Identifying Differences between Depressed Adolescent Suicide Ideators and Attempters

PubMed Central

Auerbach, Randy P.; Millner, Alexander J.; Stewart, Jeremy G.; Esposito, Erika

2015-01-01

Background Adolescent depression and suicide are pressing public health concerns, and identifying key differences among suicide ideators and attempters is critical. The goal of the current study is to test whether depressed adolescent suicide attempters report greater anhedonia severity and exhibit aberrant effort-cost computations in the face of uncertainty. Methods Depressed adolescents (n = 101) ages 13–19 years were administered structured clinical interviews to assess current mental health disorders and a history of suicidality (suicide ideators = 55, suicide attempters = 46). Then, participants completed self-report instruments assessing symptoms of suicidal ideation, depression, anhedonia, and anxiety as well as a computerized effort-cost computation task. Results Compared with depressed adolescent suicide ideators, attempters report greater anhedonia severity, even after concurrently controlling for symptoms of suicidal ideation, depression, and anxiety. Additionally, when completing the effort-cost computation task, suicide attempters are less likely to pursue the difficult, high value option when outcomes are uncertain. Follow-up, trial-level analyses of effort-cost computations suggest that receipt of reward does not influence future decision-making among suicide attempters, however, suicide ideators exhibit a win-stay approach when receiving rewards on previous trials. Limitations Findings should be considered in light of limitations including a modest sample size, which limits generalizability, and the cross-sectional design. Conclusions Depressed adolescent suicide attempters are characterized by greater anhedonia severity, which may impair the ability to integrate previous rewarding experiences to inform future decisions. Taken together, this may generate a feeling of powerlessness that contributes to increased suicidality and a needless loss of life. PMID:26233323

A case for Redundant Arrays of Inexpensive Disks (RAID)

NASA Technical Reports Server (NTRS)

Patterson, David A.; Gibson, Garth; Katz, Randy H.

1988-01-01

Increasing performance of CPUs and memories will be squandered if not matched by a similar performance increase in I/O. While the capacity of Single Large Expensive Disks (SLED) has grown rapidly, the performance improvement of SLED has been modest. Redundant Arrays of Inexpensive Disks (RAID), based on the magnetic disk technology developed for personal computers, offers an attractive alternative to SLED, promising improvements of an order of magnitude in performance, reliability, power consumption, and scalability. This paper introduces five levels of RAIDs, giving their relative cost/performance, and compares RAID to an IBM 3380 and a Fujitsu Super Eagle.

PCA-based artifact removal algorithm for stroke detection using UWB radar imaging.

PubMed

Ricci, Elisa; di Domenico, Simone; Cianca, Ernestina; Rossi, Tommaso; Diomedi, Marina

2017-06-01

Stroke patients should be dispatched at the highest level of care available in the shortest time. In this context, a transportable system in specialized ambulances, able to evaluate the presence of an acute brain lesion in a short time interval (i.e., few minutes), could shorten delay of treatment. UWB radar imaging is an emerging diagnostic branch that has great potential for the implementation of a transportable and low-cost device. Transportability, low cost and short response time pose challenges to the signal processing algorithms of the backscattered signals as they should guarantee good performance with a reasonably low number of antennas and low computational complexity, tightly related to the response time of the device. The paper shows that a PCA-based preprocessing algorithm can: (1) achieve good performance already with a computationally simple beamforming algorithm; (2) outperform state-of-the-art preprocessing algorithms; (3) enable a further improvement in the performance (and/or decrease in the number of antennas) by using a multistatic approach with just a modest increase in computational complexity. This is an important result toward the implementation of such a diagnostic device that could play an important role in emergency scenario.

Enhanced conformational sampling of carbohydrates by Hamiltonian replica-exchange simulation.

PubMed

Mishra, Sushil Kumar; Kara, Mahmut; Zacharias, Martin; Koca, Jaroslav

2014-01-01

Knowledge of the structure and conformational flexibility of carbohydrates in an aqueous solvent is important to improving our understanding of how carbohydrates function in biological systems. In this study, we extend a variant of the Hamiltonian replica-exchange molecular dynamics (MD) simulation to improve the conformational sampling of saccharides in an explicit solvent. During the simulations, a biasing potential along the glycosidic-dihedral linkage between the saccharide monomer units in an oligomer is applied at various levels along the replica runs to enable effective transitions between various conformations. One reference replica runs under the control of the original force field. The method was tested on disaccharide structures and further validated on biologically relevant blood group B, Lewis X and Lewis A trisaccharides. The biasing potential-based replica-exchange molecular dynamics (BP-REMD) method provided a significantly improved sampling of relevant conformational states compared with standard continuous MD simulations, with modest computational costs. Thus, the proposed BP-REMD approach adds a new dimension to existing carbohydrate conformational sampling approaches by enhancing conformational sampling in the presence of solvent molecules explicitly at relatively low computational cost.

Patient-centered medical home initiative produced modest economic results for Veterans Health Administration, 2010-12.

PubMed

Hebert, Paul L; Liu, Chuan-Fen; Wong, Edwin S; Hernandez, Susan E; Batten, Adam; Lo, Sophie; Lemon, Jaclyn M; Conrad, Douglas A; Grembowski, David; Nelson, Karin; Fihn, Stephan D

2014-06-01

In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary care clinics in accordance with the patient-centered medical home model. We analyzed data for fiscal years 2003-12 to assess how trends in health care use and costs changed after the implementation of PACT. We found that PACT was associated with modest increases in primary care visits and with modest decreases in both hospitalizations for ambulatory care-sensitive conditions and outpatient visits with mental health specialists. We estimated that these changes avoided $596 million in costs, compared to the investment in PACT of $774 million, for a potential net loss of $178 million in the study period. Although PACT has not generated a positive return, it is still maturing, and trends in costs and use are favorable. Adopting patient-centered care does not appear to have been a major financial risk for the VHA. Project HOPE—The People-to-People Health Foundation, Inc.

Cost-effectiveness of a program to prevent depression relapse in primary care.

PubMed

Simon, Gregory E; Von Korff, Michael; Ludman, Evette J; Katon, Wayne J; Rutter, Carolyn; Unützer, Jürgen; Lin, Elizabeth H B; Bush, Terry; Walker, Edward

2002-10-01

Evaluate the incremental cost-effectiveness of a depression relapse prevention program in primary care. Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks later. Those recovered from the current episode but at high risk for relapse (based on history of recurrent depression or dysthymia) were offered randomization to usual care or a relapse prevention intervention. The intervention included systematic patient education, two psychoeducational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and telephone and mail monitoring of medication adherence and depressive symptoms. Outcomes in both groups were assessed via blinded telephone assessments at 3, 6, 9, and 12 months and health plan claims and accounting data. Intervention patients experienced 13.9 additional depression-free days during a 12-month period (95% CI, -1.5 to 29.3). Incremental costs of the intervention were $273 (95% CI, $102 to $418) for depression treatment costs only and $160 (95% CI, -$173 to $512) for total outpatient costs. Incremental cost-effectiveness ratio was $24 per depression-free day (95% CI, -$59 to $496) for depression treatment costs only and $14 per depression-free day (95% CI, -$35 to $248) for total outpatient costs. A program to prevent depression relapse in primary care yields modest increases in days free of depression and modest increases in treatment costs. These modest differences reflect high rates of treatment in usual care. Along with other recent studies, these findings suggest that improved care of depression in primary care is a prudent investment of health care resources.

Combining Statistics and Physics to Improve Climate Downscaling

NASA Astrophysics Data System (ADS)

Gutmann, E. D.; Eidhammer, T.; Arnold, J.; Nowak, K.; Clark, M. P.

2017-12-01

Getting useful information from climate models is an ongoing problem that has plagued climate science and hydrologic prediction for decades. While it is possible to develop statistical corrections for climate models that mimic current climate almost perfectly, this does not necessarily guarantee that future changes are portrayed correctly. In contrast, convection permitting regional climate models (RCMs) have begun to provide an excellent representation of the regional climate system purely from first principles, providing greater confidence in their change signal. However, the computational cost of such RCMs prohibits the generation of ensembles of simulations or long time periods, thus limiting their applicability for hydrologic applications. Here we discuss a new approach combining statistical corrections with physical relationships for a modest computational cost. We have developed the Intermediate Complexity Atmospheric Research model (ICAR) to provide a climate and weather downscaling option that is based primarily on physics for a fraction of the computational requirements of a traditional regional climate model. ICAR also enables the incorporation of statistical adjustments directly within the model. We demonstrate that applying even simple corrections to precipitation while the model is running can improve the simulation of land atmosphere feedbacks in ICAR. For example, by incorporating statistical corrections earlier in the modeling chain, we permit the model physics to better represent the effect of mountain snowpack on air temperature changes.

An initial assessment of the cost and utilization of the Integrated Academic Information System (IAIMS) at Columbia Presbyterian Medical Center.

PubMed Central

Clayton, P. D.; Anderson, R. K.; Hill, C.; McCormack, M.

1991-01-01

The concept of "one stop information shopping" is becoming a reality at Columbia Presbyterian Medical Center (CPMC). The goal of our effort is to provide access to university and hospital administrative systems as well as clinical and library applications from a single workstation, which also provides utility functions such as word processing and mail. Since June 1987, CPMC has invested the equivalent of $23 million dollars to install a digital communications network that encompasses 18 buildings at seven geographically separate sites and to develop clinical and library applications that are integrated with the existing hospital and university administrative and research computing facilities. During June 1991, 2425 different individuals used the clinical information system, 425 different individuals used the library applications, and 900 different individuals used the hospital administrative applications via network access. If we were to freeze the system in its current state, amortize the development and network installation costs, and add projected maintenance costs for the clinical and library applications, our integrated information system would cost $2.8 million on an annual basis. This cost is 0.3% of the medical center's annual budget. These expenditures could be justified by very small improvements in time savings for personnel and/or decreased length of hospital stay and/or more efficient use of resources. In addition to the direct benefits which we detail, a major benefit is the ease with which additional computer-based applications can be added incrementally at an extremely modest cost. PMID:1666966

How wearable technologies will impact the future of health care.

PubMed

Barnard, Rick; Shea, J Timothy

2004-01-01

After four hundred years of delivering health care in hospitals, industrialized countries are now shifting towards treating patients at the "point of need". This trend will likely accelerate demand for, and adoption of, wearable computing and smart fabric and interactive textile (SFIT) solutions. These healthcare solutions will be designed to provide real-time vital and diagnostic information to health care providers, patients, and related stakeholders in such a manner as to improve quality of care, reduce the cost of care, and allow patients greater control over their own health. The current market size for wearable computing and SFIT solutions is modest; however, the future outlook is extremely strong. Venture Development Corporation, a technology market research and strategy firm, was founded in 1971. Over the years, VDC has developed and implemented a unique and highly successful methodology for forecasting and analyzing highly dynamic technology markets. VDC has extensive experience in providing multi-client and proprietary analysis in the electronic components, advanced materials, and mobile computing markets.

Reducing costs of managing and accessing navigation and ancillary data by relying on the extensive capabilities of NASA's spice system

NASA Technical Reports Server (NTRS)

Semenov, Boris V.; Acton, Charles H., Jr.; Bachman, Nathaniel J.; Elson, Lee S.; Wright, Edward D.

2005-01-01

The SPICE system of navigation and ancillary data possesses a number of traits that make its use in modern space missions of all types highly cost efficient. The core of the system is a software library providing API interfaces for storing and retrieving such data as trajectories, orientations, time conversions, and instrument geometry parameters. Applications used at any stage of a mission life cycle can call SPICE APIs to access this data and compute geometric quantities required for observation planning, engineering assessment and science data analysis. SPICE is implemented in three different languages, supported on 20+ computer environments, and distributed with complete source code and documentation. It includes capabilities that are extensively tested by everyday use in many active projects and are applicable to all types of space missions - flyby, orbiters, observatories, landers and rovers. While a customer's initial SPICE adaptation for the first mission or experiment requires a modest effort, this initial effort pays off because adaptation for subsequent missions/experiments is just a small fraction of the initial investment, with the majority of tools based on SPICE requiring no or very minor changes.

The feasibility of a public-private long-term care financing plan.

PubMed

Arling, G; Hagan, S; Buhaug, H

1992-08-01

In this study, the feasibility of a public-private long-term care (LTC) financing plan that would combine private LTC insurance with special Medicaid eligibility requirements was assessed. The plan would also raise the Medicaid asset limit from the current $2,000 to the value of an individual's insurance benefits. After using benefits the individual could enroll in Medicaid. Thus, insurance would substitute for asset spend-down, protecting individuals against catastrophic costs. This financing plan was analyzed through a computer model that simulated lifetime LTC use for a middle-income age cohort beginning at 65 years of age. LTC payments from Medicaid, personal income and assets, Medicare, and insurance were projected by the model. Assuming that LTC use and costs would not grow beyond current projections, the proposed plan would provide asset protection for the cohort without increasing Medicaid expenditures. In contrast, private insurance alone, with no change in Medicaid eligibility, would offer only limited asset protection. The results must be qualified, however, because even a modest increase in LTC cost growth or use of care (beyond current projections) could result in substantially higher Medicaid expenditures. Also, private insurance might increase personal LTC expenditures because of the added cost of insuring.

Benefits, Harms, and Costs of Osteoporosis Screening in Male Veterans

DTIC Science & Technology

2016-10-01

of many was modest, and some were negatively associated with screening (diabetes, stroke, kidney disease ). Co-morbidities had a modest...was estimated using baseline creatinine values and calculated with the Modification of Diet in Renal Disease equation. Subjects were followed to...those with diabetes, incident fractures were associated with presence of cardiovascular disease (20.8% vs 12.4%, P < 0.0001) and chronic kidney

High resolution flow field prediction for tail rotor aeroacoustics

NASA Technical Reports Server (NTRS)

Quackenbush, Todd R.; Bliss, Donald B.

1989-01-01

The prediction of tail rotor noise due to the impingement of the main rotor wake poses a significant challenge to current analysis methods in rotorcraft aeroacoustics. This paper describes the development of a new treatment of the tail rotor aerodynamic environment that permits highly accurate resolution of the incident flow field with modest computational effort relative to alternative models. The new approach incorporates an advanced full-span free wake model of the main rotor in a scheme which reconstructs high-resolution flow solutions from preliminary, computationally inexpensive simulations with coarse resolution. The heart of the approach is a novel method for using local velocity correction terms to capture the steep velocity gradients characteristic of the vortex-dominated incident flow. Sample calculations have been undertaken to examine the principal types of interactions between the tail rotor and the main rotor wake and to examine the performance of the new method. The results of these sample problems confirm the success of this approach in capturing the high-resolution flows necessary for analysis of rotor-wake/rotor interactions with dramatically reduced computational cost. Computations of radiated sound are also carried out that explore the role of various portions of the main rotor wake in generating tail rotor noise.

A series approximation model for optical light transport and output intensity field distribution in large aspect ratio cylindrical scintillation crystals

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

Tobias, Benjamin John

A series approximation has been derived for the transport of optical photons within a cylindrically symmetric light pipe and applied to the task of evaluating both the origin and angular distribution of light reaching the output plane. This analytic expression finds particular utility in first-pass photonic design applications since it may be evaluated at a very modest computational cost and is readily parameterized for relevant design constraints. It has been applied toward quantitative exploration of various scintillation crystal preparations and their impact on both quantum efficiency and noise, reproducing sensible dependencies and providing physical justification for certain gamma ray cameramore » design choices.« less

Achieving network level privacy in Wireless Sensor Networks.

PubMed

Shaikh, Riaz Ahmed; Jameel, Hassan; d'Auriol, Brian J; Lee, Heejo; Lee, Sungyoung; Song, Young-Jae

2010-01-01

Full network level privacy has often been categorized into four sub-categories: Identity, Route, Location and Data privacy. Achieving full network level privacy is a critical and challenging problem due to the constraints imposed by the sensor nodes (e.g., energy, memory and computation power), sensor networks (e.g., mobility and topology) and QoS issues (e.g., packet reach-ability and timeliness). In this paper, we proposed two new identity, route and location privacy algorithms and data privacy mechanism that addresses this problem. The proposed solutions provide additional trustworthiness and reliability at modest cost of memory and energy. Also, we proved that our proposed solutions provide protection against various privacy disclosure attacks, such as eavesdropping and hop-by-hop trace back attacks.

Achieving Network Level Privacy in Wireless Sensor Networks†

PubMed Central

Shaikh, Riaz Ahmed; Jameel, Hassan; d’Auriol, Brian J.; Lee, Heejo; Lee, Sungyoung; Song, Young-Jae

2010-01-01

Full network level privacy has often been categorized into four sub-categories: Identity, Route, Location and Data privacy. Achieving full network level privacy is a critical and challenging problem due to the constraints imposed by the sensor nodes (e.g., energy, memory and computation power), sensor networks (e.g., mobility and topology) and QoS issues (e.g., packet reach-ability and timeliness). In this paper, we proposed two new identity, route and location privacy algorithms and data privacy mechanism that addresses this problem. The proposed solutions provide additional trustworthiness and reliability at modest cost of memory and energy. Also, we proved that our proposed solutions provide protection against various privacy disclosure attacks, such as eavesdropping and hop-by-hop trace back attacks. PMID:22294881

A Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST)

NASA Astrophysics Data System (ADS)

Conti, Alberto; Arenberg, Jonathan; Baldauf, Brian

2017-01-01

The “Search for Life” (direct imaging of earth-like planets) will require extremely stable telescopes with apertures in the 10 m to 20 m range. Such apertures are larger than what can be delivered to space using current or planned future launch vehicles. Building and assembling large telescopes in space is therefore likely to require not only multiple launches but importantly assembly in spce. As a result, space-based telescopes with large apertures will require major changes to our conventional telescope design and architecture.Here we report on the concept for the Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST) to demonstrates the on-orbit robotic and/or astronaut assembly of an optical telescope in space. MODEST is a proposed International Space Station (ISS demonstration that will make use of the standard Express Logistics Carriers (ELCs) and can mounted to one of a variety of ISS pallets.MODEST will provides significant risk reduction for the next generation of space observatories, and demonstrates the technology needed to assemble a six-mirror phased telescope. Key modest features include the use of an active primary optical surface with wavefront feedback control to allow on-orbit optimization, and the precise surface control to meet optical system wavefront and stability requirements.MODEST will also be used to evaluate advances in lightweight mirror and metering structure materials such as SiC or Carbon Fiber Reinforced Polymer (CFRP) that have excellent mechanical and thermal properties, e.g. high stiffness, high modulus, high thermal conductivity, and low thermal expansion. Mirrors built from these materials can be rapidly replicated in a highly cost effective manner, making them an excellent candidate for a low cost, high performance Optical Telescope Assembly paving the way for enabling affordable solutions for the next generation of large aperture space-based telescope.MODEST post-assembly value includes space, ground, and environmental studies, a testbed for new instruments, and a tool for student’s exploration of space.

Cost Analysis of the STONE Randomized Trial: Can Health Care Costs be Reduced One Test at a Time?

PubMed

Melnikow, Joy; Xing, Guibo; Cox, Ginger; Leigh, Paul; Mills, Lisa; Miglioretti, Diana L; Moghadassi, Michelle; Smith-Bindman, Rebecca

2016-04-01

Decreasing the use of high-cost tests may reduce health care costs. To compare costs of care for patients presenting to the emergency department (ED) with suspected kidney stones randomized to 1 of 3 initial imaging tests. Patients were randomized to point-of-care ultrasound (POC US, least costly), radiology ultrasound (RAD US), or computed tomography (CT, most costly). Subsequent testing and treatment were the choice of the treating physician. A total of 2759 patients at 15 EDs were randomized to POC US (n=908), RAD US, (n=893), or CT (n=958). Mean age was 40.4 years; 51.8% were male. All medical care documented in the trial database in the 7 days following enrollment was abstracted and coded to estimate costs using national average 2012 Medicare reimbursements. Costs for initial ED care and total 7-day costs were compared using nonparametric bootstrap to account for clustering of patients within medical centers. Initial ED visit costs were modestly lower for patients assigned to RAD US: $423 ($411, $434) compared with patients assigned to CT: $448 ($438, $459) (P<0.0001). Total costs were not significantly different between groups: $1014 ($912, $1129) for POC US, $970 ($878, $1078) for RAD US, and $959 ($870, $1044) for CT. Hospital admissions contributed over 50% of total costs, though only 11% of patients were admitted. Mean total costs (and admission rates) varied substantially by site from $749 to $1239. Assignment to a less costly test had no impact on overall health care costs for ED patients. System-level interventions addressing variation in admission rates from the ED might have greater impact on costs.

American business ethics and health care costs.

PubMed

Garrett, T M; Klonoski, R J; Baillie, H W

1993-01-01

The health care industry operates in the margin between market competition and social welfare programs. Violations of business ethics on the market side add considerably to costs. When the inefficient use of resources and market distortions due to power and ignorance as well as legal and subsidized monopolies are added, increased costs can approach $100 billion. Modest remedies are suggested.

Equatorially trapped convection in a rapidly rotating shallow shell

NASA Astrophysics Data System (ADS)

Miquel, Benjamin; Xie, Jin-Han; Featherstone, Nicholas; Julien, Keith; Knobloch, Edgar

2018-05-01

Motivated by the recent discovery of subsurface oceans on planetary moons and the interest they have generated, we explore convective flows in shallow spherical shells of dimensionless gap width ɛ2≪1 in the rapid rotation limit E ≪1 , where E is the Ekman number. We employ direct numerical simulation (DNS) of the Boussinesq equations to compute the local heat flux Nu (λ ) as a function of the latitude λ and use the results to characterize the trapping of convection at low latitudes, around the equator. We show that these results are quantitatively reproduced by an asymptotically exact nonhydrostatic equatorial β -plane convection model at a much more modest computational cost than DNS. We identify the trapping parameter β =ɛ E-1 as the key parameter that controls the vigor and latitudinal extent of convection for moderate thermal forcing when E ˜ɛ and ɛ ↓0 . This model provides a theoretical paradigm for nonlinear investigations.

Energetic costs of calcification under ocean acidification

NASA Astrophysics Data System (ADS)

Spalding, Christopher; Finnegan, Seth; Fischer, Woodward W.

2017-05-01

Anthropogenic ocean acidification threatens to negatively impact marine organisms that precipitate calcium carbonate skeletons. Past geological events, such as the Permian-Triassic Mass Extinction, together with modern experiments generally support these concerns. However, the physiological costs of producing a calcium carbonate skeleton under different acidification scenarios remain poorly understood. Here we present an idealized mathematical model to quantify whole-skeleton costs, concluding that they rise only modestly (up to ˜10%) under acidification expected for 2100. The modest magnitude of this effect reflects in part the low energetic cost of inorganic, calcium carbonate relative to the proteinaceous organic matrix component of skeletons. Our analysis does, however, point to an important kinetic constraint that depends on seawater carbonate chemistry, and we hypothesize that the impact of acidification is more likely to cause extinctions within groups where the timescale of larval development is tightly constrained. The cheapness of carbonate skeletons compared to organic materials also helps explain the widespread evolutionary convergence upon calcification within the metazoa.

Digital Maps, Matrices and Computer Algebra

ERIC Educational Resources Information Center

Knight, D. G.

2005-01-01

The way in which computer algebra systems, such as Maple, have made the study of complex problems accessible to undergraduate mathematicians with modest computational skills is illustrated by some large matrix calculations, which arise from representing the Earth's surface by digital elevation models. Such problems are often considered to lie in…

Economic analysis of new space transportation systems: Executive summary

NASA Technical Reports Server (NTRS)

1971-01-01

An economic analysis of alternative space transportation systems is presented. Results indicate that the expendable systems represent modest investments, but the recurring costs of operation would remain high. The space shuttle and tug system requires a substantial investment, but would substantially reduce the recurring costs of operation. Economic benefits and costs of the different systems are also analyzed. Findings are summarized.

Home Health Care: Services and Cost

ERIC Educational Resources Information Center

Widmer, Geraldine; And Others

1978-01-01

Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

A tuned mesh-generation strategy for image representation based on data-dependent triangulation.

PubMed

Li, Ping; Adams, Michael D

2013-05-01

A mesh-generation framework for image representation based on data-dependent triangulation is proposed. The proposed framework is a modified version of the frameworks of Rippa and Garland and Heckbert that facilitates the development of more effective mesh-generation methods. As the proposed framework has several free parameters, the effects of different choices of these parameters on mesh quality are studied, leading to the recommendation of a particular set of choices for these parameters. A mesh-generation method is then introduced that employs the proposed framework with these best parameter choices. This method is demonstrated to produce meshes of higher quality (both in terms of squared error and subjectively) than those generated by several competing approaches, at a relatively modest computational and memory cost.

The Potential Economic Value of a Cutaneous Leishmaniasis Vaccine in Seven Endemic Countries in the Americas

PubMed Central

Bacon, Kristina M.; Hotez, Peter J.; Kruchten, Stephanie D.; Kamhawi, Shaden; Bottazzi, Maria Elena; Valenzuela, Jesus G.; Lee, Bruce Y.

2013-01-01

Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relative short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrates important economic benefits. PMID:23176979

Ripple Effects: Budgets Grow Modestly, but Energy Costs Cloud the Horizon

ERIC Educational Resources Information Center

Oder, Norman

2006-01-01

In this article, the author reports the ripple effects of the energy squeeze due to Hurricane Katrina and other factors that sent energy costs skyrocketing. Energy costs are a good part of why budget growth, which has been steady over the past five years, has been slowing down. The projected change from FY2005 to FY2006 is only 3.3%, compared to…

Economics of Pharmacogenetic-Guided Treatments: Underwhelming or Overstated?

PubMed

Hughes, Dyfrig A

2018-05-01

Economic evaluations have dispelled a perception that precision medicine, achieved through pharmacogenetic testing, reduces healthcare costs. For many tests aimed at preventing adverse drug reactions, cost-effectiveness analyses predict modest improvements in health benefits and increases in total costs. While there are many uncertainties in estimating the value of testing, factors that influence cost-effectiveness include the rarity of the outcome, the effectiveness of alternative treatments, and the scope and perspective of analysis. © 2018 ASCPT.

A Predictive Model to Estimate Cost Savings of a Novel Diagnostic Blood Panel for Diagnosis of Diarrhea-predominant Irritable Bowel Syndrome.

PubMed

Pimentel, Mark; Purdy, Chris; Magar, Raf; Rezaie, Ali

2016-07-01

A high incidence of irritable bowel syndrome (IBS) is associated with significant medical costs. Diarrhea-predominant IBS (IBS-D) is diagnosed on the basis of clinical presentation and diagnostic test results and procedures that exclude other conditions. This study was conducted to estimate the potential cost savings of a novel IBS diagnostic blood panel that tests for the presence of antibodies to cytolethal distending toxin B and anti-vinculin associated with IBS-D. A cost-minimization (CM) decision tree model was used to compare the costs of a novel IBS diagnostic blood panel pathway versus an exclusionary diagnostic pathway (ie, standard of care). The probability that patients proceed to treatment was modeled as a function of sensitivity, specificity, and likelihood ratios of the individual biomarker tests. One-way sensitivity analyses were performed for key variables, and a break-even analysis was performed for the pretest probability of IBS-D. Budget impact analysis of the CM model was extrapolated to a health plan with 1 million covered lives. The CM model (base-case) predicted $509 cost savings for the novel IBS diagnostic blood panel versus the exclusionary diagnostic pathway because of the avoidance of downstream testing (eg, colonoscopy, computed tomography scans). Sensitivity analysis indicated that an increase in both positive likelihood ratios modestly increased cost savings. Break-even analysis estimated that the pretest probability of disease would be 0.451 to attain cost neutrality. The budget impact analysis predicted a cost savings of $3,634,006 ($0.30 per member per month). The novel IBS diagnostic blood panel may yield significant cost savings by allowing patients to proceed to treatment earlier, thereby avoiding unnecessary testing. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

7 CFR 3575.25 - Ineligible loan purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... over tenants and services offered except for industrial-site infrastructure development, (b) Facilities... facilities, (d) Telephone systems, (e) Facilities which are not modest in size, design, and cost, (f) Finder...

Density Functional Theory and Beyond for Band-Gap Screening: Performance for Transition-Metal Oxides and Dichalcogenides.

PubMed

Li, Wenqing; Walther, Christian F J; Kuc, Agnieszka; Heine, Thomas

2013-07-09

The performance of a wide variety of commonly used density functionals, as well as two screened hybrid functionals (HSE06 and TB-mBJ), on predicting electronic structures of a large class of en vogue materials, such as metal oxides, chalcogenides, and nitrides, is discussed in terms of band gaps, band structures, and projected electronic densities of states. Contrary to GGA, hybrid functionals and GGA+U, both HSE06 and TB-mBJ are able to predict band gaps with an appreciable accuracy of 25% and thus allow the screening of various classes of transition-metal-based compounds, i.e., mixed or doped materials, at modest computational cost. The calculated electronic structures are largely unaffected by the choice of basis functions and software implementation, however, might be subject to the treatment of the core electrons.

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

Unat, Didem; Dubey, Anshu; Hoefler, Torsten

The cost of data movement has always been an important concern in high performance computing (HPC) systems. It has now become the dominant factor in terms of both energy consumption and performance. Support for expression of data locality has been explored in the past, but those efforts have had only modest success in being adopted in HPC applications for various reasons. However, with the increasing complexity of the memory hierarchy and higher parallelism in emerging HPC systems, locality management has acquired a new urgency. Developers can no longer limit themselves to low-level solutions and ignore the potential for productivity andmore » performance portability obtained by using locality abstractions. Fortunately, the trend emerging in recent literature on the topic alleviates many of the concerns that got in the way of their adoption by application developers. Data locality abstractions are available in the forms of libraries, data structures, languages and runtime systems; a common theme is increasing productivity without sacrificing performance. Furthermore, this paper examines these trends and identifies commonalities that can combine various locality concepts to develop a comprehensive approach to expressing and managing data locality on future large-scale high-performance computing systems.« less

Real-time probabilistic covariance tracking with efficient model update.

PubMed

Wu, Yi; Cheng, Jian; Wang, Jinqiao; Lu, Hanqing; Wang, Jun; Ling, Haibin; Blasch, Erik; Bai, Li

2012-05-01

The recently proposed covariance region descriptor has been proven robust and versatile for a modest computational cost. The covariance matrix enables efficient fusion of different types of features, where the spatial and statistical properties, as well as their correlation, are characterized. The similarity between two covariance descriptors is measured on Riemannian manifolds. Based on the same metric but with a probabilistic framework, we propose a novel tracking approach on Riemannian manifolds with a novel incremental covariance tensor learning (ICTL). To address the appearance variations, ICTL incrementally learns a low-dimensional covariance tensor representation and efficiently adapts online to appearance changes of the target with only O(1) computational complexity, resulting in a real-time performance. The covariance-based representation and the ICTL are then combined with the particle filter framework to allow better handling of background clutter, as well as the temporary occlusions. We test the proposed probabilistic ICTL tracker on numerous benchmark sequences involving different types of challenges including occlusions and variations in illumination, scale, and pose. The proposed approach demonstrates excellent real-time performance, both qualitatively and quantitatively, in comparison with several previously proposed trackers.

Surface tension and phase coexistence properties of the lattice fluid from a virtual site removal Monte Carlo strategy

NASA Astrophysics Data System (ADS)

Provata, Astero; Prassas, Vassilis D.; Theodorou, Doros N.

1997-10-01

A thin liquid film of lattice fluid in equilibrium with its vapor is studied in 2 and 3 dimensions with canonical Monte Carlo simulation (MC) and Self-Consistent Field Theory (SCF) in the temperature range 0.45Tc to Tc, where Tc the liquid-gas critical temperature. Extending the approach of Oates et al. [Philos. Mag. B 61, 337 (1990)] to anisotropic systems, we develop a method for the MC computation of the transverse and normal pressure profiles, hence of the surface tension, based on virtual removals of individual sites or blocks of sites from the system. Results from implementation of this new method, obtained at very modest computational cost, are in reasonable agreement with exact values and other MC estimates of the surface tension of the 2-d and 3-d model systems, respectively. SCF estimates of the interfacial density profiles, the surface tension, the vapor pressure curve and the binodal curve compare well with MC results away from Tc, but show the expected deviations at high temperatures.

Runaway Costs in Medi-Cal—A Myth

PubMed Central

Heckman, John R.; Jones, Michael W.

1980-01-01

An analysis of increases in Medi-Cal expenditures to their present level, more than $4 billion a year, shows them to be attributable largely to changes in eligibility and scope of benefits. The actual costs of providing care have risen at a relatively modest rate. If in fact costs are to be lowered from present levels, public policy makers must make important decisions concerning program changes which transcend merely altering payment and delivery methods. PMID:6996335

Repetitive Domain-Referenced Testing Using Computers: the TITA System.

ERIC Educational Resources Information Center

Olympia, P. L., Jr.

The TITA (Totally Interactive Testing and Analysis) System algorithm for the repetitive construction of domain-referenced tests utilizes a compact data bank, is highly portable, is useful in any discipline, requires modest computer hardware, and does not present a security problem. Clusters of related keyphrases, statement phrases, and distractors…

The potential economic value of a cutaneous leishmaniasis vaccine in seven endemic countries in the Americas.

PubMed

Bacon, Kristina M; Hotez, Peter J; Kruchten, Stephanie D; Kamhawi, Shaden; Bottazzi, Maria Elena; Valenzuela, Jesus G; Lee, Bruce Y

2013-01-07

Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relatively short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrate important economic benefits. Copyright © 2012 Elsevier Ltd. All rights reserved.

How might immunization rates change if cost sharing is eliminated?

PubMed

Shen, Angela K; O'Grady, Michael J; McDevitt, Roland D; Pickreign, Jeremy D; Laudenberger, Laura K; Esber, Allahna; Shortridge, Emily F

2014-01-01

There is a debate regarding the effect of cost sharing on immunization, particularly as the Affordable Care Act will eliminate cost sharing for recommended vaccines. This study estimates changes in immunization rates and spending associated with extending first-dollar coverage to privately insured children for four childhood vaccines. We used the 2008 National Immunization Survey and peer-reviewed literature to generate estimates of immunization status for each vaccine by age group and insurance type. We used the Truven Health Analytics 2006 MarketScan Commercial Claims and Encounters Database of line-item medical claims to estimate changes in immunization rates that would result from eliminating cost sharing, and we used the Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey to determine the prevalence of coverage for patients with first-dollar coverage, patients who face office visit cost sharing, and patients who face cost sharing for all vaccine cost components. We assumed that once cost sharing is removed, coverage rates in plans that impose cost sharing will rise to the level of plans that do not. We estimate that immunization rates would increase modestly and result in additional direct spending of $26.0 million to insurers/employers. Further, these payers would have an additional $11.0 million in spending associated with eliminating cost sharing for children already receiving immunizations. The effects of eliminating cost sharing for vaccines vary by vaccine. Overall, immunization rates will rise modestly given high insurance coverage for vaccinations, and these increases would be more substantial for those currently facing cost sharing. However, in addition to the removal of cost sharing for immunizations, these findings suggest other strategies to consider to further increase immunization rates.

Rising College Costs and an Illinois Effort to Control Them: A Preliminary Review

ERIC Educational Resources Information Center

North, Teresa Lynn

2013-01-01

Rising college costs are of increasing concern. At the 12 public universities in Illinois, average increases in tuition were modest, generally in the 4% range, until 1999 when individual campuses begin to increase tuition at double digit rates. In 2002-2003, the overall average increase in tuition/fees more than doubled at 13.79%. In an effort to…

The cost of acquiring public hunting access on family forests lands

Treesearch

Michael A. Kilgore; Stephanie A. Snyder; Joesph M. Schertz; Steven J. Taff

2008-01-01

To address the issue of declining access to private forest land in the United States for hunting, over 1,000 Minnesota family forest owners were surveyed to estimate the cost of acquiring non-exclusive public hunting access rights. The results indicate landowner interest in selling access rights is extremely modest. Using binary logistic regression, the mean annual...

Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study.

PubMed

Subramanian, Sujha; Hoover, Sonja; Wagner, Joann L; Donovan, Jennifer L; Kanaan, Abir O; Rochon, Paula A; Gurwitz, Jerry H; Field, Terry S

2012-01-01

In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering.

The Multiple Pendulum Problem via Maple[R

ERIC Educational Resources Information Center

Salisbury, K. L.; Knight, D. G.

2002-01-01

The way in which computer algebra systems, such as Maple, have made the study of physical problems of some considerable complexity accessible to mathematicians and scientists with modest computational skills is illustrated by solving the multiple pendulum problem. A solution is obtained for four pendulums with no restriction on the size of the…

The Cost of Penicillin Allergy Evaluation.

PubMed

Blumenthal, Kimberly G; Li, Yu; Banerji, Aleena; Yun, Brian J; Long, Aidan A; Walensky, Rochelle P

2017-09-22

Unverified penicillin allergy leads to adverse downstream clinical and economic sequelae. Penicillin allergy evaluation can be used to identify true, IgE-mediated allergy. To estimate the cost of penicillin allergy evaluation using time-driven activity-based costing (TDABC). We implemented TDABC throughout the care pathway for 30 outpatients presenting for penicillin allergy evaluation. The base-case evaluation included penicillin skin testing and a 1-step amoxicillin drug challenge, performed by an allergist. We varied assumptions about the provider type, clinical setting, procedure type, and personnel timing. The base-case penicillin allergy evaluation costs $220 in 2016 US dollars: $98 for personnel, $119 for consumables, and $3 for space. In sensitivity analyses, lower cost estimates were achieved when only a drug challenge was performed (ie, no skin test, $84) and a nurse practitioner provider was used ($170). Adjusting for the probability of anaphylaxis did not result in a changed estimate ($220); although other analyses led to modest changes in the TDABC estimate ($214-$246), higher estimates were identified with changing to a low-demand practice setting ($268), a 50% increase in personnel times ($269), and including clinician documentation time ($288). In a least/most costly scenario analyses, the lowest TDABC estimate was $40 and the highest was $537. Using TDABC, penicillin allergy evaluation costs $220; even with varied assumptions adjusting for operational challenges, clinical setting, and expanded testing, penicillin allergy evaluation still costs only about $540. This modest investment may be offset for patients treated with costly alternative antibiotics that also may result in adverse consequences. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis.

PubMed

Schrader, Andrew J; Tribble, David R; Riddle, Mark S

2017-12-01

To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD will seek medical care earlier in the disease course compared with current patterns; the second strategy aimed to optimize provider treatment practices through the implementation of a Department of Defense Clinical Practice Guideline. Outcome measures selected to compare management strategies were duty days lost averted (DDL-averted) and a cost effectiveness ratio (CER) of cost per DDL-averted (USD/DDL-averted). Increasing health care and by seeking it more often and earlier in the disease course as a stand-alone management strategy produced more DDL (worse) than the base case (up to 8,898 DDL-gained per year) at an increased cost to the Department of Defense (CER $193). Increasing provider use of an optimal evidence-based treatment algorithm through Clinical Practice Guidelines prevented 5,299 DDL per year with overall cost savings (CER -$74). A combination of both strategies produced the greatest gain in DDL-averted (6,887) with a modest cost increase (CER $118). The application of this model demonstrates that changes in TD management during deployment can be implemented to reduce DDL with likely favorable impacts on mission capability and individual health readiness. The hypothetical combination strategy evaluated prevents the most DDL compared with current practice and is associated with a modest cost increase.

Job Analysis: A Local Government's Experience.

ERIC Educational Resources Information Center

Urbanek, Steve J.

1997-01-01

A county personnel department undertook reclassification of all positions by collecting and using job analysis data to rewrite job descriptions. External pay equity and validated selection procedures resulted with only a modest increase in payroll costs. (SK)

Cost and quality trends in direct contracting arrangements.

PubMed

Lyles, Alan; Weiner, Jonathan P; Shore, Andrew D; Christianson, Jon; Solberg, Leif I; Drury, Patricia

2002-01-01

This paper presents the first empirical analysis of a 1997 initiative of the Buyers Health Care Action Group (BHCAG) known as Choice Plus. This initiative entailed direct contracts with provider-controlled delivery systems; annual care system bidding; public reports of consumer satisfaction and quality; uniform benefits; and risk-adjusted payment. After case-mix adjustment, hospital costs decreased, ambulatory care costs rose modestly, and pharmacy costs increased substantially. Process-oriented quality indicators were stable or improved. The BHCAG employer-to-provider direct contracting and consumer choice model appeared to perform reasonably well in containing costs, without measurable adverse effects on quality.

Reliably Discriminating Stock Structure with Genetic Markers:Mixture Models with Robust and Fast Computation.

PubMed

Foster, Scott D; Feutry, Pierre; Grewe, Peter M; Berry, Oliver; Hui, Francis K C; Davies, Campbell R

2018-06-26

Delineating naturally occurring and self-sustaining sub-populations (stocks) of a species is an important task, especially for species harvested from the wild. Despite its central importance to natural resource management, analytical methods used to delineate stocks are often, and increasingly, borrowed from superficially similar analytical tasks in human genetics even though models specifically for stock identification have been previously developed. Unfortunately, the analytical tasks in resource management and human genetics are not identical { questions about humans are typically aimed at inferring ancestry (often referred to as 'admixture') rather than breeding stocks. In this article, we argue, and show through simulation experiments and an analysis of yellowfin tuna data, that ancestral analysis methods are not always appropriate for stock delineation. In this work, we advocate a variant of a previouslyintroduced and simpler model that identifies stocks directly. We also highlight that the computational aspects of the analysis, irrespective of the model, are difficult. We introduce some alternative computational methods and quantitatively compare these methods to each other and to established methods. We also present a method for quantifying uncertainty in model parameters and in assignment probabilities. In doing so, we demonstrate that point estimates can be misleading. One of the computational strategies presented here, based on an expectation-maximisation algorithm with judiciously chosen starting values, is robust and has a modest computational cost. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Direct numerical simulation of particulate flows with an overset grid method

NASA Astrophysics Data System (ADS)

Koblitz, A. R.; Lovett, S.; Nikiforakis, N.; Henshaw, W. D.

2017-08-01

We evaluate an efficient overset grid method for two-dimensional and three-dimensional particulate flows for small numbers of particles at finite Reynolds number. The rigid particles are discretised using moving overset grids overlaid on a Cartesian background grid. This allows for strongly-enforced boundary conditions and local grid refinement at particle surfaces, thereby accurately capturing the viscous boundary layer at modest computational cost. The incompressible Navier-Stokes equations are solved with a fractional-step scheme which is second-order-accurate in space and time, while the fluid-solid coupling is achieved with a partitioned approach including multiple sub-iterations to increase stability for light, rigid bodies. Through a series of benchmark studies we demonstrate the accuracy and efficiency of this approach compared to other boundary conformal and static grid methods in the literature. In particular, we find that fully resolving boundary layers at particle surfaces is crucial to obtain accurate solutions to many common test cases. With our approach we are able to compute accurate solutions using as little as one third the number of grid points as uniform grid computations in the literature. A detailed convergence study shows a 13-fold decrease in CPU time over a uniform grid test case whilst maintaining comparable solution accuracy.

Extending the accuracy of the SNAP interatomic potential form

NASA Astrophysics Data System (ADS)

Wood, Mitchell A.; Thompson, Aidan P.

2018-06-01

The Spectral Neighbor Analysis Potential (SNAP) is a classical interatomic potential that expresses the energy of each atom as a linear function of selected bispectrum components of the neighbor atoms. An extension of the SNAP form is proposed that includes quadratic terms in the bispectrum components. The extension is shown to provide a large increase in accuracy relative to the linear form, while incurring only a modest increase in computational cost. The mathematical structure of the quadratic SNAP form is similar to the embedded atom method (EAM), with the SNAP bispectrum components serving as counterparts to the two-body density functions in EAM. The effectiveness of the new form is demonstrated using an extensive set of training data for tantalum structures. Similar to artificial neural network potentials, the quadratic SNAP form requires substantially more training data in order to prevent overfitting. The quality of this new potential form is measured through a robust cross-validation analysis.

Optimal spacecraft attitude control using collocation and nonlinear programming

NASA Astrophysics Data System (ADS)

Herman, A. L.; Conway, B. A.

1992-10-01

Direct collocation with nonlinear programming (DCNLP) is employed to find the optimal open-loop control histories for detumbling a disabled satellite. The controls are torques and forces applied to the docking arm and joint and torques applied about the body axes of the OMV. Solutions are obtained for cases in which various constraints are placed on the controls and in which the number of controls is reduced or increased from that considered in Conway and Widhalm (1986). DCLNP works well when applied to the optimal control problem of satellite attitude control. The formulation is straightforward and produces good results in a relatively small amount of time on a Cray X/MP with no a priori information about the optimal solution. The addition of joint acceleration to the controls significantly reduces the control magnitudes and optimal cost. In all cases, the torques and acclerations are modest and the optimal cost is very modest.

Analysis and design of asymmetrical reluctance machine

NASA Astrophysics Data System (ADS)

Harianto, Cahya A.

Over the past few decades the induction machine has been chosen for many applications due to its structural simplicity and low manufacturing cost. However, modest torque density and control challenges have motivated researchers to find alternative machines. The permanent magnet synchronous machine has been viewed as one of the alternatives because it features higher torque density for a given loss than the induction machine. However, the assembly and permanent magnet material cost, along with safety under fault conditions, have been concerns for this class of machine. An alternative machine type, namely the asymmetrical reluctance machine, is proposed in this work. Since the proposed machine is of the reluctance machine type, it possesses desirable feature, such as near absence of rotor losses, low assembly cost, low no-load rotational losses, modest torque ripple, and rather benign fault conditions. Through theoretical analysis performed herein, it is shown that this machine has a higher torque density for a given loss than typical reluctance machines, although not as high as the permanent magnet machines. Thus, the asymmetrical reluctance machine is a viable and advantageous machine alternative where the use of permanent magnet machines are undesirable.

Design concepts for a composite door frame system for general automotive applications

NASA Technical Reports Server (NTRS)

Tauber, J. A.

1976-01-01

Conceptual design, manufacturing process, and costs are explored to determine the feasibility of replacing present steel parts in automotive door structures with various composite materials. The problems of conforming to present anti-intrusion specifications with advanced materials are examined and discussed. Modest weight reductions, at competitive costs, were identified for the utilization of specific composite materials in automotive door structures.

Measuring efficiency: the association of hospital costs and quality of care.

PubMed

Jha, Ashish K; Orav, E John; Dobson, Allen; Book, Robert A; Epstein, Arnold M

2009-01-01

Providers with lower costs may be more efficient and, therefore, provide better care than those with higher costs. However, the relationship between risk-adjusted costs (often described as efficiency) and quality is not well understood. We examined the relationship between hospitals' risk-adjusted costs and their structural characteristics, nursing levels, quality of care, and outcomes. U.S. hospitals with low risk-adjusted costs were more likely to be for-profit, treat more Medicare patients, and employ fewer nurses. They provided modestly worse care for acute myocardial infarction and congestive heart failure but had comparable rates of risk-adjusted mortality. We found no evidence that low-cost providers provide better care.

Research for new UAV capabilities

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

Canavan, G.H.; Leadabrand, R.

1996-07-01

This paper discusses research for new Unmanned Aerial Vehicles (UAV) capabilities. Findings indicate that UAV performance could be greatly enhanced by modest research. Improved sensors and communications enhance near term cost effectiveness. Improved engines, platforms, and stealth improve long term effectiveness.

Interband coding extension of the new lossless JPEG standard

NASA Astrophysics Data System (ADS)

Memon, Nasir D.; Wu, Xiaolin; Sippy, V.; Miller, G.

1997-01-01

Due to the perceived inadequacy of current standards for lossless image compression, the JPEG committee of the International Standards Organization (ISO) has been developing a new standard. A baseline algorithm, called JPEG-LS, has already been completed and is awaiting approval by national bodies. The JPEG-LS baseline algorithm despite being simple is surprisingly efficient, and provides compression performance that is within a few percent of the best and more sophisticated techniques reported in the literature. Extensive experimentations performed by the authors seem to indicate that an overall improvement by more than 10 percent in compression performance will be difficult to obtain even at the cost of great complexity; at least not with traditional approaches to lossless image compression. However, if we allow inter-band decorrelation and modeling in the baseline algorithm, nearly 30 percent improvement in compression gains for specific images in the test set become possible with a modest computational cost. In this paper we propose and investigate a few techniques for exploiting inter-band correlations in multi-band images. These techniques have been designed within the framework of the baseline algorithm, and require minimal changes to the basic architecture of the baseline, retaining its essential simplicity.

Decentralized coordinated control of elastic web winding systems without tension sensor.

PubMed

Hou, Hailiang; Nian, Xiaohong; Chen, Jie; Xiao, Dengfeng

2018-06-26

In elastic web winding systems, precise regulation of web tension in each span is critical to ensure final product quality, and to achieve low cost by reducing the occurrence of web break or fold. Generally, web winding systems use load cells or swing rolls as tension sensors, which add cost, reduce system reliability and increase the difficulty of control. In this paper, a decentralized coordinated control scheme with tension observers is designed for a three-motor web-winding system. First, two tension observers are proposed to estimate the unwinding and winding tension. The designed observers consider the essential dynamic, radius, and inertial variation effects and only require the modest computational effort. Then, using the estimated tensions as feedback signals, a robust decentralized coordinated controller is adopted to reduce the interaction between subsystems. Asymptotic stabilities of the observer error dynamics and the closed-loop winding systems are demonstrated via Lyapunov stability theory. The observer gains and the controller gains can be obtained by solving matrix inequalities. Finally, some simulations and experiments are performed on a paper winding setup to test the performance of the designed observers and the observer-base DCC method, respectively. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Impact of a transition to more restrictive drug formulary on therapy discontinuation and medication adherence.

PubMed

Shirneshan, E; Kyrychenko, P; Matlin, O S; Avila, J P; Brennan, T A; Shrank, W H

2016-02-01

There is conclusive evidence demonstrating that formulary restrictions are associated with reduced utilization and pharmacy spending of the restricted drugs. However, prior efforts to implement restrictive formularies have been associated with inconsistent rates of therapy discontinuation and mixed impacts on adherence to therapy. Also, the impact of transferring patients from an already restrictive formulary to a more aggressive model has not been previously examined. This study evaluated the impact of implementation of a more restrictive formulary on therapy disruption, adherence rates, pharmacy costs and generic utilization among patients with common chronic conditions. In 2014, CVS Health implemented Value Formulary (VF), a restrictive benefit design with the aim of reducing spending while preserving access to and adherence to essential therapy, was used. A retrospective cohort study was conducted to assess changes in therapy disruption rates, pharmacy costs and generic dispensing rate (GDR) (for continuers) and medication adherence (for initiators) following the implementation of VF. The study group was selected from members of three existing employer clients transitioned from standard formulary (SF) to VF on January 2014. The control population was a matched group of six employers with the same preperiod formulary structure, business unit, adherence programmes and patient out-of-pocket cost as the study group. The control group retained SF in 2014. To assess therapy disruption after VF implementation, we categorized patients by their subsequent medication use into three groups: (i) therapy stopped, (ii) therapy continued and (iii) therapy switched. Medication adherence was measured as monthly proportion of days covered (PDC). Pharmacy cost and GDR were measured per utilizer per month (PUPM). Rates of therapy disruption in study and control groups were compared using the chi-square test. Differences in monthly PDC between matched groups were evaluated using multivariate linear regression. Impact of VF on pharmacy cost and GDR was measured through segmented regression of interrupted time series data with generalized estimating equations. A transition from SF to VF influenced drug coverage for approximately 13% of members (as their medications were either no longer covered, or covered restrictively under VF). Compared to patients whose plan sponsors retained SF, the patients that transitioned to VF had a modest (1·3%) but statistically significant increase in therapy discontinuation rates. This was offset by similarly modest improvements in adherence; patients who initiated therapy under VF demonstrated a 1·5% higher adherence to medications as compared to SF patients (P < 0·001). Medication costs in the VF group were lower by $20 PUPM (P < 0·001), and GDR was greater by 4·2% (P < 0·001). Transition of patients to a more restrictive drug formulary led to modest therapy discontinuation, similarly modest improvements in medication adherence and substantial prescription drug cost savings. As healthcare payors search for ways to control the rapid rise in spending for medications without compromising quality, the Value Formulary can serve as a useful tool. © 2016 John Wiley & Sons Ltd.

Renewable Hydrogen Carrier - Carbohydrate: Constructing the Carbon-Neutral Carbohydrate Economy

DTIC Science & Technology

2011-01-31

temperature. High fructose corn syrup , low-cost sucrose replacement, is made by stabilized glucose isomerase, which can work at ~60 °C for even about two...sustainable production, high -density storage, costly infrastructure, to eliminating safety concern. The use of renewable carbohydrate as a high -density...100% selectivity of enzymes, modest reaction conditions, and high -purity of generated hydrogen, carbohydrate is a promising hydrogen carrier for end

Small-scale nuclear reactors for remote military operations: opportunities and challenges

DTIC Science & Technology

2015-08-25

study – Report was published in March 2011  CNA study identified challenges to deploy small modular reactors (SMRs) at a base – Identified First-of...forward operating bases. The availability of deployable, cost-effective, regulated, and secure small modular reactors with a modest output electrical...defense committees on the challenges, operational requirements, constraints, cost, and life cycle analysis for a small modular reactor of less than 10

The drug budget silo mentality: the Dutch case.

PubMed

Koopmanschap, Marc A; Rutten, Frans F H

2003-01-01

This article provides a broad outline of developments in the Dutch health-care policy related to the costs, budgeting, and reimbursement of pharmaceuticals. In-hospital drugs costs are part of hospital budgets, whereas for the main part of costs, nonhospital drugs, no strict budget exists. The government sets a goal for the annual cost increase of nonhospital drugs, but has only limited means to enforce that goal. Two measures were implemented to reduce drug prices: a reference price system and a price law. Both measures had a modest and temporary impact on drug prices during the 1990s. In limiting the utilization of drugs, the package of reimbursed drugs has been restricted. This led to a shift from public to private costs and possible substitution of cheaper not reimbursed drugs by more expensive reimbursed drugs. An electronic prescription system was implemented to encourage rational prescription. Although 70% of the Dutch general practitioners reported to use the system, the estimated savings on drug costs appear to be modest and far less than expected. The use of economic evaluation for reimbursement decisions will increase. From 2005 onward a pharmacoeconomic study and budget impact analysis is formally required for new nonclustered drugs seeking a premium price. Furthermore, in the future the health-care insurers will get a more prominent role in limiting the costs of drugs and enhancing the efficient use of drugs within their overall budgets. Health-care insurers may choose which drugs to purchase and reimburse and they can negotiate drug prices with the pharmaceutical industry, wholesalers, and local pharmacists.

Trends in data locality abstractions for HPC systems

DOE PAGES

Unat, Didem; Dubey, Anshu; Hoefler, Torsten; ...

2017-05-10

The cost of data movement has always been an important concern in high performance computing (HPC) systems. It has now become the dominant factor in terms of both energy consumption and performance. Support for expression of data locality has been explored in the past, but those efforts have had only modest success in being adopted in HPC applications for various reasons. However, with the increasing complexity of the memory hierarchy and higher parallelism in emerging HPC systems, locality management has acquired a new urgency. Developers can no longer limit themselves to low-level solutions and ignore the potential for productivity andmore » performance portability obtained by using locality abstractions. Fortunately, the trend emerging in recent literature on the topic alleviates many of the concerns that got in the way of their adoption by application developers. Data locality abstractions are available in the forms of libraries, data structures, languages and runtime systems; a common theme is increasing productivity without sacrificing performance. Furthermore, this paper examines these trends and identifies commonalities that can combine various locality concepts to develop a comprehensive approach to expressing and managing data locality on future large-scale high-performance computing systems.« less

Local-metrics error-based Shepard interpolation as surrogate for highly non-linear material models in high dimensions

NASA Astrophysics Data System (ADS)

Lorenzi, Juan M.; Stecher, Thomas; Reuter, Karsten; Matera, Sebastian

2017-10-01

Many problems in computational materials science and chemistry require the evaluation of expensive functions with locally rapid changes, such as the turn-over frequency of first principles kinetic Monte Carlo models for heterogeneous catalysis. Because of the high computational cost, it is often desirable to replace the original with a surrogate model, e.g., for use in coupled multiscale simulations. The construction of surrogates becomes particularly challenging in high-dimensions. Here, we present a novel version of the modified Shepard interpolation method which can overcome the curse of dimensionality for such functions to give faithful reconstructions even from very modest numbers of function evaluations. The introduction of local metrics allows us to take advantage of the fact that, on a local scale, rapid variation often occurs only across a small number of directions. Furthermore, we use local error estimates to weigh different local approximations, which helps avoid artificial oscillations. Finally, we test our approach on a number of challenging analytic functions as well as a realistic kinetic Monte Carlo model. Our method not only outperforms existing isotropic metric Shepard methods but also state-of-the-art Gaussian process regression.

Local-metrics error-based Shepard interpolation as surrogate for highly non-linear material models in high dimensions.

PubMed

Lorenzi, Juan M; Stecher, Thomas; Reuter, Karsten; Matera, Sebastian

2017-10-28

Many problems in computational materials science and chemistry require the evaluation of expensive functions with locally rapid changes, such as the turn-over frequency of first principles kinetic Monte Carlo models for heterogeneous catalysis. Because of the high computational cost, it is often desirable to replace the original with a surrogate model, e.g., for use in coupled multiscale simulations. The construction of surrogates becomes particularly challenging in high-dimensions. Here, we present a novel version of the modified Shepard interpolation method which can overcome the curse of dimensionality for such functions to give faithful reconstructions even from very modest numbers of function evaluations. The introduction of local metrics allows us to take advantage of the fact that, on a local scale, rapid variation often occurs only across a small number of directions. Furthermore, we use local error estimates to weigh different local approximations, which helps avoid artificial oscillations. Finally, we test our approach on a number of challenging analytic functions as well as a realistic kinetic Monte Carlo model. Our method not only outperforms existing isotropic metric Shepard methods but also state-of-the-art Gaussian process regression.

Dispersion interactions with linear scaling DFT: a study of planar molecules on charged polar surfaces

NASA Astrophysics Data System (ADS)

Andrinopoulos, Lampros; Hine, Nicholas; Haynes, Peter; Mostofi, Arash

2010-03-01

The placement of organic molecules such as CuPc (copper phthalocyanine) on wurtzite ZnO (zinc oxide) charged surfaces has been proposed as a way of creating photovoltaic solar cellsfootnotetextG.D. Sharma et al., Solar Energy Materials & Solar Cells 90, 933 (2006) ; optimising their performance may be aided by computational simulation. Electronic structure calculations provide high accuracy at modest computational cost but two challenges are encountered for such layered systems. First, the system size is at or beyond the limit of traditional cubic-scaling Density Functional Theory (DFT). Second, traditional exchange-correlation functionals do not account for van der Waals (vdW) interactions, crucial for determining the structure of weakly bonded systems. We present an implementation of recently developed approachesfootnotetextP.L. Silvestrelli, P.R.L. 100, 102 (2008) to include vdW in DFT within ONETEPfootnotetextC.-K. Skylaris, P.D. Haynes, A.A. Mostofi and M.C. Payne, J.C.P. 122, 084119 (2005) , a linear-scaling package for performing DFT calculations using a basis of localised functions. We have applied this methodology to simple planar organic molecules, such as benzene and pentacene, on ZnO surfaces.

Evaluation Realities or How I Learned to Love "The Standards" While Evaluating a Computer Assisted Instruction Project.

ERIC Educational Resources Information Center

Payne, David A.

This case study presents a narrative summary of the evaluation of a two semester computer assisted instruction (CAI) project in an all minority high school. Use of PLATO software with Control Data microcomputers brought about modest achievement advantages, higher internal locus of control, more positive attitudes toward school and specific course…

CHARMM additive and polarizable force fields for biophysics and computer-aided drug design

PubMed Central

Vanommeslaeghe, K.

2014-01-01

Background Molecular Mechanics (MM) is the method of choice for computational studies of biomolecular systems owing to its modest computational cost, which makes it possible to routinely perform molecular dynamics (MD) simulations on chemical systems of biophysical and biomedical relevance. Scope of Review As one of the main factors limiting the accuracy of MD results is the empirical force field used, the present paper offers a review of recent developments in the CHARMM additive force field, one of the most popular bimolecular force fields. Additionally, we present a detailed discussion of the CHARMM Drude polarizable force field, anticipating a growth in the importance and utilization of polarizable force fields in the near future. Throughout the discussion emphasis is placed on the force fields’ parametrization philosophy and methodology. Major Conclusions Recent improvements in the CHARMM additive force field are mostly related to newly found weaknesses in the previous generation of additive force fields. Beyond the additive approximation is the newly available CHARMM Drude polarizable force field, which allows for MD simulations of up to 1 microsecond on proteins, DNA, lipids and carbohydrates. General Significance Addressing the limitations ensures the reliability of the new CHARMM36 additive force field for the types of calculations that are presently coming into routine computational reach while the availability of the Drude polarizable force fields offers a model that is an inherently more accurate model of the underlying physical forces driving macromolecular structures and dynamics. PMID:25149274

Superconducting quantum circuits at the surface code threshold for fault tolerance.

PubMed

Barends, R; Kelly, J; Megrant, A; Veitia, A; Sank, D; Jeffrey, E; White, T C; Mutus, J; Fowler, A G; Campbell, B; Chen, Y; Chen, Z; Chiaro, B; Dunsworth, A; Neill, C; O'Malley, P; Roushan, P; Vainsencher, A; Wenner, J; Korotkov, A N; Cleland, A N; Martinis, John M

2014-04-24

A quantum computer can solve hard problems, such as prime factoring, database searching and quantum simulation, at the cost of needing to protect fragile quantum states from error. Quantum error correction provides this protection by distributing a logical state among many physical quantum bits (qubits) by means of quantum entanglement. Superconductivity is a useful phenomenon in this regard, because it allows the construction of large quantum circuits and is compatible with microfabrication. For superconducting qubits, the surface code approach to quantum computing is a natural choice for error correction, because it uses only nearest-neighbour coupling and rapidly cycled entangling gates. The gate fidelity requirements are modest: the per-step fidelity threshold is only about 99 per cent. Here we demonstrate a universal set of logic gates in a superconducting multi-qubit processor, achieving an average single-qubit gate fidelity of 99.92 per cent and a two-qubit gate fidelity of up to 99.4 per cent. This places Josephson quantum computing at the fault-tolerance threshold for surface code error correction. Our quantum processor is a first step towards the surface code, using five qubits arranged in a linear array with nearest-neighbour coupling. As a further demonstration, we construct a five-qubit Greenberger-Horne-Zeilinger state using the complete circuit and full set of gates. The results demonstrate that Josephson quantum computing is a high-fidelity technology, with a clear path to scaling up to large-scale, fault-tolerant quantum circuits.

An investigation of promotional mix considerations for mail-order prescriptions: facilitating the market's acceptance of a partial health care-cost remedy.

PubMed

Strutton, D; Pelton, L E; True, S L

1993-01-01

While the U.S. health care system is confronted by a daunting assortment of problems, the foremost crisis almost certainly involves the excessive costs of health care. Mail-order prescriptions offer a modest, albeit worthwhile, measure of relief from high health care costs. This study investigates the information search behaviors and product perceptions that characterize current users and nonusers of mail-order prescriptions. Implications and recommendations concerned with the development of promotional strategies for mail-order prescriptions are derived from the findings.

Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST)

NASA Astrophysics Data System (ADS)

Baldauf, Brian; Conti, Alberto

2016-01-01

The "Search for Life" via imaging of exoplanets is a mission that requires extremely stable telescopes with apertures in the 10 m to 20 m range. The High Definition Space Telescope (HDST) envisioned for this mission would have an aperture >10 m, which is a larger payload than what can be delivered to space using a single launch vehicle. Building and assembling the mirror segments enabling large telescopes will likely require multiple launches and assembly in space. Space-based telescopes with large apertures will require major changes to system architectures.The Optical Telescope Assembly (OTA) for HDST is a primary mission cost driver. Enabling and affordable solutions for this next generation of large aperture space-based telescope are needed.This paper reports on the concept for the Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST), which demonstrates on-orbit robotic and/or astronaut assembly of a precision optical telescope in space. It will also facilitate demonstration of active correction of phase and mirror shape. MODEST is proposed to be delivered to the ISS using standard Express Logistics Carriers (ELCs) and can mounted to one of a variety of ISS pallets. Post-assembly value includes space, ground, and environmental studies, and a testbed for new instruments. This demonstration program for next generation mirror technology provides significant risk reduction and demonstrates the technology in a six-mirror phased telescope. Other key features of the demonstration include the use of an active primary optical surface with wavefront feedback control that allows on-orbit optimization and demonstration of precise surface control to meet optical system wavefront and stability requirements.MODEST will also be used to evaluate advances in lightweight mirror and metering structure materials such as SiC or Carbon Fiber Reinforced Polymer that have excellent mechanical and thermal properties, e.g. high stiffness, high modulus, high thermal conductivity, and low thermal expansion. It has been demonstrated that mirrors built from these materials can be rapidly replicated in a highly cost effective manner, making these materials excellent candidates for a low cost, high performance OTA.

Calculating the costs of an 8-week, physiotherapy-led exercise intervention in deconditioned cancer survivors in the early survivorship period (the PEACH trial).

PubMed

Broderick, J M; Guinan, E; O' Donnell, D M; Hussey, J; Tyrrell, E; Normand, C

2014-06-01

Strong evidence exists for rehabilitation programmes following a cancer diagnosis, although little is known about their cost. The effects of an 8-week, physiotherapy-led, structured group intervention during the early survivorship phase were evaluated. Significant changes in quality of life and fatigue, and promising changes in fitness were found. The overall cost for this programme was €196 per participant, including the salaries of the clinicians, overheads and equipment costs. The modest costs associated with this programme may support more routine 'cancer rehabilitation', although more robust analyses are required. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Solving multistage stochastic programming models of portfolio selection with outstanding liabilities

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

Edirisinghe, C.

1994-12-31

Models for portfolio selection in the presence of an outstanding liability have received significant attention, for example, models for pricing options. The problem may be described briefly as follows: given a set of risky securities (and a riskless security such as a bond), and given a set of cash flows, i.e., outstanding liability, to be met at some future date, determine an initial portfolio and a dynamic trading strategy for the underlying securities such that the initial cost of the portfolio is within a prescribed wealth level and the expected cash surpluses arising from trading is maximized. While the tradingmore » strategy should be self-financing, there may also be other restrictions such as leverage and short-sale constraints. Usually the treatment is limited to binomial evolution of uncertainty (of stock price), with possible extensions for developing computational bounds for multinomial generalizations. Posing as stochastic programming models of decision making, we investigate alternative efficient solution procedures under continuous evolution of uncertainty, for discrete time economies. We point out an important moment problem arising in the portfolio selection problem, the solution (or bounds) on which provides the basis for developing efficient computational algorithms. While the underlying stochastic program may be computationally tedious even for a modest number of trading opportunities (i.e., time periods), the derived algorithms may used to solve problems whose sizes are beyond those considered within stochastic optimization.« less

Cost-Effectiveness of Financial Incentives to Promote Adherence to Depot Antipsychotic Medication: Economic Evaluation of a Cluster-Randomised Controlled Trial

PubMed Central

Henderson, Catherine; Knapp, Martin; Yeeles, Ksenija; Bremner, Stephen; Eldridge, Sandra; David, Anthony S.; O’Connell, Nicola; Burns, Tom; Priebe, Stefan

2015-01-01

Background Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5% at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration ISRCTN.com 77769281 PMID:26448540

Social Identity and Achievement Gaps: Evidence from an Affirmation Intervention

ERIC Educational Resources Information Center

Dee, Thomas S.

2015-01-01

One provocative explanation for the continued persistence of minority achievement gaps involves the performance-dampening anxiety thought to be experienced by minority students in highly evaluative settings (i.e., "stereotype threat"). Recent field-experimental studies suggest that modest, low-cost "buffering" interventions…

Appliation of rad-sequencing to linkage mapping in citrus

USDA-ARS?s Scientific Manuscript database

High density linkage maps can be developed for modest cost using high-throughput DNA sequencing to genotype a defined fraction (representation) of the genome. We developed linkage maps in two citrus populations using the RAD (Restriction site Associated DNA) genotyping method which involves restrict...

Making Research Cyberinfrastructure a Strategic Choice

ERIC Educational Resources Information Center

Hacker, Thomas J.; Wheeler, Bradley C.

2007-01-01

The commoditization of low-cost hardware has enabled even modest-sized laboratories and research projects to own their own "supercomputers." The authors argue that this local solution undermines rather than amplifies the research potential of scholars. CIOs, provosts, and research technologists should consider carefully an overall…

Cost-effectiveness of CT screening in the National Lung Screening Trial.

PubMed

Black, William C; Gareen, Ilana F; Soneji, Samir S; Sicks, JoRean D; Keeler, Emmett B; Aberle, Denise R; Naeim, Arash; Church, Timothy R; Silvestri, Gerard A; Gorelick, Jeremy; Gatsonis, Constantine

2014-11-06

The National Lung Screening Trial (NLST) showed that screening with low-dose computed tomography (CT) as compared with chest radiography reduced lung-cancer mortality. We examined the cost-effectiveness of screening with low-dose CT in the NLST. We estimated mean life-years, quality-adjusted life-years (QALYs), costs per person, and incremental cost-effectiveness ratios (ICERs) for three alternative strategies: screening with low-dose CT, screening with radiography, and no screening. Estimations of life-years were based on the number of observed deaths that occurred during the trial and the projected survival of persons who were alive at the end of the trial. Quality adjustments were derived from a subgroup of participants who were selected to complete quality-of-life surveys. Costs were based on utilization rates and Medicare reimbursements. We also performed analyses of subgroups defined according to age, sex, smoking history, and risk of lung cancer and performed sensitivity analyses based on several assumptions. As compared with no screening, screening with low-dose CT cost an additional $1,631 per person (95% confidence interval [CI], 1,557 to 1,709) and provided an additional 0.0316 life-years per person (95% CI, 0.0154 to 0.0478) and 0.0201 QALYs per person (95% CI, 0.0088 to 0.0314). The corresponding ICERs were $52,000 per life-year gained (95% CI, 34,000 to 106,000) and $81,000 per QALY gained (95% CI, 52,000 to 186,000). However, the ICERs varied widely in subgroup and sensitivity analyses. We estimated that screening for lung cancer with low-dose CT would cost $81,000 per QALY gained, but we also determined that modest changes in our assumptions would greatly alter this figure. The determination of whether screening outside the trial will be cost-effective will depend on how screening is implemented. (Funded by the National Cancer Institute; NLST ClinicalTrials.gov number, NCT00047385.).

The Cost of Screening and Brief Intervention in Employee Assistance Programs

PubMed Central

Cowell, Alexander J.; Bray, Jeremy W.; Hinde, Jesse M.

2016-01-01

Few studies examine the costs of conducting screening and brief intervention (SBI) in settings outside health care. This study addresses this gap in knowledge by examining the employer-incurred costs of SBI in an employee assistance program (EAP) when delivered by counselors. Screening was self-administered as part of the intake paperwork, and the brief intervention (BI) was delivered during a regular counseling session. Training costs were $76 per counselor. The cost of a screen to the employer was $0.64; most of this cost comprised the cost of the time the client spent completing the screen. The cost of a BI was $1.86. The cost of SBI is lower than cost estimates of SBI conducted in a health care setting. The low costs for the current study suggest that only modest gains in outcomes would likely be needed to justify delivering SBI in an EAP setting. PMID:21938602

The cost of screening and brief intervention in employee assistance programs.

PubMed

Cowell, Alexander J; Bray, Jeremy W; Hinde, Jesse M

2012-01-01

Few studies examine the costs of conducting screening and brief intervention (SBI) in settings outside health care. This study addresses this gap in knowledge by examining the employer-incurred costs of SBI in an employee assistance program (EAP) when delivered by counselors. Screening was self-administered as part of the intake paperwork, and the brief intervention (BI) was delivered during a regular counseling session. Training costs were $83 per counselor. The cost of a screen to the employer was $0.64; most of this cost comprised the cost of the time the client spent completing the screen. The cost of a BI was $2.52. The cost of SBI is lower than cost estimates of SBI conducted in a health care setting. The low costs for the current study suggest that only modest gains in outcomes would likely be needed to justify delivering SBI in an EAP setting.

Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support.

PubMed

Zimlichman, Eyal; Keohane, Carol; Franz, Calvin; Everett, Wendy L; Seger, Diane L; Yoon, Catherine; Leung, Alexander A; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan E; Bates, David W

2013-07-01

In-hospital adverse events are a major cause of morbidity and mortality and represent a major cost burden to health care systems. A study was conducted to evaluate the return on investment (ROI) for the adoption of vendor-developed computerized physician oder entry (CPOE) systems in four community hospitals in Massachusetts. Of the four hospitals, two were under one management structure and implemented the same vendor-developed CPOE system (Hospital Group A), while the other two were under a second management structure and implemented another vendor-developed CPOE system (Hospital Group B). Cost savings were calculated on the basis of reduction in preventable adverse drug event (ADE) rates as measured previously. ROI, net cash flow, and the breakeven point during a 10-year cost-and-benefit model were calculated. At the time of the study, none of the participating hospitals had implemented more than a rudimentary decision support system together with CPOE. Implementation costs were lower for Hospital Group A than B ($7,130,894 total or $83/admission versus $19,293,379 total or $113/admission, respectively), as were preventable ADE-related avoided costs ($7,937,651 and $16,557,056, respectively). A cost-benefit analysis demonstrated that Hospital Group A had an ROI of 11.3%, breaking even on the investment eight years following implementation. Hospital Group B showed a negative return, with an ROI of -3.1%. Adoption of vendor CPOE systems in community hospitals was associated with a modest ROI at best when applying cost savings attributable to prevention of ADEs only. The modest financial returns can beattributed to the lack of clinical decision support tools.

The price of performance: a cost and performance analysis of the implementation of cell-free fetal DNA testing for Down syndrome in Ontario, Canada.

PubMed

Okun, N; Teitelbaum, M; Huang, T; Dewa, C S; Hoch, J S

2014-04-01

To examine the cost and performance implications of introducing cell-free fetal DNA (cffDNA) testing within modeled scenarios in a publicly funded Canadian provincial Down syndrome (DS) prenatal screening program. Two clinical algorithms were created: the first to represent the current screening program and the second to represent one that incorporates cffDNA testing. From these algorithms, eight distinct scenarios were modeled to examine: (1) the current program (no cffDNA), (2) the current program with first trimester screening (FTS) as the nuchal translucency-based primary screen (no cffDNA), (3) a program substituting current screening with primary cffDNA, (4) contingent cffDNA with current FTS performance, (5) contingent cffDNA at a fixed price to result in overall cost neutrality,(6) contingent cffDNA with an improved detection rate (DR) of FTS, (7) contingent cffDNA with higher uptake of FTS, and (8) contingent cffDNA with optimized FTS (higher uptake and improved DR). This modeling study demonstrates that introducing contingent cffDNA testing improves performance by increasing the number of cases of DS detected prenatally, and reducing the number of amniocenteses performed and concomitant iatrogenic pregnancy loss of pregnancies not affected by DS. Costs are modestly increased, although the cost per case of DS detected is decreased with contingent cffDNA testing. Contingent models of cffDNA testing can improve overall screening performance while maintaining the provision of an 11- to 13-week scan. Costs are modestly increased, but cost per prenatally detected case of DS is decreased. © 2013 John Wiley & Sons, Ltd.

Measurement Uncertainty Within the Uniform Engine Test Programme

DTIC Science & Technology

1989-05-01

Design to Cost and l.ifc (.cle Cost to Aircraft Engines AGARD LS 107 (May 1980) Microcomputer Applications in Power and Propulsion Systems AGARD LS...Flows in Propulsion Systems AGARD LS 140 (June 1985) Engine Airframe Integration for Rotorcraft AGARD LS 148 (June 1986) Design Methods Used in Solid...modest nero-thermodynamic design was of no consequence. Two engines were loaned to the proeram by the U.S. Air Force. Due to higher priority test workload

Development of an electronic manometer for intrapleural pressure monitoring.

PubMed

Krenke, Rafał; Guć, Maciej; Grabczak, Elżbieta Magdalena; Michnikowski, Marcin; Pałko, Krzysztof Jakub; Chazan, Ryszarda; Gólczewski, Tomasz

2011-01-01

Measurement of intrapleural pressure is useful during various pleural procedures. However, a pleural manometer is rarely available. The aim of this study was to (1) construct an electronic pleural manometer, (2) assess the accuracy of the measurements done with the new device, (3) calculate the costs of the manometer construction and (4) perform an initial evaluation of the device in a clinical setting. Only widely accessible elements were used to construct the device. A vascular pressure transducer was used to transform pressure into an electronic signal. Reliability of the measurements was evaluated in a laboratory setting in a prospective, single-blind manner by comparing the results with those measured by a water manometer. Functionality of the device was assessed during therapeutic thoracentesis. The cost of the new pleural manometer was calculated. We built a small, portable device which can precisely measure intrapleural pressure. The measurement results showed very high agreement with those registered with a water manometer (r = 0.999; p < 0.001). The initial evaluation of the electronic manometer during therapeutic thoracentesis showed it was easy to use. The total time needed for 6 measurements after withdrawal of different volumes of pleural fluid in 1 patient did not exceed 6 min. The total cost of the device was calculated to be <2,000 EUR. In the face of very limited offer of commercially available pleural manometers, it is possible to successfully construct a self-made, reliable, electronic pleural manometer at modest costs. The device is easy to use and enables data display and storage in the personal computer. Copyright © 2011 S. Karger AG, Basel.

Predicting future staffing needs at teaching hospitals: use of an analytical program with multiple variables.

PubMed

Mitchell, Christine C; Ashley, Stanley W; Zinner, Michael J; Moore, Francis D

2007-04-01

To develop a model to predict future staffing for the surgery service at a teaching hospital. Tertiary hospital. A computer model with potential future variables was constructed. Some of the variables were distribution of resident staff, fellows, and physician extenders; salary/wages; work hours; educational value of rotations; work units, inpatient wards, and clinics; future volume growth; and efficiency savings. Outcomes Number of staff to be hired, staffing expense, and educational impact. On a busy general surgery service, we estimated the impact of changes in resident work hours, service growth, and workflow efficiency in the next 5 years. Projecting a reduction in resident duty hours to 60 hours per week will require the hiring of 10 physician assistants at a cost of $1 134 000, a cost that is increased by $441 000 when hiring hospitalists instead. Implementing a day of didactic and simulator time (10 hours) will further increase the costs by $568 000. A 10% improvement in the efficiency of floor care, as might be gained by advanced information technology capability or by regionalization of patients, can mitigate these expenses by as much as 21%. On the other hand, a modest annual growth of 2% will increase the costs by $715 000 to $2 417 000. To simply replace residents with alternative providers requires large amounts of human and fiscal capital. The potential for simple efficiencies to mitigate some of this expense suggests that traditional patterns of care in teaching hospitals will have to change in response to educational mandates.

Basic Internet Software Toolkit.

ERIC Educational Resources Information Center

Buchanan, Larry

1998-01-01

Once schools are connected to the Internet, the next step is getting network workstations configured for Internet access. This article describes a basic toolkit comprising software currently available on the Internet for free or modest cost. Lists URLs for Web browser, Telnet, FTP, file decompression, portable document format (PDF) reader,…

Estimating direct and indirect costs of premenstrual syndrome.

PubMed

Borenstein, Jeff; Chiou, Chiun-Fang; Dean, Bonnie; Wong, John; Wade, Sally

2005-01-01

To quantify the economic impact of premenstrual syndrome (PMS) on the employer. Data were collected from 374 women aged 18-45 with regular menses. Direct costs were quantified using administrative claims of these patients and the Medicare Fee Schedule. Indirect costs were quantified by both self-reported days of work missed and lost productivity at work. Regression analyses were used to develop a model to project PMS-related direct and indirect costs. A total of 29.6% (n = 111) of the participants were diagnosed with PMS. A PMS diagnosis was associated with an average annual increase of $59 in direct costs (P < 0.026) and $4333 in indirect costs per patient (P < 0.0001) compared with patients without PMS. A PMS diagnosis correlated with a modest increase in direct medical costs and a large increase in indirect costs.

Computer simulation of space charge

NASA Astrophysics Data System (ADS)

Yu, K. W.; Chung, W. K.; Mak, S. S.

1991-05-01

Using the particle-mesh (PM) method, a one-dimensional simulation of the well-known Langmuir-Child's law is performed on an INTEL 80386-based personal computer system. The program is coded in turbo basic (trademark of Borland International, Inc.). The numerical results obtained were in excellent agreement with theoretical predictions and the computational time required is quite modest. This simulation exercise demonstrates that some simple computer simulation using particles may be implemented successfully on PC's that are available today, and hopefully this will provide the necessary incentives for newcomers to the field who wish to acquire a flavor of the elementary aspects of the practice.

Subgrid or Reynolds stress-modeling for three-dimensional turbulence computations

NASA Technical Reports Server (NTRS)

Rubesin, M. W.

1975-01-01

A review is given of recent advances in two distinct computational methods for evaluating turbulence fields, namely, statistical Reynolds stress modeling and turbulence simulation, where large eddies are followed in time. It is shown that evaluation of the mean Reynolds stresses, rather than use of a scalar eddy viscosity, permits an explanation of streamline curvature effects found in several experiments. Turbulence simulation, with a new volume averaging technique and third-order accurate finite-difference computing is shown to predict the decay of isotropic turbulence in incompressible flow with rather modest computer storage requirements, even at Reynolds numbers of aerodynamic interest.

Spherical torus fusion reactor

DOEpatents

Peng, Yueng-Kay M.

1989-04-04

A fusion reactor is provided having a near spherical-shaped plasma with a modest central opening through which straight segments of toroidal field coils extend that carry electrical current for generating a toroidal magnet plasma confinement fields. By retaining only the indispensable components inboard of the plasma torus, principally the cooled toroidal field conductors and in some cases a vacuum containment vessel wall, the fusion reactor features an exceptionally small aspect ratio (typically about 1.5), a naturally elongated plasma cross section without extensive field shaping, requires low strength magnetic containment fields, small size and high beta. These features combine to produce a spherical torus plasma in a unique physics regime which permits compact fusion at low field and modest cost.

Spherical torus fusion reactor

DOEpatents

Peng, Yueng-Kay M.

1989-01-01

A fusion reactor is provided having a near spherical-shaped plasma with a modest central opening through which straight segments of toroidal field coils extend that carry electrical current for generating a toroidal magnet plasma confinement fields. By retaining only the indispensable components inboard of the plasma torus, principally the cooled toroidal field conductors and in some cases a vacuum containment vessel wall, the fusion reactor features an exceptionally small aspect ratio (typically about 1.5), a naturally elongated plasma cross section without extensive field shaping, requires low strength magnetic containment fields, small size and high beta. These features combine to produce a spherical torus plasma in a unique physics regime which permits compact fusion at low field and modest cost.

Automatic translation of MPI source into a latency-tolerant, data-driven form

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

Nguyen, Tan; Cicotti, Pietro; Bylaska, Eric

Hiding communication behind useful computation is an important performance programming technique but remains an inscrutable programming exercise even for the expert. We present Bamboo, a code transformation framework that can realize communication overlap in applications written in MPI without the need to intrusively modify the source code. We reformulate MPI source into a task dependency graph representation, which partially orders the tasks, enabling the program to execute in a data-driven fashion under the control of an external runtime system. Experimental results demonstrate that Bamboo significantly reduces communication delays while requiring only modest amounts of programmer annotation for a variety ofmore » applications and platforms, including those employing co-processors and accelerators. Moreover, Bamboo’s performance meets or exceeds that of labor-intensive hand coding. As a result, the translator is more than a means of hiding communication costs automatically; it demonstrates the utility of semantic level optimization against a well-known library.« less

Automatic translation of MPI source into a latency-tolerant, data-driven form

DOE PAGES

Nguyen, Tan; Cicotti, Pietro; Bylaska, Eric; ...

2017-03-06

Hiding communication behind useful computation is an important performance programming technique but remains an inscrutable programming exercise even for the expert. We present Bamboo, a code transformation framework that can realize communication overlap in applications written in MPI without the need to intrusively modify the source code. We reformulate MPI source into a task dependency graph representation, which partially orders the tasks, enabling the program to execute in a data-driven fashion under the control of an external runtime system. Experimental results demonstrate that Bamboo significantly reduces communication delays while requiring only modest amounts of programmer annotation for a variety ofmore » applications and platforms, including those employing co-processors and accelerators. Moreover, Bamboo’s performance meets or exceeds that of labor-intensive hand coding. As a result, the translator is more than a means of hiding communication costs automatically; it demonstrates the utility of semantic level optimization against a well-known library.« less

Frequency adaptive metadynamics for the calculation of rare-event kinetics

NASA Astrophysics Data System (ADS)

Wang, Yong; Valsson, Omar; Tiwary, Pratyush; Parrinello, Michele; Lindorff-Larsen, Kresten

2018-08-01

The ability to predict accurate thermodynamic and kinetic properties in biomolecular systems is of both scientific and practical utility. While both remain very difficult, predictions of kinetics are particularly difficult because rates, in contrast to free energies, depend on the route taken. For this reason, specific enhanced sampling methods are needed to calculate long-time scale kinetics. It has recently been demonstrated that it is possible to recover kinetics through the so-called "infrequent metadynamics" simulations, where the simulations are biased in a way that minimally corrupts the dynamics of moving between metastable states. This method, however, requires the bias to be added slowly, thus hampering applications to processes with only modest separations of time scales. Here we present a frequency-adaptive strategy which bridges normal and infrequent metadynamics. We show that this strategy can improve the precision and accuracy of rate calculations at fixed computational cost and should be able to extend rate calculations for much slower kinetic processes.

Extending the accuracy of the SNAP interatomic potential form

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

Wood, Mitchell A.; Thompson, Aidan P.

The Spectral Neighbor Analysis Potential (SNAP) is a classical interatomic potential that expresses the energy of each atom as a linear function of selected bispectrum components of the neighbor atoms. An extension of the SNAP form is proposed that includes quadratic terms in the bispectrum components. The extension is shown to provide a large increase in accuracy relative to the linear form, while incurring only a modest increase in computational cost. The mathematical structure of the quadratic SNAP form is similar to the embedded atom method (EAM), with the SNAP bispectrum components serving as counterparts to the two-body density functionsmore » in EAM. It is also argued that the quadratic SNAP form is a special case of an artificial neural network (ANN). The effectiveness of the new form is demonstrated using an extensive set of training data for tantalum structures. Similarly to ANN potentials, the quadratic SNAP form requires substantially more training data in order to prevent overfitting, as measured by cross-validation analysis.« less

Automatic translation of MPI source into a latency-tolerant, data-driven form

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

Nguyen, Tan; Cicotti, Pietro; Bylaska, Eric

Hiding communication behind useful computation is an important performance programming technique but remains an inscrutable programming exercise even for the expert. We present Bamboo, a code transformation framework that can realize communication overlap in applications written in MPI without the need to intrusively modify the source code. Bamboo reformulates MPI source into the form of a task dependency graph that expresses a partial ordering among tasks, enabling the program to execute in a data-driven fashion under the control of an external runtime system. Experimental results demonstrate that Bamboo significantly reduces communication delays while requiring only modest amounts of programmer annotationmore » for a variety of applications and platforms, including those employing co-processors and accelerators. Moreover, Bamboo's performance meets or exceeds that of labor-intensive hand coding. The translator is more than a means of hiding communication costs automatically; it demonstrates the utility of semantic level optimization against a wellknown library.« less

Extending the accuracy of the SNAP interatomic potential form

DOE PAGES

Wood, Mitchell A.; Thompson, Aidan P.

2018-03-28

The Spectral Neighbor Analysis Potential (SNAP) is a classical interatomic potential that expresses the energy of each atom as a linear function of selected bispectrum components of the neighbor atoms. An extension of the SNAP form is proposed that includes quadratic terms in the bispectrum components. The extension is shown to provide a large increase in accuracy relative to the linear form, while incurring only a modest increase in computational cost. The mathematical structure of the quadratic SNAP form is similar to the embedded atom method (EAM), with the SNAP bispectrum components serving as counterparts to the two-body density functionsmore » in EAM. It is also argued that the quadratic SNAP form is a special case of an artificial neural network (ANN). The effectiveness of the new form is demonstrated using an extensive set of training data for tantalum structures. Similarly to ANN potentials, the quadratic SNAP form requires substantially more training data in order to prevent overfitting, as measured by cross-validation analysis.« less

Stochastic Spectral Descent for Discrete Graphical Models

DOE PAGES

Carlson, David; Hsieh, Ya-Ping; Collins, Edo; ...

2015-12-14

Interest in deep probabilistic graphical models has in-creased in recent years, due to their state-of-the-art performance on many machine learning applications. Such models are typically trained with the stochastic gradient method, which can take a significant number of iterations to converge. Since the computational cost of gradient estimation is prohibitive even for modestly sized models, training becomes slow and practically usable models are kept small. In this paper we propose a new, largely tuning-free algorithm to address this problem. Our approach derives novel majorization bounds based on the Schatten- norm. Intriguingly, the minimizers of these bounds can be interpreted asmore » gradient methods in a non-Euclidean space. We thus propose using a stochastic gradient method in non-Euclidean space. We both provide simple conditions under which our algorithm is guaranteed to converge, and demonstrate empirically that our algorithm leads to dramatically faster training and improved predictive ability compared to stochastic gradient descent for both directed and undirected graphical models.« less

Report of the National Heart, Lung, and Blood Institute Working Group on epigenetics and hypertension

USDA-ARS?s Scientific Manuscript database

Hypertension affects greater than 1 billion people worldwide and in 2009 it cost the US healthcare system more than $73 billion. Despite the availability of many antihypertensive therapies, individual responses vary, and efficacy remains a concern. Current treatments have yielded only modest reduct...

Patient-based surveying: a cost-effective approach for reaching large markets.

PubMed

Byer, S

1995-01-01

Member-based surveying is an important tool for managed care companies to discern newer and better ways in which to keep their current members satisfied, develop products that will attract new members, and to gauge changes of course in health consumer opinion. This article discusses a consumer friendly and cost-effective method to survey members and the general public that has produced a very positive response for a modest investment. The response rate will likely improve over time as the method gains broader acceptance.

CHARMM additive and polarizable force fields for biophysics and computer-aided drug design.

PubMed

Vanommeslaeghe, K; MacKerell, A D

2015-05-01

Molecular Mechanics (MM) is the method of choice for computational studies of biomolecular systems owing to its modest computational cost, which makes it possible to routinely perform molecular dynamics (MD) simulations on chemical systems of biophysical and biomedical relevance. As one of the main factors limiting the accuracy of MD results is the empirical force field used, the present paper offers a review of recent developments in the CHARMM additive force field, one of the most popular biomolecular force fields. Additionally, we present a detailed discussion of the CHARMM Drude polarizable force field, anticipating a growth in the importance and utilization of polarizable force fields in the near future. Throughout the discussion emphasis is placed on the force fields' parametrization philosophy and methodology. Recent improvements in the CHARMM additive force field are mostly related to newly found weaknesses in the previous generation of additive force fields. Beyond the additive approximation is the newly available CHARMM Drude polarizable force field, which allows for MD simulations of up to 1μs on proteins, DNA, lipids and carbohydrates. Addressing the limitations ensures the reliability of the new CHARMM36 additive force field for the types of calculations that are presently coming into routine computational reach while the availability of the Drude polarizable force fields offers an inherently more accurate model of the underlying physical forces driving macromolecular structures and dynamics. This article is part of a Special Issue entitled "Recent developments of molecular dynamics". Copyright © 2014 Elsevier B.V. All rights reserved.

Community Petascale Project for Accelerator Science and Simulation: Advancing Computational Science for Future Accelerators and Accelerator Technologies

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

Spentzouris, P.; /Fermilab; Cary, J.

The design and performance optimization of particle accelerators are essential for the success of the DOE scientific program in the next decade. Particle accelerators are very complex systems whose accurate description involves a large number of degrees of freedom and requires the inclusion of many physics processes. Building on the success of the SciDAC-1 Accelerator Science and Technology project, the SciDAC-2 Community Petascale Project for Accelerator Science and Simulation (ComPASS) is developing a comprehensive set of interoperable components for beam dynamics, electromagnetics, electron cooling, and laser/plasma acceleration modelling. ComPASS is providing accelerator scientists the tools required to enable the necessarymore » accelerator simulation paradigm shift from high-fidelity single physics process modeling (covered under SciDAC1) to high-fidelity multiphysics modeling. Our computational frameworks have been used to model the behavior of a large number of accelerators and accelerator R&D experiments, assisting both their design and performance optimization. As parallel computational applications, the ComPASS codes have been shown to make effective use of thousands of processors. ComPASS is in the first year of executing its plan to develop the next-generation HPC accelerator modeling tools. ComPASS aims to develop an integrated simulation environment that will utilize existing and new accelerator physics modules with petascale capabilities, by employing modern computing and solver technologies. The ComPASS vision is to deliver to accelerator scientists a virtual accelerator and virtual prototyping modeling environment, with the necessary multiphysics, multiscale capabilities. The plan for this development includes delivering accelerator modeling applications appropriate for each stage of the ComPASS software evolution. Such applications are already being used to address challenging problems in accelerator design and optimization. The ComPASS organization for software development and applications accounts for the natural domain areas (beam dynamics, electromagnetics, and advanced acceleration), and all areas depend on the enabling technologies activities, such as solvers and component technology, to deliver the desired performance and integrated simulation environment. The ComPASS applications focus on computationally challenging problems important for design or performance optimization to all major HEP, NP, and BES accelerator facilities. With the cost and complexity of particle accelerators rising, the use of computation to optimize their designs and find improved operating regimes becomes essential, potentially leading to significant cost savings with modest investment.« less

Estimating the health and economic effects of the proposed US Food and Drug Administration voluntary sodium reformulation: Microsimulation cost-effectiveness analysis.

PubMed

Pearson-Stuttard, Jonathan; Kypridemos, Chris; Collins, Brendan; Mozaffarian, Dariush; Huang, Yue; Bandosz, Piotr; Capewell, Simon; Whitsel, Laurie; Wilde, Parke; O'Flaherty, Martin; Micha, Renata

2018-04-01

Sodium consumption is a modifiable risk factor for higher blood pressure (BP) and cardiovascular disease (CVD). The US Food and Drug Administration (FDA) has proposed voluntary sodium reduction goals targeting processed and commercially prepared foods. We aimed to quantify the potential health and economic impact of this policy. We used a microsimulation approach of a close-to-reality synthetic population (US IMPACT Food Policy Model) to estimate CVD deaths and cases prevented or postponed, quality-adjusted life years (QALYs), and cost-effectiveness from 2017 to 2036 of 3 scenarios: (1) optimal, 100% compliance with 10-year reformulation targets; (2) modest, 50% compliance with 10-year reformulation targets; and (3) pessimistic, 100% compliance with 2-year reformulation targets, but with no further progress. We used the National Health and Nutrition Examination Survey and high-quality meta-analyses to inform model inputs. Costs included government costs to administer and monitor the policy, industry reformulation costs, and CVD-related healthcare, productivity, and informal care costs. Between 2017 and 2036, the optimal reformulation scenario achieving the FDA sodium reduction targets could prevent approximately 450,000 CVD cases (95% uncertainty interval: 240,000 to 740,000), gain approximately 2.1 million discounted QALYs (1.7 million to 2.4 million), and produce discounted cost savings (health savings minus policy costs) of approximately $41 billion ($14 billion to $81 billion). In the modest and pessimistic scenarios, health gains would be 1.1 million and 0.7 million QALYS, with savings of $19 billion and $12 billion, respectively. All the scenarios were estimated with more than 80% probability to be cost-effective (incremental cost/QALY < $100,000) by 2021 and to become cost-saving by 2031. Limitations include evaluating only diseases mediated through BP, while decreasing sodium consumption could have beneficial effects upon other health burdens such as gastric cancer. Further, the effect estimates in the model are based on interventional and prospective observational studies. They are therefore subject to biases and confounding that may have influenced also our model estimates. Implementing and achieving the FDA sodium reformulation targets could generate substantial health gains and net cost savings.

Approximations for Quantitative Feedback Theory Designs

NASA Technical Reports Server (NTRS)

Henderson, D. K.; Hess, R. A.

1997-01-01

The computational requirements for obtaining the results summarized in the preceding section were very modest and were easily accomplished using computer-aided control system design software. Of special significance is the ability of the PDT to indicate a loop closure sequence for MIMO QFT designs that employ sequential loop closure. Although discussed as part of a 2 x 2 design, the PDT is obviously applicable to designs with a greater number of inputs and system responses.

"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.

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

Bolme, David S; Mikkilineni, Aravind K; Rose, Derek C

Analog computational circuits have been demonstrated to provide substantial improvements in power and speed relative to digital circuits, especially for applications requiring extreme parallelism but only modest precision. Deep machine learning is one such area and stands to benefit greatly from analog and mixed-signal implementations. However, even at modest precisions, offsets and non-linearity can degrade system performance. Furthermore, in all but the simplest systems, it is impossible to directly measure the intermediate outputs of all sub-circuits. The result is that circuit designers are unable to accurately evaluate the non-idealities of computational circuits in-situ and are therefore unable to fully utilizemore » measurement results to improve future designs. In this paper we present a technique to use deep learning frameworks to model physical systems. Recently developed libraries like TensorFlow make it possible to use back propagation to learn parameters in the context of modeling circuit behavior. Offsets and scaling errors can be discovered even for sub-circuits that are deeply embedded in a computational system and not directly observable. The learned parameters can be used to refine simulation methods or to identify appropriate compensation strategies. We demonstrate the framework using a mixed-signal convolution operator as an example circuit.« less

Cost-benefit analysis of targeted hearing directed early testing for congenital cytomegalovirus infection.

PubMed

Bergevin, Anna; Zick, Cathleen D; McVicar, Stephanie Browning; Park, Albert H

2015-12-01

In this study, we estimate an ex ante cost-benefit analysis of a Utah law directed at improving early cytomegalovirus (CMV) detection. We use a differential cost of treatment analysis for publicly insured CMV-infected infants detected by a statewide hearing-directed CMV screening program. Utah government administrative data and multi-hospital accounting data are used to estimate and compare costs and benefits for the Utah infant population. If antiviral treatment succeeds in mitigating hearing loss for one infant per year, the public savings will offset the public costs incurred by screening and treatment. If antiviral treatment is not successful, the program represents a net cost, but may still have non-monetary benefits such as accelerated achievement of diagnostic milestones. The CMV education and treatment program costs are modest and show potential for significant cost savings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Portable, Inexpensive, Nonmydriatic Fundus Camera Based on the Raspberry Pi® Computer.

PubMed

Shen, Bailey Y; Mukai, Shizuo

2017-01-01

Purpose. Nonmydriatic fundus cameras allow retinal photography without pharmacologic dilation of the pupil. However, currently available nonmydriatic fundus cameras are bulky, not portable, and expensive. Taking advantage of recent advances in mobile technology, we sought to create a nonmydriatic fundus camera that was affordable and could be carried in a white coat pocket. Methods. We built a point-and-shoot prototype camera using a Raspberry Pi computer, an infrared-sensitive camera board, a dual infrared and white light light-emitting diode, a battery, a 5-inch touchscreen liquid crystal display, and a disposable 20-diopter condensing lens. Our prototype camera was based on indirect ophthalmoscopy with both infrared and white lights. Results. The prototype camera measured 133mm × 91mm × 45mm and weighed 386 grams. The total cost of the components, including the disposable lens, was $185.20. The camera was able to obtain good-quality fundus images without pharmacologic dilation of the pupils. Conclusion. A fully functional, inexpensive, handheld, nonmydriatic fundus camera can be easily assembled from a relatively small number of components. With modest improvements, such a camera could be useful for a variety of healthcare professionals, particularly those who work in settings where a traditional table-mounted nonmydriatic fundus camera would be inconvenient.

Accurate critical pressures for structural phase transitions of group IV, III-V, and II-VI compounds from the SCAN density functional

NASA Astrophysics Data System (ADS)

Shahi, Chandra; Sun, Jianwei; Perdew, John P.

2018-03-01

Most of the group IV, III-V, and II-VI compounds crystallize in semiconductor structures under ambient conditions. Upon application of pressure, they undergo structural phase transitions to more closely packed structures, sometimes metallic phases. We have performed density functional calculations using projector augmented wave (PAW) pseudopotentials to determine the transition pressures for these transitions within the local density approximation (LDA), the Perdew-Burke-Ernzerhof (PBE) generalized gradient approximation (GGA), and the strongly constrained and appropriately normed (SCAN) meta-GGA. LDA underestimates the transition pressure for most of the studied materials. PBE under- or overestimates in many cases. SCAN typically corrects the errors of LDA and PBE for the transition pressure. The accuracy of SCAN is comparable to that of computationally expensive methods like the hybrid functional HSE06, the random phase approximation (RPA), and quantum Monte Carlo (QMC), in cases where calculations with these methods have been reported, but at a more modest computational cost. The improvement from LDA to PBE to SCAN is especially clearcut and dramatic for covalent semiconductor-metal transitions, as for Si and Ge, where it reflects the increasing relative stabilization of the covalent semiconducting phases under increasing functional sophistication.

A Portable, Inexpensive, Nonmydriatic Fundus Camera Based on the Raspberry Pi® Computer

PubMed Central

Shen, Bailey Y.

2017-01-01

Purpose. Nonmydriatic fundus cameras allow retinal photography without pharmacologic dilation of the pupil. However, currently available nonmydriatic fundus cameras are bulky, not portable, and expensive. Taking advantage of recent advances in mobile technology, we sought to create a nonmydriatic fundus camera that was affordable and could be carried in a white coat pocket. Methods. We built a point-and-shoot prototype camera using a Raspberry Pi computer, an infrared-sensitive camera board, a dual infrared and white light light-emitting diode, a battery, a 5-inch touchscreen liquid crystal display, and a disposable 20-diopter condensing lens. Our prototype camera was based on indirect ophthalmoscopy with both infrared and white lights. Results. The prototype camera measured 133mm × 91mm × 45mm and weighed 386 grams. The total cost of the components, including the disposable lens, was $185.20. The camera was able to obtain good-quality fundus images without pharmacologic dilation of the pupils. Conclusion. A fully functional, inexpensive, handheld, nonmydriatic fundus camera can be easily assembled from a relatively small number of components. With modest improvements, such a camera could be useful for a variety of healthcare professionals, particularly those who work in settings where a traditional table-mounted nonmydriatic fundus camera would be inconvenient. PMID:28396802

``Recent experiences and future expectations in data storage technology''

NASA Astrophysics Data System (ADS)

Pfister, Jack

1990-08-01

For more than 10 years the conventional media for High Energy Physics has been 9 track magnetic tape in various densities. More recently, especially in Europe, the IBM 3480 technology has been adopted while in the United States, especially at Fermilab, 8 mm is being used by the largest experiments as a primary recording media and where possible they are using 8 mm for the production, analysis and distribution of data summary tapes. VHS and Digital Audio tape have recurrently appeared but seem to serve primarily as a back-up storage media. The reasons for what appear to be a radical departure are many. Economics (media and controllers are inexpensive), form factor (two gigabytes per shirt pocket), and convenience (fewer mounts/dismounts per minute) are dominant among the reasons. The traditional data media suppliers seem to have been content to evolve the traditional media at their own pace with only modest enhancements primarily in ``value engineering'' of extant products. Meanwhile, start-up companies providing small system and workstations sought other media both to reduce the price of their offerings and respond to the real need of lower cost back-up for lower cost systems. This happening in a market context where traditional computer systems vendors were leaving the tape market altogether or shifting to ``3480'' technology which has certainly created a climate for reconsideration and change. The newest data storage products, in most cases, are not coming from the technologies developed by the computing industry but by the audio and video industry. Just where these flopticals, opticals, 19 mm tape and the new underlying technologies, such as, ``digital paper'' may fit in the HEP computing requirement picture will be reviewed. What these technologies do for and to HEP will be discussed along with some suggestions for a methodology for tracking and evaluating extant and emerging technologies.

The Real Costs of Federal Aid to Higher Education. Heritage Lectures. No. 984

ERIC Educational Resources Information Center

Vedder, Richard

2007-01-01

New federal spending on student aid is unlikely to improve college access. The increase in access in higher education in America largely came before massive federal involvement in student financial aid programs. Evidence suggests that federal subsidies for student aid may be counterproductive. Modest provision of financial assistance serves to…

Three Colleges' Different Approaches Shape Learning in Econ 101

ERIC Educational Resources Information Center

Berrett, Dan

2013-01-01

No matter the college, a class in the principles of microeconomics is likely to cover the discipline's greatest hits. Opportunity cost? Check. Supply and demand? Ditto. The same goes for such topics as comparative advantage, elasticity, and market structures. But these touchstones of the curriculum may only modestly influence what a student…

Multidisciplinary Analysis of a Hypersonic Engine

NASA Technical Reports Server (NTRS)

Suresh, Ambady; Stewart, Mark

2003-01-01

The objective is to develop high fidelity tools that can influence ISTAR design In particular, tools for coupling Fluid-Thermal-Structural simulations RBCC/TBCC designers carefully balance aerodynamic, thermal, weight, & structural considerations; consistent multidisciplinary solutions reveal details (at modest cost) At Scram mode design point, simulations give details of inlet & combustor performance, thermal loads, structural deflections.

The prediction of satellite ephemeris errors as they result from surveillance system measurement errors

NASA Astrophysics Data System (ADS)

Simmons, B. E.

1981-08-01

This report derives equations predicting satellite ephemeris error as a function of measurement errors of space-surveillance sensors. These equations lend themselves to rapid computation with modest computer resources. They are applicable over prediction times such that measurement errors, rather than uncertainties of atmospheric drag and of Earth shape, dominate in producing ephemeris error. This report describes the specialization of these equations underlying the ANSER computer program, SEEM (Satellite Ephemeris Error Model). The intent is that this report be of utility to users of SEEM for interpretive purposes, and to computer programmers who may need a mathematical point of departure for limited generalization of SEEM.

Pricing and Welfare in Health Plan Choice.

PubMed

Bundorf, M Kate; Levin, Jonathan; Mahoney, Neale

2012-12-01

Premiums in health insurance markets frequently do not reflect individual differences in costs, either because consumers have private information or because prices are not risk rated. This creates inefficiencies when consumers self-select into plans. We develop a simple econometric model to study this problem and estimate it using data on small employers. We find a welfare loss of 2-11 percent of coverage costs compared to what is feasible with risk rating. Only about one-quarter of this is due to inefficiently chosen uniform contribution levels. We also investigate the reclassification risk created by risk rating individual incremental premiums, finding only a modest welfare cost.

Design study of wind turbines 50 kW to 3000 kW for electric utility applications. Volume 3: Supplementary design and analysis tasks

NASA Technical Reports Server (NTRS)

1976-01-01

Additional design and analysis data are provided to supplement the results of the two parallel design study efforts. The key results of the three supplemental tasks investigated are: (1) The velocity duration profile has a significant effect in determining the optimum wind turbine design parameters and the energy generation cost. (2) Modest increases in capacity factor can be achieved with small increases in energy generation costs and capital costs. (3) Reinforced concrete towers that are esthetically attractive can be designed and built at a cost comparable to those for steel truss towers. The approach used, method of analysis, assumptions made, design requirements, and the results for each task are discussed in detail.

An Examination of Unsteady Airloads on a UH-60A Rotor: Computation Versus Measurement

NASA Technical Reports Server (NTRS)

Biedron, Robert T.; Lee-Rausch, Elizabeth

2012-01-01

An unsteady Reynolds-averaged Navier-Stokes solver for unstructured grids is used to simulate the flow over a UH-60A rotor. Traditionally, the computed pressure and shear stresses are integrated on the computational mesh at selected radial stations and compared to measured airloads. However, the corresponding integration of experimental data uses only the pressure contribution, and the set of integration points (pressure taps) is modest compared to the computational mesh resolution. This paper examines the difference between the traditional integration of computed airloads and an integration consistent with that used for the experimental data. In addition, a comparison of chordwise pressure distributions between computation and measurement is made. Examination of this unsteady pressure data provides new opportunities to understand differences between computation and flight measurement.

Cost-effectiveness of fluocinolone acetonide implant versus systemic therapy for noninfectious intermediate, posterior, and panuveitis.

PubMed

Sugar, Elizabeth A; Holbrook, Janet T; Kempen, John H; Burke, Alyce E; Drye, Lea T; Thorne, Jennifer E; Louis, Thomas A; Jabs, Douglas A; Altaweel, Michael M; Frick, Kevin D

2014-10-01

To evaluate the 3-year incremental cost-effectiveness of fluocinolone acetonide implant versus systemic therapy for the treatment of noninfectious intermediate, posterior, and panuveitis. Randomized, controlled, clinical trial. Patients with active or recently active intermediate, posterior, or panuveitis enrolled in the Multicenter Uveitis Steroid Treatment Trial. Data on cost and health utility during 3 years after randomization were evaluated at 6-month intervals. Analyses were stratified by disease laterality at randomization (31 unilateral vs 224 bilateral) because of the large upfront cost of the implant. The primary outcome was the incremental cost-effectiveness ratio (ICER) over 3 years: the ratio of the difference in cost (in United States dollars) to the difference in quality-adjusted life-years (QALYs). Costs of medications, surgeries, hospitalizations, and regular procedures (e.g., laboratory monitoring for systemic therapy) were included. We computed QALYs as a weighted average of EQ-5D scores over 3 years of follow-up. The ICER at 3 years was $297,800/QALY for bilateral disease, driven by the high cost of implant therapy (difference implant - systemic [Δ]: $16,900; P < 0.001) and the modest gains in QALYs (Δ = 0.057; P = 0.22). The probability of the ICER being cost-effective at thresholds of $50,000/QALY and $100,000/QALY was 0.003 and 0.04, respectively. The ICER for unilateral disease was more favorable, namely, $41,200/QALY at 3 years, because of a smaller difference in cost between the 2 therapies (Δ = $5300; P = 0.44) and a larger benefit in QALYs with the implant (Δ = 0.130; P = 0.12). The probability of the ICER being cost-effective at thresholds of $50,000/QALY and $100,000/QALY was 0.53 and 0.74, respectively. Fluocinolone acetonide implant therapy was reasonably cost-effective compared with systemic therapy for individuals with unilateral intermediate, posterior, or panuveitis but not for those with bilateral disease. These results do not apply to the use of implant therapy when systemic therapy has failed or is contraindicated. Should the duration of implant effect prove to be substantially >3 years or should large changes in therapy pricing occur, the cost-effectiveness of implant versus systemic therapy would need to be reevaluated. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Space shuttle: News release

NASA Technical Reports Server (NTRS)

1972-01-01

The space shuttle fact sheet is presented. Four important reasons for the program are considered to be: (1) It is the only meaningful new manned space program which can be accomplished on a modest budget. (2) It is needed to make space operations less complex and costly. (3) It is required for scientific applications in civilian and military activities. (4) It will encourage greater international participation in space flight. The space shuttle and orbiter configurations are discussed along with the missions. The scope of the study and the costs of each contract for the major contractor are listed.

The Impact and Cost of Scaling up Midwifery and Obstetrics in 58 Low- and Middle-Income Countries

PubMed Central

Bartlett, Linda; Weissman, Eva; Gubin, Rehana; Patton-Molitors, Rachel; Friberg, Ingrid K.

2014-01-01

Background and Methods To guide achievement of the Millennium Development Goals, we used the Lives Saved Tool to provide a novel simulation of potential maternal, fetal, and newborn lives and costs saved by scaling up midwifery and obstetrics services, including family planning, in 58 low- and middle-income countries. Typical midwifery and obstetrics interventions were scaled to either 60% of the national population (modest coverage) or 99% (universal coverage). Findings Under even a modest scale-up, midwifery services including family planning reduce maternal, fetal, and neonatal deaths by 34%. Increasing midwifery alone or integrated with obstetrics is more cost-effective than scaling up obstetrics alone; when family planning was included, the midwifery model was almost twice as cost-effective as the obstetrics model, at $2,200 versus $4,200 per death averted. The most effective strategy was the most comprehensive: increasing midwives, obstetricians, and family planning could prevent 69% of total deaths under universal scale-up, yielding a cost per death prevented of just $2,100. Within this analysis, the interventions which midwifery and obstetrics are poised to deliver most effectively are different, with midwifery benefits delivered across the continuum of pre-pregnancy, prenatal, labor and delivery, and postpartum-postnatal care, and obstetrics benefits focused mostly on delivery. Including family planning within each scope of practice reduced the number of likely births, and thus deaths, and increased the cost-effectiveness of the entire package (e.g., a 52% reduction in deaths with midwifery and obstetrics increased to 69% when family planning was added; cost decreased from $4,000 to $2,100 per death averted). Conclusions This analysis suggests that scaling up midwifery and obstetrics could bring many countries closer to achieving mortality reductions. Midwives alone can achieve remarkable mortality reductions, particularly when they also perform family planning services - the greatest return on investment occurs with the scale-up of midwives and obstetricians together. PMID:24941336

Construction Cost Growth for New Department of Energy Nuclear Facilities

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

Kubic, Jr., William L.

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

Time Series Analysis on the Impact of Generic Substitution and Reference Pricing on Antipsychotic Costs in Finland.

PubMed

Koskinen, Hanna; Mikkola, Hennamari; Saastamoinen, Leena K; Ahola, Elina; Martikainen, Jaana E

2015-12-01

To analyze the medium- to long-term impact of generic substitution and the reference price system on the daily cost of antipsychotics in Finland. The additional impact of reference pricing over and above previously implemented generic substitution was also assessed. An interrupted time series design with a control group and segmented regression analysis was used to estimate the effect of the implementation of generic substitution and the reference price system on the daily cost of antipsychotics. The data have 69 monthly values of the average daily cost for each of the studied antipsychotics: 39 months before and 30 months after the introduction of reference pricing. For one of the studied antipsychotic, the time before the introduction of reference pricing could be further divided into time before and after the introduction of generic substitution. According to the model, 2.5 years after the implementation of reference pricing, the daily cost of the studied antipsychotics was 24.6% to 50.6% lower than it would have been if reference pricing had not been implemented. Two and a half years after the implementation of the reference price system, however, the additional impact of reference pricing over and above previously implemented generic substitution was modest, less than 1 percentage point. Although the price competition induced by reference pricing decreased the prices of antipsychotics in Finland in the short-term, the prices had a tendency to stagnate or even to turn in an upward direction in the medium- to long-term. Furthermore, the additional impact of reference pricing over and above previously implemented generic substitution remained quite modest. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

An Analysis of Home Contingencies to Improve School Behavior with Disruptive Adolescents.

ERIC Educational Resources Information Center

Trice, Ashton D.; And Others

1983-01-01

Home contingencies (allowance and curfews) based on daily reports of the academic and conduct performance of four 16-year-old disruptive students increased appropriate behavior in six areas. The least costly and simplest form of feedback--the good day card--showed modest treatment advantages over more complex methods and was preferred by parents.…

A DNA sequence analysis package for the IBM personal computer.

PubMed Central

Lagrimini, L M; Brentano, S T; Donelson, J E

1984-01-01

We present here a collection of DNA sequence analysis programs, called "PC Sequence" (PCS), which are designed to run on the IBM Personal Computer (PC). These programs are written in IBM PC compiled BASIC and take full advantage of the IBM PC's speed, error handling, and graphics capabilities. For a modest initial expense in hardware any laboratory can use these programs to quickly perform computer analysis on DNA sequences. They are written with the novice user in mind and require very little training or previous experience with computers. Also provided are a text editing program for creating and modifying DNA sequence files and a communications program which enables the PC to communicate with and collect information from mainframe computers and DNA sequence databases. PMID:6546433

Model studies of laser absorption computed tomography for remote air pollution measurement

NASA Technical Reports Server (NTRS)

Wolfe, D. C., Jr.; Byer, R. L.

1982-01-01

Model studies of the potential of laser absorption-computed tomography are presented which demonstrate the possibility of sensitive remote atmospheric pollutant measurements, over kilometer-sized areas, with two-dimensional resolution, at modest laser source powers. An analysis of this tomographic reconstruction process as a function of measurement SNR, laser power, range, and system geometry, shows that the system is able to yield two-dimensional maps of pollutant concentrations at ranges and resolutions superior to those attainable with existing, direct-detection laser radars.

Myocardial perfusion 320-row multidetector computed tomography-guided treatment strategy for the clinical management of patients with recent acute-onset chest pain: Design of the CArdiac cT in the treatment of acute CHest pain (CATCH)-2 randomized controlled trial.

PubMed

Sørgaard, Mathias; Linde, Jesper J; Hove, Jens D; Petersen, Jan R; Jørgensen, Tem B S; Abdulla, Jawdat; Heitmann, Merete; Kragelund, Charlotte; Hansen, Thomas Fritz; Udholm, Patricia M; Pihl, Christian; Kühl, J Tobias; Engstrøm, Thomas; Jensen, Jan Skov; Høfsten, Dan E; Kelbæk, Henning; Kofoed, Klaus F

2016-09-01

Patients admitted with chest pain are a diagnostic challenge because the majority does not have coronary artery disease (CAD). Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed tomography perfusion (CTP) has been shown to increase the specificity when added to CCTA, without lowering the sensitivity. This article describes the design of a randomized controlled trial, CATCH-2, comparing a clinical diagnostic management strategy of CCTA alone against CCTA in combination with CTP. Patients with acute-onset chest pain older than 50 years and with at least one cardiovascular risk factor for CAD are being prospectively enrolled to this study from 6 different clinical sites since October 2013. A total of 600 patients will be included. Patients are randomized 1:1 to clinical management based on CCTA or on CCTA in combination with CTP, determining the need for further testing with invasive coronary angiography including measurement of the fractional flow reserve in vessels with coronary artery lesions. Patients are scanned with a 320-row multidetector computed tomography scanner. Decisions to revascularize the patients are taken by the invasive cardiologist independently of the study allocation. The primary end point is the frequency of revascularization. Secondary end points of clinical outcome are also recorded. The CATCH-2 will determine whether CCTA in combination with CTP is diagnostically superior to CCTA alone in the management of patients with acute-onset chest pain. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing cost-effectiveness of drug interventions for schizophrenia.

PubMed

Magnus, Anne; Carr, Vaughan; Mihalopoulos, Cathrine; Carter, Rob; Vos, Theo

2005-01-01

To assess from a health sector perspective the incremental cost-effectiveness of eight drug treatment scenarios for established schizophrenia. Using a standardized methodology, costs and outcomes are modelled over the lifetime of prevalent cases of schizophrenia in Australia in 2000. A two-stage approach to assessment of health benefit is used. The first stage involves a quantitative analysis based on disability-adjusted life years (DALYs) averted, using best available evidence. The robustness of results is tested using probabilistic uncertainty analysis. The second stage involves application of 'second filter' criteria (equity, strength of evidence, feasibility and acceptability) to allow broader concepts of benefit to be considered. Replacing oral typicals with risperidone or olanzapine has an incremental cost-effectiveness ratio (ICER) of 48,000 Australian dollars and 92,000 Australian dollars/DALY respectively. Switching from low-dose typicals to risperidone has an ICER of 80,000 Australian dollars. Giving risperidone to people experiencing side-effects on typicals is more cost-effective at 20,000 Australian dollars. Giving clozapine to people taking typicals, with the worst course of the disorder and either little or clear deterioration, is cost-effective at 42,000 Australian dollars or 23,000 Australian dollars/DALY respectively. The least cost-effective intervention is to replace risperidone with olanzapine at 160,000 Australian dollars/DALY. Based on an 50,000 Australian dollars/DALY threshold, low-dose typical neuroleptics are indicated as the treatment of choice for established schizophrenia, with risperidone being reserved for those experiencing moderate to severe side-effects on typicals. The more expensive olanzapine should only be prescribed when risperidone is not clinically indicated. The high cost of risperidone and olanzapine relative to modest health gains underlie this conclusion. Earlier introduction of clozapine however, would be cost-effective. This work is limited by weaknesses in trials (lack of long-term efficacy data, quality of life and consumer satisfaction evidence) and the translation of effect size into a DALY change. Some stakeholders, including SANE Australia, argue the modest health gains reported in the literature do not adequately reflect perceptions by patients, clinicians and carers, of improved quality of life with these atypicals.

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

Granger, J.A.

This project, Energy Recovery Through Termites, was based on the proposed development of an energy recovery system to produce low cost animal protein for use in animal feeds. The result of my study shows that to date we are unable to establish viable colonies of termites. This is based on several key factors as follows: (a) inability to capture reproductives to establish new colonies in a confined area needed to offer recovery or harvest of protein; (b) confinement of colonies (even without queen or reproductives) has proven to be far too complex to establish in low cost and modest facilities;more » (c) the proposal is not cost effective. The resources of skill and materials could not be repaid from the protein recovered.« less

A pharmacologic continuum in the treatment of rhinorrhea: the clinician as economist.

PubMed

Meltzer, E O; Tyrell, R J; Rich, D; Wood, C C

1995-05-01

The economics of medications are now of great concern to health-care providers. Pharmacoeconomic issues are by no means simple, and yet, ironically, they assume greater importance in prescribing for modest disorders like rhinorrhea than for life-threatening conditions. The therapeutic continuum of quality and cost becomes foreshortened, and safety is an additional concern. Choosing the appropriate medication for rhinorrhea, then, can pose a challenge to the clinician, just as choosing a vital medication. This paper reviews the usage, quality, and cost of major therapies for the rhinorrhea that occurs secondary to various conditions, including nasal steroids, antihistamines and anticholinergics, and discusses the role of the clinician in factoring costs into therapy.

Can organizations benefit from worksite health promotion?

PubMed Central

Leviton, L C

1989-01-01

A decision-analytic model was developed to project the future effects of selected worksite health promotion activities on employees' likelihood of chronic disease and injury and on employer costs due to illness. The model employed a conservative set of assumptions and a limited five-year time frame. Under these assumptions, hypertension control and seat belt campaigns prevent a substantial amount of illness, injury, and death. Sensitivity analysis indicates that these two programs pay for themselves and under some conditions show a modest savings to the employer. Under some conditions, smoking cessation programs pay for themselves, preventing a modest amount of illness and death. Cholesterol reduction by behavioral means does not pay for itself under these assumptions. These findings imply priorities in prevention for employer and employee alike. PMID:2499556

An Attempt to Observe Debris from the Breakup of a Titan 3C-4 Transtage

NASA Technical Reports Server (NTRS)

Barker, E. S.; Matney, M. J.; Yanagisawa, T.; Liou, J.-C.; Abercromby, K. J.; Rodriquez, H. M.; Horstman, M. F.; Seitzer, P.

2007-01-01

In February 2007 dedicated observations were made of the orbital space predicted to contain debris from the breakup of the Titan 3C-4 transtage back on February 21, 1992. These observations were carried out on the Michigan Orbital DEbris Survey Telescope (MODEST) in Chile with its 1.3deg field of view. The search region or orbital space (inclination and right ascension of the ascending node (RAAN) was predicted using NASA#s LEGEND (LEO-to-GEO Environment Debris) code to generate a Titan debris cloud. Breakup fragments are created based on the NASA Standard Breakup Model (including fragment size, area-to-mass (A/M), and delta-V distributions). Once fragments are created, they are propagated forward in time with a subroutine GEOPROP. Perturbations included in GEOPROP are those due to solar/lunar gravity, radiation pressure, and major geopotential terms. Barker, et. al, (AMOS Conference Proceedings, 2006, pp. 596-604) used similar LEGEND predictions to correlate survey observations made by MODEST (February 2002) and found several possible night-to-night correlations in the limited survey dataset. One conc lusion of the survey search was to dedicate a MODEST run to observing a GEO region predicted to contain debris fragments and actual Titan debris objects (SSN 25000, 25001 and 30000). Such a dedicated run was undertaken with MODEST between February 17 and 23, 2007 (UT dates). MODEST#s limiting magnitude of 18.0 (S\\N approx.10) corresponds to a size of 22cm assuming a diffuse Lambertian albedo of 0.2. However, based on observed break-up data, we expect most debris fragments to be smaller than 22cm which implies a need to increase the effective sensitivity of MODEST for smaller objects. MODEST#s limiting size can be lowered by increasing the exposure time (20 instead of 5 seconds) and applying special image processing. The special processing combines individual CCD images to detect faint objects that are invisible on a single CCD image. Sub-images are cropped from six consecutive CCD images with pixel shifts between images being consistent with the predicted movement of a Titan object. A median image of all the sub-images is then created leaving only those objects with the proper Titan motion. Limiting the median image in this manner brings the needed computer time to process all images taken on one night down to about 50 hours of CPU time.

The total cost of father desertion.

PubMed

Winking, Jeffrey; Gurven, Michael

2011-01-01

The benefits of paternal investment have long been explored by assessing the impact of father's presence on child wellbeing. Previous studies, however, have only examined the average effect of father's presence on child survivorship. Here we assess the total fitness cost to men of deserting (or the benefit of staying), by considering effects on the entire progeny. We estimate the total number of children that a deserting father can expect to lose due to reduced survivorship over the life course in five populations, and compare this loss to the benefit gains from remarrying a younger wife. We compiled the observed impacts of father's absence, as well as mortality and fertility schedules, for five foraging or foraging/horticultural populations. We calculate how many additional children a man can expect to lose due to father's absence throughout a marriage. We then calculate the minimum age difference between a first and second spouse that would be necessary to overcome this cost. Because child mortality rates drop so rapidly, the costs that men experience from desertion due to augmented child mortality are modest throughout marriage. Even hypothetically inflated father effects can be overcome with modest age differences between first and second spouses. Returns to paternal investment in terms of increased child survival are not substantial compared to those received by successfully practicing a serial mating strategy. This suggests that factors other than the ability to enhance child survival, such as female choice, are important to the evolutionary history and continued adaptive functioning of men's unique reproductive strategies. Copyright © 2011 Wiley-Liss, Inc.

Limited Benefits of Heterogeneous Dual-Task Training on Transfer Effects in Older Adults.

PubMed

Lussier, Maxime; Brouillard, Philippe; Bherer, Louis

2017-09-01

It has often been reported that cognitive training has limited transfer effects. The present study addresses training context variability as a factor that could increase transfer effects, as well as the manifestation through time of transfer effects. Fifty-eight older adults were assigned to an active placebo or two dual-task training conditions, one in which the training context varies between sessions (heterogeneous training) and the other in a fixed training context (homogeneous training). Transfer was assessed with near and far-modality transfer tasks. Results show that heterogeneous and homogeneous training led to larger near-modality transfer effects than an active placebo (computer lessons). Transfer effects were roughly comparable in both training groups, but heterogeneous training led to a steeper improvement of the dual-task coordination learning curve within training sessions. Also, results indicated that dual-task cost did not improve in the active placebo group from the pre- to the post-training sessions. Heterogeneous training showed modest advantages over homogeneous training. Results also suggest that transfer effects on dual-task cost induced by training take place early on in the post-training session. These findings provide valuable insights on benefits arising from variability in the training protocol for maximizing transfer effects. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Estimating the health and economic effects of the proposed US Food and Drug Administration voluntary sodium reformulation: Microsimulation cost-effectiveness analysis

PubMed Central

Huang, Yue; Bandosz, Piotr; Capewell, Simon; Wilde, Parke

2018-01-01

Background Sodium consumption is a modifiable risk factor for higher blood pressure (BP) and cardiovascular disease (CVD). The US Food and Drug Administration (FDA) has proposed voluntary sodium reduction goals targeting processed and commercially prepared foods. We aimed to quantify the potential health and economic impact of this policy. Methods and findings We used a microsimulation approach of a close-to-reality synthetic population (US IMPACT Food Policy Model) to estimate CVD deaths and cases prevented or postponed, quality-adjusted life years (QALYs), and cost-effectiveness from 2017 to 2036 of 3 scenarios: (1) optimal, 100% compliance with 10-year reformulation targets; (2) modest, 50% compliance with 10-year reformulation targets; and (3) pessimistic, 100% compliance with 2-year reformulation targets, but with no further progress. We used the National Health and Nutrition Examination Survey and high-quality meta-analyses to inform model inputs. Costs included government costs to administer and monitor the policy, industry reformulation costs, and CVD-related healthcare, productivity, and informal care costs. Between 2017 and 2036, the optimal reformulation scenario achieving the FDA sodium reduction targets could prevent approximately 450,000 CVD cases (95% uncertainty interval: 240,000 to 740,000), gain approximately 2.1 million discounted QALYs (1.7 million to 2.4 million), and produce discounted cost savings (health savings minus policy costs) of approximately $41 billion ($14 billion to $81 billion). In the modest and pessimistic scenarios, health gains would be 1.1 million and 0.7 million QALYS, with savings of $19 billion and $12 billion, respectively. All the scenarios were estimated with more than 80% probability to be cost-effective (incremental cost/QALY < $100,000) by 2021 and to become cost-saving by 2031. Limitations include evaluating only diseases mediated through BP, while decreasing sodium consumption could have beneficial effects upon other health burdens such as gastric cancer. Further, the effect estimates in the model are based on interventional and prospective observational studies. They are therefore subject to biases and confounding that may have influenced also our model estimates. Conclusions Implementing and achieving the FDA sodium reformulation targets could generate substantial health gains and net cost savings. PMID:29634725

Silicon graphene waveguide tunable broadband microwave photonics phase shifter.

PubMed

Capmany, José; Domenech, David; Muñoz, Pascual

2014-04-07

We propose the use of silicon graphene waveguides to implement a tunable broadband microwave photonics phase shifter based on integrated ring cavities. Numerical computation results show the feasibility for broadband operation over 40 GHz bandwidth and full 360° radiofrequency phase-shift with a modest voltage excursion of 0.12 volt.

Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment.

PubMed

Richardson, Ian P; Sturtevant, Rachael; Heung, Michael; Solomon, Michael J; Younger, John G; VanEpps, J Scott

2016-01-01

Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50°C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature.

Nonperturbative renormalization-group approach preserving the momentum dependence of correlation functions

NASA Astrophysics Data System (ADS)

Rose, F.; Dupuis, N.

2018-05-01

We present an approximation scheme of the nonperturbative renormalization group that preserves the momentum dependence of correlation functions. This approximation scheme can be seen as a simple improvement of the local potential approximation (LPA) where the derivative terms in the effective action are promoted to arbitrary momentum-dependent functions. As in the LPA, the only field dependence comes from the effective potential, which allows us to solve the renormalization-group equations at a relatively modest numerical cost (as compared, e.g., to the Blaizot-Mendéz-Galain-Wschebor approximation scheme). As an application we consider the two-dimensional quantum O(N ) model at zero temperature. We discuss not only the two-point correlation function but also higher-order correlation functions such as the scalar susceptibility (which allows for an investigation of the "Higgs" amplitude mode) and the conductivity. In particular, we show how, using Padé approximants to perform the analytic continuation i ωn→ω +i 0+ of imaginary frequency correlation functions χ (i ωn) computed numerically from the renormalization-group equations, one can obtain spectral functions in the real-frequency domain.

Small Microprocessor for ASIC or FPGA Implementation

NASA Technical Reports Server (NTRS)

Kleyner, Igor; Katz, Richard; Blair-Smith, Hugh

2011-01-01

A small microprocessor, suitable for use in applications in which high reliability is required, was designed to be implemented in either an application-specific integrated circuit (ASIC) or a field-programmable gate array (FPGA). The design is based on commercial microprocessor architecture, making it possible to use available software development tools and thereby to implement the microprocessor at relatively low cost. The design features enhancements, including trapping during execution of illegal instructions. The internal structure of the design yields relatively high performance, with a significant decrease, relative to other microprocessors that perform the same functions, in the number of microcycles needed to execute macroinstructions. The problem meant to be solved in designing this microprocessor was to provide a modest level of computational capability in a general-purpose processor while adding as little as possible to the power demand, size, and weight of a system into which the microprocessor would be incorporated. As designed, this microprocessor consumes very little power and occupies only a small portion of a typical modern ASIC or FPGA. The microprocessor operates at a rate of about 4 million instructions per second with clock frequency of 20 MHz.

Prediction of Water Binding to Protein Hydration Sites with a Discrete, Semiexplicit Solvent Model.

PubMed

Setny, Piotr

2015-12-08

Buried water molecules are ubiquitous in protein structures and are found at the interface of most protein-ligand complexes. Determining their distribution and thermodynamic effect is a challenging yet important task, of great of practical value for the modeling of biomolecular structures and their interactions. In this study, we present a novel method aimed at the prediction of buried water molecules in protein structures and estimation of their binding free energies. It is based on a semiexplicit, discrete solvation model, which we previously introduced in the context of small molecule hydration. The method is applicable to all macromolecular structures described by a standard all-atom force field, and predicts complete solvent distribution within a single run with modest computational cost. We demonstrate that it indicates positions of buried hydration sites, including those filled by more than one water molecule, and accurately differentiates them from sterically accessible to water but void regions. The obtained estimates of water binding free energies are in fair agreement with reference results determined with the double decoupling method.

Adopting a corporate perspective on databases. Improving support for research and decision making.

PubMed

Meistrell, M; Schlehuber, C

1996-03-01

The Veterans Health Administration (VHA) is at the forefront of designing and managing health care information systems that accommodate the needs of clinicians, researchers, and administrators at all levels. Rather than using one single-site, centralized corporate database VHA has constructed several large databases with different configurations to meet the needs of users with different perspectives. The largest VHA database is the Decentralized Hospital Computer Program (DHCP), a multisite, distributed data system that uses decoupled hospital databases. The centralization of DHCP policy has promoted data coherence, whereas the decentralization of DHCP management has permitted system development to be done with maximum relevance to the users'local practices. A more recently developed VHA data system, the Event Driven Reporting system (EDR), uses multiple, highly coupled databases to provide workload data at facility, regional, and national levels. The EDR automatically posts a subset of DHCP data to local and national VHA management. The development of the EDR illustrates how adoption of a corporate perspective can offer significant database improvements at reasonable cost and with modest impact on the legacy system.

Robust Multivariable Optimization and Performance Simulation for ASIC Design

NASA Technical Reports Server (NTRS)

DuMonthier, Jeffrey; Suarez, George

2013-01-01

Application-specific-integrated-circuit (ASIC) design for space applications involves multiple challenges of maximizing performance, minimizing power, and ensuring reliable operation in extreme environments. This is a complex multidimensional optimization problem, which must be solved early in the development cycle of a system due to the time required for testing and qualification severely limiting opportunities to modify and iterate. Manual design techniques, which generally involve simulation at one or a small number of corners with a very limited set of simultaneously variable parameters in order to make the problem tractable, are inefficient and not guaranteed to achieve the best possible results within the performance envelope defined by the process and environmental requirements. What is required is a means to automate design parameter variation, allow the designer to specify operational constraints and performance goals, and to analyze the results in a way that facilitates identifying the tradeoffs defining the performance envelope over the full set of process and environmental corner cases. The system developed by the Mixed Signal ASIC Group (MSAG) at the Goddard Space Flight Center is implemented as a framework of software modules, templates, and function libraries. It integrates CAD tools and a mathematical computing environment, and can be customized for new circuit designs with only a modest amount of effort as most common tasks are already encapsulated. Customization is required for simulation test benches to determine performance metrics and for cost function computation.

Maintenance of Vinyl Asbestos and Asphalt Tile Floors in Institutional, Industrial and Commercial Buildings.

ERIC Educational Resources Information Center

Asphalt and Vinyl Asbestos Tile Inst., New York, NY.

The claim is made that proper planning and modest outlays of time, labor, and material costs can provide and maintain a high appearance level for floors in institutional, commercial, and industrial buildings. Instructions for four basic steps in maintaining the good looks of vinyl asbestos and asphalt tile floors are treated in the booklet--(1)…

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

Computation of an Underexpanded 3-D Rectangular Jet by the CE/SE Method

NASA Technical Reports Server (NTRS)

Loh, Ching Y.; Himansu, Ananda; Wang, Xiao Y.; Jorgenson, Philip C. E.

2000-01-01

Recently, an unstructured three-dimensional space-time conservation element and solution element (CE/SE) Euler solver was developed. Now it is also developed for parallel computation using METIS for domain decomposition and MPI (message passing interface). The method is employed here to numerically study the near-field of a typical 3-D rectangular under-expanded jet. For the computed case-a jet with Mach number Mj = 1.6. with a very modest grid of 1.7 million tetrahedrons, the flow features such as the shock-cell structures and the axis switching, are in good qualitative agreement with experimental results.

Finite difference time domain electromagnetic scattering from frequency-dependent lossy materials

NASA Technical Reports Server (NTRS)

Luebbers, Raymond J.; Beggs, John H.

1991-01-01

Four different FDTD computer codes and companion Radar Cross Section (RCS) conversion codes on magnetic media are submitted. A single three dimensional dispersive FDTD code for both dispersive dielectric and magnetic materials was developed, along with a user's manual. The extension of FDTD to more complicated materials was made. The code is efficient and is capable of modeling interesting radar targets using a modest computer workstation platform. RCS results for two different plate geometries are reported. The FDTD method was also extended to computing far zone time domain results in two dimensions. Also the capability to model nonlinear materials was incorporated into FDTD and validated.

Twenty years of workers' compensation costs due to falls from height among union carpenters, Washington state.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid; Kucera, Kristen L; Adams, Darrin; Silverstein, Barbara A

2014-09-01

Falls from height (FFH) are a longstanding, serious problem in construction. We report workers' compensation (WC) payments associated with FFH among a cohort (n = 24,830; 1989-2008) of carpenters. Mean/median payments, cost rates, and adjusted rate ratios based on hours worked were calculated using negative-binomial regression. Over the 20-year period FFH accounted for $66.6 million in WC payments or $700 per year for each full-time equivalent (2,000 hr of work). FFH were responsible for 5.5% of injuries but 15.1% of costs. Cost declines were observed, but not monotonically. Reductions were more pronounced for indemnity than medical care. Mean costs were 2.3 times greater among carpenters over 50 than those under 30; cost rates were only modestly higher. Significant progress has been made in reducing WC payments associated with FFH in this cohort particularly through 1996; primary gains reflect reduction in frequency of falls. FFH that occur remain costly. © 2014 Wiley Periodicals, Inc.

Solar project cost report for Ingham County, Medical Care Facility, Okemos, Michigan

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

Not Available

The solar energy system supplies service hot water for a 204 bed medical and geriatric care facility with laundry and kitchen. The system was designed at the time the building was designed. The 9,374 ft/sup 2/ of collectors were manufactured by Revere Copper and Brass, Inc., and are mounted at grade level behind the building. Solar heated water for use in heating service water is stored in a 5000 gallon hot water storage tank. The heaviest use of hot water occurs during the day so the requirement for thermal storage is modest. The construction costs of this solar project aremore » presented. Category costs are listed by materials, direct labor, ad subcontract costs. The subcontract costs include both materials, labor, overhead and profit for electrical, control and other minor subcontractors. The installed cost of the system was $312,825 not including prime contractor overhead and profit and general and administrative costs. (MHR)« less

Architecture Synthesis and Reduced-Cost Architectures for Human Exploration Missions

NASA Technical Reports Server (NTRS)

Woodcock, Gordon

2004-01-01

Development of architectures for human exploration missions has been pursued in the international aerospace community for a long time. This paper attempts a different approach and way of looking at architectures. Most of the emphasis is on lunar architectures with a brief look at Mars. The first step is to set forth overarching gods in order to understand origins of requirements. Then, principles and guidelines are developed for architecture formulation. It is argued that safety and cost are the primary factors. Alternative mission profiles are examined for adherence to the principles, and specific architectures formulated according to the guidelines. The guidelines themselves indicate preferred evolution paths from lunar to Mars architectures. Results of example calculations are given to illustrate the process, and an evolution path is recommended. Safety and cost criteria tend to conflict, but it is shown that cost-efficient architectures can be enhanced for good safety ratings at modest cost.

Economic Evaluation of a Worksite Obesity Prevention and Intervention Trial among Hotel Workers in Hawaii

PubMed Central

Meenan, Richard T.; Vogt, Thomas M.; Williams, Andrew E.; Stevens, Victor J.; Albright, Cheryl L.; Nigg, Claudio

2010-01-01

Objective Economic evaluation of Work, Weight, and Wellness (3W), a two-year randomized trial of a weight loss program delivered through Hawaii hotel worksites. Methods Business case analysis from hotel perspective. Program resources were micro-costed (2008 dollars). Program benefits were reduced medical costs, fewer absences, and higher productivity. Primary outcome was discounted 24-month net present value (NPV). Results Control program cost $222K to implement over 24 months ($61 per participant), intervention program cost $1.12M ($334). Including overweight participants (body mass index > 25), discounted control NPV was −$217K; −$1.1M for intervention program. Presenteeism improvement of 50% combined with baseline 10% productivity shortfall required to generate positive 24-month intervention NPV. Conclusions 3W’s positive clinical outcomes did not translate into immediate economic benefit for participating hotels, although modest cost savings were observed in the trial’s second year. PMID:20061889

a Low-Cost Chirped-Pulse Fourier Transform Microwave Spectrometer for Undergraduate Physical Chemistry Lab

NASA Astrophysics Data System (ADS)

Carroll, Brandon; Finneran, Ian; Blake, Geoffrey

2014-06-01

We present the design and construction of a simple and low-cost waveguide chirped pulse Fourier transform microwave (CP-FTMW) spectrometer suitable for gas-phase rotational spectroscopy experiments in undergraduate physical chemistry labs as well as graduate level research. The spectrometer operates with modest bandwidth, using phased locked loop (PLL) microwave sources and a direct digital synthesis (DDS) chirp source, making it an affordable for undergraduate labs. The performance of the instrument is benchmarked by acquiring the pure rotational spectrum of the J = 1 - 0 transition OCS and its isotopologues from 11-12.5 GHz.

Fusion Propulsion and Power for Future Flight

NASA Technical Reports Server (NTRS)

Froning, H. D., Jr.

1996-01-01

There are innovative magnetic and electric confinement fusion power and propulsion system designs with potential for: vacuum specific impulses of 1500-2000 seconds with rocket engine thrust/mass ratios of 5-10 g's; environmentally favorable exhaust emissions if aneutronic fusion propellants can be used; a 2 to 3-fold reduction in the mass of hypersonic airliners and SSTO aerospace planes; a 10 to 20 fold reduction in Mars expedition mass and cost (if propellant from planetary atmospheres is used); and feasibility or in-feasibility of these systems could be confirmed with a modest applied research and exploratory development cost.

The Welfare Effects of Medical Malpractice Liability

PubMed Central

Lakdawalla, Darius N.; Seabury, Seth A.

2013-01-01

We use variation in the generosity of local juries to identify the causal impact of medical malpractice liability on social welfare. Growth in malpractice payments contributed at most 5 percentage points to the 33% total real growth in medical expenditures from 1990-2003. On the other hand, malpractice leads to modest mortality reductions; the value of these more than likely exceeds the costs of malpractice liability. Therefore, reducing malpractice liability is unlikely to have a major impact on health care spending, and unlikely to be cost-effective over conventionally accepted values of a statistical life. PMID:23526860

Operating Dedicated Data Centers - Is It Cost-Effective?

NASA Astrophysics Data System (ADS)

Ernst, M.; Hogue, R.; Hollowell, C.; Strecker-Kellog, W.; Wong, A.; Zaytsev, A.

2014-06-01

The advent of cloud computing centres such as Amazon's EC2 and Google's Computing Engine has elicited comparisons with dedicated computing clusters. Discussions on appropriate usage of cloud resources (both academic and commercial) and costs have ensued. This presentation discusses a detailed analysis of the costs of operating and maintaining the RACF (RHIC and ATLAS Computing Facility) compute cluster at Brookhaven National Lab and compares them with the cost of cloud computing resources under various usage scenarios. An extrapolation of likely future cost effectiveness of dedicated computing resources is also presented.

When Learning Is Just a Click Away: Does Simple User Interaction Foster Deeper Understanding of Multimedia Messages?

ERIC Educational Resources Information Center

Mayer, Richard E.; Chandler, Paul

2001-01-01

In two experiments, students received two presentations of a narrated animation explaining how lightning forms, followed by retention and transfer tests. The goal was to determine possible benefits of incorporating a modest amount of computer-user interactivity within a multimedia explanation. Results were consistent with cognitive load theory and…

An economy of scales: A selective review of obesity's economic causes, consequences, and solutions.

PubMed

Cawley, John

2015-09-01

This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity. Copyright © 2015. Published by Elsevier B.V.

Quality-adjusted cost of care: a meaningful way to measure growth in innovation cost versus the value of health gains.

PubMed

Lakdawalla, Darius; Shafrin, Jason; Lucarelli, Claudio; Nicholson, Sean; Khan, Zeba M; Philipson, Tomas J

2015-04-01

Technology drives both health care spending and health improvement. Yet policy makers rarely see measures of cost growth that account for both effects. To fill this gap, we present the quality-adjusted cost of care, which illustrates cost growth net of growth in the value of health improvements, measured as survival gains multiplied by the value of survival. We applied the quality-adjusted cost of care to two cases. For colorectal cancer, drug cost per patient increased by $34,493 between 1998 and 2005 as a result of new drug launches, but value from offsetting health improvements netted a modest $1,377 increase in quality-adjusted cost of care. For multiple myeloma, new therapies increased treatment cost by $72,937 between 2004 and 2009, but offsetting health benefits lowered overall quality-adjusted cost of care by $67,863. However, patients with multiple myeloma on established first-line therapies saw costs rise without corresponding benefits. All three examples document rapid cost growth, but they provide starkly different answers to the question of whether society got what it paid for. Project HOPE—The People-to-People Health Foundation, Inc.

Bioassessment Methodologies for the Regulatory Testing of Freshwater Dredged Material. Proceedings of a Workshop.

DTIC Science & Technology

1986-06-01

of the metabolic effects of exposure to the suspended solid phase during the screening experiments with only modest additional costs. Like- .. wise...assays MUST continue for 10 days, durinq which time daily records must be kept of salinity , temperature, DO, obvious mortalities and any sublethal effects ...25 Adenylate Energy Charge. ................. 26 . Oxygen Consumption and Osmoregulation . .......... 26 Miscellaneous. ..................... 26

Modular Orbital Demonstration of an Evolvable Space Telescope

NASA Astrophysics Data System (ADS)

Baldauf, Brian

2016-06-01

The key driver for a telescope's sensitivityis directly related to the size of t he mirror area that collects light from the objects being observed.The "Search for Life" via imaging of exoplanets is a mission that requires extremely stable telescopes with apertures in the 10 m to 20 m range. The HDST envisioned for this mission would have an aperture >10 m, which is a larger payload than can be delivered to space using a single launch vehicle. Building and assembling the mirror segments enabling large telescopes will likely require multiple launches and assembly in space. The Optical Telescope Assembly for HDST is a primary mission cost driver. Enabling affordable solutions for this next generation of large aperture space-based telescope are needed.This reports on the concept for the MODEST, which demonstrates on-orbit robotic and/or astronaut assembly of a precision optical telescope in space. It will facilitate demonstration of active correction of phase and mirror shape. MODEST is proposed to be delivered to the ISS using standard Express Logistics Carriers and can mounted to one of a variety of ISS pallets. Post-assembly value includes space, ground, and environmental studies, a testbed for new instruments, and a tool for student's exploration of space. This demonstration program for next generation mirror technology provides significant risk reduction and demonstrates the technology in a six-mirror phased telescope. Key features of the demonstration include the use of an active primary optical surface with wavefront feedback control that allows on-orbit optimization and demonstration of precise surface control to meet optical system wavefront and stability requirements.MODEST will also be used to evaluate advances in lightweight mirror and metering structure materials such as SiC or Ceramic Matrix Composite that have excellent mechanical and thermal properties, e.g. high stiffness, high thermal conductivity, and low thermal expansion. It has been demonstrated that mirrors built from these materials can be rapidly replicated in a highly cost effective manner, making these materials excellent candidates for a low cost, high performance OTA.

The impact of PD-L1 on survival and value of the immune check point inhibitors in non-small-cell lung cancer; proposal, policies and perspective.

PubMed

Guirgis, Helmy M

2018-02-20

The impact of programmed death receptor-ligand1 (PD-L1) on costs and value of the immune check point inhibitors (ICPI) has received minimal attention. 1- Design a sliding scale to grade survival in 2nd-line non-small-cell lung cancer (NSCLC). 2- Compare costs and value of Nivolumab (Nivo), Atezolizumab (Atezo) and Pembrolizumab (Pembro) vs. Docetaxel (Doc). Previously reported median overall survival (OS) and prices posted by parent company were utilized. The OS gains over controls in days were graded (gr) from A+ to D. Docetaxel costs were calculated for 6-12 cycles and the ICPI for 1 year. Adverse events treatment costs (AEsTC) were reported separately. The cost/life-year gain (C/LYG) was computed as drug yearly-cost/OS gain over control in days × 360 days. The relative value of the ICPI were expressed as $100,000/C/LYG. Costs of Doc 6 cycles were $23,868, OS/gr 87/C, AEs gr ¾ > 20%, AEsTC $1978 and 6- 12 cycle C/LYG $98,764 -$197,528. Nivo, Atezo and Pembro gr ¾ were < 20% at average costs of $1480. In non-squamous NSCLC, Nivo demonstrated OS/g 84/C and C/LYG $558,326 as compared with 264/A and $177,645 in PD-L1 > 10%. Atezolizumab OS/g were 87/B and C/LYG $551,407 improving in enriched PD-L1 to 162/A and $332,020 respectively. Pembrolizumab in PD-L1 > 1.0% demonstrated OS/g 57/C and C/LYG $659,059 improving in > 50% PD-L1 to 201/A and $186,897. PD-L1 enrichment increased RV of Nivo from 0.18 to 0.56, Atezo from 0.16 to 0.66 and Pembro from 0.15 to 0.53. Simplified methodology to grade OS and weigh value of anticancer drugs was proposed. In 2nd-line non-squamous NSCLC, value of Doc, Nivo, Atezo and Pembro regardless of PDL-1 expression were limited and modest. Enrichment of PD-L1 resulted in unprecedented OS, improved grades and enhanced value at seemingly justifiable costs.

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

PubMed Central

Szilagyi, Peter G.; Albertin, Christina; Humiston, Sharon G.; Rand, Cynthia M.; Schaffer, Stanley; Brill, Howard; Stankaitis, Joseph; Yo, Byung-Kwang; Blumkin, Aaron; Stokley, Shannon

2015-01-01

Objective To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents. Methods We conducted a randomized controlled trial between December 2009 and December 2010 that assigned adolescents aged 11–17 years to one of three groups: mailed letter, telephone reminders, or control. Publicly insured youths (n = 4, 115) were identified in 37 participating primary care practices. The main outcome measures were immunization rates for routine vaccines (meningococcus, pertussis, HPV) and preventive visit rates at study end. Results Intervention and control groups were similar at baseline for demographics, immunization rates, and preventive visits. Among adolescents who were behind at the start, immunization rates at study end increased by 21% for mailed (P < .01 vs control), 17% for telephone (P < .05), and 13% for control groups. The proportion of adolescents with a preventive visit (within 12 months) was: mailed (65%; P <.01), telephone (63%; P <.05), and controls (59%). The number needed to treat for an additional fully vaccinated adolescent was 14 for mailed and 25 for telephone reminders; for an additional preventive visit, it was 17 and 29. The intervention cost $18.78 (mailed) or $16.68 (phone) per adolescent per year to deliver. The cost per additional adolescent fully vaccinated was $463.99 for mailed and $714.98 for telephone; the cost per additional adolescent receiving a preventive visit was $324.75 and $487.03. Conclusions Managed care-based mail or telephone reminder/recall improved adolescent immunizations and preventive visits, with modest costs and modest impact. PMID:23510607

A randomized trial of the effect of centralized reminder/recall on immunizations and preventive care visits for adolescents.

PubMed

Szilagyi, Peter G; Albertin, Christina; Humiston, Sharon G; Rand, Cynthia M; Schaffer, Stanley; Brill, Howard; Stankaitis, Joseph; Yoo, Byung-Kwang; Blumkin, Aaron; Stokley, Shannon

2013-01-01

To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents. We conducted a randomized controlled trial between December 2009 and December 2010 that assigned adolescents aged 11-17 years to one of three groups: mailed letter, telephone reminders, or control. Publicly insured youths (n = 4115) were identified in 37 participating primary care practices. The main outcome measures were immunization rates for routine vaccines (meningococcus, pertussis, HPV) and preventive visit rates at study end. Intervention and control groups were similar at baseline for demographics, immunization rates, and preventive visits. Among adolescents who were behind at the start, immunization rates at study end increased by 21% for mailed (P < .01 vs control), 17% for telephone (P < .05), and 13% for control groups. The proportion of adolescents with a preventive visit (within 12 months) was: mailed (65%; P < .01), telephone (63%; P < .05), and controls (59%). The number needed to treat for an additional fully vaccinated adolescent was 14 for mailed and 25 for telephone reminders; for an additional preventive visit, it was 17 and 29. The intervention cost $18.78 (mailed) or $16.68 (phone) per adolescent per year to deliver. The cost per additional adolescent fully vaccinated was $463.99 for mailed and $714.98 for telephone; the cost per additional adolescent receiving a preventive visit was $324.75 and $487.03. Managed care-based mail or telephone reminder/recall improved adolescent immunizations and preventive visits, with modest costs and modest impact. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Economic evaluations of fluticasone-propionate/salmeterol combination therapy for chronic obstructive pulmonary disease: a review of published studies.

PubMed

Roberts, M H; Borrego, M E; Kharat, A A; Marshik, P L; Mapel, D W

2016-01-01

This review identifies and evaluates the comprehensive reporting of peer-reviewed economic evaluations of the effectiveness of fluticasone-propionate/salmeterol combination (FSC) therapy for maintenance treatment of chronic obstructive pulmonary disease (COPD). Economic evaluations were included if published in English since 2003. Evaluation categories included in the review were cost-effectiveness, cost-utility, and cost-consequence analyses. FSC is cost-effective in comparison to short-acting bronchodilators (SABDs). Cost and outcome differences between FSC and other long-acting therapies were modest. Studies exhibited large variations in populations, designs and environment, limiting the ability to draw conclusions. Many new maintenance treatments for COPD have been approved since 2010. Most have yet to be compared to older treatments like FSC. Evaluations are needed that consider costs and outcomes from a societal perspective (e.g., patients' ability to keep working) and evaluations that include subgroup analyses to investigate differential impacts according to clusters of patient characteristics.

Contrasting benefits of different artemisinin combination therapies as first-line malaria treatments using model-based cost-effectiveness analysis

PubMed Central

Okell, Lucy C.; Cairns, Matthew; Griffin, Jamie T.; Ferguson, Neil M.; Tarning, Joel; Jagoe, George; Hugo, Pierre; Baker, Mark; D’Alessandro, Umberto; Bousema, Teun; Ubben, David; Ghani, Azra C.

2014-01-01

There are currently several recommended drug regimens for uncomplicated falciparum malaria in Africa. Each has different properties that determine its impact on disease burden. Two major antimalarial policy options are artemether–lumefantrine (AL) and dihydroartemisinin–piperaquine (DHA–PQP). Clinical trial data show that DHA–PQP provides longer protection against reinfection, while AL is better at reducing patient infectiousness. Here we incorporate pharmacokinetic-pharmacodynamic factors, transmission-reducing effects and cost into a mathematical model and simulate malaria transmission and treatment in Africa, using geographically explicit data on transmission intensity and seasonality, population density, treatment access and outpatient costs. DHA–PQP has a modestly higher estimated impact than AL in 64% of the population at risk. Given current higher cost estimates for DHA–PQP, there is a slightly greater cost per case averted, except in areas with high, seasonally varying transmission where the impact is particularly large. We find that a locally optimized treatment policy can be highly cost effective for reducing clinical malaria burden. PMID:25425081

Performance and Cost-Effectiveness of Computed Tomography Lung Cancer Screening Scenarios in a Population-Based Setting: A Microsimulation Modeling Analysis in Ontario, Canada.

PubMed

Ten Haaf, Kevin; Tammemägi, Martin C; Bondy, Susan J; van der Aalst, Carlijn M; Gu, Sumei; McGregor, S Elizabeth; Nicholas, Garth; de Koning, Harry J; Paszat, Lawrence F

2017-02-01

The National Lung Screening Trial (NLST) results indicate that computed tomography (CT) lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with >3 screening rounds is uncertain. Therefore, the objective of this study was to estimate the cost-effectiveness of lung cancer screening in a population-based setting in Ontario, Canada, and evaluate the effects of screening eligibility criteria. This study used microsimulation modeling informed by various data sources, including the Ontario Health Insurance Plan (OHIP), Ontario Cancer Registry, smoking behavior surveys, and the NLST. Persons, born between 1940 and 1969, were examined from a third-party health care payer perspective across a lifetime horizon. Starting in 2015, 576 CT screening scenarios were examined, varying by age to start and end screening, smoking eligibility criteria, and screening interval. Among the examined outcome measures were lung cancer deaths averted, life-years gained, percentage ever screened, costs (in 2015 Canadian dollars), and overdiagnosis. The results of the base-case analysis indicated that annual screening was more cost-effective than biennial screening. Scenarios with eligibility criteria that required as few as 20 pack-years were dominated by scenarios that required higher numbers of accumulated pack-years. In general, scenarios that applied stringent smoking eligibility criteria (i.e., requiring higher levels of accumulated smoking exposure) were more cost-effective than scenarios with less stringent smoking eligibility criteria, with modest differences in life-years gained. Annual screening between ages 55-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago yielded an incremental cost-effectiveness ratio of $41,136 Canadian dollars ($33,825 in May 1, 2015, United States dollars) per life-year gained (compared to annual screening between ages 60-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago), which was considered optimal at a cost-effectiveness threshold of $50,000 Canadian dollars ($41,114 May 1, 2015, US dollars). If 50% lower or higher attributable costs were assumed, the incremental cost-effectiveness ratio of this scenario was estimated to be $38,240 ($31,444 May 1, 2015, US dollars) or $48,525 ($39,901 May 1, 2015, US dollars), respectively. If 50% lower or higher costs for CT examinations were assumed, the incremental cost-effectiveness ratio of this scenario was estimated to be $28,630 ($23,542 May 1, 2015, US dollars) or $73,507 ($60,443 May 1, 2015, US dollars), respectively. This scenario would screen 9.56% (499,261 individuals) of the total population (ever- and never-smokers) at least once, which would require 4,788,523 CT examinations, and reduce lung cancer mortality in the total population by 9.05% (preventing 13,108 lung cancer deaths), while 12.53% of screen-detected cancers would be overdiagnosed (4,282 overdiagnosed cases). Sensitivity analyses indicated that the overall results were most sensitive to variations in CT examination costs. Quality of life was not incorporated in the analyses, and assumptions for follow-up procedures were based on data from the NLST, which may not be generalizable to a population-based setting. Lung cancer screening with stringent smoking eligibility criteria can be cost-effective in a population-based setting.

Parametric bicubic spline and CAD tools for complex targets shape modelling in physical optics radar cross section prediction

NASA Astrophysics Data System (ADS)

Delogu, A.; Furini, F.

1991-09-01

Increasing interest in radar cross section (RCS) reduction is placing new demands on theoretical, computation, and graphic techniques for calculating scattering properties of complex targets. In particular, computer codes capable of predicting the RCS of an entire aircraft at high frequency and of achieving RCS control with modest structural changes, are becoming of paramount importance in stealth design. A computer code, evaluating the RCS of arbitrary shaped metallic objects that are computer aided design (CAD) generated, and its validation with measurements carried out using ALENIA RCS test facilities are presented. The code, based on the physical optics method, is characterized by an efficient integration algorithm with error control, in order to contain the computer time within acceptable limits, and by an accurate parametric representation of the target surface in terms of bicubic splines.

12 CFR 602.12 - Fees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the employee doing the work. (2) For computer searches for records, the direct costs of computer... $15.00. Fee Amounts Table Type of fee Amount of fee Manual Search and Review Pro rated Salary Costs. Computer Search Direct Costs. Photocopy $0.15 a page. Other Reproduction Costs Direct Costs. Elective...

Free as a bird - A point of view. [technical advance and humanistic aspects of aviation

NASA Technical Reports Server (NTRS)

Burke, J. D.

1978-01-01

A number of ways are discussed in which ingenious people can further increase their enjoyment of experimenting in air (balloons, man-powered flight, etc.). For the lowest cost forms of flight, private sponsorship has been modestly successful. Much more could be done if people would not take themselves so seriously and always demand that advanced technology should serve some nationalistic or economic goals. For the society, the next step forward will perhaps originate if it is demonstrated to the government, manufacturers, and customers that private flying has become too costly due to those factors which limit the acquisition and introduction of new knowledge.

Direct treatment costs of HIV/AIDS in Portugal.

PubMed

Perelman, Julian; Alves, Joana; Miranda, Ana Cláudia; Mateus, Céu; Mansinho, Kamal; Antunes, Francisco; Oliveira, Joaquim; Poças, José; Doroana, Manuela; Marques, Rui; Teófilo, Eugénio; Pereira, João

2013-10-01

To analyze the direct medical costs of HIV/AIDS in Portugal from the perspective of the National Health Service. A retrospective analysis of medical records was conducted for 150 patients from five specialized centers in Portugal in 2008. Data on utilization of medical resources during 12 months and patients' characteristics were collected. A unit cost was applied to each care component using official sources and accounting data from National Health Service hospitals. The average cost of treatment was 14,277 €/patient/year. The main cost-driver was antiretroviral treatment (€ 9,598), followed by hospitalization costs (€ 1,323). Treatment costs increased with the severity of disease from € 11,901 (> 500 CD4 cells/µl) to € 23,351 (CD4 count ≤ 50 cells/ µl). Cost progression was mainly due to the increase in hospitalization costs, while antiretroviral treatment costs remained stable over disease stages. The high burden related to antiretroviral treatment is counterbalanced by relatively low hospitalization costs, which, however, increase with severity of disease. The relatively modest progression of total costs highlights that alternative public health strategies that do not affect transmission of disease may only have a limited impact on expenditure, since treatment costs are largely dominated by constant antiretroviral treatment costs.

Rightsizing LISA

NASA Technical Reports Server (NTRS)

Stebbins, Robin T.

2009-01-01

The LISA science requirements and conceptual design have been fairly stable for over a decade. In the interest of reducing costs, the LISA Project at NASA has looked for simplifications of the architecture, at downsizing of subsystems, and at descopes of the entire mission. This is a natural activity of the formulation phase, and one that is particularly timely in the current NASA budgetary context. There is, and will continue to be, enormous pressure for cost reduction from both ESA and NASA, reviewers and the broader research community. Here, the rationale for the baseline architecture is reviewed, and recent efforts to find simplifications and other reductions that might lead to savings are reported. A few possible simplifications have been found in the LISA baseline architecture. In the interest of exploring cost sensitivity, one moderate and one aggressive descope have been evaluated; the cost savings are modest and the loss of science is not.

Thin Shell, Segmented X-Ray Mirrors

NASA Technical Reports Server (NTRS)

Petre, Robert

2010-01-01

Thin foil mirrors were introduced as a means of achieving high throughput in an X-ray astronomical imaging system in applications for which high angular resolution were not necessary. Since their introduction, their high filling factor, modest mass, relative ease of construction, and modest cost have led to their use in numerous X-ray observatories, including the Broad Band X-ray Telescope, ASCA, and Suzaku. The introduction of key innovations, including epoxy replicated surfaces, multilayer coatings, and glass mirror substrates, has led to performance improvements, and in their becoming widely used for X-ray astronomical imaging at energies above 10 keV. The use of glass substrates has also led to substantial improvement in angular resolution, and thus their incorporation into the NASA concept for the International X-ray Observatory with a planned 3 in diameter aperture. This paper traces the development of foil mirrors from their inception in the 1970's through their current and anticipated future applications.

Fast and Precise Emulation of Stochastic Biochemical Reaction Networks With Amplified Thermal Noise in Silicon Chips.

PubMed

Kim, Jaewook; Woo, Sung Sik; Sarpeshkar, Rahul

2018-04-01

The analysis and simulation of complex interacting biochemical reaction pathways in cells is important in all of systems biology and medicine. Yet, the dynamics of even a modest number of noisy or stochastic coupled biochemical reactions is extremely time consuming to simulate. In large part, this is because of the expensive cost of random number and Poisson process generation and the presence of stiff, coupled, nonlinear differential equations. Here, we demonstrate that we can amplify inherent thermal noise in chips to emulate randomness physically, thus alleviating these costs significantly. Concurrently, molecular flux in thermodynamic biochemical reactions maps to thermodynamic electronic current in a transistor such that stiff nonlinear biochemical differential equations are emulated exactly in compact, digitally programmable, highly parallel analog "cytomorphic" transistor circuits. For even small-scale systems involving just 80 stochastic reactions, our 0.35-μm BiCMOS chips yield a 311× speedup in the simulation time of Gillespie's stochastic algorithm over COPASI, a fast biochemical-reaction software simulator that is widely used in computational biology; they yield a 15 500× speedup over equivalent MATLAB stochastic simulations. The chip emulation results are consistent with these software simulations over a large range of signal-to-noise ratios. Most importantly, our physical emulation of Poisson chemical dynamics does not involve any inherently sequential processes and updates such that, unlike prior exact simulation approaches, they are parallelizable, asynchronous, and enable even more speedup for larger-size networks.

A critical analysis of studies of state drug reimbursement policies: research in need of discipline.

PubMed

Soumerai, S B; Ross-Degnan, D; Fortess, E E; Abelson, J

1993-01-01

Concerns over pharmaceutical costs and appropriateness of medication use have led state Medicaid programs to restrict drug reimbursement. This article critically reviews 20 years of research on cost sharing, drug reimbursement limits, and administrative limitations on access to particular drugs via formularies, category exclusions, or prior authorization requirements; evaluates their methodological rigor; summarizes the state of current knowledge; and proposes future research directions. Drug reimbursement caps and modest cost sharing can reduce the use of both essential and less important drugs in Medicaid populations; severe reimbursement caps may precipitate serious unintended effects. Limitations on access to particular drugs can cause both rational and irrational drug substitution effects; it is unclear whether such limits reduce expenditures either for drugs or for overall health care.

Learning to not know: results of a program for ancillary cost reduction in surgical critical care.

PubMed

Barie, P S; Hydo, L J

1996-10-01

Compelling internal and external influences are stimulating global re-evaluations of care standards for efficacy and cost. Critical care uses huge amounts of resources despite widespread shortages of beds and nurses. This study tested the hypothesis that ancillary expenditures can be decreased without compromising care. Costs for laboratory tests, radiographs, blood products, nutritional supplements, and drugs were compared prospectively for all surgical intensive care unit care for two 4-month periods (January 1 to April 30, 1994 and January 1 to April 30, 1995) at a urban university center. A systematic, multidisciplinary cost-reduction program began May 1, 1994, with emphasis on laboratory and radiographic testing and procedures, and blood product, nutritional, and drug therapies. Cohorts were compared by age, Acute Physiology and Chronic Health Evaluation (APACHE) II and III admission scores, and case mix. Outcome variables were hospital mortality, days in the intensive care unit and hospital, the development of multiple organ dysfunction syndrome, and expenditures. Cost data were taken weekly from the hospital's clinical information system. No new equipment was introduced during the study period except for pumps for patient-controlled analgesia, and there were no new critical pathways or other patient care guidelines. Case mix and all noncost variables were identical. Overall costs were reduced by 29% when normalized by the number of patient-days in each period. Laboratory testing was reduced in frequency by 24 to 32%, and cost by 26 to 28%. Comparable reductions in the cost of blood products (32%) were exceeded by the reductions in expenditures for nutritional supplements (49%) and pharmaceuticals (45%) (all, p < 0.01 or less). Modestly increased (2%) x-ray charges in 1995 were owing entirely to insertion of prophylactic inferior vena cava filters (each, $2,800, n = 5) and computed tomography scans for sinusitis (each, $350, n = 5), although the 7% reduction in portable chest radiographs that was achieved did not meet expectations. Substantial reductions in physician-ordered ancillary expenditures are possible without compromising the standard of care of critically ill patients, or the support of an elaborate framework of defined care plans. With additional experience, incremental savings may accrue from refinement of successful strategies and new approaches to intractable problems.

The economic costs of quarterly monitoring and recovery management checkups for adults with chronic substance use disorders.

PubMed

Dennis, Michael L; French, Michael T; McCollister, Kathryn E; Scott, Christy K

2011-09-01

Recovery management checkups (RMCs) for clients with substance use disorders reduce the time from relapse to treatment reentry, increase treatment retention, and improve long-term outcomes. The objectives of this article are to calculate and compare the economic costs of providing outcome monitoring (OM) only with those of providing OM + RMC to help understand the feasibility of disseminating this model more widely. We estimate the total and incremental costs of OM and OM + RMC using data from a recently completed randomized controlled trial with adult chronic substance users (N = 446). Adding RMC to OM increased total intervention costs by about 50% per person per year ($707 to $1,283) and quarter ($177 to $321). It cost an average of $834 to identify a person in relapse and $2,699 to identify, link, and retain them in treatment. The increased costs of RMC are modest relative to the substantial societal costs of chronic substance users returning to regular use, crime, and other risk behaviors. Copyright © 2011 Elsevier Inc. All rights reserved.

Intermediate-mass-ratio black-hole binaries: numerical relativity meets perturbation theory.

PubMed

Lousto, Carlos O; Nakano, Hiroyuki; Zlochower, Yosef; Campanelli, Manuela

2010-05-28

We study black-hole binaries in the intermediate-mass-ratio regime 0.01≲q≲0.1 with a new technique that makes use of nonlinear numerical trajectories and efficient perturbative evolutions to compute waveforms at large radii for the leading and nonleading (ℓ, m) modes. As a proof-of-concept, we compute waveforms for q=1/10. We discuss applications of these techniques for LIGO and VIRGO data analysis and the possibility that our technique can be extended to produce accurate waveform templates from a modest number of fully nonlinear numerical simulations.

Improving the accuracy of Møller-Plesset perturbation theory with neural networks

NASA Astrophysics Data System (ADS)

McGibbon, Robert T.; Taube, Andrew G.; Donchev, Alexander G.; Siva, Karthik; Hernández, Felipe; Hargus, Cory; Law, Ka-Hei; Klepeis, John L.; Shaw, David E.

2017-10-01

Noncovalent interactions are of fundamental importance across the disciplines of chemistry, materials science, and biology. Quantum chemical calculations on noncovalently bound complexes, which allow for the quantification of properties such as binding energies and geometries, play an essential role in advancing our understanding of, and building models for, a vast array of complex processes involving molecular association or self-assembly. Because of its relatively modest computational cost, second-order Møller-Plesset perturbation (MP2) theory is one of the most widely used methods in quantum chemistry for studying noncovalent interactions. MP2 is, however, plagued by serious errors due to its incomplete treatment of electron correlation, especially when modeling van der Waals interactions and π-stacked complexes. Here we present spin-network-scaled MP2 (SNS-MP2), a new semi-empirical MP2-based method for dimer interaction-energy calculations. To correct for errors in MP2, SNS-MP2 uses quantum chemical features of the complex under study in conjunction with a neural network to reweight terms appearing in the total MP2 interaction energy. The method has been trained on a new data set consisting of over 200 000 complete basis set (CBS)-extrapolated coupled-cluster interaction energies, which are considered the gold standard for chemical accuracy. SNS-MP2 predicts gold-standard binding energies of unseen test compounds with a mean absolute error of 0.04 kcal mol-1 (root-mean-square error 0.09 kcal mol-1), a 6- to 7-fold improvement over MP2. To the best of our knowledge, its accuracy exceeds that of all extant density functional theory- and wavefunction-based methods of similar computational cost, and is very close to the intrinsic accuracy of our benchmark coupled-cluster methodology itself. Furthermore, SNS-MP2 provides reliable per-conformation confidence intervals on the predicted interaction energies, a feature not available from any alternative method.

Improving the accuracy of Møller-Plesset perturbation theory with neural networks.

PubMed

McGibbon, Robert T; Taube, Andrew G; Donchev, Alexander G; Siva, Karthik; Hernández, Felipe; Hargus, Cory; Law, Ka-Hei; Klepeis, John L; Shaw, David E

2017-10-28

Noncovalent interactions are of fundamental importance across the disciplines of chemistry, materials science, and biology. Quantum chemical calculations on noncovalently bound complexes, which allow for the quantification of properties such as binding energies and geometries, play an essential role in advancing our understanding of, and building models for, a vast array of complex processes involving molecular association or self-assembly. Because of its relatively modest computational cost, second-order Møller-Plesset perturbation (MP2) theory is one of the most widely used methods in quantum chemistry for studying noncovalent interactions. MP2 is, however, plagued by serious errors due to its incomplete treatment of electron correlation, especially when modeling van der Waals interactions and π-stacked complexes. Here we present spin-network-scaled MP2 (SNS-MP2), a new semi-empirical MP2-based method for dimer interaction-energy calculations. To correct for errors in MP2, SNS-MP2 uses quantum chemical features of the complex under study in conjunction with a neural network to reweight terms appearing in the total MP2 interaction energy. The method has been trained on a new data set consisting of over 200 000 complete basis set (CBS)-extrapolated coupled-cluster interaction energies, which are considered the gold standard for chemical accuracy. SNS-MP2 predicts gold-standard binding energies of unseen test compounds with a mean absolute error of 0.04 kcal mol -1 (root-mean-square error 0.09 kcal mol -1 ), a 6- to 7-fold improvement over MP2. To the best of our knowledge, its accuracy exceeds that of all extant density functional theory- and wavefunction-based methods of similar computational cost, and is very close to the intrinsic accuracy of our benchmark coupled-cluster methodology itself. Furthermore, SNS-MP2 provides reliable per-conformation confidence intervals on the predicted interaction energies, a feature not available from any alternative method.

A Tensor-Train accelerated solver for integral equations in complex geometries

NASA Astrophysics Data System (ADS)

Corona, Eduardo; Rahimian, Abtin; Zorin, Denis

2017-04-01

We present a framework using the Quantized Tensor Train (QTT) decomposition to accurately and efficiently solve volume and boundary integral equations in three dimensions. We describe how the QTT decomposition can be used as a hierarchical compression and inversion scheme for matrices arising from the discretization of integral equations. For a broad range of problems, computational and storage costs of the inversion scheme are extremely modest O (log ⁡ N) and once the inverse is computed, it can be applied in O (Nlog ⁡ N) . We analyze the QTT ranks for hierarchically low rank matrices and discuss its relationship to commonly used hierarchical compression techniques such as FMM and HSS. We prove that the QTT ranks are bounded for translation-invariant systems and argue that this behavior extends to non-translation invariant volume and boundary integrals. For volume integrals, the QTT decomposition provides an efficient direct solver requiring significantly less memory compared to other fast direct solvers. We present results demonstrating the remarkable performance of the QTT-based solver when applied to both translation and non-translation invariant volume integrals in 3D. For boundary integral equations, we demonstrate that using a QTT decomposition to construct preconditioners for a Krylov subspace method leads to an efficient and robust solver with a small memory footprint. We test the QTT preconditioners in the iterative solution of an exterior elliptic boundary value problem (Laplace) formulated as a boundary integral equation in complex, multiply connected geometries.

Microelectromechanical reprogrammable logic device.

PubMed

Hafiz, M A A; Kosuru, L; Younis, M I

2016-03-29

In modern computing, the Boolean logic operations are set by interconnect schemes between the transistors. As the miniaturization in the component level to enhance the computational power is rapidly approaching physical limits, alternative computing methods are vigorously pursued. One of the desired aspects in the future computing approaches is the provision for hardware reconfigurability at run time to allow enhanced functionality. Here we demonstrate a reprogrammable logic device based on the electrothermal frequency modulation scheme of a single microelectromechanical resonator, capable of performing all the fundamental 2-bit logic functions as well as n-bit logic operations. Logic functions are performed by actively tuning the linear resonance frequency of the resonator operated at room temperature and under modest vacuum conditions, reprogrammable by the a.c.-driving frequency. The device is fabricated using complementary metal oxide semiconductor compatible mass fabrication process, suitable for on-chip integration, and promises an alternative electromechanical computing scheme.

Microelectromechanical reprogrammable logic device

PubMed Central

Hafiz, M. A. A.; Kosuru, L.; Younis, M. I.

2016-01-01

In modern computing, the Boolean logic operations are set by interconnect schemes between the transistors. As the miniaturization in the component level to enhance the computational power is rapidly approaching physical limits, alternative computing methods are vigorously pursued. One of the desired aspects in the future computing approaches is the provision for hardware reconfigurability at run time to allow enhanced functionality. Here we demonstrate a reprogrammable logic device based on the electrothermal frequency modulation scheme of a single microelectromechanical resonator, capable of performing all the fundamental 2-bit logic functions as well as n-bit logic operations. Logic functions are performed by actively tuning the linear resonance frequency of the resonator operated at room temperature and under modest vacuum conditions, reprogrammable by the a.c.-driving frequency. The device is fabricated using complementary metal oxide semiconductor compatible mass fabrication process, suitable for on-chip integration, and promises an alternative electromechanical computing scheme. PMID:27021295

The Hidden Costs of Owning a Microcomputer.

ERIC Educational Resources Information Center

McDole, Thomas L.

Before purchasing computer hardware, individuals must consider the costs associated with the setup and operation of a microcomputer system. Included among the initial costs of purchasing a computer are the costs of the computer, one or more disk drives, a monitor, and a printer as well as the costs of such optional peripheral devices as a plotter…

Vector production in an academic environment: a tool to assess production costs.

PubMed

Boeke, Aaron; Doumas, Patrick; Reeves, Lilith; McClurg, Kyle; Bischof, Daniela; Sego, Lina; Auberry, Alisha; Tatikonda, Mohan; Cornetta, Kenneth

2013-02-01

Generating gene and cell therapy products under good manufacturing practices is a complex process. When determining the cost of these products, researchers must consider the large number of supplies used for manufacturing and the personnel and facility costs to generate vector and maintain a cleanroom facility. To facilitate cost estimates, the Indiana University Vector Production Facility teamed with the Indiana University Kelley School of Business to develop a costing tool that, in turn, provides pricing. The tool is designed in Microsoft Excel and is customizable to meet the needs of other core facilities. It is available from the National Gene Vector Biorepository. The tool allows cost determinations using three different costing methods and was developed in an effort to meet the A21 circular requirements for U.S. core facilities performing work for federally funded projects. The costing tool analysis reveals that the cost of vector production does not have a linear relationship with batch size. For example, increasing the production from 9 to18 liters of a retroviral vector product increases total costs a modest 1.2-fold rather than doubling in total cost. The analysis discussed in this article will help core facilities and investigators plan a cost-effective strategy for gene and cell therapy production.

Vector Production in an Academic Environment: A Tool to Assess Production Costs

PubMed Central

Boeke, Aaron; Doumas, Patrick; Reeves, Lilith; McClurg, Kyle; Bischof, Daniela; Sego, Lina; Auberry, Alisha; Tatikonda, Mohan

2013-01-01

Abstract Generating gene and cell therapy products under good manufacturing practices is a complex process. When determining the cost of these products, researchers must consider the large number of supplies used for manufacturing and the personnel and facility costs to generate vector and maintain a cleanroom facility. To facilitate cost estimates, the Indiana University Vector Production Facility teamed with the Indiana University Kelley School of Business to develop a costing tool that, in turn, provides pricing. The tool is designed in Microsoft Excel and is customizable to meet the needs of other core facilities. It is available from the National Gene Vector Biorepository. The tool allows cost determinations using three different costing methods and was developed in an effort to meet the A21 circular requirements for U.S. core facilities performing work for federally funded projects. The costing tool analysis reveals that the cost of vector production does not have a linear relationship with batch size. For example, increasing the production from 9 to18 liters of a retroviral vector product increases total costs a modest 1.2-fold rather than doubling in total cost. The analysis discussed in this article will help core facilities and investigators plan a cost-effective strategy for gene and cell therapy production. PMID:23360377

Diagnostic cost groups (DCGs) and concurrent utilization among patients with substance abuse disorders.

PubMed

Rosen, Amy K; Loveland, Susan A; Anderson, Jennifer J; Hankin, Cheryl S; Breckenridge, James N; Berlowitz, Dan R

2002-08-01

To assess the performance of Diagnostic Cost Groups (DCGs) in explaining variation in concurrent utilization for a defined subgroup, patients with substance abuse (SA) disorders, within the Department of Veterans Affairs (VA). A 60 percent random sample of veterans who used health care services during Fiscal Year (FY) 1997 was obtained from VA administrative databases. Patients with SA disorders (13.3 percent) were identified from primary and secondary ICD-9-CM diagnosis codes. Concurrent risk adjustment models were fitted and tested using the DCG/HCC model. Three outcome measures were defined: (1) "service days" (the sum of a patient's inpatient and outpatient visit days), (2) mental health/substance abuse (MH/SA) service days, and (3) ambulatory provider encounters. To improve model performance, we ran three DCG/HCC models with additional indicators for patients with SA disorders. To create a single file of veterans who used health care services in FY 1997, we merged records from all VA inpatient and outpatient files. Adding indicators for patients with mild/moderate SA disorders did not appreciably improve the R-squares for any of the outcome measures. When indicators were added for patients with severe SA who were in the most costly category, the explanatory ability of the models was modestly improved for all three outcomes. Modifying the DCG/HCC model with additional markers for SA modestly improved homogeneity and model prediction. Because considerable variation still remained after modeling, we conclude that health care systems should evaluate "off-the-shelf" risk adjustment systems before applying them to their own populations.

Diagnostics Cost Groups and Concurrent Utilization among Patients

PubMed Central

Rosen, Amy K; Loveland, Susan A; Anderson, Jennifer J; Hankin, Cheryl S; Breckenridge, James N; Berlowitz, Dan R

2002-01-01

Objective To assess the performance of Diagnostic Cost Groups (DCGs) in explaining variation in concurrent utilization for a defined subgroup, patients with substance abuse (SA) disorders, within the Department of Veterans Affairs (VA). Data Sources A 60 percent random sample of veterans who used health care services during Fiscal Year (FY) 1997 was obtained from VA administrative databases. Patients with SA disorders (13.3 percent) were identified from primary and secondary ICD-9-CM diagnosis codes. Study Design Concurrent risk adjustment models were fitted and tested using the DCG/HCC model. Three outcome measures were defined: (1) “service days” (the sum of a patient's inpatient and outpatient visit days), (2) mental health/substance abuse (MH/SA) service days, and (3) ambulatory provider encounters. To improve model performance, we ran three DCG/HCC models with additional indicators for patients with SA disorders. Data Collection To create a single file of veterans who used health care services in FY 1997, we merged records from all VA inpatient and outpatient files. Principal Findings Adding indicators for patients with mild/moderate SA disorders did not appreciably improve the R-squares for any of the outcome measures. When indicators were added for patients with severe SA who were in the most costly category, the explanatory ability of the models was modestly improved for all three outcomes. Conclusions Modifying the DCG/HCC model with additional markers for SA modestly improved homogeneity and model prediction. Because considerable variation still remained after modeling, we conclude that health care systems should evaluate “off-the-shelf” risk adjustment systems before applying them to their own populations. PMID:12236385

Economic and epidemiological impact of early antiretroviral therapy initiation in India

PubMed Central

Maddali, Manoj V; Dowdy, David W; Gupta, Amita; Shah, Maunank

2015-01-01

Introduction Recent WHO guidance advocates for early antiretroviral therapy (ART) initiation at higher CD4 counts to improve survival and reduce HIV transmission. We sought to quantify how the cost-effectiveness and epidemiological impact of early ART strategies in India are affected by attrition throughout the HIV care continuum. Methods We constructed a dynamic compartmental model replicating HIV transmission, disease progression and health system engagement among Indian adults. Our model of the Indian HIV epidemic compared implementation of early ART initiation (i.e. initiation above CD4 ≥350 cells/mm3) with delayed initiation at CD4 ≤350 cells/mm3; primary outcomes were incident cases, deaths, quality-adjusted-life-years (QALYs) and costs over 20 years. We assessed how costs and effects of early ART initiation were impacted by suboptimal engagement at each stage in the HIV care continuum. Results Assuming “idealistic” engagement in HIV care, early ART initiation is highly cost-effective ($442/QALY-gained) compared to delayed initiation at CD4 ≤350 cells/mm3 and could reduce new HIV infections to <15,000 per year within 20 years. However, when accounting for realistic gaps in care, early ART initiation loses nearly half of potential epidemiological benefits and is less cost-effective ($530/QALY-gained). We project 1,285,000 new HIV infections and 973,000 AIDS-related deaths with deferred ART initiation with current levels of care-engagement in India. Early ART initiation in this continuum resulted in 1,050,000 new HIV infections and 883,000 AIDS-related deaths, or 18% and 9% reductions (respectively), compared to current guidelines. Strengthening HIV screening increases benefits of earlier treatment modestly (1,001,000 new infections; 22% reduction), while improving retention in care has a larger modulatory impact (676,000 new infections; 47% reduction). Conclusions Early ART initiation is highly cost-effective in India but only has modest epidemiological benefits at current levels of care-engagement. Improved retention in care is needed to realize the full potential of earlier treatment. PMID:26434780

Utilizing Structural Equation Modeling and Social Cognitive Career Theory to Identify Factors in Choice of It as a Major

ERIC Educational Resources Information Center

Luse, Andy; Rursch, Julie A.; Jacobson, Doug

2014-01-01

In the United States, the number of students entering into and completing degrees in science, technology, engineering, and mathematics (STEM) areas has declined significantly over the past decade. Although modest increases have been shown in enrollments in computer-related majors in the past 4 years, the prediction is that even in 3 to 4 years…

Global Warming, Africa and National Security

DTIC Science & Technology

2008-01-15

African populations. This includes awareness from a global perspective in line with The Army Strategy for the Environment, the UN’s Intergovernmental...2 attention. At the time, computer models did not indicate a significant issue with global warming suggesting only a modest increase of 2°C9...projected climate changes. Current Science The science surrounding climate change and global warming was, until recently, a point of

Picture archiving and communication system developments expected in the 1990s

NASA Astrophysics Data System (ADS)

Drew, Philip G.; Lorah, Lawrence D.; Lydon, Michael J.; Novak, Elliott D.

1993-01-01

Among the applications for high-bandwidth systems are medical picture archiving and communication systems (PACS). Viewed in the light of developments anticipated ten years ago when these systems were first discussed, progress has been disappointingly slow. However, with the recognition that teleradiology, digital archives, and computed radiography can be regarded as PAC subsystems, and that systems confined to a single modality can be regarded as mini-PACS, it becomes clear that development of PAC systems has made remarkable progress. Growing from modest size today, the markets for PAC systems and subsystems in the U.S. is likely to exceed $600 million by the end of the decade, a market of the same magnitude as those for CT, MRI, and catheterization lab equipment. This paper discusses the forces that have stimulated growth of PAC systems - among them, the opportunity to provide better service to patients and referring physicians, a chance to expand effective service area, and a possible solution to the ubiquitous problems of lost films - as well as the impediments that have retarded growth - among them, technical limitations, especially of the radiologists' workstations, and cost. A review of these forces allows prediction of likely developments in the 1990s.

On NUFFT-based gridding for non-Cartesian MRI

NASA Astrophysics Data System (ADS)

Fessler, Jeffrey A.

2007-10-01

For MRI with non-Cartesian sampling, the conventional approach to reconstructing images is to use the gridding method with a Kaiser-Bessel (KB) interpolation kernel. Recently, Sha et al. [L. Sha, H. Guo, A.W. Song, An improved gridding method for spiral MRI using nonuniform fast Fourier transform, J. Magn. Reson. 162(2) (2003) 250-258] proposed an alternative method based on a nonuniform FFT (NUFFT) with least-squares (LS) design of the interpolation coefficients. They described this LS_NUFFT method as shift variant and reported that it yielded smaller reconstruction approximation errors than the conventional shift-invariant KB approach. This paper analyzes the LS_NUFFT approach in detail. We show that when one accounts for a certain linear phase factor, the core of the LS_NUFFT interpolator is in fact real and shift invariant. Furthermore, we find that the KB approach yields smaller errors than the original LS_NUFFT approach. We show that optimizing certain scaling factors can lead to a somewhat improved LS_NUFFT approach, but the high computation cost seems to outweigh the modest reduction in reconstruction error. We conclude that the standard KB approach, with appropriate parameters as described in the literature, remains the practical method of choice for gridding reconstruction in MRI.

Thermionic modules

DOEpatents

King, Donald B.; Sadwick, Laurence P.; Wernsman, Bernard R.

2002-06-18

Modules of assembled microminiature thermionic converters (MTCs) having high energy-conversion efficiencies and variable operating temperatures manufactured using MEMS manufacturing techniques including chemical vapor deposition. The MTCs incorporate cathode to anode spacing of about 1 micron or less and use cathode and anode materials having work functions ranging from about 1 eV to about 3 eV. The MTCs also exhibit maximum efficiencies of just under 30%, and thousands of the devices and modules can be fabricated at modest costs.

Implications of the Civil Service Reform Act of 1978 on Performance Evaluation in Navy Field Level Activity Comptroller Departments.

DTIC Science & Technology

1981-03-01

application. This was accomplished by the collection and survey of informa- tion regarding the three positions to be studied in this thesis. The...modestly, expand the scope of collective bargaining, including covering many statutory appeals by the negotiated grievance procedure. Employees will have...current inventory of budget plans and program schedules; c. Budget formulation, review and execution; d. Collection of obligation, expenditure, cost, and

Strategy for D/He-3 fusion development

NASA Technical Reports Server (NTRS)

Santarius, John F.

1988-01-01

It is concluded that Deuterium/Helium-3 fusion faces a more difficult physics development path but an easier technology development path than does Deuterium/Tritium. Early D/He-3 tests in next generation D/T fusion experiments might provide a valuable D/He-3 proof-of-principle at modest cost. At least one high leverage alternate concept should be vigorously pursued. Space applications of D/He-3 fusion are critically important to large scale development.

Affording shared responsibility for universal coverage: insights from California.

PubMed

Curtis, Rick; Neuschler, Ed

2009-01-01

This paper presents key insights from California's recent experience in developing a plan for universal health coverage with "shared responsibility" among individuals, employers, and governments. A major challenge was finding an acceptable balance among the goals of affordability, equity, and cost to the state. Although reform did not pass, the state's approach-particularly differences from Massachusetts regarding modest-income workers and related employer and public roles-provides important insights for federal reform.

FOAM-IN-PLACE FORM FITTING HELMET LINERS

DTIC Science & Technology

A urethane foam formulation has been developed to produce foamed-in-place helmet liners for Air Force crash or flying helmets. High density urethane...foam helmet liners has been foamed-in-place directly on the flying crew member’s head, producing a perfectly fitting helmet liner with a minimum of...time, labor and inconvenience. These liners were produced at an extremely modest cost. Design and fabrication of a suitable mold in which the helmet

HIPAA costs and patient perceptions privacy safeguards Mayo Clinic.

PubMed

Williams, Arthur R; Herman, David C; Moriarty, James P; Beebe, Timothy J; Bruggeman, Sandra K; Klavetter, Eric W; Steger, Paul H; Bartz, Janet K

2008-01-01

A study was conducted to assess the costs of implementation of the Health Insurance Portability and Accountability Act (HIPAA) and to report patient awareness of Notices of Privacy Practices (NPP) content and HIPAA privacy protections. All HIPAA start-up and implementation costs were collected prospectively. A random sample of 2,000 patients receiving services at the Mayo Clinic after HIPAA implementation (April 14, 2003) was surveyed about HIPAA knowledge, HIPAA content, and privacy concerns. Comprehensive measures of total HIPAA costs and costs related only to privacy practices were amortized over 7, 15, and 20 years. Patient knowledge of privacy protections and attitudes toward HIPAA were obtained from 1,309 (65.5%) respondents. The total HIPAA startup costs were $4,663,672. Fully amortized costs (annual plus start-up costs) were $1 per patient visit or $5 per patient per year. Costs for the privacy portion were $2,734,855. These costs were about $.90 per patient visit or about $4 per patient per year. Patients indicated high levels of awareness of HIPAA (71%), reading the NPP (79%), knowledge about HIPAA (80% with 6+ correct answers on a 10-item quiz), and improved feelings of privacy (44% versus 55% the same). Patients reported high levels of knowledge about HIPAA and confidence in privacy protections. HIPAA costs were modest per patient or per visit.

Strategies and methodologies to develop techniques for computer-assisted analysis of gas phase formation during altitude decompression

NASA Technical Reports Server (NTRS)

Powell, Michael R.; Hall, W. A.

1993-01-01

It would be of operational significance if one possessed a device that would indicate the presence of gas phase formation in the body during hypobaric decompression. Automated analysis of Doppler gas bubble signals has been attempted for 2 decades but with generally unfavorable results, except with surgically implanted transducers. Recently, efforts have intensified with the introduction of low-cost computer programs. Current NASA work is directed towards the development of a computer-assisted method specifically targeted to EVA, and we are most interested in Spencer Grade 4. We note that Spencer Doppler Grades 1 to 3 have increased in the FFT sonogram and spectrogram in the amplitude domain, and the frequency domain is sometimes increased over that created by the normal blood flow envelope. The amplitude perturbations are of very short duration, in both systole and diastole and at random temporal positions. Grade 4 is characteristic in the amplitude domain but with modest increases in the FFT sonogram and spectral frequency power from 2K to 4K over all of the cardiac cycle. Heart valve motion appears to characteristic display signals: (1) the demodulated Doppler signal amplitude is considerably above the Doppler-shifted blow flow signal (even Grade 4); and (2) demodulated Doppler frequency shifts are considerably greater (often several kHz) than the upper edge of the blood flow envelope. Knowledge of these facts will aid in the construction of a real-time, computer-assisted discriminator to eliminate cardiac motion artifacts. There could also exist perturbations in the following: (1) modifications of the pattern of blood flow in accordance with Poiseuille's Law, (2) flow changes with a change in the Reynolds number, (3) an increase in the pulsatility index, and/or (4) diminished diastolic flow or 'runoff.' Doppler ultrasound devices have been constructed with a three-transducer array and a pulsed frequency generator.

Cost Considerations in Nonlinear Finite-Element Computing

NASA Technical Reports Server (NTRS)

Utku, S.; Melosh, R. J.; Islam, M.; Salama, M.

1985-01-01

Conference paper discusses computational requirements for finiteelement analysis using quasi-linear approach to nonlinear problems. Paper evaluates computational efficiency of different computer architecturtural types in terms of relative cost and computing time.

Assessing Tax Form Distribution Costs: A Proposed Method for Computing the Dollar Value of Tax Form Distribution in a Public Library.

ERIC Educational Resources Information Center

Casey, James B.

1998-01-01

Explains how a public library can compute the actual cost of distributing tax forms to the public by listing all direct and indirect costs and demonstrating the formulae and necessary computations. Supplies directions for calculating costs involved for all levels of staff as well as associated public relations efforts, space, and utility costs.…

Informing Investment to Reduce Inequalities: A Modelling Approach.

PubMed

McAuley, Andrew; Denny, Cheryl; Taulbut, Martin; Mitchell, Rory; Fischbacher, Colin; Graham, Barbara; Grant, Ian; O'Hagan, Paul; McAllister, David; McCartney, Gerry

2016-01-01

Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. To provide estimates of the impact of a range of interventions on health and health inequalities. Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a 'living wage'; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Introduction of a 'living wage' generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities.

Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

PubMed

Hembree, William E

2015-01-01

Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes.

PubMed

Wang, Y Claire; Coxson, Pamela; Shen, Yu-Ming; Goldman, Lee; Bibbins-Domingo, Kirsten

2012-01-01

Sugar-sweetened beverages are a major contributor to the US obesity and diabetes epidemics. Using the Coronary Heart Disease Policy Model, we examined the potential impact on health and health spending of a nationwide penny-per-ounce excise tax on these beverages. We found that the tax would reduce consumption of these beverages by 15 percent among adults ages 25-64. Over the period 2010-20, the tax was estimated to prevent 2.4 million diabetes person-years, 95,000 coronary heart events, 8,000 strokes, and 26,000 premature deaths, while avoiding more than $17 billion in medical costs. In addition to generating approximately $13 billion in annual tax revenue, a modest tax on sugar-sweetened beverages could reduce the adverse health and cost burdens of obesity, diabetes, and cardiovascular diseases.

Thrombin products: economic impact of immune-mediated coagulopathies and practical formulary considerations.

PubMed

Voils, Stacy A

2009-07-01

Thrombin has demonstrated utility in aiding surgical hemostasis since its introduction more than 60 years ago. It is used across a wide variety of surgical procedures by virtually every specialty. Only recently have new equally effective and safe products entered the market, causing decision makers to evaluate formulary selection among products with otherwise modest differences. This evaluation includes identifying costs beyond those of acquisition and storage, as well as indirect factors such as monitoring or specialized distribution requirements. One factor to consider specifically in selection of topical thrombin products is the potential for patients to develop an immune-mediated coagulopathy (IMC) after exposure to bovine-derived thrombin. Costs due to adverse drug events fall into the category of indirect costs and, in some instances, can be substantial if bleeding due to IMC occurs.

DIGESTING THE DOUGHNUT HOLE

PubMed Central

Zissimopoulos, Julie; Goldman, Dana P.

2013-01-01

Despite its success, Medicare Part D has been widely criticized for the gap in coverage, the so-called “doughnut hole”. We compare the use of prescription drugs among beneficiaries subject to the coverage gap with usage among beneficiaries who are not exposed to it. We find that the coverage gap does, indeed, disrupt the use of prescription drugs among seniors with diabetes. But the declines in usage are modest and concentrated among higher cost, brand-name medications. Demand for high cost medications such as antipsychotics, antiasthmatics, and drugs of the central nervous system decline by 8% to 12% in the coverage gap, while use of lower cost medications with high generic penetration such as beta blockers, ACE inhibitors and antidepressants decline by 3% to 4% after reaching the gap. More importantly, lower adherence to medications is not associated with increases in medical service use. PMID:24308883

Physicians' fears of malpractice lawsuits are not assuaged by tort reforms.

PubMed

Carrier, Emily R; Reschovsky, James D; Mello, Michelle M; Mayrell, Ralph C; Katz, David

2010-09-01

Physicians contend that the threat of malpractice lawsuits forces them to practice defensive medicine, which in turn raises the cost of health care. This argument underlies efforts to change malpractice laws through legislative tort reform. We evaluated physicians' perceptions about malpractice claims in states where more objective indicators of malpractice risk, such as malpractice premiums, varied considerably. We found high levels of malpractice concern among both generalists and specialists in states where objective measures of malpractice risk were low. We also found relatively modest differences in physicians' concerns across states with and without common tort reforms. These results suggest that many policies aimed at controlling malpractice costs may have a limited effect on physicians' malpractice concerns.

Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.

PubMed

Huckfeldt, Peter J; Sood, Neeraj; Escarce, José J; Grabowski, David C; Newhouse, Joseph P

2014-03-01

Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The home health interim payment system in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The home health prospective payment system in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality. Copyright © 2014 Elsevier B.V. All rights reserved.

Effects of Medicare Payment Reform: Evidence from the Home Health Interim and Prospective Payment Systems

PubMed Central

Huckfeldt, Peter J; Sood, Neeraj; Escarce, José J; Grabowski, David C; Newhouse, Joseph P

2014-01-01

Medicare continues to implement payment reforms that shift reimbursement from fee-for-service towards episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The Home Health Interim Payment System in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The Home Health Prospective Payment System in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality. PMID:24395018

Software Solution Saves Dollars

ERIC Educational Resources Information Center

Trotter, Andrew

2004-01-01

This article discusses computer software that can give classrooms and computer labs the capabilities of costly PC's at a small fraction of the cost. A growing number of cost-conscious school districts are finding budget relief in low-cost computer software known as "open source" that can do everything from manage school Web sites to equip…

A cost-utility analysis of the use of preoperative computed tomographic angiography in abdomen-based perforator flap breast reconstruction.

PubMed

Offodile, Anaeze C; Chatterjee, Abhishek; Vallejo, Sergio; Fisher, Carla S; Tchou, Julia C; Guo, Lifei

2015-04-01

Computed tomographic angiography is a diagnostic tool increasingly used for preoperative vascular mapping in abdomen-based perforator flap breast reconstruction. This study compared the use of computed tomographic angiography and the conventional practice of Doppler ultrasonography only in postmastectomy reconstruction using a cost-utility model. Following a comprehensive literature review, a decision analytic model was created using the three most clinically relevant health outcomes in free autologous breast reconstruction with computed tomographic angiography versus Doppler ultrasonography only. Cost and utility estimates for each health outcome were used to derive the quality-adjusted life-years and incremental cost-utility ratio. One-way sensitivity analysis was performed to scrutinize the robustness of the authors' results. Six studies and 782 patients were identified. Cost-utility analysis revealed a baseline cost savings of $3179, a gain in quality-adjusted life-years of 0.25. This yielded an incremental cost-utility ratio of -$12,716, implying a dominant choice favoring preoperative computed tomographic angiography. Sensitivity analysis revealed that computed tomographic angiography was costlier when the operative time difference between the two techniques was less than 21.3 minutes. However, the clinical advantage of computed tomographic angiography over Doppler ultrasonography only showed that computed tomographic angiography would still remain the cost-effective option even if it offered no additional operating time advantage. The authors' results show that computed tomographic angiography is a cost-effective technology for identifying lower abdominal perforators for autologous breast reconstruction. Although the perfect study would be a randomized controlled trial of the two approaches with true cost accrual, the authors' results represent the best available evidence.

Systematic review on the cost-effectiveness of self-management education programme for type 2 diabetes mellitus.

PubMed

Lian, J X; McGhee, S M; Chau, J; Wong, Carlos K H; Lam, Cindy L K; Wong, William C W

2017-05-01

A review of cost-effectiveness studies on self-management education programmes for Type 2 diabetes mellitus. Cochrane, PubMed and PsycINFO databases were searched for papers published from January 2003 through September 2015. Further hand searching using the reference lists of included papers was carried out. In total, 777 papers were identified and 12 papers were finally included. We found eight programmes whose effectiveness analyses were based on randomised controlled trials and whose costs were comprehensively estimated from the stated perspective. Among these eight, four studies showed a cost per unit reduction in clinical risk factors (HbA1c or BMI) of US$491 to US$7723 or cost per glycaemic symptom day avoided of US$39. In three studies the cost per QALY gained, as estimated from a life-time model, was less than US$50,000. However, one study found the programme was not cost-effective despite a gain in QALYs at the one-year follow up. A small number of cost-effectiveness studies were identified with only eight of sufficiently good quality. The cost of a self-management education programme achieving reduction in clinical risk factors seems to be modest and is likely to be cost-effective in the long-term. Copyright © 2017 Elsevier B.V. All rights reserved.

Changes in inequality and unemployment over the 1980s: comparative cross-national responses.

PubMed

Blank, R M

1995-01-01

The steep recession in the early 1980s was followed by a recovery in nations of the Organization for Economic Cooperation and Development (OECD), but in western European countries unemployment rates remained high. On the other hand, the United States economy after 1983 revived and unemployment dropped rapidly. However, a new problem arose in the late 1980s: rising inequality in the wage rates of more and less skilled workers. The widening wage inequality in the US is proven by the fact that among male high school dropouts real wages fell by 13% between 1979-1989, while among male college graduates real wages rose by 11%. The wage inequality was modest in the Netherlands, no noticeable change occurred in France, Germany, and Italy; there was a modest rise in Canada, Japan, and Sweden; and a large rise in the United Kingdom and US in the 1980s. One hypothesis suggests the growing international competition faced by US firms; another credits the changing demand for more skilled workers driven by the technological shift in computer-intensive industries. The consequences of this wage inequality in the US has been increasing poverty: from 15.6% of households in 1979 to 18.1% in 1986, especially in younger households. In contrast, the respective percentages for Germany were 5.5 in 1979 and 6.8 in 1986. It is likely that both in the US and Europe this rising inequality is caused by international shifts in trade, employment, and technology. Policy responses are utilized by OECD countries: 1) income transfer programs, unemployment benefits, and welfare payments, which have become means-tested because of tight public budgets; 2) public sector job creation programs, with the disadvantage of high cost; 3) job placement and training programs, which are also expensive to operate; 4) wage subsidies, as tried in 1993 in the US by expanding the Earned Income Tax Credit; and 5) hiring subsidies, which encourage the private sector to increase employment.

Computer-assisted Behavioral Therapy and Contingency Management for Cannabis Use Disorder

PubMed Central

Budney, Alan J.; Stanger, Catherine; Tilford, J. Mick; Scherer, Emily; Brown, Pamela C.; Li, Zhongze; Li, Zhigang; Walker, Denise

2015-01-01

Computer-assisted behavioral treatments hold promise for enhancing access to and reducing costs of treatments for substance use disorders. This study assessed the efficacy of a computer-assisted version of an efficacious, multicomponent treatment for cannabis use disorders (CUD), i.e., motivational enhancement therapy, cognitive-behavioral therapy, and abstinence-based contingency-management (MET/CBT/CM). An initial cost comparison was also performed. Seventy-five adult participants, 59% African Americans, seeking treatment for CUD received either, MET only (BRIEF), therapist-delivered MET/CBT/CM (THERAPIST), or computer-delivered MET/CBT/CM (COMPUTER). During treatment, the THERAPIST and COMPUTER conditions engendered longer durations of continuous cannabis abstinence than BRIEF (p < .05), but did not differ from each other. Abstinence rates and reduction in days of use over time were maintained in COMPUTER at least as well as in THERAPIST. COMPUTER averaged approximately $130 (p < .05) less per case than THERAPIST in therapist costs, which offset most of the costs of CM. Results add to promising findings that illustrate potential for computer-assisted delivery methods to enhance access to evidence-based care, reduce costs, and possibly improve outcomes. The observed maintenance effects and the cost findings require replication in larger clinical trials. PMID:25938629

Spacelab experiment computer study. Volume 1: Executive summary (presentation)

NASA Technical Reports Server (NTRS)

Lewis, J. L.; Hodges, B. C.; Christy, J. O.

1976-01-01

A quantitative cost for various Spacelab flight hardware configurations is provided along with varied software development options. A cost analysis of Spacelab computer hardware and software is presented. The cost study is discussed based on utilization of a central experiment computer with optional auxillary equipment. Groundrules and assumptions used in deriving the costing methods for all options in the Spacelab experiment study are presented. The groundrules and assumptions, are analysed and the options along with their cost considerations, are discussed. It is concluded that Spacelab program cost for software development and maintenance is independent of experimental hardware and software options, that distributed standard computer concept simplifies software integration without a significant increase in cost, and that decisions on flight computer hardware configurations should not be made until payload selection for a given mission and a detailed analysis of the mission requirements are completed.

Faithful qubit transmission in a quantum communication network with heterogeneous channels

NASA Astrophysics Data System (ADS)

Chen, Na; Zhang, Lin Xi; Pei, Chang Xing

2018-04-01

Quantum communication networks enable long-distance qubit transmission and distributed quantum computation. In this paper, a quantum communication network with heterogeneous quantum channels is constructed. A faithful qubit transmission scheme is presented. Detailed calculations and performance analyses show that even in a low-quality quantum channel with serious decoherence, only modest number of locally prepared target qubits are required to achieve near-deterministic qubit transmission.

Time-optimal aircraft pursuit-evasion with a weapon envelope constraint

NASA Technical Reports Server (NTRS)

Menon, P. K. A.; Duke, E. L.

1990-01-01

The optimal pursuit-evasion problem between two aircraft, including nonlinear point-mass vehicle models and a realistic weapon envelope, is analyzed. Using a linear combination of flight time and the square of the vehicle acceleration as the performance index, a closed-form solution is obtained in nonlinear feedback form. Due to its modest computational requirements, this guidance law can be used for onboard real-time implementation.

TORC3: Token-ring clearing heuristic for currency circulation

NASA Astrophysics Data System (ADS)

Humes, Carlos, Jr.; Lauretto, Marcelo S.; Nakano, Fábio; Pereira, Carlos A. B.; Rafare, Guilherme F. G.; Stern, Julio Michael

2012-10-01

Clearing algorithms are at the core of modern payment systems, facilitating the settling of multilateral credit messages with (near) minimum transfers of currency. Traditional clearing procedures use batch processing based on MILP - mixed-integer linear programming algorithms. The MILP approach demands intensive computational resources; moreover, it is also vulnerable to operational risks generated by possible defaults during the inter-batch period. This paper presents TORC3 - the Token-Ring Clearing Algorithm for Currency Circulation. In contrast to the MILP approach, TORC3 is a real time heuristic procedure, demanding modest computational resources, and able to completely shield the clearing operation against the participating agents' risk of default.

An economic analysis of trial of labor after cesarean delivery.

PubMed

Friedman, Alexander M; Ananth, Cande V; Chen, Ling; D'Alton, Mary E; Wright, Jason D

2016-01-01

Given that cesarean delivery is one of the most commonly performed surgical procedures in the United States and an important contributor to obstetric care costs, this analysis sought to examine maternal hospital costs associated with trial of labor after cesarean delivery (TOLAC) versus repeat cesarean delivery (RCD). A national sample was used to identify women with singleton pregnancy who underwent either TOLAC or RCD from 2006 to 2012. Women with diagnoses that could confound cost via extended hospital length of stay prior to delivery were excluded. Other medical and obstetric covariates that could influence cost were included in an adjusted model. A total of 485,247 women were identified, including 365,596 (75.3%) cesarean deliveries without labor, 41,988 (8.6%) successful and 77,663 (16.0%) unsuccessful TOLAC deliveries. The inflation-adjusted median costs in this cohort were $5512 for cesarean without labor, $4175 for successful TOLAC, $5166 for all TOLAC attempts, and $5759 for failed TOLAC. In a multivariable model, hospital region was a major predictor of median cost as were demographic variables and medical comorbidities. TOLAC is associated with modest reductions of cost for maternal hospitalizations. However, other medical, demographic and hospital factors appear to be more important factors.

Improving quality of life in multiple sclerosis: an unmet need.

PubMed

Zwibel, Howard L; Smrtka, Jennifer

2011-05-01

Multiple sclerosis (MS) affects approximately 400,000 people in the United States and 2.1 million people worldwide. It is the most common chronic, non-traumatic neurological disorder afflicting young people during their peak productive ages. MS can diminish quality of life (QOL) by interfering with the ability to work, pursue leisure activities, and carry on usual life roles. Symptoms that affect QOL may include impaired mobility, fatigue, depression, pain, spasticity, cognitive impairment, sexual dysfunction, bowel and bladder dysfunction, vision and hearing problems, seizures, and sDwallowing and breathing difficulties. Direct medical costs of MS in the United States are estimated in excess of $10 billion per year. Indirect costs of MS include costs of reduced employment or unemployment, assistive equipment, disability related home modifications, and paid and unpaid personal care. Although direct medical costs predominate in the earlier stages of MS, indirect costs of productivity loss are responsible for higher costs later. Disease-modifying therapies (DMTs) lessen symptoms, reduce relapses, and delay disability progression. Unfortunately, many DMTs might produce only modest improvements in QOL. Although symptom-specific therapies do not delay disease progression, they may delay unemployment and dependency, thereby reducing indirect costs.

24 CFR 908.108 - Cost.

Code of Federal Regulations, 2010 CFR

2010-04-01

... computer hardware or software, or both, the cost of contracting for those services, or the cost of... operating budget. At the HA's option, the cost of the computer software may include service contracts to...

Comparing child protective investigation performance between law enforcement agencies and child welfare agencies.

PubMed

Jordan, Neil; Yampolskaya, Svetlana; Gustafson, Mara; Armstrong, Mary; McNeish, Roxann; Vargo, Amy

2011-01-01

This study examines the comparative effectiveness of using law enforcement agencies for child protective investigation (CPI), in contrast with the traditional approach of CPI conducted by the public child welfare agency. The analysis uses 2006-2007 data from a natural experiment conducted in Florida to show modest differences in performance and cost-efficiency between the two approaches to CPI. These findings may have implications for other states considering outsourcing CPI to law enforcement.

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.

Systematic review of integrated models of health care delivered at the primary-secondary interface: how effective is it and what determines effectiveness?

PubMed

Mitchell, Geoffrey K; Burridge, Letitia; Zhang, Jianzhen; Donald, Maria; Scott, Ian A; Dart, Jared; Jackson, Claire L

2015-01-01

Integrated multidisciplinary care is difficult to achieve between specialist clinical services and primary care practitioners, but should improve outcomes for patients with chronic and/or complex chronic physical diseases. This systematic review identifies outcomes of different models that integrate specialist and primary care practitioners, and characteristics of models that delivered favourable clinical outcomes. For quality appraisal, the Cochrane Risk of Bias tool was used. Data are presented as a narrative synthesis due to marked heterogeneity in study outcomes. Ten studies were included. Publication bias cannot be ruled out. Despite few improvements in clinical outcomes, significant improvements were reported in process outcomes regarding disease control and service delivery. No study reported negative effects compared with usual care. Economic outcomes showed modest increases in costs of integrated primary-secondary care. Six elements were identified that were common to these models of integrated primary-secondary care: (1) interdisciplinary teamwork; (2) communication/information exchange; (3) shared care guidelines or pathways; (4) training and education; (5) access and acceptability for patients; and (6) a viable funding model. Compared with usual care, integrated primary-secondary care can improve elements of disease control and service delivery at a modestly increased cost, although the impact on clinical outcomes is limited. Future trials of integrated care should incorporate design elements likely to maximise effectiveness.

Benefits of modest weight loss on the management of type 2 diabetes mellitus.

PubMed

Lau, David C W; Teoh, Hwee

2013-04-01

The epidemic of overweight and obesity is a major driver of the growing prevalence of type 2 diabetes mellitus globally. The risk of type 2 diabetes increases exponentially as body mass index rises above 25 kg/m(2). Obesity currently costs the Canadian economy approximately $7.1 billion annually whereas per capita health care cost for individuals with diabetes are 3 to 4 times that for persons without the disease. Each kilogram of weight lost through health behaviour changes in people with impaired glucose tolerance is associated with a relative diabetes risk reduction of 16%. As 80% to 90% of people with type 2 diabetes are overweight or obese, and adiposity worsens the metabolic and physiologic abnormalities associated with type 2 diabetes, weight loss is recommended as the cornerstone management measure. A modest weight loss of 5% to 10% is an achievable and realistic goal for preventing type 2 diabetes in susceptible individuals and improving glycemic and metabolic control in people with type 2 diabetes. When health behaviour modification fails to achieve glycemic and metabolic goal targets, priority should be given to antihyperglycemic agents that are associated with weight loss or weight neutrality. Every pound of body fat loss matters and every kilogram counts in the management of type 2 diabetes. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Results of the Medicare Health Support disease-management pilot program.

PubMed

McCall, Nancy; Cromwell, Jerry

2011-11-03

In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

FFTs in external or hierarchical memory

NASA Technical Reports Server (NTRS)

Bailey, David H.

1989-01-01

A description is given of advanced techniques for computing an ordered FFT on a computer with external or hierarchical memory. These algorithms (1) require as few as two passes through the external data set, (2) use strictly unit stride, long vector transfers between main memory and external storage, (3) require only a modest amount of scratch space in main memory, and (4) are well suited for vector and parallel computation. Performance figures are included for implementations of some of these algorithms on Cray supercomputers. Of interest is the fact that a main memory version outperforms the current Cray library FFT routines on the Cray-2, the Cray X-MP, and the Cray Y-MP systems. Using all eight processors on the Cray Y-MP, this main memory routine runs at nearly 2 Gflops.

Scaling up a CMS tier-3 site with campus resources and a 100 Gb/s network connection: what could go wrong?

NASA Astrophysics Data System (ADS)

Wolf, Matthias; Woodard, Anna; Li, Wenzhao; Hurtado Anampa, Kenyi; Tovar, Benjamin; Brenner, Paul; Lannon, Kevin; Hildreth, Mike; Thain, Douglas

2017-10-01

The University of Notre Dame (ND) CMS group operates a modest-sized Tier-3 site suitable for local, final-stage analysis of CMS data. However, through the ND Center for Research Computing (CRC), Notre Dame researchers have opportunistic access to roughly 25k CPU cores of computing and a 100 Gb/s WAN network link. To understand the limits of what might be possible in this scenario, we undertook to use these resources for a wide range of CMS computing tasks from user analysis through large-scale Monte Carlo production (including both detector simulation and data reconstruction.) We will discuss the challenges inherent in effectively utilizing CRC resources for these tasks and the solutions deployed to overcome them.

Megatux

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

2012-09-25

The Megatux platform enables the emulation of large scale (multi-million node) distributed systems. In particular, it allows for the emulation of large-scale networks interconnecting a very large number of emulated computer systems. It does this by leveraging virtualization and associated technologies to allow hundreds of virtual computers to be hosted on a single moderately sized server or workstation. Virtualization technology provided by modern processors allows for multiple guest OSs to run at the same time, sharing the hardware resources. The Megatux platform can be deployed on a single PC, a small cluster of a few boxes or a large clustermore » of computers. With a modest cluster, the Megatux platform can emulate complex organizational networks. By using virtualization, we emulate the hardware, but run actual software enabling large scale without sacrificing fidelity.« less

Numerical Simulation of Rolling-Airframes Using a Multi-Level Cartesian Method

NASA Technical Reports Server (NTRS)

Murman, Scott M.; Aftosmis, Michael J.; Berger, Marsha J.; Kwak, Dochan (Technical Monitor)

2002-01-01

A supersonic rolling missile with two synchronous canard control surfaces is analyzed using an automated, inviscid, Cartesian method. Sequential-static and time-dependent dynamic simulations of the complete motion are computed for canard dither schedules for level flight, pitch, and yaw maneuver. The dynamic simulations are compared directly against both high-resolution viscous simulations and relevant experimental data, and are also utilized to compute dynamic stability derivatives. The results show that both the body roll rate and canard dither motion influence the roll-averaged forces and moments on the body. At the relatively, low roll rates analyzed in the current work these dynamic effects are modest, however the dynamic computations are effective in predicting the dynamic stability derivatives which can be significant for highly-maneuverable missiles.

MODEST - JPL GEODETIC AND ASTROMETRIC VLBI MODELING AND PARAMETER ESTIMATION PROGRAM

NASA Technical Reports Server (NTRS)

Sovers, O. J.

1994-01-01

Observations of extragalactic radio sources in the gigahertz region of the radio frequency spectrum by two or more antennas, separated by a baseline as long as the diameter of the Earth, can be reduced, by radio interferometry techniques, to yield time delays and their rates of change. The Very Long Baseline Interferometric (VLBI) observables can be processed by the MODEST software to yield geodetic and astrometric parameters of interest in areas such as geophysical satellite and spacecraft tracking applications and geodynamics. As the accuracy of radio interferometry has improved, increasingly complete models of the delay and delay rate observables have been developed. MODEST is a delay model (MOD) and parameter estimation (EST) program that takes into account delay effects such as geometry, clock, troposphere, and the ionosphere. MODEST includes all known effects at the centimeter level in modeling. As the field evolves and new effects are discovered, these can be included in the model. In general, the model includes contributions to the observables from Earth orientation, antenna motion, clock behavior, atmospheric effects, and radio source structure. Within each of these categories, a number of unknown parameters may be estimated from the observations. Since all parts of the time delay model contain nearly linear parameter terms, a square-root-information filter (SRIF) linear least-squares algorithm is employed in parameter estimation. Flexibility (via dynamic memory allocation) in the MODEST code ensures that the same executable can process a wide array of problems. These range from a few hundred observations on a single baseline, yielding estimates of tens of parameters, to global solutions estimating tens of thousands of parameters from hundreds of thousands of observations at antennas widely distributed over the Earth's surface. Depending on memory and disk storage availability, large problems may be subdivided into more tractable pieces that are processed sequentially. MODEST is written in FORTRAN 77, C-language, and VAX ASSEMBLER for DEC VAX series computers running VMS. It requires 6Mb of RAM for execution. The standard distribution medium for this package is a 1600 BPI 9-track magnetic tape in DEC VAX BACKUP format. It is also available on a TK50 tape cartridge in DEC VAX BACKUP format. Instructions for use and sample input and output data are available on the distribution media. This program was released in 1993 and is a copyrighted work with all copyright vested in NASA.

An evaluation of superminicomputers for thermal analysis

NASA Technical Reports Server (NTRS)

Storaasli, O. O.; Vidal, J. B.; Jones, G. K.

1962-01-01

The feasibility and cost effectiveness of solving thermal analysis problems on superminicomputers is demonstrated. Conventional thermal analysis and the changing computer environment, computer hardware and software used, six thermal analysis test problems, performance of superminicomputers (CPU time, accuracy, turnaround, and cost) and comparison with large computers are considered. Although the CPU times for superminicomputers were 15 to 30 times greater than the fastest mainframe computer, the minimum cost to obtain the solutions on superminicomputers was from 11 percent to 59 percent of the cost of mainframe solutions. The turnaround (elapsed) time is highly dependent on the computer load, but for large problems, superminicomputers produced results in less elapsed time than a typically loaded mainframe computer.

The effect of recombinant activated factor VII in the treatment of intracerebral hemorrhage on health plan budgets.

PubMed

Earnshaw, Stephanie R; Wilson, Michele R; Joshi, Ashish V

2006-11-01

Treating patients with intracerebral hemorrhage (ICH) using recombinant activated factor VII (rFVIla) has been found to improve survival and functional outcome. To examine how the introduction of rFVIla 80 microg/kg as a treatment for ICH affects the budget of a health plan, a decision-analysis model was developed which considered both short-term hospitalization costs and long-term management of disability. Assuming a health plan enrollment of 1 million members and initial rFVIla uptake of 50% in appropriate patients, the annual health plan cost may be expected to increase by dollar 64,781 (dollar 0.005 per-member per-month). With a 5% increase in uptake each year, the annual health plan's cost may decrease compared with the current budget within three years. The implications for this sample health plan's budget are modest in the first year, and a reduction in costs is expected within three years owing to improved functional outcomes of patients.

The Value of Medical and Pharmaceutical Interventions for Reducing Obesity

PubMed Central

Michaud, Pierre-Carl; Goldman, Dana; Lakdawalla, Darius; Zheng, Yuhui; Gailey, Adam H.

2012-01-01

This paper attempts to quantify the social, private, and public-finance values of reducing obesity through pharmaceutical and medical interventions. We find that the total social value of bariatric surgery is large for treated patients, with incremental social cost-effectiveness ratios typically under $10,000 per life-year saved. On the other hand, pharmaceutical interventions against obesity yield much less social value with incremental social cost-effectiveness ratios around $50,000. Our approach accounts for: competing risks to life expectancy; health care costs; and a variety of non-medical economic consequences (pensions, disability insurance, taxes, and earnings), which account for 20% of the total social cost of these treatments. On balance, bariatric surgery generates substantial private value for those treated, in the form of health and other economic consequences. The net public fiscal effects are modest, primarily because the size of the population eligible for treatment is small while the net social effect is large once improvements in life expectancy are taken into account. PMID:22705389

The value of medical and pharmaceutical interventions for reducing obesity.

PubMed

Michaud, Pierre-Carl; Goldman, Dana P; Lakdawalla, Darius N; Zheng, Yuhui; Gailey, Adam H

2012-07-01

This paper attempts to quantify the social, private, and public-finance values of reducing obesity through pharmaceutical and medical interventions. We find that the total social value of bariatric surgery is large for treated patients, with incremental social cost-effectiveness ratios typically under $10,000 per life-year saved. On the other hand, pharmaceutical interventions against obesity yield much less social value with incremental social cost-effectiveness ratios around $50,000. Our approach accounts for: competing risks to life expectancy; health care costs; and a variety of non-medical economic consequences (pensions, disability insurance, taxes, and earnings), which account for 20% of the total social cost of these treatments. On balance, bariatric surgery generates substantial private value for those treated, in the form of health and other economic consequences. The net public fiscal effects are modest, primarily because the size of the population eligible for treatment is small. The net social effect is large once improvements in life expectancy are taken into account. Copyright © 2012 Elsevier B.V. All rights reserved.

Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

PubMed

Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

2015-01-01

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

Exo-S: A Probe-scale Space Mission to Directly Image and Spectroscopically Characterize Exoplanetary Systems Using a Starshade and Telescope System

NASA Astrophysics Data System (ADS)

Seager, Sara; Cash, Webster C.; Kasdin, N. Jeremy; Sparks, William B.; Turnbull, Margaret C.; Kuchner, Marc J.; Roberge, Aki; Domagal-Goldman, Shawn; Shaklan, Stuart; Thomson, Mark; Lisman, Doug; Martin, Suzanne; Cady, Eric; Webb, David

2014-06-01

"Exo-S" is NASA's first directed community study of a starshade and telescope system for space-based discovery and characterization of exoplanets by direct imaging. Under a cost cap of $1B, Exo-S will use a modestly sized starshade (also known as an "external occulter") and a modest aperture space telescope for high contrast observations of exoplanetary systems. The Exo-S will obtain spectra of a subset of its newly discovered exoplanets as well as already known Jupiter-mass exoplanets. Exo-S will be capable of reaching down to the discovery of Earth-size planets in the habitable zones of twenty sun-like stars, with a favorable few accessible for spectral characterization. We present highlights of the science goals, the mission design, and technology milestones already reached. At the study conclusion in 2015, NASA will evaluate the Exo-S concept for potential development at the end of this decade.

SU-D-206-02: Evaluation of Partial Storage of the System Matrix for Cone Beam Computed Tomography Using a GPU Platform

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

Matenine, D; Cote, G; Mascolo-Fortin, J

2016-06-15

Purpose: Iterative reconstruction algorithms in computed tomography (CT) require a fast method for computing the intersections between the photons’ trajectories and the object, also called ray-tracing or system matrix computation. This work evaluates different ways to store the system matrix, aiming to reconstruct dense image grids in reasonable time. Methods: We propose an optimized implementation of the Siddon’s algorithm using graphics processing units (GPUs) with a novel data storage scheme. The algorithm computes a part of the system matrix on demand, typically, for one projection angle. The proposed method was enhanced with accelerating options: storage of larger subsets of themore » system matrix, systematic reuse of data via geometric symmetries, an arithmetic-rich parallel code and code configuration via machine learning. It was tested on geometries mimicking a cone beam CT acquisition of a human head. To realistically assess the execution time, the ray-tracing routines were integrated into a regularized Poisson-based reconstruction algorithm. The proposed scheme was also compared to a different approach, where the system matrix is fully pre-computed and loaded at reconstruction time. Results: Fast ray-tracing of realistic acquisition geometries, which often lack spatial symmetry properties, was enabled via the proposed method. Ray-tracing interleaved with projection and backprojection operations required significant additional time. In most cases, ray-tracing was shown to use about 66 % of the total reconstruction time. In absolute terms, tracing times varied from 3.6 s to 7.5 min, depending on the problem size. The presence of geometrical symmetries allowed for non-negligible ray-tracing and reconstruction time reduction. Arithmetic-rich parallel code and machine learning permitted a modest reconstruction time reduction, in the order of 1 %. Conclusion: Partial system matrix storage permitted the reconstruction of higher 3D image grid sizes and larger projection datasets at the cost of additional time, when compared to the fully pre-computed approach. This work was supported in part by the Fonds de recherche du Quebec - Nature et technologies (FRQ-NT). The authors acknowledge partial support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council of Canada (Grant No. 432290).« less

Manual of phosphoric acid fuel cell power plant cost model and computer program

NASA Technical Reports Server (NTRS)

Lu, C. Y.; Alkasab, K. A.

1984-01-01

Cost analysis of phosphoric acid fuel cell power plant includes two parts: a method for estimation of system capital costs, and an economic analysis which determines the levelized annual cost of operating the system used in the capital cost estimation. A FORTRAN computer has been developed for this cost analysis.

Computer use, sleep duration and health symptoms: a cross-sectional study of 15-year olds in three countries.

PubMed

Nuutinen, Teija; Roos, Eva; Ray, Carola; Villberg, Jari; Välimaa, Raili; Rasmussen, Mette; Holstein, Bjørn; Godeau, Emmanuelle; Beck, Francois; Léger, Damien; Tynjälä, Jorma

2014-08-01

This study investigated whether computer use is associated with health symptoms through sleep duration among 15-year olds in Finland, France and Denmark. We used data from the WHO cross-national Health Behaviour in School-aged Children study collected in Finland, France and Denmark in 2010, including data on 5,402 adolescents (mean age 15.61 (SD 0.37), girls 53%). Symptoms assessed included feeling low, irritability/bad temper, nervousness, headache, stomachache, backache, and feeling dizzy. We used structural equation modeling to explore the mediating effect of sleep duration on the association between computer use and symptom load. Adolescents slept approximately 8 h a night and computer use was approximately 2 h a day. Computer use was associated with shorter sleep duration and higher symptom load. Sleep duration partly mediated the association between computer use and symptom load, but the indirect effects of sleep duration were quite modest in all countries. Sleep duration may be a potential underlying mechanism behind the association between computer use and health symptoms.

Assessing administrative costs of mental health and substance abuse services.

PubMed

Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

2004-05-01

Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

Impact of monetary incentives on adherence to referral for screening chest x-rays after syringe exchange-based tuberculin skin testing.

PubMed

Perlman, David C; Friedmann, Patricia; Horn, Leslie; Nugent, Anne; Schoeb, Veronika; Carey, Jeanne; Salomon, Nadim; Des Jarlais, Don C

2003-09-01

Syringe-exchange programs (SEPs) have proven to be valuable sites to conduct tuberculin skin testing among active injection drug users. Chest x-rays (CXRs) are needed to exclude active tuberculosis prior to initiating treatment for latent tuberculosis infection. Adherence of drug users to referral for off-site chest x-rays has been incomplete. Previous cost modeling demonstrated that a monetary incentive to promote adherence could be justified on the cost basis if it had even a modest effect on adherence. We compared adherence to referral for chest x-rays among injection drug users undergoing syringe exchange-based tuberculosis screening in New York City before and after the implementation of monetary incentives. From 1995 to 1998, there were 119 IDUs referred for CXRs based on tuberculin skin testing at the SEP. From 1999 to 2001, there were 58 IDUs referred for CXRs with a $25 incentive based on adherence. Adherence to CXR referral within 7 days was 46/58 (79%) among individuals who received the monetary incentive versus 17/119 (14%) prior to the implementation of the monetary incentive (P<.0001; odds ratio [OR]=23; 95% confidence interval [CI]=9.5-57). The median time to obtaining a CXR was significantly shorter among those given the incentive than among those referred without the incentive (2 vs. 11 days, P<.0001). In multivariate logistic regression analysis, use of the incentive was highly independently associated with increased adherence (OR=22.9; 95% CI=10-52). Monetary incentives are highly effective in increasing adherence to referral for screening CXRs to exclude active tuberculosis after syringe exchange-based tuberculin skin testing. Prior cost modeling demonstrated that monetary incentives could be justified on the cost basis if they had even a modest effect on adherence. The current data demonstrated that monetary incentives are highly effective at increasing adherence in this setting and therefore are justifiable on a cost basis. When health care interventions for drug users require referral off site, monetary incentives may be particularly valuable in promoting adherence.

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.

Digesting the doughnut hole.

PubMed

Joyce, Geoffrey F; Zissimopoulos, Julie; Goldman, Dana P

2013-12-01

Despite its success, Medicare Part D has been widely criticized for the gap in coverage, the so-called "doughnut hole". We compare the use of prescription drugs among beneficiaries subject to the coverage gap with usage among beneficiaries who are not exposed to it. We find that the coverage gap does, indeed, disrupt the use of prescription drugs among seniors with diabetes. But the declines in usage are modest and concentrated among higher cost, brand-name medications. Demand for high cost medications such as antipsychotics, antiasthmatics, and drugs of the central nervous system decline by 8-18% in the coverage gap, while use of lower cost medications with high generic penetration such as beta blockers, ACE inhibitors and antidepressants decline by 3-5% after reaching the gap. More importantly, lower adherence to medications is not associated with increases in medical service use. Copyright © 2013 Elsevier B.V. All rights reserved.

Experiences running NASTRAN on the Microvax 2 computer

NASA Technical Reports Server (NTRS)

Butler, Thomas G.; Mitchell, Reginald S.

1987-01-01

The MicroVAX operates NASTRAN so well that the only detectable difference in its operation compared to an 11/780 VAX is in the execution time. On the modest installation described here, the engineer has all of the tools he needs to do an excellent job of analysis. System configuration decisions, system sizing, preparation of the system disk, definition of user quotas, installation, monitoring of system errors, and operation policies are discussed.

Applications of computational modeling in ballistics

NASA Technical Reports Server (NTRS)

Sturek, Walter B.

1987-01-01

The development of the technology of ballistics as applied to gun launched Army weapon systems is the main objective of research at the U.S. Army Ballistic Research Laboratory (BRL). The primary research programs at the BRL consist of three major ballistic disciplines: exterior, interior, and terminal. The work done at the BRL in these areas was traditionally highly dependent on experimental testing. A considerable emphasis was placed on the development of computational modeling to augment the experimental testing in the development cycle; however, the impact of the computational modeling to this date is modest. With the availability of supercomputer computational resources recently installed at the BRL, a new emphasis on the application of computational modeling to ballistics technology is taking place. The major application areas are outlined which are receiving considerable attention at the BRL at present and to indicate the modeling approaches involved. An attempt was made to give some information as to the degree of success achieved and indicate the areas of greatest need.

Do Clouds Compute? A Framework for Estimating the Value of Cloud Computing

NASA Astrophysics Data System (ADS)

Klems, Markus; Nimis, Jens; Tai, Stefan

On-demand provisioning of scalable and reliable compute services, along with a cost model that charges consumers based on actual service usage, has been an objective in distributed computing research and industry for a while. Cloud Computing promises to deliver on this objective: consumers are able to rent infrastructure in the Cloud as needed, deploy applications and store data, and access them via Web protocols on a pay-per-use basis. The acceptance of Cloud Computing, however, depends on the ability for Cloud Computing providers and consumers to implement a model for business value co-creation. Therefore, a systematic approach to measure costs and benefits of Cloud Computing is needed. In this paper, we discuss the need for valuation of Cloud Computing, identify key components, and structure these components in a framework. The framework assists decision makers in estimating Cloud Computing costs and to compare these costs to conventional IT solutions. We demonstrate by means of representative use cases how our framework can be applied to real world scenarios.

Scientific return of a lunar elevator

NASA Astrophysics Data System (ADS)

Eubanks, T. M.; Radley, C. F.

2016-11-01

The concept of a space elevator dates back to Tsilokovsky, but they are not commonly considered in near-term plans for space exploration, perhaps because a terrestrial elevator would not be possible without considerable improvements in tether material. A Lunar Space Elevator (LSE), however, can be built with current technology using commercially available tether polymers. This paper considers missions leading to infrastructure capable of shortening the time, lowering the cost and enhancing the capabilities of robotic and human explorers. These missions use planetary scale tethers, strings many thousands of kilometers long stabilized either by rotation or by gravitational gradients. These systems promise major reduction in transport costs versus chemical rockets, in a rapid timeframe, for a modest investment. Science will thus benefit as well as commercial activities.

Cost benefits of ergonomic intervention in a hospital: a preliminary study using Oxenburgh's productivity model.

PubMed

Busse, M; Bridger, B

1997-09-01

This case study of absenteeism amongst nurses was carried out using the productivity model of Oxenburgh (1991). Data on absenteeism amongst nurses were collected from one private hospital. Areas of high risk of injury were identified and the presence of ergonomic risk factors determined. The productivity model was used to calculate the costs of absenteeism in terms of actual rates of pay and loss of productivity. Potential benefits resulting from ergonomic improvements to the work environment were estimated using the productivity model. The model predicted that even modest reductions in injury would justify the additional expenditure in a relatively short period of time. Further investigations of injuries to nurses in both State and Private Sector Hospitals seem to be justified.

Performance Comparison of Mainframe, Workstations, Clusters, and Desktop Computers

NASA Technical Reports Server (NTRS)

Farley, Douglas L.

2005-01-01

A performance evaluation of a variety of computers frequently found in a scientific or engineering research environment was conducted using a synthetic and application program benchmarks. From a performance perspective, emerging commodity processors have superior performance relative to legacy mainframe computers. In many cases, the PC clusters exhibited comparable performance with traditional mainframe hardware when 8-12 processors were used. The main advantage of the PC clusters was related to their cost. Regardless of whether the clusters were built from new computers or whether they were created from retired computers their performance to cost ratio was superior to the legacy mainframe computers. Finally, the typical annual maintenance cost of legacy mainframe computers is several times the cost of new equipment such as multiprocessor PC workstations. The savings from eliminating the annual maintenance fee on legacy hardware can result in a yearly increase in total computational capability for an organization.

How To Improve Work In Planetarium?

NASA Astrophysics Data System (ADS)

Pavicic, G.

2009-09-01

Planetariums can provide an immersive environment for scientific education, virtual reality, and entertainment (Shaw 1998). Digital projection into domes, called "full dome projection", can be a technically challenging and expensive exercise, particularly for installation with a modest budget. Here we present an alternative full dome digital projection system, which consists of a single projector and a spherical mirror that scatter the light onto the dome surface. This approach offers many advantages over the fisheye lens alternatives, and results in a similar quality for just a fraction of costs.

Application of winglets and/or wing tip extensions with active load control on the Boeing 747

NASA Technical Reports Server (NTRS)

Allison, R. L.; Perkin, B. R.; Schoenman, R. L.

1978-01-01

The application of wing tip modifications and active control technology to the Boeing 747 airplane for the purpose of improving fuel efficiency is considered. Wing tip extensions, wing tip winglets, and the use of the outboard ailerons for active wing load alleviation are described. Modest performance improvements are indicated. A costs versus benefits approach is taken to decide which, if any, of the concepts warrant further development and flight test leading to possible incorporation into production airplanes.

Mars geoscience/climatology orbiter low cost mission operations

NASA Technical Reports Server (NTRS)

Erickson, K. D.

1984-01-01

It will not be possible to support the multiple planetary missions of the magnitude and order of previous missions on the basis of foreseeable NASA funding. It is, therefore, necessary to seek innovative means for accomplishing the goals of planetary exploration with modestly allocated resources. In this connection, a Core Program set of planetary exploration missions has been recommended. Attention is given to a Mission Operations design overview which is based on the Mars Geoscience/Climatology Orbiter Phase-A study performed during spring of 1983.

Laser polishing for topography management of accelerator cavity surfaces

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

Zhao, Liang; Klopf, J. Mike; Reece, Charles E.

2015-07-20

Improved energy efficiency and reduced cost are greatly desired for advanced particle accelerators. Progress toward both can be made by atomically-smoothing the interior surface of the niobium superconducting radiofrequency accelerator cavities at the machine's heart. Laser polishing offers a green alternative to the present aggressive chemical processes. We found parameters suitable for polishing niobium in all surface states expected for cavity production. As a result, careful measurement of the resulting surface chemistry revealed a modest thinning of the surface oxide layer, but no contamination.

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.

Implementation of Hospital Computerized Physician Order Entry Systems in a Rural State: Feasibility and Financial Impact

PubMed Central

Ohsfeldt, Robert L.; Ward, Marcia M.; Schneider, John E.; Jaana, Mirou; Miller, Thomas R.; Lei, Yang; Wakefield, Douglas S.

2005-01-01

Objective The aim of this study was to estimate the costs of implementing computerized physician order entry (CPOE) systems in hospitals in a rural state and to evaluate the financial implications of statewide CPOE implementation. Methods A simulation model was constructed using estimates of initial and ongoing CPOE costs mapped onto all general hospitals in Iowa by bed quantity and current clinical information system (CIS) status. CPOE cost estimates were obtained from a leading CPOE vendor. Current CIS status was determined through mail survey of Iowa hospitals. Patient care revenue and operating cost data published by the Iowa Hospital Association were used to simulate the financial impact of CPOE adoption on hospitals. Results CPOE implementation would dramatically increase operating costs for rural and critical access hospitals in the absence of substantial costs savings associated with improved efficiency or improved patient safety. For urban and rural referral hospitals, the cost impact is less dramatic but still substantial. However, relatively modest benefits in the form of patient care cost savings or revenue enhancement would be sufficient to offset CPOE costs for these larger hospitals. Conclusion Implementation of CPOE in rural or critical access hospitals may depend on net increase in operating costs. Adoption of CPOE may be financially infeasible for these small hospitals in the absence of increases in hospital payments or ongoing subsidies from third parties. PMID:15492033

Cost-utility of universal hepatitis A vaccination in Canada.

PubMed

Bauch, C T; Anonychuk, A M; Pham, B Z; Gilca, V; Duval, B; Krahn, M D

2007-12-12

Hepatitis A (HA) vaccination in Canada is currently targeted toward high-risk groups. The cost-effectiveness and expected health outcomes of universal vaccination relative to targeted vaccination in low-incidence countries such as Canada are currently unknown. Here, we conducted a cost-utility analysis for this situation, with Canada as the study population. We included vaccine costs, time costs, infection costs, and public health costs. We assessed a range of possible universal vaccination strategies over an 80-year time horizon using multiple cost perspectives. A dynamic model was used to account for herd immunity. Aggregate health gains from switching to universal vaccination are modest (10-30 QALYs per year). However, a "9+9" strategy that replaces two doses of monovalent hepatitis B (HB) vaccine at 9/10 years (universally administered in most provinces) with two doses of bivalent HA/HB vaccine is cost-saving from the societal perspective. At a willingness to pay threshold of $50,000/QALY, mean net benefit is +49.4 QALYs (S.D. 12.6) from the societal perspective and +3.8 QALYS (S.D. 3.0) from the payer perspective for the "9+9" strategy. Net benefit from the payer perspective is sensitive to the marginal cost of HA/HB vaccine relative to HB vaccine. Similar conclusions may apply in other countries with low incidence and a targeted vaccination policy.

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

32 CFR 701.52 - Computation of fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... correspondence and preparation costs, these fees are not recoupable from the requester. (b) DD 2086, Record of... costs, as requesters may solicit a copy of that document to ensure accurate computation of fees. Costs... 32 National Defense 5 2010-07-01 2010-07-01 false Computation of fees. 701.52 Section 701.52...

12 CFR 1070.22 - Fees for processing requests for CFPB records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CFPB shall charge the requester for the actual direct cost of the search, including computer search time, runs, and the operator's salary. The fee for computer output will be the actual direct cost. For... and the cost of operating the computer to process a request) equals the equivalent dollar amount of...

Object Classification Based on Analysis of Spectral Characteristics of Seismic Signal Envelopes

NASA Astrophysics Data System (ADS)

Morozov, Yu. V.; Spektor, A. A.

2017-11-01

A method for classifying moving objects having a seismic effect on the ground surface is proposed which is based on statistical analysis of the envelopes of received signals. The values of the components of the amplitude spectrum of the envelopes obtained applying Hilbert and Fourier transforms are used as classification criteria. Examples illustrating the statistical properties of spectra and the operation of the seismic classifier are given for an ensemble of objects of four classes (person, group of people, large animal, vehicle). It is shown that the computational procedures for processing seismic signals are quite simple and can therefore be used in real-time systems with modest requirements for computational resources.

The detection and analysis of point processes in biological signals

NASA Technical Reports Server (NTRS)

Anderson, D. J.; Correia, M. J.

1977-01-01

A pragmatic approach to the detection and analysis of discrete events in biomedical signals is taken. Examples from both clinical and basic research are provided. Introductory sections discuss not only discrete events which are easily extracted from recordings by conventional threshold detectors but also events embedded in other information carrying signals. The primary considerations are factors governing event-time resolution and the effects limits to this resolution have on the subsequent analysis of the underlying process. The analysis portion describes tests for qualifying the records as stationary point processes and procedures for providing meaningful information about the biological signals under investigation. All of these procedures are designed to be implemented on laboratory computers of modest computational capacity.

U.S. aerospace industry opinion of the effect of computer-aided prediction-design technology on future wind-tunnel test requirements for aircraft development programs

NASA Technical Reports Server (NTRS)

Treon, S. L.

1979-01-01

A survey of the U.S. aerospace industry in late 1977 suggests that there will be an increasing use of computer-aided prediction-design technology (CPD Tech) in the aircraft development process but that, overall, only a modest reduction in wind-tunnel test requirements from the current level is expected in the period through 1995. Opinions were received from key spokesmen in 23 of the 26 solicited major companies or corporate divisions involved in the design and manufacture of nonrotary wing aircraft. Development programs for nine types of aircraft related to test phases and wind-tunnel size and speed range were considered.

Demonstration of Cost-Effective, High-Performance Computing at Performance and Reliability Levels Equivalent to a 1994 Vector Supercomputer

NASA Technical Reports Server (NTRS)

Babrauckas, Theresa

2000-01-01

The Affordable High Performance Computing (AHPC) project demonstrated that high-performance computing based on a distributed network of computer workstations is a cost-effective alternative to vector supercomputers for running CPU and memory intensive design and analysis tools. The AHPC project created an integrated system called a Network Supercomputer. By connecting computer work-stations through a network and utilizing the workstations when they are idle, the resulting distributed-workstation environment has the same performance and reliability levels as the Cray C90 vector Supercomputer at less than 25 percent of the C90 cost. In fact, the cost comparison between a Cray C90 Supercomputer and Sun workstations showed that the number of distributed networked workstations equivalent to a C90 costs approximately 8 percent of the C90.

A survey of computer search service costs in the academic health sciences library.

PubMed Central

Shirley, S

1978-01-01

The Norris Medical Library, University of Southern California, has recently completed an extensive survey of costs involved in the provision of computer search services beyond vendor charges for connect time and printing. In this survey costs for such items as terminal depreciation, repair contract, personnel time, and supplies are analyzed. Implications of this cost survey are discussed in relation to planning and price setting for computer search services. PMID:708953

Costs of a motivational enhancement therapy coupled with cognitive behavioral therapy versus brief advice for pregnant substance users.

PubMed

Xu, Xiao; Yonkers, Kimberly A; Ruger, Jennifer P

2014-01-01

To determine and compare costs of a nurse-administered behavioral intervention for pregnant substance users that integrated motivational enhancement therapy with cognitive behavioral therapy (MET-CBT) to brief advice (BA) administered by an obstetrical provider. Both interventions were provided concurrent with prenatal care. We conducted a micro-costing study that prospectively collected detailed resource utilization and unit cost data for each of the two intervention arms (MET-CBT and BA) within the context of a randomized controlled trial. A three-step approach for identifying, measuring and valuing resource utilization was used. All cost estimates were inflation adjusted to 2011 U.S. dollars. A total of 82 participants received the MET-CBT intervention and 86 participants received BA. From the societal perspective, the total cost (including participants' time cost) of the MET-CBT intervention was $120,483 or $1,469 per participant. In contrast, the total cost of the BA intervention was $27,199 or $316 per participant. Personnel costs (nurse therapists and obstetric providers) for delivering the intervention sessions and supervising the program composed the largest share of the MET-CBT intervention costs. Program set up costs, especially intervention material design and training costs, also contributed substantially to the overall cost. Implementation of an MET-CBT program to promote drug abstinence in pregnant women is associated with modest costs. Future cost effectiveness and cost benefit analyses integrating costs with outcomes and benefits data will enable a more comprehensive understanding of the intervention in improving the care of substance abusing pregnant women.

An economic model to evaluate cost-effectiveness of computer assisted knee replacement surgery in Norway.

PubMed

Gøthesen, Øystein; Slover, James; Havelin, Leif; Askildsen, Jan Erik; Malchau, Henrik; Furnes, Ove

2013-07-06

The use of Computer Assisted Surgery (CAS) for knee replacements is intended to improve the alignment of knee prostheses in order to reduce the number of revision operations. Is the cost effectiveness of computer assisted surgery influenced by patient volume and age? By employing a Markov model, we analysed the cost effectiveness of computer assisted surgery versus conventional arthroplasty with respect to implant survival and operation volume in two theoretical Norwegian age cohorts. We obtained mortality and hospital cost data over a 20-year period from Norwegian registers. We presumed that the cost of an intervention would need to be below NOK 500,000 per QALY (Quality Adjusted Life Year) gained, to be considered cost effective. The added cost of computer assisted surgery, provided this has no impact on implant survival, is NOK 1037 and NOK 1414 respectively for 60 and 75-year-olds per quality-adjusted life year at a volume of 25 prostheses per year, and NOK 128 and NOK 175 respectively at a volume of 250 prostheses per year. Sensitivity analyses showed that the 10-year implant survival in cohort 1 needs to rise from 89.8% to 90.6% at 25 prostheses per year, and from 89.8 to 89.9% at 250 prostheses per year for computer assisted surgery to be considered cost effective. In cohort 2, the required improvement is a rise from 95.1% to 95.4% at 25 prostheses per year, and from 95.10% to 95.14% at 250 prostheses per year. The cost of using computer navigation for total knee replacements may be acceptable for 60-year-old as well as 75-year-old patients if the technique increases the implant survival rate just marginally, and the department has a high operation volume. A low volume department might not achieve cost-effectiveness unless computer navigation has a more significant impact on implant survival, thus may defer the investments until such data are available.

Method and computer program product for maintenance and modernization backlogging

DOEpatents

Mattimore, Bernard G; Reynolds, Paul E; Farrell, Jill M

2013-02-19

According to one embodiment, a computer program product for determining future facility conditions includes a computer readable medium having computer readable program code stored therein. The computer readable program code includes computer readable program code for calculating a time period specific maintenance cost, for calculating a time period specific modernization factor, and for calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. In another embodiment, a computer-implemented method for calculating future facility conditions includes calculating a time period specific maintenance cost, calculating a time period specific modernization factor, and calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. Other embodiments are also presented.

COMPUTER PROGRAM FOR CALCULATING THE COST OF DRINKING WATER TREATMENT SYSTEMS

EPA Science Inventory

This FORTRAN computer program calculates the construction and operation/maintenance costs for 45 centralized unit treatment processes for water supply. The calculated costs are based on various design parameters and raw water quality. These cost data are applicable to small size ...

The impact of recirculating industrial air on aircraft painting operations.

PubMed

LaPuma, P T; Bolch, W E

1999-10-01

The 1990 Clean Air Act Amendments resulted in new environmental regulations for hazardous air pollutants. Industries such as painting facilities may have to treat large volumes of air, which increases the cost of an air control system. Recirculating a portion of the air back into the facility is an option to reduce the amount of air to be treated. The authors of this study developed a computer model written in Microsoft Excel 97 to analyze the impact of recirculation on worker safety and compliance costs. The model has a chemical database with over 1300 chemicals. The model will predict indoor air concentrations using mass balance calculations and results are compared to occupational exposure limits. A case study is performed on a C-130 aircraft painting facility at Hill Air Force Base, Utah. The model predicts strontium chromate concentrations found in primer paints will reach 1000 times the exposure limit. Strontium chromate and other solid particulates are nearly unaffected by recirculation because the air is filtered during recirculation. The next highest chemical, hexamethylene diisocyanate, increases from 2.6 to 10.5 times the exposure limit at 0 percent and 75 percent recirculation, respectively. Due to the level of respiratory protection required for the strontium chromate, workers are well protected from the modest increases in concentrations caused by recirculating 75 percent of the air. The initial cost of an air control system is $4.5 million with no recirculation and $1.8 million at 75 percent recirculation. The model is an excellent tool to evaluate air control options with a focus on worker safety. In the case study, the model highlights strontium chromate primers as good candidates for substitution. The model shows that recirculating 75 percent of the air at the Hill painting facility has a negligible impact on safety and could save $2.7 million on the initial expenses of a thermal treatment system.

An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke.

PubMed

Wagner, Todd H; Lo, Albert C; Peduzzi, Peter; Bravata, Dawn M; Huang, Grant D; Krebs, Hermano I; Ringer, Robert J; Federman, Daniel G; Richards, Lorie G; Haselkorn, Jodie K; Wittenberg, George F; Volpe, Bruce T; Bever, Christopher T; Duncan, Pamela W; Siroka, Andrew; Guarino, Peter D

2011-09-01

Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. We estimated the intervention costs and tracked participants' healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (P<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different. The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00372411.

Report of the Commission to Assess the Threat to the United States from Electromagnetic Pulse (EMP) Attack: Critical National Infrastructures

DTIC Science & Technology

2008-04-01

consumers and electric utilities in Arizona and Southern California. Twelve people, including five children, died as a result of the explosion. The...Modern electronics, communications, pro- tection, control and computers have allowed the physical system to be utilized fully with ever smaller... margins for error. Therefore, a relatively modest upset to the system can cause functional collapse. As the system grows in complexity and interdependence

Extraction of Vertical Profiles of Atmospheric Variables from Gridded Binary, Edition 2 (GRIB2) Model Output Files

DTIC Science & Technology

2018-01-18

processing. Specifically, the method described herein uses wgrib2 commands along with a Python script or program to produce tabular text files that in...It makes use of software that is readily available and can be implemented on many computer systems combined with relatively modest additional...example), extracts appropriate information, and lists the extracted information in a readable tabular form. The Python script used here is described in

Estimating costs and performance of systems for machine processing of remotely sensed data

NASA Technical Reports Server (NTRS)

Ballard, R. J.; Eastwood, L. F., Jr.

1977-01-01

This paper outlines a method for estimating computer processing times and costs incurred in producing information products from digital remotely sensed data. The method accounts for both computation and overhead, and may be applied to any serial computer. The method is applied to estimate the cost and computer time involved in producing Level II Land Use and Vegetative Cover Maps for a five-state midwestern region. The results show that the amount of data to be processed overloads some example computer systems, but that the processing is feasible on others.

A model to determine the economic viability of water fluoridation.

PubMed

Kroon, Jeroen; van Wyk, Philippus Johannes

2012-01-01

In view of concerns expressed by South African local authorities the aim of this study was to develop a model to determine whether water fluoridation is economically viable to reduce dental caries in South Africa. Microsoft Excel software was used to develop a model to determine economic viability of water fluoridation for 17 water providers from all nine South African provinces. Input variables for this model relate to chemical cost, labor cost, maintenance cost of infrastructure, opportunity cost, and capital depreciation. The following output variables were calculated to evaluate the cost of water fluoridation: per capita cost per year, cost-effectiveness and cost-benefit. In this model it is assumed that the introduction of community water fluoridation can reduce caries prevalence by an additional 15 percent and that the savings in cost of treatment will be equal to the average fee for a two surface restoration. Water providers included in the study serve 53.5 percent of the total population of South Africa. For all providers combined chemical cost contributes 64.5 percent to the total cost, per capita cost per year was $0.36, cost-effectiveness was calculated as $11.41 and cost-benefit of the implementation of water fluoridation was 0.34. This model confirmed that water fluoridation is an economically viable option to prevent dental caries in South African communities, as well as conclusions over the last 10 years that water fluoridation leads to significant cost savings and remains a cost-effective measure for reducing dental caries, even when the caries-preventive effectiveness is modest. © 2012 American Association of Public Health Dentistry.

26 CFR 7.57(d)-1 - Election with respect to straight line recovery of intangibles.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Tax Reform Act of 1976. Under this election taxpayers may use cost depletion to compute straight line... wells to which the election applies, cost depletion to compute straight line recovery of intangibles for... whether or not the taxpayer uses cost depletion in computing taxable income. (5) The election is made by a...

The Processing Cost of Reference Set Computation: Acquisition of Stress Shift and Focus

ERIC Educational Resources Information Center

Reinhart, Tanya

2004-01-01

Reference set computation -- the construction of a (global) comparison set to determine whether a given derivation is appropriate in context -- comes with a processing cost. I argue that this cost is directly visible at the acquisition stage: In those linguistic areas in which it has been independently established that such computation is indeed…

Some Useful Cost-Benefit Criteria for Evaluating Computer-Based Test Delivery Models and Systems

ERIC Educational Resources Information Center

Luecht, Richard M.

2005-01-01

Computer-based testing (CBT) is typically implemented using one of three general test delivery models: (1) multiple fixed testing (MFT); (2) computer-adaptive testing (CAT); or (3) multistage testing (MSTs). This article reviews some of the real cost drivers associated with CBT implementation--focusing on item production costs, the costs…

Satellite broadcasting system study

NASA Technical Reports Server (NTRS)

1972-01-01

The study to develop a system model and computer program representative of broadcasting satellite systems employing community-type receiving terminals is reported. The program provides a user-oriented tool for evaluating performance/cost tradeoffs, synthesizing minimum cost systems for a given set of system requirements, and performing sensitivity analyses to identify critical parameters and technology. The performance/ costing philosophy and what is meant by a minimum cost system is shown graphically. Topics discussed include: main line control program, ground segment model, space segment model, cost models and launch vehicle selection. Several examples of minimum cost systems resulting from the computer program are presented. A listing of the computer program is also included.

Costs of immune responses are related to host body size and lifespan

DOE PAGES

Brace, Amber J.; Lajeunesse, Marc J.; Ardia, Daniel R.; ...

2017-06-01

A central assumption in ecological immunology is that immune responses are costly, with costs manifesting directly (e.g., increases in metabolic rate and increased amino acid usage) or as tradeoffs with other life processes (e.g., reduced growth and reproductive success). Across taxa, host longevity, timing of maturity, and reproductive effort affect the organization of immune systems. It is reasonable, therefore, to expect that these and related factors should also affect immune activation costs. Specifically, species that spread their breeding efforts over a long lifetime should experience lower immune costs than those that mature and breed quickly and die comparatively early. Likewise,more » body mass should affect immune costs, as body size affects the extent to which hosts are exposed to parasites as well as how hosts can combat infections (via its effects on metabolic rates and other factors). Here in this paper, we used phylogenetic meta-regression to reveal that, in general, animals incur costs of immune activation, but small species that are relatively long-lived incur the largest costs. These patterns probably arise because of the relative need for defense when infection risk is comparatively high and fitness can only be realized over a comparatively long period. However, given the diversity of species considered here and the overall modest effects of body mass and life history on immune costs, much more research is necessary before generalizations are appropriate.« less

Costs of immune responses are related to host body size and lifespan

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

Brace, Amber J.; Lajeunesse, Marc J.; Ardia, Daniel R.

A central assumption in ecological immunology is that immune responses are costly, with costs manifesting directly (e.g., increases in metabolic rate and increased amino acid usage) or as tradeoffs with other life processes (e.g., reduced growth and reproductive success). Across taxa, host longevity, timing of maturity, and reproductive effort affect the organization of immune systems. It is reasonable, therefore, to expect that these and related factors should also affect immune activation costs. Specifically, species that spread their breeding efforts over a long lifetime should experience lower immune costs than those that mature and breed quickly and die comparatively early. Likewise,more » body mass should affect immune costs, as body size affects the extent to which hosts are exposed to parasites as well as how hosts can combat infections (via its effects on metabolic rates and other factors). Here in this paper, we used phylogenetic meta-regression to reveal that, in general, animals incur costs of immune activation, but small species that are relatively long-lived incur the largest costs. These patterns probably arise because of the relative need for defense when infection risk is comparatively high and fitness can only be realized over a comparatively long period. However, given the diversity of species considered here and the overall modest effects of body mass and life history on immune costs, much more research is necessary before generalizations are appropriate.« less

Mild KCC2 Hypofunction Causes Inconspicuous Chloride Dysregulation that Degrades Neural Coding

PubMed Central

Doyon, Nicolas; Prescott, Steven A.; De Koninck, Yves

2016-01-01

Disinhibition caused by Cl− dysregulation is implicated in several neurological disorders. This form of disinhibition, which stems primarily from impaired Cl− extrusion through the co-transporter KCC2, is typically identified by a depolarizing shift in GABA reversal potential (EGABA). Here we show, using computer simulations, that intracellular [Cl−] exhibits exaggerated fluctuations during transient Cl− loads and recovers more slowly to baseline when KCC2 level is even modestly reduced. Using information theory and signal detection theory, we show that increased Cl− lability and settling time degrade neural coding. Importantly, these deleterious effects manifest after less KCC2 reduction than needed to produce the gross changes in EGABA required for detection by most experiments, which assess KCC2 function under weak Cl− load conditions. By demonstrating the existence and functional consequences of “occult” Cl− dysregulation, these results suggest that modest KCC2 hypofunction plays a greater role in neurological disorders than previously believed. PMID:26858607

Diversification of Processors Based on Redundancy in Instruction Set

NASA Astrophysics Data System (ADS)

Ichikawa, Shuichi; Sawada, Takashi; Hata, Hisashi

By diversifying processor architecture, computer software is expected to be more resistant to plagiarism, analysis, and attacks. This study presents a new method to diversify instruction set architecture (ISA) by utilizing the redundancy in the instruction set. Our method is particularly suited for embedded systems implemented with FPGA technology, and realizes a genuine instruction set randomization, which has not been provided by the preceding studies. The evaluation results on four typical ISAs indicate that our scheme can provide a far larger degree of freedom than the preceding studies. Diversified processors based on MIPS architecture were actually implemented and evaluated with Xilinx Spartan-3 FPGA. The increase of logic scale was modest: 5.1% in Specialized design and 3.6% in RAM-mapped design. The performance overhead was also modest: 3.4% in Specialized design and 11.6% in RAM-mapped design. From these results, our scheme is regarded as a practical and promising way to secure FPGA-based embedded systems.

Probabilistic Space Weather Forecasting: a Bayesian Perspective

NASA Astrophysics Data System (ADS)

Camporeale, E.; Chandorkar, M.; Borovsky, J.; Care', A.

2017-12-01

Most of the Space Weather forecasts, both at operational and research level, are not probabilistic in nature. Unfortunately, a prediction that does not provide a confidence level is not very useful in a decision-making scenario. Nowadays, forecast models range from purely data-driven, machine learning algorithms, to physics-based approximation of first-principle equations (and everything that sits in between). Uncertainties pervade all such models, at every level: from the raw data to finite-precision implementation of numerical methods. The most rigorous way of quantifying the propagation of uncertainties is by embracing a Bayesian probabilistic approach. One of the simplest and most robust machine learning technique in the Bayesian framework is Gaussian Process regression and classification. Here, we present the application of Gaussian Processes to the problems of the DST geomagnetic index forecast, the solar wind type classification, and the estimation of diffusion parameters in radiation belt modeling. In each of these very diverse problems, the GP approach rigorously provide forecasts in the form of predictive distributions. In turn, these distributions can be used as input for ensemble simulations in order to quantify the amplification of uncertainties. We show that we have achieved excellent results in all of the standard metrics to evaluate our models, with very modest computational cost.

Cooperative Monitoring Center Occasional Paper/16: The Potential of Technology for the Control of Small Weapons: Applications in Developing Countries

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

ALTMANN, JURGEN

2000-07-01

For improving the control of small arms, technology provides many possibilities. Present and future technical means are described in several areas. With the help of sensors deployed on the ground or on board aircraft, larger areas can be monitored. Using tags, seals, and locks, important objects and installations can be safeguarded better. With modern data processing and communication systems, more information can be available, and it can be more speedily processed. Together with navigation and transport equipment, action can be taken faster and at greater range. Particular considerations are presented for cargo control at roads, seaports, and airports, for monitoringmore » designated lines, and for the control of legal arms. By starting at a modest level, costs can be kept low, which would aid developing countries. From the menu of technologies available, systems need to be designed for the intended application and with an understanding of the local conditions. It is recommended that states start with short-term steps, such as acquiring more and better radio transceivers, vehicles, small aircraft, and personal computers. For the medium term, states should begin with experiments and field testing of technologies such as tags, sensors, and digital communication equipment.« less

Strategies for sustainable management of renewable resources during environmental change.

PubMed

Lindkvist, Emilie; Ekeberg, Örjan; Norberg, Jon

2017-03-15

As a consequence of global environmental change, management strategies that can deal with unexpected change in resource dynamics are becoming increasingly important. In this paper we undertake a novel approach to studying resource growth problems using a computational form of adaptive management to find optimal strategies for prevalent natural resource management dilemmas. We scrutinize adaptive management, or learning-by-doing, to better understand how to simultaneously manage and learn about a system when its dynamics are unknown. We study important trade-offs in decision-making with respect to choosing optimal actions (harvest efforts) for sustainable management during change. This is operationalized through an artificially intelligent model where we analyze how different trends and fluctuations in growth rates of a renewable resource affect the performance of different management strategies. Our results show that the optimal strategy for managing resources with declining growth is capable of managing resources with fluctuating or increasing growth at a negligible cost, creating in a management strategy that is both efficient and robust towards future unknown changes. To obtain this strategy, adaptive management should strive for: high learning rates to new knowledge, high valuation of future outcomes and modest exploration around what is perceived as the optimal action. © 2017 The Author(s).

Universal and adapted vocabularies for generic visual categorization.

PubMed

Perronnin, Florent

2008-07-01

Generic Visual Categorization (GVC) is the pattern classification problem which consists in assigning labels to an image based on its semantic content. This is a challenging task as one has to deal with inherent object/scene variations as well as changes in viewpoint, lighting and occlusion. Several state-of-the-art GVC systems use a vocabulary of visual terms to characterize images with a histogram of visual word counts. We propose a novel practical approach to GVC based on a universal vocabulary, which describes the content of all the considered classes of images, and class vocabularies obtained through the adaptation of the universal vocabulary using class-specific data. The main novelty is that an image is characterized by a set of histograms - one per class - where each histogram describes whether the image content is best modeled by the universal vocabulary or the corresponding class vocabulary. This framework is applied to two types of local image features: low-level descriptors such as the popular SIFT and high-level histograms of word co-occurrences in a spatial neighborhood. It is shown experimentally on two challenging datasets (an in-house database of 19 categories and the PASCAL VOC 2006 dataset) that the proposed approach exhibits state-of-the-art performance at a modest computational cost.

On Increasing Network Lifetime in Body Area Networks Using Global Routing with Energy Consumption Balancing

PubMed Central

Tsouri, Gill R.; Prieto, Alvaro; Argade, Nikhil

2012-01-01

Global routing protocols in wireless body area networks are considered. Global routing is augmented with a novel link cost function designed to balance energy consumption across the network. The result is a substantial increase in network lifetime at the expense of a marginal increase in energy per bit. Network maintenance requirements are reduced as well, since balancing energy consumption means all batteries need to be serviced at the same time and less frequently. The proposed routing protocol is evaluated using a hardware experimental setup comprising multiple nodes and an access point. The setup is used to assess network architectures, including an on-body access point and an off-body access point with varying number of antennas. Real-time experiments are conducted in indoor environments to assess performance gains. In addition, the setup is used to record channel attenuation data which are then processed in extensive computer simulations providing insight on the effect of protocol parameters on performance. Results demonstrate efficient balancing of energy consumption across all nodes, an average increase of up to 40% in network lifetime corresponding to a modest average increase of 0.4 dB in energy per bit, and a cutoff effect on required transmission power to achieve reliable connectivity. PMID:23201987

On increasing network lifetime in body area networks using global routing with energy consumption balancing.

PubMed

Tsouri, Gill R; Prieto, Alvaro; Argade, Nikhil

2012-09-26

Global routing protocols in wireless body area networks are considered. Global routing is augmented with a novel link cost function designed to balance energy consumption across the network. The result is a substantial increase in network lifetime at the expense of a marginal increase in energy per bit. Network maintenance requirements are reduced as well, since balancing energy consumption means all batteries need to be serviced at the same time and less frequently. The proposed routing protocol is evaluated using a hardware experimental setup comprising multiple nodes and an access point. The setup is used to assess network architectures, including an on-body access point and an off-body access point with varying number of antennas. Real-time experiments are conducted in indoor environments to assess performance gains. In addition, the setup is used to record channel attenuation data which are then processed in extensive computer simulations providing insight on the effect of protocol parameters on performance. Results demonstrate efficient balancing of energy consumption across all nodes, an average increase of up to 40% in network lifetime corresponding to a modest average increase of 0.4 dB in energy per bit, and a cutoff effect on required transmission power to achieve reliable connectivity.

Mapping the economic costs and benefits of conservation.

PubMed

Naidoo, Robin; Ricketts, Taylor H

2006-10-01

Resources for biodiversity conservation are severely limited, requiring strategic investment. Understanding both the economic benefits and costs of conserving ecosystems will help to allocate scarce dollars most efficiently. However, although cost-benefit analyses are common in many areas of policy, they are not typically used in conservation planning. We conducted a spatial evaluation of the costs and benefits of conservation for a landscape in the Atlantic forests of Paraguay. We considered five ecosystem services (i.e., sustainable bushmeat harvest, sustainable timber harvest, bioprospecting for pharmaceutical products, existence value, and carbon storage in aboveground biomass) and compared them to estimates of the opportunity costs of conservation. We found a high degree of spatial variability in both costs and benefits over this relatively small (approximately 3,000 km(2)) landscape. Benefits exceeded costs in some areas, with carbon storage dominating the ecosystem service values and swamping opportunity costs. Other benefits associated with conservation were more modest and exceeded costs only in protected areas and indigenous reserves. We used this cost-benefit information to show that one potential corridor between two large forest patches had net benefits that were three times greater than two otherwise similar alternatives. Spatial cost-benefit analysis can powerfully inform conservation planning, even though the availability of relevant data may be limited, as was the case in our study area. It can help us understand the synergies between biodiversity conservation and economic development when the two are indeed aligned and to clearly understand the trade-offs when they are not.

Mapping the Economic Costs and Benefits of Conservation

PubMed Central

Naidoo, Robin; Ricketts, Taylor H

2006-01-01

Resources for biodiversity conservation are severely limited, requiring strategic investment. Understanding both the economic benefits and costs of conserving ecosystems will help to allocate scarce dollars most efficiently. However, although cost-benefit analyses are common in many areas of policy, they are not typically used in conservation planning. We conducted a spatial evaluation of the costs and benefits of conservation for a landscape in the Atlantic forests of Paraguay. We considered five ecosystem services (i.e., sustainable bushmeat harvest, sustainable timber harvest, bioprospecting for pharmaceutical products, existence value, and carbon storage in aboveground biomass) and compared them to estimates of the opportunity costs of conservation. We found a high degree of spatial variability in both costs and benefits over this relatively small (~3,000 km2) landscape. Benefits exceeded costs in some areas, with carbon storage dominating the ecosystem service values and swamping opportunity costs. Other benefits associated with conservation were more modest and exceeded costs only in protected areas and indigenous reserves. We used this cost-benefit information to show that one potential corridor between two large forest patches had net benefits that were three times greater than two otherwise similar alternatives. Spatial cost-benefit analysis can powerfully inform conservation planning, even though the availability of relevant data may be limited, as was the case in our study area. It can help us understand the synergies between biodiversity conservation and economic development when the two are indeed aligned and to clearly understand the trade-offs when they are not. PMID:17076583

Low-Budget Computer Programming in Your School (An Alternative to the Cost of Large Computers). Illinois Series on Educational Applications of Computers. No. 14.

ERIC Educational Resources Information Center

Dennis, J. Richard; Thomson, David

This paper is concerned with a low cost alternative for providing computer experience to secondary school students. The brief discussion covers the programmable calculator and its relevance for teaching the concepts and the rudiments of computer programming and for computer problem solving. A list of twenty-five programming activities related to…

Computers in Education: Their Use and Cost, Education Automation Monograph Number 2.

ERIC Educational Resources Information Center

American Data Processing, Inc., Detroit, MI.

This monograph on the cost and use of computers in education consists of two parts. Part I is a report of the President's Science Advisory Committee concerning the cost and use of the computer in undergraduate, secondary, and higher education. In addition, the report contains a discussion of the interaction between research and educational uses of…

A computer program for analysis of fuelwood harvesting costs

Treesearch

George B. Harpole; Giuseppe Rensi

1985-01-01

The fuelwood harvesting computer program (FHP) is written in FORTRAN 60 and designed to select a collection of harvest units and systems from among alternatives to satisfy specified energy requirements at a lowest cost per million Btu's as recovered in a boiler, or thousand pounds of H2O evaporative capacity kiln drying. Computed energy costs are used as a...

12 CFR Appendix K to Part 226 - Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 3 2014-01-01 2014-01-01 false Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions K Appendix K to Part 226 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED..., App. K Appendix K to Part 226—Total Annual Loan Cost Rate Computations for Reverse Mortgage...

12 CFR Appendix K to Part 226 - Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 3 2013-01-01 2013-01-01 false Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions K Appendix K to Part 226 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED..., App. K Appendix K to Part 226—Total Annual Loan Cost Rate Computations for Reverse Mortgage...

Individualized adjustments to reference phantom internal organ dosimetry—scaling factors given knowledge of patient external anatomy

NASA Astrophysics Data System (ADS)

Wayson, Michael B.; Bolch, Wesley E.

2018-04-01

Internal radiation dose estimates for diagnostic nuclear medicine procedures are typically calculated for a reference individual. Resultantly, there is uncertainty when determining the organ doses to patients who are not at 50th percentile on either height or weight. This study aims to better personalize internal radiation dose estimates for individual patients by modifying the dose estimates calculated for reference individuals based on easily obtainable morphometric characteristics of the patient. Phantoms of different sitting heights and waist circumferences were constructed based on computational reference phantoms for the newborn, 10 year-old, and adult. Monoenergetic photons and electrons were then simulated separately at 15 energies. Photon and electron specific absorbed fractions (SAFs) were computed for the newly constructed non-reference phantoms and compared to SAFs previously generated for the age-matched reference phantoms. Differences in SAFs were correlated to changes in sitting height and waist circumference to develop scaling factors that could be applied to reference SAFs as morphometry corrections. A further set of arbitrary non-reference phantoms were then constructed and used in validation studies for the SAF scaling factors. Both photon and electron dose scaling methods were found to increase average accuracy when sitting height was used as the scaling parameter (~11%). Photon waist circumference-based scaling factors showed modest increases in average accuracy (~7%) for underweight individuals, but not for overweight individuals. Electron waist circumference-based scaling factors did not show increases in average accuracy. When sitting height and waist circumference scaling factors were combined, modest average gains in accuracy were observed for photons (~6%), but not for electrons. Both photon and electron absorbed doses are more reliably scaled using scaling factors computed in this study. They can be effectively scaled using sitting height alone as patient-specific morphometric parameter.

Individualized adjustments to reference phantom internal organ dosimetry-scaling factors given knowledge of patient external anatomy.

PubMed

Wayson, Michael B; Bolch, Wesley E

2018-04-13

Internal radiation dose estimates for diagnostic nuclear medicine procedures are typically calculated for a reference individual. Resultantly, there is uncertainty when determining the organ doses to patients who are not at 50th percentile on either height or weight. This study aims to better personalize internal radiation dose estimates for individual patients by modifying the dose estimates calculated for reference individuals based on easily obtainable morphometric characteristics of the patient. Phantoms of different sitting heights and waist circumferences were constructed based on computational reference phantoms for the newborn, 10 year-old, and adult. Monoenergetic photons and electrons were then simulated separately at 15 energies. Photon and electron specific absorbed fractions (SAFs) were computed for the newly constructed non-reference phantoms and compared to SAFs previously generated for the age-matched reference phantoms. Differences in SAFs were correlated to changes in sitting height and waist circumference to develop scaling factors that could be applied to reference SAFs as morphometry corrections. A further set of arbitrary non-reference phantoms were then constructed and used in validation studies for the SAF scaling factors. Both photon and electron dose scaling methods were found to increase average accuracy when sitting height was used as the scaling parameter (~11%). Photon waist circumference-based scaling factors showed modest increases in average accuracy (~7%) for underweight individuals, but not for overweight individuals. Electron waist circumference-based scaling factors did not show increases in average accuracy. When sitting height and waist circumference scaling factors were combined, modest average gains in accuracy were observed for photons (~6%), but not for electrons. Both photon and electron absorbed doses are more reliably scaled using scaling factors computed in this study. They can be effectively scaled using sitting height alone as patient-specific morphometric parameter.

Informing Investment to Reduce Inequalities: A Modelling Approach

PubMed Central

McAuley, Andrew; Denny, Cheryl; Taulbut, Martin; Mitchell, Rory; Fischbacher, Colin; Graham, Barbara; Grant, Ian; O’Hagan, Paul; McAllister, David; McCartney, Gerry

2016-01-01

Background Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. Objectives To provide estimates of the impact of a range of interventions on health and health inequalities. Materials and Methods Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a ‘living wage’; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Results Introduction of a ‘living wage’ generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Conclusions Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities. PMID:27486857

A Framework for Robust Multivariable Optimization of Integrated Circuits in Space Applications

NASA Technical Reports Server (NTRS)

DuMonthier, Jeffrey; Suarez, George

2013-01-01

Application Specific Integrated Circuit (ASIC) design for space applications involves multiple challenges of maximizing performance, minimizing power and ensuring reliable operation in extreme environments. This is a complex multidimensional optimization problem which must be solved early in the development cycle of a system due to the time required for testing and qualification severely limiting opportunities to modify and iterate. Manual design techniques which generally involve simulation at one or a small number of corners with a very limited set of simultaneously variable parameters in order to make the problem tractable are inefficient and not guaranteed to achieve the best possible results within the performance envelope defined by the process and environmental requirements. What is required is a means to automate design parameter variation, allow the designer to specify operational constraints and performance goals, and to analyze the results in a way which facilitates identifying the tradeoffs defining the performance envelope over the full set of process and environmental corner cases. The system developed by the Mixed Signal ASIC Group (MSAG) at the Goddard Space Flight Center is implemented as framework of software modules, templates and function libraries. It integrates CAD tools and a mathematical computing environment, and can be customized for new circuit designs with only a modest amount of effort as most common tasks are already encapsulated. Customization is required for simulation test benches to determine performance metrics and for cost function computation. Templates provide a starting point for both while toolbox functions minimize the code required. Once a test bench has been coded to optimize a particular circuit, it is also used to verify the final design. The combination of test bench and cost function can then serve as a template for similar circuits or be re-used to migrate the design to different processes by re-running it with the new process specific device models. The system has been used in the design of time to digital converters for laser ranging and time-of-flight mass spectrometry to optimize analog, mixed signal and digital circuits such as charge sensitive amplifiers, comparators, delay elements, radiation tolerant dual interlocked (DICE) flip-flops and two of three voter gates.

PCS: a pallet costing system for wood pallet manufacturers (version 1.0 for Windows®)

Treesearch

A. Jefferson, Jr. Palmer; Cynthia D. West; Bruce G. Hansen; Marshall S. White; Hal L. Mitchell

2002-01-01

The Pallet Costing System (PCS) is a computer-based, Microsoft Windows® application that computes the total and per-unit cost of manufacturing an order of wood pallets. Information about the manufacturing facility, along with the pallet-order requirements provided by the customer, is used in determining production cost. The major cost factors addressed by PCS...

Analysis of heliographic missions complementary to ISPM. [International Solar Polar Mission

NASA Technical Reports Server (NTRS)

Driver, J. M.

1984-01-01

Five concepts were formulated, analyzed, and compared for satisfying heliographic science mission objectives both with and without a concurrent International Solar Polar Mission (ISPM) Spacecraft. Key astrodynamic constraints and performance factors are known from literature for the Lagrange point mission and the sun-synchronous earth orbit mission, but are set forth in this paper for the three solar orbiting missions concepts considered. Any of these five missions should be doable at modest cost since no strong cost drivers were encountered in the analyses. The mission to be flown depends on mission capability to meet science measurement needs more than on strong economic factors. Each mission offers special advantages for particular measurement emphasis. Based on selected qualitative mission discriminators, an overall 'best mission' was selected and described in some detail.

Maximizing the Scientific Return of Low Cost Planetary Missions Using Solar Electric Propulsion(abstract)

NASA Technical Reports Server (NTRS)

Russell, C. T.; Metzger, A.; Pieters, C.; Elphic, R. C.; McCord, T.; Head, J.; Abshire, J.; Philips, R.; Sykes, M.; A'Hearn, M.;

Cost-effective fabrication of thermal- and chemical-stable ZIF-9 nanocrystals at ammonia atmosphere

NASA Astrophysics Data System (ADS)

Ebrahimi, Arash; Mansournia, Mohammadreza

2017-12-01

In this study, room temperature synthesis of zeolitic imidazolate framework-9 (ZIF-9) nanocrystals is reported for the first time at ammonia atmosphere in the absence of any organic additive. High thermal stability of the as-fabricated ZIF-9 up to 300 °C is illustrated by TG and XRD data. Also, the chemical resistance of product to harsh and severe solvothermal conditions introduces it to be an objective as potential material in many applications. Besides, the modest microporosity of the as-obtained ZIF-9 materials attracts more attentions for further investigation compared to those fabricated in organic solvents. By and large, the represented low-cost and room temperature synthetic method can be applicable in the large scale preparation of ZIF-9 for potentially practical utilization.

48 CFR 42.709-4 - Computing interest.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Computing interest. 42.709... MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.709-4 Computing interest. For 42.709-1(a)(1)(ii), compute interest on any paid portion of the disallowed cost as follows: (a) Consider...

48 CFR 42.709-4 - Computing interest.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Computing interest. 42.709... MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.709-4 Computing interest. For 42.709-1(a)(1)(ii), compute interest on any paid portion of the disallowed cost as follows: (a) Consider...

48 CFR 42.709-4 - Computing interest.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Computing interest. 42.709... MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.709-4 Computing interest. For 42.709-1(a)(1)(ii), compute interest on any paid portion of the disallowed cost as follows: (a) Consider...

Second-principles method for materials simulations including electron and lattice degrees of freedom

NASA Astrophysics Data System (ADS)

García-Fernández, Pablo; Wojdeł, Jacek C.; Íñiguez, Jorge; Junquera, Javier

2016-05-01

We present a first-principles-based (second-principles) scheme that permits large-scale materials simulations including both atomic and electronic degrees of freedom on the same footing. The method is based on a predictive quantum-mechanical theory—e.g., density functional theory—and its accuracy can be systematically improved at a very modest computational cost. Our approach is based on dividing the electron density of the system into a reference part—typically corresponding to the system's neutral, geometry-dependent ground state—and a deformation part—defined as the difference between the actual and reference densities. We then take advantage of the fact that the bulk part of the system's energy depends on the reference density alone; this part can be efficiently and accurately described by a force field, thus avoiding explicit consideration of the electrons. Then, the effects associated to the difference density can be treated perturbatively with good precision by working in a suitably chosen Wannier function basis. Further, the electronic model can be restricted to the bands of interest. All these features combined yield a very flexible and computationally very efficient scheme. Here we present the basic formulation of this approach, as well as a practical strategy to compute model parameters for realistic materials. We illustrate the accuracy and scope of the proposed method with two case studies, namely, the relative stability of various spin arrangements in NiO (featuring complex magnetic interactions in a strongly-correlated oxide) and the formation of a two-dimensional electron gas at the interface between band insulators LaAlO3 and SrTiO3 (featuring subtle electron-lattice couplings and screening effects). We conclude by discussing ways to overcome the limitations of the present approach (most notably, the assumption of a fixed bonding topology), as well as its many envisioned possibilities and future extensions.

Extended solvent-contact model approach to blind SAMPL5 prediction challenge for the distribution coefficients of drug-like molecules

NASA Astrophysics Data System (ADS)

Chung, Kee-Choo; Park, Hwangseo

2016-11-01

The performance of the extended solvent-contact model has been addressed in the SAMPL5 blind prediction challenge for distribution coefficient (LogD) of drug-like molecules with respect to the cyclohexane/water partitioning system. All the atomic parameters defined for 41 atom types in the solvation free energy function were optimized by operating a standard genetic algorithm with respect to water and cyclohexane solvents. In the parameterizations for cyclohexane, the experimental solvation free energy (Δ G sol ) data of 15 molecules for 1-octanol were combined with those of 77 molecules for cyclohexane to construct a training set because Δ G sol values of the former were unavailable for cyclohexane in publicly accessible databases. Using this hybrid training set, we established the LogD prediction model with the correlation coefficient ( R), average error (AE), and root mean square error (RMSE) of 0.55, 1.53, and 3.03, respectively, for the comparison of experimental and computational results for 53 SAMPL5 molecules. The modest accuracy in LogD prediction could be attributed to the incomplete optimization of atomic solvation parameters for cyclohexane. With respect to 31 SAMPL5 molecules containing the atom types for which experimental reference data for Δ G sol were available for both water and cyclohexane, the accuracy in LogD prediction increased remarkably with the R, AE, and RMSE values of 0.82, 0.89, and 1.60, respectively. This significant enhancement in performance stemmed from the better optimization of atomic solvation parameters by limiting the element of training set to the molecules with experimental Δ G sol data for cyclohexane. Due to the simplicity in model building and to low computational cost for parameterizations, the extended solvent-contact model is anticipated to serve as a valuable computational tool for LogD prediction upon the enrichment of experimental Δ G sol data for organic solvents.

A Review of High-Performance Computational Strategies for Modeling and Imaging of Electromagnetic Induction Data

NASA Astrophysics Data System (ADS)

Newman, Gregory A.

2014-01-01

Many geoscientific applications exploit electrostatic and electromagnetic fields to interrogate and map subsurface electrical resistivity—an important geophysical attribute for characterizing mineral, energy, and water resources. In complex three-dimensional geologies, where many of these resources remain to be found, resistivity mapping requires large-scale modeling and imaging capabilities, as well as the ability to treat significant data volumes, which can easily overwhelm single-core and modest multicore computing hardware. To treat such problems requires large-scale parallel computational resources, necessary for reducing the time to solution to a time frame acceptable to the exploration process. The recognition that significant parallel computing processes must be brought to bear on these problems gives rise to choices that must be made in parallel computing hardware and software. In this review, some of these choices are presented, along with the resulting trade-offs. We also discuss future trends in high-performance computing and the anticipated impact on electromagnetic (EM) geophysics. Topics discussed in this review article include a survey of parallel computing platforms, graphics processing units to multicore CPUs with a fast interconnect, along with effective parallel solvers and associated solver libraries effective for inductive EM modeling and imaging.

Mammography Use Among Medicare Beneficiaries After Elimination of Cost Sharing.

PubMed

Sabatino, Susan A; Thompson, Trevor D; Guy, Gery P; de Moor, Janet S; Tangka, Florence K

2016-04-01

We examined mammography use before and after Medicare eliminated cost sharing for screening mammography in January 2011. Using National Health Interview Survey data, we examined changes in mammography use between 2010 and 2013 among Medicare beneficiaries aged 65-74 years. Logistic regression and predictive margins were used to examine changes in use after adjusting for covariates. In 2013, 74.7% of women reported a mammogram within 2 years, a 3.5 percentage point increase (95% confidence interval, -0.3, 7.2) compared with 2010. Increases occurred among women aged 65-69 years, unmarried women, and women with usual sources of care and 2-5 physician visits in the prior year. After adjustment, mammography use increased in 2013 versus 2010 (74.8% vs. 71.3%, P=0.039). Interactions between year and income, insurance, race, or ethnicity were not significant. There was a modest increase in mammography use from 2010 to 2013 among Medicare beneficiaries aged 65-74 years, possibly consistent with an effect of eliminating Medicare cost sharing during this time. Findings suggest that eliminating cost sharing might increase use of recommended screening services.

Mammography screening: how important is cost as a barrier to use?

PubMed Central

Urban, N; Anderson, G L; Peacock, S

1994-01-01

OBJECTIVES. Recent legislation will improve insurance coverage for screening mammography and effectively lower its cost to many women. Although cost has been cited as a barrier to use, evidence of the magnitude of its effect on use is limited. METHODS. Mammography use in the past 2 years among women aged 50 to 75 residing in four suburban or rural counties in Washington State was estimated from 1989 survey data. Logistic regression analysis was used to estimate the odds ratio of mammography use as a function of economic and other variables. Within a residential area, averages were used to measure the market price of mammography and the time cost to obtain a mammogram. RESULTS. Use was lower among women who faced a higher net price or who preferred to obtain a mammogram during weekend or evening hours and higher among women with higher incomes. Visiting no doctor regularly and smoking were predictors of failure to use mammography. CONCLUSION. The effects of economic variables on mammography use are important and stable across subsets of the population, but they are modest in size. PMID:8279611

Mammography screening: how important is cost as a barrier to use?

PubMed

Urban, N; Anderson, G L; Peacock, S

1994-01-01

Recent legislation will improve insurance coverage for screening mammography and effectively lower its cost to many women. Although cost has been cited as a barrier to use, evidence of the magnitude of its effect on use is limited. Mammography use in the past 2 years among women aged 50 to 75 residing in four suburban or rural counties in Washington State was estimated from 1989 survey data. Logistic regression analysis was used to estimate the odds ratio of mammography use as a function of economic and other variables. Within a residential area, averages were used to measure the market price of mammography and the time cost to obtain a mammogram. Use was lower among women who faced a higher net price or who preferred to obtain a mammogram during weekend or evening hours and higher among women with higher incomes. Visiting no doctor regularly and smoking were predictors of failure to use mammography. The effects of economic variables on mammography use are important and stable across subsets of the population, but they are modest in size.

Meshfree and efficient modeling of swimming cells

NASA Astrophysics Data System (ADS)

Gallagher, Meurig T.; Smith, David J.

2018-05-01

Locomotion in Stokes flow is an intensively studied problem because it describes important biological phenomena such as the motility of many species' sperm, bacteria, algae, and protozoa. Numerical computations can be challenging, particularly in three dimensions, due to the presence of moving boundaries and complex geometries; methods which combine ease of implementation and computational efficiency are therefore needed. A recently proposed method to discretize the regularized Stokeslet boundary integral equation without the need for a connected mesh is applied to the inertialess locomotion problem in Stokes flow. The mathematical formulation and key aspects of the computational implementation in matlab® or GNU Octave are described, followed by numerical experiments with biflagellate algae and multiple uniflagellate sperm swimming between no-slip surfaces, for which both swimming trajectories and flow fields are calculated. These computational experiments required minutes of time on modest hardware; an extensible implementation is provided in a GitHub repository. The nearest-neighbor discretization dramatically improves convergence and robustness, a key challenge in extending the regularized Stokeslet method to complicated three-dimensional biological fluid problems.

Seeing the forest for the trees: Networked workstations as a parallel processing computer

NASA Technical Reports Server (NTRS)

Breen, J. O.; Meleedy, D. M.

1992-01-01

Unlike traditional 'serial' processing computers in which one central processing unit performs one instruction at a time, parallel processing computers contain several processing units, thereby, performing several instructions at once. Many of today's fastest supercomputers achieve their speed by employing thousands of processing elements working in parallel. Few institutions can afford these state-of-the-art parallel processors, but many already have the makings of a modest parallel processing system. Workstations on existing high-speed networks can be harnessed as nodes in a parallel processing environment, bringing the benefits of parallel processing to many. While such a system can not rival the industry's latest machines, many common tasks can be accelerated greatly by spreading the processing burden and exploiting idle network resources. We study several aspects of this approach, from algorithms to select nodes to speed gains in specific tasks. With ever-increasing volumes of astronomical data, it becomes all the more necessary to utilize our computing resources fully.

Effects of Geometric Details on Slat Noise Generation and Propagation

NASA Technical Reports Server (NTRS)

Khorrami, Mehdi R.; Lockard, David P.

2009-01-01

The relevance of geometric details to the generation and propagation of noise from leading-edge slats is considered. Typically, such details are omitted in computational simulations and model-scale experiments thereby creating ambiguities in comparisons with acoustic results from flight tests. The current study uses two-dimensional, computational simulations in conjunction with a Ffowcs Williams-Hawkings (FW-H) solver to investigate the effects of previously neglected slat "bulb" and "blade" seals on the local flow field and the associated acoustic radiation. The computations show that the presence of the "blade" seal at the cusp in the simulated geometry significantly changes the slat cove flow dynamics, reduces the amplitudes of the radiated sound, and to a lesser extent, alters the directivity beneath the airfoil. Furthermore, the computations suggest that a modest extension of the baseline "blade" seal further enhances the suppression of slat noise. As a side issue, the utility and equivalence of FW-H methodology for calculating far-field noise as opposed to a more direct approach is examined and demonstrated.

Development of an autonomous video rendezvous and docking system, phase 2

NASA Technical Reports Server (NTRS)

Tietz, J. C.; Richardson, T. E.

1983-01-01

The critical elements of an autonomous video rendezvous and docking system were built and used successfully in a physical laboratory simulation. The laboratory system demonstrated that a small, inexpensive electronic package and a flight computer of modest size can analyze television images to derive guidance information for spacecraft. In the ultimate application, the system would use a docking aid consisting of three flashing lights mounted on a passive target spacecraft. Television imagery of the docking aid would be processed aboard an active chase vehicle to derive relative positions and attitudes of the two spacecraft. The demonstration system used scale models of the target spacecraft with working docking aids. A television camera mounted on a 6 degree of freedom (DOF) simulator provided imagery of the target to simulate observations from the chase vehicle. A hardware video processor extracted statistics from the imagery, from which a computer quickly computed position and attitude. Computer software known as a Kalman filter derived velocity information from position measurements.

On the Rapid Computation of Various Polylogarithmic Constants

NASA Technical Reports Server (NTRS)

Bailey, David H.; Borwein, Peter; Plouffe, Simon

1996-01-01

We give algorithms for the computation of the d-th digit of certain transcendental numbers in various bases. These algorithms can be easily implemented (multiple precision arithmetic is not needed), require virtually no memory, and feature run times that scale nearly linearly with the order of the digit desired. They make it feasible to compute, for example, the billionth binary digit of log(2) or pi on a modest workstation in a few hours run time. We demonstrate this technique by computing the ten billionth hexadecimal digit of pi, the billionth hexadecimal digits of pi-squared, log(2) and log-squared(2), and the ten billionth decimal digit of log(9/10). These calculations rest on the observation that very special types of identities exist for certain numbers like pi, pi-squared, log(2) and log-squared(2). These are essentially polylogarithmic ladders in an integer base. A number of these identities that we derive in this work appear to be new, for example a critical identity for pi.

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

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

A fixed collector employing reversible vee-trough concentrator and a vacuum tube receiver for high temperature solar energy systems

NASA Technical Reports Server (NTRS)

Selcuk, M. K.

1976-01-01

A solar heat collection system employing non-tracking reflectors integrated with a fixed vacuum tube receiver which achieves modest year-round concentration (about 2) of the sunlight at low capital costs is discussed. The axis of the vee-trough reflector lies in a east-west direction and requires reversal of the reflector surfaces only twice a year without disturbing the receiver tubes and associated plumbing. It collects most of the diffuse flux. The vacuum tube receiver with selective absorber has no convection losses while radiation and conduction losses are minimal. Significant cost reductions are offered since the vee-trough can be fabricated from inexpensive polished or plastic reflector laminated sheet metal covering 2/3 of the collection area, and only about 1/3 of the area is covered with the more expensive vacuum tube receivers. Thermal and economic performance of the vee-trough vacuum tube system, year-round variation of the concentration factor, incident flux, useful heat per unit area at various operation temperatures and energy cost estimates are presented. The electrical energy cost is estimated to be 77 mills/kWh, and the system construction cost is estimated to be $1140/kWe.

ParkinsonNet: A Low-Cost Health Care Innovation With A Systems Approach From The Netherlands.

PubMed

Bloem, Bas R; Rompen, Lonneke; Vries, Nienke M de; Klink, Ab; Munneke, Marten; Jeurissen, Patrick

2017-11-01

ParkinsonNet, a low-cost innovation to optimize care for patients with Parkinson disease, was developed in 2004 as a network of physical therapists in several regions in the Netherlands. Since that time, the network has achieved full national reach, with 70 regional networks and around 3,000 specifically trained professionals from 12 disciplines. Key elements include the empowerment of professionals who are highly trained and specialized in Parkinson disease, the empowerment of patients by education and consultation, and the empowerment of integrated multidisciplinary teams to better address and manage the disease. Studies have found that the ParkinsonNet approach leads to outcomes that are at least as good as, if not better than, outcomes from usual care. One study found a 50 percent reduction in hip fractures and fewer inpatient admissions. Other studies suggest that ParkinsonNet leads to modest but important cost savings (at least US$439 per patient annually). These cost savings outweigh the costs of building and maintaining the network. Because of ParkinsonNet's success, the program has now spread to several other countries and serves as a model of a successful and scalable frugal innovation.

Selective inhibition of a multicomponent response can be achieved without cost

PubMed Central

Westrick, Zachary; Ivry, Richard B.

2014-01-01

Behavioral flexibility frequently requires the ability to modify an on-going action. In some situations, optimal performance requires modifying some components of an on-going action without interrupting other components of that action. This form of control has been studied with the selective stop-signal task, in which participants are instructed to abort only one movement of a multicomponent response. Previous studies have shown a transient disruption of the nonaborted component, suggesting limitations in our ability to use selective inhibition. This cost has been attributed to a structural limitation associated with the recruitment of a cortico-basal ganglia pathway that allows for the rapid inhibition of action but operates in a relatively generic manner. Using a model-based approach, we demonstrate that, with a modest amount of training and highly compatible stimulus-response mappings, people can perform a selective-stop task without any cost on the nonaborted component. Prior reports of behavioral costs in selective-stop tasks reflect, at least in part, a sampling bias in the method commonly used to estimate such costs. These results suggest that inhibition can be selectively controlled and present a challenge for models of inhibitory control that posit the operation of generic processes. PMID:25339712

Accrued Cost Savings of a Free Clinic Using Quality-Adjusted Life Years Saved and Return on Investment.

PubMed

Sanders, Jim; Lacey, Marcus; Guse, Clare E

2017-01-01

Savings garnered through the provision of preventive services is a form of profit for health systems. Free clinics have been using this logic to demonstrate their cost-savings. The Community-Based Chronic Disease Management (CCDM) clinic treats hypertension using nurse-led teams, clinical protocols, and community-based settings. We calculated CCDM's cost-effectiveness from 2007 to 2013 using 2 metrics: Quality-adjusted life years (QALYs) saved and return on investment (ROI). QALYs were calculated using the Clinical Preventive Burden (CPB) score for hypertension care. ROI was calculated by tallying the savings from prevented heart attacks, strokes, and emergency department visits against the total operating costs. Using conservative assumptions for cost estimates, hypertension care resulted in a value of QALYs saved of $711,000 to $2,133,000 and an ROI ratio range of 0.35 to 1.20. Our study shows that when using conservative assumptions to calculate cost-savings, our free clinic did not save money. Cost-savings did occur, but the amount was modest, was less than that of cost-inputs, and was not likely captured by any single health entity. Although free clinics remain a vital health care access point for many Americans, it has yet to be demonstrated that they generate a net savings. © Copyright 2017 by the American Board of Family Medicine.

Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries

PubMed Central

Cambiano, Valentina; Ford, Deborah; Mabugu, Travor; Napierala Mavedzenge, Sue; Miners, Alec; Mugurungi, Owen; Nakagawa, Fumiyo; Revill, Paul; Phillips, Andrew

2015-01-01

Background Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. Methods The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, self-testing is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. Results We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. Conclusions This analysis suggests that introducing self-testing offers some health benefits and may well save costs. PMID:25767214

Analysis of Crack Arrest Toughness.

DTIC Science & Technology

1988-01-15

kl,. and that the microstructural features that effect "eligibility" may have a modest effect on K,. 1953 to 1955 he sered in the Titani im Section of...ductile fracture criterion, computations which assumed that the 6-Aa history was the same for rapid fracture as it was for stable crack growth agree...around the crack tip [25]. The 8-Aa history , used as the fracture criterion for the first 4 mm of growth in the dynamic analysis, was obtained from the

Toward using games to teach fundamental computer science concepts

NASA Astrophysics Data System (ADS)

Edgington, Jeffrey Michael

Video and computer games have become an important area of study in the field of education. Games have been designed to teach mathematics, physics, raise social awareness, teach history and geography, and train soldiers in the military. Recent work has created computer games for teaching computer programming and understanding basic algorithms. We present an investigation where computer games are used to teach two fundamental computer science concepts: boolean expressions and recursion. The games are intended to teach the concepts and not how to implement them in a programming language. For this investigation, two computer games were created. One is designed to teach basic boolean expressions and operators and the other to teach fundamental concepts of recursion. We describe the design and implementation of both games. We evaluate the effectiveness of these games using before and after surveys. The surveys were designed to ascertain basic understanding, attitudes and beliefs regarding the concepts. The boolean game was evaluated with local high school students and students in a college level introductory computer science course. The recursion game was evaluated with students in a college level introductory computer science course. We present the analysis of the collected survey information for both games. This analysis shows a significant positive change in student attitude towards recursion and modest gains in student learning outcomes for both topics.

Sertraline treatment for depression associated with acute coronary syndromes: a cost analysis from the viewpoint of the Italian Healthcare System.

PubMed

Lattanzio, Fabrizia; Cherubini, Antonio; Furneri, Gianluca; Di Bari, Mauro; Marchionni, Niccolò

2008-02-01

Depressive disorders (DD) are independent risk factors for rehospitalization after acute coronary syndromes (ACS) and, hence, for increased healthcare costs. A placebo-controlled safety trial of 24 weeks of treatment with sertraline after ACS (Sertraline Anti-Depressant Heart Attack Randomized Trial, SADHART) suggested that active treatment was associated with reduced rehospitalization due to coronary and non-coronary events. With the SADHART database, a cost analysis was carried out to determine the economic consequences of treating DD after ACS in the perspective of the Italian Healthcare System. Clinical information on medical events and rehospitalizations recorded over the study period was drawn from the original SADHART database, which did not contain information necessary for estimating indirect costs. Analysis was therefore limited to direct medical costs due to rehospitalizations, emergency room visits and hospital procedures, and the average Italian Diagnosis-Related Group (DRG) tariffs were applied. With the exclusion of the cost of sertraline treatment, the average direct cost per patient over the study period was 3,418+/-8,290 euro in the active treatment group and 4,409+/-9,439 euro in the placebo group (p=0.3). After including the cost of 24 weeks of sertraline treatment, the average cost in sertraline-treated patients was only modestly increased, to 3,524+/-8,290 euro. Treatment of major DD in patients with recent ACS can improve patient care without additional costs, and possibly with some savings, to the healthcare system.

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

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

Financial Management of a Large Multi-site Randomized Clinical Trial

PubMed Central

Sheffet, Alice J.; Flaxman, Linda; Tom, MeeLee; Hughes, Susan E.; Longbottom, Mary E.; Howard, Virginia J.; Marler, John R.; Brott, Thomas G.

2014-01-01

Background The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) received five years’ funding ($21,112,866) from the National Institutes of Health to compare carotid stenting to surgery for stroke prevention in 2,500 randomized participants at 40 sites. Aims Herein we evaluate the change in the CREST budget from a fixed to variable-cost model and recommend strategies for the financial management of large-scale clinical trials. Methods Projections of the original grant’s fixed-cost model were compared to the actual costs of the revised variable-cost model. The original grant’s fixed-cost budget included salaries, fringe benefits, and other direct and indirect costs. For the variable-cost model, the costs were actual payments to the clinical sites and core centers based upon actual trial enrollment. We compared annual direct and indirect costs and per-patient cost for both the fixed and variable models. Differences between clinical site and core center expenditures were also calculated. Results Using a variable-cost budget for clinical sites, funding was extended by no-cost extension from five to eight years. Randomizing sites tripled from 34 to 109. Of the 2,500 targeted sample size, 138 (5.5%) were randomized during the first five years and 1,387 (55.5%) during the no-cost extension. The actual per-patient costs of the variable model were 9% ($13,845) of the projected per-patient costs ($152,992) of the fixed model. Conclusions Performance-based budgets conserve funding, promote compliance, and allow for additional sites at modest additional cost. Costs of large-scale clinical trials can thus be reduced through effective management without compromising scientific integrity. PMID:24661748

Financial management of a large multisite randomized clinical trial.

PubMed

Sheffet, Alice J; Flaxman, Linda; Tom, MeeLee; Hughes, Susan E; Longbottom, Mary E; Howard, Virginia J; Marler, John R; Brott, Thomas G

2014-08-01

The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) received five years' funding ($21 112 866) from the National Institutes of Health to compare carotid stenting to surgery for stroke prevention in 2500 randomized participants at 40 sites. Herein we evaluate the change in the CREST budget from a fixed to variable-cost model and recommend strategies for the financial management of large-scale clinical trials. Projections of the original grant's fixed-cost model were compared to the actual costs of the revised variable-cost model. The original grant's fixed-cost budget included salaries, fringe benefits, and other direct and indirect costs. For the variable-cost model, the costs were actual payments to the clinical sites and core centers based upon actual trial enrollment. We compared annual direct and indirect costs and per-patient cost for both the fixed and variable models. Differences between clinical site and core center expenditures were also calculated. Using a variable-cost budget for clinical sites, funding was extended by no-cost extension from five to eight years. Randomizing sites tripled from 34 to 109. Of the 2500 targeted sample size, 138 (5·5%) were randomized during the first five years and 1387 (55·5%) during the no-cost extension. The actual per-patient costs of the variable model were 9% ($13 845) of the projected per-patient costs ($152 992) of the fixed model. Performance-based budgets conserve funding, promote compliance, and allow for additional sites at modest additional cost. Costs of large-scale clinical trials can thus be reduced through effective management without compromising scientific integrity. © 2014 The Authors. International Journal of Stroke © 2014 World Stroke Organization.

Impact of scaffold rigidity on the design and evolution of an artificial Diels-Alderase

PubMed Central

Preiswerk, Nathalie; Beck, Tobias; Schulz, Jessica D.; Milovník, Peter; Mayer, Clemens; Siegel, Justin B.; Baker, David; Hilvert, Donald

2014-01-01

By combining targeted mutagenesis, computational refinement, and directed evolution, a modestly active, computationally designed Diels-Alderase was converted into the most proficient biocatalyst for [4+2] cycloadditions known. The high stereoselectivity and minimal product inhibition of the evolved enzyme enabled preparative scale synthesis of a single product diastereomer. X-ray crystallography of the enzyme–product complex shows that the molecular changes introduced over the course of optimization, including addition of a lid structure, gradually reshaped the pocket for more effective substrate preorganization and transition state stabilization. The good overall agreement between the experimental structure and the original design model with respect to the orientations of both the bound product and the catalytic side chains contrasts with other computationally designed enzymes. Because design accuracy appears to correlate with scaffold rigidity, improved control over backbone conformation will likely be the key to future efforts to design more efficient enzymes for diverse chemical reactions. PMID:24847076

Simulated quantum computation of molecular energies.

PubMed

Aspuru-Guzik, Alán; Dutoi, Anthony D; Love, Peter J; Head-Gordon, Martin

2005-09-09

The calculation time for the energy of atoms and molecules scales exponentially with system size on a classical computer but polynomially using quantum algorithms. We demonstrate that such algorithms can be applied to problems of chemical interest using modest numbers of quantum bits. Calculations of the water and lithium hydride molecular ground-state energies have been carried out on a quantum computer simulator using a recursive phase-estimation algorithm. The recursive algorithm reduces the number of quantum bits required for the readout register from about 20 to 4. Mappings of the molecular wave function to the quantum bits are described. An adiabatic method for the preparation of a good approximate ground-state wave function is described and demonstrated for a stretched hydrogen molecule. The number of quantum bits required scales linearly with the number of basis functions, and the number of gates required grows polynomially with the number of quantum bits.

Thermionic/AMTEC cascade converter concept for high-efficiency space power

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

Hagan, T.H. van; Smith, J.N. Jr.; Schuller, M.

1996-12-31

This paper presents trade studies that address the use of the thermionic/AMTEC cell--a cascaded, high-efficiency, static power conversion concept that appears well-suited to space power applications. Both the thermionic and AMTEC power conversion approaches have been shown to be promising candidates for space power. Thermionics offers system compactness via modest efficiency at high heat rejection temperatures, and AMTEC offers high efficiency at modest heat rejection temperature. From a thermal viewpoint the two are ideally suited for cascaded power conversion: thermionic heat rejection and AMTEC heat source temperatures are essentially the same. In addition to realizing conversion efficiencies potentially as highmore » as 35--40%, such a cascade offers the following perceived benefits: survivability; simplicity; technology readiness; and technology growth. Mechanical approaches and thermal/electric matching criteria for integrating thermionics and AMTEC into a single conversion device are described. Focusing primarily on solar thermal space power applications, parametric trends are presented to show the performance and cost potential that should be achievable with present-day technology in cascaded thermionic/AMTEC systems.« less

Chemical vapor deposition techniques and related methods for manufacturing microminiature thermionic converters

DOEpatents

King, Donald B.; Sadwick, Laurence P.; Wernsman, Bernard R.

2002-06-25

Methods of manufacturing microminiature thermionic converters (MTCs) having high energy-conversion efficiencies and variable operating temperatures using MEMS manufacturing techniques including chemical vapor deposition. The MTCs made using the methods of the invention incorporate cathode to anode spacing of about 1 micron or less and use cathode and anode materials having work functions ranging from about 1 eV to about 3 eV. The MTCs also exhibit maximum efficiencies of just under 30%, and thousands of the devices can be fabricated at modest costs.

Optical devices

DOEpatents

Chaves, Julio C.; Falicoff, Waqidi; Minano, Juan C.; Benitez, Pablo; Dross, Oliver; Parkyn, Jr., William A.

2010-07-13

An optical manifold for efficiently combining a plurality of blue LED outputs to illuminate a phosphor for a single, substantially homogeneous output, in a small, cost-effective package. Embodiments are disclosed that use a single or multiple LEDs and a remote phosphor, and an intermediate wavelength-selective filter arranged so that backscattered photoluminescence is recycled to boost the luminance and flux of the output aperture. A further aperture mask is used to boost phosphor luminance with only modest loss of luminosity. Alternative non-recycling embodiments provide blue and yellow light in collimated beams, either separately or combined into white.

Recommendations for evaluation of computational methods

NASA Astrophysics Data System (ADS)

Jain, Ajay N.; Nicholls, Anthony

2008-03-01

The field of computational chemistry, particularly as applied to drug design, has become increasingly important in terms of the practical application of predictive modeling to pharmaceutical research and development. Tools for exploiting protein structures or sets of ligands known to bind particular targets can be used for binding-mode prediction, virtual screening, and prediction of activity. A serious weakness within the field is a lack of standards with respect to quantitative evaluation of methods, data set preparation, and data set sharing. Our goal should be to report new methods or comparative evaluations of methods in a manner that supports decision making for practical applications. Here we propose a modest beginning, with recommendations for requirements on statistical reporting, requirements for data sharing, and best practices for benchmark preparation and usage.

Algorithm For Optimal Control Of Large Structures

NASA Technical Reports Server (NTRS)

Salama, Moktar A.; Garba, John A..; Utku, Senol

1989-01-01

Cost of computation appears competitive with other methods. Problem to compute optimal control of forced response of structure with n degrees of freedom identified in terms of smaller number, r, of vibrational modes. Article begins with Hamilton-Jacobi formulation of mechanics and use of quadratic cost functional. Complexity reduced by alternative approach in which quadratic cost functional expressed in terms of control variables only. Leads to iterative solution of second-order time-integral matrix Volterra equation of second kind containing optimal control vector. Cost of algorithm, measured in terms of number of computations required, is of order of, or less than, cost of prior algoritms applied to similar problems.

Hospital length of stay and cost burden of HIV, tuberculosis, and HIV-tuberculosis coinfection among pregnant women in the United States.

PubMed

Falana, Adeola; Akpojiyovwi, Vanessa; Sey, Esther; Akpaffiong, Andika; Agumbah, Olive; Chienye, Samara; Banks, Jamie; Jones, Erin; Spooner, Kiara K; Salemi, Jason L; Olaleye, Omonike A; Onyiego, Sherri D; Salihu, Hamisu M

2018-05-01

We sought to determine hospital length of stay (LOS) and cost burden associated with hospital admissions among pregnant women with HIV monoinfection, tuberculosis (TB) monoinfection, or HIV-TB coinfection in the United States. Analysis covered the period from 2002-2014 using data from the Nationwide Inpatient Sample. Relevant ICD-9-CM codes were used to determine HIV and TB status. Costs associated with hospitalization were calculated and adjusted to 2010 dollars using the medical care component of the Consumer Price Index. We found modest annual average reduction in HIV, TB, and HIV-TB coinfection rates over the study period. The mean LOS was lowest among mothers free of HIV or TB disease and highest among those with HIV-TB coinfection. The average LOS among mothers diagnosed with TB monoinfection was 60% higher than for those with HIV monoinfection. The cost associated with pregnancy-related hospital admissions among mothers with HIV was approximately 30% higher than disease-free mothers, and the cost more than doubled among patients with TB monoinfection or HIV-TB coinfection. TB significantly increased hospital care cost among HIV-positive and HIV-negative pregnant women. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Physical activity coaching by Australian Exercise Physiologists is cost effective for patients referred from general practice.

PubMed

Ewald, Ben; Stacey, Fiona; Johnson, Natalie; Plotnikoff, Ronald C; Holliday, Elizabeth; Brown, Wendy; James, Erica L

2018-02-01

Interventions to promote physical activity for sedentary patients seen in general practice may be a way to reduce the burden of chronic disease. Coaching by an exercise physiologist is publicly funded in Australia, but cost effectiveness has not been documented. In a three-arm randomised controlled trial, face-to-face coaching and telephone coaching over 12 weeks were compared with a control group using the outcome of step count for one week at baseline, three months and twelve months. Program costs and time-based costs were considered. Quality of life was measured as a secondary outcome. At 12 months, the intervention groups were more active than controls by 1,002 steps per day (95%CI 244, 1,759). This was achieved at a cost of AUD$245 per person. There was no change in reported quality of life or utility values. Coaching achieved a modest increase in activity equivalent to 10 minutes walking per day, at a cost of AUD$245 per person. Face-to-face and telephone counselling were both effective. Implication for public health: Persistence of increases nine months after the end of coaching suggests it creates long-term change and is a good value health intervention. © 2017 The Authors.

Modeling cascading diffusion of new energy technologies: case study of residential solid oxide fuel cells in the US and internationally.

PubMed

Herron, Seth; Williams, Eric

2013-08-06

Subsidy programs for new energy technologies are motivated by the experience curve: increased adoption of a technology leads to learning and economies of scale that lower costs. Geographic differences in fuel prices and climate lead to large variability in the economic performance of energy technologies. The notion of cascading diffusion is that regions with favorable economic conditions serve as the basis to build scale and reduce costs so that the technology becomes attractive in new regions. We develop a model of cascading diffusion and implement via a case study of residential solid oxide fuel cells (SOFCs) for combined heating and power. We consider diffusion paths within the U.S. and internationally. We construct market willingness-to-pay curves and estimate future manufacturing costs via an experience curve. Combining market and cost results, we find that for rapid cost reductions (learning rate = 25%), a modest public subsidy can make SOFC investment profitable for 20-160 million households. If cost reductions are slow however (learning rate = 15%), residential SOFCs may not become economically competitive. Due to higher energy prices in some countries, international diffusion is more favorable than domestic, mitigating much of the uncertainty in the learning rate.

Solving optimization problems on computational grids.

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

Wright, S. J.; Mathematics and Computer Science

2001-05-01

Multiprocessor computing platforms, which have become more and more widely available since the mid-1980s, are now heavily used by organizations that need to solve very demanding computational problems. Parallel computing is now central to the culture of many research communities. Novel parallel approaches were developed for global optimization, network optimization, and direct-search methods for nonlinear optimization. Activity was particularly widespread in parallel branch-and-bound approaches for various problems in combinatorial and network optimization. As the cost of personal computers and low-end workstations has continued to fall, while the speed and capacity of processors and networks have increased dramatically, 'cluster' platforms havemore » become popular in many settings. A somewhat different type of parallel computing platform know as a computational grid (alternatively, metacomputer) has arisen in comparatively recent times. Broadly speaking, this term refers not to a multiprocessor with identical processing nodes but rather to a heterogeneous collection of devices that are widely distributed, possibly around the globe. The advantage of such platforms is obvious: they have the potential to deliver enormous computing power. Just as obviously, however, the complexity of grids makes them very difficult to use. The Condor team, headed by Miron Livny at the University of Wisconsin, were among the pioneers in providing infrastructure for grid computations. More recently, the Globus project has developed technologies to support computations on geographically distributed platforms consisting of high-end computers, storage and visualization devices, and other scientific instruments. In 1997, we started the metaneos project as a collaborative effort between optimization specialists and the Condor and Globus groups. Our aim was to address complex, difficult optimization problems in several areas, designing and implementing the algorithms and the software infrastructure need to solve these problems on computational grids. This article describes some of the results we have obtained during the first three years of the metaneos project. Our efforts have led to development of the runtime support library MW for implementing algorithms with master-worker control structure on Condor platforms. This work is discussed here, along with work on algorithms and codes for integer linear programming, the quadratic assignment problem, and stochastic linear programmming. Our experiences in the metaneos project have shown that cheap, powerful computational grids can be used to tackle large optimization problems of various types. In an industrial or commercial setting, the results demonstrate that one may not have to buy powerful computational servers to solve many of the large problems arising in areas such as scheduling, portfolio optimization, or logistics; the idle time on employee workstations (or, at worst, an investment in a modest cluster of PCs) may do the job. For the optimization research community, our results motivate further work on parallel, grid-enabled algorithms for solving very large problems of other types. The fact that very large problems can be solved cheaply allows researchers to better understand issues of 'practical' complexity and of the role of heuristics.« less

Costs of colorectal cancer in different states of the disease.

PubMed

Färkkilä, Niilo; Torvinen, Saku; Sintonen, Harri; Saarto, Tiina; Järvinen, Heikki; Hänninen, Juha; Taari, Kimmo; Roine, Risto P

2015-04-01

This cross-sectional study estimates the resource use and costs among prevalent colorectal cancer (CRC) patients in different states of the disease. Altogether 508 Finnish CRC patients (aged 26-96; colon cancer 56%; female 47%) answered a questionnaire enquiring about informal care, work capacity, and demographic factors. Furthermore, data on direct medical resource use and productivity costs were obtained from registries. Patients were divided into five mutually exclusive groups based on the disease state and the time from diagnosis: primary treatments (the first six months after the diagnosis), rehabilitation, remission, metastatic disease, and palliative care. The costs were calculated for a six-month period. Multivariate modeling was performed to find the cost drivers. The costs were highest during the primary treatment state and the advanced disease states. The total costs for the cross-sectional six-month period were €22 200 in the primary treatment state, €2106 in the rehabilitation state, €2812 in the remission state, €20 540 in the metastatic state, and €21 146 in the palliative state. Most of the costs were direct medical costs. The informal care cost was highest per patient in the palliative care state, amounting to 33% of the total costs. The productivity costs varied between disease states, constituting 19-40% of the total costs, and were highest in the primary treatment state. The first six months after the diagnosis of CRC are resource intensive, but compared with the metastatic disease state, which lasts on average for 2-3 years, the costs are rather modest. Informal care constitutes a remarkable share of the total costs, especially in the palliative state. These results form a basis for the evaluation of the cost effectiveness of new treatments when allocating resources in CRC treatment.

Performance limits and trade-offs in entropy-driven biochemical computers.

PubMed

Chu, Dominique

2018-04-14

It is now widely accepted that biochemical reaction networks can perform computations. Examples are kinetic proof reading, gene regulation, or signalling networks. For many of these systems it was found that their computational performance is limited by a trade-off between the metabolic cost, the speed and the accuracy of the computation. In order to gain insight into the origins of these trade-offs, we consider entropy-driven computers as a model of biochemical computation. Using tools from stochastic thermodynamics, we show that entropy-driven computation is subject to a trade-off between accuracy and metabolic cost, but does not involve time-trade-offs. Time trade-offs appear when it is taken into account that the result of the computation needs to be measured in order to be known. We argue that this measurement process, although usually ignored, is a major contributor to the cost of biochemical computation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Time to change the blind men and the elephant approach to Parkinson disease?

PubMed

Racette, Brad A; Willis, Allison W

2015-07-14

Parkinson disease (PD) is a progressive neurodegenerative disease that is associated with substantial morbidity and early mortality. Disease-related costs exceed $10 billion, not including medications, out-of-pocket expenses, or societal costs. Symptomatic treatment with levodopa, which has been available for over 30 years, and advanced therapies such as deep brain stimulation improve outcomes. Yet most new medications for PD provide a therapeutic benefit that is relatively modest compared to the benefits from levodopa. Despite dozens of neuroprotective clinical trials, there are no medications proven to slow the progression of the disease. Given these limitations, we provide evidence of the potential public health impact of a research agenda that emphasizes identification of risk factors to reduce disease burden through exposure mitigation. In addition, we emphasize health care policy that focuses on increasing health care expenditures for neurologic evaluation and management services to increase access to specialists to improve disease outcomes and reduce costs through better disease management. © 2015 American Academy of Neurology.

Time to change the blind men and the elephant approach to Parkinson disease?

PubMed Central

Willis, Allison W.

2015-01-01

Parkinson disease (PD) is a progressive neurodegenerative disease that is associated with substantial morbidity and early mortality. Disease-related costs exceed $10 billion, not including medications, out-of-pocket expenses, or societal costs. Symptomatic treatment with levodopa, which has been available for over 30 years, and advanced therapies such as deep brain stimulation improve outcomes. Yet most new medications for PD provide a therapeutic benefit that is relatively modest compared to the benefits from levodopa. Despite dozens of neuroprotective clinical trials, there are no medications proven to slow the progression of the disease. Given these limitations, we provide evidence of the potential public health impact of a research agenda that emphasizes identification of risk factors to reduce disease burden through exposure mitigation. In addition, we emphasize health care policy that focuses on increasing health care expenditures for neurologic evaluation and management services to increase access to specialists to improve disease outcomes and reduce costs through better disease management. PMID:26070339

Technical assessment of maglev system concepts. Final report

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

Lever, J.H.

1998-10-01

The Government Maglev System Assessment Team operated from 1991 to 1993 as part of the National Maglev Initiative. They assessed the technical viability of four US Maglev system concepts, using the French TGV high speed train and the German TR07 Maglev system as assessment baselines. Maglev in general offers advantages that include high speed potential, excellent system control, high capacity, low energy consumption, low maintenance, modest land requirements, low operating costs, and ability to meet a variety of transportation missions. Further, the US Maglev concepts could provide superior performance to TR07 for similar cost or similar performance for less cost.more » They also could achieve both lower trip times and lower energy consumption along typical US routes. These advantages result generally from the use of large gap magnetic suspensions, more powerful linear synchronous motors and tilting vehicles. Innovative concepts for motors, guideways, suspension, and superconducting magnets all contribute to a potential for superior long term performance of US Maglev systems compared with TGV and TR07.« less

How Low-Income Subsidy Recipients Respond to Medicare Part D Cost Sharing.

PubMed

Stuart, Bruce; Hendrick, Franklin B; Xu, Jing; Dougherty, J Samantha

2017-06-01

To determine the magnitude and mechanisms of response to Medicare Part D cost sharing by low-income subsidy (LIS) recipients using oral hypoglycemic agents (OHAs) and statins. Medicare data for a 5 percent random sample of beneficiaries with diabetes enrolled in fee-for-service Part D drug plans in 2008. We evaluated the impact of differences between generic and brand cost sharing rates among cohorts of LIS and non-LIS recipients to determine if wider price spreads increased the generic dispensing rate (GDR) and reduced total drug use and cost. We found little association between cost sharing and aggregate OHA and statin use. In adjusted analyses, non-LIS beneficiaries who paid 46 percent of total OHA costs had 2.5 percent fewer OHA days supply than full benefit dual eligibles who paid just 5 percent of their therapy costs. For statins, the difference in days supply between those facing the lowest and highest cost sharing was 4.6 percent. Higher cost sharing was associated with filling fewer but larger prescriptions for both generics and brands. Higher generic and brand copays had little association with OHA and statin use among LIS recipients. This implies that modest changes in required cost sharing for these medicines would have very little substantive impact on generic dispensing or utilization patterns among LIS recipients and thus would have little effect on total program spending. At the same time, any increases in out-of-pocket costs would be expected to shift costs and place greater financial burden on low-income beneficiaries, particularly those in poor health. © Health Research and Educational Trust.

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury.

PubMed

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas R

2014-04-01

To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence-related injury. Benefit-cost analysis. Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared with the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. By contrast, the costs associated with the programme were modest: setup costs of software modifications and prevention strategies were £107 769, while the annual operating costs of the system were estimated as £210 433 (2003 UK pound). The cumulative social benefit-cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit-cost ratio of 14.80 for the health service and 19.1 for the criminal justice system. Each of these benefit-cost ratios is above 1 across a wide range of sensitivity analyses. An effective information-sharing partnership between health services, police and local government in Cardiff, UK, led to substantial cost savings for the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented.

Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial.

PubMed

D'Amico, Francesco; Rehill, Amritpal; Knapp, Martin; Lowery, David; Cerga-Pashoja, Arlinda; Griffin, Mark; Iliffe, Steve; Warner, James

2016-06-01

Although available evidence is modest, exercise could be beneficial in reducing behavioural and psychological symptoms of dementia. We aim to evaluate the cost-effectiveness of a dyadic exercise regimen for individuals with dementia and their main carer as therapy for behavioural and psychological symptoms of dementia. Cost-effectiveness analysis within a two-arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored, for 20-30 min at least five times per week). The study randomised 131 community-dwelling individuals with dementia and clinically significant behavioural and psychological symptoms with a carer willing and able to participate in the exercise regimen; 52 dyads provided sufficient cost data for analyses. Mean intervention cost was £284 per dyad. For the subsample of 52 dyads, the intervention group had significantly higher mean cost from a societal perspective (mean difference £2728.60, p = 0.05), but costs were not significantly different from a health and social care perspective. The exercise intervention was more cost-effective than treatment as usual from both societal and health and social care perspectives for the measure of behavioural and psychological symptoms (Neuropsychiatric Inventory). It does not appear cost-effective in terms of cost per quality-adjusted life year gain. The exercise intervention has the potential to be seen as cost-effective when considering behavioural and psychological symptoms but did not appear cost-effective when considering quality-adjusted life year gains. Copyright © 2015 John Wiley & Sons, Ltd.

The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.

PubMed

Michaelidis, Constantinos I; Fine, Michael J; Lin, Chyongchiou Jeng; Linder, Jeffrey A; Nowalk, Mary Patricia; Shields, Ryan K; Zimmerman, Richard K; Smith, Kenneth J

2016-11-08

Ambulatory antibiotic prescribing contributes to the development of antibiotic resistance and increases societal costs. Here, we estimate the hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States. In an exploratory analysis, we used published data to develop point and range estimates for the hidden societal cost of antibiotic resistance (SCAR) attributable to each ambulatory antibiotic prescription in the United States. We developed four estimation methods that focused on the antibiotic-resistance attributable costs of hospitalization, second-line inpatient antibiotic use, second-line outpatient antibiotic use, and antibiotic stewardship, then summed the estimates across all methods. The total SCAR attributable to each ambulatory antibiotic prescription was estimated to be $13 (range: $3-$95). The greatest contributor to the total SCAR was the cost of hospitalization ($9; 69 % of the total SCAR). The costs of second-line inpatient antibiotic use ($1; 8 % of the total SCAR), second-line outpatient antibiotic use ($2; 15 % of the total SCAR) and antibiotic stewardship ($1; 8 %). This apperars to be an error.; of the total SCAR) were modest contributors to the total SCAR. Assuming an average antibiotic cost of $20, the total SCAR attributable to each ambulatory antibiotic prescription would increase antibiotic costs by 65 % (range: 15-475 %) if incorporated into antibiotic costs paid by patients or payers. Each ambulatory antibiotic prescription is associated with a hidden SCAR that substantially increases the cost of an antibiotic prescription in the United States. This finding raises concerns regarding the magnitude of misalignment between individual and societal antibiotic costs.

An Economic Analysis of Robot-Assisted Therapy for Long-Term Upper-Limb Impairment After Stroke

PubMed Central

Wagner, Todd H.; Lo, Albert C.; Peduzzi, Peter; Bravata, Dawn M.; Huang, Grant D.; Krebs, Hermano I.; Ringer, Robert J.; Federman, Daniel G.; Richards, Lorie G.; Haselkorn, Jodie K.; Wittenberg, George F.; Volpe, Bruce T.; Bever, Christopher T.; Duncan, Pamela W.; Siroka, Andrew; Guarino, Peter D.

2015-01-01

Background and Purpose Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. Methods We estimated the intervention costs and tracked participants' healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. Results A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (P<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different. Conclusions The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation. Clinical Trial Registration URL: http://clinicaltrials.gov. Unique identifier: NCT00372411. PMID:21757677

An Immersed Boundary method with divergence-free velocity interpolation and force spreading

NASA Astrophysics Data System (ADS)

Bao, Yuanxun; Donev, Aleksandar; Griffith, Boyce E.; McQueen, David M.; Peskin, Charles S.

2017-10-01

The Immersed Boundary (IB) method is a mathematical framework for constructing robust numerical methods to study fluid-structure interaction in problems involving an elastic structure immersed in a viscous fluid. The IB formulation uses an Eulerian representation of the fluid and a Lagrangian representation of the structure. The Lagrangian and Eulerian frames are coupled by integral transforms with delta function kernels. The discretized IB equations use approximations to these transforms with regularized delta function kernels to interpolate the fluid velocity to the structure, and to spread structural forces to the fluid. It is well-known that the conventional IB method can suffer from poor volume conservation since the interpolated Lagrangian velocity field is not generally divergence-free, and so this can cause spurious volume changes. In practice, the lack of volume conservation is especially pronounced for cases where there are large pressure differences across thin structural boundaries. The aim of this paper is to greatly reduce the volume error of the IB method by introducing velocity-interpolation and force-spreading schemes with the properties that the interpolated velocity field in which the structure moves is at least C1 and satisfies a continuous divergence-free condition, and that the force-spreading operator is the adjoint of the velocity-interpolation operator. We confirm through numerical experiments in two and three spatial dimensions that this new IB method is able to achieve substantial improvement in volume conservation compared to other existing IB methods, at the expense of a modest increase in the computational cost. Further, the new method provides smoother Lagrangian forces (tractions) than traditional IB methods. The method presented here is restricted to periodic computational domains. Its generalization to non-periodic domains is important future work.

ARK: Aggregation of Reads by K-Means for Estimation of Bacterial Community Composition.

PubMed

Koslicki, David; Chatterjee, Saikat; Shahrivar, Damon; Walker, Alan W; Francis, Suzanna C; Fraser, Louise J; Vehkaperä, Mikko; Lan, Yueheng; Corander, Jukka

2015-01-01

Estimation of bacterial community composition from high-throughput sequenced 16S rRNA gene amplicons is a key task in microbial ecology. Since the sequence data from each sample typically consist of a large number of reads and are adversely impacted by different levels of biological and technical noise, accurate analysis of such large datasets is challenging. There has been a recent surge of interest in using compressed sensing inspired and convex-optimization based methods to solve the estimation problem for bacterial community composition. These methods typically rely on summarizing the sequence data by frequencies of low-order k-mers and matching this information statistically with a taxonomically structured database. Here we show that the accuracy of the resulting community composition estimates can be substantially improved by aggregating the reads from a sample with an unsupervised machine learning approach prior to the estimation phase. The aggregation of reads is a pre-processing approach where we use a standard K-means clustering algorithm that partitions a large set of reads into subsets with reasonable computational cost to provide several vectors of first order statistics instead of only single statistical summarization in terms of k-mer frequencies. The output of the clustering is then processed further to obtain the final estimate for each sample. The resulting method is called Aggregation of Reads by K-means (ARK), and it is based on a statistical argument via mixture density formulation. ARK is found to improve the fidelity and robustness of several recently introduced methods, with only a modest increase in computational complexity. An open source, platform-independent implementation of the method in the Julia programming language is freely available at https://github.com/dkoslicki/ARK. A Matlab implementation is available at http://www.ee.kth.se/ctsoftware.

Distributed Evaluation of Local Sensitivity Analysis (DELSA), with application to hydrologic models

USGS Publications Warehouse

Rakovec, O.; Hill, Mary C.; Clark, M.P.; Weerts, A. H.; Teuling, A. J.; Uijlenhoet, R.

2014-01-01

This paper presents a hybrid local-global sensitivity analysis method termed the Distributed Evaluation of Local Sensitivity Analysis (DELSA), which is used here to identify important and unimportant parameters and evaluate how model parameter importance changes as parameter values change. DELSA uses derivative-based “local” methods to obtain the distribution of parameter sensitivity across the parameter space, which promotes consideration of sensitivity analysis results in the context of simulated dynamics. This work presents DELSA, discusses how it relates to existing methods, and uses two hydrologic test cases to compare its performance with the popular global, variance-based Sobol' method. The first test case is a simple nonlinear reservoir model with two parameters. The second test case involves five alternative “bucket-style” hydrologic models with up to 14 parameters applied to a medium-sized catchment (200 km2) in the Belgian Ardennes. Results show that in both examples, Sobol' and DELSA identify similar important and unimportant parameters, with DELSA enabling more detailed insight at much lower computational cost. For example, in the real-world problem the time delay in runoff is the most important parameter in all models, but DELSA shows that for about 20% of parameter sets it is not important at all and alternative mechanisms and parameters dominate. Moreover, the time delay was identified as important in regions producing poor model fits, whereas other parameters were identified as more important in regions of the parameter space producing better model fits. The ability to understand how parameter importance varies through parameter space is critical to inform decisions about, for example, additional data collection and model development. The ability to perform such analyses with modest computational requirements provides exciting opportunities to evaluate complicated models as well as many alternative models.

[Cost analysis for navigation in knee endoprosthetics].

PubMed

Cerha, O; Kirschner, S; Günther, K-P; Lützner, J

2009-12-01

Total knee arthroplasty (TKA) is one of the most frequent procedures in orthopaedic surgery. The outcome depends on a range of factors including alignment of the leg and the positioning of the implant in addition to patient-associated factors. Computer-assisted navigation systems can improve the restoration of a neutral leg alignment. This procedure has been established especially in Europe and North America. The additional expenses are not reimbursed in the German DRG system (Diagnosis Related Groups). In the present study a cost analysis of computer-assisted TKA compared to the conventional technique was performed. The acquisition expenses of various navigation systems (5 and 10 year depreciation), annual costs for maintenance and software updates as well as the accompanying costs per operation (consumables, additional operating time) were considered. The additional operating time was determined on the basis of a meta-analysis according to the current literature. Situations with 25, 50, 100, 200 and 500 computer-assisted TKAs per year were simulated. The amount of the incremental costs of the computer-assisted TKA depends mainly on the annual volume and the additional operating time. A relevant decrease of the incremental costs was detected between 50 and 100 procedures per year. In a model with 100 computer-assisted TKAs per year an additional operating time of 14 mins and a 10 year depreciation of the investment costs, the incremental expenses amount to 300-395 depending on the navigation system. Computer-assisted TKA is associated with additional costs. From an economical point of view an amount of more than 50 procedures per year appears to be favourable. The cost-effectiveness could be estimated if long-term results will show a reduction of revisions or a better clinical outcome.

Costs and cost-effectiveness of full implementation of a biennial faecal occult blood test screening program for bowel cancer in Australia.

PubMed

Pignone, Michael P; Flitcroft, Kathy L; Howard, Kirsten; Trevena, Lyndal J; Salkeld, Glenn P; St John, D James B

2011-02-21

To examine the costs and cost-effectiveness of full implementation of biennial bowel cancer screening for Australian residents aged 50-74 years. Identification of existing economic models from 1993 to 2010 through searches of PubMed and economic analysis databases, and by seeking expert advice; and additional modelling to determine the costs and cost-effectiveness of full implementation of biennial faecal occult blood test screening for the five million adults in Australia aged 50-74 years. Estimated number of deaths from bowel cancer prevented, costs, and cost-effectiveness (cost per life-year gained [LYG]) of biennial bowel cancer screening. We identified six relevant economic analyses, all of which found colorectal cancer (CRC) screening to be very cost-effective, with costs per LYG under $55,000 per year in 2010 Australian dollars. Based on our additional modelling, we conservatively estimate that full implementation of biennial screening for people aged 50-74 years would have gross costs of $150 million, reduce CRC mortality by 15%-25%, prevent 300-500 deaths from bowel cancer, and save 3600-6000 life-years annually, for an undiscounted cost per LYG of $25,000-$41,667, compared with no screening, and not taking cost savings as a result of treatment into consideration. The additional expenditure required, after accounting for reductions in CRC incidence, savings in CRC treatment costs, and existing ad-hoc colonoscopy use, is likely to be less than $50 million annually. Full implementation of biennial faecal occult blood test screening in Australia can reduce bowel cancer mortality, and is an efficient use of health resources that would require modest additional government investment.

Cost and Cost-Effectiveness of Students for Nutrition and eXercise (SNaX).

PubMed

Ladapo, Joseph A; Bogart, Laura M; Klein, David J; Cowgill, Burton O; Uyeda, Kimberly; Binkle, David G; Stevens, Elizabeth R; Schuster, Mark A

2016-04-01

To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Five intervention and 5 control middle schools (mean enrollment, 1520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. The costs of implementing the program over 5 weeks were $5433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. SNaX demonstrated the feasibility and cost-effectiveness of a middle school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Cost and Cost-effectiveness of Students for Nutrition and Exercise (SNaX)

PubMed Central

Ladapo, Joseph A.; Bogart, Laura M.; Klein, David J.; Cowgill, Burton O.; Uyeda, Kimberly; Binkle, David G.; Stevens, Elizabeth R.; Schuster, Mark A.

2015-01-01

Objective To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Methods Five intervention and five control middle schools (mean enrollment = 1,520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. Results The costs of implementing the program over 5 weeks were $5,433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8,637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. Conclusions SNaX demonstrated the feasibility and cost-effectiveness of a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. PMID:26427719

Low-Cost Computer-Aided Instruction/Computer-Managed Instruction (CAI/CMI) System: Feasibility Study. Final Report.

ERIC Educational Resources Information Center

Lintz, Larry M.; And Others

This study investigated the feasibility of a low cost computer-aided instruction/computer-managed instruction (CAI/CMI) system. Air Force instructors and training supervisors were surveyed to determine the potential payoffs of various CAI and CMI functions. Results indicated that a wide range of capabilities had potential for resident technical…

Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria.

PubMed

Gruber, R; Walter, E; Helbich, T H

2011-01-01

To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria. We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n=166; masses n=152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings. 11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were € 242 per case from a hospital perspective, and € 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective. In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Cost-benefit analysis of childhood asthma management through school-based clinic programs.

PubMed

Tai, Teresa; Bame, Sherry I

2011-04-01

Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

Network Computer Technology. Phase I: Viability and Promise within NASA's Desktop Computing Environment

NASA Technical Reports Server (NTRS)

Paluzzi, Peter; Miller, Rosalind; Kurihara, West; Eskey, Megan

1998-01-01

Over the past several months, major industry vendors have made a business case for the network computer as a win-win solution toward lowering total cost of ownership. This report provides results from Phase I of the Ames Research Center network computer evaluation project. It identifies factors to be considered for determining cost of ownership; further, it examines where, when, and how network computer technology might fit in NASA's desktop computing architecture.

Computer programs for estimating civil aircraft economics

NASA Technical Reports Server (NTRS)

Maddalon, D. V.; Molloy, J. K.; Neubawer, M. J.

1980-01-01

Computer programs for calculating airline direct operating cost, indirect operating cost, and return on investment were developed to provide a means for determining commercial aircraft life cycle cost and economic performance. A representative wide body subsonic jet aircraft was evaluated to illustrate use of the programs.

Cost-effectiveness analysis of apatinib treatment for chemotherapy-refractory advanced gastric cancer.

PubMed

Chen, Hong-Dou; Zhou, Jing; Wen, Feng; Zhang, Peng-Fei; Zhou, Ke-Xun; Zheng, Han-Rui; Yang, Yu; Li, Qiu

2017-02-01

Apatinib, a third-line or later treatment for advanced gastric cancer (aGC), was shown to improve overall survival and progression-free survival (PFS) compared with placebo in the phase III trial. Given the modest benefit with high costs, we further evaluated the cost-effectiveness of apatinib for patients with chemotherapy-refractory aGC. A Markov model was developed to simulate the disease process of aGC (PFS, progressive disease, and death) and estimate the incremental cost-effectiveness ratio (ICER) of apatinib to placebo. The health outcomes and utility scores were derived from the phase III trial and previously published sources, respectively. Total costs were calculated from the perspective of the Chinese health-care payer. Sensitivity analysis was used to explore model uncertainties. Treatment with apatinib was estimated to provide an incremental 0.09 quality-adjusted life years (QALYs) at an incremental cost of $8113.86 compared with placebo, which resulted in an ICER of $90,154.00 per QALY. Sensitivity analysis showed that across the wide variation of parameters, the ICER exceeded the willingness-to-pay threshold of $23,700.00 per QALY which was three times the Gross Domestic Product per Capita in China. Apatinib is not a cost-effective option for patients with aGC who experienced failure of at least two lines chemotherapy in China. However, for its positive clinical value and subliminal demand, apatinib can provide a new therapeutic option.

10 CFR Appendix I to Part 504 - Procedures for the Computation of the Real Cost of Capital

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Procedures for the Computation of the Real Cost of Capital I Appendix I to Part 504 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS Pt. 504, App. I Appendix I to Part 504—Procedures for the Computation of the Real Cost of Capital (a) The firm's real after-tax weighted average...

Grid connected integrated community energy system. Phase II: final state 2 report. Cost benefit analysis, operating costs and computer simulation

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

Not Available

1978-03-22

A grid-connected Integrated Community Energy System (ICES) with a coal-burning power plant located on the University of Minnesota campus is planned. The cost benefit analysis performed for this ICES, the cost accounting methods used, and a computer simulation of the operation of the power plant are described. (LCL)

Nonlinear and parallel algorithms for finite element discretizations of the incompressible Navier-Stokes equations

NASA Astrophysics Data System (ADS)

Arteaga, Santiago Egido

1998-12-01

The steady-state Navier-Stokes equations are of considerable interest because they are used to model numerous common physical phenomena. The applications encountered in practice often involve small viscosities and complicated domain geometries, and they result in challenging problems in spite of the vast attention that has been dedicated to them. In this thesis we examine methods for computing the numerical solution of the primitive variable formulation of the incompressible equations on distributed memory parallel computers. We use the Galerkin method to discretize the differential equations, although most results are stated so that they apply also to stabilized methods. We also reformulate some classical results in a single framework and discuss some issues frequently dismissed in the literature, such as the implementation of pressure space basis and non- homogeneous boundary values. We consider three nonlinear methods: Newton's method, Oseen's (or Picard) iteration, and sequences of Stokes problems. All these iterative nonlinear methods require solving a linear system at every step. Newton's method has quadratic convergence while that of the others is only linear; however, we obtain theoretical bounds showing that Oseen's iteration is more robust, and we confirm it experimentally. In addition, although Oseen's iteration usually requires more iterations than Newton's method, the linear systems it generates tend to be simpler and its overall costs (in CPU time) are lower. The Stokes problems result in linear systems which are easier to solve, but its convergence is much slower, so that it is competitive only for large viscosities. Inexact versions of these methods are studied, and we explain why the best timings are obtained using relatively modest error tolerances in solving the corresponding linear systems. We also present a new damping optimization strategy based on the quadratic nature of the Navier-Stokes equations, which improves the robustness of all the linearization strategies considered and whose computational cost is negligible. The algebraic properties of these systems depend on both the discretization and nonlinear method used. We study in detail the positive definiteness and skewsymmetry of the advection submatrices (essentially, convection-diffusion problems). We propose a discretization based on a new trilinear form for Newton's method. We solve the linear systems using three Krylov subspace methods, GMRES, QMR and TFQMR, and compare the advantages of each. Our emphasis is on parallel algorithms, and so we consider preconditioners suitable for parallel computers such as line variants of the Jacobi and Gauss- Seidel methods, alternating direction implicit methods, and Chebyshev and least squares polynomial preconditioners. These work well for moderate viscosities (moderate Reynolds number). For small viscosities we show that effective parallel solution of the advection subproblem is a critical factor to improve performance. Implementation details on a CM-5 are presented.

A small Internet controllable observatory for research and education at the University of North Dakota

NASA Astrophysics Data System (ADS)

Hardersen, P. S.; de Silva, S.; Reddy, V.; Cui, P.; Kumar, S.; Gaffey, M. J.

2006-06-01

One of the challenges in astronomy education today is to introduce college students to the real-world practice and science of observational astronomy. Along with a good theoretical background, college students can gain an earlier, deeper understanding of the astronomy profession through direct observational and data reduction experience. However, building and managing a modest observatory is still too costly for many colleges and universities. Fortunately, advances in commercial astronomical hardware and software now allow universities to build and operate small Internet controllable observatories for a modest investment. The advantages of an Internet observatory include: 1) remote operation from a comfortable location, 2) immediate data access, 3) telescope control via a web browser, and 4) allowing both on-campus and distance education students the ability to conduct a variety of observing projects. Internet capabilities vastly expand the number of students who will be able to use the observatory, thus exposing them to astronomy as a science and as a potential career. In September 2005, the University of North Dakota (UND) Department of Space Studies began operating a small, recently renovated Internet controllable observatory. Housed within a roll-off roof 10 miles west of UND, the observatory includes a Meade 16-inch, f/10 Schmidt-Cassegrain telescope, an SBIG STL-6303e CCD with broadband filters, ACP observatory control software, focuser, and associated equipment. The observatory cost \\25,000 to build in 1996; 2005 renovation costs total \\28,000. An observatory operator prepares the telescope for use each night. Through remote operation, the roof is opened and the telescope/CCD power is turned on. The telescope is then aligned and focused before allowing students to access the observatory. Students communicate with the observatory operator via an online chat room and via telephone, if necessary, to answer questions and resolve any problems. Additional observatory enhancements are planned for installation and testing in 2006.

Cost-effectiveness of disease-modifying therapy for multiple sclerosis

PubMed Central

Bajorska, A.; Chappel, A.; Schwid, S.R.; Mehta, L.R.; Weinstock-Guttman, B.; Holloway, R.G.; Dick, A.W.

2011-01-01

Objective: To evaluate the cost-effectiveness of disease-modifying therapies (DMTs) in the United States compared to basic supportive therapy without DMT for patients with relapsing multiple sclerosis (MS). Methods: Using data from a longitudinal MS survey, we generated 10-year disease progression paths for an MS cohort. We used first-order annual Markov models to estimate transitional probabilities. Costs associated with losses of employment were obtained from the Bureau of Labor Statistics. Medical costs were estimated using the Centers for Medicare and Medicaid Services reimbursement rates and other sources. Outcomes were measured as gains in quality-adjusted life-years (QALY) and relapse-free years. Monte Carlo simulations, resampling methods, and sensitivity analyses were conducted to evaluate model uncertainty. Results: Using DMT for 10 years resulted in modest health gains for all DMTs compared to treatment without DMT (0.082 QALY or <1 quality-adjusted month gain for glatiramer acetate, and 0.126–0.192 QALY gain for interferons). The cost-effectiveness of all DMTs far exceeded $800,000/QALY. Reducing the cost of DMTs had by far the greatest impact on the cost-effectiveness of these treatments (e.g., cost reduction by 67% would improve the probability of Avonex being cost-effective at $164,000/QALY to 50%). Compared to treating patients with all levels of disease, starting DMT earlier was associated with a lower (more favorable) incremental cost-effectiveness ratio compared to initiating treatment at any disease state. Conclusion: Use of DMT in MS results in health gains that come at a very high cost. PMID:21775734

A Cost-Benefit Study of Doing Astrophysics On The Cloud: Production of Image Mosaics

NASA Astrophysics Data System (ADS)

Berriman, G. B.; Good, J. C. Deelman, E.; Singh, G. Livny, M.

2009-09-01

Utility grids such as the Amazon EC2 and Amazon S3 clouds offer computational and storage resources that can be used on-demand for a fee by compute- and data-intensive applications. The cost of running an application on such a cloud depends on the compute, storage and communication resources it will provision and consume. Different execution plans of the same application may result in significantly different costs. We studied via simulation the cost performance trade-offs of different execution and resource provisioning plans by creating, under the Amazon cloud fee structure, mosaics with the Montage image mosaic engine, a widely used data- and compute-intensive application. Specifically, we studied the cost of building mosaics of 2MASS data that have sizes of 1, 2 and 4 square degrees, and a 2MASS all-sky mosaic. These are examples of mosaics commonly generated by astronomers. We also study these trade-offs in the context of the storage and communication fees of Amazon S3 when used for long-term application data archiving. Our results show that by provisioning the right amount of storage and compute resources cost can be significantly reduced with no significant impact on application performance.

Cost-effectiveness analysis of a collaborative care programme for depression in primary care.

PubMed

Aragonès, Enric; López-Cortacans, Germán; Sánchez-Iriso, Eduardo; Piñol, Josep-Lluís; Caballero, Antonia; Salvador-Carulla, Luis; Cabasés, Juan

2014-04-01

Collaborative care programmes lead to better outcomes in the management of depression. A programme of this nature has demonstrated its effectiveness in primary care in Spain. Our objective was to evaluate the cost-effectiveness of this programme compared to usual care. A bottom-up cost-effectiveness analysis was conducted within a randomized controlled trial (2007-2010). The intervention consisted of a collaborative care programme with clinical, educational and organizational procedures. Outcomes were monitored over a 12 months period. Primary outcomes were incremental cost-effectiveness ratios (ICER): mean differences in costs divided by quality-adjusted life years (QALY) and mean differences in costs divided by depression-free days (DFD). Analyses were performed from a healthcare system perspective (considering healthcare costs) and from a society perspective (including healthcare costs plus loss of productivity costs). Three hundred and thirty-eight adult patients with major depression were assessed at baseline. Only patients with complete data were included in the primary analysis (166 in the intervention group and 126 in the control group). From a healthcare perspective, the average incremental cost of the programme compared to usual care was €182.53 (p<0.001). Incremental effectiveness was 0.045 QALY (p=0.017) and 40.09 DFD (p=0.011). ICERs were €4,056/QALY and €4.55/DFD. These estimates and their uncertainty are graphically represented in the cost-effectiveness plane. The amount of 13.6% of patients with incomplete data may have introduced a bias. Available data about non-healthcare costs were limited, although they may represent most of the total cost of depression. The intervention yields better outcomes than usual care with a modest increase in costs, resulting in favourable ICERs. This supports the recommendation for its implementation. Copyright © 2014 Elsevier B.V. All rights reserved.

Systems cost/performance analysis (study 2.3). Volume 3: Programmer's manual and user's guide. [for unmanned spacecraft

NASA Technical Reports Server (NTRS)

Janz, R. F.

1974-01-01

The systems cost/performance model was implemented as a digital computer program to perform initial program planning, cost/performance tradeoffs, and sensitivity analyses. The computer is described along with the operating environment in which the program was written and checked, the program specifications such as discussions of logic and computational flow, the different subsystem models involved in the design of the spacecraft, and routines involved in the nondesign area such as costing and scheduling of the design. Preliminary results for the DSCS-II design are also included.

Cost Optimization Model for Business Applications in Virtualized Grid Environments

NASA Astrophysics Data System (ADS)

Strebel, Jörg

The advent of Grid computing gives enterprises an ever increasing choice of computing options, yet research has so far hardly addressed the problem of mixing the different computing options in a cost-minimal fashion. The following paper presents a comprehensive cost model and a mixed integer optimization model which can be used to minimize the IT expenditures of an enterprise and help in decision-making when to outsource certain business software applications. A sample scenario is analyzed and promising cost savings are demonstrated. Possible applications of the model to future research questions are outlined.

Telemedicine in Complex Diabetes Management.

PubMed

McDonnell, Marie E

2018-05-24

Telehealth has the potential to positively transform the quality and cost-effectiveness of complex diabetes management in adults. This review explores the landscape of telemedicine approaches and evidence for incorporation into general practice. Telemedicine for diabetes care is feasible based on over 100 randomized clinical trials. Evidence shows modest benefits in A1c lowering and other clinical outcomes that are better sustained over time vs. usual care. While telemedicine interventions are likely cost-effective in diabetes care, more research is needed using implementation science approaches. Telehealth platforms have been shown to be both feasible and effective for health care delivery in diabetes, although there are many caveats that require tailoring to the institution, clinician, and patient population. Research in diabetes telehealth should focus next on how to increase access to patients who are known to be marginalized from traditional models of health care.

Promoting occupational health interventions in early return to work by implementing financial subsidies: a Swedish case study

PubMed Central

2013-01-01

Background In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived. Methods The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions. Results The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy – for coordinated interventions – was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed. Conclusions The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law. PMID:23566064

Efficacy of web-based personalized normative feedback: a two-year randomized controlled trial.

PubMed

Neighbors, Clayton; Lewis, Melissa A; Atkins, David C; Jensen, Megan M; Walter, Theresa; Fossos, Nicole; Lee, Christine M; Larimer, Mary E

2010-12-01

Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = -0.16, 95% CI [-0.02, -0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = -0.29, 95% CI [-0.15, -0.58]). Few other effects were evident. The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies. (c) 2010 APA, all rights reserved.

75 FR 75393 - Schools and Libraries Universal Service Support Mechanism and A National Broadband Plan for Our...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... anchors, both as centers for digital literacy and as hubs for access to public computers. While their... expansion of computer labs, and facilitated deployment of new educational applications that would not have... computer fees to help defray the cost of computers or training fees to help cover the cost of training...

IUWare and Computing Tools: Indiana University's Approach to Low-Cost Software.

ERIC Educational Resources Information Center

Sheehan, Mark C.; Williams, James G.

1987-01-01

Describes strategies for providing low-cost microcomputer-based software for classroom use on college campuses. Highlights include descriptions of the software (IUWare and Computing Tools); computing center support; license policies; documentation; promotion; distribution; staff, faculty, and user training; problems; and future plans. (LRW)

The Next Generation of Personal Computers.

ERIC Educational Resources Information Center

Crecine, John P.

1986-01-01

Discusses factors converging to create high-capacity, low-cost nature of next generation of microcomputers: a coherent vision of what graphics workstation and future computing environment should be like; hardware developments leading to greater storage capacity at lower costs; and development of software and expertise to exploit computing power…

Cut Costs with Thin Client Computing.

ERIC Educational Resources Information Center

Hartley, Patrick H.

2001-01-01

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

12 CFR 1402.21 - Categories of requesters-fees.

Code of Federal Regulations, 2013 CFR

2013-01-01

... searches made by computer, the Farm Credit System Insurance Corporation will determine the hourly cost of... the cost of search (including the operator time and the cost of operating the computer to process a... 1402.21 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION RELEASING INFORMATION Fees for...

12 CFR 1402.21 - Categories of requesters-fees.

Code of Federal Regulations, 2014 CFR

2014-01-01

... searches made by computer, the Farm Credit System Insurance Corporation will determine the hourly cost of... the cost of search (including the operator time and the cost of operating the computer to process a... 1402.21 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION RELEASING INFORMATION Fees for...

12 CFR 1402.21 - Categories of requesters-fees.

Code of Federal Regulations, 2012 CFR

2012-01-01

... searches made by computer, the Farm Credit System Insurance Corporation will determine the hourly cost of... the cost of search (including the operator time and the cost of operating the computer to process a... 1402.21 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION RELEASING INFORMATION Fees for...

12 CFR 1402.21 - Categories of requesters-fees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... searches made by computer, the Farm Credit System Insurance Corporation will determine the hourly cost of... the cost of search (including the operator time and the cost of operating the computer to process a... 1402.21 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION RELEASING INFORMATION Fees for...

12 CFR 1402.21 - Categories of requesters-fees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... searches made by computer, the Farm Credit System Insurance Corporation will determine the hourly cost of... the cost of search (including the operator time and the cost of operating the computer to process a... 1402.21 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION RELEASING INFORMATION Fees for...

Solar Living House Final Technical Report

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

Walters, Bradley

The Solar Living House is a high-performance solar-powered dwelling designed by a team of faculty and students from the University of Florida, in collaboration with Santa Fe College, the National University of Singapore, and Alachua Habitat for Humanity. The project was designed in accordance with the Solar Decathlon 2015, a research, design, education, and outreach program developed by the U.S. Department of Energy (DOE). The Solar Living House is fundamentally a house for living, centered on people and the activities of daily life while quietly introducing advanced design, construction, and engineering technologies. The 993 square-foot two-bedroom one-bath home was designedmore » to embrace and frame an exterior courtyard space. This courtyard acts as an extension of the interior living spaces, maximizing the spatial potentials of a modest building footprint and introducing natural light into the primary living spaces of the house. Research Outcomes: The Solar Living House advances work on high-performance buildings through three principal technological innovations: wet/dry modular construction, a building automation system, and solar dehumidification systems. Wet / Dry Modular Construction: The house is designed as a series of five modules, including one that is designated as the “wet core.” The wet core consolidates the mechanical systems and bathroom into a single module to reduce plumbing runs, efficiency losses, and on-site construction time. The other four modules are designed to eliminate interior load bearing walls to allow for maximum flexibility in the reconfiguring of the space over time. The modules are designed to meet the structural challenges of both Florida’s hurricanes and California’s earthquakes. Building Automation System: The house is equipped with an integrated building automation system, allowing the houses environmental systems, lights, security systems, and smoke detectors to be programmed, monitored, and controlled through any mobile or computing device. These systems allow for more precise calibrations of temperature/humidity/lighting to correspond with user needs and preferences, minimizing energy losses with economical night- or day-time setbacks. Solar Dehumidification System: The most significant technological innovation in the Solar Living House is the solar thermal dehumidification system. This system generates hot water through two rooftop-mounted evacuated tube solar thermal collectors. The hot water is used to continually dry a regenerative solid desiccant material, typically white silica gel. The solid desiccant is used to adsorb moisture and humidity from the air without additional mechanical cooling. This strategy allows humidity to be modulated independently of air temperature, providing greater thermal comfort and reducing the opportunity for the growth of mold spores within the house while also reducing the overall energy consumption of the HVAC system. Economic Feasibility: The team set aggressive goals for affordability, targeting a construction cost of $138,710. An independent professional cost estimator determined the overall project costs, as designed, would be $333,799, or $336.15 per square foot of finished floor area. This is more than 2.4 times the target construction cost. By comparison, the average construction cost for a home in the United States in 2015 was $289,415, or $103.29 per square foot of finished floor area. Following work on the Solar Living House, team leaders incorporated many of its objectives into a net-zero energy home on a site in Gainesville, Florida. This site-built home avoided many of the constraints and complications of modular construction necessitated by the Solar Decathlon, allowing it to be built for a much more modest budget. This two-bedroom two bath 1,800 square foot home was constructed for $135.39 per square foot, including active photovoltaic solar systems, careful attention to continuous air barriers, increased insulation levels, and permanent site constructions. This project suggest that high-performance buildings can be realized for more modest budgets. Public Benefits: Work on the Solar Living House and Solar Decathlon 2015 offered our student team unparalleled learning opportunities. Because of the duration of the project, a number of students participated at different points in their education, from first year undergraduates all the way through to advanced graduate students. The opportunity for collaboration with students and faculty from the National University of Singapore was also extraordinary, allowing for a sharing of technical knowledge and cultural exchange. The wider public has benefited from this work as its findings have been shared through public presentations and publications. It serves as a useful stepping stone along the path towards affordable, high-performance buildings.« less

Economic benefit of fertility control in wild horse populations

USGS Publications Warehouse

Bartholow, J.

2007-01-01

I projected costs for several contraceptive treatments that could be used by the Bureau of Land Management (BLM) to manage 4 wild horse (Equus caballus) populations. Potential management alternatives included existing roundup and selective removal methods combined with contraceptives of different duration and effectiveness. I projected costs for a 20-year economic life using the WinEquus?? wild horse population model and state-by-state cost estimates reflecting BLM's operational expenses. Findings revealed that 1) currently available 2-year contraceptives in most situations are capable of reducing variable operating costs by 15%, 2) experimental 3-year contraceptives may be capable of reducing costs by 18%, and 3) combining contraceptives with modest changes to herd sex ratio (e.g., 55-60% M) could trim costs by 30%. Predicted savings can increase when contraception is applied in conjunction with a removal policy that targets horses aged 0-4 years instead of 0-5 years. However, reductions in herd size result in greater variation in annual operating expenses. Because the horse program's variable operating costs make up about half of the total program costs (which include other fixed costs), contraceptive application and management can only reduce total costs by 14%, saving about $6.1 million per year. None of the contraceptive options I examined eliminated the need for long-term holding facilities over the 20-year period simulated, but the number of horses held may be reduced by about 17% with contraceptive treatment. Cost estimates were most sensitive to the oldest age adoptable and per-day holding costs. The BLM will experience significant cost savings as carefully designed contraceptive programs become widespread in the wild horse herds it manages.

Cost-Effectiveness Analysis of Radiation Therapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma.

PubMed

Rodin, Danielle; Caulley, Lisa; Burger, Emily; Kim, Jane; Johnson-Obaseki, Stephanie; Palma, David; Louie, Alexander V; Hansen, Aaron; O'Sullivan, Brian

2017-03-15

The objective of this study was to compare the cost-effectiveness of transoral robotic surgery (TORS) versus the standard treatment modality for oropharyngeal squamous cell carcinoma (OPSCC), radiation therapy (RT), in a subset of patients with early-stage OPSCC. We developed a microsimulation state-transition model associated with RT and TORS for patients with clinically staged T1N0M0 to T2N1M0 OPSCC. Transition probabilities, utilities, and costs for each health state were estimated from recently published data and discounted by 3% annually over a lifetime time horizon. Model outcomes included lifetime costs (in 2014 US dollars), health benefits (quality-adjusted life-years [QALYs]), and cost-effectiveness ratios from a societal perspective. Under base-case assumptions, TORS was associated with modest gains in QALYs. RT yielded 10.43 QALYs at a cost of $123,410 per patient, whereas TORS yielded 11.10 QALYs at a cost of $178,480. This resulted in an incremental cost-effectiveness ratio of $82,190/QALY gained. The incremental cost-effectiveness ratio was most sensitive to the need for adjuvant therapy, cost of late toxicity, age at diagnosis, disease state utilities, and discount rate. Accounting for joint parameter uncertainty, RT had a higher probability of demonstrating a cost-effective profile compared with TORS, at 54% compared with 46%. By use of standard benchmarks for cost-effectiveness in the United States, TORS may be a cost-effective alternative for the subset of patients with early-stage OPSCC but demonstrates considerable sensitivity to assumptions around quality of life. Copyright © 2016. Published by Elsevier Inc.

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

PubMed

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

2011-01-01

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

An evaluation of the budget impact of a new 20% subcutaneous immunoglobulin (Ig20Gly) for the management of primary immunodeficiency diseases in Switzerland.

PubMed

Pollock, Richard F; Meckley, Lisa M

2018-01-01

While most individual primary immunodeficiency diseases (PID) are rare, the collective prevalence of PID results in a substantial economic and clinical burden. The aim of this study was to evaluate the budgetary implications of Ig20Gly (Immune Globulin Subcutaneous [human] 20% solution; CUVITRU ® , Baxalta US Inc, now part of Shire Plc, Westlake Village, CA, USA) as a treatment for PID relative to intravenous immunoglobulin (IVIG) and other subcutaneous immunoglobulin (SCIG) formulations in the Swiss health care setting. A budget impact model was developed in Microsoft Excel to capture the estimated prevalence of PID in Switzerland, the proportion of patients treated in different health care settings, and the costs of administering SCIG and IVIG in each setting. Unit costs were based on a recent cost-minimization analysis of SCIG in Lausanne, and drug costs were taken from the Spezialitätenliste. All costs were reported in 2016 Swiss Francs (CHF), and future costs were not discounted. The total cost of treating PID in Switzerland was estimated to be CHF 11.16 m over 3 years, comprising CHF 9.28 m of drug costs and CHF 1.87 m of ancillary costs, including health care professional time and other administration costs, such as pumps and needle sets. The analysis showed that using Ig20Gly in place of other SCIG formulations would be cost neutral, while using Ig20Gly in place of IVIG would result in savings of 4.0%. Ig20Gly would be cost neutral relative to existing SCIG products and would result in cost savings relative to IVIG in patients with PID in Switzerland, even with modest uptake.

Costs of cloud computing for a biometry department. A case study.

PubMed

Knaus, J; Hieke, S; Binder, H; Schwarzer, G

2013-01-01

"Cloud" computing providers, such as the Amazon Web Services (AWS), offer stable and scalable computational resources based on hardware virtualization, with short, usually hourly, billing periods. The idea of pay-as-you-use seems appealing for biometry research units which have only limited access to university or corporate data center resources or grids. This case study compares the costs of an existing heterogeneous on-site hardware pool in a Medical Biometry and Statistics department to a comparable AWS offer. The "total cost of ownership", including all direct costs, is determined for the on-site hardware, and hourly prices are derived, based on actual system utilization during the year 2011. Indirect costs, which are difficult to quantify are not included in this comparison, but nevertheless some rough guidance from our experience is given. To indicate the scale of costs for a methodological research project, a simulation study of a permutation-based statistical approach is performed using AWS and on-site hardware. In the presented case, with a system utilization of 25-30 percent and 3-5-year amortization, on-site hardware can result in smaller costs, compared to hourly rental in the cloud dependent on the instance chosen. Renting cloud instances with sufficient main memory is a deciding factor in this comparison. Costs for on-site hardware may vary, depending on the specific infrastructure at a research unit, but have only moderate impact on the overall comparison and subsequent decision for obtaining affordable scientific computing resources. Overall utilization has a much stronger impact as it determines the actual computing hours needed per year. Taking this into ac count, cloud computing might still be a viable option for projects with limited maturity, or as a supplement for short peaks in demand.

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

PubMed Central

Evers, Silvia MAA; de Vries, Hein; Hoving, Ciska

2013-01-01

Background Although effective smoking cessation interventions exist, information is limited about their cost-effectiveness and cost-utility. Objective To assess the cost-effectiveness and cost-utility of an Internet-based multiple computer-tailored smoking cessation program and tailored counseling by practice nurses working in Dutch general practices compared with an Internet-based multiple computer-tailored program only and care as usual. Methods The economic evaluation was embedded in a randomized controlled trial, for which 91 practice nurses recruited 414 eligible smokers. Smokers were randomized to receive multiple tailoring and counseling (n=163), multiple tailoring only (n=132), or usual care (n=119). Self-reported cost and quality of life were assessed during a 12-month follow-up period. Prolonged abstinence and 24-hour and 7-day point prevalence abstinence were assessed at 12-month follow-up. The trial-based economic evaluation was conducted from a societal perspective. Uncertainty was accounted for by bootstrapping (1000 times) and sensitivity analyses. Results No significant differences were found between the intervention arms with regard to baseline characteristics or effects on abstinence, quality of life, and addiction level. However, participants in the multiple tailoring and counseling group reported significantly more annual health care–related costs than participants in the usual care group. Cost-effectiveness analysis, using prolonged abstinence as the outcome measure, showed that the mere multiple computer-tailored program had the highest probability of being cost-effective. Compared with usual care, in this group €5100 had to be paid for each additional abstinent participant. With regard to cost-utility analyses, using quality of life as the outcome measure, usual care was probably most efficient. Conclusions To our knowledge, this was the first study to determine the cost-effectiveness and cost-utility of an Internet-based smoking cessation program with and without counseling by a practice nurse. Although the Internet-based multiple computer-tailored program seemed to be the most cost-effective treatment, the cost-utility was probably highest for care as usual. However, to ease the interpretation of cost-effectiveness results, future research should aim at identifying an acceptable cutoff point for the willingness to pay per abstinent participant. PMID:23491820

Cloud computing for comparative genomics with windows azure platform.

PubMed

Kim, Insik; Jung, Jae-Yoon; Deluca, Todd F; Nelson, Tristan H; Wall, Dennis P

2012-01-01

Cloud computing services have emerged as a cost-effective alternative for cluster systems as the number of genomes and required computation power to analyze them increased in recent years. Here we introduce the Microsoft Azure platform with detailed execution steps and a cost comparison with Amazon Web Services.

Cloud Computing for Comparative Genomics with Windows Azure Platform

PubMed Central

Kim, Insik; Jung, Jae-Yoon; DeLuca, Todd F.; Nelson, Tristan H.; Wall, Dennis P.

2012-01-01

Cloud computing services have emerged as a cost-effective alternative for cluster systems as the number of genomes and required computation power to analyze them increased in recent years. Here we introduce the Microsoft Azure platform with detailed execution steps and a cost comparison with Amazon Web Services. PMID:23032609

One Health approach to cost-effective rabies control in India.

PubMed

Fitzpatrick, Meagan C; Shah, Hiral A; Pandey, Abhishek; Bilinski, Alyssa M; Kakkar, Manish; Clark, Andrew D; Townsend, Jeffrey P; Abbas, Syed Shahid; Galvani, Alison P

2016-12-20

Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a "One Health" committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond.

One Health approach to cost-effective rabies control in India

PubMed Central

Shah, Hiral A.; Pandey, Abhishek; Bilinski, Alyssa M.; Kakkar, Manish; Clark, Andrew D.; Galvani, Alison P.

2016-01-01

Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a “One Health” committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond. PMID:27994161

The Next Generation of Lab and Classroom Computing - The Silver Lining

DTIC Science & Technology

2016-12-01

desktop infrastructure (VDI) solution, as well as the computing solutions at three universities, was selected as the basis for comparison. The research... infrastructure , VDI, hardware cost, software cost, manpower, availability, cloud computing, private cloud, bring your own device, BYOD, thin client...virtual desktop infrastructure (VDI) solution, as well as the computing solutions at three universities, was selected as the basis for comparison. The

Visual Information (6)

DTIC Science & Technology

1987-12-01

definition 33., below). 7. Commercial VI Production. A completed VI production, purchased off-the- shelf; i.e., from the stocks of a vendor. 8. Computer ...Generated Graphics. The production of graphics through an electronic medium based on a computer or computer techniques. 9. Contract VI Production. A VI...displays, presentations, and exhibits prepared manually, by machine, or by computer . 16. Indirect Costs. An item of cost (or the aggregate thereof) that is

Cloud computing for comparative genomics

PubMed Central

2010-01-01

Background Large comparative genomics studies and tools are becoming increasingly more compute-expensive as the number of available genome sequences continues to rise. The capacity and cost of local computing infrastructures are likely to become prohibitive with the increase, especially as the breadth of questions continues to rise. Alternative computing architectures, in particular cloud computing environments, may help alleviate this increasing pressure and enable fast, large-scale, and cost-effective comparative genomics strategies going forward. To test this, we redesigned a typical comparative genomics algorithm, the reciprocal smallest distance algorithm (RSD), to run within Amazon's Elastic Computing Cloud (EC2). We then employed the RSD-cloud for ortholog calculations across a wide selection of fully sequenced genomes. Results We ran more than 300,000 RSD-cloud processes within the EC2. These jobs were farmed simultaneously to 100 high capacity compute nodes using the Amazon Web Service Elastic Map Reduce and included a wide mix of large and small genomes. The total computation time took just under 70 hours and cost a total of $6,302 USD. Conclusions The effort to transform existing comparative genomics algorithms from local compute infrastructures is not trivial. However, the speed and flexibility of cloud computing environments provides a substantial boost with manageable cost. The procedure designed to transform the RSD algorithm into a cloud-ready application is readily adaptable to similar comparative genomics problems. PMID:20482786

Cloud computing for comparative genomics.

PubMed

Wall, Dennis P; Kudtarkar, Parul; Fusaro, Vincent A; Pivovarov, Rimma; Patil, Prasad; Tonellato, Peter J

2010-05-18

Large comparative genomics studies and tools are becoming increasingly more compute-expensive as the number of available genome sequences continues to rise. The capacity and cost of local computing infrastructures are likely to become prohibitive with the increase, especially as the breadth of questions continues to rise. Alternative computing architectures, in particular cloud computing environments, may help alleviate this increasing pressure and enable fast, large-scale, and cost-effective comparative genomics strategies going forward. To test this, we redesigned a typical comparative genomics algorithm, the reciprocal smallest distance algorithm (RSD), to run within Amazon's Elastic Computing Cloud (EC2). We then employed the RSD-cloud for ortholog calculations across a wide selection of fully sequenced genomes. We ran more than 300,000 RSD-cloud processes within the EC2. These jobs were farmed simultaneously to 100 high capacity compute nodes using the Amazon Web Service Elastic Map Reduce and included a wide mix of large and small genomes. The total computation time took just under 70 hours and cost a total of $6,302 USD. The effort to transform existing comparative genomics algorithms from local compute infrastructures is not trivial. However, the speed and flexibility of cloud computing environments provides a substantial boost with manageable cost. The procedure designed to transform the RSD algorithm into a cloud-ready application is readily adaptable to similar comparative genomics problems.

Low-cost data analysis systems for processing multispectral scanner data

NASA Technical Reports Server (NTRS)

Whitely, S. L.

1976-01-01

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

Benchmarking undedicated cloud computing providers for analysis of genomic datasets.

PubMed

Yazar, Seyhan; Gooden, George E C; Mackey, David A; Hewitt, Alex W

2014-01-01

A major bottleneck in biological discovery is now emerging at the computational level. Cloud computing offers a dynamic means whereby small and medium-sized laboratories can rapidly adjust their computational capacity. We benchmarked two established cloud computing services, Amazon Web Services Elastic MapReduce (EMR) on Amazon EC2 instances and Google Compute Engine (GCE), using publicly available genomic datasets (E.coli CC102 strain and a Han Chinese male genome) and a standard bioinformatic pipeline on a Hadoop-based platform. Wall-clock time for complete assembly differed by 52.9% (95% CI: 27.5-78.2) for E.coli and 53.5% (95% CI: 34.4-72.6) for human genome, with GCE being more efficient than EMR. The cost of running this experiment on EMR and GCE differed significantly, with the costs on EMR being 257.3% (95% CI: 211.5-303.1) and 173.9% (95% CI: 134.6-213.1) more expensive for E.coli and human assemblies respectively. Thus, GCE was found to outperform EMR both in terms of cost and wall-clock time. Our findings confirm that cloud computing is an efficient and potentially cost-effective alternative for analysis of large genomic datasets. In addition to releasing our cost-effectiveness comparison, we present available ready-to-use scripts for establishing Hadoop instances with Ganglia monitoring on EC2 or GCE.

Benchmarking Undedicated Cloud Computing Providers for Analysis of Genomic Datasets

PubMed Central

Yazar, Seyhan; Gooden, George E. C.; Mackey, David A.; Hewitt, Alex W.

2014-01-01

A major bottleneck in biological discovery is now emerging at the computational level. Cloud computing offers a dynamic means whereby small and medium-sized laboratories can rapidly adjust their computational capacity. We benchmarked two established cloud computing services, Amazon Web Services Elastic MapReduce (EMR) on Amazon EC2 instances and Google Compute Engine (GCE), using publicly available genomic datasets (E.coli CC102 strain and a Han Chinese male genome) and a standard bioinformatic pipeline on a Hadoop-based platform. Wall-clock time for complete assembly differed by 52.9% (95% CI: 27.5–78.2) for E.coli and 53.5% (95% CI: 34.4–72.6) for human genome, with GCE being more efficient than EMR. The cost of running this experiment on EMR and GCE differed significantly, with the costs on EMR being 257.3% (95% CI: 211.5–303.1) and 173.9% (95% CI: 134.6–213.1) more expensive for E.coli and human assemblies respectively. Thus, GCE was found to outperform EMR both in terms of cost and wall-clock time. Our findings confirm that cloud computing is an efficient and potentially cost-effective alternative for analysis of large genomic datasets. In addition to releasing our cost-effectiveness comparison, we present available ready-to-use scripts for establishing Hadoop instances with Ganglia monitoring on EC2 or GCE. PMID:25247298

Evaluating Thin Client Computers for Use by the Polish Army

DTIC Science & Technology

2006-06-01

43 Figure 15. Annual Electricity Cost and Savings for 5 to 100 Users (source: Thin Client Computing...50 percent in hard costs in the first year of thin client network deployment.20 However, the greatest savings come from the reduction in soft costs ...resources from both the classrooms and home. The thin client solution increased the reliability of the IT infrastructure and resulted in cost savings

Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

PubMed

Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

2016-09-01

The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use. Project HOPE—The People-to-People Health Foundation, Inc.

Potential Savings of Harmonising Hospital and Community Formularies for Chronic Disease Medications Initiated in Hospital

PubMed Central

Lapointe-Shaw, Lauren; Fischer, Hadas D.; Newman, Alice; John-Baptiste, Ava; Anderson, Geoffrey M.; Rochon, Paula A.; Bell, Chaim M.

2012-01-01

Background Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices. Methods We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI), angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) following hospital admission from April 1st 2008-March 31st 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB) over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class. Results The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47%) for PPIs, $162 thousand (17%) for ACE inhibitors and $14 thousand (4%) for ARBs over the year following discharge. Interpretation In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs. PMID:22761882

Potential savings of harmonising hospital and community formularies for chronic disease medications initiated in hospital.

PubMed

Lapointe-Shaw, Lauren; Fischer, Hadas D; Newman, Alice; John-Baptiste, Ava; Anderson, Geoffrey M; Rochon, Paula A; Bell, Chaim M

2012-01-01

Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices. We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI), angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) following hospital admission from April 1(st) 2008-March 31(st) 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB) over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class. The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47%) for PPIs, $162 thousand (17%) for ACE inhibitors and $14 thousand (4%) for ARBs over the year following discharge. In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs.

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury

PubMed Central

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas

2018-01-01

Objective To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence related injury. Methods Cost benefit analysis Results Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared to the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. In contrast, the costs associated with the programme are modest: setup costs of software modifications and prevention strategies were £107,769, while the annual operating costs of the system were estimated as £210,433 (2003 UK Pound). The cumulative social benefit/cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit cost ratio of 14.8 for the health service and 19.1 for the criminal justice system. Each of these benefit/cost ratios is above 1 across a wide range of sensitivity analyses. Conclusions An effective information sharing partnership between health services, police, and local government in Cardiff, UK, led to substantial cost savings to the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented. PMID:24048916

Health-care costs of underweight, overweight and obesity: Australian population-based study.

PubMed

Clifford, Susan A; Gold, Lisa; Mensah, Fiona K; Jansen, Pauline W; Lucas, Nina; Nicholson, Jan M; Wake, Melissa

2015-12-01

Child health varies with body mass index (BMI), but it is unknown by what age or how much this attracts additional population health-care costs. We aimed to determine the (1) cross-sectional relationships between BMI and costs across the first decade of life and (2) in longitudinal analyses, whether costs increase with duration of underweight or obesity. Baby (n = 4230) and Kindergarten (n = 4543) cohorts in the nationally representative Longitudinal Study of Australian Children. Medicare Benefits Scheme (including all general practitioner plus a large proportion of paediatrician visits) plus prescription medication costs to federal government from birth to sixth (Baby cohort) and fourth to tenth (Kindergarten cohort) birthdays. biennial BMI measurements over the same period. Among Australian children under 10 years of age, 5-6% were underweight, 11-18% overweight and 5-6% obese. Excess costs with low and high BMI became evident from age 4-5 years, with normal weight accruing the least, obesity the most, and underweight and overweight intermediate costs. Relative to overall between-child variation, these excess costs per child were very modest, with a maximum of $94 per year at age 4-5 years. Nonetheless, this projects to a substantial cost to government of approximately $13 million per annum for all Australian children aged less than 10 years. Substantial excess population costs provide further economic justification for promoting healthy body weight. However, obese children's low individual excess health-care costs mean that effective treatments are likely to increase short-term costs to the public health purse during childhood. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

A Low Cost Micro-Computer Based Local Area Network for Medical Office and Medical Center Automation

PubMed Central

Epstein, Mel H.; Epstein, Lynn H.; Emerson, Ron G.

1984-01-01

A Low Cost Micro-computer based Local Area Network for medical office automation is described which makes use of an array of multiple and different personal computers interconnected by a local area network. Each computer on the network functions as fully potent workstations for data entry and report generation. The network allows each workstation complete access to the entire database. Additionally, designated computers may serve as access ports for remote terminals. Through “Gateways” the network may serve as a front end for a large mainframe, or may interface with another network. The system provides for the medical office environment the expandability and flexibility of a multi-terminal mainframe system at a far lower cost without sacrifice of performance.

Influence of computational fluid dynamics on experimental aerospace facilities: A fifteen year projection

NASA Technical Reports Server (NTRS)

1983-01-01

An assessment was made of the impact of developments in computational fluid dynamics (CFD) on the traditional role of aerospace ground test facilities over the next fifteen years. With improvements in CFD and more powerful scientific computers projected over this period it is expected to have the capability to compute the flow over a complete aircraft at a unit cost three orders of magnitude lower than presently possible. Over the same period improvements in ground test facilities will progress by application of computational techniques including CFD to data acquisition, facility operational efficiency, and simulation of the light envelope; however, no dramatic change in unit cost is expected as greater efficiency will be countered by higher energy and labor costs.

Minnesota Computer Aided Library System (MCALS); University of Minnesota Subsystem Cost/Benefits Analysis.

ERIC Educational Resources Information Center

Lourey, Eugene D., Comp.

The Minnesota Computer Aided Library System (MCALS) provides a basis of unification for library service program development in Minnesota for eventual linkage to the national information network. A prototype plan for communications functions is illustrated. A cost/benefits analysis was made to show the cost/effectiveness potential for MCALS. System…

Data Bases at a State Institution--Costs, Uses and Needs. AIR Forum Paper 1978.

ERIC Educational Resources Information Center

McLaughlin, Gerald W.

The cost-benefit of administrative data at a state college is placed in perspective relative to the institutional involvement in computer use. The costs of computer operations, personnel, and peripheral equipment expenses related to instruction are analyzed. Data bases and systems support institutional activities, such as registration, and aid…

Computer assisted yarding cost analysis.

Treesearch

Ronald W. Mifflin

1980-01-01

Programs for a programable calculator and a desk-top computer are provided for quickly determining yarding cost and comparing the economics of alternative yarding systems. The programs emphasize the importance of the relationship between production rate and machine rate, which is the hourly cost of owning and operating yarding equipment. In addition to generating the...

7 CFR 993.159 - Payments for services performed with respect to reserve tonnage prunes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... overhead costs, which include those for supervision, indirect labor, fuel, power and water, taxes and... tonnage prunes. The Committee will compute the average industry cost for holding reserve pool prunes by... choose to exclude the high and low data in computing an industry average. The industry average costs may...

7 CFR 993.159 - Payments for services performed with respect to reserve tonnage prunes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... overhead costs, which include those for supervision, indirect labor, fuel, power and water, taxes and... tonnage prunes. The Committee will compute the average industry cost for holding reserve pool prunes by... choose to exclude the high and low data in computing an industry average. The industry average costs may...

7 CFR 993.159 - Payments for services performed with respect to reserve tonnage prunes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... overhead costs, which include those for supervision, indirect labor, fuel, power and water, taxes and... tonnage prunes. The Committee will compute the average industry cost for holding reserve pool prunes by... choose to exclude the high and low data in computing an industry average. The industry average costs may...

Is nuclear matter a quantum crystal?

NASA Technical Reports Server (NTRS)

Canuto, V.; Chitre, S. M.

1973-01-01

A possible alternative to the ordinary gas-like computation for nuclear matter is investigated under the assumption that the nucleons are arranged in a lattice. BCC, FCC and HCP structures are investigated. Only HCP shows a minimum in the energy vs. density curve with a modest binding energy of -1.5 MeV. The very low density limit is investigated and sensible results are obtained only if the tensor force decreases with the density. A study of the elastic properties indicates that the previous structures are mechanically unstable against shearing stresses.

Waterspout, Gust Fronts and Associated Cloud Systems

NASA Technical Reports Server (NTRS)

Simpson, J.

1983-01-01

Nine waterspouts observed on five experimental days during the GATE period of observations are discussed. Primary data used are from 2 aircraft flying in different patterns, one above the other between 30 and 300 m. There is strong evidence associating whirl initiation with cumulus outflow. Computations prepared from estimates of convergence with the region suggest the possibility of vortex generation within 4 minutes. This analysis supports (1) the importance cumulus outflows may have in waterspout initiation and (2) the possibility that sea surface temperature gradients may be important in enabling waterspout development from modest size cumuli.

Scan-stratified case-control sampling for modeling blood-brain barrier integrity in multiple sclerosis.

PubMed

Pomann, Gina-Maria; Sweeney, Elizabeth M; Reich, Daniel S; Staicu, Ana-Maria; Shinohara, Russell T

2015-09-10

Multiple sclerosis (MS) is an immune-mediated neurological disease that causes morbidity and disability. In patients with MS, the accumulation of lesions in the white matter of the brain is associated with disease progression and worse clinical outcomes. Breakdown of the blood-brain barrier in newer lesions is indicative of more active disease-related processes and is a primary outcome considered in clinical trials of treatments for MS. Such abnormalities in active MS lesions are evaluated in vivo using contrast-enhanced structural MRI, during which patients receive an intravenous infusion of a costly magnetic contrast agent. In some instances, the contrast agents can have toxic effects. Recently, local image regression techniques have been shown to have modest performance for assessing the integrity of the blood-brain barrier based on imaging without contrast agents. These models have centered on the problem of cross-sectional classification in which patients are imaged at a single study visit and pre-contrast images are used to predict post-contrast imaging. In this paper, we extend these methods to incorporate historical imaging information, and we find the proposed model to exhibit improved performance. We further develop scan-stratified case-control sampling techniques that reduce the computational burden of local image regression models, while respecting the low proportion of the brain that exhibits abnormal vascular permeability. Copyright © 2015 John Wiley & Sons, Ltd.

Retrievable payload carrier, next generation Long Duration Exposure Facility: Update 1992

NASA Technical Reports Server (NTRS)

Perry, A. T.; Cagle, J. A.; Newman, S. C.

1993-01-01

Access to space and cost have been two major inhibitors of low Earth orbit research. The Retrievable Payload Carrier (RPC) Program is a commercial space program which strives to overcome these two barriers to space experimentation. The RPC Program's fleet of spacecraft, ground communications station, payload processing facility, and experienced integration and operations team will provide a convenient 'one-stop shop' for investigators seeking to use the unique vantage point and environment of low Earth orbit for research. The RPC is a regularly launched and retrieved, free-flying spacecraft providing resources adequate to meet modest payload/experiment requirements, and presenting ample surface area, volume, mass, and growth capacity for investigator usage. Enhanced capabilities of ground communications, solar-array-supplied electrical power, central computing, and on-board data storage pick up on the path where NASA's Long Duration Exposure Facility (LDEF) blazed the original technology trail. Mission lengths of 6-18 months, or longer, are envisioned. The year 1992 was designated as the 'International Space Year' and coincides with the 500th anniversary of Christopher Columbus's voyage to the New World. This is a fitting year in which to launch the full scale development of our unique shop of discovery whose intent is to facilitate retrieving technological rewards from another new world: space. Presented is an update on progress made on the RPC Program's development since the November 1991 LDEF Materials Workshop.

Fixman compensating potential for general branched molecules

NASA Astrophysics Data System (ADS)

Jain, Abhinandan; Kandel, Saugat; Wagner, Jeffrey; Larsen, Adrien; Vaidehi, Nagarajan

2013-12-01

The technique of constraining high frequency modes of molecular motion is an effective way to increase simulation time scale and improve conformational sampling in molecular dynamics simulations. However, it has been shown that constraints on higher frequency modes such as bond lengths and bond angles stiffen the molecular model, thereby introducing systematic biases in the statistical behavior of the simulations. Fixman proposed a compensating potential to remove such biases in the thermodynamic and kinetic properties calculated from dynamics simulations. Previous implementations of the Fixman potential have been limited to only short serial chain systems. In this paper, we present a spatial operator algebra based algorithm to calculate the Fixman potential and its gradient within constrained dynamics simulations for branched topology molecules of any size. Our numerical studies on molecules of increasing complexity validate our algorithm by demonstrating recovery of the dihedral angle probability distribution function for systems that range in complexity from serial chains to protein molecules. We observe that the Fixman compensating potential recovers the free energy surface of a serial chain polymer, thus annulling the biases caused by constraining the bond lengths and bond angles. The inclusion of Fixman potential entails only a modest increase in the computational cost in these simulations. We believe that this work represents the first instance where the Fixman potential has been used for general branched systems, and establishes the viability for its use in constrained dynamics simulations of proteins and other macromolecules.

School food cost-benefits: England.

PubMed

Nelson, Michael

2013-06-01

To estimate the costs per relevant unit (pupils and meals) associated with improvements to school food and the potential economic and health gains that may result. Calculation of costs per relevant unit (pupils and meals) based on (i) Department for Education expenditure to support improvements in school food, 2005–2011 and (ii) measures of the changes in the number of pupils taking school lunch and the number of meals served over the same time period; plus examples of the use of linked data to predict longer-term economic and health outcomes of healthier eating at school. England. Local authorities, government departments and non-departmental public bodies. Analysis of investment over a 6-year period indicates that costs of setting up and maintaining a change organization such as the School Food Trust were low in relation to short-term benefits in nutrition and behaviour. Models that predict long-terms gains to the exchequer and to quality-adjusted life years need further elaboration. Modest levels of government investment in the delivery and promotion of healthier school food is likely to yield both short-term and long-term benefits in relation to nutrition, learning, economics and health.

Efficiently enforcing artisanal fisheries to protect estuarine biodiversity.

PubMed

Duarte de Paula Costa, Micheli; Mills, Morena; Richardson, Anthony J; Fuller, Richard A; Muelbert, José H; Possingham, Hugh P

2018-06-26

Artisanal fisheries support millions of livelihoods worldwide, yet ineffective enforcement can allow for continued environmental degradation due to overexploitation. Here, we use spatial planning to design an enforcement strategy for a pre-existing spatial closure for artisanal fisheries considering climate variability, existing seasonal fishing closures, representative conservation targets and enforcement costs. We calculated enforcement cost in three ways, based on different assumptions about who could be responsible for monitoring the fishery. We applied this approach in the Patos Lagoon estuary (Brazil), where we found three important results. First, spatial priorities for enforcement were similar under different climate scenarios. Second, we found that the cost and percentage of area enforced varied among scenarios tested by the conservation planning analysis, with only a modest increase in budget needed to incorporate climate variability. Third, we found that spatial priorities for enforcement depend on whether enforcement is carried out by a central authority or by the community itself. Here, we demonstrated a method that can be used to efficiently design enforcement plans, resulting in the conservation of biodiversity and estuarine resources. Also, cost of enforcement can be potentially reduced when fishers are empowered to enforce management within their fishing grounds. © 2018 by the Ecological Society of America.

FEL for the polymer processing industries

NASA Astrophysics Data System (ADS)

Kelley, Michael J.

1997-05-01

Polymers are everywhere in modern life because of their unique combination of end-use functionalities, ease of processing, recycling potential and modest cost. The physical and economic scope of the infrastructure committed to present polymers makes the introduction of entirely new chemistry unlikely. Rather, the breadth of commercial offerings more likely to shrink in the face of the widening mandate for recycling, especially of packaging. Improved performance and new functionality must therefore come by routes such as surface modification. However they must come with little environmental impact and at painfully low cost. Processing with strongly absorbed light offers unique advantages. The journal and patent literatures disclose a number of examples of benefits that can be achieved, principally by use of excimer lasers or special UV lamps. Examples of commercialization are few, however, because of the unit cost and maximum scale of existing light sources. A FEL, however, offers unique advantages: tunability to the optimum wavelength, potential for scale up to high average power, and a path to attractively low unit cost of light. A business analysis of prospective applications defines the technical and economic requirements a FEL for polymer surface processing must meet. These are compared to FEL technology as it now stands and as it is envisioned.

Rethinking FCV/BEV Vehicle Range: A Consumer Value Trade-off Perspective

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

Lin, Zhenhong; Greene, David L

2010-01-01

The driving range of FCV and BEV is often analyzed by simple analogy to conventional vehicles without proper consideration of differences in energy storage technology, infrastructure, and market context. This study proposes a coherent framework to optimize the driving range by minimizing costs associated with range, including upfront storage cost, fuel availability cost for FCV and range anxiety cost for BEV. It is shown that the conventional assumption of FCV range can lead to overestimation of FCV market barrier by over $8000 per vehicle in the near-term market. Such exaggeration of FCV market barrier can be avoided with range optimization.more » Compared to the optimal BEV range, the 100-mile range chosen by automakers appears to be near optimal for modest drivers, but far less than optimal for frequent drivers. With range optimization, the probability that the BEV is unable to serve a long-trip day is generally less than 5%, depending on driving intensity. Range optimization can help diversify BEV products for different consumers. It is also demonstrated and argued that the FCV/BEV range should adapt to the technology and infrastructure developments.« less

Implementation of GINA guidelines in Ho Chi Minh City: a model for Viet Nam.

PubMed

Tho, N V; Loan, H T H; Thao, N T P; Dung, N T T; Lan, L T T

2012-12-21

The Global Initiative for Asthma (GINA) guidelines have not been implemented effectively in primary care settings in Viet Nam. To estimate the proportion of patients with controlled asthma and the direct health care costs of managing asthma according to GINA guidelines at four out-patient clinics in Ho Chi Minh City (HCMC), Viet Nam. One hundred and six patients with asthma were treated and followed up according to GINA guidelines for 12 months. Clinical and pulmonary function responses and direct health care costs were evaluated every 3 months during the study. The proportion of patients with controlled asthma rose from 1.0% at the start of the study to 36.8% by the end of the study (P < 0.0001). The proportion of patients who had at least one hospitalisation per year decreased significantly, from 32.1% to 5.7% (P < 0.0001). The annual per patient median direct health care cost was US$169. Using asthma controllers continuously gave better asthma control than using them intermittently (OR 12.9, 95%CI 4.7-35.7). The implementation of GINA guidelines at out-patient clinics in HCMC, Viet Nam, improved asthma control with modest direct health care costs.

Using Thermal Radiation in Detection of Negative Obstacles

NASA Technical Reports Server (NTRS)

Rankin, Arturo L.; Matthies, Larry H.

2009-01-01

A method of automated detection of negative obstacles (potholes, ditches, and the like) ahead of ground vehicles at night involves processing of imagery from thermal-infrared cameras aimed at the terrain ahead of the vehicles. The method is being developed as part of an overall obstacle-avoidance scheme for autonomous and semi-autonomous offroad robotic vehicles. The method could also be applied to help human drivers of cars and trucks avoid negative obstacles -- a development that may entail only modest additional cost inasmuch as some commercially available passenger cars are already equipped with infrared cameras as aids for nighttime operation.

Microminiature thermionic converters

DOEpatents

King, Donald B.; Sadwick, Laurence P.; Wernsman, Bernard R.

2001-09-25

Microminiature thermionic converts (MTCs) having high energy-conversion efficiencies and variable operating temperatures. Methods of manufacturing those converters using semiconductor integrated circuit fabrication and micromachine manufacturing techniques are also disclosed. The MTCs of the invention incorporate cathode to anode spacing of about 1 micron or less and use cathode and anode materials having work functions ranging from about 1 eV to about 3 eV. Existing prior art thermionic converter technology has energy conversion efficiencies ranging from 5-15%. The MTCs of the present invention have maximum efficiencies of just under 30%, and thousands of the devices can be fabricated at modest costs.

A history of semi-active laser dome and window materials

NASA Astrophysics Data System (ADS)

Sullivan, Roger M.

2014-05-01

Semi-Active Laser (SAL) guidance systems were developed starting in the mid-1960's and today form an important class of precision guided weapons. The laser wavelengths generally fall in the short wave infrared region of the spectrum. Relative to passive, image based, infrared seekers the optical demands placed on the domes or windows of SAL seekers is very modest, allowing the use of low cost, easily manufactured materials, such as polycarbonate. This paper will examine the transition of SAL window and dome science and technology from the laboratory to battlefield, with special emphasis on the story of polycarbonate domes.

Optical manifold for light-emitting diodes

DOEpatents

Chaves, Julio C.; Falicoff, Waqidi; Minano, Juan C.; Benitez, Pablo; Parkyn, Jr., William A.; Alvarez, Roberto; Dross, Oliver

2008-06-03

An optical manifold for efficiently combining a plurality of blue LED outputs to illuminate a phosphor for a single, substantially homogeneous output, in a small, cost-effective package. Embodiments are disclosed that use a single or multiple LEDs and a remote phosphor, and an intermediate wavelength-selective filter arranged so that backscattered photoluminescence is recycled to boost the luminance and flux of the output aperture. A further aperture mask is used to boost phosphor luminance with only modest loss of luminosity. Alternative non-recycling embodiments provide blue and yellow light in collimated beams, either separately or combined into white.

42 CFR 417.588 - Computation of adjusted average per capita cost (AAPCC).

Code of Federal Regulations, 2012 CFR

2012-10-01

..., COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.588 Computation... 42 Public Health 3 2012-10-01 2012-10-01 false Computation of adjusted average per capita cost (AAPCC). 417.588 Section 417.588 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

42 CFR 417.588 - Computation of adjusted average per capita cost (AAPCC).

Code of Federal Regulations, 2011 CFR

2011-10-01

... MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.588 Computation of... 42 Public Health 3 2011-10-01 2011-10-01 false Computation of adjusted average per capita cost (AAPCC). 417.588 Section 417.588 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

42 CFR 417.588 - Computation of adjusted average per capita cost (AAPCC).

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.588 Computation of... 42 Public Health 3 2010-10-01 2010-10-01 false Computation of adjusted average per capita cost (AAPCC). 417.588 Section 417.588 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

hPIN/hTAN: Low-Cost e-Banking Secure against Untrusted Computers

NASA Astrophysics Data System (ADS)

Li, Shujun; Sadeghi, Ahmad-Reza; Schmitz, Roland

We propose hPIN/hTAN, a low-cost token-based e-banking protection scheme when the adversary has full control over the user's computer. Compared with existing hardware-based solutions, hPIN/hTAN depends on neither second trusted channel, nor secure keypad, nor computationally expensive encryption module.

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

PubMed

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

2016-07-27

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

HMO market penetration and hospital cost inflation in California.

PubMed

Robinson, J C

1991-11-20

OBJECTIVE--Health maintenance organizations (HMOs) have stimulated price competition in California hospital markets since 1983, when the state legislature eliminated barriers to selective contracting by conventional health insurance plans. This study measures the impact of HMO-induced price competition on the rate of inflation in average cost per admission for 298 private, non-HMO hospitals between 1982 and 1988. DATA--HMO market penetration was calculated using discharge abstract data on insurance coverage, ZIP code of residence, and hospital of choice for 3.35 million patients in 1983 and 3.41 million patients in 1988. Data on hospital characteristics were obtained from the American Hospital Association and other sources. -HMO coverage grew from an average of 8.3% of all admissions in local hospital markets in 1983 to 17.0% of all admissions in 1988. The average rate of growth in costs per admission between 1982 and 1988 was 9.4% lower in markets with relatively high HMO penetration compared with markets with relatively low HMO penetration (95% confidence interval, 5.2 to 13.8). Cost savings for these 298 hospitals are estimated at $1.04 billion for 1988. CONCLUSION--Price competition between HMOs and conventional health insurers can significantly reduce hospital cost inflation if legislative barriers to selective contracting are removed. The impact of competition in California was modest, however, when evaluated in terms of the 74.5% average rate of California hospital cost inflation during these years.

Complete distributed computing environment for a HEP experiment: experience with ARC-connected infrastructure for ATLAS

NASA Astrophysics Data System (ADS)

Read, A.; Taga, A.; O-Saada, F.; Pajchel, K.; Samset, B. H.; Cameron, D.

2008-07-01

Computing and storage resources connected by the Nordugrid ARC middleware in the Nordic countries, Switzerland and Slovenia are a part of the ATLAS computing Grid. This infrastructure is being commissioned with the ongoing ATLAS Monte Carlo simulation production in preparation for the commencement of data taking in 2008. The unique non-intrusive architecture of ARC, its straightforward interplay with the ATLAS Production System via the Dulcinea executor, and its performance during the commissioning exercise is described. ARC support for flexible and powerful end-user analysis within the GANGA distributed analysis framework is also shown. Whereas the storage solution for this Grid was earlier based on a large, distributed collection of GridFTP-servers, the ATLAS computing design includes a structured SRM-based system with a limited number of storage endpoints. The characteristics, integration and performance of the old and new storage solutions are presented. Although the hardware resources in this Grid are quite modest, it has provided more than double the agreed contribution to the ATLAS production with an efficiency above 95% during long periods of stable operation.

Quantum Computation using Arrays of N Polar Molecules in Pendular States.

PubMed

Wei, Qi; Cao, Yudong; Kais, Sabre; Friedrich, Bretislav; Herschbach, Dudley

2016-11-18

We investigate several aspects of realizing quantum computation using entangled polar molecules in pendular states. Quantum algorithms typically start from a product state |00⋯0⟩ and we show that up to a negligible error, the ground states of polar molecule arrays can be considered as the unentangled qubit basis state |00⋯0⟩ . This state can be prepared by simply allowing the system to reach thermal equilibrium at low temperature (<1 mK). We also evaluate entanglement, characterized by concurrence of pendular state qubits in dipole arrays as governed by the external electric field, dipole-dipole coupling and number N of molecules in the array. In the parameter regime that we consider for quantum computing, we find that qubit entanglement is modest, typically no greater than 10 -4 , confirming the negligible entanglement in the ground state. We discuss methods for realizing quantum computation in the gate model, measurement-based model, instantaneous quantum polynomial time circuits and the adiabatic model using polar molecules in pendular states. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Two-body Schrödinger wave functions in a plane-wave basis via separation of dimensions

NASA Astrophysics Data System (ADS)

Jerke, Jonathan; Poirier, Bill

2018-03-01

Using a combination of ideas, the ground and several excited electronic states of the helium atom and the hydrogen molecule are computed to chemical accuracy—i.e., to within 1-2 mhartree or better. The basic strategy is very different from the standard electronic structure approach in that the full two-electron six-dimensional (6D) problem is tackled directly, rather than starting from a single-electron Hartree-Fock approximation. Electron correlation is thus treated exactly, even though computational requirements remain modest. The method also allows for exact wave functions to be computed, as well as energy levels. From the full-dimensional 6D wave functions computed here, radial distribution functions and radial correlation functions are extracted—as well as a 2D probability density function exhibiting antisymmetry for a single Cartesian component. These calculations support a more recent interpretation of Hund's rule, which states that the lower energy of the higher spin-multiplicity states is actually due to reduced screening, rather than reduced electron-electron repulsion. Prospects for larger systems and/or electron dynamics applications appear promising.

Comparison of scientific computing platforms for MCNP4A Monte Carlo calculations

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

Hendricks, J.S.; Brockhoff, R.C.

1994-04-01

The performance of seven computer platforms is evaluated with the widely used and internationally available MCNP4A Monte Carlo radiation transport code. All results are reproducible and are presented in such a way as to enable comparison with computer platforms not in the study. The authors observed that the HP/9000-735 workstation runs MCNP 50% faster than the Cray YMP 8/64. Compared with the Cray YMP 8/64, the IBM RS/6000-560 is 68% as fast, the Sun Sparc10 is 66% as fast, the Silicon Graphics ONYX is 90% as fast, the Gateway 2000 model 4DX2-66V personal computer is 27% as fast, and themore » Sun Sparc2 is 24% as fast. In addition to comparing the timing performance of the seven platforms, the authors observe that changes in compilers and software over the past 2 yr have resulted in only modest performance improvements, hardware improvements have enhanced performance by less than a factor of [approximately]3, timing studies are very problem dependent, MCNP4Q runs about as fast as MCNP4.« less

Global Static Indexing for Real-Time Exploration of Very Large Regular Grids

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

Pascucci, V; Frank, R

2001-07-23

In this paper we introduce a new indexing scheme for progressive traversal and visualization of large regular grids. We demonstrate the potential of our approach by providing a tool that displays at interactive rates planar slices of scalar field data with very modest computing resources. We obtain unprecedented results both in terms of absolute performance and, more importantly, in terms of scalability. On a laptop computer we provide real time interaction with a 2048{sup 3} grid (8 Giga-nodes) using only 20MB of memory. On an SGI Onyx we slice interactively an 8192{sup 3} grid (1/2 tera-nodes) using only 60MB ofmore » memory. The scheme relies simply on the determination of an appropriate reordering of the rectilinear grid data and a progressive construction of the output slice. The reordering minimizes the amount of I/O performed during the out-of-core computation. The progressive and asynchronous computation of the output provides flexible quality/speed tradeoffs and a time-critical and interruptible user interface.« less

Two-body Schrödinger wave functions in a plane-wave basis via separation of dimensions.

PubMed

Jerke, Jonathan; Poirier, Bill

2018-03-14

Using a combination of ideas, the ground and several excited electronic states of the helium atom and the hydrogen molecule are computed to chemical accuracy-i.e., to within 1-2 mhartree or better. The basic strategy is very different from the standard electronic structure approach in that the full two-electron six-dimensional (6D) problem is tackled directly, rather than starting from a single-electron Hartree-Fock approximation. Electron correlation is thus treated exactly, even though computational requirements remain modest. The method also allows for exact wave functions to be computed, as well as energy levels. From the full-dimensional 6D wave functions computed here, radial distribution functions and radial correlation functions are extracted-as well as a 2D probability density function exhibiting antisymmetry for a single Cartesian component. These calculations support a more recent interpretation of Hund's rule, which states that the lower energy of the higher spin-multiplicity states is actually due to reduced screening, rather than reduced electron-electron repulsion. Prospects for larger systems and/or electron dynamics applications appear promising.

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

Keyes, D.; McInnes, L. C.; Woodward, C.

This report is an outcome of the workshop Multiphysics Simulations: Challenges and Opportunities, sponsored by the Institute of Computing in Science (ICiS). Additional information about the workshop, including relevant reading and presentations on multiphysics issues in applications, algorithms, and software, is available via https://sites.google.com/site/icismultiphysics2011/. We consider multiphysics applications from algorithmic and architectural perspectives, where 'algorithmic' includes both mathematical analysis and computational complexity and 'architectural' includes both software and hardware environments. Many diverse multiphysics applications can be reduced, en route to their computational simulation, to a common algebraic coupling paradigm. Mathematical analysis of multiphysics coupling in this form is not alwaysmore » practical for realistic applications, but model problems representative of applications discussed herein can provide insight. A variety of software frameworks for multiphysics applications have been constructed and refined within disciplinary communities and executed on leading-edge computer systems. We examine several of these, expose some commonalities among them, and attempt to extrapolate best practices to future systems. From our study, we summarize challenges and forecast opportunities. We also initiate a modest suite of test problems encompassing features present in many applications.« less

Virtualization and cloud computing in dentistry.

PubMed

Chow, Frank; Muftu, Ali; Shorter, Richard

2014-01-01

The use of virtualization and cloud computing has changed the way we use computers. Virtualization is a method of placing software called a hypervisor on the hardware of a computer or a host operating system. It allows a guest operating system to run on top of the physical computer with a virtual machine (i.e., virtual computer). Virtualization allows multiple virtual computers to run on top of one physical computer and to share its hardware resources, such as printers, scanners, and modems. This increases the efficient use of the computer by decreasing costs (e.g., hardware, electricity administration, and management) since only one physical computer is needed and running. This virtualization platform is the basis for cloud computing. It has expanded into areas of server and storage virtualization. One of the commonly used dental storage systems is cloud storage. Patient information is encrypted as required by the Health Insurance Portability and Accountability Act (HIPAA) and stored on off-site private cloud services for a monthly service fee. As computer costs continue to increase, so too will the need for more storage and processing power. Virtual and cloud computing will be a method for dentists to minimize costs and maximize computer efficiency in the near future. This article will provide some useful information on current uses of cloud computing.

Specialized computer architectures for computational aerodynamics

NASA Technical Reports Server (NTRS)

Stevenson, D. K.

1978-01-01

In recent years, computational fluid dynamics has made significant progress in modelling aerodynamic phenomena. Currently, one of the major barriers to future development lies in the compute-intensive nature of the numerical formulations and the relative high cost of performing these computations on commercially available general purpose computers, a cost high with respect to dollar expenditure and/or elapsed time. Today's computing technology will support a program designed to create specialized computing facilities to be dedicated to the important problems of computational aerodynamics. One of the still unresolved questions is the organization of the computing components in such a facility. The characteristics of fluid dynamic problems which will have significant impact on the choice of computer architecture for a specialized facility are reviewed.

An exploratory case study of the impact of expanding cost-effectiveness analysis for second-line nivolumab for patients with squamous non-small cell lung cancer in Canada: Does it make a difference?

PubMed

Shafrin, Jason; Skornicki, Michelle; Brauer, Michelle; Villeneuve, Julie; Lees, Michael; Hertel, Nadine; Penrod, John R; Jansen, Jeroen

2018-04-26

Health technology appraisal agencies often rely on cost-effectiveness analyses to inform coverage decisions for new treatments. These assessments, however, frequently measure a treatment's value from the payer's perspective, and may not capture value generated from reduced caregiving costs, increased productivity, value based on patient risk preferences, option value or the insurance value to non-patients. To examine how using a broader societal perspective of treatment value affects cost-effectiveness estimates, this case study analyzed the net monetary benefit (NMB) of second-line nivolumab treatment of patients with squamous non-small cell lung cancer (NSCLC) in Canada. The comparator was treatment with docetaxel. NMB was measured from three perspectives: (i) traditional payer, (ii) traditional societal and (iii) broad societal. Nivolumab was more effective (increased quality-adjusted life years by 0.66 versus docetaxel), but also increased costs by $100,168 CAD. When valuing a quality-adjusted life year at $150,000, the net monetary benefit from the payer perspective suggested that costs modestly exceed benefits (NMB: -$1031). Adopting a societal perspective, however, nivolumab's benefits outweighed its costs (NMB: +$6752 and +$91,084 from the traditional and broad societal perspectives, respectively). Broadening cost-effectiveness analysis beyond the traditional payer perspective had a significant impact on the result and should be considered in order to capture all treatment benefits and costs of societal relevance. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Measuring costs of data collection at village clinics by village doctors for a syndromic surveillance system-a cross sectional survey from China.

PubMed

Ding, Yan; Fei, Yang; Xu, Biao; Yang, Jun; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

2015-07-25

Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors expressed their willingness to join in the surveillance if a proper subsidy was provided. This study aims to measure the costs of data collection by village clinics to provide a reference regarding the subsidy level required for village clinics to participate in data collection. We conducted a cross-sectional survey with a village clinic questionnaire and a staff questionnaire using a purposive sampling strategy. We tracked reported events using the ISSC internal database. Cost data included staff time, and the annual depreciation and opportunity costs of computers. We measured the village doctors' time costs for data collection by multiplying the number of full time employment equivalents devoted to the surveillance by the village doctors' annual salaries and benefits, which equaled their net incomes. We estimated the depreciation and opportunity costs of computers by calculating the equivalent annual computer cost and then allocating this to the surveillance based on the percentage usage. The estimated total annual cost of collecting data was 1,423 Chinese Renminbi (RMB) in 2012 (P25 = 857, P75 = 3284), including 1,250 RMB (P25 = 656, P75 = 3000) staff time costs and 134 RMB (P25 = 101, P75 = 335) depreciation and opportunity costs of computers. The total costs of collecting data from the village clinics for the syndromic surveillance system was calculated to be low compared with the individual net income in County A.

Climate Modeling with a Million CPUs

NASA Astrophysics Data System (ADS)

Tobis, M.; Jackson, C. S.

2010-12-01

Michael Tobis, Ph.D. Research Scientist Associate University of Texas Institute for Geophysics Charles S. Jackson Research Scientist University of Texas Institute for Geophysics Meteorological, oceanographic, and climatological applications have been at the forefront of scientific computing since its inception. The trend toward ever larger and more capable computing installations is unabated. However, much of the increase in capacity is accompanied by an increase in parallelism and a concomitant increase in complexity. An increase of at least four additional orders of magnitude in the computational power of scientific platforms is anticipated. It is unclear how individual climate simulations can continue to make effective use of the largest platforms. Conversion of existing community codes to higher resolution, or to more complex phenomenology, or both, presents daunting design and validation challenges. Our alternative approach is to use the expected resources to run very large ensembles of simulations of modest size, rather than to await the emergence of very large simulations. We are already doing this in exploring the parameter space of existing models using the Multiple Very Fast Simulated Annealing algorithm, which was developed for seismic imaging. Our experiments have the dual intentions of tuning the model and identifying ranges of parameter uncertainty. Our approach is less strongly constrained by the dimensionality of the parameter space than are competing methods. Nevertheless, scaling up remains costly. Much could be achieved by increasing the dimensionality of the search and adding complexity to the search algorithms. Such ensemble approaches scale naturally to very large platforms. Extensions of the approach are anticipated. For example, structurally different models can be tuned to comparable effectiveness. This can provide an objective test for which there is no realistic precedent with smaller computations. We find ourselves inventing new code to manage our ensembles. Component computations involve tens to hundreds of CPUs and tens to hundreds of hours. The results of these moderately large parallel jobs influence the scheduling of subsequent jobs, and complex algorithms may be easily contemplated for this. The operating system concept of a "thread" re-emerges at a very coarse level, where each thread manages atomic computations of thousands of CPU-hours. That is, rather than multiple threads operating on a processor, at this level, multiple processors operate within a single thread. In collaboration with the Texas Advanced Computing Center, we are developing a software library at the system level, which should facilitate the development of computations involving complex strategies which invoke large numbers of moderately large multi-processor jobs. While this may have applications in other sciences, our key intent is to better characterize the coupled behavior of a very large set of climate model configurations.

Projected cost comparison of Trabectome, iStent, and endoscopic cyclophotocoagulation versus glaucoma medication in the Ontario Health Insurance Plan.

PubMed

Iordanous, Yiannis; Kent, Jerrod S; Hutnik, Cindy M L; Malvankar-Mehta, Monali S

2014-02-01

To compare the direct cost of treating glaucoma patients with Trabectome, iStent, and endoscopic cyclophotocoagulation (ECP) versus topical medications in Ontario, Canada. Costs are projected over a 6-year period, and presented on a per-patient level from the perspective of the Ontario Health Insurance Plan (OHIP). The per-bottle cost of each medication was obtained from the 2011 Ontario Drug Benefit (ODB) formulary. A wastage adjustment fee was added to the cost, as was a pharmacy markup, and an ODB dispensing fee. Previously published medication prescription rates were used to determine the frequency with which each medication is prescribed. We estimated the overall cost by taking a weighted average of the cost of each class of glaucoma medications.The cost of each glaucoma device was determined by contacting local distributors. We then added the cost of disposables used during surgery (viscoelastic and keratome) to the cost of each procedure. Start-up costs for each device and surgeons' fees were excluded from the overall cost. At 6 years, treatment with the Trabectome offered a cumulative cost savings of $279.23, $1572.55, and $2424.71 per patient versus monodrug, bidrug, and tridrug therapy, respectively. A cumulative cost difference of -$20.77, $1272.55, and $2124.71 per patient were found when comparing iStent versus monodrug, bidrug, and tridrug therapy, respectively. Treatment with ECP yielded a cost savings of $779.23, $2072.55, and $2924.71 per patient versus monodrug, bidrug, and tridrug therapy, respectively. Over a projected period of 6 years, the Trabectome, iStent, and ECP may all offer a modest cost savings to OHIP versus the cost of glaucoma medication. Further analysis of direct and indirect costs to patients as well as quality of life assessments will help further delineate the role of these treatments in the glaucoma treatment paradigm.

Cost implications of ACGME's 2011 changes to resident duty hours and the training environment.

PubMed

Nuckols, Teryl K; Escarce, José J

2012-02-01

In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) will implemented stricter duty-hour limits and related changes to the training environment. This may affect preventable adverse event (PAE) rates. To estimate direct costs under various implementation approaches, and examine net costs to teaching hospitals and cost-effectiveness to society across a range of hypothetical changes in PAEs. A decision-analytical model represented direct costs and PAE rates, mortality, and costs. Published literature and publicly available data. Patients admitted to hospitals with ACGME-accredited programs. One year. All teaching hospitals, major teaching hospitals, society. ACGME's 2011 Common Program Requirements. Direct annual costs (all accredited hospitals), net cost (major teaching hospitals), cost per death averted (society). RESULTS OF BASE-ANALYSIS: Nationwide, duty-hour changes would cost $177 million annually if interns maintain current productivity, vs. up to $982 million if they transfer work to a mixture of substitutes; training-environment changes will cost $204 million. If PAEs decline by 7.2-25.8%, net costs to major teaching hospitals will be zero. If PAEs fall by 3%, the cost to society per death averted would be -$523,000 (95%-confidence interval: -$1.82 million to $685,000) to $2.44 million ($271,000 to $6.91 million). If PAEs rise, the policy will be cost-increasing for teaching hospitals and society. The total direct annual cost nationwide would be up to $1.34 billion using nurse practitioners/physician assistants, $1.64 billion using attending physicians, $820 million hiring additional residents, vs. 1.42 billion using mixed substitutes. The effect on PAEs is unknown. Data were limited for some model parameters. Implementation decisions greatly affect the cost. Unless PAEs decline substantially, teaching hospitals will lose money. If PAEs decline modestly, the requirements might be cost-saving or cost-effective to society.

Processor Would Find Best Paths On Map

NASA Technical Reports Server (NTRS)

Eberhardt, Silvio P.

1990-01-01

Proposed very-large-scale integrated (VLSI) circuit image-data processor finds path of least cost from specified origin to any destination on map. Cost of traversal assigned to each picture element of map. Path of least cost from originating picture element to every other picture element computed as path that preserves as much as possible of signal transmitted by originating picture element. Dedicated microprocessor at each picture element stores cost of traversal and performs its share of computations of paths of least cost. Least-cost-path problem occurs in research, military maneuvers, and in planning routes of vehicles.

Using Amazon's Elastic Compute Cloud to dynamically scale CMS computational resources

NASA Astrophysics Data System (ADS)

Evans, D.; Fisk, I.; Holzman, B.; Melo, A.; Metson, S.; Pordes, R.; Sheldon, P.; Tiradani, A.

2011-12-01

Large international scientific collaborations such as the Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider have traditionally addressed their data reduction and analysis needs by building and maintaining dedicated computational infrastructure. Emerging cloud computing services such as Amazon's Elastic Compute Cloud (EC2) offer short-term CPU and storage resources with costs based on usage. These services allow experiments to purchase computing resources as needed, without significant prior planning and without long term investments in facilities and their management. We have demonstrated that services such as EC2 can successfully be integrated into the production-computing model of CMS, and find that they work very well as worker nodes. The cost-structure and transient nature of EC2 services makes them inappropriate for some CMS production services and functions. We also found that the resources are not truely "on-demand" as limits and caps on usage are imposed. Our trial workflows allow us to make a cost comparison between EC2 resources and dedicated CMS resources at a University, and conclude that it is most cost effective to purchase dedicated resources for the "base-line" needs of experiments such as CMS. However, if the ability to use cloud computing resources is built into an experiment's software framework before demand requires their use, cloud computing resources make sense for bursting during times when spikes in usage are required.

Critical analysis of economic tools and economic measurement applied to rheumatoid arthritis.

PubMed

Her, Minyoung; Kavanaugh, Arthur

2012-01-01

Rheumatoid arthritis (RA) is chronic, progressive systemic inflammatory disease that if uncontrolled may lead to significant joint damage, dysfunction, work disability and other sequelae that result in large economic losses. A rich literature estimating the economic burden of RA, has been intensified recently, driven by costly biologic agents that have had a notable effect improving the outcomes of patients with RA. In order to optimally assess the value of therapies, it is best to take a comprehensive approach, considering all related costs of illness. This includes direct costs (e.g. the costs of the medications themselves and the monitoring required), indirect costs (e.g. loss of productivity, such as employment due to uncontrolled disease) and intangible cost (e.g. effects on pain and quality of life). Indirect costs constitute a substantial part of total cost in the patient with RA. In order to help assess the impact of RA on productivity, various tools for measuring productive loss like absenteeism and presenteeism have been introduced. No single tool reflects the entire spectrum of the productive loss clearly, as other factors such as use of a human capital approach or friction cost approach affect the valuation of productive loss monetarily. Although favourable outcomes are achieved with the use of biologic agents, their higher acquisition costs, as compared to traditional disease-modifying anti-rheumatic drugs (DMARDs) remain a barrier to their use. Assessments of the cost effectiveness of novel therapies are critically important, but published results have been contradictory, in some measure due to the heterogeneity of instruments utilised. While the various instruments appear to be valid and reliable, correlations between instruments has been modest, driven by factors such as differences in recall times, attribution and other confounders.

Economic modeling of new stent platforms to evaluate cost effectiveness: analysis of the TAXUS Liberté versus TAXUS express stents.

PubMed

Turco, Mark A; Kansal, Anuraag R; Stern, Sean; Amorosi, Stacey L; Underwood, Paul L; Lissovoy, Greg D E; Dawkins, Keith D

2012-08-01

With the changing health care environment, cost effectiveness is an important adjunct to clinical investigation when assessing new medical devices. This study presents an economic model to evaluate cost effectiveness of coronary stents. Markov modeling was developed comparing total costs (Medicare payer perspective) between TAXUS Liberté and TAXUS Express based on 3-year clinical outcomes from the TAXUS ATLAS Small Vessel and Long Lesion trials. The TAXUS Liberté 2.25-mm stent provided cost savings relative to TAXUS Express from a payer perspective ($17,605 vs. $20,281), driven by reduced target vessel revascularization (0.16 events/patient vs. 0.33 events/patient). In probabilistic sensitivity analyses, TAXUS Liberté was less costly with fewer major adverse cardiac events in over 99% of parameter sets. The TAXUS Liberté Long (38 mm) stent was cost neutral relative to TAXUS Express from a payer perspective ($18,545 vs. $18,551) with fewer myocardial infarctions and cardiac deaths. Accounting for angiography-driven revascularizations, TAXUS Liberté 2.25 mm still provided cost savings relative to TAXUS Express ($16,822 vs. $19,139), although TAXUS Liberté Long was more expensive than TAXUS Express ($17,886 vs. $17,652). From a hospital perspective, TAXUS Liberté Long provided cost savings up to a price premium of $671/stent, driven by fewer stents employed per patient. This analysis confirms the utility of economic modeling in assessing new stent platforms. TAXUS Liberté 2.25 mm is economically dominant relative to TAXUS Express when treating small vessels. TAXUS Liberté Long is cost neutral to modestly more costly than TAXUS Express 2.25 mm from a payer perspective. ©2012, Wiley Periodicals, Inc.

Do the potential benefits of metal-on-metal hip resurfacing justify the increased cost and risk of complications?

PubMed

Bozic, Kevin J; Pui, Christine M; Ludeman, Matthew J; Vail, Thomas P; Silverstein, Marc D

2010-09-01

Metal-on-metal hip resurfacing arthroplasty (MoM HRA) may offer potential advantages over total hip arthroplasty (THA) for certain patients with advanced osteoarthritis of the hip. However, the cost effectiveness of MoM HRA compared with THA is unclear. The purpose of this study was to compare the clinical effectiveness and cost-effectiveness of MoM HRA to THA. A Markov decision model was constructed to compare the quality-adjusted life-years (QALYs) and costs associated with HRA versus THA from the healthcare system perspective over a 30-year time horizon. We performed sensitivity analyses to evaluate the impact of patient characteristics, clinical outcome probabilities, quality of life and costs on the discounted incremental costs, incremental clinical effectiveness, and the incremental cost-effectiveness ratio (ICER) of HRA compared to THA. MoM HRA was associated with modest improvements in QALYs at a small incremental cost, and had an ICER less than $50,000 per QALY gained for men younger than 65 and for women younger than 55. MoM HRA and THA failure rates, device costs, and the difference in quality of life after conversion from HRA to THA compared to primary THA had the largest impact on costs and quality of life. MoM HRA could be clinically advantageous and cost-effective in younger men and women. Further research on the comparative effectiveness of MoM HRA versus THA should include assessments of the quality of life and resource use in addition to the clinical outcomes associated with both procedures. Level I, economic and decision analysis. See Guidelines for Authors for a complete description of levels of evidence.

Cost-effectiveness of structured group psychoeducation versus unstructured group support for bipolar disorder: Results from a multi-centre pragmatic randomised controlled trial.

PubMed

Camacho, E M; Ntais, D; Jones, S; Riste, L; Morriss, R; Lobban, F; Davies, L M

2017-03-15

Bipolar disorder (BD) costs the English economy an estimated £5.2billion/year, largely through incomplete recovery. This analysis estimated the cost-effectiveness of group psychoeducation (PEd), versus group peer support (PS), for treating BD. A 96-week pragmatic randomised controlled trial (RCT), conducted in NHS primary care. The primary analysis compared PEd with PS, using multiple imputed datasets for missing values. An economic model was used to compare PEd with treatment as usual (TAU). The perspective was Health and Personal Social Services. Participants receiving PEd (n=153) used more (costly) health-related resources than PS (n=151) (net cost per person £1098 (95% CI, £252-£1943)), with a quality-adjusted life year (QALY) gain of 0.023 (95% CI, 0.001-0.056). The cost per QALY gained was £47,739. PEd may be cost-effective (versus PS) if decision makers are willing to pay at least £37,500 per QALY gained. PEd costs £10,765 more than PS to avoid one relapse. The economic model indicates that PEd may be cost-effective versus TAU if it reduces the probability of relapse (by 15%) or reduces the probability of and increases time to relapse (by 10%). Participants were generally inconsistent in attending treatment sessions and low numbers had complete cost/QALY data. Factors contributing to pervasive uncertainty of the results are discussed. This is the first economic evaluation of PEd versus PS in a pragmatic trial. PEd is associated with a modest improvement in health status and higher costs than PS. There is a high level of uncertainty in the data and results. Copyright © 2017 Elsevier B.V. All rights reserved.

Family practice residencies in community health centers--an approach to cost and access concerns.

PubMed Central

Zweifler, J

1995-01-01

An inadequate number of trained primary care clinicians limits access to care at Community Health Centers. If family practice residents working in these centers can provide care to patients at a cost that is comparable to the center's hiring its own physicians, then expansion of Family Practice Residency Programs into community centers can address both cost and access concerns. A cost-benefit analysis of the Family Practice Residency Program at the Fresno, CA, community center was performed; the community center is affiliated with the University of California at San Francisco. Costs included (a) residents' salaries, (b) supervision of the family practice residents, (c) family practice program costs for educational activities apart from supervision at the community center, and (d) administrative costs attributable to family practice residents in the community center. Benefits were based on the number of patients that residents saw in the community center. Using this approach, a cost of $7,700 per resident per year was calculated. This cost is modest compared with the cost of training residents in inpatient settings. The added costs attributable to training residents in community health centers can be shared with agencies that are concerned with medical education, providing physicians to underserved communities, and increasing the supply of primary care physicians. Redirecting graduate medical education funding from hospitals to selected ambulatory care training centers of excellence would facilitate placing residents in community centers. This change would have the dual advantage of addressing the current imbalance between training in ambulatory care and hospital sites and increasing the capacity of community health centers to meet the health care needs of underserved populations. PMID:7610223

Cost-effectiveness of a multicomponent primary care program targeting frail elderly people.

PubMed

Ruikes, Franca G H; Adang, Eddy M; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M; Zuidema, Sytse U

2018-05-16

Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L). Adjusted mean costs directly related to the intervention were €456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were €1583 (95% CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care. The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended. The study was registered in the ClinicalTrials.govProtocol Registration System: ( NCT01499797 ; December 26, 2011). Retrospectively registered.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

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

26 CFR 1.179-5 - Time and manner of making election.

Code of Federal Regulations, 2010 CFR

2010-04-01

... desktop computer costing $1,500. On Taxpayer's 2003 Federal tax return filed on April 15, 2004, Taxpayer elected to expense under section 179 the full cost of the laptop computer and the full cost of the desktop... provided by the Internal Revenue Code, the regulations under the Code, or other guidance published in the...

Costs, needs must be balanced when buying computer systems.

PubMed

Krantz, G M; Doyle, J J; Stone, S G

1989-06-01

A healthcare institution must carefully examine its internal needs and external requirements before selecting an information system. The system's costs must be carefully weighed because significant computer cost overruns can cripple overall hospital finances. A New Jersey hospital carefully studied these issues and determined that a contract with a regional data center was its best option.

Obesity drug therapy.

PubMed

Baretić, M

2013-09-01

Obesity is a chronic disease, and it requires chronic therapy. Hypertension, dyslipidemia, diabetes and cardiovascular diseases are leading causes of mortality in the modern world. All of them are strongly linked to obesity. While treating obesity, those conditions are also managed. Obese patients should always be treated through lifestyle interventions, though the results of such interventions are modest. Pharmacotherapy is a second step in the treatment of obesity, approved only when weight loss targets were not reached through lifestyle intervention. During the history of antiobesity drugs, many of them were withdrawn because of their side effects. Various guidelines recommend prescribing drug therapy for obesity through consideration of the potential benefits and limitations. Orlistat deactivates intestinal lipase and inhibits intestinal fat lipolysis. It is actually the only drug on the European market approved for the treatment of obesity. Orlistat therapy reduces weight to a modest extent, but it reduces the incidence of diabetes beyond the result achieved with lifestyle changes. Recently, some effective antiobesity drugs like sibutramine and rimonabant have been removed from the market due to their side effects. The new combination of topimarate and fentermine is approved in the US but not in Europe. The cost effectiveness of long-term pharmacotherapy of obesity is still an unresolved question.

Coupled Human-Environment Dynamics of Forest Pest Spread and Control in a Multi-Patch, Stochastic Setting

PubMed Central

Ali, Qasim; Bauch, Chris T.; Anand, Madhur

2015-01-01

Background The transportation of camp firewood infested by non-native forest pests such as Asian long-horned beetle (ALB) and emerald ash borer (EAB) has severe impacts on North American forests. Once invasive forest pests are established, it can be difficult to eradicate them. Hence, preventing the long-distance transport of firewood by individuals is crucial. Methods Here we develop a stochastic simulation model that captures the interaction between forest pest infestations and human decisions regarding firewood transportation. The population of trees is distributed across 10 patches (parks) comprising a “low volume” partition of 5 patches that experience a low volume of park visitors, and a “high volume” partition of 5 patches experiencing a high visitor volume. The infestation spreads within a patch—and also between patches—according to the probability of between-patch firewood transportation. Individuals decide to transport firewood or buy it locally based on the costs of locally purchased versus transported firewood, social norms, social learning, and level of concern for observed infestations. Results We find that the average time until a patch becomes infested depends nonlinearly on many model parameters. In particular, modest increases in the tree removal rate, modest increases in public concern for infestation, and modest decreases in the cost of locally purchased firewood, relative to baseline (current) values, cause very large increases in the average time until a patch becomes infested due to firewood transport from other patches, thereby better preventing long-distance spread. Patches that experience lower visitor volumes benefit more from firewood movement restrictions than patches that experience higher visitor volumes. Also, cross–patch infestations not only seed new infestations, they can also worsen existing infestations to a surprising extent: long-term infestations are more intense in the high volume patches than the low volume patches, even when infestation is already endemic everywhere. Conclusions The success of efforts to prevent long-distance spread of forest pests may depend sensitively on the interaction between outbreak dynamics and human social processes, with similar levels of effort producing very different outcomes depending on where the coupled human and natural system exists in parameter space. Further development of such modeling approaches through better empirical validation should yield more precise recommendations for ways to optimally prevent the long-distance spread of invasive forest pests. PMID:26430902

A Low Cost Spacecraft Architecture for Robotic Lunar Exploration Projects

NASA Technical Reports Server (NTRS)

Lemke, Lawrence G.; Gonzales, Andrew A.

2006-01-01

A program of frequent, capable, but affordable lunar robotic missions prior to return of humans to the moon can contribute to the Vision for Space Exploration (VSE) NASA is tasked to execute. The Lunar Reconnaissance Orbiter (LRO) and its secondary payload are scheduled to orbit the moon, and impact it, respectively, in 2008. It is expected that the sequence of missions occurring for approximately the decade after 2008 will place an increasing emphasis on soft landed payloads. These missions are requited to explore intrinsic characteristics of the moon, such as hydrogen distribution in the regolith, and levitated dust, to demonstrate the ability to access and process in-situ resources, and to demonstrate functions critical to supporting human presence, such as automated precision navigation and landing. Additional factors governing the design of spacecraft to accomplish this diverse set of objectives are: operating within a relatively modest funding profile, the need tb visit multiple sites (both polar and equatorial) repeatedly, and to use the current generation of launch vehicles. In the US, this implies use of the Evolved Expendable Launch Vehicles, or EELVs, although this design philosophy may be extended to launch vehicles of other nations, as well. Many of these factors are seemingly inconsistent with each other. For example, the cost of a spacecraft usually increases with mass; therefore the desire to fly frequent, modestly priced spacecraft seems to imply small spacecraft (< 1 Mt, injected mass). On the other hand, the smallest of the EELVs will inject approx. 3 Mt. on a Trans Lunar Injection (TLI) trajectory md would therefore be wasteful or launching a single, small spacecraft. Increasing the technical capability of a spacecraft (such as autonomous navigation and soft landing) also usually increases cost. A strategy for spacecraft design that meets these conflicting requirements is presented. Taken together, spacecraft structure and propulsion subsystems constitute the majority of spacecraft mass; saving development and integration cost on these elements is critical to controlling cost. Therefore, a low cost, modular design for spacecraft structure and propulsion subsystems is presented which may be easily scaled up or down for either insertion into lunar orbit or braking for landing on the lunar surface. In order to effectively use the approx.3 Mt mass-to-TLI of the EELV, two low cost spacecraft will be manifested on the same launch. One spacecraft will be located on top of the other for launch and the two will have to be released in sequence in order to achieve all mission objectives. The two spacecraft could both be landers, both orbiters, or one lander and one orbiter. In order to achieve mass efficiency, the body of the spacecraft will serve the dual purposes of carrying launch loads and providing attachment points for all the spacecraft subsystems. In order to avoid unaffordable technology development costs, small liquid propulsion components and autonomous, scene-matching navigation cameras may be adapted from military missile programs in order to execute precision soft landings.

Next Generation Astronomical X-ray Optics: High Angular Resolution, Light Weight, and Low Production Cost

NASA Technical Reports Server (NTRS)

Zhang. W. W.; Biskach, M. P.; Blake, P. N.; Chan, K. W.; Gaskin, J. A.; Hong, M. L.; Jones, W. D.; Kolos, L. D.; Mazzarella, J. R.; McClelland, R. S.;

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk

PubMed Central

Thorndike, Anne N.

2012-01-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees’ nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs. PMID:22708000

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk.

PubMed

Thorndike, Anne N

2011-02-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees' nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs.

Cost sharing and HEDIS performance.

PubMed

Chernew, Michael; Gibson, Teresa B

2008-12-01

Physicians, health plans, and health systems are increasingly evaluated and rewarded based on Health Plan Effectiveness Data and Information Set (HEDIS) and HEDIS-like performance measures. Concurrently, employers and health plans continue to try to control expenditures by increasing out-of-pocket costs for patients. The authors use fixed-effect logit models to assess how rising copayment rates for physician office visits and prescription drugs affect performance on HEDIS measures. Findings suggest that the increase in copayment rates lowers performance scores, demonstrating the connection between financial aspects of plan design and quality performance, and highlighting the potential weakness of holding plans and providers responsible for performance when payers and benefit plan managers also influence performance. Yet the effects are not consistent across all domains and, in many cases, are relatively modest in magnitude. This may reflect the HEDIS definitions and suggests that more sensitive measures may capture the impact of benefit design changes on performance.

For two regional health foundations, returns from the Kentucky Health Issues Poll are worth the investments.

PubMed

Walsh, Sarah E; Myers, Gail; Chubinski, Jennifer; Zepeda, Susan G

2014-09-01

With finite resources to advance their missions, regional health foundations should critically evaluate the investments they make. This article reviews the costs and associated benefits of large-scale public opinion polling--specifically, the annual Kentucky Health Issues Poll, which is sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati. In addition to the information generated by the poll, the sponsoring foundations have benefited from increased name recognition and credibility with key stakeholders, including state policy makers and the media. Furthermore, jointly funding the poll has strengthened the relationship between the sponsoring foundations and has fostered other key collaborations. We find that the benefits from this poll more than justify its modest costs ($120,000 per year) and hope that this assessment may prove informative for other funders considering similar investments. Project HOPE—The People-to-People Health Foundation, Inc.

X-ray optics for the LAMAR facility, an overview. [Large Area Modular Array of Reflectors

NASA Technical Reports Server (NTRS)

Gorenstein, P.

1979-01-01

The paper surveys the Large Area Modular Array of Reflectors (LAMAR), the concept of which is based on meeting two major requirements in X-ray astronomy, large collecting area and moderately good or better angular resolution for avoiding source confusion and imaging source fields. It is shown that the LAMAR provides the same sensitivity and signal to noise in imaging as a single large telescope having the same area and angular resolution but is a great deal less costly to develop, construct, and integrate into a space mission. Attention is also given to the LAMAR modular nature which will allow for an evolutionary development from a modest size array on Spacelab to a Shuttle launched free flyer. Finally, consideration is given to manufacturing methods which show promise of making LAMAR meet the criteria of good angular resolution, relatively low cost, and capability for fast volume production.

Stress distribution characteristics in the vicinity of coal seam floor

NASA Astrophysics Data System (ADS)

Cui, Zimo; Chanda, Emmanuel; Zhao, Jingli; Wang, Zhihe

2018-01-01

Although longwall top-coal caving (LTCC) has been a popular, more productive and cost-effective method in recent years, roadway floor heave and rock bursts frequently appear when exploiting such coal seams with large dip angle. This paper proposes addressing this problem by adopting three-dimensional roadway layout of stagger arrangement (3-D RLSA). In this study, the first step was to analyse the stress distribution characteristics in the vicinity of coal seam floor based on the stress slip line field theory. In the second step, numerical calculation using FLAC3D was conducted. Finally, an evaluation of the 3-D RLSA for solving this particular issue was given. Results indicate that for this particular mine the proposed 3-D RLSA results in 24% increase in the coal recovery ratio and a modest reduction in excavation and maintenance costs compared to the conventional LTCC method.

Possible implications of large scale radiation processing of food

NASA Astrophysics Data System (ADS)

Zagórski, Z. P.

Large scale irradiation has been discussed in terms of the participation of processing cost in the final value of the improved product. Another factor has been taken into account and that is the saturation of the market with the new product. In the case of succesful projects the participation of irradiation cost is low, and the demand for the better product is covered. A limited availability of sources makes the modest saturation of the market difficult with all food subjected to correct radiation treatment. The implementation of the preservation of food needs a decided selection of these kinds of food which comply to all conditions i.e. of acceptance by regulatory bodies, real improvement of quality and economy. The last condition prefers the possibility of use of electron beams of low energy. The best fullfilment of conditions for succesful processing is observed in the group of dry food, in expensive spices in particular.

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

PubMed

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

2012-09-01

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

20 CFR 226.13 - Cost-of-living increase in employee vested dual benefit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... RAILROAD RETIREMENT ACT COMPUTING EMPLOYEE, SPOUSE, AND DIVORCED SPOUSE ANNUITIES Computing an Employee... increase is based on the cost-of-living increases in social security benefits during the period from...

Impact of DOTS expansion on tuberculosis related outcomes and costs in Haiti.

PubMed

Jacquet, Vary; Morose, Willy; Schwartzman, Kevin; Oxlade, Olivia; Barr, Graham; Grimard, Franque; Menzies, Dick

2006-08-15

Implementation of the World Health Organization's DOTS strategy (Directly Observed Treatment Short-course therapy) can result in significant reduction in tuberculosis incidence. We estimated potential costs and benefits of DOTS expansion in Haiti from the government, and societal perspectives. Using decision analysis incorporating multiple Markov processes (Markov modelling), we compared expected tuberculosis morbidity, mortality and costs in Haiti with DOTS expansion to reach all of the country, and achieve WHO benchmarks, or if the current situation did not change. Probabilities of tuberculosis related outcomes were derived from the published literature. Government health expenditures, patient and family costs were measured in direct surveys in Haiti and expressed in 2003 US$. Starting in 2003, DOTS expansion in Haiti is anticipated to cost $4.2 million and result in 63,080 fewer tuberculosis cases, 53,120 fewer tuberculosis deaths, and net societal savings of $131 million, over 20 years. Current government spending for tuberculosis is high, relative to the per capita income, and would be only slightly lower with DOTS. Societal savings would begin within 4 years, and would be substantial in all scenarios considered, including higher HIV seroprevalence or drug resistance, unchanged incidence following DOTS expansion, or doubling of initial and ongoing costs for DOTS expansion. A modest investment for DOTS expansion in Haiti would provide considerable humanitarian benefit by reducing tuberculosis-related morbidity, mortality and costs for patients and their families. These benefits, together with projected minimal Haitian government savings, argue strongly for donor support for DOTS expansion.

Energy and cost associated with ventilating office buildings in a tropical climate.

PubMed

Rim, Donghyun; Schiavon, Stefano; Nazaroff, William W

2015-01-01

Providing sufficient amounts of outdoor air to occupants is a critical building function for supporting occupant health, well-being and productivity. In tropical climates, high ventilation rates require substantial amounts of energy to cool and dehumidify supply air. This study evaluates the energy consumption and associated cost for thermally conditioning outdoor air provided for building ventilation in tropical climates, considering Singapore as an example locale. We investigated the influence on energy consumption and cost of the following factors: outdoor air temperature and humidity, ventilation rate (L/s per person), indoor air temperature and humidity, air conditioning system coefficient of performance (COP), and cost of electricity. Results show that dehumidification of outdoor air accounts for more than 80% of the energy needed for building ventilation in Singapore's tropical climate. Improved system performance and/or a small increase in the indoor temperature set point would permit relatively large ventilation rates (such as 25 L/s per person) at modest or no cost increment. Overall, even in a thermally demanding tropical climate, the energy cost associated with increasing ventilation rate up to 25 L/s per person is less than 1% of the wages of an office worker in an advanced economy like Singapore's. This result implies that the benefits of increasing outdoor air ventilation rate up to 25 L/s per person--which is suggested to provide for productivity increases, lower sick building syndrome symptom prevalence, and reduced sick leave--can be much larger than the incremental cost of ventilation.

Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period.

PubMed

Redondo-González, O; Tenías-Burillo, J M; Ruiz-Gonzalo, J

2017-07-01

Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (β-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.

A review of high-speed, convective, heat-transfer computation methods

NASA Technical Reports Server (NTRS)

Tauber, Michael E.

1989-01-01

The objective of this report is to provide useful engineering formulations and to instill a modest degree of physical understanding of the phenomena governing convective aerodynamic heating at high flight speeds. Some physical insight is not only essential to the application of the information presented here, but also to the effective use of computer codes which may be available to the reader. A discussion is given of cold-wall, laminar boundary layer heating. A brief presentation of the complex boundary layer transition phenomenon follows. Next, cold-wall turbulent boundary layer heating is discussed. This topic is followed by a brief coverage of separated flow-region and shock-interaction heating. A review of heat protection methods follows, including the influence of mass addition on laminar and turbulent boundary layers. Also discussed are a discussion of finite-difference computer codes and a comparison of some results from these codes. An extensive list of references is also provided from sources such as the various AIAA journals and NASA reports which are available in the open literature.

A review of high-speed, convective, heat-transfer computation methods

NASA Technical Reports Server (NTRS)

Tauber, Michael E.

1989-01-01

The objective is to provide useful engineering formulations and to instill a modest degree of physical understanding of the phenomena governing convective aerodynamic heating at high flight speeds. Some physical insight is not only essential to the application of the information presented here, but also to the effective use of computer codes which may be available to the reader. Given first is a discussion of cold-wall, laminar boundary layer heating. A brief presentation of the complex boundary layer transition phenomenon follows. Next, cold-wall turbulent boundary layer heating is discussed. This topic is followed by a brief coverage of separated flow-region and shock-interaction heating. A review of heat protection methods follows, including the influence of mass addition on laminar and turbulent boundary layers. Next is a discussion of finite-difference computer codes and a comparison of some results from these codes. An extensive list of references is also provided from sources such as the various AIAA journals and NASA reports which are available in the open literature.

Effects of Geometric Details on Slat Noise Generation and Propagation

NASA Technical Reports Server (NTRS)

Khorrami, Mehdi R.; Lockard, David P.

2006-01-01

The relevance of geometric details to the generation and propagation of noise from leading-edge slats is considered. Typically, such details are omitted in computational simulations and model-scale experiments thereby creating ambiguities in comparisons with acoustic results from flight tests. The current study uses two-dimensional, computational simulations in conjunction with a Ffowcs Williams-Hawkings (FW-H) solver to investigate the effects of previously neglected slat "bulb" and "blade" seals on the local flow field and the associated acoustic radiation. The computations clearly show that the presence of the "blade" seal at the cusp significantly changes the slat cove flow dynamics, reduces the amplitudes of the radiated sound, and to a lesser extent, alters the directivity beneath the airfoil. Furthermore, it is demonstrated that a modest extension of the baseline "blade" seal further enhances the suppression of slat noise. As a side issue, the utility and equivalence of FW-H methodology for calculating far-field noise as opposed to a more direct approach is examined and demonstrated.

Assessment of time-dependent density functional theory with the restricted excitation space approximation for excited state calculations of large systems

NASA Astrophysics Data System (ADS)

Hanson-Heine, Magnus W. D.; George, Michael W.; Besley, Nicholas A.

2018-06-01

The restricted excitation subspace approximation is explored as a basis to reduce the memory storage required in linear response time-dependent density functional theory (TDDFT) calculations within the Tamm-Dancoff approximation. It is shown that excluding the core orbitals and up to 70% of the virtual orbitals in the construction of the excitation subspace does not result in significant changes in computed UV/vis spectra for large molecules. The reduced size of the excitation subspace greatly reduces the size of the subspace vectors that need to be stored when using the Davidson procedure to determine the eigenvalues of the TDDFT equations. Furthermore, additional screening of the two-electron integrals in combination with a reduction in the size of the numerical integration grid used in the TDDFT calculation leads to significant computational savings. The use of these approximations represents a simple approach to extend TDDFT to the study of large systems and make the calculations increasingly tractable using modest computing resources.