, research institutions, medical facilities, and some industries. The information contained in this report covers general capabilities and requirements for the various disposal/processing facilities and brokerage companies, but is not considered exhaustive. Typically, each facility has extensive waste acceptance criteria and will require a generator to thoroughly characterize their wastes. Then a contractual agreement between the waste generator and the disposal/processing/broker entity must be in place before waste is accepted. Costs for tritiated waste transportation, processing and disposal vary based a number of factors. In many cases, wastes with very low radioactivity are priced primarily based on weight or volume. For higher activities, costs are based on both volume and activity, with the activity-based charges usually being much larger than volume-based charges. Other factors affecting cost include location, waste classification and form, other hazards in the waste, etc. Costs may be based on general guidelines used by an individual disposal or processing site, but final costs are established by specific contract with each generator. For this report, seven hypothetical waste streams intended to represent commercially-generated tritiated waste were defined in order to calculate comparative costs. Ballpark costs for disposition of these hypothetical waste streams were calculated. These costs ranged from thousands to millions of dollars. Due to the complexity of the cost-determining factors mentioned above, the costs calculated in this report should be understood to represent very rough cost estimates for the various hypothetical wastes. Actual costs could be higher or could be lower due to quantity discounts or other factors.« less

Cost-utility of COBRA-light versus COBRA therapy in patients with early rheumatoid arthritis: the COBRA-light trial.

PubMed

Ter Wee, Marieke M; Coupé, Veerle Mh; den Uyl, Debby; Blomjous, Birgit S; Kooijmans, Esmee; Kerstens, Pit Jsm; Nurmohamed, Mike T; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E; Boers, Maarten; Lems, Willem F

2017-01-01

To evaluate if COmbinatie therapie Bij Reumatoïde Artritis (COBRA)-light therapy is cost-effective in treating patients with early rheumatoid arthritis (RA) compared with COBRA therapy. This economic evaluation was performed next to the open-label, randomised non-inferiority COBRA-light trial in 164 patients with early RA. Non-responders to COBRA or COBRA-light received etanercept (50 mg/week) for 3-6 months. The societal perspective analysis took medical direct, non-medical direct and indirect costs into account. Costs were measured with patient cost diaries for the follow-up period of 52 weeks. Bootstrapping techniques estimated uncertainty around the cost-effectiveness ratios, presented in cost-effectiveness planes. 164 patients were randomised to either COBRA or COBRA-light strategy. At week 52, COBRA-light proved to be non-inferior to COBRA therapy on all clinical outcome measures. The results of the base-case cost-utility analysis (intention-to-treat analyses) revealed that COBRA-light strategy is more expensive (k€9.3 (SD 0.9) compared with COBRA (k€7.2 (SD 0.8)), but the difference in costs were not significant (k€2.0; 95% CI -0.3 to 4.4). Also, both strategies produced similar quality-adjusted life-years (QALYs). The sensitivity analyses showed robustness of these results. In a per-protocol sensitivity analysis, in which costs of etanercept were assumed to be provided as prescribed according to protocol, both arms had much higher costs: COBRA-light: k€11.5 (8.3) compared with k€8.5 (6.8) for COBRA, and the difference in costs was significant (k€2.9; 0.6 to 5.3). In the base-case cost-utility analysis, the two strategies produced similar QALYs for similar costs. But it is anticipated that if protocol had been followed correctly, the COBRA-light strategy would have been more costly due to additional etanercept costs, for a limited health gain. Given the limited added benefit and high costs of starting etanercept in the presence of low disease activity in our trial, such a strategy needs better justification than is available now. 55552928, Results.

Highly Efficient Photocatalytic H2 Evolution from Water using Visible Light and Structure-Controlled Graphitic Carbon Nitride**

PubMed Central

Martin, David James; Qiu, Kaipei; Shevlin, Stephen Andrew; Handoko, Albertus Denny; Chen, Xiaowei; Guo, Zhengxiao; Tang, Junwang

2014-01-01

The major challenge of photocatalytic water splitting, the prototypical reaction for the direct production of hydrogen by using solar energy, is to develop low-cost yet highly efficient and stable semiconductor photocatalysts. Herein, an effective strategy for synthesizing extremely active graphitic carbon nitride (g-C3N4) from a low-cost precursor, urea, is reported. The g-C3N4 exhibits an extraordinary hydrogen-evolution rate (ca. 20 000 μmol h−1 g−1 under full arc), which leads to a high turnover number (TON) of over 641 after 6 h. The reaction proceeds for more than 30 h without activity loss and results in an internal quantum yield of 26.5 % under visible light, which is nearly an order of magnitude higher than that observed for any other existing g-C3N4 photocatalysts. Furthermore, it was found by experimental analysis and DFT calculations that as the degree of polymerization increases and the proton concentration decreases, the hydrogen-evolution rate is significantly enhanced. PMID:25045013

Teaching ABC & Cost Behaviors to Non-Numbers People

ERIC Educational Resources Information Center

Taylor, Virginia Anne; Rudnick, Martin

2007-01-01

Simply put, a cost analysis studies how you spend your money. Activity based costing models associate costs with services and cost benefit analysis weighs whether or not the costs expended were worth the money given the efforts involved and the results achieved. This study seeks to understand the financial choices and information seeking behaviors…

A low cost mobile phone dark-field microscope for nanoparticle-based quantitative studies.

PubMed

Sun, Dali; Hu, Tony Y

2018-01-15

Dark-field microscope (DFM) analysis of nanoparticle binding signal is highly useful for a variety of research and biomedical applications, but current applications for nanoparticle quantification rely on expensive DFM systems. The cost, size, limited robustness of these DFMs limits their utility for non-laboratory settings. Most nanoparticle analyses use high-magnification DFM images, which are labor intensive to acquire and subject to operator bias. Low-magnification DFM image capture is faster, but is subject to background from surface artifacts and debris, although image processing can partially compensate for background signal. We thus mated an LED light source, a dark-field condenser and a 20× objective lens with a mobile phone camera to create an inexpensive, portable and robust DFM system suitable for use in non-laboratory conditions. This proof-of-concept mobile DFM device weighs less than 400g and costs less than $2000, but analysis of images captured with this device reveal similar nanoparticle quantitation results to those acquired with a much larger and more expensive desktop DFMM system. Our results suggest that similar devices may be useful for quantification of stable, nanoparticle-based activity and quantitation assays in resource-limited areas where conventional assay approaches are not practical. Copyright © 2017 Elsevier B.V. All rights reserved.

Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

PubMed

Seidman, Gabriel; Atun, Rifat

2017-04-13

Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

Quantifying the correlation between photoplethysmography and laser Doppler flowmetry microvascular low-frequency oscillations

NASA Astrophysics Data System (ADS)

Mizeva, Irina; Di Maria, Costanzo; Frick, Peter; Podtaev, Sergey; Allen, John

2015-03-01

Photoplethysmography (PPG) and laser Doppler flowmetry (LDF) are two recognized optical techniques that can track low-frequency perfusion changes in microcirculation. The aim of this study was to determine, in healthy subjects, the correlation between the techniques for specific low-frequency bands previously defined for microcirculation. Twelve healthy male subjects (age range 18 to 50 years) were studied, with PPG and LDF signals recorded for 20 min from their right and left index (PPG) and middle (LDF) fingers. Wavelet analysis comprised dividing the low-frequency integral wavelet spectrum (IWS) into five established physiological bands relating to cardiac, respiratory, myogenic, neurogenic, and endothelial activities. The correlation between PPG and LDF was quantified using wavelet correlation analysis and Spearman correlation analysis of the median IWS amplitude. The median wavelet correlation between signals (right-left side average) was 0.45 (cardiac), 0.49 (respiratory), 0.86 (myogenic), 0.91 (neurogenic), and 0.91 (endothelial). The correlation of IWS amplitude values (right-left side average) was statistically significant for the cardiac (ρ=0.64, p<0.05) and endothelial (ρ=0.62, p<0.05) bands. This pilot study has shown good correlation between PPG and LDF for specific physiological frequency bands. In particular, the results suggest that PPG has the potential to be a low-cost replacement for LDF for endothelial activity assessments.

Central Appalachia: Production potential of low-sulfur coal

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

Watkins, J.

The vast preponderance of eastern US low sulfur and 1.2-lbs SO{sub 2}/MMBtu compliance coal comes from a relatively small area composed of 14 counties located in eastern Kentucky, southern West Virginia and western Virginia. These 14 counties accounted for 68% of all Central Appalachian coal production in 1989 as well as 85% of all compliance coal shipped to electric utilities from this region. A property-by-property analysis of total production potential in 10 of the 14 counties (Floyd, Knott, Letcher, Harlan, Martin and Pike in Kentucky and Boone, Kanawha, Logan and Mingo in West Virginia) resulted in the following estimates ofmore » active and yet to be developed properties: (1) total salable reserves for all sulfur levels were 5.9 billion tons and (2) 1.2-lbs. SO{sub 2}/MMBtu compliance'' reserves totaled 2.38 billion tons. This potential supply of compliance coal is adequate to meet the expanded utility demand expected under acid rain for the next 20 years. Beyond 2010, compliance supplies will begin to reach depletion levels in some areas of the study region. A review of the cost structure for all active mines was used to categorize the cost structure for developing potential supplies. FOB cash costs for all active mines in the ten counties ranged from $15 per ton to $35 per ton and the median mine cost was about $22 per ton. A total of 47 companies with the ability to produce and ship coal from owned or leased reserves are active in the ten-county region. Identified development and expansion projects controlled by active companies are capable of expanding the region's current production level by over 30 million tons per year over the next twenty years. Beyond this period the issue of reserve depletion for coal of all sulfur levels in the ten county region will become a pressing issue. 11 figs., 12 tabs.« less

Use of low frequency repetitive transcranial magnetic stimulation to reduce context-dependent learning in people with Parkinson's disease.

PubMed

Lee, Ya-Yun; Fisher, Beth E

2017-05-22

Compared with age-matched non-disabled adults, people with Parkinson's disease (PD) demonstrated greater context-dependent learning, a phenomenon in which an individual shows inferior motor performance when the testing environmental context is different from the original practice context. Additionally, enhanced context- dependency has been shown to be associated with an increased activation of the dorsolateral prefrontal cortex (DLPFC). This study aimed to determine whether context-dependent learning in people with PD could be reduced by decreasing DLPFC activation with low frequency repetitive transcranial magnetic stimulation (rTMS). Quasi-experimental pre-post test controlled study. University laboratory. Twenty-seven participants (18 individuals with PD and 9 age-matched non- disabled adults) were recruited into the PD, PD_rTMS (PD participants who received low frequency rTMS), and Control groups. All participants practiced a finger sequence task containing 3 sequences embedded within specific contexts (colored circles and spatial location on a computer screen) on the first day. On day 2, the participants were tested under the SWITCH and SAME conditions. In the SWITCH condition, the sequence-context association changed from that of practice; in the SAME condition, the sequence-context association remained the same as practice. The PD_rTMS group received 1 Hz rTMS applied over the left DLPFC on the second day before the testing conditions. Switch cost, the performance difference between the SWITCH and SAME conditions, was calculated to indicate context-dependency. All participants improved throughout practice on the first day. Analysis of the switch cost revealed a significant group main effect (p = 0.050). Post-hoc analysis revealed that the PD_rTMS group had significantly smaller switch cost than the PD group (p = 0.031) but not the Control group. Low frequency rTMS applied over DLPFC reduced context-dependency in people with PD. The findings provide a preliminary evidence of using low frequency rTMS as an adjuvant intervention approach to facilitate individuals with PD to generalize a learned motor task from one environmental context to another.

Clinical process cost analysis.

PubMed

Marrin, C A; Johnson, L C; Beggs, V L; Batalden, P B

1997-09-01

New systems of reimbursement are exerting enormous pressure on clinicians and hospitals to reduce costs. Using cheaper supplies or reducing the length of stay may be a satisfactory short-term solution, but the best strategy for long-term success is radical reduction of costs by reengineering the processes of care. However, few clinicians or institutions know the actual costs of medical care; nor do they understand, in detail, the activities involved in the delivery of care. Finally, there is no accepted method for linking the two. Clinical process cost analysis begins with the construction of a detailed flow diagram incorporating each activity in the process of care. The cost of each activity is then calculated, and the two are linked. This technique was applied to Diagnosis Related Group 75 to analyze the real costs of the operative treatment of lung cancer at one institution. Total costs varied between $6,400 and $7,700. The major driver of costs was personnel time, which accounted for 55% of the total. Forty percent of the total cost was incurred in the operating room. The cost of care decreased progressively during hospitalization. Clinical process cost analysis provides detailed information about the costs and processes of care. The insights thus obtained may be used to reduce costs by reengineering the process.

A cost-effectiveness analysis of online, radio and print tobacco control advertisements targeting 25-39 year-old males.

PubMed

Clayforth, Cassandra; Pettigrew, Simone; Mooney, Katie; Lansdorp-Vogelaar, Iris; Rosenberg, Michael; Slevin, Terry

2014-06-01

To assess the relative cost-effectiveness of various non-television advertising media in encouraging 25-39 year-old male smokers to respond to a cessation-related call to action. Information about how new electronic media compare in effectiveness is important to inform the implementation of future tobacco control media campaigns. Two testimonial advertisements featuring members of the target group were developed for radio, press and online media. Multiple waves of media activity were scheduled over a period of seven weeks, including an initial integrated period that included all three media and subsequent single media phases that were interspersed with a week of no media activity. The resulting Quit website hits, Quitline telephone calls, and registrations to online and telephone counselling services were compared to advertising costs to determine the relative cost-effectiveness of each media in isolation and the integrated approach. The online-only campaign phase was substantially more cost-effective than the other phases, including the integrated approach. This finding is contrary to the current assumption that the use of a consistent message across multiple media simultaneously is the most cost-effective way of reaching and affecting target audiences. Online advertising may be a highly cost-effective channel for low-budget tobacco control media campaigns. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

Integrating AgI/AgBr biphasic heterostructures encased by few layer h-BN with enhanced catalytic activity and stability.

PubMed

Wu, Wen; Lv, Xiaomeng; Wang, Jiaxi; Xie, Jimin

2017-06-15

Using freshly prepared water-soluble KBr crystal as facile, low-cost sacrificial template, AgBr nanocubes were synthesized through one-pot precipitation method, then navy bean shaped AgI/AgBr biphasic heterostructures were synthesized through anion-exchange reaction and encased within few-layer h-BN to obtain final product. The obtained heterostructured AgI/AgBr/h-BN composite without plasmonic noble metal nanoparticles was used as stable and high active photocatalyst for dye degradation under visible light irradiation, comparing both with self-prepared normal AgBr, AgBr cubes, AgI/AgBr navy beans and other related catalysts reported in the literature. The significant boosting of activity was attributed to the formation of AgI/AgBr interface and the coupling of few-layer h-BN, the latter of which not only effectively suppresses the reduction of silver ions but greatly enhance the charge separation. Furthermore, it was suggested that the photogenerated holes and superoxide radical were the main active species according to photoelectron chemical measurements, electron spin resonance spin-trap analysis and radical trapping experiments. Finally, the possible mechanism of enhanced photocatalytic activity and stability was discussed and proposed. The work demonstrates that engineering Ag-based semiconductor coupling with h-BN would profit the design strategy for low-cost, solar-driven photocatalysts. Copyright © 2017 Elsevier Inc. All rights reserved.

The relationship between safety net activities and hospital financial performance

PubMed Central

2010-01-01

Background During the 1990's hospitals in the U.S were faced with cost containment charges, which may have disproportionately impacted hospitals that serve poor patients. The purposes of this paper are to study the impact of safety net activities on total profit margins and operating expenditures, and to trace these relationships over the 1990s for all U.S urban hospitals, controlling for hospital and market characteristics. Methods The primary data source used for this analysis is the Annual Survey of Hospitals from the American Hospital Association and Medicare Hospital Cost Reports for years 1990-1999. Ordinary least square, hospital fixed effects, and two-stage least square analyses were performed for years 1990-1999. Logged total profit margin and operating expenditure were the dependent variables. The safety net activities are the socioeconomic status of the population in the hospital serving area, and Medicaid intensity. In some specifications, we also included uncompensated care burden. Results We found little evidence of negative effects of safety net activities on total margin. However, hospitals serving a low socioeconomic population had lower expenditure raising concerns for the quality of the services provided. Conclusions Despite potentially negative policy and market changes during the 1990s, safety net activities do not appear to have imperiled the survival of hospitals. There may, however, be concerns about the long-term quality of the services for hospitals serving low socioeconomic population. PMID:20074367

Cost of common low back pain and lumbar radiculopathy in rheumatologic consultation in Lomé.

PubMed

Fianyo, Eyram; Oniankitan, Owonayo; Tagbor Komi, C; Kakpovi, Kodjo; Houzou, Prénam; Koffi-Tessio Viwalé, E S; Mijiyawa, Moustafa

2017-03-01

The cost of low back pain was the subject of few studies in black Africa. To assess the cost of common low back pain and lumbar radiculopathy in Lomé. A six months study was realised in the rheumatologic department of CHU Sylvanus Olympio. 103 consecutive patients suffering from a common low back pain or lumbar radiculopathy were included. To assess direct, indirect and non-financial costs they were questioned about their expense during the year. Financial cost of common low back pain and lumbar radiculopathy amounted to 107.2 $ US (extremes: 5.8 and 726.1 $ US). This amount, quadruple of guaranteed minimum wage, felled under two headings: direct cost (56.3 $ US; 53% of total sum), indirect cost (50.3 $ US; 47% of total sum). Non-financial cost were: disruption in daily activities (94%), impact in emotional and sexual life (59%), impact on the family's budget (69%), abandon of family's projects (58%) or of leisure (42%). In black Africa top priority is given to the fight against infectious diseases those cause an important mortality. But common low back pain and lumbar radiculopathy, those have social and economic impact, should be given more attention.

Design of Complex BPF with Automatic Digital Tuning Circuit for Low-IF Receivers

NASA Astrophysics Data System (ADS)

Kondo, Hideaki; Sawada, Masaru; Murakami, Norio; Masui, Shoichi

This paper describes the architecture and implementations of an automatic digital tuning circuit for a complex bandpass filter (BPF) in a low-power and low-cost transceiver for applications such as personal authentication and wireless sensor network systems. The architectural design analysis demonstrates that an active RC filter in a low-IF architecture can be at least 47.7% smaller in area than a conventional gm-C filter; in addition, it features a simple implementation of an associated tuning circuit. The principle of simultaneous tuning of both the center frequency and bandwidth through calibration of a capacitor array is illustrated as based on an analysis of filter characteristics, and a scalable automatic digital tuning circuit with simple analog blocks and control logic having only 835 gates is introduced. The developed capacitor tuning technique can achieve a tuning error of less than ±3.5% and lower a peaking in the passband filter characteristics. An experimental complex BPF using 0.18µm CMOS technology can successfully reduce the tuning error from an initial value of -20% to less than ±2.5% after tuning. The filter block dimensions are 1.22mm × 1.01mm; and in measurement results of the developed complex BPF with the automatic digital tuning circuit, current consumption is 705µA and the image rejection ratio is 40.3dB. Complete evaluation of the BPF indicates that this technique can be applied to low-power, low-cost transceivers.

Intelligent Controls for Net-Zero Energy Buildings

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

Li, Haorong; Cho, Yong; Peng, Dongming

2011-10-30

The goal of this project is to develop and demonstrate enabling technologies that can empower homeowners to convert their homes into net-zero energy buildings in a cost-effective manner. The project objectives and expected outcomes are as follows: • To develop rapid and scalable building information collection and modeling technologies that can obtain and process “as-built” building information in an automated or semiautomated manner. • To identify low-cost measurements and develop low-cost virtual sensors that can monitor building operations in a plug-n-play and low-cost manner. • To integrate and demonstrate low-cost building information modeling (BIM) technologies. • To develop decision supportmore » tools which can empower building owners to perform energy auditing and retrofit analysis. • To develop and demonstrate low-cost automated diagnostics and optimal control technologies which can improve building energy efficiency in a continual manner.« less

Development of a low-cost double rotor axial flux motor with soft magnetic composite and ferrite permanent magnet materials

NASA Astrophysics Data System (ADS)

Liu, Chengcheng; Zhu, Jianguo; Wang, Youhua; Guo, Youguang; Lei, Gang; Liu, Xiaojing

2015-05-01

This paper proposes a low-cost double rotor axial flux motor (DRAFM) with low cost soft magnetic composite (SMC) core and ferrite permanent magnets (PMs). The topology and operating principle of DRAFM and design considerations for best use of magnetic materials are presented. A 905 W 4800 rpm DRAFM is designed for replacing the high cost NdFeB permanent magnet synchronous motor (PMSM) in a refrigerator compressor. By using the finite element method, the electromagnetic parameters and performance of the DRAFM operated under the field oriented control scheme are calculated. Through the analysis, it is shown that that the SMC and ferrite PM materials can be good candidates for low-cost electric motor applications.

Cost-effectiveness of two versus three or more doses of intermittent preventive treatment for malaria during pregnancy in sub-Saharan Africa: a modelling study of meta-analysis and cost data.

PubMed

Fernandes, Silke; Sicuri, Elisa; Kayentao, Kassoum; van Eijk, Anne Maria; Hill, Jenny; Webster, Jayne; Were, Vincent; Akazili, James; Madanitsa, Mwayi; ter Kuile, Feiko O; Hanson, Kara

2015-03-01

In 2012, WHO changed its recommendation for intermittent preventive treatment of malaria during pregnancy (IPTp) from two doses to monthly doses of sulfadoxine-pyrimethamine during the second and third trimesters, but noted the importance of a cost-effectiveness analysis to lend support to the decision of policy makers. We therefore estimated the incremental cost-effectiveness of IPTp with three or more (IPTp-SP3+) versus two doses of sulfadoxine-pyrimethamine (IPTp-SP2). For this analysis, we used data from a 2013 meta-analysis of seven studies in sub-Saharan Africa. We developed a decision tree model with a lifetime horizon. We analysed the base case from a societal perspective. We did deterministic and probabilistic sensitivity analyses with appropriate parameter ranges and distributions for settings with low, moderate, and high background risk of low birthweight, and did a separate analysis for HIV-negative women. Parameters in the model were obtained for all countries included in the original meta-analysis. We did simulations in hypothetical cohorts of 1000 pregnant women receiving either IPTp-SP3+ or IPTp-SP2. We calculated disability-adjusted life-years (DALYs) for low birthweight, severe to moderate anaemia, and clinical malaria. We calculated cost estimates from data obtained in observational studies, exit surveys, and from public procurement databases. We give financial and economic costs in constant 2012 US$. The main outcome measure was the incremental cost per DALY averted. The delivery of IPTp-SP3+ to 1000 pregnant women averted 113·4 DALYs at an incremental cost of $825·67 producing an incremental cost-effectiveness ratio (ICER) of $7·28 per DALY averted. The results remained robust in the deterministic sensitivity analysis. In the probabilistic sensitivity analyses, the ICER was $7·7 per DALY averted for moderate risk of low birthweight, $19·4 per DALY averted for low risk, and $4·0 per DALY averted for high risk. The ICER for HIV-negative women was $6·2 per DALY averted. Our findings lend strong support to the WHO guidelines that recommend a monthly dose of IPTp-SP from the second trimester onwards. Malaria in Pregnancy Consortium and the Bill & Melinda Gates Foundation. Copyright © 2015 Fernandes et al. Open Access article distributed under the terms of CC BY-NC-SA. Published by .. All rights reserved.

Integrated operations/payloads/fleet analysis. Volume 2: Payloads

NASA Technical Reports Server (NTRS)

1971-01-01

The payloads for NASA and non-NASA missions of the integrated fleet are analyzed to generate payload data for the capture and cost analyses for the period 1979 to 1990. Most of the effort is on earth satellites, probes, and planetary missions because of the space shuttle's ability to retrieve payloads for repair, overhaul, and maintenance. Four types of payloads are considered: current expendable payload; current reusable payload; low cost expendable payload, (satellite to be used with expendable launch vehicles); and low cost reusable payload (satellite to be used with the space shuttle/space tug system). Payload weight analysis, structural sizing analysis, and the influence of mean mission duration on program cost are also discussed. The payload data were computerized, and printouts of the data for payloads for each program or mission are included.

Evaluation of active control technology for short haul aircraft. [cost effectiveness

NASA Technical Reports Server (NTRS)

Renshaw, J. H.; Bennett, J. A.; Harris, O. C.; Honrath, J. F.; Patterson, R. W.

1975-01-01

An evaluation of the economics of short-haul aircraft designed with active controls technology and low wing-loading to achieve short field performance with good ride quality is presented. Results indicate that for such a system incorporating gust load alleviation and augmented stability the direct operating cost is better than for aircraft without active controls.

System analysis of graphics processor architecture using virtual prototyping

NASA Astrophysics Data System (ADS)

Hancock, William R.; Groat, Jeff; Steeves, Todd; Spaanenburg, Henk; Shackleton, John

1995-06-01

Honeywell has been actively involved in the definition of the next generation display processors for military and commercial cockpits. A major concern is how to achieve super graphics workstation performance in avionics application. Most notable are requirements for low volume, low power, harsh environmental conditions, real-time performance and low cost. This paper describes the application of VHDL to the system analysis tasks associated with achieving these goals in a cost effective manner. The paper will describe the top level architecture identified to provide the graphical and video processing power needed to drive future high resolution display devices and to generate more natural panoramic 3D formats. The major discussion, however, will be on the use of VHDL to model the processing elements and customized pipelines needed to realize the architecture and for doing the complex system tradeoff studies necessary to achieve a cost effective implementation. New software tools have been developed to allow 'virtual' prototyping in the VHDL environment. This results in a hardware/software codesign using VHDL performance and functional models. This unique architectural tool allows simulation and tradeoffs within a standard and tightly integrated toolset, which eventually will be used to specify and design the entire system from the top level requirements and system performance to the lowest level individual ASICs. New processing elements, algorithms, and standard graphical inputs can be designed, tested and evaluated without the costly hardware prototyping using the innovative 'virtual' prototyping techniques which are evolving on this project. In addition, virtual prototyping of the display processor does not bind the preliminary design to point solutions as a physical prototype will. when the development schedule is known, one can extrapolate processing elements performance and design the system around the most current technology.

Implementation of a low-cost mobile devices to support medical diagnosis.

PubMed

García Sánchez, Carlos; Botella Juan, Guillermo; Ayuso Márquez, Fermín; González Rodríguez, Diego; Prieto-Matías, Manuel; Tirado Fernández, Francisco

2013-01-01

Medical imaging has become an absolutely essential diagnostic tool for clinical practices; at present, pathologies can be detected with an earliness never before known. Its use has not only been relegated to the field of radiology but also, increasingly, to computer-based imaging processes prior to surgery. Motion analysis, in particular, plays an important role in analyzing activities or behaviors of live objects in medicine. This short paper presents several low-cost hardware implementation approaches for the new generation of tablets and/or smartphones for estimating motion compensation and segmentation in medical images. These systems have been optimized for breast cancer diagnosis using magnetic resonance imaging technology with several advantages over traditional X-ray mammography, for example, obtaining patient information during a short period. This paper also addresses the challenge of offering a medical tool that runs on widespread portable devices, both on tablets and/or smartphones to aid in patient diagnostics.

Flat-plate solar array progress and plans

NASA Technical Reports Server (NTRS)

Callaghan, W. T.; Henry, P. K.

1984-01-01

The Flat-Plate Solar Array Project (FSA), sponsored by the U.S. Department of Energy (DOE) and managed by the Jet Propulsion Laboratory (JPL), has achieved progress in a broad range of technical activities since that reported at the Fourth European Communities Conference. A particularly important analysis has been completed recently which confirms the adoption into practice by the U.S. Photovoltaic (PV Industry, of all the low-cost module technology elements proposed at the 16th Project Integration Meeting for a $2.80/Wp (1980 U.S. Dollars) design approach in the fall of 1980. This work presents along with a projection, using the same techniques, for what is believed to be a very credible ribbon-based module design for less that $0.55/Wp (1980 U.S. Dollars). Other areas to be reported upon include low-cost Si feedstock refinement; ribbon growth; process sequence development for cells; environmental isolation; engineering science investigations; and module testing progress.

Implementation of a Low-Cost Mobile Devices to Support Medical Diagnosis

PubMed Central

García Sánchez, Carlos; Botella Juan, Guillermo; Ayuso Márquez, Fermín; González Rodríguez, Diego; Prieto-Matías, Manuel; Tirado Fernández, Francisco

2013-01-01

Medical imaging has become an absolutely essential diagnostic tool for clinical practices; at present, pathologies can be detected with an earliness never before known. Its use has not only been relegated to the field of radiology but also, increasingly, to computer-based imaging processes prior to surgery. Motion analysis, in particular, plays an important role in analyzing activities or behaviors of live objects in medicine. This short paper presents several low-cost hardware implementation approaches for the new generation of tablets and/or smartphones for estimating motion compensation and segmentation in medical images. These systems have been optimized for breast cancer diagnosis using magnetic resonance imaging technology with several advantages over traditional X-ray mammography, for example, obtaining patient information during a short period. This paper also addresses the challenge of offering a medical tool that runs on widespread portable devices, both on tablets and/or smartphones to aid in patient diagnostics. PMID:24489600

The electrophotonic silicon biosensor

NASA Astrophysics Data System (ADS)

Juan-Colás, José; Parkin, Alison; Dunn, Katherine E.; Scullion, Mark G.; Krauss, Thomas F.; Johnson, Steven D.

2016-09-01

The emergence of personalized and stratified medicine requires label-free, low-cost diagnostic technology capable of monitoring multiple disease biomarkers in parallel. Silicon photonic biosensors combine high-sensitivity analysis with scalable, low-cost manufacturing, but they tend to measure only a single biomarker and provide no information about their (bio)chemical activity. Here we introduce an electrochemical silicon photonic sensor capable of highly sensitive and multiparameter profiling of biomarkers. Our electrophotonic technology consists of microring resonators optimally n-doped to support high Q resonances alongside electrochemical processes in situ. The inclusion of electrochemical control enables site-selective immobilization of different biomolecules on individual microrings within a sensor array. The combination of photonic and electrochemical characterization also provides additional quantitative information and unique insight into chemical reactivity that is unavailable with photonic detection alone. By exploiting both the photonic and the electrical properties of silicon, the sensor opens new modalities for sensing on the microscale.

A low-cost wheat bran medium for biodegradation of the benzidine-based carcinogenic dye Trypan Blue using a microbial consortium.

PubMed

Lade, Harshad; Kadam, Avinash; Paul, Diby; Govindwar, Sanjay

2015-03-25

Environmental release of benzidine-based dyes is a matter of health concern. Here, a microbial consortium was enriched from textile dye contaminated soils and investigated for biodegradation of the carcinogenic benzidine-based dye Trypan Blue using wheat bran (WB) as growth medium. The PCR-DGGE analysis of enriched microbial consortium revealed the presence of 15 different bacteria. Decolorization studies suggested that the microbial consortium has high metabolic activity towards Trypan Blue as complete removal of 50 mg∙L-1 dye was observed within 24 h at 30 ± 0.2 °C and pH 7. Significant reduction in TOC (64%) and COD (88%) of dye decolorized broths confirmed mineralization. Induction in azoreductase (500%), NADH-DCIP reductase (264%) and laccase (275%) proved enzymatic decolorization of dye. HPLC analysis of dye decolorized products showed the formation of six metabolites while the FTIR spectrum indicated removal of diazo bonds at 1612.30 and 1581.34 cm-1. The proposed dye degradation pathway based on GC-MS and enzyme analysis suggested the formation of two low molecular weight intermediates. Phytotoxicity and acute toxicity studies revealed the less toxic nature of the dye degradation products. These results provide experimental evidence for the utilization of agricultural waste as a novel low-cost growth medium for biodegradation of benzidine-based dyes, and suggested the potential of the microbial consortium in detoxification.

A Low-Cost Wheat Bran Medium for Biodegradation of the Benzidine-Based Carcinogenic Dye Trypan Blue Using a Microbial Consortium

PubMed Central

Lade, Harshad; Kadam, Avinash; Paul, Diby; Govindwar, Sanjay

2015-01-01

Environmental release of benzidine-based dyes is a matter of health concern. Here, a microbial consortium was enriched from textile dye contaminated soils and investigated for biodegradation of the carcinogenic benzidine-based dye Trypan Blue using wheat bran (WB) as growth medium. The PCR-DGGE analysis of enriched microbial consortium revealed the presence of 15 different bacteria. Decolorization studies suggested that the microbial consortium has high metabolic activity towards Trypan Blue as complete removal of 50 mg∙L−1 dye was observed within 24 h at 30 ± 0.2 °C and pH 7. Significant reduction in TOC (64%) and COD (88%) of dye decolorized broths confirmed mineralization. Induction in azoreductase (500%), NADH-DCIP reductase (264%) and laccase (275%) proved enzymatic decolorization of dye. HPLC analysis of dye decolorized products showed the formation of six metabolites while the FTIR spectrum indicated removal of diazo bonds at 1612.30 and 1581.34 cm−1. The proposed dye degradation pathway based on GC-MS and enzyme analysis suggested the formation of two low molecular weight intermediates. Phytotoxicity and acute toxicity studies revealed the less toxic nature of the dye degradation products. These results provide experimental evidence for the utilization of agricultural waste as a novel low-cost growth medium for biodegradation of benzidine-based dyes, and suggested the potential of the microbial consortium in detoxification. PMID:25815522

Can Low-income Americans Afford to Satisfy MyPyramid Fruit and Vegetable Guidelines?

ERIC Educational Resources Information Center

Stewart, Hayden; Hyman, Jeffrey; Frazao, Elizabeth; Buzby, Jean C.; Carlson, Andrea

2011-01-01

Objective: To estimate the costs of satisfying MyPyramid fruit and vegetable guidelines, with a focus on whether low-income households can bear these costs. Design: Descriptive analysis of the 2008 National Consumer Panel with information on the food purchases of 64,440 households across the contiguous United States was used to analyze the cost of…

76 FR 1 - Continuous Construction-Permanent Loan Guarantees Under the Section 538 Guaranteed Rural Rental...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... UMRA, the Agency generally must prepare a written statement, including a cost- benefit analysis, for... projects that have low loan-to-cost ratio, as specified by the Agency in a Notice published periodically in... permanent loans. Only projects that have low loan-to-cost ratios, which will be defined by the Agency in a...

Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

PubMed Central

2010-01-01

Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage. PMID:20236531

Validation of a low-cost EEG device for mood induction studies.

PubMed

Rodríguez, Alejandro; Rey, Beatriz; Alcañiz, Mariano

2013-01-01

New electroencephalography (EEG) devices, more portable and cheaper, are appearing on the market. Studying the reliability of these EEG devices for emotional studies would be interesting, as these devices could be more economical and compatible with Virtual Reality (VR) settings. Therefore, the aim in this work was to validate a low-cost EEG device (Emotiv Epoc) to monitor brain activity during a positive emotional induction procedure. Emotional pictures (IAPS) were used to induce a positive mood in sixteen participants. Changes in the brain activity of subjects were compared between positive induction and neutral conditions. Obtained results were in accordance with previous scientific literature regarding frontal EEG asymmetry, which supports the possibility of using this low-cost EEG device in future mood induction studies combined with VR.

Population-level consequences of antipredator behavior: a metaphysiological model based on the functional ecology of the leaf-eared mouse.

PubMed

Ramos-Jiliberto, Rodrigo; González-Olivares, Eduardo; Bozinovic, Francisco

2002-08-01

We present a predator-prey metaphysiological model, based on the available behavioral and physiological information of the sigmodontine rodent Phyllotis darwini. The model is focused on the population-level consequences of the antipredator behavior, performed by the rodent population, which is assumed to be an inducible response of predation avoidance. The decrease in vulnerability is explicitly considered to have two associated costs: a decreasing foraging success and an increasing metabolic loss. The model analysis was carried out on a reduced form of the system by means of numerical and analytical tools. We evaluated the stability properties of equilibrium points in the phase plane, and carried out bifurcation analyses of rodent equilibrium density under varying conditions of three relevant parameters. The bifurcation parameters chosen represent predator avoidance effectiveness (A), foraging cost of antipredator behavior (C(1)'), and activity-metabolism cost (C(4)'). Our analysis suggests that the trade-offs involved in antipredator behavior plays a fundamental role in the stability properties of the system. Under conditions of high foraging cost, stability decreases as antipredator effectiveness increases. Under the complementary scenario (not considering the highest foraging costs), the equilibria are either stable when both costs are low, or unstable when both costs are higher, independent of antipredator effectiveness. No evidence of stabilizing effects of antipredator behavior was found. Copyright 2002 Elsevier Science (USA).

INTEGRATED BIOPROCESS SYSTEMS FOR LOW-COST ENVIRONMENTAL REMEDIATION AND SUSTAINABLE BIOFERTILIZER PRODUCTION

EPA Science Inventory

Preliminary techno-economic analysis of these processes will be undertaken, utilizing the literature and including key supporting data and proof-of-principle experiments. The emphasis on low-cost bioreactors and operation greatly enhances the economic feasibility and practica...

Cost-Effectiveness and Value of Information Analysis of Brief Interventions to Promote Physical Activity in Primary Care.

PubMed

Gc, Vijay Singh; Suhrcke, Marc; Hardeman, Wendy; Sutton, Stephen; Wilson, Edward C F

2018-01-01

Brief interventions (BIs) delivered in primary care have shown potential to increase physical activity levels and may be cost-effective, at least in the short-term, when compared with usual care. Nevertheless, there is limited evidence on their longer term costs and health benefits. To estimate the cost-effectiveness of BIs to promote physical activity in primary care and to guide future research priorities using value of information analysis. A decision model was used to compare the cost-effectiveness of three classes of BIs that have been used, or could be used, to promote physical activity in primary care: 1) pedometer interventions, 2) advice/counseling on physical activity, and (3) action planning interventions. Published risk equations and data from the available literature or routine data sources were used to inform model parameters. Uncertainty was investigated with probabilistic sensitivity analysis, and value of information analysis was conducted to estimate the value of undertaking further research. In the base-case, pedometer interventions yielded the highest expected net benefit at a willingness to pay of £20,000 per quality-adjusted life-year. There was, however, a great deal of decision uncertainty: the expected value of perfect information surrounding the decision problem for the National Health Service Health Check population was estimated at £1.85 billion. Our analysis suggests that the use of pedometer BIs is the most cost-effective strategy to promote physical activity in primary care, and that there is potential value in further research into the cost-effectiveness of brief (i.e., <30 minutes) and very brief (i.e., <5 minutes) pedometer interventions in this setting. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Multimodal microscopy and the stepwise multi-photon activation fluorescence of melanin

NASA Astrophysics Data System (ADS)

Lai, Zhenhua

The author's work is divided into three aspects: multimodal microscopy, stepwise multi-photon activation fluorescence (SMPAF) of melanin, and customized-profile lenses (CPL) for on-axis laser scanners, which will be introduced respectively. A multimodal microscope provides the ability to image samples with multiple modalities on the same stage, which incorporates the benefits of all modalities. The multimodal microscopes developed in this dissertation are the Keck 3D fusion multimodal microscope 2.0 (3DFM 2.0), upgraded from the old 3DFM with improved performance and flexibility, and the multimodal microscope for targeting small particles (the "Target" system). The control systems developed for both microscopes are low-cost and easy-to-build, with all components off-the-shelf. The control system have not only significantly decreased the complexity and size of the microscope, but also increased the pixel resolution and flexibility. The SMPAF of melanin, activated by a continuous-wave (CW) mode near-infrared (NIR) laser, has potential applications for a low-cost and reliable method of detecting melanin. The photophysics of melanin SMPAF has been studied by theoretical analysis of the excitation process and investigation of the spectra, activation threshold, and photon number absorption of melanin SMPAF. SMPAF images of melanin in mouse hair and skin, mouse melanoma, and human black and white hairs are compared with images taken by conventional multi-photon fluorescence microscopy (MPFM) and confocal reflectance microscopy (CRM). SMPAF images significantly increase specificity and demonstrate the potential to increase sensitivity for melanin detection compared to MPFM images and CRM images. Employing melanin SMPAF imaging to detect melanin inside human skin in vivo has been demonstrated, which proves the effectiveness of melanin detection using SMPAF for medical purposes. Selective melanin ablation with micrometer resolution has been presented using the Target system. Compared to the traditional selective photothermolysis, this method demonstrates higher precision, higher specificity and deeper penetration. Therefore, the SMPAF guided selective ablation of melanin is a promising tool of removing melanin for both medical and cosmetic purposes. Three CPLs have been designed for low-cost linear-motion scanners, low-cost fast spinning scanners and high-precision fast spinning scanners. Each design has been tailored to the industrial manufacturing ability and market demands.

High Cost of Hospitalization for Colonic Diverticular Bleeding Depended on Repeated Bleeding and Blood Transfusion: Analysis with Diagnosis Procedure Combination Data in Japan.

PubMed

Ito, Yoichiro; Sakata, Yasuhisa; Yoshida, Hisako; Nonaka, Sayuri; Fujii, Susumu; Tanaka, Yuichiro; Shirai, Shimpei; Takeshita, Eri; Akutagawa, Takashi; Kawakubo, Hiroharu; Yamamoto, Koji; Tsuruoka, Nanae; Shimoda, Ryo; Iwakiri, Ryuichi; Fujimoto, Kazuma

2017-01-01

Bleeding from a colonic diverticulum is serious in aged patients. The aim of this study was to determine the risk factors for high-cost hospitalization of colonic diverticular bleeding using the diagnosis procedure combination (DPC) data. From January 2009 to December 2015, 78 patients with colonic diverticular bleeding were identified by DPC data in Saga Medical School Hospital. All patients underwent colonic endoscopy within 3 days. The patients were divided into 2 groups: the low-cost group (DPC cost of <500,000 yen) and the high-cost group (DPC cost of >500,000 yen). Univariate analysis revealed that aging, hypertension, rebleeding, a low hemoglobin concentration at admission, and blood transfusion were risk factors for high hospitalization cost. Multivariate analysis revealed that rebleeding (OR 5.3; 95% CI 1.3-21.3; p = 0.017) and blood transfusion (OR 3.8; 95% CI 1.01-14.2; p = 0.048) were definite risk factors for high hospitalization cost. Rebleeding and blood transfusion were related to high hospitalization cost for colonic diverticular bleeding. © 2017 S. Karger AG, Basel.

A Handful of Bacteria: A Simple Activity That Engages Students to Think and Write Like a Scientist

ERIC Educational Resources Information Center

Song, Pengfei

2014-01-01

Non-major students taking science courses to fulfill degree requirements may show low interest in traditional lecture-based classrooms. While professors may try to incorporate hands-on activities to the classroom to foster enthusiasm, the development of a low-cost, low-hazard scienitfic activity that engages students can be challenging. Moreover,…

Preliminary efficacy of prize-based contingency management to increase activity levels in healthy adults.

PubMed

Washington, Wendy Donlin; Banna, Kelly M; Gibson, Amanda L

2014-01-01

An estimated 30% of Americans meet the criteria for obesity. Effective, low-cost interventions to increase physical activity are needed to prevent and treat obesity. In this study, 11 healthy adults wore Fitbit accelerometers for 3 weeks. During the initial baseline, subjects earned prize draws for wearing the Fitbit. During intervention, percentile schedules were used to calculate individual prize-draw criteria. The final week was a return to baseline. Four subjects increased step counts as a result of the intervention. A bout analysis of interresponse times revealed that subjects increased overall step counts by increasing daily minutes active and within-bout response rates and decreasing pauses between bouts of activity. Strategies to improve effectiveness are suggested, such as modification of reinforcement probability and amount and identification of the function of periods of inactivity. © Society for the Experimental Analysis of Behavior.

The environmental monitoring of Cultural Heritage through Low Cost strategies: The frescoes of the crypt of St. Francesco d'Assisi's, Irsina (Basilicata, Southern Italy)

NASA Astrophysics Data System (ADS)

Sileo, Maria; Gizzi, Fabrizio; Masini, Nicola

2015-04-01

One of the main tools of assessment and diagnosis used to define appropriate strategies for the preservation of cultural heritage is the environmental monitoring. To achieve an environmental monitoring are needed high costs of purchase and maintenance, high costs of instrumental and for the management of the plants and processing of results. These costs imply that the technologies for environmental monitoring are not as common but their use is limited to the study very famous monuments or sites. To extend the use and dissemination of such technologies to a greater number of monuments, through the project Pro_Cult (Advanced methodological approaches and technologies for Protection and Security of Cultural Heritage) a research aimed at testing low cost technologies has been performed. The aim of the research is to develop low cost monitoring systems, assessing their effectiveness in a comparative way with commercial high cost ones. To this aim an environmental monitoring system using the Arduino system was designed and developed. It is an electronics prototyping platform based on open-source hardware and software flexible and user friendly. This system is connected to sensors for the detection of environmental parameters of non high purchase cost but with respect to the medium potential detection sensors accurately. This low cost system was tested in the framework of a microclimate monitoring project of the crypt of St. Francis of Assisi in Irsina (Southern Italy) enriched by a precious cycle of medieval frescoes. The aim of this research was to compare two monitoring systems, the first, at low cost, using Arduino system, and the second, a standard commercial product for a full yearly cycle and assess the reliability and the results obtained by the two systems. This paper shows the results of the comparative analysis of an entire monitoring yearly cycle in relation to the problems of degradation affecting the paintings of medieval crypt [1]. The obtained results proved the capability and reliability of the designed low cost monitoring system for investigating the indoor microclimate in relation with decay pathologies. Acknowledgements The authors thank Basilicata Region for supporting this activity in the framework of the Project "PRO_CULT" (Advanced methodological approaches and technologies for Protection and Security of Cultural Heritage) financed by Regional Operational Programme ERDF 2007/2013 [1] M. Sileo, M. Biscione, F.T. Gizzi, N. Masini & M.I. Martinez-Garrido, 2014 - Low cost strategies for the environmental monitoring of Cultural Heritage: Preliminary data from the crypt of St. Francesco d'Assisi, Irsina (Basilicata, Southern Italy). Science, Technology and Cultural Heritage, Edited by Miguel Angel Rogerio-Candelera, 27-34. ISBN: 978-1-138-02744-2.

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali.

PubMed

Somda, Zana C; Meltzer, Martin I; Perry, Helen N; Messonnier, Nancy E; Abdulmumini, Usman; Mebrahtu, Goitom; Sacko, Massambou; Touré, Kandioura; Ki, Salimata Ouédraogo; Okorosobo, Tuoyo; Alemu, Wondimagegnehu; Sow, Idrissa

2009-01-08

Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO) African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR). This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR. We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles. Over the period studied (2002-2005), the average cost to implement the IDSR program in Eritrea was $0.16 per capita, $0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from $35,899 to $69,920 at the region level, $10,790 to $13,941 at the district level, and $1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines), service availability, distance, and the epidemiological profile of the country. This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.

Cost-effective treatment of low-risk carcinoma not invading bladder muscle.

PubMed

Green, David A; Rink, Michael; Cha, Eugene K; Xylinas, Evanguelos; Chughtai, Bilal; Scherr, Douglas S; Shariat, Shahrokh F; Lee, Richard K

2013-03-01

Study Type - Therapy (cost effectiveness analysis) Level of Evidence 2a What's known on the subject? and What does the study add? Bladder cancer is one of the costliest malignancies to treat throughout the life of a patient. The most cost-effective management for low-risk non-muscle-invasive bladder cancer is not known. The current study shows that employing cystoscopic office fulguration for low-risk appearing bladder cancer recurrences can materially impact the cost-effectiveness of therapy. In a follow-up protocol where office fulguration is routinely employed for low-risk bladder cancers, peri-operative intravesical chemotherapy may not provide any additional cost-effectiveness benefit. To examine the cost-effectiveness of fulguration vs transurethral resection of bladder tumour (TURBT) with and without perioperative intravesical chemotherapy (PIC) for managing low-risk carcinoma not invading bladder muscle (NMIBC). Low-risk NMIBC carries a low progression rate, lending support to the use of office-based fulguration for small recurrences rather than traditional TURBT. A Markov state transition model was created to simulate treatment of NMIBC with vs without PIC, with recurrence treated by formal TURBT vs treatment with fulguration. Costing data were obtained from the Medicare Resource Based Relative Value Scale. Data regarding the success of PIC were obtained from the peer-reviewed literature, as were corresponding utilities for bladder cancer-related procedures. Sensitivity analyses were performed. At 5-year follow-up, a strategy of fulguration without PIC was the most cost-effective (mean cost-effectiveness = US $654.8/quality-adjusted life year), despite a lower recurrence rate with PIC. Both fulguration strategies dominated each TURBT strategy. Sensitivity analysis showed that fulguration without PIC dominated all other strategies when the recurrence rate after PIC was increased to ≥14.2% per year. Similarly, the cost-effectiveness of TURBT becomes more competitive with fulguration when the total cost of TURBT declines < US $1175. The present study shows that fulguration without PIC was the most cost-effective strategy for treating low-risk NMIBC. The effectiveness of PIC and the cost of TURBT can materially impact the cost-effectiveness of the different management strategies. These results should be considered in treatment decisions in the context of preserving oncological control. © 2012 BJU INTERNATIONAL.

Reductive Degradation: Versatile, Low Cost.

ERIC Educational Resources Information Center

Water and Sewage Works, 1979

1979-01-01

This article discusses the use of reductive degradation as an economical and effective treatment of chlorinated hydrocarbons. Comparisons with activated carbon treatment show lower capital equipment and treatment costs. (CS)

Inkjet Printed Surface Enhanced Raman Spectroscopy Array on Cellulose Paper

PubMed Central

Yu, Wei W.; White, Ian M.

2011-01-01

A novel, ultra low-cost surface enhanced Raman spectroscopy (SERS) substrate has been developed by modifying the surface chemistry of cellulose paper and patterning nanoparticle arrays, all with a consumer inkjet printer. Micro/nanofabrication of SERS substrates for on-chip chemical and biomolecular analysis has been under intense investigation. However, the high cost of producing these substrates and the limited shelf life severely limit their use, especially for routine laboratory analysis and for point-of-sample analysis in the field. Paper-based microfluidic biosensing systems have shown great potential as low-cost disposable analysis tools. In this work, this concept is extended to SERS-based detection. Using an inexpensive consumer inkjet printer, cellulose paper substrates are modified to be hydrophobic in the sensing regions. Synthesized silver nanoparticles are printed onto this hydrophobic paper substrate with microscale precision to form sensing arrays. The hydrophobic surface prevents the aqueous sample from spreading throughout the paper and thus concentrates the analyte within the sensing region. A SERS fingerprint signal for Rhodamine 6G dye was observed for samples with as low as 10 femtomoles of analyte in a total sample volume of 1 μL. This extraordinarily simple technique can be used to construct SERS microarrays immediately before sample analysis, enabling ultra low-cost chemical and biomolecular detection in the lab as well as in the field at the point of sample collection. PMID:21058689

Active Removal of Large Debris: Electrical Propulsion Capabilities

NASA Astrophysics Data System (ADS)

Billot Soccodato, Carole; Lorand, Anthony; Perrin, Veronique; Couzin, Patrice; FontdecabaBaig, Jordi

2013-08-01

The risk for current operational spacecraft or future market induced by large space debris, dead satellites or rocket bodies, in Low Earth Orbit has been identified several years ago. Many potential solutions and architectures are traded with a main objective of reducing cost per debris. Based on cost consideration, specially driven by launch cost, solutions constructed on multi debris capture capacities seem to be much affordable The recent technologic evolutions in electric propulsion and solar power generation can be used to combine high potential vehicles for debris removal. The present paper reports the first results of a study funded by CNES that addresses full electric solutions for large debris removal. Some analysis are currently in progress as the study will end in August. It compares the efficiency of in-orbit Active Removal of typical debris using electric propulsion The electric engine performances used in this analysis are demonstrated through a 2012/2013 PPS 5000 on-ground tests campaign. The traded missions are based on a launch in LEO, the possible vehicle architectures with capture means or contact less, the selection of deorbiting or reorbiting strategy. For contact less strategy, the ion-beam shepherd effect towards the debris problematic will be addressed. Vehicle architecture and performance of the overall system will be stated, showing the adequacy and the limits of each solution.

Design and evaluation of low-cost stainless steel fiberglass foam blades for large wind driven generating systems

NASA Technical Reports Server (NTRS)

Eggert, W. S.

1982-01-01

A low cost wind turbine blade based on a stainless steel fiberglass foam Budd blade design concept, was evaluated for its principle characteristics, low cost features, and its advantages and disadvantages. A blade structure was designed and construction methods and materials were selected. A complete blade tooling concepts, various technical and economic analysis, and evaluations of the blade design were performed. A comprehensive fatigue test program is conducted to provide data to verify the design stress allowables.

Design and evaluation of low-cost stainless steel fiberglass foam blades for large wind driven generating systems

NASA Astrophysics Data System (ADS)

Eggert, W. S.

1982-10-01

A low cost wind turbine blade based on a stainless steel fiberglass foam Budd blade design concept, was evaluated for its principle characteristics, low cost features, and its advantages and disadvantages. A blade structure was designed and construction methods and materials were selected. A complete blade tooling concepts, various technical and economic analysis, and evaluations of the blade design were performed. A comprehensive fatigue test program is conducted to provide data to verify the design stress allowables.

Development of CMOS Active Pixel Image Sensors for Low Cost Commercial Applications

NASA Technical Reports Server (NTRS)

Fossum, E.; Gee, R.; Kemeny, S.; Kim, Q.; Mendis, S.; Nakamura, J.; Nixon, R.; Ortiz, M.; Pain, B.; Zhou, Z.;

Feasibility of a low-cost hearing screening in rural Indiana.

PubMed

Khan, Khalid M; Bielko, Sylvanna L; Barnes, Priscilla A; Evans, Sydney S; Main, Anna L K

2017-09-18

Hearing loss remains a neglected public health issue in the rural and agricultural communities in the United States and therefore, promotion of a low-cost hearing screening may be important for these underserved populations. The major objectives of our study were to assess feasibility of a low-cost telephone-administered hearing test in rural Indiana and to identify the challenges, barriers and viable implementation strategies associated with this test. Also, we evaluated whether a focus group session could change the hearing health attitude of rural residents. We recruited 126 adults from six rural Indiana counties who participated in study activities in the following order: 1) a pre-focus group demographic, knowledge and attitude survey, 2) a focus group for discussing the feasibility of a telephone-administered hearing screening, 3) a post focus group attitude survey and 4) hearing was screened using an audiometer and self-assessment scale. These activities generated both qualitative and quantitative data, which were subsequently analyzed. Hearing impairment was perceived as an important public health issue. Many participants expressed interests to try the low-cost National Hearing Test (NHT). However, participants recommended NHT to be facilitated by community organizations to provide access to landline phones. The focus group turned out to be an excellent awareness building activity producing significant improvement in hearing health attitudes. Comparison of self and audiometric evaluations indicated underestimation of hearing handicap in our rural study population. The study results underscore the urgent need for an effective strategy to promote low-cost hearing screening in rural US communities.

A cost-benefit/cost-effectiveness analysis of an unsanctioned supervised smoking facility in the Downtown Eastside of Vancouver, Canada.

PubMed

Jozaghi, Ehsan

2014-11-13

Smoking crack involves the risk of transmitting diseases such as HIV and hepatitis C (HCV). The current study determines whether the formerly unsanctioned supervised smoking facility (SSF)-operated by the grassroot organization, Vancouver Area Network of Drug Users (VANDU) for the last few years-costs less than the costs incurred for health-care services as a direct consequence of not having such a program in Vancouver, Canada. The data pertaining to the attendance at the SSF was gathered in 2012-2013 by VANDU. By relying on this data, a mathematical model was employed to estimate the number of HCV infections prevented by the former facility in Vancouver's Downtown Eastside (DTES). The DTES SSF's benefit-cost ratio was conservatively estimated at 12.1:1 due to its low operating cost. The study used 70% and 90% initial pipe-sharing rates for sensitivity analysis. At 80% sharing rate, the marginal HCV cases prevented were determined to be 55 cases. Moreover, at 80% sharing rate, the marginal cost-effectiveness ratio ranges from $1,705 to $97,203. The results from both the baseline and sensitivity analysis demonstrated that the establishment of the SSF by VANDU on average had annually saved CAD$1.8 million dollars in taxpayer's money. Funding SSFs in Vancouver is an efficient and effective use of financial resources in the public health domain; therefore, Vancouver Coastal Health should actively participate in their establishment in order to reduce HCV and other blood-borne infections such as HIV within the non-injecting drug users.

Investigation of advanced navigation and guidance system concepts for all-weather rotorcraft operations

NASA Technical Reports Server (NTRS)

Upton, H. W.; Boen, G. E.; Moore, J.

1982-01-01

Results are presented of a survey conducted of active helicopter operators to determine the extent to which they wish to operate in IMC conditions, the visibility limits under which they would operate, the revenue benefits to be gained, and the percent of aircraft cost they would pay for such increased capability. Candidate systems were examined for capability to meet the requirements of a mission model constructed to represent the modes of flight normally encountered in low visibility conditions. Recommendations are made for development of high resolution radar, simulation of the control display system for steep approaches, and for development of an obstacle sensing system for detecting wires. A cost feasibility analysis is included.

Stratified cost-utility analysis of C-Leg versus mechanical knees: Findings from an Italian sample of transfemoral amputees.

PubMed

Cutti, Andrea Giovanni; Lettieri, Emanuele; Del Maestro, Martina; Radaelli, Giovanni; Luchetti, Martina; Verni, Gennero; Masella, Cristina

2017-06-01

The fitting rate of the C-Leg electronic knee (Otto-Bock, D) has increased steadily over the last 15 years. Current cost-utility studies, however, have not considered the patients' characteristics. To complete a cost-utility analysis involving C-Leg and mechanical knee users; "age at the time of enrollment," "age at the time of first prosthesis," and "experience with the current type of prosthesis" are assumed as non-nested stratification parameters. Cohort retrospective. In all, 70 C-Leg and 57 mechanical knee users were selected. For each stratification criteria, we evaluated the cost-utility of C-Leg versus mechanical knees by computing the incremental cost-utility ratio, that is, the ratio of the "difference in cost" and the "difference in utility" of the two technologies. Cost consisted of acquisition, maintenance, transportation, and lodging expenses. Utility was measured in terms of quality-adjusted life years, computed on the basis of participants' answers to the EQ-5D questionnaire. Patients over 40 years at the time of first prosthesis were the only group featuring an incremental cost-utility ratio (88,779 €/quality-adjusted life year) above the National Institute for Health and Care Excellence practical cost-utility threshold (54,120 €/quality-adjusted live year): C-Leg users experience a significant improvement of "mobility," but limited outcomes on "usual activities," "self-care," "depression/anxiety," and reduction of "pain/discomfort." The stratified cost-utility results have relevant clinical implications and provide useful information for practitioners in tailoring interventions. Clinical relevance A cost-utility analysis that considered patients characteristics provided insights on the "affordability" of C-Leg compared to mechanical knees. In particular, results suggest that C-Leg has a significant impact on "mobility" for first-time prosthetic users over 40 years, but implementation of specific low-cost physical/psychosocial interventions is required to retun within cost-utility thresholds.

No Cost/Low Cost: A Solution for Creative Physical Education Activities

ERIC Educational Resources Information Center

Messerole, Michael J.; Black, Bryan M.

2014-01-01

This article describes how the use of Pringles cans and other tube containers can help physical education teachers gain a new perspective on incorporating a reusable, recyclable, durable product to create fun activities that support the development of fundamental skills in the physical education environment.

A Quantitative Features Analysis of Recommended No- and Low-Cost Preschool E-Books

ERIC Educational Resources Information Center

Parette, Howard P.; Blum, Craig; Luthin, Katie

2015-01-01

In recent years, recommended e-books have drawn increasing attention from early childhood education professionals. This study applied a quantitative descriptive features analysis of cost (n = 70) and no-cost (n = 60) e-books recommended by the Texas Computer Education Association. While t tests revealed no statistically significant differences…

Fabrication and characterization of mesoporous activated carbon from Lemna minor using one-step H3PO4 activation for Pb(II) removal

NASA Astrophysics Data System (ADS)

Huang, Yang; Li, Shunxing; Lin, Haibin; Chen, Jianhua

2014-10-01

A low cost and locally available material, Lemna minor, was used to fabricate activated carbon using H3PO4 activation. After H3PO4 activation, the L. minor activated carbons (LACs) possess high mesoporosity (92.2%) and a surface area of 531.9 m2/g according to Brunauer-Emmett-Teller (BET) analysis. Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectrometer (XPS) analyses reveal the presence of rich hydroxyl, carboxyl, amide and phosphate functional groups on the LACs surface, leading to facile Pb(II) binding to the surface through strong chemisorptive bonds or ion-exchange. The kinetic and equilibrium data were well described by pseudo-first-order model and Langmuir isotherm, with the maximum monolayer adsorption capacity (qm) 170.9 mg/g at 25 °C. The intra-particle diffusion mechanism was partially responsible for the adsorption. The adsorption process was spontaneous and endothermic with negative ΔG and positive ΔH. The Pb(II)-loaded LACs could be easily regenerated using 0.1-M HCl and reused for seven cycles without significant adsorption capacity reduction. The maximum percentage removal rate for Pb(II) (20 mg/L) was found to be 91.8% within 30 min, at optimum conditions of pH 6.0 and 25 °C. These suggested that the low-cost LACs could be used as a potential adsorbent in the treatment of lead-contaminated water.

Economic evaluation of Mumbai and its satellite cancer registries: Implications for expansion of data collection☆

PubMed Central

Koyande, Shravani; Subramanian, Sujha; Edwards, Patrick; Hoover, Sonja; Deshmane, Vinay; Tankga, Florence; Dikshit, Rajesh; Saraiya, Mona

2018-01-01

Background The Mumbai Cancer Registry is a population-based cancer registry that has been in operation for more than five decades and has successfully initiated and integrated three satellite registries in Pune, Nagpur, and Aurangabad, each covering specific urban populations of the Indian state Maharashtra. Data collectors at the satellites perform data abstraction, but Mumbai carries out all other core registration activities such as data analysis and quality assurance. Each of the three satellite registries follows the same data collection methodology as the main Mumbai Cancer Registry. This study examines the cost of operating the Mumbai and its satellite cancer registries. Methods We modified and used the Centers for Disease Control and Prevention’s (CDC’s) International Registry Costing Tool (IntRegCosting Tool) to collect cost and resource use data for the Mumbai Cancer Registry and three satellites. Results Almost 60% of the registration expenditure was borne by the Indian Cancer Society, which hosts the Mumbai Cancer Registry, and more than half of the registry expenditure was related to data collection activities. Across the combined registries, 93% of the expenditure was spent on labor. Overall, registration activities had a low cost per case of 226.10 Indian rupees (or a little less than 4.00 US dollars in 2014 [used average exchange rate in 2014: 1 US $ = 60 Indian rupees]). Conclusion The centralization of fixed-cost activities in Mumbai likely resulted in economies of scale in operating the Mumbai and satellite registries, which, together, report on almost 20,000 cancer cases annually. In middle-income countries like India, where financial resources are limited, the operational framework provided by the Mumbai and satellite registries can serve as a model for other registries looking to expand data collection. PMID:27726981

Economic evaluation of Mumbai and its satellite cancer registries: Implications for expansion of data collection.

PubMed

Koyande, Shravani; Subramanian, Sujha; Edwards, Patrick; Hoover, Sonja; Deshmane, Vinay; Tankga, Florence; Dikshit, Rajesh; Saraiya, Mona

2016-12-01

The Mumbai Cancer Registry is a population-based cancer registry that has been in operation for more than five decades and has successfully initiated and integrated three satellite registries in Pune, Nagpur, and Aurangabad, each covering specific urban populations of the Indian state Maharashtra. Data collectors at the satellites perform data abstraction, but Mumbai carries out all other core registration activities such as data analysis and quality assurance. Each of the three satellite registries follows the same data collection methodology as the main Mumbai Cancer Registry. This study examines the cost of operating the Mumbai and its satellite cancer registries. We modified and used the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool (IntRegCosting Tool) to collect cost and resource use data for the Mumbai Cancer Registry and three satellites. Almost 60% of the registration expenditure was borne by the Indian Cancer Society, which hosts the Mumbai Cancer Registry, and more than half of the registry expenditure was related to data collection activities. Across the combined registries, 93% of the expenditure was spent on labor. Overall, registration activities had a low cost per case of 226.10 Indian rupees (or a little less than 4.00 US dollars in 2014 [used average exchange rate in 2014: 1 US $=60 Indian rupees]). The centralization of fixed-cost activities in Mumbai likely resulted in economies of scale in operating the Mumbai and satellite registries, which, together, report on almost 20,000 cancer cases annually. In middle-income countries like India, where financial resources are limited, the operational framework provided by the Mumbai and satellite registries can serve as a model for other registries looking to expand data collection. Copyright © 2016 Elsevier Ltd. All rights reserved.

Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces costs: a randomized, controlled clinical trial and health economic evaluation.

PubMed

Rosenfeld, Mark; Seferiadis, Aris; Gunnarsson, Ronny

2006-07-15

To examine and compare the costs and consequences in a partial economic evaluation of two competing interventions in patients exposed to whiplash trauma in automobile crashes. The interventions were an active involvement and intervention using early mobilization and a standard intervention of rest, recommended short-term immobilization in a cervical collar and a cautious, gradual self-exercise program according to a leaflet. The study was randomized and controlled. The aim of the study was to compare the costs of an active involvement and intervention versus a standard intervention and to relate them to the clinical benefits in patients exposed to whiplash trauma in automobile crashes to facilitate decision-making regarding intervention and resource allocation. There is very little known about the health economic aspects of various interventions in the target treatment group of patients. Based on a prospective, randomized, clinical trial, data on clinical effectiveness and resources used for the active involvement and intervention and standard intervention were collected for a comparative analysis of the costs related to physical therapy treatment and sick leave. A cost-consequence analysis consisting of a modified cost-effectiveness analysis was used. The costs were significantly lower after 6 and 36 months with an active involvement and intervention as compared with the standard intervention. The active involvement and intervention were significantly superior in reducing experienced pain and reducing sick leave. For patients exposed to whiplash trauma in a motor vehicle collision, an active involvement and intervention were both less costly and more effective than a standard intervention.

Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial.

PubMed

Sørensen, J; Primdahl, J; Horn, H C; Hørslev-Petersen, K

2015-01-01

To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient clinics and general practice, prescription and non-prescription medicine, dietary supplements, other health-care resources, and complementary and alternative care. Measures of effectiveness and costs were collected by self-reported questionnaires at inclusion and after 12 and 24 months. Incremental cost-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Changes in disease activity, functional status, and health-related quality of life were not statistically significantly different for the three groups, although the mean scores were better for the shared care and nurse care groups compared with the rheumatologist group. Shared care and nurse care were non-significantly less costly than rheumatologist care. As both shared care and nurse care were associated with slightly better EQ-5D improvements and lower costs, they dominated rheumatologist care. At EUR 10,000 per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Shared care and nurse care seem to cost less but provide broadly similar health outcomes compared with rheumatologist outpatient care. However, it is still uncertain whether nurse care and shared care are cost-effective in comparison with rheumatologist outpatient care.

Galactic and Solar Cosmic Ray Shielding in Deep Space

NASA Technical Reports Server (NTRS)

Wilson, John W.; Cucinotta, Francis A.; Tai, H.; Simonsen, Lisa C.; Shinn, Judy L.; Thibeault, Shelia; Kim, M. Y.

1997-01-01

An analysis of the radiation hazards in support of NASA deep space exploration activities is presented. The emphasis is on materials required for radiation protection shielding. Aluminum has been found to be a poor shield material when dose equivalent is used with exposure limits for low Earth orbit (LEO) as a guide for shield requirements. Because the radiation issues are cost related-the parasitic shield mass has high launch costs, the use of aluminum as a basic construction material is clearly not cost-effective and alternate materials need to be developed. In this context, polyethylene is examined as a potentially useful material and demonstrates important advantages as an alternative to aluminum construction. Although polyethylene is useful as a shield material, it may not meet other design criteria (strength, stability, thermal); other polymer materials must be examined.

Long-term impact of highly active antiretroviral therapy on HIV-related health care costs.

PubMed

Keiser, P; Nassar, N; Kvanli, M B; Turner, D; Smith, J W; Skiest, D

2001-05-01

Highly active antiretroviral therapy (HAART) is associated with decreased opportunistic infections, hospitalization, and HIV-related health care costs over relatively short periods of time. We have previously demonstrated that decreases in total HIV cost are proportional to penetration of protease inhibitor therapy in our clinic. To determine the effects of HAART on HIV health care use and costs over 44 months. A comprehensive HIV service within a Veterans Affairs Medical Center. A cost-effectiveness analysis of HAART. The mean monthly number of hospital days, infectious diseases clinic visits, emergency room visits, non-HIV-related outpatient visits, inpatient costs, and antiretroviral treatment costs per patient were determined by dividing these during the period from January 1995 through June 1998 into four intervals. Viral load tests were available from October 1996. Cost-effectiveness of HAART was evaluated by determining the costs of achieving an undetectable viral load over time. Mean monthly hospitalization and associated inpatient costs decreased and remained low 2 years after the introduction of protease inhibitors (37 hospital days per 100 patients). Total cost decreased from $1905 per patient per month during the first quarter to $1090 per patient per month in the third quarter but increased to $1391 per patient per month in the fourth quarter. Antiretroviral treatment costs increased throughout the entire observation period from $79 per patient per month to $518 per patient per month. Hospitalization costs decreased from $1275 per patient per month in the first quarter to less than $500 per patient per month in each of the third and fourth quarters. The percentage of patients with a viral load <500 copies/mL increased from 21% in October 1996 to 47% in June of 1997 (p =.014). The cost of achieving an undetectable viral load decreased from $4438 per patient per month to $2669 per patient per month, but this trend did not reach statistical significance (p =.18). After an initial decrease, there was an increase in the total monthly cost of caring for HIV patients. Cost increases were primarily due to antiretroviral treatment costs, but these costs were offset by a marked decrease in inpatient-related costs. Increases in costs were not related to antiretroviral treatment failures as measured by the proportion of patients with low or undetectable viral loads. The cost of achieving an undetectable viral load remained stable despite increases in the cost of procuring antiretroviral agents.

SERI Solar Energy Storage Program: FY 1984

NASA Astrophysics Data System (ADS)

Luft, W.; Bohn, M.; Copeland, R. J.; Kreith, F.; Nix, R. G.

1985-02-01

The activities of the Solar Energy Research Institute's Solar Energy Research Institute's Solar Energy Storage Program during its sixth year are summarized. During FY 1984 a study was conducted to identify the most promising high-temperature containment concepts considering corrosion resistance, material strength at high temperature, reliability of performance, and cost. Of the two generic types of high-temperature thermal storage concepts, the single-tank system was selected using a two-medium approach to the thermocline maintenance. This concept promises low costs, but further research is required. A conceptual design for a sand-to-air direct-contact heat exchanger was developed using dual-lock hoppers to introduce the sand into the fluidized-bed exchanger, and using cyclones to remove sand particles from the output air stream. Preliminary cost estimates indicate heat exchanger subsystem annual levelized costs of about $4/GJ with compressor costs of an additional $0.75/GJ. An economic analysis comparing sensible and latent heat storage for nitrate and carbonate salts with solely sensible heat storage showed 3%-21% cost savings with combined sensible and latent heat storage.

Development of a Low-cost, Comprehensive Recording System for Circadian Rhythm Behavior.

PubMed

Kwon, Jea; Park, Min Gu; Lee, Seung Eun; Lee, C Justin

2018-02-01

Circadian rhythm is defined as a 24-hour biological oscillation, which persists even without any external cues but also can be re-entrained by various environmental cues. One of the widely accepted circadian rhythm behavioral experiment is measuring the wheel-running activity (WRA) of rodents. However, the price for commercially available WRA recording system is not easily affordable for researchers due to high-cost implementation of sensors for wheel rotation. Here, we developed a cost-effective and comprehensive system for circadian rhythm recording by measuring the house-keeping activities (HKA). We have monitored animal's HKA as electrical signal by simply connecting animal housing cage with a standard analog/digital converter: input to the metal lid and ground to the metal grid floor. We show that acquired electrical signals are combined activities of eating, drinking and natural locomotor behaviors which are well-known indicators of circadian rhythm. Post-processing of measured electrical signals enabled us to draw actogram, which verifies HKA to be reliable circadian rhythm indicator. To provide easy access of HKA recording system for researchers, we have developed user-friendly MATLAB-based software, Circa Analysis. This software provides functions for easy extraction of scalable "touch activity" from raw data files by automating seven steps of post-processing and drawing actograms with highly intuitive user-interface and various options. With our cost-effective HKA circadian rhythm recording system, we have estimated the cost of our system to be less than $150 per channel. We anticipate our system will benefit many researchers who would like to study circadian rhythm.

When does mass screening for open neural tube defects in low-risk pregnancies result in cost savings?

PubMed Central

Tosi, L L; Detsky, A S; Roye, D P; Morden, M L

1987-01-01

Using a decision analysis model, we estimated the savings that might be derived from a mass prenatal screening program aimed at detecting open neural tube defects (NTDs) in low-risk pregnancies. Our baseline analysis showed that screening v. no screening could be expected to save approximately $8 per pregnancy given a cost of $7.50 for the maternal serum alpha-feto-protein (MSAFP) test and a cost of $42,507 for hospital and rehabilitation services for the first 10 years of life for a child with spina bifida. When a more liberal estimate of the costs of caring for such a child was used, the savings with the screening program were more substantial. We performed extensive sensitivity analyses, which showed that the savings were somewhat sensitive to the cost of the MSAFP test and highly sensitive to the specificity (but not the sensitivity) of the test. A screening program for NTDs in low-risk pregnancies may result in substantial savings in direct health care costs if the screening protocol is followed rigorously and efficiently. PMID:2433011

Estimating the Cost of Neurosurgical Procedures in a Low-Income Setting: An Observational Economic Analysis.

PubMed

Abdelgadir, Jihad; Tran, Tu; Muhindo, Alex; Obiga, Doomwin; Mukasa, John; Ssenyonjo, Hussein; Muhumza, Michael; Kiryabwire, Joel; Haglund, Michael M; Sloan, Frank A

2017-05-01

There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). During the study period, October 2014 to September 2015, 1440 charts were reviewed. Of these patients, 434 had surgery, whereas the other 1006 were treated nonsurgically. Thirteen types of procedures were performed at the hospital. The estimated mean cost of a neurosurgical procedure was $542.14 (standard deviation [SD], $253.62). The mean cost of different procedures ranged from $291 (SD, $101) for burr hole evacuations to $1,221 (SD, $473) for excision of brain tumors. For most surgeries, overhead costs represented the largest proportion of the total cost (29%-41%). This is the first study using primary data to determine the cost of neurosurgery in a low-resource setting. Operating theater capacity is likely the binding constraint on operative volume, and thus, investing in operating theaters should achieve a higher level of efficiency. Findings from this study could be used by stakeholders and policy makers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. Copyright © 2017 Elsevier Inc. All rights reserved.

On-Field Demonstration Results of Medium Concentration System HSun®

NASA Astrophysics Data System (ADS)

Mendes-Lopes, J.; Pina, L.; Reis, F.; Coelho, S.; Wemans, J.; Sorasio, G.; Pereira, N.

2011-12-01

The paper presents the HSUN®, a new medium concentration photovoltaic (CPV) system, developed and produced by WS Energia S.A. The low cost manufacturing and standard components used by HSUN® technology increases the potential of the system to reach grid parity. The system was designed to have stable performance and low cost manufacturing, with a total active collector area of 1.68 m2 and 6.3 kg/m2 of weight. Based on a 20X integrated parabolic trough with coupled reflective secondary optics, the system uses high efficiency silicon cells, a passive cooling integrated system and is integrated in 1-axis horizontal tracking structure, the WS CPV HORIZON®. The open-chain configuration ensures that the wind drag is greatly reduced, increasing the reliability of the tracker, while the optimized optics design enables a high acceptance angle and uniform distribution of radiation throughout the PV receiver, using low-cost and low-weight components. Ray tracing simulations and experimental imaging acquisitions of the radiation profile were performed and compared, finite element models were used to perform thermal and structural analysis, and a specifically developed model was used to predict the electrical parameters of the receiver as a function of the concentration. All the components that integrate HSUN® technology are produced with machines used in mature industrial sectors thus guarantying mass production and benefiting from economies of scale. The on-field results are presented and discussed.

Automated array assembly task, phase 1

NASA Technical Reports Server (NTRS)

Carbajal, B. G.

1977-01-01

An assessment of state-of-the-art technologies that are applicable to silicon solar cell and solar cell module fabrication is provided. The assessment consists of a technical feasibility evaluation and a cost projection for high-volume production of silicon solar cell modules. The cost projection was approached from two directions; a design-to-cost analysis assigned cost goals to each major process element in the fabrication scheme, and a cost analysis built up projected costs for alternate technologies for each process element. A technical evaluation was used in combination with the cost analysis to identify a baseline low cost process. A novel approach to metal pattern design based on minimum power loss was developed. These design equations were used as a tool in the evaluation of metallization technologies.

Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru.

PubMed

Shah, L; Rojas, M; Mori, O; Zamudio, C; Kaufman, J S; Otero, L; Gotuzzo, E; Seas, C; Brewer, T F

2017-04-01

We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.

Evaluation of fatigue-prone details using a low-cost thermoelastic stress analysis system.

DOT National Transportation Integrated Search

2016-11-01

This study was designed to develop a novel approach for in situ evaluation of stress fields in the vicinity of fatigue-prone details on highway bridges using a low-cost microbolometer thermal imager. : The method was adapted into a field-deployable i...

Ion Torren Semiconductor Sequencing Allows Rapid, Low Cost Sequencing of the Human Exome (7th Annual SFAF Meeting, 2012)

ScienceCinema

Jenkins, David

2018-01-10

David Jenkins on "Ion Torrent semiconductor sequencing allows rapid, low-cost sequencing of the human exome" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

Ion Torren Semiconductor Sequencing Allows Rapid, Low Cost Sequencing of the Human Exome (7th Annual SFAF Meeting, 2012)

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

Jenkins, David

David Jenkins on "Ion Torrent semiconductor sequencing allows rapid, low-cost sequencing of the human exome" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

Epidemiological and Economic Impact of Monovalent and Pentavalent Rotavirus Vaccines in Low and Middle Income Countries: A Cost-effectiveness Modeling Analysis.

PubMed

Paternina-Caicedo, Angel; De la Hoz-Restrepo, Fernando; Alvis-Guzmán, Nelson

2015-07-01

The competing choices of vaccination with either RV1 or RV5, the potential budget impact of vaccines on the EPI with different prices and new evidence make important an updated analysis for health decision makers in each country. The objective of this study is to assess cost-effectiveness of the monovalent and pentavalent rotavirus vaccines and impact on children deaths, inpatient and outpatient visits in 116 low and middle income countries that represent approximately 99% of rotavirus mortality. A decision tree model followed hypothetical cohorts of children from birth up to 5 years of age for each country in 2010. Inputs were gathered from international databases and previous research on incidence and effectiveness of monovalent and pentavalent vaccines. Costs were expressed in 2010 international dollars. Outcomes were reported in terms of cost per disability-adjusted life-year averted, comparing no vaccination with either monovalent or pentavalent mass introduction. Vaccine price was assumed fixed for all world low-income and middle-income countries. Around 292,000 deaths, 3.34 million inpatient cases and 23.09 million outpatient cases would occur with no vaccination. In the base-case scenario, monovalent vaccination would prevent 54.7% of inpatient cases and 45.4% of deaths. Pentavalent vaccination would prevent 51.4% of inpatient cases and 41.1% of deaths. The vaccine was cost-effective in all world countries in the base-case scenario for both vaccines. Cost per disability-adjusted life-year averted in all selected countries was I$372 for monovalent, and I$453 for pentavalent vaccination. Rotavirus vaccine is cost-effective in most analyzed countries. Despite cost-effectiveness analysis is a useful tool for decision making in middle-income countries, for low-income countries health decision makers should also assess the impact of introducing either vaccine on local resources and budget impact analysis of vaccination.

Nickel supported on nitrogen-doped carbon nanotubes as hydrogen oxidation reaction catalyst in alkaline electrolyte

DOE PAGES

Zhuang, Zhongbin; Giles, Stephen A.; Zheng, Jie; ...

2016-01-14

The development of a low-cost, high-performance platinum-group-metal-free hydroxide exchange membrane fuel cell is hindered by the lack of a hydrogen oxidation reaction catalyst at the anode. Here we report that a composite catalyst, nickel nanoparticles supported on nitrogen-doped carbon nanotubes, has hydrogen oxidation activity similar to platinum-group metals in alkaline electrolyte. Although nitrogen-doped carbon nanotubes are a very poor hydrogen oxidation catalyst, as a support, it increases the catalytic performance of nickel nanoparticles by a factor of 33 (mass activity) or 21 (exchange current density) relative to unsupported nickel nanoparticles. Density functional theory calculations indicate that the nitrogen-doped support stabilizesmore » the nanoparticle against reconstruction, while nitrogen located at the edge of the nanoparticle tunes local adsorption sites by affecting the d-orbitals of nickel. Here, owing to its high activity and low cost, our catalyst shows significant potential for use in low-cost, high-performance fuel cells.« less

Nickel supported on nitrogen-doped carbon nanotubes as hydrogen oxidation reaction catalyst in alkaline electrolyte

PubMed Central

Zhuang, Zhongbin; Giles, Stephen A.; Zheng, Jie; Jenness, Glen R.; Caratzoulas, Stavros; Vlachos, Dionisios G.; Yan, Yushan

2016-01-01

The development of a low-cost, high-performance platinum-group-metal-free hydroxide exchange membrane fuel cell is hindered by the lack of a hydrogen oxidation reaction catalyst at the anode. Here we report that a composite catalyst, nickel nanoparticles supported on nitrogen-doped carbon nanotubes, has hydrogen oxidation activity similar to platinum-group metals in alkaline electrolyte. Although nitrogen-doped carbon nanotubes are a very poor hydrogen oxidation catalyst, as a support, it increases the catalytic performance of nickel nanoparticles by a factor of 33 (mass activity) or 21 (exchange current density) relative to unsupported nickel nanoparticles. Density functional theory calculations indicate that the nitrogen-doped support stabilizes the nanoparticle against reconstruction, while nitrogen located at the edge of the nanoparticle tunes local adsorption sites by affecting the d-orbitals of nickel. Owing to its high activity and low cost, our catalyst shows significant potential for use in low-cost, high-performance fuel cells. PMID:26762466

Combining Community Engagement and Scientific Approaches in Next-Generation Monitor Siting: The Case of the Imperial County Community Air Network.

PubMed

Wong, Michelle; Bejarano, Esther; Carvlin, Graeme; Fellows, Katie; King, Galatea; Lugo, Humberto; Jerrett, Michael; Meltzer, Dan; Northcross, Amanda; Olmedo, Luis; Seto, Edmund; Wilkie, Alexa; English, Paul

2018-03-15

Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities. By engaging community residents in the project design, monitor siting processes, data dissemination, and other key activities, the resulting air monitoring network data are relevant, trusted, understandable, and used by community residents. Integration of spatial analysis and air monitoring best practices into the network development process ensures that the data are reliable and appropriate for use in research activities. This combined approach results in a community air monitoring network that is better able to inform community residents, support research activities, guide public policy, and improve public health. Here we detail the monitor siting process and outline the advantages and challenges of this approach.

Combining Community Engagement and Scientific Approaches in Next-Generation Monitor Siting: The Case of the Imperial County Community Air Network

PubMed Central

Wong, Michelle; Bejarano, Esther; Carvlin, Graeme; King, Galatea; Lugo, Humberto; Jerrett, Michael; Northcross, Amanda; Olmedo, Luis; Seto, Edmund; Wilkie, Alexa; English, Paul

2018-01-01

Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities. By engaging community residents in the project design, monitor siting processes, data dissemination, and other key activities, the resulting air monitoring network data are relevant, trusted, understandable, and used by community residents. Integration of spatial analysis and air monitoring best practices into the network development process ensures that the data are reliable and appropriate for use in research activities. This combined approach results in a community air monitoring network that is better able to inform community residents, support research activities, guide public policy, and improve public health. Here we detail the monitor siting process and outline the advantages and challenges of this approach. PMID:29543726

Green Building Premium Cost Analysis in Indonesia Using Work Breakdown Structure Method

NASA Astrophysics Data System (ADS)

Basten, V.; Latief, Y.; Berawi, M. A.; Riswanto; Muliarto, H.

2018-03-01

The concept of green building in the construction industry is indispensable for mitigating environmental issues such as waste, pollution, and carbon emissions. There are some countries that have Green Building rating tools. Indonesia particularly is the country which has Greenship rating tools but the number of Green Building is relatively low. Development of building construction is depended on building investors or owner initiation, so this research is conducted to get the building aspects that have significant effect on the attractiveness using The Green Building Concept. The method in this research is work breakdown structure method that detailing the green building activities. The particular activities will be processed to get the cost elements for the green building achievement that it was targeted to improve better than conventional building. The final result of the study was a very significant work package on green building construction in the city of Indonesia case study.

Production of fatty acid butyl esters using the low cost naturally immobilized Carica papaya lipase.

PubMed

Su, Erzheng; Wei, Dongzhi

2014-07-09

In this work, the low cost naturally immobilized Carica papaya lipase (CPL) was investigated for production of fatty acid butyl esters (FABE) to fulfill the aim of reducing the lipase cost in the enzymatic butyl-biodiesel process. The CPL showed specificities to different alcohol acyl acceptors. Alcohols with more than three carbon atoms did not have negative effects on the CPL activity. The CPL catalyzed butanolysis for FABE production was systematically investigated. The reaction solvent, alcohol/oil molar ratio, enzyme amount, reaction temperature, and water activity all affected the butanolysis process. Under the optimized conditions, the highest conversion of 96% could be attained in 24 h. These optimal conditions were further applied to CPL catalyzed butanolysis of other vegetable oils. All of them showed very high conversion. The CPL packed-bed reactor was further developed, and could be operated continuously for more than 150 h. All of these results showed that the low cost Carica papaya lipase can be used as a promising lipase for biodiesel production.

Cost analysis of new and retrofit hot-air type solar assisted heating systems

NASA Technical Reports Server (NTRS)

Stewart, R. D.; Hawkins, B. J.

1978-01-01

A detailed cost analysis/cost improvement study was performed on two Department of Energy/National Aeronautics and Space Administration operational test sites to determine actual costs and potential cost improvements of new and retrofit hot air type, solar assisted heating and hot water systems for single family sized structures. This analysis concentrated on the first cost of a system which included procurement, installation, and integration of a solar assisted heating and hot water system on a new or retrofit basis; it also provided several cost projections which can be used as inputs to payback analyses, depending upon the degree of optimism or future improvements assumed. Cost definitions were developed for five categories of cost, and preliminary estimates were developed for each. The costing methodology, approach, and results together with several candidate low cost designs are described.

Electric Propulsion Upper-Stage for Launch Vehicle Capability Enhancement

NASA Technical Reports Server (NTRS)

Kemp, Gregory E.; Dankanich, John W.; Woodcock, Gordon R.; Wingo, Dennis R.

2007-01-01

The NASA In-Space Propulsion Technology Project Office initiated a preliminary study to evaluate the performance benefits of a solar electric propulsion (SEP) upper-stage with existing and near-term small launch vehicles. The analysis included circular and elliptical Low Earth Orbit (LEO) to Geosynchronous Earth Orbit (GEO) transfers, and LEO to Low Lunar Orbit (LLO) applications. SEP subsystem options included state-of-the-art and near-term solar arrays and electric thrusters. In-depth evaluations of the Aerojet BPT-4000 Hall thruster and NEXT gridded ion engine were conducted to compare performance, cost and revenue potential. Preliminary results indicate that Hall thruster technology is favored for low-cost, low power SEP stages, while gridded-ion engines are favored for higher power SEP systems unfettered by transfer time constraints. A low-cost point design is presented that details one possible stage configuration and outlines system limitations, in particular fairing volume constraints. The results demonstrate mission enhancements to large and medium class launch vehicles, and mission enabling performance when SEP system upper stages are mounted to low-cost launchers such as the Minotaur and Falcon 1. Study results indicate the potential use of SEP upper stages to double GEO payload mass capability and to possibly enable launch on demand capability for GEO assets. Transition from government to commercial applications, with associated cost/benefit analysis, has also been assessed. The sensitivity of system performance to specific impulse, array power, thruster size, and component costs are also discussed.

[An analysis of cost and profit of a nursing unit using performance-based costing: case of a general surgical ward in a general hospital].

PubMed

Lim, Ji Young

2008-02-01

The aim of this study was to analyze net income of a surgical nursing ward in a general hospital. Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at won 119,913,334.5. The cost volume of the allocated medical department was won 91,588,200.3, and the ward consumed cost was won 28,325,134.2. The revenue of the surgical nursing ward was won 33,269,925.0. The expense of a surgical nursing ward was 28,325,134.2. Therefore, the net income of a surgical nursing ward was won 4,944,790.8. We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

Person-Centered, Physical Activity for Patients with Low Back Pain: Piloting Service Delivery

PubMed Central

Bloxham, Saul; Barter, Phil; Scragg, Slafka; Peers, Charles; Jane, Ben; Layden, Joe

2016-01-01

Low back pain (LBP) is one of the most common and costly conditions in industrialized countries. Exercise therapy has been used to treat LBP, although typically using only one mode of exercise. This paper describes the method and initial findings of a person-centered, group physical activity programme which featured as part of a multidisciplinary approach to treating LBP. Six participants (aged 50.7 ± 17 years) completed a six-week physical activity programme lasting two hours per week. A multicomponent approach to physical activity was adopted which included aerobic fitness, core activation, muscular strength and endurance, Nordic Walking, flexibility and exercise gaming. In addition, participants were required to use diary sheets to record physical activity completed at home. Results revealed significant (p < 0.05) improvements in back strength (23%), aerobic fitness (23%), negative wellbeing (32%) and disability (16%). Person’s Correlation Coefficient analysis revealed significant (p < 0.05) relationships between improvement in perceived pain and aerobic fitness (r = 0.93). It was concluded that a person-centered, multicomponent approach to physical activity may be optimal for supporting patients who self-manage LBP. PMID:27417616

State-of-the-art low-cost solar reflector materials

NASA Astrophysics Data System (ADS)

Kennedy, C.; Jorgensen, G.

1994-11-01

Solar thermal technologies generate power by concentrating sunlight with large mirrors. The National Renewable Energy Laboratory (NREL) is working with industrial partners to develop the optical reflector materials needed for the successful deployment of this technology. The reflector materials must be low in cost and maintain high specular reflectance for extended lifetimes in severe outdoor environments. Currently, the best candidate materials for solar mirrors are silver-coated low-iron glass and silvered polymer films. Polymer reflectors are lighter in weight, offer greater flexibility in system design, and have the potential for lower cost than glass mirrors. In parallel with collaborative activities, several innovative candidate reflector-material constructions were investigated at NREL. The low-cost material requirement necessitates manufacturing compatible with mass-production techniques. Future cooperative efforts with the web-coating industry offers the promise of exciting new alternative materials and the potential for dramatic cost savings in developing advanced solar reflector materials.

Assessment of low-cost manufacturing process sequences. [photovoltaic solar arrays

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.

1979-01-01

An extensive research and development activity to reduce the cost of manufacturing photovoltaic solar arrays by a factor of approximately one hundred is discussed. Proposed and actual manufacturing process descriptions were compared to manufacturing costs. An overview of this methodology is presented.

Activity-Based Management Accounting for DoD Depot Maintenance

DTIC Science & Technology

1994-08-01

used to establish a management accounting system for the depots is described. The current accounting system does not provide the information to answer...nondirect costs are tied solely to direct labor hours. A possible alternative management accounting system uses Activity-Based Costing (ABC). ABC links...along with its probable benefits and costs. Accounting, Management accounting , Cost analysis, Depot maintenance cost.

Assessing the impact of electrolyte conductivity and viscosity on the reactor cost and pressure drop of redox-active polymer flow batteries

NASA Astrophysics Data System (ADS)

Iyer, Vinay A.; Schuh, Jonathon K.; Montoto, Elena C.; Pavan Nemani, V.; Qian, Shaoyi; Nagarjuna, Gavvalapalli; Rodríguez-López, Joaquín; Ewoldt, Randy H.; Smith, Kyle C.

2017-09-01

Redox-active small molecules, used traditionally in redox flow batteries (RFBs), are susceptible to crossover and require expensive ion exchange membranes (IEMs) to achieve long lifetimes. Redox-active polymer (RAP) solutions show promise as candidate electrolytes to mitigate crossover through size-exclusion, enabling the use of porous separators instead of IEMs. Here, poly(vinylbenzyl ethyl viologen) is studied as a surrogate RAP for RFBs. For oxidized RAPs, ionic conductivity varies weakly between 1.6 and 2.1 S m-1 for RAP concentrations of 0.13-1.27 mol kg-1 (monomeric repeat unit per kg solvent) and 0.32 mol kg-1 LiBF4 with a minor increase upon reduction. In contrast, viscosity varies between 1.8 and 184.0 mPa s over the same concentration range with weakly shear-thinning rheology independent of oxidation state. Techno-economic analysis is used to quantify reactor cost as a function of electrolyte transport properties for RAP concentrations of 0.13-1.27 mol kg-1, assuming a hypothetical 3V cell and facile kinetics. Among these concentrations, reactor cost is minimized over a current density range of 600-1000 A m-2 with minimum reactor cost between 11-17 per kWh, and pumping pressures below 10 kPa. The predicted low reactor cost of RAP RFBs is enabled by sustained ionic mobility in spite of the high viscosity of concentrated RAP solutions.

Behavior analysis for elderly care using a network of low-resolution visual sensors

NASA Astrophysics Data System (ADS)

Eldib, Mohamed; Deboeverie, Francis; Philips, Wilfried; Aghajan, Hamid

2016-07-01

Recent advancements in visual sensor technologies have made behavior analysis practical for in-home monitoring systems. The current in-home monitoring systems face several challenges: (1) visual sensor calibration is a difficult task and not practical in real-life because of the need for recalibration when the visual sensors are moved accidentally by a caregiver or the senior citizen, (2) privacy concerns, and (3) the high hardware installation cost. We propose to use a network of cheap low-resolution visual sensors (30×30 pixels) for long-term behavior analysis. The behavior analysis starts by visual feature selection based on foreground/background detection to track the motion level in each visual sensor. Then a hidden Markov model (HMM) is used to estimate the user's locations without calibration. Finally, an activity discovery approach is proposed using spatial and temporal contexts. We performed experiments on 10 months of real-life data. We show that the HMM approach outperforms the k-nearest neighbor classifier against ground truth for 30 days. Our framework is able to discover 13 activities of daily livings (ADL parameters). More specifically, we analyze mobility patterns and some of the key ADL parameters to detect increasing or decreasing health conditions.

Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries

PubMed Central

Siapka, Mariana; Remme, Michelle; Obure, Carol Dayo; Maier, Claudia B; Dehne, Karl L

2014-01-01

Abstract Objective To synthesize the data available – on costs, efficiency and economies of scale and scope – for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale-up of human immunodeficiency virus (HIV) services in low- and middle-income countries. Methods The relevant peer-reviewed and “grey” literature from low- and middle-income countries was systematically reviewed. Search and analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Findings Of the 82 empirical costing and efficiency studies identified, nine provided data on economies of scale. Scale explained much of the variation in the costs of several HIV services, particularly those of targeted HIV prevention for key populations and HIV testing and treatment. There is some evidence of economies of scope from integrating HIV counselling and testing services with several other services. Cost efficiency may also be improved by reducing input prices, task shifting and improving client adherence. Conclusion HIV programmes need to optimize the scale of service provision to achieve efficiency. Interventions that may enhance the potential for economies of scale include intensifying demand-creation activities, reducing the costs for service users, expanding existing programmes rather than creating new structures, and reducing attrition of existing service users. Models for integrated service delivery – which is, potentially, more efficient than the implementation of stand-alone services – should be investigated further. Further experimental evidence is required to understand how to best achieve efficiency gains in HIV programmes and assess the cost–effectiveness of each service-delivery model. PMID:25110375

Activity-based costing and its application in a Turkish university hospital.

PubMed

Yereli, Ayşe Necef

2009-03-01

Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.

Design and development of low cost polyurethane biopolymer based on castor oil and glycerol for biomedical applications

PubMed Central

Tan, A. C. W.; Polo‐Cambronell, B. J.; Provaggi, E.; Ardila‐Suárez, C.; Ramirez‐Caballero, G. E.; Baldovino‐Medrano, V. G.

2017-01-01

Abstract In the current study, we present the synthesis of novel low cost bio‐polyurethane compositions with variable mechanical properties based on castor oil and glycerol for biomedical applications. A detailed investigation of the physicochemical properties of the polymer was carried out by using mechanical testing, ATR‐FTIR, and X‐ray photoelectron spectroscopy (XPS). Polymers were also tested in short term in‐vitro cell culture with human mesenchymal stem cells to evaluate their biocompatibility for potential applications as biomaterial. FTIR analysis confirmed the synthesis of castor oil and glycerol based PU polymers. FTIR also showed that the addition of glycerol as co‐polyol increases crosslinking within the polymer backbone hence enhancing the bulk mechanical properties of the polymer. XPS data showed that glycerol incorporation leads to an enrichment of oxidized organic species on the surface of the polymers. Preliminary investigation into in vitro biocompatibility showed that serum protein adsorption can be controlled by varying the glycerol content with polymer backbone. An alamar blue assay looking at the metabolic activity of the cells indicated that castor oil based PU and its variants containing glycerol are non‐toxic to the cells. This study opens an avenue for using low cost bio‐polyurethane based on castor oil and glycerol for biomedical applications. PMID:29159831

[Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

PubMed

Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

2011-08-01

Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

Controlling porosity in lignin-derived nanoporous carbon for supercapacitor applications

DOE PAGES

Jeon, Ju-Won; Zhang, Libing; Lutkenhaus, Jodie L.; ...

2015-02-01

Low-cost renewable lignin has been used as a precursor to produce porous carbons. However, to date, it has not been easy to obtain high surface area porous carbon without activation processes or templating agents. Here, we demonstrate that low molecular weight lignin yields highly porous carbon (1092 m² g⁻¹) with more graphitization through direct carbonization without additional activation processes or templating agents. We found that molecular weight and oxygen consumption during carbonization are critical factors to obtain high surface area, graphitized porous carbons. This highly porous carbon from low-cost renewable lignin sources is a good candidate for supercapacitor electrode materials.

Controlling porosity in lignin-derived nanoporous carbon for supercapacitor applications

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

Jeon, Ju-Won; Zhang, Libing; Lutkenhaus, Jodie L.

Low-cost renewable lignin has been used as a precursor to produce porous carbons. However, to date, it has not been easy to obtain high surface area porous carbon without activation processes or templating agents. Here, we demonstrate that low molecular weight lignin yields highly porous carbon (1092 m² g⁻¹) with more graphitization through direct carbonization without additional activation processes or templating agents. We found that molecular weight and oxygen consumption during carbonization are critical factors to obtain high surface area, graphitized porous carbons. This highly porous carbon from low-cost renewable lignin sources is a good candidate for supercapacitor electrode materials.

Meet our Neighbours - a tactile experience

NASA Astrophysics Data System (ADS)

Canas, L.; Lobo Correia, A.

2013-09-01

Planetary science is a key field in astronomy that draws lots of attention and that engages large amounts of enthusiasts. On its essence, it is a visual science and the current resources and activities for the inclusion of visually impaired children, although increasing, are still costly and somewhat scarce. Therefore there is a paramount need to develop more low cost resources in order to provide experiences that can reach all, even the more socially deprived communities. "Meet our neighbours!-a tactile experience", plans to promote and provide inclusion activities for visually impaired children and their non-visually impaired peers through the use of astronomy hands-on low cost activities. Is aimed for children from the ages of 6 to 12 years old and produce data set 13 tactile images of the main objects of the Solar System that can be used in schools, science centres and outreach associations. Accessing several common problems through tactile resources, with this project we present ways to successfully provide low cost solutions (avoiding the expensive tactile printing costs), promote inclusion and interactive hands-on activities for visually impaired children and their non-visually impaired peers and create dynamic interactions based on oral knowledge transmission between them. Here we describe the process of implementing such initiative near target communities: establishing a bridge between scientists, children and teachers. The struggles and challenges perceived during the project and the enrichment experience of engaging astronomy with these specific groups, broadening horizons in an overall experience accessible to all.

[Costing nuclear medicine diagnostic procedures].

PubMed

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

The Cost Effectiveness of Pandemic Influenza Interventions: A Pandemic Severity Based Analysis

PubMed Central

Milne, George J.; Halder, Nilimesh; Kelso, Joel K.

2013-01-01

Background The impact of a newly emerged influenza pandemic will depend on its transmissibility and severity. Understanding how these pandemic features impact on the effectiveness and cost effectiveness of alternative intervention strategies is important for pandemic planning. Methods A cost effectiveness analysis of a comprehensive range of social distancing and antiviral drug strategies intended to mitigate a future pandemic was conducted using a simulation model of a community of ∼30,000 in Australia. Six pandemic severity categories were defined based on case fatality ratio (CFR), using data from the 2009/2010 pandemic to relate hospitalisation rates to CFR. Results Intervention strategies combining school closure with antiviral treatment and prophylaxis are the most cost effective strategies in terms of cost per life year saved (LYS) for all severity categories. The cost component in the cost per LYS ratio varies depending on pandemic severity: for a severe pandemic (CFR of 2.5%) the cost is ∼$9 k per LYS; for a low severity pandemic (CFR of 0.1%) this strategy costs ∼$58 k per LYS; for a pandemic with very low severity similar to the 2009 pandemic (CFR of 0.03%) the cost is ∼$155 per LYS. With high severity pandemics (CFR >0.75%) the most effective attack rate reduction strategies are also the most cost effective. During low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, while for high severity pandemics costs are dominated by hospitalisation costs and productivity losses due to death. Conclusions The most cost effective strategies for mitigating an influenza pandemic involve combining sustained social distancing with the use of antiviral agents. For low severity pandemics the most cost effective strategies involve antiviral treatment, prophylaxis and short durations of school closure; while these are cost effective they are less effective than other strategies in reducing the infection rate. PMID:23585906

Evaluation of the adsorption potential of eco-friendly activated carbon prepared from cherry kernels for the removal of Pb2+, Cd2+ and Ni2+ from aqueous wastes.

PubMed

Pap, Sabolč; Radonić, Jelena; Trifunović, Snežana; Adamović, Dragan; Mihajlović, Ivana; Vojinović Miloradov, Mirjana; Turk Sekulić, Maja

2016-12-15

Development, characterization and evaluation of the efficiency of cost-effective medium for the removal of Pb 2+ , Cd 2+ and Ni 2+ from aqueous systems, as a novel, eco-friendly solution for wastewater remediation were done. The precursors for low-cost adsorbent were lignocellulosic raw materials (sweet/sour cherry kernels), as industrial byproducts and components of organic solid waste. Activated carbon synthesis was carried out by thermochemical conversion (H 3 PO 4 , 500 °C) in the complete absence of inert atmosphere. Characterization of the activated carbon was performed by elemental analysis, FTIR, SEM, EDX and BET. BET surface area corresponds to 657.1 m 2  g -1 . The evaluation also included the influence of pH, contact time, solute concentration and adsorbent dose on the separation efficiency in the batch operational mode. The equilibrium and kinetic studies of adsorption were done. The maximum adsorption capacity of the activated carbon for Cd 2+ ions was calculated from the Langmuir isotherm and found to be 198.7 mg g -1 . Adsorption of Pb 2+ and Ni 2+ were better suitable to Freundlich model with the maximum adsorption capacity of 180.3 mg g -1 and 76.27 mg g -1 , respectively. The results indicate that the pseudo-second-order model best describes adsorption kinetic data. Based on desorption study results, activated carbon was successfully regenerated with HNO 3 for 3 cycles. In order to provide the results for basic cost-effective analysis, competing ion-effects in a real sample have been evaluated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Low-cost solar array project and Proceedings of the 15th Project Integration Meeting

NASA Technical Reports Server (NTRS)

1980-01-01

Progress made by the Low-Cost Solar Array Project during the period December 1979 to April 1980 is described. Project analysis and integration, technology development in silicon material, large area silicon sheet and encapsulation, production process and equipment development, engineering, and operation are included.

[Cost-benefit analysis to substituting natural gas for coal project in large Chinese cities].

PubMed

Mao, Xianqiang; Peng, Yingdeng; Guo, Xiurui

2002-09-01

Since China's large cities were faced with serious coal-smoke pollution with PM10 and SO2 as the main pollutants, natural gas is becoming one of the most attractive clean replacers of coal. To clarify the wide disputation and doubt on the rationality of burning natural gas instead of coal, cost-benefit analysis (CBA) of urban natural gas substitution projects in Beijing and Chongqing was done respectively, in which, the health benefit was carefully estimated with epidemical dose-response function as the main external benefit. The final result shows that in large cities with intensively concentrated population and economic activities, natural gas consumption as municipal civil energy has obvious priority in terms of large environmental benefit from reducing non-point and low-altitude air pollutant concentration. This paper finally recommends that market oriented system reform in natural gas production and retailing system should be considered.

Global cost estimates of reducing carbon emissions through avoided deforestation

PubMed Central

Kindermann, Georg; Obersteiner, Michael; Sohngen, Brent; Sathaye, Jayant; Andrasko, Kenneth; Rametsteiner, Ewald; Schlamadinger, Bernhard; Wunder, Sven; Beach, Robert

2008-01-01

Tropical deforestation is estimated to cause about one-quarter of anthropogenic carbon emissions, loss of biodiversity, and other environmental services. United Nations Framework Convention for Climate Change talks are now considering mechanisms for avoiding deforestation (AD), but the economic potential of AD has yet to be addressed. We use three economic models of global land use and management to analyze the potential contribution of AD activities to reduced greenhouse gas emissions. AD activities are found to be a competitive, low-cost abatement option. A program providing a 10% reduction in deforestation from 2005 to 2030 could provide 0.3–0.6 Gt (1 Gt = 1 × 105 g) CO2·yr−1 in emission reductions and would require $0.4 billion to $1.7 billion·yr−1 for 30 years. A 50% reduction in deforestation from 2005 to 2030 could provide 1.5–2.7 Gt CO2·yr−1 in emission reductions and would require $17.2 billion to $28.0 billion·yr−1. Finally, some caveats to the analysis that could increase costs of AD programs are described. PMID:18650377

Dynamic programming on a shared-memory multiprocessor

NASA Technical Reports Server (NTRS)

Edmonds, Phil; Chu, Eleanor; George, Alan

1993-01-01

Three new algorithms for solving dynamic programming problems on a shared-memory parallel computer are described. All three algorithms attempt to balance work load, while keeping synchronization cost low. In particular, for a multiprocessor having p processors, an analysis of the best algorithm shows that the arithmetic cost is O(n-cubed/6p) and that the synchronization cost is O(absolute value of log sub C n) if p much less than n, where C = (2p-1)/(2p + 1) and n is the size of the problem. The low synchronization cost is important for machines where synchronization is expensive. Analysis and experiments show that the best algorithm is effective in balancing the work load and producing high efficiency.

Costs and benefits of low-sulphur fuel standard for Baltic Sea shipping.

PubMed

Antturi, Jim; Hänninen, Otto; Jalkanen, Jukka-Pekka; Johansson, Lasse; Prank, Marje; Sofiev, Mikhail; Ollikainen, Markku

2016-12-15

The maximum allowable fuel sulphur content for shipping in the Baltic Sea dropped from 1%S to 0.1%S in 1 January 2015. We provide a cost-benefit analysis of the sulphur reduction policy in the Baltic Sea Sulphur Emission Control Area (SECA). We calculated the abatement costs based on shipowners' optimal decision-making in choosing between low-sulphur fuel and a sulphur scrubber, and the benefits were modelled through a high-resolution impact pathway analysis, which took into account the formation and dispersion of the emissions, and considered the positive health impacts resulting from lowered ambient PM 2.5 concentrations. Our basic result indicates that for the Baltic Sea only, the latest sulphur regulation is not cost-effective. The expected annual cost is roughly €465 M and benefit 2200 saved Disability Adjusted Life-Years (DALYs) or monetized €105 M. Based on our sensitivity analysis, the benefits yet have a potential to exceed the costs. The analysis neither takes into account the acidifying impact of sulphur nor the impact North Sea shipping has on the cost-benefit ratio. Lastly, a similar approach is found highly recommendable to study the implications of the upcoming Tier III NO x standard for shipping. Copyright © 2016 Elsevier Ltd. All rights reserved.

A study of power generation from a low-cost hydrokinetic energy system

NASA Astrophysics Data System (ADS)

Davila Vilchis, Juana Mariel

The kinetic energy in river streams, tidal currents, or other artificial water channels has been used as a feasible source of renewable power through different conversion systems. Thus, hydrokinetic energy conversion systems are attracting worldwide interest as another form of distributed alternative energy. Because these systems are still in early stages of development, the basic approaches need significant research. The main challenges are not only to have efficient systems, but also to convert energy more economically so that the cost-benefit analysis drives the growth of this alternative energy form. One way to view this analysis is in terms of the energy conversion efficiency per unit cost. This study presents a detailed assessment of a prototype hydrokinetic energy system along with power output costs. This experimental study was performed using commercial low-cost blades of 20 in diameter inside a tank with water flow speed up to 1.3 m/s. The work was divided into two stages: (a) a fixed-pitch blade configuration, using a radial permanent magnet generator (PMG), and (b) the same hydrokinetic turbine, with a variable-pitch blade and an axial-flux PMG. The results indicate that even though the efficiency of a simple blade configuration is not high, the power coefficient is in the range of other, more complicated designs/prototypes. Additionally, the low manufacturing and operation costs of this system offer an option for low-cost distributed power applications.

[Cost management: the implementation of the activity-based costing method in sterile processing department].

PubMed

Jericó, Marli de Carvalho; Castilho, Valéria

2010-09-01

This exploratory case study was performed aiming at implementing the Activity-based Costing (ABC) method in a sterile processing department (SPD) of a major teaching hospital. Data collection was performed throughout 2006. Documentary research techniques and non participant closed observation were used. The ABC implementation allowed for learning the activity-based costing of both the chemical and physical disinfection cycle/load: (dollar 9.95) and (dollar 12.63), respectively; as well as the cost for sterilization by steam under pressure (autoclave) (dollar 31.37) and low temperature steam and gaseous formaldehyde sterilization (LTSF) (dollar 255.28). The information provided by the ABC method has optimized the overall understanding of the cost driver process and provided the foundation for assessing performance and improvement in the SPD processes.

Optofluidic refractive-index sensors employing bent waveguide structures for low-cost, rapid chemical and biomedical sensing.

PubMed

Liu, I-Chen; Chen, Pin-Chuan; Chau, Lai-Kwan; Chang, Guo-En

2018-01-08

We propose and develop an intensity-detection-based refractive-index (RI) sensor for low-cost, rapid RI sensing. The sensor is composed of a polymer bent ridge waveguide (BRWG) structure on a low-cost glass substrate and is integrated with a microfluidic channel. Different-RI solutions flowing through the BRWG sensing region induce output optical power variations caused by optical bend losses, enabling simple and real-time RI detection. Additionally, the sensors are fabricated using rapid and cost-effective vacuum-less processes, attaining the low cost and high throughput required for mass production. A good RI solution of 5.31 10 -4 × RIU -1 is achieved from the RI experiments. This study demonstrates mass-producible and compact RI sensors for rapid and sensitive chemical analysis and biomedical sensing.

Cost-effectiveness analysis of adding low dose ribavirin to peginterferon alfa-2a for treatment of chronic hepatitis C infected thalassemia major patients in iran.

PubMed

Mehrazmay, Alireza; Alavian, Seyed Moayed; Moradi-Lakeh, Maziar; Mokhtari Payam, Mahdi; Hashemi-Meshkini, Amir; Behnava, Bita; Miri, Seyyed Mohammad; Karimi Elizee, Pegah; Tabatabaee, Seyed Vahid; Keshvari, Maryam; Bagheri Lankarani, Kamran

2013-01-01

The prevalence of hepatitis C in Iran is 1% and 18% in general population and thalassemia patients respectively. The cost effectiveness analysis of adding Ribavirin to Peginterferon alfa-2a (PEG IFN alfa-2a) as a combination treatment strategy of chronic hepatitis C in thalassemia patients in comparison with monotherapy could help clinicians and policy makers to provide the best treatment for the patients. In this study we aimed to assess whether adding Ribavirin to PEG IFN alfa-2a is a cost effective strategy in different genotypes and different subgroups of 280 patients with chronic hepatitis C infection from the perspective of society in Iranian setting. A cost effectiveness analysis including all costs and outcomes of treatments for chronic hepatitis C infected thalassemia major patients was conducted. We constructed a decision tree of treatment course in which a hypothetical cohort of 100 patients received "PEG IFN alfa-2a" or "Peg IFN alfa-2a plus Ribavirin." The cost analysis was based on cost data for 2008 and we used 9300 Iranian Rials (IR Rial) as exchange rate declared by the Iranian Central Bank on that time to calculating costs by US Dollar (USD). To evaluate whether a strategy is cost effective, one time and three times of GDP per capita were used as threshold based on recommendation of the World Health Organization. The Incremental Cost Effectiveness Ratio (ICER) for combination therapy in genotype-1 and genotypes non-1 subgroups was 2,673 and 19,211 US dollars (USD) per one Sustain Virological Response (SVR), respectively. In low viral load and high viral load subgroups, the ICER was 5,233 and 14,976 USD per SVR, respectively. The calculated ICER for combination therapy in subgroup of patients with previously resistant to monotherapy was 13,006 USD per SVR. Combination therapy in previously resistant patients to combination therapy was a dominant strategy. Adding low dose of Ribavirin to PEG IFN alfa-2a for treatment of chronic hepatitis C patients with genotype-1 was "highly cost effective" and in patients with low viral load and in previous monotherapy resistant patients was "cost effective."

The cost structure of routine infant immunization services: a systematic analysis of six countries

PubMed Central

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

2017-01-01

Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

The cost structure of routine infant immunization services: a systematic analysis of six countries.

PubMed

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

2017-10-01

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Impact of Physical Activity Interventions on Blood Pressure in Brazilian Populations

PubMed Central

Bento, Vivian Freitas Rezende; Albino, Flávia Barbizan; de Moura, Karen Fernandes; Maftum, Gustavo Jorge; dos Santos, Mauro de Castro; Guarita-Souza, Luiz César; Faria Neto, José Rocha; Baena, Cristina Pellegrino

2015-01-01

Background High blood pressure is associated with cardiovascular disease, which is the leading cause of mortality in the Brazilian population. Lifestyle changes, including physical activity, are important for lowering blood pressure levels and decreasing the costs associated with outcomes. Objective Assess the impact of physical activity interventions on blood pressure in Brazilian individuals. Methods Meta-analysis and systematic review of studies published until May 2014, retrieved from several health sciences databases. Seven studies with 493 participants were included. The analysis included parallel studies of physical activity interventions in adult populations in Brazil with a description of blood pressure (mmHg) before and after the intervention in the control and intervention groups. Results Of 390 retrieved studies, eight matched the proposed inclusion criteria for the systematic review and seven randomized clinical trials were included in the meta-analysis. Physical activity interventions included aerobic and resistance exercises. There was a reduction of -10.09 (95% CI: -18.76 to -1.43 mmHg) in the systolic and -7.47 (95% CI: -11.30 to -3.63 mmHg) in the diastolic blood pressure. Conclusions Available evidence on the effects of physical activity on blood pressure in the Brazilian population shows a homogeneous and significant effect at both systolic and diastolic blood pressures. However, the strength of the included studies was low and the methodological quality was also low and/or regular. Larger studies with more rigorous methodology are necessary to build robust evidence. PMID:26016783

An evaluation of the emerging interventions against Respiratory Syncytial Virus (RSV)-associated acute lower respiratory infections in children.

PubMed

Nair, Harish; Verma, Vasundhara R; Theodoratou, Evropi; Zgaga, Lina; Huda, Tanvir; Simões, Eric A F; Wright, Peter F; Rudan, Igor; Campbell, Harry

2011-04-13

Respiratory Syncytial Virus (RSV) is the leading cause of acute lower respiratory infections (ALRI) in children. It is estimated to cause approximately 33.8 million new episodes of ALRI in children annually, 96% of these occurring in developing countries. It is also estimated to result in about 53,000 to 199,000 deaths annually in young children. Currently there are several vaccine and immunoprophylaxis candidates against RSV in the developmental phase targeting active and passive immunization. We used a modified CHNRI methodology for setting priorities in health research investments. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging vaccines against RSV relevant to 12 criteria of interest. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies). The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to the sensitive nature of their involvement in such exercises. They answered questions from the CHNRI framework and their "collective optimism" towards each criterion was documented on a scale from 0 to 100%. In the case of candidate vaccines for active immunization of infants against RSV, the experts expressed very low levels of optimism for low product cost, affordability and low cost of development; moderate levels of optimism regarding the criteria of answerability, likelihood of efficacy, deliverability, sustainability and acceptance to end users for the interventions; and high levels of optimism regarding impact on equity and acceptance to health workers. While considering the candidate vaccines targeting pregnant women, the panel expressed low levels of optimism for low product cost, affordability, answerability and low development cost; moderate levels of optimism for likelihood of efficacy, deliverability, sustainability and impact on equity; high levels of optimism regarding acceptance to end users and health workers. The group also evaluated immunoprophylaxis against RSV using monoclonal antibodies and expressed no optimism towards low product cost; very low levels of optimism regarding deliverability, affordability, sustainability, low implementation cost and impact on equity; moderate levels of optimism against the criteria of answerability, likelihood of efficacy, acceptance to end-users and health workers; and high levels of optimism regarding low development cost. They felt that either of these vaccines would have a high impact on reducing burden of childhood ALRI due to RSV and reduce the overall childhood ALRI burden by a maximum of about 10%. Although monoclonal antibodies have proven to be effective in providing protection to high-risk infants, their introduction in resource poor settings might be limited by high cost associated with them. Candidate vaccines for active immunization of infants against RSV hold greatest promise. Introduction of a low cost vaccine against RSV would reduce the inequitable distribution of burden due to childhood ALRI and will most likely have a high impact on morbidity and mortality due to severe ALRI.

Adsorptive Removal of Toxic Chromium from Waste-Water Using Wheat Straw and Eupatorium adenophorum

PubMed Central

Song, Dagang; Pan, Kaiwen; Tariq, Akash; Azizullah, Azizullah; Sun, Feng; Li, Zilong; Xiong, Qinli

2016-01-01

Environmental pollution with heavy metals is a serious issue worldwide posing threats to humans, animals and plants and to the stability of overall ecosystem. Chromium (Cr) is one of most hazardous heavy metals with a high carcinogenic and recalcitrant nature. Aim of the present study was to select low-cost biosorbent using wheat straw and Eupatorium adenophorum through simple carbonization process, capable of removing Cr (VI) efficiently from wastewater. From studied plants a low cost adsorbent was prepared for removing Cr (VI) from aqueous solution following very simple carbonization method excluding activation process. Several factors such as pH, contact time, sorbent dosage and temperature were investigated for attaining ideal condition. For analysis of adsorption equilibrium isotherm data, Langmuir, Freundlich and Temkin models were used while pseudo-first-order, pseudo-second-order, external diffusion and intra-particle diffusion models were used for the analysis of kinetic data. The obtained results revealed that 99.9% of Cr (VI) removal was observed in the solution with a pH of 1.0. Among all the tested models Langmuir model fitted more closely according to the data obtained. Increase in adsorption capacity was observed with increasing temperature revealing endothermic nature of Cr (VI). The maximum Cr (VI) adsorption potential of E. adenophorum and wheat straw was 89.22 mg per 1 gram adsorbent at 308K. Kinetic data of absorption precisely followed pseudo-second-order model. Present study revealed highest potential of E. adenophorum and wheat straw for producing low cost adsorbent and to remove Cr (VI) from contaminated water. PMID:27911906

Combining Cluster Analysis and Small Unmanned Aerial Systems (sUAS) for Accurate and Low-cost Bathymetric Surveying

NASA Astrophysics Data System (ADS)

Maples, B. L.; Alvarez, L. V.; Moreno, H. A.; Chilson, P. B.; Segales, A.

2017-12-01

Given that classical in-situ direct surveying for geomorphological subsurface information in rivers is time-consuming, labor-intensive, costly, and often involves high-risk activities, it is obvious that non-intrusive technologies, like UAS-based, LIDAR-based remote sensing, have a promising potential and benefits in terms of efficient and accurate measurement of channel topography over large areas within a short time; therefore, a tremendous amount of attention has been paid to the development of these techniques. Over the past two decades, efforts have been undertaken to develop a specialized technique that can penetrate the water body and detect the channel bed to derive river and coastal bathymetry. In this research, we develop a low-cost effective technique for water body bathymetry. With the use of a sUAS and a light-weight sonar, the bathymetry and volume of a small reservoir have been surveyed. The sUAS surveying approach is conducted under low altitudes (2 meters from the water) using the sUAS to tow a small boat with the sonar attached. A cluster analysis is conducted to optimize the sUAS data collection and minimize the standard deviation created by under-sampling in areas of highly variable bathymetry, so measurements are densified in regions featured by steep slopes and drastic changes in the reservoir bed. This technique provides flexibility, efficiency, and free-risk to humans while obtaining high-quality information. The irregularly-spaced bathymetric survey is then interpolated using unstructured Triangular Irregular Network (TIN)-based maps to avoid re-gridding or re-sampling issues.

Adsorptive Removal of Toxic Chromium from Waste-Water Using Wheat Straw and Eupatorium adenophorum.

PubMed

Song, Dagang; Pan, Kaiwen; Tariq, Akash; Azizullah, Azizullah; Sun, Feng; Li, Zilong; Xiong, Qinli

2016-01-01

Environmental pollution with heavy metals is a serious issue worldwide posing threats to humans, animals and plants and to the stability of overall ecosystem. Chromium (Cr) is one of most hazardous heavy metals with a high carcinogenic and recalcitrant nature. Aim of the present study was to select low-cost biosorbent using wheat straw and Eupatorium adenophorum through simple carbonization process, capable of removing Cr (VI) efficiently from wastewater. From studied plants a low cost adsorbent was prepared for removing Cr (VI) from aqueous solution following very simple carbonization method excluding activation process. Several factors such as pH, contact time, sorbent dosage and temperature were investigated for attaining ideal condition. For analysis of adsorption equilibrium isotherm data, Langmuir, Freundlich and Temkin models were used while pseudo-first-order, pseudo-second-order, external diffusion and intra-particle diffusion models were used for the analysis of kinetic data. The obtained results revealed that 99.9% of Cr (VI) removal was observed in the solution with a pH of 1.0. Among all the tested models Langmuir model fitted more closely according to the data obtained. Increase in adsorption capacity was observed with increasing temperature revealing endothermic nature of Cr (VI). The maximum Cr (VI) adsorption potential of E. adenophorum and wheat straw was 89.22 mg per 1 gram adsorbent at 308K. Kinetic data of absorption precisely followed pseudo-second-order model. Present study revealed highest potential of E. adenophorum and wheat straw for producing low cost adsorbent and to remove Cr (VI) from contaminated water.

Cost-utility of COBRA-light versus COBRA therapy in patients with early rheumatoid arthritis: the COBRA-light trial

PubMed Central

ter Wee, Marieke M; Coupé, Veerle MH; den Uyl, Debby; Blomjous, Birgit S; Kooijmans, Esmee; Kerstens, Pit JSM; Nurmohamed, Mike T; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E; Boers, Maarten; Lems, Willem F

2017-01-01

Objective To evaluate if COmbinatie therapie Bij Reumatoïde Artritis (COBRA)-light therapy is cost-effective in treating patients with early rheumatoid arthritis (RA) compared with COBRA therapy. Methods This economic evaluation was performed next to the open-label, randomised non-inferiority COBRA-light trial in 164 patients with early RA. Non-responders to COBRA or COBRA-light received etanercept (50 mg/week) for 3–6 months. The societal perspective analysis took medical direct, non-medical direct and indirect costs into account. Costs were measured with patient cost diaries for the follow-up period of 52 weeks. Bootstrapping techniques estimated uncertainty around the cost-effectiveness ratios, presented in cost-effectiveness planes. Results 164 patients were randomised to either COBRA or COBRA-light strategy. At week 52, COBRA-light proved to be non-inferior to COBRA therapy on all clinical outcome measures. The results of the base-case cost-utility analysis (intention-to-treat analyses) revealed that COBRA-light strategy is more expensive (k€9.3 (SD 0.9) compared with COBRA (k€7.2 (SD 0.8)), but the difference in costs were not significant (k€2.0; 95% CI –0.3 to 4.4). Also, both strategies produced similar quality-adjusted life-years (QALYs). The sensitivity analyses showed robustness of these results. In a per-protocol sensitivity analysis, in which costs of etanercept were assumed to be provided as prescribed according to protocol, both arms had much higher costs: COBRA-light: k€11.5 (8.3) compared with k€8.5 (6.8) for COBRA, and the difference in costs was significant (k€2.9; 0.6 to 5.3). Conclusions In the base-case cost-utility analysis, the two strategies produced similar QALYs for similar costs. But it is anticipated that if protocol had been followed correctly, the COBRA-light strategy would have been more costly due to additional etanercept costs, for a limited health gain. Given the limited added benefit and high costs of starting etanercept in the presence of low disease activity in our trial, such a strategy needs better justification than is available now. Trial registration number 55552928, Results. PMID:29119006

Towards Smart Homes Using Low Level Sensory Data

PubMed Central

Khattak, Asad Masood; Truc, Phan Tran Ho; Hung, Le Xuan; Vinh, La The; Dang, Viet-Hung; Guan, Donghai; Pervez, Zeeshan; Han, Manhyung; Lee, Sungyoung; Lee, Young-Koo

2011-01-01

Ubiquitous Life Care (u-Life care) is receiving attention because it provides high quality and low cost care services. To provide spontaneous and robust healthcare services, knowledge of a patient’s real-time daily life activities is required. Context information with real-time daily life activities can help to provide better services and to improve healthcare delivery. The performance and accuracy of existing life care systems is not reliable, even with a limited number of services. This paper presents a Human Activity Recognition Engine (HARE) that monitors human health as well as activities using heterogeneous sensor technology and processes these activities intelligently on a Cloud platform for providing improved care at low cost. We focus on activity recognition using video-based, wearable sensor-based, and location-based activity recognition engines and then use intelligent processing to analyze the context of the activities performed. The experimental results of all the components showed good accuracy against existing techniques. The system is deployed on Cloud for Alzheimer’s disease patients (as a case study) with four activity recognition engines to identify low level activity from the raw data captured by sensors. These are then manipulated using ontology to infer higher level activities and make decisions about a patient’s activity using patient profile information and customized rules. PMID:22247682

Green Adsorbents for Wastewaters: A Critical Review

PubMed Central

Kyzas, George Z.; Kostoglou, Margaritis

2014-01-01

One of the most serious environmental problems is the existence of hazardous and toxic pollutants in industrial wastewaters. The major hindrance is the simultaneous existence of many/different types of pollutants as (i) dyes; (ii) heavy metals; (iii) phenols; (iv) pesticides and (v) pharmaceuticals. Adsorption is considered to be one of the most promising techniques for wastewater treatment over the last decades. The economic crisis of the 2000s led researchers to turn their interest in adsorbent materials with lower cost. In this review article, a new term will be introduced, which is called “green adsorption”. Under this term, it is meant the low-cost materials originated from: (i) agricultural sources and by-products (fruits, vegetables, foods); (ii) agricultural residues and wastes; (iii) low-cost sources from which most complex adsorbents will be produced (i.e., activated carbons after pyrolysis of agricultural sources). These “green adsorbents” are expected to be inferior (regarding their adsorption capacity) to the super-adsorbents of previous literature (complex materials as modified chitosans, activated carbons, structurally-complex inorganic composite materials etc.), but their cost-potential makes them competitive. This review is a critical approach to green adsorption, discussing many different (maybe in some occasions doubtful) topics such as: (i) adsorption capacity; (ii) kinetic modeling (given the ultimate target to scale up the batch experimental data to fixed-bed column calculations for designing/optimizing commercial processes) and (iii) critical techno-economical data of green adsorption processes in order to scale-up experiments (from lab to industry) with economic analysis and perspectives of the use of green adsorbents. PMID:28788460

Implications of early and guideline adherent physical therapy for low back pain on utilization and costs.

PubMed

Childs, John D; Fritz, Julie M; Wu, Samuel S; Flynn, Timothy W; Wainner, Robert S; Robertson, Eric K; Kim, Forest S; George, Steven Z

2015-04-09

Initial management decisions following a new episode of low back pain (LBP) are thought to have profound implications for health care utilization and costs. The purpose of this study was to evaluate the impact of early and guideline adherent physical therapy for low back pain on utilization and costs within the Military Health System (MHS). Patients presenting to a primary care setting with a new complaint of LBP from January 1, 2007 to December 31, 2009 were identified from the MHS Management Analysis and Reporting Tool. Descriptive statistics, utilization, and costs were examined on the basis of timing of referral to physical therapy and adherence to practice guidelines over a 2-year period. Utilization outcomes (advanced imaging, lumbar injections or surgery, and opioid use) were compared using adjusted odds ratios with 99% confidence intervals. Total LBP-related health care costs over the 2-year follow-up were compared using linear regression models. 753,450 eligible patients with a primary care visit for LBP between 18-60 years of age were considered. Physical therapy was utilized by 16.3% (n = 122,723) of patients, with 24.0% (n = 17,175) of those receiving early physical therapy that was adherent to recommendations for active treatment. Early referral to guideline adherent physical therapy was associated with significantly lower utilization for all outcomes and 60% lower total LBP-related costs. The potential for cost savings in the MHS from early guideline adherent physical therapy may be substantial. These results also extend the findings from similar studies in civilian settings by demonstrating an association between early guideline adherent care and utilization and costs in a single payer health system. Future research is necessary to examine which patients with LBP benefit early physical therapy and determine strategies for providing early guideline adherent care.

Improved ethanol yield and reduced minimum ethanol selling price (MESP) by modifying low severity dilute acid pretreatment with deacetylation and mechanical refining: 2) Techno-economic analysis

PubMed Central

2012-01-01

Background Our companion paper discussed the yield benefits achieved by integrating deacetylation, mechanical refining, and washing with low acid and low temperature pretreatment. To evaluate the impact of the modified process on the economic feasibility, a techno-economic analysis (TEA) was performed based on the experimental data presented in the companion paper. Results The cost benefits of dilute acid pretreatment technology combined with the process alternatives of deacetylation, mechanical refining, and pretreated solids washing were evaluated using cost benefit analysis within a conceptual modeling framework. Control cases were pretreated at much lower acid loadings and temperatures than used those in the NREL 2011 design case, resulting in much lower annual ethanol production. Therefore, the minimum ethanol selling prices (MESP) of the control cases were $0.41-$0.77 higher than the $2.15/gallon MESP of the design case. This increment is highly dependent on the carbohydrate content in the corn stover. However, if pretreatment was employed with either deacetylation or mechanical refining, the MESPs were reduced by $0.23-$0.30/gallon. Combing both steps could lower the MESP further by $0.44 ~ $0.54. Washing of the pretreated solids could also greatly improve the final ethanol yields. However, the large capital cost of the solid–liquid separation unit negatively influences the process economics. Finally, sensitivity analysis was performed to study the effect of the cost of the pretreatment reactor and the energy input for mechanical refining. A 50% cost reduction in the pretreatment reactor cost reduced the MESP of the entire conversion process by $0.11-$0.14/gallon, while a 10-fold increase in energy input for mechanical refining will increase the MESP by $0.07/gallon. Conclusion Deacetylation and mechanical refining process options combined with low acid, low severity pretreatments show improvements in ethanol yields and calculated MESP for cellulosic ethanol production. PMID:22967479

Low cost thermal camera for use in preclinical detection of diabetic peripheral neuropathy in primary care setting

NASA Astrophysics Data System (ADS)

Joshi, V.; Manivannan, N.; Jarry, Z.; Carmichael, J.; Vahtel, M.; Zamora, G.; Calder, C.; Simon, J.; Burge, M.; Soliz, P.

2018-02-01

Diabetic peripheral neuropathy (DPN) accounts for around 73,000 lower-limb amputations annually in the US on patients with diabetes. Early detection of DPN is critical. Current clinical methods for diagnosing DPN are subjective and effective only at later stages. Until recently, thermal cameras used for medical imaging have been expensive and hence prohibitive to be installed in primary care setting. The objective of this study is to compare results from a low-cost thermal camera with a high-end thermal camera used in screening for DPN. Thermal imaging has demonstrated changes in microvascular function that correlates with nerve function affected by DPN. The limitations for using low-cost cameras for DPN imaging are: less resolution (active pixels), frame rate, thermal sensitivity etc. We integrated two FLIR Lepton (80x60 active pixels, 50° HFOV, thermal sensitivity < 50mK) as one unit. Right and left cameras record the videos of right and left foot respectively. A compactible embedded system (raspberry pi3 model Bv1.2) is used to configure the sensors, capture and stream the video via ethernet. The resulting video has 160x120 active pixels (8 frames/second). We compared the temperature measurement of feet obtained using low-cost camera against the gold standard highend FLIR SC305. Twelve subjects (aged 35-76) were recruited. Difference in the temperature measurements between cameras was calculated for each subject and the results show that the difference between the temperature measurements of two cameras (mean difference=0.4, p-value=0.2) is not statistically significant. We conclude that the low-cost thermal camera system shows potential for use in detecting early-signs of DPN in under-served and rural clinics.

Low Budget Biology 3: A Collection of Low Cost Labs and Activities.

ERIC Educational Resources Information Center

Wartski, Bert; Wartski, Lynn Marie

This document contains biology labs, demonstrations, and activities that use low budget materials. The goal is to get students involved in the learning process by experiencing biology. Each lab has a teacher preparation section which outlines the purpose of the lab, some basic information, a list of materials , and how to prepare the different…

Cost effectiveness of a smoking cessation program in patients admitted for coronary heart disease.

PubMed

Quist-Paulsen, Petter; Lydersen, Stian; Bakke, Per S; Gallefoss, Frode

2006-04-01

Smoking cessation is probably the most important action to reduce mortality after a coronary event. Smoking cessation programs are not widely implemented in patients with coronary heart disease, however, possibly because they are thought not to be worth their costs. Our objectives were to estimate the cost effectiveness of a smoking cessation program, and to compare it with other treatment modalities in cardiovascular medicine. A cost-effectiveness analysis was performed on the basis of a recently conducted randomized smoking cessation intervention trial in patients admitted for coronary heart disease. The cost per life year gained by the smoking cessation program was derived from the resources necessary to implement the program, the number needed to treat to get one additional quitter from the program, and the years of life gained if quitting smoking. The cost effectiveness was estimated in a low-risk group (i.e. patients with stable coronary heart disease) and a high-risk group (i.e. patients after myocardial infarction or unstable angina), using survival data from previously published investigations, and with life-time extrapolation of the survival curves by survival function modeling. In a lifetime perspective, the incremental cost per year of life gained by the smoking cessation program was euro 280 and euro 110 in the low and high-risk group, respectively (2000 prices). These costs compare favorably to other treatment modalities in patients with coronary heart disease, being approximately 1/25 the cost of both statins in the low-risk group and angiotensin-converting enzyme inhibitors in the high-risk group. In a sensitivity analysis, the costs remained low in a wide range of assumptions. A nurse-led smoking cessation program with several months of intervention is very cost-effective compared with other treatment modalities in patients with coronary heart disease.

Electric Pulse Discharge Activated Carbon Supercapacitors for Transportation Application

NASA Astrophysics Data System (ADS)

Nayak, Subhadarshi; Agrawal, Jyoti

2012-03-01

ScienceTomorrow is developing a high-speed, low-cost process for synthesizing high-porosity electrodes for electrochemical double-layer capacitors. Four types of coal (lignite, subbituminous, bituminous, and anthracite) were used as precursor materials for spark discharge activation with multiscale porous structure. The final porosity and pore distribution depended, among other factors, on precursor type. The high gas content in low-grade carbon resulted in mechanical disintegration, whereas high capacitance was attained in higher-grade coal. The properties, including capacitance, mechanical robustness, and internal conductivity, were excellent when the cost is taken into consideration.

[Cost-effectiveness of drotrecogin alpha [activated] in the treatment of severe sepsis in Spain].

PubMed

Sacristán, José A; Prieto, Luis; Huete, Teresa; Artigas, Antonio; Badia, Xavier; Chinn, Christopher; Hudson, Peter

2004-01-01

The PROWESS clinical trial has shown that treatment with drotrecogin alpha (activated) in patients with severe sepsis is associated with a reduction in the absolute risk of death compared with standard treatment. The aim of the present study was to assess the cost-effectiveness of drotrecogin alpha (activated) versus that of standard care in the treatment of severe sepsis in Spain. A decision analysis model was drawn up to compare costs to hospital discharge and the long-term efficacy of drotrecogin alpha (activated) versus those of standard care in the treatment of severe sepsis in Spain from the perspective of the health care payer. Most of the information for creating the model was obtained from the PROWESS clinical trial. A two-fold baseline analysis was performed: a) for all patients included in the PROWESS clinical trial and b) for the patients with two or more organ failures. The major variables for clinical assessment were the reduction in mortality and years of life gained (YLG). Cost-effectiveness was expressed as cost per YLG. A sensitivity analysis was applied using 3% and 5% discount rates for YLG and by modifying the patterns of health care, intensive care unit costs, and life expectancy by initial co-morbidity and therapeutic efficacy of drotrecogin alpha (activated). Treatment with drotrecogin alfa (activated) was associated with a 6.0% drop in the absolute risk of death (p = 0.005) when all of the patients from the PROWESS trial were included and with a 7.3% reduction (p = 0.005) when the analysis was restricted to patients with two or more organ failures. The cost-effectiveness of drotrecogin alfa (activated) was 13,550 euros per YLG with respect to standard care after analysing all of the patients and 9,800 euros per YLG in the group of patients with two or more organ failures. In the sensitivity analysis, the results ranged from 7,322 to 16,493 euros per YLG. The factors with the greatest impact on the results were the change in the efficacy of drotrecogin alfa (activated), adjustment of survival by initial co-morbidity and the application of discount rates to YLG. Treatment with drotrecogin alfa (activated) presents a favorable cost-effectiveness ratio compared with other health care interventions commonly used in Spain.

Offset Printing Plate Quality Sensor on a Low-Cost Processor

PubMed Central

Poljak, Jelena; Botella, Guillermo; García, Carlos; Poljaček, Sanja Mahović; Prieto-Matías, Manuel; Tirado, Francisco

2013-01-01

The aim of this work is to develop a microprocessor-based sensor that measures the quality of the offset printing plate through the introduction of different image analysis applications. The main features of the presented system are the low cost, the low amount of power consumption, its modularity and easy integration with other industrial modules for printing plates, and its robustness against noise environments. For the sake of clarity, a viability analysis of previous software is presented through different strategies, based on dynamic histogram and Hough transform. This paper provides performance and scalability data compared with existing costly commercial devices. Furthermore, a general overview of quality control possibilities for printing plates is presented and could be useful to a system where such controls are regularly conducted. PMID:24284766

Staged, High-Pressure Oxy-Combustion Technology: Development and Scale-Up

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

Axelbaum, Richard; Kumfer, Benjamin; Gopan, Akshay

The immediate need for a high efficiency, low cost carbon capture process has prompted the recent development of pressurized oxy-combustion. With a greater combustion pressure the dew point of the flue gas is increased, allowing for effective integration of the latent heat of flue gas moisture into the Rankine cycle. This increases the net plant efficiency and reduces costs. A novel, transformational process, named Staged, Pressurized Oxy-Combustion (SPOC), achieves additional step changes in efficiency and cost reduction by significantly reducing the recycle of flue gas. The research and development activities conducted under Phases I and II of this project (FE0009702)more » include: SPOC power plant cost and performance modeling, CFD-assisted design of pressurized SPOC boilers, theoretical analysis of radiant heat transfer and ash deposition, boiler materials corrosion testing, construction of a 100 kWth POC test facility, and experimental testing. The results of this project have advanced the technology readiness level (TRL) of the SPOC technology from 1 to 5.« less

Cost-effectiveness of WHO-Recommended Algorithms for TB Case Finding at Ethiopian HIV Clinics.

PubMed

Adelman, Max W; McFarland, Deborah A; Tsegaye, Mulugeta; Aseffa, Abraham; Kempker, Russell R; Blumberg, Henry M

2018-01-01

The World Health Organization (WHO) recommends active tuberculosis (TB) case finding and a rapid molecular diagnostic test (Xpert MTB/RIF) to detect TB among people living with HIV (PLHIV) in high-burden settings. Information on the cost-effectiveness of these recommended strategies is crucial for their implementation. We conducted a model-based cost-effectiveness analysis comparing 2 algorithms for TB screening and diagnosis at Ethiopian HIV clinics: (1) WHO-recommended symptom screen combined with Xpert for PLHIV with a positive symptom screen and (2) current recommended practice algorithm (CRPA; based on symptom screening, smear microscopy, and clinical TB diagnosis). Our primary outcome was US$ per disability-adjusted life-year (DALY) averted. Secondary outcomes were additional true-positive diagnoses, and false-negative and false-positive diagnoses averted. Compared with CRPA, combining a WHO-recommended symptom screen with Xpert was highly cost-effective (incremental cost of $5 per DALY averted). Among a cohort of 15 000 PLHIV with a TB prevalence of 6% (900 TB cases), this algorithm detected 8 more true-positive cases than CRPA, and averted 2045 false-positive and 8 false-negative diagnoses compared with CRPA. The WHO-recommended algorithm was marginally costlier ($240 000) than CRPA ($239 000). In sensitivity analysis, the symptom screen/Xpert algorithm was dominated at low Xpert sensitivity (66%). In this model-based analysis, combining a WHO-recommended symptom screen with Xpert for TB diagnosis among PLHIV was highly cost-effective ($5 per DALY averted) and more sensitive than CRPA in a high-burden, resource-limited setting.

Disease activity-guided dose optimisation of adalimumab and etanercept is a cost-effective strategy compared with non-tapering tight control rheumatoid arthritis care: analyses of the DRESS study.

PubMed

Kievit, Wietske; van Herwaarden, Noortje; van den Hoogen, Frank Hj; van Vollenhoven, Ronald F; Bijlsma, Johannes Wj; van den Bemt, Bart Jf; van der Maas, Aatke; den Broeder, Alfons A

2016-11-01

A disease activity-guided dose optimisation strategy of adalimumab or etanercept (TNFi (tumour necrosis factor inhibitors)) has shown to be non-inferior in maintaining disease control in patients with rheumatoid arthritis (RA) compared with usual care. However, the cost-effectiveness of this strategy is still unknown. This is a preplanned cost-effectiveness analysis of the Dose REduction Strategy of Subcutaneous TNF inhibitors (DRESS) study, a randomised controlled, open-label, non-inferiority trial performed in two Dutch rheumatology outpatient clinics. Patients with low disease activity using TNF inhibitors were included. Total healthcare costs were measured and quality adjusted life years (QALY) were based on EQ5D utility scores. Decremental cost-effectiveness analyses were performed using bootstrap analyses; incremental net monetary benefit (iNMB) was used to express cost-effectiveness. 180 patients were included, and 121 were allocated to the dose optimisation strategy and 59 to control. The dose optimisation strategy resulted in a mean cost saving of -€12 280 (95 percentile -€10 502; -€14 104) per patient per 18 months. There is an 84% chance that the dose optimisation strategy results in a QALY loss with a mean QALY loss of -0.02 (-0.07 to 0.02). The decremental cost-effectiveness ratio (DCER) was €390 493 (€5 085 184; dominant) of savings per QALY lost. The mean iNMB was €10 467 (€6553-€14 037). Sensitivity analyses using 30% and 50% lower prices for TNFi remained cost-effective. Disease activity-guided dose optimisation of TNFi results in considerable cost savings while no relevant loss of quality of life was observed. When the minimal QALY loss is compensated with the upper limit of what society is willing to pay or accept in the Netherlands, the net savings are still high. NTR3216; Post-results. 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/.

Climate Informed Low Flow Frequency Analysis Using Nonstationary Modeling

NASA Astrophysics Data System (ADS)

Liu, D.; Guo, S.; Lian, Y.

2014-12-01

Stationarity is often assumed for frequency analysis of low flows in water resources management and planning. However, many studies have shown that flow characteristics, particularly the frequency spectrum of extreme hydrologic events,were modified by climate change and human activities and the conventional frequency analysis without considering the non-stationary characteristics may lead to costly design. The analysis presented in this paper was based on the more than 100 years of daily flow data from the Yichang gaging station 44 kilometers downstream of the Three Gorges Dam. The Mann-Kendall trend test under the scaling hypothesis showed that the annual low flows had significant monotonic trend, whereas an abrupt change point was identified in 1936 by the Pettitt test. The climate informed low flow frequency analysis and the divided and combined method are employed to account for the impacts from related climate variables and the nonstationarities in annual low flows. Without prior knowledge of the probability density function for the gaging station, six distribution functions including the Generalized Extreme Values (GEV), Pearson Type III, Gumbel, Gamma, Lognormal, and Weibull distributions have been tested to find the best fit, in which the local likelihood method is used to estimate the parameters. Analyses show that GEV had the best fit for the observed low flows. This study has also shown that the climate informed low flow frequency analysis is able to exploit the link between climate indices and low flows, which would account for the dynamic feature for reservoir management and provide more accurate and reliable designs for infrastructure and water supply.

Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework.

PubMed

Carvalho, Natalie; Jit, Mark; Cox, Sarah; Yoong, Joanne; Hutubessy, Raymond C W

2018-01-01

In low- and middle-income countries, budget impact is an important criterion for funding new interventions, particularly for large public health investments such as new vaccines. However, budget impact analyses remain less frequently conducted and less well researched than cost-effectiveness analyses. The objective of this study was to fill the gap in research on budget impact analyses by assessing (1) the quality of stand-alone budget impact analyses, and (2) the feasibility of extending cost-effectiveness analyses to capture budget impact. We developed a budget impact analysis checklist and scoring system for budget impact analyses, which we then adapted for cost-effectiveness analyses, based on current International Society for Pharmacoeconomics and Outcomes Research Task Force recommendations. We applied both budget impact analysis and cost-effectiveness analysis checklists and scoring systems to examine the extent to which existing economic evaluations provide sufficient evidence about budget impact to enable decision making. We used rotavirus vaccination as an illustrative case in which low- and middle-income countries uptake has been limited despite demonstrated cost effectiveness. A systematic literature review was conducted to identify economic evaluations of rotavirus vaccine in low- and middle-income countries published between January 2000 and February 2017. We critically appraised the quality of budget impact analyses, and assessed the extension of cost-effectiveness analyses to provide useful budget impact information. Six budget impact analyses and 60 cost-effectiveness analyses were identified. Budget impact analyses adhered to most International Society for Pharmacoeconomics and Outcomes Research recommendations, with key exceptions being provision of undiscounted financial streams for each budget period and model validation. Most cost-effectiveness analyses could not be extended to provide useful budget impact information; cost-effectiveness analyses also rarely presented undiscounted annual costs, or estimated financial streams during the first years of programme scale-up. Cost-effectiveness analyses vastly outnumber budget impact analyses of rotavirus vaccination, despite both being critical for policy decision making. Straightforward changes to the presentation of cost-effectiveness analyses results could facilitate their adaptation into budget impact analyses.

47 CFR 54.8 - Prohibition on participation: suspension and debarment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... support mechanism, the high-cost support mechanism, the rural health care support mechanism, and the low... activities associated with or relating to the schools and libraries support mechanism, the high-cost support... with or relating to the schools and libraries support mechanism, the high-cost support mechanism, the...

Variations in costs for the care of low-birth-weight infants among academic hospitals.

PubMed

Herrod, Henry G; Chang, Cyril F; Steinberg, Stephanie S

2010-05-01

To determine the relative role that academic hospitals (AHs) play in providing neonatal care for low-birth-weight infants within a single state and to determine if there are variations in inpatient costs for neonatal services among AHs. Retrospective analysis of hospital costs for low-birth-weight infants. Cases were identified using 2003-2005 data from the Tennessee Hospital Discharge Data System. A specific focus was discharge data from the 5 AHs that support obstetrical residencies and have a neonatal intensive care unit. Cases included all discharged infants with a birth weight of <2500 grams. The 5 AHs discharged 18% of the total normal-birth-weight infants and 30% of the low-birth-weight infants for the entire state. AHs had higher costs associated with these infants than did other hospitals, with a single exception The difference in costs at this hospital was consistent with the finding of lower utilization rates of hospital services, a shorter average length of stay, and lower costs for infants insured by the state Medicaid program. Academic obstetrical hospitals discharged a disproportionately high percentage of low-birth-weight infants compared with other Tennessee hospitals. The lower costs observed in the Shelby County hospital indicates that other hospitals could potentially lower their costs for the care of low-birth-weight infants.

Economic implications of three strategies for the control of taeniasis.

PubMed

Alexander, Anu; John, K R; Jayaraman, T; Oommen, Anna; Venkata Raghava, M; Dorny, Pierre; Rajshekhar, Vedantam

2011-11-01

To evaluate the cost-effectiveness of three strategies for the control of taeniasis in a community, in terms of cost per case treated. A study was conducted in South India to determine the prevalence of taeniasis by screening stool samples from 653 randomly chosen subjects, for coproantigens. The costs incurred in the project were used to estimate the cost per case screened and treated. A one-way sensitivity analysis was carried out for varying rates of taeniasis, different screening strategies and mass therapy. Further sensitivity analysis was carried out with different manpower and test costs. The rate of taeniasis as detected by ELISA for coproantigen was 3 per 1000 (2 of 653 samples). Our study showed that mass therapy without screening for taeniasis would be the most economical strategy in terms of cost per case treated if field workers are employed exclusively for either mass therapy or screening. For each strategy, costs per case treated are higher at low prevalence of taeniasis, with a sharp rise below 15%. In places that are endemic for taeniasis and neurocysticercosis, mass therapy or screening for taeniasis should be considered. Screening by stool microscopy is not cost-effective in terms of cost per case of taeniasis treated owing to its low sensitivity. Although the cost per case of taeniasis treated is high at low prevalence of taeniasis for all options, incorporating mass therapy into existing mass drug distribution programmes might prove to be the most cost-effective control strategy. © 2011 Blackwell Publishing Ltd.

Collaborative field research and training in occupational health and ergonomics.

PubMed

Kogi, K

1998-01-01

Networking collaborative research and training in Asian developing countries includes three types of joint activities: field studies of workplace potentials for better safety and health, intensive action training for improvement of working conditions in small enterprises, and action-oriented workshops on low-cost improvements for managers, workers, and farmers. These activities were aimed at identifying workable strategies for making locally adjusted improvements in occupational health and ergonomics. Many improvements have resulted as direct outcomes. Most these improvements were multifaceted, low-cost, and practicable using local skills. Three common features of these interactive processes seem important in facilitating realistic improvements: 1) voluntary approaches building on local achievements; 2) the use of practical methods for identifying multiple improvements; and 3) participatory steps for achieving low-cost results first. The effective use of group work tools is crucial. Stepwise training packages have thus proven useful for promoting local problem-solving interventions based on voluntary initiatives.

Commercialization Plan Support for Development of Low Cost Vacuum Insulating Glazing: Cooperative Research and Development Final Report, CRADA Number CRD-11-449

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

Dameron, Arrelaine

During the duration of this CRADA, V-Glass and NREL will partner in testing, analysis, performance forecasting, costing, and evaluation of V-Glass’s GRIPWELD™ process technology for creating a low cost hermetic seal for conventional and vacuum glazing. Upon successful evaluation of hermeticity, V-Glass’s GRIPWELD™ will be evaluated for its potential use in highly insulating window glazing.

Space station (modular) mission analysis. Volume 1: Mission analysis

NASA Technical Reports Server (NTRS)

1971-01-01

The mission analysis on the modular space station considers experimental requirements and options characterized by low initial cost and incremental manning. Features that affect initial development and early operating costs are identified and their impacts on the program are assessed. Considered are the areas of experiment, mission, operations, information management, and long life and safety analyses.

The Saskatchewan/New Brunswick Healthy Start-Départ Santé intervention: implementation cost estimates of a physical activity and healthy eating intervention in early learning centers.

PubMed

Sari, Nazmi; Muhajarine, Nazeem; Froehlich Chow, Amanda

2017-01-19

Participation in daily physical activity and consuming a balanced diet high in fruits and vegetables and low in processed foods are behaviours associated with positive health outcomes during all stages of life. Previous literature suggests that the earlier these behaviours are established the greater the health benefits. As such, early learning settings have been shown to provide an effective avenue for exploring and influencing the physical activity and healthy eating behaviours of children before school entry. However, in addition to improving individual level health of children, such interventions may also result in a number of social benefits for the society. In fact, research among adult populations has shown that sufficient participation in physical activity can significantly lower hospital stays and physician visits, in turn leading to positive economic outcomes. To our knowledge there is very limited literature about economic evaluations of interventions implemented in early learning centers to increase physical activity and healthy eating behaviours among children. The primary purpose of this paper is to identify inputs and costs needed to implement a physical activity and healthy eating intervention (Healthy Start-Départ Santé (HS-DS)) in early learning centres throughout Saskatchewan and New Brunswick over the course of three years. In doing so, implementation cost is estimated to complete the first phase of a social return on investment analysis of this intervention. In order to carry out this evaluation the first step was to identify the inputs and costs needed to implement the intervention, along with the corresponding outputs. With stakeholder interviews and using existing database, we estimated the implementation cost by measuring, valuing and monetizing each individual input. Our results show that the total annual cost of implementing HS-DS was $378,753 in the first year, this total cost decreased slightly in the second year ($356,861) and again in the third year ($312,179). On average, the total annual cost is about $350,000 which implies an annual cost of $285 per child. Among all inputs, time-cost accounted for the larger share of total resources need to implement the intervention. Overall, administration and support services accounted for the largest portion of the total implementation cost each year: 74% (year 1), 79% (year 2), and 75% (year 3). The results from this study shed lights for future implementation of similar interventions in this context. It also helps to assess the cost effectiveness of future interventions.

Environmentally friendly and cost-efficient analysis of aflatoxins in corn

USDA-ARS?s Scientific Manuscript database

The extraction procedure adds a significant cost to the overall expense of aflatoxin analysis in agricultural commodities. An inexpensive and low-waste extraction method using a household espresso coffee maker was tested. This appliance was used for the high-temperature /high-pressure extraction of ...

Activity-based costing via an information system: an application created for a breast imaging center.

PubMed

Hawkins, H; Langer, J; Padua, E; Reaves, J

2001-06-01

Activity-based costing (ABC) is a process that enables the estimation of the cost of producing a product or service. More accurate than traditional charge-based approaches, it emphasizes analysis of processes, and more specific identification of both direct and indirect costs. This accuracy is essential in today's healthcare environment, in which managed care organizations necessitate responsible and accountable costing. However, to be successfully utilized, it requires time, effort, expertise, and support. Data collection can be tedious and expensive. By integrating ABC with information management (IM) and systems (IS), organizations can take advantage of the process orientation of both, extend and improve ABC, and decrease resource utilization for ABC projects. In our case study, we have examined the process of a multidisciplinary breast center. We have mapped the constituent activities and established cost drivers. This information has been structured and included in our information system database for subsequent analysis.

Low Cost Processing of Commingled Thermoplastic Composites

NASA Astrophysics Data System (ADS)

Chiasson, Matthew Lee

A low cost vacuum consolidation process has been investigated for use with commingled thermoplastic matrix composites. In particular, the vacuum consolidation behaviour of commingled polypropylene/glass fibre and commingled nylon/carbon fibre precursors were studied. Laminates were consolidated in a convection oven under vacuum pressure. During processing, the consolidation of the laminate packs was measured by use of non-contact eddy current sensors. The consolidation curves are then used to tune an empirical consolidation model. The overall quality of the resulting laminates is also discussed. Dynamic mechanical analysis, differential scanning calorimetry and mechanical tensile testing were also performed in order to determine the effects of varying processing parameters on the physical and mechanical properties of the laminates. Through this analysis, it was determined that the nylon/carbon fibre blend was not suitable for vacuum consolidation, while the polypropylene/glass fibre blend is a viable option for vacuum consolidation. The ultimate goal of this work is to provide a foundation from which low cost unmanned aerial vehicle (UAV) components can be designed and manufactured from thermoplastic matrix composites using a low cost processing technique as an alternative to traditional thermoset composite materials.

Do health benefits outweigh the costs of mass recreational programs? An economic analysis of four Ciclovía programs.

PubMed

Montes, Felipe; Sarmiento, Olga L; Zarama, Roberto; Pratt, Michael; Wang, Guijing; Jacoby, Enrique; Schmid, Thomas L; Ramos, Mauricio; Ruiz, Oscar; Vargas, Olga; Michel, Gabriel; Zieff, Susan G; Valdivia, Juan Alejandro; Cavill, Nick; Kahlmeier, Sonja

2012-02-01

One promising public health intervention for promoting physical activity is the Ciclovía program. The Ciclovía is a regular multisectorial community-based program in which streets are temporarily closed for motorized transport, allowing exclusive access to individuals for recreational activities and physical activity. The objective of this study was to conduct an analysis of the cost-benefit ratios of physical activity of the Ciclovía programs of Bogotá and Medellín in Colombia, Guadalajara in México, and San Francisco in the U.S.A. The data of the four programs were obtained from program directors and local surveys. The annual cost per capita of the programs was: U.S. $6.0 for Bogotá, U.S. $23.4 for Medellín, U.S. $6.5 for Guadalajara, and U.S. $70.5 for San Francisco. The cost-benefit ratio for health benefit from physical activity was 3.23-4.26 for Bogotá, 1.83 for Medellín, 1.02-1.23 for Guadalajara, and 2.32 for San Francisco. For the program of Bogotá, the cost-benefit ratio was more sensitive to the prevalence of physically active bicyclists; for Guadalajara, the cost-benefit ratio was more sensitive to user costs; and for the programs of Medellín and San Francisco, the cost-benefit ratios were more sensitive to operational costs. From a public health perspective for promoting physical activity, these Ciclovía programs are cost beneficial.

An Analysis of Anxiety-Related Postings on Sina Weibo.

PubMed

Tian, Xianyun; He, Fang; Batterham, Philip; Wang, Zheng; Yu, Guang

2017-07-13

This study examines anxiety-related postings on Sina Weibo to gain insight into social networking about mental health. The themes of a random sample of anxiety-related postings ( n = 1000) were assessed. The disclosure of anxiety was the most common theme. The prevalence of anxiety was higher in certain areas where the economy is stronger than others, and the people living there suffered from more stress. Users who talked about feeling anxious tended to be more active on social media during leisure hours and less active during work hours. Our findings may be developed to detect and help individuals who may suffer from anxiety disorders at a low cost.

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial

PubMed Central

2011-01-01

Background Low back pain (LBP), with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI) of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP. Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days), Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB) and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP) and 12 months (evaluate the outcomes at long term). Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration ISRCTN: ISRCTN58719694 PMID:21859489

GFZ Wireless Seismic Array (GFZ-WISE), a Wireless Mesh Network of Seismic Sensors: New Perspectives for Seismic Noise Array Investigations and Site Monitoring

PubMed Central

Picozzi, Matteo; Milkereit, Claus; Parolai, Stefano; Jaeckel, Karl-Heinz; Veit, Ingo; Fischer, Joachim; Zschau, Jochen

2010-01-01

Over the last few years, the analysis of seismic noise recorded by two dimensional arrays has been confirmed to be capable of deriving the subsoil shear-wave velocity structure down to several hundred meters depth. In fact, using just a few minutes of seismic noise recordings and combining this with the well known horizontal-to-vertical method, it has also been shown that it is possible to investigate the average one dimensional velocity structure below an array of stations in urban areas with a sufficient resolution to depths that would be prohibitive with active source array surveys, while in addition reducing the number of boreholes required to be drilled for site-effect analysis. However, the high cost of standard seismological instrumentation limits the number of sensors generally available for two-dimensional array measurements (i.e., of the order of 10), limiting the resolution in the estimated shear-wave velocity profiles. Therefore, new themes in site-effect estimation research by two-dimensional arrays involve the development and application of low-cost instrumentation, which potentially allows the performance of dense-array measurements, and the development of dedicated signal-analysis procedures for rapid and robust estimation of shear-wave velocity profiles. In this work, we present novel low-cost wireless instrumentation for dense two-dimensional ambient seismic noise array measurements that allows the real–time analysis of the surface-wavefield and the rapid estimation of the local shear-wave velocity structure for site response studies. We first introduce the general philosophy of the new system, as well as the hardware and software that forms the novel instrument, which we have tested in laboratory and field studies. PMID:22319298

Early diagnosis of osteoporosis using radiogrammetry and texture analysis from hand and wrist radiographs in Indian population.

PubMed

Areeckal, A S; Jayasheelan, N; Kamath, J; Zawadynski, S; Kocher, M; David S, S

2018-03-01

We propose an automated low cost tool for early diagnosis of onset of osteoporosis using cortical radiogrammetry and cancellous texture analysis from hand and wrist radiographs. The trained classifier model gives a good performance accuracy in classifying between healthy and low bone mass subjects. We propose a low cost automated diagnostic tool for early diagnosis of reduction in bone mass using cortical radiogrammetry and cancellous texture analysis of hand and wrist radiographs. Reduction in bone mass could lead to osteoporosis, a disease observed to be increasingly occurring at a younger age in recent times. Dual X-ray absorptiometry (DXA), currently used in clinical practice, is expensive and available only in urban areas in India. Therefore, there is a need to develop a low cost diagnostic tool in order to facilitate large-scale screening of people for early diagnosis of osteoporosis at primary health centers. Cortical radiogrammetry from third metacarpal bone shaft and cancellous texture analysis from distal radius are used to detect low bone mass. Cortical bone indices and cancellous features using Gray Level Run Length Matrices and Laws' masks are extracted. A neural network classifier is trained using these features to classify healthy subjects and subjects having low bone mass. In our pilot study, the proposed segmentation method shows 89.9 and 93.5% accuracy in detecting third metacarpal bone shaft and distal radius ROI, respectively. The trained classifier shows training accuracy of 94.3% and test accuracy of 88.5%. An automated diagnostic technique for early diagnosis of onset of osteoporosis is developed using cortical radiogrammetric measurements and cancellous texture analysis of hand and wrist radiographs. The work shows that a combination of cortical and cancellous features improves the diagnostic ability and is a promising low cost tool for early diagnosis of increased risk of osteoporosis.

Economic evaluation of participatory learning and action with women's groups facilitated by Accredited Social Health Activists to improve birth outcomes in rural eastern India.

PubMed

Sinha, Rajesh Kumar; Haghparast-Bidgoli, Hassan; Tripathy, Prasanta Kishore; Nair, Nirmala; Gope, Rajkumar; Rath, Shibanand; Prost, Audrey

2017-01-01

Neonatal mortality remains unacceptably high in many low and middle-income countries, including India. A community mobilisation intervention using participatory learning and action with women's groups facilitated by Accredited Social Health Activists (ASHAs) was conducted to improve maternal and newborn health. The intervention was evaluated through a cluster-randomised controlled trial conducted in Jharkhand and Odisha, eastern India. This aims to assess the cost-effectiveness this intervention. Costs were estimated from the provider's perspective and calculated separately for the women's group intervention and for activities to strengthen Village Health Sanitation and Nutrition Committees (VHNSC) conducted in all trial areas. Costs were estimated at 2017 prices and converted to US dollar (USD). The incremental cost-effectiveness ratio (ICER) was calculated with respect to a do-nothing alternative and compared with the WHO thresholds for cost-effective interventions. ICERs were calculated for cases of neonatal mortality and disability-adjusted life years (DALYs) averted. The incremental cost of the intervention was USD 83 per averted DALY (USD 99 inclusive of VHSNC strengthening costs), and the incremental cost per newborn death averted was USD 2545 (USD 3046 inclusive of VHSNC strengthening costs). The intervention was highly cost-effective according to WHO threshold, as the cost per life year saved or DALY averted was less than India's Gross Domestic Product (GDP) per capita. The robustness of the findings to assumptions was tested using a series of one-way sensitivity analyses. The sensitivity analysis does not change the conclusion that the intervention is highly cost-effective. Participatory learning and action with women's groups facilitated by ASHAs was highly cost-effective to reduce neonatal mortality in rural settings with low literacy levels and high neonatal mortality rates. This approach could effectively complement facility-based care in India and can be scaled up in comparable high mortality settings.

The Automated Array Assembly Task of the Low-cost Silicon Solar Array Project, Phase 2

NASA Technical Reports Server (NTRS)

Coleman, M. G.; Grenon, L.; Pastirik, E. M.; Pryor, R. A.; Sparks, T. G.

1978-01-01

An advanced process sequence for manufacturing high efficiency solar cells and modules in a cost-effective manner is discussed. Emphasis is on process simplicity and minimizing consumed materials. The process sequence incorporates texture etching, plasma processes for damage removal and patterning, ion implantation, low pressure silicon nitride deposition, and plated metal. A reliable module design is presented. Specific process step developments are given. A detailed cost analysis was performed to indicate future areas of fruitful cost reduction effort. Recommendations for advanced investigations are included.

Resting-state functional brain connectivity: lessons from functional near-infrared spectroscopy.

PubMed

Niu, Haijing; He, Yong

2014-04-01

Resting-state functional near-infrared spectroscopy (R-fNIRS) is an active area of interest and is currently attracting considerable attention as a new imaging tool for the study of resting-state brain function. Using variations in hemodynamic concentration signals, R-fNIRS measures the brain's low-frequency spontaneous neural activity, combining the advantages of portability, low-cost, high temporal sampling rate and less physical burden to participants. The temporal synchronization of spontaneous neuronal activity in anatomically separated regions is referred to as resting-state functional connectivity (RSFC). In the past several years, an increasing body of R-fNIRS RSFC studies has led to many important findings about functional integration among local or whole-brain regions by measuring inter-regional temporal synchronization. Here, we summarize recent advances made in the R-fNIRS RSFC methodologies, from the detection of RSFC (e.g., seed-based correlation analysis, independent component analysis, whole-brain correlation analysis, and graph-theoretical topological analysis), to the assessment of RSFC performance (e.g., reliability, repeatability, and validity), to the application of RSFC in studying normal development and brain disorders. The literature reviewed here suggests that RSFC analyses based on R-fNIRS data are valid and reliable for the study of brain function in healthy and diseased populations, thus providing a promising imaging tool for cognitive science and clinics.

Low Temperature Geothermal Play Fairway Analysis For The Appalachian Basin: Phase 1 Revised Report November 18, 2016

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

Jordan, Teresa E.; Richards, Maria C.; Horowitz, Franklin G.

Geothermal energy is an attractive sustainable energy source. Yet project developers need confirmation of the resource base to warrant their time and financial resources. The Geothermal Play Fairway Analysis of the Appalachian Basin evaluated risk metrics that communicate the favorability of potential low-temperature geothermal energy resources in reservoirs more than 1000 m below the surface. This analysis is focused on the direct use of the heat, rather than on electricity production. Four risk factors of concern for direct-use geothermal plays in the Appalachian Basin portions of New York, Pennsylvania, and West Virginia are examined individually, and then in combination: 1)more » thermal resource quality, 2) natural reservoir quality, 3) induced seismicity, and 4) utilization opportunities. Uncertainty in the risk estimation is quantified. Based on these metrics, geothermal plays in the Appalachian Basin were identified as potentially viable for a variety of direct-use-heat applications. The methodologies developed in this project may be applied in other sedimentary basins as a foundation for low temperature (50-150 °C), direct use geothermal resource, risk, and uncertainty assessment. Three methods with which to combine the four risk factors were used. Among these, the averaging of the individual risk factors indicates the most favorable counties within the study area are the West Virginia counties of Monongalia, Harrison, Lewis (dubbed the Morgantown–Clarksburg play fairway), Putnam, and Kanawha (Charleston play fairway), the New York counties of Chemung and Steuben plus adjacent Bradford county in Pennsylvania (Corning–Ithaca play fairway), and the Pennsylvania counties of Mercer, Crawford, Erie, and Warren, and adjacent Chautauqua county in New York (together, the Meadville–Jamestown play fairway). These higher priority regions are surrounded by broader medium priority zones. Also worthy of additional exploration is a broad region near Pittsburgh Pennsylvania, for which the available geological data are insufficient to fully analyze the geological risks but yet the population is high. First, to assess the spatial variation in the depth to which one would need to drill to obtain geothermal temperatures that are useful to a future project, the project used bottom-hole temperature data from Appalachian Basin oil and gas exploration. These bottom hole temperature data are abundant but of low quality. Second, the project examined the potential for sufficient water flow rates through rocks to harvest heat from a geothermal well field, considering only natural reservoirs. This analysis provides a very incomplete picture of spatial variability of natural reservoirs because the oil and gas reservoir data lack key properties and are spatially biased toward those locations with profitable amounts of hydrocarbons in the rock pore spaces. Third, in light of the fact that earthquake activity has been induced in several states by subsurface work related to the oil and gas industry, this project examined the potential for similar activity in the Appalachian Basin. Acknowledging that data for such a task are insufficient, we utilized what was available: records of seismic activity, regional estimates of the orientations of stress in the rocks, and locations and orientations of zones of lateral change in rock properties at depths down to several kilometers below Earth’s surface. With these data, we created a first approximation of spatially variable risks for induced earthquakes. Because no data existed with which to test the reliability of these methods, the results have a high degree of uncertainty. Fourth, we examined the spatial variability of the above-the-ground factors that contribute to the economical viability of projects to tap low-temperature geothermal resources for direct-use. We worked principally with population density as a regionally known variable that would impact the cost of district heating. The resulting maps omit the costs of producing the hot water from the ground, because the below-ground costs are directly coupled to the thermal resource risk factor and natural reservoir risk factor – later analyses of those costs will be needed. The result of the district heating analysis is highly skewed: few census locations yielded a low estimated surface cost. The team also identified more than 165 prospects for high value direct-use geothermal energy opportunities such as industrial sites, university campuses, and federal facilities, among others. At the closure of this regional analysis, the most significant technical uncertainties are 1) reservoir distribution and capacities; 2) validity of thermal resource maps, and 3) the holistic estimation of Levelized Cost of Heat for favorable geological situations.« less

[Cost-benefit analysis of mental health activities in the workplace].

PubMed

Tarumi, Kimio; Hagihara, Akihito

2013-01-01

In order to examine the cost-benefit of mental health care activities in the workplace, the total costs of the fiscal year 2005, during which the old-type mental health care was conducted, and those of the fiscal years from 2006 to 2008, during which the new-type mental health care was conducted according to the governmental guidelines of each year, were compared using about 3,000 workers in a particular workplace in 2005. The total cost comprised the sum of the medical fees, the payment compensation for sick absences, and expenditures for health care activities of mentally ill health workers. The total costs from 2006 to 2008 were not markedly different from those in 2005, and the benefit due to new-type activity was not shown. However, the following was found: payment compensation for sick absences accounted for 60% of the total cost; personnel expenses which were a large part of the expenditure of health care activities largely changed over the years because of the age structure of the staff in charge. The results show that a cost-benefit analysis may be a useful tool for examining health care activities in the workplace for various members in the workplace although health care issues usually tend to be solved by specialists.

A portable low-cost long-term live-cell imaging platform for biomedical research and education.

PubMed

Walzik, Maria P; Vollmar, Verena; Lachnit, Theresa; Dietz, Helmut; Haug, Susanne; Bachmann, Holger; Fath, Moritz; Aschenbrenner, Daniel; Abolpour Mofrad, Sepideh; Friedrich, Oliver; Gilbert, Daniel F

2015-02-15

Time-resolved visualization and analysis of slow dynamic processes in living cells has revolutionized many aspects of in vitro cellular studies. However, existing technology applied to time-resolved live-cell microscopy is often immobile, costly and requires a high level of skill to use and maintain. These factors limit its utility to field research and educational purposes. The recent availability of rapid prototyping technology makes it possible to quickly and easily engineer purpose-built alternatives to conventional research infrastructure which are low-cost and user-friendly. In this paper we describe the prototype of a fully automated low-cost, portable live-cell imaging system for time-resolved label-free visualization of dynamic processes in living cells. The device is light-weight (3.6 kg), small (22 × 22 × 22 cm) and extremely low-cost (<€1250). We demonstrate its potential for biomedical use by long-term imaging of recombinant HEK293 cells at varying culture conditions and validate its ability to generate time-resolved data of high quality allowing for analysis of time-dependent processes in living cells. While this work focuses on long-term imaging of mammalian cells, the presented technology could also be adapted for use with other biological specimen and provides a general example of rapidly prototyped low-cost biosensor technology for application in life sciences and education. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Behavioral, normative and control beliefs underlying low-fat dietary and regular physical activity behaviors for adults diagnosed with type 2 diabetes and/or cardiovascular disease.

PubMed

White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A

2007-08-01

Promoting healthy lifestyle behaviors is an important aspect of interventions designed to improve the management of chronic diseases such as Type 2 diabetes and cardiovascular disease. The present study used Ajzen's (1991) theory of planned behavior as a framework to examine beliefs amongst adults diagnosed with these conditions who do and do not engage in low-fat dietary and regular physical activity behaviors. Participants (N = 192) completed a questionnaire assessing their behavioral, normative and control beliefs in relation to regular, moderate physical activity and eating foods low in saturated fats. Measures of self-reported behavior were also examined. The findings revealed that, in general, it is the underlying behavioral beliefs that are important determinants for both physical activity and low-fat food consumption with some evidence to suggest that pressure from significant others is an important consideration for low-fat food consumption. Laziness, as a barrier to engaging in physical activity, also emerged as an important factor. To encourage a healthy lifestyle amongst this population, interventions should address the perceived costs associated with behavioral performance and encourage people to maintain healthy behaviors in light of these costs.

Exploring the "Sharkcano": Biogeochemical observations of the Kavachi submarine volcano (Solomon Islands) using simple, cost-effective methods.

NASA Astrophysics Data System (ADS)

Phillips, B. T.; Albert, S.; Carey, S.; DeCiccio, A.; Dunbabin, M.; Flinders, A. F.; Grinham, A. R.; Henning, B.; Howell, C.; Kelley, K. A.; Scott, J. J.

2015-12-01

Kavachi is a highly active undersea volcano located in the Western Province of the Solomon Islands, known for its frequent phreatomagmatic eruptions and ephemeral island-forming activity. The remote location of Kavachi and its explosive behavior has restricted scientific exploration of the volcano, limiting observations to surface imagery and peripheral water-column data. An expedition to Kavachi in January 2015 was timed with a rare lull in volcanic activity, allowing for observation of the inside of Kavachi's caldera and its flanks. Here we present medium-resolution bathymetry of the main peak paired with benthic imagery, petrologic analysis of samples from the caldera rim, measurements of gas flux over the main peak, and hydrothermal plume structure data. A second peak was discovered to the Southwest of the main cone and displayed evidence of diffuse-flow venting. Populations of gelatinous animals, small fish, and sharks were observed inside the active crater, raising new questions about the ecology of active submarine volcanoes. Most equipment used in this study was lightweight, relatively low-cost, and deployed using small boats; these methods may offer developing nations an economic means to explore deep-sea environments within their own territorial waters.

Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda.

PubMed

Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham; Clarke, Siân E

2017-06-01

In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision, allowances for CHWs and provision of mRDTs and ACTs. The opportunity costs of time utilised by CHWs were estimated based on self-reporting. Household costs of subsequent treatment-seeking at public health centres and private health providers were captured in a sample of households. mRDTs performed by CHWs was associated with large improvements in appropriate treatment of malaria in both transmission settings. This resulted in low incremental costs for the health sector at US$3.0 per appropriately treated child in the moderate-to-high transmission area. Higher incremental costs at US$13.3 were found in the low transmission area due to lower utilisation of CHW services and higher programme costs. Incremental costs from a societal perspective were marginally higher. The use of mRDTs by CHWs improved the targeting of ACTs to children with malaria and was likely to be considered a cost-effective intervention compared to a presumptive diagnosis in the moderate-to-high transmission area. In contrast to this, in the low transmission area with low attendance, RDT use by CHWs was not a low cost intervention. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

PubMed Central

Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham; Clarke, Siân E

2017-01-01

Abstract In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever ‘appropriately treated for malaria with ACT’ were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision, allowances for CHWs and provision of mRDTs and ACTs. The opportunity costs of time utilised by CHWs were estimated based on self-reporting. Household costs of subsequent treatment-seeking at public health centres and private health providers were captured in a sample of households. mRDTs performed by CHWs was associated with large improvements in appropriate treatment of malaria in both transmission settings. This resulted in low incremental costs for the health sector at US$3.0 per appropriately treated child in the moderate-to-high transmission area. Higher incremental costs at US$13.3 were found in the low transmission area due to lower utilisation of CHW services and higher programme costs. Incremental costs from a societal perspective were marginally higher. The use of mRDTs by CHWs improved the targeting of ACTs to children with malaria and was likely to be considered a cost-effective intervention compared to a presumptive diagnosis in the moderate-to-high transmission area. In contrast to this, in the low transmission area with low attendance, RDT use by CHWs was not a low cost intervention. PMID:28453718

An economic analysis of the benefits of sterilizing medical instruments in low-temperature systems instead of steam.

PubMed

McCreanor, Victoria; Graves, Nicholas

2017-07-01

Hydrogen peroxide-based, low-temperature sterilization has been shown to do less damage to medical instruments than steam autoclaves. However, low-temperature systems are more expensive to run. Higher costs need to be balanced against savings from reduced repair costs to determine value for money when choosing how to sterilize certain instruments, which are able to be reprocessed in either system. This analysis examines the economic effects of using low-temperature sterilization systems to reprocess rigid and semi-rigid endoscopes, which are sensitive to heat and moisture, but still able to be sterilized using steam. It examines the changes to costs and frequency of repairs expected over 10 years, resulting from a choice to sterilize these instruments in a low-temperature system instead of steam. Overall, the results showed that increased sterilization costs are outweighed by the savings associated with less frequent repairs. Over a 10-year period, in large health care facilities, the probability of achieving an internal rate of return of at least 6% is 0.81. Our model shows it is likely to be a good decision for large health care facilities to invest in low-temperature sterilization systems. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Simulation analysis of a microcomputer-based, low-cost Omega navigation system

NASA Technical Reports Server (NTRS)

Lilley, R. W.; Salter, R. J., Jr.

1976-01-01

The current status of research on a proposed micro-computer-based, low-cost Omega Navigation System (ONS) is described. The design approach emphasizes minimum hardware, maximum software, and the use of a low-cost, commercially-available microcomputer. Currently under investigation is the implementation of a low-cost navigation processor and its interface with an omega sensor to complete the hardware-based ONS. Sensor processor functions are simulated to determine how many of the sensor processor functions can be handled by innovative software. An input data base of live Omega ground and flight test data was created. The Omega sensor and microcomputer interface modules used to collect the data are functionally described. Automatic synchronization to the Omega transmission pattern is described as an example of the algorithms developed using this data base.

Automated packaging platform for low-cost high-performance optical components manufacturing

NASA Astrophysics Data System (ADS)

Ku, Robert T.

2004-05-01

Delivering high performance integrated optical components at low cost is critical to the continuing recovery and growth of the optical communications industry. In today's market, network equipment vendors need to provide their customers with new solutions that reduce operating expenses and enable new revenue generating IP services. They must depend on the availability of highly integrated optical modules exhibiting high performance, small package size, low power consumption, and most importantly, low cost. The cost of typical optical system hardware is dominated by linecards that are in turn cost-dominated by transmitters and receivers or transceivers and transponders. Cost effective packaging of optical components in these small size modules is becoming the biggest challenge to be addressed. For many traditional component suppliers in our industry, the combination of small size, high performance, and low cost appears to be in conflict and not feasible with conventional product design concepts and labor intensive manual assembly and test. With the advent of photonic integration, there are a variety of materials, optics, substrates, active/passive devices, and mechanical/RF piece parts to manage in manufacturing to achieve high performance at low cost. The use of automation has been demonstrated to surpass manual operation in cost (even with very low labor cost) as well as product uniformity and quality. In this paper, we will discuss the value of using an automated packaging platform.for the assembly and test of high performance active components, such as 2.5Gb/s and 10 Gb/s sources and receivers. Low cost, high performance manufacturing can best be achieved by leveraging a flexible packaging platform to address a multitude of laser and detector devices, integration of electronics and handle various package bodies and fiber configurations. This paper describes the operation and results of working robotic assemblers in the manufacture of a Laser Optical Subassembly (LOS), its subsequent automated testing and burn/in process; and the placement of the LOS into a package body and hermetically sealing the package. The LOS and Package automated assembler robots have achieved a metrics of less than 1 um accuracy and 0.1 um resolution. The paper also discusses a method for the critical alignment of a single-mode fiber as the last step of the manufacturing process. This approach is in contrast to the conventional manual assembly where sub-micron fiber alignment and fixation steps are performed much earlier during the assembly process. Finally the paper discusses the value of this automated platform manufacturing approach as a key enabler for low cost small form factor optical components for the new XFP MSA class of transceiver modules.

Production of highly efficient activated carbons from industrial wastes for the removal of pharmaceuticals from water-A full factorial design.

PubMed

Jaria, Guilaine; Silva, Carla Patrícia; Oliveira, João A B P; Santos, Sérgio M; Gil, María Victoria; Otero, Marta; Calisto, Vânia; Esteves, Valdemar I

2018-02-26

The wide occurrence of pharmaceuticals in aquatic environments urges the development of cost-effective solutions for their removal from water. In a circular economy context, primary paper mill sludge (PS) was used to produce activated carbon (AC) aiming the adsorptive removal of these contaminants. The use of low-cost precursors for the preparation of ACs capable of competing with commercial ACs continues to be a challenge. A full factorial design of four factors (pyrolysis temperature, residence time, precursor/activating agent ratio, and type of activating agent) at two levels was applied to the production of AC using PS as precursor. The responses analysed were the yield of production, percentage of adsorption for three pharmaceuticals (sulfamethoxazole, carbamazepine, and paroxetine), specific surface area (S BET ), and total organic carbon (TOC). Statistical analysis was performed to evaluate influencing factors in the responses and to determine the most favourable production conditions. Four ACs presented very good responses, namely on the adsorption of the pharmaceuticals under study (average adsorption percentage around 78%, which is above that of commercial AC), and S BET between 1389 and 1627 m 2  g -1 . A desirability analysis pointed out 800 °C for 60 min and a precursor/KOH ratio of 1:1 (w/w) as the optimal production conditions. Copyright © 2018 Elsevier B.V. All rights reserved.

Low skeletal muscle mass is associated with increased hospital expenditure in patients undergoing cancer surgery of the alimentary tract.

PubMed

van Vugt, Jeroen L A; Buettner, Stefan; Levolger, Stef; Coebergh van den Braak, Robert R J; Suker, Mustafa; Gaspersz, Marcia P; de Bruin, Ron W F; Verhoef, Cornelis; van Eijck, Casper H C; Bossche, Niek; Groot Koerkamp, Bas; IJzermans, Jan N M

2017-01-01

Low skeletal muscle mass is associated with poor postoperative outcomes in cancer patients. Furthermore, it is associated with increased healthcare costs in the United States. We investigated its effect on hospital expenditure in a Western-European healthcare system, with universal access. Skeletal muscle mass (assessed on CT) and costs were obtained for patients who underwent curative-intent abdominal cancer surgery. Low skeletal muscle mass was defined based on pre-established cut-offs. The relationship between low skeletal muscle mass and hospital costs was assessed using linear regression analysis and Mann-Whitney U-tests. 452 patients were included (median age 65, 61.5% males). Patients underwent surgery for colorectal cancer (38.9%), colorectal liver metastases (27.4%), primary liver tumours (23.2%), and pancreatic/periampullary cancer (10.4%). In total, 45.6% had sarcopenia. Median costs were €2,183 higher in patients with low compared with patients with high skeletal muscle mass (€17,144 versus €14,961; P<0.001). Hospital costs incrementally increased with lower sex-specific skeletal muscle mass quartiles (P = 0.029). After adjustment for confounders, low skeletal muscle mass was associated with a cost increase of €4,061 (P = 0.015). Low skeletal muscle mass was independently associated with increased hospital costs of about €4,000 per patient. Strategies to reduce skeletal muscle wasting could reduce hospital costs in an era of incremental healthcare costs and an increasingly ageing population.

The impact of reference pricing and extension of generic substitution on the daily cost of antipsychotic medication in Finland.

PubMed

Koskinen, Hanna; Ahola, Elina; Saastamoinen, Leena K; Mikkola, Hennamari; Martikainen, Jaana E

2014-12-01

To assess the impact of reference pricing and extension of generic substitution on the daily cost of antipsychotic drugs in Finland during the first year after its launch. Furthermore, the additional impact of reference pricing on prior implemented generic substitution is assessed. A retrospective analysis was performed between 2006 and 2010. A segmented linear regression analysis of interrupted time series was used to estimate changes in the levels and trends in the cost of one day of treatment. Of the study drugs, clozapine belonged to generic substitution already at the start of the study period while olanzapine and quetiapine were included in generic substitution alongside with reference pricing in 2009. Risperidone was included in generic substitution in 2008, before reference pricing. A substantial decrease in the daily cost of all four antipsychotic substances was seen after one year of the implementation of reference pricing and the extension of generic substitution. The impact ranged from -29.9% to -66.3%, and it was most substantial on the daily cost of olanzapine. Also in the daily cost of risperidone a substantial decrease of -43.3% was observed. However, most of these savings, -32.6%, were generated by generic substitution which had been adopted prior. Reference pricing and the extension of generic substitution produced substantial savings on antipsychotic medication costs during the first year after its launch, but the intensity of the impact differed between active substances. Furthermore, our results suggest that the additional cost savings from reference pricing after prior implemented generic substitution, are comparatively low.

Cybertran : a systems analysis solution to the high cost and low passenger appeal of conventional rail transportation systems

DOT National Transportation Integrated Search

1996-01-01

This paper will first describe the CyberTran system, and then describe the systems analysis process relative to capital costs that led to the particular vehicle size and system configuration. Following this will be a discussion on the particular aspe...

Integration of RAMS in LCC analysis for linear transport infrastructures. A case study for railways.

NASA Astrophysics Data System (ADS)

Calle-Cordón, Álvaro; Jiménez-Redondo, Noemi; Morales-Gámiz, F. J.; García-Villena, F. A.; Garmabaki, Amir H. S.; Odelius, Johan

2017-09-01

Life-cycle cost (LCC) analysis is an economic technique used to assess the total costs associated with the lifetime of a system in order to support decision making in long term strategic planning. For complex systems, such as railway and road infrastructures, the cost of maintenance plays an important role in the LCC analysis. Costs associated with maintenance interventions can be more reliably estimated by integrating the probabilistic nature of the failures associated to these interventions in the LCC models. Reliability, Maintainability, Availability and Safety (RAMS) parameters describe the maintenance needs of an asset in a quantitative way by using probabilistic information extracted from registered maintenance activities. Therefore, the integration of RAMS in the LCC analysis allows obtaining reliable predictions of system maintenance costs and the dependencies of these costs with specific cost drivers through sensitivity analyses. This paper presents an innovative approach for a combined RAMS & LCC methodology for railway and road transport infrastructures being developed under the on-going H2020 project INFRALERT. Such RAMS & LCC analysis provides relevant probabilistic information to be used for condition and risk-based planning of maintenance activities as well as for decision support in long term strategic investment planning.

Low-Cost Air Quality Monitoring Tools: From Research to Practice (A Workshop Summary)

PubMed Central

Griswold, William G.; RS, Abhijit; Johnston, Jill E.; Herting, Megan M.; Thorson, Jacob; Collier-Oxandale, Ashley; Hannigan, Michael

2017-01-01

In May 2017, a two-day workshop was held in Los Angeles (California, U.S.A.) to gather practitioners who work with low-cost sensors used to make air quality measurements. The community of practice included individuals from academia, industry, non-profit groups, community-based organizations, and regulatory agencies. The group gathered to share knowledge developed from a variety of pilot projects in hopes of advancing the collective knowledge about how best to use low-cost air quality sensors. Panel discussion topics included: (1) best practices for deployment and calibration of low-cost sensor systems, (2) data standardization efforts and database design, (3) advances in sensor calibration, data management, and data analysis and visualization, and (4) lessons learned from research/community partnerships to encourage purposeful use of sensors and create change/action. Panel discussions summarized knowledge advances and project successes while also highlighting the questions, unresolved issues, and technological limitations that still remain within the low-cost air quality sensor arena. PMID:29143775

Rocket Design for the Future

NASA Technical Reports Server (NTRS)

Follett, William W.; Rajagopal, Raj

2001-01-01

The focus of the AA MDO team is to reduce product development cost through the capture and automation of best design and analysis practices and through increasing the availability of low-cost, high-fidelity analysis. Implementation of robust designs reduces costs associated with the Test-Fall-Fix cycle. RD is currently focusing on several technologies to improve the design process, including optimization and robust design, expert and rule-based systems, and collaborative technologies.

Vertically aligned single-walled carbon nanotubes as low-cost and high electrocatalytic counter electrode for dye-sensitized solar cells.

PubMed

Dong, Pei; Pint, Cary L; Hainey, Mel; Mirri, Francesca; Zhan, Yongjie; Zhang, Jing; Pasquali, Matteo; Hauge, Robert H; Verduzco, Rafael; Jiang, Mian; Lin, Hong; Lou, Jun

2011-08-01

A novel dye-sensitized solar cell (DSSC) structure using vertically aligned single-walled carbon nanotubes (VASWCNTs) as the counter electrode has been developed. In this design, the VASWCNTs serve as a stable high surface area and highly active electrocatalytic counter-electrode that could be a promising alternative to the conventional Pt analogue. Utilizing a scalable dry transfer approach to form a VASWCNTs conductive electrode, the DSSCs with various lengths of VASWCNTs were studied. VASWCNTs-DSSC with 34 μm original length was found to be the optimal choice in the present study. The highest conversion efficiencies of VASWCNTs-DSSC achieved 5.5%, which rivals that of the reference Pt DSSC. From the electrochemical impedance spectroscopy analysis, it shows that the new DSSC offers lower interface resistance between the electrolyte and the counter electrode. This reproducible work emphasizes the promise of VASWCNTs as efficient and stable counter electrode materials in DSSC device design, especially taking into account the low-cost merit of this promising material.

Scalable Low-Cost Fabrication of Disposable Paper Sensors for DNA Detection

PubMed Central

2015-01-01

Controlled integration of features that enhance the analytical performance of a sensor chip is a challenging task in the development of paper sensors. A critical issue in the fabrication of low-cost biosensor chips is the activation of the device surface in a reliable and controllable manner compatible with large-scale production. Here, we report stable, well-adherent, and repeatable site-selective deposition of bioreactive amine functionalities and biorepellant polyethylene glycol-like (PEG) functionalities on paper sensors by aerosol-assisted, atmospheric-pressure, plasma-enhanced chemical vapor deposition. This approach requires only 20 s of deposition time, compared to previous reports on cellulose functionalization, which takes hours. A detailed analysis of the near-edge X-ray absorption fine structure (NEXAFS) and its sensitivity to the local electronic structure of the carbon and nitrogen functionalities. σ*, π*, and Rydberg transitions in C and N K-edges are presented. Application of the plasma-processed paper sensors in DNA detection is also demonstrated. PMID:25423585

Scalable Low-Cost Fabrication of Disposable Paper Sensors for DNA Detection

DOE PAGES

Gandhiraman, Ram P.; Nordlund, Dennis; Jayan, Vivek; ...

2014-11-25

Controlled integration of features that enhance the analytical performance of a sensor chip is a challenging task in the development of paper sensors. A critical issue in the fabrication of low-cost biosensor chips is the activation of the device surface in a reliable and controllable manner compatible with large-scale production. Here, we report stable, well-adherent, and repeatable site-selective deposition of bioreactive amine functionalities and biorepellant polyethylene glycol-like (PEG) functionalities on paper sensors by aerosol-assisted, atmospheric-pressure, plasma-enhanced chemical vapor deposition. This approach requires only 20 s of deposition time, compared to previous reports on cellulose functionalization, which takes hours. We presentmore » a detailed analysis of the near-edge X-ray absorption fine structure (NEXAFS) and its sensitivity to the local electronic structure of the carbon and nitrogen functionalities. σ*, π*, and Rydberg transitions in C and N K-edges. Lastly, application of the plasma-processed paper sensors in DNA detection is also demonstrated.« less

Image Processing Occupancy Sensor

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

The Image Processing Occupancy Sensor, or IPOS, is a novel sensor technology developed at the National Renewable Energy Laboratory (NREL). The sensor is based on low-cost embedded microprocessors widely used by the smartphone industry and leverages mature open-source computer vision software libraries. Compared to traditional passive infrared and ultrasonic-based motion sensors currently used for occupancy detection, IPOS has shown the potential for improved accuracy and a richer set of feedback signals for occupant-optimized lighting, daylighting, temperature setback, ventilation control, and other occupancy and location-based uses. Unlike traditional passive infrared (PIR) or ultrasonic occupancy sensors, which infer occupancy based only onmore » motion, IPOS uses digital image-based analysis to detect and classify various aspects of occupancy, including the presence of occupants regardless of motion, their number, location, and activity levels of occupants, as well as the illuminance properties of the monitored space. The IPOS software leverages the recent availability of low-cost embedded computing platforms, computer vision software libraries, and camera elements.« less

Maternal influenza immunization in Malawi: Piloting a maternal influenza immunization program costing tool by examining a prospective program

PubMed Central

Pecenka, Clint; Munthali, Spy; Chunga, Paul; Levin, Ann; Morgan, Win; Lambach, Philipp; Bhat, Niranjan; Neuzil, Kathleen M.; Ortiz, Justin R.

2017-01-01

Background This costing study in Malawi is a first evaluation of a Maternal Influenza Immunization Program Costing Tool (Costing Tool) for maternal immunization. The tool was designed to help low- and middle-income countries plan for maternal influenza immunization programs that differ from infant vaccination programs because of differences in the target population and potential differences in delivery strategy or venue. Methods This analysis examines the incremental costs of a prospective seasonal maternal influenza immunization program that is added to a successful routine childhood immunization and antenatal care program. The Costing Tool estimates financial and economic costs for different vaccine delivery scenarios for each of the major components of the expanded immunization program. Results In our base scenario, which specifies a donated single dose pre-filled vaccine formulation, the total financial cost of a program that would reach 2.3 million women is approximately $1.2 million over five years. The economic cost of the program, including the donated vaccine, is $10.4 million over the same period. The financial and economic costs per immunized pregnancy are $0.52 and $4.58, respectively. Other scenarios examine lower vaccine uptake, reaching 1.2 million women, and a vaccine purchased at $2.80 per dose with an alternative presentation. Conclusion This study estimates the financial and economic costs associated with a prospective maternal influenza immunization program in a low-income country. In some scenarios, the incremental delivery cost of a maternal influenza immunization program may be as low as some estimates of childhood vaccination programs, assuming the routine childhood immunization and antenatal care systems are capable of serving as the platform for an additional vaccination program. However, purchasing influenza vaccines at the prices assumed in this analysis, instead of having them donated, is likely to be challenging for lower-income countries. This result should be considered as a starting point to understanding the costs of maternal immunization programs in low- and middle-income countries. PMID:29281710

Maternal influenza immunization in Malawi: Piloting a maternal influenza immunization program costing tool by examining a prospective program.

PubMed

Pecenka, Clint; Munthali, Spy; Chunga, Paul; Levin, Ann; Morgan, Win; Lambach, Philipp; Bhat, Niranjan; Neuzil, Kathleen M; Ortiz, Justin R; Hutubessy, Raymond

2017-01-01

This costing study in Malawi is a first evaluation of a Maternal Influenza Immunization Program Costing Tool (Costing Tool) for maternal immunization. The tool was designed to help low- and middle-income countries plan for maternal influenza immunization programs that differ from infant vaccination programs because of differences in the target population and potential differences in delivery strategy or venue. This analysis examines the incremental costs of a prospective seasonal maternal influenza immunization program that is added to a successful routine childhood immunization and antenatal care program. The Costing Tool estimates financial and economic costs for different vaccine delivery scenarios for each of the major components of the expanded immunization program. In our base scenario, which specifies a donated single dose pre-filled vaccine formulation, the total financial cost of a program that would reach 2.3 million women is approximately $1.2 million over five years. The economic cost of the program, including the donated vaccine, is $10.4 million over the same period. The financial and economic costs per immunized pregnancy are $0.52 and $4.58, respectively. Other scenarios examine lower vaccine uptake, reaching 1.2 million women, and a vaccine purchased at $2.80 per dose with an alternative presentation. This study estimates the financial and economic costs associated with a prospective maternal influenza immunization program in a low-income country. In some scenarios, the incremental delivery cost of a maternal influenza immunization program may be as low as some estimates of childhood vaccination programs, assuming the routine childhood immunization and antenatal care systems are capable of serving as the platform for an additional vaccination program. However, purchasing influenza vaccines at the prices assumed in this analysis, instead of having them donated, is likely to be challenging for lower-income countries. This result should be considered as a starting point to understanding the costs of maternal immunization programs in low- and middle-income countries.

A Cost Comparison Between Active and Naval Reserve Force FFG 7 Class Ships

DTIC Science & Technology

1993-06-01

so in our hypothetical depreciation schedule 1/30th of the depreciable cost would be expensed each year. Under GAAP , the historical cost of the asset...and Support Costs (VAMOSC) data base provided by the* aval Center For Cost Analysis. The thesis also sets up theoretical depreciation schedules for...VAMOSC) data base provided by the Naval Center for Cost Analysis. The thesis also sets up theoretical depreciation schedules for selected ships to

Low cost ground receiving systems for television signals from high powered communications satellites, volume 1

NASA Technical Reports Server (NTRS)

Hesler, J. P.; Hwang, Y. C.; Zampini, J. J.

1972-01-01

The fabrication and evaluation of 10 engineering prototype ground signal processing systems of three converter types are reported for use with satellite television. Target cost converters and cost sensitivity analysis are discussed along with the converter configurations.

Implementation of a cost-accounting model in a biobank: practical implications.

PubMed

Gonzalez-Sanchez, Maria Beatriz; Lopez-Valeiras, Ernesto; García-Montero, Andres C

2014-01-01

Given the state of global economy, cost measurement and control have become increasingly relevant over the past years. The scarcity of resources and the need to use these resources more efficiently is making cost information essential in management, even in non-profit public institutions. Biobanks are no exception. However, no empirical experiences on the implementation of cost accounting in biobanks have been published to date. The aim of this paper is to present a step-by-step implementation of a cost-accounting tool for the main production and distribution activities of a real/active biobank, including a comprehensive explanation on how to perform the calculations carried out in this model. Two mathematical models for the analysis of (1) production costs and (2) request costs (order management and sample distribution) have stemmed from the analysis of the results of this implementation, and different theoretical scenarios have been prepared. Global analysis and discussion provides valuable information for internal biobank management and even for strategic decisions at the research and development governmental policies level.

Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness.

PubMed

Reilly, Kathryn L; Reeves, Penny; Deeming, Simon; Yoong, Sze Lin; Wolfenden, Luke; Nathan, Nicole; Wiggers, John

2018-03-20

No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy. An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy. The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness. The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.

Cost-analysis of an oral health outreach program for preschool children in a low socioeconomic multicultural area in Sweden.

PubMed

Wennhall, Inger; Norlund, Anders; Matsson, Lars; Twetman, Svante

2010-01-01

The aim was to calculate the total and the net costs per child included in a 3-year caries preventive program for preschool children and to make estimates of expected lowest and highest costs in a sensitivity analysis. The direct costs for prevention and dental care were applied retrospectively to a comprehensive oral health outreach project for preschool children conducted in a low-socioeconomic multi-cultural urban area. The outcome was compared with historical controls from the same area with conventional dental care. The cost per minute for the various dental professions was added to the cost of materials, rental facilities and equipment based on accounting data. The cost for fillings was extracted from a specified per diem list. Overhead costs were assumed to correspond to 50% of salaries and all costs were calculated as net present value per participating child in the program and expressed in Euro. The results revealed an estimated total cost of 310 Euro per included child (net present value) in the 3-year program. Half of the costs were attributed to the first year of the program and the costs of manpower constituted 45% of the total costs. When the total cost was reduced with the cost of conventional care and the revenue of avoided fillings, the net cost was estimated to 30 Euro. A sensitivity analysis displayed that a net gain could be possible with a maximal outcome of the program. In conclusion, the estimated net costs were displayed and available to those considering implementation of a similar population-based preventive program in areas where preschool children are at high caries risk.

Low Cost Electroencephalographic Acquisition Amplifier to serve as Teaching and Research Tool

PubMed Central

Jain, Ankit; Kim, Insoo; Gluckman, Bruce J.

2012-01-01

We describe the development and testing of a low cost, easily constructed electroencephalographic acquisition amplifier for noninvasive Brain Computer Interface (BCI) education and research. The acquisition amplifier is constructed from newly available off-the-shelf integrated circuit components, and readily sends a 24-bit data stream via USB bus to a computer platform. We demonstrate here the hardware’s use in the analysis of a visually evoked P300 paradigm for a choose one-of-eight task. This clearly shows the applicability of this system as a low cost teaching and research tool. PMID:22254699

Toward a low-cost gait analysis system for clinical and free-living assessment.

PubMed

Ladha, Cassim; Del Din, Silvia; Nazarpour, Kianoush; Hickey, Aodhan; Morris, Rosie; Catt, Michael; Rochester, Lynn; Godfrey, Alan

2016-08-01

Gait is an important clinical assessment tool since changes in gait may reflect changes in general health. Measurement of gait is a complex process which has been restricted to bespoke clinical facilities until recently. The use of inexpensive wearable technologies is an attractive alternative and offers the potential to assess gait in any environment. In this paper we present the development of a low cost analysis gait system built using entirely open source components. The system is used to capture spatio-temporal gait characteristics derived from an existing conceptual model, sensitive to ageing and neurodegenerative pathology (e.g. Parkinson's disease). We demonstrate the system is suitable for use in a clinical unit and will lead to pragmatic use in a free-living (home) environment. The system consists of a wearable (tri-axial accelerometer and gyroscope) with a Raspberry Pi module for data storage and analysis. This forms ongoing work to develop gait as a low cost diagnostic in modern healthcare.

Cognitive costs of encoding novel natural activities: Can "learning by doing" be distracting and deceptive?

PubMed

von Stülpnagel, Rul; Schult, Janette C; Richter, Claudia; Steffens, Melanie C

2016-01-01

Findings from action memory research suggest that the enactment of simple actions and naturalistic activities results in similar memory performance to that from their observation. However, little is known about potential differences between the conditions during the encoding of the to-be-studied actions and activities. We analysed the cognitive costs of encoding two novel naturalistic activities studied via enactment or via observation in four experiments. In addition to memory performance, we measured objective cognitive costs with a secondary task and subjective cognitive costs with repeated ratings of mental effort and estimates of general activity difficulty. Memory performance was comparable across study conditions throughout all experiments. The enactment of activities repeatedly resulted in slower reaction times in the secondary task than did observation, suggesting higher objective costs. In contrast, subjective costs were rated lower after enactment than after observation. Findings from a pantomimic enactment condition suggested that the low ratings of subjective costs after enactment represent a misinterpretation of task demands. Our findings imply that the widespread belief about "learning by doing" as an easy way of learning does not stem from an actual advantage in memory performance, but rather from continuous feedback about one's performance resulting from enactment.

Evaluation of a Low-cost and Low-noise Active Dry Electrode for Long-term Biopotential Recording

PubMed Central

Pourahmad, Ali; Mahnam, Amin

2016-01-01

Wet Ag/AgCl electrodes, although very popular in clinical diagnosis, are not appropriate for expanding applications of wearable biopotential recording systems which are used repetitively and for a long time. Here, the development of a low-cost and low-noise active dry electrode is presented. The performance of the new electrodes was assessed for recording electrocardiogram (ECG) and electroencephalogram (EEG) in comparison with that of typical gel-based electrodes in a series of long-term recording experiments. The ECG signal recorded by these electrodes was well comparable with usual Ag/AgCl electrodes with a correlation up to 99.5% and mean power line noise below 6.0 μVRMS. The active electrodes were also used to measure alpha wave and steady state visual evoked potential by recording EEG. The recorded signals were comparable in quality with signals recorded by standard gel electrodes, suggesting that the designed electrodes can be employed in EEG-based rehabilitation systems and brain-computer interface applications. The mean power line noise in EEG signals recorded by the active electrodes (1.3 μVRMS) was statistically lower than when conventional gold cup electrodes were used (2.0 μVRMS) with a significant level of 0.05, and the new electrodes appeared to be more resistant to the electromagnetic interferences. These results suggest that the developed low-cost electrodes can be used to develop wearable monitoring systems for long-term biopotential recording. PMID:28028495

Comparison between low-cost marker-less and high-end marker-based motion capture systems for the computer-aided assessment of working ergonomics.

PubMed

Patrizi, Alfredo; Pennestrì, Ettore; Valentini, Pier Paolo

2016-01-01

The paper deals with the comparison between a high-end marker-based acquisition system and a low-cost marker-less methodology for the assessment of the human posture during working tasks. The low-cost methodology is based on the use of a single Microsoft Kinect V1 device. The high-end acquisition system is the BTS SMART that requires the use of reflective markers to be placed on the subject's body. Three practical working activities involving object lifting and displacement have been investigated. The operational risk has been evaluated according to the lifting equation proposed by the American National Institute for Occupational Safety and Health. The results of the study show that the risk multipliers computed from the two acquisition methodologies are very close for all the analysed activities. In agreement to this outcome, the marker-less methodology based on the Microsoft Kinect V1 device seems very promising to promote the dissemination of computer-aided assessment of ergonomics while maintaining good accuracy and affordable costs. PRACTITIONER’S SUMMARY: The study is motivated by the increasing interest for on-site working ergonomics assessment. We compared a low-cost marker-less methodology with a high-end marker-based system. We tested them on three different working tasks, assessing the working risk of lifting loads. The two methodologies showed comparable precision in all the investigations.

Low-Budget Computer Programming in Your School (An Alternative to the Cost of Large Computers). Illinois Series on Educational Applications of Computers. No. 14.

ERIC Educational Resources Information Center

Dennis, J. Richard; Thomson, David

This paper is concerned with a low cost alternative for providing computer experience to secondary school students. The brief discussion covers the programmable calculator and its relevance for teaching the concepts and the rudiments of computer programming and for computer problem solving. A list of twenty-five programming activities related to…

Pits, pipes, ponds--and me.

PubMed

Mara, Duncan

2013-05-01

My life in low-cost sanitation and low-cost wastewater treatment and the use of treated wastewater in agriculture and aquaculture really has been 'pits, pipes and ponds' - 'pits' are low-cost sanitation technologies (LCST) such as VIP latrines and pour-flush toilets; 'pipes' are low-cost sewerage, principally condominial (simplified) sewerage; and 'ponds' are low-cost wastewater treatment systems, especially waste stabilization ponds, and the use of treated wastewater in agriculture and aquaculture. 'Pits' were mainly working on World Bank LCST research projects, with fieldwork principally in Zimbabwe, 'pipes' were working on condominial sewerage projects in Brazil and disseminating this LCST to a wider global audience, and 'ponds' were waste stabilization ponds, with fieldwork mainly in Brazil, Colombia, Portugal and the United Kingdom, the development of aerated rock filters to polish facultative-pond effluents, and the human-health aspects of treated wastewater use in agriculture and aquaculture, with fieldwork in Brazil and the UK, and the application of quantitative microbial risk analysis. The paper provides a professional perspective and lessons from historical developments and gives recommended future directions based on my career working on low-cost sanitation technologies and treated wastewater use in agriculture and aquaculture. Copyright © 2013 Elsevier Ltd. All rights reserved.

Daily calcium intake and physical activity status in urban women living on low incomes in Davao, Philippines: a primary study for osteoporosis prevention.

PubMed

Miura, Shoko; Nakamori, Masayo; Yagi, Masumi; Saavedra, Ophelia L; Ikemoto, Shinji; Yamamoto, Shigeru

2009-08-01

Low calcium intake and physical inactivity are modifiable risk factors of osteoporosis; however, little information is available about the prevalence of these risk factors among urban Filipino women living on low-incomes. The present study, therefore, investigated daily calcium intake, main calcium sources, and physical activity status in this population. The study group comprised healthy women aged in their 30 s who had participated in our previous survey using heel speed of sound (SOS) measurement in Davao, Philippines. The women were stratified into three groups based on SOS score and 20 were randomly selected from each, giving 60 in total. Calcium intake was measured by direct analysis of the food samples collected from 3-days 24 hour-food duplicate method. Physical activity was estimated based on pedometer determined walking steps over 5 days. The median [25%, 75%] calcium intake per day was 289 [225, 434] mg. Traditional foods derived from local small fish and plants were the main calcium sources. The median walking steps per day was 8750 [6920, 10836]. Although three groups did not show significantly different calcium intakes and walking steps, consumption of low-cost small fish and plant foods could be encouraged along with walking in urban Filipino women living on low-incomes.

Balancing low cost with reliable operation in the rotordynamic design of the ALS Liquid Hydrogen Fuel Turbopump

NASA Technical Reports Server (NTRS)

Greenhill, L. M.

1990-01-01

The Air Force/NASA Advanced Launch System (ALS) Liquid Hydrogen Fuel Turbopump (FTP) has primary design goals of low cost and high reliability, with performance and weight having less importance. This approach is atypical compared with other rocket engine turbopump design efforts, such as on the Space Shuttle Main Engine (SSME), which emphasized high performance and low weight. Similar to the SSME turbopumps, the ALS FTP operates supercritically, which implies that stability and bearing loads strongly influence the design. In addition, the use of low cost/high reliability features in the ALS FTP such as hydrostatic bearings, relaxed seal clearances, and unshrouded turbine blades also have a negative influence on rotordynamics. This paper discusses the analysis conducted to achieve a balance between low cost and acceptable rotordynamic behavior, to ensure that the ALS FTP will operate reliably without subsynchronous instabilities or excessive bearing loads.

Economic evaluation on CO₂-EOR of onshore oil fields in China

DOE PAGES

Wei, Ning; Li, Xiaochun; Dahowski, Robert T.; ...

2015-06-01

Carbon dioxide enhanced oil recovery (CO₂-EOR) and sequestration in depleted oil reservoirs is a plausible option for utilizing anthropogenic CO₂ to increase oil production while storing CO₂ underground. Evaluation of the storage resources and cost of potential CO₂-EOR projects is an essential step before the commencement of large-scale deployment of such activities. In this paper, a hybrid techno-economic evaluation method, including a performance model and cost model for onshore CO₂-EOR projects, has been developed based on previous studies. Total 296 onshore oil fields, accounting for about 70% of total mature onshore oil fields in China, were evaluated by the techno-economicmore » method. The key findings of this study are summarized as follows: (1) deterministic analysis shows there are approximately 1.1 billion tons (7.7 billion barrels) of incremental crude oil and 2.2 billion tons CO₂ storage resource for onshore CO₂-EOR at net positive revenue within the Chinese oil fields reviewed under the given operating strategy and economic assumptions. (2) Sensitivity study highlights that the cumulative oil production and cumulative CO₂ storage resource are very sensitive to crude oil price, CO₂ cost, project lifetime, discount rate and tax policy. High oil price, short project lifetime, low discount rate, low CO₂ cost, and low tax policy can greatly increase the net income of the oil enterprise, incremental oil recovery and CO₂ storage resource. (3) From this techno-economic evaluation, the major barriers to large-scale deployment of CO₂-EOR include complex geological conditions, low API of crude oil, high tax policy, and lack of incentives for the CO₂-EOR project.« less

Economic evaluation on CO₂-EOR of onshore oil fields in China

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

Wei, Ning; Li, Xiaochun; Dahowski, Robert T.

Carbon dioxide enhanced oil recovery (CO₂-EOR) and sequestration in depleted oil reservoirs is a plausible option for utilizing anthropogenic CO₂ to increase oil production while storing CO₂ underground. Evaluation of the storage resources and cost of potential CO₂-EOR projects is an essential step before the commencement of large-scale deployment of such activities. In this paper, a hybrid techno-economic evaluation method, including a performance model and cost model for onshore CO₂-EOR projects, has been developed based on previous studies. Total 296 onshore oil fields, accounting for about 70% of total mature onshore oil fields in China, were evaluated by the techno-economicmore » method. The key findings of this study are summarized as follows: (1) deterministic analysis shows there are approximately 1.1 billion tons (7.7 billion barrels) of incremental crude oil and 2.2 billion tons CO₂ storage resource for onshore CO₂-EOR at net positive revenue within the Chinese oil fields reviewed under the given operating strategy and economic assumptions. (2) Sensitivity study highlights that the cumulative oil production and cumulative CO₂ storage resource are very sensitive to crude oil price, CO₂ cost, project lifetime, discount rate and tax policy. High oil price, short project lifetime, low discount rate, low CO₂ cost, and low tax policy can greatly increase the net income of the oil enterprise, incremental oil recovery and CO₂ storage resource. (3) From this techno-economic evaluation, the major barriers to large-scale deployment of CO₂-EOR include complex geological conditions, low API of crude oil, high tax policy, and lack of incentives for the CO₂-EOR project.« less

Solubilization and Upgrading of High Polyethylene Terephthalate Loadings in a Low-Costing Bifunctional Ionic Liquid

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

Sun, Jian; Liu, Dajiang; Young, Robert P.

Polyethylene terephthalate (PET) is of significant commercial importance, but is difficult to recycle. Chemical inertness and resistance to biodegradation make the recycling of PET challenging and most solvents for PET are highly toxic. In this work, we demonstrate for the first time that a low cost (~$1.2/kg) and biocompatible ionic liquid (IL), cholinium phosphate ([Ch]3[PO4]) can play bifunctional roles in PET solubilization and glycolytic degradation. High loading of PET (10 wt%) is readily dissolved in [Ch]3[PO4] at relatively low temperatures (120 °C, 1h) and even in water-rich conditions. Tandem in situ confocal microscopy and Fourier Transform Infrared (FTIR) spectroscopy studiesmore » give detailed information on the solubilization mechanism in terms of morphological and chemical changes that occur. In depth analysis of PET-IL solution reveals that the high PET solubilization in [Ch]3[PO4] can be ascribed to significant PET depolymerization. Acid precipitation yields terephthalic acid as the dominant depolymerized monomer with a theoretical yield of ~95%. Further exploration shows that in the presence of ethylene glycol, [Ch]3[PO4] catalyzed glycolysis of PET can efficiently occur with ~100% PET conversion and ~60.6% bis(2-hydroxyethyl)terephthalate (BHET) yield under metal free conditions. The IL can be reused at least three times without an apparent decrease in activity. NMR analysis reveals that strong hydrogen bond interactions between EG and the IL play an important role for EG activation and promotion of the glycolysis reaction. This study opens up avenues for exploring environmentally benign and efficient technology of ILs for solubilizing and recycling postconsumer polyester plastics.« less

Analysis of the costs of dialysis and the effects of an incentive mechanism for low-cost dialysis modalities.

PubMed

Cleemput, Irina; De Laet, Chris

2013-05-01

Treatment costs of end-stage renal disease with dialysis are high and vary between dialysis modalities. Public healthcare payers aim at stimulating the use of less expensive dialysis modalities, with maintenance of healthcare quality. This study examines the effects of Belgian financial incentive mechanisms for the use of low-cost dialysis treatments. First, the costs of different dialysis modalities were calculated from the hospital's perspective. Data were obtained through a hospital survey. The balance between costs and revenues was simulated for an average Belgian dialysis programme. Incremental profits were calculated in function of the proportion of patients on alternative dialysis modalities. Hospital haemodialysis is the most expensive modality per patient year, followed by peritoneal dialysis and finally satellite haemodialysis. Under current reimbursement rules mean profits of a dialysis programme are maximal if about 28% of patients are treated with a low-cost dialysis modality. This is only slightly lower than the observed percentage in Belgian dialysis centres in the same period. In Belgium, the financial incentives for the use of low-cost dialysis modalities only had a modest impact due to the continuing profits that could be generated by high-cost dialysis. Profit neutrality is crucial for the success of any financial incentive mechanism for low-cost dialysis modalities. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Early Childhood Benefits at Low Cost--Evidence from a Randomized Trail in Mexico

ERIC Educational Resources Information Center

Cárdenas, Sergio; Evans, David K.; Holland, Peter

2015-01-01

The evidence that investments in early child development can pay high, long-term dividends, is mounting, both in developed and developing countries. However, recent meta-analysis identified very few studies in developing countries. The authors report on the evaluation impact of a low-cost, community-based parent training program for early child…

Development of a low-cost NIR instrument for minced meat analysis: Part 1 - Spectrophotometer and sample presentations

USDA-ARS?s Scientific Manuscript database

The feasibility of using a compact, low-cost NIR spectrophotometer to predict moisture (MC) and total fat content of minced pork was demonstrated. Results were compared with those obtained using two research type instruments with high signal to noise ratio (S/N). The NIR measuring head of the compac...

Preparation and properties of low-cost graphene counter electrodes for dye-sensitized solar cells

NASA Astrophysics Data System (ADS)

Wu, Qishuang; Shen, Yue; Wang, Qiandi; Gu, Feng; Cao, Meng; Wang, Linjun

2013-12-01

With the advantages of excellent electrical properties, high catalytic activity and low-cost preparation, Graphene is one of the most expected carbon materials to replace the expensive Pt as counter electrodes for dye-sensitized solar cells (DSSCs). In this paper, graphene counter electrodes were obtained by simple doctor-blade coating method on fluorine tin oxides (FTOs). The samples were investigated by X-ray diffraction (XRD), Raman spectroscopy and scanning electron microscope (SEM). Then the low-cost graphene electrodes were applied in typical sandwich-type DSSCs with TiO2 or ZnO as photoanodes, and their photoelectric conversion efficiency (η) were about 4.34% and 2.28%, respectively, which were a little lower than those of Pt electrodes but much higher than those of graphite electrodes. This law was consistent with the test results of electrochemical impedance spectroscopy (EIS). Low-cost graphene electrodes can be applied in DSSCs by process optimization.

Flight related tuberculosis contact investigations in the United States: comparative risk and economic analysis of alternate protocols.

PubMed

Marienau, Karen J; Cramer, Elaine H; Coleman, Margaret S; Marano, Nina; Cetron, Martin S

2014-01-01

In-flight transmission risk of Mycobacterium tuberculosis is not well defined, although studies suggest it is low. The impact of flight-related tuberculosis (TB) contact investigations (TBCIs) on TB prevention and control is not well established, and they compete for resources with activities with established benefits. We sought to determine the risks and cost-benefits of using more restrictive criteria in comparison to the Centers for Disease Control and Prevention (CDC) 2008 protocol for TBCIs. The risk-benefits of a modified CDC protocol were analyzed in comparison to the 2008 CDC protocol using data from flight-related TBCIs conducted in the United States from 2007 through 2009. We predicted the numbers and characteristics of case-travelers that would be identified using each protocol's criteria, and results of the associated passenger-contacts' TB screening tests. The economic analysis compared the costs of TBCIs to avoided costs of TB treatment and mortality using a Return on Investment model. The estimated in-flight transmission risk using a modified CDC protocol was 1.4%-19% versus 1.1%-24% for the 2008 protocol. Numbers of TBCIs and immediate costs to health departments were reduced by half. Long-term cost-benefits were comparable. CDC's modified protocol appears to be a feasible alternative that will conserve public health resources without jeopardizing the public's health. Published by Elsevier Ltd.

A cost analysis of microalgal biomass and biodiesel production in open raceways treating municipal wastewater and under optimum light wavelength.

PubMed

Kang, Zion; Kim, Byung-Hyuk; Ramanan, Rishiram; Choi, Jong-Eun; Yang, Ji-Won; Oh, Hee-Mock; Kim, Hee-Sik

2015-01-01

Open raceway ponds are cost-efficient for mass cultivation of microalgae compared with photobioreactors. Although low-cost options like wastewater as nutrient source is studied to overcome the commercialization threshold for biodiesel production from microalgae, a cost analysis on the use of wastewater and other incremental increases in productivity has not been elucidated. We determined the effect of using wastewater and wavelength filters on microalgal productivity. Experimental results were then fitted into a model, and cost analysis was performed in comparison with control raceways. Three different microalgal strains, Chlorella vulgaris AG10032, Chlorella sp. JK2, and Scenedesmus sp. JK10, were tested for nutrient removal under different light wavelengths (blue, green, red, and white) using filters in batch cultivation. Blue wavelength showed an average of 27% higher nutrient removal and at least 42% higher chemical oxygen demand removal compared with white light. Naturally, the specific growth rate of microalgae cultivated under blue wavelength was on average 10.8% higher than white wavelength. Similarly, lipid productivity was highest in blue wavelength, at least 46.8% higher than white wavelength, whereas FAME composition revealed a mild increase in oleic and palmitic acid levels. Cost analysis reveals that raceways treating wastewater and using monochromatic wavelength would decrease costs from 2.71 to 0.73 $/kg biomass. We prove that increasing both biomass and lipid productivity is possible through cost-effective approaches, thereby accelerating the commercialization of low-value products from microalgae, like biodiesel.

Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market

PubMed Central

2013-01-01

Background The price of antiretroviral drugs (ARVs) in low income countries declined steadily in recent years. This raises concerns about the commercial viability of the market of ARVs in low income countries. Methods Using 2 costing scenarios, we modeled the production cost of the most commonly used ARVs in low income countries in 2010 and 2012, and assessed whether, at the median price paid by low income countries, their manufacturers would still make profits. By interviews we consulted 11 generic manufacturers on the current state of the ARV market, and on what would be required to ensure their continued commitment to supply ARVs to low income countries. Results Using the lowest prices for active pharmaceutical ingredients (API) quoted to WHO, and applying published assumptions about the production cost of ARVs, our baseline estimate was that Indian generic manufacturers would have made profits on only 1 out of 13 formulations of ARVs in both 2010 and 2012, and publicly owned manufacturers would have made profits on 5 and 3 out of 13 formulations in 2010 and 2012, respectively. We needed to assume a 20% and a 40% lower API cost for our model to predict that publicly owned and Indian manufacturers, respectively, would make profits on the sale of the majority of their ARVs. Between 2010 and 2012, we estimate that - across the ARV portfolio - the gross profit on sales of ARVs to low income countries decreased with between 6% and 7% of their sales price. Generic manufacturers consider that current prices are unsustainable. They suggested amendments to the tender procedures, simplified regulatory procedures, improved forecasting, and simplification of the ARV guidelines as critical improvements to maintain a viable ARV market. Conclusions While recent price decreases indicate that there is still space for price reduction, our estimate that gross profit margin on sales decreased by 6 to 7% between 2010 and 2012 lends credibility to assertions by generic manufacturers that the ARV market in low income countries is under considerable price pressure. This might create problems for the quality and/or the continued supply of ARVs to low income countries. PMID:23410145

Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market.

PubMed

Nakakeeto, Olive N; Elliott, Brian V

2013-02-15

The price of antiretroviral drugs (ARVs) in low income countries declined steadily in recent years. This raises concerns about the commercial viability of the market of ARVs in low income countries. Using 2 costing scenarios, we modeled the production cost of the most commonly used ARVs in low income countries in 2010 and 2012, and assessed whether, at the median price paid by low income countries, their manufacturers would still make profits. By interviews we consulted 11 generic manufacturers on the current state of the ARV market, and on what would be required to ensure their continued commitment to supply ARVs to low income countries. Using the lowest prices for active pharmaceutical ingredients (API) quoted to WHO, and applying published assumptions about the production cost of ARVs, our baseline estimate was that Indian generic manufacturers would have made profits on only 1 out of 13 formulations of ARVs in both 2010 and 2012, and publicly owned manufacturers would have made profits on 5 and 3 out of 13 formulations in 2010 and 2012, respectively. We needed to assume a 20% and a 40% lower API cost for our model to predict that publicly owned and Indian manufacturers, respectively, would make profits on the sale of the majority of their ARVs. Between 2010 and 2012, we estimate that--across the ARV portfolio--the gross profit on sales of ARVs to low income countries decreased with between 6% and 7% of their sales price. Generic manufacturers consider that current prices are unsustainable. They suggested amendments to the tender procedures, simplified regulatory procedures, improved forecasting, and simplification of the ARV guidelines as critical improvements to maintain a viable ARV market. While recent price decreases indicate that there is still space for price reduction, our estimate that gross profit margin on sales decreased by 6 to 7% between 2010 and 2012 lends credibility to assertions by generic manufacturers that the ARV market in low income countries is under considerable price pressure. This might create problems for the quality and/or the continued supply of ARVs to low income countries.

Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

PubMed

Gregório, João; Russo, Giuliano; Lapão, Luís Velez

2016-01-01

The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimization in the design of a 12 gigahertz low cost ground receiving system for broadcast satellites. Volume 1: System design, performance, and cost analysis

NASA Technical Reports Server (NTRS)

Ohkubo, K.; Han, C. C.; Albernaz, J.; Janky, J. M.; Lusignan, B. B.

1972-01-01

The technical and economical feasibility of using the 12 GHz band for broadcasting from satellites were examined. Among the assigned frequency bands for broadcast satellites, the 12 GHz band system offers the most channels. It also has the least interference on and from the terrestrial communication links. The system design and analysis are carried out on the basis of a decision analysis model. Technical difficulties in achieving low-cost 12 GHz ground receivers are solved by making use of a die cast aluminum packaging, a hybrid integrated circuit mixer, a cavity stabilized Gunn oscillator and other state-of-the-art microwave technologies for the receiver front-end. A working model was designed and tested, which used frequency modulation. A final design for the 2.6 GHz system ground receiver is also presented. The cost of the ground-terminal was analyzed and minimized for a given figure-of-merit (a ratio of receiving antenna gain to receiver system noise temperature). The results were used to analyze the performance and cost of the whole satellite system.

Cost-effectiveness of sofosbuvir plus ribavirin with or without pegylated interferon for the treatment of chronic hepatitis C in Italy.

PubMed

Cure, Sandrine; Guerra, Ines; Cammà, Calogero; Craxì, Antonio; Carosi, Giampiero

2015-01-01

Across Italy up to 7.3% of the population is infected with hepatitis C virus (HCV), with long-term complications resulting in high medical costs and significant morbidity and mortality. Current treatment options have limitations due to side effects, interferon intolerability and ineligibility, long treatment durations and low sustained virological response (SVR) rates, especially for the most severe patients). Sofosbuvir is the first nucleotide polymerase inhibitor with pan-genotypic activity. Sofosbuvir, administered with ribavirin (RBV) and with or without pegylated interferon (PEG-INF), resulted in >90% SVR across treatment-naïve (TN) genotype (GT) 1-6 patients. It is also the first treatment option for patients that are unsuitable for interferon (UI). This analysis evaluates the cost - effectiveness of sofosbuvir for GTs 1-6 in Italy. A Markov model followed a cohort of 10,000 patients until they reached 80 years old. Approximately 20% of naïve and 30% of experienced patients initiated treatment at the cirrhosis stage. Comparators included PEG-INF + RBV for all GTs and plus telaprevir or boceprevir for GT1, or no treatment. Costs and outcomes were discounted at 3% and the cost perspective was that of the National Health Service in Italy. Sofosbuvir was cost-effective with incremental cost-effectiveness ratios (ICERs) below €40,000/QALY in all patient populations, particularly in cirrhotic patients. The exception was for a mixed cohort of GT2 TN patients where the ICER was €68,500/QALY and for a cirrhotic cohort of GT4/5/6 where the ICER was €68,434/QALY. Nevertheless, the prevalence of HCV in this patient population is expected to be low. Results were robust to sensitivity analysis. Sofosbuvir-based regimens are cost-effective in Italy, particular for the most severe patients. The interferon-free regimens are a real treatment option for UI patients. The high cure rates of this breakthrough treatment are expected to substantially reduce the burden of HCV in Italy.

MISSE-7 MESA Miniaturized Electrostatic Analyzer - Ion Spectra Analysis Preliminary Results

NASA Astrophysics Data System (ADS)

Enloe, C. L.; Balthazor, R. L.; McHarg, M. G.; Clark, A. L.; Waite, D.; Wallerstein, A. J.; Wilson, K. A.

2011-12-01

The 7th Materials on the International Space Station Experiment (MISSE-7) was launched in November 2009 and retrieved on STS-134 in April 2011. One of the onboard experiments, the Miniaturized Electrostatic Analyzer (MESA), is a small low-cost low-size/weight/power ion and electron spectrometer that was pointed into ram during the majority of the time onboard. Over 800 Mb of data has been obtained by taking spectra every three minutes on-orbit. The data has been analyzed with a novel "parameterizing the parameters" method suitable for on-orbit data analysis using low-cost microcontrollers. Preliminary results are shown.

Economic Costs of Childhood Lead Exposure in Low- and Middle-Income Countries

PubMed Central

Trasande, Leonardo

2013-01-01

Background: Children’s blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries. Objective: Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries. Methods: We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure. Results: We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6–1162.5 billion. Conclusions: We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries. Citation: Attina TM, Trasande L. 2013. Economic costs of childhood lead exposure in low- and middle-income countries. Environ Health Perspect 121:1097–1102; http://dx.doi.org/10.1289/ehp.1206424 PMID:23797342

Screening, prevention and treatment of cervical cancer -- a global and regional generalized cost-effectiveness analysis.

PubMed

Ginsberg, Gary Michael; Edejer, Tessa Tan-Torres; Lauer, Jeremy A; Sepulveda, Cecilia

2009-10-09

The paper calculates regional generalized cost-effectiveness estimates of screening, prevention, treatment and combined interventions for cervical cancer. Using standardised WHO-CHOICE methodology, a cervical cancer model was employed to provide estimates of screening, vaccination and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. In regions characterized by high income, low mortality and high existing treatment coverage, the addition of any screening programme to the current high treatment levels is very cost-effective. However, based on projections of the future price per dose (representing the economic costs of the vaccination excluding monopolistic rents and vaccine development cost) vaccination is the most cost-effective intervention. In regions characterized by low income, low mortality and existing treatment coverage around 50%, expanding treatment with or without combining it with screening appears to be cost-effective or very cost-effective. Abandoning treatment in favour of screening in a no-treatment scenario would not be cost-effective. Vaccination is usually the most cost-effective intervention. Penta or tri-annual PAP smears appear to be cost-effective, though when combined with HPV-DNA testing they are not cost-effective. In regions characterized by low income, high mortality and low treatment levels, expanding treatment with or without adding screening would be very cost-effective. A one off vaccination plus expanding treatment was usually very cost-effective. One-off PAP or VIA screening at age 40 are more cost-effective than other interventions though less effective overall. From a cost-effectiveness perspective, consideration should be given to implementing vaccination (depending on cost per dose and longevity of efficacy) and screening programmes on a worldwide basis to reduce the burden of disease from cervical cancer. Treatment should also be increased where coverage is low.

GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa.

PubMed

Emmett, Susan D; Tucci, Debara L; Smith, Magteld; Macharia, Isaac M; Ndegwa, Serah N; Nakku, Doreen; Mukara, Kaitesi B; Kaitesi, Mukara B; Ibekwe, Titus S; Mulwafu, Wakisa; Gong, Wenfeng; Francis, Howard W; Saunders, James E

2015-09-01

Cochlear implantation and deaf education are cost effective in Sub-Saharan Africa. Cost effectiveness of pediatric cochlear implantation has been well established in developed countries but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe-to-profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the United States and Europe, developing cost-effective management strategies in these settings is critical. Costs were obtained from experts in Nigeria, South Africa, Kenya, Rwanda, Uganda, and Malawi using known costs and published data, with estimation when necessary. A disability adjusted life years (DALY) model was applied using 3% discounting and 10-year length of analysis. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the WHO standard of cost-effectiveness ratio/gross domestic product per capita (CER/GDP) less than 3. Cochlear implantation was cost effective in South Africa and Nigeria, with CER/GDP of 1.03 and 2.05, respectively. Deaf education was cost effective in all countries investigated, with CER/GDP ranging from 0.55 to 1.56. The most influential factor in the sensitivity analysis was device cost, with the cost-effective threshold reached in all countries using discounted device costs that varied directly with GDP. Cochlear implantation and deaf education are equally cost effective in lower-middle and upper-middle income economies of Nigeria and South Africa. Device cost may have greater impact in the emerging economies of Kenya, Uganda, Rwanda, and Malawi.

Cost-effectiveness analysis of offering free leisure centre memberships to physically inactive members of the public receiving state benefits: a case study.

PubMed

Verhoef, Talitha I; Trend, Verena; Kelly, Barry; Robinson, Nigel; Fox, Paul; Morris, Stephen

2016-07-22

We evaluated the cost-effectiveness of the Give-it-a-Go programme, which offers free leisure centre memberships to physically inactive members of the public in a single London Borough receiving state benefits. A decision analytic Markov model was developed to analyse lifetime costs and quality-adjusted life-years (QALYs) of 1025 people recruited to the intervention versus no intervention. In the intervention group, people were offered 4 months of free membership at a leisure centre. Physical activity levels were assessed at 0 and 4 months using the International Physical Activity Questionnaire (IPAQ). Higher levels of physical activity were assumed to decrease the risk of coronary heart disease, stroke and diabetes mellitus type II, as well as improve mental health. Costs were assessed from a National Health Service (NHS) perspective. Uncertainty was assessed using one-way and probabilistic sensitivity analyses. One-hundred fifty nine participants (15.5 %) completed the programme by attending the leisure centre for 4 months. Compared with no intervention, Give it a Go increased costs by £67.25 and QALYs by 0.0033 (equivalent to 1.21 days in full health) per recruited person. The incremental costs per QALY gained were £20,347. The results were highly sensitive to the magnitude of mental health gain due to physical activity and the duration of the effect of the programme (1 year in the base case analysis). When the mental health gain was omitted from the analysis, the incremental cost per QALY gained increased to almost £1.5 million. In the probabilistic sensitivity analysis, the incremental costs per QALY gained were below £20,000 in 39 % of the 5000 simulations. Give it a Go did not significantly increase life-expectancy, but had a positive influence on quality of life due to the mental health gain of physical activity. If the increase in physical activity caused by Give it a Go lasts for more than 1 year, the programme would be cost-effective given a willingness to pay for a QALY of £20,000.

Economic evaluation of alternative wastewater treatment plant options for pulp and paper industry.

PubMed

Buyukkamaci, Nurdan; Koken, Emre

2010-11-15

Excessive water consumption in pulp and paper industry results in high amount of wastewater. Pollutant characteristics of the wastewater vary depending on the processes used in production and the quality of paper produced. However, in general, high organic material and suspended solid contents are considered as major pollutants of pulp and paper industry effluents. The major pollutant characteristics of pulp and paper industry effluents in Turkey were surveyed and means of major pollutant concentrations, which were grouped in three different pollution grades (low, moderate and high strength effluents), and flow rates within 3000 to 10,000m(3)/day range with 1000m(3)/day steps were used as design parameters. Ninety-six treatment plants were designed using twelve flow schemes which were combinations of physical treatment, chemical treatment, aerobic and anaerobic biological processes. Detailed comparative cost analysis which includes investment, operation, maintenance and rehabilitation costs was prepared to determine optimum treatment processes for each pollution grade. The most economic and technically optimal treatment processes were found as extended aeration activated sludge process for low strength effluents, extended aeration activated sludge process or UASB followed by an aeration basin for medium strength effluents, and UASB followed by an aeration basin or UASB followed by the conventional activated sludge process for high strength effluents. Copyright © 2010 Elsevier B.V. All rights reserved.

A systematic review of cost-effectiveness analyses of drugs for postmenopausal osteoporosis.

PubMed

Hiligsmann, Mickaël; Evers, Silvia M; Ben Sedrine, Wafa; Kanis, John A; Ramaekers, Bram; Reginster, Jean-Yves; Silverman, Stuart; Wyers, Caroline E; Boonen, Annelies

2015-03-01

Given the limited availability of healthcare resources and the recent introduction of new anti-osteoporosis drugs, the interest in the cost effectiveness of drugs in postmenopausal osteoporosis remains and even increases. This study aims to identify all recent economic evaluations on drugs for postmenopausal osteoporosis, to critically appraise the reporting quality, and to summarize the results. A literature search using Medline, the National Health Service Economic Evaluation database and the Cost-Effectiveness Analysis Registry was undertaken to identify original articles published between January 1, 2008 and December 31, 2013. Studies that assessed cost effectiveness of drugs in postmenopausal osteoporosis were included. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to assess the quality of reporting of these articles. Of 1,794 articles identified, 39 studies fulfilled the inclusion criteria. They were conducted in 14 different countries and nine active interventions were assessed. When compared with no treatment, active osteoporotic drugs were generally cost effective in postmenopausal women aged over 60-65 years with low bone mass, especially those with prior vertebral fractures. Key drivers of cost effectiveness included individual fracture risk, medication adherence, selected comparators and country-specific analyses. Quality of reporting varied between studies with an average score of 17.9 out of 24 (range 7-21.5). This review found a substantial number of published cost-effectiveness analyses of drugs in osteoporosis in the last 6 years. Results and critical appraisal of these articles can help decision makers when prioritizing health interventions and can inform the development of future economic evaluations.

Cost-effectiveness of Apixaban Compared With Edoxaban for Stroke Prevention in Nonvalvular Atrial Fibrillation.

PubMed

Lip, Gregory Y H; Lanitis, Tereza; Kongnakorn, Thitima; Phatak, Hemant; Chalkiadaki, Corina; Liu, Xianchen; Kuznik, Andreas; Lawrence, Jack; Dorian, Paul

2015-11-01

The purpose of this analysis was to assess the cost-effectiveness of apixaban 5 mg BID versus high- and low-dose edoxaban (60 mg and 30 mg once daily) as intended starting dose strategies for stroke prevention in patients from a UK National Health Service perspective. A previously developed and validated Markov model was adapted to evaluate the lifetime clinical and economic impact of apixaban 5 mg BID versus edoxaban (high and low dose) in patients with nonvalvular atrial fibrillation. A pairwise indirect treatment comparison was conducted for clinical end points, and price parity was assumed between apixaban and edoxaban. Costs in 2012 British pounds, life-years, and quality-adjusted life-years (QALYs) gained, discounted at 3.5% per annum, were estimated. Apixaban was predicted to increase life expectancy and QALYs versus low- and high-dose edoxaban. These gains were achieved at cost-savings versus low-dose edoxaban, thus being dominant and nominal increases in costs versus high-dose edoxaban. The incremental cost-effectiveness ratio of apixaban versus high-dose edoxaban was £6763 per QALY gained. Apixaban was deemed to be dominant (less costly and more effective) versus low-dose edoxaban and a cost-effective alternative to high-dose edoxaban. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

COST ANALYSIS OF ACTIVATED CARBON VERSUS PHOTOCATALYTIC OXIDATION FOR REMOVING ORGANIC COMPOUNDS FROM INDOOR AIR

EPA Science Inventory

A cost comparison has been conducted of 1 m3/s indoor air cleaners using granular activated carbon (GAC) vs. photocatalytic oxidation (PCO) for treating a steady-state inlet volatile organic compound (VOC) concentration of 0.3 mg/m3. The commercial GAC unit was costed assuming t...

Active damage interrogation system for structural health monitoring

NASA Astrophysics Data System (ADS)

Lichtenwalner, Peter F.; Dunne, James P.; Becker, Ronald S.; Baumann, Erwin W.

1997-05-01

An integrated and automated smart structures approach for in situ damage assessment has been implemented and evaluated in a laboratory environment for health monitoring of a realistic aerospace structural component. This approach, called Active Damage Interrogation (ADI), utilizes an array of piezoelectric transducers attached to or embedded within the structure for both actuation and sensing. The ADI system, which is model independent, actively interrogates the structure through broadband excitation of multiple actuators across the desired frequency range. Statistical analysis of the changes in transfer functions between actuator/sensor pairs is used to detect, localize, and assess the severity of damage in the structure. This paper presents the overall concept of the ADI system and provides experimental results of damage assessment studies conducted for a composite structural component of the MD-900 Explorer helicopter rotor system. The potential advantages of this approach include simplicity (no need for a model), sensitivity, and low cost implementation. The results obtained thus far indicate considerably promise for integrated structural health monitoring of aerospace vehicles, leading to the practice of condition-based maintenance and consequent reduction in life cycle costs.

A model-based economic evaluation of improved primary care management of patients with type 2 diabetes in Australia.

PubMed

Haji Ali Afzali, Hossein; Gray, Jodi; Beilby, Justin; Holton, Christine; Karnon, Jonathan

2013-12-01

There are few studies investigating the economic value of the Australian practice nurse workforce on the management of chronic conditions. This is particularly important in Australia, where the government needs evidence to inform decisions on whether to maintain or redirect current financial incentives that encourage practices to recruit practice nurses. The objective of this study was to estimate the lifetime costs and quality-adjusted life-years (QALYs) associated with two models of practice nurse involvement in clinical-based activities (high and low level) in the management of type 2 diabetes within the primary care setting. A previously validated state transition model (the United Kingdom Prospective Diabetes Study Outcomes Model) was adapted, which uses baseline prognostic factors (e.g. gender, haemoglobin A1c [HbA1c]) to predict the risk of occurrence of diabetes-related complications (e.g. stroke). The model was populated by data from Australian and UK observational studies. Costs and utility values associated with complications were summed over patients' lifetimes to estimate costs and QALY gains from the perspective of the health care system. All costs were expressed in 2011 Australian dollars (AU$). The base-case analysis assumed a 40-year time horizon with an annual discount rate of 5 %. Relative to low-level involvement of practice nurses in the provision of clinical-based activities, the high-level model was associated with lower mean lifetime costs of management of complications (-AU$8,738; 95 % confidence interval [CI] -AU$12,522 to -AU$4,954), and a greater average gain in QALYs (0.3; 95 % CI 0.2-0.4). A range of sensitivity analyses were performed, in which the high-level model was dominant in all cases. Our results suggest that the high-level model is a dominant management strategy over the low-level model in all modelled scenarios. These findings indicate the need for effective primary care-based incentives to encourage general practices not only to employ practice nurses, but to better integrate them into the provision of clinical services.

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali

PubMed Central

Somda, Zana C; Meltzer, Martin I; Perry, Helen N; Messonnier, Nancy E; Abdulmumini, Usman; Mebrahtu, Goitom; Sacko, Massambou; Touré, Kandioura; Ki, Salimata Ouédraogo; Okorosobo, Tuoyo; Alemu, Wondimagegnehu; Sow, Idrissa

2009-01-01

Background Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO) African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR). This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR. Methods We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles. Results Over the period studied (2002–2005), the average cost to implement the IDSR program in Eritrea was $0.16 per capita, $0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from $35,899 to $69,920 at the region level, $10,790 to $13,941 at the district level, and $1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines), service availability, distance, and the epidemiological profile of the country. Conclusion This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR. PMID:19133149

Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study.

PubMed

Brennan, Aline; Jackson, Arthur; Horgan, Mary; Bergin, Colm J; Browne, John P

2015-04-03

It is anticipated that demands on ambulatory HIV services will increase in coming years as a consequence of the increased life expectancy of HIV patients on highly active anti-retroviral therapy (HAART). Accurate cost data are needed to enable evidence based policy decisions be made about new models of service delivery, new technologies and new medications. A micro-costing study was carried out in an HIV outpatient clinic in a single regional centre in the south of Ireland. The costs of individual appointment types were estimated based on staff grade and time. Hospital resources used by HIV patients who attended the ambulatory care service in 2012 were identified and extracted from existing hospital systems. Associations between patient characteristics and costs per patient month, in 2012 euros, were examined using univariate and multivariate analyses. The average cost of providing ambulatory HIV care was found to be €973 (95% confidence interval €938-€1008) per patient month in 2012. Sensitivity analysis, varying the base-case staff time estimates by 20% and diagnostic testing costs by 60%, estimated the average cost to vary from a low of €927 per patient month to a high of €1019 per patient month. The vast majority of costs were due to the cost of HAART. Women were found to have significantly higher HAART costs per patient month while patients over 50 years of age had significantly lower HAART costs using multivariate analysis. This study provides the estimated cost of ambulatory care in a regional HIV centre in Ireland. These data are valuable for planning services at a local level, and the identification of patient factors, such as age and gender, associated with resource use is of interest both nationally and internationally for the long-term planning of HIV care provision.

Design and development of low cost polyurethane biopolymer based on castor oil and glycerol for biomedical applications.

PubMed

Tan, A C W; Polo-Cambronell, B J; Provaggi, E; Ardila-Suárez, C; Ramirez-Caballero, G E; Baldovino-Medrano, V G; Kalaskar, D M

2018-02-01

In the current study, we present the synthesis of novel low cost bio-polyurethane compositions with variable mechanical properties based on castor oil and glycerol for biomedical applications. A detailed investigation of the physicochemical properties of the polymer was carried out by using mechanical testing, ATR-FTIR, and X-ray photoelectron spectroscopy (XPS). Polymers were also tested in short term in-vitro cell culture with human mesenchymal stem cells to evaluate their biocompatibility for potential applications as biomaterial. FTIR analysis confirmed the synthesis of castor oil and glycerol based PU polymers. FTIR also showed that the addition of glycerol as co-polyol increases crosslinking within the polymer backbone hence enhancing the bulk mechanical properties of the polymer. XPS data showed that glycerol incorporation leads to an enrichment of oxidized organic species on the surface of the polymers. Preliminary investigation into in vitro biocompatibility showed that serum protein adsorption can be controlled by varying the glycerol content with polymer backbone. An alamar blue assay looking at the metabolic activity of the cells indicated that castor oil based PU and its variants containing glycerol are non-toxic to the cells. This study opens an avenue for using low cost bio-polyurethane based on castor oil and glycerol for biomedical applications. © 2017 The Authors Biopolymers Published by Wiley Periodicals, Inc.

High-Throughput Assay and Discovery of Small Molecules that Interrupt Malaria Transmission

PubMed Central

Plouffe, David M.; Wree, Melanie; Du, Alan Y.; Meister, Stephan; Li, Fengwu; Patra, Kailash; Lubar, Aristea; Okitsu, Shinji L.; Flannery, Erika L.; Kato, Nobutaka; Tanaseichuk, Olga; Comer, Eamon; Zhou, Bin; Kuhen, Kelli; Zhou, Yingyao; Leroy, Didier; Schreiber, Stuart L.; Scherer, Christina A.; Vinetz, Joseph; Winzeler, Elizabeth A.

2016-01-01

Summary Preventing transmission is an important element of malaria control. However, most of the current available methods to assay for malaria transmission blocking are relatively low throughput and cannot be applied to large chemical libraries. We have developed a high-throughput and cost-effective assay, the Saponin-lysis Sexual Stage Assay (SaLSSA), for identifying small molecules with transmission-blocking capacity. SaLSSA analysis of 13,983 unique compounds uncovered that >90% of well-characterized antimalarials, including endoperoxides and 4-aminoquinolines, as well as compounds active against asexual blood stages, lost most of their killing activity when parasites developed into metabolically quiescent stage V gametocytes. On the other hand, we identified compounds with consistent low nanomolar transmission-blocking activity, some of which showed cross-reactivity against asexual blood and liver stages. The data clearly emphasize substantial physiological differences between sexual and asexual parasites and provide a tool and starting points for the discovery and development of transmission-blocking drugs. PMID:26749441

Psychosocial Costs of Racism to Whites: Exploring Patterns through Cluster Analysis

ERIC Educational Resources Information Center

Spanierman, Lisa B.; Poteat, V. Paul; Beer, Amanda M.; Armstrong, Patrick Ian

2006-01-01

Participants (230 White college students) completed the Psychosocial Costs of Racism to Whites (PCRW) Scale. Using cluster analysis, we identified 5 distinct cluster groups on the basis of PCRW subscale scores: the unempathic and unaware cluster contained the lowest empathy scores; the insensitive and afraid cluster consisted of low empathy and…

A review of promising new immunoassay technology for monitoring forest herbicides

Treesearch

Charles K. McMahon

1993-01-01

Rising costs of classical instrumental methods of chemical analysis coupled with an increasing need for environmental monitoring has lead to the development of highly sensitive, low-cost immunochemical methods of analysis for the detection of environmental contaminants. These methods known simply as immunoassays are chemical assays which use antibodies as reagents. A...

The differential impact of low-carbon technologies on climate change mitigation cost under a range of socioeconomic and climate policy scenarios.

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

Barron, Robert W.; McJeon, Haewon C.

2015-05-01

This paper considers the effect of several key parameters of low carbon energy technologies on the cost of abatement. A methodology for determining the minimum level of performance required for a parameter to have a statistically significant impact on CO2 abatement cost is developed and used to evaluate the impact of eight key parameters of low carbon energy supply technologies on the cost of CO2 abatement. The capital cost of nuclear technology is found to have the greatest impact of the parameters studied. The cost of biomass and CCS technologies also have impacts, while their efficiencies have little, if any.more » Sensitivity analysis of the results with respect to population, GDP, and CO2 emission constraint show that the minimum performance level and impact of nuclear technologies is consistent across the socioeconomic scenarios studied, while the other technology parameters show different performance under higher population, lower GDP scenarios. Solar technology was found to have a small impact, and then only at very low costs. These results indicate that the cost of nuclear is the single most important driver of abatement cost, and that trading efficiency for cost may make biomass and CCS technologies more competitive.« less

Development of an all-metal thick film cost effective metallization system for solar cells

NASA Technical Reports Server (NTRS)

Ross, B.; Parker, J.

1983-01-01

Improved thick film solar cell contacts for the high volume production of low cost silicon solar arrays are needed. All metal screenable pastes made from economical base metals and suitable for application to low to high conductivity silicon were examined. Silver fluoride containing copper pastes and fluorocarbon containing copper pastes were discussed. The effect of hydrogen on the adhesion of metals to silicon was investigated. A cost analysis of various paste materials is provided.

Low cost missions to explore the diversity of near Earth objects

NASA Technical Reports Server (NTRS)

Belton, Michael J. S.; Delamere, Alan

1992-01-01

We propose a series of low-cost flyby missions to perform a reconnaissance of near-Earth cometary nuclei and asteroids. The primary scientific goal is to study the physical and chemical diversity in these objects. The mission concept is based on the Pegasus launch vehicle. Mission costs, inclusive of launch, development, mission operations, and analysis are expected to be near $50 M per mission. Launch opportunities occur in all years. The benefits of this reconnaissance to society are stressed.

Improved, low cost inorganic-organic separators for rechargeable silver-zinc batteries

NASA Technical Reports Server (NTRS)

Sheibley, D. W.

1979-01-01

Several flexible, low-cost inorganic-organic separators with performance characteristics and cycle life equal to, or better than, the Lewis Research Center Astropower separator were developed. These new separators can be made on continuous-production equipment at about one-fourth the cost of the Astropower separator produced the same way. In test cells, these new separators demonstrate cycle life improvement, acceptable operating characteristics, and uniform current density. The various separator formulas, test cell construction, and data analysis are described.

Economic costs of childhood lead exposure in low- and middle-income countries.

PubMed

Attina, Teresa M; Trasande, Leonardo

2013-09-01

Children's blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries. Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries. We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure. We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6-1162.5 billion. We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries.

Costs of a school-based dental mobile service in South Africa.

PubMed

Molete, M P; Chola, L; Hofman, K J

2016-10-19

The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review.

PubMed

Mogasale, Vittal; Ramani, Enusa; Wee, Hyeseung; Kim, Jerome H

2016-12-01

Use of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers. To review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries. Peer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination. The publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014. No participants are involved, only costs are collected. Oral cholera vaccination and cost estimation. A systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$). Ten studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014). The reported cost categories are not standardized at collection point and may lead to misclassification. Costs for some OCV campaigns are not available and analysis does not include direct and indirect costs to vaccine recipients. Vaccine delivery cost estimation is needed for budgeting and economic analysis of vaccination programs. The cost categorization methodology presented in this study is helpful in collecting OCV delivery costs in a standardized manner, comparing delivery costs, planning vaccination campaigns and informing decision-making.

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

Elgowainy, Amgad; Han, Jeongwoo; Ward, Jacob

This study provides a comprehensive lifecycle analysis (LCA), or cradle-to-grave (C2G) analysis, of the cost and greenhouse gas (GHG) emissions of a variety of vehicle-fuel pathways, as well as the levelized cost of driving (LCD) and cost of avoided GHG emissions. This study also estimates the technology readiness levels (TRLs) of key fuel and vehicle technologies along the pathways. The C2G analysis spans a full portfolio of midsize light-duty vehicles (LDVs), including conventional internal combustion engine vehicles (ICEVs), flexible fuel vehicles (FFVs), hybrid electric vehicles (HEVs), plug-in hybrid electric vehicles (PHEVs), battery electric vehicles (BEVs), and fuel cell electric vehiclesmore » (FCEVs). In evaluating the vehicle-fuel combinations, this study considers both low-volume and high-volume “CURRENT TECHNOLOGY” cases (nominally 2015) and a high-volume “FUTURE TECHNOLOGY” lower-carbon case (nominally 2025–2030). For the CURRENT TECHNOLOGY case, low-volume vehicle and fuel production pathways are examined to determine costs in the near term.« less

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

Elgowainy, Amgad; Han, Jeongwoo; Ward, Jacob

This study provides a comprehensive life-cycle analysis (LCA), or cradle-to-grave (C2G) analysis, of the cost and greenhouse gas (GHG) emissions of a variety of vehicle-fuel pathways, as well as the levelized cost of driving (LCD) and cost of avoided GHG emissions. This study also estimates the technology readiness levels (TRLs) of key fuel and vehicle technologies along the pathways. The C2G analysis spans a full portfolio of midsize light-duty vehicles (LDVs), including conventional internal combustion engine vehicles (ICEVs), flexible fuel vehicles (FFVs), hybrid electric vehicles (HEVs), plug-in hybrid electric vehicles (PHEVs), battery electric vehicles (BEVs), and fuel cell electric vehiclesmore » (FCEVs). In evaluating the vehicle-fuel combinations, this study considers both low-volume and high-volume “CURRENT TECHNOLOGY” cases (nominally 2015) and a high-volume “FUTURE TECHNOLOGY” lower-carbon case (nominally 2025–2030). For the CURRENT TECHNOLOGY case, low-volume vehicle and fuel production pathways are examined to determine costs in the near term.« less

Mission management, planning, and cost: PULSE Attitude And Control Systems (AACS)

NASA Technical Reports Server (NTRS)

1990-01-01

The Pluto unmanned long-range scientific explorer (PULSE) is a probe that will do a flyby of Pluto. It is a low weight, relatively low costing vehicle which utilizes mostly off-the-shelf hardware, but not materials or techniques that will be available after 1999. A design, fabrication, and cost analysis is presented. PULSE will be launched within the first decade of the twenty-first century. The topics include: (1) scientific instrumentation; (2) mission management, planning, and costing; (3) power and propulsion systems; (4) structural subsystem; (5) command, control, and communication; and (6) attitude and articulation control.

A low cost LST pointing control system

NASA Technical Reports Server (NTRS)

Glaese, J. R.; Kennel, H. F.; Nurre, G. S.; Seltzer, S. M.; Shelton, H. L.

1975-01-01

Vigorous efforts to reduce costs, coupled with changes in LST guidelines, took place in the Fall of 1974. These events made a new design of the LST and its Pointing and Attitude Control System possible. The major design changes are summarized as: an annular Support Systems Module; removal of image motion compensation; reaction wheels instead of CMG's; a magnetic torquer system to also perform the emergency and backup functions, eliminating the previously required mass expulsion system. Preliminary analysis indicates the Low Cost LST concept can meet the newly defined requirements and results in a significantly reduced development cost.

Enoxaparin. A pharmacoeconomic appraisal of its use in thromboembolic prophylaxis after total hip arthroplasty.

PubMed

Dunn, C J; Goa, K L

1996-08-01

Total hip arthroplasty (THA) is a major orthopaedic procedure with a high risk of postoperative thromboembolism. Increasing demand for this type of surgery, together with its high cost, has led to examination of means by which the cost of THA may be minimised. Current clinical opinion favours the use of suitable pharmacological thromboprophylaxis in patients undergoing THA; such prophylaxis may be provided with subcutaneous standard unfractionated heparin (UFH), oral warfarin or subcutaneous low molecular weight heparin (LMWH). Traditionally, LMWHs have been perceived as being more expensive to use than UFH or warfarin because of their relatively high acquisition cost. However, recent pharmacoeconomic data have shown that cost savings are possible when LMWHs are used. This is attributed mainly to reduced frequency of administration, reductions in costs associated with diagnosis and treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and the lack of need for laboratory monitoring of blood coagulation parameters. LMWHs have proportionally less anti-factor IIa (antithrombin) activity relative to anti-factor Xa activity than UFH. Enoxaparin, a LMWH with a mean molecular weight of 4 to 5kD, is reported to have approximately 5 times less activity against thrombin than UFH, for equivalent anti-factor Xa activity. Randomised clinical trials in patients undergoing THA have shown enoxaparin to be at least as effective as UFH in the prevention of DVT and PE, with consistent trends towards a lower incidence of DVT with enoxaparin than with UFH. Similar rates of haemorrhagic complications were reported for enoxaparin and UFH in most trials, although a significantly higher total transfusion requirement was reported for UFH than for enoxaparin in a double-blind study. A significantly higher incidence of bleeding was observed with UFH than with enoxaparin in another study, with similar transfusion requirements for both treatment groups. Cost comparisons in which costs were assigned retrospectively to clinical data have shown cost advantages for LMWHs in general over UFH when costs of administration, hospital bed occupancy and laboratory/radiology procedures are calculated. Cost savings with LMWHs were attributed mainly to reductions in the cost of managing thromboembolic complications in patients receiving these drugs. One meta-analysis showed a saving of $US50 000 (1993 figures) for LMWH over UFH (both subcutaneously twice daily) for every 1000 patients. Subcutaneous enoxaparin at a dosage of 30mg twice daily was shown to be more cost effective than oral warfarin in the prophylaxis of DVT and PE in 2 North American studies in which costs were related to outcomes. One study comprised the application of a decision analysis to a hypothetical group of 10 000 patients; an incremental cost effectiveness of $US12 288 (1993 figures) per death averted was reported for enoxaparin. Enoxaparin was also associated with an overall incremental cost effectiveness of $Can29 140 (1992 figures) per year of life saved (YLS) in the other study, in which costs were applied to clinical data obtained retrospectively from 10 randomised trials. Although no cost-effectiveness analyses have been carried out to compare enoxaparin with UFH, a UK cost comparison reported an overall cost saving of pounds 20 per patient (figures from 1989 to 1990) with enoxaparin 40mg once daily subcutaneously over subcutaneous UFH 5000IU 3 times daily. It has also been suggested that the use of once- or twice-daily enoxaparin in preference to UFH may reduce the overall length of hospital stay; a significant difference emerged in 1 analysis (9.9 or 9.5 vs 11.3 days). Pharmacoeconomic data therefore support the use of enoxaparin as an effective thromboprophylactic treatment with potential cost advantages over warfarin and UFH. Cost-effecti

Cardiorespiratory costs of growth in low birth weight infants.

PubMed

Schulze, K; Kashyap, S; Ramakrishnan, R

1993-02-01

The energy cost of growth includes two components: the energy stored in new tissues and the energy expended in all energy requiring steps associated with nutrient intake and net tissue accretion. Most of the energy expended in growth is accounted for by the energy cost of tissue anabolism: peptide bonds, lipogenesis, substrate transport, etc. However, to the extent that additional work is required of the heart and lungs for growth-related increases in O2 and CO2 transport, increased energy is also expended in cardiorespiratory work. Indirect estimates of these costs can be gained by examining the effects of diet and weight gain on heart rate and respiratory frequency. We studied 66 healthy low birth weight infants, mean study weight = 2010 g, fed constant intakes of protein (2.25-3.9 g/kg per day) and energy (100-150 kcal/kg per day). These diets led to rates of weight gain ranging from 13.9 to 21.7 g/kg per day, among the diet groups. Bi-weekly 6-h assessments of energy expenditure, heart rate, respiratory frequency and state of sleep were made after full enteral intake was achieved. After adjustment of heart rate for the effect of postnatal age, heart rate during active sleep was related to weight gain (y = 0.97 x + 144, r2 = 0.15), nitrogen-energy ratio of the diet (y = 5.9 x + 139,2 r2 = 0.22), and energy expenditure (y = 0.53 x + 129, r2 = 0.13). Multiple regression analysis revealed that age-adjusted heart rate during active and quiet sleep was significantly related to a combination of the same three variables (r2 = 0.31).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis and evaluation of processes and equipment in tasks 2 and 4 of the low-cost solar array project

NASA Technical Reports Server (NTRS)

Goldman, H.; Wolf, M.

1978-01-01

Several experimental and projected Czochralski crystal growing process methods were studied and compared to available operations and cost-data of recent production Cz-pulling, in order to elucidate the role of the dominant cost contributing factors. From this analysis, it becomes apparent that the specific add-on costs of the Cz-process can be expected to be reduced by about a factor of three by 1982, and about a factor of five by 1986. A format to guide in the accumulation of the data needed for thorough techno-economic analysis of solar cell production processes was developed.

Economic analysis of the design and fabrication of a space qualified power system

NASA Technical Reports Server (NTRS)

Ruselowski, G.

1980-01-01

An economic analysis was performed to determine the cost of the design and fabrication of a low Earth orbit, 2 kW photovoltaic/battery, space qualified power system. A commercially available computer program called PRICE (programmed review of information for costing and evaluation) was used to conduct the analysis. The sensitivity of the various cost factors to the assumptions used is discussed. Total cost of the power system was found to be $2.46 million with the solar array accounting for 70.5%. Using the assumption that the prototype becomes the flight system, 77.3% of the total cost is associated with manufacturing. Results will be used to establish whether the cost of space qualified hardware can be reduced by the incorporation of commercial design, fabrication, and quality assurance methods.

Space suit bioenergetics: framework and analysis of unsuited and suited activity.

PubMed

Carr, Christopher E; Newman, Dava J

2007-11-01

Metabolic costs limit the duration and intensity of extravehicular activity (EVA), an essential component of future human missions to the Moon and Mars. Energetics Framework: We present a framework for comparison of energetics data across and between studies. This framework, applied to locomotion, differentiates between muscle efficiency and energy recovery, two concepts often confused in the literature. The human run-walk transition in Earth gravity occurs at the point for which energy recovery is approximately the same for walking and running, suggesting a possible role for recovery in gait transitions. Muscular Energetics: Muscle physiology limits the overall efficiency by which chemical energy is converted through metabolism to useful work. Unsuited Locomotion: Walking and running use different methods of energy storage and release. These differences contribute to the relative changes in the metabolic cost of walking and running as gravity is varied, with the metabolic cost of locomoting at a given velocity changing in proportion to gravity for running and less than in proportion for walking. Space Suits: Major factors affecting the energetic cost of suited movement include suit pressurization, gravity, velocity, surface slope, and space suit configuration. Apollo lunar surface EVA traverse metabolic rates, while unexpectedly low, were higher than other activity categories. The Lunar Roving Vehicle facilitated even lower metabolic rates, thus longer duration EVAs. Muscles and tendons act like springs during running; similarly, longitudinal pressure forces in gas pressure space suits allow spring-like storage and release of energy when suits are self-supporting.

Chronic pesticide poisoning from persistent low-dose exposures in Ecuadorean floriculture workers: toward validating a low-cost test battery.

PubMed

Breilh, Jaime; Pagliccia, Nino; Yassi, Annalee

2012-01-01

Chronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador's floriculture industry. First we had to develop a case definition; as with all occupational diseases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis, we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis suggested three distinct manifestations of pesticide poisoning. We then determined sensitivity and specificity of various combinations of symptoms and simple neurotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone--the current screening standard. While sensitivity and specificity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings.

Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services

PubMed Central

Rajabi, A; Dabiri, A

2012-01-01

Background Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990’s. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. Methods: To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. Results: The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Conclusion: Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services. PMID:23113171

Factors influencing mode of transport in older adolescents: a qualitative study

PubMed Central

2013-01-01

Background Since a decline in activity levels occurs in adolescence, active transport could be important to increase daily physical activity in older adolescents (17–18 years). To promote active transport, it is necessary to be aware of the barriers and facilitators of this type of transport, but also of other transport modes. This study sought to uncover the factors influencing the choice of transport mode for short distance travel to various destinations in older adolescents using focus groups. Methods Thirty-two focus group volunteers (mean age of 17 ± 1.2 years) were recruited from the two final years of the secondary school in Antwerp (Belgium). Five focus groups were conducted (five to eight participants/group). Content analysis was performed using NVivo 9 software (QSR International). Grounded theory was used to derive categories and subcategories. Results Data were categorized in three main themes with several subcategories: personal factors (high autonomy, low costs and health), social factors (good social support) and physical environmental factors (short travel time, good access to transport modes and to facilities, good weather, an adapted built environment, perceived safety and ecology). Conclusions For older adolescents, the interplay between short travel time, high autonomy, good social support, low costs, good access to transport modes and facilities, and good weather was important for choosing active transport over other transport forms for travelling short distances to various destinations. Other well-known factors such as safety, ecology and health seemed not to have a big influence on their transport mode choice. PMID:23574974

Cost analysis of life support systems

NASA Technical Reports Server (NTRS)

Yakut, M. M.

1973-01-01

A methodology was developed to predict realistic relative cost of Life Support Systems (LSS) and to define areas of major cost impacts in the development cycle. Emphasis was given to tailoring the cost data for usage by program planners and designers. The equipment classifications used based on the degree of refinement were as follows: (1) Working model; (2) low-fidelity prototype; (3) high-fidelity prototype; and (4) flight-qualified system. The major advanced LSS evaluated included the following: (1) Carbon dioxide removal; (2) oxygen recovery systems; (3) water recovery systems; (4) atmosphere analysis system.

Leisure-time physical activity and direct cost of short-term sickness absence among Finnish municipal employees.

PubMed

Tolonen, Anu; Rahkonen, Ossi; Lahti, Jouni

2017-03-04

We aimed to examine the direct costs of short-term (1-14 days) sickness absence and the effect of employees' physical activity on the costs. The Finnish Helsinki Health Study survey (2007) was used in the analysis (n = 3,935). Physical activity was classified into inactive, moderately active, and vigorously active. Sickness absence (3 years follow-up) and salary data were derived from the employer's registers. On average, an employee was absent 6 days a year due to short-term sickness absence, with a production loss of 2,350 EUR during the 3 years. The vigorously active had less sickness absence than those less active. The direct cost of sickness absence of a vigorously active employee was 404 EUR less than that of an inactive employee. Promoting physical activity among employees may decrease direct cost of short-term sickness absence.

Cost Convergence between Public and For-Profit Hospitals under Prospective Payment and High Competition in Taiwan

PubMed Central

Xirasagar, Sudha; Lin, Herng-Ching

2004-01-01

Objective To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses. Data Sources Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment). Study Design Retrospective population-based, cross-sectional study. Data Analysis Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics. Principal Findings Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses. Conclusions We find that the empirical evidence supports both our hypotheses. PMID:15544646

Active management of labor

PubMed Central

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

2000-01-01

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

Costs associated with women's physical activity musculoskeletal injuries: the women's injury study.

PubMed

Kaplan, Robert M; Herrmann, Alison K; Morrison, James T; DeFina, Laura F; Morrow, James R

2014-08-01

Despite benefits of physical activity (PA), exercise is also associated with risks. Musculoskeletal injury (MSI) risk increases with exercise frequency/intensity. MSI is associated with costs including medical care and time lost from work. To evaluate the economic costs associated with PA-related MSIs in community-dwelling women. Participants included 909 women in the Women's Injury Study reporting PA behaviors and MSI incidence weekly via the Internet for up to 3 years (mean follow-up 1.89 years). Participants provided consent to obtain health records. Costs were estimated by medical records and self-reports of medical care. Components included physician visits, medical facility contacts, medication costs, and missed work. Of 909 participants, 243 reported 323 episodes of expenditure or contact with the health care system associated with PA. Total costs of episodes ranged from $0-$18,934. Modal cost was $0 (mean = $433 ± $1670). Costs were positively skewed with nearly all participants reporting no or very low costs. About 1 in 4 community-dwelling women who are physically active experienced a PA-related MSI. The majority of injuries were minor, and large expenses associated with MSI were rare. The long-term health benefits and costs savings resulting from PA likely outweigh the minor costs associated with MSI from a physically-active lifestyle.

Microbial synthesis of rhamnolipids by Pseudomonas aeruginosa (ATCC 10145) on waste frying oil as low cost carbon source.

PubMed

Wadekar, S D; Kale, S B; Lali, A M; Bhowmick, D N; Pratap, A P

2012-01-01

Vegetable edible oils and fats are mainly used for frying purposes in households and the food industry. The oil undergoes degradation during frying and hence has to be replaced from time to time. Rhamnolipids are produced by microbial cultivation using refined vegetable oils as a carbon source and Pseudomonas aeruginosa (ATCC 10145). The raw material cost accounts for 10-30% of the overall cost of biosurfactant production and can be reduced by using low-cost substrates. In this research, attention was focused on the preparation of rhamnolipids, which are biosurfactants, using potential frying edible oils as a carbon source via a microbial fermentation technique. The use of low-cost substrates as a carbon source was emphasized to tilt the cost of production for rhamnolipids. The yield was 2.8 g/L and 7.5 g/L from waste frying oil before and after activated earth treatment, respectively. The crude product contained mainly dirhamnolipids, confirmed by thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC), liquid chromatography-mass spectroscopy (LC-MS), and (1)H-nuclear magnetic resonance (NMR). Hence, the treatment can be used to convert waste frying oil as a low-cost substrate into a cost-effective carbon source.

On the powerful use of simulations in the quake-catcher network to efficiently position low-cost earthquake sensors

USGS Publications Warehouse

Benson, K.; Estrada, T.; Taufer, M.; Lawrence, J.; Cochran, E.

2011-01-01

The Quake-Catcher Network (QCN) uses low-cost sensors connected to volunteer computers across the world to monitor seismic events. The location and density of these sensors' placement can impact the accuracy of the event detection. Because testing different special arrangements of new sensors could disrupt the currently active project, this would best be accomplished in a simulated environment. This paper presents an accurate and efficient framework for simulating the low cost QCN sensors and identifying their most effective locations and densities. Results presented show how our simulations are reliable tools to study diverse scenarios under different geographical and infrastructural constraints. ?? 2011 IEEE.

Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study.

PubMed

Lévesque, Renee; Marcelli, Daniele; Cardinal, Héloïse; Caron, Marie-Line; Grooteman, Muriel P C; Bots, Michiel L; Blankestijn, Peter J; Nubé, Menso J; Grassmann, Aileen; Canaud, Bernard; Gandjour, Afschin

2015-12-01

The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l'Université de Montréal) arm of a parallel-group randomized controlled trial (RCT), the CONvective TRAnsport STudy. An economic evaluation was conducted for the period of the RCT (74 months). In addition, a Markov state transition model was constructed to simulate costs and health benefits over lifetime. The primary outcome was costs per quality-adjusted life-year (QALY) gained. The analysis had the perspective of the Quebec public healthcare system. A total of 130 patients were randomly allocated to OL-HDF (n = 67) and LF-HD (n = 63). The cost-utility ratio of OL-HDF versus LF-HD was Can$53,270 per QALY gained over lifetime. This ratio was fairly robust in the sensitivity analysis. The cost-utility ratio was lower than that of LF-HD compared with no treatment (immediate death), which was Can$93,008 per QALY gained. High-efficiency OL-HDF can be considered a cost-effective treatment for ESRD in a Canadian setting. Further research is needed to assess cost effectiveness in other settings and healthcare systems.

Space shuttle/food system study. Volume 2, Appendix A: Active heating system-screening analysis. Appendix B: Reconstituted food heating techniques analysis

NASA Technical Reports Server (NTRS)

1974-01-01

Technical data are presented which were used to evaluate active heating methods to be incorporated into the space shuttle food system design, and also to evaluate the relative merits and penalties associated with various approaches to the heating of rehydrated food during space flight. Equipment heating candidates were subject to a preliminary screening performed by a selection rationale process which considered the following parameters; (1) gravitational effect; (2) safety; (3) operability; (4) system compatibility; (5) serviceability; (6) crew acceptability; (7) crew time; (8) development risk; and (9) operating cost. A hot air oven, electrically heated food tray, and microwave oven were selected for further consideration and analysis. Passive, semi-active, and active food preparation approaches were also studied in an effort to determine the optimum method for heating rehydrated food. Potential complexity, cost, vehicle impact penalties, and palatability were considered in the analysis. A summary of the study results is provided along with cost estimates for each of the potential sytems

Patients with lower activation associated with higher costs; delivery systems should know their patients' 'scores'.

PubMed

Hibbard, Judith H; Greene, Jessica; Overton, Valerie

2013-02-01

Patient activation is a term that describes the skills and confidence that equip patients to become actively engaged in their health care. Health care delivery systems are turning to patient activation as yet another tool to help them and their patients improve outcomes and influence costs. In this article we examine the relationship between patient activation levels and billed care costs. In an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, we found that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percent higher in the first half of the next year than the costs of patients with the highest activation levels, both significant differences. What's more, patient activation was a significant predictor of cost even after adjustment for a commonly used "risk score" specifically designed to predict future costs. As health care delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, knowing patients' ability and willingness to manage their health will be a relevant piece of information integral to health care providers' ability to improve outcomes and lower costs.

Technology for low cost solid rocket boosters.

NASA Technical Reports Server (NTRS)

Ciepluch, C.

1971-01-01

A review of low cost large solid rocket motors developed at the Lewis Research Center is given. An estimate is made of the total cost reduction obtainable by incorporating this new technology package into the rocket motor design. The propellant, case material, insulation, nozzle ablatives, and thrust vector control are discussed. The effect of the new technology on motor cost is calculated for a typical expandable 260-in. booster application. Included in the cost analysis is the influence of motor performance variations due to specific impulse and weight changes. It is found for this application that motor costs may be reduced by up to 30% and that the economic attractiveness of future large solid rocket motors will be improved when the new technology is implemented.

Revenue-based cost assignment: a potent but hidden threat to the survival of the multispecialty medical practice.

PubMed

Cooper, Robin; Kramer, Theresa R

2010-03-01

To demonstrate detrimental effects of revenue-based cost assignment (RBCA) in clinical practice and to compare that system with activity-based costing (ABC). Four cost-allocation methods including RBCA were applied to a comprehensive ophthalmology practice using typical accounting methods. Data were obtained by a survey of practitioners or practices and/or extracted from decision support and practice management systems. Inaccuracies and distortions in reported costs were enumerated. Accounting scenario analysis was used to predict resultant provider and managerial decisions. A sampling survey was used to analyze other specialties. ABC was applied to the practice. RBCA causes procedures with higher profitability to appear less profitable and those with lower profitability to appear more profitable. The distortion in reported costs, in medical settings, is often sufficient to incentivize providers with higher profitability to exit a practice and those with lower profitability to remain in it. The departure of providers causes the residual practice profits to decline. These detrimental effects occur in many subspecialties, which suggests a national effect on health care. ABC allocation can reduce cost distortions and eliminate detrimental effects. RBCA leads to fragmentation of health care and a reduction in the profitability of multispecialty practices. Its use may slow the updating of reimbursement and help eliminate low-profitability specialties.

Cost Minimization Analysis of Two Treatment Regimens for Low-Risk Rhabdomyosarcoma in Children: A Report From the Children’s Oncology Group

PubMed Central

Russell, Heidi; Swint, J. Michael; Lal, Lincy; Meza, Jane; Walterhouse, David; Hawkins, Douglas S.; Okcu, M. Fatih

2015-01-01

Background Recent Children’s Oncology Group trials for low-risk rhabdomyosarcoma attempted to reduce therapy while maintaining excellent outcomes. D9602 delivered 45 weeks of outpatient vincristine and dactinomycin (VA) for patients in Subgroup A. ARST0331 reduced the duration of therapy to 22 weeks but added four doses of cyclophosphamide to VA for patients in Subset 1. Failure-free survival was similar. We undertook a cost minimization comparison to help guide future decision-making. Procedure Addressing the costs of treatment from the healthcare perspective we modeled a simple decision-analytic model from aggregate clinical trial data. Medical care inputs and probabilities were estimated from trial reports and focused chart review. Costs of radiation, surgery and off-therapy surveillance were excluded. Unit costs were obtained from literature and national reimbursement and inpatient utilization databases and converted to 2012 US dollars. Model uncertainty was assessed with first-order sensitivity analysis. Results Direct medical costs were $46,393 for D9602 and $43,261 for ARST0331 respectively, making ARST0331 the less costly strategy. Dactinomycin contributed the most to D9602 total costs but varied with age (42–69%). Chemotherapy administration costs accounted for the largest proportion of ARST0331 total costs (39–57%). ARST0331 incurred fewer costs than D9602 under most alternative distributive models and alternative clinical practice assumptions. Conclusions Cost analysis suggests that ARST0331 may incur fewer costs than D9602 from the healthcare system’s perspective. Attention to the services driving the costs provides directions for future efficiency improvements. Future studies should prospectively consider the patient and family’s perspective. PMID:24453105

Cost minimization analysis of two treatment regimens for low-risk rhabdomyosarcoma in children: a report from the Children's Oncology Group.

PubMed

Russell, Heidi; Swint, J Michael; Lal, Lincy; Meza, Jane; Walterhouse, David; Hawkins, Douglas S; Okcu, M Fatih

2014-06-01

Recent Children's Oncology Group trials for low-risk rhabdomyosarcoma attempted to reduce therapy while maintaining excellent outcomes. D9602 delivered 45 weeks of outpatient vincristine and dactinomycin (VA) for patients in Subgroup A. ARST0331 reduced the duration of therapy to 22 weeks but added four doses of cyclophosphamide to VA for patients in Subset 1. Failure-free survival was similar. We undertook a cost minimization comparison to help guide future decision-making. Addressing the costs of treatment from the healthcare perspective we modeled a simple decision-analytic model from aggregate clinical trial data. Medical care inputs and probabilities were estimated from trial reports and focused chart review. Costs of radiation, surgery and off-therapy surveillance were excluded. Unit costs were obtained from literature and national reimbursement and inpatient utilization databases and converted to 2012 US dollars. Model uncertainty was assessed with first-order sensitivity analysis. Direct medical costs were $46,393 for D9602 and $43,261 for ARST0331 respectively, making ARST0331 the less costly strategy. Dactinomycin contributed the most to D9602 total costs but varied with age (42-69%). Chemotherapy administration costs accounted for the largest proportion of ARST0331 total costs (39-57%). ARST0331 incurred fewer costs than D9602 under most alternative distributive models and alternative clinical practice assumptions. Cost analysis suggests that ARST0331 may incur fewer costs than D9602 from the healthcare system's perspective. Attention to the services driving the costs provides directions for future efficiency improvements. Future studies should prospectively consider the patient and family's perspective. © 2014 Wiley Periodicals, Inc.

A national survey of candidates: II: motivations, obstacles, and ideas on increasing interest in psychoanalytic training.

PubMed

Katz, Debra A; Kaplan, Marcia; Stromberg, Sarah E

2012-10-01

A national survey of candidates was conducted to identify motivations for pursuing psychoanalytic training, obstacles that prevent progression or completion, and candidates' ideas on how best to increase interest among potential trainees. In 2009-2010, 40 percent of candidates on the affiliate member e-mail list completed an anonymous web-based survey. Candidates strongly endorsed contact with a personal psychotherapist, psychoanalyst, or supervisor as the most important influence in discovering psychoanalysis and deciding to pursue training. They identified the total cost of analytic training as the greatest obstacle. This was followed by the cost of personal analysis, loss of income for low-fee cases, time away from family, and difficulty finding cases. To enhance training, local institutes should work to improve institute atmosphere and provide assistance with finding cases; national organizations should increase outreach activities and publicize psychoanalysis. Psychoanalytic institutes could recruit future candidates by working to increase personal contact with psychoanalysts, reducing the cost of training, improving institute atmosphere, assisting with case-finding, enhancing outreach activities, and widely publicizing psychoanalysis. Narrative comments from candidates and the implications of these findings regarding engagement of future trainees are discussed.

Improving The Discipline of Cost Estimation and Analysis

NASA Technical Reports Server (NTRS)

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

2000-01-01

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

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

PubMed

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

2018-06-12

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

["Activity based costing" in radiology].

PubMed

Klose, K J; Böttcher, J

2002-05-01

The introduction of diagnosis related groups for reimbursement of hospital services in Germany (g-drg) demands for a reconsideration of utilization of radiological products and costs related to them. Traditional cost accounting as approach to internal, department related budgets are compared with the accounting method of activity based costing (ABC). The steps, which are necessary to implement ABC in radiology are developed. The introduction of a process-oriented cost analysis is feasible for radiology departments. ABC plays a central role in the set-up of decentralized controlling functions within this institutions. The implementation seems to be a strategic challenge for department managers to get more appropriate data for adequate enterprise decisions. The necessary steps of process analysis can be used for other purposes (Certification, digital migration) as well.

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

PubMed

Barnett, Paul G

2009-07-01

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

Advancements in noncontact, multiparameter physiological measurements using a webcam.

PubMed

Poh, Ming-Zher; McDuff, Daniel J; Picard, Rosalind W

2011-01-01

We present a simple, low-cost method for measuring multiple physiological parameters using a basic webcam. By applying independent component analysis on the color channels in video recordings, we extracted the blood volume pulse from the facial regions. Heart rate (HR), respiratory rate, and HR variability (HRV, an index for cardiac autonomic activity) were subsequently quantified and compared to corresponding measurements using Food and Drug Administration-approved sensors. High degrees of agreement were achieved between the measurements across all physiological parameters. This technology has significant potential for advancing personal health care and telemedicine.

Surveillance for falsified and substandard medicines in Africa and Asia by local organizations using the low-cost GPHF Minilab

PubMed Central

Petersen, Albert; Held, Nadja

2017-01-01

Background Substandard and falsified medical products present a serious threat to public health, especially in low- and middle-income countries. Their identification using pharmacopeial analysis is expensive and requires sophisticated equipment and highly trained personnel. Simple, low-cost technologies are required in addition to full pharmacopeial analysis in order to accomplish widespread routine surveillance for poor-quality medicines in low- and middle-income countries. Methods Ten faith-based drug supply organizations in seven countries of Africa and Asia were each equipped with a Minilab of the Global Pharma Health Fund (GPHF, Frankfurt, Germany), suitable for the analysis of about 85 different essential medicines by thin-layer chromatography. Each organization was asked to collect approximately 100 medicine samples from private local medicine outlets, especially from the informal sector. The medicine samples were tested locally according to the Minilab protocols. Medicines which failed Minilab testing were subjected to confirmatory analysis in a WHO-prequalified medicine quality control laboratory in Kenya. Results Out of 869 medicine samples, 21 were confirmed to be substandard or falsified medical products. Twelve did not contain the stated active pharmaceutical ingredient (API), six contained insufficient amounts of the API, and three showed insufficient dissolution of the API. The highest proportion of substandard and falsified medicines was found in Cameroon (7.1%), followed by the Democratic Republic of Congo (2.7%) and Nigeria (1.1%). Antimalarial medicines were most frequently found to be substandard or falsified (9.5% of all antimalarials). Thin-layer chromatography according to the Minilab protocols was found to be specific and reproducible in the identification of medicines which did not contain the stated API. Since only samples which failed Minilab testing were subjected to confirmatory testing using pharmacopeial methods, this study did not assess the sensitivity of the Minilab methodology in the detection of substandard medicines, and may underestimate the prevalence of poor-quality medicines. Conclusions Surveillance for poor-quality medicines can be carried out by local organizations in low- and middle-income countries using a simple, low-cost technology. Such surveillance can identify an important subgroup of the circulating substandard and falsified medical products and can help to prevent them from causing harm in patients. A collaboration of the national drug regulatory authorities with faith-based organizations and other NGOs may therefore represent a promising strategy towards the Sustainable Development Goal of “ensuring access to quality medicines”. PMID:28877208

Carbonaceous materials and their advances as a counter electrode in dye-sensitized solar cells: challenges and prospects.

PubMed

Kouhnavard, Mojgan; Ludin, Norasikin Ahmad; Ghaffari, Babak V; Sopian, Kamarozzaman; Ikeda, Shoichiro

2015-05-11

Dye-sensitized solar cells (DSSCs) serve as low-costing alternatives to silicon solar cells because of their low material and fabrication costs. Usually, they utilize Pt as the counter electrode (CE) to catalyze the iodine redox couple and to complete the electric circuit. Given that Pt is a rare and expensive metal, various carbon materials have been intensively investigated because of their low costs, high surface areas, excellent electrochemical stabilities, reasonable electrochemical activities, and high corrosion resistances. In this feature article, we provide an overview of recent studies on the electrochemical properties and photovoltaic performances of carbon-based CEs (e.g., activated carbon, nanosized carbon, carbon black, graphene, graphite, carbon nanotubes, and composite carbon). We focus on scientific challenges associated with each material and highlight recent advances achieved in overcoming these obstacles. Finally, we discuss possible future directions for this field of research aimed at obtaining highly efficient DSSCs. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Primary treatments for clinically localised prostate cancer: a comprehensive lifetime cost-utility analysis.

PubMed

Cooperberg, Matthew R; Ramakrishna, Naren R; Duff, Steven B; Hughes, Kathleen E; Sadownik, Sara; Smith, Joseph A; Tewari, Ashutosh K

2013-03-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Multiple treatment alternatives exist for localised prostate cancer, with few high-quality studies directly comparing their comparative effectiveness and costs. The present study is the most comprehensive cost-effectiveness analysis to date for localised prostate cancer, conducted with a lifetime horizon and accounting for survival, health-related quality-of-life, and cost impact of secondary treatments and other downstream events, as well as primary treatment choices. The analysis found minor differences, generally slightly favouring surgical methods, in quality-adjusted life years across treatment options. However, radiation therapy (RT) was consistently more expensive than surgery, and some alternatives, e.g. intensity-modulated RT for low-risk disease, were dominated - that is, both more expensive and less effective than competing alternatives. To characterise the costs and outcomes associated with radical prostatectomy (open, laparoscopic, or robot-assisted) and radiation therapy (RT: dose-escalated three-dimensional conformal RT, intensity-modulated RT, brachytherapy, or combination), using a comprehensive, lifetime decision analytical model. A Markov model was constructed to follow hypothetical men with low-, intermediate-, and high-risk prostate cancer over their lifetimes after primary treatment; probabilities of outcomes were based on an exhaustive literature search yielding 232 unique publications. In each Markov cycle, patients could have remission, recurrence, salvage treatment, metastasis, death from prostate cancer, and death from other causes. Utilities for each health state were determined, and disutilities were applied for complications and toxicities of treatment. Costs were determined from the USA payer perspective, with incorporation of patient costs in a sensitivity analysis. Differences across treatments in quality-adjusted life years across methods were modest, ranging from 10.3 to 11.3 for low-risk patients, 9.6-10.5 for intermediate-risk patients and 7.8-9.3 for high-risk patients. There were no statistically significant differences among surgical methods, which tended to be more effective than RT methods, with the exception of combined external beam + brachytherapy for high-risk disease. RT methods were consistently more expensive than surgical methods; costs ranged from $19 901 (robot-assisted prostatectomy for low-risk disease) to $50 276 (combined RT for high-risk disease). These findings were robust to an extensive set of sensitivity analyses. Our analysis found small differences in outcomes and substantial differences in payer and patient costs across treatment alternatives. These findings may inform future policy discussions about strategies to improve efficiency of treatment selection for localised prostate cancer. © 2012 BJU International.

Integration of OLEDs in biomedical sensor systems: design and feasibility analysis

NASA Astrophysics Data System (ADS)

Rai, Pratyush; Kumar, Prashanth S.; Varadan, Vijay K.

2010-04-01

Organic (electronic) Light Emitting Diodes (OLEDs) have been shown to have applications in the field of lighting and flexible display. These devices can also be incorporated in sensors as light source for imaging/fluorescence sensing for miniaturized systems for biomedical applications and low-cost displays for sensor output. The current device capability aligns well with the aforementioned applications as low power diffuse lighting and momentary/push button dynamic display. A top emission OLED design has been proposed that can be incorporated with the sensor and peripheral electrical circuitry, also based on organic electronics. Feasibility analysis is carried out for an integrated optical imaging/sensor system, based on luminosity and spectrum band width. A similar study is also carried out for sensor output display system that functions as a pseudo active OLED matrix. A power model is presented for device power requirements and constraints. The feasibility analysis is also supplemented with the discussion about implementation of ink-jet printing and stamping techniques for possibility of roll to roll manufacturing.

Dyes removal from water using low cost absorbents

NASA Astrophysics Data System (ADS)

Giraldo, S.; Ramirez, A. P.; Ulloa, M.; Flórez, E.; Y Acelas, N.

2017-12-01

In this study, the removal capacity of low cost adsorbents during the adsorption of Methylene Blue (MB) and Congo Red (CR) at different concentrations (50 and 100mg·L-1) was evaluated. These adsorbents were produced from wood wastes (cedar and teak) by chemical activation (ZnCl2). Both studied materials, Activated Cedar (AC) and activated teak (AT) showed a good fit of their experimental data to the pseudo second order kinetic model and Langmuir isotherms. The maximum adsorption capacities for AC were 2000.0 and 444.4mg·g-1 for MB and CR, respectively, while for AT, maximum adsorption capacities of 1052.6 and 86.4mg·g-1 were found for MB and CR, respectively.

A cost-consequences analysis of a primary care librarian question and answering service.

PubMed

McGowan, Jessie; Hogg, William; Zhong, Jianwei; Zhao, Xue

2012-01-01

Cost consequences analysis was completed from randomized controlled trial (RCT) data for the Just-in-time (JIT) librarian consultation service in primary care that ran from October 2005 to April 2006. The service was aimed at providing answers to clinical questions arising during the clinical encounter while the patient waits. Cost saving and cost avoidance were also analyzed. The data comes from eighty-eight primary care providers in the Ottawa area working in Family Health Networks (FHNs) and Family Health Groups (FHGs). We conducted a cost consequences analysis based on data from the JIT project. We also estimated the potential economic benefit of JIT librarian consultation service to the health care system. The results show that the cost per question for the JIT service was $38.20. The cost could be as low as $5.70 per question for a regular service. Nationally, if this service was implemented and if family physicians saw additional patients when the JIT service saved them time, up to 61,100 extra patients could be seen annually. A conservative estimate of the cost savings and cost avoidance per question for JIT was $11.55. The cost per question, if the librarian service was used at full capacity, is quite low. Financial savings to the health care system might exceed the cost of the service. Saving physician's time during their day could potentially lead to better access to family physicians by patients. Implementing a librarian consultation service can happen quickly as the time required to train professional librarians to do this service is short.

Cost-effectiveness of iso- versus low-osmolality contrast media in outpatients with high risk of contrast medium-induced nephropathy.

PubMed

Chicaíza-Becerra, Liliana Alejandra; García-Molina, Mario; Gamboa, Óscar

2012-06-01

Contrast media can cause acute renal failure by direct toxic effects on the tubular cells and kidney ischemia. Diabetics and hospitalized patients have a greater risk of developing contrast-induced nephropathy than the general population. The cost effectiveness of iso and low-osmolality contrast media was assessed in high risk outpatients. The analysis was based on a systematic literature review comparing the nephrotoxic effects of iso- to low-osmolality contrast media. Only direct costs were considered; these were obtained from the official tariff manual. Incremental cost-effectiveness ratios, efficiency curves and acceptability curves were calculated. Univariate sensitivity analyses were performed for costs and effects, as well as probabilistic analyses. Zero and 3% discounts were applied to results. The cost-effectiveness threshold was equal to the per capita GDP per life-year gained. Alternatives with Iopamidol and Iodixanol are preferable to the others, because both reduce risk of contrast-induced nephropathy and are less costly. The incremental cost-effectiveness of the Iodixanol alternative compared to the Iopamidol alternative is US$ 14,660 per additional life year gained; this is more than twice the threshold. The low-osmolality contrast medium, Iopamidol, appears to be cost-effective when compared with Iohexol or other low-osmolality contrast media (Iopromide, Iobitridol, Iomeprol, Iopentol and Ioxilan) in contrast-induced nephropathy, high-risk outpatients. The choice of the iso-osmolality contrast medium, Iodixanol, depends on its cost per vial and on the willingness to pay.

The importance of context in early autism intervention: A qualitative South African study.

PubMed

Guler, Jessy; de Vries, Petrus J; Seris, Noleen; Shabalala, Nokuthula; Franz, Lauren

2017-09-01

The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.

Low cost passive solar adobe house

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

Not Available

1981-12-21

A brief description, photographs, and cost breakdown of a hybrid direct-gain passive solar adobe house constructed in the City of El Paso, Texas. The 3-panel active solar domestic hot water system acts as a back-up to the direct gain passive system.

Comparison of anti-plaque efficacy between a low and high cost dentifrice: A short term randomized double-blind trial

PubMed Central

Ganavadiya, Rahul; Shekar, B. R. Chandra; Goel, Pankaj; Hongal, Sudheer G.; Jain, Manish; Gupta, Ruchika

2014-01-01

Objective: The aim of this study was to compare the anti-plaque efficacy of a low and high cost commercially available tooth paste among 13-20 years old adolescents in a Residential Home, Bhopal, India. Materials and Methods: The study was randomized double-blind parallel clinical trial conducted in a Residential Home, Bhopal, India. A total of 65 patients with established dental plaque and gingivitis were randomly assigned to either low cost or high cost dentifrice group for 4 weeks. The plaque and gingival scores at baseline and post-intervention were assessed and compared. Statistical analysis was performed using paired t-test and the independent sample t-test. The statistical significance was fixed at 0.05. Results: Results indicated a significant reduction in plaque and gingival scores in both groups post-intervention compared with the baseline. Difference between the groups was not significant. No adverse events were reported and both the dentifrices were well-tolerated. Conclusion: Low cost dentifrice is equally effective to the high cost dentifrice in reducing plaque and gingival inflammation. PMID:25202220

Cost-Effectiveness Analysis of Fosfomycin for Treatment of Uncomplicated Urinary Tract Infections in Ontario

PubMed Central

Dahan, Sybil; Iliza, Ange Christelle; LeLorier, Jacques

2017-01-01

Background and Objective. Bacterial resistance to antibiotics traditionally used to treat uncomplicated urinary tract infections (uUTIs) is rising in Canada. We compared the cost-per-patient in Ontario of including fosfomycin (an antibiotic with a low resistance profile) as an option for first-line empirical treatment of uUTIs with current cost of treatment with sulfonamides, fluoroquinolones, and nitrofurantoin. Methods. A decision-tree model was used to perform a cost-minimization analysis. All possible outcomes of a uUTI caused by bacterial species treated with either sulfonamides, fluoroquinolones, nitrofurantoin, or fosfomycin were included. Results. In the base case analysis, the cost-per-patient for treating uUTI with fosfomycin was $105.12. This is similar to the cost-per-patient for each of the other currently reimbursed antibiotics (e.g., $96.19 for sulfonamides, $98.85 for fluoroquinolones, and $99.09 for nitrofurantoins). The weighted average cost-per-patient for treating uUTI was not substantially elevated with the inclusion of fosfomycin in the treatment landscape ($98.41 versus $98.29 with and without fosfomycin, resp.). The sensitivity analyses revealed that most (88.34%) of the potential variation in cost was associated with the probability of progressing to pyelonephritis and hospitalization for pyelonephritis. Conclusion. Fosfomycin in addition to being a safe and effective agent to treat uUTI has a low resistance profile, offers a single-dose treatment administration, and is similar in cost to other reimbursed antibiotics. PMID:28316632

Cost Analysis and Performance Assessment of Partner Services for Human Immunodeficiency Virus and Sexually Transmitted Diseases, New York State, 2014.

PubMed

Johnson, Britney L; Tesoriero, James; Feng, Wenhui; Qian, Feng; Martin, Erika G

2017-12-01

To estimate the programmatic costs of partner services for HIV, syphilis, gonorrhea, and chlamydial infection. New York State and local health departments conducting partner services activities in 2014. A cost analysis estimated, from the state perspective, total program costs and cost per case assignment, patient interview, partner notification, and disease-specific key performance indicator. Data came from contracts, a time study of staff effort, and statewide surveillance systems. Disease-specific costs per case assignment (mean: $580; range: $502-$1,111), patient interview ($703; $608-$1,609), partner notification ($1,169; $950-$1,936), and key performance indicator ($2,697; $1,666-$20,255) varied across diseases. Most costs (79 percent) were devoted to gonorrhea and chlamydial infection investigations. Cost analysis complements cost-effectiveness analysis in evaluating program performance and guiding improvements. © Health Research and Educational Trust.

Educational Impacts and Cost-Effectiveness of Conditional Cash Transfer Programs in Developing Countries: A Meta-Analysis

ERIC Educational Resources Information Center

García, Sandra; Saavedra, Juan E.

2017-01-01

We meta-analyze for impact and cost-effectiveness 94 studies from 47 conditional cash transfer programs in low- and middle-income countries worldwide, focusing on educational outcomes that include enrollment, attendance, dropout, and school completion. To conceptually guide and interpret the empirical findings of our meta-analysis, we present a…

Cost analysis of adjustments of the epidemiological surveillance system to mass gatherings.

PubMed

Zieliński, Andrzej

2011-01-01

The article deals with the problem of economical analysis of public health activities at mass gatherings. After presentation of elementary review of basic economical approaches to cost analysis author tries to analyze applicability of those methods to planning of mass gatherings. Difficulties in comparability of different events and lack of the outcome data at the stage of planning make most of the economic approaches unsuitable to application at the planning stage. Even applicability of cost minimization analysis may be limited to comparison of predicted costs of preconceived standards of epidemiological surveillance. Cost effectiveness performed ex post after the event when both costs and obtained effects are known, may bring more information for future selection of most effective procedures.

The silver lining of disposable sporicidal privacy curtains in an intensive care unit.

PubMed

Kotsanas, Despina; Wijesooriya, W R P L I; Sloane, Tracy; Stuart, Rhonda L; Gillespie, Elizabeth E

2014-04-01

The environment is a well-known source of health care-acquired infection. Because of the known risk of contamination, patient privacy curtains require frequent changes to decrease the risk of spread from patients to curtain and visa versa. Fourteen disposable sporicidal privacy curtains were tested from December 2012 to June 2013 while hanging in a busy intensive care unit. Significant bacterial pathogens were identified and total bacteria enumerated as colony-forming units. Antimicrobial activity of curtain swatches was also tested against a range of bacteria in the laboratory. Measurements were recorded as zone of inhibition and contact inhibition. A cost analysis to replace standard curtains with disposable sporicidal curtains was also undertaken. Cultures grew low numbers of skin and environmental microorganisms with no methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, or Clostridium difficile detected. Vancomycin-resistant enterococci were recovered in very low numbers from 2 curtains where vancomycin-resistant enterococci-infected patients had been located. Privacy curtains demonstrated antimicrobial activity against C difficile and 13 additional bacterial pathogens. We conclude that disposable sporicidal privacy curtains are cost-effective and best replaced at 6 months in a high-risk area such as an intensive care unit. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Economic analysis of blood product transfusions according to the treatment of acute myeloid leukemia in the elderly.

PubMed

Cannas, G; Fattoum, J; Boukhit, M; Thomas, X

2015-01-01

Blood transfusion requirement represents one of the most significant cost driver associated with acute myeloid leukemia (AML). Low-intensity treatments (low-dose cytarabine, hypomethylating agents) have the potential to reduce transfusion dependence, and improve health-related quality of life. We assessed the cost-effectiveness of treatment types regarding blood product transfusions in a cohort of 214 AML patients aged ≥ 70 years. Analyzes did not indicate any significant overall survival (OS) advantage of intensive chemotherapy comparatively to low-intensity treatment. The difference was significant when compared to best supportive care (BSC) (P<0.0001). Blood products transfusion cost per patient was 1.3 times lower with low-intensity therapy and 2.7 times lower with BSC than with intensive chemotherapy. Mean transfusion cost per patient according to OS varied from 2.4 to 1.3 times less with low-intensity treatment comparatively to intensive chemotherapy for patients having OS ≤ 13.3 months. Costs varied from 3.5 to 2.6 times less with BSC comparatively to intensive chemotherapy. In contrast, mean transfusion costs were comparable among treatments for patients with OS>13.3 months. Low-intensity treatments represent a cost-effective alternative to BSC and require a reduced number of transfused blood products comparatively to intensive chemotherapy, while OS was not significantly different. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Economic Short-Term Cost Model for Stereotactic Radiotherapy of Neovascular AMD].

PubMed

Neubauer, A S; Reznicek, L; Minartz, C; Ziemssen, F

2016-08-01

Stereotactic radiation therapy (Oraya, OT) is available as a second line therapy for patients who, despite intensive anti-VEGF therapy for neovascular AMD, do not show an improvement in CNV. As OT is expensive (5,308 €), the short term economics for starting this therapy were investigated. A short-term cost model was set up in MS Excel with a two year time horizon. On the basis of the data of the randomised, controlled INTREPID pivotal trial and current treatment practice in Germany, the costs were compared of conventional anti-VEGF therapy, with or without a single OT treatment. Patients with an active lesion after initial anti-VEGF therapy and a maximum lesion diameter ≤ 4 mm were included. Modeled cost components/aspects were direct savings from injection number, control follow-up examinations and aids, as well as anti-VEGF switches. Costs for Germany were employed and a univariate sensitivity analysis was performed to address the existing uncertainty. For the patients with a maximum AMD lesion diameter ≤ 4 mm and a macula volume > 7.4 mm(3), the INTREPID trial showed a mean reduction of 3.68 intravitreal injections for 16 Gy radiation versus sham over a time period of 2 years. These 3.68 IVM result in ~ 4,500 € direct cost savings. Moreover, due to the higher response rate with 16 Gy radiation, the number of follow-up visits and aids can be reduced, which results in savings between 207 € and 1,224 € over 2 years. After radiation, fewer anti-VEGF switches for low or non-responders are expected, which is modeled to result in ~ 1.7 fewer injections over 2 years. Due to overall fewer injections, fewer endophthalmitis cases would be expected. However, endophthalmitis and microvascular abnormalities, which can be observed in a few cases, are associated with low or non-quantifiable costs in this cost-cost comparison model. In summary, cost reductions of between 6,400 and 8,500 € are predicted in the model over two years, which have to be compared to the costs of a single application of OT. The short-term economic analysis shows that anti-VEGF therapy combined with OT results in savings above the costs for OT itself over a 2 year time horizon. Overall, the approach gives potential cost reductions, if the appropriate indication is followed. Georg Thieme Verlag KG Stuttgart · New York.

Development of Low Cost Satellite Communications System for Helicopters and General Aviation

NASA Technical Reports Server (NTRS)

Farazian, K.; Abbe, B.; Divsalar, D.; Raphaeli, D.; Tulintseff, A.; Wu, T.; Hinedi, S.

1994-01-01

In this paper, the development of low-cost satellite communications (SATCOM) system for helicopters and General Aviation (GA) aircrafts is described. System design and standards analysis have been conducted to meet the low-cost, light-weight, small-size and low-power system requirements for helicopters and GA aircraft environments. Other specific issues investigated include coding schemes, spatial diversity, and antenna arraying techniques. Coding schemes employing Channel State Information (CSI) and inverleaving have been studied in order to mitigate severe banking angle fading and the periodic RF signal blockage due to the helicopter rotor blades. In addition, space diversity and antenna arraying techniques have been investigated to further reduce the fading effects and increase the link margin.

Demand and supply of emergency help: an economic analysis of Red Cross services.

PubMed

Hackl, Franz; Pruckner, Gerald Josef

2006-08-01

This paper analyzes supply and demand side characteristics of (voluntary) Red Cross services in Austria. The demand side analysis is based on a contingent valuation study on people's willingness to pay for emergency treatment, transportation services and disaster relief activities. The supply side is identified by a high percentage of volunteers in the Red Cross organization which makes the provision of emergency help at low cost possible. We find that aggregate benefits of Red Cross services exceed their cost of production. Policy conclusions are drawn with respect to future recruitment and funding: whereas intrinsic motivation is important for the decision to volunteer, and financial incentives play a minor role in general, the young Red Cross activists work voluntarily for self-realization reasons and to continue their education. Age-specific recruitment strategies accompanied by word-of-mouth advertising are recommended to address potential volunteers. As long as the volunteering character of Red Cross services will be maintained and cost of production will not go up an increase of funds does not seem necessary in the future. Moreover, a radical change in the structure of funding may crowd out both donations and voluntary labor supply.

Synthesis and characterization of low-cost activated carbon prepared from Malawian baobab fruit shells by H3PO4 activation for removal of Cu(II) ions: equilibrium and kinetics studies

NASA Astrophysics Data System (ADS)

Vunain, Ephraim; Kenneth, Davie; Biswick, Timothy

2017-12-01

In this study, low-cost activated carbon (AC) prepared from baobab fruit shells by chemical activation using phosphoric acid was evaluated for the removal of Cu(II) ions from aqueous solution. The prepared activated carbon samples were characterized using N2-adsorption-desorption isotherms, SEM, FTIR, EDX and XRD analysis. The sample activated at 700 °C was chosen as our optimized sample because its physicochemical properties and BET results were similar to those of a commercial sample. The N2-adsorption-desorption results of the optimized sample revealed a BET surface area of 1089 m2/g, micropore volume of 0.3764 cm3/g, total pore volume of 0.4330 cm3/g and pore size of 1.45 nm. Operational parameters such as pH, initial copper concentration, contact time, adsorbent dosage and temperature were studied in a batch mode. Equilibrium data were obtained by testing the adsorption data using three different isotherm models: Langmuir, Freundlich and Dubinin-Radushkevish (D-R) models. It was found that the adsorption of copper correlated well with the Langmuir isotherm model with a maximum monolayer adsorption capacity of 3.0833 mg/g. The kinetics of the adsorption process was tested through pseudo-first-order and pseudo-second-order models. The pseudo-second-order kinetic model provided the best correlation for the experimental data studied. The adsorption followed chemisorption process. The study provided an effective use of baobab fruit shells as a valuable source of adsorbents for the removal of copper ions from aqueous solution. This study could add economic value to baobab fruit shells in Malawi, reduce disposal problems, and offer an economic source of AC to the AC users.

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation.

PubMed

Hollinghurst, Sandra; Sharp, Debbie; Ballard, Kathleen; Barnett, Jane; Beattie, Angela; Evans, Maggie; Lewith, George; Middleton, Karen; Oxford, Frances; Webley, Fran; Little, Paul

2008-12-11

An economic evaluation of therapeutic massage, exercise, and lessons in the Alexander technique for treating persistent back pain. Cost consequences study and cost effectiveness analysis at 12 month follow-up of a factorial randomised controlled trial. 579 patients with chronic or recurrent low back pain recruited from primary care. Normal care (control), massage, and six or 24 lessons in the Alexander technique. Half of each group were randomised to a prescription for exercise from a doctor plus behavioural counselling from a nurse. Costs to the NHS and to participants. Comparison of costs with Roland-Morris disability score (number of activities impaired by pain), days in pain, and quality adjusted life years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost effectiveness ratios and cost effectiveness acceptability curves. Intervention costs ranged from pound30 for exercise prescription to pound596 for 24 lessons in Alexander technique plus exercise. Cost of health services ranged from pound50 for 24 lessons in Alexander technique to pound124 for exercise. Incremental cost effectiveness analysis of single therapies showed that exercise offered best value ( pound61 per point on disability score, pound9 per additional pain-free day, pound2847 per QALY gain). For two-stage therapy, six lessons in Alexander technique combined with exercise was the best value (additional pound64 per point on disability score, pound43 per additional pain-free day, pound5332 per QALY gain). An exercise prescription and six lessons in Alexander technique alone were both more than 85% likely to be cost effective at values above pound20 000 per QALY, but the Alexander technique performed better than exercise on the full range of outcomes. A combination of six lessons in Alexander technique lessons followed by exercise was the most effective and cost effective option.

Cost-benefit analysis of prophylactic granulocyte colony-stimulating factor during CHOP antineoplastic therapy for non-Hodgkin's lymphoma.

PubMed

Dranitsaris, G; Altmayer, C; Quirt, I

1997-06-01

Several randomised comparative trials have shown that granulocyte colony-stimulating factor (G-CSF) reduces the duration of neutropenia, hospitalisation and intravenous antibacterial use in patients with cancer who are receiving high-dosage antineoplastic therapy. However, one area that has received less attention is the role of G-CSF in standard-dosage antineoplastic regimens. One such treatment that is considered to have a low potential for inducing fever and neutropenia is the CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone) for non-Hodgkin's lymphoma. We conducted a cost-benefit analysis from a societal perspective in order to estimate the net cost or benefit of prophylactic G-CSF in this patient population. This included direct costs for hospitalisation with antibacterial support, as well as indirect societal costs, such as time off work and antineoplastic therapy delays secondary to neutropenia. The findings were then tested by a comprehensive sensitivity analysis. The administration of G-CSF at a dosage of 5 micrograms/kg/day for 11 doses following CHOP resulted in an overall net cost of $Can1257. In the sensitivity analysis, lowering the G-CSF dosage to 2 micrograms/kg/day generated a net benefit of $Can6564, indicating a situation that was cost saving to society. The results of the current study suggest that the use of G-CSF in patients receiving CHOP antineoplastic therapy produces a situation that is close to achieving cost neutrality. However, low-dosage (2 micrograms/kg/day) G-CSF is an economically attractive treatment strategy because it may result in overall savings to society.

Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

PubMed

Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M

2015-04-01

(1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

GPACC program cost work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 3

NASA Technical Reports Server (NTRS)

1985-01-01

The results of detailed cost estimates and economic analysis performed on the updated Model 101 configuration of the general purpose Aft Cargo Carrier (ACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the ACC on the Space Transportation System (STS). The detailed cost estimates for the ACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/ACC launch vehicle cost impacts for delivering payloads to a 160 NM low Earth orbit (LEO).

DACC program cost and work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 2

NASA Technical Reports Server (NTRS)

1985-01-01

Results of detailed cost estimates and economic analysis performed on the updated 201 configuration of the dedicated Aft Cargo Carrier (DACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the DACC on the Space Transportation System (STS). The detailed cost estimates for the DACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/DACC launch vehicle cost impacts for delivering an orbital transfer vehicle to a 120 NM low Earth orbit (LEO).

How Much? Cost Models for Online Education.

ERIC Educational Resources Information Center

Lorenzo, George

2001-01-01

Reviews some of the research being done in the area of cost models for online education. Describes a cost analysis handbook; an activity-based costing model that was based on an economic model for traditional instruction at the Indiana University Purdue University Indianapolis; and blending other costing models. (LRW)

Cost-effectiveness with multiple outcomes.

PubMed

Bjørner, Jakob; Keiding, Hans

2004-12-01

In a large number of situations, activities in health care have to be measured in terms of outcome and cost. However, the cases where outcome is fully captured by a single measure are rather few, so that one uses some index for outcome, computed by weighing together several outcome measures using subjective and somewhat arbitrary weights. In the paper we propose an approach to cost-effectiveness analysis where such artificial aggregation is avoided. This is achieved by assigning to each activity the weights which are the most favourable in a comparison with the other options available, so that activities which have a poor score in this method are guaranteed to be inferior. The method corresponds to applying Data envelopment analysis, known from the theory of productivity, to the context of health economic evaluations. The method is applied to an analysis of the cost-effectiveness of alternative health plans using data from the Medical Outcome Study (JAMA 1996; 276: 1039-1047), where outcome is measured as improvement in mental and physical health. 2004 John Wiley & Sons, Ltd.

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

ERIC Educational Resources Information Center

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

2006-01-01

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

High Performance, Low Cost Hydrogen Generation from Renewable Energy

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

Ayers, Katherine; Dalton, Luke; Roemer, Andy

Renewable hydrogen from proton exchange membrane (PEM) electrolysis is gaining strong interest in Europe, especially in Germany where wind penetration is already at critical levels for grid stability. For this application as well as biogas conversion and vehicle fueling, megawatt (MW) scale electrolysis is required. Proton has established a technology roadmap to achieve the necessary cost reductions and manufacturing scale up to maintain U.S. competitiveness in these markets. This project represents a highly successful example of the potential for cost reduction in PEM electrolysis, and provides the initial stack design and manufacturing development for Proton’s MW scale product launch. Themore » majority of the program focused on the bipolar assembly, from electrochemical modeling to subscale stack development through prototyping and manufacturing qualification for a large active area cell platform. Feasibility for an advanced membrane electrode assembly (MEA) with 50% reduction in catalyst loading was also demonstrated. Based on the progress in this program and other parallel efforts, H2A analysis shows the status of PEM electrolysis technology dropping below $3.50/kg production costs, exceeding the 2015 target.« less

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

PubMed Central

van der Roer, Nicole; van Tulder, Maurits W; Barendse, Johanna M; van Mechelen, Willem; Franken, Willemien K; Ooms, Arjan C; de Vet, Henrica CW

2004-01-01

Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available. PMID:15560843

Rock bed thermal storage: Concepts and costs

NASA Astrophysics Data System (ADS)

Allen, Kenneth; von Backström, Theodor; Joubert, Eugene; Gauché, Paul

2016-05-01

Thermal storage enables concentrating solar power (CSP) plants to provide baseload or dispatchable power. Currently CSP plants use two-tank molten salt thermal storage, with estimated capital costs of about 22-30 /kWhth. In the interests of reducing CSP costs, alternative storage concepts have been proposed. In particular, packed rock beds with air as the heat transfer fluid offer the potential of lower cost storage because of the low cost and abundance of rock. Two rock bed storage concepts which have been formulated for use at temperatures up to at least 600 °C are presented and a brief analysis and cost estimate is given. The cost estimate shows that both concepts are capable of capital costs less than 15 /kWhth at scales larger than 1000 MWhth. Depending on the design and the costs of scaling containment, capital costs as low as 5-8 /kWhth may be possible. These costs are between a half and a third of current molten salt costs.

Laparoscopic Versus Open Cholecystectomy: A Cost-Effectiveness Analysis at Rwanda Military Hospital.

PubMed

Silverstein, Allison; Costas-Chavarri, Ainhoa; Gakwaya, Mussa R; Lule, Joseph; Mukhopadhyay, Swagoto; Meara, John G; Shrime, Mark G

2017-05-01

Laparoscopic cholecystectomy is first-line treatment for uncomplicated gallstone disease in high-income countries due to benefits such as shorter hospital stays, reduced morbidity, more rapid return to work, and lower mortality as well-being considered cost-effective. However, there persists a lack of uptake in low- and middle-income countries. Thus, there is a need to evaluate laparoscopic cholecystectomy in comparison with an open approach in these settings. A cost-effectiveness analysis was performed to evaluate laparoscopic and open cholecystectomies at Rwanda Military Hospital (RMH), a tertiary care referral hospital in Rwanda. Sensitivity and threshold analyses were performed to determine the robustness of the results. The laparoscopic and open cholecystectomy costs and effectiveness values were $2664.47 with 0.87 quality-adjusted life years (QALYs) and $2058.72 with 0.75 QALYs, respectively. The incremental cost-effectiveness ratio for laparoscopic over open cholecystectomy was $4946.18. Results are sensitive to the initial laparoscopic equipment investment and number of cases performed annually but robust to other parameters. The laparoscopic intervention is more cost-effective with investment costs less than $91,979, greater than 65 cases annually, or at willingness-to-pay (WTP) thresholds greater than $3975/QALY. At RMH, while laparoscopic cholecystectomy may be a more effective approach, it is also more expensive given the low caseload and high investment costs. At commonly accepted WTP thresholds, it is not cost-effective. However, as investment costs decrease and/or case volume increases, the laparoscopic approach may become favorable. Countries and hospitals should aspire to develop innovative, low-cost options in high volume to combat these barriers and provide laparoscopic surgery.

Sample to answer visualization pipeline for low-cost point-of-care blood cell counting

NASA Astrophysics Data System (ADS)

Smith, Suzanne; Naidoo, Thegaran; Davies, Emlyn; Fourie, Louis; Nxumalo, Zandile; Swart, Hein; Marais, Philip; Land, Kevin; Roux, Pieter

2015-03-01

We present a visualization pipeline from sample to answer for point-of-care blood cell counting applications. Effective and low-cost point-of-care medical diagnostic tests provide developing countries and rural communities with accessible healthcare solutions [1], and can be particularly beneficial for blood cell count tests, which are often the starting point in the process of diagnosing a patient [2]. The initial focus of this work is on total white and red blood cell counts, using a microfluidic cartridge [3] for sample processing. Analysis of the processed samples has been implemented by means of two main optical visualization systems developed in-house: 1) a fluidic operation analysis system using high speed video data to determine volumes, mixing efficiency and flow rates, and 2) a microscopy analysis system to investigate homogeneity and concentration of blood cells. Fluidic parameters were derived from the optical flow [4] as well as color-based segmentation of the different fluids using a hue-saturation-value (HSV) color space. Cell count estimates were obtained using automated microscopy analysis and were compared to a widely accepted manual method for cell counting using a hemocytometer [5]. The results using the first iteration microfluidic device [3] showed that the most simple - and thus low-cost - approach for microfluidic component implementation was not adequate as compared to techniques based on manual cell counting principles. An improved microfluidic design has been developed to incorporate enhanced mixing and metering components, which together with this work provides the foundation on which to successfully implement automated, rapid and low-cost blood cell counting tests.

Managing Distance Education Institutions through Value Chain Analysis: the Nigerian Experience.

ERIC Educational Resources Information Center

Aderinto, J. A.; Akintayo, M. O.

Value chain analysis can gauge, analyze, and predict organization effects to control cost in light of achieving strategic organization objectives of distance education. Value chain analysis enables organizations to accomplish their goal or mission through cost effectiveness or differentiation. The value chain activity structure in a distance…

Polycrystalline silicon study: Low-cost silicon refining technology prospects and semiconductor-grade polycrystalline silicon availability through 1988

NASA Technical Reports Server (NTRS)

Costogue, E. N.; Ferber, R.; Lutwack, R.; Lorenz, J. H.; Pellin, R.

1984-01-01

Photovoltaic arrays that convert solar energy into electrical energy can become a cost effective bulk energy generation alternative, provided that an adequate supply of low cost materials is available. One of the key requirements for economic photovoltaic cells is reasonably priced silicon. At present, the photovoltaic industry is dependent upon polycrystalline silicon refined by the Siemens process primarily for integrated circuits, power devices, and discrete semiconductor devices. This dependency is expected to continue until the DOE sponsored low cost silicon refining technology developments have matured to the point where they are in commercial use. The photovoltaic industry can then develop its own source of supply. Silicon material availability and market pricing projections through 1988 are updated based on data collected early in 1984. The silicon refining industry plans to meet the increasing demands of the semiconductor device and photovoltaic product industries are overviewed. In addition, the DOE sponsored technology research for producing low cost polycrystalline silicon, probabilistic cost analysis for the two most promising production processes for achieving the DOE cost goals, and the impacts of the DOE photovoltaics program silicon refining research upon the commercial polycrystalline silicon refining industry are addressed.

The cost of integrating a physical activity counselor in the primary health care team.

PubMed

Hogg, William E; Zhao, Xue; Angus, Douglas; Fortier, Michelle; Zhong, Jianwei; O'Sullivan, Tracey; Sigal, Ronald J; Blanchard, Chris

2012-01-01

This article assesses direct costs of integrating a physical activity counselor (PAC) into primary health care teams to improve physical activity levels of inactive patients. A monthly cost analysis was conducted using data from 120 inactive patients, aged 18 to 69 years, who were recruited from a community-based family medicine practice. Relevant cost items for the intensive counseling group included (1) office expenses; (2) equipment purchases; (3) operating costs; (4) costs of training the PAC; and (5) labor costs. Physical and human capital were amortized over a 5-year horizon at a discount rate of 5%. Integrating a PAC into the primary health care team incurred an estimated one-time cost of CA$91.43 per participant per month. Results were very sensitive to the number of patients counseled. The costs associated with the intervention are lower than many other intervention studies attempting to improve population physical activity levels. Demonstrating this competitive cost base should encourage additional research to assess the effectiveness of integrating a PAC into primary health care teams to promote active living among patients who do not meet recommended physical activity levels.

A novel clot lysis assay for recombinant plasminogen activator.

PubMed

Jamialahmadi, Oveis; Fazeli, Ahmad; Hashemi-Najafabadi, Sameereh; Fazeli, Mohammad Reza

2015-03-01

Recombinant plasminogen activator (r-PA, reteplase) is an engineered variant of alteplase. When expressed in E. coli, it appears as inclusion bodies that require refolding to recover its biological activity. An important step following refolding is to determine the activity of refolded protein. Current methods for enzymatic activity of thrombolytic drugs are costly and complex. Here a straightforward and low-cost clot lysis assay was developed. It quantitatively measures the activity of the commercial reteplase and is also capable of screening refolding conditions. As evidence for adequate accuracy and sensitivity of the current assay, r-PA activity measurements are shown to be comparable to those obtained from chromogenic substrate assay.

Annual health examination program, Ames Research Center

NASA Technical Reports Server (NTRS)

Hughes, L.; Ladou, J.

1975-01-01

A cost analysis of a low-volume multiphasic health testing program is presented. The results indicate that unit costs are similar to those of high-volume automated programs. The comparability in unit cost appears to result from the savings in personnel and space requirements of the smaller program as compared with the larger ones.

Which method is best for the induction of labour? A systematic review, network meta-analysis and cost-effectiveness analysis.

PubMed

Alfirevic, Zarko; Keeney, Edna; Dowswell, Therese; Welton, Nicky J; Medley, Nancy; Dias, Sofia; Jones, Leanne V; Gyte, Gillian; Caldwell, Deborah M

2016-08-01

More than 150,000 pregnant women in England and Wales have their labour induced each year. Multiple pharmacological, mechanical and complementary methods are available to induce labour. To assess the relative effectiveness, safety and cost-effectiveness of labour induction methods and, data permitting, effects in different clinical subgroups. We carried out a systematic review using Cochrane methods. The Cochrane Pregnancy and Childbirth Group's Trials Register was searched (March 2014). This contains over 22,000 reports of controlled trials (published from 1923 onwards) retrieved from weekly searches of OVID MEDLINE (1966 to current); Cochrane Central Register of Controlled Trials (The Cochrane Library); EMBASE (1982 to current); Cumulative Index to Nursing and Allied Health Literature (1984 to current); ClinicalTrials.gov; the World Health Organization International Clinical Trials Registry Portal; and hand-searching of relevant conference proceedings and journals. We included randomised controlled trials examining interventions to induce labour compared with placebo, no treatment or other interventions in women eligible for third-trimester induction. We included outcomes relating to efficacy, safety and acceptability to women. In addition, for the economic analysis we searched the Database of Abstracts of Reviews of Effects, and Economic Evaluations Databases, NHS Economic Evaluation Database and the Health Technology Assessment database. We carried out a network meta-analysis (NMA) using all of the available evidence, both direct and indirect, to produce estimates of the relative effects of each treatment compared with others in a network. We developed a de novo decision tree model to estimate the cost-effectiveness of various methods. The costs included were the intervention and other hospital costs incurred (price year 2012-13). We reviewed the literature to identify preference-based utilities for the health-related outcomes in the model. We calculated incremental cost-effectiveness ratios, expected costs, utilities and net benefit. We represent uncertainty in the optimal intervention using cost-effectiveness acceptability curves. We identified 1190 studies; 611 were eligible for inclusion. The interventions most likely to achieve vaginal delivery (VD) within 24 hours were intravenous oxytocin with amniotomy [posterior rank 2; 95% credible intervals (CrIs) 1 to 9] and higher-dose (≥ 50 µg) vaginal misoprostol (rank 3; 95% CrI 1 to 6). Compared with placebo, several treatments reduced the odds of caesarean section, but we observed considerable uncertainty in treatment rankings. For uterine hyperstimulation, double-balloon catheter had the highest probability of being among the best three treatments, whereas vaginal misoprostol (≥ 50 µg) was most likely to increase the odds of excessive uterine activity. For other safety outcomes there were insufficient data or there was too much uncertainty to identify which treatments performed 'best'. Few studies collected information on women's views. Owing to incomplete reporting of the VD within 24 hours outcome, the cost-effectiveness analysis could compare only 20 interventions. The analysis suggested that most interventions have similar utility and differ mainly in cost. With a caveat of considerable uncertainty, titrated (low-dose) misoprostol solution and buccal/sublingual misoprostol had the highest likelihood of being cost-effective. There was considerable uncertainty in findings and there were insufficient data for some planned subgroup analyses. Overall, misoprostol and oxytocin with amniotomy (for women with favourable cervix) is more successful than other agents in achieving VD within 24 hours. The ranking according to safety of different methods was less clear. The cost-effectiveness analysis suggested that titrated (low-dose) oral misoprostol solution resulted in the highest utility, whereas buccal/sublingual misoprostol had the lowest cost. There was a high degree of uncertainty as to the most cost-effective intervention. Future trials should be powered to detect a method that is more cost-effective than misoprostol solution and report outcomes included in this NMA. This study is registered as PROSPERO CRD42013005116. The National Institute for Health Research Health Technology Assessment programme.

Development of low cost medium for ethanol production from syngas by Clostridium ragsdalei.

PubMed

Gao, Jie; Atiyeh, Hasan K; Phillips, John R; Wilkins, Mark R; Huhnke, Raymond L

2013-11-01

The development of a low cost medium for ethanol production is critical for process feasibility. Ten media were formulated for Clostridium ragsdalei by reduction, elimination and replacement of expensive nutrients. Cost analysis and effects of medium components on growth and product formation were investigated. Fermentations were performed in 250 mL bottles using syngas (20% CO, 15% CO2, 5% H2 and 60% N2). The standard medium M1 cost is $9.83/L, of which 93% is attributed to morpholinoethane sulfonic acid (MES) buffer. Statistical analysis of the results showed that MES removal did not affect cell growth and ethanol production (P>0.05). Based on cells' elemental composition, a minimal mineral concentration medium M7 was formulated, which provided 29% higher ethanol yield from CO at 3% of the cost compared to medium M1. Ethanol yield from CO in the completely defined medium M9 was 36% higher than while at 5% the cost of medium M1. Copyright © 2013 Elsevier Ltd. All rights reserved.

Formulation of microemulsion propolis fluoride (PF) as varnish topical agent to stop activity of teeth caries

NASA Astrophysics Data System (ADS)

Sahlan, Muhamad; Prakoso, Chandra Dwi; Darwita, Risqa Rina; Hermansyah, Heri

2017-02-01

Topical fluoride is proven to have higher efficacy in preventing dental caries with low production cost and easy to apply. The objective of this research is to formulate alternative agent topical fluoride NH4F 5% mixed with extract ethanol propolis (EEP) in the micro-emulsion system that has high stability, antimicrobial activity, and remineralization capability to arrest teeth caries activity. By using total plate count (TPC) analysis, formulation 2.7% EEP; 6,3% surfactant; and 90,9% NH4F shows good perform to inhibit cariogenic bacteria development around 78-80%. Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray (EDX) result also showed that sample successfully remineralized enamel surface. In addition, sample showed good pH, flavonoid, and polyphenol stability for 40 days.

Integrated operations/payloads/fleet analysis. Volume 3: System costs. Appendix A: Program direct costs

NASA Technical Reports Server (NTRS)

1971-01-01

Individualized program direct costs for each satellite program are presented. This breakdown provides the activity level dependent costs for each satellite program. The activity level dependent costs, or, more simply, program direct costs, are comprised of the total payload costs (as these costs are strictly program dependent) and the direct launch vehicle costs. Only those incremental launch vehicle costs associated directly with the satellite program are considered. For expendable launch vehicles the direct costs include the vehicle investment hardware costs and the launch operations costs. For the reusable STS vehicles the direct costs include only the launch operations, recovery operations, command and control, vehicle maintenance, and propellant support. The costs associated with amortization of reusable vehicle investment, RDT&E range support, etc., are not included.

Counting the costs of accreditation in acute care: an activity-based costing approach

PubMed Central

Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

2015-01-01

Objectives To assess the costs of hospital accreditation in Australia. Design Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Setting Acute care hospitals accredited by the Australian Council for Health Care Standards. Participants Six acute public hospitals across four States. Results Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. Conclusions This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. PMID:26351190

Conceptual and Preliminary Design of a Low-Cost Precision Aerial Delivery System

DTIC Science & Technology

2016-06-01

test results. It includes an analysis of the failure modes encountered during flight experimentation , methodology used for conducting coordinate...and experimentation . Additionally, the current and desired end state of the research is addressed. Finally, this chapter outlines the methodology ...preliminary design phases are utilized to investigate and develop a potentially low-cost alternative to existing systems. Using an Agile methodology

Carbon-doped boron nitride nanosheet as a promising catalyst for N2O reduction by CO or SO2 molecule: A comparative DFT study

NASA Astrophysics Data System (ADS)

Esrafili, Mehdi D.; Saeidi, Nasibeh

2018-06-01

We report for the first time, the catalytic activity of the experimentally available carbon-doped boron nitride nanosheet (C-BNNS) towards the reduction of N2O in the presence of CO or SO2 molecule. According to our density functional theory calculations, C-doping can introduce high spin density into BN monolayer which is mainly localized over the C and its neighboring N atoms. The Hirshfeld charge density analysis reveals that the electron-rich C-BNNS acts as an electron donating support to activate N2O molecule which is an important step in the reduction of N2O. The N2O reduction reaction starts with the dissociative adsorption of N2O over the C-BNNS surface, yielding the N2 molecule and an activated oxygen moiety (Oads) adsorbed over the C atom. The reaction then proceeds via the elimination of Oads by a CO or SO2 molecule. The obtained low activation energies clearly indicate that the metal-free C-BNNS surface can be regarded as a highly active catalyst for the reduction of N2O. The results of this study may open new avenues in searching low cost and highly active BN-based catalysts for low temperature reduction of N2O.

FDA's proposed ban on trans fats: How do the costs and benefits stack up?

PubMed

Cohen, Joshua T

2014-03-01

The goal of this commentary was to compare the benefits and costs of the US Food and Drug Administration's proposed ban on artificial trans fats in US food versus other public health risks and interventions. This analysis assessed the remaining risk posed by artificial trans fats versus other risks, comparing them in terms of: (1) population disease burden (prevention of lost life-years and decreased quality of life, aggregated and expressed as quality-adjusted life-years [QALYs]); (2) individual mortality risks for other "voluntary" activities; and (3) cost-effectiveness, which is the unit cost incurred by an intervention per QALY gained. The population impact of remaining trans fats is small compared with many other risks. Conversely, lifetime individual risks are comparable to other individual risks that might be considered notable. Finally, the ban achieves public health gains at low to no cost. The US Food and Drug Administration's ban on trans fats is sensible from the perspective of economic efficiency. Comparing the health risk addressed and the efficiency of the ban with other benchmarks can help decision makers and the population to better evaluate it. Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.

Low dose aspirin in the prevention of recurrent spontaneous preterm labour - the APRIL study: a multicenter randomized placebo controlled trial.

PubMed

Visser, Laura; de Boer, Marjon A; de Groot, Christianne J M; Nijman, Tobias A J; Hemels, Marieke A C; Bloemenkamp, Kitty W M; Bosmans, Judith E; Kok, Marjolein; van Laar, Judith O; Sueters, Marieke; Scheepers, Hubertina; van Drongelen, Joris; Franssen, Maureen T M; Sikkema, J Marko; Duvekot, Hans J J; Bekker, Mireille N; van der Post, Joris A M; Naaktgeboren, Christiana; Mol, Ben W J; Oudijk, Martijn A

2017-07-14

Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more than 2.5 million pregnancies each year. A recent meta-analysis showed possible benefits of the use of low dose aspirin in the prevention of recurrent spontaneous preterm birth. We will assess the (cost-)effectiveness of low dose aspirin in comparison with placebo in the prevention of recurrent spontaneous preterm birth in a randomized clinical trial. Women with a singleton pregnancy and a history of spontaneous preterm birth in a singleton pregnancy (22-37 weeks of gestation) will be asked to participate in a multicenter, randomized, double blinded, placebo controlled trial. Women will be randomized to low dose aspirin (80 mg once daily) or placebo, initiated from 8 to 16 weeks up to maximal 36 weeks of gestation. The primary outcome measure will be preterm birth, defined as birth at a gestational age (GA) < 37 weeks. Secondary outcomes will be a composite of adverse neonatal outcome and maternal outcomes, including subgroups of prematurity, as well as intrauterine growth restriction (IUGR) and costs from a healthcare perspective. Preterm birth will be analyzed as a group, as well as separately for spontaneous or indicated onset. Analysis will be performed by intention to treat. In total, 406 pregnant women have to be randomized to show a reduction of 35% in preterm birth from 36 to 23%. If aspirin is effective in preventing preterm birth, we expect that there will be cost savings, because of the low costs of aspirin. To evaluate this, a cost-effectiveness analysis will be performed comparing preventive treatment with aspirin with placebo. This trial will provide evidence as to whether or not low dose aspirin is (cost-) effective in reducing recurrence of spontaneous preterm birth. Clinical trial registration number of the Dutch Trial Register: NTR 5675 . EudraCT-registration number: 2015-003220-31.

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 3: assessment of economic outcome.

PubMed

Ghogawala, Zoher; Whitmore, Robert G; Watters, William C; Sharan, Alok; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Groff, Michael W; Wang, Jeffrey C; Resnick, Daniel K; Dhall, Sanjay S; Kaiser, Michael G

2014-07-01

A comprehensive economic analysis generally involves the calculation of indirect and direct health costs from a societal perspective as opposed to simply reporting costs from a hospital or payer perspective. Hospital charges for a surgical procedure must be converted to cost data when performing a cost-effectiveness analysis. Once cost data has been calculated, quality-adjusted life year data from a surgical treatment are calculated by using a preference-based health-related quality-of-life instrument such as the EQ-5D. A recent cost-utility analysis from a single study has demonstrated the long-term (over an 8-year time period) benefits of circumferential fusions over stand-alone posterolateral fusions. In addition, economic analysis from a single study has found that lumbar fusion for selected patients with low-back pain can be recommended from an economic perspective. Recent economic analysis, from a single study, finds that femoral ring allograft might be more cost-effective compared with a specific titanium cage when performing an anterior lumbar interbody fusion plus posterolateral fusion.