maximize cost effectiveness: Topics by Science.gov

Sample records for maximize cost effectiveness

Presenting evidence and summary measures to best inform societal decisions when comparing multiple strategies.

PubMed

Eckermann, Simon; Willan, Andrew R

2011-07-01

Multiple strategy comparisons in health technology assessment (HTA) are becoming increasingly important, with multiple alternative therapeutic actions, combinations of therapies and diagnostic and genetic testing alternatives. Comparison under uncertainty of incremental cost, effects and cost effectiveness across more than two strategies is conceptually and practically very different from that for two strategies, where all evidence can be summarized in a single bivariate distribution on the incremental cost-effectiveness plane. Alternative methods for comparing multiple strategies in HTA have been developed in (i) presenting cost and effects on the cost-disutility plane and (ii) summarizing evidence with multiple strategy cost-effectiveness acceptability (CEA) and expected net loss (ENL) curves and frontiers. However, critical questions remain for the analyst and decision maker of how these techniques can be best employed across multiple strategies to (i) inform clinical and cost inference in presenting evidence, and (ii) summarize evidence of cost effectiveness to inform societal reimbursement decisions where preferences may be risk neutral or somewhat risk averse under the Arrow-Lind theorem. We critically consider how evidence across multiple strategies can be best presented and summarized to inform inference and societal reimbursement decisions, given currently available methods. In the process, we make a number of important original findings. First, in presenting evidence for multiple strategies, the joint distribution of costs and effects on the cost-disutility plane with associated flexible comparators varying across replicates for cost and effect axes ensure full cost and effect inference. Such inference is usually confounded on the cost-effectiveness plane with comparison relative to a fixed origin and axes. Second, in summarizing evidence for risk-neutral societal decision making, ENL curves and frontiers are shown to have advantages over the CEA frontier in directly presenting differences in expected net benefit (ENB). The CEA frontier, while identifying strategies that maximize ENB, only presents their probability of maximizing net benefit (NB) and, hence, fails to explain why strategies maximize ENB at any given threshold value. Third, in summarizing evidence for somewhat risk-averse societal decision making, trade-offs between the strategy maximizing ENB and other potentially optimal strategies with higher probability of maximizing NB should be presented over discrete threshold values where they arise. However, the probabilities informing these trade-offs and associated discrete threshold value regions should be derived from bilateral CEA curves to prevent confounding by other strategies inherent in multiple strategy CEA curves. Based on these findings, a series of recommendations are made for best presenting and summarizing cost-effectiveness evidence for reimbursement decisions when comparing multiple strategies, which are contrasted with advice for comparing two strategies. Implications for joint research and reimbursement decisions are also discussed.
Using return on investment to maximize conservation effectiveness in Argentine grasslands.

PubMed

Murdoch, William; Ranganathan, Jai; Polasky, Stephen; Regetz, James

2010-12-07

The rapid global loss of natural habitats and biodiversity, and limited resources, place a premium on maximizing the expected benefits of conservation actions. The scarcity of information on the fine-grained distribution of species of conservation concern, on risks of loss, and on costs of conservation actions, especially in developing countries, makes efficient conservation difficult. The distribution of ecosystem types (unique ecological communities) is typically better known than species and arguably better represents the entirety of biodiversity than do well-known taxa, so we use conserving the diversity of ecosystem types as our conservation goal. We define conservation benefit to include risk of conversion, spatial effects that reward clumping of habitat, and diminishing returns to investment in any one ecosystem type. Using Argentine grasslands as an example, we compare three strategies: protecting the cheapest land ("minimize cost"), maximizing conservation benefit regardless of cost ("maximize benefit"), and maximizing conservation benefit per dollar ("return on investment"). We first show that the widely endorsed goal of saving some percentage (typically 10%) of a country or habitat type, although it may inspire conservation, is a poor operational goal. It either leads to the accumulation of areas with low conservation benefit or requires infeasibly large sums of money, and it distracts from the real problem: maximizing conservation benefit given limited resources. Second, given realistic budgets, return on investment is superior to the other conservation strategies. Surprisingly, however, over a wide range of budgets, minimizing cost provides more conservation benefit than does the maximize-benefit strategy.
Endogenous patient responses and the consistency principle in cost-effectiveness analysis.

PubMed

Liu, Liqun; Rettenmaier, Andrew J; Saving, Thomas R

2012-01-01

In addition to incurring direct treatment costs and generating direct health benefits that improve longevity and/or health-related quality of life, medical interventions often have further or "unrelated" financial and health impacts, raising the issue of what costs and effects should be included in calculating the cost-effectiveness ratio of an intervention. The "consistency principle" in medical cost-effectiveness analysis (CEA) requires that one include both the cost and the utility benefit of a change (in medical expenditures, consumption, or leisure) caused by an intervention or neither of them. By distinguishing between exogenous changes directly brought about by an intervention and endogenous patient responses to the exogenous changes, and within a lifetime utility maximization framework, this article addresses 2 questions related to the consistency principle: 1) how to choose among alternative internally consistent exclusion/inclusion rules, and 2) what to do with survival consumption costs and earnings. It finds that, for an endogenous change, excluding or including both the cost and the utility benefit of the change does not alter cost-effectiveness results. Further, in agreement with the consistency principle, welfare maximization implies that consumption costs and earnings during the extended life directly caused by an intervention should be included in CEA.
Implementing a trustworthy cost-accounting model.

PubMed

Spence, Jay; Seargeant, Dan

2015-03-01

Hospitals and health systems can develop an effective cost-accounting model and maximize the effectiveness of their cost-accounting teams by focusing on six key areas: Implementing an enhanced data model. Reconciling data efficiently. Accommodating multiple cost-modeling techniques. Improving transparency of cost allocations. Securing department manager participation. Providing essential education and training to staff members and stakeholders.
Using return on investment to maximize conservation effectiveness in Argentine grasslands

PubMed Central

Murdoch, William; Ranganathan, Jai; Polasky, Stephen; Regetz, James

2010-01-01

The rapid global loss of natural habitats and biodiversity, and limited resources, place a premium on maximizing the expected benefits of conservation actions. The scarcity of information on the fine-grained distribution of species of conservation concern, on risks of loss, and on costs of conservation actions, especially in developing countries, makes efficient conservation difficult. The distribution of ecosystem types (unique ecological communities) is typically better known than species and arguably better represents the entirety of biodiversity than do well-known taxa, so we use conserving the diversity of ecosystem types as our conservation goal. We define conservation benefit to include risk of conversion, spatial effects that reward clumping of habitat, and diminishing returns to investment in any one ecosystem type. Using Argentine grasslands as an example, we compare three strategies: protecting the cheapest land (“minimize cost”), maximizing conservation benefit regardless of cost (“maximize benefit”), and maximizing conservation benefit per dollar (“return on investment”). We first show that the widely endorsed goal of saving some percentage (typically 10%) of a country or habitat type, although it may inspire conservation, is a poor operational goal. It either leads to the accumulation of areas with low conservation benefit or requires infeasibly large sums of money, and it distracts from the real problem: maximizing conservation benefit given limited resources. Second, given realistic budgets, return on investment is superior to the other conservation strategies. Surprisingly, however, over a wide range of budgets, minimizing cost provides more conservation benefit than does the maximize-benefit strategy. PMID:21098281
Developing a conservation strategy to maximize persistence of an endangered freshwater mussel species while considering management effectiveness and cost

USGS Publications Warehouse

Smith, David R.; McRae, Sarah E.; Augspurger, Tom; Ratcliffe, Judith A.; Nichols, Robert B.; Eads, Chris B.; Savidge, Tim; Bogan, Arthur E.

2015-01-01

We used a structured decision-making process to develop conservation strategies to increase persistence of Dwarf Wedgemussel (Alasmidonta heterodon) in North Carolina, USA, while accounting for uncertainty in management effectiveness and considering costs. Alternative conservation strategies were portfolios of management actions that differed by location of management actions on the landscape. Objectives of the conservation strategy were to maximize species persistence, maintain genetic diversity, maximize public support, and minimize management costs. We compared 4 conservation strategies: 1) the ‘status quo’ strategy represented current management, 2) the ‘protect the best’ strategy focused on protecting the best populations in the Tar River basin, 3) the ‘expand the distribution’ strategy focused on management of extant populations and establishment of new populations in the Neuse River basin, and 4) the ‘hybrid’ strategy combined elements of each strategy to balance conservation in the Tar and Neuse River basins. A population model informed requirements for population management, and experts projected performance of alternative strategies over a 20-y period. The optimal strategy depended on the relative value placed on competing objectives, which can vary among stakeholders. The protect the best and hybrid strategies were optimal across a wide range of relative values with 2 exceptions: 1) if minimizing management cost was of overriding concern, then status quo was optimal, or 2) if maximizing population persistence in the Neuse River basin was emphasized, then expand the distribution strategy was optimal. The optimal strategy was robust to uncertainty in management effectiveness. Overall, the structured decision process can help identify the most promising strategies for endangered species conservation that maximize conservation benefit given the constraint of limited funding.
Strategic Placement of Treatments (SPOTS): Maximizing the Effectiveness of Fuel and Vegetation Treatments on Problem Fire Behavior and Effects

Treesearch

Diane M. Gercke; Susan A. Stewart

2006-01-01

In 2005, eight U.S. Forest Service and Bureau of Land Management interdisciplinary teams participated in a test of strategic placement of treatments (SPOTS) techniques to maximize the effectiveness of fuel treatments in reducing problem fire behavior, adverse fire effects, and suppression costs. This interagency approach to standardizing the assessment of risks and...
Cost-Effective Fuel Treatment Planning

NASA Astrophysics Data System (ADS)

Kreitler, J.; Thompson, M.; Vaillant, N.

2014-12-01

The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those that use only benefits. Variations across the heterogeneous surfaces of costs and benefits create opportunities for fuel treatments to maximize the expected averted loss of benefits. By targeting these opportunities we demonstrate how incorporating costs in fuel treatment prioritization can improve the outcome of fuel treatment planning.
Comprehensive home-based care coordination for vulnerable elders with dementia: Maximizing Independence at Home-Plus-Study protocol.

PubMed

Samus, Quincy M; Davis, Karen; Willink, Amber; Black, Betty S; Reuland, Melissa; Leoutsakos, Jeannie; Roth, David L; Wolff, Jennifer; Gitlin, Laura N; Lyketsos, Constantine G; Johnston, Deirdre

2017-12-01

Despite availability of effective care strategies for dementia, most health care systems are not yet organized or equipped to provide comprehensive family-centered dementia care management. Maximizing Independence at Home-Plus is a promising new model of dementia care coordination being tested in the U.S. through a Health Care Innovation Award funded by the Centers for Medicare and Medicaid Services that may serve as a model to address these delivery gaps, improve outcomes, and lower costs. This report provides an overview of the Health Care Innovation Award aims, study design, and methodology. This is a prospective, quasi-experimental intervention study of 342 community-living Medicare-Medicaid dual eligibles and Medicare-only beneficiaries with dementia in Maryland. Primary analyses will assess the impact of Maximizing Independence at Home-Plus on risk of nursing home long-term care placement, hospitalization, and health care expenditures (Medicare, Medicaid) at 12, 18 (primary end point), and 24 months, compared to a propensity-matched comparison group. The goals of the Maximizing Independence at Home-Plus model are to improve care coordination, ability to remain at home, and life quality for participants and caregivers, while reducing total costs of care for this vulnerable population. This Health Care Innovation Award project will provide timely information on the impact of Maximizing Independence at Home-Plus care coordination model on a variety of outcomes including effects on Medicaid and Medicare expenditures and service utilization. Participant characteristic data, cost savings, and program delivery costs will be analyzed to develop a risk-adjusted payment model to encourage sustainability and facilitate spread.
Structural interventions to prevent HIV/sexually transmitted disease: are they cost-effective for women in the southern United States?

PubMed

Cohen, Deborah A; Wu, Shin-Yi; Farley, Thomas A

2006-07-01

Structural interventions are theoretically promising for populations with a low prevalence of HIV, because they can reach large numbers of people to influence their social norms and collective risky behaviors for a relatively low cost per person. Because HIV transmission is continuing to increase among women in the southern United States, interventions to stem this epidemic are particularly warranted. This study explores whether structural interventions may be a cost-effective way to prevent HIV in this population. We used the cost-effectiveness estimator, "Maximizing the Benefit" to determine the relative cost-effectiveness of 6 structural HIV prevention interventions. "Maximizing the Benefit" is a spreadsheet tool using mathematical models to estimate the cost per HIV infection prevented taking into account the epidemiologic contexts, behavioral change as a result of an intervention, and the costs of intervention. We applied estimates of HIV prevalence related to blacks in the southern United States. All the structural interventions were cost-effective compared with average lifetime treatment costs of HIV, but mass media, condom availability, and alcohol taxes theoretically prevented the largest numbers of HIV infections. Although the assumptions used in cost-effectiveness estimates have many limitations, they do allow for a relative comparison of different interventions and help to inform policy decisions related to the allocation of HIV prevention resources. Structural interventions hold the greatest promise in reducing HIV transmission among low-prevalence populations.
Unifying cost and information in information-theoretic competitive learning.

PubMed

Kamimura, Ryotaro

2005-01-01

In this paper, we introduce costs into the framework of information maximization and try to maximize the ratio of information to its associated cost. We have shown that competitive learning is realized by maximizing mutual information between input patterns and competitive units. One shortcoming of the method is that maximizing information does not necessarily produce representations faithful to input patterns. Information maximizing primarily focuses on some parts of input patterns that are used to distinguish between patterns. Therefore, we introduce the cost, which represents average distance between input patterns and connection weights. By minimizing the cost, final connection weights reflect input patterns well. We applied the method to a political data analysis, a voting attitude problem and a Wisconsin cancer problem. Experimental results confirmed that, when the cost was introduced, representations faithful to input patterns were obtained. In addition, improved generalization performance was obtained within a relatively short learning time.
Cost Effectiveness of Alternative Route Special Education Teacher Preparation

ERIC Educational Resources Information Center

Sindelar, Paul T.; Dewey, James F.; Rosenberg, Michael S.; Corbett, Nancy L.; Denslow, David; Lotfinia, Babik

2012-01-01

In this study, the authors estimated costs of alternative route preparation to provide states a basis for allocating training funds to maximize production. Thirty-one special education alternative route program directors were interviewed and completed cost tables. Two hundred and twenty-four program graduates were also surveyed. The authors…
Power Converters Maximize Outputs Of Solar Cell Strings

NASA Technical Reports Server (NTRS)

Frederick, Martin E.; Jermakian, Joel B.

1993-01-01

Microprocessor-controlled dc-to-dc power converters devised to maximize power transferred from solar photovoltaic strings to storage batteries and other electrical loads. Converters help in utilizing large solar photovoltaic arrays most effectively with respect to cost, size, and weight. Main points of invention are: single controller used to control and optimize any number of "dumb" tracker units and strings independently; power maximized out of converters; and controller in system is microprocessor.
Cost-Effective Strategies for Rural Community Outreach, Hawaii, 2010–2011

PubMed Central

Barbato, Anna; Holuby, R. Scott; Ciarleglio, Anita E.; Taniguchi, Ronald

2014-01-01

Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members. PMID:25496555
Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

PubMed

Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

2014-12-11

Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.
Axiomatic foundations for cost-effectiveness analysis.

PubMed

Canning, David

2013-12-01

We show that individual utilities can be measured in units of healthy life years. Social preferences over these life metric utilities are assumed to satisfy the Pareto principle, anonymity, and invariance to a change in origin. These axioms generate a utilitarian social welfare function implying the use of cost-effectiveness analysis in ordering health projects, based on maximizing the healthy years equivalents gained from a fixed health budget. For projects outside the health sector, our cost-effectiveness axioms imply a form of cost-benefit analysis where both costs and benefits are measured in equivalent healthy life years. Copyright © 2013 John Wiley & Sons, Ltd.
Cost-effectiveness analysis and HIV screening: the emergency medicine perspective.

PubMed

Hsu, Heather; Walensky, Rochelle P

2011-07-01

Cost-effectiveness analysis is a useful tool for decisionmakers charged with prioritizing of the myriad medical interventions in the emergency department (ED). This analytic approach may be especially helpful for ranking programs that are competing for scarce resources while attempting to maximize net health benefits. In this article, we review the health economics literature on HIV screening in EDs and introduce the methods of cost-effectiveness analysis for medical interventions. We specifically describe the incremental cost-effectiveness ratio--its calculation, the derivation of ratio components, and the interpretation of these ratios. Copyright © 2011. Published by Mosby, Inc.
Future costs in cost effectiveness analysis.

PubMed

Lee, Robert H

2008-07-01

This paper resolves several controversies in CEA. Generalizing [Garber, A.M., Phelps, C.E., 1997. Economic foundations of cost-effectiveness analysis. Journal of Health Economics 16 (1), 1-31], the paper shows accounting for unrelated future costs distorts decision making. After replicating [Meltzer, D., 1997. Accounting for future costs in medical cost-effectiveness analysis. Journal of Health Economics 16 (1), 33-64] quite different conclusion that unrelated future costs should be included in CEA, the paper shows that Meltzer's findings result from modeling the budget constraint as an annuity, which is problematic. The paper also shows that related costs should be included in CEA. This holds for a variety of models, including a health maximization model. CEA should treat costs in the manner recommended by Garber and Phelps.
Optimizing Household Chlorination Marketing Strategies: A Randomized Controlled Trial on the Effect of Price and Promotion on Adoption in Haiti.

PubMed

Ritter, Michael; Camille, Eveline; Velcine, Christophe; Guillaume, Rose-Kerline; Lantagne, Daniele

2017-07-01

Household water treatment can reduce diarrheal morbidity and mortality in developing countries, but adoption remains low and supply is often unreliable. To test effects of marketing strategies on consumers and suppliers, we randomized 1,798 households in rural Haiti and collected data on purchases of a household chlorination product for 4 months. Households received randomly selected prices ($0.11-$0.56 per chlorine bottle), and half received monthly visits from sales agents. Each $0.22 drop in price increased purchases by 0.10 bottles per household per month ( P < 0.001). At the mean price, each 1% drop in price increased purchases by 0.45% (elasticity = 0.45). There is suggestive evidence that household visits by some sales agents increased purchases at mid-range prices; however, the additional revenue did not offset visit cost. Choosing the lowest price and conducting visits maximizes chlorine purchase, whereas slightly raising the retail price and not conducting visits maximizes cost recovery. For the equivalent cost, price discounts increase purchases 4.2 times as much as adding visits at the current retail price. In this context, price subsidies may be a more cost-effective use of resources than household visits, though all marketing strategies tested offer cost-effective ways to achieve incremental health impact. Decisions about pricing and promotion for health products in developing countries affect health impact, cost recovery, and cost-effectiveness, and tradeoffs between these goals should be made explicit in program design.
Rural Policy in a New Century.

ERIC Educational Resources Information Center

Marshall, Ray

Past rural policies are reviewed, noting the effects of globalization and information technology. Rural business profits can be maximized by direct cost or value-added competition, but cost competition limits the development of productive capacity and leads to unequal income distribution. In contrast, value-added competition could create steep…

Cost-effective cloud computing: a case study using the comparative genomics tool, roundup.

PubMed

Kudtarkar, Parul; Deluca, Todd F; Fusaro, Vincent A; Tonellato, Peter J; Wall, Dennis P

2010-12-22

Comparative genomics resources, such as ortholog detection tools and repositories are rapidly increasing in scale and complexity. Cloud computing is an emerging technological paradigm that enables researchers to dynamically build a dedicated virtual cluster and may represent a valuable alternative for large computational tools in bioinformatics. In the present manuscript, we optimize the computation of a large-scale comparative genomics resource-Roundup-using cloud computing, describe the proper operating principles required to achieve computational efficiency on the cloud, and detail important procedures for improving cost-effectiveness to ensure maximal computation at minimal costs. Utilizing the comparative genomics tool, Roundup, as a case study, we computed orthologs among 902 fully sequenced genomes on Amazon's Elastic Compute Cloud. For managing the ortholog processes, we designed a strategy to deploy the web service, Elastic MapReduce, and maximize the use of the cloud while simultaneously minimizing costs. Specifically, we created a model to estimate cloud runtime based on the size and complexity of the genomes being compared that determines in advance the optimal order of the jobs to be submitted. We computed orthologous relationships for 245,323 genome-to-genome comparisons on Amazon's computing cloud, a computation that required just over 200 hours and cost $8,000 USD, at least 40% less than expected under a strategy in which genome comparisons were submitted to the cloud randomly with respect to runtime. Our cost savings projections were based on a model that not only demonstrates the optimal strategy for deploying RSD to the cloud, but also finds the optimal cluster size to minimize waste and maximize usage. Our cost-reduction model is readily adaptable for other comparative genomics tools and potentially of significant benefit to labs seeking to take advantage of the cloud as an alternative to local computing infrastructure.
An Interactive Life Cycle Cost Forecasting Tool

DTIC Science & Technology

1990-03-01

of Phase in period PO - Length of Phase out period PV - Present value viii AFIT/GOR/ENS/90M-17 Abstract A tool was developed for Monte Carlo...and B. Note that this is for a given configuration. The E represents effectiveness and is equated to some function of the quantity of systems A and B...purchased. Either strategy, maximizing effectiveness or minimizing cost, leads to some type of cost comparison among the proposed systems. The problem
Alternative trailer configurations for maximizing payloads

Treesearch

Jason D. Thompson; Dana Mitchell; John Klepac

2017-01-01

In order for harvesting contractors to stay ahead of increasing costs, it is imperative that they employ all options to maximize productivity and efficiency. Transportation can account for half the cost to deliver wood to a mill. Contractors seek to maximize truck payload to increase productivity. The Forest Operations Research Unit, Southern Research Station, USDA...
The 'fixed cost effect' on practice management.

PubMed

Tipton, E F; Finley, J B

1999-01-01

To obtain a better understanding of the behavior of "non-professional" costs in a medical practice, the authors analyzed the expenses of a 19-doctor practice. The analysis revealed that 80 percent of these expenses were fixed costs. Fixed costs, as opposed to variable costs, remain static in total but vary on a per unit basis as volume changes. Organizations with high fixed cost must maximize capacity to achieve profitability. Thus, the relationship among volume, capacity, cost and profit must be understood by medical practices negotiating rates for service units.
Isometric strength training lowers the O2 cost of cycling during moderate-intensity exercise.

PubMed

Zoladz, Jerzy A; Szkutnik, Zbigniew; Majerczak, Joanna; Grandys, Marcin; Duda, Krzysztof; Grassi, Bruno

2012-12-01

The effect of maximal voluntary isometric strength training of knee extensor muscles on pulmonary V'O(2) on-kinetics, the O(2) cost of cycling and peak oxygen uptake (V'O(2peak)) in humans was studied. Seven healthy males (mean ± SD, age 22.3 ± 2.0 years, body weight 75.0 ± 9.2 kg, V'O(2peak) 49.5 ± 3.8 ml kg(-1) min(-1)) performed maximal isometric strength training lasting 7 weeks (4 sessions per week). Force during maximal voluntary contraction (MVC) increased by 15 % (P < 0.001) after 1 week of training, and by 19 % (P < 0.001) after 7 weeks of training. This increase in MVC was accompanied by no significant changes in the time constant of the V'O(2) on-kinetics during 6 min of moderate and heavy cycling intensities. Strength training resulted in a significant decrease (by ~7 %; P < 0.02) in the amplitude of the fundamental component of the V'O(2) on-kinetics, and therefore in a lower O(2) cost of cycling during moderate cycling intensity. The amplitude of the slow component of V'O(2) on-kinetics during heavy cycling intensity did not change with training. Training had no effect on the V'O(2peak), whereas the maximal power output reached at V'O(2peak) was slightly but significantly increased (P < 0.05). Isometric strength training rapidly (i.e., after 1 week) decreases the O(2) cost of cycling during moderate-intensity exercise, whereas it does not affect the amplitude of the slow component of the V'O(2) on-kinetics during heavy-intensity exercise. Isometric strength training can have beneficial effects on performance during endurance events.
Stanol esters as a component of maximal dietary therapy in the National Cholesterol Education Program Adult Treatment Panel III report.

PubMed

Grundy, Scott M

2005-07-04

Use of plant stanols/sterols in forms that are sufficiently bioavailable for therapeutic effect should be a key element of maximal dietary therapy. This principle was recognized by National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) and has been amply confirmed by experimental studies in humans. Since the introduction of statins, dietary therapy for control of elevated low-density lipoprotein (LDL) cholesterol levels has received less attention. The time has come, however, to reassert the importance of maximal dietary therapy as a cost-effective means for treatment of elevated LDL concentrations and for lifetime prevention of coronary heart disease.
The aerobic demand of backstroke swimming, and its relation to body size, stroke technique, and performance.

PubMed

Smith, H K; Montpetit, R R; Perrault, H

1988-01-01

Few studies have examined the aerobic demand of backstroke swimming, and its relation to body morphology, technique, or performance. The aims of this study were thus to: i) describe the aerobic demand of backstroke swimming in proficient swimmers at high velocities; ii) assess the effects of body size and stroke technique on submaximal and maximal O2 costs, and; iii) test for a relationship between submaximal O2 costs and maximal performance. Sixteen male competitive swimmers were tested during backstroke swimming at velocities from 1.0 to 1.4 m.s-1. Results showed that VO2 increased linearly with velocity (m.s-1) following the equation VO2 = 6.28v - 3.81 (r = 0.77, SEE/Y = 14.9%). VO2 was also related to the subjects' body mass, height, and armspan. Longer distances per stroke were associated with lower O2 costs, and better maximal performances. A significant relation was found between VO2 at 1.1 m.s-1, adjusted for body mass, and 400 m performance (r = -0.78). Submaximal VO2 was also related to reported times for 100 m and 200 m races. Multiple correlation analyses indicated that VO2 at 1.1 m.s-1 and VO2max accounted for up to 78% of the variance in maximal performances. These results suggest that the assessment of submaximal and maximal VO2 during backstroke swimming may be of value in the training and testing programs of competitive swimmers.
Predicted harvest time effects on switchgrass moisture content, nutrient concentration, yield, and profitability

USDA-ARS?s Scientific Manuscript database

Production costs change with harvest date of switchgrass (Panicum virgatum L.) as a result of nutrient recycling and changes in yield of this perennial crop. This study examines the range of cost of production from an early, yield-maximizing harvest date to a late winter harvest date at low moisture...
Optimization of power systems with voltage security constraints

NASA Astrophysics Data System (ADS)

Rosehart, William Daniel

As open access market principles are applied to power systems, significant changes in their operation and control are occurring. In the new marketplace, power systems are operating under higher loading conditions as market influences demand greater attention to operating cost versus stability margins. Since stability continues to be a basic requirement in the operation of any power system, new tools are being considered to analyze the effect of stability on the operating cost of the system, so that system stability can be incorporated into the costs of operating the system. In this thesis, new optimal power flow (OPF) formulations are proposed based on multi-objective methodologies to optimize active and reactive power dispatch while maximizing voltage security in power systems. The effects of minimizing operating costs, minimizing reactive power generation and/or maximizing voltage stability margins are analyzed. Results obtained using the proposed Voltage Stability Constrained OPF formulations are compared and analyzed to suggest possible ways of costing voltage security in power systems. When considering voltage stability margins the importance of system modeling becomes critical, since it has been demonstrated, based on bifurcation analysis, that modeling can have a significant effect of the behavior of power systems, especially at high loading levels. Therefore, this thesis also examines the effects of detailed generator models and several exponential load models. Furthermore, because of its influence on voltage stability, a Static Var Compensator model is also incorporated into the optimization problems.
Cost-effectiveness and the socialization of health care.

PubMed

Musgrove, P

1995-01-01

The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.
7 CFR 3405.7 - Joint project proposals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... agricultural sciences. The goals of such joint initiatives should include maximizing the use of limited...), increasing cost-effectiveness through achieving economies of scale, strengthening the scope and quality of a...
7 CFR 3405.7 - Joint project proposals.

Code of Federal Regulations, 2013 CFR

2013-01-01

... agricultural sciences. The goals of such joint initiatives should include maximizing the use of limited...), increasing cost-effectiveness through achieving economies of scale, strengthening the scope and quality of a...
7 CFR 3405.7 - Joint project proposals.

Code of Federal Regulations, 2012 CFR

2012-01-01

... agricultural sciences. The goals of such joint initiatives should include maximizing the use of limited...), increasing cost-effectiveness through achieving economies of scale, strengthening the scope and quality of a...
Effects of disputes and easement violations on the cost-effectiveness of land conservation

PubMed Central

Arcese, Peter

2015-01-01

Conservation initiatives to protect and restore valued species communities in human-dominated landscapes face challenges linked to their potential costs. Conservation easements on private land may represent a cost-effective alternative to land purchase, but long-term costs to monitor and enforce easements, or defend legal challenges, remain uncertain. We explored the cost-effectiveness of conservation easements, defined here as the fraction of the high-biodiversity landscape potentially protected via investment in easements versus land purchase. We show that easement violation and dispute rates substantially affect the estimated long-term cost-effectiveness of an easement versus land purchase strategy. Our results suggest that conservation easements can outperform land purchase as a strategy to protect biodiversity as long as the rate of disputes and legal challenges is low, pointing to a critical need for monitoring data to reduce costs and maximize the value of conservation investments. PMID:26413430
Optimal design of solidification processes

NASA Technical Reports Server (NTRS)

Dantzig, Jonathan A.; Tortorelli, Daniel A.

1991-01-01

An optimal design algorithm is presented for the analysis of general solidification processes, and is demonstrated for the growth of GaAs crystals in a Bridgman furnace. The system is optimal in the sense that the prespecified temperature distribution in the solidifying materials is obtained to maximize product quality. The optimization uses traditional numerical programming techniques which require the evaluation of cost and constraint functions and their sensitivities. The finite element method is incorporated to analyze the crystal solidification problem, evaluate the cost and constraint functions, and compute the sensitivities. These techniques are demonstrated in the crystal growth application by determining an optimal furnace wall temperature distribution to obtain the desired temperature profile in the crystal, and hence to maximize the crystal's quality. Several numerical optimization algorithms are studied to determine the proper convergence criteria, effective 1-D search strategies, appropriate forms of the cost and constraint functions, etc. In particular, we incorporate the conjugate gradient and quasi-Newton methods for unconstrained problems. The efficiency and effectiveness of each algorithm is presented in the example problem.
Parallel barrier effectiveness : Dulles noise barrier project

DOT National Transportation Integrated Search

1990-05-01

In an effort to minimize the cost and maximize the effectiveness of highway noise barriers, the Federal Highway Administration and a National Pooled Fund Panel (made up of 14 States) funded a field study program on an experimental highway noise barri...
Managing the vitamin A program portfolio: a case study of Zambia, 2013-2042.

PubMed

Fiedler, John L; Lividini, Keith

2014-03-01

Micronutrient deficiencies continue to constitute a major burden of disease, particularly in Africa and South Asia. Programs to address micronutrient deficiencies have been increasing in number, type, and scale in recent years, creating an ever-growing need to understand their combined coverage levels, costs, and impacts so as to more effectively combat deficiencies, avoid putting individuals at risk for excess intakes, and ensure the efficient use of public health resources. To analyze combinations of the two current programs--sugar fortification and Child Health Week (CHW)--together with four prospective programs--vegetable oil fortification, wheat flour fortification, maize meal fortification, and biofortified vitamin A maize--to identify Zambia's optimal vitamin A portfolio. Combining program cost estimates and 30-year Zambian food demand projections, together with the Zambian 2005 Living Conditions Monitoring Survey, the annual costs, coverage, impact, and cost-effectiveness of 62 Zambian portfolios were modeled for the period from 2013 to 2042. Optimal portfolios are identified for each of five alternative criteria: average cost-effectiveness, incremental cost-effectiveness, coverage maximization, health impact maximization, and affordability. The most likely scenario is identified to be one that starts with the current portfolio and takes into account all five criteria. Starting with CHW and sugar fortification, it phases in vitamin A maize, oil, wheat flour, and maize meal (in that order) to eventually include all six individual interventions. Combining cost and Household Consumption and Expenditure Survey (HCES) data provides a powerful evidence-generating tool with which to understand how individual micronutrient programs interact and to quantify the tradeoffs involved in selecting alternative program portfolios.
Maximizing the Potential of Telecommunications Technology.

ERIC Educational Resources Information Center

Young, Dennis M.

2003-01-01

Offers advice on planning a reliable and cost-effective school telecommunications system, including issues such as the layered nature of many schools' systems, and the move from centralized to distributed networks. (EV)
[Maximization of economic yield, minimum cost optimal diets and cultivation diversification for small scale farmers of the highland region of Guatemala].

PubMed

Alarcón, J A; Immink, M D; Méndez, L F

1989-12-01

The present study was conducted as part of an evaluation of the economic and nutritional effects of a crop diversification program for small-scale farmers in the Western highlands of Guatemala. Linear programming models are employed in order to obtain optimal combinations of traditional and non-traditional food crops under different ecological conditions that: a) provide minimum cost diets for auto-consumption, and b) maximize net income and market availability of dietary energy. Data used were generated by means of an agroeconomic survey conducted in 1983 among 726 farming households. Food prices were obtained from the Institute of Agrarian Marketing; data on production costs, from the National Bank of Agricultural Development in Guatemala. The gestation periods for each crop were obtained from three different sources, and then averaged. The results indicated that the optimal cropping pattern for the minimum-cost diets for auto consumption include traditional foods (corn, beans, broad bean, wheat, potato), non-traditional foods (carrots, broccoli, beets) and foods of animal origin (milk, eggs). A significant number of farmers included in the sample did not have sufficient land availability to produce all foods included in the minimum-cost diet. Cropping patterns which maximize net incomes include only non-traditional foods: onions, carrots, broccoli and beets for farmers in the low highland areas, and raddish, broccoli, cauliflower and carrots for farmers in the higher parts. Optimal cropping patterns which maximize market availability of dietary energy include traditional and non-traditional foods; for farmers in the lower areas: wheat, corn, beets, carrots and onions; for farmers in the higher areas: potato, wheat, raddish, carrots and cabbage.
Green Energy in New Construction: Maximize Energy Savings and Minimize Cost

ERIC Educational Resources Information Center

Ventresca, Joseph

2010-01-01

People often use the term "green energy" to refer to alternative energy technologies. But green energy doesn't guarantee maximum energy savings at a minimum cost--a common misconception. For school business officials, green energy means getting the lowest energy bills for the lowest construction cost, which translates into maximizing green energy…

Proposal for the Development of a Standardized Protocol for Assessing the Economic Costs of HIV Prevention Interventions

PubMed Central

Pinkerton, Steven D.; Pearson, Cynthia R.; Eachus, Susan R.; Berg, Karina M.; Grimes, Richard M.

2008-01-01

Summary Maximizing our economic investment in HIV prevention requires balancing the costs of candidate interventions against their effects and selecting the most cost-effective interventions for implementation. However, many HIV prevention intervention trials do not collect cost information, and those that do use a variety of cost data collection methods and analysis techniques. Standardized cost data collection procedures, instrumentation, and analysis techniques are needed to facilitate the task of assessing intervention costs and to ensure comparability across intervention trials. This article describes the basic elements of a standardized cost data collection and analysis protocol and outlines a computer-based approach to implementing this protocol. Ultimately, the development of such a protocol would require contributions and “buy-in” from a diverse range of stakeholders, including HIV prevention researchers, cost-effectiveness analysts, community collaborators, public health decision makers, and funding agencies. PMID:18301128
Cost-Effective Cloud Computing: A Case Study Using the Comparative Genomics Tool, Roundup

PubMed Central

Kudtarkar, Parul; DeLuca, Todd F.; Fusaro, Vincent A.; Tonellato, Peter J.; Wall, Dennis P.

2010-01-01

Background Comparative genomics resources, such as ortholog detection tools and repositories are rapidly increasing in scale and complexity. Cloud computing is an emerging technological paradigm that enables researchers to dynamically build a dedicated virtual cluster and may represent a valuable alternative for large computational tools in bioinformatics. In the present manuscript, we optimize the computation of a large-scale comparative genomics resource—Roundup—using cloud computing, describe the proper operating principles required to achieve computational efficiency on the cloud, and detail important procedures for improving cost-effectiveness to ensure maximal computation at minimal costs. Methods Utilizing the comparative genomics tool, Roundup, as a case study, we computed orthologs among 902 fully sequenced genomes on Amazon’s Elastic Compute Cloud. For managing the ortholog processes, we designed a strategy to deploy the web service, Elastic MapReduce, and maximize the use of the cloud while simultaneously minimizing costs. Specifically, we created a model to estimate cloud runtime based on the size and complexity of the genomes being compared that determines in advance the optimal order of the jobs to be submitted. Results We computed orthologous relationships for 245,323 genome-to-genome comparisons on Amazon’s computing cloud, a computation that required just over 200 hours and cost $8,000 USD, at least 40% less than expected under a strategy in which genome comparisons were submitted to the cloud randomly with respect to runtime. Our cost savings projections were based on a model that not only demonstrates the optimal strategy for deploying RSD to the cloud, but also finds the optimal cluster size to minimize waste and maximize usage. Our cost-reduction model is readily adaptable for other comparative genomics tools and potentially of significant benefit to labs seeking to take advantage of the cloud as an alternative to local computing infrastructure. PMID:21258651
Cost Scaling of a Real-World Exhaust Waste Heat Recovery Thermoelectric Generator: A Deeper Dive

NASA Astrophysics Data System (ADS)

Hendricks, Terry J.; Yee, Shannon; LeBlanc, Saniya

2016-03-01

Cost is equally important to power density or efficiency for the adoption of waste heat recovery thermoelectric generators (TEG) in many transportation and industrial energy recovery applications. In many cases, the system design that minimizes cost (e.g., the /W value) can be very different than the design that maximizes the system's efficiency or power density, and it is important to understand the relationship between those designs to optimize TEG performance-cost compromises. Expanding on recent cost analysis work and using more detailed system modeling, an enhanced cost scaling analysis of a waste heat recovery TEG with more detailed, coupled treatment of the heat exchangers has been performed. In this analysis, the effect of the heat lost to the environment and updated relationships between the hot-side and cold-side conductances that maximize power output are considered. This coupled thermal and thermoelectric (TE) treatment of the exhaust waste heat recovery TEG yields modified cost scaling and design optimization equations, which are now strongly dependent on the heat leakage fraction, exhaust mass flow rate, and heat exchanger effectiveness. This work shows that heat exchanger costs most often dominate the overall TE system costs, that it is extremely difficult to escape this regime, and in order to achieve TE system costs of 1/W it is necessary to achieve heat exchanger costs of 1/(W/K). Minimum TE system costs per watt generally coincide with maximum power points, but preferred TE design regimes are identified where there is little cost penalty for moving into regions of higher efficiency and slightly lower power outputs. These regimes are closely tied to previously identified low cost design regimes. This work shows that the optimum fill factor F opt minimizing system costs decreases as heat losses increase, and increases as exhaust mass flow rate and heat exchanger effectiveness increase. These findings have profound implications on the design and operation of various TE waste heat recovery systems. This work highlights the importance of heat exchanger costs on the overall TEG system costs, quantifies the possible TEG performance-cost domain space based on heat exchanger effects, and provides a focus for future system research and development efforts.
Policies with Varying Costs and Benefits: A Land Conservation Classroom Game

ERIC Educational Resources Information Center

Dissanayake, Sahan T. M.; Jacobson, Sarah A.

2016-01-01

Some policies try to maximize net benefits by targeting different individuals to participate. This is difficult when costs and benefits of participation vary independently, such as in land conservation. The authors share a classroom game that explores cases in which minimizing costs may not maximize benefits and vice versa. The game is a…
Maximizing return on socioeconomic investment in phase II proof-of-concept trials.

PubMed

Chen, Cong; Beckman, Robert A

2014-04-01

Phase II proof-of-concept (POC) trials play a key role in oncology drug development, determining which therapeutic hypotheses will undergo definitive phase III testing according to predefined Go-No Go (GNG) criteria. The number of possible POC hypotheses likely far exceeds available public or private resources. We propose a design strategy for maximizing return on socioeconomic investment in phase II trials that obtains the greatest knowledge with the minimum patient exposure. We compare efficiency using the benefit-cost ratio, defined to be the risk-adjusted number of truly active drugs correctly identified for phase III development divided by the risk-adjusted total sample size in phase II and III development, for different POC trial sizes, powering schemes, and associated GNG criteria. It is most cost-effective to conduct small POC trials and set the corresponding GNG bars high, so that more POC trials can be conducted under socioeconomic constraints. If δ is the minimum treatment effect size of clinical interest in phase II, the study design with the highest benefit-cost ratio has approximately 5% type I error rate and approximately 20% type II error rate (80% power) for detecting an effect size of approximately 1.5δ. A Go decision to phase III is made when the observed effect size is close to δ. With the phenomenal expansion of our knowledge in molecular biology leading to an unprecedented number of new oncology drug targets, conducting more small POC trials and setting high GNG bars maximize the return on socioeconomic investment in phase II POC trials. ©2014 AACR.
Economics of installation of solar heating plants

NASA Astrophysics Data System (ADS)

Popel, O. S.; Frid, S. Y.; Shpiltayn, E. E.

1984-04-01

An engineering-economic analysis of solar heating plants for determination of their cost effectiveness involves calculating the maximum economically feasibile extra capital investment on their installation and calculating the fraction of the total heat demand covered by such a plant which makes replacement of conventional heating plant maximally economical. The annual economic effect of solar heating is calculated in terms of normalized cost differential, as criterion for its competitiveness with conventional heating. Plant performance characteristics, namely dependence of both the percent demand coverage and the annual cost differential on the area of solar radiation collectors is then considered. Analysis of the cost equation, assuming that the extra fixed cost is proportional to the collector area, reveals the necessary and sufficient condition for decrease of annual operating cost.
Bird community conservation and carbon offsets in western North America.

PubMed

Schuster, Richard; Martin, Tara G; Arcese, Peter

2014-01-01

Conservation initiatives to protect and restore valued species and communities in human-dominated landscapes face huge challenges linked to the cost of acquiring habitat. We ask how the sale of forest carbon offsets could reduce land acquisition costs, and how the alternate goals of maximizing α or β-diversity in focal communities could affect the prioritization land parcels over a range of conservation targets. Maximizing total carbon storage and carbon sequestration potential reduced land acquisition costs by up to 48%. Maximizing β rather than α-diversity within forest and savannah bird communities reduced acquisition costs by up to 15%, and when these solutions included potential carbon credit revenues, acquisition cost reductions up to 32% were achieved. However, the total cost of conservation networks increased exponentially as area targets increased in all scenarios. Our results indicate that carbon credit sales have the potential to enhance conservation outcomes in human-dominated landscapes by reducing the net acquisition costs of land conservation in old and maturing forests essential for the persistence of old forest plant and animal communities. Maximizing β versus α-diversity may further reduce costs by reducing the total area required to meet conservation targets and enhancing landscape heterogeneity. Although the potential value of carbon credit sales declined as a fraction of total acquisition costs, even conservative scenarios using a carbon credit value of $12.5/T suggest reductions in acquisition cost of up to $235 M, indicating that carbon credit sales could substantially reduce the costs of conservation.
Bird Community Conservation and Carbon Offsets in Western North America

PubMed Central

Schuster, Richard; Martin, Tara G.; Arcese, Peter

2014-01-01

Conservation initiatives to protect and restore valued species and communities in human-dominated landscapes face huge challenges linked to the cost of acquiring habitat. We ask how the sale of forest carbon offsets could reduce land acquisition costs, and how the alternate goals of maximizing α or β-diversity in focal communities could affect the prioritization land parcels over a range of conservation targets. Maximizing total carbon storage and carbon sequestration potential reduced land acquisition costs by up to 48%. Maximizing β rather than α-diversity within forest and savannah bird communities reduced acquisition costs by up to 15%, and when these solutions included potential carbon credit revenues, acquisition cost reductions up to 32% were achieved. However, the total cost of conservation networks increased exponentially as area targets increased in all scenarios. Our results indicate that carbon credit sales have the potential to enhance conservation outcomes in human-dominated landscapes by reducing the net acquisition costs of land conservation in old and maturing forests essential for the persistence of old forest plant and animal communities. Maximizing β versus α-diversity may further reduce costs by reducing the total area required to meet conservation targets and enhancing landscape heterogeneity. Although the potential value of carbon credit sales declined as a fraction of total acquisition costs, even conservative scenarios using a carbon credit value of $12.5/T suggest reductions in acquisition cost of up to $235 M, indicating that carbon credit sales could substantially reduce the costs of conservation. PMID:24918621
A note on the depreciation of the societal perspective in economic evaluation of health care.

PubMed

Johannesson, M

1995-07-01

It is common in cost-effectiveness analyses of health care to only include health care costs, with the argument that some fictive 'health care budget' should be used to maximize the health effects. This paper provides a criticism of the 'health care budget' approach to cost-effectiveness analysis of health care. It is argued that the approach is ad hoc and lacks theoretical foundation. The approach is also inconsistent with using a fixed budget as the decision rule for cost-effectiveness analysis. That is the case unless only costs that fall into a single annual actual budget are included in the analysis, which would mean that any cost paid by the patients should be excluded as well as any future cost changes and all costs that fall on other budgets. Furthermore the prices facing the budget holder should be used, rather than opportunity costs. It is concluded that the 'health care budget' perspective should be abandoned and the societal perspective reinstated in economic evaluation of health care.
Maximize Energy Efficiency in Buildings | Climate Neutral Research Campuses

Science.gov Websites

Buildings on a research campus, especially laboratory buildings, often represent the most cost-effective plans, campuses can evaluate the following: Energy Management Building Management New Buildings Design
Capability 9.1 Exploration

NASA Technical Reports Server (NTRS)

Eckelkamp, Rick; Blacic, Jim

2005-01-01

The exploration challenge are: To build an efficient, cost effective exploration infrastructure, To coordinate exploration robots & crews from multiple. earth sites to accomplish science and exploration objectives. and To maximize self-sufficiency of the lunar/planetary exploration team.
Financial management of a hospice program.

PubMed

Simione, Robert J; Simione, Kathleen A

2002-07-01

Agencies interested in starting hospice programs or maximizing the benefits of existing programs need to implement and maintain accurate and effective internal cost accounting systems. Once established, a cost accounting system provides the administrators of the hospice program with information to prepare budget projections, perform break-even analysis, and develop other reports to assist in making sound business decisions to ensure success.
Communication of potential benefits and harm to patients and payers in psychiatry: a review and commentary.

PubMed

Wu, Renrong; Kemp, David E; Sajatovic, Martha; Zhao, Jingping; Calabrese, Joseph R; Gao, Keming

2011-12-01

Communicating potential benefits and harm to patients and payers is essential for high-quality care. However, there are no published guidelines or consensuses on how to communicate potential benefits and harm to patients and payers. The goal of this review was to identify key elements for communication between clinicians, patients, and payers to achieve maximal benefits and minimal risk. Literature published from January 1980 to July 2011 and cited on MEDLINE was searched using the terms communication, benefit, harm, effectiveness, cost, cost-effectiveness, psychiatry, bipolar disorder, schizophrenia, and major depressive disorder. Elements related to communicating benefits and/or harm to patients and payers were identified, with only key elements discussed in detail here. Evidence-based medicine, number needed to treat to benefit (NNTB) or harm (NNTH), and the likelihood of being helped or harmed (LHH) have been advocated as the basis for communication in all specialties of medicine. Phase-dependent communication of benefits and harm is novel, especially in patients with different phases of illness, such as bipolar disorder. Duration-dependent (short-term versus long-term) communication is essential for all psychiatric disorders to reduce the burden of relapse and adverse events with long-term treatment. For drugs with multiple therapeutic indications, a disease-dependent approach is crucial to maximize benefits and minimize harm. The exclusion of comorbid psychiatric disorders in pivotal efficacy trials affects their generalizability. Communicating cost (direct versus indirect) is an essential component in reducing health care expenditures. The results of available cost-effectiveness analyses of psychiatric pharmacotherapy have been inconsistent and/or contradictory. Evidence-based communication of potential benefits and harm to patients and payers, using NNTB, NNTH, and LHH, should be the key principle that guides decision making. Phase-, duration-, and disease-dependent communication and evidence-based cost-saving principles can maximize benefit and reduce harm. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.
Cost-efficient scheduling of FAST observations

NASA Astrophysics Data System (ADS)

Luo, Qi; Zhao, Laiping; Yu, Ce; Xiao, Jian; Sun, Jizhou; Zhu, Ming; Zhong, Yi

2018-03-01

A cost-efficient schedule for the Five-hundred-meter Aperture Spherical radio Telescope (FAST) requires to maximize the number of observable proposals and the overall scientific priority, and minimize the overall slew-cost generated by telescope shifting, while taking into account the constraints including the astronomical objects visibility, user-defined observable times, avoiding Radio Frequency Interference (RFI). In this contribution, first we solve the problem of maximizing the number of observable proposals and scientific priority by modeling it as a Minimum Cost Maximum Flow (MCMF) problem. The optimal schedule can be found by any MCMF solution algorithm. Then, for minimizing the slew-cost of the generated schedule, we devise a maximally-matchable edges detection-based method to reduce the problem size, and propose a backtracking algorithm to find the perfect matching with minimum slew-cost. Experiments on a real dataset from NASA/IPAC Extragalactic Database (NED) show that, the proposed scheduler can increase the usage of available times with high scientific priority and reduce the slew-cost significantly in a very short time.
Improving mobility : saving lives : safety service patrols

DOT National Transportation Integrated Search

1999-01-01

This brochure describes how safety service patrols can be of value in minimizing disruption of incidents and maximizing traffic flow. The service patrols are equipped to handle emergencies and are a cost effective component of traffic management syst...
Techniques for cash management in scheduling manufacturing operations

NASA Astrophysics Data System (ADS)

Morady Gohareh, Mehdy; Shams Gharneh, Naser; Ghasemy Yaghin, Reza

2017-06-01

The objective in traditional scheduling is usually time based. Minimizing the makespan, total flow times, total tardi costs, etc. are instances of these objectives. In manufacturing, processing each job entails a cost paying and price receiving. Thus, the objective should include some notion of managing the flow of cash. We have defined two new objectives: maximization of average and minimum available cash. For single machine scheduling, it is demonstrated that scheduling jobs in decreasing order of profit ratios maximizes the former and improves productivity. Moreover, scheduling jobs in increasing order of costs and breaking ties in decreasing order of prices maximizes the latter and creates protection against financial instability.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Canavan, G.H.

This note studies the impact of maximizing the stability index rather than minimizing the first strike cost in choosing offensive missile allocations. It does so in the context of a model in which exchanges between vulnerable missile forces are modeled probabilistically, converted into first and second strike costs through approximations to the value target sets at risk, and the stability index is taken to be their ratio. The value of the allocation that minimizes the first strike cost for both attack preferences are derived analytically. The former recovers results derived earlier. The latter leads to an optimum at unity allocationmore » for which the stability index is determined analytically. For values of the attack preference greater than about unity, maximizing the stability index increases the cost of striking first 10--15%. For smaller values of the attack preference, maximizing the index increases the second strike cost a similar amount. Both are stabilizing, so if both sides could be trusted to target on missiles in order to minimize damage to value and maximize stability, the stability index for vulnerable missiles could be increased by about 15%. However, that would increase the cost to the first striker by about 15%. It is unclear why--having decided to strike--he would do so in a way that would increase damage to himself.« less
Planning Routes Across Economic Terrains: Maximizing Utility, Following Heuristics

PubMed Central

Zhang, Hang; Maddula, Soumya V.; Maloney, Laurence T.

2010-01-01

We designed an economic task to investigate human planning of routes in landscapes where travel in different kinds of terrain incurs different costs. Participants moved their finger across a touch screen from a starting point to a destination. The screen was divided into distinct kinds of terrain and travel within each kind of terrain imposed a cost proportional to distance traveled. We varied costs and spatial configurations of terrains and participants received fixed bonuses minus the total cost of the routes they chose. We first compared performance to a model maximizing gain. All but one of 12 participants failed to adopt least-cost routes and their failure to do so reduced their winnings by about 30% (median value). We tested in detail whether participants’ choices of routes satisfied three necessary conditions (heuristics) for a route to maximize gain. We report failures of one heuristic for 7 out of 12 participants. Last of all, we modeled human performance with the assumption that participants assign subjective utilities to costs and maximize utility. For 7 out 12 participants, the fitted utility function was an accelerating power function of actual cost and for the remaining 5, a decelerating power function. We discuss connections between utility aggregation in route planning and decision under risk. Our task could be adapted to investigate human strategy and optimality of route planning in full-scale landscapes. PMID:21833269
Cost Scaling of a Real-World Exhaust Waste Heat Recovery Thermoelectric Generator: A Deeper Dive

NASA Technical Reports Server (NTRS)

Hendricks, Terry J.; Yee, Shannon; LeBlanc, Saniya

2015-01-01

Cost is equally important to power density or efficiency for the adoption of waste heat recovery thermoelectric generators (TEG) in many transportation and industrial energy recovery applications. In many cases the system design that minimizes cost (e.g., the $/W value) can be very different than the design that maximizes the system's efficiency or power density, and it is important to understand the relationship between those designs to optimize TEG performance-cost compromises. Expanding on recent cost analysis work and using more detailed system modeling, an enhanced cost scaling analysis of a waste heat recovery thermoelectric generator with more detailed, coupled treatment of the heat exchangers has been performed. In this analysis, the effect of the heat lost to the environment and updated relationships between the hot-side and cold-side conductances that maximize power output are considered. This coupled thermal and thermoelectric treatment of the exhaust waste heat recovery thermoelectric generator yields modified cost scaling and design optimization equations, which are now strongly dependent on the heat leakage fraction, exhaust mass flow rate, and heat exchanger effectiveness. This work shows that heat exchanger costs most often dominate the overall TE system costs, that it is extremely difficult to escape this regime, and in order to achieve TE system costs of $1/W it is necessary to achieve heat exchanger costs of $1/(W/K). Minimum TE system costs per watt generally coincide with maximum power points, but Preferred TE Design Regimes are identified where there is little cost penalty for moving into regions of higher efficiency and slightly lower power outputs. These regimes are closely tied to previously-identified low cost design regimes. This work shows that the optimum fill factor Fopt minimizing system costs decreases as heat losses increase, and increases as exhaust mass flow rate and heat exchanger effectiveness increase. These findings have profound implications on the design and operation of various thermoelectric (TE) waste heat 3 recovery systems. This work highlights the importance of heat exchanger costs on the overall TEG system costs, quantifies the possible TEG performance-cost domain space based on heat exchanger effects, and provides a focus for future system research and development efforts.
Interconnection-wide hour-ahead scheduling in the presence of intermittent renewables and demand response: A surplus maximizing approach

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

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

This study describes a new approach for solving the multi-area electricity resource allocation problem when considering both intermittent renewables and demand response. The method determines the hourly inter-area export/import set that maximizes the interconnection (global) surplus satisfying transmission, generation and load constraints. The optimal inter-area transfer set effectively makes the electricity price uniform over the interconnection apart from constrained areas, which overall increases the consumer surplus more than it decreases the producer surplus. The method is computationally efficient and suitable for use in simulations that depend on optimal scheduling models. The method is demonstrated on a system that represents Northmore » America Western Interconnection for the planning year of 2024. Simulation results indicate that effective use of interties reduces the system operation cost substantially. Excluding demand response, both the unconstrained and the constrained scheduling solutions decrease the global production cost (and equivalently increase the global economic surplus) by 12.30B and 10.67B per year, respectively, when compared to the standalone case in which each control area relies only on its local supply resources. This cost saving is equal to 25% and 22% of the annual production cost. Including 5% demand response, the constrained solution decreases the annual production cost by 10.70B, while increases the annual surplus by 9.32B in comparison to the standalone case.« less

Interconnection-wide hour-ahead scheduling in the presence of intermittent renewables and demand response: A surplus maximizing approach

DOE PAGES

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

2016-12-23

This study describes a new approach for solving the multi-area electricity resource allocation problem when considering both intermittent renewables and demand response. The method determines the hourly inter-area export/import set that maximizes the interconnection (global) surplus satisfying transmission, generation and load constraints. The optimal inter-area transfer set effectively makes the electricity price uniform over the interconnection apart from constrained areas, which overall increases the consumer surplus more than it decreases the producer surplus. The method is computationally efficient and suitable for use in simulations that depend on optimal scheduling models. The method is demonstrated on a system that represents Northmore » America Western Interconnection for the planning year of 2024. Simulation results indicate that effective use of interties reduces the system operation cost substantially. Excluding demand response, both the unconstrained and the constrained scheduling solutions decrease the global production cost (and equivalently increase the global economic surplus) by 12.30B and 10.67B per year, respectively, when compared to the standalone case in which each control area relies only on its local supply resources. This cost saving is equal to 25% and 22% of the annual production cost. Including 5% demand response, the constrained solution decreases the annual production cost by 10.70B, while increases the annual surplus by 9.32B in comparison to the standalone case.« less
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

PubMed

Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M

Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.
Dietary nitrate does not reduce oxygen cost of exercise or improve muscle mitochondrial function in patients with mitochondrial myopathy.

PubMed

Nabben, Miranda; Schmitz, Joep P J; Ciapaite, Jolita; le Clercq, Carlijn M P; van Riel, Natal A; Haak, Harm R; Nicolay, Klaas; de Coo, Irenaeus F M; Smeets, Hubert; Praet, Stephan F; van Loon, Luc J; Prompers, Jeanine J

2017-05-01

Muscle weakness and exercise intolerance negatively affect the quality of life of patients with mitochondrial myopathy. Short-term dietary nitrate supplementation has been shown to improve exercise performance and reduce oxygen cost of exercise in healthy humans and trained athletes. We investigated whether 1 wk of dietary inorganic nitrate supplementation decreases the oxygen cost of exercise and improves mitochondrial function in patients with mitochondrial myopathy. Ten patients with mitochondrial myopathy (40 ± 5 yr, maximal whole body oxygen uptake = 21.2 ± 3.2 ml·min -1 ·kg body wt -1 , maximal work load = 122 ± 26 W) received 8.5 mg·kg body wt -1 ·day -1 inorganic nitrate (~7 mmol) for 8 days. Whole body oxygen consumption at 50% of the maximal work load, in vivo skeletal muscle oxidative capacity (evaluated from postexercise phosphocreatine recovery using 31 P-magnetic resonance spectroscopy), and ex vivo mitochondrial oxidative capacity in permeabilized skinned muscle fibers (measured with high-resolution respirometry) were determined before and after nitrate supplementation. Despite a sixfold increase in plasma nitrate levels, nitrate supplementation did not affect whole body oxygen cost during submaximal exercise. Additionally, no beneficial effects of nitrate were found on in vivo or ex vivo muscle mitochondrial oxidative capacity. This is the first time that the therapeutic potential of dietary nitrate for patients with mitochondrial myopathy was evaluated. We conclude that 1 wk of dietary nitrate supplementation does not reduce oxygen cost of exercise or improve mitochondrial function in the group of patients tested. Copyright © 2017 the American Physiological Society.
Using a genetic algorithm to optimize a water-monitoring network for accuracy and cost effectiveness

NASA Astrophysics Data System (ADS)

Julich, R. J.

2004-05-01

The purpose of this project is to determine the optimal spatial distribution of water-monitoring wells to maximize important data collection and to minimize the cost of managing the network. We have employed a genetic algorithm (GA) towards this goal. The GA uses a simple fitness measure with two parts: the first part awards a maximal score to those combinations of hydraulic head observations whose net uncertainty is closest to the value representing all observations present, thereby maximizing accuracy; the second part applies a penalty function to minimize the number of observations, thereby minimizing the overall cost of the monitoring network. We used the linear statistical inference equation to calculate standard deviations on predictions from a numerical model generated for the 501-observation Death Valley Regional Flow System as the basis for our uncertainty calculations. We have organized the results to address the following three questions: 1) what is the optimal design strategy for a genetic algorithm to optimize this problem domain; 2) what is the consistency of solutions over several optimization runs; and 3) how do these results compare to what is known about the conceptual hydrogeology? Our results indicate the genetic algorithms are a more efficient and robust method for solving this class of optimization problems than have been traditional optimization approaches.
Ground support system methodology and architecture

NASA Technical Reports Server (NTRS)

Schoen, P. D.

1991-01-01

A synergistic approach to systems test and support is explored. A building block architecture provides transportability of data, procedures, and knowledge. The synergistic approach also lowers cost and risk for life cycle of a program. The determination of design errors at the earliest phase reduces cost of vehicle ownership. Distributed scaleable architecture is based on industry standards maximizing transparency and maintainability. Autonomous control structure provides for distributed and segmented systems. Control of interfaces maximizes compatibility and reuse, reducing long term program cost. Intelligent data management architecture also reduces analysis time and cost (automation).
Cost - effectiveness analysis of the antiplatelet treatment administered on ischemic stroke patients using goal programming approach

NASA Astrophysics Data System (ADS)

Rajendran, Rasvini; Zainuddin, Zaitul Marlizawati; Idris, Badrisyah

2014-09-01

There are numerous ways to prevent or treat ischemic stroke and each of these competing alternatives is associated with a different effectiveness and a cost. In circumstances where health funds are budgeted and thus fixed, cost-effectiveness analysis (CEA) can provide information on how to comprehend the largest health gains with that limited fund as CEA is used to compare different strategies for preventing or treating a single disease. The most common medications for ischemic stroke are the anti-platelet drugs. While some drugs are more effective than others, they are also more expensive. This paper will thus assess the CEA of anti-platelet drug available for ischemic stroke patients using goal programming (GP) approach subject to in-patients days and patients' quality-of-life. GP presents a way of striving towards several objectives simultaneously whereby in this case we will consider minimizing the cost and maximizing the effectiveness.
Financing Higher Education: Federal Income-Tax Consequences.

ERIC Educational Resources Information Center

Kelly, Marci

1991-01-01

The current income tax law's effects on common elements of education financing are discussed, including scholarships, loans, employment, and related issues. In light of recent tax changes that increase the after-tax cost of education, information for maximizing remaining tax advantages is offered. (MSE)
Refining Lung Cancer Screening Criteria in the Era of Value-Based Medicine.

PubMed

Shapiro, Steven D

2017-02-01

In a Perspective on the Research Article by ten Haaf and colleagues, Steven Shapiro discusses the challenges of identifying screening strategies that maximize the number of cancers diagnosed, while minimizing the harms of overdiagnosis and maintaining cost-effectiveness.
Cost considerations in using simulations for medical training.

PubMed

Fletcher, J D; Wind, Alexander P

2013-10-01

This article reviews simulation used for medical training, techniques for assessing simulation-based training, and cost analyses that can be included in such assessments. Simulation in medical training appears to take four general forms: human actors who are taught to simulate illnesses and ailments in standardized ways; virtual patients who are generally presented via computer-controlled, multimedia displays; full-body manikins that simulate patients using electronic sensors, responders, and controls; and part-task anatomical simulations of various body parts and systems. Techniques for assessing costs include benefit-cost analysis, return on investment, and cost-effectiveness analysis. Techniques for assessing the effectiveness of simulation-based medical training include the use of transfer effectiveness ratios and incremental transfer effectiveness ratios to measure transfer of knowledge and skill provided by simulation to the performance of medical procedures. Assessment of costs and simulation effectiveness can be combined with measures of transfer using techniques such as isoperformance analysis to identify ways of minimizing costs without reducing performance effectiveness or maximizing performance without increasing costs. In sum, economic analysis must be considered in training assessments if training budgets are to compete successfully with other requirements for funding. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Using a spreadsheet/table template for economic value added analysis.

PubMed

Cassey, Margaret

2008-01-01

Translating clinical research into practical applications that are cost effective has received significant attention as staff nurses attempt to expand new knowledge into an already complex daily workflow. spreadsheet/table template created in a word processing format can assist with setting up and carrying out the analysis of costs for comparing different approaches to routine activities. By encouraging nurses to take the initiative to examine parts of everyday nursing practice with an eye to cost analysis, significant contributions can be made to maximizing the bottom line.
Patriot Express Program Could Be More Cost-Effective for Overseas Permanent Change of Station and Temporary Duty Travel

DTIC Science & Technology

2015-07-06

Department of Defense F r a u d , W a s t e & A b u s e Results in Brief Patriot Express Program Could Be More Cost-Effective for Overseas...availability for passengers traveling overseas. July 6, 2015 As a result , DoD did not maximize its return on investment in the Patriot Express Program and...comments from the Commander, Naval Supply Systems Command, partially addressed Recommendation 3.b. As a result of management comments, we redirected
Course Presentation of the Joint-Products Problem with Costs Associated with Dumping

ERIC Educational Resources Information Center

Borland, Melvin V.; Howsen, Roy M.

2009-01-01

The typical profit-maximization solution for the joint-production problem found in intermediate texts, managerial texts, and other texts concerned with optimal pricing is oversimplified and inconsistent with profit maximization, unless there is either no excess of any of the joint products or no costs associated with dumping. However, it is an…
A cooperative reduction model for regional air pollution control in China that considers adverse health effects and pollutant reduction costs.

PubMed

Xie, Yujing; Zhao, Laijun; Xue, Jian; Hu, Qingmi; Xu, Xiang; Wang, Hongbo

2016-12-15

How to effectively control severe regional air pollution has become a focus of global concern recently. The non-cooperative reduction model (NCRM) is still the main air pollution control pattern in China, but it is both ineffective and costly, because each province must independently fight air pollution. Thus, we proposed a cooperative reduction model (CRM), with the goal of maximizing the reduction in adverse health effects (AHEs) at the lowest cost by encouraging neighboring areas to jointly control air pollution. CRM has two parts: a model of optimal pollutant removal rates using two optimization objectives (maximizing the reduction in AHEs and minimizing pollutant reduction cost) while meeting the regional pollution control targets set by the central government, and a model that allocates the cooperation benefits (i.e., health improvement and cost reduction) among the participants according to their contributions using the Shapley value method. We applied CRM to the case of sulfur dioxide (SO 2 ) reduction in Yangtze River Delta region. Based on data from 2003 to 2013, and using mortality due to respiratory and cardiovascular diseases as the health endpoints, CRM saves 437 more lives than NCRM, amounting to 12.1% of the reduction under NCRM. CRM also reduced costs by US $65.8×10 6 compared with NCRM, which is 5.2% of the total cost of NCRM. Thus, CRM performs significantly better than NCRM. Each province obtains significant benefits from cooperation, which can motivate them to actively cooperate in the long term. A sensitivity analysis was performed to quantify the effects of parameter values on the cooperation benefits. Results shown that the CRM is not sensitive to the changes in each province's pollutant carrying capacity and the minimum pollutant removal capacity, but sensitive to the maximum pollutant reduction capacity. Moreover, higher cooperation benefits will be generated when a province's maximum pollutant reduction capacity increases. Copyright Â© 2016 Elsevier B.V. All rights reserved.
7 CFR 1467.12 - The WRPO development.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS WETLANDS RESERVE PROGRAM § 1467.12 The WRPO... WRPO will be developed to ensure that cost-effective restoration and maximization of wildlife benefits and wetland functions and values will result. Specifically, the WRPO will consider and address, to the...
7 CFR 1467.12 - The WRPO development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS WETLANDS RESERVE PROGRAM § 1467.12 The WRPO... WRPO will be developed to ensure that cost-effective restoration and maximization of wildlife benefits and wetland functions and values will result. Specifically, the WRPO will consider and address, to the...
The effects of safety practice, technology adoption, and firm characteristics on motor carrier safety

DOT National Transportation Integrated Search

2004-01-01

The theory of the firm suggests that firms should maximize profit by investing in safety until : marginal cost is equal to the marginal benefit. This paper addresses motor carrier safety from the : perspective of the firm, developing the theoretical ...
A Universal Nutrient Application Strategy For The Bioremediation Of Oil-Polluted Beaches

EPA Science Inventory

Biostimulation by nutrient application is a viable technology for restoring oil-contaminated beaches. Maximizing the nutrient residence time is key for achieving a rapid cost-effective cleanup. We considered the nutrient injection strategy through a perforated pipe at the high ti...
Impact and cost-effectiveness of current and future tuberculosis diagnostics: the contribution of modelling

PubMed Central

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

2014-01-01

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

PubMed

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

2016-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. © The Author(s) 2015.
An Efficient, Non-iterative Method of Identifying the Cost-Effectiveness Frontier

PubMed Central

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D.

2015-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we additionally provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. PMID:25926282

Social welfare with a foreign competitor

NASA Astrophysics Data System (ADS)

Ferreira, Fernanda A.

2009-11-01

In this paper, we consider a mixed market in which a state-owned welfare-maximizing public (domestic) firm competes against a profit-maximizing private (foreign) firm. We suppose that the domestic firm is less efficient than the foreign firm. However, the domestic firm can lower its marginal costs by conducting cost-reducing R&D investment. We examine the impacts of entry of a foreign firm on decisions upon cost-reducing R&D investment by the domestic firm and how these affect the domestic welfare.
Improving Control of Tuberculosis in Low-Burden Countries: Insights from Mathematical Modeling

PubMed Central

White, Peter J.; Abubakar, Ibrahim

2016-01-01

Tuberculosis control and elimination remains a challenge for public health even in low-burden countries. New technology and novel approaches to case-finding, diagnosis, and treatment are causes for optimism but they need to be used cost-effectively. This in turn requires improved understanding of the epidemiology of TB and analysis of the effectiveness and cost-effectiveness of different interventions. We describe the contribution that mathematical modeling can make to understanding epidemiology and control of TB in different groups, guiding improved approaches to public health interventions. We emphasize that modeling is not a substitute for collecting data but rather is complementary to empirical research, helping determine what are the key questions to address to maximize the public-health impact of research, helping to plan studies, and making maximal use of available data, particularly from surveillance, and observational studies. We provide examples of how modeling and related empirical research inform policy and discuss how a combination of these approaches can be used to address current questions of key importance, including use of whole-genome sequencing, screening and treatment for latent infection, and combating drug resistance. PMID:27199896
Small satellite multi mission C2 for maximum effect

USGS Publications Warehouse

Miller, E.; Medina, O.; Lane, C.R.; Kirkham, A.; Ivancic, W.; Jones, B.; Risty, R.

2006-01-01

This paper discusses US Air Force, US Army, US Navy, and NASA demonstrations based around the Virtual Mission Operations Center (VMOC) and its application in fielding a Multi Mission Satellite Operations Center (MMSOC) designed to integrate small satellites into the inherently tiered system environment of operations. The intent is to begin standardizing the spacecraft to ground interfaces needed to reduce costs, maximize space effects to the user, and allow the generation of Tactics, Techniques and Procedures (TTPs) that lead to Responsive Space employment. Combining the US Air Force/Army focus of theater command and control of payloads with the US Navy's user collaboration and FORCEnet consistent approach lays the groundwork for the fundamental change needed to maximize responsive space effects.
2007 National Small Business Conference: Critical Infrastructure Opportunities

DTIC Science & Technology

2007-05-18

Flooding of Subway Tunnels From IED Bomber Maximize lives saved – provide time to evacuate Recent advances in inflatable structure technology: • Stronger...Polimetry/ Signal Processing technologies (Radar & Sonar) Low Cost Advanced Composite Structures Low Cost Composite Sandwich Structures and...Ubiquitous Chem/Bio Detect 34 High Impact Technology Solutions Resilient Tunnel Prevent Flooding of Subway Tunnels From IED Bomber Maximize lives saved
Estimating the Economic Value of Information for Screening in Disseminating and Targeting Effective School-based Preventive Interventions: An Illustrative Example.

PubMed

Johnston, Stephen S; Salkever, David S; Ialongo, Nicholas S; Slade, Eric P; Stuart, Elizabeth A

2017-11-01

When candidates for school-based preventive interventions are heterogeneous in their risk of poor outcomes, an intervention's expected economic net benefits may be maximized by targeting candidates for whom the intervention is most likely to yield benefits, such as those at high risk of poor outcomes. Although increasing amounts of information about candidates may facilitate more accurate targeting, collecting information can be costly. We present an illustrative example to show how cost-benefit analysis results from effective intervention demonstrations can help us to assess whether improved targeting accuracy justifies the cost of collecting additional information needed to make this improvement.
Prudent Investing: Maximizing Profits from the Law Library.

ERIC Educational Resources Information Center

Schultz, Jon S.

1990-01-01

In response to budgetary constraints, the University of Houston Law Center's faculty services department provides trained research assistants to faculty not needing a full-time assistant. The research assistants are supervised by a lawyer-librarian. The program has been successful, well received, and cost effective. (MSE)
Health center streamlines use of audiovisual aids.

PubMed

Brantz, M H

1978-09-01

Audiovisual aids and programs can be used to help provide effective and efficient in-hospital continuing education programs. The cost of audiovisual equipment can be minimized and use can be maximized by implementing standardization policies that identify and simplify the number and types of equipment to be purchased.
State Policy Initiatives for Financing Energy Efficiency in Public Buildings.

ERIC Educational Resources Information Center

Business Officer, 1984

1984-01-01

Alternative financing methods (other than state financing) for developing cost-effective energy efficiency projects are discussed. It is suggested that by properly financing energy efficiency investments, state campuses can generate immediate positive cash savings. The following eight initiatives for maximizing energy savings potential are…
The Application of Incentives and the Defense Business Operations Fund

DTIC Science & Technology

1993-12-01

The Defense Business Operations Fund (DBOF) is an attempt to incorporate private sector business incentives into the public sector. Truly efficient...or resources are missing an organization will not become more cost effective and efficient. The private sector goal is profit maximization. This goal
A Selective Role for Dopamine in Learning to Maximize Reward But Not to Minimize Effort: Evidence from Patients with Parkinson's Disease.

PubMed

Skvortsova, Vasilisa; Degos, Bertrand; Welter, Marie-Laure; Vidailhet, Marie; Pessiglione, Mathias

2017-06-21

Instrumental learning is a fundamental process through which agents optimize their choices, taking into account various dimensions of available options such as the possible reward or punishment outcomes and the costs associated with potential actions. Although the implication of dopamine in learning from choice outcomes is well established, less is known about its role in learning the action costs such as effort. Here, we tested the ability of patients with Parkinson's disease (PD) to maximize monetary rewards and minimize physical efforts in a probabilistic instrumental learning task. The implication of dopamine was assessed by comparing performance ON and OFF prodopaminergic medication. In a first sample of PD patients ( n = 15), we observed that reward learning, but not effort learning, was selectively impaired in the absence of treatment, with a significant interaction between learning condition (reward vs effort) and medication status (OFF vs ON). These results were replicated in a second, independent sample of PD patients ( n = 20) using a simplified version of the task. According to Bayesian model selection, the best account for medication effects in both studies was a specific amplification of reward magnitude in a Q-learning algorithm. These results suggest that learning to avoid physical effort is independent from dopaminergic circuits and strengthen the general idea that dopaminergic signaling amplifies the effects of reward expectation or obtainment on instrumental behavior. SIGNIFICANCE STATEMENT Theoretically, maximizing reward and minimizing effort could involve the same computations and therefore rely on the same brain circuits. Here, we tested whether dopamine, a key component of reward-related circuitry, is also implicated in effort learning. We found that patients suffering from dopamine depletion due to Parkinson's disease were selectively impaired in reward learning, but not effort learning. Moreover, anti-parkinsonian medication restored the ability to maximize reward, but had no effect on effort minimization. This dissociation suggests that the brain has evolved separate, domain-specific systems for instrumental learning. These results help to disambiguate the motivational role of prodopaminergic medications: they amplify the impact of reward without affecting the integration of effort cost. Copyright © 2017 the authors 0270-6474/17/376087-11$15.00/0.
Labor costs incurred by anesthesiology groups because of operating rooms not being allocated and cases not being scheduled to maximize operating room efficiency.

PubMed

Abouleish, Amr E; Dexter, Franklin; Epstein, Richard H; Lubarsky, David A; Whitten, Charles W; Prough, Donald S

2003-04-01

Determination of operating room (OR) block allocation and case scheduling is often not based on maximizing OR efficiency, but rather on tradition and surgeon convenience. As a result, anesthesiology groups often incur additional labor costs. When negotiating financial support, heads of anesthesiology departments are often challenged to justify the subsidy necessary to offset these additional labor costs. In this study, we describe a method for calculating a statistically sound estimate of the excess labor costs incurred by an anesthesiology group because of inefficient OR allocation and case scheduling. OR information system and anesthesia staffing data for 1 yr were obtained from two university hospitals. Optimal OR allocation for each surgical service was determined by maximizing the efficiency of use of the OR staff. Hourly costs were converted to dollar amounts by using the nationwide median compensation for academic and private-practice anesthesia providers. Differences between actual costs and the optimal OR allocation were determined. For Hospital A, estimated annual excess labor costs were $1.6 million (95% confidence interval, $1.5-$1.7 million) and $2.0 million ($1.89-$2.05 million) when academic and private-practice compensation, respectively, was calculated. For Hospital B, excess labor costs were $1.0 million ($1.08-$1.17 million) and $1.4 million ($1.32-1.43 million) for academic and private-practice compensation, respectively. This study demonstrates a methodology for an anesthesiology group to estimate its excess labor costs. The group can then use these estimates when negotiating for subsidies with its hospital, medical school, or multispecialty medical group. We describe a new application for a previously reported statistical method to calculate operating room (OR) allocations to maximize OR efficiency. When optimal OR allocations and case scheduling are not implemented, the resulting increase in labor costs can be used in negotiations as a statistically sound estimate for the increased labor cost to the anesthesiology department.
Cost-effectiveness of a one-year coaching program for healthy physical activity in early rheumatoid arthritis.

PubMed

Brodin, Nina; Lohela-Karlsson, Malin; Swärdh, Emma; Opava, Christina H

2015-01-01

To describe cost-effectiveness of the Physical Activity in Rheumatoid Arthritis (PARA) study intervention. Costs were collected and estimated retrospectively. Cost-effectiveness was calculated based on the intervention cost per patient with respect to change in health status (EuroQol global visual analog scale--EQ-VAS and EuroQol--EQ-5D) and activity limitation (Health assessment questionnaire - HAQ) using cost-effectiveness- and cost-minimization analyses. Total cost of the one-year intervention program was estimated to be €67 317 or €716 per participant. Estimated difference in total societal cost between the intervention (IG) and control (CG) was €580 per participant. Incremental cost-effectiveness ratio (ICER) for one point (1/100) of improvement in EQ-VAS was estimated to be €116. By offering the intervention to more affected participants in the IG compared to less affected participants, 15.5 extra points of improvement in EQ-VAS and 0.13 points of improvement on HAQ were gained at the same cost. "Ordinary physiotherapy" was most cost-effective with regard to EQ-5D. The intervention resulted in improved effect in health status for the IG with a cost of €116 per extra point in VAS. The intervention was cost-effective if targeted towards a subgroup of more affected patients when evaluating the effect using VAS and HAQ. The physical activity coaching intervention resulted in an improved effect on VAS for the intervention group, to a higher cost. In order to maximize cost-effectiveness, this type of physical activity coaching intervention should be targeted towards patients largely affected by their RA. The intervention is cost-effective from the patients' point of view, but not from that of the general population.
Wake Sensor Evaluation Program and Results of JFK-1 Wake Vortex Sensor Intercomparisons

NASA Technical Reports Server (NTRS)

Barker, Ben C., Jr.; Burnham, David C.; Rudis, Robert P.

1997-01-01

The overall approach should be to: (1) Seek simplest, sufficiently robust, integrated ground based sensor systems (wakes and weather) for AVOSS; (2) Expand all sensor performance cross-comparisons and data mergings in on-going field deployments; and (3) Achieve maximal cost effectiveness through hardware/info sharing. An effective team is in place to accomplish the above tasks.
Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008-2011.

PubMed

Li, Fuzhong; Harmer, Peter

2015-07-30

Exercise is effective in reducing falls in people with Parkinson disease. However, information on the cost effectiveness of this approach is lacking. We conducted a cost-effectiveness analysis of Tai Ji Quan for reducing falls among patients with mild-to-moderate Parkinson disease. We used data from a previous intervention trial to analyze resource use costs related to intervention delivery and number of falls observed during a 9-month study period. Cost effectiveness was estimated via incremental cost-effectiveness ratio (ICER) in which Tai Ji Quan was compared with 2 alternative interventions (Resistance training and Stretching) on the primary outcome of per fall prevented and the secondary outcome of per participant quality-adjusted life years (QALY) gained. We also conducted subgroup and sensitivity analyses. Tai Ji Quan was more effective than either Resistance training or Stretching; it had the lowest cost and was the most effective in improving primary and secondary outcomes. Compared with Stretching, Tai Ji Quan cost an average of $175 less for each additional fall prevented and produced a substantial improvement in QALY gained at a lower cost. Results from subgroup and sensitivity analyses showed no variation in cost-effectiveness estimates. However, sensitivity analyses demonstrated a much lower ICER ($27) when only intervention costs were considered. Tai Ji Quan represents a cost-effective strategy for optimizing spending to prevent falls and maximize health gains in people with Parkinson disease. While these results are promising, they warrant further validation.
Impact of reconstruction strategies on system performance measures : maximizing safety and mobility while minimizing life-cycle costs : final report, December 8, 2008.

DOT National Transportation Integrated Search

2008-12-08

The objective of this research is to develop a general methodological framework for planning and : evaluating the effectiveness of highway reconstruction strategies on the systems performance : measures, in particular safety, mobility, and the tot...
Prevention

Treesearch

Barbara Illman; Gary Man

2010-01-01

Prevention is considered the most cost-effective element of the Forest Service Invasive Species Strategy (USDA Forest Service 2004). What makes prevention difficult is the desire to maximize free trade and the resulting benefits to society while, at the same time, protecting natural resources. The role of science is to first identify which commodities pose an...
Partnerships for Change: Maximizing Consultative Services

ERIC Educational Resources Information Center

Reinhardt, Patricia

2011-01-01

Consultation offers a cost-effective option that can develop into a satisfying, collaborative relationship that is highly productive, given the right ingredients: content and process knowledge on the part of the consultant, a systemic approach to change, and a foundation of professional and ethical standards on which to build a trustworthy…
The Cost-Effectiveness of 22 Approaches for Raising Student Achievement

ERIC Educational Resources Information Center

Yeh, Stuart S.

2011-01-01

As a consequence of the federal "No Child Left Behind" (NCLB) law, there is tremendous pressure on school principals, teachers, school superintendents, district staff, state departments of education and governors to maximize the increase in student achievement that is obtained with every dollar of expenditure. Currently, teachers are…
Do bioflavonoids in Juniperus virginiana heartwood stimulate oviposition in the ladybird Coleomegilla maculata?

USDA-ARS?s Scientific Manuscript database

Maximizing the reproductive potential of ladybird beetles fed factitious foods or artificial diets, in lieu of natural prey, is a major challenge to cost-effective mass-rearing for augmentative biological control. In this study, we tested the hypothesis that compounds in redcedar, Juniperus (J.) vir...
Strategies for Effective Desegregation.

ERIC Educational Resources Information Center

Hawley, Willis D.; And Others

A synthesis of existing research and commentary, this book seeks to clarify the national experience with school desegregation and to identify ways of maximizing the potential benefits and reducing the possible costs of desegregation. Chapters 1 and 9 discuss assumptions about the overall consequences of desegregation, while Chapters 2 through 8…

Improved minimum cost and maximum power two stage genome-wide association study designs.

PubMed

Stanhope, Stephen A; Skol, Andrew D

2012-01-01

In a two stage genome-wide association study (2S-GWAS), a sample of cases and controls is allocated into two groups, and genetic markers are analyzed sequentially with respect to these groups. For such studies, experimental design considerations have primarily focused on minimizing study cost as a function of the allocation of cases and controls to stages, subject to a constraint on the power to detect an associated marker. However, most treatments of this problem implicitly restrict the set of feasible designs to only those that allocate the same proportions of cases and controls to each stage. In this paper, we demonstrate that removing this restriction can improve the cost advantages demonstrated by previous 2S-GWAS designs by up to 40%. Additionally, we consider designs that maximize study power with respect to a cost constraint, and show that recalculated power maximizing designs can recover a substantial amount of the planned study power that might otherwise be lost if study funding is reduced. We provide open source software for calculating cost minimizing or power maximizing 2S-GWAS designs.
Maximizing nursing staff development. The learning laboratory.

PubMed

Kleinknecht, M K; Hefferin, E A

1990-01-01

To survive in today's cost-conscious medical-center environment, nursing education must show how it contributes effectively to promoting and maintaining the currency and competency of nursing staff practice, the quality of patient care, and the overall functioning of the medical center. In the face of limited resources, nursing education increasingly must promote staff's self-assessment of their own knowledge and skill deficiencies and use of self-study mechanisms to meet established performance standards. This survey explored the current use of learning laboratory centers used by nursing education for maximizing staff access to and use of needed remedial and practice update learning opportunities.
'Pedometers cost buttons': the feasibility of implementing a pedometer based walking programme within the community

PubMed Central

2011-01-01

Background Recent studies have suggested that walking interventions may be effective (at least in the short term) at increasing physical activity amongst those people who are the most inactive. This is a leading objective of contemporary public health policy in the UK and worldwide. However, before committing money from limited budgets to implement walking interventions more widely in the community, policymakers will want to know whether similar impacts can be expected and whether any changes will be required to the process to ensure uptake and success. This paper utilises the findings from a recent community-based pedometer study (Walking for Wellbeing in the West - WWW) undertaken in Glasgow, Scotland to address issues of feasibility. Methods An economic analysis of the WWW study assessed the costs of the interventions (minimal and maximal) and combined these with the effects to present incremental cost-effectiveness ratios (cost/person achieving the target of an additional 15,000 steps/week). A qualitative evaluation, involving focus group discussions with WWW participants and short interviews with members of the WWW research team, explored perceived benefits and barriers associated with walking, as well as the successful aspects and challenges associated with the interventions. Results The incremental cost effectiveness associated with the interventions was estimated as £92 and £591 per person achieving the target for the minimal and maximal interventions respectively. The qualitative evaluation gave insight into the process by which the results were achieved, and identified several barriers and facilitators that would need to be addressed before implementing the interventions in the wider community, in order to ensure their effective transfer. These included assessing the impact of the relationship between researchers and participants on the results, and the motivational importance of monitoring and assessing performance. Conclusions The results suggest that pedometer based walking interventions may be considered cost-effective and suitable for implementation within the wider community. However, several research gaps remain, including the importance and impact of the researcher/participant relationship, the impact of assessment on motivation and effectiveness, and the longer term impact on physical and mental health, resource utilisation and quality of life. Trial registration Current Control Trials Ltd ISRCTN88907382 PMID:21453509
Modeling regulated water utility investment incentives

NASA Astrophysics Data System (ADS)

Padula, S.; Harou, J. J.

2014-12-01

This work attempts to model the infrastructure investment choices of privatized water utilities subject to rate of return and price cap regulation. The goal is to understand how regulation influences water companies' investment decisions such as their desire to engage in transfers with neighbouring companies. We formulate a profit maximization capacity expansion model that finds the schedule of new supply, demand management and transfer schemes that maintain the annual supply-demand balance and maximize a companies' profit under the 2010-15 price control process in England. Regulatory incentives for costs savings are also represented in the model. These include: the CIS scheme for the capital expenditure (capex) and incentive allowance schemes for the operating expenditure (opex) . The profit-maximizing investment program (what to build, when and what size) is compared with the least cost program (social optimum). We apply this formulation to several water companies in South East England to model performance and sensitivity to water network particulars. Results show that if companies' are able to outperform the regulatory assumption on the cost of capital, a capital bias can be generated, due to the fact that the capital expenditure, contrarily to opex, can be remunerated through the companies' regulatory capital value (RCV). The occurrence of the 'capital bias' or its entity depends on the extent to which a company can finance its investments at a rate below the allowed cost of capital. The bias can be reduced by the regulatory penalties for underperformances on the capital expenditure (CIS scheme); Sensitivity analysis can be applied by varying the CIS penalty to see how and to which extent this impacts the capital bias effect. We show how regulatory changes could potentially be devised to partially remove the 'capital bias' effect. Solutions potentially include allowing for incentives on total expenditure rather than separately for capex and opex and allowing both opex and capex to be remunerated through a return on the company's regulatory capital value.
Selecting cost-effective areas for restoration of ecosystem services.

PubMed

Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

2015-04-01

Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.
Sample size calculation in cost-effectiveness cluster randomized trials: optimal and maximin approaches.

PubMed

Manju, Md Abu; Candel, Math J J M; Berger, Martijn P F

2014-07-10

In this paper, the optimal sample sizes at the cluster and person levels for each of two treatment arms are obtained for cluster randomized trials where the cost-effectiveness of treatments on a continuous scale is studied. The optimal sample sizes maximize the efficiency or power for a given budget or minimize the budget for a given efficiency or power. Optimal sample sizes require information on the intra-cluster correlations (ICCs) for effects and costs, the correlations between costs and effects at individual and cluster levels, the ratio of the variance of effects translated into costs to the variance of the costs (the variance ratio), sampling and measuring costs, and the budget. When planning, a study information on the model parameters usually is not available. To overcome this local optimality problem, the current paper also presents maximin sample sizes. The maximin sample sizes turn out to be rather robust against misspecifying the correlation between costs and effects at the cluster and individual levels but may lose much efficiency when misspecifying the variance ratio. The robustness of the maximin sample sizes against misspecifying the ICCs depends on the variance ratio. The maximin sample sizes are robust under misspecification of the ICC for costs for realistic values of the variance ratio greater than one but not robust under misspecification of the ICC for effects. Finally, we show how to calculate optimal or maximin sample sizes that yield sufficient power for a test on the cost-effectiveness of an intervention.
[Principles of health economic evaluation for use by caregivers].

PubMed

Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

2017-01-01

The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
One-Shot Coherence Dilution.

PubMed

Zhao, Qi; Liu, Yunchao; Yuan, Xiao; Chitambar, Eric; Ma, Xiongfeng

2018-02-16

Manipulation and quantification of quantum resources are fundamental problems in quantum physics. In the asymptotic limit, coherence distillation and dilution have been proposed by manipulating infinite identical copies of states. In the nonasymptotic setting, finite data-size effects emerge, and the practically relevant problem of coherence manipulation using finite resources has been left open. This Letter establishes the one-shot theory of coherence dilution, which involves converting maximally coherent states into an arbitrary quantum state using maximally incoherent operations, dephasing-covariant incoherent operations, incoherent operations, or strictly incoherent operations. We introduce several coherence monotones with concrete operational interpretations that estimate the one-shot coherence cost-the minimum amount of maximally coherent states needed for faithful coherence dilution. Furthermore, we derive the asymptotic coherence dilution results with maximally incoherent operations, incoherent operations, and strictly incoherent operations as special cases. Our result can be applied in the analyses of quantum information processing tasks that exploit coherence as resources, such as quantum key distribution and random number generation.
Facilitating Transfer: An Issue of the 90's.

ERIC Educational Resources Information Center

Coleman, Catherine

Recently the state legislatures in Texas and Arkansas have passed initiatives to maximize transfer effectiveness from two- to four-year institutions. These initiatives, and others being undertaken on a national level, were stimulated by the rising cost of higher education, a decline in transfer rates and low achievement among students who do…
Learning curves in health care.

PubMed

Waldman, J Deane; Yourstone, Steven A; Smith, Howard L

2003-01-01

This article explores the uses of learning curve theory in medicine. Though effective application of learning curve theory in health care can result in higher quality and lower cost, it is seldom methodically applied in clinical practice. Fundamental changes are necessary in the corporate culture of medicine in order to capitalize maximally on the benefits of learning.
Maximizing purchase decision factors other than price.

PubMed

Berkowitz, D A; Diamond, J F; Montagnolo, A J

1992-05-01

Assessing and acquiring technology does not have to be chaotic, driven solely by price, clinical preference, and emotion. With the tools available, it can be distilled to a process of organized common sense, which results in maximum flexibility for the user and allows materiel managers to procure the best, most cost-effective equipment for the hospital.
Influence of feedstock particle size on lignocellulose conversion--a review.

PubMed

Vidal, Bernardo C; Dien, Bruce S; Ting, K C; Singh, Vijay

2011-08-01

Feedstock particle sizing can impact the economics of cellulosic ethanol commercialization through its effects on conversion yield and energy cost. Past studies demonstrated that particle size influences biomass enzyme digestibility to a limited extent. Physical size reduction was able to increase conversion rates to maximum of ≈ 50%, whereas chemical modification achieved conversions of >70% regardless of biomass particle size. This suggests that (1) mechanical pretreatment by itself is insufficient to attain economically feasible biomass conversion, and, therefore, (2) necessary particle sizing needs to be determined in the context of thermochemical pretreatment employed for lignocellulose conversion. Studies of thermochemical pretreatments that have taken into account particle size as a factor have exhibited a wide range of maximal sizes (i.e., particle sizes below which no increase in pretreatment effectiveness, measured in terms of the enzymatic conversion resulting from the pretreatment, were observed) from <0.15 to 50 mm. Maximal sizes as defined above were dependent on the pretreatment employed, with maximal size range decreasing as follows: steam explosion > liquid hot water > dilute acid and base pretreatments. Maximal sizes also appeared dependent on feedstock, with herbaceous or grassy biomass exhibiting lower maximal size range (<3 mm) than woody biomass (>3 mm). Such trends, considered alongside the intensive energy requirement of size reduction processes, warrant a more systematic study of particle size effects across different pretreatment technologies and feedstock, as a requisite for optimizing the feedstock supply system.
Wireless Sensor Network-Based Service Provisioning by a Brokering Platform

PubMed Central

Guijarro, Luis; Pla, Vicent; Vidal, Jose R.; Naldi, Maurizio; Mahmoodi, Toktam

2017-01-01

This paper proposes a business model for providing services based on the Internet of Things through a platform that intermediates between human users and Wireless Sensor Networks (WSNs). The platform seeks to maximize its profit through posting both the price charged to each user and the price paid to each WSN. A complete analysis of the profit maximization problem is performed in this paper. We show that the service provider maximizes its profit by incentivizing all users and all Wireless Sensor Infrastructure Providers (WSIPs) to join the platform. This is true not only when the number of users is high, but also when it is moderate, provided that the costs that the users bear do not trespass a cost ceiling. This cost ceiling depends on the number of WSIPs, on the value of the intrinsic value of the service and on the externality that the WSIP has on the user utility. PMID:28498347
Wireless Sensor Network-Based Service Provisioning by a Brokering Platform.

PubMed

Guijarro, Luis; Pla, Vicent; Vidal, Jose R; Naldi, Maurizio; Mahmoodi, Toktam

2017-05-12

This paper proposes a business model for providing services based on the Internet of Things through a platform that intermediates between human users and Wireless Sensor Networks (WSNs). The platform seeks to maximize its profit through posting both the price charged to each user and the price paid to each WSN. A complete analysis of the profit maximization problem is performed in this paper. We show that the service provider maximizes its profit by incentivizing all users and all Wireless Sensor Infrastructure Providers (WSIPs) to join the platform. This is true not only when the number of users is high, but also when it is moderate, provided that the costs that the users bear do not trespass a cost ceiling. This cost ceiling depends on the number of WSIPs, on the value of the intrinsic value of the service and on the externality that the WSIP has on the user utility.
Monetary Shocks in Models with Inattentive Producers.

PubMed

Alvarez, Fernando E; Lippi, Francesco; Paciello, Luigi

2016-04-01

We study models where prices respond slowly to shocks because firms are rationally inattentive. Producers must pay a cost to observe the determinants of the current profit maximizing price, and hence observe them infrequently. To generate large real effects of monetary shocks in such a model the time between observations must be long and/or highly volatile. Previous work on rational inattentiveness has allowed for observation intervals that are either constant-but-long ( e.g . Caballero, 1989 or Reis, 2006) or volatile-but-short ( e.g . Reis's, 2006 example where observation costs are negligible), but not both. In these models, the real effects of monetary policy are small for realistic values of the duration between observations. We show that non-negligible observation costs produce both of these effects: intervals between observations are infrequent and volatile. This generates large real effects of monetary policy for realistic values of the average time between observations.
Monetary Shocks in Models with Inattentive Producers

PubMed Central

Alvarez, Fernando E.; Lippi, Francesco; Paciello, Luigi

2016-01-01

We study models where prices respond slowly to shocks because firms are rationally inattentive. Producers must pay a cost to observe the determinants of the current profit maximizing price, and hence observe them infrequently. To generate large real effects of monetary shocks in such a model the time between observations must be long and/or highly volatile. Previous work on rational inattentiveness has allowed for observation intervals that are either constant-but-long (e.g. Caballero, 1989 or Reis, 2006) or volatile-but-short (e.g. Reis's, 2006 example where observation costs are negligible), but not both. In these models, the real effects of monetary policy are small for realistic values of the duration between observations. We show that non-negligible observation costs produce both of these effects: intervals between observations are infrequent and volatile. This generates large real effects of monetary policy for realistic values of the average time between observations. PMID:27516627
Optimum sample size allocation to minimize cost or maximize power for the two-sample trimmed mean test.

PubMed

Guo, Jiin-Huarng; Luh, Wei-Ming

2009-05-01

When planning a study, sample size determination is one of the most important tasks facing the researcher. The size will depend on the purpose of the study, the cost limitations, and the nature of the data. By specifying the standard deviation ratio and/or the sample size ratio, the present study considers the problem of heterogeneous variances and non-normality for Yuen's two-group test and develops sample size formulas to minimize the total cost or maximize the power of the test. For a given power, the sample size allocation ratio can be manipulated so that the proposed formulas can minimize the total cost, the total sample size, or the sum of total sample size and total cost. On the other hand, for a given total cost, the optimum sample size allocation ratio can maximize the statistical power of the test. After the sample size is determined, the present simulation applies Yuen's test to the sample generated, and then the procedure is validated in terms of Type I errors and power. Simulation results show that the proposed formulas can control Type I errors and achieve the desired power under the various conditions specified. Finally, the implications for determining sample sizes in experimental studies and future research are discussed.
Advancements in Combined Sewerage System Management

EPA Science Inventory

EPA National CSO Control Policy has nine minimum controls/long-term control plans: Maximization of flow to WWTP; Select CSO controls that will meet CWA requirements; Cost/performance considerations to demonstrate reasonable control alternatives; Maximization of WWF treatment at ...
Risk Management Interventions to Reduce Injuries and Maximize Economic Benefits in U.S. Mining.

PubMed

Griffin, Stephanie C; Bui, David P; Gowrisankaran, Gautam; Lutz, Eric A; He, Charles; Hu, Chengcheng; Burgess, Jefferey L

2018-03-01

Risk management (RM) is a cyclical process of identifying and ranking risks, implementing controls, and evaluating their effectiveness. This study aims to identify effective RM interventions in the U.S. mining industry. RM interventions were identified in four companies representing metal, aggregate, and coal mining sectors. Injury rates were determined using Mine Safety and Health Administration (MSHA) data and changes in injury rates identified through change point analysis. Program implementation costs and associated changes in injury costs were evaluated for select interventions. Six of 20 RM interventions were associated with a decline in all injuries and one with a reduction in lost-time injuries, all with a positive return on investment. Reductions in injuries and associated costs were observed following implementation of a limited number of specific RM interventions.
Optimal Repellent Usage to Combat Dengue Fever.

PubMed

Dorsett, Chasity; Oh, Hyunju; Paulemond, Marie Laura; Rychtář, Jan

2016-05-01

Dengue fever is one of the most important vector-borne diseases. It is transmitted by Aedes Stegomyia aegypti, and one of the most effective strategies to combat the disease is the reduction of exposure to bites of these mosquitoes. In this paper, we present a game-theoretical model in which individuals choose their own level of protection against mosquito bites in order to maximize their own benefits, effectively balancing the cost of protection and the risk of contracting the dengue fever. We find that even when the usage of protection is strictly voluntary, as soon as the cost of protection is about 10,000 times less than the cost of contracting dengue fever, the optimal level of protection will be within 5 % of the level needed for herd immunity.

Maximizing mitigation benefits: research to support a mitigation cost framework-final report.

DOT National Transportation Integrated Search

2016-08-01

Tracking environmental costs in the project development process has been a challenging task for state : departments of transportation (DOTs). Previous research identified the need to accurately track and : subsequently estimate project costs resultin...
Can we maximize both value and quality in gynecologic cancer care? A work in progress.

PubMed

Havrilesky, Laura J; Fountain, Cynthia

2014-01-01

Value is defined as desirable health outcomes achieved per monetary unit spent. Comparative effectiveness research and cost-effectiveness research are methods that have been developed to quantify effectiveness and value to inform management decisions. In this article we review the comparative and cost-effectiveness literature in the field of ovarian cancer treatment. Studies have shown that improved ovarian cancer survival is associated with complete primary surgical cytoreduction, with treatment at high volume facilities by subspecialist providers (gynecologic oncologists) and with National Comprehensive Cancer Network (NCCN) guideline-adherent care in both surgical staging and chemotherapy regimens. Intraperitoneal/intravenous chemotherapy (compared with intravenous alone) has been associated with improved survival and cost-effectiveness. Bevacizumab for primary and maintenance therapy has been found to not be cost-effective (even in selective subsets) despite a small progression-free survival (PFS) advantage. For platinum-sensitive recurrent ovarian cancer, secondary cytoreduction and platinum-based combinations are associated with improved overall survival (OS); several platinum-based combinations have also been found cost-effective. For platinum-resistant recurrence, single agent therapy and supportive care are cost-effective compared with combination therapies. Although little prospective clinical research has been done around end-of-life care, one study reported that for platinum-resistant ovarian cancer, palliative intervention would potentially reduce costs and increase quality adjusted life years compared with usual care (based on improvement in quality of life [QOL]). Overall, cost comparisons of individual chemotherapy regimens are highly dependent on market prices of novel therapeutic agents.
Optimizing Experimental Designs Relative to Costs and Effect Sizes.

ERIC Educational Resources Information Center

Headrick, Todd C.; Zumbo, Bruno D.

A general model is derived for the purpose of efficiently allocating integral numbers of units in multi-level designs given prespecified power levels. The derivation of the model is based on a constrained optimization problem that maximizes a general form of a ratio of expected mean squares subject to a budget constraint. This model provides more…
Examining the Effect of Instructor Experience on Flight Training Time

ERIC Educational Resources Information Center

Polstra, Philip A., Sr.

2012-01-01

Maximizing training efficiency is desirable in many areas of business. The ever increasing costs of flight training combined with a predicted shortage of pilots have resulted in steps being taken to improve flight training efficiency. In the past, the majority of airline pilots received their flight training in the military. Over time a growing…
An Industrial Engineering Approach to Cost Containment of Pharmacy Education.

PubMed

Duncan, Wendy; Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

2015-11-25

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students' recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes.
Optimal location selection for the installation of urban green roofs considering honeybee habitats along with socio-economic and environmental effects.

PubMed

Gwak, Jae Ha; Lee, Bo Kyeong; Lee, Won Kyung; Sohn, So Young

2017-03-15

This study proposes a new framework for the selection of optimal locations for green roofs to achieve a sustainable urban ecosystem. The proposed framework selects building sites that can maximize the benefits of green roofs, based not only on the socio-economic and environmental benefits to urban residents, but also on the provision of urban foraging sites for honeybees. The framework comprises three steps. First, building candidates for green roofs are selected considering the building type. Second, the selected building candidates are ranked in terms of their expected socio-economic and environmental effects. The benefits of green roofs are improved energy efficiency and air quality, reduction of urban flood risk and infrastructure improvement costs, reuse of storm water, and creation of space for education and leisure. Furthermore, the estimated cost of installing green roofs is also considered. We employ spatial data to determine the expected effects of green roofs on each building unit, because the benefits and costs may vary depending on the location of the building. This is due to the heterogeneous spatial conditions. In the third step, the final building sites are proposed by solving the maximal covering location problem (MCLP) to determine the optimal locations for green roofs as urban honeybee foraging sites. As an illustrative example, we apply the proposed framework in Seoul, Korea. This new framework is expected to contribute to sustainable urban ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.
Maximizing the use of local materials in HMA surfaces.

DOT National Transportation Integrated Search

2012-04-01

One approach to reducing initial construction costs is to maximize the use of locally available aggregates. The main concern with using : locally available carbonate aggregates, however, is that they tend to polish under traffic and provide inadequat...
Cost-effectiveness analysis of intracameral cefuroxime use for prophylaxis of endophthalmitis after cataract surgery.

PubMed

Sharifi, Emile; Porco, Travis C; Naseri, Ayman

2009-10-01

To evaluate the cost-effectiveness of intracameral cefuroxime for postoperative endophthalmitis prophylaxis, and to determine the efficacy threshold necessary for alternative antibiotics to attain cost-effective equivalence with intracameral cefuroxime. Cost-effectiveness analysis. We study a hypothetical cohort of 100,000 patients undergoing cataract surgery as a part of the cost analysis. A cost-effectiveness model was constructed to analyze different antibiotic prophylactic regimens for postoperative endophthalmitis with intracameral cefuroxime as our base case. Efficacy was defined as the absolute reduction in rate of infection from background rate of infection, which was sourced from the literature. Antibiotic cost data were derived from the Red Book 2007 edition, and salary data were taken from the United States Bureau of Labor Statistics. Multivariate sensitivity analysis assessed the performance of antibiotic options under different scenarios. Cost per case of endophthalmitis prevented; theoretical maximal cost-effectiveness; efficacy threshold necessary to achieve cost-effective equivalence with intracameral cefuroxime; ratio indicating how many times more effective or less expensive alternative antibiotics would have to be to achieve cost-effective equivalence with intracameral cefuroxime. The cost-effectiveness ratio for intracameral cefuroxime is $1403 per case of postoperative endophthalmitis prevented. By comparison, the least expensive topical fluoroquinolone in our study, ciprofloxacin, would have to be >8 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. The most expensive topical fluoroquinolones studied, gatifloxacin and moxifloxacin, would have to be > or =19 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. A sensitivity analysis reveals that even in the worst case scenario for intracameral cefuroxime efficacy and with a 50% reduction in the cost of 4th-generation fluoroquinolones, gatifloxacin and moxifloxacin would have to be > or =9 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. Administration of intracameral cefuroxime is relatively cost-effective in preventing endophthalmitis after cataract surgery. Owing to their high costs, many commonly used topical antibiotics are not cost-effective compared with intracameral cefuroxime, even under optimistic assumptions about their efficacy.
Cost-Effectiveness of a New Nordic Diet as a Strategy for Health Promotion

PubMed Central

Jensen, Jørgen Dejgård; Saxe, Henrik; Denver, Sigrid

2015-01-01

Inappropriate diets constitute an important health risk and an increasing environmental burden. Healthy regional diets may contribute to meeting this dual challenge. A palatable, healthy and sustainable New Nordic diet (NND) based on organic products from the Nordic region has been developed. This study assesses whether a large-scale introduction of NND is a cost-effective health promotion strategy by combining an economic model for estimating the utility-maximizing composition of NND, a life cycle assessment model to assess environmental effects of the dietary change, and a health impact model to assess impacts on the disease burden. Consumer expenditure for food and beverages in the NND is about 16% higher than currently, with the largest relative difference in low-income households. Environmental loads from food consumption are 15%–25% lower, and more than 18,000 disability-adjusted life years (DALY) will be saved per year in Denmark. NND exhibits a cost-effectiveness ratio of about €73,000–94,000 per DALY saved. This cost-effectiveness improves considerably, if the NND’s emphasis on organic and Nordic-origin products is relaxed. PMID:26133129
A theoretical model of the evolution of maternal effects under parent-offspring conflict.

PubMed

Uller, Tobias; Pen, Ido

2011-07-01

The evolution of maternal effects on offspring phenotype should depend on the extent of parent-offspring conflict and costs and constraints associated with maternal and offspring strategies. Here, we develop a model of maternal effects on offspring dispersal phenotype under parent-offspring conflict to evaluate such dependence. In the absence of evolutionary constraints and costs, offspring evolve dispersal rates from different patch types that reflect their own, rather than the maternal, optima. This result also holds true when offspring are unable to assess their own environment because the maternal phenotype provides an additional source of information. Consequently, maternal effects on offspring diapause, dispersal, and other traits that do not necessarily represent costly resource investment are more likely to maximize offspring than maternal fitness. However, when trait expression was costly, the evolutionarily stable dispersal rates tended to deviate from those under both maternal and offspring control. We use our results to (re)interpret some recent work on maternal effects and their adaptive value and provide suggestions for future work. © 2011 The Author(s). Evolution© 2011 The Society for the Study of Evolution.
Cost-Effectiveness of a New Nordic Diet as a Strategy for Health Promotion.

PubMed

Jensen, Jørgen Dejgård; Saxe, Henrik; Denver, Sigrid

2015-06-30

Inappropriate diets constitute an important health risk and an increasing environmental burden. Healthy regional diets may contribute to meeting this dual challenge. A palatable, healthy and sustainable New Nordic diet (NND) based on organic products from the Nordic region has been developed. This study assesses whether a large-scale introduction of NND is a cost-effective health promotion strategy by combining an economic model for estimating the utility-maximizing composition of NND, a life cycle assessment model to assess environmental effects of the dietary change, and a health impact model to assess impacts on the disease burden. Consumer expenditure for food and beverages in the NND is about 16% higher than currently, with the largest relative difference in low-income households. Environmental loads from food consumption are 15%-25% lower, and more than 18,000 disability-adjusted life years (DALY) will be saved per year in Denmark. NND exhibits a cost-effectiveness ratio of about €73,000-94,000 per DALY saved. This cost-effectiveness improves considerably, if the NND's emphasis on organic and Nordic-origin products is relaxed.
A user-friendly approach to cost accounting in laboratory animal facilities.

PubMed

Baker, David G

2011-08-19

Cost accounting is an essential management activity for laboratory animal facility management. In this report, the author describes basic principles of cost accounting and outlines steps for carrying out cost accounting in laboratory animal facilities. Methods of post hoc cost accounting analysis for maximizing the efficiency of facility operations are also described.
Cost-effectiveness analysis of implants versus autologous perforator flaps using the BREAST-Q.

PubMed

Matros, Evan; Albornoz, Claudia R; Razdan, Shantanu N; Mehrara, Babak J; Macadam, Sheina A; Ro, Teresa; McCarthy, Colleen M; Disa, Joseph J; Cordeiro, Peter G; Pusic, Andrea L

2015-04-01

Reimbursement has been recognized as a physician barrier to autologous reconstruction. Autologous reconstructions are more expensive than prosthetic reconstructions, but provide greater health-related quality of life. The authors' hypothesis is that autologous tissue reconstructions are cost-effective compared with prosthetic techniques when considering health-related quality of life and patient satisfaction. A cost-effectiveness analysis from the payer perspective, including patient input, was performed for unilateral and bilateral reconstructions with deep inferior epigastric perforator (DIEP) flaps and implants. The effectiveness measure was derived using the BREAST-Q and interpreted as the cost for obtaining 1 year of perfect breast health-related quality-adjusted life-year. Costs were obtained from the 2010 Nationwide Inpatient Sample. The incremental cost-effectiveness ratio was generated. A sensitivity analysis for age and stage at diagnosis was performed. BREAST-Q scores from 309 patients with implants and 217 DIEP flap reconstructions were included. The additional cost for obtaining 1 year of perfect breast-related health for a unilateral DIEP flap compared with implant reconstruction was $11,941. For bilateral DIEP flaps compared with implant reconstructions, the cost for an additional breast health-related quality-adjusted life-year was $28,017. The sensitivity analysis demonstrated that the cost for an additional breast health-related quality-adjusted life-year for DIEP flaps compared with implants was less for younger patients and earlier stage breast cancer. DIEP flaps are cost-effective compared with implants, especially for unilateral reconstructions. Cost-effectiveness of autologous techniques is maximized in women with longer life expectancy. Patient-reported outcomes findings can be incorporated into cost-effectiveness analyses to demonstrate the relative value of reconstructive procedures.
A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types.

PubMed

Tricco, Andrea C; Cogo, Elise; Isaranuwatchai, Wanrudee; Khan, Paul A; Sanmugalingham, Geetha; Antony, Jesmin; Hoch, Jeffrey S; Straus, Sharon E

2015-04-22

Complex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base. We searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013. Overall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types. Our results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings. Please see related article: http://dx.doi.org/10.1186/s12916-015-0288-5.
Culture Moderates Biases in Search Decisions.

PubMed

Pattaratanakun, Jake A; Mak, Vincent

2015-08-01

Prior studies suggest that people often search insufficiently in sequential-search tasks compared with the predictions of benchmark optimal strategies that maximize expected payoff. However, those studies were mostly conducted in individualist Western cultures; Easterners from collectivist cultures, with their higher susceptibility to escalation of commitment induced by sunk search costs, could exhibit a reversal of this undersearch bias by searching more than optimally, but only when search costs are high. We tested our theory in four experiments. In our pilot experiment, participants generally undersearched when search cost was low, but only Eastern participants oversearched when search cost was high. In Experiments 1 and 2, we obtained evidence for our hypothesized effects via a cultural-priming manipulation on bicultural participants in which we manipulated the language used in the program interface. We obtained further process evidence for our theory in Experiment 3, in which we made sunk costs nonsalient in the search task-as expected, cross-cultural effects were largely mitigated. © The Author(s) 2015.
Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

PubMed Central

Nachega, Jean B; Mugavero, Michael J; Zeier, Michele; Vitória, Marco; Gallant, Joel E

2011-01-01

Since the advent of highly active antiretroviral therapy (HAART), the treatment of human immunodeficiency virus (HIV) infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART). The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to study not only implications for individual tolerability, toxicity, adherence, persistence and virologic efficacy, but also cost, scalability, and potential for dissemination and implementation, such that limited human and financial resources are optimally allocated for maximal efficiency, coverage and sustainability of global HIV/AIDS treatment. PMID:21845035
Maximizing phylogenetic diversity in biodiversity conservation: Greedy solutions to the Noah's Ark problem.

PubMed

Hartmann, Klaas; Steel, Mike

2006-08-01

The Noah's Ark Problem (NAP) is a comprehensive cost-effectiveness methodology for biodiversity conservation that was introduced by Weitzman (1998) and utilizes the phylogenetic tree containing the taxa of interest to assess biodiversity. Given a set of taxa, each of which has a particular survival probability that can be increased at some cost, the NAP seeks to allocate limited funds to conserving these taxa so that the future expected biodiversity is maximized. Finding optimal solutions using this framework is a computationally difficult problem to which a simple and efficient "greedy" algorithm has been proposed in the literature and applied to conservation problems. We show that, although algorithms of this type cannot produce optimal solutions for the general NAP, there are two restricted scenarios of the NAP for which a greedy algorithm is guaranteed to produce optimal solutions. The first scenario requires the taxa to have equal conservation cost; the second scenario requires an ultrametric tree. The NAP assumes a linear relationship between the funding allocated to conservation of a taxon and the increased survival probability of that taxon. This relationship is briefly investigated and one variation is suggested that can also be solved using a greedy algorithm.
Cost Implications of Value-Based Pricing for Companion Diagnostic Tests in Precision Medicine.

PubMed

Zaric, Gregory S

2016-07-01

Many interpretations of personalized medicine, also referred to as precision medicine, include discussions of companion diagnostic tests that allow drugs to be targeted to those individuals who are most likely to benefit or that allow treatment to be designed in a way such that individuals who are unlikely to benefit do not receive treatment. Many authors have commented on the clinical and competitive implications of companion diagnostics, but there has been relatively little formal analysis of the cost implications of companion diagnostics, although cost reduction is often cited as a significant benefit of precision medicine. We investigate the potential impact on costs of precision medicine implemented through the use of companion diagnostics. We develop a framework in which the costs of companion diagnostic tests are determined by considerations of profit maximization and cost effectiveness. We analyze four scenarios that are defined by the incremental cost-effectiveness ratio of the new drug in the absence of a companion diagnostic test. We find that, in most scenarios, precision medicine strategies based on companion diagnostics should be expected to lead to increases in costs in the short term and that costs would fall only in a limited number of situations.
Fitting of full Cobb-Douglas and full VRTS cost frontiers by solving goal programming problem

NASA Astrophysics Data System (ADS)

Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Madhusudhana Rao, B.

2017-11-01

The present research article first defines two popular production functions viz, Cobb-Douglas and VRTS production frontiers and their dual cost functions and then derives their cost limited maximal outputs. This paper tells us that the cost limited maximal output is cost efficient. Here the one side goal programming problem is proposed by which the full Cobb-Douglas cost frontier, full VRTS frontier can be fitted. This paper includes the framing of goal programming by which stochastic cost frontier and stochastic VRTS frontiers are fitted. Hasan et al. [1] used a parameter approach Stochastic Frontier Approach (SFA) to examine the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur stock Exchange (KLSE) market over the period 2005-2010. AshkanHassani [2] exposed Cobb-Douglas Production Functions application in construction schedule crashing and project risk analysis related to the duration of construction projects. Nan Jiang [3] applied Stochastic Frontier analysis to a panel of New Zealand dairy forms in 1998/99-2006/2007.
Cost-Effectiveness of a Community Pharmacist-Led Sleep Apnea Screening Program - A Markov Model.

PubMed

Perraudin, Clémence; Le Vaillant, Marc; Pelletier-Fleury, Nathalie

2013-01-01

Despite the high prevalence and major public health ramifications, obstructive sleep apnea syndrome (OSAS) remains underdiagnosed. In many developed countries, because community pharmacists (CP) are easily accessible, they have been developing additional clinical services that integrate the services of and collaborate with other healthcare providers (general practitioners (GPs), nurses, etc.). Alternative strategies for primary care screening programs for OSAS involving the CP are discussed. To estimate the quality of life, costs, and cost-effectiveness of three screening strategies among patients who are at risk of having moderate to severe OSAS in primary care. Markov decision model. Published data. Hypothetical cohort of 50-year-old male patients with symptoms highly evocative of OSAS. The 5 years after initial evaluation for OSAS. Societal. Screening strategy with CP (CP-GP collaboration), screening strategy without CP (GP alone) and no screening. Quality of life, survival and costs for each screening strategy. Under almost all modeled conditions, the involvement of CPs in OSAS screening was cost effective. The maximal incremental cost for "screening strategy with CP" was about 455€ per QALY gained. Our results were robust but primarily sensitive to the treatment costs by continuous positive airway pressure, and the costs of untreated OSAS. The probabilistic sensitivity analysis showed that the "screening strategy with CP" was dominant in 80% of cases. It was more effective and less costly in 47% of cases, and within the cost-effective range (maximum incremental cost effectiveness ratio at €6186.67/QALY) in 33% of cases. CP involvement in OSAS screening is a cost-effective strategy. This proposal is consistent with the trend in Europe and the United States to extend the practices and responsibilities of the pharmacist in primary care.

Can reoperative surgery be profitable? Maximizing reimbursement.

PubMed

Senagore, Anthony J

2006-11-01

It is interesting to review the topic of reoperative surgery from the aspect of cost-effectiveness or, worse yet, profitability for either the institution or surgeon. The majority of the published material focuses on indications, risk factors, and short- and long-term outcomes. The context of the discussion is framed by the question "Can you make money doing reoperative surgery?" The short answer is that if this is all you do, probably not. Few, if any, publications assess the impact a redo procedure has on the factors that directly affect the fee schedule: surgeon time consumption (intraoperative and postoperative), stress (physical and psychological), and malpractice effects. Far more work needs to be done to understand the cost and resource consumption effects of major reoperative surgery.
Identifying Effective Policy and Technologic Reforms for Sustainable Groundwater Management in Oman

NASA Astrophysics Data System (ADS)

Madani, K.; Zekri, S.; Karimi, A.

2014-12-01

Oman has gone through three decades of efforts aimed at addressing groundwater over-pumping and the consequent seawater intrusion. Example of measures adopted by the government since the 1990's include a vast subsidy program of irrigation modernization, a freeze on drilling new wells, delimitation of several no-drill zones, a crop substitution program, re-use of treated wastewater and construction of recharge dams. With no major success through these measures, the government laid the ground for water quotas by creating a new regulation in 1995. Nevertheless, groundwater quotas have not been enforced to date due to the high implementation and monitoring costs of traditional flow meters. This presentation discusses how sustainable groundwater management can be secured in Oman using a suit of policy and technologic reforms at a reasonable economic, political and practical cost. Data collected from farms with smart meters and low-cost wireless smart irrigation systems have been used to propose sustainable groundwater withdrawal strategies for Oman using a detailed hydro-economic model that couples a MODFLOW-SEAWAT model of the coastal aquifers with a dynamic profit maximization model. The hydro-economic optimization model was flexible to be run both as a social planner model to maximize the social welfare in the region, and as an agent-based model to capture the behavior of farmers interested in maximizing their profits independently. This flexibility helped capturing the trade-off between the optimality of the social planner solution developed at the system's level and its practicality (stability) with respect to the concerns and behaviors of the profit-maximizing farmers. The idetified promising policy and technolgical reforms for Oman include strict enforcement of groundwater quotas, smart metering, changing crop mixes, improving irrigation technologies, and revising geographical distribution of the farming activities. The presentation will discuss how different combinations of these reforms would affect groundwater and energy use, groundwater level and salinity, crop yield, and agricultural revenues in the future.
Evaluating alternative service contracts for medical equipment.

PubMed

De Vivo, L; Derrico, P; Tomaiuolo, D; Capussotto, C; Reali, A

2004-01-01

Managing medical equipments is a formidable task that has to be pursued maximizing the benefits within a highly regulated and cost-constrained environment. Clinical engineers are uniquely equipped to determine which policies are the most efficacious and cost effective for a health care institution to ensure that medical devices meet appropriate standards of safety, quality and performance. Part of this support is a strategy for preventive and corrective maintenance. This paper describes an alternative scheme of OEM (Original Equipment Manufacturer) service contract for medical equipment that combines manufacturers' technical support and in-house maintenance. An efficient and efficacious organization can reduce the high cost of medical equipment maintenance while raising reliability and quality. Methodology and results are discussed.
Hughes integrated synthetic aperture radar: High performance at low cost

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

Bayma, R.W.

1996-11-01

This paper describes the background and development of the low cost high-performance Hughes Integrated Synthetic Aperture Radar (HISAR{trademark}) which has a full range of capabilities for real-time reconnaissance, surveillance and earth resource mapping. HISAR uses advanced Synthetic Aperture Radar (SAR) technology to make operationally effective images of near photo quality, day or night and in all weather conditions. This is achieved at low cost by maximizing the use of commercially available radar and signal-processing equipment in the fabrication. Furthermore, HISAR is designed to fit into an executive-class aircraft making it available for a wide range of users. 4 refs., 8more » figs.« less
A dimension-wise analysis method for the structural-acoustic system with interval parameters

NASA Astrophysics Data System (ADS)

Xu, Menghui; Du, Jianke; Wang, Chong; Li, Yunlong

2017-04-01

The interval structural-acoustic analysis is mainly accomplished by interval and subinterval perturbation methods. Potential limitations for these intrusive methods include overestimation or interval translation effect for the former and prohibitive computational cost for the latter. In this paper, a dimension-wise analysis method is thus proposed to overcome these potential limitations. In this method, a sectional curve of the system response surface along each input dimensionality is firstly extracted, the minimal and maximal points of which are identified based on its Legendre polynomial approximation. And two input vectors, i.e. the minimal and maximal input vectors, are dimension-wisely assembled by the minimal and maximal points of all sectional curves. Finally, the lower and upper bounds of system response are computed by deterministic finite element analysis at the two input vectors. Two numerical examples are studied to demonstrate the effectiveness of the proposed method and show that, compared to the interval and subinterval perturbation method, a better accuracy is achieved without much compromise on efficiency by the proposed method, especially for nonlinear problems with large interval parameters.
The Trade-Offs of Developing a Case Management Model for Chronically Mentally Ill People.

ERIC Educational Resources Information Center

Belcher, John R.

1993-01-01

Addresses role of case management in care of chronically mentally ill persons. Notes that case management can be effective if designed so that services match client needs and service costs are measured accurately. Contends that profit-maximizing nature of U.S. health care system makes some form of capitation likely in design of case management…
Project To Design a Marketing Plan for Promoting Educators' Awareness of and Access to ERIC Products. Proposed Marketing Plan.

ERIC Educational Resources Information Center

Contemporary Associates, Inc., Washington, DC.

The proposed strategy, which is designed to maximize the effectiveness and minimize the costs of marketing the Information Analysis Products (IAPs) produced by the 16 ERIC Clearinghouses, is based on a study of the concept of centralized versus decentralized ordering of selected ERIC products. The experiment measured four variables--postage,…
Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

PubMed Central

Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

2016-01-01

Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a preferred strategy for each glaucoma stage, according to a cost-effectiveness ratio ranking. PMID:28033286
Valuation effects of health cost containment measures.

PubMed

Strange, M L; Ezzell, J R

2000-01-01

This study reports the findings of research into the valuation effects of health cost containment activities by publicly traded corporations. The motivation for this study was employers' increasing cost of providing health care insurance to their employees and employers' efforts to contain those costs. A 1990 survey of corporate health benefits indicated that these costs represented 25 percent of employers' net earnings and this would rise by the year 2000 if no actions were taken to reduce cost. Health cost containment programs that are implemented by firms should be seen by shareholders as a wealth maximizing effort. As such, this should be reflected in share price. This study employed standard event study methodology where the event is a media announcement or report regarding an attempt by a firm to contain the costs of providing health insurance and other health related benefits to employees. It examined abnormal returns on a number of event days and for a number of event intervals. Of the daily and interval returns that are least significant at the 10 percent level, virtually all are negative. Cross-sectional analysis shows that the abnormal returns are related negatively to a unionization variable.
Cost and performance model for redox flow batteries

NASA Astrophysics Data System (ADS)

Viswanathan, Vilayanur; Crawford, Alasdair; Stephenson, David; Kim, Soowhan; Wang, Wei; Li, Bin; Coffey, Greg; Thomsen, Ed; Graff, Gordon; Balducci, Patrick; Kintner-Meyer, Michael; Sprenkle, Vincent

2014-02-01

A cost model is developed for all vanadium and iron-vanadium redox flow batteries. Electrochemical performance modeling is done to estimate stack performance at various power densities as a function of state of charge and operating conditions. This is supplemented with a shunt current model and a pumping loss model to estimate actual system efficiency. The operating parameters such as power density, flow rates and design parameters such as electrode aspect ratio and flow frame channel dimensions are adjusted to maximize efficiency and minimize capital costs. Detailed cost estimates are obtained from various vendors to calculate cost estimates for present, near-term and optimistic scenarios. The most cost-effective chemistries with optimum operating conditions for power or energy intensive applications are determined, providing a roadmap for battery management systems development for redox flow batteries. The main drivers for cost reduction for various chemistries are identified as a function of the energy to power ratio of the storage system. Levelized cost analysis further guide suitability of various chemistries for different applications.
Low-cost extrapolation method for maximal LTE radio base station exposure estimation: test and validation.

PubMed

Verloock, Leen; Joseph, Wout; Gati, Azeddine; Varsier, Nadège; Flach, Björn; Wiart, Joe; Martens, Luc

2013-06-01

An experimental validation of a low-cost method for extrapolation and estimation of the maximal electromagnetic-field exposure from long-term evolution (LTE) radio base station installations are presented. No knowledge on downlink band occupation or service characteristics is required for the low-cost method. The method is applicable in situ. It only requires a basic spectrum analyser with appropriate field probes without the need of expensive dedicated LTE decoders. The method is validated both in laboratory and in situ, for a single-input single-output antenna LTE system and a 2×2 multiple-input multiple-output system, with low deviations in comparison with signals measured using dedicated LTE decoders.
Cost-effectiveness of Collaborative Care for Depression in Human Immunodeficiency Virus Clinics

PubMed Central

Fortney, John C; Gifford, Allen L; Rimland, David; Monson, Thomas; Rodriguez-Barradas, Maria C.; Pyne, Jeffrey M

2015-01-01

Objective To examine the cost-effectiveness of the HITIDES intervention. Design Randomized controlled effectiveness and implementation trial comparing depression collaborative care with enhanced usual care. Setting Three Veterans Health Administration (VHA) HIV clinics in the Southern US. Subjects 249 HIV-infected patients completed the baseline interview; 123 were randomized to the intervention and 126 to usual care. Intervention HITIDES consisted of an off-site HIV depression care team that delivered up to 12 months of collaborative care. The intervention used a stepped-care model for depression treatment and specific recommendations were based on the Texas Medication Algorithm Project and the VA/Department of Defense Depression Treatment Guidelines. Main outcome measure(s) Quality-adjusted life years (QALYs) were calculated using the 12-Item Short Form Health Survey, the Quality of Well Being Scale, and by converting depression-free days to QALYs. The base case analysis used outpatient, pharmacy, patient, and intervention costs. Cost-effectiveness was calculated using incremental cost effectiveness ratios (ICERs) and net health benefit (NHB). ICER distributions were generated using nonparametric bootstrap with replacement sampling. Results The HITIDES intervention was more effective and cost-saving compared to usual care in 78% of bootstrapped samples. The intervention NHB was positive and therefore deemed cost-effective using an ICER threshold of $50,000/QALY. Conclusions In HIV clinic settings this intervention was more effective and cost-saving compared to usual care. Implementation of off-site depression collaborative care programs in specialty care settings may be a strategy that not only improves outcomes for patients, but also maximizes the efficient use of limited healthcare resources. PMID:26102447
Maximizing resources in the local treatment of prostate cancer: A summary of cost-effectiveness studies.

PubMed

Muralidhar, Vinayak; Nguyen, Paul L

2017-02-01

Prostate cancer is a common diagnosis with several treatment options for the newly diagnosed patient, including radiation, surgery, active surveillance, and watchful waiting. Although tailoring of treatment to individual patient needs is an important goal, the recent passage of the Affordable Care Act has placed renewed interest in cost containment and cost-effectiveness. We sought to conduct a literature review of recent US-based studies to analyze the cost-effectiveness of initial local treatments for localized prostate cancer. We conducted a systematic literature search through PubMed, the Cost-Effectiveness Analysis Registry, and manual cross-referencing of articles. We identified US-based studies with cost analyses starting in 2005 that studied the cost-effectiveness of initial local treatments for localized prostate cancer (surgery, radiation, or observation). There were eight studies that met our inclusion and exclusion criteria. Most studies took the cost perspective of Medicare, and two studies also considered the societal cost in terms of lost patient time. Most studies also used a Markov model with inputs based on the available literature for the effectiveness and toxicity of the different treatment options. The radiation-focused studies tended to find brachytherapy (BT) or stereotactic body radiation therapy (SBRT) to be more cost-effective than intensity-modulated radiation therapy or proton beam therapy. These findings were primarily based on the lower cost of SBRT or BT with roughly equal efficacy and toxicity. The two studies focused on surgery found surgery to be more cost effective than intensity-modulated radiation therapy, at least for low-risk disease, and one study found BT to be more cost-effective than surgery, and watchful waiting to be the most cost-effective option overall. Cost-effectiveness analysis is important because it helps patients, physicians, and policymakers make quantitatively-based decisions, which balance treatment efficacy, toxicity, and costs. Significant methodological heterogeneity in the studies we found limit the ability to compare their results directly, but most found that for favorable-risk prostate cancer, shorter or simpler treatments tended to be more cost-effective, including no treatment (watchful waiting) in one study. Copyright © 2017 Elsevier Inc. All rights reserved.
Low-Cost Learning Systems: The General Concept and Some Specific Examples.

ERIC Educational Resources Information Center

Nichols, Daryl G.

1982-01-01

Discusses Low Cost Learning (LCL), an instructional system that maximizes available resources while minimizing cost per pupil, and its use in primary education in Southeast Asia. Short descriptions of LCL programs in the Philippines, Indonesia, Thailand, and Liberia are provided. (JJD)
Cost-effective management alternatives for Snake River Chinook salmon: a biological-economic synthesis.

PubMed

Halsing, David L; Moore, Michael R

2008-04-01

The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can provide valuable tools for science-based policy and management.
Cost-effective management alternatives for Snake river chinook salmon: A biological-economic synthesis

USGS Publications Warehouse

Halsing, D.L.; Moore, M.R.

2008-01-01

The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can provide valuable tools for science-based policy and management.
The effect of prey density on foraging mode selection in juvenile lumpfish: balancing food intake with the metabolic cost of foraging.

PubMed

Killen, Shaun S; Brown, Joseph A; Gamperl, A Kurt

2007-07-01

1. In many species, individuals will alter their foraging strategy in response to changes in prey density. However, previous work has shown that prey density has differing effects on the foraging mode decisions of ectotherms as compared with endotherms. This is likely due to differences in metabolic demand; however, the relationship between metabolism and foraging mode choice in ectotherms has not been thoroughly studied. 2. Juvenile lumpfish Cyclopterus lumpus forage using one of two modes: they can actively search for prey while swimming, or they can 'sit-and-wait' for prey while clinging to the substrate using a ventral adhesive disk. The presence of these easily distinguishable foraging modes makes juvenile lumpfish ideal for the study of foraging mode choice in ectotherms. 3. Behavioural observations conducted during laboratory experiments showed that juvenile lumpfish predominantly use the 'cling' foraging mode when prey is abundant, but resort to the more costly 'swim' mode to seek out food when prey is scarce. The metabolic cost of active foraging was also quantified for juvenile lumpfish using swim-tunnel respirometry, and a model was devised to predict the prey density at which lumpfish should switch between the swim and cling foraging modes to maximize energy intake. 4. The results of this model do not agree with previous observations of lumpfish behaviour, and thus it appears that juvenile lumpfish do not try to maximize their net energetic gain. Instead, our data suggest that juvenile lumpfish forage in a manner that reduces activity and conserves space in their limited aerobic scope. This behavioural flexibility is of great benefit to this species, as it allows young individuals to divert energy towards growth as opposed to activity. In a broader context, our results support previous speculation that ectotherms often forage in a manner that maintains a minimum prey encounter rate, but does not necessarily maximize net energy gain.
The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion

PubMed Central

Kerkum, Yvette L.; Buizer, Annemieke I.; van den Noort, Josien C.; Becher, Jules G.; Harlaar, Jaap; Brehm, Merel-Anne

2015-01-01

Introduction Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A spring-like AFO may enhance push-off power, which may come at the cost of reducing the knee flexion less effectively. Optimizing this trade-off between enhancing push-off power and normalizing knee flexion in stance is expected to maximize gait efficiency. This study investigated the effects of varying AFO stiffness on gait biomechanics and efficiency in children with CP who walk with excessive knee flexion in stance. Fifteen children with spastic CP (11 boys, 10±2 years) were prescribed with a ventral shell spring-hinged AFO (vAFO). The hinge was set into a rigid, or spring-like setting, using both a stiff and flexible performance. At baseline (i.e. shoes-only) and for each vAFO, a 3D-gait analysis and 6-minute walk test with breath-gas analysis were performed at comfortable speed. Lower limb joint kinematics and kinetics were calculated. From the 6-minute walk test, walking speed and the net energy cost were determined. A generalized estimation equation (p<0.05) was used to analyze the effects of different conditions. Compared to shoes-only, all vAFOs improved the knee angle and net moment similarly. Ankle power generation and work were preserved only by the spring-like vAFOs. All vAFOs decreased the net energy cost compared to shoes-only, but no differences were found between vAFOs, showing that the effects of spring-like vAFOs to promote push-off power did not lead to greater reductions in walking energy cost. These findings suggest that, in this specific group of children with spastic CP, the vAFO stiffness that maximizes gait efficiency is primarily determined by its effect on knee kinematics and kinetics rather than by its effect on push-off power. Trial Registration Dutch Trial Register NTR3418 PMID:26600039
The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion.

PubMed

Kerkum, Yvette L; Buizer, Annemieke I; van den Noort, Josien C; Becher, Jules G; Harlaar, Jaap; Brehm, Merel-Anne

2015-01-01

Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A spring-like AFO may enhance push-off power, which may come at the cost of reducing the knee flexion less effectively. Optimizing this trade-off between enhancing push-off power and normalizing knee flexion in stance is expected to maximize gait efficiency. This study investigated the effects of varying AFO stiffness on gait biomechanics and efficiency in children with CP who walk with excessive knee flexion in stance. Fifteen children with spastic CP (11 boys, 10±2 years) were prescribed with a ventral shell spring-hinged AFO (vAFO). The hinge was set into a rigid, or spring-like setting, using both a stiff and flexible performance. At baseline (i.e. shoes-only) and for each vAFO, a 3D-gait analysis and 6-minute walk test with breath-gas analysis were performed at comfortable speed. Lower limb joint kinematics and kinetics were calculated. From the 6-minute walk test, walking speed and the net energy cost were determined. A generalized estimation equation (p<0.05) was used to analyze the effects of different conditions. Compared to shoes-only, all vAFOs improved the knee angle and net moment similarly. Ankle power generation and work were preserved only by the spring-like vAFOs. All vAFOs decreased the net energy cost compared to shoes-only, but no differences were found between vAFOs, showing that the effects of spring-like vAFOs to promote push-off power did not lead to greater reductions in walking energy cost. These findings suggest that, in this specific group of children with spastic CP, the vAFO stiffness that maximizes gait efficiency is primarily determined by its effect on knee kinematics and kinetics rather than by its effect on push-off power. Dutch Trial Register NTR3418.
Cost study of dermal substitutes and topical negative pressure in the surgical treatment of burns.

PubMed

Hop, M Jenda; Bloemen, Monica C T; van Baar, Margriet E; Nieuwenhuis, Marianne K; van Zuijlen, Paul P M; Polinder, Suzanne; Middelkoop, Esther

2014-05-01

A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment. The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity. Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP (p=0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 (p<0.001). However, mean total costs per patient did not differ significantly between groups (range €29097-€43774). Costs of the interventional treatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Can the real opportunity cost stand up: displaced services, the straw man outside the room.

PubMed

Eckermann, Simon; Pekarsky, Brita

2014-04-01

In current literature, displaced services have been suggested to provide a basis for determining a threshold value for the effects of a new technology as part of a reimbursement process when budgets are fixed. We critically examine the conditions under which displaced services would represent an economically meaningful threshold value. We first show that if we assume that the least cost-effective services are displaced to finance a new technology, then the incremental cost-effectiveness ratio (ICER) of the displaced services (d) only coincides with that related to the opportunity cost of adopting that new technology, the ICER of the most cost-effective service in expansion (n), under highly restrictive conditions-namely, complete allocative efficiency in existing provision of health care interventions. More generally, reimbursement of new technology with a fixed budget comprises two actions; adoption and financing through displacement and the effect of reimbursement is the net effect of these two actions. In order for the reimbursement process to be a pathway to allocative efficiency within a fixed budget, the net effect of the strategy of reimbursement is compared with the most cost-effective alternative strategy for reimbursement: optimal reallocation, the health gain maximizing expansion of existing services financed by the health loss minimizing contraction. The shadow price of the health effects of a new technology, βc = (1/n + 1/d - 1/m)(-1), accounts for both imperfect displacement (the ICER of the displaced service, d < m, the ICER of the least cost-effective of the existing services in contraction) and the allocative inefficiency (n < m) characteristic of health systems.
Basic Economic Principles

NASA Technical Reports Server (NTRS)

Tideman, T. N.

1972-01-01

An economic approach to design efficient transportation systems involves maximizing an objective function that reflects both goals and costs. A demand curve can be derived by finding the quantities of a good that solve the maximization problem as one varies the price of that commodity, holding income and the prices of all other goods constant. A supply curve is derived by applying the idea of profit maximization of firms. The production function determines the relationship between input and output.
Space Shuttle Orbiter oxygen partial pressure sensing and control system improvements

NASA Technical Reports Server (NTRS)

Frampton, Robert F.; Hoy, Dennis M.; Kelly, Kevin J.; Walleshauser, James J.

1992-01-01

A program aimed at developing a new PPO2 oxygen sensor and a replacement amplifier for the Space Shuttle Orbiter is described. Experimental design methodologies used in the test and modeling process made it possible to enhance the effectiveness of the program and to reduce its cost. Significant cost savings are due to the increased lifetime of the basic sensor cell, the maximization of useful sensor life through an increased amplifier gain adjustment capability, the use of streamlined production processes for the manufacture of the assemblies, and the refurbishment capability of the replacement sensor.
An Industrial Engineering Approach to Cost Containment of Pharmacy Education

PubMed Central

Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

2015-01-01

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students’ recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes. PMID:26839421
The role of managed care in improving outcomes in epilepsy.

PubMed

Stern, John M

2011-07-01

The burden of epilepsy for patients and payers is large and onerous. The heterogeneous nature of the condition and the lack of diagnostic or treatment biomarkers present considerable clinical challenge. Despite expansion of the treatment armamentarium, selection of maximally appropriate therapy for individual patients remains a challenge, especially in those with treatment-refractory epilepsy. While numerous factors play a role in resolving these uncertainties, 3 key factors stand out. An overwhelming quantity of clinical data support the notion that the most effective therapies-measured by the ability to control seizures while minimizing adverse effects-are typically the most cost-effective. A second consideration is maximizing adherence to prescribed therapies, which has been an ongoing dilemma in the treatment of epilepsy because the condition occurs episodically. Poor adherence has a profound effect on treatment and costs, and several strategies for improving adherence have been identified. If properly observed, these can improve outcomes and lower expenditures. The third consideration is the monitoring of therapeutic response. This is essentially through ongoing care by the prescriber with careful assessment of seizures, patient satisfaction with treatment, dose-related adverse effects, and the subjective aspects of idiosyncratic toxicity; however, laboratory testing can also have a role. The resources needed to provide this monitoring vary across treatments. From a systemic point of view, engagement of all stakeholders-patients, payers, and physicians-in overseeing the effective and efficient use of healthcare resources will benefit all parties involved.
The costs of stunting in South Asia and the benefits of public investments in nutrition.

PubMed

Shekar, Meera; Dayton Eberwein, Julia; Kakietek, Jakub

2016-05-01

South Asia is home to the largest number of stunted children worldwide: 65 million or 37% of all South Asian children under 5 were stunted in 2014. The costs to society as a result of stunting during childhood are high and include increased mortality, increased morbidity (in childhood and later as adults), decreased cognitive ability, poor educational outcomes, lost earnings and losses to national economic productivity. Conversely, investing in nutrition provides many benefits for poverty reduction and economic growth. This article draws from analyses conducted in four sub-Saharan countries to demonstrate that investments in nutrition can also be very cost-effective in South Asian countries. Specifically, the analyses demonstrate that scaling up a set of 10 critical nutrition-specific interventions is highly cost-effective when considered as a package. Most of the interventions are also very cost-effective when considered individually. By modelling cost-effectiveness of different scale-up scenarios, the analysis offers insights into ways in which the impact of investing in nutrition interventions can be maximized under budget constraints. Rigorous estimations of the costs and benefits of nutrition investments, similar to those reported here for sub-Saharan countries, are an important next step for all South Asian countries in order to drive political commitment and action and to enhance allocative efficiency of nutrition resources. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
NASA Headquarters/Kennedy Space Center: Organization and Small Spacecraft Launch Services

NASA Technical Reports Server (NTRS)

Sierra, Albert; Beddel, Darren

1999-01-01

The objectives of the Kennedy Space Center's (KSC) Expendable Launch Vehicles (ELV) Program are to provide safe, reliable, cost effective ELV launches, maximize customer satisfaction, and perform advanced payload processing capability development. Details are given on the ELV program organization, products and services, foreign launch vehicle policy, how to get a NASA launch service, and some of the recent NASA payloads.
Maximizing Resource Utilization in Video Streaming Systems

ERIC Educational Resources Information Center

Alsmirat, Mohammad Abdullah

2013-01-01

Video streaming has recently grown dramatically in popularity over the Internet, Cable TV, and wire-less networks. Because of the resource demanding nature of video streaming applications, maximizing resource utilization in any video streaming system is a key factor to increase the scalability and decrease the cost of the system. Resources to…
A Numerical and Experimental Study of Ejector Internal Flow Structure and Geometry Modification for Maximized Performance

NASA Astrophysics Data System (ADS)

Falsafioon, Mehdi; Aidoun, Zine; Poirier, Michel

2017-12-01

A wide range of industrial refrigeration systems are good candidates to benefit from the cooling and refrigeration potential of supersonic ejectors. These are thermally activated and can use waste heat recovery from industrial processes where it is abundantly generated and rejected to the environment. In other circumstances low cost heat from biomass or solar energy may also be used in order to produce a cooling effect. Ejector performance is however typically modest and needs to be maximized in order to take full advantage of the simplicity and low cost of the technology. In the present work, the behavior of ejectors with different nozzle exit positions has been investigated using a prototype as well as a CFD model. The prototype was used in order to measure the performance advantages of refrigerant (R-134a) flowing inside the ejector. For the CFD model, it is assumed that the ejectors are axi-symmetric along x-axis, thus the generated model is in 2D. The preliminary CFD results are validated with experimental data over a wide range of conditions and are in good accordance in terms of entrainment and compression ratios. Next, the flow patterns of four different topologies are studied in order to discuss the optimum geometry in term of ejector entrainment improvement. Finally, The numerical simulations were used to find an optimum value corresponding to maximized entrainment ratio for fixed operating conditions.
Effects of Strength Training on Postpubertal Adolescent Distance Runners.

PubMed

Blagrove, Richard C; Howe, Louis P; Cushion, Emily J; Spence, Adam; Howatson, Glyn; Pedlar, Charles R; Hayes, Philip R

2018-06-01

Strength training activities have consistently been shown to improve running economy (RE) and neuromuscular characteristics, such as force-producing ability and maximal speed, in adult distance runners. However, the effects on adolescent (<18 yr) runners remains elusive. This randomized control trial aimed to examine the effect of strength training on several important physiological and neuromuscular qualities associated with distance running performance. Participants (n = 25, 13 female, 17.2 ± 1.2 yr) were paired according to their sex and RE and randomly assigned to a 10-wk strength training group (STG) or a control group who continued their regular training. The STG performed twice weekly sessions of plyometric, sprint, and resistance training in addition to their normal running. Outcome measures included body mass, maximal oxygen uptake (V˙O2max), speed at V˙O2max, RE (quantified as energy cost), speed at fixed blood lactate concentrations, 20-m sprint, and maximal voluntary contraction during an isometric quarter-squat. Eighteen participants (STG: n = 9, 16.1 ± 1.1 yr; control group: n = 9, 17.6 ± 1.2 yr) completed the study. The STG displayed small improvements (3.2%-3.7%; effect size (ES), 0.31-0.51) in RE that were inferred as "possibly beneficial" for an average of three submaximal speeds. Trivial or small changes were observed for body composition variables, V˙O2max and speed at V˙O2max; however, the training period provided likely benefits to speed at fixed blood lactate concentrations in both groups. Strength training elicited a very likely benefit and a possible benefit to sprint time (ES, 0.32) and maximal voluntary contraction (ES, 0.86), respectively. Ten weeks of strength training added to the program of a postpubertal distance runner was highly likely to improve maximal speed and enhances RE by a small extent, without deleterious effects on body composition or other aerobic parameters.
Update on value-based medicine.

PubMed

Brown, Melissa M; Brown, Gary C

2013-05-01

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

PubMed Central

Vandbakk, Kristine; Welde, Boye; Kruken, Andrea Hovstein; Baumgart, Julia; Ettema, Gertjan; Karlsen, Trine; Sandbakk, Øyvind

2017-01-01

This study compared the effects of adding upper-body sprint-intervals or continuous double poling endurance training to the normal training on maximal upper-body strength and endurance capacity in female cross-country skiers. In total, 17 female skiers (age: 18.1±0.8yr, body mass: 60±7 kg, maximal oxygen uptake (VO2max): 3.30±0.37 L.min-1) performed an 8-week training intervention. Here, either two weekly sessions of six to eight 30-s maximal upper-body double poling sprint-intervals (SIG, n = 8) or 45–75 min of continuous low-to-moderate intensity double poling on roller skis (CG, n = 9) were added to their training. Before and after the intervention, the participants were tested for physiological and kinematical responses during submaximal and maximal diagonal and double poling treadmill roller skiing. Additionally, we measured maximal upper-body strength (1RM) and average power at 40% 1RM in a poling-specific strength exercise. SIG improved absolute VO2max in diagonal skiing more than CG (8% vs 2%, p<0.05), and showed a tendency towards higher body-mass normalized VO2max (7% vs 2%, p = 0.07). Both groups had an overall improvement in double poling peak oxygen uptake (10% vs 6% for SIG and CG) (both p<0.01), but no group-difference was observed. SIG improved 1RM strength more than CG (18% vs 10%, p<0.05), while there was a tendency for difference in average power at 40% 1RM (20% vs 14%, p = 0.06). Oxygen cost and kinematics (cycle length and rate) in double poling and diagonal remained unchanged in both groups. In conclusion, our study demonstrates that adding upper-body sprint-interval training is more effective than continuous endurance training in improving upper-body maximal strength and VO2max. PMID:28241030
A Perspective on the Use of Storable Propellants for Future Space Vehicle Propulsion

NASA Technical Reports Server (NTRS)

Boyd, William C.; Brasher, Warren L.

1989-01-01

Propulsion system configurations for future NASA and DOD space initiatives are driven by the continually emerging new mission requirements. These initiatives cover an extremely wide range of mission scenarios, from unmanned planetary programs, to manned lunar and planetary programs, to earth-oriented (Mission to Planet Earth) programs, and they are in addition to existing and future requirements for near-earth missions such as to geosynchronous earth orbit (GEO). Increasing space transportation costs, and anticipated high costs associated with space-basing of future vehicles, necessitate consideration of cost-effective and easily maintainable configurations which maximize the use of existing technologies and assets, and use budgetary resources effectively. System design considerations associated with the use of storable propellants to fill these needs are presented. Comparisons in areas such as complexity, performance, flexibility, maintainability, and technology status are made for earth and space storable propellants, including nitrogen tetroxide/monomethylhydrazine and LOX/monomethylhydrazine.
New approach in the evaluation of a fitness program at a worksite.

PubMed

Shirasaya, K; Miyakawa, M; Yoshida, K; Tanaka, C; Shimada, N; Kondo, T

1999-03-01

The most common methods for the economic evaluation of a fitness program at a worksite are cost-effectiveness, cost-benefit, and cost-utility analyses. In this study, we applied a basic microeconomic theory, "neoclassical firm's problems," as the new approach for it. The optimal number of physical-exercise classes that constitute the core of the fitness program are determined using the cubic health production function. The optimal number is defined as the number that maximizes the profit of the program. The optimal number corresponding to any willingness-to-pay amount of the participants for the effectiveness of the program is presented using a graph. For example, if the willingness-to-pay is $800, the optimal number of classes is 23. Our method can be applied to the evaluation of any health care program if the health production function can be estimated.
Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality.

PubMed

Bowblis, John R; Roberts, Amy Restorick

2018-06-01

Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.
Economics of gynecologic morcellation.

PubMed

Bortoletto, Pietro; Friedman, Jaclyn; Milad, Magdy P

2018-02-01

As the Food and Drug Administration raised concern over the power morcellator in 2014, the field has seen significant change, with patients and physicians questioning which procedure is safest and most cost-effective. The economic impact of these decisions is poorly understood. Multiple new technologies have been developed to allow surgeons to continue to afford patients the many benefits of minimally invasive surgery while minimizing the risks of power morcellation. At the same time, researchers have focused on the true benefits of the power morcellator from a safety and cost perspective, and consistently found that with careful patient selection, by preventing laparotomies, it can be a cost-effective tool. Changes since 2014 have resulted in new techniques and technologies to allow these minimally invasive procedures to continue to be offered in a safe manner. With this rapid change, physicians are altering their practice and patients are attempting to educate themselves to decide what is best for them. This evolution has allowed us to refocus on the cost implications of new developments, allowing stakeholders the opportunity to maximize patient safety and surgical outcomes while minimizing cost.
Xanthophyllomyces dendrorhous for the industrial production of astaxanthin.

PubMed

Rodríguez-Sáiz, Marta; de la Fuente, Juan Luis; Barredo, José Luis

2010-10-01

Astaxanthin is a red xanthophyll (oxygenated carotenoid) with large importance in the aquaculture, pharmaceutical, and food industries. The green alga Haematococcus pluvialis and the heterobasidiomycetous yeast Xanthophyllomyces dendrorhous are currently known as the main microorganisms useful for astaxanthin production at the industrial scale. The improvement of astaxanthin titer by microbial fermentation is a requirement to be competitive with the synthetic manufacture by chemical procedures, which at present is the major source in the market. In this review, we show how the isolation of new strains of X. dendrorhous from the environment, the selection of mutants by the classical methods of random mutation and screening, and the rational metabolic engineering, have provided improved strains with higher astaxanthin productivity. To reduce production costs and enhance competitiveness from an industrial point of view, low-cost raw materials from industrial and agricultural origin have been adopted to get the maximal astaxanthin productivity. Finally, fermentation parameters have been studied in depth, both at flask and fermenter scales, to get maximal astaxanthin titers of 4.7 mg/g dry cell matter (420 mg/l) when X. dendrorhous was fermented under continuous white light. The industrial scale-up of this biotechnological process will provide a cost-effective method, alternative to synthetic astaxanthin, for the commercial exploitation of the expensive astaxanthin (about $2,500 per kilogram of pure astaxanthin).
Sail Plan Configuration Optimization for a Modern Clipper Ship

NASA Astrophysics Data System (ADS)

Gerritsen, Margot; Doyle, Tyler; Iaccarino, Gianluca; Moin, Parviz

2002-11-01

We investigate the use of gradient-based and evolutionary algorithms for sail shape optimization. We present preliminary results for the optimization of sheeting angles for the rig of the future three-masted clipper yacht Maltese Falcon. This yacht will be equipped with square-rigged masts made up of yards of circular arc cross sections. This design is especially attractive for megayachts because it provides a large sail area while maintaining aerodynamic and structural efficiency. The rig remains almost rigid in a large range of wind conditions and therefore a simple geometrical model can be constructed without accounting for the true flying shape. The sheeting angle optimization studies are performed using both gradient-based cost function minimization and evolutionary algorithms. The fluid flow is modeled by the Reynolds-averaged Navier-Stokes equations with the Spallart-Allmaras turbulence model. Unstructured non-conforming grids are used to increase robustness and computational efficiency. The optimization process is automated by integrating the system components (geometry construction, grid generation, flow solver, force calculator, optimization). We compare the optimization results to those done previously by user-controlled parametric studies using simple cost functions and user intuition. We also investigate the effectiveness of various cost functions in the optimization (driving force maximization, ratio of driving force to heeling force maximization).
Space shuttle low cost/risk avionics study

NASA Technical Reports Server (NTRS)

1971-01-01

All work breakdown structure elements containing any avionics related effort were examined for pricing the life cycle costs. The analytical, testing, and integration efforts are included for the basic onboard avionics and electrical power systems. The design and procurement of special test equipment and maintenance and repair equipment are considered. Program management associated with these efforts is described. Flight test spares and labor and materials associated with the operations and maintenance of the avionics systems throughout the horizontal flight test are examined. It was determined that cost savings can be achieved by using existing hardware, maximizing orbiter-booster commonality, specifying new equipments to MIL quality standards, basing redundancy on cost effective analysis, minimizing software complexity and reducing cross strapping and computer-managed functions, utilizing compilers and floating point computers, and evolving the design as dictated by the horizontal flight test schedules.
Optimization of Magneto-Rheological Damper for Maximizing Magnetic Flux Density in the Fluid Flow Gap Through FEA and GA Approaches

NASA Astrophysics Data System (ADS)

Krishna, Hemanth; Kumar, Hemantha; Gangadharan, Kalluvalappil

2017-08-01

A magneto rheological (MR) fluid damper offers cost effective solution for semiactive vibration control in an automobile suspension. The performance of MR damper is significantly depends on the electromagnetic circuit incorporated into it. The force developed by MR fluid damper is highly influenced by the magnetic flux density induced in the fluid flow gap. In the present work, optimization of electromagnetic circuit of an MR damper is discussed in order to maximize the magnetic flux density. The optimization procedure was proposed by genetic algorithm and design of experiments techniques. The result shows that the fluid flow gap size less than 1.12 mm cause significant increase of magnetic flux density.

Outplanting Wyoming big sagebrush following wldfire: stock performance and economics

USGS Publications Warehouse

Dettweiler-Robinson, Eva; Bakker, Jonathan D.; Evans, James R.; Newsome, Heidi; Davies, G. Matt; Wirth, Troy A.; Pyke, David A.; Easterly, Richard T.; Salstrom, Debra; Dunwiddle, Peter W.

2013-01-01

mycorrhizal amendments. Most mortality occurred during the first year after planting; this period is the greatest barrier to establishment of sagebrush stock. The proportion of healthy stock in Year 1 was positively related to subsequent survival to Year 3. Costs were minimized, and survival maximized, by planting container stock or bare-root stock with a hydrogel dip. Our results indicate that outplanting is an ecologically and economically effective way of establishing Wyoming big sagebrush. However, statistical analyses were limited by the fact that data about initial variables (stock quality, site conditions, weather) were often unrecorded and by the lack of a replicated experimental design. Sharing consistent data and using an experimental approach would help land managers and restoration practitioners maximize the success of outplanting efforts.
Optimization of laminated stacking sequence for buckling load maximization by genetic algorithm

NASA Technical Reports Server (NTRS)

Le Riche, Rodolphe; Haftka, Raphael T.

1992-01-01

The use of a genetic algorithm to optimize the stacking sequence of a composite laminate for buckling load maximization is studied. Various genetic parameters including the population size, the probability of mutation, and the probability of crossover are optimized by numerical experiments. A new genetic operator - permutation - is proposed and shown to be effective in reducing the cost of the genetic search. Results are obtained for a graphite-epoxy plate, first when only the buckling load is considered, and then when constraints on ply contiguity and strain failure are added. The influence on the genetic search of the penalty parameter enforcing the contiguity constraint is studied. The advantage of the genetic algorithm in producing several near-optimal designs is discussed.
Strategic real-estate planning can generate revenue.

PubMed

Hayes, D; Hays, S

2001-12-01

Many healthcare organizations treat their real estate as liabilities rather than assets and overlook opportunities to generate significant additional revenue and reduce costs. An Ernst & Young Study found that to maximize the return on investment in their real-estate holdings, healthcare organizations need to include property management in their strategic plan, manage construction and expansion effectively, adapt and reuse their facilities where possible, and pursue innovative real-estate strategies. Managing real-estate assets effectively can free up capital to use for other core business needs.
Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

PubMed

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.
Data-Driven Engineering of Social Dynamics: Pattern Matching and Profit Maximization

PubMed Central

Peng, Huan-Kai; Lee, Hao-Chih; Pan, Jia-Yu; Marculescu, Radu

2016-01-01

In this paper, we define a new problem related to social media, namely, the data-driven engineering of social dynamics. More precisely, given a set of observations from the past, we aim at finding the best short-term intervention that can lead to predefined long-term outcomes. Toward this end, we propose a general formulation that covers two useful engineering tasks as special cases, namely, pattern matching and profit maximization. By incorporating a deep learning model, we derive a solution using convex relaxation and quadratic-programming transformation. Moreover, we propose a data-driven evaluation method in place of the expensive field experiments. Using a Twitter dataset, we demonstrate the effectiveness of our dynamics engineering approach for both pattern matching and profit maximization, and study the multifaceted interplay among several important factors of dynamics engineering, such as solution validity, pattern-matching accuracy, and intervention cost. Finally, the method we propose is general enough to work with multi-dimensional time series, so it can potentially be used in many other applications. PMID:26771830
Data-Driven Engineering of Social Dynamics: Pattern Matching and Profit Maximization.

PubMed

Peng, Huan-Kai; Lee, Hao-Chih; Pan, Jia-Yu; Marculescu, Radu

2016-01-01

In this paper, we define a new problem related to social media, namely, the data-driven engineering of social dynamics. More precisely, given a set of observations from the past, we aim at finding the best short-term intervention that can lead to predefined long-term outcomes. Toward this end, we propose a general formulation that covers two useful engineering tasks as special cases, namely, pattern matching and profit maximization. By incorporating a deep learning model, we derive a solution using convex relaxation and quadratic-programming transformation. Moreover, we propose a data-driven evaluation method in place of the expensive field experiments. Using a Twitter dataset, we demonstrate the effectiveness of our dynamics engineering approach for both pattern matching and profit maximization, and study the multifaceted interplay among several important factors of dynamics engineering, such as solution validity, pattern-matching accuracy, and intervention cost. Finally, the method we propose is general enough to work with multi-dimensional time series, so it can potentially be used in many other applications.
Effect of leg exercise training on vascular volumes during 30 days of 6 deg head-down bed rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Vernikos, J.; Wade, C. E.; Barnes, P. R.

1992-01-01

In order to investigate the effects of leg exercise training on vascular volumes during 30 d of 6-deg head-down bed rest, plasma and red cell volumes, body density, and water balance were measured in 19 men confined to bed rest (BR). One group had no exercise training (NOE), another near-maximal variable-intensity isotonic exercise (ITE) for 60 min/d, and the third near-maximal intermittent isokinetic exercise (IKE) for 60 min/d. Mean energy costs for the NOE, IKE, and ITE regimens were determined. Body densities within groups and mean urine volumes between groups were unchanged during BR. Changes in red cell volume followed changes in plasma volume. There was close coupling between resting plasma volume and plasma protein and osmotic content. It is argued that the ITE training protocol is better than the IKE protocol for maintaining plasma volume during prolonged exposure to BR.
Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer

PubMed Central

Mafé, Juan J.; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno

2017-01-01

Background Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. Methods A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. Results One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). Conclusions The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile. PMID:28932560
Extending the cost-benefit model of thermoregulation: high-temperature environments.

PubMed

Vickers, Mathew; Manicom, Carryn; Schwarzkopf, Lin

2011-04-01

The classic cost-benefit model of ectothermic thermoregulation compares energetic costs and benefits, providing a critical framework for understanding this process (Huey and Slatkin 1976 ). It considers the case where environmental temperature (T(e)) is less than the selected temperature of the organism (T(sel)), and it predicts that, to minimize increasing energetic costs of thermoregulation as habitat thermal quality declines, thermoregulatory effort should decrease until the lizard thermoconforms. We extended this model to include the case where T(e) exceeds T(sel), and we redefine costs and benefits in terms of fitness to include effects of body temperature (T(b)) on performance and survival. Our extended model predicts that lizards will increase thermoregulatory effort as habitat thermal quality declines, gaining the fitness benefits of optimal T(b) and maximizing the net benefit of activity. Further, to offset the disproportionately high fitness costs of high T(e) compared with low T(e), we predicted that lizards would thermoregulate more effectively at high values of T(e) than at low ones. We tested our predictions on three sympatric skink species (Carlia rostralis, Carlia rubrigularis, and Carlia storri) in hot savanna woodlands and found that thermoregulatory effort increased as thermal quality declined and that lizards thermoregulated most effectively at high values of T(e).
Introducing health gains in location-allocation models: A stochastic model for planning the delivery of long-term care

NASA Astrophysics Data System (ADS)

Cardoso, T.; Oliveira, M. D.; Barbosa-Póvoa, A.; Nickel, S.

2015-05-01

Although the maximization of health is a key objective in health care systems, location-allocation literature has not yet considered this dimension. This study proposes a multi-objective stochastic mathematical programming approach to support the planning of a multi-service network of long-term care (LTC), both in terms of services location and capacity planning. This approach is based on a mixed integer linear programming model with two objectives - the maximization of expected health gains and the minimization of expected costs - with satisficing levels in several dimensions of equity - namely, equity of access, equity of utilization, socioeconomic equity and geographical equity - being imposed as constraints. The augmented ε-constraint method is used to explore the trade-off between these conflicting objectives, with uncertainty in the demand and delivery of care being accounted for. The model is applied to analyze the (re)organization of the LTC network currently operating in the Great Lisbon region in Portugal for the 2014-2016 period. Results show that extending the network of LTC is a cost-effective investment.
Constrained Allocation Flux Balance Analysis

PubMed Central

Mori, Matteo; Hwa, Terence; Martin, Olivier C.

2016-01-01

New experimental results on bacterial growth inspire a novel top-down approach to study cell metabolism, combining mass balance and proteomic constraints to extend and complement Flux Balance Analysis. We introduce here Constrained Allocation Flux Balance Analysis, CAFBA, in which the biosynthetic costs associated to growth are accounted for in an effective way through a single additional genome-wide constraint. Its roots lie in the experimentally observed pattern of proteome allocation for metabolic functions, allowing to bridge regulation and metabolism in a transparent way under the principle of growth-rate maximization. We provide a simple method to solve CAFBA efficiently and propose an “ensemble averaging” procedure to account for unknown protein costs. Applying this approach to modeling E. coli metabolism, we find that, as the growth rate increases, CAFBA solutions cross over from respiratory, growth-yield maximizing states (preferred at slow growth) to fermentative states with carbon overflow (preferred at fast growth). In addition, CAFBA allows for quantitatively accurate predictions on the rate of acetate excretion and growth yield based on only 3 parameters determined by empirical growth laws. PMID:27355325
An Analytic Approach for Optimal Geometrical Design of GaAs Nanowires for Maximal Light Harvesting in Photovoltaic Cells

PubMed Central

Wu, Dan; Tang, Xiaohong; Wang, Kai; Li, Xianqiang

2017-01-01

Semiconductor nanowires(NWs) with subwavelength scale diameters have demonstrated superior light trapping features, which unravel a new pathway for low cost and high efficiency future generation solar cells. Unlike other published work, a fully analytic design is for the first time proposed for optimal geometrical parameters of vertically-aligned GaAs NW arrays for maximal energy harvesting. Using photocurrent density as the light absorbing evaluation standard, 2 μm length NW arrays whose multiple diameters and periodicity are quantitatively identified achieving the maximal value of 29.88 mA/cm2 under solar illumination. It also turns out that our method has wide suitability for single, double and four different diameters of NW arrays for highest photon energy harvesting. To validate this analytical method, intensive numerical three-dimensional finite-difference time-domain simulations of the NWs’ light harvesting are also carried out. Compared with the simulation results, the predicted maximal photocurrent densities lie within 1.5% tolerance for all cases. Along with the high accuracy, through directly disclosing the exact geometrical dimensions of NW arrays, this method provides an effective and efficient route for high performance photovoltaic design. PMID:28425488
Cost-effectiveness of strategies to market and train primary health care physicians in brief intervention techniques for hazardous alcohol use.

PubMed

Gomel, M K; Wutzke, S E; Hardcastle, D M; Lapsley, H; Reznik, R B

1998-07-01

The cost-effectiveness of strategies to market and train primary care physicians in brief intervention for hazardous alcohol consumption was examined. Physicians were randomly assigned to one of three marketing strategies designed to promote the "uptake" of a brief intervention package for hazardous and harmful alcohol consumption. The strategies were direct mail, tele-marketing, or academic detailing. One hundred and twenty-seven of those physicians who requested the package during the marketing phase (phase 1) and who also agreed to participate in the training and support phase of the project (phase 2) were matched into one of three training and support conditions: training and no support, training and minimal support, training and maximal support. An additional 34 physicians were randomly selected and assigned to a control condition. The ultimate aim of training and support was to maximise physician screening and counselling rates. Tele-marketing was found to be more cost-effective than academic detailing and direct mail in promoting the uptake of the package. For the training and support phase costs and effects increased with the level of support, hence the issue to be considered is whether the additional cost incurred in moving from one strategy to another is warranted given the increase in the level of outcome.
Estimating costs of sea lice control strategy in Norway.

PubMed

Liu, Yajie; Bjelland, Hans Vanhauwaer

2014-12-01

This paper explores the costs of sea lice control strategies associated with salmon aquaculture at a farm level in Norway. Diseases can cause reduction in growth, low feed efficiency and market prices, increasing mortality rates, and expenditures on prevention and treatment measures. Aquaculture farms suffer the most direct and immediate economic losses from diseases. The goal of a control strategy is to minimize the total disease costs, including biological losses, and treatment costs while to maximize overall profit. Prevention and control strategies are required to eliminate or minimize the disease, while cost-effective disease control strategies at the fish farm level are designed to reduce the losses, and to enhance productivity and profitability. Thus, the goal can be achieved by integrating models of fish growth, sea lice dynamics and economic factors. A production function is first constructed to incorporate the effects of sea lice on production at a farm level, followed by a detailed cost analysis of several prevention and treatment strategies associated with sea lice in Norway. The results reveal that treatments are costly and treatment costs are very sensitive to treatment types used and timing of the treatment conducted. Applying treatment at an early growth stage is more economical than at a later stage. Copyright © 2014 Elsevier B.V. All rights reserved.
Evaluation of patient compliance, quality of life impact and cost-effectiveness of a "test in-train out" exercise-based rehabilitation program for patients with intermittent claudication.

PubMed

Malagoni, Anna Maria; Vagnoni, Emidia; Felisatti, Michele; Mandini, Simona; Heidari, Mahdi; Mascoli, Francesco; Basaglia, Nino; Manfredini, Roberto; Zamboni, Paolo; Manfredini, Fabio

2011-01-01

Patients with intermittent claudication (IC) could benefit from low-cost, effective rehabilitative programs. This retrospective study evaluates compliance, impact on Quality of Life (QoL) and cost-effectiveness of a hospital prescribed, at-home performed (Test-in/Train-out) rehabilitative program for patients with IC. Two-hundred and eighty-nine patients with IC (71 ± 10.1 years, M = 210) were enrolled for a 2-year period. Two daily 10-min home walking sessions at maximal asymptomatic speed were prescribed, with serial check-ups at the hospital. Compliance with the program was assessed by assigning a score of 1 (lowest compliance) to 4 (highest compliance). The SF-36 questionnaire and a constant-load treadmill test were used to evaluate QoL and Initial/Absolute Claudication Distance, respectively. Both direct and indirect costs of the program were considered for cost-effectiveness analysis. Two-hundred and fifty patients (70.5 ± 9.2 years, M = 191), at Fontaine's II-B stage (86%), were included in the study. No adverse events were reported. The average compliance score was 3.1. At discharge, both SF-36 domains and walking performance significantly increased (P < 0.0001). A total of 1,839 in-hospital check-ups (7.36 /patient) were performed. Direct and indirect costs represented 93% and 7% of the total costs, respectively. The average costs of a visit and of a therapy cycle were C68.93 and C507.20, respectively. The cost to walk an additional meter before stopping was C9.22. A Test-in/Train-out program provided favourable patient compliance, QoL impact and cost-effectiveness in patients with IC.
[Measures to reduce lighting-related energy use and costs at hospital nursing stations].

PubMed

Su, Chiu-Ching; Chen, Chen-Hui; Chen, Shu-Hwa; Ping, Tsui-Chu

2011-06-01

Hospitals have long been expected to deliver medical services in an environment that is comfortable and bright. This expectation keeps hospital energy demand stubbornly high and energy costs spiraling due to escalating utility fees. Hospitals must identify appropriate strategies to control electricity usage in order to control operating costs effectively. This paper proposes several electricity saving measures that both support government policies aimed at reducing global warming and help reduce energy consumption at the authors' hospital. The authors held educational seminars, established a website teaching energy saving methods, maximized facility and equipment use effectiveness (e.g., adjusting lamp placements, power switch and computer saving modes), posted signs promoting electricity saving, and established a regularized energy saving review mechanism. After implementation, average nursing staff energy saving knowledge had risen from 71.8% to 100% and total nursing station electricity costs fell from NT$16,456 to NT$10,208 per month, representing an effective monthly savings of 37.9% (NT$6,248). This project demonstrated the ability of a program designed to slightly modify nursing staff behavior to achieve effective and meaningful results in reducing overall electricity use.
The goal of value-based medicine analyses: comparability. The case for neovascular macular degeneration.

PubMed

Brown, Gary C; Brown, Melissa M; Brown, Heidi C; Kindermann, Sylvia; Sharma, Sanjay

2007-01-01

To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. Among 21 cost-utility analyses performed on interventions for neovascular macular degeneration, 15 (71%) met value-based medicine criteria. The 6 others (29%) were not comparable owing to (1) varying utility methodology, (2) varying utility respondents, (3) differing costs utilized, (4) differing cost bases, and (5) varying study perspectives. Among value-based medicine studies, laser photocoagulation confers a 4.4% value gain (improvement in quality of life) for the treatment of classic subfoveal choroidal neovascularization. Intravitreal pegaptanib confers a 5.9% value gain (improvement in quality of life) for classic, minimally classic, and occult subfoveal choroidal neovascularization, and photodynamic therapy with verteporfin confers a 7.8% to 10.7% value gain for the treatment of classic subfoveal choroidal neovascularization. Intravitreal ranibizumab therapy confers greater than a 15% value gain for the treatment of subfoveal occult and minimally classic subfoveal choroidal neovascularization. The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds.
THE GOAL OF VALUE-BASED MEDICINE ANALYSES: COMPARABILITY. THE CASE FOR NEOVASCULAR MACULAR DEGENERATION

PubMed Central

Brown, Gary C.; Brown, Melissa M.; Brown, Heidi C.; Kindermann, Sylvia; Sharma, Sanjay

2007-01-01

Purpose To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). Methods A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. Results Among 21 cost-utility analyses performed on interventions for neovascular macular degeneration, 15 (71%) met value-based medicine criteria. The 6 others (29%) were not comparable owing to (1) varying utility methodology, (2) varying utility respondents, (3) differing costs utilized, (4) differing cost bases, and (5) varying study perspectives. Among value-based medicine studies, laser photocoagulation confers a 4.4% value gain (improvement in quality of life) for the treatment of classic subfoveal choroidal neovascularization. Intravitreal pegaptanib confers a 5.9% value gain (improvement in quality of life) for classic, minimally classic, and occult subfoveal choroidal neovascularization, and photodynamic therapy with verteporfin confers a 7.8% to 10.7% value gain for the treatment of classic subfoveal choroidal neovascularization. Intravitreal ranibizumab therapy confers greater than a 15% value gain for the treatment of subfoveal occult and minimally classic subfoveal choroidal neovascularization. Conclusions The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds. PMID:18427606
Adaptive multibeam phased array design for a Spacelab experiment

NASA Technical Reports Server (NTRS)

Noji, T. T.; Fass, S.; Fuoco, A. M.; Wang, C. D.

1977-01-01

The parametric tradeoff analyses and design for an Adaptive Multibeam Phased Array (AMPA) for a Spacelab experiment are described. This AMPA Experiment System was designed with particular emphasis to maximize channel capacity and minimize implementation and cost impacts for future austere maritime and aeronautical users, operating with a low gain hemispherical coverage antenna element, low effective radiated power, and low antenna gain-to-system noise temperature ratio.
Fe-FeS2 adsorbent prepared with iron powder and pyrite by facile ball milling and its application for arsenic removal.

PubMed

Min, Xiaobo; Li, Yangwenjun; Ke, Yong; Shi, Meiqing; Chai, Liyuan; Xue, Ke

2017-07-01

Arsenic is one of the major pollutants and a worldwide concern because of its toxicity and chronic effects on human health. An adsorbent of Fe-FeS 2 mixture for effective arsenic removal was successfully prepared by mechanical ball milling. The products before and after arsenic adsorption were characterized with scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy. The adsorbent shows high arsenic removal efficiency when molar ratio of iron to pyrite is 5:5. The experimental data of As(III) adsorption are fitted well with the Langmuir isotherm model with a maximal adsorption capacity of 101.123 mg/g. And As(V) data were described perfectly by the Freundlich model with a maximal adsorption capacity of 58.341 L/mg. As(III) is partial oxidized to As(V) during the adsorption process. High arsenic uptake capability and cost-effectiveness of waste make it potentially attractive for arsenic removal.

Integrating economic costs and biological traits into global conservation priorities for carnivores.

PubMed

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-08-27

Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy.
Providing Focus for Financial Management.

ERIC Educational Resources Information Center

Falender, Andrew J.

1983-01-01

A case study of financial turnaround at the highly specialized New England Conservatory of Music describes five strategies to balance costs and resources within the framework of the school's objectives. Areas of cost minimizing and revenue maximizing are outlined and discussed. (MSE)
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.
Cost-effectiveness of population-based, community, workplace and individual policies for diabetes prevention in the UK.

PubMed

Breeze, P R; Thomas, C; Squires, H; Brennan, A; Greaves, C; Diggle, P; Brunner, E; Tabak, A; Preston, L; Chilcott, J

2017-08-01

To analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention within a common framework. A micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality-adjusted life-years are collected for each person. All interventions generate more life-years and lifetime quality-adjusted life-years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost-saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs. The model enables a wide range of diabetes prevention interventions to be evaluated according to cost-effectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
Recruitment of rural healthcare professionals for live continuing education.

PubMed

Holuby, Ronnie Scott; Pellegrin, Karen L; Barbato, Anna; Ciarleglio, Anita

2015-01-01

Introduction The availability of rural healthcare is a growing concern in the United States as fewer healthcare providers choose to work in rural areas. Accessing quality continuing education (CE) for rural healthcare practitioners (HCPs) remains a challenge and may pose a barrier to quality care. Methods To maximize attendance at a live, in-person, free CE program focusing on geriatric medication and issues specifically targeted to HCPs in rural areas, two methods were implemented sequentially. The first method used formal advertising implemented by a professional marketing service to promote CE events. The second method enlisted local healthcare organizations and physician groups to promote the CE event to their employees. Cost per attendee was calculated for comparison. Results Professional marketing services recruited 31 HCPs (March 2011) and resulted in a per-participant recruitment cost of US$428.62. Local healthcare organizations and physician groups' marketing recruited 48 HCPs (July-August 2011) and resulted in a per-participant recruitment cost of US$55.19. Discussion Providing free CE coordinated through local healthcare organizations and physician groups was the most cost-effective method of recruiting rural HCPs for CE. Formal advertising added cost without increasing the number of participants per event. Although this is the first study of the cost-effectiveness of recruitment methods targeting HCPs in rural areas, results are consistent with research on cost-effectiveness of outreach to rural lay community members.
Recruitment of rural healthcare professionals for live continuing education.

PubMed

Holuby, Ronnie Scott; Pellegrin, Karen L; Barbato, Anna; Ciarleglio, Anita

2015-01-01

The availability of rural healthcare is a growing concern in the United States as fewer healthcare providers choose to work in rural areas. Accessing quality continuing education (CE) for rural healthcare practitioners (HCPs) remains a challenge and may pose a barrier to quality care. To maximize attendance at a live, in-person, free CE program focusing on geriatric medication and issues specifically targeted to HCPs in rural areas, two methods were implemented sequentially. The first method used formal advertising implemented by a professional marketing service to promote CE events. The second method enlisted local healthcare organizations and physician groups to promote the CE event to their employees. Cost per attendee was calculated for comparison. Professional marketing services recruited 31 HCPs (March 2011) and resulted in a per-participant recruitment cost of US$428.62. Local healthcare organizations and physician groups' marketing recruited 48 HCPs (July-August 2011) and resulted in a per-participant recruitment cost of US$55.19. Providing free CE coordinated through local healthcare organizations and physician groups was the most cost-effective method of recruiting rural HCPs for CE. Formal advertising added cost without increasing the number of participants per event. Although this is the first study of the cost-effectiveness of recruitment methods targeting HCPs in rural areas, results are consistent with research on cost-effectiveness of outreach to rural lay community members.
Estimating economic thresholds for pest control: an alternative procedure.

PubMed

Ramirez, O A; Saunders, J L

1999-04-01

An alternative methodology to determine profit maximizing economic thresholds is developed and illustrated. An optimization problem based on the main biological and economic relations involved in determining a profit maximizing economic threshold is first advanced. From it, a more manageable model of 2 nonsimultaneous reduced-from equations is derived, which represents a simpler but conceptually and statistically sound alternative. The model recognizes that yields and pest control costs are a function of the economic threshold used. Higher (less strict) economic thresholds can result in lower yields and, therefore, a lower gross income from the sale of the product, but could also be less costly to maintain. The highest possible profits will be obtained by using the economic threshold that results in a maximum difference between gross income and pest control cost functions.
Methodology for conceptual remote sensing spacecraft technology: insertion analysis balancing performance, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David A.; Duclos, Donald P.; Barrera, Mark J.; Mosher, Todd J.; Lao, Norman Y.

1997-12-01

Emerging technologies and micro-instrumentation are changing the way remote sensing spacecraft missions are developed and implemented. Government agencies responsible for procuring space systems are increasingly requesting analyses to estimate cost, performance and design impacts of advanced technology insertion for both state-of-the-art systems as well as systems to be built 5 to 10 years in the future. Numerous spacecraft technology development programs are being sponsored by Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) agencies with the goal of enhancing spacecraft performance, reducing mass, and reducing cost. However, it is often the case that technology studies, in the interest of maximizing subsystem-level performance and/or mass reduction, do not anticipate synergistic system-level effects. Furthermore, even though technical risks are often identified as one of the largest cost drivers for space systems, many cost/design processes and models ignore effects of cost risk in the interest of quick estimates. To address these issues, the Aerospace Corporation developed a concept analysis methodology and associated software tools. These tools, collectively referred to as the concept analysis and design evaluation toolkit (CADET), facilitate system architecture studies and space system conceptual designs focusing on design heritage, technology selection, and associated effects on cost, risk and performance at the system and subsystem level. CADET allows: (1) quick response to technical design and cost questions; (2) assessment of the cost and performance impacts of existing and new designs/technologies; and (3) estimation of cost uncertainties and risks. These capabilities aid mission designers in determining the configuration of remote sensing missions that meet essential requirements in a cost- effective manner. This paper discuses the development of CADET modules and their application to several remote sensing satellite mission concepts.
Rough sets and Laplacian score based cost-sensitive feature selection

PubMed Central

Yu, Shenglong

2018-01-01

Cost-sensitive feature selection learning is an important preprocessing step in machine learning and data mining. Recently, most existing cost-sensitive feature selection algorithms are heuristic algorithms, which evaluate the importance of each feature individually and select features one by one. Obviously, these algorithms do not consider the relationship among features. In this paper, we propose a new algorithm for minimal cost feature selection called the rough sets and Laplacian score based cost-sensitive feature selection. The importance of each feature is evaluated by both rough sets and Laplacian score. Compared with heuristic algorithms, the proposed algorithm takes into consideration the relationship among features with locality preservation of Laplacian score. We select a feature subset with maximal feature importance and minimal cost when cost is undertaken in parallel, where the cost is given by three different distributions to simulate different applications. Different from existing cost-sensitive feature selection algorithms, our algorithm simultaneously selects out a predetermined number of “good” features. Extensive experimental results show that the approach is efficient and able to effectively obtain the minimum cost subset. In addition, the results of our method are more promising than the results of other cost-sensitive feature selection algorithms. PMID:29912884
Rough sets and Laplacian score based cost-sensitive feature selection.

PubMed

Yu, Shenglong; Zhao, Hong

2018-01-01

Cost-sensitive feature selection learning is an important preprocessing step in machine learning and data mining. Recently, most existing cost-sensitive feature selection algorithms are heuristic algorithms, which evaluate the importance of each feature individually and select features one by one. Obviously, these algorithms do not consider the relationship among features. In this paper, we propose a new algorithm for minimal cost feature selection called the rough sets and Laplacian score based cost-sensitive feature selection. The importance of each feature is evaluated by both rough sets and Laplacian score. Compared with heuristic algorithms, the proposed algorithm takes into consideration the relationship among features with locality preservation of Laplacian score. We select a feature subset with maximal feature importance and minimal cost when cost is undertaken in parallel, where the cost is given by three different distributions to simulate different applications. Different from existing cost-sensitive feature selection algorithms, our algorithm simultaneously selects out a predetermined number of "good" features. Extensive experimental results show that the approach is efficient and able to effectively obtain the minimum cost subset. In addition, the results of our method are more promising than the results of other cost-sensitive feature selection algorithms.
On the role of budget sufficiency, cost efficiency, and uncertainty in species management

USGS Publications Warehouse

van der Burg, Max Post; Bly, Bartholomew B.; Vercauteren, Tammy; Grand, James B.; Tyre, Andrew J.

2014-01-01

Many conservation planning frameworks rely on the assumption that one should prioritize locations for management actions based on the highest predicted conservation value (i.e., abundance, occupancy). This strategy may underperform relative to the expected outcome if one is working with a limited budget or the predicted responses are uncertain. Yet, cost and tolerance to uncertainty rarely become part of species management plans. We used field data and predictive models to simulate a decision problem involving western burrowing owls (Athene cunicularia hypugaea) using prairie dog colonies (Cynomys ludovicianus) in western Nebraska. We considered 2 species management strategies: one maximized abundance and the other maximized abundance in a cost-efficient way. We then used heuristic decision algorithms to compare the 2 strategies in terms of how well they met a hypothetical conservation objective. Finally, we performed an info-gap decision analysis to determine how these strategies performed under different budget constraints and uncertainty about owl response. Our results suggested that when budgets were sufficient to manage all sites, the maximizing strategy was optimal and suggested investing more in expensive actions. This pattern persisted for restricted budgets up to approximately 50% of the sufficient budget. Below this budget, the cost-efficient strategy was optimal and suggested investing in cheaper actions. When uncertainty in the expected responses was introduced, the strategy that maximized abundance remained robust under a sufficient budget. Reducing the budget induced a slight trade-off between expected performance and robustness, which suggested that the most robust strategy depended both on one's budget and tolerance to uncertainty. Our results suggest that wildlife managers should explicitly account for budget limitations and be realistic about their expected levels of performance.
Is a biomarker-based diagnostic strategy for invasive aspergillosis cost effective in high-risk haematology patients?

PubMed

Macesic, N; Morrissey, C O; Liew, D; Bohensky, M A; Chen, S C-A; Gilroy, N M; Milliken, S T; Szer, J; Slavin, M A

2017-10-01

Empirical antifungal therapy is frequently used in hematology patients at high risk of invasive aspergillosis (IA), with substantial cost and toxicity. Biomarkers for IA aim for earlier and more accurate diagnosis and targeted treatment. However, data on the cost-effectiveness of a biomarker-based diagnostic strategy (BDS) are limited. We evaluated the cost effectiveness of BDS using results from a randomized controlled trial (RCT) and individual patient costing data. Data inputs derived from a published RCT were used to construct a decision-analytic model to compare BDS (Aspergillus galactomannan and PCR on blood) with standard diagnostic strategy (SDS) of culture and histology in terms of total costs, length of stay, IA incidence, mortality, and years of life saved. Costs were estimated for each patient using hospital costing data to day 180 and follow-up for survival was modeled to five years using a Gompertz survival model. Treatment costs were determined for 137 adults undergoing allogeneic hematopoietic stem cell transplant or receiving chemotherapy for acute leukemia in four Australian centers (2005-2009). Median total costs at 180 days were similar between groups (US$78,774 for SDS [IQR US$50,808-123,476] and US$81,279 for BDS [IQR US$59,221-123,242], P = .49). All-cause mortality was 14.7% (10/68) for SDS and 10.1% (7/69) for BDS, (P = .573). The costs per life-year saved were US$325,448, US$81,966, and US$3,670 at 180 days, one year and five years, respectively. BDS is not cost-sparing but is cost-effective if a survival benefit is maintained over several years. An individualized institutional approach to diagnostic strategies may maximize utility and cost-effectiveness. © The Author 2017. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Quantifying incident-induced travel delays on freeways using traffic sensor data : phase II

DOT National Transportation Integrated Search

2010-12-01

Traffic incidents cause approximately 50 percent of freeway congestion in metropolitan areas, resulting in extra travel time and fuel cost. Quantifying incident-induced delay (IID) will help people better understand the real costs of incidents, maxim...
Forecasting and Maximizing Post-Secondary Futures: Dilemmas Over Negative Futures and Their Hidden Costs.

ERIC Educational Resources Information Center

Hoffman, Benjamin B.

Forecasting models for maximizing postsecondary futures and applications of the model are considered. The forecasting of broad human futures has many parallels to human futures in the field of medical prognosis. The concept of "exasperated negative" is used to refer to the suppression of critical information about a negative future with…
[Methods of investigation in clinical cardiology. VIII. Socioeconomic evaluation of clinical cardiology practice].

PubMed

Lázaro de Mercado, P

1997-06-01

Health services are systems whose mission is to improve the health status of both individuals and society in general. In recent decades, these systems have faced challenges such as their increasing complexity, limited resources, rapid innovation and diffusion of medical technologies, pressures on demand from society and professionals, and the lack of knowledge of the effects of these factors on costs and society's health. In addition, health care expenditures have grown twice as fast as wealth in industrialized countries during the last 25 years. These problems have prompted cost containment as a key issue in health policy and, at the same time, have promoted the development of socioeconomic evaluation as a scientific activity in the frame of health services research. Socioeconomic evaluation tries to determine if the sacrifice made by society, which devotes part of its limited resources to health care, maximizes the outcomes for population. This article describes basic concepts and methods of economic appraisal in health services which are illustrated with examples of clinical practice in cardiology. Common methods of evaluation are described; the relation between the clinical outcome of a procedure and its associated costs is emphasized in explaining the types of efficiency analysis (cost-efficacy, cost-effectiveness, cost-utility, and cost-benefit); and finally a guide for socioeconomic evaluation is provided.
Cost effectiveness of recycling: A systems model

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

Tonjes, David J., E-mail: david.tonjes@stonybrook.edu; Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000; Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044

Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have alsomore » found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.« less
Test plan for the soils facility demonstration: A petroleum contaminated soil bioremediation facility

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

Lombard, K.H.

1994-08-01

The objectives of this test plan are to show the value added by using bioremediation as an effective and environmentally sound method to remediate petroleum contaminated soils (PCS) by: demonstrating bioremediation as a permanent method for remediating soils contaminated with petroleum products; establishing the best operating conditions for maximizing bioremediation and minimizing volatilization for SRS PCS during different seasons; determining the minimum set of analyses and sampling frequency to allow efficient and cost-effective operation; determining best use of existing site equipment and personnel to optimize facility operations and conserve SRS resources; and as an ancillary objective, demonstrating and optimizing newmore » and innovative analytical techniques that will lower cost, decrease time, and decrease secondary waste streams for required PCS assays.« less
NWTC Aerodynamics Studies Improve Energy Capture and Lower Costs of Wind-Generated Electricity

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

2015-08-01

Researchers at the National Wind Technology Center (NWTC) at the National Renewable Energy Laboratory (NREL) have expanded wind turbine aerodynamic research from blade and rotor aerodynamics to wind plant and atmospheric inflow effects. The energy capture from wind plants is dependent on all of these aerodynamic interactions. Research at the NWTC is crucial to understanding how wind turbines function in large, multiple-row wind plants. These conditions impact the cumulative fatigue damage of turbine structural components that ultimately effect the useful lifetime of wind turbines. This work also is essential for understanding and maximizing turbine and wind plant energy production. Bothmore » turbine lifetime and wind plant energy production are key determinants of the cost of wind-generated electricity.« less
[Research progress of ecosystem service flow.

PubMed

Liu, Hui Min; Fan, Yu Long; Ding, Sheng Yan

2016-07-01

With the development of social economy, human disturbance has resulted in a variety of ecosystem service degradation or disappearance. Ecosystem services flow plays an important role in delivery, transformation and maintenance of ecosystem services, and becomes one of the new research directions. In this paper, based on the classification of ecosystem services flow, we analyzed ecosystem service delivery carrier, and investigated the mechanism of ecosystem service flow, including the information, property, scale features, quantification and cartography. Moreover, a tentative analysis on cost-effective of ecosystem services flow (such as transportation costs, conversion costs, usage costs and cost of relativity) was made to analyze the consumption cost in ecosystem services flow process. It aimed to analyze dissipation cost in ecosystem services flow process. To a certain extent, the study of ecosystem service flow solved the problem of "double counting" in ecosystem services valuation, which could make a contribution for the sake of recognizing hot supply and consumption spots of ecosystem services. In addition, it would be conducive to maximizing the ecosystem service benefits in the transmission process and putting forward scientific and reasonable ecological compensation.
Optimal Investment Under Transaction Costs: A Threshold Rebalanced Portfolio Approach

NASA Astrophysics Data System (ADS)

Tunc, Sait; Donmez, Mehmet Ali; Kozat, Suleyman Serdar

2013-06-01

We study optimal investment in a financial market having a finite number of assets from a signal processing perspective. We investigate how an investor should distribute capital over these assets and when he should reallocate the distribution of the funds over these assets to maximize the cumulative wealth over any investment period. In particular, we introduce a portfolio selection algorithm that maximizes the expected cumulative wealth in i.i.d. two-asset discrete-time markets where the market levies proportional transaction costs in buying and selling stocks. We achieve this using "threshold rebalanced portfolios", where trading occurs only if the portfolio breaches certain thresholds. Under the assumption that the relative price sequences have log-normal distribution from the Black-Scholes model, we evaluate the expected wealth under proportional transaction costs and find the threshold rebalanced portfolio that achieves the maximal expected cumulative wealth over any investment period. Our derivations can be readily extended to markets having more than two stocks, where these extensions are pointed out in the paper. As predicted from our derivations, we significantly improve the achieved wealth over portfolio selection algorithms from the literature on historical data sets.

Quality competition and uncertainty in a horizontally differentiated hospital market.

PubMed

Montefiori, Marcello

2014-01-01

The chapter studies hospital competition in a spatially differentiated market in which patient demand reflects the quality/distance mix that maximizes their utility. Treatment is free at the point of use and patients freely choose the provider which best fits their expectations. Hospitals might have asymmetric objectives and costs, however they are reimbursed using a uniform prospective payment. The chapter provides different equilibrium outcomes, under perfect and asymmetric information. The results show that asymmetric costs, in the case where hospitals are profit maximizers, allow for a social welfare and quality improvement. On the other hand, the presence of a publicly managed hospital which pursues the objective of quality maximization is able to ensure a higher level of quality, patient surplus and welfare. However, the extent of this outcome might be considerably reduced when high levels of public hospital inefficiency are detectable. Finally, the negative consequences caused by the presence of asymmetric information are highlighted in the different scenarios of ownership/objectives and costs. The setting adopted in the model aims at describing the up-coming European market for secondary health care, focusing on hospital behavior and it is intended to help the policy-maker in understanding real world dynamics.
Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis.

PubMed

Lo, Nathan C; Gurarie, David; Yoon, Nara; Coulibaly, Jean T; Bendavid, Eran; Andrews, Jason R; King, Charles H

2018-01-23

Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5-20%) and high-prevalence (25-50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, "hot spots" of transmission, and noncompliance to MDA. Copyright © 2018 the Author(s). Published by PNAS.
Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis

PubMed Central

Yoon, Nara; Coulibaly, Jean T.; Bendavid, Eran; Andrews, Jason R.; King, Charles H.

2018-01-01

Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5–20%) and high-prevalence (25–50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, “hot spots” of transmission, and noncompliance to MDA. PMID:29301964
Characterization of HMA mixtures containing high reclaimed asphalt pavement content with crumb rubber additives.

DOT National Transportation Integrated Search

2013-03-01

As the price of petroleum and material costs escalate and pressures of maintaining the sustainability of our environment, owners must continually find methods to decrease material costs and maximize their benefits. This paper presents the findings of...
7 CFR 625.10 - Cost-share payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF... the cost with landowners of restoring land enrolled in HFRP as provided in the HFRP restoration plan. The HFRP restoration plan may include periodic manipulation to maximize wildlife habitat and preserve...
NASA's Microgravity Science Research Program

NASA Technical Reports Server (NTRS)

1996-01-01

The ongoing challenge faced by NASA's Microgravity Science Research Program is to work with the scientific and engineering communities to secure the maximum return from our Nation's investments by: assuring that the best possible science emerges from the science community for microgravity investigations; ensuring the maximum scientific return from each investigation in the most timely and cost-effective manner; and enhancing the distribution of data and applications of results acquired through completed investigations to maximize their benefits.
Open-RAC: Open-Design, Recirculating and Auto-Cleaning Zebrafish Maintenance System.

PubMed

Nema, Shubham; Bhargava, Yogesh

2017-08-01

Zebrafish is a vertebrate animal model. Their maintenance in large number under laboratory conditions is a daunting task. Commercially available recirculating zebrafish maintenance systems are used to efficiently handle the tasks of automatic sediment cleaning from zebrafish tanks with minimal waste of water. Due to their compact nature, they also ensure the maximal use of available lab space. However, the high costs of commercial systems present a limitation to researchers with limited funds. A cost-effective zebrafish maintenance system with major features offered by commercially available systems is highly desirable. Here, we describe a compact and recirculating zebrafish maintenance system. Our system is composed of cost-effective components, which are available in local markets and/or can be procured via online vendors. Depending on the expertise of end users, the system can be assembled in 2 days. The system is completely customizable as it offers geometry independent zebrafish tanks that are capable of auto-cleaning the sediments. Due to these features, we called our setup as Open-RAC (Open-design, Recirculating and Auto-Cleaning zebrafish maintenance system). Open-RAC is a cost-effective and viable alternative to the currently available zebrafish maintenance systems. Thus, we believe that the use of Open-RAC could promote the zebrafish research by removing the cost barrier for researchers.
Evidence for the long term cost effectiveness of home care reablement programs.

PubMed

Lewin, Gill F; Alfonso, Helman S; Alan, Janine J

2013-01-01

The objectives of this study were to determine whether older individuals who participated in a reablement (restorative) program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years). Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time. Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years. The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.
Use of nonlinear programming to optimize performance response to energy density in broiler feed formulation.

PubMed

Guevara, V R

2004-02-01

A nonlinear programming optimization model was developed to maximize margin over feed cost in broiler feed formulation and is described in this paper. The model identifies the optimal feed mix that maximizes profit margin. Optimum metabolizable energy level and performance were found by using Excel Solver nonlinear programming. Data from an energy density study with broilers were fitted to quadratic equations to express weight gain, feed consumption, and the objective function income over feed cost in terms of energy density. Nutrient:energy ratio constraints were transformed into equivalent linear constraints. National Research Council nutrient requirements and feeding program were used for examining changes in variables. The nonlinear programming feed formulation method was used to illustrate the effects of changes in different variables on the optimum energy density, performance, and profitability and was compared with conventional linear programming. To demonstrate the capabilities of the model, I determined the impact of variation in prices. Prices for broiler, corn, fish meal, and soybean meal were increased and decreased by 25%. Formulations were identical in all other respects. Energy density, margin, and diet cost changed compared with conventional linear programming formulation. This study suggests that nonlinear programming can be more useful than conventional linear programming to optimize performance response to energy density in broiler feed formulation because an energy level does not need to be set.
Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

PubMed

Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

2016-01-01

The Affordable Care Act's marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool--plan recommendations--in improving marketplace decisions. Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Primary data were gathered using an online choice experiment and questionnaire. Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers' decisions.
Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement.

PubMed

Egede, Leonard E; Gebregziabher, Mulugeta; Dismuke, Clara E; Lynch, Cheryl P; Axon, R Neal; Zhao, Yumin; Mauldin, Patrick D

2012-12-01

To examine the longitudinal effects of medication nonadherence (MNA) on key costs and estimate potential savings from increased adherence using a novel methodology that accounts for shared correlation among cost categories. Veterans with type 2 diabetes (740,195) were followed from January 2002 until death, loss to follow-up, or December 2006. A novel multivariate, generalized, linear, mixed modeling approach was used to assess the differential effect of MNA, defined as medication possession ratio (MPR) ≥0.8 on healthcare costs. A sensitivity analysis was performed to assess potential cost savings at different MNA levels using the Consumer Price Index to adjust estimates to 2012 dollar value. Mean MPR for the full sample over 5 years was 0.78, with a mean of 0.93 for the adherent group and 0.58 for the MNA group. In fully adjusted models, all annual cost categories increased ∼3% per year (P = 0.001) during the 5-year study time period. MNA was associated with a 37% lower pharmacy cost, 7% lower outpatient cost, and 41% higher inpatient cost. Based on sensitivity analyses, improving adherence in the MNA group would result in annual estimated cost savings ranging from ∼$661 million (MPR <0.6 vs. ≥0.6) to ∼$1.16 billion (MPR <1 vs. 1). Maximal incremental annual savings would occur by raising MPR from <0.8 to ≥0.8 ($204,530,778) among MNA subjects. Aggressive strategies and policies are needed to achieve optimal medication adherence in diabetes. Such approaches may further the so-called "triple aim" of achieving better health, better quality care, and lower cost.
Building uncertainty into cost-effectiveness rankings: portfolio risk-return tradeoffs and implications for decision rules.

PubMed

O'Brien, B J; Sculpher, M J

2000-05-01

Current principles of cost-effectiveness analysis emphasize the rank ordering of programs by expected economic return (eg, quality-adjusted life-years gained per dollar expended). This criterion ignores the variance associated with the cost-effectiveness of a program, yet variance is a common measure of risk when financial investment options are appraised. Variation in health care program return is likely to be a criterion of program selection for health care managers with fixed budgets and outcome performance targets. Characterizing health care resource allocation as a risky investment problem, we show how concepts of portfolio analysis from financial economics can be adopted as a conceptual framework for presenting cost-effectiveness data from multiple programs as mean-variance data. Two specific propositions emerge: (1) the current convention of ranking programs by expected return is a special case of the portfolio selection problem in which the decision maker is assumed to be indifferent to risk, and (2) for risk-averse decision makers, the degree of joint risk or covariation in cost-effectiveness between programs will create incentives to diversify an investment portfolio. The conventional normative assumption of risk neutrality for social-level public investment decisions does not apply to a large number of health care resource allocation decisions in which health care managers seek to maximize returns subject to budget constraints and performance targets. Portfolio theory offers a useful framework for studying mean-variance tradeoffs in cost-effectiveness and offers some positive predictions (and explanations) of actual decision making in the health care sector.
A Goal Programming Optimization Model for The Allocation of Liquid Steel Production

NASA Astrophysics Data System (ADS)

Hapsari, S. N.; Rosyidi, C. N.

2018-03-01

This research was conducted in one of the largest steel companies in Indonesia which has several production units and produces a wide range of steel products. One of the important products in the company is billet steel. The company has four Electric Arc Furnace (EAF) which produces liquid steel which must be procesed further to be billet steel. The billet steel plant needs to make their production process more efficient to increase the productvity. The management has four goals to be achieved and hence the optimal allocation of the liquid steel production is needed to achieve those goals. In this paper, a goal programming optimization model is developed to determine optimal allocation of liquid steel production in each EAF, to satisfy demand in 3 periods and the company goals, namely maximizing the volume of production, minimizing the cost of raw materials, minimizing maintenance costs, maximizing sales revenues, and maximizing production capacity. From the results of optimization, only maximizing production capacity goal can not achieve the target. However, the model developed in this papare can optimally allocate liquid steel so the allocation of production does not exceed the maximum capacity of the machine work hours and maximum production capacity.
US neurologists: attitudes on rationing.

PubMed

Holloway, R G; Ringel, S P; Bernat, J L; Keran, C M; Lawyer, B L

2000-11-28

To assess neurologists' attitudes on rationing health care and to determine whether neurologists would set healthcare priorities in ways that are consistent with cost-effectiveness research. Cost-effectiveness research can suggest ways to maximize health benefits within fixed budgets but is currently being underused in resource allocation decisions. The authors surveyed a random sample of neurologists practicing in the United States (response rate, 44.4%) with three hypothetical scenarios. Two scenarios were designed to address general attitudes on allocating finite resources with emphasis on formulary decisions for costly drugs. The third scenario was designed to assess whether neurologists would optimize the allocation of a fixed budget as recommended by cost-effectiveness analysis. Three-quarters of respondents thought that neurologists make daily decisions that effectively ration healthcare resources, and 60% felt a professional responsibility to consider the financial impact of individualized treatment decisions on other patients. Only 25% of respondents thought that there should be no restrictions placed on any of the five newer antiepileptic agents. In a 1995 survey, 75% of similarly sampled neurologists agreed that no restrictions should be placed on the availability of FDA-approved medications. Nearly half (46%) of respondents favored a less effective test and would be willing to let patients die to ensure the offering of a more equitable alternative. Most neurologists recognize the need to ration health care, and although they think cost-effectiveness research is one method to achieve efficient distribution of resources, many think that considerable attention should also be given to equity.
The Basic Economics of CD-ROM Pricing.

ERIC Educational Resources Information Center

Erkkila, John E.

1991-01-01

This explanation of how the basic economic model of pricing applies to the CD-ROM industry considers the supply and demand sides of the market and compares three distinct pricing strategies: (1) pricing to maximize profits; (2) average cost pricing; and (3) marginal cost pricing. (EAM)
Nonlinear Dynamic Model-Based Multiobjective Sensor Network Design Algorithm for a Plant with an Estimator-Based Control System

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

Paul, Prokash; Bhattacharyya, Debangsu; Turton, Richard

Here, a novel sensor network design (SND) algorithm is developed for maximizing process efficiency while minimizing sensor network cost for a nonlinear dynamic process with an estimator-based control system. The multiobjective optimization problem is solved following a lexicographic approach where the process efficiency is maximized first followed by minimization of the sensor network cost. The partial net present value, which combines the capital cost due to the sensor network and the operating cost due to deviation from the optimal efficiency, is proposed as an alternative objective. The unscented Kalman filter is considered as the nonlinear estimator. The large-scale combinatorial optimizationmore » problem is solved using a genetic algorithm. The developed SND algorithm is applied to an acid gas removal (AGR) unit as part of an integrated gasification combined cycle (IGCC) power plant with CO 2 capture. Due to the computational expense, a reduced order nonlinear model of the AGR process is identified and parallel computation is performed during implementation.« less
Nonlinear Dynamic Model-Based Multiobjective Sensor Network Design Algorithm for a Plant with an Estimator-Based Control System

DOE PAGES

Paul, Prokash; Bhattacharyya, Debangsu; Turton, Richard; ...

2017-06-06

Here, a novel sensor network design (SND) algorithm is developed for maximizing process efficiency while minimizing sensor network cost for a nonlinear dynamic process with an estimator-based control system. The multiobjective optimization problem is solved following a lexicographic approach where the process efficiency is maximized first followed by minimization of the sensor network cost. The partial net present value, which combines the capital cost due to the sensor network and the operating cost due to deviation from the optimal efficiency, is proposed as an alternative objective. The unscented Kalman filter is considered as the nonlinear estimator. The large-scale combinatorial optimizationmore » problem is solved using a genetic algorithm. The developed SND algorithm is applied to an acid gas removal (AGR) unit as part of an integrated gasification combined cycle (IGCC) power plant with CO 2 capture. Due to the computational expense, a reduced order nonlinear model of the AGR process is identified and parallel computation is performed during implementation.« less
[Meeting the needs of the European working time directive in german medical profession].

PubMed

Friedrich, M; Popov, A F; Schmitto, J D; Bireta, C; Emmert, A; Tirilomis, T

2011-06-01

The legal obligation of the European Working Time Directive with its implementation into a German Working Hours Act requires German hospitals to give up old structures and requires the implementation of new working time models. The failure of the revision of the European Working Time Directive in April 2009 prevented that any changes of status quo might happen in the near future. Fundamental terms of the working law for the medical area have been elucidated and have been implemented into concrete calculation formulas. The planned working time has been clearly determined. Particularly, on-call duties and a signed "OptOut-declaration" have huge effects on the upper limit of the working time that is to be determined. Shift duty leads to the greatest limitations of the upper limit of the working time. The Working Hours Act defines the maximal, available, individual working time budget and thus the working time budget of a hospital and it limits the maximal availability of the service providers of a hospital as well as defining the maximal personnel costs. Transparency in this area lays the foundation for an effective time management and the creation of new working time models in accordance with the European Working Time Directive as well as the Working Hours Act and the "TVÄ" (labour contract for doctors at municipal hospitals). It is possible, with the knowledge of the maximal working time budget and the thereof resulting personnel costs, to calculate the economical revenues better. The reallocation of the working time of doctors enables efficiency enhancement. It is necessary to demand a clear definition of the tasks of doctors with the consequential discharge of tasks that should not/do not belong to the responsibilities of a doctor. This would lead to a more attractive working environment for doctors at hospitals and thus to an improvement of the care of the patients. The implementation of the European Time Directive is not to be seen as unrealizable, as has been generally heard; instead, it enables the urgently necessary structural reform at German hospitals. © Georg Thieme Verlag KG Stuttgart · New York.
Model-based optimal design of active cool thermal energy storage for maximal life-cycle cost saving from demand management in commercial buildings

DOE PAGES

Cui, Borui; Gao, Dian-ce; Xiao, Fu; ...

2016-12-23

This article provides a method in comprehensive evaluation of cost-saving potential of active cool thermal energy storage (CTES) integrated with HVAC system for demand management in non-residential building. The active storage is beneficial by shifting peak demand for peak load management (PLM) as well as providing longer duration and larger capacity of demand response (DR). In this research, a model-based optimal design method using genetic algorithm is developed to optimize the capacity of active CTES aiming for maximizing the life-cycle cost saving concerning capital cost associated with storage capacity as well as incentives from both fast DR and PLM. Inmore » the method, the active CTES operates under a fast DR control strategy during DR events while under the storage-priority operation mode to shift peak demand during normal days. The optimal storage capacities, maximum annual net cost saving and corresponding power reduction set-points during DR event are obtained by using the proposed optimal design method. Lastly, this research provides guidance in comprehensive evaluation of cost-saving potential of CTES integrated with HVAC system for building demand management including both fast DR and PLM.« less
Model-based optimal design of active cool thermal energy storage for maximal life-cycle cost saving from demand management in commercial buildings

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

Cui, Borui; Gao, Dian-ce; Xiao, Fu

This article provides a method in comprehensive evaluation of cost-saving potential of active cool thermal energy storage (CTES) integrated with HVAC system for demand management in non-residential building. The active storage is beneficial by shifting peak demand for peak load management (PLM) as well as providing longer duration and larger capacity of demand response (DR). In this research, a model-based optimal design method using genetic algorithm is developed to optimize the capacity of active CTES aiming for maximizing the life-cycle cost saving concerning capital cost associated with storage capacity as well as incentives from both fast DR and PLM. Inmore » the method, the active CTES operates under a fast DR control strategy during DR events while under the storage-priority operation mode to shift peak demand during normal days. The optimal storage capacities, maximum annual net cost saving and corresponding power reduction set-points during DR event are obtained by using the proposed optimal design method. Lastly, this research provides guidance in comprehensive evaluation of cost-saving potential of CTES integrated with HVAC system for building demand management including both fast DR and PLM.« less

Corneal Collagen Cross-Linking in the Management of Keratoconus in Canada: A Cost-Effectiveness Analysis.

PubMed

Leung, Victoria C; Pechlivanoglou, Petros; Chew, Hall F; Hatch, Wendy

2017-08-01

To use patient-level microsimulation models to evaluate the comparative cost-effectiveness of early corneal cross-linking (CXL) and conventional management with penetrating keratoplasty (PKP) when indicated in managing keratoconus in Canada. Cost-utility analysis using individual-based, state-transition microsimulation models. Simulated cohorts of 100 000 individuals with keratoconus who entered each treatment arm at 25 years of age. Fellow eyes were modeled separately. Simulated individuals lived up to a maximum of 110 years. We developed 2 state-transition microsimulation models to reflect the natural history of keratoconus progression and the impact of conventional management with PKP versus CXL. We collected data from the published literature to inform model parameters. We used realistic parameters that maximized the potential costs and complications of CXL, while minimizing those associated with PKP. In each treatment arm, we allowed simulated individuals to move through health states in monthly cycles from diagnosis until death. For each treatment strategy, we calculated the total cost and number of quality-adjusted life years (QALYs) gained. Costs were measured in Canadian dollars. Costs and QALYs were discounted at 5%, converting future costs and QALYs into present values. We used an incremental cost-effectiveness ratio (ICER = difference in lifetime costs/difference in lifetime health outcomes) to compare the cost-effectiveness of CXL versus conventional management with PKP. Lifetime costs and QALYs for CXL were estimated to be Can$5530 (Can$4512, discounted) and 50.12 QALYs (16.42 QALYs, discounted). Lifetime costs and QALYs for conventional management with PKP were Can$2675 (Can$1508, discounted) and 48.93 QALYs (16.09 QALYs, discounted). The discounted ICER comparing CXL to conventional management was Can$9090/QALY gained. Sensitivity analyses revealed that in general, parameter variations did not influence the cost-effectiveness of CXL. CXL is cost-effective compared with conventional management with PKP in the treatment of keratoconus. Our ICER of Can$9090/QALY falls well below the range of Can$20 000 to Can$100 000/QALY and below US$50 000/QALY, thresholds generally used to evaluate the cost-effectiveness of health interventions in Canada and the United States. This study provides strong economic evidence for the cost-effectiveness of early CXL in keratoconus. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Integrating Economic Costs and Biological Traits into Global Conservation Priorities for Carnivores

PubMed Central

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-01-01

Background Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. Methodology/Principal Findings We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Conclusions/Significance Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy. PMID:19710911
Sustainable thresholds for cooperative epidemiological models.

PubMed

Barrios, Edwin; Gajardo, Pedro; Vasilieva, Olga

2018-05-22

In this paper, we introduce a method for computing sustainable thresholds for controlled cooperative models described by a system of ordinary differential equations, a property shared by a wide class of compartmental models in epidemiology. The set of sustainable thresholds refers to constraints (e.g., maximal "allowable" number of human infections; maximal "affordable" budget for disease prevention, diagnosis and treatments; etc.), parameterized by thresholds, that can be sustained by applying an admissible control strategy starting at the given initial state and lasting the whole period of the control intervention. This set, determined by the initial state of the dynamical system, virtually provides useful information for more efficient (or cost-effective) decision-making by exhibiting the trade-offs between different types of constraints and allowing the user to assess future outcomes of control measures on transient behavior of the dynamical system. In order to accentuate the originality of our approach and to reveal its potential significance in real-life applications, we present an example relying on the 2013 dengue outbreak in Cali, Colombia, where we compute the set of sustainable thresholds (in terms of the maximal "affordable" budget and the maximal "allowable" levels of active infections among human and vector populations) that could be sustained during the epidemic outbreak. Copyright © 2018 Elsevier Inc. All rights reserved.
Differential effects of male nutrient balance on pre- and post-copulatory traits, and consequences for female reproduction in Drosophila melanogaster

PubMed Central

Morimoto, Juliano; Wigby, Stuart

2016-01-01

Male fitness depends on the expression of costly traits involved in obtaining mates (pre-copulatory) and fertilization (post-copulatory). However, very little is known about the nutrient requirements for these traits and whether males compromise their diet to maximize one trait at the expense of another. Here we used Nutritional Geometry to investigate macronutrient requirements for pre- and post-copulatory traits in Drosophila, when males were the first or second to mate with females. We found no significant effects of male diet on sperm competitiveness. However, although males self-regulate their macronutrient intake at a protein-to-carbohydrate ratio (“P:C ratio”) of 1:1.5, this ratio does not coincide with their optima for several key reproductive traits: both the short-term (~24 hr) rate of offspring production after a female’s first mating, as well as the total offspring number sired when males were second to mate were maximized at a P:C ratio of 1:9, whereas male attractiveness (latency to mate), were maximised at a P:C ratio of 1:1. These results suggest a compromised optimum diet, and no single diet that simultaneously maximizes all male reproductive traits. The protein intake of first males also negatively affected female offspring production following remating, suggesting a long-term intersexual effect of male nutrition. PMID:27270223
Differences in Patterns of Reproductive Allocation between the Sexes in Nicrophorus orbicollis.

PubMed

Smith, Ashlee N; Creighton, J Curtis; Belk, Mark C

2015-01-01

Organisms are selected to maximize lifetime reproductive success by balancing the costs of current reproduction with costs to future survival and fecundity. Males and females typically face different reproductive costs, which makes comparisons of their reproductive strategies difficult. Burying beetles provide a unique system that allows us to compare the costs of reproduction between the sexes because males and females are capable of raising offspring together or alone and carcass preparation and offspring care represent the majority of reproductive costs for both sexes. Because both sexes perform the same functions of carcass preparation and offspring care, we predict that they would experience similar costs and have similar life history patterns. In this study we assess the cost of reproduction in male Nicrophorus orbicollis and compare to patterns observed in females. We compare the reproductive strategies of single males and females that provided pre- and post-hatching parental care. There is a cost to reproduction for both males and females, but the sexes respond to these costs differently. Females match brood size with carcass size, and thus maximize the lifetime number of offspring on a given size carcass. Males cull proportionately more offspring on all carcass sizes, and thus have a lower lifetime number of offspring compared to females. Females exhibit an adaptive reproductive strategy based on resource availability, but male reproductive strategies are not adaptive in relation to resource availability.
Design optimization of sinusoidal glass honeycomb for flat plate solar collectors

NASA Technical Reports Server (NTRS)

Mcmurrin, J. C.; Buchberg, H.

1980-01-01

The design of honeycomb made of sinusoidally corrugated glass strips was optimized for use in water-cooled, single-glazed flat plate solar collectors with non-selective black absorbers. Cell diameter (d), cell height (L), and pitch/diameter ratio (P/d) maximizing solar collector performance and cost effectiveness for given cell wall thickness (t sub w) and optical properties of glass were determined from radiative and convective honeycomb characteristics and collector performance all calculated with experimentally validated algorithms. Relative lifetime values were estimated from present materials costs and postulated production methods for corrugated glass honeycomb cover assemblies. A honeycomb with P/d = 1.05, d = 17.4 mm, L = 146 mm and t sub w = 0.15 mm would provide near-optimal performance over the range delta T sub C greater than or equal to 0 C and less than or equal to 80 C and be superior in performance and cost effectiveness to a non-honeycomb collector with a 0.92/0.12 selective black absorber.
Exploring the Potential Health Impact and Cost-Effectiveness of AIDS Vaccine within a Comprehensive HIV/AIDS Response in Low- and Middle-Income Countries

PubMed Central

Harmon, Thomas M.; Fisher, Kevin A.; McGlynn, Margaret G.; Stover, John; Warren, Mitchell J.; Teng, Yu; Näveke, Arne

2016-01-01

Background The Investment Framework Enhanced (IFE) proposed in 2013 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs). This article describes additional modeling which looks more closely at the potential health impact and cost-effectiveness of AIDS vaccination in LMICs as part of UNAIDS IFE. Methods An epidemiological model was used to explore the potential impact of AIDS vaccination in LMICs in combination with other interventions through 2070. Assumptions were based on perspectives from research, vaccination and public health experts, as well as observations from other HIV/AIDS interventions and vaccination programs. Sensitivity analyses varied vaccine efficacy, duration of protection, coverage, and cost. Results If UNAIDS IFE goals were fully achieved, new annual HIV infections in LMICs would decline from 2.0 million in 2014 to 550,000 in 2070. A 70% efficacious vaccine introduced in 2027 with three doses, strong uptake and five years of protection would reduce annual new infections by 44% over the first decade, by 65% the first 25 years and by 78% to 122,000 in 2070. Vaccine impact would be much greater if the assumptions in UNAIDS IFE were not fully achieved. An AIDS vaccine would be cost-effective within a wide range of scenarios. Interpretation Even a modestly effective vaccine could contribute strongly to a sustainable response to HIV/AIDS and be cost-effective, even with optimistic assumptions about other interventions. Higher efficacy would provide even greater impact and cost-effectiveness, and would support broader access. Vaccine efficacy and cost per regimen are critical in achieving cost-effectiveness, with cost per regimen being particularly critical in low-income countries and at lower efficacy levels. PMID:26731116
Autonomous Flight Rules Concept: User Implementation Costs and Strategies

NASA Technical Reports Server (NTRS)

Cotton, William B.; Hilb, Robert

2014-01-01

The costs to implement Autonomous Flight Rules (AFR) were examined for estimates in acquisition, installation, training and operations. The user categories were airlines, fractional operators, general aviation and unmanned aircraft systems. Transition strategies to minimize costs while maximizing operational benefits were also analyzed. The primary cost category was found to be the avionics acquisition. Cost ranges for AFR equipment were given to reflect the uncertainty of the certification level for the equipment and the extent of existing compatible avionics in the aircraft to be modified.
Advanced General Aviation Turbine Engine (GATE) concepts

NASA Technical Reports Server (NTRS)

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

1979-01-01

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

PubMed

Waldman, S A; Terzic, A

2017-01-01

Success in pharmaceutical development led to a record 51 drugs approved in the past year, surpassing every previous year since 1950. Technology innovation enabled identification and exploitation of increasingly precise disease targets ensuring next generation diagnostic and therapeutic products for patient management. The expanding biopharmaceutical portfolio stands, however, in contradistinction to the unsustainable costs that reflect remarkable challenges of clinical development programs. This annual Therapeutic Innovations issue juxtaposes advances in translating molecular breakthroughs into transformative therapies with essential considerations for lowering attrition and improving the cost-effectiveness of the drug-development paradigm. Realizing the discovery-translation-application continuum mandates a congruent approval, adoption, and access triad. © 2016 ASCPT.
Managing Innovation to Maximize Value Along the Discovery-Translation-Application Continuum

PubMed Central

Waldman, SA; Terzic, A

2017-01-01

Success in pharmaceutical development led to a record 51 drug approved in the past year, surpassing every previous year since 1950. Technology innovation enabled identification and exploitation of increasingly precise disease targets ensuring a next generation diagnostic and therapeutic products for patient management. The expanding biopharmaceutical portfolio stands however in contradistinction to the unsustainable costs that reflect remarkable challenges of clinical development programs. This annual Therapeutic Innovations issue juxtaposes advances in translating molecular breakthroughs into transformative therapies with essential considerations for lowering attrition and improving the cost-effectiveness of the drug development paradigm. Realizing the discovery-translation-application continuum mandates a congruent approval, adoption and access triad. PMID:27869291
The cost of different types of lameness in dairy cows calculated by dynamic programming.

PubMed

Cha, E; Hertl, J A; Bar, D; Gröhn, Y T

2010-10-01

Traditionally, studies which placed a monetary value on the effect of lameness have calculated the costs at the herd level and rarely have they been specific to different types of lameness. These costs which have been calculated from former studies are not particularly useful for farmers in making economically optimal decisions depending on individual cow characteristics. The objective of this study was to calculate the cost of different types of lameness at the individual cow level and thereby identify the optimal management decision for each of three representative lameness diagnoses. This model would provide a more informed decision making process in lameness management for maximal economic profitability. We made modifications to an existing dynamic optimization and simulation model, studying the effects of various factors (incidence of lameness, milk loss, pregnancy rate and treatment cost) on the cost of different types of lameness. The average cost per case (US$) of sole ulcer, digital dermatitis and foot rot were 216.07, 132.96 and 120.70, respectively. It was recommended that 97.3% of foot rot cases, 95.5% of digital dermatitis cases and 92.3% of sole ulcer cases be treated. The main contributor to the total cost per case of sole ulcer was milk loss (38%), treatment cost for digital dermatitis (42%) and the effect of decreased fertility for foot rot (50%). This model affords versatility as it allows for parameters such as production costs, economic values and disease frequencies to be altered. Therefore, cost estimates are the direct outcome of the farm specific parameters entered into the model. Thus, this model can provide farmers economically optimal guidelines specific to their individual cows suffering from different types of lameness. Copyright © 2010 Elsevier B.V. All rights reserved.
Influencing Busy People in a Social Network

PubMed Central

Sarkar, Kaushik; Sundaram, Hari

2016-01-01

We identify influential early adopters in a social network, where individuals are resource constrained, to maximize the spread of multiple, costly behaviors. A solution to this problem is especially important for viral marketing. The problem of maximizing influence in a social network is challenging since it is computationally intractable. We make three contributions. First, we propose a new model of collective behavior that incorporates individual intent, knowledge of neighbors actions and resource constraints. Second, we show that the multiple behavior influence maximization is NP-hard. Furthermore, we show that the problem is submodular, implying the existence of a greedy solution that approximates the optimal solution to within a constant. However, since the greedy algorithm is expensive for large networks, we propose efficient heuristics to identify the influential individuals, including heuristics to assign behaviors to the different early adopters. We test our approach on synthetic and real-world topologies with excellent results. We evaluate the effectiveness under three metrics: unique number of participants, total number of active behaviors and network resource utilization. Our heuristics produce 15-51% increase in expected resource utilization over the naïve approach. PMID:27711127
Comparative statics of games between relatives.

PubMed

Milchtaich, Igal

2006-03-01

According to Hamilton's theory of kin selection, species tend to evolve behavior such that each organism appears to be attempting to maximize its inclusive fitness. In particular, two neighbors are likely to help each other if the cost of doing so is less than the benefit multiplied by r, their coefficient of relatedness. Since the latter is less than unity, mutual altruism benefits both neighbors. However, is it theoretically possible that acting so as to maximize the inclusive, rather than personal, fitness may harm both parties. This may occur in strategic symmetric pairwise interactions (more specifically, nxn games), in which the outcome depends on both sides' actions. In this case, the equilibrium outcome may be less favorable to the interactants' personal fitness than if each of them acted so as to maximize the latter. This paper shows, however, that such negative effect of relatedness on fitness is incompatible with evolutionary stability. If the symmetric equilibrium strategies are evolutionarily stable, a higher coefficient of relatedness can only entail higher personal fitness for the two neighbors. This suggests that negative comparative statics as above are not likely to occur in nature.
Influencing Busy People in a Social Network.

PubMed

Sarkar, Kaushik; Sundaram, Hari

2016-01-01

We identify influential early adopters in a social network, where individuals are resource constrained, to maximize the spread of multiple, costly behaviors. A solution to this problem is especially important for viral marketing. The problem of maximizing influence in a social network is challenging since it is computationally intractable. We make three contributions. First, we propose a new model of collective behavior that incorporates individual intent, knowledge of neighbors actions and resource constraints. Second, we show that the multiple behavior influence maximization is NP-hard. Furthermore, we show that the problem is submodular, implying the existence of a greedy solution that approximates the optimal solution to within a constant. However, since the greedy algorithm is expensive for large networks, we propose efficient heuristics to identify the influential individuals, including heuristics to assign behaviors to the different early adopters. We test our approach on synthetic and real-world topologies with excellent results. We evaluate the effectiveness under three metrics: unique number of participants, total number of active behaviors and network resource utilization. Our heuristics produce 15-51% increase in expected resource utilization over the naïve approach.
Spatially explicit estimates of forest carbon emissions, mitigation costs and REDD+ opportunities in Indonesia

NASA Astrophysics Data System (ADS)

Graham, Victoria; Laurance, Susan G.; Grech, Alana; Venter, Oscar

2017-04-01

Carbon emissions from the conversion and degradation of tropical forests contribute to anthropogenic climate change. Implementing programs to reduce emissions from tropical forest loss in Southeast Asia are perceived to be expensive due to high opportunity costs of avoided deforestation. However, these costs are not representative of all REDD+ opportunities as they are typically based on average costs across large land areas and are primarily for reducing deforestation from oil palm or pulp concessions. As mitigation costs and carbon benefits can vary according to site characteristics, spatially-explicit information should be used to assess cost-effectiveness and to guide the allocation of scarce REDD+ resources. We analyzed the cost-effectiveness of the following REDD+ strategies in Indonesia, one of the world’s largest sources of carbon emissions from deforestation: halting additional deforestation in protected areas, timber and oil palm concessions, reforesting degraded land and employing reduced-impact logging techniques in logging concessions. We discover that when spatial variation in costs and benefits is considered, low-cost options emerged even for the two most expensive strategies: protecting forests from conversion to oil palm and timber plantations. To achieve a low emissions reduction target of 25%, we suggest funding should target deforestation in protected areas, and oil palm and timber concessions to maximize emissions reductions at the lowest cumulative cost. Low-cost opportunities for reducing emissions from oil palm are where concessions have been granted on deep peat deposits or unproductive land. To achieve a high emissions reduction target of 75%, funding is allocated across all strategies, emphasizing that no single strategy can reduce emissions cost-effectively across all of Indonesia. These findings demonstrate that by using a spatially-targeted approach to identify high priority locations for reducing emissions from deforestation and forest degradation, REDD+ resources can be allocated cost-effectively across Indonesia.
China's medical savings accounts: an analysis of the price elasticity of demand for health care.

PubMed

Yu, Hao

2017-07-01

Although medical savings accounts (MSAs) have drawn intensive attention across the world for their potential in cost control, there is limited evidence of their impact on the demand for health care. This paper is intended to fill that gap. First, we built up a dynamic model of a consumer's problem of utility maximization in the presence of a nonlinear price schedule embedded in an MSA. Second, the model was implemented using data from a 2-year MSA pilot program in China. The estimated price elasticity under MSAs was between -0.42 and -0.58, i.e., higher than that reported in the literature. The relatively high price elasticity suggests that MSAs as an insurance feature may help control costs. However, the long-term effect of MSAs on health costs is subject to further analysis.
Energy neutral and low power wireless communications

NASA Astrophysics Data System (ADS)

Orhan, Oner

Wireless sensor nodes are typically designed to have low cost and small size. These design objectives impose restrictions on the capacity and efficiency of the transceiver components and energy storage units that can be used. As a result, energy becomes a bottleneck and continuous operation of the sensor network requires frequent battery replacements, increasing the maintenance cost. Energy harvesting and energy efficient transceiver architectures are able to overcome these challenges by collecting energy from the environment and utilizing the energy in an intelligent manner. However, due to the nature of the ambient energy sources, the amount of useful energy that can be harvested is limited and unreliable. Consequently, optimal management of the harvested energy and design of low power transceivers pose new challenges for wireless network design and operation. The first part of this dissertation is on energy neutral wireless networking, where optimal transmission schemes under different system setups and objectives are investigated. First, throughput maximization for energy harvesting two-hop networks with decode-and-forward half-duplex relays is studied. For a system with two parallel relays, various combinations of the following four transmission modes are considered: Broadcast from the source, multi-access from the relays, and successive relaying phases I and II. Next, the energy cost of the processing circuitry as well as the transmission energy are taken into account for communication over a broadband fading channel powered by an energy harvesting transmitter. Under this setup, throughput maximization, energy maximization, and transmission completion time minimization problems are studied. Finally, source and channel coding for an energy-limited wireless sensor node is investigated under various energy constraints including energy harvesting, processing and sampling costs. For each objective, optimal transmission policies are formulated as the solutions of a convex optimization problem, and the properties of these optimal policies are identified. In the second part of this thesis, low power transceiver design is considered for millimeter wave communication systems. In particular, using an additive quantization noise model, the effect of analog-digital conversion (ADC) resolution and bandwidth on the achievable rate is investigated for a multi-antenna system under a receiver power constraint. Two receiver architectures, analog and digital combining, are compared in terms of performance.
Characterizing Potentially Inappropriate Prescribing of Proton Pump Inhibitors in Older People in Primary Care in Ireland from 1997 to 2012.

PubMed

Moriarty, Frank; Bennett, Kathleen; Cahir, Caitriona; Fahey, Tom

2016-12-01

To characterize prescribing of proton pump inhibitors (PPIs) and medicines that increase gastrointestinal bleeding risk (ulcerogenic) in older people from 1997 to 2012 and assess factors associated with maximal-dose prescribing in long-term PPI users. Repeated cross-sectional study of pharmacy claims data. Eastern Health Board region of Ireland. Individuals aged 65 and older from a means-tested health plan in 1997, 2002, 2007, and 2012 (range 78,489-133,884 individuals). PPI prescribing prevalence was determined per study year, categorized according to duration (≤8 or >8 weeks), dosage (maximal or maintenance), and co-prescribed drugs. Logistic regression in long-term PPI users was used to determine whether age, sex, polypharmacy, and ulcerogenic medicine use were associated with being prescribed a maximal dose rather than a maintenance dose. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) are presented. Half of this older population received a PPI in 2007 and 2012. Long-term use (>8 weeks) of maximal doses rose from 0.8% of individuals in 1997 to 23.6% in 2012. Although some ulcerogenic medicines and polypharmacy were significantly associated with maximal PPI doses, any nonsteroidal anti-inflammatory drug use was significantly associated with lower odds of maximal PPI dose (adjusted OR = 0.87, 95% CI = 0.85-0.89), as were aspirin use and older age. Adjusting for medication and demographic factors, odds of being prescribed a maximal PPI dose were significantly higher in 2012 than in 1997 (adjusted OR = 6.30, 95% CI = 5.76-6.88). Long-term maximal-dose PPI prescribing is highly prevalent in older adults and is not consistently associated with gastrointestinal bleeding risk factors. Interventions involving prescribers and patients may promote appropriate PPI use, reducing costs and adverse effects of PPI overprescribing. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
The effect of breathing an ambient low‐density, hyperoxic gas on the perceived effort of breathing and maximal performance of exercise in well‐trained athletes

PubMed Central

Ansley, L; Petersen, D; Thomas, A; Gibson, A St Clair; Robson‐Ansley, P; Noakes, T D

2007-01-01

Background The role of the perception of breathing effort in the regulation of performance of maximal exercise remains unclear. Aims To determine whether the perceived effort of ventilation is altered through substituting a less dense gas for normal ambient air and whether this substitution affects performance of maximal incremental exercise in trained athletes. Methods Eight highly trained cyclists (mean SD) maximal oxygen consumption (VO2max) = 69.9 (7.9) (mlO2/kg/min) performed two randomised maximal tests in a hyperbaric chamber breathing ambient air composed of either 35% O2/65% N2 (nitrox) or 35% O2/65% He (heliox). A ramp protocol was used in which power output was incremented at 0.5 W/s. The trials were separated by at least 48 h. The perceived effort of breathing was obtained via Borg Category Ratio Scales at 3‐min intervals and at fatigue. Oxygen consumption (VO2) and minute ventilation (VE) were monitored continuously. Results Breathing heliox did not change the sensation of dyspnoea: there were no differences between trials for the Borg scales at any time point. Exercise performance was not different between the nitrox and heliox trials (peak power output = 451 (58) and 453 (56) W), nor was VO2max (4.96 (0.61) and 4.88 (0.65) l/min) or maximal VE (157 (24) and 163 (22) l/min). Between‐trial variability in peak power output was less than either VO2max or maximal VE. Conclusion Breathing a less dense gas does not improve maximal performance of exercise or reduce the perception of breathing effort in highly trained athletes, although an attenuated submaximal tidal volume and VE with a concomitant reduction in VO2 suggests an improved gas exchange and reduced O2 cost of ventilation when breathing heliox. PMID:17062658

Experimental Investigations to evaluate the effects of cutting parameters on cutting temperature and residual stresses during milling process of the AISI 1045

NASA Astrophysics Data System (ADS)

Abdelkrim, M.; Brabie, G.; Belloufi, A.; Catalin, T.; Chirita, B.

2017-08-01

Today major metal cutting companies in industrial countries, looking to gain time and reduce manufacturing costs while respecting the environment. There are many phenomena which affect the quality and production costs of the product, including cutting efforts, cutting temperature, residual stresses, etc. A better understanding of these phenomena will reduce production costs and maximize productivity. The aim of this work is to analyze the effect of machining conditions (cutting speed, feed speed and cutting depth) on cutting temperature and residual stresses, during the milling operations using the response surface method. A good accuracy between predicted and measured values of the cutting temperature was found, the cutting speed and the depth of cut are parameters whose effect is most sensitive to the residual stresses and the cutting temperature.However, little influence has been registered in the case of an increase of the feed rate. The percentage of error is 4.57%, indicating that the numerical approach can accurately predict the cutting temperature of the AISI 1045.
Care delivery considerations for widespread and equitable implementation of inherited cancer predisposition testing

PubMed Central

Cragun, Deborah; Kinney, Anita Y; Pal, Tuya

2017-01-01

Introduction DNA sequencing advances through next-generation sequencing (NGS) and several practice changing events, have led to shifting paradigms for inherited cancer predisposition testing. These changes necessitated a means by which to maximize health benefits without unnecessarily inflating healthcare costs and exacerbating health disparities. Areas covered NGS-based tests encompass multi-gene panel tests, whole exome sequencing, and whole genome sequencing, all of which test for multiple genes simultaneously, compared to prior sequencing practices through which testing was performed sequentially for one or two genes. Taking an ecological approach, this article synthesizes the current literature to consider the broad impact of these advances from the individual patient-, interpersonal-, organizational-, community- and policy-levels. Furthermore, the authors describe how multi-level factors that impact genetic testing and follow-up care reveal great potential to widen existing health disparities if these issues are not addressed. Expert Commentary As we consider ways to maximize patient benefit from testing in a cost effective manner, it is important to consider perspectives from multiple levels. This information is needed to guide the development of interventions such that the promise of genomic testing may be realized by all populations, regardless of race, ethnicity and ability to pay. PMID:27910721
Exercise interventions: defusing the world's osteoporosis time bomb.

PubMed Central

Kai, Ming Chan; Anderson, Mary; Lau, Edith M. C.

2003-01-01

Osteoporosis is a major public health problem, affecting millions of people worldwide. The associated health care costs are growing in parallel with increases in elderly populations, and it is expected that the number of osteoporotic fractures will double over the next 50 years. The best way to address osteoporosis is prevention. Some interventions to maximize and preserve bone mass have multiple health benefits and are cost-effective. For example, modifications to diet and lifestyle can help to prevent osteoporosis, and could potentially lead to a significant decrease in fracture rates; and exercise is a valuable adjunct to programmes aimed at alleviating the risks and symptoms of osteoporosis. Practising exercise at a young age helps maximize the mineral density of bones while they are still growing and maturing, and continuing to excercise minimizes bone loss later in life. Not only does exercise improve bone health, it also increases muscle strength, coordination, balance, flexibility and leads to better overall health. Walking, aerobic exercise, and t'ai chi are the best forms of exercise to stimulate bone formation and strengthen the muscles that help support bones. Encouraging physical activity at all ages is therefore a top priority to prevent osteoporosis. PMID:14758410
Skating to where the puck is going to be: a plan for clinical trials and translation research in mood disorders.

PubMed

Frank, Ellen; Rush, A John; Blehar, Mary; Essock, Susan; Hargreaves, William; Hogan, Michael; Jarrett, Robin; Johnson, Robert L; Katon, Wayne J; Lavori, Phillip; McNulty, James P; Niederehe, George; Ryan, Neal; Stuart, Gail; Thomas, Stephen B; Tollefson, Gary D; Vitiello, Benedetto

2002-09-15

As part of the National Institute of Mental Health Strategic Plan for Mood Disorders Research effort, the Clinical Trials and Translation Workgroup was asked to define priorities for clinical trials in mood disorders and for research on how best to translate the results of such research to clinical practice settings. Through two face-to-face meetings and a series of conference calls, we established priorities based on the literature to date and what was known about research currently in progress in this area. We defined five areas of priority that cut across developmental stages, while noting that research on adult mood disorders was at a more advanced stage in each of these areas than research on child or geriatric disorders. The five areas of priority are: 1) maximizing the effectiveness and cost-effectiveness of initial (acute) treatments for mood disorders already known to be efficacious in selected populations and settings when they are applied across all populations and care settings; 2) learning what further treatments or services are most likely to reduce symptoms and improve functioning when the first treatment is delivered well, but the mood disorder does not remit or show adequate improvement; 3) learning what treatments or services are most cost-effective in preventing recurrence or relapse and maintaining optimal functioning after a patient's mood disorder has remitted or responded maximally to treatment; 4) developing and validating clinical, psychosocial, biological, or other markers that predict: a) which treatments are most effective, b) course of illness, c) risk of adverse events/tolerability and acceptability for individual patients or well-defined subgroups of patients; 5) developing clinical trial designs and methods that result in lower research costs and greater generalizability earlier in the treatment development and testing process. A rationale for the importance of each of these priorities is provided.
"Bird in the hand" cash was more effective than prize draws in increasing physician questionnaire response.

PubMed

Drummond, Frances J; O'Leary, Eamonn; O'Neill, Ciaran; Burns, Richeal; Sharp, Linda

2014-02-01

To investigate the effects of two monetary incentives on response rates to postal questionnaires from primary care physicians (PCPs). The PCPs were randomized into three arms (n=550 per arm), namely (1) €5 sent with the questionnaire (cash); (2) entry into a draw on return of completed questionnaire (prize); or (3) no incentive. Effects of incentives on response rates and item nonresponse were examined, as was cost-effectiveness. Response rates were significantly higher in the cash (66.1%; 95% confidence interval [CI]: 61.9, 70.4%) and prize arms (44.8%; 95% CI: 40.1, 49.3%) compared with the no-incentive arm (39.9%; 95% CI: 35.4, 44.3%). Adjusted relative risk of response was 1.17 (95% CI: 1.02, 1.35) and 1.68 (95% CI: 1.48, 1.91) in the prize and cash arms, respectively, compared with the no-incentive group. Costs per completed questionnaire were €9.85, €11.15, and €6.31 for the cash, prize, and no-incentive arms, respectively. Compared with the no-incentive arm, costs per additional questionnaire returned in the cash and prize arms were €14.72 and €37.20, respectively. Both a modest cash incentive and entry into a prize draw were effective in increasing response rates. The cash incentive was most effective and the most cost-effective. Where it is important to maximize response, a modest cash incentive may be cost-effective. Copyright © 2014 Elsevier Inc. All rights reserved.
A concept analysis of optimality in perinatal health.

PubMed

Kennedy, Holly Powell

2006-01-01

This analysis was conducted to describe the concept of optimality and its appropriateness for perinatal health care. The concept was identified in 24 scientific disciplines. Across all disciplines, the universal definition of optimality is the robust, efficient, and cost-effective achievement of best possible outcomes within a rule-governed framework. Optimality, specifically defined for perinatal health care, is the maximal perinatal outcome with minimal intervention placed against the context of the woman's social, medical, and obstetric history.
Agile: From Software to Mission Systems

NASA Technical Reports Server (NTRS)

Trimble, Jay; Shirley, Mark; Hobart, Sarah

2017-01-01

To maximize efficiency and flexibility in Mission Operations System (MOS) design, we are evolving principles from agile and lean methods for software, to the complete mission system. This allows for reduced operational risk at reduced cost, and achieves a more effective design through early integration of operations into mission system engineering and flight system design. The core principles are assessment of capability through demonstration, risk reduction through targeted experiments, early test and deployment, and maturation of processes and tools through use.
Guidelines for antimicrobial prophylaxis.

PubMed

Nahata, M C

1996-08-01

Antimicrobials are frequently used to prevent infections. Principles of prophylaxis, and antimicrobial prophylaxis in surgery, tuberculosis, acquired immunodeficiency syndrome, influenza A, traveller's diarrhoea, malaria, recurrent otitis media, Haemophilus influenzae type b infection, pertussis, rheumatic fever, and urinary tract infection are described. Various strategies to improve the prophylactic use of antibiotics are discussed. Collaborative efforts among health care disciplines are needed to assure optimal antimicrobial prophylaxis. This should maximize efficacy and minimize adverse effects, the development of bacterial resistance and associated costs.
Protein and carbohydrate intake influence sperm number and fertility in male cockroaches, but not sperm viability.

PubMed

Bunning, Harriet; Rapkin, James; Belcher, Laurence; Archer, C Ruth; Jensen, Kim; Hunt, John

2015-03-07

It is commonly assumed that because males produce many, tiny sperm, they are cheap to produce. Recent work, however, suggests that sperm production is not cost-free. If sperm are costly to produce, sperm number and/or viability should be influenced by diet, and this has been documented in numerous species. Yet few studies have examined the exact nutrients responsible for mediating these effects. Here, we quantify the effects of protein (P) and carbohydrate (C) intake on sperm number and viability in the cockroach Nauphoeta cinerea, as well as the consequences for male fertility. We found the intake of P and C influenced sperm number, being maximized at a high intake of diets with a P : C ratio of 1 : 2, but not sperm viability. The nutritional landscapes for male fertility and sperm number were closely aligned, suggesting that sperm number is the major determinant of male fertility in N. cinerea. Under dietary choice, males regulate nutrient intake at a P : C ratio of 1 : 4.95, which is midway between the ratios needed to maximize sperm production and pre-copulatory attractiveness in this species. This raises the possibility that males regulate nutrient intake to balance the trade-off between pre- and post-copulatory traits in this species. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
Defender-Attacker Decision Tree Analysis to Combat Terrorism.

PubMed

Garcia, Ryan J B; von Winterfeldt, Detlof

2016-12-01

We propose a methodology, called defender-attacker decision tree analysis, to evaluate defensive actions against terrorist attacks in a dynamic and hostile environment. Like most game-theoretic formulations of this problem, we assume that the defenders act rationally by maximizing their expected utility or minimizing their expected costs. However, we do not assume that attackers maximize their expected utilities. Instead, we encode the defender's limited knowledge about the attacker's motivations and capabilities as a conditional probability distribution over the attacker's decisions. We apply this methodology to the problem of defending against possible terrorist attacks on commercial airplanes, using one of three weapons: infrared-guided MANPADS (man-portable air defense systems), laser-guided MANPADS, or visually targeted RPGs (rocket propelled grenades). We also evaluate three countermeasures against these weapons: DIRCMs (directional infrared countermeasures), perimeter control around the airport, and hardening airplanes. The model includes deterrence effects, the effectiveness of the countermeasures, and the substitution of weapons and targets once a specific countermeasure is selected. It also includes a second stage of defensive decisions after an attack occurs. Key findings are: (1) due to the high cost of the countermeasures, not implementing countermeasures is the preferred defensive alternative for a large range of parameters; (2) if the probability of an attack and the associated consequences are large, a combination of DIRCMs and ground perimeter control are preferred over any single countermeasure. © 2016 Society for Risk Analysis.
Condition-dependent mate choice: A stochastic dynamic programming approach.

PubMed

Frame, Alicia M; Mills, Alex F

2014-09-01

We study how changing female condition during the mating season and condition-dependent search costs impact female mate choice, and what strategies a female could employ in choosing mates to maximize her own fitness. We address this problem via a stochastic dynamic programming model of mate choice. In the model, a female encounters males sequentially and must choose whether to mate or continue searching. As the female searches, her own condition changes stochastically, and she incurs condition-dependent search costs. The female attempts to maximize the quality of the offspring, which is a function of the female's condition at mating and the quality of the male with whom she mates. The mating strategy that maximizes the female's net expected reward is a quality threshold. We compare the optimal policy with other well-known mate choice strategies, and we use simulations to examine how well the optimal policy fares under imperfect information. Copyright © 2014 Elsevier Inc. All rights reserved.
Distributed-Memory Fast Maximal Independent Set

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

Kanewala Appuhamilage, Thejaka Amila J.; Zalewski, Marcin J.; Lumsdaine, Andrew

The Maximal Independent Set (MIS) graph problem arises in many applications such as computer vision, information theory, molecular biology, and process scheduling. The growing scale of MIS problems suggests the use of distributed-memory hardware as a cost-effective approach to providing necessary compute and memory resources. Luby proposed four randomized algorithms to solve the MIS problem. All those algorithms are designed focusing on shared-memory machines and are analyzed using the PRAM model. These algorithms do not have direct efficient distributed-memory implementations. In this paper, we extend two of Luby’s seminal MIS algorithms, “Luby(A)” and “Luby(B),” to distributed-memory execution, and we evaluatemore » their performance. We compare our results with the “Filtered MIS” implementation in the Combinatorial BLAS library for two types of synthetic graph inputs.« less
An entropy maximization problem related to optical communication

NASA Technical Reports Server (NTRS)

Mceliece, R. J.; Rodemich, E. R.; Swanson, L.

1986-01-01

In relation to a problem in optical communication, the paper considers the general problem of maximizing the entropy of a stationary radom process that is subject to an average transition cost constraint. By using a recent result of Justesen and Hoholdt, an exact solution to the problem is presented and a class of finite state encoders that give a good approximation to the exact solution is suggested.
Planned Missing Data Designs for Research in Cognitive Development

ERIC Educational Resources Information Center

Rhemtulla, Mijke; Little, Todd D.

2012-01-01

Data collection can be the most time- and cost-intensive part of developmental research. This article describes some long-proposed but little-used research designs that have the potential to maximize data quality (reliability and validity) while minimizing research cost. In "planned missing data designs", missing data are used…
Soybean Cultivar Variation in Response to Elevated Ozone Concentration

USDA-ARS?s Scientific Manuscript database

Crop losses to ozone damage are conservatively estimated to cost $1 to $3 billion in the U.S. These costs will rise as surface-level ozone increases over this century. A critical step in maximizing soybean yield in a future of rising tropospheric ozone is identifying variation in cultivar responses,...
Achieving Realistic Energy and Greenhouse Gas Emission Reductions in U.S. Cities

NASA Astrophysics Data System (ADS)

Blackhurst, Michael F.

2011-12-01

In recognizing that energy markets and greenhouse gas emissions are significantly influences by local factors, this research examines opportunities for achieving realistic energy greenhouse gas emissions from U.S. cities through provisions of more sustainable infrastructure. Greenhouse gas reduction opportunities are examined through the lens of a public program administrator charged with reducing emissions given realistic financial constraints and authority over emissions reductions and energy use. Opportunities are evaluated with respect to traditional public policy metrics, such as benefit-cost analysis, net benefit analysis, and cost-effectiveness. Section 2 summarizes current practices used to estimate greenhouse gas emissions from communities. I identify improved and alternative emissions inventory techniques such as disaggregating the sectors reported, reporting inventory uncertainty, and aligning inventories with local organizations that could facilitate emissions mitigation. The potential advantages and challenges of supplementing inventories with comparative benchmarks are also discussed. Finally, I highlight the need to integrate growth (population and economic) and business as usual implications (such as changes to electricity supply grids) into climate action planning. I demonstrate how these techniques could improve decision making when planning reductions, help communities set meaningful emission reduction targets, and facilitate CAP implementation and progress monitoring. Section 3 evaluates the costs and benefits of building energy efficiency are estimated as a means of reducing greenhouse gas emissions in Pittsburgh, PA and Austin, TX. Two policy objectives were evaluated: maximize GHG reductions given initial budget constraints or maximize social savings given target GHG reductions. This approach explicitly evaluates the trade-offs between three primary and often conflicting program design parameters: initial capital constraints, social savings, and GHG reductions. Results suggest uncertainty in local stocks, demands, and efficiency significantly impacts anticipated outcomes. Annual greenhouse gas reductions of 1 ton CO2 eq/capita/yr in Pittsburgh could cost near nothing or over $20 per capita annually. Capital-constrained policies generate slightly less social savings (a present value of a few hundred dollars per capita) than policies that maximize social savings. However, sectors, technologies, and end uses targeted for intervention vary depending on policy objectives and constraints. The optimal efficiency investment strategy for some end uses varies significantly (in excess of 100%) between Pittsburgh and Austin, suggesting that resources and guidance conducted at the national scale may mislead state and local decision-makers. Section 3 then evaluates the impact of rebound effects on modeled efficiency program outcomes. Differential rebound effects across end-uses can change the optimal program design strategy, i.e., the end-uses and technologies targeted for intervention. The rebound effect results suggest that rebound should be integral to effective efficiency program design. Section 4 evaluates the life cycle assessment costs and benefits of the widespread retrofit of green roofs in a typical urban mixed-use neighborhood. Shadow-cost analysis was used to evaluate the cost-effectiveness of green roofs' many benefits. Results suggest green roofs are currently not cost effective on a private cost basis, but multi-family and commercial building green roofs are competitive when social benefits are included. Multifamily and commercial green roofs are also competitive alternatives for reducing greenhouse gases and storm water run-off. However, green roofs are not competitive energy conservation techniques. GHG impacts are dominated by the material production and use phases. Energy impacts are dominated by the use phase, with urban heat island (UHI) impacts being an order of magnitude higher than direct building impacts. Results highlight the importance of clarifying sustainable infrastructure costs and benefits across many public and private organizations (e.g., private building owners, storm water agencies, efficiency stakeholders, and roofing contractors) to identify appropriate incentives and effective program design strategies. Section 5 synthesizes the work and provides guidance for local and state sustainability program administrators. Section 5 highlights the unrealized social benefits associated with sustainability and reflects upon the role of local and state governments in overcoming barriers to achieving more sustainable infrastructure. Section 5 encourages program administrators to consider their local markets for sustainability as influences by resource pricing, weather, infrastructure condition, jurisdiction, and other factors. The differences between sustainability programming and traditional municipal programming are highlighted, namely that sustainability programming often requires self-selection for participation and is subject to new sources of uncertain regarding user behavior, technology breadth and change, and the scope of costs and benefits. These characteristic issues of sustainable infrastructure opportunities provide new challenges to program administrators, requiring new paradigms and support resources. (Abstract shortened by UMI.)
Maximally reliable Markov chains under energy constraints.

PubMed

Escola, Sean; Eisele, Michael; Miller, Kenneth; Paninski, Liam

2009-07-01

Signal-to-noise ratios in physical systems can be significantly degraded if the outputs of the systems are highly variable. Biological processes for which highly stereotyped signal generations are necessary features appear to have reduced their signal variabilities by employing multiple processing steps. To better understand why this multistep cascade structure might be desirable, we prove that the reliability of a signal generated by a multistate system with no memory (i.e., a Markov chain) is maximal if and only if the system topology is such that the process steps irreversibly through each state, with transition rates chosen such that an equal fraction of the total signal is generated in each state. Furthermore, our result indicates that by increasing the number of states, it is possible to arbitrarily increase the reliability of the system. In a physical system, however, an energy cost is associated with maintaining irreversible transitions, and this cost increases with the number of such transitions (i.e., the number of states). Thus, an infinite-length chain, which would be perfectly reliable, is infeasible. To model the effects of energy demands on the maximally reliable solution, we numerically optimize the topology under two distinct energy functions that penalize either irreversible transitions or incommunicability between states, respectively. In both cases, the solutions are essentially irreversible linear chains, but with upper bounds on the number of states set by the amount of available energy. We therefore conclude that a physical system for which signal reliability is important should employ a linear architecture, with the number of states (and thus the reliability) determined by the intrinsic energy constraints of the system.
Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba.

PubMed

Baly, Alberto; Toledo, Maria E; Rodriguez, Karina; Benitez, Juan R; Rodriguez, Maritza; Boelaert, Marleen; Vanlerberghe, Veerle; Van der Stuyft, Patrick

2012-01-01

To assess the economic cost of routine Aedes aegypti control in an at-risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak. The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January-July) and during an outbreak (August-December). Data sources were bookkeeping records, direct observations and interviews. The total economic cost per inhabitant (p.i.) per month. (p.m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p.i. p.m. Incremental costs during the outbreak were mainly incurred by the population and the primary/secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p.i. p.m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0% direct medical, 9.0% direct non-medical and 29.0% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses. Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In-depth studies should assess which mix of activities and actors could maximize the effectiveness and cost-effectiveness of routine Aedes control and dengue prevention. © 2011 Blackwell Publishing Ltd.
Short-Term Effects of Rolling Massage on Energy Cost of Running and Power of the Lower Limbs.

PubMed

Giovanelli, Nicola; Vaccari, Filippo; Floreani, Mirco; Rejc, Enrico; Copetti, Jasmine; Garra, Marco; Biasutti, Lea; Lazzer, Stefano

2018-05-10

Self-myofascial release (SMFR) is a type of self-massage that is becoming popular among athletes. However, SMFR effects on running performance have not been investigated yet. The aim of the present study was to evaluate the effects of SMFR on cost of running (Cr). In addition, we evaluated the effects of SMFR on lower limbs muscle power. The measurement of Cr and lower limb muscle power during squat jump (SJ) and counter movement jump (CMJ) were performed before (PRE), immediately after (POST) and 3hours after (POST 3h) a SMFR protocol (experimental condition). In the "control condition" testing session, the same measurements were performed without undergoing the SMFR protocol. Experimental and control conditions were tested in a randomized order. Cr at POST trended to increase as compared to PRE (+6.2±8.3%, p=0.052), while at POST 3h Cr was restored to PRE values (+0.28±9.5%, p=0.950). In the experimental condition, no significant "Time" effect was observed for maximal power exerted during SJ. On the other hand, maximal power exerted during CMJ at POST and POST 3h was significantly higher than that observed at PRE (+7.9±6.3%, p=0.002; and +10.0±8.7%, p=0.004, respectively). The rate of force development measured during CMJ also increased after SMFR, reaching statistical significance at 200 ms from force onset at POST 3h (+38.9%, p=0.024). an acute use of foam roller for SMFR performed immediately prior to running may negatively affect the endurance running performance, while its use should be added before explosive motor performances that include stretch-shortening cycles.
The optimal imaging strategy for patients with stable chest pain: a cost-effectiveness analysis.

PubMed

Genders, Tessa S S; Petersen, Steffen E; Pugliese, Francesca; Dastidar, Amardeep G; Fleischmann, Kirsten E; Nieman, Koen; Hunink, M G Myriam

2015-04-07

The optimal imaging strategy for patients with stable chest pain is uncertain. To determine the cost-effectiveness of different imaging strategies for patients with stable chest pain. Microsimulation state-transition model. Published literature. 60-year-old patients with a low to intermediate probability of coronary artery disease (CAD). Lifetime. The United States, the United Kingdom, and the Netherlands. Coronary computed tomography (CT) angiography, cardiac stress magnetic resonance imaging, stress single-photon emission CT, and stress echocardiography. Lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. The strategy that maximized QALYs and was cost-effective in the United States and the Netherlands began with coronary CT angiography, continued with cardiac stress imaging if angiography found at least 50% stenosis in at least 1 coronary artery, and ended with catheter-based coronary angiography if stress imaging induced ischemia of any severity. For U.K. men, the preferred strategy was optimal medical therapy without catheter-based coronary angiography if coronary CT angiography found only moderate CAD or stress imaging induced only mild ischemia. In these strategies, stress echocardiography was consistently more effective and less expensive than other stress imaging tests. For U.K. women, the optimal strategy was stress echocardiography followed by catheter-based coronary angiography if echocardiography induced mild or moderate ischemia. Results were sensitive to changes in the probability of CAD and assumptions about false-positive results. All cardiac stress imaging tests were assumed to be available. Exercise electrocardiography was included only in a sensitivity analysis. Differences in QALYs among strategies were small. Coronary CT angiography is a cost-effective triage test for 60-year-old patients who have nonacute chest pain and a low to intermediate probability of CAD. Erasmus University Medical Center.

The economics of stone disease.

PubMed

Canvasser, Noah E; Alken, Peter; Lipkin, Michael; Nakada, Stephen Y; Sodha, Hiren S; Tepeler, Abdulkadir; Lotan, Yair

2017-09-01

The rising prevalence of kidney stone disease is associated with significant costs to healthcare systems worldwide. This is in part due to direct procedural and medical management costs, as well as indirect costs to health systems, patients, and families. A number of manuscripts evaulating the economics of stone disease have been published since the 2008s International Consultation on Stone Disease. These highlight costs associated with stone disease, including acute management, surgical management, and medical management. This work hopes to highlight optimization in care by reducing inefficient treatments and maximizing cost-efficient preventative strategies.
Low cost booster and high performance orbit injection propulsion extended abstract

NASA Technical Reports Server (NTRS)

Sackheim, R. L.

1994-01-01

Space transportation is currently a major element of cost for communications satellite systems. For every dollar spent in manufacturing the satellite, somewhere between 1 and 3 dollars must be spent to launch the satellite into its initial operational orbit. This also makes the weight of the satellite a very critical cost factor because it is important to maximize the useful payload that is placed into orbit to maximize the return on the original investment. It seems apparent then, that tremendous economic advantage for satellite communications systems can be gained from improvements in two key highly leveraged propulsion areas. The first and most important economic improvement can be achieved by significantly lowering the cost of today's launch vehicles. The second gain that would greatly benefit the communications satellite business position is to increase both the useful (payload) weight placed into the orbit and the revenue generating lifetime of the satellite on-orbit. The point of this paper is to first explain that these two goals can best be achieved by cost reduction and performance increasing advancements in rocket propulsion for both the launch vehicle and for the satellite on-board apogee insertion and on-orbit velocity control systems.
Abatement vs. treatment for efficient diffuse source water pollution management in terrestrial-marine systems.

PubMed

Roebeling, P C; Cunha, M C; Arroja, L; van Grieken, M E

2015-01-01

Marine ecosystems are affected by water pollution originating from coastal catchments. The delivery of water pollutants can be reduced through water pollution abatement as well as water pollution treatment. Hence, sustainable economic development of coastal regions requires balancing of the marginal costs from water pollution abatement and/or treatment and the associated marginal benefits from marine resource appreciation. Water pollution delivery reduction costs are, however, not equal across abatement and treatment options. In this paper, an optimal control approach is developed and applied to explore welfare maximizing rates of water pollution abatement and/or treatment for efficient diffuse source water pollution management in terrestrial-marine systems. For the case of diffuse source dissolved inorganic nitrogen water pollution in the Tully-Murray region, Queensland, Australia, (agricultural) water pollution abatement cost, (wetland) water pollution treatment cost and marine benefit functions are determined to explore welfare maximizing rates of water pollution abatement and/or treatment. Considering partial (wetland) treatment costs and positive water quality improvement benefits, results show that welfare gains can be obtained, primarily, through diffuse source water pollution abatement (improved agricultural management practices) and, to a minor extent, through diffuse source water pollution treatment (wetland restoration).
Risk, Issues and Lessons Learned: Maximizing Risk Management in the DoD Ground Domain

DTIC Science & Technology

2011-10-01

Carnegie Mellon University “Risk Management Overview for TACOM” Benefits of Risk Management include: • Risk is a proactive approach - preventing... Chili (no beans) 13 • Hot dog sub-assy Unclassified How does the FMEA work? Execute the analysis and discover the potential failures and effects...34 - --· . -· A c u i.rition Benefits of FMEAs • Prevent major risks, reduce failures, minimize cost and reduce development time - Do it right the first time
Optimizing your options: Extracting the full economic value of transmission when planning under uncertainty

DOE PAGES

Munoz, Francisco D.; Watson, Jean -Paul; Hobbs, Benjamin F.

2015-06-04

In this study, the anticipated magnitude of needed investments in new transmission infrastructure in the U.S. requires that these be allocated in a way that maximizes the likelihood of achieving society's goals for power system operation. The use of state-of-the-art optimization tools can identify cost-effective investment alternatives, extract more benefits out of transmission expansion portfolios, and account for the huge economic, technology, and policy uncertainties that the power sector faces over the next several decades.
In Situ Surveying of Saturn's Rings

NASA Technical Reports Server (NTRS)

Clark, P. E.; Curtis, S. A.; Rilee, M. L.; Cheung, C.

2004-01-01

The Saturn Autonomous Ring Array (SARA) mission concept is a new application for the Autonomous Nano-Technology Swarm (ANTS) architecture, a paradigm being developed for exploration of high surface area and/or multibody targets to minimize costs and maximize effectiveness of survey operations. Systems designed with ANTS architecture are built from potentially very large numbers of highly autonomous, yet socially interactive, specialists, in approximately ten specialist classes. Here, we analyze requirements for such a mission as well as specialized autonomous operations which would support this application.
Effective utilization of clinical laboratories.

PubMed

Murphy, J; Henry, J B

1978-11-01

Effective utilization of clinical laboratories requires that underutilization, overutilization, and malutilization be appreciated and eliminated or reduced. Optimal patient care service, although subjective to a major extent, is reflected in terms of outcome and cost. Increased per diem charges, reduced hospital stay, and increased laboratory workload over the past decade all require each laboratory to examine its internal operations to achieve economy and efficiency as well as maximal effectiveness. Increased research and development, an active managerial role on the part of pathologists, internal self-assessment, and an aggressive response to sophisticated scientific and clinical laboratory data base requirements are not only desirable but essential. The importance of undergraduate and graduate medical education in laboratory medicine to insure understanding as well as effective utilization is stressed. The costs and limitations as well as the accuracy, precision, sensitivity, specificity, and pitfalls of measurements and examinations must also be fully appreciated. Medical malpractice and defensive medicine and the use of critical values, emergency and routine services, and an active clinical role by the pathologist are of the utmost value in assuring effective utilization of the laboratory. A model for the optimal use of the laboratory including economy and efficiency has been achieved in the blood bank in regard to optimal hemotherapy for elective surgery, assuring superior patient care in a cost effective and safe manner.
Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

PubMed Central

Barnes, Andrew J.; Hanoch, Yaniv; Rice, Thomas

2016-01-01

Objective The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions. Study Setting Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. Study Design We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Data Collection Primary data were gathered using an online choice experiment and questionnaire. Principal Findings Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. Conclusions As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers’ decisions. PMID:27028008
Children with suspected craniosynostosis: a cost-effectiveness analysis of diagnostic strategies.

PubMed

Medina, L Santiago; Richardson, Randy R; Crone, Kerry

2002-07-01

Our purpose was to evaluate the clinical and economic impact of three evaluation strategies in children at different risks of craniosynostosis. A decision-analytic and cost-effectiveness model was constructed to compare three evaluation in strategies in children with suspected synostosis: no imaging, radiography (if abnormal, followed by three-dimensional CT [3D CT]), and 3D CT. Three risk groups were analyzed on the basis of the prevalence (pretest probability) of disease: low (completly healthy children; prevalence, 34/100,000), intermediate (healthy children with head deformity; prevalence, 1/115), and high risk (children with syndromic craniofacial disorders [i.e., Crouzon's syndrome or Apert's syndrome]; prevalence, 9-10/10). Test performance (sensitivity and specificity) of the evaluation strategies was obtained from the literature. Costs (not charge) estimates were obtained from the hospital cost-accounting database and from the Medicaid fee schedule. In the low-risk group, the radiographic and 3D CT strategies resulted in a cost per quality-adjusted life year (QALY) gained of more than $560,000. In the intermediate-risk group, the radiographic strategy resulted in a cost per QALY gained of $54,600. Three-dimensional CT was more effective than the two other strategies but at a higher cost-hence, with a cost per QALY gained of $374,200. In the high-risk group, 3D CT was the most effective strategy with a cost per QALY gained of $33,800. Less experienced radiologists and poor-quality studies increased the evaluation cost per QALY gained for all of the risk groups because of decreased effectiveness. Radiologic screening of completely healthy children (low risk) for synostosis is not warranted because of the high cost per QALY gained of the radiographic and 3D CT strategies. In healthy children with head deformity (intermediate risk), the radiographic strategy had a reasonable cost per QALY gained. Three-dimensional CT was more effective but had a high cost per QALY gained. In children with syndromic craniofacial disorders (high risk), 3D CT was the most effective strategy and had a reasonable cost per QALY gained. Selection of children with suspected craniosynostosis based on their risk group and use of the most appropriate evaluation strategy could maximize clinical and economic outcomes for these patients.
Physical health correlates of pathological and healthy dependency in urban women.

PubMed

Porcerelli, John H; Bornstein, Robert F; Markova, Tsveti; Huprich, Steven K

2009-10-01

This study assessed the relationship between dependency and indicators of health/illness, healthcare costs, and utilization. Dependency ratings were obtained using the Relationship Profile Test (Bornstein and Languirand, 2003), a questionnaire that assesses healthy and pathological dependency: destructive overdependence (DO), dysfunctional detachment (DD), and healthy dependency (HD). The sample consisted of primarily low-income, African-American, and female primary care patients (N = 110). DO and DD were significantly associated with indices of increased illness, with DO evidencing slightly larger effect sizes than DD. HD was significantly (negatively) associated with 1 health/illness variable. DD and DO were associated with higher total outpatient costs with DD also being associated with average costs per visit. DO and HD were associated with utilization (increased hospital days and fewer emergency room visits, respectively). Further research is recommended to inform researchers and clinicians about the dependency-illness relationship and to develop interventions that maximize HD and minimize pathological dependency.
Looking Under the Hood of the Cadillac Tax.

PubMed

Glied, Sherry; Striar, Adam

2016-06-01

One effect of the Affordable Care Act's "Cadillac tax" (now delayed until 2020) is to undo part of the existing federal tax preference for employer-sponsored insurance. The specific features of this tax on high-cost health plans--notably, the inclusion of tax-favored savings vehicles such as health savings accounts (HSAs) in the formula for determining who is subject to the tax--are designed primarily to maximize revenue and minimize coverage disruptions, not to reduce health spending. Thus, at least initially, these savings accounts, rather than enrollee cost-sharing or other plan features, are likely to be affected most by the tax as employers act to limit their HSA contributions. Because high earners are the ones benefiting most from tax-preferred accounts, the high-cost plan tax will probably be more progressive than prior analyses have suggested, while having only a modest impact on total health spending.
Bundled Payments in Total Joint Replacement: Keeping Our Care Affordable and High in Quality.

PubMed

McLawhorn, Alexander S; Buller, Leonard T

2017-09-01

The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control. Early results of bundled payments are promising, but preserving access to care for patients with high comorbidity burdens and those requiring more complex care is a lingering concern. Hospitals, regardless of current participation in bundled payments, should develop care pathways for TJA to maximize efficiency and patient safety.
Academic Building Systems. A Technique to Maximize Control of Construction Costs.

ERIC Educational Resources Information Center

Clark, Donald H.

1972-01-01

Academic Building Systems (ABS) is an architectural planning and design method which allows the construction owner to respond to the need for less expensive structures, economically adaptable to the changing conditions of the academic world, by providing the owner with the maximum controls over the variable cost factors in educational facility…
The Enforcer Aircraft Program: A Lower-Cost Alternative Weapon System.

DTIC Science & Technology

1984-03-01

armoured striking forces. NATO’s air forces then, sns 1.select the optimum aircraft(s) to maximize the damage to the enemy while minimizing the cost to...the reascns Congress kept the Enforcer program alive was their inclination to support the underdog , an underdog with persuasiveness and tenacity. To
Flip the tip: an automated, high quality, cost-effective patch clamp screen.

PubMed

Lepple-Wienhues, Albrecht; Ferlinz, Klaus; Seeger, Achim; Schäfer, Arvid

2003-01-01

The race for creating an automated patch clamp has begun. Here, we present a novel technology to produce true gigaseals and whole cell preparations at a high rate. Suspended cells are flushed toward the tip of glass micropipettes. Seal, whole-cell break-in, and pipette/liquid handling are fully automated. Extremely stable seals and access resistance guarantee high recording quality. Data obtained from different cell types sealed inside pipettes show long-term stability, voltage clamp and seal quality, as well as block by compounds in the pM range. A flexible array of independent electrode positions minimizes consumables consumption at maximal throughput. Pulled micropipettes guarantee a proven gigaseal substrate with ultra clean and smooth surface at low cost.
Reservoir Stimulation Optimization with Operational Monitoring for Creation of EGS

DOE Data Explorer

Fernandez, Carlos A.

2013-09-25

EGS field projects have not sustained production at rates greater than ½ of what is needed for economic viability. The primary limitation that makes commercial EGS infeasible is our current inability to cost-effectively create high-permeability reservoirs from impermeable, igneous rock within the 3,000-10,000 ft depth range. Our goal is to develop a novel fracturing fluid technology that maximizes reservoir permeability while reducing stimulation cost and environmental impact. Laboratory equipment development to advance laboratory characterization/monitoring is also a priority of this project to study and optimize the physicochemical properties of these fracturing fluids in a range of reservoir conditions. Barrier G is the primarily intended GTO barrier to be addressed as well as support addressing barriers D, E and I.
Reservoir Stimulation Optimization with Operational Monitoring for Creation of EGS

DOE Data Explorer

Carlos A. Fernandez

2014-09-15

EGS field projects have not sustained production at rates greater than ½ of what is needed for economic viability. The primary limitation that makes commercial EGS infeasible is our current inability to cost-effectively create high-permeability reservoirs from impermeable, igneous rock within the 3,000-10,000 ft depth range. Our goal is to develop a novel fracturing fluid technology that maximizes reservoir permeability while reducing stimulation cost and environmental impact. Laboratory equipment development to advance laboratory characterization/monitoring is also a priority of this project to study and optimize the physicochemical properties of these fracturing fluids in a range of reservoir conditions. Barrier G is the primarily intended GTO barrier to be addressed as well as support addressing barriers D, E and I.
Cooperation in scale-free networks with limited associative capacities

NASA Astrophysics Data System (ADS)

Poncela, Julia; Gómez-Gardeñes, Jesús; Moreno, Yamir

2011-05-01

In this work we study the effect of limiting the number of interactions (the associative capacity) that a node can establish per round of a prisoner’s dilemma game. We focus on the way this limitation influences the level of cooperation sustained by scale-free networks. We show that when the game includes cooperation costs, limiting the associative capacity of nodes to a fixed quantity renders in some cases larger values of cooperation than in the unrestricted scenario. This allows one to define an optimum capacity for which cooperation is maximally enhanced. Finally, for the case without cooperation costs, we find that even a tight limitation of the associative capacity of nodes yields the same levels of cooperation as in the original network.
Quantifying the real-world cost saving from using surgical adjuncts to prevent complications during cataract surgery.

PubMed

Jamison, Aaron; Benjamin, Larry; Lockington, David

2018-06-06

Surgical adjuncts in cataract surgery are often perceived as sometimes necessary, always expensive, particularly in the "lean" cost-saving era. However, prevention of a surgical complication, rather than subsequent management, should always be the preferred strategy. We wished to model real-world costs associated with surgical adjuncts use and test the maxim for cataract surgery-"if you think of it, use it". We compared UK list prices for equipment and related costs of preventing vitreous loss (VL) via use of surgical adjuncts vs its subsequent management in a hypothetical cataract surgery scenario of a white swollen cataract with a moderately dilated pupil. The original surgery costs for the "cautious with adjuncts, no complications" approach was £943.54, including adjuncts costing £137.47. In the "minimalist, no adjunct" scenario, management of VL using the Anterior Vitrectomy Kit cost £142.45, and additional management and follow-up costs resulted in total cost of £1178.20 (£234.66 (25%) more expensive). If left aphakic, an additional operation for secondary iris clip IOL insertion and further follow-up to address the impact of the complication ultimately cost £2124.67 overall. An additional initial spend on surgical adjuncts of £137.47 could potentially prevent £1293.60 (9× increase) in direct costs in this scenario. Through simple scenario modelling, we have demonstrated the cost benefits provided by the use of precautionary surgical adjuncts during cataract surgery. VL costs significantly more in terms of complication management and follow-up. This supports the cataract surgeon's maxim-"if you think of it, use it".
Integrated billing and accounts receivable management system needed to maximize payments and cope with managed care.

PubMed

Sanders, J; Wold, D; Sullivan, T

1999-01-01

The billing and accounts receivable management process in medical practices today has evolved into a multidisciplinary function. This function requires efficient, coordinated performance by physicians and all staff members, from the point of initial patient contact through aggressive follow-up on delinquent payments for services rendered. Offices with deficient or nonexistent billing and accounts receivable management systems typically experience collection ratios that are less than industry norms. They also experience poor cash flow and unnecessary overhead costs. To avoid costly inefficiencies and ensure that it maximizes payments from third-party payors and patients, a medical practice must have an integrated billing and accounts receivable management system that includes components outlined in this article.

Taxi trips distribution modeling based on Entropy-Maximizing theory: A case study in Harbin city-China

NASA Astrophysics Data System (ADS)

Tang, Jinjun; Zhang, Shen; Chen, Xinqiang; Liu, Fang; Zou, Yajie

2018-03-01

Understanding Origin-Destination distribution of taxi trips is very important for improving effects of transportation planning and enhancing quality of taxi services. This study proposes a new method based on Entropy-Maximizing theory to model OD distribution in Harbin city using large-scale taxi GPS trajectories. Firstly, a K-means clustering method is utilized to partition raw pick-up and drop-off location into different zones, and trips are assumed to start from and end at zone centers. A generalized cost function is further defined by considering travel distance, time and fee between each OD pair. GPS data collected from more than 1000 taxis at an interval of 30 s during one month are divided into two parts: data from first twenty days is treated as training dataset and last ten days is taken as testing dataset. The training dataset is used to calibrate model while testing dataset is used to validate model. Furthermore, three indicators, mean absolute error (MAE), root mean square error (RMSE) and mean percentage absolute error (MPAE), are applied to evaluate training and testing performance of Entropy-Maximizing model versus Gravity model. The results demonstrate Entropy-Maximizing model is superior to Gravity model. Findings of the study are used to validate the feasibility of OD distribution from taxi GPS data in urban system.
Pricing behavior of non-profit agencies. The case of blood products.

PubMed

Jacobs, P; Wilder, R P

1984-04-01

In this study we examine the pricing behavior of a non-profit agency, the American National Red Cross blood service units. Two alternative hypotheses are presented: one in which the agency maximizes profits,, and one in which output is maximized subject to a breakeven constraint. Following a general approach developed by Eckstein and Fromm , pricing equations for separate blood products are applied to cross-sectional data from Red Cross blood centers to determine the impact of demand, cost, competition, and subsidy variables. The impact of these variables, in particular the impact of the fixed subsidy on price, is shown to be consistent with the output-maximizing model.
Trading strategies for distribution company with stochastic distributed energy resources

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

Zhang, Chunyu; Wang, Qi; Wang, Jianhui

2016-09-01

This paper proposes a methodology to address the trading strategies of a proactive distribution company (PDISCO) engaged in the transmission-level (TL) markets. A one-leader multi-follower bilevel model is presented to formulate the gaming framework between the PDISCO and markets. The lower-level (LL) problems include the TL day-ahead market and scenario-based real-time markets, respectively with the objectives of maximizing social welfare and minimizing operation cost. The upper-level (UL) problem is to maximize the PDISCO’s profit across these markets. The PDISCO’s strategic offers/bids interactively influence the outcomes of each market. Since the LL problems are linear and convex, while the UL problemmore » is non-linear and non-convex, an equivalent primal–dual approach is used to reformulate this bilevel model to a solvable mathematical program with equilibrium constraints (MPEC). The effectiveness of the proposed model is verified by case studies.« less
Techno-economic analysis of different pretreatment processes for lignocellulosic-based bioethanol production.

PubMed

da Silva, André Rodrigues Gurgel; Torres Ortega, Carlo Edgar; Rong, Ben-Guang

2016-10-01

In this work, a method based on process synthesis, simulation and evaluation has been used to setup and study the industrial scale lignocellulosic bioethanol productions processes. Scenarios for pretreatment processes of diluted acid, liquid hot water and ammonia fiber explosion were studied. Pretreatment reactor temperature, catalyst loading and water content as well as solids loading in the hydrolysis reactor were evaluated regarding its effects on the process energy consumption and bioethanol concentration. The best scenarios for maximizing ethanol concentration and minimizing total annual costs (TAC) were selected and their minimum ethanol selling price was calculated. Ethanol concentration in the range of 2-8% (wt.) was investigated after the pretreatment. The best scenarios maximizing the ethanol concentration and minimizing TAC obtained a reduction of 19.6% and 30.2% respectively in the final ethanol selling price with respect to the initial base case. Copyright © 2016 Elsevier Ltd. All rights reserved.
Quantifying and minimizing entropy generation in AMTEC cells

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

Hendricks, T.J.; Huang, C.

1997-12-31

Entropy generation in an AMTEC cell represents inherent power loss to the AMTEC cell. Minimizing cell entropy generation directly maximizes cell power generation and efficiency. An internal project is on-going at AMPS to identify, quantify and minimize entropy generation mechanisms within an AMTEC cell, with the goal of determining cost-effective design approaches for maximizing AMTEC cell power generation. Various entropy generation mechanisms have been identified and quantified. The project has investigated several cell design techniques in a solar-driven AMTEC system to minimize cell entropy generation and produce maximum power cell designs. In many cases, various sources of entropy generation aremore » interrelated such that minimizing entropy generation requires cell and system design optimization. Some of the tradeoffs between various entropy generation mechanisms are quantified and explained and their implications on cell design are discussed. The relationship between AMTEC cell power and efficiency and entropy generation is presented and discussed.« less
Linking Costs and Survival in the Treatment of Older Adults With Chronic Myeloid Leukemia: An Analysis of SEER-Medicare Data From 1995 to 2007.

PubMed

Lin, Pei-Jung; Winn, Aaron N; Parsons, Susan K; Neumann, Peter J; Weiss, Elisa S; Cohen, Joshua T

2016-04-01

The high prices of chronic myeloid leukemia (CML) therapy are well recognized, but less discussion has focused on the value of health care spending on the disease. This study examined whether the added costs have been "worth" the benefits among older adults with CML. We analyzed trends in health care costs and survival over time of 2164 CML patients over age 65 using the Surveillance, Epidemiology and End Results-Medicare-linked database. We estimated life expectancy over a 15-year duration after diagnosis using a Weibull survival model and projected the corresponding costs using a 2-part model, adjusting for patient characteristics. We estimated population-level survival, total health care costs, and incremental cost-effectiveness ratios (expressed as cost per life year gained) over the period of 1995-2007. We found that therapeutic improvements in the treatment of CML have been associated with survival gains among older adults. Mean life expectancy was 2.2 years in 1995 and increased to 4.2 years in 2007. During the same timeframe, CML care costs have increased, from $127,000 in 1995 to $278,000 in 2007 (2010 dollars), mostly due to increasing tyrosine kinase inhibitor costs. The aggregated incremental cost-effectiveness ratio was $74,000/life year gained. Our findings showed that, despite high costs, CML care may provide reasonable value for money among older patients between 1995-2007. Our study sheds light on the value of health care spending on CML by considering both the costs and the benefits. Future research should investigate strategies to improve treatment adherence to maximize the value of CML care.
Convergence of decision rules for value-based pricing of new innovative drugs.

PubMed

Gandjour, Afschin

2015-04-01

Given the high costs of innovative new drugs, most European countries have introduced policies for price control, in particular value-based pricing (VBP) and international reference pricing. The purpose of this study is to describe how profit-maximizing manufacturers would optimally adjust their launch sequence to these policies and how VBP countries may best respond. To decide about the launching sequence, a manufacturer must consider a tradeoff between price and sales volume in any given country as well as the effect of price in a VBP country on the price in international reference pricing countries. Based on the manufacturer's rationale, it is best for VBP countries in Europe to implicitly collude in the long term and set cost-effectiveness thresholds at the level of the lowest acceptable VBP country. This way, international reference pricing countries would also converge towards the lowest acceptable threshold in Europe.
Structures technology for a new generation of rotorcraft

NASA Technical Reports Server (NTRS)

Bartlett, Felton D., Jr.

1989-01-01

This paper presents an overview of structures research at the U. S. Army Aerostructures Directorate. The objectives of this research are to investigate, explore, and demonstrate emerging technologies that will provide lighter, safer, more survivable, and more cost-effective structures for rotorcraft in the 1990s and beyond. The emphasis of today's R&D is to contribute proven structures technology to the U. S. rotorcraft industry and Army aviation that directly impacts tomorrow's fleet readiness and mission capabilities. The primary contributor toward meeting these challenges is the development of high-strength and durable composites to minimize structural weight while maximizing cost effectiveness. Special aviation issues such as delamination of dynamic components, impact damage to thin skins, crashworthiness, and affordable manufacturing need to be resolved before the full potential of composites technology can be realized. To that end, this paper highlights research into composites structural integrity, crashworthiness, and materials applications which addresses these issues.
Low thrust vehicle concept study

NASA Technical Reports Server (NTRS)

1980-01-01

Low thrust chemical (hydrogen-oxygen) propulsion systems configured specifically for low acceleration orbit transfer of large space systems were defined. Results indicate that it is cost effective and least risk to combine the OTV and stowed spacecraft in a single 65 K Shuttle. The study shows that the engine for an optimized low thrust stage (1) does not require very low thrust; (2) 1-3 K thrust range appears optimum; (3) thrust transient is not a concern; (4) throttling probably not worthwhile; and (5) multiple thrusters complicate OTV/LSS design and aggravate LSS loads. Regarding the optimum vehicle for low acceleration missions, the single shuttle launch (LSS and expendable OTV) is most cost effective and least risky. Multiple shuttles increase diameter 20%. The space based radar structure short OTV (which maximizes space available for packaged LSS) favors use of torus tank. Propellant tank pressures/vapor residuals are little affected by engine thrust level or number of burns.
Cutting Costs.

ERIC Educational Resources Information Center

Kennedy, Mike

2003-01-01

Offers ten suggestions for schools and universities to maximize their budgets: energy upgrades, security technology, maintenance management systems, partnerships, modernized washrooms, windows, facilities assessment, outsourcing, alternative fuels, and building commissioning. (EV)
Dopaminergic Balance between Reward Maximization and Policy Complexity

PubMed Central

Parush, Naama; Tishby, Naftali; Bergman, Hagai

2011-01-01

Previous reinforcement-learning models of the basal ganglia network have highlighted the role of dopamine in encoding the mismatch between prediction and reality. Far less attention has been paid to the computational goals and algorithms of the main-axis (actor). Here, we construct a top-down model of the basal ganglia with emphasis on the role of dopamine as both a reinforcement learning signal and as a pseudo-temperature signal controlling the general level of basal ganglia excitability and motor vigilance of the acting agent. We argue that the basal ganglia endow the thalamic-cortical networks with the optimal dynamic tradeoff between two constraints: minimizing the policy complexity (cost) and maximizing the expected future reward (gain). We show that this multi-dimensional optimization processes results in an experience-modulated version of the softmax behavioral policy. Thus, as in classical softmax behavioral policies, probability of actions are selected according to their estimated values and the pseudo-temperature, but in addition also vary according to the frequency of previous choices of these actions. We conclude that the computational goal of the basal ganglia is not to maximize cumulative (positive and negative) reward. Rather, the basal ganglia aim at optimization of independent gain and cost functions. Unlike previously suggested single-variable maximization processes, this multi-dimensional optimization process leads naturally to a softmax-like behavioral policy. We suggest that beyond its role in the modulation of the efficacy of the cortico-striatal synapses, dopamine directly affects striatal excitability and thus provides a pseudo-temperature signal that modulates the tradeoff between gain and cost. The resulting experience and dopamine modulated softmax policy can then serve as a theoretical framework to account for the broad range of behaviors and clinical states governed by the basal ganglia and dopamine systems. PMID:21603228
Treatment of very early rheumatoid arthritis with symptomatic therapy, disease-modifying antirheumatic drugs, or biologic agents: a cost-effectiveness analysis.

PubMed

Finckh, Axel; Bansback, Nick; Marra, Carlo A; Anis, Aslam H; Michaud, Kaleb; Lubin, Stanley; White, Marc; Sizto, Sonia; Liang, Matthew H

2009-11-03

Long-term control or remission of rheumatoid arthritis (RA) may be possible with very early treatment. However, no optimal first therapeutic strategy has been determined. To assess the potential cost-effectiveness of major therapeutic strategies for very early RA. Decision analytic model with probabilistic sensitivity analyses. Published data, the National Data Bank for Rheumatic Diseases, and actual 2007 hospital costs. U.S. adults with very early RA (symptom duration
Occulting Light Concentrators in Liquid Scintillator Neutrino Detectors

NASA Astrophysics Data System (ADS)

Buizza Avanzini, Margherita; Cabrera, Anatael; Dusini, Stefano; Grassi, Marco; He, Miao; Wu, Wenjie

2017-09-01

The experimental efforts characterizing the era of precision neutrino physics revolve around collecting high-statistics neutrino samples and attaining an excellent energy and position resolution. Next generation liquid-based neutrino detectors, such as JUNO, HyperKamiokande, etc, share the use of a large target mass, and the need of pushing light collection to the edge for maximal calorimetric information. Achieving high light collection implies considerable costs, especially when considering detector masses of several kt. A traditional strategy to maximize the effective photo-coverage with the minimum number of PMTs relies on Light Concentrators (LC), such as Winston Cones. In this paper, the authors introduce a novel concept called Occulting Light Concentrators (OLC), whereby a traditional LC gets tailored to a conventional PMT, by taking into account its single-photoelectron collection efficiency profile and thus occulting the worst performing portion of the photocathode. Thus, the OLC shape optimization takes into account not only the optical interface of the PMT, but also the maximization of the PMT detection performances. The light collection uniformity across the detector is another advantage of the OLC system. By considering the case of JUNO, we will show OLC capabilities in terms of light collection and energy resolution.
Consensus for nonmelanoma skin cancer treatment: basal cell carcinoma, including a cost analysis of treatment methods.

PubMed

Kauvar, Arielle N B; Cronin, Terrence; Roenigk, Randall; Hruza, George; Bennett, Richard

2015-05-01

Basal cell carcinoma (BCC) is the most common cancer in the US population affecting approximately 2.8 million people per year. Basal cell carcinomas are usually slow-growing and rarely metastasize, but they do cause localized tissue destruction, compromised function, and cosmetic disfigurement. To provide clinicians with guidelines for the management of BCC based on evidence from a comprehensive literature review, and consensus among the authors. An extensive review of the medical literature was conducted to evaluate the optimal treatment methods for cutaneous BCC, taking into consideration cure rates, recurrence rates, aesthetic and functional outcomes, and cost-effectiveness of the procedures. Surgical approaches provide the best outcomes for BCCs. Mohs micrographic surgery provides the highest cure rates while maximizing tissue preservation, maintenance of function, and cosmesis. Mohs micrographic surgery is an efficient and cost-effective procedure and remains the treatment of choice for high-risk BCCs and for those in cosmetically sensitive locations. Nonsurgical modalities may be used for low-risk BCCs when surgery is contraindicated or impractical, but the cure rates are lower.
Establishment and outcomes of a model primary care pharmacy service system.

PubMed

Carmichael, Jannet M; Alvarez, Autumn; Chaput, Ryan; DiMaggio, Jennifer; Magallon, Heather; Mambourg, Scott

2004-03-01

The establishment and outcomes of a model primary care pharmacy service system are described. A primary care pharmacy practice model was established at a government health care facility in March 1996. The original objective was to establish a primary pharmacy practice model that would demonstrate improved patient outcomes and maximize the pharmacist's contributions to drug therapy. Since its inception, many improvements have been realized and supported by advanced computer and automated systems, expanded disease state management practices, and unique practitioner and administrative support. Many outcomes studies have been performed on the pharmacist-initiated and -managed clinics, leading to improved patient care and conveying the quality-conscious and cost-effective role pharmacists can play as independent practitioners in this environment. These activities demonstrate cutting-edge leadership in health-system pharmacy. Redesign has been used to improve consistent access to a medication expert and has significantly improved the quality of patient care while easing physicians' workload without increasing health care costs. A system using pharmacists as independent practitioners to promote primary care has achieved high-quality and cost-effective patient care.
The Right to Move: A Multidisciplinary Lifespan Conceptual Framework

PubMed Central

Antonucci, Toni C.; Ashton-Miller, James A.; Brant, Jennifer; Falk, Emily B.; Halter, Jeffrey B.; Hamdemir, Levent; Konrath, Sara H.; Lee, Joyce M.; McCullough, Wayne R.; Persad, Carol C.; Seydel, Roland; Smith, Jacqui; Webster, Noah J.

2012-01-01

This paper addresses the health problems and opportunities that society will face in 2030. We propose a proactive model to combat the trend towards declining levels of physical activity and increasing obesity. The model emphasizes the need to increase physical activity among individuals of all ages. We focus on the right to move and the benefits of physical activity. The paper introduces a seven-level model that includes cells, creature (individual), clan (family), community, corporation, country, and culture. At each level the model delineates how increased or decreased physical activity influences health and well-being across the life span. It emphasizes the importance of combining multiple disciplines and corporate partners to produce a multifaceted cost-effective program that increases physical activity at all levels. The goal of this paper is to recognize exercise as a powerful, low-cost solution with positive benefits to cognitive, emotional, and physical health. Further, the model proposes that people of all ages should incorporate the “right to move” into their life style, thereby maximizing the potential to maintain health and well-being in a cost-effective, optimally influential manner. PMID:23251148
A comparative assessment of the financial costs and carbon benefits of REDD+ strategies in Southeast Asia

NASA Astrophysics Data System (ADS)

Graham, Victoria; Laurance, Susan G.; Grech, Alana; McGregor, Andrew; Venter, Oscar

2016-11-01

REDD+ holds potential for mitigating emissions from tropical forest loss by providing financial incentives for carbon stored in forests, but its economic viability is under scrutiny. The primary narrative raised in the literature is that REDD+ will be of limited utility for reducing forest carbon loss in Southeast Asia, while the level of finance committed falls short of profits from alternative land-use activities in the region, including large-scale timber and oil palm operations. Here we assess the financial costs and carbon benefits of various REDD+ strategies deployed in the region. We find the cost of reducing emissions ranges from 9 to 75 per tonne of avoided carbon emissions. The strategies focused on reducing forest degradation and promoting forest regrowth are the most cost-effective ways of reducing emissions and used in over 60% of REDD+ projects. By comparing the financial costs and carbon benefits of a broader range of strategies than previously assessed, we highlight the variation between different strategies and draw attention to opportunities where REDD+ can achieve maximum carbon benefits cost-effectively. These findings have broad policy implications for Southeast Asia. Until carbon finance escalates, emissions reductions can be maximized from reforestation, reduced-impact logging and investing in improved management of protected areas. Targeting cost-efficient opportunities for REDD+ is important to improve the efficiency of national REDD+ policy, which in-turn fosters greater financial and political support for the scheme.
Efficient design of cluster randomized trials with treatment-dependent costs and treatment-dependent unknown variances.

PubMed

van Breukelen, Gerard J P; Candel, Math J J M

2018-06-10

Cluster randomized trials evaluate the effect of a treatment on persons nested within clusters, where treatment is randomly assigned to clusters. Current equations for the optimal sample size at the cluster and person level assume that the outcome variances and/or the study costs are known and homogeneous between treatment arms. This paper presents efficient yet robust designs for cluster randomized trials with treatment-dependent costs and treatment-dependent unknown variances, and compares these with 2 practical designs. First, the maximin design (MMD) is derived, which maximizes the minimum efficiency (minimizes the maximum sampling variance) of the treatment effect estimator over a range of treatment-to-control variance ratios. The MMD is then compared with the optimal design for homogeneous variances and costs (balanced design), and with that for homogeneous variances and treatment-dependent costs (cost-considered design). The results show that the balanced design is the MMD if the treatment-to control cost ratio is the same at both design levels (cluster, person) and within the range for the treatment-to-control variance ratio. It still is highly efficient and better than the cost-considered design if the cost ratio is within the range for the squared variance ratio. Outside that range, the cost-considered design is better and highly efficient, but it is not the MMD. An example shows sample size calculation for the MMD, and the computer code (SPSS and R) is provided as supplementary material. The MMD is recommended for trial planning if the study costs are treatment-dependent and homogeneity of variances cannot be assumed. © 2018 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.
A Golden Opportunity to Review Higher Education Retiree Health Benefits

ERIC Educational Resources Information Center

Powers, Ed; Straker, Garry

2004-01-01

Many higher education institutions today are struggling with the costs of their retiree health plans. The answer to controlling these costs may come in the form of a defined contribution retiree health plan for both current and future retirees. This article examines how such a plan can maximize availability of Medicare Part D prescription…
Adoption of Emissions Abating Technologies by U.S. Electricity Producing Firms Under the SO2 Emission Allowance Market

NASA Astrophysics Data System (ADS)

Creamer, Gregorio Bernardo

The objective of this research is to determine the adaptation strategies that coal-based, electricity producing firms in the United States utilize to comply with the emission control regulations imposed by the SO2 Emissions Allowance Market created by the Clean Air Act Amendment of 1990, and the effect of market conditions on the decision making process. In particular, I take into consideration (1) the existence of carbon contracts for the provision of coal that may a affect coal prices at the plant level, and (2) local and geographical conditions, as well as political arrangements that may encourage firms to adopt strategies that appear socially less efficient. As the electricity producing sector is a regulated sector, firms do not necessarily behave in a way that maximizes the welfare of society when reacting to environmental regulations. In other words, profit maximization actions taken by the firm do not necessarily translate into utility maximization for society. Therefore, the environmental regulator has to direct firms into adopting strategies that are socially efficient, i.e., that maximize utility. The SO 2 permit market is an instrument that allows each firm to reduce marginal emissions abatement costs according to their own production conditions and abatement costs. Companies will be driven to opt for a cost-minimizing emissions abatement strategy or a combination of abatement strategies when adapting to new environmental regulations or markets. Firms may adopt one or more of the following strategies to reduce abatement costs while meeting the emission constraints imposed by the SO2 Emissions Allowance Market: (1) continue with business as usual on the production site while buying SO2 permits to comply with environmental regulations, (2) switch to higher quality, lower sulfur coal inputs that will generate less SO2 emissions, or (3) adopting new emissions abating technologies. A utility optimization condition is that the marginal value of each input should be equal to the product generated by using it and to the activities that are required by new regulations. The comparative technological and scale efficiency factors of coal-based electricity producing plants are calculated using the Data Envelopment Analysis (DEA) framework, and used as proxies to test this condition. In the empirical analysis, econometric models of the response of firms to emissions control are analyzed around the following aspects: (1) characterization of the behavior of firms and their efficiency, (2) relevant variables that trigger the adoption of technology, that is, the acquisition of scrubbers , and (3) the influence of exogenous variables, such as the existence of contracts, distance from mine to plant, and local conditions of the region where plants are located.

CPV performance versus soiling effects: Cleaning policies

NASA Astrophysics Data System (ADS)

Sanchez, D.; Trujillo, P.; Martinez, M.; Ferrer, J. P.; Rubio, F.

2012-10-01

In order to improve the performance of the CPV Plants in a cost effective way it is important to define the best cleaning policies, analyzing the effect of soiling in the surface of CPV modules. The energy generation of a CPV technology based in Fresnel Lens improves up to 7% when the surface of the module is cleaned. Some experimental measurements have been carried out over CPV modules and a model has been defined to analyze what is the best cleaning policy for that Technology in Puertollano. The power losses because of soiling and the critical time until the power losses stabilizes are obtained from the measurements; they are used as an input for the simulation. Using an established cleaning cost and the feeding tariff from Spain in 2007 it has been obtained that cleaning only reports a profit during the summer. The conclusion of the work is that the cleaning tasks have to be carefully planned together with the meteorological forecast in order to maximize the investment made in the cleaning.
Recruitment of Individuals With Dementia and Their Carers for Social Research: Lessons Learned From Nine Studies.

PubMed

Beattie, Elizabeth; Fielding, Elaine; O'Reilly, Maria; Brooks, Deborah; MacAndrew, Margaret; McCrow, Judy

2018-05-01

Many health and social care research studies report difficulties recruiting sufficient numbers of participants, adding to time and money expenditures and potentially jeopardizing the generalizability of findings. The current article reports the effectiveness and resource requirements of recruitment strategies used in nine dementia-related studies conducted in Australia. Articles, notices, or advertisements in targeted specialist newsletters were the most cost-effective method of recruitment. The use of service providers to aid recruitment yielded mixed results, but was lengthy in terms of research time. Online and social media were low cost but not reliably effective in terms of recruitment potential. Despite using multiple strategies to maximize recruitment, significant challenges were encountered achieving the required sample sizes; in most cases these challenges resulted in delays in the recruitment phase. Implications for researchers in the fields of dementia and general social/health research are discussed. [Res Gerontol Nurs. 2018; 11(3):119-128.]. Copyright 2018, SLACK Incorporated.
Planning for human papillomavirus (HPV) vaccination in sub-Saharan Africa: a modeling-based approach.

PubMed

Tracy, J Kathleen; Schluterman, Nicholas H; Greene, Christina; Sow, Samba O; Gaff, Holly D

2014-05-30

Human papillomavirus (HPV) vaccines have the potential to reduce cervical cancer incidence and mortality, particularly in the parts of the developing world that bear the greatest burden of disease. This research sought to predict the impact and cost-effectiveness of an HPV vaccination program in an example low-resource country with a high burden of cervical cancer: Mali, West Africa. Novel compartmental mathematical models projected the impact of adolescent HPV vaccination in urban and rural areas of Mali. The models accounted for two high-risk vaccine-types: HPV 16 and 18. We then attached comprehensive real cost and cost-effectiveness estimates. Our models predict that HPV vaccination in Mali will reduce cervical cancer burden by a factor roughly equal to vaccine coverage. A point vaccination program was simulated in a cohort of 333,146 urban and 588,982 rural Malian women, age 10-14. Vaccination of 50% of girls reduced the peak prevalence of HPV 16/18 to 5.0% in the urban setting and 9.6% in the rural setting, down from 11.7% and 22.0%, respectively, with no vaccination. The 50% vaccination scenario averted 1145 cervical cancer deaths in the urban group and 2742 in the rural group. The cost per discounted life-year saved in this scenario was 1030 US dollars (urban) and 725 dollars (rural). The cost per life-year saved was higher at 90% coverage, but was still in the range of a "cost-effective" public health intervention. This research yielded the most comprehensive real cost estimates of HPV vaccination yet published for sub-Saharan Africa. Our models indicate that HPV vaccination in Mali will be cost-effective when introduced. To maximize the benefit using limited resources, vaccination programs may begin with a target coverage of about 50%. We anticipate that costs of reaching late adopters after the First Vaccinated Wave of vaccination will be higher, but worthwhile. Copyright © 2014 Elsevier Ltd. All rights reserved.
Pricing the Services in Dynamic Environment: Agent Pricing Model

NASA Astrophysics Data System (ADS)

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

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

PubMed

Antoñanzas, Fernando; Rodríguez-Ibeas, Roberto

2011-07-20

In this paper, we carry out a theoretical analysis of the strategic choice made by firms regarding the type of food they market when they face consumers who care about the healthy/unhealthy attributes of the product but incur in emotional/health costs when the food they consume has unhealthy attributes. We consider a two-stage game. In the first stage, one of the firms chooses the unhealthy content of its product. In the second stage, both firms simultaneously decide their prices. We find that, depending on the parameters of the model, product differentiation can be maximal or less than maximal. The firm that produces the unhealthy food charges a higher price and obtains a larger share of the market unless the emotional/health costs and the unhealthy food production costs are relatively high. We also find that educational campaigns will not always reduce the demand for the unhealthy food or the degree of the unhealthy attribute.JEL Classification:I10, I18, L11.
Healthy vs. unhealthy food: a strategic choice for firms and consumers

PubMed Central

2011-01-01

In this paper, we carry out a theoretical analysis of the strategic choice made by firms regarding the type of food they market when they face consumers who care about the healthy/unhealthy attributes of the product but incur in emotional/health costs when the food they consume has unhealthy attributes. We consider a two-stage game. In the first stage, one of the firms chooses the unhealthy content of its product. In the second stage, both firms simultaneously decide their prices. We find that, depending on the parameters of the model, product differentiation can be maximal or less than maximal. The firm that produces the unhealthy food charges a higher price and obtains a larger share of the market unless the emotional/health costs and the unhealthy food production costs are relatively high. We also find that educational campaigns will not always reduce the demand for the unhealthy food or the degree of the unhealthy attribute. JEL Classification:I10, I18, L11 PMID:22828271
Shifting orders among suppliers considering risk, price and transportation cost

NASA Astrophysics Data System (ADS)

Revitasari, C.; Pujawan, I. N.

2018-04-01

Supplier order allocation is an important supply chain decision for an enterprise. It is related to the supplier’s function as a raw material provider and other supporting materials that will be used in production process. Most of works on order allocation has been based on costs and other supply chain performance, but very limited of them taking risks into consideration. In this paper we address the problem of order allocation of a single commodity sourced from multiple suppliers considering supply risks in addition to the attempt of minimizing transportation costs. The supply chain risk was investigated and a procedure was proposed in the risk mitigation phase as a form of risk profile. The objective including risk profile in order allocation is to maximize the product flow from a risky supplier to a relatively less risky supplier. The proposed procedure is applied to a sugar company. The result suggests that order allocations should be maximized to suppliers that have a relatively low risk and minimized to suppliers that have a relatively larger risks.
Optimization of Adaptive Intraply Hybrid Fiber Composites with Reliability Considerations

NASA Technical Reports Server (NTRS)

Shiao, Michael C.; Chamis, Christos C.

1994-01-01

The reliability with bounded distribution parameters (mean, standard deviation) was maximized and the reliability-based cost was minimized for adaptive intra-ply hybrid fiber composites by using a probabilistic method. The probabilistic method accounts for all naturally occurring uncertainties including those in constituent material properties, fabrication variables, structure geometry, and control-related parameters. Probabilistic sensitivity factors were computed and used in the optimization procedures. For actuated change in the angle of attack of an airfoil-like composite shell structure with an adaptive torque plate, the reliability was maximized to 0.9999 probability, with constraints on the mean and standard deviation of the actuation material volume ratio (percentage of actuation composite material in a ply) and the actuation strain coefficient. The reliability-based cost was minimized for an airfoil-like composite shell structure with an adaptive skin and a mean actuation material volume ratio as the design parameter. At a O.9-mean actuation material volume ratio, the minimum cost was obtained.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Tom, Nathan M.; Madhi, Farshad; Yeung, Ronald W.

The aim of this paper is to maximize the power-to-load ratio of the Berkeley Wedge: a one-degree-of-freedom, asymmetrical, energy-capturing, floating breakwater of high performance that is relatively free of viscosity effects. Linear hydrodynamic theory was used to calculate bounds on the expected time-averaged power (TAP) and corresponding surge restraining force, pitch restraining torque, and power take-off (PTO) control force when assuming that the heave motion of the wave energy converter remains sinusoidal. This particular device was documented to be an almost-perfect absorber if one-degree-of-freedom motion is maintained. The success of such or similar future wave energy converter technologies would requiremore » the development of control strategies that can adapt device performance to maximize energy generation in operational conditions while mitigating hydrodynamic loads in extreme waves to reduce the structural mass and overall cost. This paper formulates the optimal control problem to incorporate metrics that provide a measure of the surge restraining force, pitch restraining torque, and PTO control force. The optimizer must now handle an objective function with competing terms in an attempt to maximize power capture while minimizing structural and actuator loads. A penalty weight is placed on the surge restraining force, pitch restraining torque, and PTO actuation force, thereby allowing the control focus to be placed either on power absorption or load mitigation. Thus, in achieving these goals, a per-unit gain in TAP would not lead to a greater per-unit demand in structural strength, hence yielding a favorable benefit-to-cost ratio. Demonstrative results in the form of TAP, reactive TAP, and the amplitudes of the surge restraining force, pitch restraining torque, and PTO control force are shown for the Berkeley Wedge example.« less
Balancing Power Absorption and Structural Loading for an Asymmetric Heave Wave-Energy Converter in Regular Waves

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

Tom, Nathan M.; Madhi, Farshad; Yeung, Ronald W.

2016-06-24

The aim of this paper is to maximize the power-to-load ratio of the Berkeley Wedge: a one-degree-of-freedom, asymmetrical, energy-capturing, floating breakwater of high performance that is relatively free of viscosity effects. Linear hydrodynamic theory was used to calculate bounds on the expected time-averaged power (TAP) and corresponding surge restraining force, pitch restraining torque, and power take-off (PTO) control force when assuming that the heave motion of the wave energy converter remains sinusoidal. This particular device was documented to be an almost-perfect absorber if one-degree-of-freedom motion is maintained. The success of such or similar future wave energy converter technologies would requiremore » the development of control strategies that can adapt device performance to maximize energy generation in operational conditions while mitigating hydrodynamic loads in extreme waves to reduce the structural mass and overall cost. This paper formulates the optimal control problem to incorporate metrics that provide a measure of the surge restraining force, pitch restraining torque, and PTO control force. The optimizer must now handle an objective function with competing terms in an attempt to maximize power capture while minimizing structural and actuator loads. A penalty weight is placed on the surge restraining force, pitch restraining torque, and PTO actuation force, thereby allowing the control focus to be placed either on power absorption or load mitigation. Thus, in achieving these goals, a per-unit gain in TAP would not lead to a greater per-unit demand in structural strength, hence yielding a favorable benefit-to-cost ratio. Demonstrative results in the form of TAP, reactive TAP, and the amplitudes of the surge restraining force, pitch restraining torque, and PTO control force are shown for the Berkeley Wedge example.« less
Maximizing mitigation benefits : project summary.

DOT National Transportation Integrated Search

2016-04-30

The research team: : - Reviewed methods, techniques, and : processes at select state DOTs for estimating : mitigations costs for the following states: : Arizona, California, Colorado, Florida, New : York, North Carolina, Ohio, Oregon, : Pennsylvania,...
Optimized flexible cover films for improved conversion efficiency in thin film flexible solar cells

NASA Astrophysics Data System (ADS)

Guterman, Sidney; Wen, Xin; Gudavalli, Ganesh; Rhajbhandari, Pravakar; Dhakal, Tara P.; Wilt, David; Klotzkin, David

2018-05-01

Thin film solar cell technologies are being developed for lower cost and flexible applications. For such technologies, it is desirable to have inexpensive, flexible cover strips. In this paper, we demonstrate that transparent silicone cover glass adhesive can be doped with TiO2 nanoparticles to achieve an optimal refractive index and maximize the performance of the cell. Cells covered with the film doped with nanoparticles at the optimal concentration demonstrated a ∼1% increase in photocurrent over the plain (undoped) film. In addition, fused silica beads can be incorporated into the flexible cover slip to realize a built-in pseudomorphic glass diffuser layer as well. This additional degree of freedom in engineering flexible solar cell covers allows maximal performance from a given cell for minimal increased cost.
Hamilton's rule, inclusive fitness maximization, and the goal of individual behaviour in symmetric two-player games.

PubMed

Okasha, S; Martens, J

2016-03-01

Hamilton's original work on inclusive fitness theory assumed additivity of costs and benefits. Recently, it has been argued that an exact version of Hamilton's rule for the spread of a pro-social allele (rb > c) holds under nonadditive pay-offs, so long as the cost and benefit terms are defined as partial regression coefficients rather than pay-off parameters. This article examines whether one of the key components of Hamilton's original theory can be preserved when the rule is generalized to the nonadditive case in this way, namely that evolved organisms will behave as if trying to maximize their inclusive fitness in social encounters. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.
Cardiac output and performance during a marathon race in middle-aged recreational runners.

PubMed

Billat, Véronique L; Petot, Hélène; Landrain, Morgan; Meilland, Renaud; Koralsztein, Jean Pierre; Mille-Hamard, Laurence

2012-01-01

Despite the increasing popularity of marathon running, there are no data on the responses of stroke volume (SV) and cardiac output (CO) to exercise in this context. We sought to establish whether marathon performance is associated with the ability to sustain high fractional use of maximal SV and CO (i.e, cardiac endurance) and/or CO, per meter (i.e., cardiac cost). We measured the SV, heart rate (HR), CO, and running speed of 14 recreational runners in an incremental, maximal laboratory test and then during a real marathon race (mean performance: 3 hr 30 min ± 45 min). Our data revealed that HR, SV and CO were all in a high but submaximal steady state during the marathon (87.0 ± 1.6%, 77.2 ± 2.6%, and 68.7 ± 2.8% of maximal values, respectively). Marathon performance was inversely correlated with an upward drift in the CO/speed ratio (mL of CO × m(-1)) (r = -0.65, P < 0.01) and positively correlated with the runner's ability to complete the race at a high percentage of the speed at maximal SV (r = 0.83, P < 0.0002). Our results showed that marathon performance is inversely correlated with cardiac cost and positively correlated with cardiac endurance. The CO response could be a benchmark for race performance in recreational marathon runners.
Drilling cost-cutting

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

Capuano, L.E. Jr.

This presentation by Louis E. Capuano, Jr., President, ThermaSource, Inc., discusses cost-cutting in the drilling phase of geothermal energy exploration and production. All aspects of a geothermal project including the drilling must be streamlined to make it viable and commercial. If production could be maximized from each well, there would be a reduction in drilling costs. This could be achieved in several ways, including big hole and multi-hole completion, directional drilling, better knowledge of the resource and where to penetrate, etc.
Neural Basis of Empathy and Its Dysfunction in Autism Spectrum Disorders (ASD)

DTIC Science & Technology

2012-08-01

donation behavior in rhesus monkeys when there is no perceived cost to self. These findings potentially implicate shared neural mechanisms and validate the...egalitarian and monogamous ones, like prairie voles and humans, when there is no perceived cost to self. These findings potentially implicate shared neural...maximally self-regarding in this context in the absence of OT. Thus, OT robustly enhanced prosocial choices when there was no potential cost to self, but
Sex differences in metabolic rates in field crickets and their dipteran parasitoids.

PubMed

Kolluru, G R; Chappell, M A; Zuk, M

2004-11-01

Sex differences in metabolic rate (MR) can result from dimorphism in the performance of energetically demanding activities. Male crickets (Teleogryllus oceanicus) engage in costly calling and aggressive activity not performed by females. Consistent with this difference, we found higher maximal MR, factorial scope, and fat content in males than females. T. oceanicus song is also costly because it attracts the parasitoid fly Ormia ochracea. Parasitized crickets had reduced maximal MR consistent with a metabolic cost to harboring larvae. This cost was greater for females, either because females invest more heavily into reproduction at the expense of metabolic capacity, or because males are under stronger selection to respond to infection. Little is known about O. ochracea outside of its auditory system and parasitic lifestyle. We observed greater resting MR in male flies, possibly reflecting a sex difference in the requirement for metabolic power output, because male flies perform potentially costly mating behavior not seen in females. We found a positive relationship between larval density within a cricket and pupal resting MR, suggesting that crickets in good condition are able to both harbor more larvae and produce larvae with higher resting MR. These results reveal a complex interplay between the metabolism of crickets and their fly parasitoids.
Impact of target organ damage assessment in the evaluation of global risk in patients with essential hypertension.

PubMed

Viazzi, Francesca; Leoncini, Giovanna; Parodi, Denise; Ratto, Elena; Vettoretti, Simone; Vaccaro, Valentina; Parodi, Angelica; Falqui, Valeria; Tomolillo, Cinzia; Deferrari, Giacomo; Pontremoli, Roberto

2005-03-01

Accurate assessment of cardiovascular risk is a key step toward optimizing the treatment of hypertensive patients. We analyzed the impact and cost-effectiveness of routine, thorough assessment of target organ damage (TOD) in evaluating risk profile in hypertension. A total of 380 never-treated patients with essential hypertension underwent routine work-up plus evaluation of albuminuria and ultrasonography of cardiac and vascular structures. The impact of these tests on risk stratification, as indicated by European Society of Hypertension-European Society of Cardiology guidelines, was assessed in light of their cost and sensitivity. The combined use of all of these tests greatly improved the detection of TOD, therefore leading to the identification of a higher percentage of patients who were at high/very high risk, as compared with those who were detected by routine clinical work-up (73% instead of 42%; P < 0.0001). Different signs of TOD only partly cluster within the same subgroup of patients; thus, all three tests should be performed to maximize the sensitivity of the evaluation process. The diagnostic algorithm yielding the lowest cost per detected case of TOD is the search for microalbuminuria, followed by echocardiography and then carotid ultrasonography. Adopting lower cut-off values to define microalbuminuria allows us to optimize further the cost-effectiveness of diagnostic algorithms. In conclusion, because of its low cost and widespread availability, measuring albuminuria is an attractive and cost-effective screening test that is especially suitable as the first step in the large-scale diagnostic work-up of hypertensive patients.
The production economics of nursing: a discussion paper.

PubMed

Newbold, David

2008-01-01

Nursing is numerically the largest health profession providing direct care, and this, plus the imperative for effective cost control, makes their costs and impact a legitimate study focus and policy target. Production theory techniques can help nurse executives maximize outcome and minimize costs, yet little of such evidence currently exists in mainstream nursing workforce research. The balance of available evidence supports an inverse association between nurse staffing levels and adverse outcomes. However, 'adequate' staffing levels may be perceived as expensive and some providers may try to reduce them. The response, in some US and Australian states, is legislation to force hospitals to implement mandatory minimum patient-to-nurse (P/N) ratios. In this paper, existing data from Aiken et al. [2003. Education levels of hospital nurses and patient mortality. Journal of the American Medical Association 290, 1617-1623] is re-interpreted using production theory, to illustrate the possible relationship between two key workforce variables "Staff Level" and "Staff Mix", and clinical outcome, and show how this informs decision making. Consistent with other studies, this suggests that diminishing returns to each variable exist. This preliminary analysis suggests that increasing the number of graduate RNs in the workforce might be the most cost-effective way to expand the nursing workforce. However, more detailed and rigorous research is needed to estimate speciality specific cost and production functions and compute the optimal solution. This can predict the most cost-effective staff combination for a set outcome, or the set of inputs yielding best outcome for a given budget. With this, nurse executives can systematically maintain service quality or safety in the most economical way.
Demonstrating the cost effectiveness of an expert occupational and environmental health nurse: application of AAOHN's success tools. American Association of Occupational Health Nurses.

PubMed

Morris, J A; Smith, P S

2001-12-01

According to DiBenedetto, "Occupational health nurses enhance and maximize the health, safety, and productivity of the domestic and global work force" (1999b). This project clearly defined the multiple roles and activities provided by an occupational and environmental health nurse and assistant, supported by a part time contract occupational health nurse. A well defined estimate of the personnel costs for each of these roles is helpful both in demonstrating current value and in future strategic planning for this department. The model highlighted both successes and a business cost savings opportunity for integrated disability management. The AAOHN's Success Tools (1998) were invaluable in launching the development of this cost effectiveness model. The three methods were selected from several tools of varying complexities offered. Collecting available data to develop these metrics required internal consultation with finance, human resources, and risk management, as well as communication with external health, safety, and environmental providers in the community. Benchmarks, surveys, and performance indicators can be found readily in the literature and online. The primary motivation for occupational and environmental health nurses to develop cost effectiveness analyses is to demonstrate the value and worth of their programs and services. However, it can be equally important to identify which services are not cost effective so knowledge and skills may be used in ways that continue to provide value to employers (AAOHN, 1996). As evidence based health care challenges the occupational health community to demonstrate business rationale and financial return on investment, occupational and environmental health nurses must meet that challenge if they are to define their preferred future (DiBenedetto, 2000).

A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

PubMed

Garrison, Louis P; Neumann, Peter J; Willke, Richard J; Basu, Anirban; Danzon, Patricia M; Doshi, Jalpa A; Drummond, Michael F; Lakdawalla, Darius N; Pauly, Mark V; Phelps, Charles E; Ramsey, Scott D; Towse, Adrian; Weinstein, Milton C

2018-02-01

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
A simulation model for designing effective interventions in early childhood caries.

PubMed

Hirsch, Gary B; Edelstein, Burton L; Frosh, Marcy; Anselmo, Theresa

2012-01-01

Early childhood caries (ECC)--tooth decay among children younger than 6 years--is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effect in reducing caries experience and cost in a population of children aged birth to 5 years. System dynamics is a computer simulation technique useful to policy makers in choosing the most appropriate interventions for their populations. This study of Colorado preschool children models 6 categories of ECC intervention--applying fluorides, limiting cariogenic bacterial transmission from mothers to children, using xylitol directly with children, clinical treatment, motivational interviewing, and combinations of these--to compare their relative effect and cost. The model projects 10-year intervention costs ranging from $6 million to $245 million and relative reductions in cavity prevalence ranging from none to 79.1% from the baseline. Interventions targeting the youngest children take 2 to 4 years longer to affect the entire population of preschool-age children but ultimately exert a greater benefit in reducing ECC; interventions targeting the highest-risk children provide the greatest return on investment, and combined interventions that target ECC at several stages of its natural history have the greatest potential for cavity reduction. Some interventions save more in dental repair than their cost; all produce substantial reductions in repair cost. By using data relevant to any geographic area, this system model can provide policy makers with information to maximize the return on public health and clinical care investments.
Informed actions: where to cost effectively manage multiple threats to species to maximize return on investment.

PubMed

Auerbach, Nancy A; Tulloch, Ayesha I T; Possingham, Hugh P

Conservation practitioners, faced with managing multiple threats to biodiversity and limited funding, must prioritize investment in different management actions. From an economic perspective, it is routine practice to invest where the highest rate of return is expected. This return-on-investment (ROI) thinking can also benefit species conservation, and researchers are developing sophisticated approaches to support decision-making for cost-effective conservation. However, applied use of these approaches is limited. Managers may be wary of “black-box” algorithms or complex methods that are difficult to explain to funding agencies. As an alternative, we demonstrate the use of a basic ROI analysis for determining where to invest in cost-effective management to address threats to species. This method can be applied using basic geographic information system and spreadsheet calculations. We illustrate the approach in a management action prioritization for a biodiverse region of eastern Australia. We use ROI to prioritize management actions for two threats to a suite of threatened species: habitat degradation by cattle grazing, and predation by invasive red foxes (Vulpes vulpes). We show how decisions based on cost-effective threat management depend upon how expected benefits to species are defined and how benefits and costs co-vary. By considering a combination of species richness, restricted habitats, species vulnerability, and costs of management actions, small investments can result in greater expected benefit compared with management decisions that consider only species richness. Furthermore, a landscape management strategy that implements multiple actions is more efficient than managing only for one threat, or more traditional approaches that don't consider ROI. Our approach provides transparent and logical decision support for prioritizing different actions intended to abate threats associated with multiple species; it is of use when managers need a justifiable and repeatable approach to investment.
Using Length of Stay to Control for Unobserved Heterogeneity When Estimating Treatment Effect on Hospital Costs with Observational Data: Issues of Reliability, Robustness, and Usefulness.

PubMed

May, Peter; Garrido, Melissa M; Cassel, J Brian; Morrison, R Sean; Normand, Charles

2016-10-01

To evaluate the sensitivity of treatment effect estimates when length of stay (LOS) is used to control for unobserved heterogeneity when estimating treatment effect on cost of hospital admission with observational data. We used data from a prospective cohort study on the impact of palliative care consultation teams (PCCTs) on direct cost of hospital care. Adult patients with an advanced cancer diagnosis admitted to five large medical and cancer centers in the United States between 2007 and 2011 were eligible for this study. Costs were modeled using generalized linear models with a gamma distribution and a log link. We compared variability in estimates of PCCT impact on hospitalization costs when LOS was used as a covariate, as a sample parameter, and as an outcome denominator. We used propensity scores to account for patient characteristics associated with both PCCT use and total direct hospitalization costs. We analyzed data from hospital cost databases, medical records, and questionnaires. Our propensity score weighted sample included 969 patients who were discharged alive. In analyses of hospitalization costs, treatment effect estimates are highly sensitive to methods that control for LOS, complicating interpretation. Both the magnitude and significance of results varied widely with the method of controlling for LOS. When we incorporated intervention timing into our analyses, results were robust to LOS-controls. Treatment effect estimates using LOS-controls are not only suboptimal in terms of reliability (given concerns over endogeneity and bias) and usefulness (given the need to validate the cost-effectiveness of an intervention using overall resource use for a sample defined at baseline) but also in terms of robustness (results depend on the approach taken, and there is little evidence to guide this choice). To derive results that minimize endogeneity concerns and maximize external validity, investigators should match and analyze treatment and comparison arms on baseline factors only. Incorporating intervention timing may deliver results that are more reliable, more robust, and more useful than those derived using LOS-controls. © Health Research and Educational Trust.
End-of-Life Care Interventions: An Economic Analysis

PubMed Central

Pham, B; Krahn, M

2014-01-01

Background The annual cost of providing care for patients in their last year of life is estimated to account for approximately 9% of the Ontario health care budget. Access to integrated, comprehensive support and pain/symptom management appears to be inadequate and inequitable. Objective To evaluate the cost-effectiveness of end-of-life (EoL) care interventions included in the EoL care mega-analysis. Data Sources Multiple sources were used, including systematic reviews, linked health administration databases, survey data, planning documents, expert input, and additional literature searches. Review Methods We conducted a literature review of cost-effectiveness studies to inform the primary economic analysis. We conducted the primary economic analysis and budget impact analysis for an Ontario cohort of decedents and their families and included interventions pertaining to team-based models of care, patient care planning discussions, educational interventions for patients and caregivers, and supportive interventions for informal caregivers. The time horizon was the last year of life. Costs were in 2013 Canadian dollars. Effectiveness measures included days at home, percentage dying at home, and quality-adjusted life-days. We developed a Markov model; model inputs were obtained from a cohort of Ontario decedents assembled from Institute for Clinical Evaluative Sciences databases and published literature. Results In-home palliative team care was cost-effective; it increased the chance of dying at home by 10%, increased the average number of days at home (6 days) and quality-adjusted life-days (0.5 days), and it reduced costs by approximately $4,400 per patient. Expanding in-home palliative team care to those currently not receiving such services (approximately 45,000 per year, at an annual cost of $76–108 million) is likely to improve quality of life, reduce the use of acute care resources, and save $191–$385 million in health care costs. Results for the other interventions were uncertain. Limitations The cost-effectiveness analysis was based in part on the notion that resources allocated to EoL care interventions were designed to maximize quality-adjusted life-years (QALY) for patients and their family, but improving QALYs may not be the intended aim of EoL interventions. Conclusions In-home palliative team care was cost-effective, but firm conclusions about the cost-effectiveness of other interventions were not possible. PMID:26339303
End-of-Life Care Interventions: An Economic Analysis.

PubMed

Pham, B; Krahn, M

2014-01-01

The annual cost of providing care for patients in their last year of life is estimated to account for approximately 9% of the Ontario health care budget. Access to integrated, comprehensive support and pain/symptom management appears to be inadequate and inequitable. To evaluate the cost-effectiveness of end-of-life (EoL) care interventions included in the EoL care mega-analysis. Multiple sources were used, including systematic reviews, linked health administration databases, survey data, planning documents, expert input, and additional literature searches. We conducted a literature review of cost-effectiveness studies to inform the primary economic analysis. We conducted the primary economic analysis and budget impact analysis for an Ontario cohort of decedents and their families and included interventions pertaining to team-based models of care, patient care planning discussions, educational interventions for patients and caregivers, and supportive interventions for informal caregivers. The time horizon was the last year of life. Costs were in 2013 Canadian dollars. Effectiveness measures included days at home, percentage dying at home, and quality-adjusted life-days. We developed a Markov model; model inputs were obtained from a cohort of Ontario decedents assembled from Institute for Clinical Evaluative Sciences databases and published literature. In-home palliative team care was cost-effective; it increased the chance of dying at home by 10%, increased the average number of days at home (6 days) and quality-adjusted life-days (0.5 days), and it reduced costs by approximately $4,400 per patient. Expanding in-home palliative team care to those currently not receiving such services (approximately 45,000 per year, at an annual cost of $76-108 million) is likely to improve quality of life, reduce the use of acute care resources, and save $191-$385 million in health care costs. Results for the other interventions were uncertain. The cost-effectiveness analysis was based in part on the notion that resources allocated to EoL care interventions were designed to maximize quality-adjusted life-years (QALY) for patients and their family, but improving QALYs may not be the intended aim of EoL interventions. In-home palliative team care was cost-effective, but firm conclusions about the cost-effectiveness of other interventions were not possible.
Critical prevalence of antibodies minimizing vaccination costs for hepatitis A, hepatitis B, varicella, measles and tetanus in adults and adolescents in Catalonia, Spain.

PubMed

Plans-Rubió, Pedro

2004-09-28

The prevalence of seropositive individuals that makes costs of vaccinating all individuals equal to that for screening and vaccination of susceptible individuals is defined as the critical prevalence of antibodies (p*). Screening and vaccination is more efficient when the prevalence of seropositive individuals (p) in the population is higher than p*. In this study, the formula to obtain p* was derived from the cost-effectiveness equations, showing that it depends on screening and vaccination costs, programme compliance, screening test performance, vaccine efficacy and disease costs. The formula was used to determine the least costly vaccination strategy for hepatitis A and B, varicella, measles and tetanus in adults and adolescents in Catalonia. The least costly vaccination strategy was vaccination without screening (since p was lower than p*) for hepatitis B, measles and tetanus in adults and adolescents (5-14 years) and for hepatitis A in individuals aged 5-24 years, and screening and vaccination (since p was higher than p*) for varicella in adults and adolescents and for hepatitis A in adults aged >24 years. Vaccination strategies based on the critical prevalence of antibodies could maximize the immunity level in the community from available resources.
Employer Health and Productivity Roadmap™ strategy.

PubMed

Parkinson, Michael D

2013-12-01

The National Institute for Occupational Safety and Health Total Worker Health™ Program defines essential elements of an integrated health protection and health promotion model to improve the health, safety, and performance of employers and employees. The lack of a clear strategy to address the core drivers of poor health, excessive medical costs, and lost productivity has deterred a comprehensive, integrated, and proactive approach to meet these challenges. The Employer Health and Productivity Roadmap™, comprising six interrelated and integrated core elements, creates a framework of shared accountability for both employers and their health and productivity partners to implement and monitor actionable measures that improve health, maximize productivity, and reduce excessive costs. The strategy is most effective when linked to a financially incentivized health management program or consumer-directed health plan insurance benefit design.
Pay-for-performance in orthopedics: how we got here and where we are going.

PubMed

Goldman, Ashton H; Kates, Stephen

2017-06-01

Recent health laws have shifted from the traditional fee-for-service model toward a pay-for-performance model. In this changing climate, it is imperative that a provider understands these changes and recognizes the importance of health services research on medicine. Increasing the value of care by improving quality and decreasing cost has been the focus of several projects. Preventing complications may be an effective way to increase value. Patient risk stratification is a modifiable variable that will allow for improved patient selection. This in turn may reduce adverse events, thereby lessening the economic burden of complications, increased length of stay, and hospital readmission. Providers must partner with their hospitals to align their goals and maximize quality and efficiency in order to decrease costs.
The benefits of integrating cost-benefit analysis and risk assessment

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

Fisher, K.; Clarke-Whistler, K.

1995-12-31

It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements inmore » health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada`s concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health.« less
Restoration ecology: two-sex dynamics and cost minimization.

PubMed

Molnár, Ferenc; Caragine, Christina; Caraco, Thomas; Korniss, Gyorgy

2013-01-01

We model a spatially detailed, two-sex population dynamics, to study the cost of ecological restoration. We assume that cost is proportional to the number of individuals introduced into a large habitat. We treat dispersal as homogeneous diffusion in a one-dimensional reaction-diffusion system. The local population dynamics depends on sex ratio at birth, and allows mortality rates to differ between sexes. Furthermore, local density dependence induces a strong Allee effect, implying that the initial population must be sufficiently large to avert rapid extinction. We address three different initial spatial distributions for the introduced individuals; for each we minimize the associated cost, constrained by the requirement that the species must be restored throughout the habitat. First, we consider spatially inhomogeneous, unstable stationary solutions of the model's equations as plausible candidates for small restoration cost. Second, we use numerical simulations to find the smallest rectangular cluster, enclosing a spatially homogeneous population density, that minimizes the cost of assured restoration. Finally, by employing simulated annealing, we minimize restoration cost among all possible initial spatial distributions of females and males. For biased sex ratios, or for a significant between-sex difference in mortality, we find that sex-specific spatial distributions minimize the cost. But as long as the sex ratio maximizes the local equilibrium density for given mortality rates, a common homogeneous distribution for both sexes that spans a critical distance yields a similarly low cost.
Restoration Ecology: Two-Sex Dynamics and Cost Minimization

PubMed Central

Molnár, Ferenc; Caragine, Christina; Caraco, Thomas; Korniss, Gyorgy

2013-01-01

We model a spatially detailed, two-sex population dynamics, to study the cost of ecological restoration. We assume that cost is proportional to the number of individuals introduced into a large habitat. We treat dispersal as homogeneous diffusion in a one-dimensional reaction-diffusion system. The local population dynamics depends on sex ratio at birth, and allows mortality rates to differ between sexes. Furthermore, local density dependence induces a strong Allee effect, implying that the initial population must be sufficiently large to avert rapid extinction. We address three different initial spatial distributions for the introduced individuals; for each we minimize the associated cost, constrained by the requirement that the species must be restored throughout the habitat. First, we consider spatially inhomogeneous, unstable stationary solutions of the model’s equations as plausible candidates for small restoration cost. Second, we use numerical simulations to find the smallest rectangular cluster, enclosing a spatially homogeneous population density, that minimizes the cost of assured restoration. Finally, by employing simulated annealing, we minimize restoration cost among all possible initial spatial distributions of females and males. For biased sex ratios, or for a significant between-sex difference in mortality, we find that sex-specific spatial distributions minimize the cost. But as long as the sex ratio maximizes the local equilibrium density for given mortality rates, a common homogeneous distribution for both sexes that spans a critical distance yields a similarly low cost. PMID:24204810
Selective Perioperative Administration of Pasireotide is More Cost-Effective Than Routine Administration for Pancreatic Fistula Prophylaxis.

PubMed

Denbo, Jason W; Slack, Rebecca S; Bruno, Morgan; Cloyd, Jordan M; Prakash, Laura; Fleming, Jason B; Kim, Michael P; Aloia, Thomas A; Vauthey, Jean-Nicolas; Lee, Jeffrey E; Katz, Matthew H G

2017-04-01

In a randomized trial, pasireotide significantly decreased the incidence and severity of postoperative pancreatic fistula (POPF). Subsequent analyses concluded that its routine use is cost-effective. We hypothesized that selective administration of the drug to patients at high risk for POPF would be more cost-effective. Consecutive patients who did not receive pasireotide and underwent pancreatoduodenectomy (PD) or distal pancreatectomy (DP) between July 2011 and January 2014 were distributed into groups based on their risk of POPF using a multivariate recursive partitioning regression tree analysis (RPA) of preoperative clinical factors. The costs of treating hypothetical patients in each risk group were then computed based upon actual institutional hospital costs and previously published relative risk values associated with pasireotide. Among 315 patients who underwent pancreatectomy, grade B/C POPF occurred in 64 (20%). RPA allocated patients who underwent PD into four groups with a risk for grade B/C POPF of 0, 10, 29, or 60% (P < 0.001) on the basis of diagnosis, pancreatic duct diameter, and body mass index. Patients who underwent DP were allocated to three groups with a grade B/C POPF risk of 14, 26, or 44% (P = 0.05) on the basis of pancreatic duct diameter alone. Although the routine administration of pasireotide to all 315 patients would have theoretically saved $30,892 over standard care, restriction of pasireotide to only patients at high risk for POPF would have led to a cost savings of $831,916. Preoperative clinical characteristics can be used to characterize patients' risk for POPF following pancreatectomy. Selective administration of pasireotide only to patients at high risk for grade B/C POPF may maximize the cost-efficacy of prophylactic pasireotide.
The complex interface between economy and healthcare: An introductory overview for clinicians.

PubMed

Ottolini, Federica Liliana; Buggio, Laura; Somigliana, Edgardo; Vercellini, Paolo

2016-12-01

In a period of generalized economic crisis, it seems particularly appropriate to try to manage a continuing growing sector such as healthcare in the best possible way. The crucial aim of optimization of available healthcare resources is obtaining the maximum possible benefit with the minimum expenditure. This has important social implications, whether individual citizens or tax-funded national health services eventually have to pay the bill. The keyword here is efficiency, which means either, maximizing the benefit from a fixed sum of money, or minimizing the resources required for a defined benefit. In order to achieve these objectives, economic evaluation is a helpful tool. Five different types of economic evaluation exist in the health-care field: cost-minimization, cost-benefit, cost-consequences, cost-effectiveness and cost-utility analysis. The objective of this narrative review is to provide an overview of the principal methods used for economic evaluation in healthcare. Economic evaluation represents a starting point for the allocation of resources, the decision of the valuable investments and the division of budgets across different health programs. Moreover, economic evaluation allows the comparison of different procedures in terms of quality of life and life expectancy, bearing in mind that cost-effectiveness is only one of multiple facets in the decision making-process. Economic evaluation is important to critically evaluate clinical interventions and ensure that we are implementing the most cost-effective management protocols. Clinicians are called to fulfill the complex task of optimizing the use of resources, and, at the same time, improving the quality of healthcare assistance. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Maximizing algebraic connectivity in air transportation networks

NASA Astrophysics Data System (ADS)

Wei, Peng

In air transportation networks the robustness of a network regarding node and link failures is a key factor for its design. An experiment based on the real air transportation network is performed to show that the algebraic connectivity is a good measure for network robustness. Three optimization problems of algebraic connectivity maximization are then formulated in order to find the most robust network design under different constraints. The algebraic connectivity maximization problem with flight routes addition or deletion is first formulated. Three methods to optimize and analyze the network algebraic connectivity are proposed. The Modified Greedy Perturbation Algorithm (MGP) provides a sub-optimal solution in a fast iterative manner. The Weighted Tabu Search (WTS) is designed to offer a near optimal solution with longer running time. The relaxed semi-definite programming (SDP) is used to set a performance upper bound and three rounding techniques are discussed to find the feasible solution. The simulation results present the trade-off among the three methods. The case study on two air transportation networks of Virgin America and Southwest Airlines show that the developed methods can be applied in real world large scale networks. The algebraic connectivity maximization problem is extended by adding the leg number constraint, which considers the traveler's tolerance for the total connecting stops. The Binary Semi-Definite Programming (BSDP) with cutting plane method provides the optimal solution. The tabu search and 2-opt search heuristics can find the optimal solution in small scale networks and the near optimal solution in large scale networks. The third algebraic connectivity maximization problem with operating cost constraint is formulated. When the total operating cost budget is given, the number of the edges to be added is not fixed. Each edge weight needs to be calculated instead of being pre-determined. It is illustrated that the edge addition and the weight assignment can not be studied separately for the problem with operating cost constraint. Therefore a relaxed SDP method with golden section search is developed to solve both at the same time. The cluster decomposition is utilized to solve large scale networks.
Estimating the Cost of Early Infant Male Circumcision in Zimbabwe: Results From a Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp.

PubMed

Mangenah, Collin; Mavhu, Webster; Hatzold, Karin; Biddle, Andrea K; Madidi, Ngonidzashe; Ncube, Getrude; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M; Thirumurthy, Harsha

2015-08-15

Safe and cost-effective programs for implementing early infant male circumcision (EIMC) in Africa need to be piloted. We present results on a relative cost analysis within a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. Between January and June 2013, male infants who met inclusion criteria were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. We evaluated the overall unit cost plus the key cost drivers of EIMC using both AccuCirc and Mogen clamp. Direct costs included consumable and nonconsumable supplies, device, personnel, associated staff training, and environmental costs. Indirect costs comprised capital and support personnel costs. In 1-way sensitivity analyses, we assessed potential changes in unit costs due to variations in main parameters, one at a time, holding all other values constant. The unit costs of EIMC using AccuCirc and Mogen clamp were $49.53 and $55.93, respectively. Key cost drivers were consumable supplies, capacity utilization, personnel costs, and device price. Unit prices are likely to be lowest at full capacity utilization and increase as capacity utilization decreases. Unit prices also fall with lower personnel salaries and increase with higher device prices. EIMC has a lower unit cost when using AccuCirc compared with Mogen clamp. To minimize unit costs, countries planning to scale-up EIMC using AccuCirc need to control costs of consumables and personnel. There is also need to negotiate a reasonable device price and maximize capacity utilization.
Self-optimization and auto-stabilization of receiver in DPSK transmission system.

PubMed

Jang, Y S

2008-03-17

We propose a self-optimization and auto-stabilization method for a 1-bit DMZI in DPSK transmission. Using the characteristics of eye patterns, the optical frequency transmittance of a 1-bit DMZI is thermally controlled to maximize the power difference between the constructive and destructive output ports. Unlike other techniques, this control method can be realized without additional components, making it simple and cost effective. Experimental results show that error-free performance is maintained when the carrier optical frequency variation is approximately 10% of the data rate.
Is it time to abandon paper? The use of emails and the Internet for health services research--a cost-effectiveness and qualitative study.

PubMed

Hunter, Jennifer; Corcoran, Katherine; Leeder, Stephen; Phelps, Kerryn

2013-10-01

A multidisciplinary primary care clinic in Sydney, Australia, was planning to use electronic questionnaires to measure patient-reported outcomes. Semi-structured interviews with 20 patients were undertaken to explore, among other things, practical issues regarding different questionnaire formats. The response rates and costs of email versus postal invitations were also evaluated. Compared with postal invitations, email invitations offered a cost-effective and practical alternative, with a greater proportion of patients volunteering for an interview. Assuming the interface is well-designed and user-friendly, many patients were happy to use the Internet to answer questionnaires. Most patients thought alternate formats should also be offered. Patients discussed advantages and disadvantages of the Internet format. Although more younger patients and females had given the clinic an email address; both sexes, and young and old patients, expressed strong preferences for either wanting or not wanting to use the Internet. Researchers should consider using email invitations as a cost-effective first-line strategy to recruit patients to participate in health services research. Internet questionnaires are potentially cheaper than paper questionnaires, and the format is acceptable to many patients. However, for the time being, concurrent alternate formats need to be offered to ensure wider acceptability and to maximize response rates. © 2012 John Wiley & Sons Ltd.
The hepatitis C cascade of care: identifying priorities to improve clinical outcomes.

PubMed

Linas, Benjamin P; Barter, Devra M; Leff, Jared A; Assoumou, Sabrina A; Salomon, Joshua A; Weinstein, Milton C; Kim, Arthur Y; Schackman, Bruce R

2014-01-01

As highly effective hepatitis C virus (HCV) therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them. We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator) to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation. Sustained virologic responses (SVRs), life expectancy, quality-adjusted life expectancy (QALE), costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs). We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was $14.5 million per 10,000 newly diagnosed individuals. We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost-effective. Priority should be given to developing and evaluating interventions addressing multiple points along the cascade rather than options focusing solely on single points.
The Hepatitis C Cascade of Care: Identifying Priorities to Improve Clinical Outcomes

PubMed Central

Linas, Benjamin P.; Barter, Devra M.; Leff, Jared A.; Assoumou, Sabrina A.; Salomon, Joshua A.; Weinstein, Milton C.; Kim, Arthur Y.; Schackman, Bruce R.

2014-01-01

Background As highly effective hepatitis C virus (HCV) therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them. Methods We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator) to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation. Main measures Sustained virologic responses (SVRs), life expectancy, quality-adjusted life expectancy (QALE), costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs). Results We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was $14.5 million per 10,000 newly diagnosed individuals. Conclusions We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost-effective. Priority should be given to developing and evaluating interventions addressing multiple points along the cascade rather than options focusing solely on single points. PMID:24842841

Optimizing molluscicide treatment strategies in different control stages of schistosomiasis in the People's Republic of China.

PubMed

Yang, Guo-Jing; Sun, Le-Ping; Hong, Qing-Biao; Zhu, Hong-Ru; Yang, Kun; Gao, Qi; Zhou, Xiao-Nong

2012-11-14

The application of chemical molluscicides is still one of the most effective measures for schistosomiasis control in P. R. China. By applying diverse molluscicide treatment scenarios on different snail densities in the field, we attempted to understand the cost-effectiveness of molluscicide application so as to prescribe an optimal management approach to control intermediate host snail Oncomelania hupensis under acceptable thresholds based on the goal of the National Schistosomiasis Control Programme. The molluscicidal field trial was carried out in the marshland of an island along the Yangtze River, Jiangsu province, P.R. China in October 2010. Three plots in the island representing low-density, medium-density and high-density groups were identified after the baseline survey on snail density. Each snail density plot was divided into four experimental units in which molluscicide (50% niclosamide ethanolamine salt wettable powder) was applied once, twice, trice and four times, respectively. The logistic regression model to correlate snail mortality rate with the covariates of number of molluscicidal treatment and snail density, and a linear regression model to investigate the relationship between cost-effectiveness and number of molluscicidal treatment as well as snail density were established. The study revealed that increase in the number of molluscicide treatments led to increased snail mortality across all three population density groups. The most cost-effective regimen was seen in the high snail density group with a single molluscicide treatment. For both high and low density groups, the more times molluscicide were applied, the less cost-effectiveness was. However, for the median density group, the level of cost-effectiveness for two applications was slightly higher than that in one time. We concluded that different stages of the national schistosomiasis control/elimination programme, namely morbidity control, transmission control and transmission interruption, should utilize different molluscicide treatment strategies to maximize cost-effectiveness.
Reliability and cost: A sensitivity analysis

NASA Technical Reports Server (NTRS)

Suich, Ronald C.; Patterson, Richard L.

1991-01-01

In the design phase of a system, how a design engineer or manager choose between a subsystem with .990 reliability and a more costly subsystem with .995 reliability is examined, along with the justification of the increased cost. High reliability is not necessarily an end in itself but may be desirable in order to reduce the expected cost due to subsystem failure. However, this may not be the wisest use of funds since the expected cost due to subsystem failure is not the only cost involved. The subsystem itself may be very costly. The cost of the subsystem nor the expected cost due to subsystem failure should not be considered separately but the total of the two costs should be maximized, i.e., the total of the cost of the subsystem plus the expected cost due to subsystem failure.
Salinity effect on the maximal growth temperature of some bacteria isolated from marine enviroments.

PubMed

Stanley, S O; Morita, R Y

1968-01-01

Salinity of the growth medium was found to have a marked effect on the maximal growth temperature of four bacteria isolated from marine sources. Vibrio marinus MP-1 had a maximal growth temperature of 21.2 C at a salinity of 35% and a maximal growth temperature of 10.5 C at a salinity of 7%, the lowest salinity at which it would grow. This effect was shown to be due to the presence of various cations in the medium. The order of effectiveness of cations in restoring the normal maximal growth temperature, when added to dilute seawater, was Na(+) > Li(+) > Mg(++) > K(+) > Rb(+) > NH(4) (+). The anions tested, with the exception of SO(4)=, had no marked effect on the maximal growth temperature response. In a completely defined medium, the highest maximal growth temperature was 20.0 C at 0.40 m NaCl. A decrease in the maximal growth temperature was observed at both low and high concentrations of NaCl.
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.
Cost estimates for flood resilience and protection strategies in New York City.

PubMed

Aerts, Jeroen C J H; Botzen, W J Wouter; de Moel, Hans; Bowman, Malcolm

2013-08-01

In the aftermaths of Hurricanes Irene, in 2011, and Sandy, in 2012, New York City has come to recognize the critical need to better prepare for future storm surges and to anticipate future trends, such as climate change and socio-economic developments. The research presented in this report assesses the costs of six different flood management strategies to anticipate long-term challenges the City will face. The proposed strategies vary from increasing resilience by upgrading building codes and introducing small scale protection measures, to creating green infrastructure as buffer zones and large protective engineering works such as storm surge barriers. The initial investment costs of alternative strategies vary between $11.6 and $23.8 bn, maximally. We show that a hybrid solution, combining protection of critical infrastructure and resilience measures that can be upgraded over time, is less expensive. However, with increasing risk in the future, storm surge barriers may become cost-effective, as they can provide protection to the largest areas in both New York and New Jersey. © 2013 New York Academy of Sciences.
Managing a closed-loop supply chain inventory system with learning effects

NASA Astrophysics Data System (ADS)

Jauhari, Wakhid Ahmad; Dwicahyani, Anindya Rachma; Hendaryani, Oktiviandri; Kurdhi, Nughthoh Arfawi

2018-02-01

In this paper, we propose a closed-loop supply chain model consisting of a retailer and a manufacturer. We intend to investigate the impact of learning in regular production, remanufacturing and reworking. The customer demand is assumed deterministic and will be satisfied from both regular production and remanufacturing process. The return rate of used items depends on quality. We propose a mathematical model with the objective is to maximize the joint total profit by simultaneously determining the length of ordering cycle for the retailer and the number of regular production and remanufacturing cycle. The algorithm is suggested for finding the optimal solution. A numerical example is presented to illustrate the application of using a proposed model. The results show that the integrated model performs better in reducing total cost compared to the independent model. The total cost is most affected by the changes in the values of unit production cost and acceptable quality level. In addition, the changes in the defective items proportion and the fraction of holding costs significantly influence the retailer's ordering period.
Energy intensity, life-cycle greenhouse gas emissions, and economic assessment of liquid biofuel pipelines.

PubMed

Strogen, Bret; Horvath, Arpad; Zilberman, David

2013-12-01

Petroleum fuels are predominantly transported domestically by pipelines, whereas biofuels are almost exclusively transported by rail, barge, and truck. As biofuel production increases, new pipelines may become economically attractive. Location-specific variables impacting pipeline viability include construction costs, availability and costs of alternative transportation modes, electricity prices and emissions (if priced), throughput, and subsurface temperature. When transporting alcohol or diesel-like fuels, pipelines have a lower direct energy intensity than rail, barge, and trucks if fluid velocity is under 1 m/s for 4-inch diameter pipelines and 2 m/s for 8-inch or larger pipelines. Across multiple hypothetical state-specific scenarios, profit-maximizing design velocities range from 1.2 to 1.9 m/s. In costs and GHG emissions, optimized pipelines outperform trucks in each state and rail and barge in most states, if projected throughput exceeds four billion liters/year. If emissions are priced, optimum design diameters typically increase to reduce pumping energy demands, increasing the cost-effectiveness of pipeline projects. Copyright © 2013 Elsevier Ltd. All rights reserved.
Vehicle registration compliance in Wisconsin : [summary].

DOT National Transportation Integrated Search

2015-03-01

The Wisconsin Department of Transportation (WisDOT) conducted an investigation : to improve its passenger vehicle registration processes, with the goals to modernize : techniques, reduce costs, enhance security and maximize compliance. WisDOTs : D...
Bio-plastic (poly-hydroxy-alkanoate) production from municipal sewage sludge in the Netherlands: a technology push or a demand driven process?

PubMed

Bluemink, E D; van Nieuwenhuijzen, A F; Wypkema, E; Uijterlinde, C A

Valorisation of components from municipal 'waste' water and sewage sludge gets more and more attention in order to come to a circular economy by developing an efficient 'waste' to value concept. On behalf of the transition team 'Grondstoffenfabriek' ('Resource factory') a preliminary research was performed for all the Dutch water boards to assess the technical and economical feasibility of poly-hydroxy-alkanoate (PHA)-production from sewage sludge, a valuable product to produce bio-plastics. This study reveals that the production of bio-plastics from sewage sludge is feasible based on technical aspects, but not yet economically interesting, even though the selling price is relatively close to the actual PHA market price. (Selling price is in this particular case the indicative cost effective selling price. The cost effective selling price covers only the total production costs of the product.) Future process optimization (maximizing the volatile fatty acids production, PHA storage capacity, etc.) and market developments are needed and will result in cost reductions of the various sub-processes. PHA-production from sewage sludge at this stage is just a technology; every further research is needed to incorporate the backward integration approach, taking into account the market demand including associated product quality aspects.
Cost shifting revisited: the case of service intensity.

PubMed

Friesner, Daniel L; Rosenman, Robert

2002-02-01

This paper examines whether a health care provider's choice of service intensity for any patient group affects its cost shifting behavior. Our theoretical models indicate that firms may respond to lower prospective payment by decreasing service intensity to all of its patient groups, thereby giving firms an alternative to cost shifting. Additionally, the conditions under which cost shifting and lower service intensity occur are identical, regardless of profit status. Using a panel of California hospitals, we found that nonprofit hospitals do cost shift, while profit-maximizing hospitals do not. However, both firms respond to lower prospective payment by decreasing service intensity, thus supporting our theoretical conclusion that lower service intensity can be used as an alternative to cost shifting.
Gains from trans-boundary water quality management in linked catchment and coastal socio-ecological systems: a case study for the Minho region

NASA Astrophysics Data System (ADS)

Roebeling, P. C.; Brito, A. G.; Rocha, J.; Alves, H.; Mamede, J.

2012-04-01

Worldwide, aquatic and coastal ecosystems are affected by point and diffuse source water pollution originating from rural, urban and industrial land uses in catchments, even though these ecosystems are of vital importance from an environmental and economic perspective. Integrated Catchment and Coastal Zone Management (ICCZM) specifically takes into account this inherent relationship between terrestrial land use, surface and ground water pollution, aquatic and coastal ecosystem state, and associated environmental values. To warrant sustainable regional economic development, we need to balance the marginal costs from terrestrial water pollution abatement and the associated marginal benefits from aquatic and coastal resource appreciation. In doing so, however, we need to differentiate between intra- and trans-boundary catchments because benefactors and beneficiaries from water quality improvement are not one and the same. In trans-boundary catchments, private (national) welfare maximizing rates of water quality improvement differ across nations as benefits from water quality improvement generally accrue to one nation while the costs are paid by multiple nations. While approaches for water quality management in linked catchment and coastal socio-ecological systems are fairly recent though existent, water quality management in trans-boundary catchments poses additional challenges. The objective of this paper is to develop and apply a deterministic optimal control approach that allows us to explore private and social welfare maximizing rates of water pollution abatement in linked catchment and coastal socio-ecological systems. For a case study of the Minho region in the Iberian Peninsula, we estimate nation-specific water pollution abatement cost (based on management practice adoption) and benefit (based on aquatic and coastal environmental values) functions, to determine as well as compare private (national) and social (trans-national) welfare maximizing rates of water pollution abatement. The presented approach differs from existing approaches in a number of ways. First, we explicitly present an analytical derivation of private (national) and social (trans-national) welfare maximizing rates of water pollution abatement using nation-specific abatement cost functions. Second, the analytical optimal control approach provides an elegant and easily understandable solution concept that contributes to the development of efficient water quality improvement targets. Finally, we go beyond the usual cost-effectiveness analysis based on arbitrary 'tolerable' or target levels of pollution as we specifically account for the negative external costs of increased water pollution in the downstream aquatic and coastal environment. Results for the Minho region show that some private (national) welfare gains can be obtained through the adoption of win-win management practices, leading to a 12% reduction in the annual rate of water pollution and an almost 7% increase in annual regional income. Maximum social (trans-national) welfare gains can, however, be obtained through the adoption of win-win and lose-win management practices across Spain and Portugal, leading to a 36% reduction in water pollution and a 14% increase in regional income. Yet, non-cooperation in water pollution mitigation would only lead to a 16%-32% reduction in water pollution and a 8%-13% increase in regional income. Hence, social (trans-national) welfare losses from non-cooperation between Spain and Portugal would equate to between 16 and 81 million Euros per year.
Relationships between self-reported health related quality of life and measures of standardized exercise capacity and metabolic efficiency in a middle-aged and aged healthy population.

PubMed

Lindholm, E; Brevinge, H; Bergh, C H; Körner, U; Lundholm, K

2003-08-01

The purpose of this study was to evaluate to what extent self-reported health related quality of life (HRQL), assessed by the Swedish standard version of the Medical Outcome Study Short-Form 36 (SF-36), is related to measured exercise capacity and metabolic efficiency in a cohort of healthy subjects from the Gothenburg area of Sweden. Individuals were invited to take part in the evaluation where HRQL was compared with the maximal power output expressed in Watts assessed during a standardized treadmill test with incremental work loads. Whole body respiratory gas exchanges (CO2/O2) were simultaneously measured. Estimate of metabolic efficiency was derived from oxygen uptake per Watt produced (ml O2/min/W) near maximal work. The health status profile in the current population largely agreed with normative data from an age- and gender-matched reference group, although some measured scores were slightly better than reference scores. Males and females had a similar relationship between energy cost (ml O2/min) for production of maximal work (W), while the regressions for maximal exercise power and age were significantly different between males and females (p < 0.01). The overall metabolic efficiency was the same in individuals between 40 and 74 years of age (10.4 +/- 0.07 ml O2/min/ Watt). Maximal exercise power was only related to the SF-36 subscale physical functioning (PF), but unrelated to other physical subscales such as role limitations due to physical problems, good general health and vitality. There was also a discrepancy between measured maximal power and PF in many subjects, particularly in males who experienced either intact or severely reduced PF. Our results demonstrate that simultaneous measurements of self-reported and objective measures of PF should add a more integrated view for evaluation of therapeutic effectiveness, since the overall correlation was poor between objective and subjective scores among individuals.
Variation in the costs of delivering routine immunization services in Peru.

PubMed

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.
Cost as a technology driver. [in aerospace R and D

NASA Technical Reports Server (NTRS)

Fitzgerald, P. E., Jr.; Savage, M.

1976-01-01

Cost managment as a guiding factor in optimum development of technology, and proper timing of cost-saving programs in the development of a system or technology with payoffs in development and operational advances are discussed and illustrated. Advances enhancing the performance of hardware or software advances raising productivity or reducing cost, are outlined, with examples drawn from: thermochemical thrust maximization, development of cryogenic storage tanks, improvements in fuel cells for Space Shuttle, design of a spacecraft pyrotechnic initiator, cost cutting by reduction in the number of parts to be joined, and cost cutting by dramatic reductions in circuit component number with small-scale double-diffused integrated circuitry. Program-focused supporting research and technology models are devised to aid judicious timing of cost-conscious research programs.
Notification: EPA Conferences - Maximizing Cost Efficiencies

EPA Pesticide Factsheets

Project #OA-FY15-0381, September 19, 2014. The U.S. Environmental Protection Agency (EPA) Office of Inspector General (OIG) plans to begin preliminary research in October 2014 for an audit of conference spending.
Addressing Cancer Drug Costs and Value

Cancer.gov

The President’s Cancer Panel has released its latest report, Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The report recommends six actions to maximize the value and affordability of cancer drug treatment.
Exploiting Redundancy and Application Scalability for Cost-Effective, Time-Constrained Execution of HPC Applications on Amazon EC2

DOE PAGES

Marathe, Aniruddha P.; Harris, Rachel A.; Lowenthal, David K.; ...

2015-12-17

The use of clouds to execute high-performance computing (HPC) applications has greatly increased recently. Clouds provide several potential advantages over traditional supercomputers and in-house clusters. The most popular cloud is currently Amazon EC2, which provides fixed-cost and variable-cost, auction-based options. The auction market trades lower cost for potential interruptions that necessitate checkpointing; if the market price exceeds the bid price, a node is taken away from the user without warning. We explore techniques to maximize performance per dollar given a time constraint within which an application must complete. Specifically, we design and implement multiple techniques to reduce expected cost bymore » exploiting redundancy in the EC2 auction market. We then design an adaptive algorithm that selects a scheduling algorithm and determines the bid price. We show that our adaptive algorithm executes programs up to seven times cheaper than using the on-demand market and up to 44 percent cheaper than the best non-redundant, auction-market algorithm. We extend our adaptive algorithm to incorporate application scalability characteristics for further cost savings. In conclusion, we show that the adaptive algorithm informed with scalability characteristics of applications achieves up to 56 percent cost savings compared to the expected cost for the base adaptive algorithm run at a fixed, user-defined scale.« less
Pricing and reimbursement of pharmaceuticals in the Czech Republic and Sweden.

PubMed

Davidova, Jana; Praznovcova, Lenka; Lundborg, Cecilia Stålsby

2008-01-01

To describe and compare price regulation and reimbursement in the Czech Republic and Sweden. Legal documents, government reports, statutory information, annual reports and scientific articles were searched using the keywords: pharmaceutical market regulation, drug policy, drug pricing, drug reimbursement and patients' participation in costs concerning both countries. Approaches to regulation and regulatory steps concerning prices were compared between the countries. (i) Institutional responsibilities in pricing and reimbursement of pharmaceuticals; (ii) principles of patients' participation in costs on pharmaceuticals. Substantial differences were found in terms of pricing. In the Czech Republic, the Ministry of Finance sets maximal prices for pharmaceuticals whereas in Sweden there is a process of price regulation combined with reimbursement decisions taken by the Pharmaceutical Benefits Board. Together with a system of state-owned pharmacies, this ensures that drug prices in Sweden are fixed at the same level throughout the country. In the Czech Republic, prices may differ, since only maximal price levels are set. In both countries, decisions about reimbursement are taken at the national or state level whereas insurance funds or county councils are responsible for covering costs. The private share of pharmaceutical expenditures is substantially lower in the Czech Republic, even though there is no maximal level for patient's co-payment, as there is in Sweden. Differences in price setting and some other regulations of the pharmaceutical market were found. Both systems are designed to promote rational use of pharmaceuticals; and are based on social solidarity.
Review of Strategies to Enhance Outcomes for Patients with Type 2 Diabetes: Payers' Perspective

PubMed Central

Greenapple, Rhonda

2011-01-01

Background Diabetes and its clinical consequences exact a great toll on patients and on society in terms of its effects on morbidity and mortality and its staggering economic impact. Objective To review various programs and strategies that aim at enhancing adherence to antihyperglycemic therapy and suggest the best approach to improving patient outcomes and reducing healthcare costs. Discussion Treatment goals for patients with diabetes have been defined, and multiple safe and effective medications are available. Nevertheless, the majority of patients with diabetes fail to achieve treatment goals, because of difficulty with adherence to medication regimens and lifestyle modifications, and because of economic barriers. This article discusses various initiatives developed to improve patient outcomes, including consumer-driven health plans and wellness and prevention programs. Furthermore, economic incentives to patients, such as value-based insurance design, may increase adherence; nevertheless, evidence suggests that such programs alone provide only modest gains. Primary providers in disease management programs can include nurses, case managers, or pharmacists. Supportive interventions across several modalities have been shown to be effective. Conclusion An approach that uses a combination of strategies designed to impact patients' health-related behaviors across a variety of modalities may help to improve outcomes and reduce costs. Additional novel, innovative interdisciplinary initiatives are necessary to effect meaningful change that can facilitate improved health outcomes for patients with diabetes and maximize cost-effectiveness approaches for payers. PMID:25126364
Pressure ulcer prevention in high-risk postoperative cardiovascular patients.

PubMed

Jackson, Melissa; McKenney, Teresa; Drumm, Jennifer; Merrick, Brian; LeMaster, Tamara; VanGilder, Catherine

2011-08-01

Little has been published about how to prevent pressure ulcers in severely debilitated, immobile patients in intensive care units. To present a possible prevention strategy for postoperative cardiovascular surgery patients at high risk for development of pressure ulcers. Staff chose to implement air fluidized therapy beds, which provide maximal immersion and envelopment as a measure for preventing pressure ulcers in patients who (1) required vasopressors for at least 24 hours and (2) required mechanical ventilation for at least 24 hours postoperatively. Only 1 of 27 patients had a pressure ulcer develop while on the air fluidized therapy bed (February 2008 through August 2008), and that ulcer was only a stage I ulcer, compared with 40 ulcers in 25 patients before the intervention. Patients spent a mean of 7.9 days on the mattress, and the cost of bed rental was approximately $18000, which was similar to the cost of treatment of 1 pressure ulcer in stage III or IV (about $40000) and was considered cost-effective.

Running from Paris to Beijing: biomechanical and physiological consequences.

PubMed

Millet, Guillaume Y; Morin, Jean-Benoît; Degache, Francis; Edouard, Pascal; Feasson, Léonard; Verney, Julien; Oullion, Roger

2009-12-01

The purpose of this study was to examine the physiological and biomechanical changes occurring in a subject after running 8,500 km in 161 days (i.e. 52.8 km daily). Three weeks before, 3 weeks after (POST) and 5 months after (POST+5) running from Paris to Beijing, energy cost of running (Cr), knee flexor and extensor isokinetic strength and biomechanical parameters (using a treadmill dynamometer) at different velocities were assessed in an experienced ultra-runner. At POST, there was a tendency toward a 'smoother' running pattern, as shown by (a) a higher stride frequency and duty factor, and a reduced aerial time without a change in contact time, (b) a lower maximal vertical force and loading rate at impact and (c) a decrease in both potential and kinetic energy changes at each step. This was associated with a detrimental effect on Cr (+6.2%) and a loss of strength at all angular velocities for both knee flexors and extensors. At POST+5, the subject returned to his original running patterns at low but not at high speeds and maximal strength remained reduced at low angular velocities (i.e. at high levels of force). It is suggested that the running pattern changes observed in the present study were a strategy adopted by the subject to reduce the deleterious effects of long distance running. However, the running pattern changes could partly be linked to the decrease in maximal strength.
Metabolism, growth, and the energetic definition of fitness: a quantitative genetic study in the land snail Cornu aspersum.

PubMed

Bruning, Andrea; Gaitán-Espitia, Juan Diego; González, Avia; Bartheld, José Luis; Nespolo, Roberto F

2013-01-01

Life-history evolution-the way organisms allocate time and energy to reproduction, survival, and growth-is a central question in evolutionary biology. One of its main tenets, the allocation principle, predicts that selection will reduce energy costs of maintenance in order to divert energy to survival and reproduction. The empirical support for this principle is the existence of a negative relationship between fitness and metabolic rate, which has been observed in some ectotherms. In juvenile animals, a key function affecting fitness is growth rate, since fast growers will reproduce sooner and maximize survival. In principle, design constraints dictate that growth rate cannot be reduced without affecting maintenance costs. Hence, it is predicted that juveniles will show a positive relationship between fitness (growth rate) and metabolic rate, contrarily to what has been observed in adults. Here we explored this problem using land snails (Cornu aspersum). We estimated the additive genetic variance-covariance matrix for growth and standard metabolic rate (SMR; rate of CO2 production) using 34 half-sibling families. We measured eggs, hatchlings, and juveniles in 208 offspring that were isolated right after egg laying (i.e., minimizing maternal and common environmental variance). Surprisingly, our results showed that additive genetic effects (narrow-sense heritabilities, h(2)) and additive genetic correlations (rG) were small and nonsignificant. However, the nonadditive proportion of phenotypic variances and correlations (rC) were unexpectedly large and significant. In fact, nonadditive genetic effects were positive for growth rate and SMR ([Formula: see text]; [Formula: see text]), supporting the idea that fitness (growth rate) cannot be maximized without incurring maintenance costs. Large nonadditive genetic variances could result as a consequence of selection eroding the additive genetic component, which suggests that past selection could have produced nonadditive genetic correlation. It is predicted that this correlation is reduced when adulthood is attained and selection starts to promote the reduction in metabolic rate.
[Optimal versus maximal safety of the blood transfusion chain in The Netherlands; results of a conference. College for Blood Transfusion of the Dutch Red Cross].

PubMed

van der Poel, C L; de Boer, J E; Reesink, H W; Sibinga, C T

1998-02-07

An invitational conference was held on September 11, 1996 by the Medical Advisory Commission to the Blood Transfusion Council of the Netherlands Red Cross, addressing the issues of 'maximal' versus 'optimal' safety measures for the blood supply. Invited were blood transfusion specialists, clinicians, representatives of patient interest groups, the Ministry and Inspectorate of Health and members of parliament. Transfusion experts and clinicians were found to advocate an optimal course, following strategies of evidence-based medicine, cost-benefit analyses and medical technology assessment. Patient groups depending on blood products, such as haemophilia patients would rather opt for maximal safety. Insurance companies would choose likewise, to exclude any risk if possible. Health care juridical advisers would advise to choose for optimal safety, but to reserve funds covering the differences with 'maximal safety' in case of litigation. Politicians and the general public would sooner choose for maximal rather than optimal security. The overall impression persists that however small the statistical risk may be, in the eyes of many it is unacceptable. This view is very stubborn.
Cardiac Output and Performance during a Marathon Race in Middle-Aged Recreational Runners

PubMed Central

Billat, Véronique L.; Petot, Hélène; Landrain, Morgan; Meilland, Renaud; Koralsztein, Jean Pierre; Mille-Hamard, Laurence

2012-01-01

Purpose. Despite the increasing popularity of marathon running, there are no data on the responses of stroke volume (SV) and cardiac output (CO) to exercise in this context. We sought to establish whether marathon performance is associated with the ability to sustain high fractional use of maximal SV and CO (i.e, cardiac endurance) and/or CO, per meter (i.e., cardiac cost). Methods. We measured the SV, heart rate (HR), CO, and running speed of 14 recreational runners in an incremental, maximal laboratory test and then during a real marathon race (mean performance: 3 hr 30 min ± 45 min). Results. Our data revealed that HR, SV and CO were all in a high but submaximal steady state during the marathon (87.0 ± 1.6%, 77.2 ± 2.6%, and 68.7 ± 2.8% of maximal values, respectively). Marathon performance was inversely correlated with an upward drift in the CO/speed ratio (mL of CO × m−1) (r = −0.65, P < 0.01) and positively correlated with the runner's ability to complete the race at a high percentage of the speed at maximal SV (r = 0.83, P < 0.0002). Conclusion. Our results showed that marathon performance is inversely correlated with cardiac cost and positively correlated with cardiac endurance. The CO response could be a benchmark for race performance in recreational marathon runners. PMID:22645458
Translating comparative effectiveness research into Medicaid payment policy: views from medical and pharmacy directors.

PubMed

Weissman, Joel S; Westrich, Kimberly; Hargraves, J Lee; Pearson, Steven D; Dubois, Robert; Emond, Sarah; Olufajo, Olubode A

2015-03-01

As the USA seeks to expand the conduct and dissemination of comparative effectiveness research (CER), views of key stakeholders will help guide the way. We surveyed 60 medical and pharmacy directors from 46 state Medicaid programs. Over 90% felt that CER would lead to better clinical decision-making and overall value within 5 years and were willing to consider cost-effectiveness in setting medical policy. However, perceived poor quality, inconclusive research, restrictive legislative mandates, lack of budget impact and coverage recommendations, and lack of an independent body to interpret study results were major barriers cited to using CER evidence. Given the significant resources being invested in CER, it is critical that these barriers are overcome to maximize its usefulness for stakeholders.
Vehicle path-planning in three dimensions using optics analogs for optimizing visibility and energy cost

NASA Technical Reports Server (NTRS)

Rowe, Neil C.; Lewis, David H.

1989-01-01

Path planning is an important issue for space robotics. Finding safe and energy-efficient paths in the presence of obstacles and other constraints can be complex although important. High-level (large-scale) path planning for robotic vehicles was investigated in three-dimensional space with obstacles, accounting for: (1) energy costs proportional to path length; (2) turn costs where paths change trajectory abruptly; and (3) safety costs for the danger associated with traversing a particular path due to visibility or invisibility from a fixed set of observers. Paths optimal with respect to these cost factors are found. Autonomous or semi-autonomous vehicles were considered operating either in a space environment around satellites and space platforms, or aircraft, spacecraft, or smart missiles operating just above lunar and planetary surfaces. One class of applications concerns minimizing detection, as for example determining the best way to make complex modifications to a satellite without being observed by hostile sensors; another example is verifying there are no paths (holes) through a space defense system. Another class of applications concerns maximizing detection, as finding a good trajectory between mountain ranges of a planet while staying reasonably close to the surface, or finding paths for a flight between two locations that maximize the average number of triangulation points available at any time along the path.
Optimal flight initiation distance.

PubMed

Cooper, William E; Frederick, William G

2007-01-07

Decisions regarding flight initiation distance have received scant theoretical attention. A graphical model by Ydenberg and Dill (1986. The economics of fleeing from predators. Adv. Stud. Behav. 16, 229-249) that has guided research for the past 20 years specifies when escape begins. In the model, a prey detects a predator, monitors its approach until costs of escape and of remaining are equal, and then flees. The distance between predator and prey when escape is initiated (approach distance = flight initiation distance) occurs where decreasing cost of remaining and increasing cost of fleeing intersect. We argue that prey fleeing as predicted cannot maximize fitness because the best prey can do is break even during an encounter. We develop two optimality models, one applying when all expected future contribution to fitness (residual reproductive value) is lost if the prey dies, the other when any fitness gained (increase in expected RRV) during the encounter is retained after death. Both models predict optimal flight initiation distance from initial expected fitness, benefits obtainable during encounters, costs of escaping, and probability of being killed. Predictions match extensively verified predictions of Ydenberg and Dill's (1986) model. Our main conclusion is that optimality models are preferable to break-even models because they permit fitness maximization, offer many new testable predictions, and allow assessment of prey decisions in many naturally occurring situations through modification of benefit, escape cost, and risk functions.
Computational Models Used to Assess US Tobacco Control Policies.

PubMed

Feirman, Shari P; Glasser, Allison M; Rose, Shyanika; Niaura, Ray; Abrams, David B; Teplitskaya, Lyubov; Villanti, Andrea C

2017-11-01

Simulation models can be used to evaluate existing and potential tobacco control interventions, including policies. The purpose of this systematic review was to synthesize evidence from computational models used to project population-level effects of tobacco control interventions. We provide recommendations to strengthen simulation models that evaluate tobacco control interventions. Studies were eligible for review if they employed a computational model to predict the expected effects of a non-clinical US-based tobacco control intervention. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Six primary non-clinical intervention types were examined across the 40 studies: taxation, youth prevention, smoke-free policies, mass media campaigns, marketing/advertising restrictions, and product regulation. Simulation models demonstrated the independent and combined effects of these interventions on decreasing projected future smoking prevalence. Taxation effects were the most robust, as studies examining other interventions exhibited substantial heterogeneity with regard to the outcomes and specific policies examined across models. Models should project the impact of interventions on overall tobacco use, including nicotine delivery product use, to estimate preventable health and cost-saving outcomes. Model validation, transparency, more sophisticated models, and modeling policy interactions are also needed to inform policymakers to make decisions that will minimize harm and maximize health. In this systematic review, evidence from multiple studies demonstrated the independent effect of taxation on decreasing future smoking prevalence, and models for other tobacco control interventions showed that these strategies are expected to decrease smoking, benefit population health, and are reasonable to implement from a cost perspective. Our recommendations aim to help policymakers and researchers minimize harm and maximize overall population-level health benefits by considering the real-world context in which tobacco control interventions are implemented. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Probabilistic distance-based quantizer design for distributed estimation

NASA Astrophysics Data System (ADS)

Kim, Yoon Hak

2016-12-01

We consider an iterative design of independently operating local quantizers at nodes that should cooperate without interaction to achieve application objectives for distributed estimation systems. We suggest as a new cost function a probabilistic distance between the posterior distribution and its quantized one expressed as the Kullback Leibler (KL) divergence. We first present the analysis that minimizing the KL divergence in the cyclic generalized Lloyd design framework is equivalent to maximizing the logarithmic quantized posterior distribution on the average which can be further computationally reduced in our iterative design. We propose an iterative design algorithm that seeks to maximize the simplified version of the posterior quantized distribution and discuss that our algorithm converges to a global optimum due to the convexity of the cost function and generates the most informative quantized measurements. We also provide an independent encoding technique that enables minimization of the cost function and can be efficiently simplified for a practical use of power-constrained nodes. We finally demonstrate through extensive experiments an obvious advantage of improved estimation performance as compared with the typical designs and the novel design techniques previously published.
Freeway bottleneck removals : workshop enhancement and technology transfer.

DOT National Transportation Integrated Search

2009-12-01

As transportation improvement projects become increasingly costly and complex and as funding sources are not : keeping pace with needs in highly urbanized areas, it becomes critical that existing freeway systems be finetuned to : maximize capacity...
Notification: EPA Conferences – Maximizing Cost Efficiencies

EPA Pesticide Factsheets

Project #OA-FY14-0381, February 2, 2015. The EPA OIG plans to begin field work with an objective modified from our October 2, 2014, kickoff meeting with the Office of the Chief Financial Officer (OCFO).
How to Assess the Value of Medicines?

PubMed Central

Simoens, Steven

2010-01-01

This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value. PMID:21607066
How to assess the value of medicines?

PubMed

Simoens, Steven

2010-01-01

This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value.
Tilted membrane panel: A new module concept to maximize the impact of air bubbles for membrane fouling control in microalgae harvesting.

PubMed

Eliseus, A; Bilad, M R; Nordin, N A H M; Putra, Z A; Wirzal, M D H

2017-10-01

Microalgae harvesting using membrane technology is challenging because of its high fouling propensity. As an established fouling mitigation technique, efficacy of air bubbles can be improved by maximizing the impact of shear-rates in scouring foulant. In this study, it is achieved by tilting the membrane panel. We investigate the effect of tilting angle, switching period as well as aeration rate during microalgal broth filtration. Results show that higher tilting angles (up to 20°) improve permeability of up to 2.7 times of the vertical panel. In addition, operating a one-sided panel is better than a two-sided panel, in which the later involved switching mode. One-sided membrane panel only require a half of area, yet its performance is comparable with of a large-scale module. This tilted panel can lead to significant membrane cost reductions and eventually improves the competitiveness of membrane technology for microalgae harvesting application. Copyright © 2017 Elsevier Ltd. All rights reserved.
Does Risk Aversion Affect Transmission and Generation Planning? A Western North America Case Study

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

Munoz, Francisco; van der Weijde, Adriaan Hendrik; Hobbs, Benjamin F.

Here, we investigate the effects of risk aversion on optimal transmission and generation expansion planning in a competitive and complete market. To do so, we formulate a stochastic model that minimizes a weighted average of expected transmission and generation costs and their conditional value at risk (CVaR). We also show that the solution of this optimization problem is equivalent to the solution of a perfectly competitive risk-averse Stackelberg equilibrium, in which a risk-averse transmission planner maximizes welfare after which risk-averse generators maximize profits. Furthermore, this model is then applied to a 240-bus representation of the Western Electricity Coordinating Council, inmore » which we examine the impact of risk aversion on levels and spatial patterns of generation and transmission investment. Although the impact of risk aversion remains small at an aggregate level, state-level impacts on generation and transmission investment can be significant, which emphasizes the importance of explicit consideration of risk aversion in planning models.« less
Does Risk Aversion Affect Transmission and Generation Planning? A Western North America Case Study

DOE PAGES

Munoz, Francisco; van der Weijde, Adriaan Hendrik; Hobbs, Benjamin F.; ...

2017-04-07

Here, we investigate the effects of risk aversion on optimal transmission and generation expansion planning in a competitive and complete market. To do so, we formulate a stochastic model that minimizes a weighted average of expected transmission and generation costs and their conditional value at risk (CVaR). We also show that the solution of this optimization problem is equivalent to the solution of a perfectly competitive risk-averse Stackelberg equilibrium, in which a risk-averse transmission planner maximizes welfare after which risk-averse generators maximize profits. Furthermore, this model is then applied to a 240-bus representation of the Western Electricity Coordinating Council, inmore » which we examine the impact of risk aversion on levels and spatial patterns of generation and transmission investment. Although the impact of risk aversion remains small at an aggregate level, state-level impacts on generation and transmission investment can be significant, which emphasizes the importance of explicit consideration of risk aversion in planning models.« less
Maximising Longwall performance and profitability by the introduction of moving car bunker systems into outbye haulage layouts

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

Barlow, P.M.

1996-12-31

In order to maximize the profitability of Longwall mining operations, outbye materials handling systems should be cost effectively engineered to both fully harmonize with cyclical surges in output and to maintain high levels of availability. With the introduction of new Longwall systems into existing mines, the upgrading of outbye haulage to handle peak production from the Longwall panel can prove to be extremely expensive and is often unnecessary. In addition, despite high levels of investment in new equipment, many mines are still failing to achieve planned gains in Longwall productivity due to persistent downtime on outbye haulage routes. This papermore » details the planning, production and engineering considerations necessary to maximize profitability by the introduction of moving car bunker systems to underground haulage layouts. It also examines case studies of recent installations within the North American coal mining industry and charts the significant success being achieved in improving profitability at these mines.« less
Enhancement of Terrestrial Carbon Sinks through the Reclamation of Abandoned Mined Lands

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

Gary Kronrad

2004-10-31

This project will determine the optimal forest management method to employ for each of the major commercial tree species so that profitability of timber production only or the combination of timber production and carbon sequestration is maximized. The goal of this project is to achieve DOE's long-term cost goal of sequestering carbon at $10 or less per ton. Because the potential of a forest ecosystem to sequester carbon depends on the species, site quality and management regimes utilized, this project will determine how to optimize carbon sequestration by determining how to optimally manage each species, given a range of sitemore » qualities and economic variables. This project also will determine the effects of a carbon credit market on the method and profitability of forest management, the cost of sequestering carbon, and the amount of carbon that can be sequestered. Information from this project will be used to produce user-friendly manuals which will contain economic and biological data for each of the species. These manuals will inform landowners and forest managers how to manage forests for timber and/or carbon credits, how to maximize financial returns, how much money can be earned, and how much carbon can be stored. Manuals will be disseminated through state and federal agricultural extension services and the forest service of each state, and will be published in forest landowner magazines.« less
Enhancement of Terrestrial Carbon Sinks through the Reclamation of Abandoned Mined Lands

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

Gary Kronrad

2006-01-31

This project will determine the optimal forest management method to employ for each of the major commercial tree species so that profitability of timber production only or the combination of timber production and carbon sequestration is maximized. The goal of this project is to achieve DOE's long-term cost goal of sequestering carbon at $10 or less per ton. Because the potential of a forest ecosystem to sequester carbon depends on the species, site quality and management regimes utilized, this project will determine how to optimize carbon sequestration by determining how to optimally manage each species, given a range of sitemore » qualities and economic variables. This project also will determine the effects of a carbon credit market on the method and profitability of forest management, the cost of sequestering carbon, and the amount of carbon that can be sequestered. Information from this project will be used to produce user-friendly manuals which will contain economic and biological data for each of the species. These manuals will inform landowners and forest managers how to manage forests for timber and/or carbon credits, how to maximize financial returns, how much money can be earned, and how much carbon can be stored. Manuals will be disseminated through state and federal agricultural extension services and the forest service of each state, and will be published in forest landowner magazines.« less
Enhancement of Terrestrial Carbon Sinks through the Reclamation of Abandoned Mined Lands

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

Gary Kronrad

2005-04-30

This project will determine the optimal forest management method to employ for each of the major commercial tree species so that profitability of timber production only or the combination of timber production and carbon sequestration is maximized. The goal of this project is to achieve DOE's long-term cost goal of sequestering carbon at $10 or less per ton. Because the potential of a forest ecosystem to sequester carbon depends on the species, site quality and management regimes utilized, this project will determine how to optimize carbon sequestration by determining how to optimally manage each species, given a range of sitemore » qualities and economic variables. This project also will determine the effects of a carbon credit market on the method and profitability of forest management, the cost of sequestering carbon, and the amount of carbon that can be sequestered. Information from this project will be used to produce user-friendly manuals which will contain economic and biological data for each of the species. These manuals will inform landowners and forest managers how to manage forests for timber and/or carbon credits, how to maximize financial returns, how much money can be earned, and how much carbon can be stored. Manuals will be disseminated through state and federal agricultural extension services and the forest service of each state, and will be published in forest landowner magazines.« less

Enhancement of Terrestrial Carbon Sinks throught the Reclamation of Abandoned Mined Lands

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

Gary Kronrad

2006-06-30

This project will determine the optimal forest management method to employ for each of the major commercial tree species so that profitability of timber production only or the combination of timber production and carbon sequestration is maximized. The goal of this project is to achieve DOE's long-term cost goal of sequestering carbon at $10 or less per ton. Because the potential of a forest ecosystem to sequester carbon depends on the species, site quality and management regimes utilized, this project will determine how to optimize carbon sequestration by determining how to optimally manage each species, given a range of sitemore » qualities and economic variables. This project also will determine the effects of a carbon credit market on the method and profitability of forest management, the cost of sequestering carbon, and the amount of carbon that can be sequestered. Information from this project will be used to produce user-friendly manuals which will contain economic and biological data for each of the species. These manuals will inform landowners and forest managers how to manage forests for timber and/or carbon credits, how to maximize financial returns, how much money can be earned, and how much carbon can be stored. Manuals will be disseminated through state and federal agricultural extension services and the forest service of each state, and will be published in forest landowner magazines.« less
The psychiatric nurse specialist: a valuable asset in the general hospital.

PubMed

Fife, B; Lemler, S

1983-04-01

In summary, what are the ways in which the psychiatric/mental clinical specialist contributes to cost-effectiveness, the professional growth of nursing staff, and quality patient care in the general hospital setting? All services of the psychiatric/mental health clinical specialist are ultimately directed toward increasing the effectiveness with which staff can deliver care. This goal is accomplished by helping staff nurses maximize their knowledge, by providing needed educational opportunities, by promoting the use of a holistic model of care, and by helping staff cope with their own stress. In our experience, high quality care that meets the physiological, psychological, and sociological needs of patients decreases the length of the hospital stay, prevents repeated hospitalizations, and minimizes the development of psychosocial problems secondary to the illness. With the necessary support and cooperation from administration, this clinical specialist role reduces health care costs, promotes a higher level of functioning in patients and their families, and increases the level of job satisfaction for the staff who provide direct bedside care.
Recent advances in yeast cell-surface display technologies for waste biorefineries.

PubMed

Liu, Zhuo; Ho, Shih-Hsin; Hasunuma, Tomohisa; Chang, Jo-Shu; Ren, Nan-Qi; Kondo, Akihiko

2016-09-01

Waste biorefinery aims to maximize the output of value-added products from various artificial/agricultural wastes by using integrated bioprocesses. To make waste biorefinery economically feasible, it is thus necessary to develop a low-cost, environment-friendly technique to perform simultaneous biodegradation and bioconversion of waste materials. Cell-surface display engineering is a novel, cost-effective technique that can auto-immobilize proteins on the cell exterior of microorganisms, and has been applied for use with waste biofinery. Through tethering different enzymes (e.g., cellulase, lipase, and protease) or metal-binding peptides on cell surfaces, various yeast strains can effectively produce biofuels and biochemicals from sugar/protein-rich waste materials, catalyze waste oils into biodiesels, or retrieve heavy metals from wastewater. This review critically summarizes recent applications of yeast cell-surface display on various types of waste biorefineries, highlighting its potential and future challenges with regard to commercializing this technology. Copyright © 2016 Elsevier Ltd. All rights reserved.
What a difference a day makes—female behaviour is less predictable near ovulation

PubMed Central

Richter, S. Helene; Gamer, Matthias; Kaiser, Sylvia; Sachser, Norbert

2017-01-01

‘Animal personalities’ have been shown to exist in many species. Yet, fluctuations in the stability of these inter-individual behavioural differences are not well understood. Against this background, we wondered whether behavioural consistency over time is affected by the reproductive cycle. Female mice were tested twice at an interval of eight weeks in four paradigms assessing social interest as well as anxiety-like behaviour and exploratory locomotion. Twenty-two individuals were tested repeatedly near ovulation, whereas another twenty-two were tested repeatedly in the non-receptive phase. While we found no major behavioural effects at the group level, the reproductive state indeed had profound effects on behavioural stability over time: social interest as well as anxiety-like behaviour proved to be significantly less predictable near ovulation. It is generally believed that phenotypic plasticity is limited due to the costs it brings about. In this context, our data indicate that females accept higher costs in phases directly related to fitness maximization. PMID:28484619
Global alliances effect in coalition forming

NASA Astrophysics Data System (ADS)

Vinogradova, Galina; Galam, Serge

2014-11-01

Coalition forming is investigated among countries, which are coupled with short range interactions, under the influence of externally-set opposing global alliances. The model extends a recent Natural Model of coalition forming inspired from Statistical Physics, where instabilities are a consequence of decentralized maximization of the individual benefits of actors. In contrast to physics where spins can only evaluate the immediate cost/benefit of a flip of orientation, countries have a long horizon of rationality, which associates with the ability to envision a way up to a better configuration even at the cost of passing through intermediate loosing states. The stabilizing effect is produced through polarization by the global alliances of either a particular unique global interest factor or multiple simultaneous ones. This model provides a versatile theoretical tool for the analysis of real cases and design of novel strategies. Such analysis is provided for several real cases including the Eurozone. The results shed a new light on the understanding of the complex phenomena of planned stabilization in the coalition forming.
Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health

PubMed Central

Thornton, Rachel L. J.; Glover, Crystal M.; Cené, Crystal W.; Glik, Deborah C.; Henderson, Jeffrey A.; Williams, David R.

2017-01-01

Research reveals that the opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. This article reviews scientific evidence from promising interventions focused on the social determinants of health, and describes ways in which they can improve population health and reduce health disparities. We show that there is sufficient evidence to support policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. When available, cost-effectiveness evaluations show that these interventions lead to long-term societal savings; however, more routine attention to cost considerations is needed for these interventions. We also discuss challenges to implementation, including the need for long-term financing in order to scale-up effective interventions for implementation at the local, state, or national level. Although we know enough to act, questions remain about how to optimally scale-up these interventions and maximize their benefits for the most vulnerable populations. PMID:27503966
Titrating versus targeting home care services to frail elderly clients: an application of agency theory and cost-benefit analysis to home care policy.

PubMed

Weissert, William; Chernew, Michael; Hirth, Richard

2003-02-01

The article summarizes the shortcomings of current home care targeting policy, provides a conceptual framework for understanding the sources of its problems, and proposes an alternative resource allocation method. Methods required for different aspects of the study included synthesis of the published literature, regression analysis of risk predictors, and comparison of actual resource allocations with simulated budgets. Problems of imperfect agency ranging from unclear goals and inappropriate incentives to lack of information about the marginal effectiveness of home care could be mitigated with an improved budgeting method that combines client selection and resource allocation. No program can produce its best outcome performance when its goals are unclear and its technology is unstandardized. Titration of care would reallocate resources to maximize marginal benefit for marginal cost.
Optimal technology investment strategies for a reusable launch vehicle

NASA Technical Reports Server (NTRS)

Moore, A. A.; Braun, R. D.; Powell, R. W.

1995-01-01

Within the present budgetary environment, developing the technology that leads to an operationally efficient space transportation system with the required performance is a challenge. The present research focuses on a methodology to determine high payoff technology investment strategies. Research has been conducted at Langley Research Center in which design codes for the conceptual analysis of space transportation systems have been integrated in a multidisciplinary design optimization approach. The current study integrates trajectory, propulsion, weights and sizing, and cost disciplines where the effect of technology maturation on the development cost of a single stage to orbit reusable launch vehicle is examined. Results show that the technology investment prior to full-scale development has a significant economic payoff. The design optimization process is used to determine strategic allocations of limited technology funding to maximize the economic payoff.
Beyond bricks and mortar: recent research on substance use disorder recovery management.

PubMed

Dennis, Michael L; Scott, Christy K; Laudet, Alexandre

2014-04-01

Scientific advances in the past 15 years have clearly highlighted the need for recovery management approaches to help individuals sustain recovery from chronic substance use disorders. This article reviews some of the recent findings related to recovery management: (1) continuing care, (2) recovery management checkups, (3) 12-step or mutual aid, and (4) technology-based interventions. The core assumption underlying these approaches is that earlier detection and re-intervention will improve long-term outcomes by minimizing the harmful consequences of the condition and maximizing or promoting opportunities for maintaining healthy levels of functioning in related life domains. Economic analysis is important because it can take a year or longer for such interventions to offset their costs. The article also examines the potential of smartphones and other recent technological developments to facilitate more cost-effective recovery management options.
Stabilization for sampled-data neural-network-based control systems.

PubMed

Zhu, Xun-Lin; Wang, Youyi

2011-02-01

This paper studies the problem of stabilization for sampled-data neural-network-based control systems with an optimal guaranteed cost. Unlike previous works, the resulting closed-loop system with variable uncertain sampling cannot simply be regarded as an ordinary continuous-time system with a fast-varying delay in the state. By defining a novel piecewise Lyapunov functional and using a convex combination technique, the characteristic of sampled-data systems is captured. A new delay-dependent stabilization criterion is established in terms of linear matrix inequalities such that the maximal sampling interval and the minimal guaranteed cost control performance can be obtained. It is shown that the newly proposed approach can lead to less conservative and less complex results than the existing ones. Application examples are given to illustrate the effectiveness and the benefits of the proposed method.
Final Report DOE SSL Grant (No. DE-EE0006673) Advanced Light Extraction Structure for OLED Lighting

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

Cooper, Gregory; Monickam, Selina

The innovation proposed in this grant is to demonstrate a novel internal light extraction (ILE) design that can maximize the energy efficiency of Organic Light Emitting Diode (OLED) lighting devices without negatively impacting the device voltage, efficacy or angular color dependences. Even though, OLEDs have unique features compared to its inorganic counterparts, LEDs, in terms of technology development and market readiness levels, it still lags LEDs by several years. The main challenges as identified in the National Research Council’s 2013 Assessment on Solid State Lighting, are the cost of the materials and the low light extraction efficacy [1]. Improving themore » light extraction will improve both the $/Klm and lm/W, two important metrics DOE uses to measure the cost effectiveness of a light source.« less
Cost-effectiveness of exercise therapy versus general practitioner care for osteoarthritis of the hip: design of a randomised clinical trial.

PubMed

van Es, Pauline P; Luijsterburg, Pim A J; Dekker, Joost; Koopmanschap, Marc A; Bohnen, Arthur M; Verhaar, Jan A N; Koes, Bart W; Bierma-Zeinstra, Sita M A

2011-10-12

Osteoarthritis (OA) is the most common joint disease, causing pain and functional impairments. According to international guidelines, exercise therapy has a short-term effect in reducing pain/functional impairments in knee OA and is therefore also generally recommended for hip OA. Because of its high prevalence and clinical implications, OA is associated with considerable (healthcare) costs. However, studies evaluating cost-effectiveness of common exercise therapy in hip OA are lacking. Therefore, this randomised controlled trial is designed to investigate the cost-effectiveness of exercise therapy in conjunction with the general practitioner's (GP) care, compared to GP care alone, for patients with hip OA. Patients aged ≥ 45 years with OA of the hip, who consulted the GP during the past year for hip complaints and who comply with the American College of Rheumatology criteria, are included. Patients are randomly assigned to either exercise therapy in addition to GP care, or to GP care alone. Exercise therapy consists of (maximally) 12 treatment sessions with a physiotherapist, and home exercises. These are followed by three additional treatment sessions in the 5th, 7th and 9th month after the first treatment session. GP care consists of usual care for hip OA, such as general advice or prescribing pain medication. Primary outcomes are hip pain and hip-related activity limitations (measured with the Hip disability Osteoarthritis Outcome Score [HOOS]), direct costs, and productivity costs (measured with the PROductivity and DISease Questionnaire). These parameters are measured at baseline, at 6 weeks, and at 3, 6, 9 and 12 months follow-up. To detect a 25% clinical difference in the HOOS pain score, with a power of 80% and an alpha 5%, 210 patients are required. Data are analysed according to the intention-to-treat principle. Effectiveness is evaluated using linear regression models with repeated measurements. An incremental cost-effectiveness analysis and an incremental cost-utility analysis will also be performed. The results of this trial will provide insight into the cost-effectiveness of adding exercise therapy to GPs' care in the treatment of OA of the hip. This trial is registered in the Dutch trial registry http://www.trialregister.nl: trial number NTR1462.
A framework for improving the cost-effectiveness of DSM program evaluations

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

Sonnenblick, R.; Eto, J.

The prudence of utility demand-side management (DSM) investments hinges on their performance, yet evaluating performance is complicated because the energy saved by DSM programs can never be observed directly but only inferred. This study frames and begins to answer the following questions: (1) how well do current evaluation methods perform in improving confidence in the measurement of energy savings produced by DSM programs; (2) in view of this performance, how can limited evaluation resources be best allocated to maximize the value of the information they provide? The authors review three major classes of methods for estimating annual energy savings: trackingmore » database (sometimes called engineering estimates), end-use metering, and billing analysis and examine them in light of the uncertainties in current estimates of DSM program measure lifetimes. The authors assess the accuracy and precision of each method and construct trade-off curves to examine the costs of increases in accuracy or precision. Several approaches for improving evaluations for the purpose of assessing program cost effectiveness are demonstrated. The methods can be easily generalized to other evaluation objectives, such as shared savings incentive payments.« less
Two additional principles for determining which species to monitor.

PubMed

Wilson, Howard B; Rhodes, Jonathan R; Possingham, Hugh P

2015-11-01

Monitoring to detect population declines is widespread, but also costly. There is, consequently, a need to optimize monitoring to maximize cost-effectiveness. Here we develop a quantitative decision analysis framework for how to optimally allocate resources for monitoring among species. By keeping the framework simple, we analytically establish two new principles about which species are optimal to monitor for detecting declines: (1) those that lie on the boundary between species being allocated resources for conservation action and species that are not and (2) those with the greatest uncertainty in whether they are declining. These two principles are in addition to other factors that are also important in monitoring decisions, such as complementarity. We demonstrate the efficacy of these principles when other factors are not present, and show how the two principles can be combined. This analysis demonstrates that the most cost-effective species to monitor are ones where the information gained from monitoring is most likely to change the allocation of funds for action, not necessarily the most vulnerable or endangered. We suggest these results are general and apply to all ecological monitoring, not just of biological species: monitoring and information are only valuable when they are likely to change how people act.
Design optimization of a fuzzy distributed generation (DG) system with multiple renewable energy sources

NASA Astrophysics Data System (ADS)

Ganesan, T.; Elamvazuthi, I.; Shaari, Ku Zilati Ku; Vasant, P.

2012-09-01

The global rise in energy demands brings major obstacles to many energy organizations in providing adequate energy supply. Hence, many techniques to generate cost effective, reliable and environmentally friendly alternative energy source are being explored. One such method is the integration of photovoltaic cells, wind turbine generators and fuel-based generators, included with storage batteries. This sort of power systems are known as distributed generation (DG) power system. However, the application of DG power systems raise certain issues such as cost effectiveness, environmental impact and reliability. The modelling as well as the optimization of this DG power system was successfully performed in the previous work using Particle Swarm Optimization (PSO). The central idea of that work was to minimize cost, minimize emissions and maximize reliability (multi-objective (MO) setting) with respect to the power balance and design requirements. In this work, we introduce a fuzzy model that takes into account the uncertain nature of certain variables in the DG system which are dependent on the weather conditions (such as; the insolation and wind speed profiles). The MO optimization in a fuzzy environment was performed by applying the Hopfield Recurrent Neural Network (HNN). Analysis on the optimized results was then carried out.
Estimating the Cost of Early Infant Male Circumcision in Zimbabwe: Results From a Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp

PubMed Central

Mavhu, Webster; Hatzold, Karin; Biddle, Andrea K.; Madidi, Ngonidzashe; Ncube, Getrude; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M.; Thirumurthy, Harsha

2015-01-01

Background: Safe and cost-effective programs for implementing early infant male circumcision (EIMC) in Africa need to be piloted. We present results on a relative cost analysis within a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. Methods: Between January and June 2013, male infants who met inclusion criteria were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. We evaluated the overall unit cost plus the key cost drivers of EIMC using both AccuCirc and Mogen clamp. Direct costs included consumable and nonconsumable supplies, device, personnel, associated staff training, and environmental costs. Indirect costs comprised capital and support personnel costs. In 1-way sensitivity analyses, we assessed potential changes in unit costs due to variations in main parameters, one at a time, holding all other values constant. Results: The unit costs of EIMC using AccuCirc and Mogen clamp were $49.53 and $55.93, respectively. Key cost drivers were consumable supplies, capacity utilization, personnel costs, and device price. Unit prices are likely to be lowest at full capacity utilization and increase as capacity utilization decreases. Unit prices also fall with lower personnel salaries and increase with higher device prices. Conclusions: EIMC has a lower unit cost when using AccuCirc compared with Mogen clamp. To minimize unit costs, countries planning to scale-up EIMC using AccuCirc need to control costs of consumables and personnel. There is also need to negotiate a reasonable device price and maximize capacity utilization. PMID:26017658
Biobankonomics: developing a sustainable business model approach for the formation of a human tissue biobank.

PubMed

Vaught, Jimmie; Rogers, Joyce; Carolin, Todd; Compton, Carolyn

2011-01-01

The preservation of high-quality biospecimens and associated data for research purposes is being performed in variety of academic, government, and industrial settings. Often these are multimillion dollar operations, yet despite these sizable investments, the economics of biobanking initiatives is not well understood. Fundamental business principles must be applied to the development and operation of such resources to ensure their long-term sustainability and maximize their impact. The true costs of developing and maintaining operations, which may have a variety of funding sources, must be better understood. Among the issues that must be considered when building a biobank economic model are: understanding the market need for the particular type of biobank under consideration and understanding and efficiently managing the biobank's "value chain," which includes costs for case collection, tissue processing, storage management, sample distribution, and infrastructure and administration. By using these value chain factors, a Total Life Cycle Cost of Ownership (TLCO) model may be developed to estimate all costs arising from owning, operating, and maintaining a large centralized biobank. The TLCO approach allows for a better delineation of a biobank's variable and fixed costs, data that will be needed to implement any cost recovery program. This article represents an overview of the efforts made recently by the National Cancer Institute's Office of Biorepositories and Biospecimen Research as part of its effort to develop an appropriate cost model and cost recovery program for the cancer HUman Biobank (caHUB) initiative. All of these economic factors are discussed in terms of maximizing caHUB's potential for long-term sustainability but have broad applicability to the wide range of biobanking initiatives that currently exist.
Societal and Economic Effect of Meniscus Scaffold Procedures for Irreparable Meniscus Injuries.

PubMed

Rongen, Jan J; Govers, Tim M; Buma, Pieter; Grutters, Janneke P C; Hannink, Gerjon

2016-07-01

Meniscus scaffolds are currently evaluated clinically for their efficacy in preventing the development of osteoarthritis as well as for their efficacy in treating patients with chronic symptoms. Procedural costs, therapeutic consequences, clinical efficacy, and future events should all be considered to maximize the monetary value of this intervention. To examine the socioeconomic effect of treating patients with irreparable medial meniscus injuries with a meniscus scaffold. Economic and decision analysis; Level of evidence, 2. Two Markov simulation models for patients with an irreparable medial meniscus injury were developed. Model 1 was used to investigate the lifetime cost-effectiveness of a meniscus scaffold compared with standard partial meniscectomy by the possibility of preventing the development of osteoarthritis. Model 2 was used to investigate the short-term (5-year) cost-effectiveness of a meniscus scaffold compared with standard partial meniscectomy by alleviating clinical symptoms, specifically in chronic patients with previous meniscus surgery. For both models, probabilistic Monte Carlo simulations were applied. Treatment effectiveness was expressed as quality-adjusted life-years (QALYs), while costs (estimated in euros) were assessed from a societal perspective. We assumed €20,000 as a reference value for the willingness to pay per QALY. Next, comprehensive sensitivity analyses were performed to identify the most influential variables on the cost-effectiveness of meniscus scaffolds. Model 1 demonstrated an incremental cost-effectiveness ratio of a meniscus scaffold treatment of €54,463 per QALY (€5991/0.112). A threshold analysis demonstrated that a meniscus scaffold should offer a relative risk reduction of at least 0.34 to become cost-effective, assuming a willingness to pay of €20,000. Decreasing the costs of the meniscus scaffold procedure by 33% (€10,160 instead of €15,233; an absolute change of €5073) resulted in an incremental cost-effectiveness ratio of €7876 per QALY. Model 2 demonstrated an incremental cost-effectiveness ratio of a meniscus scaffold treatment of €297,727 per QALY (€9825/0.033). On the basis of the current efficacy data, a meniscus scaffold provides a relative risk reduction of "limited benefit" postoperatively of 0.37 compared with standard treatment. A threshold analysis revealed that assuming a willingness to pay of €20,000, a meniscus scaffold would not be cost-effective within a period of 5 years. Most influential variables on the cost-effectiveness of meniscus scaffolds were the cost of the scaffold procedure, cost associated with osteoarthritis, and quality of life before and after the scaffold procedure. Results of the current health technology assessment emphasize that the monetary value of meniscus scaffold procedures is very much dependent on a number of influential variables. Therefore, before implementing the technology in the health care system, it is important to critically assess these variables in a relevant context. The models can be improved as additional clinical data regarding the efficacy of the meniscus scaffold become available. © 2016 The Author(s).
Constant Observation of Suicidal Patients: The Intervention We Love to Hate.

PubMed

Russ, Mark J

2016-09-01

Constant observation (CO) of psychiatric inpatients at risk for suicidal behavior has been criticized in the literature because of the absence of demonstrable effectiveness, associated costs, staff and patient acceptance, and related issues. Our inability to demonstrate effectiveness, however, is an ethical conundrum that cannot readily be solved. Frequent and often vociferous references in the literature to the absence of an evidence base for this intervention carries the risk that CO may be underutilized in particular clinical circumstances with untoward results. A case is made for shifting focus from the lack of evidence supporting CO to agreement on an observation protocol that achieves the desired goal of maximizing patient safety. A sample protocol is presented.
The OPTIMIST study: optimisation of cost effectiveness through individualised FSH stimulation dosages for IVF treatment. A randomised controlled trial.

PubMed

van Tilborg, Theodora C; Eijkemans, Marinus J C; Laven, Joop S E; Koks, Carolien A M; de Bruin, Jan Peter; Scheffer, Gabrielle J; van Golde, Ron J T; Fleischer, Kathrin; Hoek, Annemieke; Nap, Annemiek W; Kuchenbecker, Walter K H; Manger, Petra A; Brinkhuis, Egbert A; van Heusden, Arne M; Sluijmer, Alexander V; Verhoeff, Arie; van Hooff, Marcel H A; Friederich, Jaap; Smeenk, Jesper M J; Kwee, Janet; Verhoeve, Harold R; Lambalk, Cornelis B; Helmerhorst, Frans M; van der Veen, Fulco; Mol, Ben Willem J; Torrance, Helen L; Broekmans, Frank J M

2012-09-18

Costs of in vitro fertilisation (IVF) are high, which is partly due to the use of follicle stimulating hormone (FSH). FSH is usually administered in a standard dose. However, due to differences in ovarian reserve between women, ovarian response also differs with potential negative consequences on pregnancy rates. A Markov decision-analytic model showed that FSH dose individualisation according to ovarian reserve is likely to be cost-effective in women who are eligible for IVF. However, this has never been confirmed in a large randomised controlled trial (RCT). The aim of the present study is to assess whether an individualised FSH dose regime based on an ovarian reserve test (ORT) is more cost-effective than a standard dose regime. Multicentre RCT in subfertile women indicated for a first IVF or intracytoplasmic sperm injection cycle, who are aged < 44 years, have a regular menstrual cycle and no major abnormalities at transvaginal sonography. Women with polycystic ovary syndrome, endocrine or metabolic abnormalities and women undergoing IVF with oocyte donation, will not be included. Ovarian reserve will be assessed by measuring the antral follicle count. Women with a predicted poor response or hyperresponse will be randomised for a standard versus an individualised FSH regime (150 IU/day, 225-450 IU/day and 100 IU/day, respectively). Participants will undergo a maximum of three stimulation cycles during maximally 18 months. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months after randomisation. Secondary outcomes are parameters for ovarian response, multiple pregnancies, number of cycles needed per live birth, total IU of FSH per stimulation cycle, and costs. All data will be analysed according to the intention-to-treat principle. Cost-effectiveness analysis will be performed to assess whether the health and associated economic benefits of individualised treatment of subfertile women outweigh the additional costs of an ORT. The results of this study will be integrated into a decision model that compares cost-effectiveness of the three dose-adjustment strategies to a standard dose strategy. The study outcomes will provide scientific foundation for national and international guidelines. NTR2657.

The application of iodine and magnetic susceptibility surface geochemical surveys in the Lodgepole Play, Eastern Williston Basin, North Dakota

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

Tedesco, S.A.

1996-06-01

The use of surface geochemistry as a first pass exploration tool is becoming more prevalent in petroleum exploration. This is especially true due to the high cost of 2-D and 3-D surveys in defining small targets such as the Waulsortian mounds of the Lodgepole Formation. Surface geochemical surveys are very effective in pinpointing specific target areas for seismic surveying and thus reducing costs. Presented are examples of surface geochemical surveys utilizing magnetic susceptibility and iodine methods in delineating reservoirs in the Lodgepole, Mission Canyon and Red River formations. The types of surveys presented vary from reconnaissance to detail and examplesmore » of how to define a grid will be discussed. Surface geochemical surveys can be very effective when the areal extent of the target(s) and the purpose of the survey are clearly defined prior to implementation. By determining which areas have microseepage and which areas do not, surface geochemistry can be a very effective tool in focusing exploration efforts and maximizing exploration dollars.« less
Incorporating uncertainty of management costs in sensitivity analyses of matrix population models.

PubMed

Salomon, Yacov; McCarthy, Michael A; Taylor, Peter; Wintle, Brendan A

2013-02-01

The importance of accounting for economic costs when making environmental-management decisions subject to resource constraints has been increasingly recognized in recent years. In contrast, uncertainty associated with such costs has often been ignored. We developed a method, on the basis of economic theory, that accounts for the uncertainty in population-management decisions. We considered the case where, rather than taking fixed values, model parameters are random variables that represent the situation when parameters are not precisely known. Hence, the outcome is not precisely known either. Instead of maximizing the expected outcome, we maximized the probability of obtaining an outcome above a threshold of acceptability. We derived explicit analytical expressions for the optimal allocation and its associated probability, as a function of the threshold of acceptability, where the model parameters were distributed according to normal and uniform distributions. To illustrate our approach we revisited a previous study that incorporated cost-efficiency analyses in management decisions that were based on perturbation analyses of matrix population models. Incorporating derivations from this study into our framework, we extended the model to address potential uncertainties. We then applied these results to 2 case studies: management of a Koala (Phascolarctos cinereus) population and conservation of an olive ridley sea turtle (Lepidochelys olivacea) population. For low aspirations, that is, when the threshold of acceptability is relatively low, the optimal strategy was obtained by diversifying the allocation of funds. Conversely, for high aspirations, the budget was directed toward management actions with the highest potential effect on the population. The exact optimal allocation was sensitive to the choice of uncertainty model. Our results highlight the importance of accounting for uncertainty when making decisions and suggest that more effort should be placed on understanding the distributional characteristics of such uncertainty. Our approach provides a tool to improve decision making. © 2013 Society for Conservation Biology.
5 strategies for improving performance of academic medical centers.

PubMed

Valletta, Robert M; Harkness, Alicia

2013-06-01

Academic medical centers should consider five strategies for becoming more cost-efficient and profitable as reforms are implemented: Make faculty responsible for cost and quality. Explore opportunities to collaborate with community hospitals. Extend care and education beyond the walls of the organization, employing technology and innovative teaching practices. Maximize healthcare IT investment by sharing data-rich patient records with other medical centers and research institutes. Align research with business strategy.
Cost Reduction in Vertically Related Industries: Integration versus Nonlinear Pricing,

DTIC Science & Technology

1983-05-01

monopoly controlled -.0. by a welfare (profit plus consumer surplus) maximizing social planner. In the latter case (and only then), it is assumed...sufficient for both superior welfare and profit performance. Inducing the same final good implies that both consumer surplus and industry revenue will be...profits at zero, industry cost savings translate dollar for dollar into higher profits for the upstream monopolist. And, with the same consumer surplus
On-Line Thermal Barrier Coating Monitoring for Real-Time Failure Protection and Life Maximization

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

Dennis H. LeMieux

2004-10-01

Under the sponsorship of the U. S. Department of Energy's National Energy Laboratory, Siemens Westinghouse Power Corporation proposes a four year program titled, ''On-Line Thermal Barrier Coating (TBC) Monitor for Real-Time Failure Protection and Life Maximization'', to develop, build and install the first generation of an on-line TBC monitoring system for use on land -based advanced gas turbines (AGT). Federal deregulation in electric power generation has accelerated power plant owner's demand for improved reliability availability maintainability (RAM) of the land-based advanced gas turbines. As a result, firing temperatures have been increased substantially in the advanced turbine engines, and the TBCsmore » have been developed for maximum protection and life of all critical engine components operating at these higher temperatures. Losing TBC protection can therefore accelerate the degradation of substrate components materials and eventually lead to a premature failure of critical component and costly unscheduled power outages. This program seeks to substantially improve the operating life of high cost gas turbine components using TBC; thereby, lowering the cost of maintenance leading to lower cost of electricity. Siemens Westinghouse Power Corporation has teamed with Indigo Systems; a supplier of state-of-the-art infrared camera systems, and Wayne State University, a leading research organization.« less
Hybrid solar converters for maximum exergy and inexpensive dispatchable electricity

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

Branz, Howard M.; Regan, William; Gerst, Kacy J.

Photovoltaic (PV) solar energy systems are being deployed at an accelerating rate to supply low-carbon electricity worldwide. However, PV is unlikely to economically supply much more than 10% of the world's electricity unless there is a dramatic reduction in the cost of electricity storage. There is an important scientific and technological opportunity to address the storage challenge by developing inexpensive hybrid solar converters that collect solar heat at temperatures between about 200 and 600 °C and also incorporate PV. Since heat can be stored and converted to electricity at relatively low cost, collection of high exergy content (high temperature) solarmore » heat can provide energy that is dispatchable on demand to meet loads that are not well matched to solar insolation. However, PV cells can collect and convert much of the solar spectrum to electricity more efficiently and inexpensively than solar thermal systems. Advances in spectrum-splitting optics, high-temperature PV cells, thermal management and system design are needed for transformational hybrid converters. We propose that maximizing the exergy output from the solar converters while minimizing the cost of exergy can help propel solar energy toward a higher contribution to carbon-free electricity in the long term than the prevailing paradigm of maximizing the energy output while minimizing the cost of energy« less
NASA Regional Planetary Image Facility

NASA Technical Reports Server (NTRS)

Arvidson, Raymond E.

2001-01-01

The Regional Planetary Image Facility (RPIF) provided access to data from NASA planetary missions and expert assistance about the data sets and how to order subsets of the collections. This ensures that the benefit/cost of acquiring the data is maximized by widespread dissemination and use of the observations and resultant collections. The RPIF provided education and outreach functions that ranged from providing data and information to teachers, involving small groups of highly motivated students in its activities, to public lectures and tours. These activities maximized dissemination of results and data to the educational and public communities.
Intelligent transportation systems : tools to maximize state transportation investments

DOT National Transportation Integrated Search

1997-07-28

This Issue Brief summarizes national ITS goals and state transportation needs. It reviews states experience with ITS to date and discusses the utility of ITS technologies to improve transportation infrastructure. The Issue Brief also provides cost...
Managing risks in the project pipeline.

DOT National Transportation Integrated Search

2013-08-01

This research focuses on how to manage the risks of project costs and revenue uncertainties over the long-term, and identifies significant : process improvements to ensure projects are delivered on time and as intended, thus maximizing the miles pave...
NREL to Assist in Development and Evaluation of Class 6 Plug-in Hybrid

Science.gov Websites

, and emissions, as well as the potential impacts on life-cycle costs, barriers to implementation, and application and maximizing potential energy efficiency, emissions, economic, and performance impacts."
The costs and benefits of library site licenses to academic journals

PubMed Central

Bergstrom, Carl T.; Bergstrom, Theodore C.

2004-01-01

Scientific publishing is rapidly shifting from a paper-based system to one of predominantly electronic distribution, in which universities purchase site licenses for online access to journal contents. Will these changes necessarily benefit the scientific community? By using basic microeconomics and elementary statistical theory, we address this question and find a surprising answer. If a journal is priced to maximize the publisher's profits, scholars on average are likely to be worse off when universities purchase site licenses than they would be if access were by individual subscriptions only. However, site licenses are not always disadvantageous. Journals issued by professional societies and university presses are often priced so as to maximize subscriptions while recovering average costs. When such journals are sustained by institutional site licenses, the net benefits to the scientific community are larger than if these journals are sold only by individual subscriptions. PMID:14715902
The costs and benefits of library site licenses to academic journals.

PubMed

Bergstrom, Carl T; Bergstrom, Theodore C

2004-01-20

Scientific publishing is rapidly shifting from a paper-based system to one of predominantly electronic distribution, in which universities purchase site licenses for online access to journal contents. Will these changes necessarily benefit the scientific community? By using basic microeconomics and elementary statistical theory, we address this question and find a surprising answer. If a journal is priced to maximize the publisher's profits, scholars on average are likely to be worse off when universities purchase site licenses than they would be if access were by individual subscriptions only. However, site licenses are not always disadvantageous. Journals issued by professional societies and university presses are often priced so as to maximize subscriptions while recovering average costs. When such journals are sustained by institutional site licenses, the net benefits to the scientific community are larger than if these journals are sold only by individual subscriptions.
The anterior insula bidirectionally modulates cost-benefit decision-making on a rodent gambling task.

PubMed

Daniel, M L; Cocker, P J; Lacoste, J; Mar, A C; Houeto, J L; Belin-Rauscent, A; Belin, D

2017-11-01

Deficits in cost-benefit decision-making, as assessed in the Iowa Gambling Task (IGT), are commonly observed in neuropsychiatric disorders such as addiction. There is considerable variation in the maximization of rewards on such tasks, both in the general population and in rodent models, suggesting individual differences in decision-making may represent a key endophenotype for vulnerability to neuropsychiatric disorders. Increasing evidence suggests that the insular cortex, which is involved in interoception and emotional processes in humans, may be a key neural locus in the control of decision-making processes. However, the extent to which the insula contributes to individual differences in cost-benefit decision-making remains unknown. Using male Sprague Dawley rats, we first assessed individual differences in the performance over the course of a single session on a rodent analogue of the IGT (rGT). Rats were matched for their ability to maximize reward and received bilateral excitotoxic or sham lesions of the anterior insula cortex (AIC). Animals were subsequently challenged on a second rGT session with altered contingencies. Finally, animals were also assessed for instrumental conditioning and reversal learning. AIC lesions produced bidirectional alterations on rGT performance; rats that had performed optimally prior to surgery subsequently showed impairments, and animals that had performed poorly showed improvements in comparison with sham-operated controls. These bidirectional effects were not attributable to alterations in behavioural flexibility or in motivation. These data suggest that the recruitment of the AIC during decision-making may be state-dependent and help guide response selection towards subjectively favourable options. © 2017 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Human skeletal muscle metabolic economy in vivo: effects of contraction intensity, age, and mobility impairment

PubMed Central

Christie, Anita D.; Tonson, Anne; Larsen, Ryan G.; DeBlois, Jacob P.

2014-01-01

We tested the hypothesis that older muscle has greater metabolic economy (ME) in vivo than young, in a manner dependent, in part, on contraction intensity. Twenty young (Y; 24 ± 1 yr, 10 women), 18 older healthy (O; 73 ± 2, 9 women) and 9 older individuals with mild-to-moderate mobility impairment (OI; 74 ± 1, 7 women) received stimulated twitches (2 Hz, 3 min) and performed nonfatiguing voluntary (20, 50, and 100% maximal; 12 s each) isometric dorsiflexion contractions. Torque-time integrals (TTI; Nm·s) were calculated and expressed relative to maximal fat-free muscle cross-sectional area (cm2), and torque variability during voluntary contractions was calculated as the coefficient of variation. Total ATP cost of contraction (mM) was determined from flux through the creatine kinase reaction, nonoxidative glycolysis and oxidative phosphorylation, and used to calculate ME (Nm·s·cm−2·mM ATP−1). While twitch torque relaxation was slower in O and OI compared with Y (P ≤ 0.001), twitch TTI, ATP cost, and economy were similar across groups (P ≥ 0.15), indicating comparable intrinsic muscle economy during electrically induced isometric contractions in vivo. During voluntary contractions, normalized TTI and total ATP cost did not differ significantly across groups (P ≥ 0.20). However, ME was lower in OI than Y or O at 20% and 50% MVC (P ≤ 0.02), and torque variability was greater in OI than Y or O at 20% MVC (P ≤ 0.05). These results refute the hypothesis of greater muscle ME in old age, and provide support for lower ME in impaired older adults as a potential mechanism or consequence of age-related reductions in functional mobility. PMID:25163917
Restructuring American health care financing: first of all, do no harm!

PubMed

Berk, P D

1993-07-01

Health care costs are climbing throughout the western world. Aging populations and the costs of advanced technology are the principal forces behind much of this global increase. No country has yet succeeded in containing these growing costs other than by some form of rationing. A variety of experimental strategies, including managed competition, are being considered or tested, but none is clearly effective. American health care expenditures differ, not in that they are rising, but in their enormously high starting point. Among other things, our higher costs reflect administrative costs of more than 20%, double those of Canada and nearly triple the European average; a malpractice system that, whatever its possible advantages, costs more than 10 times as much as it pays out to the injured; the enormous medical costs of poverty; maldistribution of physician specialties and incomes; and reimbursement systems that eliminate consumer input and oversight. Restructuring the system of health care financing to bring administrative costs in line with those of other nations could save at least $70 billion annually; another $25 billion or more could be saved by replacing the malpractice system with more cost-effective alternatives. These savings could defray the costs of insuring all those not now covered, without increasing either costs to the middle class, through taxation of benefits, or total health care expenditures. With all Americans covered, the necessary restructuring of the system of health care delivery could be conducted without the current pressure for immediate drastic reform, which carries with it the risk of serious error. In dealing with the sick, physicians are taught to apply two maxims: "primum non nocere" or "first of all, do no harm!"; and the rule of therapeutic restraint. The latter states that a severe chronic illness may respond better, and with fewer complications, to gradual corrective measures than to highly aggressive therapy. Both rules could well be applied to curing the American health care system.
Cost Description and Comparative Cost Efficiency of Post-Exposure Prophylaxis and Canine Mass Vaccination against Rabies in N'Djamena, Chad.

PubMed

Mindekem, Rolande; Lechenne, Monique Sarah; Naissengar, Kemdongarti Service; Oussiguéré, Assandi; Kebkiba, Bidjeh; Moto, Daugla Doumagoum; Alfaroukh, Idriss Oumar; Ouedraogo, Laurent Tinoanga; Salifou, Sahidou; Zinsstag, Jakob

2017-01-01

Rabies claims approximately 59,000 human lives annually and is a potential risk to 3.3 billion people in over 100 countries worldwide. Despite being fatal in almost 100% of cases, human rabies can be prevented by vaccinating dogs, the most common vector, and the timely administration of post-exposure prophylaxis (PEP) to exposed victims. For the control and prevention of human rabies in N'Djamena, the capital city of Chad, a free mass vaccination campaign for dogs was organized in 2012 and 2013. The campaigns were monitored by parallel studies on the incidence of canine rabies based on diagnostic testing of suspect animals and the incidence of human bite exposure recorded at selected health facilities. Based on the cost description of the campaign and the need for PEP registered in health centers, three cost scenarios were compared: cumulative cost-efficiency of (1) PEP alone, (2) dog mass vaccination and PEP, (3) dog mass vaccination, PEP, and maximal communication between human health and veterinary workers (One Health communication). Assuming ideal One Health communication, the cumulative prospective cost of dog vaccination and PEP break even with the cumulative prospective cost of PEP alone in the 10th year from the start of the calculation (2012). The cost efficiency expressed in cost per human exposure averted is much higher with canine vaccination and One Health communication than with PEP alone. As shown in other studies, our cost-effectiveness analysis highlights that canine vaccination is financially the best option for animal rabies control and rabies prevention in humans. This study also provides evidence of the beneficial effect of One Health communication. Only with close communication between the human and animal health sectors will the decrease in animal rabies incidence be translated into a decline for PEP. An efficiently applied One Health concept would largely reduce the cost of PEP in resource poor countries and should be implemented for zoonosis control in general.
Cost Description and Comparative Cost Efficiency of Post-Exposure Prophylaxis and Canine Mass Vaccination against Rabies in N’Djamena, Chad

PubMed Central

Mindekem, Rolande; Lechenne, Monique Sarah; Naissengar, Kemdongarti Service; Oussiguéré, Assandi; Kebkiba, Bidjeh; Moto, Daugla Doumagoum; Alfaroukh, Idriss Oumar; Ouedraogo, Laurent Tinoanga; Salifou, Sahidou; Zinsstag, Jakob

2017-01-01

Rabies claims approximately 59,000 human lives annually and is a potential risk to 3.3 billion people in over 100 countries worldwide. Despite being fatal in almost 100% of cases, human rabies can be prevented by vaccinating dogs, the most common vector, and the timely administration of post-exposure prophylaxis (PEP) to exposed victims. For the control and prevention of human rabies in N’Djamena, the capital city of Chad, a free mass vaccination campaign for dogs was organized in 2012 and 2013. The campaigns were monitored by parallel studies on the incidence of canine rabies based on diagnostic testing of suspect animals and the incidence of human bite exposure recorded at selected health facilities. Based on the cost description of the campaign and the need for PEP registered in health centers, three cost scenarios were compared: cumulative cost-efficiency of (1) PEP alone, (2) dog mass vaccination and PEP, (3) dog mass vaccination, PEP, and maximal communication between human health and veterinary workers (One Health communication). Assuming ideal One Health communication, the cumulative prospective cost of dog vaccination and PEP break even with the cumulative prospective cost of PEP alone in the 10th year from the start of the calculation (2012). The cost efficiency expressed in cost per human exposure averted is much higher with canine vaccination and One Health communication than with PEP alone. As shown in other studies, our cost-effectiveness analysis highlights that canine vaccination is financially the best option for animal rabies control and rabies prevention in humans. This study also provides evidence of the beneficial effect of One Health communication. Only with close communication between the human and animal health sectors will the decrease in animal rabies incidence be translated into a decline for PEP. An efficiently applied One Health concept would largely reduce the cost of PEP in resource poor countries and should be implemented for zoonosis control in general. PMID:28421186
Designer drugs: the evolving science of drug discovery.

PubMed

Wanke, L A; DuBose, R F

1998-07-01

Drug discovery and design are fundamental to drug development. Until recently, most drugs were discovered through random screening or developed through molecular modification. New technologies are revolutionizing this phase of drug development. Rational drug design, using powerful computers and computational chemistry and employing X-ray crystallography, nuclear magnetic resonance spectroscopy, and three-dimensional quantitative structure activity relationship analysis, is creating highly specific, biologically active molecules by virtual reality modeling. Sophisticated screening technologies are eliminating all but the most active lead compounds. These new technologies promise more efficacious, safe, and cost-effective medications, while minimizing drug development time and maximizing profits.
The effects of rebate contracts on the health care system.

PubMed

Graf, Julia

2014-06-01

Group purchasing organizations gain increasing importance with respect to the supply of pharmaceutical products and frequently use multiple, exclusive or partially exclusive rebate contracts to exercise market power. Based on a Hotelling model of horizontal and vertical product differentiation, we examine the controversy around whether a superior rebate scheme exists, as far as consumer surplus, firms' profits and total welfare are concerned. We find that firms clearly prefer partially exclusive over multiple, and multiple over exclusive rebate contracts. In contrast, no rebate form exists that lowers total costs per se for the consumers or maximizes total welfare.
NASA Space Biology Research Associate Program for the 21st Century

NASA Technical Reports Server (NTRS)

Sonnenfeld, Gerald

2000-01-01

The Space Biology Research Associate Program for the 21st Century provided a unique opportunity to train individuals to conduct biological research in hypo- and hyper-gravity, and to conduct ground-based research. This grant was developed to maximize the potential for Space Biology as an emerging discipline and to train a cadre of space biologists. The field of gravitational and space biology is rapidly growing at the future of the field is reflected in the quality and education of its personnel. Our chief objective was to train and develop these scientists rapidly and in a cost effective model.

Can nurse practitioners and physicians beat parochialism into plowshares?

PubMed

Phillips, Robert L; Harper, Doreen C; Wakefield, Mary; Green, Larry A; Fryer, George E

2002-01-01

Nurse practitioners have evolved into a large and flexible workforce. Far too often, nurse practitioner and physician professional organizations do not work together but rather expend considerable effort jousting in policy arenas. Turf battles interfere with joint advocacy for needed health system change and delay development of interdisciplinary teams that could help patients. A combined, consistent effort is urgently needed for studying, training, and deploying a collaborative, integrated workforce aimed at improving the health care system of tomorrow. The country can ill afford doctors and nurses who ignore one another's capabilities and fail to maximize each other's contributions cost-effectively.
The Influence of Injection Molding Parameter on Properties of Thermally Conductive Plastic

NASA Astrophysics Data System (ADS)

Hafizah Azis, N.; Zulafif Rahim, M.; Sa'ude, Nasuha; Rafai, N.; Yusof, M. S.; Tobi, ALM; Sharif, ZM; Rasidi Ibrahim, M.; Ismail, A. E.

2017-05-01

Thermally conductive plastic is the composite between metal-plastic material that is becoming popular because if it special characteristic. Injection moulding was regarded as the best process for mass manufacturing of the plastic composite due to its low production cost. The objective of this research is to find the best combination of the injection parameter setting and to find the most significant factor that effect the strength and thermal conductivity of the composite. Several parameter such as the volume percentage of copper powder, nozzle temperature and injection pressure of injection moulding machine were investigated. The analysis was done using Design Expert Software by implementing design of experiment method. From the analysis, the significant effects were determined and mathematical models of only significant effect were established. In order to ensure the validity of the model, confirmation run was done and percentage errors were calculated. It was found that the best combination parameter setting to maximize the value of tensile strength is volume percentage of copper powder of 3.00%, the nozzle temperature of 195°C and the injection pressure of 65%, and the best combination parameter settings to maximize the value of thermal conductivity is volume percentage of copper powder of 7.00%, the nozzle temperature of 195°C and the injection pressure of 65% as recommended..
Windscapes shape seabird instantaneous energy costs but adult behavior buffers impact on offspring.

PubMed

Elliott, Kyle Hamish; Chivers, Lorraine S; Bessey, Lauren; Gaston, Anthony J; Hatch, Scott A; Kato, Akiko; Osborne, Orla; Ropert-Coudert, Yan; Speakman, John R; Hare, James F

2014-01-01

Windscapes affect energy costs for flying animals, but animals can adjust their behavior to accommodate wind-induced energy costs. Theory predicts that flying animals should decrease air speed to compensate for increased tailwind speed and increase air speed to compensate for increased crosswind speed. In addition, animals are expected to vary their foraging effort in time and space to maximize energy efficiency across variable windscapes. We examined the influence of wind on seabird (thick-billed murre Uria lomvia and black-legged kittiwake Rissa tridactyla) foraging behavior. Airspeed and mechanical flight costs (dynamic body acceleration and wing beat frequency) increased with headwind speed during commuting flights. As predicted, birds adjusted their airspeed to compensate for crosswinds and to reduce the effect of a headwind, but they could not completely compensate for the latter. As we were able to account for the effect of sampling frequency and wind speed, we accurately estimated commuting flight speed with no wind as 16.6 ms(?1) (murres) and 10.6 ms(?1) (kittiwakes). High winds decreased delivery rates of schooling fish (murres), energy (murres) and food (kittiwakes) but did not impact daily energy expenditure or chick growth rates. During high winds, murres switched from feeding their offspring with schooling fish, which required substantial above-water searching, to amphipods, which required less above-water searching. Adults buffered the adverse effect of high winds on chick growth rates by switching to other food sources during windy days or increasing food delivery rates when weather improved.
Resource Allocation and Seed Size Selection in Perennial Plants under Pollen Limitation.

PubMed

Huang, Qiaoqiao; Burd, Martin; Fan, Zhiwei

2017-09-01

Pollen limitation may affect resource allocation patterns in plants, but its role in the selection of seed size is not known. Using an evolutionarily stable strategy model of resource allocation in perennial iteroparous plants, we show that under density-independent population growth, pollen limitation (i.e., a reduction in ovule fertilization rate) should increase the optimal seed size. At any level of pollen limitation (including none), the optimal seed size maximizes the ratio of juvenile survival rate to the resource investment needed to produce one seed (including both ovule production and seed provisioning); that is, the optimum maximizes the fitness effect per unit cost. Seed investment may affect allocation to postbreeding adult survival. In our model, pollen limitation increases individual seed size but decreases overall reproductive allocation, so that pollen limitation should also increase the optimal allocation to postbreeding adult survival. Under density-dependent population growth, the optimal seed size is inversely proportional to ovule fertilization rate. However, pollen limitation does not affect the optimal allocation to postbreeding adult survival and ovule production. These results highlight the importance of allocation trade-offs in the effect pollen limitation has on the ecology and evolution of seed size and postbreeding adult survival in perennial plants.
Successful Demolition of Historic Cape Canaveral Air Force Station Launch Facilities: Managing the Process to Maximize Recycle Value to Fund Demolition

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

Jones, A.; Hambro, L.; Hooper, K.

2008-07-01

This paper will present the history of the Atlas 36 and Titan 40 Space Launch Complexes (SLC), the facility assessment process, demolition planning, recycle methodology, and actual facility demolition that resulted in a 40% reduction in baseline cost. These two SLC launched hundreds of payloads into space from Cape Canaveral Air Force Station (AFS), Florida. The Atlas-Centaur family of rockets could lift small- to medium-size satellites designed for communications, weather, or military use, placing them with near pinpoint accuracy into their intended orbits. The larger Titan family was relied upon for heavier lifting needs, including launching military satellites as wellmore » as interplanetary probes. But despite their efficiency and cost-effectiveness, the Titan rockets, as well as earlier generation Atlas models, were retired in 2005. Concerns about potential environmental health hazards from PCBs and lead-based paint chipping off the facilities also contributed to the Air Force's decision in 2005 to dismantle and demolish the Atlas and Titan missile-launching systems. Lockheed Martin secured the complex following the final launch, removed equipment and turned over the site to the Air Force for decommissioning and demolition (D and D). AMEC was retained by the Air Force to perform demolition planning and facility D and D in 2004. AMEC began with a review of historical information, interviews with past operations personnel, and 100% facility assessment of over 100 structures. There where numerous support buildings that due to their age contained asbestos containing material (ACM), PCB-impacted material, and universal material that had to be identified and removed prior to demolition. Environmental testing had revealed that the 36B mobile support tower (MST) exceeded the TSCA standard for polychlorinated biphenyls (PCB) paint (<50 ppm), as did the high bay sections of the Titan Vertical Integration Building (VIB). Thus, while most of the steel structures could be completely recycled, about one-third of 36B MST and the affected areas of the VIB were to be consigned to an on-site regulated waste landfill. In all, it is estimated that approximately 10,000,000 kg (11,000 tons) of PCB-coated steel will be land-filled and 23,000,000 kg (25,000 tons) will be recycled. The recycling of the steel and other materials made it possible to do additional demolition by using these funds. Therefore, finding ways to maximize the recycle value of materials became a key factor in the pre-demolition characterization and implementation strategy. This paper will present the following: - Critical elements in demolition planning working at an active launch facility; - Characterization and strategy to maximize steel recycle; - Waste disposition strategy to maximize recycle/reuse and minimize disposal; - Recycle options available at DOD installations that allow for addition funds for demolition; - Innovation in demolition methodologies for large structures - explosive demolition and large-scale dismantlement; - H and S aspects of explosive demolition and large scale dismantlement. In conclusion: The Cape Canaveral AFS Demolition Program has been a great success due to the integration of multiple operations and contractors working together to determine the most cost-effective demolition methods. It is estimated that by extensive pre-planning and working with CCAFS representatives, as well as maximizing the recycle credits of various material, primarily steel, that the government will be able to complete what was base-lined to be a $30 M demolition program for < $20 M. Other factors included a competitive subcontractor environment where they were encouraged with incentives to maximize recycle/reuse of material and creative demolition solutions. Also, by overlapping multiple demolition tasks at multiple facilities allowed for a reduction in field oversight. (authors)« less
Male circumcision at different ages in Rwanda: a cost-effectiveness study.

PubMed

Binagwaho, Agnes; Pegurri, Elisabetta; Muita, Jane; Bertozzi, Stefano

2010-01-19

There is strong evidence showing that male circumcision (MC) reduces HIV infection and other sexually transmitted infections (STIs). In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time) and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests). One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP) per capita per life-year gained. Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure) and is cost-saving (the cost-effectiveness ratio is negative), even though savings from infant circumcision will be realized later in time. The cost per infection averted is US$3,932 for adolescent MC and US$4,949 for adult MC. Results for infant MC appear robust. Infant MC remains highly cost-effective across a reasonable range of variation in the base case scenario. Adolescent MC is highly cost-effective for the base case scenario but this high cost-effectiveness is not robust to small changes in the input variables. Adult MC is neither cost-saving nor highly cost-effective when considering only the direct benefit for the circumcised man. The study suggests that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young. Infant MC can be integrated into existing health services (i.e., neonatal visits and vaccination sessions) and over time has better potential than adolescent and adult circumcision to achieve the very high coverage of the population required for maximal reduction of HIV incidence. In the presence of infant MC, adolescent and adult MC would evolve into a "catch-up" campaign that would be needed at the start of the program but would eventually become superfluous. Please see later in the article for the Editors' Summary.
Variation in the costs of delivering routine immunization services in Peru.

PubMed Central

Walker, D.; Mosqueira, N. R.; Penny, M. E.; Lanata, C. F.; Clark, A. D.; Sanderson, C. F. B.; Fox-Rushby, J. A.

2004-01-01

OBJECTIVE: Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). METHODS: We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. FINDINGS: The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. CONCLUSION: This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation. PMID:15628205
Magellan Project: Evolving enhanced operations efficiency to maximize science value

NASA Technical Reports Server (NTRS)

Cheuvront, Allan R.; Neuman, James C.; Mckinney, J. Franklin

1994-01-01

Magellan has been one of NASA's most successful spacecraft, returning more science data than all planetary spacecraft combined. The Magellan Spacecraft Team (SCT) has maximized the science return with innovative operational techniques to overcome anomalies and to perform activities for which the spacecraft was not designed. Commanding the spacecraft was originally time consuming because the standard development process was envisioned as manual tasks. The Program understood that reducing mission operations costs were essential for an extended mission. Management created an environment which encouraged automation of routine tasks, allowing staff reduction while maximizing the science data returned. Data analysis and trending, command preparation, and command reviews are some of the tasks that were automated. The SCT has accommodated personnel reductions by improving operations efficiency while returning the maximum science data possible.
Maximizing Health or Sufficient Capability in Economic Evaluation? A Methodological Experiment of Treatment for Drug Addiction.

PubMed

Goranitis, Ilias; Coast, Joanna; Day, Ed; Copello, Alex; Freemantle, Nick; Frew, Emma

2017-07-01

Conventional practice within the United Kingdom and beyond is to conduct economic evaluations with "health" as evaluative space and "health maximization" as the decision-making rule. However, there is increasing recognition that this evaluative framework may not always be appropriate, and this is particularly the case within public health and social care contexts. This article presents a methodological case study designed to explore the impact of changing the evaluative space within an economic evaluation from health to capability well-being and the decision-making rule from health maximization to the maximization of sufficient capability. Capability well-being is an evaluative space grounded on Amartya Sen's capability approach and assesses well-being based on individuals' ability to do and be the things they value in life. Sufficient capability is an egalitarian approach to decision making that aims to ensure everyone in society achieves a normatively sufficient level of capability well-being. The case study is treatment for drug addiction, and the cost-effectiveness of 2 psychological interventions relative to usual care is assessed using data from a pilot trial. Analyses are undertaken from a health care and a government perspective. For the purpose of the study, quality-adjusted life years (measured using the EQ-5D-5L) and years of full capability equivalent and years of sufficient capability equivalent (both measured using the ICECAP-A [ICEpop CAPability measure for Adults]) are estimated. The study concludes that different evaluative spaces and decision-making rules have the potential to offer opposing treatment recommendations. The implications for policy makers are discussed.
Mussel processing wastewater: a low-cost substrate for the production of astaxanthin by Xanthophyllomyces dendrorhous.

PubMed

Amado, Isabel Rodríguez; Vázquez, José Antonio

2015-11-09

The use of astaxanthin in different industries such as the chemical, pharmaceutical, food, animal feed and cosmetic has been receiving increasing attention in recent years. Natural supplies of the pigment include crustacean by-products, algal, and microbial cultivation, being the yeast Xanthophyllomyces dendrorhous together with the alga Haematococcus pluvialis the most promising microorganisms for this bioproduction. Different vegetable by-products of the food industry have been explored so far as low-cost substrates for the production of astaxanthin by X. dendrorhous. This study focuses for the first time on the use of a low-cost formulated medium from a marine by-product, mussel-processing wastewater, for the production of astaxanthin by the yeast X. dendrorhous. The yeast was able to grow in non-saccharified mussel broth, revealing the ability of the microorganism to hydrolyze glycogen. However, partial glycogen saccharification with α-amylase was needed for astaxanthin biosynthesis, obtaining maximal productions of 22.5-26.0 mg/L towards the end of the culture and coinciding with yeast highest amylolytic activity. Cultivations in totally-saccharified media revealed an increase in maximal cell concentrations and a decrease in maximal growth rates and astaxanthin production with increasing glucose initial concentration. Astaxanthin production was higher in partially-saccharified mussel-processing waste than in synthetic medium (yeast peptone dextrose) containing glucose as carbon source (13 mg/L), suggesting this by-product is a promising nutritive medium for astaxanthin production. The use of this effluent also contributes towards the recycling and depuration of this highly pollutant effluent.
Fertilizer standards for controlling groundwater nitrate pollution from agriculture: El Salobral-Los Llanos case study, Spain

NASA Astrophysics Data System (ADS)

Peña-Haro, S.; Llopis-Albert, C.; Pulido-Velazquez, M.; Pulido-Velazquez, D.

2010-10-01

SummaryAlthough the legislation on groundwater quality targets pollutant concentration, the effects of measures on non-point source pollution control are often evaluated in terms of their emission reduction potential at the source, not on their capacity of reducing the pollutant concentration in groundwater. This paper applies a hydro-economic modelling framework to an aquifer, El Salobral-Los Llanos aquifer (Mancha Oriental, Spain), where nitrate concentrations higher than those allowed by the EU Water Framework Directive and Groundwater Directive are locally found due to the intense fertilizer use in irrigated crops. The approach allows defining the economically optimal allocation of spatially variable fertilizer standards in agricultural basins using a hydro-economic model that links the fertilizer application with groundwater nitrate concentration at different control sites while maximizing net economic benefits. The methodology incorporates results from agronomic simulations, groundwater flow and transport into a management framework that yields the fertilizer allocation that maximizes benefits in agriculture while meeting the environmental standards. The cost of applying fertilizer standards was estimated as the difference between the private net revenues from actual application and the scenarios generated considering the application of the standards. Furthermore, the cost of applying fertilizer standards was compared with the cost of taxing nitrogen fertilizers in order to reduce the fertilizer use to a level that the nitrate concentration in groundwater was below the limit. The results show the required reduction of fertilizer application in the different crop areas depending on its location with regards to the control sites, crop types and soil-plant conditions, groundwater flow and transport processes, time horizon for meeting the standards, and the cost of implementing such a policy (as forgone benefits). According to the results, a high fertilizer price would be required to reduce nitrate concentrations in groundwater below the standard of 50 mg/l. In this particular case, it is more cost-efficient to apply standards to fertilizer use than taxes, although the instrument of fertilizer standards is more difficult to implement and control.
Designed To Maximize Learning and Minimize Costs.

ERIC Educational Resources Information Center

Dolan, Thomas G.

2002-01-01

Describes how the Durant Road Middle School in Raleigh, North Carolina sets a new standard in environmental school design. "Daylighting," bringing daylight into the building for psychological, health, and energy-saving benefits, plays a central role in the design. (EV)
Evaluation of Epoke Bulk Spreader for winter maintenance.

DOT National Transportation Integrated Search

2013-12-01

In the current economic climate, it is imperative to maximize efficiency while minimizing costs. As a : result, ODOT is evaluating new methods to reduce expenditures in their winter maintenance budget. One : such evaluation is of the Epoke Bulk Sprea...
Dynamic mobility applications, program evaluation : national-level impacts and costs estimation : final report.

DOT National Transportation Integrated Search

2016-07-01

The vision of the Dynamic Mobility Applications (DMA) program is to expedite the development, testing, and deployment of innovative mobility applications that maximize system productivity and enhance mobility of individuals within the surface transpo...
When deception becomes easy: the effects of task switching and goal neglect on the truth proportion effect

PubMed Central

Van Bockstaele, Bram; Wilhelm, Christine; Meijer, Ewout; Debey, Evelyne; Verschuere, Bruno

2015-01-01

Lying is typically more cognitively demanding than truth telling. Yet, recent cognitive models of lying propose that lying can be just as easy as truth telling, depending on contextual factors. In line with this idea, research has shown that the cognitive cost of deception decreases when people frequently respond deceptively, while it increases when people rarely respond deceptively (i.e., the truth proportion effect). In the present study, we investigated two possible underlying mechanisms of the truth proportion effect. In Experiment 1 (N = 121), we controlled for the impact of switch costs by keeping the number of switches between deceptive and truthful responses constant. We found that people who often responded deceptively made fewer errors when responding deceptively than people who only occasionally responded deceptively, replicating the truth proportion effect. Thus, while the truth proportion effect in earlier studies may be partially driven by the cost of switching between truthful and deceptive responses, we still found evidence for the truth proportion effect while controlling for switch costs. In Experiment 2 (N = 68), we assessed whether the truth proportion effect is influenced by goal neglect. According to this view, the truth proportion effect should be reduced if participants are cued to maintain the task goals, while it should be larger when participants are allowed to neglect the task goals. In line with this hypothesis, we found a smaller truth proportion effect when participants were cued with the task goals compared to when they were not cued. This study shows that the truth proportion effect is influenced by goal neglect, implying that frequent deceptive responding strengthens the goal of responding deceptively. Our findings imply that the accuracy of lie detection tests could be increased by using a majority of truth-items (i.e., induce the truth proportion effect), and that the truth proportion effect should be maximized by (1) increasing the number of truth-lie task switches and (2) inducing goal neglect. PMID:26579047
Efficient Coding and Energy Efficiency Are Promoted by Balanced Excitatory and Inhibitory Synaptic Currents in Neuronal Network

PubMed Central

Yu, Lianchun; Shen, Zhou; Wang, Chen; Yu, Yuguo

2018-01-01

Selective pressure may drive neural systems to process as much information as possible with the lowest energy cost. Recent experiment evidence revealed that the ratio between synaptic excitation and inhibition (E/I) in local cortex is generally maintained at a certain value which may influence the efficiency of energy consumption and information transmission of neural networks. To understand this issue deeply, we constructed a typical recurrent Hodgkin-Huxley network model and studied the general principles that governs the relationship among the E/I synaptic current ratio, the energy cost and total amount of information transmission. We observed in such a network that there exists an optimal E/I synaptic current ratio in the network by which the information transmission achieves the maximum with relatively low energy cost. The coding energy efficiency which is defined as the mutual information divided by the energy cost, achieved the maximum with the balanced synaptic current. Although background noise degrades information transmission and imposes an additional energy cost, we find an optimal noise intensity that yields the largest information transmission and energy efficiency at this optimal E/I synaptic transmission ratio. The maximization of energy efficiency also requires a certain part of energy cost associated with spontaneous spiking and synaptic activities. We further proved this finding with analytical solution based on the response function of bistable neurons, and demonstrated that optimal net synaptic currents are capable of maximizing both the mutual information and energy efficiency. These results revealed that the development of E/I synaptic current balance could lead a cortical network to operate at a highly efficient information transmission rate at a relatively low energy cost. The generality of neuronal models and the recurrent network configuration used here suggest that the existence of an optimal E/I cell ratio for highly efficient energy costs and information maximization is a potential principle for cortical circuit networks. Summary We conducted numerical simulations and mathematical analysis to examine the energy efficiency of neural information transmission in a recurrent network as a function of the ratio of excitatory and inhibitory synaptic connections. We obtained a general solution showing that there exists an optimal E/I synaptic ratio in a recurrent network at which the information transmission as well as the energy efficiency of this network achieves a global maximum. These results reflect general mechanisms for sensory coding processes, which may give insight into the energy efficiency of neural communication and coding. PMID:29773979
Efficient Coding and Energy Efficiency Are Promoted by Balanced Excitatory and Inhibitory Synaptic Currents in Neuronal Network.

PubMed

Yu, Lianchun; Shen, Zhou; Wang, Chen; Yu, Yuguo

2018-01-01

Selective pressure may drive neural systems to process as much information as possible with the lowest energy cost. Recent experiment evidence revealed that the ratio between synaptic excitation and inhibition (E/I) in local cortex is generally maintained at a certain value which may influence the efficiency of energy consumption and information transmission of neural networks. To understand this issue deeply, we constructed a typical recurrent Hodgkin-Huxley network model and studied the general principles that governs the relationship among the E/I synaptic current ratio, the energy cost and total amount of information transmission. We observed in such a network that there exists an optimal E/I synaptic current ratio in the network by which the information transmission achieves the maximum with relatively low energy cost. The coding energy efficiency which is defined as the mutual information divided by the energy cost, achieved the maximum with the balanced synaptic current. Although background noise degrades information transmission and imposes an additional energy cost, we find an optimal noise intensity that yields the largest information transmission and energy efficiency at this optimal E/I synaptic transmission ratio. The maximization of energy efficiency also requires a certain part of energy cost associated with spontaneous spiking and synaptic activities. We further proved this finding with analytical solution based on the response function of bistable neurons, and demonstrated that optimal net synaptic currents are capable of maximizing both the mutual information and energy efficiency. These results revealed that the development of E/I synaptic current balance could lead a cortical network to operate at a highly efficient information transmission rate at a relatively low energy cost. The generality of neuronal models and the recurrent network configuration used here suggest that the existence of an optimal E/I cell ratio for highly efficient energy costs and information maximization is a potential principle for cortical circuit networks. We conducted numerical simulations and mathematical analysis to examine the energy efficiency of neural information transmission in a recurrent network as a function of the ratio of excitatory and inhibitory synaptic connections. We obtained a general solution showing that there exists an optimal E/I synaptic ratio in a recurrent network at which the information transmission as well as the energy efficiency of this network achieves a global maximum. These results reflect general mechanisms for sensory coding processes, which may give insight into the energy efficiency of neural communication and coding.
Optimization of space manufacturing systems

NASA Technical Reports Server (NTRS)

Akin, D. L.

1979-01-01

Four separate analyses are detailed: transportation to low earth orbit, orbit-to-orbit optimization, parametric analysis of SPS logistics based on earth and lunar source locations, and an overall program option optimization implemented with linear programming. It is found that smaller vehicles are favored for earth launch, with the current Space Shuttle being right at optimum payload size. Fully reusable launch vehicles represent a savings of 50% over the Space Shuttle; increased reliability with less maintenance could further double the savings. An optimization of orbit-to-orbit propulsion systems using lunar oxygen for propellants shows that ion propulsion is preferable by a 3:1 cost margin over a mass driver reaction engine at optimum values; however, ion engines cannot yet operate in the lower exhaust velocity range where the optimum lies, and total program costs between the two systems are ambiguous. Heavier payloads favor the use of a MDRE. A parametric model of a space manufacturing facility is proposed, and used to analyze recurring costs, total costs, and net present value discounted cash flows. Parameters studied include productivity, effects of discounting, materials source tradeoffs, economic viability of closed-cycle habitats, and effects of varying degrees of nonterrestrial SPS materials needed from earth. Finally, candidate optimal scenarios are chosen, and implemented in a linear program with external constraints in order to arrive at an optimum blend of SPS production strategies in order to maximize returns.
Skeletal muscle work efficiency with age: the role of non-contractile processes.

PubMed

Layec, Gwenael; Hart, Corey R; Trinity, Joel D; Le Fur, Yann; Jeong, Eun-Kee; Richardson, Russell S

2015-02-01

Although skeletal muscle work efficiency probably plays a key role in limiting mobility of the elderly, the physiological mechanisms responsible for this diminished function remain incompletely understood. Thus, in the quadriceps of young (n=9) and old (n=10) subjects, we measured the cost of muscle contraction (ATP cost) with 31P-magnetic resonance spectroscopy (31P-MRS) during (i) maximal intermittent contractions to elicit a metabolic demand from both cross-bridge cycling and ion pumping and (ii) a continuous maximal contraction to predominantly tax cross-bridge cycling. The ATP cost of the intermittent contractions was significantly greater in the old (0.30±0.22 mM·min-1·N·m-1) compared with the young (0.13±0.03 mM·min-1·N·m-1, P<0.05). In contrast, at the end of the continuous contraction protocol, the ATP cost in the old (0.10±0.07 mM·min-1·N·m-1) was not different from the young (0.06±0.02 mM·min-1·N·m-1, P=0.2). In addition, the ATP cost of the intermittent contractions correlated significantly with the single leg peak power of the knee-extensors assessed during incremental dynamic exercise (r=-0.55; P<0.05). Overall, this study reveals an age-related increase in the ATP cost of contraction, probably mediated by an excessive energy demand from ion pumping, which probably contributes to both the decline in muscle efficiency and functional capacity associated with aging.
[Cost of an intraperitoneal chemohyperthermia (IPCH) related to cytoreductive surgery].

PubMed

Bonastre, J; Jan, P; de Pouvourville, G; Pocard, M; Estphan, G; Elias, D

2005-10-01

A complete cytoreductive surgery followed with an intraperitoneal chemohyperthermia (IPCH) is a new treatment allowing curing some patients with a peritoneal carcinomatosis. The cost of this treatment, evaluated in different countries, is high. In France, we do not have any cost evaluation of this therapy, and this state slows its diffusion in our country. The aim of this study is to evaluate the real cost of maximal cytoreductive surgery with IPCH, and to compare it with the financial support given by the Ministery of Health. The real cost of this therapy was established on the standard analytic accountancy of our Institute. The analysis of the financial support received was done after the classification of the patients in the current official diagnosis-related groups, and according to the current rates of reimbursing of these acts. Seventy-three patients were treated with IPCH in our Institute during 2002 and 2003. The real mean cost for our hospital was 39,358 euros per patient, with a mean hospital staying of 27.7 days. In counterpart, our hospital received a mean financial support of 20,485 euros, resulting in a deficit of 18,873 euros per patient (and close to 1.4 million of euros for the two years). Our current classification of diagnosis-related groups does not allow to describe the real importance of this therapy which combines a maximal cytoreductive surgery with IPCH. In our system of reimbursing, the hospital which offers this type of new therapy to its patients receives only half of the real rate. Two correctives measures are suitable: to describe this combining treatment in the official list of medical acts, and to determine its specific cost for reimbursing.

Effects of well spacing on geological storage site distribution costs and surface footprint.

PubMed

Eccles, Jordan; Pratson, Lincoln F; Chandel, Munish Kumar

2012-04-17

Geological storage studies thus far have not evaluated the scale and cost of the network of distribution pipelines that will be needed to move CO(2) from a central receiving point at a storage site to injection wells distributed about the site. Using possible injection rates for deep-saline sandstone aquifers, we estimate that the footprint of a sequestration site could range from <100 km(2) to >100,000 km(2), and that distribution costs could be <$0.10/tonne to >$10/tonne. Our findings are based on two models for determining well spacing: one which minimizes spacing in order to maximize use of the volumetric capacity of the reservoir, and a second that determines spacing to minimize subsurface pressure interference between injection wells. The interference model, which we believe more accurately reflects reservoir dynamics, produces wider well spacings and a counterintuitive relationship whereby total injection site footprint and thus distribution cost declines with decreasing permeability for a given reservoir thickness. This implies that volumetric capacity estimates should be reexamined to include well spacing constraints, since wells will need to be spaced further apart than void space calculations might suggest. We conclude that site-selection criteria should include thick, low-permeability reservoirs to minimize distribution costs and site footprint.
The Foot's Arch and the Energetics of Human Locomotion.

PubMed

Stearne, Sarah M; McDonald, Kirsty A; Alderson, Jacqueline A; North, Ian; Oxnard, Charles E; Rubenson, Jonas

2016-01-19

The energy-sparing spring theory of the foot's arch has become central to interpretations of the foot's mechanical function and evolution. Using a novel insole technique that restricted compression of the foot's longitudinal arch, this study provides the first direct evidence that arch compression/recoil during locomotion contributes to lowering energy cost. Restricting arch compression near maximally (~80%) during moderate-speed (2.7 ms(-1)) level running increased metabolic cost by + 6.0% (p < 0.001, d = 0.67; unaffected by foot strike technique). A simple model shows that the metabolic energy saved by the arch is largely explained by the passive-elastic work it supplies that would otherwise be done by active muscle. Both experimental and model data confirm that it is the end-range of arch compression that dictates the energy-saving role of the arch. Restricting arch compression had no effect on the cost of walking or incline running (3°), commensurate with the smaller role of passive-elastic mechanics in these gaits. These findings substantiate the elastic energy-saving role of the longitudinal arch during running, and suggest that arch supports used in some footwear and orthotics may increase the cost of running.
Subjective costs drive overly patient foraging strategies in rats on an intertemporal foraging task.

PubMed

Wikenheiser, Andrew M; Stephens, David W; Redish, A David

2013-05-14

Laboratory studies of decision making often take the form of two-alternative, forced-choice paradigms. In natural settings, however, many decision problems arise as stay/go choices. We designed a foraging task to test intertemporal decision making in rats via stay/go decisions. Subjects did not follow the rate-maximizing strategy of choosing only food items associated with short delays. Instead, rats were often willing to wait for surprisingly long periods, and consequently earned a lower rate of food intake than they might have by ignoring long-delay options. We tested whether foraging theory or delay discounting models predicted the behavior we observed but found that these models could not account for the strategies subjects selected. Subjects' behavior was well accounted for by a model that incorporated a cost for rejecting potential food items. Interestingly, subjects' cost sensitivity was proportional to environmental richness. These findings are at odds with traditional normative accounts of decision making but are consistent with retrospective considerations having a deleterious influence on decisions (as in the "sunk-cost" effect). More broadly, these findings highlight the utility of complementing existing assays of decision making with tasks that mimic more natural decision topologies.
A methodology for spacecraft technology insertion analysis balancing benefit, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David Allen

Emerging technologies are changing the way space missions are developed and implemented. Technology development programs are proceeding with the goal of enhancing spacecraft performance and reducing mass and cost. However, it is often the case that technology insertion assessment activities, in the interest of maximizing performance and/or mass reduction, do not consider synergistic system-level effects. Furthermore, even though technical risks are often identified as a large cost and schedule driver, many design processes ignore effects of cost and schedule uncertainty. This research is based on the hypothesis that technology selection is a problem of balancing interrelated (and potentially competing) objectives. Current spacecraft technology selection approaches are summarized, and a Methodology for Evaluating and Ranking Insertion of Technology (MERIT) that expands on these practices to attack otherwise unsolved problems is demonstrated. MERIT combines the modern techniques of technology maturity measures, parametric models, genetic algorithms, and risk assessment (cost and schedule) in a unique manner to resolve very difficult issues including: user-generated uncertainty, relationships between cost/schedule and complexity, and technology "portfolio" management. While the methodology is sufficiently generic that it may in theory be applied to a number of technology insertion problems, this research focuses on application to the specific case of small (<500 kg) satellite design. Small satellite missions are of particular interest because they are often developed under rigid programmatic (cost and schedule) constraints and are motivated to introduce advanced technologies into the design. MERIT is demonstrated for programs procured under varying conditions and constraints such as stringent performance goals, not-to-exceed costs, or hard schedule requirements. MERIT'S contributions to the engineering community are its: unique coupling of the aspects of performance, cost, and schedule; assessment of system level impacts of technology insertion; procedures for estimating uncertainties (risks) associated with advanced technology; and application of heuristics to facilitate informed system-level technology utilization decisions earlier in the conceptual design phase. MERIT extends the state of the art in technology insertion assessment selection practice and, if adopted, may aid designers in determining the configuration of complex systems that meet essential requirements in a timely, cost-effective manner.
Six Sessions of Sprint Interval Training Improves Running Performance in Trained Athletes.

PubMed

Koral, Jerome; Oranchuk, Dustin J; Herrera, Roberto; Millet, Guillaume Y

2018-03-01

Koral, J, Oranchuk, DJ, Herrera, R, and Millet, GY. Six sessions of sprint interval training improves running performance in trained athletes. J Strength Cond Res 32(3): 617-623, 2018-Sprint interval training (SIT) is gaining popularity with endurance athletes. Various studies have shown that SIT allows for similar or greater endurance, strength, and power performance improvements than traditional endurance training but demands less time and volume. One of the main limitations in SIT research is that most studies were performed in a laboratory using expensive treadmills or ergometers. The aim of this study was to assess the performance effects of a novel short-term and highly accessible training protocol based on maximal shuttle runs in the field (SIT-F). Sixteen (12 male, 4 female) trained trail runners completed a 2-week procedure consisting of 4-7 bouts of 30 seconds at maximal intensity interspersed by 4 minutes of recovery, 3 times a week. Maximal aerobic speed (MAS), time to exhaustion at 90% of MAS before test (Tmax at 90% MAS), and 3,000-m time trial (TT3000m) were evaluated before and after training. Data were analyzed using a paired samples t-test, and Cohen's (d) effect sizes were calculated. Maximal aerobic speed improved by 2.3% (p = 0.01, d = 0.22), whereas peak power (PP) and mean power (MP) increased by 2.4% (p = 0.009, d = 0.33) and 2.8% (p = 0.002, d = 0.41), respectively. TT3000m was 6% shorter (p < 0.001, d = 0.35), whereas Tmax at 90% MAS was 42% longer (p < 0.001, d = 0.74). Sprint interval training in the field significantly improved the 3,000-m run, time to exhaustion, PP, and MP in trained trail runners. Sprint interval training in the field is a time-efficient and cost-free means of improving both endurance and power performance in trained athletes.
Six Sessions of Sprint Interval Training Improves Running Performance in Trained Athletes

PubMed Central

Oranchuk, Dustin J.; Herrera, Roberto; Millet, Guillaume Y.

2018-01-01

Abstract Koral, J, Oranchuk, DJ, Herrera, R, and Millet, GY. Six sessions of sprint interval training improves running performance in trained athletes. J Strength Cond Res 32(3): 617–623, 2018—Sprint interval training (SIT) is gaining popularity with endurance athletes. Various studies have shown that SIT allows for similar or greater endurance, strength, and power performance improvements than traditional endurance training but demands less time and volume. One of the main limitations in SIT research is that most studies were performed in a laboratory using expensive treadmills or ergometers. The aim of this study was to assess the performance effects of a novel short-term and highly accessible training protocol based on maximal shuttle runs in the field (SIT-F). Sixteen (12 male, 4 female) trained trail runners completed a 2-week procedure consisting of 4–7 bouts of 30 seconds at maximal intensity interspersed by 4 minutes of recovery, 3 times a week. Maximal aerobic speed (MAS), time to exhaustion at 90% of MAS before test (Tmax at 90% MAS), and 3,000-m time trial (TT3000m) were evaluated before and after training. Data were analyzed using a paired samples t-test, and Cohen's (d) effect sizes were calculated. Maximal aerobic speed improved by 2.3% (p = 0.01, d = 0.22), whereas peak power (PP) and mean power (MP) increased by 2.4% (p = 0.009, d = 0.33) and 2.8% (p = 0.002, d = 0.41), respectively. TT3000m was 6% shorter (p < 0.001, d = 0.35), whereas Tmax at 90% MAS was 42% longer (p < 0.001, d = 0.74). Sprint interval training in the field significantly improved the 3,000-m run, time to exhaustion, PP, and MP in trained trail runners. Sprint interval training in the field is a time-efficient and cost-free means of improving both endurance and power performance in trained athletes. PMID:29076961
Effect of cost-effective substrates on growth cycle and yield of lingzhi or reishi medicinal mushroom, Ganoderma lucidum (higher Basidiomycetes) from Northwestern Himalaya (India).

PubMed

Mehta, Sheetal; Jandaik, Savita; Gupta, Dharmesh

2014-01-01

To find a cost-effective alternative substrate, the medicinal mushroom Ganoderma lucidum was grown on sawdusts of sheesham, mango, and poplar. Optimum spawn level was determined by spawning in substrates at various levels (1, 2, 3, and 4%). To determine the effect of supplementation, substrates were supplemented with wheat bran, rice bran and corn flour at different concentrations (10, 20, and 30%). Duration of growth cycle, mushroom yield, and biological efficiency data were recorded. Among substrates, mango sawdust was superior, with 1.5-fold higher yields than poplar sawdust, which was the least suitable. However with respect to fructification, mango sawdust produced the first primordia earlier (21±1 days) compared with the other investigated substrates. 3% spawn level was found to be optimal irrespective of the substrate. Yield and biological efficiency (BE) were maximally enhanced by supplementation with wheat bran, whereas rice bran was the least suitable supplement among those tested. Growth cycle shortened and mushroom yield increased to a maximum at the 20% level of supplements. Mango sawdust in combination with 20% wheat bran, if spawned at the 3% level, resulted in a high yield (BE = 58.57%).
Applying complex models to poultry production in the future--economics and biology.

PubMed

Talpaz, H; Cohen, M; Fancher, B; Halley, J

2013-09-01

The ability to determine the optimal broiler feed nutrient density that maximizes margin over feeding cost (MOFC) has obvious economic value. To determine optimal feed nutrient density, one must consider ingredient prices, meat values, the product mix being marketed, and the projected biological performance. A series of 8 feeding trials was conducted to estimate biological responses to changes in ME and amino acid (AA) density. Eight different genotypes of sex-separate reared broilers were fed diets varying in ME (2,723-3,386 kcal of ME/kg) and AA (0.89-1.65% digestible lysine with all essential AA acids being indexed to lysine) levels. Broilers were processed to determine carcass component yield at many different BW (1.09-4.70 kg). Trial data generated were used in model constructed to discover the dietary levels of ME and AA that maximize MOFC on a per broiler or per broiler annualized basis (bird × number of cycles/year). The model was designed to estimate the effects of dietary nutrient concentration on broiler live weight, feed conversion, mortality, and carcass component yield. Estimated coefficients from the step-wise regression process are subsequently used to predict the optimal ME and AA concentrations that maximize MOFC. The effects of changing feed or meat prices across a wide spectrum on optimal ME and AA levels can be evaluated via parametric analysis. The model can rapidly compare both biological and economic implications of changing from current practice to the simulated optimal solution. The model can be exploited to enhance decision making under volatile market conditions.
Estimated impact and cost-effectiveness of rotavirus vaccination in India: effects of geographic and economic disparities.

PubMed

Rheingans, Richard; Anderson, John D; Anderson, Benjamin; Chakraborty, Poulomy; Atherly, Deborah; Pindolia, Deepa

2014-08-11

India accounts for 23% of global rotavirus mortality in under-five children, with more than 100,000 deaths from rotavirus annually. Introduction of a vaccine in India is considered to be the most effective intervention for preventing rotavirus mortality. Recent research suggests that there is considerable variation in rotavirus mortality burden across regional, gender and socio-economic subpopulations within India. In addition, there is potential variability in who would likely receive rotavirus vaccine if introduced. We use available household data to estimate heterogeneity in rotavirus mortality risk, vaccination benefits, and cost-effectiveness across geographic and socio-economic groups within India. We account for heterogeneity by modeling estimated three-dose routine vaccinations as a proxy for a generalized rotavirus vaccine, and mortality for subpopulations of children aggregated by region and state, socio-economic status and sex, separately. Results are presented for six geographic regions and for Bihar, Uttar Pradesh, and Madhya Pradesh, three high mortality states accounting for 56% of national mortality estimates. Impact estimates accounting for disparities predict rotavirus vaccine introduction will prevent 35,000 deaths at an average cost of $118/DALY averted (7292 INR/DALY averted). Rotavirus vaccines are most cost-effective for the poor living in high mortality regions and states. Reductions in geographic and socio-economic disparities based on regional estimates could prevent an additional 9400 deaths annually, while reductions in socio-economic disparities in the three highest morality states alone could prevent an additional 10,600 deaths annually. Understanding the impact of heterogeneity can help improve strategies to maximize the benefits of rotavirus vaccination introduction, leading to fewer lives lost as a result of rotavirus disease. Copyright © 2014. Published by Elsevier Ltd.
An intertemporal decision framework for electrochemical energy storage management

NASA Astrophysics Data System (ADS)

He, Guannan; Chen, Qixin; Moutis, Panayiotis; Kar, Soummya; Whitacre, Jay F.

2018-05-01

Dispatchable energy storage is necessary to enable renewable-based power systems that have zero or very low carbon emissions. The inherent degradation behaviour of electrochemical energy storage (EES) is a major concern for both EES operational decisions and EES economic assessments. Here, we propose a decision framework that addresses the intertemporal trade-offs in terms of EES degradation by deriving, implementing and optimizing two metrics: the marginal benefit of usage and the average benefit of usage. These metrics are independent of the capital cost of the EES system, and, as such, separate the value of EES use from the initial cost, which provides a different perspective on storage valuation and operation. Our framework is proved to produce the optimal solution for EES life-cycle profit maximization. We show that the proposed framework offers effective ways to assess the economic values of EES, to make investment decisions for various applications and to inform related subsidy policies.
Dishonest Academic Conduct: From the Perspective of the Utility Function.

PubMed

Sun, Ying; Tian, Rui

Dishonest academic conduct has aroused extensive attention in academic circles. To explore how scholars make decisions according to the principle of maximal utility, the author has constructed the general utility function based on the expected utility theory. The concrete utility functions of different types of scholars were deduced. They are as follows: risk neutral, risk averse, and risk preference. Following this, the assignment method was adopted to analyze and compare the scholars' utilities of academic conduct. It was concluded that changing the values of risk costs, internal condemnation costs, academic benefits, and the subjective estimation of penalties following dishonest academic conduct can lead to changes in the utility of academic dishonesty. The results of the current study suggest that within scientific research, measures to prevent and govern dishonest academic conduct should be formulated according to the various effects of the above four variables.
Maximizing Efficiency and Reducing Robotic Surgery Costs Using the NASA Task Load Index.

PubMed

Walters, Carrie; Webb, Paula J

2017-10-01

Perioperative leaders at our facility were struggling to meet efficiency targets for robotic surgery procedures while also maintaining the satisfaction of the surgical team. We developed a human resources time and motion study tool and used it in conjunction with the NASA Task Load Index to observe and analyze the required workload of personnel assigned to 25 robotic surgery procedures. The time and motion study identified opportunities to enlist the help of nonlicensed support personnel to ensure safe patient care and improve OR efficiency. Using the NASA Task Load Index demonstrated that high temporal, effort, and physical demands existed for personnel assisting with and performing robotic surgery. We believe that this process could be used to develop cost-effective staffing models, resulting in safe and efficient care for all surgical patients. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Small space station electrical power system design concepts

NASA Technical Reports Server (NTRS)

Jones, G. M.; Mercer, L. N.

1976-01-01

A small manned facility, i.e., a small space station, placed in earth orbit by the Shuttle transportation system would be a viable, cost effective addition to the basic Shuttle system to provide many opportunities for R&D programs, particularly in the area of earth applications. The small space station would have many similarities with Skylab. This paper presents design concepts for an electrical power system (EPS) for the small space station based on Skylab experience, in-house work at Marshall Space Flight Center, SEPS (Solar Electric Propulsion Stage) solar array development studies, and other studies sponsored by MSFC. The proposed EPS would be a solar array/secondary battery system. Design concepts expressed are based on maximizing system efficiency and five year operational reliability. Cost, weight, volume, and complexity considerations are inherent in the concepts presented. A small space station EPS based on these concepts would be highly efficient, reliable, and relatively inexpensive.
Achieving full connectivity of sites in the multiperiod reserve network design problem

USGS Publications Warehouse

Jafari, Nahid; Nuse, Bryan L.; Moore, Clinton; Dilkina, Bistra; Hepinstall-Cymerman, Jeffrey

2017-01-01

The conservation reserve design problem is a challenge to solve because of the spatial and temporal nature of the problem, uncertainties in the decision process, and the possibility of alternative conservation actions for any given land parcel. Conservation agencies tasked with reserve design may benefit from a dynamic decision system that provides tactical guidance for short-term decision opportunities while maintaining focus on a long-term objective of assembling the best set of protected areas possible. To plan cost-effective conservation over time under time-varying action costs and budget, we propose a multi-period mixed integer programming model for the budget-constrained selection of fully connected sites. The objective is to maximize a summed conservation value over all network parcels at the end of the planning horizon. The originality of this work is in achieving full spatial connectivity of the selected sites during the schedule of conservation actions.
Approaches of Russian oil companies to optimal capital structure

NASA Astrophysics Data System (ADS)

Ishuk, T.; Ulyanova, O.; Savchitz, V.

2015-11-01

Oil companies play a vital role in Russian economy. Demand for hydrocarbon products will be increasing for the nearest decades simultaneously with the population growth and social needs. Change of raw-material orientation of Russian economy and the transition to the innovative way of the development do not exclude the development of oil industry in future. Moreover, society believes that this sector must bring the Russian economy on to the road of innovative development due to neo-industrialization. To achieve this, the government power as well as capital management of companies are required. To make their optimal capital structure, it is necessary to minimize the capital cost, decrease definite risks under existing limits, and maximize profitability. The capital structure analysis of Russian and foreign oil companies shows different approaches, reasons, as well as conditions and, consequently, equity capital and debt capital relationship and their cost, which demands the effective capital management strategy.
Experiences in Delta mission planning

NASA Technical Reports Server (NTRS)

Kork, J.

1981-01-01

The Delta launch vehicle has experienced 153 successful launches since 1960 and 40 more are scheduled. Relying on up-to-date technology and proven flight hardware, the Delta vehicle has been used for low to high circular and geosynchronous transfer orbits, high elliptic probes, and lunar and planetary missions. A history of Delta launches and configuration modifications is presented, noting a 92-95% success rate and its cost effective role in reimbursable missions. Elements of mission planning such as feasibility studies (1-3 yrs), spacecraft restraints manuals, reference trajectories, preliminary mission analysis, detailed test objectives, range/safety studies, guided nominal trajectory, and mission specific studies are discussed. Trajectory shaping determines vehicle and spacecraft restraints, optimizes the trajectory, and maximizes the payload capabilities. Improvements in the Delta vehicle have boosted payloads from 100 to 2890 lbs., improving the price per pound ratio, as costs have risen, only by a factor of three. Current launch schedules extend well into 1985.
Systematic design for trait introgression projects.

PubMed

Cameron, John N; Han, Ye; Wang, Lizhi; Beavis, William D

2017-10-01

Using an Operations Research approach, we demonstrate design of optimal trait introgression projects with respect to competing objectives. We demonstrate an innovative approach for designing Trait Introgression (TI) projects based on optimization principles from Operations Research. If the designs of TI projects are based on clear and measurable objectives, they can be translated into mathematical models with decision variables and constraints that can be translated into Pareto optimality plots associated with any arbitrary selection strategy. The Pareto plots can be used to make rational decisions concerning the trade-offs between maximizing the probability of success while minimizing costs and time. The systematic rigor associated with a cost, time and probability of success (CTP) framework is well suited to designing TI projects that require dynamic decision making. The CTP framework also revealed that previously identified 'best' strategies can be improved to be at least twice as effective without increasing time or expenses.
Using Google Adwords to recruit family carers of people with dementia.

PubMed

O'Dwyer, Siobhan T; Moyle, Wendy

2014-06-01

Online advertising is a new frontier in research recruitment and Google Adwords (GA) is one method of online advertising. Only a handful of studies, however, have described its cost and effectiveness and none have focused on older adults. The aim of this paper is to describe a GA campaign used to recruit family carers of people with dementia and provide insight for researchers planning to use GA to recruit other older adults. A GA campaign was used to recruit family carers of people with dementia to a cross-sectional study of wellbeing. The ads were viewed more than 450,000 times in a six-week period, but only 49 surveys were completed, at a cost of $122 per survey. GA has promise, but much remains to be understood about how to maximize its potential in ageing research. Recommendations for the design of future GA campaigns are provided. © 2013 ACOTA.
Optimal Energy Management for a Smart Grid using Resource-Aware Utility Maximization

NASA Astrophysics Data System (ADS)

Abegaz, Brook W.; Mahajan, Satish M.; Negeri, Ebisa O.

2016-06-01

Heterogeneous energy prosumers are aggregated to form a smart grid based energy community managed by a central controller which could maximize their collective energy resource utilization. Using the central controller and distributed energy management systems, various mechanisms that harness the power profile of the energy community are developed for optimal, multi-objective energy management. The proposed mechanisms include resource-aware, multi-variable energy utility maximization objectives, namely: (1) maximizing the net green energy utilization, (2) maximizing the prosumers' level of comfortable, high quality power usage, and (3) maximizing the economic dispatch of energy storage units that minimize the net energy cost of the energy community. Moreover, an optimal energy management solution that combines the three objectives has been implemented by developing novel techniques of optimally flexible (un)certainty projection and appliance based pricing decomposition in an IBM ILOG CPLEX studio. A real-world, per-minute data from an energy community consisting of forty prosumers in Amsterdam, Netherlands is used. Results show that each of the proposed mechanisms yields significant increases in the aggregate energy resource utilization and welfare of prosumers as compared to traditional peak-power reduction methods. Furthermore, the multi-objective, resource-aware utility maximization approach leads to an optimal energy equilibrium and provides a sustainable energy management solution as verified by the Lagrangian method. The proposed resource-aware mechanisms could directly benefit emerging energy communities in the world to attain their energy resource utilization targets.
Capsiate supplementation reduces oxidative cost of contraction in exercising mouse skeletal muscle in vivo.

PubMed

Yashiro, Kazuya; Tonson, Anne; Pecchi, Émilie; Vilmen, Christophe; Le Fur, Yann; Bernard, Monique; Bendahan, David; Giannesini, Benoît

2015-01-01

Chronic administration of capsiate is known to accelerate whole-body basal energy metabolism, but the consequences in exercising skeletal muscle remain very poorly documented. In order to clarify this issue, the effect of 2-week daily administration of either vehicle (control) or purified capsiate (at 10- or 100-mg/kg body weight) on skeletal muscle function and energetics were investigated throughout a multidisciplinary approach combining in vivo and in vitro measurements in mice. Mechanical performance and energy metabolism were assessed strictly non-invasively in contracting gastrocnemius muscle using magnetic resonance (MR) imaging and 31-phosphorus MR spectroscopy (31P-MRS). Regardless of the dose, capsiate treatments markedly disturbed basal bioenergetics in vivo including intracellular pH alkalosis and decreased phosphocreatine content. Besides, capsiate administration did affect neither mitochondrial uncoupling protein-3 gene expression nor both basal and maximal oxygen consumption in isolated saponin-permeabilized fibers, but decreased by about twofold the Km of mitochondrial respiration for ADP. During a standardized in vivo fatiguing protocol (6-min of repeated maximal isometric contractions electrically induced at a frequency of 1.7 Hz), both capsiate treatments reduced oxidative cost of contraction by 30-40%, whereas force-generating capacity and fatigability were not changed. Moreover, the rate of phosphocreatine resynthesis during the post-electrostimulation recovery period remained unaffected by capsiate. Both capsiate treatments further promoted muscle mass gain, and the higher dose also reduced body weight gain and abdominal fat content. These findings demonstrate that, in addition to its anti-obesity effect, capsiate supplementation improves oxidative metabolism in exercising muscle, which strengthen this compound as a natural compound for improving health.

Kinematic adaptations during running: effects of footwear, surface, and duration.

PubMed

Hardin, Elizabeth C; van den Bogert, Antonie J; Hamill, Joseph

2004-05-01

Repetitive impacts encountered during locomotion may be modified by footwear and/or surface. Changes in kinematics may occur either as a direct response to altered mechanical conditions or over time as active adaptations. : To investigate how midsole hardness, surface stiffness, and running duration influence running kinematics. In the first of two experiments, 12 males ran at metabolic steady state under six conditions; combinations of midsole hardness (40 Shore A, 70 Shore A), and surface stiffness (100 kN x m, 200 kN x m, and 350 kN x m). In the second experiment, 10 males ran for 30 min on a 12% downhill grade. In both experiments, subjects ran at 3.4 m x s on a treadmill while 2-D hip, knee, and ankle kinematics were determined using high-speed videography (200 Hz). Oxygen cost and heart rate data were also collected. Kinematic adaptations to midsole, surface, and running time were studied. Stance time, stride cycle time, and maximal knee flexion were invariant across conditions in each experiment. Increased midsole hardness resulted in greater peak ankle dorsiflexion velocity (P = 0.0005). Increased surface stiffness resulted in decreased hip and knee flexion at contact, reduced maximal hip flexion, and increased peak angular velocities of the hip, knee, and ankle. Over time, hip flexion at contact decreased, plantarflexion at toe-off increased, and peak dorsiflexion and plantarflexion velocity increased. Lower-extremity kinematics adapted to increased midsole hardness, surface stiffness, and running duration. Changes in limb posture at impact were interpreted as active adaptations that compensate for passive mechanical effects. The adaptations appeared to have the goal of minimizing metabolic cost at the expense of increased exposure to impact shock.
Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: study protocol of a randomized clinical trial.

PubMed

Kairy, Dahlia; Veras, Mirella; Archambault, Philippe; Hernandez, Alejandro; Higgins, Johanne; Levin, Mindy F; Poissant, Lise; Raz, Amir; Kaizer, Franceen

2016-03-01

Telerehabilitation (TR), or the provision of rehabilitation services from a distance using telecommunication tools such as the Internet, can contribute to ensure that patients receive the best care at the right time. This study aims to assess the effect of an interactive virtual reality (VR) system that allows ongoing rehabilitation of the upper extremity (UE) following a stroke, while the person is in their own home, with offline monitoring and feedback from a therapist at a distance. A single-blind (evaluator is blind to group assignment) two-arm randomized controlled trial is proposed, with participants who have had a stroke and are no longer receiving rehabilitation services randomly allocated to: (1) 4-week written home exercise program, i.e. usual care discharge home program or (2) a 4-week home-based TR exercise program using VR in addition to usual care i.e. treatment group. Motor recovery of the UE will be assessed using the Fugl-Meyer Assessment-UE and the Box and Block tests. To determine the efficacy of the system in terms of functional recovery, the Motor Activity Log, a self-reported measure of UE use will be used. Impact on quality of life will be determined using the Stroke Impact Scale-16. Lastly, a preliminary cost-effectiveness analysis will be conducted using costs and outcomes for all groups. Findings will contribute to evidence regarding the use of TR and VR to provide stroke rehabilitation services from a distance. This approach can enhance continuity of care once patients are discharged from rehabilitation, in order to maximize their recovery beyond the current available services. Copyright © 2015 Elsevier Inc. All rights reserved.
Reproducibility, Controllability, and Optimization of Lenr Experiments

NASA Astrophysics Data System (ADS)

Nagel, David J.

2006-02-01

Low-energy nuclear reaction (LENR) measurements are significantly and increasingly reproducible. Practical control of the production of energy or materials by LENR has yet to be demonstrated. Minimization of costly inputs and maximization of desired outputs of LENR remain for future developments.
Lightweight, High Performance, Low Cost Propulsion Systems for Mars Exploration Missions to Maximize Science Payload

NASA Astrophysics Data System (ADS)

Trinh, H. P.

2012-06-01

Utilization of new cold hypergolic propellants and leverage Missile Defense Agency technology for propulsion systems on Mars explorations will provide an increase of science payload and have significant payoffs and benefits for NASA missions.
Position Paper: Dental General Practice Residency Programs: Financing and Operations.

ERIC Educational Resources Information Center

Hanson, Paul W.

1983-01-01

A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)
What Price Excellence?

ERIC Educational Resources Information Center

Fischer, Robert J.; Wass, Hannelore

1970-01-01

This article discusses through the use of three case studies, the possible problems caused by pressure placed on high achievers to excell academically. Perhaps the maximization of academic achievement may well be accomplished at some crucial personal or social cost for the individual. (Author/KJ)
Variation in Urban Transit Costs and Revenues by Type of Service

DOT National Transportation Integrated Search

1987-01-12

This research explores whether the public authorities that currently provide mass transit service in the nation's urban areas are able to operate any of those services "profitably," where that term is defined to maximize the possibilities for profita...
Analyzing CMOS/SOS fabrication for LSI arrays

NASA Technical Reports Server (NTRS)

Ipri, A. C.

1978-01-01

Report discusses set of design rules that have been developed as result of work with test arrays. Set of optimum dimensions is given that would maximize process output and would correspondingly minimize costs in fabrication of large-scale integration (LSI) arrays.
Navigating Benefit Transfer for Salmon Improvements in the Western US

EPA Science Inventory

A perennial problem in environmental resource management is targeting an efficient level of resource provision that maximizes societal well-being. Such management requires knowledge of both costs and benefits associated with varying management options. This paper illustrates the ...
Biofuel supply chain considering depreciation cost of installed plants

NASA Astrophysics Data System (ADS)

Rabbani, Masoud; Ramezankhani, Farshad; Giahi, Ramin; Farshbaf-Geranmayeh, Amir

2016-06-01

Due to the depletion of the fossil fuels and major concerns about the security of energy in the future to produce fuels, the importance of utilizing the renewable energies is distinguished. Nowadays there has been a growing interest for biofuels. Thus, this paper reveals a general optimization model which enables the selection of preprocessing centers for the biomass, biofuel plants, and warehouses to store the biofuels. The objective of this model is to maximize the total benefits. Costs of the model consist of setup cost of preprocessing centers, plants and warehouses, transportation costs, production costs, emission cost and the depreciation cost. At first, the deprecation cost of the centers is calculated by means of three methods. The model chooses the best depreciation method in each period by switching between them. A numerical example is presented and solved by CPLEX solver in GAMS software and finally, sensitivity analyses are accomplished.
Segregation effects during solidification in weightless melts. [effects of evaporation and solidification on crystalization

NASA Technical Reports Server (NTRS)

Li, C.

1975-01-01

Computer programs are developed and used in the study of the combined effects of evaporation and solidification in space processing. The temperature and solute concentration profiles during directional solidification of binary alloys with surface evaporation were mathematically formulated. Computer results are included along with an econotechnical model of crystal growth. This model allows: prediction of crystal size, quality, and cost; systematic selection of the best growth equipment or alloy system; optimization of growth or material parameters; and a maximization of zero-gravity effects. Segregation in GaAs crystals was examined along with vibration effects on GaAs crystal growth. It was found that a unique segregation pattern and strong convention currents exist in GaAs crystal growth. Some beneficial effects from vibration during GaAs growth were discovered. The implications of the results in space processing are indicated.
Wind farm and solar park effects on plant–soil carbon cycling: uncertain impacts of changes in ground-level microclimate

PubMed Central

Armstrong, Alona; Waldron, Susan; Whitaker, Jeanette; Ostle, Nicholas J

2014-01-01

Global energy demand is increasing as greenhouse gas driven climate change progresses, making renewable energy sources critical to future sustainable power provision. Land-based wind and solar electricity generation technologies are rapidly expanding, yet our understanding of their operational effects on biological carbon cycling in hosting ecosystems is limited. Wind turbines and photovoltaic panels can significantly change local ground-level climate by a magnitude that could affect the fundamental plant–soil processes that govern carbon dynamics. We believe that understanding the possible effects of changes in ground-level microclimates on these phenomena is crucial to reducing uncertainty of the true renewable energy carbon cost and to maximize beneficial effects. In this Opinions article, we examine the potential for the microclimatic effects of these land-based renewable energy sources to alter plant–soil carbon cycling, hypothesize likely effects and identify critical knowledge gaps for future carbon research. PMID:24132939
On the relative independence of thinking biases and cognitive ability.

PubMed

Stanovich, Keith E; West, Richard F

2008-04-01

In 7 different studies, the authors observed that a large number of thinking biases are uncorrelated with cognitive ability. These thinking biases include some of the most classic and well-studied biases in the heuristics and biases literature, including the conjunction effect, framing effects, anchoring effects, outcome bias, base-rate neglect, "less is more" effects, affect biases, omission bias, myside bias, sunk-cost effect, and certainty effects that violate the axioms of expected utility theory. In a further experiment, the authors nonetheless showed that cognitive ability does correlate with the tendency to avoid some rational thinking biases, specifically the tendency to display denominator neglect, probability matching rather than maximizing, belief bias, and matching bias on the 4-card selection task. The authors present a framework for predicting when cognitive ability will and will not correlate with a rational thinking tendency. (c) 2008 APA, all rights reserved.
The effect of ankle foot orthosis stiffness on the energy cost of walking: a simulation study.

PubMed

Bregman, D J J; van der Krogt, M M; de Groot, V; Harlaar, J; Wisse, M; Collins, S H

2011-11-01

In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot Orthoses are frequently prescribed. However, it is unknown what Ankle Foot Orthoses stiffness should be used to obtain the most efficient gait. The aim of this simulation study was to gain insights into the effect of variation in Ankle Foot Orthosis stiffness on the amount of energy stored in the Ankle Foot Orthosis and the energy cost of walking. We developed a two-dimensional forward-dynamic walking model with a passive spring at the ankle representing the Ankle Foot Orthosis and two constant torques at the hip for propulsion. We varied Ankle Foot Orthosis stiffness while keeping speed and step length constant. We found an optimal stiffness, at which the energy delivered at the hip joint was minimal. Energy cost decreased with increasing energy storage in the ankle foot orthosis, but the most efficient gait did not occur with maximal energy storage. With maximum storage, push-off occurred too late to reduce the impact of the contralateral leg with the floor. Maximum return prior to foot strike was also suboptimal, as push-off occurred too early and its effects were subsequently counteracted by gravity. The optimal Ankle Foot Orthosis stiffness resulted in significant push-off timed just prior to foot strike and led to greater ankle plantar-flexion velocity just before contralateral foot strike. Our results suggest that patient energy cost might be reduced by the proper choice of Ankle Foot Orthosis stiffness. Copyright © 2011 Elsevier Ltd. All rights reserved.
Similar Gender Dimorphism in the Costs of Reproduction across the Geographic Range of Fraxinus ornus

PubMed Central

Verdú, Miguel; Spanos, Kostas; čaňová, Ingrid; Slobodník, Branko; Paule, Ladislav

2007-01-01

Background and Aims The reproductive costs for individuals with the female function have been hypothesized to be greater than for those with the male function because the allocation unit per female flower is very high due to the necessity to nurture the embryos until seed dispersal occurs, while the male reproductive allocation per flower is lower because it finishes once pollen is shed. Consequently, males may invest more resources in growth than females. This prediction was tested across a wide geographical range in a tree with a dimorphic breeding system (Fraxinus ornus) consisting of males and hermaphrodites functioning as females. The contrasting ecological conditions found across the geographical range allowed the evaluation of the hypothesis that the reproductive costs of sexual dimorphism varies with environmental stressors. Methods By using random-effects meta-analysis, the differences in the reproductive and vegetative investment of male and hermaphrodite trees of F. ornus were analysed in 10 populations from the northern (Slovakia), south-eastern (Greece) and south-western (Spain) limits of its European distribution. The variation in gender-dimorphism with environmental stress was analysed by running a meta-regression between these effect sizes and the two environmental stress indicators: one related to temperature (the frost-free period) and another related to water availability (moisture deficit). Key Results Most of the effect sizes showed that males produced more flowers and grew more quickly than hermaphrodites. Gender differences in reproduction and growth were not minimized or maximized under adverse climatic conditions such as short frost-free periods or severe aridity. Conclusions The lower costs of reproduction for F. ornus males allow them to grow more quickly than hermaphrodites, although such differences in sex-specific reproductive costs are not magnified under stressful conditions. PMID:17098751
Optimizing bulk milk dioxin monitoring based on costs and effectiveness.

PubMed

Lascano-Alcoser, V H; Velthuis, A G J; van der Fels-Klerx, H J; Hoogenboom, L A P; Oude Lansink, A G J M

2013-07-01

Dioxins are environmental pollutants, potentially present in milk products, which have negative consequences for human health and for the firms and farms involved in the dairy chain. Dioxin monitoring in feed and food has been implemented to detect their presence and estimate their levels in food chains. However, the costs and effectiveness of such programs have not been evaluated. In this study, the costs and effectiveness of bulk milk dioxin monitoring in milk trucks were estimated to optimize the sampling and pooling monitoring strategies aimed at detecting at least 1 contaminated dairy farm out of 20,000 at a target dioxin concentration level. Incidents of different proportions, in terms of the number of contaminated farms, and concentrations were simulated. A combined testing strategy, consisting of screening and confirmatory methods, was assumed as well as testing of pooled samples. Two optimization models were built using linear programming. The first model aimed to minimize monitoring costs subject to a minimum required effectiveness of finding an incident, whereas the second model aimed to maximize the effectiveness for a given monitoring budget. Our results show that a high level of effectiveness is possible, but at high costs. Given specific assumptions, monitoring with 95% effectiveness to detect an incident of 1 contaminated farm at a dioxin concentration of 2 pg of toxic equivalents/g of fat [European Commission's (EC) action level] costs €2.6 million per month. At the same level of effectiveness, a 73% cost reduction is possible when aiming to detect an incident where 2 farms are contaminated at a dioxin concentration of 3 pg of toxic equivalents/g of fat (EC maximum level). With a fixed budget of €40,000 per month, the probability of detecting an incident with a single contaminated farm at a dioxin concentration equal to the EC action level is 4.4%. This probability almost doubled (8.0%) when aiming to detect the same incident but with a dioxin concentration equal to the EC maximum level. This study shows that the effectiveness of finding an incident depends not only on the ratio at which, for testing, collected truck samples are mixed into a pooled sample (aiming at detecting certain concentration), but also the number of collected truck samples. In conclusion, the optimal cost-effective monitoring depends on the number of contaminated farms and the concentration aimed at detection. The models and study results offer quantitative support to risk managers of food industries and food safety authorities. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Flexible CRISPR library construction using parallel oligonucleotide retrieval

PubMed Central

Read, Abigail; Gao, Shaojian; Batchelor, Eric

2017-01-01

Abstract CRISPR/Cas9-based gene knockout libraries have emerged as a powerful tool for functional screens. We present here a set of pre-designed human and mouse sgRNA sequences that are optimized for both high on-target potency and low off-target effect. To maximize the chance of target gene inactivation, sgRNAs were curated to target both 5΄ constitutive exons and exons that encode conserved protein domains. We describe here a robust and cost-effective method to construct multiple small sized CRISPR library from a single oligo pool generated by array synthesis using parallel oligonucleotide retrieval. Together, these resources provide a convenient means for individual labs to generate customized CRISPR libraries of variable size and coverage depth for functional genomics application. PMID:28334828
An excellent navigation system and experience in craniomaxillofacial navigation surgery: a double-center study

PubMed Central

Dai, Jiewen; Wu, Jinyang; Wang, Xudong; Yang, Xudong; Wu, Yunong; Xu, Bing; Shi, Jun; Yu, Hongbo; Cai, Min; Zhang, Wenbin; Zhang, Lei; Sun, Hao; Shen, Guofang; Zhang, Shilei

2016-01-01

Numerous problems regarding craniomaxillofacial navigation surgery are not well understood. In this study, we performed a double-center clinical study to quantitatively evaluate the characteristics of our navigation system and experience in craniomaxillofacial navigation surgery. Fifty-six patients with craniomaxillofacial disease were included and randomly divided into experimental (using our AccuNavi-A system) and control (using Strker system) groups to compare the surgical effects. The results revealed that the average pre-operative planning time was 32.32 mins vs 29.74 mins between the experimental and control group, respectively (p > 0.05). The average operative time was 295.61 mins vs 233.56 mins (p > 0.05). The point registration orientation accuracy was 0.83 mm vs 0.92 mm. The maximal average preoperative navigation orientation accuracy was 1.03 mm vs 1.17 mm. The maximal average persistent navigation orientation accuracy was 1.15 mm vs 0.09 mm. The maximal average navigation orientation accuracy after registration recovery was 1.15 mm vs 1.39 mm between the experimental and control group. All patients healed, and their function and profile improved. These findings demonstrate that although surgeons should consider the patients’ time and monetary costs, our qualified navigation surgery system and experience could offer an accurate guide during a variety of craniomaxillofacial surgeries. PMID:27305855
Wind farm optimization using evolutionary algorithms

NASA Astrophysics Data System (ADS)

Ituarte-Villarreal, Carlos M.

In recent years, the wind power industry has focused its efforts on solving the Wind Farm Layout Optimization (WFLO) problem. Wind resource assessment is a pivotal step in optimizing the wind-farm design and siting and, in determining whether a project is economically feasible or not. In the present work, three (3) different optimization methods are proposed for the solution of the WFLO: (i) A modified Viral System Algorithm applied to the optimization of the proper location of the components in a wind-farm to maximize the energy output given a stated wind environment of the site. The optimization problem is formulated as the minimization of energy cost per unit produced and applies a penalization for the lack of system reliability. The viral system algorithm utilized in this research solves three (3) well-known problems in the wind-energy literature; (ii) a new multiple objective evolutionary algorithm to obtain optimal placement of wind turbines while considering the power output, cost, and reliability of the system. The algorithm presented is based on evolutionary computation and the objective functions considered are the maximization of power output, the minimization of wind farm cost and the maximization of system reliability. The final solution to this multiple objective problem is presented as a set of Pareto solutions and, (iii) A hybrid viral-based optimization algorithm adapted to find the proper component configuration for a wind farm with the introduction of the universal generating function (UGF) analytical approach to discretize the different operating or mechanical levels of the wind turbines in addition to the various wind speed states. The proposed methodology considers the specific probability functions of the wind resource to describe their proper behaviors to account for the stochastic comportment of the renewable energy components, aiming to increase their power output and the reliability of these systems. The developed heuristic considers a variable number of system components and wind turbines with different operating characteristics and sizes, to have a more heterogeneous model that can deal with changes in the layout and in the power generation requirements over the time. Moreover, the approach evaluates the impact of the wind-wake effect of the wind turbines upon one another to describe and evaluate the power production capacity reduction of the system depending on the layout distribution of the wind turbines.
A portfolio-based approach to optimize proof-of-concept clinical trials.

PubMed

Mallinckrodt, Craig; Molenberghs, Geert; Persinger, Charles; Ruberg, Stephen; Sashegyi, Andreas; Lindborg, Stacy

2012-01-01

Improving proof-of-concept (PoC) studies is a primary lever for improving drug development. Since drug development is often done by institutions that work on multiple drugs simultaneously, the present work focused on optimum choices for rates of false positive (α) and false negative (β) results across a portfolio of PoC studies. Simple examples and a newly derived equation provided conceptual understanding of basic principles regarding optimum choices of α and β in PoC trials. In examples that incorporated realistic development costs and constraints, the levels of α and β that maximized the number of approved drugs and portfolio value varied by scenario. Optimum choices were sensitive to the probability the drug was effective and to the proportion of total investment cost prior to establishing PoC. Results of the present investigation agree with previous research in that it is important to assess optimum levels of α and β. However, the present work also highlighted the need to consider cost structure using realistic input parameters relevant to the question of interest.

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