Evaluating the benefits of digital pathology implementation: Time savings in laboratory logistics.

PubMed

Baidoshvili, Alexi; Bucur, Anca; van Leeuwen, Jasper; van der Laak, Jeroen; Kluin, Philip; van Diest, Paul J

2018-06-20

The benefits of digital pathology for workflow improvement and thereby cost savings in pathology, at least partly outweighing investment costs, are increasingly recognized. Successful implementations in a variety of scenarios start to demonstrate cost benefits of digital pathology for both research and routine diagnostics, contributing to a sound business case encouraging further adoption. To further support new adopters, there is still a need for detailed assessment of the impact this technology has on the relevant pathology workflows with emphasis on time saving. To assess the impact of digital pathology adoption on logistic laboratory tasks (i.e. not including pathologists' time for diagnosis making) in LabPON, a large regional pathology laboratory in The Netherlands. To quantify the benefits of digitization we analyzed the differences between the traditional analog and new digital workflows, carried out detailed measurements of all relevant steps in key analog and digital processes, and compared time spent. We modeled and assessed the logistic savings in five workflows: (1) Routine diagnosis, (2) Multi-disciplinary meeting, (3) External revision requests, (4) Extra stainings and (5) External consultation. On average over 19 working hours were saved on a typical day by working digitally, with the highest savings in routine diagnosis and multi-disciplinary meeting workflows. By working digitally, a significant amount of time could be saved in a large regional pathology lab with a typical case mix. We also present the data in each workflow per task and concrete logistic steps to allow extrapolation to the context and case mix of other laboratories. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Application of automated measurement and verification to utility energy efficiency program data

DOE PAGES

Granderson, Jessica; Touzani, Samir; Fernandes, Samuel; ...

2017-02-17

Trustworthy savings calculations are critical to convincing regulators of both the cost-effectiveness of energy efficiency program investments and their ability to defer supply-side capital investments. Today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of energy efficiency programs. They also require time-consuming data acquisition. A spectrum of savings calculation approaches is used, with some relying more heavily on measured data and others relying more heavily on estimated, modeled, or stipulated data. The increasing availability of “smart” meters and devices that report near-real time data, combined with new analytical approaches to quantifymore » savings, offers the potential to conduct M&V more quickly and at lower cost, with comparable or improved accuracy. Commercial energy management and information systems (EMIS) technologies are beginning to offer these ‘M&V 2.0’ capabilities, and program administrators want to understand how they might assist programs in quickly and accurately measuring energy savings. This paper presents the results of recent testing of the ability to use automation to streamline the M&V process. In this paper, we apply an automated whole-building M&V tool to historic data sets from energy efficiency programs to begin to explore the accuracy, cost, and time trade-offs between more traditional M&V, and these emerging streamlined methods that use high-resolution energy data and automated computational intelligence. For the data sets studied we evaluate the fraction of buildings that are well suited to automated baseline characterization, the uncertainty in gross savings that is due to M&V 2.0 tools’ model error, and indications of labor time savings, and how the automated savings results compare to prior, traditionally determined savings results. The results show that 70% of the buildings were well suited to the automated approach. In a majority of the cases (80%) savings and uncertainties for each individual building were quantified to levels above the criteria in ASHRAE Guideline 14. In addition the findings suggest that M&V 2.0 methods may also offer time-savings relative to traditional approaches. Lastly, we discuss the implications of these findings relative to the potential evolution of M&V, and pilots currently being launched to test how M&V automation can be integrated into ratepayer-funded programs and professional implementation and evaluation practice.« less

Application of automated measurement and verification to utility energy efficiency program data

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

Granderson, Jessica; Touzani, Samir; Fernandes, Samuel

Trustworthy savings calculations are critical to convincing regulators of both the cost-effectiveness of energy efficiency program investments and their ability to defer supply-side capital investments. Today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of energy efficiency programs. They also require time-consuming data acquisition. A spectrum of savings calculation approaches is used, with some relying more heavily on measured data and others relying more heavily on estimated, modeled, or stipulated data. The increasing availability of “smart” meters and devices that report near-real time data, combined with new analytical approaches to quantifymore » savings, offers the potential to conduct M&V more quickly and at lower cost, with comparable or improved accuracy. Commercial energy management and information systems (EMIS) technologies are beginning to offer these ‘M&V 2.0’ capabilities, and program administrators want to understand how they might assist programs in quickly and accurately measuring energy savings. This paper presents the results of recent testing of the ability to use automation to streamline the M&V process. In this paper, we apply an automated whole-building M&V tool to historic data sets from energy efficiency programs to begin to explore the accuracy, cost, and time trade-offs between more traditional M&V, and these emerging streamlined methods that use high-resolution energy data and automated computational intelligence. For the data sets studied we evaluate the fraction of buildings that are well suited to automated baseline characterization, the uncertainty in gross savings that is due to M&V 2.0 tools’ model error, and indications of labor time savings, and how the automated savings results compare to prior, traditionally determined savings results. The results show that 70% of the buildings were well suited to the automated approach. In a majority of the cases (80%) savings and uncertainties for each individual building were quantified to levels above the criteria in ASHRAE Guideline 14. In addition the findings suggest that M&V 2.0 methods may also offer time-savings relative to traditional approaches. Lastly, we discuss the implications of these findings relative to the potential evolution of M&V, and pilots currently being launched to test how M&V automation can be integrated into ratepayer-funded programs and professional implementation and evaluation practice.« less

Community Savings Groups, Financial Security, and HIV Risk Among Female Sex Workers in Iringa, Tanzania.

PubMed

Mantsios, Andrea; Galai, Noya; Mbwambo, Jessie; Likindikoki, Samuel; Shembilu, Catherine; Mwampashi, Ard; Beckham, S W; Leddy, Anna; Davis, Wendy; Sherman, Susan; Kennedy, Caitlin; Kerrigan, Deanna

2018-02-24

This study assessed the association between community savings group participation and consistent condom use (CCU) among female sex workers (FSW) in Iringa, Tanzania. Using cross-sectional data from a survey of venue-based FSW (n = 496), logistic regression was used to examine the associations between financial indicators including community savings group participation and CCU. Over one-third (35%) of the women participated in a savings group. Multivariable regression results indicated that participating in a savings group was significantly associated with nearly two times greater odds of CCU with new clients in the last 30 days (aOR = 1.77, 95% CI 1.10-2.86). Exploratory mediation analysis indicated that the relationship between savings group participation and CCU was partially mediated by financial security, as measured by monthly income. Findings indicate that community savings groups may play an important role in reducing sexual risk behaviors of FSW and hold promise as part of comprehensive, community-led HIV prevention strategies among FSW.

Principles of continuous quality improvement applied to intravenous therapy.

PubMed

Dunavin, M K; Lane, C; Parker, P E

1994-01-01

Documentation of the application of the principles of continuous quality improvement (CQI) to the health care setting is crucial for understanding the transition from traditional management models to CQI models. A CQI project was designed and implemented by the IV Therapy Department at Lawrence Memorial Hospital to test the application of these principles to intravenous therapy and as a learning tool for the entire organization. Through a prototype inventory project, significant savings in cost and time were demonstrated using check sheets, flow diagrams, control charts, and other statistical tools, as well as using the Plan-Do-Check-Act cycle. As a result, a primary goal, increased time for direct patient care, was achieved. Eight hours per week in nursing time was saved, relationships between two work areas were improved, and $6,000 in personnel costs, storage space, and inventory were saved.

Potential time savings to radiology department personnel in a PACS-based environment

NASA Astrophysics Data System (ADS)

Saarinen, Allan O.; Wilson, M. C.; Iverson, Scott C.; Loop, John W.

1990-08-01

A purported benefit of digital imaging and archiving of radiographic procedures is the presumption of time savings to radiologists, radiology technologists, and radiology departmentpersonnel involved with processingfilms and managing theflimfile room. As part of the University of Washington's evaluation of Picture Archiving and Communication Systems (PACS)for the U.S. Army Medical Research and Development Command, a study was performed which evaluated the current operationalpractices of the film-based radiology department at the University of Washington Medical Center (UWMC). Industrial engineering time and motion studies were conducted to document the length of time requiredforfilm processing in various modalities, the proportion of the total exam time usedforfilm processing, the amount of time radiologists spent searchingfor and looking at images, and the amount of time file room personnel spent collating reports, making loans, updatingfilm jacket information, and purging files. This evaluation showed that better than one-half of the tasks in the file room may be eliminated with PACS and radiologists may save easily 10 percent of the time they spend reading films by no longer having to searchforfilms. Radiology technologists may also save as much as 10 percent of their time with PACS, although this estimate is subject to significant patient mix aberrations and measurement error. Given that the UWMC radiology department operates efficiently, similar improvements are forecast for other radiology departments and larger improvements areforecastfor less efficient departments.

Managing Air Quality - Multi-Pollutant Planning and Control

EPA Pesticide Factsheets

Describes how planning controls for multiple pollutants at the same time can save money and time and achieve significant benefits, and how control strategies can address both climate change and air quality.

The impact of labor-saving technology on first birth intervals in rural Ethiopia.

PubMed

Gibson, Mhairi; Mace, Ruth

2002-02-01

Across the developing world labor-saving technologies introduce considerable savings in the time and energy that women allocate to work. Hormonal studies on natural fertility populations indicate that such a reduction in energetic expenditure (rather than improved nutritional status alone) can lead to increased ovarian function. Other qualitative studies have highlighted a link between labor-saving technology and behavioral changes affecting subsequent age at marriage, which may affect fertility. This biodemographic study was designed to investigate whether these physiological and behavioral changes affect fertility at a population level by focusing on a recent water development scheme in Southern Ethiopia. The demographic consequences of a reduction in women's workload following the installation of water points, specifically the variation in length of first birth interval (time lapsed between marriage and first birth), are investigated. First birth interval length is closely associated with lifetime fertility in populations that do not practice contraception, longer intervals being associated with lower fertility. Using life tables and multivariate hazard modeling techniques a number of significant predictors of first birth interval length are identified. Covariates such as age at marriage, season of marriage, village ecology, and access to improved water supply have significant effects on variation in first birth intervals. When entered into models as a time-varying covariate, access to a water tap stand is associated with an immediate reduction in length of first birth intervals.

Implementation and evaluation of an automated dispensing system.

PubMed

Schwarz, H O; Brodowy, B A

1995-04-15

An institution's experience in replacing a traditional unit dose cassette-exchange system with an automated dispensing system is described. A 24-hour unit dose cassette-exchange system was replaced with an automated dispensing system (Pyxis's Medstation Rx) on a 36-bed cardiovascular surgery unit and an 8-bed cardiovascular intensive care unit. Significantly fewer missing doses were reported after Medstation Rx was implemented. No conclusions could be made about the impact of the system on the reporting of medication errors. The time savings for pharmacy associated with the filling, checking, and delivery of new medication orders equated to about 0.5 full-time equivalent (FTE). Medstation Rx also saved substantial nursing time for acquisition of controlled substances and for controlled-substance inventory taking at shift changes. A financial analysis showed that Medstation Rx could save the institution about $1 million over five years if all personnel time savings could be translated into FTE reductions. The automated system was given high marks by the nurses in a survey; 80% wanted to keep the system on their unit. Pilot implementation of an automated dispensing system improved the efficiency of drug distribution over that of the traditional unit dose cassette-exchange system.

Physician Education on Controllable Costs Significantly Reduces Cost of Laparoscopic Hysterectomy.

PubMed

Croft, Katherine; Mattingly, Patricia J; Bosse, Patrick; Naumann, R Wendel

2017-01-01

To determine whether educating surgeons about their controllable instrumentation costs by providing cost data on total laparoscopic hysterectomy (LH) would reduce the cost of this procedure. Prospective cohort study (Canadian Task Force classification III). Academic-affiliated community hospital. Patients who underwent LH between April 2014 and March 2015 with surgeons who performed at least 10 LHs during that time period, along with a second group who underwent LH with the same cohort of surgeons between July 2015 and September 2015. The cost of LH was calculated for all surgeons who performed more than 10 LHs between April 2014 and March 2015. Itemized cost data were collected. The individual costs, as well as a summary of the data, were shared with all of the physicians to highlight areas of potential cost savings. The costs were then measured for 3 months after the educational intervention (July-September 2015) to gauge the impact of physician cost education. Thirteen surgeons met the criteria for inclusion in this analysis. Together, they performed 271 hysterectomies, with an average instrumentation cost of $1539.47 ± $294.16 and an average operating room time of 178 ± 26 minutes. Bipolar instrument choice represented 37% of the baseline costs, followed by 10% for trocar, 9% for cuff closure, and 8% for uterine manipulator. This same group of surgeons performed a total of 69 hysterectomies in the 3-month follow-up period of July-September 2015, with an average instrumentation cost of $1282.62 ± $235.03 and an average operating room time of 163 ± 50 minutes. There was statistically significant cost reduction of $256.85 ± $190.69 (p = .022), with no significant change in operating room time. Bipolar instrument cost decreased significantly, by $130.02 ± $125.02 (p = .021), representing 51% of the total cost savings. Trocar, cuff closure, and uterine manipulator costs were not significant sources of cost savings on average, but did represent sources of cost savings for some surgeons individually. Given adequate education about the products available for use in their institution, surgeons make informed decisions regarding the choice of instrumentation, allowing them to directly impact the cost of total LH, resulting in cost savings. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

The influence of multiple goals on driving behavior: the case of safety, time saving, and fuel saving.

PubMed

Dogan, Ebru; Steg, Linda; Delhomme, Patricia

2011-09-01

Due to the innate complexity of the task drivers have to manage multiple goals while driving and the importance of certain goals may vary over time leading to priority being given to different goals depending on the circumstances. This study aimed to investigate drivers' behavioral regulation while managing multiple goals during driving. To do so participants drove on urban and rural roads in a driving simulator while trying to manage fuel saving and time saving goals, besides the safety goals that are always present during driving. A between-subjects design was used with one group of drivers managing two goals (safety and fuel saving) and another group managing three goals (safety, fuel saving, and time saving) while driving. Participants were provided continuous feedback on the fuel saving goal via a meter on the dashboard. The results indicate that even when a fuel saving or time saving goal is salient, safety goals are still given highest priority when interactions with other road users take place and when interacting with a traffic light. Additionally, performance on the fuel saving goal diminished for the group that had to manage fuel saving and time saving together. The theoretical implications for a goal hierarchy in driving tasks and practical implications for eco-driving are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Extended operating times are more efficient, save money and maintain a high staff and patient satisfaction.

PubMed

Herron, Jonathan Blair Thomas; French, Rachel; Gilliam, Andrew Douglas

2018-01-01

Current public sector austerity measures necessitate efficiency savings throughout the NHS. Performance targets have resulted in activity being performed in the private sector, waiting list initiative lists and requests for staff to work overtime. This has resulted in staff fatigue and additional agency costs. Adoption of extended operating theatre times (0800-1800 hours) may improve productivity and efficiency, with potentially significant financial savings; however, implementation may adversely affect staff morale and patient compliance. A pilot period of four months of extended operating times (4.5 hour sessions) was completed and included all theatre surgical specialties. Outcome measures included: the number of cases completed, late starts, early finishes, cancelled operations, theatre overruns, preoperative assessment and 18-week targets. The outcomes were then compared to pre-existing normal working day operating lists (0900-1700). Theatre staff, patient and surgical trainee satisfaction with the system were also considered by use of an anonymous questionnaire. The study showed that in-session utilisation time was unchanged by extended operating hours 88.7% (vs 89.2%). The service was rated as 'good' or 'excellent' by 87.5% of patients. Over £345,000 was saved by reducing premium payments. Savings of £225,000 were made by reducing privately outsourced operation and a further £63,000 by reviewing staff hours. Day case procedures increased from 2.8 to 3.2 cases/day with extended operating. There was no significant increase in late starts (5.1% vs 6.8%) or cancellation rates (0.75% vs 1.02%). Theatre over-runs reduced from 5% to 3.4%. The 18 weeks target for surgery was achieved in 93.7% of cases (vs 88.3%). The number of elective procedures increased from 4.1 to 4.89 cases/day. Only 13.33% of trainees (n = 33) surveyed felt that extended operating had a negative impact on training. The study concludes that extended operating increased productivity from 2.8 patients per session to 3.2 patients per session with potential savings of just over £2.4 million per financial year. Extrapolating this to the other 155 trusts in England could be a potential saving of £372 million per year. Staff, trainee and patient satisfaction was unaffected. An improved 18 weeks target position was achieved with a significant reduction in private sector work. However, some staff had difficulty with arranging childcare and taking public transport and this may prevent full implementation.

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

PubMed

Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

2018-02-01

To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p < 0.001). The mean operating theatre time, surgeon procedure time and length of stay were all significantly lower under local anaesthesia compared to general anaesthesia. Time variables such as operating theatre time and length of stay were the most significant predictors of the total costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

Using skype as an alternative for residency selection interviews.

PubMed

Edje, Louito; Miller, Christine; Kiefer, Jacklyn; Oram, David

2013-09-01

Residency interviews can place significant time and financial burdens on applicants. To determine whether the use of Skype as a screening tool during interview season in a family medicine residency is cost-effective and time-efficient for the applicant and the residency program. We surveyed 2 groups of medical students during interviews for our family medicine program. Thirty-two students were interviewed via our face-to-face, traditional interview (TI) process, and 10 students, the second group, who did not meet the program's standard interview selection criteria for TI, underwent our Skype interview (SI) process. Using an unpaired t test, we found that the applicants' costs of an SI were significantly less than a TI, $566 (95% confidence interval [CI] $784-$349, P < .001). Direct cash savings plus indirect salary savings to the program were $5,864, with a time savings of 7 interview days. Three of the applicants who were participants in the SI limb of the study were in our final rank order list. For interviewing in family medicine residencies, use of Skype may be a cost-effective and time-efficient screening tool for both the applicant and the program. Alternate uses of SI may include the time-sensitive, postmatch Supplemental Offer and Acceptance Program.

Using Skype as an Alternative for Residency Selection Interviews

PubMed Central

Edje, Louito; Miller, Christine; Kiefer, Jacklyn; Oram, David

2013-01-01

Background Residency interviews can place significant time and financial burdens on applicants. Objective To determine whether the use of Skype as a screening tool during interview season in a family medicine residency is cost-effective and time-efficient for the applicant and the residency program. Methods We surveyed 2 groups of medical students during interviews for our family medicine program. Thirty-two students were interviewed via our face-to-face, traditional interview (TI) process, and 10 students, the second group, who did not meet the program's standard interview selection criteria for TI, underwent our Skype interview (SI) process. Results Using an unpaired t test, we found that the applicants' costs of an SI were significantly less than a TI, $566 (95% confidence interval [CI] $784–$349, P < .001). Direct cash savings plus indirect salary savings to the program were $5,864, with a time savings of 7 interview days. Three of the applicants who were participants in the SI limb of the study were in our final rank order list. Conclusions For interviewing in family medicine residencies, use of Skype may be a cost-effective and time-efficient screening tool for both the applicant and the program. Alternate uses of SI may include the time-sensitive, postmatch Supplemental Offer and Acceptance Program. PMID:24404318

Circadian occurrence of variceal bleeding in patients with liver cirrhosis.

PubMed

Siringo, S; Bolondi, L; Sofia, S; Hermida, R C; Gramantieri, L; Gaiani, S; Piscaglia, F; Carbone, C; Misitano, B; Corinaldesi, R

1996-12-01

Several clinical events have a rhythmicity over the 24 h period. We assessed the presence of periodic rhythm in the occurrence of haematemesis in patients with liver cirrhosis under different daylight regimens, namely during standard time and during daylight savings. Over a 48 month period there were 212 consecutive admissions of 118 cirrhotics with variceal bleeding. Complete data were available for 181 episodes of bleeding: 121 (66.9%) started with haematemesis and 60 (33.1%) started with melaena. One hundred and two (56%) episodes occurred during daylight savings and 79 (44%) occurred during standard time. The cosinor test showed a 24 h biphasic peak for the occurrence of haematemesis (09.45 and 21.45 h). Moreover, a biphasic diurnal asymmetric frequency was also found by multiple component rhythmometry. The time peaks of onset of variceal haemorrhage did not change significantly during standard time and daylight savings. Patients with more than one haematemesis episode significantly bled over the same time interval. The present study confirms that over the 24 h period variceal bleeding in cirrhotic patients occurs with a predictable rhythmicity that does not seem to be under the control of the light-dark cycle. The finding of a chronorisk for variceal haemorrhage addresses specific questions for pathophysiological studies as well as for new treatment strategies.

Performance analysis of male handball goalkeepers at the World Handball championship 2015

PubMed Central

Hansen, Clint; Sanz-Lopez, Fernando; Whiteley, Rodney; Popovic, Nebojsa; Ahmed, Hosny Abdelrahman

2017-01-01

Goalkeepers have a very important role in handball. In coaching communities it is well recognized that goalkeepers’ performances can predict team ranking in major tournaments. Despite this, few studies have been conducted on elite goalkeepers participating in World Championships. Therefore, the purpose of this study was to analyse goalkeepers’ save performance during the 88 matches of the 2015 men’s World Championships tournament. Goalkeepers from 24 national teams were analysed using a tracking camera system and bespoke software (Prozone Handball V.1.2, Prozone, Leeds, UK). The purpose of this study was to examine time-motion performance parameters and to evaluate the save rates for each goalkeeper. The mean total distance covered in a game by the goalkeepers was 1634±999 m. Goalkeepers spent most of the time walking or standing. The total amount of shots to the goal was 6893, with a mean save percentage of 30% (2088 saves). A significant relationship was identified between the goalkeepers’ save statistics and the final team rankings. The save rate is important for teams to achieve a higher ranking, and therefore the selection and training of goalkeepers requires more than just assessing physical abilities. The throwing distribution and success/save rate during the Qatar 2015 Men Handball World Championships suggest strong and weak parts of the goal area, and coaches can use this information to adjust their training approaches for both goalkeepers and shooters. PMID:29472743

Performance analysis of male handball goalkeepers at the World Handball championship 2015.

PubMed

Hansen, Clint; Sanz-Lopez, Fernando; Whiteley, Rodney; Popovic, Nebojsa; Ahmed, Hosny Abdelrahman; Cardinale, Marco

2017-12-01

Goalkeepers have a very important role in handball. In coaching communities it is well recognized that goalkeepers' performances can predict team ranking in major tournaments. Despite this, few studies have been conducted on elite goalkeepers participating in World Championships. Therefore, the purpose of this study was to analyse goalkeepers' save performance during the 88 matches of the 2015 men's World Championships tournament. Goalkeepers from 24 national teams were analysed using a tracking camera system and bespoke software (Prozone Handball V.1.2, Prozone, Leeds, UK). The purpose of this study was to examine time-motion performance parameters and to evaluate the save rates for each goalkeeper. The mean total distance covered in a game by the goalkeepers was 1634±999 m. Goalkeepers spent most of the time walking or standing. The total amount of shots to the goal was 6893, with a mean save percentage of 30% (2088 saves). A significant relationship was identified between the goalkeepers' save statistics and the final team rankings. The save rate is important for teams to achieve a higher ranking, and therefore the selection and training of goalkeepers requires more than just assessing physical abilities. The throwing distribution and success/save rate during the Qatar 2015 Men Handball World Championships suggest strong and weak parts of the goal area, and coaches can use this information to adjust their training approaches for both goalkeepers and shooters.

Microwaving logs for energy savings and improved paper properties for mechanical pulps

Treesearch

C. Tim Scott; John Klungness; Mike Lentz; Eric Horn; Masood Akhtar

2002-01-01

High-power microwave cooking of commercial black spruce pulpwood logs was investigated as a pretreatment for mechanical pulping. Several dozen logs were treated at a variety of power levels (10 to 50 kW) and for various times (1 to 10 min). The mechanical pulping trials resulted in significant energy savings-up to 15% for the highest power level. In addition, there was...

Financial Capability and Sociodemographic Factors among Survivors of Human Trafficking.

PubMed

Okech, David; McGarity, Stephen Vandiver; Hansen, Nathan; Burns, Abigail C; Howard, Waylon

2018-01-01

Improving the economic well-being of the girls and women is a key to reducing re-trafficking and in providing stability that survivors can use to rebuild their lives. The study looks at how various sociodemographic traits affected the financial capability of n = 144 women and girls who received intervention at a residential care facility in Ghana, West Africa. Three domain of financial capability are assessed in this, i.e., financial risk, financial planning, and financial saving. A scaled likelihood ratio test (chi-square difference test) was used to evaluate the significance of each direct covariate effect(%). Each of the overall goodness-of-fit indices suggested that the initial CFA model fit the data well, χ 2 (19, N = 144)  = 31.45, p = 0.04, RMSEA = 0.067 (90% CI: 0.017-0.108), TLI = 0.923, CFI = 0.948. Older women reported lower levels of financial savings than younger women. We found that women with secondary school education or higher reported significantly higher financial risk than women with less education. Women with children reported lower levels of financial saving than women without children. Married women indicated significantly more financial saving than single women. There was a significant negative effect of time spent in trafficking conditions on financial saving, indicating the highest average level of financial savings at intervention and decreased thereafter. Programs and policies in resource-scarce contexts that aim to assist trafficking survivors must go beyond providing psychosocial counseling and focus also on economic development opportunities.

Impact of Extended Daylight Saving Time on National Energy Consumption Report to Congress

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

Belzer, D. B.; Hadley, S. W.; Chin, S-M.

2008-10-01

The Energy Policy Act of 2005 (Pub. L. No. 109-58; EPAct 2005) amended the Uniform Time Act of 1966 (Pub. L. No. 89-387) to increase the portion of the year that is subject to Daylight Saving Time. (15 U.S.C. 260a note) EPAct 2005 extended the duration of Daylight Saving Time in the spring by changing its start date from the first Sunday in April to the second Sunday in March, and in the fall by changing its end date from the last Sunday in October to the first Sunday in November. (15 U.S.C. 260a note) EPAct 2005 also called formore » the Department of Energy to evaluate the impact of Extended Daylight Saving Time on energy consumption in the United States and to submit a report to Congress. (15 U.S.C. 260a note) This report presents the results of impacts of Extended Daylight Saving Time on the national energy consumption in the United States. The key findings are: (1) The total electricity savings of Extended Daylight Saving Time were about 1.3 Tera Watt-hour (TWh). This corresponds to 0.5 percent per each day of Extended Daylight Saving Time, or 0.03 percent of electricity consumption over the year. In reference, the total 2007 electricity consumption in the United States was 3,900 TWh. (2) In terms of national primary energy consumption, the electricity savings translate to a reduction of 17 Trillion Btu (TBtu) over the spring and fall Extended Daylight Saving Time periods, or roughly 0.02 percent of total U.S. energy consumption during 2007 of 101,000 TBtu. (3) During Extended Daylight Saving Time, electricity savings generally occurred over a three- to five-hour period in the evening with small increases in usage during the early-morning hours. On a daily percentage basis, electricity savings were slightly greater during the March (spring) extension of Extended Daylight Saving Time than the November (fall) extension. On a regional basis, some southern portions of the United States exhibited slightly smaller impacts of Extended Daylight Saving Time on energy savings compared to the northern regions, a result possibly due to a small, offsetting increase in household air conditioning usage. (4) Changes in national traffic volume and motor gasoline consumption for passenger vehicles in 2007 were determined to be statistically insignificant and therefore, could not be attributed to Extended Daylight Saving Time.« less

Ambient air conditions and variation in urban trail use.

PubMed

Holmes, Ann M; Lindsey, Greg; Qiu, Chenchen

2009-11-01

This study examines the effect of air quality and administrative policies on use of urban trails in Indianapolis, IN. Attention is focused on two policy variables: (1) issuance of air pollution advisories and (2) the adoption of Daylight Savings Time. Results suggest that while trail use varies with air quality, current public advisories regarding air pollution may be of limited effectiveness in reducing trail users' exposures to hazardous pollutants. In contrast, the adoption of Daylight Savings Time was associated with a statistically significant increase in traffic levels.

Dynamic Weather Routes: A Weather Avoidance Concept for Trajectory-Based Operations

NASA Technical Reports Server (NTRS)

McNally, B. David; Love, John

2011-01-01

The integration of convective weather modeling with trajectory automation for conflict detection, trial planning, direct routing, and auto resolution has uncovered a concept that could help controllers, dispatchers, and pilots identify improved weather routes that result in significant savings in flying time and fuel burn. Trajectory automation continuously and automatically monitors aircraft in flight to find those that could potentially benefit from improved weather reroutes. Controllers, dispatchers, and pilots then evaluate reroute options to assess their suitability given current weather and traffic. In today's operations aircraft fly convective weather avoidance routes that were implemented often hours before aircraft approach the weather and automation does not exist to automatically monitor traffic to find improved weather routes that open up due to changing weather conditions. The automation concept runs in real-time and employs two keysteps. First, a direct routing algorithm automatically identifies flights with large dog legs in their routes and therefore potentially large savings in flying time. These are common - and usually necessary - during convective weather operations and analysis of Fort Worth Center traffic shows many aircraft with short cuts that indicate savings on the order of 10 flying minutes. The second and most critical step is to apply trajectory automation with weather modeling to determine what savings could be achieved by modifying the direct route such that it avoids weather and traffic and is acceptable to controllers and flight crews. Initial analysis of Fort Worth Center traffic suggests a savings of roughly 50% of the direct route savings could be achievable.The core concept is to apply trajectory automation with convective weather modeling in real time to identify a reroute that is free of weather and traffic conflicts and indicates enough time and fuel savings to be considered. The concept is interoperable with today's integrated FMS/datalink. Auxiliary(lat/long) waypoints define a minimum delay reroute between current position and a downstream capture fix beyond the weather. These auxiliary waypoints can be uplinked to equipped aircraft and auto-loaded into the FMS. Alternatively, for unequipped aircraft, auxiliary waypoints can be replaced by nearby named fixes, but this could reduce potential savings. The presentation includes an overview of the automation approach and focuses on several cases in terms of potential savings, reroute complexity, best auxiliary waypoint solution vs. named fix solution, and other metrics.

Energy monitoring system based on human activity in the workplace

NASA Astrophysics Data System (ADS)

Mustafa, Nur Hanim; Husain, Mohd Nor; Aziz, Mohamad Zoinol Abidin Abdul; Othman, Mohd Azlishah; Malek, Fareq

2015-05-01

Human behaviors always related to day routine activities in a smart house directly give the significant factor to manage energy usage in human life. An Addition that, the factor will contribute to the best efficiency of the system. This paper will focus on the monitoring efficiency based on duration time in office hours around 8am until 5pm which depend on human behavior at working place. Besides that, the correlation coefficient method is used to show the relation between energy consumption and energy saving based on the total hours of time energy spent. In future, the percentages of energy monitoring system usage will be increase to manage energy saving based on human behaviors. This scenario will help to see the human activity in the workplace in order to get the energy saving and support world green environment.

Deceleration-stats save much time during phototrophic culture optimization.

PubMed

Hoekema, Sebastiaan; Rinzema, Arjen; Tramper, Johannes; Wijffels, René H; Janssen, Marcel

2014-04-01

In case of phototrophic cultures, photobioreactor costs contribute significantly to the total operating costs. Therefore one of the most important parameters to be determined is the maximum biomass production rate, if biomass or a biomass associated product is the desired product. This is traditionally determined in time consuming series of chemostat cultivations. The goal of this work is to assess the experimental time that can be saved by applying the deceleration stat (D-stat) technique to assess the maximum biomass production rate of a phototrophic cultivation system, instead of a series of chemostat cultures. A mathematical model developed by Geider and co-workers was adapted in order to describe the rate of photosynthesis as a function of the local light intensity. This is essential for the accurate description of biomass productivity in phototrophic cultures. The presented simulations demonstrate that D-stat experiments executed in the absence of pseudo steady-state (i.e., the arbitrary situation that the observed specific growth rate deviates <5% from the dilution rate) can still be used to accurately determine the maximum biomass productivity of the system. Moreover, this approach saves up to 94% of the time required to perform a series of chemostat experiments that has the same accuracy. In case more information on the properties of the system is required, the reduction in experimental time is reduced but still significant. © 2013 Wiley Periodicals, Inc.

Innovative Phase Change Approach for Significant Energy Savings

DTIC Science & Technology

2016-09-01

September 2016 Innovative Phase Change Approach For Significant Energy Savings September 2016 8 After conducting a market survey...FINAL REPORT Innovative Phase Change Approach for Significant Energy Savings ESTCP Project EW-201138 SEPTEMBER 2016 Dr. Aly H Shaaban Applied...5a. CONTRACT NUMBER W912HQ-11-C-0011 Innovative Phase Change Approach for Significant Energy Savings 5b. GRANT NUMBER 5c. PROGRAM

An Abbreviated Protocol for High-Risk Screening Breast MRI Saves Time and Resources.

PubMed

Harvey, Susan C; Di Carlo, Phillip A; Lee, Bonmyong; Obadina, Eniola; Sippo, Dorothy; Mullen, Lisa

2016-04-01

To review the ability of an abbreviated, high-risk, screening, breast MRI protocol to detect cancer and save resources. High-risk screening breast MR images were reviewed, from both an abbreviated protocol and a full diagnostic protocol. Differences in cancer detection, scanner utilization, interpretation times, and need for additional imaging were recorded in an integrated data form, and reviewed and compared. A total of 568 MRI cases were reviewed, with the abbreviated and full protocols. No difference was found in the number of cancers detected. Scan times were decreased by 18.8 minutes per case, for a total of 10,678 minutes (178 hours). Interpretation time, on average, was 1.55 minutes for the abbreviated protocol, compared with 6.43 minutes for the full protocol. Review of the full protocol led to a significant change in the final BI-RADS(®) assessment in 12 of 568 (2.1%) cases. Abbreviated MRI is as effective as full-protocol MRI for demonstration of cancers in the high-risk screening setting, with only 12 (2.1%) cases recommended for additional MRI evaluation. The efficiency and resource savings of an abbreviated protocol would be significant, and would allow for opportunities to provide MRI for additional patients, as well as improved radiologist time management and workflow, with the potential to add real-time MRI interpretation or double reading. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

An Abbreviated Protocol for High-Risk Screening Breast MRI Saves Time and Resources.

PubMed

Harvey, Susan C; Di Carlo, Phillip A; Lee, Bonmyong; Obadina, Eniola; Sippo, Dorothy; Mullen, Lisa

2016-11-01

To review the ability of an abbreviated, high-risk, screening, breast MRI protocol to detect cancer and save resources. High-risk screening breast MR images were reviewed, from both an abbreviated protocol and a full diagnostic protocol. Differences in cancer detection, scanner utilization, interpretation times, and need for additional imaging were recorded in an integrated data form, and reviewed and compared. A total of 568 MRI cases were reviewed, with the abbreviated and full protocols. No difference was found in the number of cancers detected. Scan times were decreased by 18.8 minutes per case, for a total of 10,678 minutes (178 hours). Interpretation time, on average, was 1.55 minutes for the abbreviated protocol, compared with 6.43 minutes for the full protocol. Review of the full protocol led to a significant change in the final BI-RADS ® assessment in 12 of 568 (2.1%) cases. Abbreviated MRI is as effective as full-protocol MRI for demonstration of cancers in the high-risk screening setting, with only 12 (2.1 %) cases recommended for additional MRI evaluation. The efficiency and resource savings of an abbreviated protocol would be significant, and would allow for opportunities to provide MRI for additional patients, as well as improved radiologist time management and workflow, with the potential to add real-time MRI interpretation or double reading. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Determinants of success in Shared Savings Programs: An analysis of ACO and market characteristics.

PubMed

Ouayogodé, Mariétou H; Colla, Carrie H; Lewis, Valerie A

2017-03-01

Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs' first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. In the first year, performance is quite heterogeneous, yet organizational structure does not consistently predict performance. Organizations with large financial benchmarks at baseline have greater opportunities to achieve savings. Findings on prior risk bearing suggest that ACOs learn over time under risk-bearing contracts. Given the lack of predictive power for organizational characteristics, CMS should continue to encourage diversity in organizational structures for ACO participants, and provide alternative funding and risk bearing mechanisms to continue to allow a diverse group of organizations to participate. III. Copyright © 2016 Elsevier Inc. All rights reserved.

Determinants of Success in Shared Savings Programs: An Analysis of ACO and Market Characteristics

PubMed Central

Colla, Carrie H.; Lewis, Valerie A.

2016-01-01

Background Medicare’s Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. Objective To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. Methods We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs’ first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). Results When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. Conclusions In the first year performance is quite heterogeneous, yet organizational structure does not consistently predict performance. Organizations with large financial benchmarks at baseline have greater opportunities to achieve savings. Findings on prior risk bearing suggest that ACOs learn over time under risk-bearing contracts. Implications Given the lack of predictive power for organizational characteristics, CMS should continue to encourage diversity in organizational structures for ACO participants, and provide alternative funding and risk bearing mechanisms to continue to allow a diverse group of organizations to participate. Level of evidence III PMID:27687917

Computer multitasking with Desqview 386 in a family practice.

PubMed Central

Davis, A E

1990-01-01

Computers are now widely used in medical practice for accounting and secretarial tasks. However, it has been much more difficult to use computers in more physician-related activities of daily practice. I investigated the Desqview multitasking system on a 386 computer as a solution to this problem. Physician-directed tasks of management of patient charts, retrieval of reference information, word processing, appointment scheduling and office organization were each managed by separate programs. Desqview allowed instantaneous switching back and forth between the various programs. I compared the time and cost savings and the need for physician input between Desqview 386, a 386 computer alone and an older, XT computer. Desqview significantly simplified the use of computer programs for medical information management and minimized the necessity for physician intervention. The time saved was 15 minutes per day; the costs saved were estimated to be $5000 annually. PMID:2383848

Matched Child Savings Accounts in Low-Resource Communities: Who Saves?

PubMed Central

Karimli, Leyla; Ssewamala, Fred M.; Neilands, Torsten B.; McKay, Mary McKernan

2015-01-01

This study examines variations in saving behavior among poor families enrolled in a Child Savings Account program for orphaned and vulnerable school-going children in Uganda. We employ multilevel analyses using longitudinal data from a cluster-randomized experimental design. Our analyses reveal the following significant results: (1) given the average number of months during which the account was open (18 months), families saved on average, USD 54.72, which, after being matched by the program (2:1 match rate) comes to USD 164.16—enough to cover approximately five academic terms of post-primary education; (2) children's saving behavior was not associated with quality of family relations; it was, however, significantly associated with family financial socialization; (3) family demographics were significantly associated with children's saving behavior in the matched Child Savings Account program; and (4) children enrolled in some schools saved better compared to children enrolled in other schools within the same treatment group. PMID:26636025

Preoperative computed tomography angiography for planning DIEP flap breast reconstruction reduces operative time and overall complications

PubMed Central

Rozen, Warren Matthew; Chowdhry, Muhammad; Band, Bassam; Ramakrishnan, Venkat V.; Griffiths, Matthew

2016-01-01

Background The approach and operative techniques associated with breast reconstruction have steadily been refined since its inception, with abdominal perforator-based flaps becoming the gold standard reconstructive option for women undergoing breast cancer surgery. The current study comprises a cohort of 632 patients, in whom specific operative times are recorded by a blinded observer, and aims to address the potential benefits seen with the use of computer tomography (CT) scanning preoperatively on operative outcomes, complications and surgical times. Methods A prospectively recorded, retrospective review was undertaken of patients undergoing autologous breast reconstruction with a DIEP flap at the St Andrews Centre over a 4-year period from 2010 to 2014. Computed tomography angiography (CTA) scanning of patients began in September 2012 and thus 2 time periods were compared: 2 years prior to the use of CTA scans and 2 years afterwards. For all patients, key variables were collected including patient demographics, operative times, flap harvest time, pedicle length, surgeon experience and complications. Results In group 1, comprising patients within the period prior to CTA scans, 265 patients underwent 312 flaps; whilst in group 2, the immediately following 2 years, 275 patients had 320 flaps. The use of preoperative CTA scans demonstrated a significant reduction in flap harvest time of 13 minutes (P<0.013). This significant time saving was seen in all flap modifications: unilateral, bilateral and bipedicled DIEP flaps. The greatest time saving was seen in bipedicle flaps, with a 35-minute time saving. The return to theatre rate significantly dropped from 11.2% to 6.9% following the use of CTA scans, but there was no difference in the total failure rate. Conclusions The study has demonstrated both a benefit to flap harvest time as well as overall operative times when using preoperative CTA. The use of CTA was associated with a significant reduction in complications requiring a return to theatre in the immediate postoperative period. Modern scanners and techniques can reduce the level of ionising radiation, facilitating patients being able to benefit from the advantages that this preoperative planning can convey. PMID:27047777

Panel Discussion: Using Shielded Sprayers to Control Weeds in Nursery Beds

Treesearch

Dwight H. Stallard

2005-01-01

Shielded sprayers have proven to be more effective than mechanical-type machines at controlling weeds in hardwood crops. Hand weeding times are reduced significantly, lowering costs and saving time for nursery personnel to do other jobs.Individual papers from this publication

AIRSLUG: A fortran program for the computation of type curves to estimate transmissivity and storativity from prematurely terminated air-pressurized slug tests

USGS Publications Warehouse

Greene, E.A.; Shapiro, A.M.

1998-01-01

The Fortran code AIRSLUG can be used to generate the type curves needed to analyze the recovery data from prematurely terminated air-pressurized slug tests. These type curves, when used with a graphical software package, enable the engineer or scientist to analyze field tests to estimate transmissivity and storativity. Prematurely terminating the slug test can significantly reduce the overall time needed to conduct the test, especially at low-permeability sites, thus saving time and money.The Fortran code AIRSLUG can be used to generate the type curves needed to analyze the recovery data from prematurely terminated air-pressurized slug tests. These type curves, when used with a graphical software package, enable the engineer or scientist to analyze field tests to estimate transmissivity and storativity. Prematurely terminating the slug test can significantly reduce the overall time needed to conduct the test, especially at low-permeability sites, thus saving time and money.

17 CFR 232.13 - Date of filing; adjustment of filing date.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed filed on.... Eastern Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed... Daylight Savings Time, whichever is currently in effect, shall be deemed filed on the same business day. (4...

17 CFR 232.13 - Date of filing; adjustment of filing date.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed filed on.... Eastern Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed... Daylight Savings Time, whichever is currently in effect, shall be deemed filed on the same business day. (4...

17 CFR 232.13 - Date of filing; adjustment of filing date.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed filed on.... Eastern Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed... Daylight Savings Time, whichever is currently in effect, shall be deemed filed on the same business day. (4...

17 CFR 232.13 - Date of filing; adjustment of filing date.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed filed on.... Eastern Standard Time or Eastern Daylight Saving Time, whichever is currently in effect, shall be deemed... Daylight Savings Time, whichever is currently in effect, shall be deemed filed on the same business day. (4...

Cast Off expansion plan by rapid improvement through Optimization tool design, Tool Parameters and using Six Sigma’s ECRS Technique

NASA Astrophysics Data System (ADS)

Gopalakrishnan, T.; Saravanan, R.

2017-03-01

Powerful management concepts step-up the quality of the product, time saving in producing the product thereby increase the production rate, improves tools and techniques, work culture, work place and employee motivation and morale. In this paper discussed about the case study of optimizing the tool design, tool parameters to cast off expansion plan according ECRS technique. The proposed designs and optimal tool parameters yielded best results and meet the customer demand without expansion plan. Hence the work yielded huge savings of money (direct and indirect cost), time and improved the motivation and more of employees significantly.

Optimizing Aircraft Trajectories with Multiple Cruise Altitudes in the Presence of Winds

NASA Technical Reports Server (NTRS)

Ng, Hok K.; Sridhar, Banavar; Grabbe, Shon

2014-01-01

This study develops a trajectory optimization algorithm for approximately minimizing aircraft travel time and fuel burn by combining a method for computing minimum-time routes in winds on multiple horizontal planes, and an aircraft fuel burn model for generating fuel-optimal vertical profiles. It is applied to assess the potential benefits of flying user-preferred routes for commercial cargo flights operating between Anchorage, Alaska and major airports in Asia and the contiguous United States. Flying wind optimal trajectories with a fuel-optimal vertical profile reduces average fuel burn of international flights cruising at a single altitude by 1-3 percent. The potential fuel savings of performing en-route step climbs are not significant for many shorter domestic cargo flights that have only one step climb. Wind-optimal trajectories reduce fuel burn and travel time relative to the flight plan route by up to 3 percent for the domestic cargo flights. However, for trans-oceanic traffic, the fuel burn savings could be as much as 10 percent. The actual savings in operations will vary from the simulation results due to differences in the aircraft models and user defined cost indices. In general, the savings are proportional to trip length, and depend on the en-route wind conditions and aircraft types.

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK.

PubMed

Claxton, L; Taylor, M; Kay, E

2016-02-12

The effect of sugarfree gum (SFG) on the prevention of dental caries has been established for some time. With increased constraints placed on healthcare budgets, the importance of economic considerations in decision-making about oral health interventions has increased. The aim of this study was to demonstrate the potential cost savings in dental care associated with increased levels of SFG usage. The analysis examined the amount of money which would hypothetically be saved if the UK 12-year-old population chewed more SFG. The number of sticks chewed per year and the caries risk reduction were modelled to create a dose response curve. The costs of tooth restoration, tooth extraction in primary care settings and under general anaesthetic were considered, and the effects of caries reduction on these costs calculated. If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year. Sensitivity analyses of the key parameters demonstrated that cost savings would still be likely to be observed even in scenarios with less significant increases in SFG use. This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved.

Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

PubMed

Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

2015-04-22

To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P < 0.0001), readmissions (-36.7%, P < 0.0001), and bed days (-17.2%, P < 0.0001). The effect size increased over time for admissions and bed days. The relative odds of any admission and readmission over the 4 years were 27% and 45% lower, respectively, in the treatment group. Cumulative program savings from reduced hospital claims was $3,549 over 4-years; savings values for each program year were significant and increased with time (P = 0.003 to P < 0.0001). Savings calculations did not adjust for pooled costs (and savings) in Australia's risk equalization system for private insurers. Results confirm and extend prior program outcomes and support the longitudinal value of the MHG program in reducing hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

Fast and memory efficient text image compression with JBIG2.

PubMed

Ye, Yan; Cosman, Pamela

2003-01-01

In this paper, we investigate ways to reduce encoding time, memory consumption and substitution errors for text image compression with JBIG2. We first look at page striping where the encoder splits the input image into horizontal stripes and processes one stripe at a time. We propose dynamic dictionary updating procedures for page striping to reduce the bit rate penalty it incurs. Experiments show that splitting the image into two stripes can save 30% of encoding time and 40% of physical memory with a small coding loss of about 1.5%. Using more stripes brings further savings in time and memory but the return diminishes. We also propose an adaptive way to update the dictionary only when it has become out-of-date. The adaptive updating scheme can resolve the time versus bit rate tradeoff and the memory versus bit rate tradeoff well simultaneously. We then propose three speedup techniques for pattern matching, the most time-consuming encoding activity in JBIG2. When combined together, these speedup techniques can save up to 75% of the total encoding time with at most 1.7% of bit rate penalty. Finally, we look at improving reconstructed image quality for lossy compression. We propose enhanced prescreening and feature monitored shape unifying to significantly reduce substitution errors in the reconstructed images.

Year-Round Daylight Saving Time Study : Volume 1. Interim Report on the Operation and Effects of Daylight Saving Time

DOT National Transportation Integrated Search

1975-06-01

The analyses of the effects of Year-Round Daylight Saving Time were not conslusive because they could not be reliablyseparated from other changes occuring simultaneously including fuel availability constraints, speed limit reductions, Sunday gasoline...

M & V Shootout: Setting the Stage For Testing the Performance of New Energy Baseline

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

Touzani, Samir; Custodio, Claudine; Sohn, Michael

Trustworthy savings calculations are critical to convincing investors in energy efficiency projects of the benefit and cost-effectiveness of such investments and their ability to replace or defer supply-side capital investments. However, today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of efficiency projects. They also require time-consuming data acquisition and often do not deliver results until years after the program period has ended. A spectrum of savings calculation approaches are used, with some relying more heavily on measured data and others relying more heavily on estimated or modeled data, or stipulatedmore » information. The rising availability of “smart” meters, combined with new analytical approaches to quantifying savings, has opened the door to conducting M&V more quickly and at lower cost, with comparable or improved accuracy. Energy management and information systems (EMIS) technologies, not only enable significant site energy savings, but are also beginning to offer M&V capabilities. This paper expands recent analyses of public-domain, whole-building M&V methods, focusing on more novel baseline modeling approaches that leverage interval meter data. We detail a testing procedure and metrics to assess the performance of these new approaches using a large test dataset. We also provide conclusions regarding the accuracy, cost, and time trade-offs between more traditional M&V and these emerging streamlined methods. Finally, we discuss the potential evolution of M&V to better support the energy efficiency industry through low-cost approaches, and the long-term agenda for validation of building energy analytics.« less

Chapter 10: Peak Demand and Time-Differentiated Energy Savings Cross-Cutting Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Stern, Frank; Spencer, Justin

Savings from electric energy efficiency measures and programs are often expressed in terms of annual energy and presented as kilowatt-hours per year (kWh/year). However, for a full assessment of the value of these savings, it is usually necessary to consider the measure or program's impact on peak demand as well as time-differentiated energy savings. This cross-cutting protocol describes methods for estimating the peak demand and time-differentiated energy impacts of measures implemented through energy efficiency programs.

Project Lateday : The Level of Accidents Under the Effect of Daylight Saving All Year

DOT National Transportation Integrated Search

1975-10-01

Year-round daylight saving time (YRDST) has recently been observed in the United States. The observance of double daylight saving time (DDST) is under some consideration. One of the principal expected effects of the adoption of these time systems is ...

Estimated time of arrival and debiasing the time saving bias.

PubMed

Eriksson, Gabriella; Patten, Christopher J D; Svenson, Ola; Eriksson, Lars

2015-01-01

The time saving bias predicts that the time saved when increasing speed from a high speed is overestimated, and underestimated when increasing speed from a slow speed. In a questionnaire, time saving judgements were investigated when information of estimated time to arrival was provided. In an active driving task, an alternative meter indicating the inverted speed was used to debias judgements. The simulated task was to first drive a distance at a given speed, and then drive the same distance again at the speed the driver judged was required to gain exactly 3 min in travel time compared with the first drive. A control group performed the same task with a speedometer and saved less than the targeted 3 min when increasing speed from a high speed, and more than 3 min when increasing from a low speed. Participants in the alternative meter condition were closer to the target. The two studies corroborate a time saving bias and show that biased intuitive judgements can be debiased by displaying the inverted speed. Practitioner Summary: Previous studies have shown a cognitive bias in judgements of the time saved by increasing speed. This simulator study aims to improve driver judgements by introducing a speedometer indicating the inverted speed in active driving. The results show that the bias can be reduced by presenting the inverted speed and this finding can be used when designing in-car information systems.

Effects of daylight savings time changes on stock market volatility.

PubMed

Berument, M Hakan; Dogan, Nukhet; Onar, Bahar

2010-04-01

The presence of daylight savings time effects on stock returns and on stock volatility was investigated using an EGARCH specification to model the conditional variance. The evidence gathered from the major United States stock markets for the period between 1967 and 2007 did not support the existence of the daylight savings time effect on stock returns or on volatility. Returns on the first business day following daylight savings time changes were not lower nor was the volatility higher, as would be expected if there were an effect.

A statistical analysis of the energy policy act of 2005, its changes to the daylight saving program, and impact on residential energy consumption

NASA Astrophysics Data System (ADS)

Murray, Patrick L.

Government programs designed to decrease resource consumption, improve productivity and capitalize on extended daylight hours in the summer have been developed and implemented throughout the world for nearly three hundred years. In 2005, The United States government adopted an extended daylight savings program that increases the number of weeks where the country observes Daylight Saving Time (DST) from 31 to 35 weeks. The program took effect in March 2007. Arguments in support of DST programs highlight the portion of electricity consumption attributed to residential lighting in the evening hours. Adjusting clocks forward by one hour in summer months is believed to reduce electricity consumption due to lighting and therefore significantly reduce residential energy consumption during the period of DST. This paper evaluates the efficacy of the changes to DST resulting from the Energy Policy Act of 2005. The study focuses on changes to household electricity consumption during the extended four weeks of DST. Arizona, one of two states that continue to opt out of DST serves as the study's control for a comparison with neighboring states, Colorado, Nebraska, Nevada, New Mexico, Oklahoma, Texas and Utah. Results from the regression analysis of a Difference in Difference model indicate that contrary to evaluations by Congress and the Department of Energy, the four week period of Extended Daylight Saving Time does not produce a significant decrease in per capita electricity consumption in Southwestern states.

A SIEPON based transmitter sleep mode energy-efficient mechanism in EPON

NASA Astrophysics Data System (ADS)

Nikoukar, AliAkbar; Hwang, I.-Shyan; Wang, Chien-Jung; Ab-Rahman, Mohammad Syuhaimi; Liem, Andrew Tanny

2015-06-01

The main energy consumption in computer networks is the access networks. The passive optical network (PON) has the least energy consumption among access network technologies. In addition, the time division multiplexing (TDM) Ethernet PON (EPON) is one of the best candidates to improve energy consumption by time utilization. The optical network unit (ONU) can utilize the time and save the energy in the EPON by turning off its transmitter/receiver when there is no upstream/downstream traffic. The ITU-T and IEEE organizations are published standards for energy-saving in the TDM-PON. Although their standards provide the framework to accomplish the energy-saving, the algorithms/criteria to generate events to accommodate various operational policies, time to wake up, parameter values for timers are out of scope of the standards. Many studies have proposed schemes for energy-saving in TDM-PON to achieve maximum energy saving. Even so, these schemes increase the mean packet delay and consequently, reduce the quality of service (QoS). In this paper, first we take a look to the state of the art for PON energy-saving. Additionally, a mechanism based on SIEPON standard in EPON with new components in the ONUs and optical line terminal (OLT) is proposed to save the transmitter energy and guarantee QoS. The proposed mechanism follows the SIEPON standard, considers the QoS first, and then saves the energy as far as possible. The ONU sleep controller unit (OSC) and green dynamic bandwidth allocation (GDBA) are used to calculate the ONU transmitter sleep (Tx) duration and grant the proper time to the ONUs. Simulation results show that the proposed energy-saving mechanism not only promises the QoS performance in terms of mean packet delay, packet loss, throughput, and jitter, but also saves energy in different maximum cycle times.

Immunity-Based Optimal Estimation Approach for a New Real Time Group Elevator Dynamic Control Application for Energy and Time Saving

PubMed Central

Baygin, Mehmet; Karakose, Mehmet

2013-01-01

Nowadays, the increasing use of group elevator control systems owing to increasing building heights makes the development of high-performance algorithms necessary in terms of time and energy saving. Although there are many studies in the literature about this topic, they are still not effective enough because they are not able to evaluate all features of system. In this paper, a new approach of immune system-based optimal estimate is studied for dynamic control of group elevator systems. The method is mainly based on estimation of optimal way by optimizing all calls with genetic, immune system and DNA computing algorithms, and it is evaluated with a fuzzy system. The system has a dynamic feature in terms of the situation of calls and the option of the most appropriate algorithm, and it also adaptively works in terms of parameters such as the number of floors and cabins. This new approach which provides both time and energy saving was carried out in real time. The experimental results comparatively demonstrate the effects of method. With dynamic and adaptive control approach in this study carried out, a significant progress on group elevator control systems has been achieved in terms of time and energy efficiency according to traditional methods. PMID:23935433

Treatment reviews of older people on polypharmacy in primary care: cluster controlled trial comparing two approaches

PubMed Central

Denneboom, Wilma; Dautzenberg, Maaike GH; Grol, Richard; De Smet, Peter AGM

2007-01-01

Background Older people are prone to problems related to use of medicines. As they tend to use many different medicines, monitoring pharmacotherapy for older people in primary care is important. Aim To determine which procedure for treatment reviews (case conferences versus written feedback) results in more medication changes, measured at different moments in time. To determine the costs and savings related to such an intervention. Design of study Randomised, controlled trial, randomisation at the level of the community pharmacy. Setting Primary care; treatment reviews were performed by 28 pharmacists and 77 GPs concerning 738 older people (≥75 years) on polypharmacy (>five medicines). Method In one group, pharmacists and GPs performed case conferences on prescription-related problems; in the other group, pharmacists provided results of a treatment review to GPs as written feedback. Number of medication changes was counted following clinically-relevant recommendations. Costs and savings associated with the intervention at various times were calculated. Results In the case-conference group significantly more medication changes were initiated (42 versus 22, P = 0.02). This difference was also present 6 months after treatment reviews (36 versus 19, P = 0.02). Nine months after treatment reviews, the difference was no longer significant (33 versus 19, P = 0.07). Additional costs in the case-conference group seem to be covered by the slightly greater savings in this group. Conclusion Performing treatment reviews with case conferences leads to greater uptake of clinically-relevant recommendations. Extra costs seem to be covered by related savings. The effect of the intervention declines over time, so performing treatment reviews for older people should be integrated in the routine collaboration between GPs and pharmacists. PMID:17761060

The Anesthesia Preoperative Evaluation Clinic (APEC): a prospective randomized controlled trial assessing impact on consultation time, direct costs, patient education and satisfaction with anesthesia care.

PubMed

Schiff, J H; Frankenhauser, S; Pritsch, M; Fornaschon, S A; Snyder-Ramos, S A; Heal, C; Schmidt, K; Martin, E; Böttiger, B W; Motsch, J

2010-07-01

Anesthetic preoperative evaluation clinics (APECs) are relatively new institutions. Although cost effective, APECs have not been universally adopted in Europe. The aim of this study was to compare preoperative anesthetic assessment in wards with an APEC, assessing time, information gain, patient satisfaction and secondary costs. Two hundred and seven inpatients were randomized to be assessed at the APEC or on the ward by the same two senior anesthetists. The outcomes measured were the length of time for each consultation, the amount of information passed on to patients and the level of patient satisfaction. The consultation time was used to calculate impact on direct costs. A multivariate analysis was conducted to detect confounding variables. Ninety-four patients were seen in the APEC, and 78 were seen on the ward. The total time for the consultation was shorter for the APEC (mean 8.4 minutes [P<0.01]), and we calculated savings of 6.4 Euro per patient. More information was passed on to the patients seen in the APEC (P<0.01). The general satisfaction scores were comparable between groups. A multivariate analysis found that the consultation time was significantly influenced by the type of anesthesia, the magnitude of the operation and the location of the consultation. Gain in information was significantly influenced by age, education and the location of the visit. The APEC reduced consultation times and costs and had a positive impact on patient education. The cost savings are related to personnel costs and, therefore, are independent of other potential savings of an APEC, whereas global patient satisfaction remains unaltered.

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK

PubMed Central

Claxton, L.; Taylor, M.; Kay, E.

2016-01-01

Introduction The effect of sugarfree gum (SFG) on the prevention of dental caries has been established for some time. With increased constraints placed on healthcare budgets, the importance of economic considerations in decision-making about oral health interventions has increased. The aim of this study was to demonstrate the potential cost savings in dental care associated with increased levels of SFG usage. Methods The analysis examined the amount of money which would hypothetically be saved if the UK 12-year-old population chewed more SFG. The number of sticks chewed per year and the caries risk reduction were modelled to create a dose response curve. The costs of tooth restoration, tooth extraction in primary care settings and under general anaesthetic were considered, and the effects of caries reduction on these costs calculated. Results If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year. Sensitivity analyses of the key parameters demonstrated that cost savings would still be likely to be observed even in scenarios with less significant increases in SFG use. Conclusion This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved. PMID:26868801

A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France.

PubMed

Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Rémi

2013-04-01

The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14-23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544-1,020 million vs. EUR 177-538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306-380 million savings (37-56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13-33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71-89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types.

Optimal subhourly electricity resource dispatch under multiple price signals with high renewable generation availability

DOE PAGES

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

2018-01-28

This article proposes a system-wide optimal resource dispatch strategy that enables a shift from a primarily energy cost-based approach, to a strategy using simultaneous price signals for energy, power and ramping behavior. A formal method to compute the optimal sub-hourly power trajectory is derived for a system when the price of energy and ramping are both significant. Optimal control functions are obtained in both time and frequency domains, and a discrete-time solution suitable for periodic feedback control systems is presented. The method is applied to North America Western Interconnection for the planning year 2024, and it is shown that anmore » optimal dispatch strategy that simultaneously considers both the cost of energy and the cost of ramping leads to significant cost savings in systems with high levels of renewable generation: the savings exceed 25% of the total system operating cost for a 50% renewables scenario.« less

Optimal subhourly electricity resource dispatch under multiple price signals with high renewable generation availability

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

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

This article proposes a system-wide optimal resource dispatch strategy that enables a shift from a primarily energy cost-based approach, to a strategy using simultaneous price signals for energy, power and ramping behavior. A formal method to compute the optimal sub-hourly power trajectory is derived for a system when the price of energy and ramping are both significant. Optimal control functions are obtained in both time and frequency domains, and a discrete-time solution suitable for periodic feedback control systems is presented. The method is applied to North America Western Interconnection for the planning year 2024, and it is shown that anmore » optimal dispatch strategy that simultaneously considers both the cost of energy and the cost of ramping leads to significant cost savings in systems with high levels of renewable generation: the savings exceed 25% of the total system operating cost for a 50% renewables scenario.« less

Daylight Saving Time Transitions and Road Traffic Accidents

PubMed Central

Lahti, Tuuli; Nysten, Esa; Haukka, Jari; Sulander, Pekka; Partonen, Timo

2010-01-01

Circadian rhythm disruptions may have harmful impacts on health. Circadian rhythm disruptions caused by jet lag compromise the quality and amount of sleep and may lead to a variety of symptoms such as fatigue, headache, and loss of attention and alertness. Even a minor change in time schedule may cause considerable stress for the body. Transitions into and out of daylight saving time alter the social and environmental timing twice a year. According to earlier studies, this change in time-schedule leads to sleep disruption and fragmentation of the circadian rhythm. Since sleep deprivation decreases motivation, attention, and alertness, transitions into and out of daylight saving time may increase the amount of accidents during the following days after the transition. We studied the amount of road traffic accidents one week before and one week after transitions into and out of daylight saving time during years from 1981 to 2006. Our results demonstrated that transitions into and out of daylight saving time did not increase the number of traffic road accidents. PMID:20652036

High Efficiency, High Performance Clothes Dryer

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

Peter Pescatore; Phil Carbone

This program covered the development of two separate products; an electric heat pump clothes dryer and a modulating gas dryer. These development efforts were independent of one another and are presented in this report in two separate volumes. Volume 1 details the Heat Pump Dryer Development while Volume 2 details the Modulating Gas Dryer Development. In both product development efforts, the intent was to develop high efficiency, high performance designs that would be attractive to US consumers. Working with Whirlpool Corporation as our commercial partner, TIAX applied this approach of satisfying consumer needs throughout the Product Development Process for bothmore » dryer designs. Heat pump clothes dryers have been in existence for years, especially in Europe, but have not been able to penetrate the market. This has been especially true in the US market where no volume production heat pump dryers are available. The issue has typically been around two key areas: cost and performance. Cost is a given in that a heat pump clothes dryer has numerous additional components associated with it. While heat pump dryers have been able to achieve significant energy savings compared to standard electric resistance dryers (over 50% in some cases), designs to date have been hampered by excessively long dry times, a major market driver in the US. The development work done on the heat pump dryer over the course of this program led to a demonstration dryer that delivered the following performance characteristics: (1) 40-50% energy savings on large loads with 35 F lower fabric temperatures and similar dry times; (2) 10-30 F reduction in fabric temperature for delicate loads with up to 50% energy savings and 30-40% time savings; (3) Improved fabric temperature uniformity; and (4) Robust performance across a range of vent restrictions. For the gas dryer development, the concept developed was one of modulating the gas flow to the dryer throughout the dry cycle. Through heat modulation in a gas dryer, significant time and energy savings, combined with dramatically reduced fabric temperatures, was achieved in a cost-effective manner. The key design factor lay in developing a system that matches the heat input to the dryer with the fabrics ability to absorb it. The development work done on the modulating gas dryer over the course of this program led to a demonstration dryer that delivered the following performance characteristics: (1) Up to 25% reduction in energy consumption for small and medium loads; (2) Up to 35% time savings for large loads with 10-15% energy reduction and no adverse effect on cloth temperatures; (3) Reduced fabric temperatures, dry times and 18% energy reduction for delicate loads; and, (4) Robust performance across a range of vent restrictions.« less

Media Adjunct Programming: An Individualized Media-Managed Approach to Academic Pilot Training.

ERIC Educational Resources Information Center

McCombs, Barbara Leherissey; And Others

Media adjunct programing (MAP) techniques for presenting individualized, self-paced instruction were compared to traditional instructor-classroom (TIC) techniques in an undergraduate pilot Weather course. The MAP group completed the course in significantly less time than did the TIC group, representing a 29 percent time savings. In addition, MAP…

The effect of handover location on trauma theatre start time: An estimated cost saving of £131 000 per year.

PubMed

Nahas, Sam; Ali, Adam; Majid, Kiran; Joseph, Roshan; Huber, Chris; Babu, Victor

2018-02-08

The National Health Service was estimated to be in £2.45 billion deficit in 2015 to 2016. Trauma theatre utilization and efficiency has never been so important as it is estimated to cost £15/minute. Structured questionnaires were given to 23 members of staff at our Trust who are actively involved in the organization or delivery of orthopaedic trauma lists at least once per week. This was used to identify key factors that may improve theatre efficiency. Following focus group evaluation, the location of the preoperative theatre meeting was changed, with all staff involved being required to attend this. Our primary outcome measure was mean theatre start time (time of arrival in the anaesthetic room) during the 1 month immediately preceding the change and the month following the change. Theatre start time was improved on average 24 minutes (1 month premeeting and postmeeting change). This equates to a saving of £360 per day, or £131 040 per year. Changing the trauma meeting location to a venue adjacent to the trauma theatre can improve theatre start times, theatre efficiency, and therefore result in significant cost savings. Copyright © 2018 John Wiley & Sons, Ltd.

Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

PubMed

Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

2017-04-01

The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Daylight savings time and myocardial infarction.

PubMed

Sandhu, Amneet; Seth, Milan; Gurm, Hitinder S

2014-01-01

Prior research has shown a transient increase in the incidence of acute myocardial infarction (AMI) after daylight savings time (DST) in the spring as well as a decrease in AMI after returning to standard time in the fall. These findings have not been verified in a broader population and if extant, may have significant public health and policy implications. We assessed changes in admissions for AMI undergoing percutaneous coronary intervention (PCI) in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) database for the weeks following the four spring and three fall DST changes between March 2010 and September 2013. A negative binomial regression model was used to adjust for trend and seasonal variation. There was no difference in the total weekly number of PCIs performed for AMI for either the fall or spring time changes in the time period analysed. After adjustment for trend and seasonal effects, the Monday following spring time changes was associated with a 24% increase in daily AMI counts (p=0.011), and the Tuesday following fall changes was conversely associated with a 21% reduction (p=0.044). No other weekdays in the weeks following DST changes demonstrated significant associations. In the week following the seasonal time change, DST impacts the timing of presentations for AMI but does not influence the overall incidence of this disease.

Will the Measurement Robots Take Our Jobs? An Update on the State of Automated M&V for Energy Efficiency Programs

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

Granderson, Jessica; Touzani, Samir; Taylor, Cody

Trustworthy savings calculations are critical to convincing regulators of both the cost-effectiveness of energy efficiency program investments and their ability to defer supply-side capital investments. Today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of energy efficiency programs. They also require time-consuming data acquisition. A spectrum of savings calculation approaches is used, with some relying more heavily on measured data and others relying more heavily on estimated, modeled, or stipulated data. The rising availability of “smart” meters and devices that report near-real time data, combined with new analytical approaches to quantifyingmore » savings, offers potential to conduct M&V more quickly and at lower cost, with comparable or improved accuracy. Commercial energy management and information systems (EMIS) technologies are beginning to offer M&V capabilities, and program administrators want to understand how they might assist programs in quickly and accurately measuring energy savings. This paper presents the results of recent testing of the ability to use automation to streamline some parts of M&V. Here in this paper, we detail metrics to assess the performance of these new M&V approaches, and a framework to compute the metrics. We also discuss the accuracy, cost, and time trade-offs between more traditional M&V, and these emerging streamlined methods that use high-resolution energy data and automated computational intelligence. Finally we discuss the potential evolution of M&V and early results of pilots currently underway to incorporate M&V automation into ratepayer-funded programs and professional implementation and evaluation practice.« less

Utilizing Clinical Pharmacy Specialists to Address Access to Care Barriers in the Veteran Population for the Management of Diabetes.

PubMed

Edwards, Krystal L; Hadley, Ryan L; Baby, Nidhu; Yeary, Julianne C; Chastain, Lisa M; Brown, Crystal D

2017-08-01

To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluated outcomes in patients with type 2 diabetes mellitus referred to CPSs at Fort Worth Outpatient Clinic (FWOPC) or the endocrinologist-managed specialty clinic at the Dallas VA Medical Center (DVAMC). The primary outcome was percentage of patients reaching hemoglobin A1c (HbA1c) goal of <8%. Secondary outcomes were percentage of patients reaching HbA1c <7%, time to reach HbA1c goals of <8% and <7%, and cost savings. There was no statistically significant difference in the number of patients reaching HbA1c goal <8% in the FWOPC (65.3%) compared to the DVAMC (55.8%). Secondary end points comparing FWOPC and DVAMC found no difference in patients reaching HbA1c <7% (20.8% vs 19.2%) and time to reach HbA1c goal of <8% (4.5 vs 6 months) and <7% (8.5 vs 7.5 months). Cost-saving analysis demonstrated a composite of US$350 292 could be saved by the VANTHCS facility if patients continued to be referred to CPS. CPSs can be utilized in diabetes management to provide similar health outcomes as the endocrinologist-managed clinic and to potentially allow for facility cost savings.

Panama Canal : a new course for the canal

DOT National Transportation Integrated Search

1999-01-01

While the Panama Canal provides significant time savings, passage through this narrow waterway presents a host of challenges. Soon all canal pilots will have a new tool in their efforts to safely guide vessels through this difficult canal: a Communic...

Elliptical field-of-view PROPELLER imaging.

PubMed

Devaraj, Ajit; Pipe, James G

2009-09-01

Traditionally two-dimensional scans are designed to support an isotropic field-of-view (iFOV). When imaging elongated objects, significant savings in scan time can potentially be achieved by supporting an elliptical field-of-view (eFOV). This work presents an empirical closed-form solution to adapt the PROPELLER trajectory for an eFOV. The proposed solution is built on the geometry of the PROPELLER trajectory permitting the scan prescription and data reconstruction to remain largely similar to standard PROPELLER. The achieved FOV is experimentally validated by the point spread function (PSF) of a phantom scan. The details of potential savings in scan time and the signal-to-noise ratio (SNR) performance in comparison to iFOV scans for both phantom and in-vivo images are also described.

Impact of daylight savings time on spontaneous pregnancy loss in in vitro fertilization patients.

PubMed

Liu, Constance; Politch, Joseph A; Cullerton, Evan; Go, Kathryn; Pang, Samuel; Kuohung, Wendy

2017-01-01

Transition into daylight savings time (DST) has studied negative impacts on health, but little is known regarding impact on fertility. This retrospective cohort study evaluates DST impact on pregnancy and pregnancy loss rates in 1,654 autologous in vitro fertilization cycles (2009 to 2012). Study groups were identified based on the relationship of DST to embryo transfer. Pregnancy rates were similar in Spring and Fall (41.4%, 42.2%). Pregnancy loss rates were also comparable between Spring and Fall (15.5%, 17.1%), but rates of loss were significantly higher in Spring when DST occurred after embryo transfer (24.3%). Loss was marked in patients with a history of prior spontaneous pregnancy loss (60.5%).

[Preparation and administration of cytotoxic drugs: prickly innovation].

PubMed

Mullot, H; Simon, L; Payen, C; Gentes, P

2005-06-01

The requirement for safe and optimal administration of cytotoxic drugs led us to test a new product manufactured by Codan. The transfer set (CONNECT SET) and the administration set (CYTO-AD-SET) were assessed successively by pharmacist assistance within a centralized unit for cytotoxic drug preparation and by the nursing staff in an ambulatory unit. Transfer sets can be handled in the centralized units without using needles, but with an increased sterilization load and production cost. Assessment of the administration sets demonstrated time saving for the nursing staff. These materials require significant expenditures, careful training, and a change in treatment routine, but provide important time savings for the nursing staff and considerable improvement in the safety of handling cytotoxic drugs.

[Saving motives in young, middle-aged, and older adults. Preliminary results of a new inventory for exploring lifespan saving motives].

PubMed

Rager, B; Lang, F R; Wagner, G G

2012-12-01

There is some research on personal reasons for saving money in the economic sciences. However, not much is known about the age differences of saving motives. In this vein, the future time perspective (FTP) is known to play a critical role for motivation across the life span. In this study, we introduce a new Saving Motive Inventory (SMI), which also covers saving goals after retirement. Furthermore, it is argued that additional saving motives that are not based on economic models of life-cycle saving also exist. In accordance with the socio-emotional selectivity theory, we explored age differences in an online survey with 496 participants from young (19-44 years), middle-aged (45-64 years), and older (65-86 years) adulthood, who completed a questionnaire on saving motives, personality, and future-related thinking (e.g., Future Time Perspective Scale, Life Orientation Test). Results of the explorative Factor Analysis (EFA) are consistent with the theoretical expectations. The factors are generativity, educational investment, consumption, indifference, and provision for death and dying. Together these five factors account for 67% of the variance. In general, the inventory is reliable and valid with respect to the expected internal and external criteria. It contributes to better understanding of saving motives over the lifespan, especially with respect to effects of the future time perspective.

Early endocrine attending surgeon presence increases operating room efficiency.

PubMed

Clark, Audra; Dackiw, Alan P; White, Wendy D; Nwariaku, Fiemu E; Holt, Shelby A; Rabaglia, Jennifer L; Oltmann, Sarah C

2016-10-01

Preincision operating room (OR) preparation varies greatly. Cases requiring exacting preoperative setup may be more sensitive to inconsistent team members and trainees. Leadership and oversight by the surgeon may facilitate a timely start. The study hypothesized that early attending presence in the OR expedites surgery start time, improving efficiency, and decreasing cost. Prospective data collection of endocrine surgery cases at an urban teaching hospital was performed. Time points recorded in minutes. Cost/min of OR time was $54. Patients classified as in the OR ≤10 min before attending arrival or >10 min before attending arrival. A total of 227 cases (166 thyroid, 54 parathyroid, 10 adrenal) were performed over 14 mo. Of the patients, 128 were in the OR ≤10 min before attending arrival, and 99 patients were >10 min (3 ± 3 min versus 35 ± 14 min, P < 0.01). The ≤10 min procedures started sooner after patient arrival in OR (40 ± 11 versus 63 ± 19, P < 0.01) which equated to $1202 of savings before incision. Although attending time in the OR before incision was equivalent between groups for adrenal and parathyroid, time to incision was shorter in the ≤10 min groups, saving $2416 ± 477 and $1458 ± 244, respectively (P < 0.01). Attending time in OR before thyroidectomy was 13 min longer in ≤10 min than >10 min (P < 0.01), but incisions were made 20 min sooner (P < 0.01) equating to $1076 ± 120 in savings. Early attending presence in the OR shortens time to incision. For parathyroid and adrenal cases, this does not require additional surgeon time. In ORs without consistent teams, early attending presence in the OR improves efficiency and yields significant cost savings. Copyright © 2016 Elsevier Inc. All rights reserved.

Using the cost-effectiveness of allogeneic islet transplantation to inform induced pluripotent stem cell-derived β-cell therapy reimbursement.

PubMed

Archibald, Peter R T; Williams, David J

2015-11-01

In the present study a cost-effectiveness analysis of allogeneic islet transplantation was performed and the financial feasibility of a human induced pluripotent stem cell-derived β-cell therapy was explored. Previously published cost and health benefit data for islet transplantation were utilized to perform the cost-effectiveness and sensitivity analyses. It was determined that, over a 9-year time horizon, islet transplantation would become cost saving and 'dominate' the comparator. Over a 20-year time horizon, islet transplantation would incur significant cost savings over the comparator (GB£59,000). Finally, assuming a similar cost of goods to islet transplantation and a lack of requirement for immunosuppression, a human induced pluripotent stem cell-derived β-cell therapy would dominate the comparator over an 8-year time horizon.

A model for consolidation of clinical microbiology laboratory services within a multihospital health-care system.

PubMed

Carter, Elliot; Stubbs, James R; Bennett, Betsy

2004-01-01

To determine the cost-effectiveness of consolidating clinical microbiology services in a three-hospital health-care network while maintaining high-quality laboratory services, a retrospective review of the total costs of maintaining separate clinical microbiology laboratories within our health-care system was compared to the cost of providing these services after consolidation. Turnaround times before and after consolidation were compared to assess efficiency of the consolidated services. Input of clinicians was also solicited to ensure that quality of services and customer satisfaction remained high. The results of the consolidation project show that the net fiscal saving because of consolidation of clinical microbiology services within our health-care system will be approximately 100,000 dollars per fiscal year. This value includes increased courier charges as well as personnel savings. Although fiscal savings are an integral part of any laboratory consolidation plan, the financial considerations must be balanced by quality of service. The response to consolidation from clinicians was decidedly mixed before implementation of the plan because of fear of increased turnaround times and limited access to laboratory information. The consolidation process, however, was smooth with few physician complaints. The consolidation of our clinical microbiology services illustrates that significant financial savings can be achieved without compromise of efficiency or quality of service.

Prospects for reducing the processing cost of lithium ion batteries

DOE PAGES

Wood III, David L.; Li, Jianlin; Daniel, Claus

2014-11-06

A detailed processing cost breakdown is given for lithium-ion battery (LIB) electrodes, which focuses on: elimination of toxic, costly N-methylpyrrolidone (NMP) dispersion chemistry; doubling the thicknesses of the anode and cathode to raise energy density; and, reduction of the anode electrolyte wetting and SEI-layer formation time. These processing cost reduction technologies generically adaptable to any anode or cathode cell chemistry and are being implemented at ORNL. This paper shows step by step how these cost savings can be realized in existing or new LIB manufacturing plants using a baseline case of thin (power) electrodes produced with NMP processing and amore » standard 10-14-day wetting and formation process. In particular, it is shown that aqueous electrode processing can cut the electrode processing cost and energy consumption by an order of magnitude. Doubling the thickness of the electrodes allows for using half of the inactive current collectors and separators, contributing even further to the processing cost savings. Finally wetting and SEI-layer formation cost savings are discussed in the context of a protocol with significantly reduced time. These three benefits collectively offer the possibility of reducing LIB pack cost from $502.8 kWh-1-usable to $370.3 kWh-1-usable, a savings of $132.5/kWh (or 26.4%).« less

The effectiveness of the 55 MPH national maximum speed limit as a life saving benefit

DOT National Transportation Integrated Search

1980-10-01

The report contains an analysis of the life saving benefits resulting from the 55 mph NMSL from 1974-1979. Monthly fatality data from 1970-1979 was used in a time series model to arrive at the estimated safety benefits (lives saved). The time series ...

An energy saving mechanism of EPON networks for real time video transmission

NASA Astrophysics Data System (ADS)

Liu, Chien-Ping; Wu, Ho-Ting; Chiang, Yun-Ting; Chien, Shieh-Chieh; Ke, Kai-Wei

2015-07-01

Modern access networks are constructed widely by passive optical networks (PONs) to meet the growing bandwidth demand. However, higher bandwidth means more energy consumption. To save energy, a few research works propose the dual-mode energy saving mechanism that allows the ONU to operate between active and sleep modes periodically. However, such dual-mode energy saving design may induce unnecessary power consumption or packet delay increase in the case where only downstream data exist for most of the time. In this paper, we propose a new tri-mode energy saving scheme for Ethernet PON (EPON). The new tri-mode energy saving design, combining the dual-mode saving mechanism with the doze mode, allows the ONU to switch among these three modes alternatively. In the doze mode, the ONU may receive downstream data while keeping its transmitter close. Such scenario is often observed for real time video downstream transmission. Furthermore, the low packet delay of high priority upstream data can be attained through the use of early wake-up mechanism employed in both energy saving modes. The energy saving and system efficiency can thus be achieved jointly while maintaining the differentiated QoS for data with various priorities. Performance results via simulation have demonstrated the effectiveness of such mechanism.

A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France

PubMed Central

Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Remi

2013-01-01

The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14–23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544–1,020 million vs. EUR 177–538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306–380 million savings (37–56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13–33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71–89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. PMID:23563511

Wastewater treatment process impact on energy savings and greenhouse gas emissions.

PubMed

Mamais, D; Noutsopoulos, C; Dimopoulou, A; Stasinakis, A; Lekkas, T D

2015-01-01

The objective of this research was to assess the energy consumption of wastewater treatment plants (WWTPs), to apply a mathematical model to evaluate their carbon footprint, and to propose energy saving strategies that can be implemented to reduce both energy consumption and greenhouse gas (GHG) emissions in Greece. The survey was focused on 10 WWTPs in Greece with a treatment capacity ranging from 10,000 to 4,000,000 population equivalents (PE). Based on the results, annual specific energy consumption ranged from 15 to 86 kWh/PE. The highest energy consumer in all the WWTPs was aeration, accounting for 40-75% of total energy requirements. The annual GHG emissions varied significantly according to the treatment schemes employed and ranged between 61 and 161 kgCO₂e/PE. The highest values of CO₂emissions were obtained in extended aeration systems and the lowest in conventional activated sludge systems. Key strategies that the wastewater industry could adopt to mitigate GHG emissions are identified and discussed. A case study is presented to demonstrate potential strategies for energy savings and GHG emission reduction. Given the results, it is postulated that the reduction of dissolved oxygen (DO) set points and sludge retention time can provide significant energy savings and decrease GHG emissions.

From Tragedy to Triumph: Rebuilding Greensburg, Kansas To Be a 100% Renewable Energy City; Preprint

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

Pless, S.; Billman, L.; Wallach, D.

On May 4, 2007, Greensburg, Kansas, was hit by a 1.7-mile wide tornado with 200 mph-plus wind speeds. This tornado destroyed or severely damaged 90% of Greensburg?s structures. We discuss the progress made in rebuilding Greensburg, with a focus on the built environment and on meeting Greensburg?s goal of 100% renewable energy, 100% of the time. We also discuss key disaster recovery efforts that enabled Greensburg to reach this goal. Key strategies included a Sustainable Comprehensive Master Plan, an ordinance resolving that city-owned buildings achieve LEED Platinum and 42% energy savings, a strong focus on rebuilding 'right' with an integratedmore » design process, attracting significant and sustained technical experts and national media attention, and linking renewable and energy efficiency technologies to business development. After three years, more than half the homes that have been rebuilt are rated at an average of 40% energy savings. All significant commercial buildings, including the school, hospital, banks, courthouse, and retail buildings, have been rebuilt to LEED Gold and Platinum standards and exceed 40% savings, with many exceeding 50% savings. Greensburg recently constructed a 12.5-MW community wind farm to provide all the remaining energy needed for its energy-efficient buildings and homes.« less

Reinforcement Learning and Savings Behavior.

PubMed

Choi, James J; Laibson, David; Madrian, Brigitte C; Metrick, Andrew

2009-12-01

We show that individual investors over-extrapolate from their personal experience when making savings decisions. Investors who experience particularly rewarding outcomes from saving in their 401(k)-a high average and/or low variance return-increase their 401(k) savings rate more than investors who have less rewarding experiences with saving. This finding is not driven by aggregate time-series shocks, income effects, rational learning about investing skill, investor fixed effects, or time-varying investor-level heterogeneity that is correlated with portfolio allocations to stock, bond, and cash asset classes. We discuss implications for the equity premium puzzle and interventions aimed at improving household financial outcomes.

Scheduling for energy and reliability management on multiprocessor real-time systems

NASA Astrophysics Data System (ADS)

Qi, Xuan

Scheduling algorithms for multiprocessor real-time systems have been studied for years with many well-recognized algorithms proposed. However, it is still an evolving research area and many problems remain open due to their intrinsic complexities. With the emergence of multicore processors, it is necessary to re-investigate the scheduling problems and design/develop efficient algorithms for better system utilization, low scheduling overhead, high energy efficiency, and better system reliability. Focusing cluster schedulings with optimal global schedulers, we study the utilization bound and scheduling overhead for a class of cluster-optimal schedulers. Then, taking energy/power consumption into consideration, we developed energy-efficient scheduling algorithms for real-time systems, especially for the proliferating embedded systems with limited energy budget. As the commonly deployed energy-saving technique (e.g. dynamic voltage frequency scaling (DVFS)) will significantly affect system reliability, we study schedulers that have intelligent mechanisms to recuperate system reliability to satisfy the quality assurance requirements. Extensive simulation is conducted to evaluate the performance of the proposed algorithms on reduction of scheduling overhead, energy saving, and reliability improvement. The simulation results show that the proposed reliability-aware power management schemes could preserve the system reliability while still achieving substantial energy saving.

Cost savings from peritoneal dialysis therapy time extension using icodextrin.

PubMed

Johnson, David W; Vincent, Kaia; Blizzard, Sophie; Rumpsfeld, Markus; Just, Paul

2003-01-01

Previous retrospective studies have reported that icodextrin may prolong peritoneal dialysis (PD) treatment time in patients with refractory fluid overload (RFO). Because the annual cost of PD therapy is lower than that of hemodialysis (HD) therapy in Australia, we prospectively investigated the ability of icodextrin to prolong PD technique survival in patients with RFO. We used a computer model to estimate the savings associated with that therapeutic strategy, based on annual therapy costs determined in a regional PD and HD costing exercise. Patients who met standard criteria for RFO and who were otherwise to be converted immediately to HD, were asked to consent to an open-label assessment of the ability of icodextrin to delay the need to start HD. Time to conversion to HD was measured. The study enrolled 39 patients who were followed for a mean period of 1.1 years. Icodextrin significantly increased peritoneal ultrafiltration by a median value of 368 mL daily. It prolonged technique survival by a mean period of 1.21 years [95% confidence interval (CI): 0.80-1.62 years]. Extension of PD treatment time by icodextrin was particularly marked for patients who had ultrafiltration failure (UFF, n = 20), defined as net daily peritoneal ultrafiltration < 1 L daily (mean extension time: 1.70 years; 95% CI: 1.16-2.25 years). Overall, annualized savings were US$3,683 per patient per year. If just the patients with UFF were considered, the savings increased to US$4,893 per year. Icodextrin prolongs PD technique survival in patients with RFO, permitting them to continue on their preferred therapy. In Australia, that practice is highly cost-effective, particularly in individuals with UFF.

Cost savings at the end of life. What do the data show?

PubMed

Emanuel, E J

1996-06-26

Medical care at the end of life consumes 10% to 12% of the total health care budget and 27% of the Medicare budget. Many people claim that increased use of hospice and advance directives and lower use of high-technology interventions for terminally ill patients will produce significant cost savings. However, the studies on cost savings from hospice and advance directives are not definitive. The 3 randomized trials show no savings from these interventions, but either they are too small for confidence in their negative results or their intervention and cost accounting are flawed. The nonrandomized trials of hospice and advance directives show a wide range of savings, from 68% to none. Five methodological issues obscure the assessment of these studies: (1) selection bias in those patients who use hospice and advance directives, (2) the different time frames of assessing the costs, (3) the limited types of medical costs evaluated, (4) the variability of reporting the savings, and (5) the lack of generalizability of the findings to other patient populations. A more definitive study that assessed patients' end-of-life care preferences, use of hospice and advance directives, and direct and indirect costs would be desirable. In the absence of such a study, the existing data suggest that hospice and advance directives can save between 25% and 40% of health care costs during the last month of life, with savings decreasing to 10% to 17% over the last 6 months of life and decreasing further to 0% to 10% over the last 12 months of life. These savings are less than most people anticipate. Nevertheless, they do indicate that hospice and advance directives should be encouraged because they certainly do not cost more and they provide a means for patients to exercise their autonomy over end-of-life decisions.

[Estimation of surgical treatment capacity for managing mass casualty incidents based on time needed for life-saving emergency operations].

PubMed

Kanz, K-G; Huber-Wagner, S; Lefering, R; Kay, M; Qvick, M; Biberthaler, P; Mutschler, W

2006-04-01

The surgical treatment capacity of a hospital constitutes a significant restriction in the capability to deal with critically injured patients from multiple or mass casualty incidents (MCI). With regard to the time needed for life-saving operative interventions there are no basic reference values available in the literature, which can aid in detailed planning for management of mass casualty incidents. The data of 20,815 trauma patients, recorded in the trauma registry hosted by the German Association for Trauma Surgery DGU, were analyzed to extract the median duration of life-saving surgical interventions carried out in an operating theatre. Inclusion criteria were an ISS > or = 16 and the performance of relevant ICPM coded procedures within 6 h after trauma room admission. Orthopedic procedures as well as the placement of ICP catheters and chest tubes or performance of laparoscopies were not included. Complete data sets with the required variables were available from 9,988 trauma patients with an ISS > or = 16, and included 7,907 interventions that took place within 6 h after hospital admission. From among 1,228 patients 1,793 operations could be identified as relevant life-saving emergency operations. Acute injury to the abdomen was the major cause accounting for 54.1% of all emergency surgical procedures with a median intervention duration of 137 min followed by head injuries accounting for 26.3% with a median duration of 110 min. Interventions in the pelvis amounted to 11.5% taking an average of 136 min, 5.0% were in the thorax requiring 91 min and 3.1% major amputations with 142 min. The average cut to suture time for all emergency surgical interventions was 130 min. A prerequisite for estimating the surgical operation capacity for critically injured patients of an MCI is the number of OR teams available during and outside of the normal working hours of the hospital. The average operation time of 130 min calculated from investigation of 1,793 emergency life-saving surgical procedures provides a realistic guideline. Used in combination with the number of available OR teams the prospective treatment capacity can be estimated and projected into an actual incident admission capacity. The identification and numerical value of such significant variables are the basis for operations research and realistic planning in emergency and disaster medicine.

Energy Savings Lifetimes and Persistence

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

Hoffman, Ian M.; Schiller, Steven R.; Todd, Annika

2016-02-01

This technical brief explains the concepts of energy savings lifetimes and savings persistence and discusses how program administrators use these factors to calculate savings for efficiency measures, programs and portfolios. Savings lifetime is the length of time that one or more energy efficiency measures or activities save energy, and savings persistence is the change in savings throughout the functional life of a given efficiency measure or activity. Savings lifetimes are essential for assessing the lifecycle benefits and cost effectiveness of efficiency activities and for forecasting loads in resource planning. The brief also provides estimates of savings lifetimes derived from amore » national collection of costs and savings for electric efficiency programs and portfolios.« less

Computerized Fleet Maintenance.

ERIC Educational Resources Information Center

Cataldo, John J.

The computerization of school bus maintenance records by the Niskayuna (New York) Central School District enabled the district's transportation department to engage in management practices resulting in significant savings. The district obtains computer analyses of the work performed on all vehicles, including time spent, parts, labor, costs,…

Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

PubMed Central

Alby, Kevin; Kerr, Alan; Jones, Melissa; Gilligan, Peter H.

2015-01-01

Matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory. PMID:25994167

Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.

PubMed

Tran, Anthony; Alby, Kevin; Kerr, Alan; Jones, Melissa; Gilligan, Peter H

2015-08-01

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Sokaogon Chippewa Community Emission-Free and Treaty Resource Protection Clean Energy Initiative

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

Quade, Ron

Final Report for DOE project DE-IE0000036 The Sokaogon Chippewa Community received a tribal clean energy initiative grant and installed a community wide solar system estimated to produce 606 kw of carbon free clean energy on seventeen (17) tribal buildings and three (3) residential homes significantly reducing the tribes’ energy bills over the life of the system, potentially saving the tribe up to $2.7 million in energy savings over a thirty (30) year time span. Fifteen (15) solar installations utilized aluminum roof-top mounting systems while two (2) installations utilized a ground mount aluminum racking system.

Home Energy Assessments

ScienceCinema

Dispenza, Jason

2017-12-27

A home energy assessment, also known as a home energy audit, is the first step to assess how much energy your home consumes and to evaluate what measures you can take to make your home more energy efficient. An assessment will show you problems that may, when corrected, save you significant amounts of money over time. This video shows some of the ways that a contractor may test your home during an assessment, and helps you understand how an assessment can help you move toward energy savings. Find out more at: http://www.energysavers.gov/your_home/energy_audits/index.cfm/mytopic=11160

Fifteen Minute Test May Save 15% or More on Rosacea Treatment.

PubMed

Darwin, Evan; Cervantes, Jessica; Lev-Tov, Hadar

2018-06-01

Rosacea is a common inflammatory skin condition that impacts a large portion of fair-skinned populations. The redness associated with rosacea can be a significant challenge. Brimonidine sulfate and oxymetazoline HCL were both recently approved by the FDA for the management of facial redness. These agents, however, are costly, and not all patients respond to the medication. Herein, we describe a clinical pearl that helps to optimize patient selection for the medications. This saves the patient and the health care system both time and money. J Drugs Dermatol. 2018;17(5):692-693.

31 CFR 315.10 - Limitations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... each series of bonds and savings notes for each specific year, which has varied from time to time, can..., DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C.... Specific limitations have been placed on the amounts of bonds of each series and savings notes that might...

31 CFR 315.10 - Limitations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... each series of bonds and savings notes for each specific year, which has varied from time to time, can..., DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C.... Specific limitations have been placed on the amounts of bonds of each series and savings notes that might...

31 CFR 315.10 - Limitations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... each series of bonds and savings notes for each specific year, which has varied from time to time, can..., DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C.... Specific limitations have been placed on the amounts of bonds of each series and savings notes that might...

31 CFR 315.10 - Limitations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... each series of bonds and savings notes for each specific year, which has varied from time to time, can..., DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C.... Specific limitations have been placed on the amounts of bonds of each series and savings notes that might...

Energy Saving in DC Electric Railways by Battery Substation

NASA Astrophysics Data System (ADS)

Sugimoto, Takeshi

New rolling vehicles used in dc electric railways are of the regenerative type. At less busy time a part of regenerative power is not used for powering vehicles, and canceled by changed air brake. Recently, significant attention has been paid to the development of secondary batteries for hybrid and electric motorcars. The use of this battery enables reduction in electric power consumption. Because we can charge excess regenerative power and use for powering vehicles after. Before the fact we compared the actual and simulated effective coefficient of regenerative energy, we confirmed the suitability of the simulation model. In this simulation, we studied the energy-saving effect of the battery substations and determined the battery capacity at which maximum power saving is achieved. We found that the power consumption could be reduced remarkably by using a 15-20kWh battery substation.

Airspace Technology Demonstration 3 (ATD-3): Dynamic Weather Routes (DWR) Technology Transfer Document Summary Version 1.0

NASA Technical Reports Server (NTRS)

Sheth, Kapil; Wang, Easter Mayan Chan

2016-01-01

Airspace Technology Demonstration #3 (ATD-3) is part of NASA's Airspace Operations and Safety Program (AOSP) - specifically, its Airspace Technology Demonstrations (ATD) Project. ATD-3 is a multiyear research and development effort which proposes to develop and demonstrate automation technologies and operating concepts that enable air navigation service providers and airspace users to continuously assess weather, winds, traffic, and other information to identify, evaluate, and implement workable opportunities for flight plan route corrections that can result in significant flight time and fuel savings in en route airspace. In order to ensure that the products of this tech-transfer are relevant and useful, NASA has created strong partnerships with the FAA and key industry stakeholders. This summary document and accompanying technology artifacts satisfy the first of three Research Transition Products (RTPs) defined in the Applied Traffic Flow Management (ATFM) Research Transition Team (RTT) Plan. This transfer consists of NASA's legacy Dynamic Weather Routes (DWR) work for efficient routing for en-route weather avoidance. DWR is a ground-based trajectory automation system that continuously and automatically analyzes active airborne aircraft in en route airspace to identify opportunities for simple corrections to flight plan routes that can save significant flying time, at least five minutes wind-corrected, while avoiding weather and considering traffic conflicts, airspace sector congestion, special use airspace, and FAA routing restrictions. The key benefit of the DWR concept is to let automation continuously and automatically analyze active flights to find those where simple route corrections can save significant time and fuel. Operators are busy during weather events. It is more effective to let automation find the opportunities for high-value route corrections.

A Mixed Integer Linear Program for Solving a Multiple Route Taxi Scheduling Problem

NASA Technical Reports Server (NTRS)

Montoya, Justin Vincent; Wood, Zachary Paul; Rathinam, Sivakumar; Malik, Waqar Ahmad

2010-01-01

Aircraft movements on taxiways at busy airports often create bottlenecks. This paper introduces a mixed integer linear program to solve a Multiple Route Aircraft Taxi Scheduling Problem. The outputs of the model are in the form of optimal taxi schedules, which include routing decisions for taxiing aircraft. The model extends an existing single route formulation to include routing decisions. An efficient comparison framework compares the multi-route formulation and the single route formulation. The multi-route model is exercised for east side airport surface traffic at Dallas/Fort Worth International Airport to determine if any arrival taxi time savings can be achieved by allowing arrivals to have two taxi routes: a route that crosses an active departure runway and a perimeter route that avoids the crossing. Results indicate that the multi-route formulation yields reduced arrival taxi times over the single route formulation only when a perimeter taxiway is used. In conditions where the departure aircraft are given an optimal and fixed takeoff sequence, accumulative arrival taxi time savings in the multi-route formulation can be as high as 3.6 hours more than the single route formulation. If the departure sequence is not optimal, the multi-route formulation results in less taxi time savings made over the single route formulation, but the average arrival taxi time is significantly decreased.

Far-field radiation patterns of aperture antennas by the Winograd Fourier transform algorithm

NASA Technical Reports Server (NTRS)

Heisler, R.

1978-01-01

A more time-efficient algorithm for computing the discrete Fourier transform, the Winograd Fourier transform (WFT), is described. The WFT algorithm is compared with other transform algorithms. Results indicate that the WFT algorithm in antenna analysis appears to be a very successful application. Significant savings in cpu time will improve the computer turn around time and circumvent the need to resort to weekend runs.

31 CFR 321.27 - Supplements, amendments, or revisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FINANCIAL INSTITUTIONS OF UNITED STATES SAVINGS BONDS AND UNITED STATES SAVINGS NOTES (FREEDOM SHARES... any time or from time to time, revise, supplement, amend or withdraw, in whole or in part, the...

Reinforcement Learning and Savings Behavior*

PubMed Central

Choi, James J.; Laibson, David; Madrian, Brigitte C.; Metrick, Andrew

2009-01-01

We show that individual investors over-extrapolate from their personal experience when making savings decisions. Investors who experience particularly rewarding outcomes from saving in their 401(k)—a high average and/or low variance return—increase their 401(k) savings rate more than investors who have less rewarding experiences with saving. This finding is not driven by aggregate time-series shocks, income effects, rational learning about investing skill, investor fixed effects, or time-varying investor-level heterogeneity that is correlated with portfolio allocations to stock, bond, and cash asset classes. We discuss implications for the equity premium puzzle and interventions aimed at improving household financial outcomes. PMID:20352013

Saving in cycles: how to get people to save more money.

PubMed

Tam, Leona; Dholakia, Utpal

2014-02-01

Low personal savings rates are an important social issue in the United States. We propose and test one particular method to get people to save more money that is based on the cyclical time orientation. In contrast to conventional, popular methods that encourage individuals to ignore past mistakes, focus on the future, and set goals to save money, our proposed method frames the savings task in cyclical terms, emphasizing the present. Across the studies, individuals who used our proposed cyclical savings method, compared with individuals who used a linear savings method, provided an average of 74% higher savings estimates and saved an average of 78% more money. We also found that the cyclical savings method was more efficacious because it increased implementation planning and lowered future optimism regarding saving money.

Evaluation of Time Spent by Pharmacists and Nurses Based on the Location of Pharmacist Involvement in Medication History Collection.

PubMed

Chhabra, Anmol; Quinn, Andrea; Ries, Amanda

2018-01-01

Accurate history collection is integral to medication reconciliation. Studies support pharmacy involvement in the process, but assessment of global time spent is limited. The authors hypothesized the location of a medication-focused interview would impact time spent. The objective was to compare time spent by pharmacists and nurses based on the location of a medication-focused interview. Time spent by the interviewing pharmacist, admitting nurse, and centralized pharmacist verifying admission orders was collected. Patient groups were based on whether the interview was conducted in the emergency department (ED) or medical floor. The primary end point was a composite of the 3 time points. Secondary end points were individual time components and number and types of transcription discrepancies identified during medical floor interviews. Pharmacists and nurses spent an average of ten fewer minutes per ED patient versus a medical floor patient ( P = .028). Secondary end points were not statistically significant. Transcription discrepancies were identified at a rate of 1 in 4 medications. Post hoc analysis revealed the time spent by pharmacists and nurses was 2.4 minutes shorter per medication when interviewed in the ED ( P < .001). The primary outcome was statistically and clinically significant. Limitations included inability to blind and lack of cost-saving analysis. Pharmacist involvement in ED medication reconciliation leads to time savings during the admission process.

Coordinated platooning with multiple speeds

DOE PAGES

Luo, Fengqiao; Larson, Jeffrey; Munson, Todd

2018-03-22

In a platoon, vehicles travel one after another with small intervehicle distances; trailing vehicles in a platoon save fuel because they experience less aerodynamic drag. This work presents a coordinated platooning model with multiple speed options that integrates scheduling, routing, speed selection, and platoon formation/dissolution in a mixed-integer linear program that minimizes the total fuel consumed by a set of vehicles while traveling between their respective origins and destinations. The performance of this model is numerically tested on a grid network and the Chicago-area highway network. We find that the fuel-savings factor of a multivehicle system significantly depends on themore » time each vehicle is allowed to stay in the network; this time affects vehicles’ available speed choices, possible routes, and the amount of time for coordinating platoon formation. For problem instances with a large number of vehicles, we propose and test a heuristic decomposed approach that applies a clustering algorithm to partition the set of vehicles and then routes each group separately. When the set of vehicles is large and the available computational time is small, the decomposed approach finds significantly better solutions than does the full model.« less

Coordinated platooning with multiple speeds

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

Luo, Fengqiao; Larson, Jeffrey; Munson, Todd

In a platoon, vehicles travel one after another with small intervehicle distances; trailing vehicles in a platoon save fuel because they experience less aerodynamic drag. This work presents a coordinated platooning model with multiple speed options that integrates scheduling, routing, speed selection, and platoon formation/dissolution in a mixed-integer linear program that minimizes the total fuel consumed by a set of vehicles while traveling between their respective origins and destinations. The performance of this model is numerically tested on a grid network and the Chicago-area highway network. We find that the fuel-savings factor of a multivehicle system significantly depends on themore » time each vehicle is allowed to stay in the network; this time affects vehicles’ available speed choices, possible routes, and the amount of time for coordinating platoon formation. For problem instances with a large number of vehicles, we propose and test a heuristic decomposed approach that applies a clustering algorithm to partition the set of vehicles and then routes each group separately. When the set of vehicles is large and the available computational time is small, the decomposed approach finds significantly better solutions than does the full model.« less

31 CFR 351.6 - When may I redeem my Series EE savings bond?

Code of Federal Regulations, 2012 CFR

2012-07-01

... before January 1, 2003. You may redeem your Series EE savings bond at any time beginning six months after... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false When may I redeem my Series EE savings... SAVINGS BONDS, SERIES EE Maturities, Redemption Values, and Investment Yields of Series EE Savings Bonds...

31 CFR 351.6 - When may I redeem my Series EE savings bond?

Code of Federal Regulations, 2013 CFR

2013-07-01

... before January 1, 2003. You may redeem your Series EE savings bond at any time beginning six months after... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false When may I redeem my Series EE savings... SAVINGS BONDS, SERIES EE Maturities, Redemption Values, and Investment Yields of Series EE Savings Bonds...

31 CFR 351.6 - When may I redeem my Series EE savings bond?

Code of Federal Regulations, 2011 CFR

2011-07-01

... before January 1, 2003. You may redeem your Series EE savings bond at any time beginning six months after... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false When may I redeem my Series EE savings... SAVINGS BONDS, SERIES EE Maturities, Redemption Values, and Investment Yields of Series EE Savings Bonds...

Costs and savings associated with community water fluoridation programs in Colorado.

PubMed

O'Connell, Joan M; Brunson, Diane; Anselmo, Theresa; Sullivan, Patrick W

2005-11-01

Local, state, and national health policy makers require information on the economic burden of oral disease and the cost-effectiveness of oral health programs to set policies and allocate resources. In this study, we estimate the cost savings associated with community water fluoridation programs (CWFPs) in Colorado and potential cost savings if Colorado communities without fluoridation programs or naturally high fluoride levels were to implement CWFPs. We developed an economic model to compare the costs associated with CWFPs with treatment savings achieved through averted tooth decay. Treatment savings included those associated with direct medical costs and indirect nonmedical costs (i.e., patient time spent on dental visit). We estimated program costs and treatment savings for each water system in Colorado in 2003 dollars. We obtained parameter estimates from published studies, national surveys, and other sources. We calculated net costs for Colorado water systems with existing CWFPs and potential net costs for systems without CWFPs. The analysis includes data for 172 public water systems in Colorado that serve populations of 1000 individuals or more. We used second-order Monte Carlo simulations to evaluate the inherent uncertainty of the model assumptions on the results and report the 95% credible range from the simulation model. We estimated that Colorado CWFPs were associated with annual savings of 148.9 million dollars (credible range, 115.1 million dollars to 187.2 million dollars) in 2003, or an average of 60.78 dollars per person (credible range, 46.97 dollars dollars to 76.41 dollars). We estimated that Colorado would save an additional 46.6 million dollars (credible range, 36.0 dollars to 58.6 dollars million) annually if CWFPs were implemented in the 52 water systems without such programs and for which fluoridation is recommended. Colorado realizes significant annual savings from CWFPs; additional savings and reductions in morbidity could be achieved if fluoridation programs were implemented in other areas.

Potential Influence of Advance Care Planning and Palliative Care Consultation on ICU Costs for Patients With Chronic and Serious Illness.

PubMed

Khandelwal, Nita; Benkeser, David C; Coe, Norma B; Curtis, J Randall

2016-08-01

To estimate the potential ICU-related cost savings if in-hospital advance care planning and ICU-based palliative care consultation became standard of care for patients with chronic and serious illness. Decision analysis using literature estimates and inpatient administrative data from Premier. Patients with chronic, life-limiting illness admitted to a hospital within the Premier network. None. Using Premier data (2008-2012), ICU resource utilization and costs were tracked over a 1-year time horizon for 2,097,563 patients with chronic life-limiting illness. Using a Markov microsimulation model, we explored the potential cost savings from the hospital system perspective under a variety of scenarios by varying the interventions' efficacies and availabilities. Of 2,097,563 patients, 657,825 (31%) used the ICU during the 1-year time horizon; mean ICU spending per patient was 11.3k (SD, 17.6k). In the base-case analysis, if in-hospital advance care planning and ICU-based palliative care consultation were systematically provided, we estimated a mean reduction in ICU costs of 2.8k (SD, 14.5k) per patient and an ICU cost saving of 25%. Among the simulated patients who used the ICU, the receipt of both interventions could have resulted in ICU cost savings of 1.9 billion, representing a 6% reduction in total hospital costs for these patients. In-hospital advance care planning and palliative care consultation have the potential to result in significant cost savings. Studies are needed to confirm these findings, but our results provide guidance for hospitals and policymakers.

Reducing Overutilization of Testing for Clostridium difficile Infection in a Pediatric Hospital System: A Quality Improvement Initiative.

PubMed

Klatte, J Michael; Selvarangan, Rangaraj; Jackson, Mary Anne; Myers, Angela L

2016-01-01

Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing. A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A p-chart was generated to evaluate the percentage of these submitted specimens tested biweekly over a 12-month period. Cost savings for patients and the laboratory were assessed at the study period's conclusion. Run chart analysis revealed an initial shift after the interventions, suggesting a temporary decrease in testing submission; however, no sustained differences in numbers of specimens submitted biweekly were observed over time. On the p-chart, the mean percentage of specimens tested before the intervention was 100%. After the intervention, the average percentage of specimens tested dropped to 53.8%. Resultant laboratory cost savings totaled nearly $3600, and patient savings on testing charges were ∼$32 000. Automatic laboratory declination of nondiarrheal stools submitted for CDI testing resulted in a sustained decrease in the number of specimens tested, resulting in significant laboratory and patient cost savings. Despite multiple educational efforts, no sustained changes in physician ordering practices were observed. Copyright © 2016 by the American Academy of Pediatrics.

Daylight savings time and myocardial infarction

PubMed Central

Sandhu, Amneet; Seth, Milan; Gurm, Hitinder S

2014-01-01

Background Prior research has shown a transient increase in the incidence of acute myocardial infarction (AMI) after daylight savings time (DST) in the spring as well as a decrease in AMI after returning to standard time in the fall. These findings have not been verified in a broader population and if extant, may have significant public health and policy implications. Methods We assessed changes in admissions for AMI undergoing percutaneous coronary intervention (PCI) in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) database for the weeks following the four spring and three fall DST changes between March 2010 and September 2013. A negative binomial regression model was used to adjust for trend and seasonal variation. Results There was no difference in the total weekly number of PCIs performed for AMI for either the fall or spring time changes in the time period analysed. After adjustment for trend and seasonal effects, the Monday following spring time changes was associated with a 24% increase in daily AMI counts (p=0.011), and the Tuesday following fall changes was conversely associated with a 21% reduction (p=0.044). No other weekdays in the weeks following DST changes demonstrated significant associations. Conclusions In the week following the seasonal time change, DST impacts the timing of presentations for AMI but does not influence the overall incidence of this disease. PMID:25332784

Saving the On-Scene Time for Out-of-Hospital Cardiac Arrest Patients: The Registered Nurses' Role and Performance in Emergency Medical Service Teams.

PubMed

Lin, Ming-Wei; Wu, Che-Yu; Pan, Chih-Long; Tian, Zhong; Wen, Jyh-Horng; Wen, Jet-Chau

2017-01-01

For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases. The average on-scene time of RN-attended cases showed a decrease of 21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended. In NT-O and T-CS cases, the RNs' attendance can notably save the on-scene time with a statistical significance ( P = .016 and .017, resp.). Furthermore, the return of spontaneous circulation within two hours (ROSC 2 h ) rate in the NT-O cases was increased by 12.86%. Based on the findings, the role of RNs in the EMTs could save the golden time in the prehospital medical care in Taiwan.

Time-saving design of experiment protocol for optimization of LC-MS data processing in metabolomic approaches.

PubMed

Zheng, Hong; Clausen, Morten Rahr; Dalsgaard, Trine Kastrup; Mortensen, Grith; Bertram, Hanne Christine

2013-08-06

We describe a time-saving protocol for the processing of LC-MS-based metabolomics data by optimizing parameter settings in XCMS and threshold settings for removing noisy and low-intensity peaks using design of experiment (DoE) approaches including Plackett-Burman design (PBD) for screening and central composite design (CCD) for optimization. A reliability index, which is based on evaluation of the linear response to a dilution series, was used as a parameter for the assessment of data quality. After identifying the significant parameters in the XCMS software by PBD, CCD was applied to determine their values by maximizing the reliability and group indexes. Optimal settings by DoE resulted in improvements of 19.4% and 54.7% in the reliability index for a standard mixture and human urine, respectively, as compared with the default setting, and a total of 38 h was required to complete the optimization. Moreover, threshold settings were optimized by using CCD for further improvement. The approach combining optimal parameter setting and the threshold method improved the reliability index about 9.5 times for a standards mixture and 14.5 times for human urine data, which required a total of 41 h. Validation results also showed improvements in the reliability index of about 5-7 times even for urine samples from different subjects. It is concluded that the proposed methodology can be used as a time-saving approach for improving the processing of LC-MS-based metabolomics data.

Energy-saving scheme based on downstream packet scheduling in ethernet passive optical networks

NASA Astrophysics Data System (ADS)

Zhang, Lincong; Liu, Yejun; Guo, Lei; Gong, Xiaoxue

2013-03-01

With increasing network sizes, the energy consumption of Passive Optical Networks (PONs) has grown significantly. Therefore, it is important to design effective energy-saving schemes in PONs. Generally, energy-saving schemes have focused on sleeping the low-loaded Optical Network Units (ONUs), which tends to bring large packet delays. Further, the traditional ONU sleep modes are not capable of sleeping the transmitter and receiver independently, though they are not required to transmit or receive packets. Clearly, this approach contributes to wasted energy. Thus, in this paper, we propose an Energy-Saving scheme that is based on downstream Packet Scheduling (ESPS) in Ethernet PON (EPON). First, we design both an algorithm and a rule for downstream packet scheduling at the inter- and intra-ONU levels, respectively, to reduce the downstream packet delay. After that, we propose a hybrid sleep mode that contains not only ONU deep sleep mode but also independent sleep modes for the transmitter and the receiver. This ensures that the energy consumed by the ONUs is minimal. To realize the hybrid sleep mode, a modified GATE control message is designed that involves 10 time points for sleep processes. In ESPS, the 10 time points are calculated according to the allocated bandwidths in both the upstream and the downstream. The simulation results show that ESPS outperforms traditional Upstream Centric Scheduling (UCS) scheme in terms of energy consumption and the average delay for both real-time and non-real-time packets downstream. The simulation results also show that the average energy consumption of each ONU in larger-sized networks is less than that in smaller-sized networks; hence, our ESPS is better suited for larger-sized networks.

A comprehensive in vitro study of image accuracy and quality for periodontal diagnosis. Part 1: the influence of X-ray generator on periodontal measurements using conventional and digital receptors.

PubMed

Vandenberghe, Bart; Corpas, Livia; Bosmans, Hilde; Yang, Jie; Jacobs, Reinhilde

2011-08-01

The aim of this study was the determination of image accuracy and quality for periodontal diagnosis using various X-ray generators with conventional and digital radiographs. Thirty-one in vitro periodontal defects were evaluated on intraoral conventional (E-, F/E-speed) and digital images (three indirect, two direct sensors). Standardised radiographs were made with an alternating current (AC), a high-frequency (HF) and a direct current (DC) X-ray unit at rising exposure times (20-160 ms with 20-ms interval) with a constant kV of 70. Three observers assessed bone levels for comparison to the gold standard. Lamina dura, contrast, trabecularisation, crater and furcation involvements were evaluated. Irrespective X-ray generator-type, measurement deviations increased at higher exposure times for solid-state, but decreased for photostimulable storage phosphor (PSP) systems. Accuracy for HF or DC was significantly higher than AC (p < 0.0001), especially at low exposure times. At 0.5- to 1-mm clinical deviation, 27-53% and 32-55% dose savings were demonstrated when using HF or DC generators compared to AC, but only for PSP. No savings were found for solid-state sensors, indicating their higher sensitivity. The use of digital sensors compared to film allowed 15-90% dose savings using the AC tube, whilst solid-state sensors allowed approximately 50% savings compared to PSP, depending on tube type and threshold level.. Accuracy of periodontal diagnosis increases when using HF or DC generators and/or digital receptors with adequate diagnostic information at lower exposure times.

NREL, Sandia, and Johnson Controls See Significant Water Savings for HPC

Science.gov Websites

Cooling | Energy Systems Integration Facility | NREL NREL, Sandia and Johnson Controls save 1M Gallons of Water a Year for HPC Cooling NREL, Sandia, and Johnson Controls See Significant Water Savings for HPC Cooling NREL partnered with Sandia National Laboratories and Johnson Controls to install the

Energy-saving framework for passive optical networks with ONU sleep/doze mode.

PubMed

Van, Dung Pham; Valcarenghi, Luca; Dias, Maluge Pubuduni Imali; Kondepu, Koteswararao; Castoldi, Piero; Wong, Elaine

2015-02-09

This paper proposes an energy-saving passive optical network framework (ESPON) that aims to incorporate optical network unit (ONU) sleep/doze mode into dynamic bandwidth allocation (DBA) algorithms to reduce ONU energy consumption. In the ESPON, the optical line terminal (OLT) schedules both downstream (DS) and upstream (US) transmissions in the same slot in an online and dynamic fashion whereas the ONU enters sleep mode outside the slot. The ONU sleep time is maximized based on both DS and US traffic. Moreover, during the slot, the ONU might enter doze mode when only its transmitter is idle to further improve energy efficiency. The scheduling order of data transmission, control message exchange, sleep period, and doze period defines an energy-efficient scheme under the ESPON. Three schemes are designed and evaluated in an extensive FPGA-based evaluation. Results show that whilst all the schemes significantly save ONU energy for different evaluation scenarios, the scheduling order has great impact on their performance. In addition, the ESPON allows for a scheduling order that saves ONU energy independently of the network reach.

Hospice Enrollment Saves Money For Medicare And Improves Care Quality Across A Number Of Different Lengths-Of-Stay

PubMed Central

Kelley, Amy S.; Deb, Partha; Du, Qingling; Carlson, Melissa D. Aldridge; Morrison, R. Sean

2013-01-01

Despite its demonstrated potential to both improve quality of care and lower costs, the Medicare hospice benefit has been seen as producing savings only for patients enrolled 53–105 days before death. Using data from the Health and Retirement Study, 2002–08, and individual Medicare claims, and overcoming limitations of previous work, we found $2,561 in savings to Medicare for each patient enrolled in hospice 53–105 days before death, compared to a matched, nonhospice control. Even higher savings were seen, however, with more common, shorter enrollment periods: $2,650, $5,040, and $6,430 per patient enrolled 1–7, 8–14, and 15–30 days prior to death, respectively. Within all periods examined, hospice patients also had significantly lower rates of hospital service use and in-hospital death than matched controls. Instead of attempting to limit Medicare hospice participation, the Centers for Medicare and Medicaid Services should focus on ensuring the timely enrollment of qualified patients who desire the benefit. PMID:23459735

Automated Training Evaluation (ATE). Final Report.

ERIC Educational Resources Information Center

Charles, John P.; Johnson, Robert M.

The automation of weapons system training presents the potential for significant savings in training costs in terms of manpower, time, and money. The demonstration of the technical feasibility of automated training through the application of advanced digital computer techniques and advanced training techniques is essential before the application…

Short-term versus long-term rainfall time series in the assessment of potable water savings by using rainwater in houses.

PubMed

Ghisi, Enedir; Cardoso, Karla Albino; Rupp, Ricardo Forgiarini

2012-06-15

The main objective of this article is to assess the possibility of using short-term instead of long-term rainfall time series to evaluate the potential for potable water savings by using rainwater in houses. The analysis was performed considering rainfall data from 1960 to 1995 for the city of Santa Bárbara do Oeste, located in the state of São Paulo, southeastern Brazil. The influence of the rainfall time series, roof area, potable water demand and percentage rainwater demand on the potential for potable water savings was evaluated. The potential for potable water savings was estimated using computer simulations considering a set of long-term rainfall time series and different sets of short-term rainfall time series. The ideal rainwater tank capacity was also assessed for some cases. It was observed that the higher the percentage rainwater demand and the shorter the rainfall time series, the larger the difference between the potential for potable water savings and the greater the variation in the ideal rainwater tank size. The sets of short-term rainfall time series considered adequate for different scenarios ranged from 1 to 13 years depending on the roof area, percentage rainwater demand and potable water demand. The main finding of the research is that sets of short-term rainfall time series can be used to assess the potential for potable water savings by using rainwater, as the results obtained are similar to those obtained from the long-term rainfall time series. Copyright © 2012 Elsevier Ltd. All rights reserved.

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure.

PubMed

Roy, Sanjoy; Hammond, Jeffrey; Panish, Jessica; Shnoda, Pullen; Savidge, Sandy; Wilson, Mark

2015-01-01

This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAP ™ Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p < 0.00001). Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p < 0.001). Scores in five of the six sources of stress were significantly lower for mechanical fixation. Mechanical fixation with ETHICON SECURESTRAP ™ Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

PubMed Central

Roy, Sanjoy; Hammond, Jeffrey; Panish, Jessica; Shnoda, Pullen; Savidge, Sandy; Wilson, Mark

2015-01-01

Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p < 0.00001). Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p < 0.001). Scores in five of the six sources of stress were significantly lower for mechanical fixation. Conclusions. Mechanical fixation with ETHICON SECURESTRAPTM Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure. PMID:26240834

Leyla loop: a time-saving suture technique for robotic atrial closure

PubMed Central

Kılıç, Leyla; Şenay, Şahin; Ümit Güllü, A.; Alhan, Cem

2013-01-01

The longer durations of cardiopulmonary bypass and aortic cross-clamp times remain the disadvantages of robotic or minimally invasive cardiac surgery. For this reason, every small contribution to speeding up these procedures is of the utmost importance. Here, we present a practical, easy and time-saving suture technique for atrial closure. It consists of a hand-made loop at one end of the suture and saves the time otherwise consumed by knotting. It may also be used during conventional or minimally invasive cardiac surgery. PMID:23760357

Early tracheostomy in trauma patients saves time and money.

PubMed

Hyde, Glendon A; Savage, Stephanie A; Zarzaur, Ben L; Hart-Hyde, Jensen E; Schaefer, Candace B; Croce, Martin A; Fabian, Timothy C

2015-01-01

Patients suffering traumatic brain and chest wall injuries are often difficult to liberate from the ventilator yet best timing of tracheostomy remains ill-defined. While prior studies have addressed early versus late tracheostomy, they generally suffer from the use of historical controls, which cannot account for variations in management over time. Propensity scoring can be utilized to identify controls from the same patient population, minimizing impact of confounding variables. The purpose of this study was to determine outcomes associated with early versus late tracheostomy by application of propensity scoring. Patients requiring intubation within 48h and receiving tracheostomy from January 2010 to June 2012 were identified. Early tracheostomy (ET) was a tracheostomy performed by the fifth hospital day. ET patients were matched to late tracheostomy patients (LT, tracheostomy after day 5) using propensity scoring and compared for multiple outcomes. Cost for services was calculated using average daily billing rates at our institution. One hundred and six patients were included, 53 each in the ET (mean day tracheostomy=4) and the LT (mean day tracheostomy=10) cohorts. The average age was 47 years and 94% suffered blunt injury, with an average NISS of 23.7. Patients in the ET group had significantly shorter TICU LOS (21.4 days vs. 28.6 days, p<0.0001) and significantly fewer ventilator days (16.7 days vs. 21.9, p<0.0001) compared to the LT group. ET patients also had significantly less VAP (34% vs. 64.2%, p=0.0019). In the current era of increased health-care costs, early tracheostomy significantly decreased both pulmonary morbidity and critical care resource utilization. This translates to an appreciable cost savings, at minimum $52,173 per patient and a potential total savings of $2.8million/year for the entire LT cohort. For trauma patients requiring prolonged ventilator support, early tracheostomy should be performed. Copyright © 2014 Elsevier Ltd. All rights reserved.

An energy-aware routing protocol for query-based applications in wireless sensor networks.

PubMed

Ahvar, Ehsan; Ahvar, Shohreh; Lee, Gyu Myoung; Crespi, Noel

2014-01-01

Wireless sensor network (WSN) typically has energy consumption restriction. Designing energy-aware routing protocol can significantly reduce energy consumption in WSNs. Energy-aware routing protocols can be classified into two categories, energy savers and energy balancers. Energy saving protocols are used to minimize the overall energy consumed by a WSN, while energy balancing protocols attempt to efficiently distribute the consumption of energy throughout the network. In general terms, energy saving protocols are not necessarily good at balancing energy consumption and energy balancing protocols are not always good at reducing energy consumption. In this paper, we propose an energy-aware routing protocol (ERP) for query-based applications in WSNs, which offers a good trade-off between traditional energy balancing and energy saving objectives and supports a soft real time packet delivery. This is achieved by means of fuzzy sets and learning automata techniques along with zonal broadcasting to decrease total energy consumption.

An Energy-Aware Routing Protocol for Query-Based Applications in Wireless Sensor Networks

PubMed Central

Crespi, Noel

2014-01-01

Wireless sensor network (WSN) typically has energy consumption restriction. Designing energy-aware routing protocol can significantly reduce energy consumption in WSNs. Energy-aware routing protocols can be classified into two categories, energy savers and energy balancers. Energy saving protocols are used to minimize the overall energy consumed by a WSN, while energy balancing protocols attempt to efficiently distribute the consumption of energy throughout the network. In general terms, energy saving protocols are not necessarily good at balancing energy consumption and energy balancing protocols are not always good at reducing energy consumption. In this paper, we propose an energy-aware routing protocol (ERP) for query-based applications in WSNs, which offers a good trade-off between traditional energy balancing and energy saving objectives and supports a soft real time packet delivery. This is achieved by means of fuzzy sets and learning automata techniques along with zonal broadcasting to decrease total energy consumption. PMID:24696640

Cogeneration Technology Alternatives Study (CTAS). Volume 1: Summary

NASA Technical Reports Server (NTRS)

Barna, G. J.; Burns, R. K.; Sagerman, G. D.

1980-01-01

Various advanced energy conversion systems that can use coal or coal-derived fuels for industrial cogeneration applications were compared to provide information needed by DOE to establish research and development funding priorities for advanced-technology systems that could significantly advance the use of coal or coal-derived fuels in industrial cogeneration. Steam turbines, diesel engines, open-cycle gas turbines, combined cycles, closed-cycle gas turbines, Stirling engines, phosphoric acid fuel cells, molten carbonate fuel cells, and thermionics were studied with technology advancements appropriate for the 1985-2000 time period. The various advanced systems were compared and evaluated for wide diversity of representative industrial plants on the basis of fuel energy savings, annual energy cost savings, emissions savings, and rate of return on investment as compared with purchasing electricity from a utility and providing process heat with an on-site boiler. Also included in the comparisons and evaluations are results extrapolated to the national level.

Cogeneration Technology Alternatives Study (CTAS). Volume 2: Comparison and evaluation of results

NASA Technical Reports Server (NTRS)

1984-01-01

CTAS compared and evaluated various advanced energy conversion systems that can use coal or coal-derived fuels for industrial cogeneration applications. The principal aim of the study was to provide information needed by DOE to establish research and development (R&D) funding priorities for advanced-technology systems that could significantly advance the use of coal or coal-derived fuels in industrial cogeneration. Steam turbines, diesel engines, open-cycle gas turbines, combined cycles, closed-cycle gas turbines, Stirling engines, phosphoric acid fuel cells, molten carbonate fuel cells, and thermionics were studied with technology advancements appropriate for the 1985-2000 time period. The various advanced systems were compared and evaluated for a wide diversity of representative industrial plants on the basis of fuel energy savings, annual energy cost savings, emissions savings, and rate of return on investment (ROI) as compared with purchasing electricity from a utility and providing process heat with an on-site boiler.

Economic Analysis of the Reduction of Blood Transfusions during Surgical Procedures While Continuous Hemoglobin Monitoring Is Used

PubMed Central

Ribed-Sánchez, Borja; Varea-Díaz, Sara; Corbacho-Fabregat, Carlos; Pérez-Oteyza, Jaime; Belda-Iniesta, Cristóbal

2018-01-01

Background: Two million transfusions are performed in Spain every year. These come at a high economic price for the health system, increasing the morbidity and mortality rates. The way of obtaining the hemoglobin concentration value is via invasive and intermittent methods, the results of which take time to obtain. The drawbacks of this method mean that some transfusions are unnecessary. New continuous noninvasive hemoglobin measurement technology can save unnecessary transfusions. Methods: A prospective study was carried out with a historical control of two homogeneous groups. The control group used the traditional hemoglobin measurement methodology. The experimental group used the new continuous hemoglobin measurement technology. The difference was analyzed by comparing the transfused units of the groups. The economic savings was calculated by multiplying the cost of a transfusion by the difference in units, taking into account measurement costs. Results: The percentage of patients needing a transfusion decreased by 7.4%, and the number of transfused units per patient by 12.56%. Economic savings per patient were €20.59. At the national level, savings were estimated to be 13,500 transfusions (€1.736 million). Conclusions: Constant monitoring of the hemoglobin level significantly reduces the need for blood transfusions. By using this new measurement technology, health care facilities can significantly reduce costs and improve care quality. PMID:29702617

Economic impact of thermostable vaccines.

PubMed

Lee, Bruce Y; Wedlock, Patrick T; Haidari, Leila A; Elder, Kate; Potet, Julien; Manring, Rachel; Connor, Diana L; Spiker, Marie L; Bonner, Kimberly; Rangarajan, Arjun; Hunyh, Delphine; Brown, Shawn T

2017-05-25

While our previous work has shown that replacing existing vaccines with thermostable vaccines can relieve bottlenecks in vaccine supply chains and thus increase vaccine availability, the question remains whether this benefit would outweigh the additional cost of thermostable formulations. Using HERMES simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, we simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact. Costs measured included the costs of vaccines, logistics, and disease outcomes averted. Replacing a particular vaccine with a thermostable version yielded cost savings in many cases even when charging a price premium (two or three times the current vaccine price). For example, replacing the current pentavalent vaccine with a thermostable version without increasing the vaccine price saved from $366 to $10,945 per 100 members of the vaccine's target population. Doubling the vaccine price still resulted in cost savings that ranged from $300 to $10,706, and tripling the vaccine price resulted in cost savings from $234 to $10,468. As another example, a thermostable rotavirus vaccine (RV) at its current (year) price saved between $131 and $1065. Doubling and tripling the thermostable rotavirus price resulted in cost savings ranging from $102 to $936 and $73 to $808, respectively. Switching to thermostable formulations was highly cost-effective or cost-effective in most scenarios explored. Medical cost and productivity savings could outweigh even significant price premiums charged for thermostable formulations of vaccines, providing support for their use. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Pitfalls of insulin pump clocks: technical glitches that may potentially affect medical care in patients with diabetes.

PubMed

Aldasouqi, Saleh A; Reed, Amy J

2014-11-01

The objective was to raise awareness about the importance of ensuring that insulin pumps internal clocks are set up correctly at all times. This is a very important safety issue because all commercially available insulin pumps are not GPS-enabled (though this is controversial), nor equipped with automatically adjusting internal clocks. Special attention is paid to how basal and bolus dose errors can be introduced by daylight savings time changes, travel across time zones, and am-pm clock errors. Correct setting of insulin pump internal clock is crucial for appropriate insulin delivery. A comprehensive literature review is provided, as are illustrative cases. Incorrect setting can potentially result in incorrect insulin delivery, with potential harmful consequences, if too much or too little insulin is delivered. Daylight saving time changes may not significantly affect basal insulin delivery, given the triviality of the time difference. However, bolus insulin doses can be dramatically affected. Such problems may occur when pump wearers have large variations in their insulin to carb ratio, especially if they forget to change their pump clock in the spring. More worrisome than daylight saving time change is the am-pm clock setting. If this setting is set up incorrectly, both basal rates and bolus doses will be affected. Appropriate insulin delivery through insulin pumps requires correct correlation between dose settings and internal clock time settings. Because insulin pumps are not GPS-enabled or automatically time-adjusting, extra caution should be practiced by patients to ensure correct time settings at all times. Clinicians and diabetes educators should verify the date/time of insulin pumps during patients' visits, and should remind their patients to always verify these settings. © 2014 Diabetes Technology Society.

Pitfalls of Insulin Pump Clocks

PubMed Central

Reed, Amy J.

2014-01-01

The objective was to raise awareness about the importance of ensuring that insulin pumps internal clocks are set up correctly at all times. This is a very important safety issue because all commercially available insulin pumps are not GPS-enabled (though this is controversial), nor equipped with automatically adjusting internal clocks. Special attention is paid to how basal and bolus dose errors can be introduced by daylight savings time changes, travel across time zones, and am-pm clock errors. Correct setting of insulin pump internal clock is crucial for appropriate insulin delivery. A comprehensive literature review is provided, as are illustrative cases. Incorrect setting can potentially result in incorrect insulin delivery, with potential harmful consequences, if too much or too little insulin is delivered. Daylight saving time changes may not significantly affect basal insulin delivery, given the triviality of the time difference. However, bolus insulin doses can be dramatically affected. Such problems may occur when pump wearers have large variations in their insulin to carb ratio, especially if they forget to change their pump clock in the spring. More worrisome than daylight saving time change is the am-pm clock setting. If this setting is set up incorrectly, both basal rates and bolus doses will be affected. Appropriate insulin delivery through insulin pumps requires correct correlation between dose settings and internal clock time settings. Because insulin pumps are not GPS-enabled or automatically time-adjusting, extra caution should be practiced by patients to ensure correct time settings at all times. Clinicians and diabetes educators should verify the date/time of insulin pumps during patients’ visits, and should remind their patients to always verify these settings. PMID:25355713

What affects the quality of economic analysis for life-saving investments?

PubMed

Hahn, Robert W; Kosec, Katrina; Neumann, Peter J; Wallsten, Scott

2006-06-01

Economic analysis of life-saving investments in both the public and private sectors has the potential to dramatically improve longevity and the quality of life, but only if the analyses on which decisions are based are done well. In this article, we analyze a data set that provides information on the content and quality of journal articles that measure the cost-effectiveness of life-saving investments. Our study is the first to provide a detailed multivariate analysis of factors affecting objective measures of quality. We also explore whether a series of recommendations by an expert panel convened by the U.S. Public Health Service affect the way analyses of specific life-saving investments are done. Our results suggest that four factors are positively correlated with an index we construct to measure analytical quality: (1) having at least one author affiliated with a university, (2) publication in a journal that has experience in publishing these analyses, (3) if the life-saving investment is located in the United States, and (4) if the analysis considers a measure of social costs or benefits. Somewhat surprisingly, a study's funding source and whether it is affiliated with industry are not significantly correlated with the quality index. Finally, neither time nor the panel guidelines had an impact on the index.

Societal economic costs and benefits from death: another look.

PubMed

Stack, Steven

2007-04-01

B. Yang and D. Lester (2007) have produced an innovative contribution to the relevant literature. Unlike previous studies, they incorporate estimates of cost savings from suicide. Their argument could be strengthened in 3 ways. First, they may have underestimated some of the cost savings by relying on inflated estimates of mental health usage by suicidal persons. The present analysis shows that only 20% of suicidal individuals see a mental health professional during the last year of life, much lower than previous estimates. Further, persons dying of cancer are 4 times more likely than suicides to report high usage of medical services. Second, our economy relies heavily on the health care sector for job creation, so that we need to exercise caution in interpreting savings in medical care; such savings may also represent costs in employment opportunities for nurses, doctors, and other medical personnel. Third, an anticipated criticism, the costs of the grieving of significant others, needs to be considered. Suicidal persons are shown to have less dense social networks, a sign of fewer potential grievers than in the case of natural deaths. Future work is needed to adjust lost earnings for the lower occupational status of suicides; this is another reason why Yang and Lester may be underestimating cost savings from suicide.

I-SAVE: AN INTERACTIVE REAL-TIME MONITOR AND CONTROLLER TO INFLUENCE ENERGY CONSERVATION BEHAVIOR BY IMPULSE SAVING

EPA Science Inventory

Simulation-based model to explore the benefits of monitoring and control to energy saving opportunities in residential homes; an adaptive algorithm to predict the type of electrical loads; a prototype user friendly interface monitoring and control device to save energy; a p...

School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project.

PubMed

Rodriguez, Eunice; Rivera, Diana Austria; Perlroth, Daniella; Becker, Edmund; Wang, Nancy Ewen; Landau, Melinda

2013-12-01

With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs. © 2013, American School Health Association.

Analysis of Multi-Flight Common Routes for Traffic Flow Management

NASA Technical Reports Server (NTRS)

Sheth, Kapil; Clymer, Alexis; Morando, Alex; Shih, Fu-Tai

2016-01-01

This paper presents an approach for creating common weather avoidance reroutes for multiple flights and the associated benefits analysis, which is an extension of the single flight advisories generated using the Dynamic Weather Routes (DWR) concept. These multiple flight advisories are implemented in the National Airspace System (NAS) Constraint Evaluation and Notification Tool (NASCENT), a nation-wide simulation environment to generate time- and fuel-saving alternate routes for flights during severe weather events. These single flight advisories are clustered together in the same Center by considering parameters such as a common return capture fix. The clustering helps propose routes called, Multi-Flight Common Routes (MFCR), that avoid weather and other airspace constraints, and save time and fuel. It is expected that these routes would also provide lower workload for traffic managers and controllers since a common route is found for several flights, and presumably the route clearances would be easier and faster. This study was based on 30-days in 2014 and 2015 each, which had most delays attributed to convective weather. The results indicate that many opportunities exist where individual flight routes can be clustered to fly along a common route to save a significant amount of time and fuel, and potentially reducing the amount of coordination needed.

A Framework to Improve Energy Efficient Behaviour at Home through Activity and Context Monitoring

PubMed Central

García, Óscar; Alonso, Ricardo S.; Corchado, Juan M.

2017-01-01

Real-time Localization Systems have been postulated as one of the most appropriated technologies for the development of applications that provide customized services. These systems provide us with the ability to locate and trace users and, among other features, they help identify behavioural patterns and habits. Moreover, the implementation of policies that will foster energy saving in homes is a complex task that involves the use of this type of systems. Although there are multiple proposals in this area, the implementation of frameworks that combine technologies and use Social Computing to influence user behaviour have not yet reached any significant savings in terms of energy. In this work, the CAFCLA framework (Context-Aware Framework for Collaborative Learning Applications) is used to develop a recommendation system for home users. The proposed system integrates a Real-Time Localization System and Wireless Sensor Networks, making it possible to develop applications that work under the umbrella of Social Computing. The implementation of an experimental use case aided efficient energy use, achieving savings of 17%. Moreover, the conducted case study pointed to the possibility of attaining good energy consumption habits in the long term. This can be done thanks to the system’s real time and historical localization, tracking and contextual data, based on which customized recommendations are generated. PMID:28758987

Applications of data compression techniques in modal analysis for on-orbit system identification

NASA Technical Reports Server (NTRS)

Carlin, Robert A.; Saggio, Frank; Garcia, Ephrahim

1992-01-01

Data compression techniques have been investigated for use with modal analysis applications. A redundancy-reduction algorithm was used to compress frequency response functions (FRFs) in order to reduce the amount of disk space necessary to store the data and/or save time in processing it. Tests were performed for both single- and multiple-degree-of-freedom (SDOF and MDOF, respectively) systems, with varying amounts of noise. Analysis was done on both the compressed and uncompressed FRFs using an SDOF Nyquist curve fit as well as the Eigensystem Realization Algorithm. Significant savings were realized with minimal errors incurred by the compression process.

Off-line data reduction

NASA Astrophysics Data System (ADS)

Gutowski, Marek W.

1992-12-01

Presented is a novel, heuristic algorithm, based on fuzzy set theory, allowing for significant off-line data reduction. Given the equidistant data, the algorithm discards some points while retaining others with their original values. The fraction of original data points retained is typically {1}/{6} of the initial value. The reduced data set preserves all the essential features of the input curve. It is possible to reconstruct the original information to high degree of precision by means of natural cubic splines, rational cubic splines or even linear interpolation. Main fields of application should be non-linear data fitting (substantial savings in CPU time) and graphics (storage space savings).

Improving value of travel time savings estimation for more effective transportation project evaluation.

DOT National Transportation Integrated Search

2012-12-01

Estimates of value of time (VOT) and value of travel time savings (VTTS) are critical elements in benefitcost : analyses of transportation projects and in developing congestion pricing policies. In addition, : differences in VTTS among various modes ...

Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy.

PubMed

Borrero, Sonya; Zite, Nikki; Potter, Joseph E; Trussell, James; Smith, Kenneth

2013-12-01

Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. We constructed a cost-effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a postpartum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies and save a significant amount of public funds. Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly funded, postpartum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to cost savings of $215 million each year. © 2013.

Peer Review of March 2013 LDV Rebound Report By Small and Hymel

EPA Science Inventory

The regulatory option of encouraging the adoption of advanced technologies for improving vehicle efficiency can result in significant fuel savings and GHG emissions benefits. At the same time, it is possible that some of these benefits might be offset by additional driving that i...

Providing Increased Transit Capacity During Peak Periods : Examination of Two Techniques

DOT National Transportation Integrated Search

1975-02-01

It is shown that reduction of bus route lengths increases the number of round trips per bus possible in a given time period. For bus routes accessed mainly by auto, it is shown that significant savings in energy due to reduced auto miles travelled ar...

Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort.

PubMed

Goudra, B; Singh, P M; Borle, A; Gouda, G

2016-01-01

Use of electronic medical record systems has increased in the recent years. Epic is one such system gaining popularity in the USA. Epic is a private company, which invented the electronic documentation system adopted in our hospital. In spite of many presumed advantages, its use is not critically analyzed. Some of the perceived advantages are increased efficiency and protection against litigation as a result of accurate documentation. In this study, retrospective data of 305 patients who underwent endoscopic retrograde cholangiopancreatography (wherein electronic charting was used - "Epic group") were compared with 288 patients who underwent the same procedure with documentation saved on a paper chart ("paper group"). Time of various events involved in the procedure such as anesthesia start, endoscope insertion, endoscope removal, and transfer to the postanesthesia care unit were routinely documented. From this data, the various time durations were calculated. Both "anesthesia start to scope insertion" times and "scope removal to transfer" times were significantly less in the Epic group compared to the paper group. Use of Epic system led to a saving of 4 min of procedure time per patient. However, the mean oxygen saturation was significantly less in the Epic group. In spite of perceived advantages of Epic documentation system, significant hurdles remain with its use. Although the system allows seamless flow of patients, failure to remove all artifacts can lead to errors and become a source of potential litigation hazard.

Improving on-time surgical starts: the impact of implementing pre-OR timeouts and performance pay.

PubMed

Martin, Luke; Langell, John

2017-11-01

Operating room (OR) time is expensive. Underutilized OR time negatively impacts efficiency and is an unnecessary cost for hospitals. The purpose of this study was to evaluate the impact of a pre-OR timeout and performance pay incentive on the frequency of on-time, first surgical starts. At a single Veterans Affairs Medical Center, we implemented a pre-OR timeout in the form of a safety-briefing checklist and a modest performance pay incentive for on-time starts (>90% compliance) for attending surgeons. Data were collected on all first-start cases beginning before implementation in 2008 and continued through 2015. Each year, an average of 960 first starts occurred across nine surgical divisions. Before implementation of either the timeout or pay incentive, only 15% of cases started on time, and by 2015, greater than 72% were on time (P < 0.001). Over the study period, there were significant improvements in on-time starts (P = 0.01), of delays <15 min (P = 0.01), and of delays 16 to 30 min (P = 0.04). The trends for delays of 31 to 60 min or >60 min were not significant (P = 0.31; P = 0.81). Assuming a loss of 7 min per case for delays <15 min and 20 min per case for delays of 16 to 30 min, the total OR time saved from implementing these measures was 37,556 min. At an estimated cost of $20/min, gross savings from this project were $751,120. Implementation of a pre-OR timeout and performance pay for on-time starts significantly improves OR utilization and reduces unnecessary costs. Published by Elsevier Inc.

Efficient Kill-Save Ratios Ease Up the Cognitive Demands on Counterintuitive Moral Utilitarianism.

PubMed

Trémolière, Bastien; Bonnefon, Jean-François

2014-07-01

The dual-process model of moral judgment postulates that utilitarian responses to moral dilemmas (e.g., accepting to kill one to save five) are demanding of cognitive resources. Here we show that utilitarian responses can become effortless, even when they involve to kill someone, as long as the kill-save ratio is efficient (e.g., 1 is killed to save 500). In Experiment 1, participants responded to moral dilemmas featuring different kill-save ratios under high or low cognitive load. In Experiments 2 and 3, participants responded at their own pace or under time pressure. Efficient kill-save ratios promoted utilitarian responding and neutered the effect of load or time pressure. We discuss whether this effect is more easily explained by a parallel-activation model or by a default-interventionist model. © 2014 by the Society for Personality and Social Psychology, Inc.

31 CFR 351.6 - When may I redeem my Series EE savings bond?

Code of Federal Regulations, 2014 CFR

2014-07-01

... before January 1, 2003. You may redeem your Series EE savings bond at any time beginning six months after... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false When may I redeem my Series EE... SAVINGS BONDS, SERIES EE Maturities, Redemption Values, and Investment Yields of Series EE Savings Bonds...

31 CFR 351.6 - When may I redeem my Series EE savings bond?

Code of Federal Regulations, 2010 CFR

2010-07-01

... before January 1, 2003. You may redeem your Series EE savings bond at any time beginning six months after... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false When may I redeem my Series EE... SAVINGS BONDS, SERIES EE Maturities, Redemption Values, and Investment Yields of Series EE Savings Bonds...

Exploring efficacy of residential energy efficiency programs in Florida

NASA Astrophysics Data System (ADS)

Taylor, Nicholas Wade

Electric utilities, government agencies, and private interests in the U.S. have committed and continue to invest substantial resources in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. Program investments, and the demand for impact evaluations that accompany them, are projected to grow in coming years due to increased pressure from state-level energy regulation, costs and challenges of building additional production capacity, fuel costs and potential carbon or renewable energy regulation. This dissertation provides detailed analyses of ex-post energy savings from energy efficiency programs in three key sectors of residential buildings: new, single-family, detached homes; retrofits to existing single-family, detached homes; and retrofits to existing multifamily housing units. Each of the energy efficiency programs analyzed resulted in statistically significant energy savings at the full program group level, yet savings for individual participants and participant subgroups were highly variable. Even though savings estimates were statistically greater than zero, those energy savings did not always meet expectations. Results also show that high variability in energy savings among participant groups or subgroups can negatively impact overall program performance and can undermine marketing efforts for future participation. Design, implementation, and continued support of conservation programs based solely on deemed or projected savings is inherently counter to the pursuit of meaningful energy conservation and reductions in greenhouse gas emissions. To fully understand and optimize program impacts, consistent and robust measurement and verification protocols must be instituted in the design phase and maintained over time. Furthermore, marketing for program participation must target those who have the greatest opportunity for savings. In most utility territories it is not possible to gain access to the type of large scale datasets that would facilitate robust program analysis. Along with measuring and optimizing energy conservation programs, utilities should provide public access to historical consumption data. Open access to data, program optimization, consistent measurement and verification and transparency in reported savings are essential to reducing energy use and its associated environmental impacts.

Disposable laparoscopic surgical instruments and the economic effects of repackaging.

PubMed

Takeuchi, Hiroyuki; Kikuchi, Iwaho; Kitade, Mari; Kumakiri, Jun; Kinoshita, Katsuyuki; Takehiro, Yuka; Tanimura, Emiko

2005-04-01

The purpose of this study was to evaluate the economic effects of repackaging disposable laparoscopic surgical instruments. We repacked a total of 28 disposable instruments for gynecologic laparoscopic surgery into one package. The time of preparation of surgical instruments, the amount of medical waste, and other economic effects were compared before and after the repackaging of disposable instruments. The time required for the preparation of surgical instruments was shortened by 22 minutes per operation, and medical waste decreased by 400 g, by repackaging the instruments, resulting in an estimated direct economic saving of $10,000 per year. Indirect economic effects might include savings due to a reduced inventory of surgical instruments and simplified cost-accounting for each operation. It is likely that preparation for surgery can be significantly improved and the cost reduced by repackaging the laparoscopic surgical instruments.

Pipeline active filter utilizing a booth type multiplier

NASA Technical Reports Server (NTRS)

Nathan, Robert (Inventor)

1987-01-01

Multiplier units of the modified Booth decoder and carry-save adder/full adder combination are used to implement a pipeline active filter wherein pixel data is processed sequentially, and each pixel need only be accessed once and multiplied by a predetermined number of weights simultaneously, one multiplier unit for each weight. Each multiplier unit uses only one row of carry-save adders, and the results are shifted to less significant multiplier positions and one row of full adders to add the carry to the sum in order to provide the correct binary number for the product Wp. The full adder is also used to add this product Wp to the sum of products .SIGMA.Wp from preceding multiply units. If m.times.m multiplier units are pipelined, the system would be capable of processing a kernel array of m.times.m weighting factors.

47 CFR 73.99 - Presunrise service authorization (PSRA) and postsunset service authorization (PSSA).

Code of Federal Regulations, 2013 CFR

2013-10-01

... authorization. (c) Extended Daylight Saving Time Pre-Sunrise Authorizations: (1) Between the first Sunday in... presunrise operations during extended daylight saving time and shall issue conforming authorizations. These...

47 CFR 73.99 - Presunrise service authorization (PSRA) and postsunset service authorization (PSSA).

Code of Federal Regulations, 2011 CFR

2011-10-01

... authorization. (c) Extended Daylight Saving Time Pre-Sunrise Authorizations: (1) Between the first Sunday in... presunrise operations during extended daylight saving time and shall issue conforming authorizations. These...

Spaceborne GPS: Current Status and Future Visions

NASA Technical Reports Server (NTRS)

Bauer, Frank H.; Hartman, Kate; Lightsey, E. Glenn

1998-01-01

The Global Positioning System (GPS), developed by the Department of Defense is quickly revolutionizing the architecture of future spacecraft and spacecraft systems. Significant savings in spacecraft life cycle cost, in power, and in mass can be realized by exploiting GPS technology in spaceborne vehicles. These savings are realized because GPS is a systems sensor--it combines the ability to sense space vehicle trajectory, attitude, time, and relative ranging between vehicles into one package. As a result, a reduced spacecraft sensor complement can be employed and significant reductions in space vehicle operations cost can be realized through enhanced on-board autonomy. This paper provides an overview of the current status of spaceborne GPS, a description of spaceborne GPS receivers available now and in the near future, a description of the 1997-2000 GPS flight experiments, and the spaceborne GPS team's vision for the future.

Accident rates and the impact of daylight saving time transitions.

PubMed

Robb, David; Barnes, Thomas

2018-02-01

One-third of nations have adopted some form of Daylight Saving Time (DST). Associated costs and benefits include impacts on accident rates. Using data from 12.6 million accident claims in New Zealand during 2005-2016, we model accident rates as a function of various date-based predictors including days before/after the start and end of DST, holidays, day of week, and month of year. This is the first study to consider multiple accident categories (Road, Work, Falls and Home & Community), and the first in the southern hemisphere. The start of DST is associated with significantly higher rates of road accidents (first day +16% and second day +12%). Evidence that accident rates for Falls and Home & Community decline (increase) prior to the start (end) of DST suggest potential behavioural adaption from anticipating the change. While Work accidents show limited impact from DST changes, they exhibit a significant decline over the course of the week (Friday 13% lower than Monday), whereas Road accidents exhibit a significant increase (Friday 19% higher than Monday). Our results have implications for both DST implementation and policy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of implant cost and surgical time in arthroscopic transosseous and transosseous equivalent rotator cuff repair.

PubMed

Black, Eric M; Austin, Luke S; Narzikul, Alexa; Seidl, Adam J; Martens, Kelly; Lazarus, Mark D

2016-09-01

We investigated the cost savings associated with arthroscopic transosseous (anchorless) double-row rotator cuff repair compared with double-row anchored (transosseous-equivalent [TOE]) repair. All patients undergoing double-row arthroscopic rotator cuff repair from 2009 to 2012 by a single surgeon were eligible for inclusion. The study included 2 consecutive series of patients undergoing anchorless or TOE repair. Excluded from the study were revision repairs, subscapularis repairs, patients with poor tendon quality or excursion requiring medialized repair, and partial repairs. Rotator cuff implant costs (paid by the institution) and surgical times were compared between the 2 groups, controlling for rotator cuff tear size and additional procedures performed. The study included 344 patients, 178 with TOE repairs and 166 with anchorless repairs. Average implant cost for TOE repairs was $1014.10 ($813.00 for small, $946.67 for medium, $1104.56 for large, and $1507.29 for massive tears). This was significantly more expensive compared with anchorless repairs, which averaged $678.05 ($659.75 for small, $671.39 for medium, $695.55 for large, and $716.00 for massive tears). Average total operative time in TOE and anchorless groups was not significantly different (99 vs. 98 minutes). There was larger (although not statistically significant) case time variation in the TOE group. Compared with TOE repair, anchorless rotator cuff repair provides substantial implant-related cost savings, with no significant differences in surgical time for medium and large rotator cuff tears. Case time for TOE repair varied more with extremes in tear size. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Reducing Operating Costs and Energy Consumption at Water Utilities

EPA Pesticide Factsheets

Due to their unique combination of high energy usage and potential for significant savings, utilities are turning to energy-efficient technologies to help save money. Learn about cost and energy saving technologies from this brochure.

Travelers’ Value of Time and Reliability as Measured on Katy Freeway : Final Report.

DOT National Transportation Integrated Search

2016-09-01

The value of travel time savings (VOT) is an estimate of what travelers would be willing to pay in order to save time on a particular trip. If travelers would pay $1 to reduce their travel time by six minutes, then they have a VOT of $10 per hour. VO...

Reagent and labor cost optimization through automation of fluorescence in situ hybridization (FISH) with the VP 2000: an Italian case study.

PubMed

Zanatta, Lucia; Valori, Laura; Cappelletto, Eleonora; Pozzebon, Maria Elena; Pavan, Elisabetta; Dei Tos, Angelo Paolo; Merkle, Dennis

2015-02-01

In the modern molecular diagnostic laboratory, cost considerations are of paramount importance. Automation of complex molecular assays not only allows a laboratory to accommodate higher test volumes and throughput but also has a considerable impact on the cost of testing from the perspective of reagent costs, as well as hands-on time for skilled laboratory personnel. The following study tracked the cost of labor (hands-on time) and reagents for fluorescence in situ hybridization (FISH) testing in a routine, high-volume pathology and cytogenetics laboratory in Treviso, Italy, over a 2-y period (2011-2013). The laboratory automated FISH testing with the VP 2000 Processor, a deparaffinization, pretreatment, and special staining instrument produced by Abbott Molecular, and compared hands-on time and reagent costs to manual FISH testing. The results indicated significant cost and time saving when automating FISH with VP 2000 when more than six FISH tests were run per week. At 12 FISH assays per week, an approximate total cost reduction of 55% was observed. When running 46 FISH specimens per week, the cost saving increased to 89% versus manual testing. The results demonstrate that the VP 2000 processor can significantly reduce the cost of FISH testing in diagnostic laboratories. © 2014 Society for Laboratory Automation and Screening.

Directions for lunar construction - A derivation of requirements from a construction scenario analysis

NASA Technical Reports Server (NTRS)

Dias, William S.; Matijevic, Jacob R.; Venkataraman, Subramani T.; Smith, Jeffrey H.; Lindemann, Randel A.; Levin, Richard R.

1992-01-01

This paper provides an initial trade-off study among several lunar construction options available to the Space Exploration Initiative. The relative time effectiveness of Extra-Vehicular Activity (EVA), Intra-Vehicular Activity (IVA), and Earth-based remote control assembly and construction methods are studied. Also considered is whether there is any construction time savings to building roads in advance, or surveying the construction sites with orbiters or rovers in advance. The study was conducted by adding detail to a potentially real scenario - a nuclear power plant - and applying time multipliers for the various control options and terrain alternatives, provided by roboticists among the authors. The authors conclude that IVA is a faster construction method than either EVA or construction conducted remotely from Earth. Surveying proposed sites in advance, with orbiters and rovers, provides a significant time savings through adding to certainty, and therefore may be cost effective. Developing a heavy-lift launch capability and minimizing assembly and construction processes by landing large payloads is probably worthwhile to the degree possible, as construction activities would use a large amount of surface operations time.

A mobile asset sharing policy for hospitals with real time locating systems.

PubMed

Demircan-Yıldız, Ece Arzu; Fescioglu-Unver, Nilgun

2016-01-01

Each year, hospitals lose a considerable amount of time and money due to misplaced mobile assets. In addition the assets which remain in departments that frequently use them depreciate early, while other assets of the same type in different departments are rarely used. A real time locating system can prevent these losses when used with appropriate asset sharing policies. This research quantifies the amount of time a medium size hospital saves by using real time locating system and proposes an asset selection rule to eliminate the asset usage imbalance problem. The asset selection rule proposed is based on multi objective optimization techniques. The effectiveness of this rule on asset to patient time and asset utilization rate variance performance measures were tested using discrete event simulation method. Results show that the proposed asset selection rule improved the usage balance significantly. Sensitivity analysis showed that the proposed rule is robust to changes in demand rates and user preferences. Real time locating systems enable saving considerable amount of time in hospitals, and they can still be improved by integrating decision support mechanisms. Combining tracking technology and asset selection rules helps improve healthcare services.

A new perspective on life-saving procedures in a battlefield setting: Emergency cricothyroidotomy, needle thoracostomy, and chest tube thoracostomy with night vision goggles.

PubMed

Bilge, Sedat; Aydın, Attila; Bilge, Meltem; Aydın, Cemile; Çevik, Erdem; Eryılmaz, Mehmet

2017-11-01

In the patients with multiple and serious trauma, early applications of life-saving procedures are related to improved survival. We tried to experimentally determine the feasibility of life-saving interventions that are performed with the aid of night vision goggles (NVG) in nighttime combat scenario. Chest tube thoracostomy (CTT), emergency cricothyroidotomy (EC), and needle thoracostomy (NT) interventions were performed by 10 combatant medical staff. The success and duration of interventions were explored in the study. Procedures were performed on the formerly prepared manikins/models in a bright room and in a dark room with the aid of NVG. Operators graded the ease of interventions. All interventions were found successful. Operators stated that both CTT and EC interventions were more difficult in dark than in daytime (p<0.05). No significant difference was observed in the difficulty in the NT interventions. No significant difference was observed in terms of completion times of interventions between in daytime and in dark scenario. The operators who use NVGs have to be aware of that they can perform their tactic and medical activities without taking off the NVGs and without the requirement of an extra light source.

Hybrid Power Management for Office Equipment

NASA Astrophysics Data System (ADS)

Gingade, Ganesh P.

Office machines (such as printers, scanners, fax, and copiers) can consume significant amounts of power. Few studies have been devoted to power management of office equipment. Most office machines have sleep modes to save power. Power management of these machines are usually timeout-based: a machine sleeps after being idle long enough. Setting the timeout duration can be difficult: if it is too long, the machine wastes power during idleness. If it is too short, the machine sleeps too soon and too often--the wakeup delay can significantly degrade productivity. Thus, power management is a tradeoff between saving energy and keeping short response time. Many power management policies have been published and one policy may outperform another in some scenarios. There is no definite conclusion which policy is always better. This thesis describes two methods for office equipment power management. The first method adaptively reduces power based on a constraint of the wakeup delay. The second method is a hybrid with multiple candidate policies and it selects the most appropriate power management policy. Using six months of request traces from 18 different offices, we demonstrate that the hybrid policy outperforms individual policies. We also discover that power management based on business hours does not produce consistent energy savings.

Reducing airflow energy use in multiple zone vav systems

NASA Astrophysics Data System (ADS)

Tukur, Ahmed Gidado

Variable Air Volume (VAV) systems are the most popular HVAC systems in commercial buildings. VAV systems are designed to deliver airflows at design conditions which only occur for a few hours in a year. Minimizing energy use in VAV systems requires reducing the amount of airflow delivered through the system at part load conditions. Air Handling Unit (AHU) fans are the major drivers of airflow in VAV systems and installing a Variable Frequency Drive (VFD) is the most common method of regulating airflow in VAV systems. A VFD drive does not necessarily save energy without use of an appropriate control strategy. Static pressure reset (SPR) is considered to be the most energy efficient control strategy for AHU fans with VFDs installed. The implementation of SPR however has many challenges; for example, rogue zones--zones which have faulty sensors or failed controls and actuators, system dynamics like hunting and system diversity. By investigating the parameters associated with the implementation of SPR in VAV systems, a new, improved, more stable SPR algorithm was developed and validated. This approach was further improved using Fault Detection and Diagnostics (FDD) to eliminate rogue zones. Additionally, a CO2-Demand Control Ventilation (DCV) based minimum airflow control was used to further reduce ventilation airflow and save more energy from SPR. Energy savings ranging from 25% to 51% were recorded in actual buildings with the new SPR algorithm. Finally, a methodology that utilizes historical VAV data was developed to estimate the potential savings that could be realized using SPR. The approach employed first determines an effective system loss coefficient as a function of mean damper position using the historical duct static pressure, VAV damper positions and airflows. Additionally, the historical data is used to identify the maximum mean duct damper position realizable as a result of insuring a sufficient number of VAVs are fully open at any time. Savings are estimated by shifting the damper distribution mean at each time to this maximum value and reducing the static pressure to achieve the same overall system airflow rate. The methodology was tested on three different buildings with varying system characteristics. Savings estimates correlated well to the savings actually realized from SPR. This result has significant implications for energy service providers, who could use the predictions to guarantee savings from SPR.

Daylight Savings Time Transitions and the Incidence Rate of Unipolar Depressive Episodes.

PubMed

Hansen, Bertel T; Sønderskov, Kim M; Hageman, Ida; Dinesen, Peter T; Østergaard, Søren D

2017-05-01

Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate of depressive episodes. This seems likely because daylight savings time transitions affect circadian rhythms, which are implicated in the etiology of depressive disorder. Therefore, we investigated the effects of daylight savings time transitions on the incidence rate of unipolar depressive episodes. Using time series intervention analysis of nationwide data from the Danish Psychiatric Central Research Register from 1995 to 2012, we compared the observed trend in the incidence rate of hospital contacts for unipolar depressive episodes after the transitions to and from summer time to the predicted trend in the incidence rate. The analyses were based on 185,419 hospital contacts for unipolar depression and showed that the transition from summer time to standard time were associated with an 11% increase (95% CI = 7%, 15%) in the incidence rate of unipolar depressive episodes that dissipated over approximately 10 weeks. The transition from standard time to summer time was not associated with a parallel change in the incidence rate of unipolar depressive episodes. This study shows that the transition from summer time to standard time was associated with an increase in the incidence rate of unipolar depressive episodes. Distress associated with the sudden advancement of sunset, marking the coming of a long period of short days, may explain this finding. See video abstract at, http://links.lww.com/EDE/B179.

Insights from Smart Meters: Identifying Specific Actions, Behaviors, and Characteristics That Drive Savings in Behavior-Based Programs

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

Todd, A.; Perry, M.; Smith, B.

2014-12-01

In this report, we use smart meter data to analyze specific actions, behaviors, and characteristics that drive energy savings in a BB program. Specifically, we examine a Home Energy Report (HER) program. These programs typically obtain 1% to 3% annual savings, and recent studies have shown hourly savings of between 0.5% and 3%.1 But what is driving these savings? What types of households tend to be “high-savers,” and what behaviors are they adopting? There are several possibilities: one-time behaviors (e.g., changing thermostat settings), reoccurring habitual behaviors (e.g., turning off lights), and equipment purchase behaviors (e.g., energy efficient appliances); these maymore » vary across households, regions, and over time.« less

Insights from Smart Meters. Identifying Specific Actions, Behaviors and Characteristics that drive savings in Behavior-Based Programs

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

Todd, Annika; Perry, Michael; Smith, Brian

2014-12-01

In this report, we use smart meter data to analyze specific actions, behaviors, and characteristics that drive energy savings in a behavior-based (BB) program. Specifically, we examine a Home Energy Report (HER) program. These programs typically obtain 1% to 3% annual savings, and recent studies have shown hourly savings of between 0.5% and 3%. But what is driving these savings? What types of households tend to be “high-savers”, and what behaviors are they adopting? There are several possibilities: one-time behaviors (e.g., changing thermostat settings); reoccurring habitual behaviors (e.g., turning off lights); and equipment purchase behaviors (e.g., energy efficient appliances), andmore » these may vary across households, regions, and over time.« less

The Impact of Diabetes on the Labour Force Participation, Savings and Retirement Income of Workers Aged 45-64 Years in Australia

PubMed Central

Schofield, Deborah; Cunich, Michelle; Kelly, Simon; Passey, Megan E.; Shrestha, Rupendra; Callander, Emily; Tanton, Robert; Veerman, Lennert

2015-01-01

Background Diabetes is a debilitating and costly condition. The costs of reduced labour force participation due to diabetes can have severe economic impacts on individuals by reducing their living standards during working and retirement years. Methods A purpose-built microsimulation model of Australians aged 45-64 years in 2010, Health&WealthMOD2030, was used to estimate the lost savings at age 65 due to premature exit from the labour force because of diabetes. Regression models were used to examine the differences between the projected savings and retirement incomes of people at age 65 for those currently working full or part time with no chronic health condition, full or part time with diabetes, and people not in the labour force due to diabetes. Results All Australians aged 45-65 years who are employed full time in 2010 will have accumulated some savings at age 65; whereas only 90.5% of those who are out of the labour force due to diabetes will have done so. By the time they reach age 65, those who retire from the labour force early due to diabetes have a median projected savings of less than $35,000. This is far lower than the median value of total savings for those who remained in the labour force full time with no chronic condition, projected to have $638,000 at age 65. Conclusions Not only does premature retirement due to diabetes limit the immediate income available to individuals with this condition, but it also reduces their long-term financial capacity by reducing their accumulated savings and the income these savings could generate in retirement. Policies designed to support the labour force participation of those with diabetes, or interventions to prevent the onset of the disease itself, should be a priority to preserve living standards comparable with others who do not suffer from this condition. PMID:25706941

A New Method to Directly Observe Tuberculosis Treatment: Skype Observed Therapy, a Patient-Centered Approach.

PubMed

Buchman, Tavora; Cabello, Celina

Tuberculosis (TB) treatment completion is in part determined by patient's adherence to long-term drug regimens. To best ensure compliance, directly observed therapy (DOT) is considered the standard of practice. Nassau County Department of Health TB Control is responsible for providing DOT to patients with TB. Tuberculosis Control sought to use and evaluate Skype Observed Therapy (SOT) as an alternative to DOT for eligible patients. The evaluation included analysis of patient's acceptance and adherence to drug regimen using SOT. Tuberculosis Control assessed staff efficiency and cost savings for this program. Percentages of SOT of patients and successful SOT visits, mileage, and travel time savings. Twenty percent of the caseload used SOT and 100% of patients who were eligible opted in. Average SOT success was 79%. Total mileage savings and time saved were $9,929.07 and 614 hours. Because SOT saves cost and time and is a suitable alternative to DOT for patients, it should be considered as part of new policies and practices in TB control programs.

White Nail Radio Transmitter: Billion Dollar Savings through Energy Efficiency

DTIC Science & Technology

2011-05-10

increase efficiency and reduce overall energy consumption ashore by 50 percent CNO, Navy Energy Vision, P 10 White Nail Vision Your Cell Phone Cell...Estimated Total Number of transmitters 3,000,000 Estimated total power saved Watt 1,250,000,000 Cell Phone Transmitter Efficiency 1.25 Gigawatts saved...Greenhouse Gas Power 4 1 Energy Navy Use 7.3 Billion kWh White Nail Cell Phone Savings 11 Billion kWh One and a half times!!! Saves the output of four of

41 CFR 109-6.400 - Scope and applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... scheduled to depart before the beginning of regular working hours, or if there will be a significant savings in time, a Government motor vehicle may be issued at the close of the preceding working day. Similarly, when scheduled to return after the close of working hours, the motor vehicle may be returned the...

Significance of a Behavioral Economic Index of Reward Value in Predicting Drinking Problem Resolution

ERIC Educational Resources Information Center

Tucker, Jalie A.; Vuchinich, Rudy E.; Black, Bethany C.; Rippens, Paula D.

2006-01-01

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to…

14 CFR § 1204.1600 - Issuance of motor vehicle for home-to-work.

Code of Federal Regulations, 2014 CFR

2014-01-01

... temporary duty travel is authorized to travel by Government motor vehicle and the official authorizing the travel determines that there will be a significant savings in time, a Government motor vehicle may be... ADMINISTRATION ADMINISTRATIVE AUTHORITY AND POLICY Temporary Duty Travel-Issuance of Motor Vehicle for Home-to...

14 CFR 1204.1600 - Issuance of motor vehicle for home-to-work.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ADMINISTRATIVE AUTHORITY AND POLICY Temporary Duty Travel-Issuance of Motor Vehicle for Home-to-Work... travel is authorized to travel by Government motor vehicle and the official authorizing the travel determines that there will be a significant savings in time, a Government motor vehicle may be issued at the...

14 CFR 1204.1600 - Issuance of motor vehicle for home-to-work.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ADMINISTRATIVE AUTHORITY AND POLICY Temporary Duty Travel-Issuance of Motor Vehicle for Home-to-Work... travel is authorized to travel by Government motor vehicle and the official authorizing the travel determines that there will be a significant savings in time, a Government motor vehicle may be issued at the...

14 CFR 1204.1600 - Issuance of motor vehicle for home-to-work.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ADMINISTRATIVE AUTHORITY AND POLICY Temporary Duty Travel-Issuance of Motor Vehicle for Home-to-Work... travel is authorized to travel by Government motor vehicle and the official authorizing the travel determines that there will be a significant savings in time, a Government motor vehicle may be issued at the...

14 CFR 1204.1600 - Issuance of motor vehicle for home-to-work.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ADMINISTRATIVE AUTHORITY AND POLICY Temporary Duty Travel-Issuance of Motor Vehicle for Home-to-Work... travel is authorized to travel by Government motor vehicle and the official authorizing the travel determines that there will be a significant savings in time, a Government motor vehicle may be issued at the...

Electronic Survey Administration: Assessment in the Twenty-First Century

ERIC Educational Resources Information Center

Olsen, Danny R.; Wygant, Steven A.; Brown, Bruce L.

2004-01-01

Recent advances in electronic data collection have opened broad new possibilities for educational assessment. Potentially significant savings in time, money, and effort make Web-based and e-mail-based surveys more and more attractive as alternatives to mail surveys and face-to-face interviews. Yet, as with any major change, questions and obstacles…

Semuloparin for prevention of venous thromboembolism after major orthopedic surgery: results from three randomized clinical trials, SAVE-HIP1, SAVE-HIP2 and SAVE-KNEE.

PubMed

Lassen, M R; Fisher, W; Mouret, P; Agnelli, G; George, D; Kakkar, A; Mismetti, P; Turpie, A G G

2012-05-01

Semuloparin is a novel ultra-low-molecular-weight heparin under development for venous thromboembolism (VTE) prevention in patients at increased risk, such as surgical and cancer patients. Three Phase III studies compared semuloparin and enoxaparin after major orthopedic surgery: elective knee replacement (SAVE-KNEE), elective hip replacement (SAVE-HIP1) and hip fracture surgery (SAVE-HIP2). All studies were multinational, randomized and double-blind. Semuloparin and enoxaparin were administered for 7-10 days after surgery. Mandatory bilateral venography was to be performed between days 7 and 11. The primary efficacy endpoint was a composite of any deep vein thrombosis, non-fatal pulmonary embolism or all-cause death. Safety outcomes included major bleeding, clinically relevant non-major (CRNM) bleeding, and any clinically relevant bleeding (major bleeding plus CRNM). In total, 1150, 2326 and 1003 patients were randomized in SAVE-KNEE, SAVE-HIP1 and SAVE-HIP2, respectively. In all studies, the incidences of the primary efficacy endpoint were numerically lower in the semuloparin group vs. the enoxaparin group, but the difference was statistically significant only in SAVE-HIP1. In SAVE-HIP1, clinically relevant bleeding and major bleeding were significantly lower in the semuloparin vs. the enoxaparin group. In SAVE-KNEE and SAVE-HIP2, clinically relevant bleeding tended to be higher in the semuloparin group, but rates of major bleeding were similar in the two groups. Other safety parameters were generally similar between treatment groups. Semuloparin was superior to enoxaparin for VTE prevention after hip replacement surgery, but failed to demonstrate superiority after knee replacement surgery and hip fracture surgery. Semuloparin and enoxaparin exhibited generally similar safety profiles. © 2012 International Society on Thrombosis and Haemostasis.

Cost savings associated with the use of the Ho:YAG laser in knee arthroscopy: a comparative retrospective review of 140 conventional and laser-assisted procedures

NASA Astrophysics Data System (ADS)

Johnson, Michael D.

1994-09-01

The impact of using the 2.1 micrometers Ho:YAG laser in orthopaedic surgery has not been fully investigated, especially as to what affect it may have on an employee's return to work and normal activities. In this retrospective review of 140 patients who underwent arthroscopic surgery at our facility, there were found to be significant decreases in time on crutches and time off from work when laser-assisted knee arthroscopies were compared to procedures where conventional mechanical or motorized instruments were used. The patients who had laser-assisted knee arthroscopies discontinued use of crutches 5 days earlier than the conventional group and returned to work 10 days earlier than their counterparts who had undergone conventional arthroscopic surgery. The ability to return to work more quickly translates into significant cost savings for employers who otherwise would have to replace the worker with temporary help, pay overtime, or face lost productivity due to an employee's absence following arthroscopic knee surgery.

31 CFR 315.93 - Supplements, amendments, or revisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... SAVINGS BONDS, SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES Miscellaneous Provisions § 315.93 Supplements, amendments, or revisions. The Secretary of the Treasury may at any time, or from time to time, prescribe additional, supplemental, amendatory, or revised rules and regulations...

Energy Efficiency Improvement and Cost Saving Oportunities for the Concrete Industry

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

Kermeli, Katerina; Worrell, Ernst; Masanet, Eric

2011-12-01

The U.S. concrete industry is the main consumer of U.S.-produced cement. The manufacturing of ready mixed concrete accounts for more than 75% of the U.S. concrete production following the manufacturing of precast concrete and masonry units. The most significant expenditure is the cost of materials accounting for more than 50% of total concrete production costs - cement only accounts for nearly 24%. In 2009, energy costs of the U.S. concrete industry were over $610 million. Hence, energy efficiency improvements along with efficient use of materials without negatively affecting product quality and yield, especially in times of increased fuel and materialmore » costs, can significantly reduce production costs and increase competitiveness. The Energy Guide starts with an overview of the U.S. concrete industry’s structure and energy use, a description of the various manufacturing processes, and identification of the major energy consuming areas in the different industry segments. This is followed by a description of general and process related energy- and cost-efficiency measures applicable to the concrete industry. Specific energy and cost savings and a typical payback period are included based on literature and case studies, when available. The Energy Guide intends to provide information on cost reduction opportunities to energy and plant managers in the U.S. concrete industry. Every cost saving opportunity should be assessed carefully prior to implementation in individual plants, as the economics and the potential energy and material savings may differ.« less

17 CFR 240.0-2 - Business hours of the Commission.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Eastern Daylight Saving Time, whichever currently is in effect in Washington, DC, provided that hours for... 8 a.m. to 10 p.m., Eastern Standard Time or Eastern Daylight Saving Time, whichever is currently in... Saturdays, Sundays and federal holidays, from 8 a.m. to 5:30 p.m., Eastern Standard Time or Eastern Daylight...

17 CFR 240.0-2 - Business hours of the Commission.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Eastern Daylight Saving Time, whichever currently is in effect in Washington, DC, provided that hours for... 8 a.m. to 10 p.m., Eastern Standard Time or Eastern Daylight Saving Time, whichever is currently in... Saturdays, Sundays and federal holidays, from 8 a.m. to 5:30 p.m., Eastern Standard Time or Eastern Daylight...

The paper crisis: from hospitals to medical practices.

PubMed

Park, Gregory; Neaveill, Rodney S

2009-01-01

Hospitals, not unlike physician practices, are faced with an increasing burden of managing piles of hard copy documents including insurance forms, requests for information, and advance directives. Healthcare organizations are moving to transform paper-based forms and documents into digitized files in order to save time and money and to have those documents available at a moment's notice. The cost of these document management/imaging systems can be easily justified with the significant savings of resources realized from the implementation of these systems. This article illustrates the enormity of the "paper problem" in healthcare and outlines just a few of the required processes that could be improved with the use of automated document management/imaging systems.

The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children.

PubMed

Brown, Vicki; Ananthapavan, Jaithri; Veerman, Lennert; Sacks, Gary; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marjory

2018-05-15

Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M⁻AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m²). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372⁻25,155); total cost-savings AUD126.3M (95% UI AUD58.7M⁻196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812⁻15,679); total cost-savings AUD90.9M (95% UI AUD44.3M⁻136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP.

The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children

PubMed Central

Veerman, Lennert; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marjory

2018-01-01

Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M–AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m2). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372–25,155); total cost-savings AUD126.3M (95% UI AUD58.7M–196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812–15,679); total cost-savings AUD90.9M (95% UI AUD44.3M–136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP. PMID:29762517

Attitudes towards and perceptions of eco-driving and the role of feedback systems.

PubMed

Harvey, Joan; Thorpe, Neil; Fairchild, Richard

2013-01-01

This paper addresses whether eco-driving may be encouraged by providing drivers with feedback, and how eco-driving attitudes fit with other environmental attitudes. Eight focus groups, including fleet drivers, discussed how feedback and other motives might affect driving behaviour. A survey of 350 respondents investigated attitudes towards saving fuel, the role of incentives and use of eco-friendly products. The focus groups' findings show that the environment is a lower priority than comfort and convenience, that feedback might provide a stimulus to eco-driving and that saving money was less important than saving time. The attitude survey showed that price, convenience, attitudes and eco-driving are not conceptually linked together, that convenience is rated as more important than saving money from fuel efficiency and that although the environment is of concern, it is not a high enough priority to increase fuel efficiency. The findings are discussed in relation to the low level of priority given to environmental concerns and the inability of financial incentives presenting significant challenges in terms of changing the subjective norms of the majority of drivers. This paper, using focus groups and a questionnaire, aims to understand how feedback devices, attitudes and motivation can improve eco-driving behaviours. The incentive to save money by better fuel economy was found to be insufficient, and roles for feedback devices and how information is presented are identified.

Reducing the length of postnatal hospital stay: implications for cost and quality of care.

PubMed

Bowers, John; Cheyne, Helen

2016-01-15

UK health services are under pressure to make cost savings while maintaining quality of care. Typically reducing the length of time patients stay in hospital and increasing bed occupancy are advocated to achieve service efficiency. Around 800,000 women give birth in the UK each year making maternity care a high volume, high cost service. Although average length of stay on the postnatal ward has fallen substantially over the years there is pressure to make still further reductions. This paper explores and discusses the possible cost savings of further reductions in length of stay, the consequences for postnatal services in the community, and the impact on quality of care. We draw on a range of pre-existing data sources including, national level routinely collected data, workforce planning data and data from national surveys of women's experience. Simulation and a financial model were used to estimate excess demand, work intensity and bed occupancy to explore the quantitative, organisational consequences of reducing the length of stay. These data are discussed in relation to findings of national surveys to draw inferences about potential impacts on cost and quality of care. Reducing the length of time women spend in hospital after birth implies that staff and bed numbers can be reduced. However, the cost savings may be reduced if quality and access to services are maintained. Admission and discharge procedures are relatively fixed and involve high cost, trained staff time. Furthermore, it is important to retain a sufficient bed contingency capacity to ensure a reasonable level of service. If quality of care is maintained, staffing and bed capacity cannot be simply reduced proportionately: reducing average length of stay on a typical postnatal ward by six hours or 17% would reduce costs by just 8%. This might still be a significant saving over a high volume service however, earlier discharge results in more women and babies with significant care needs at home. Quality and safety of care would also require corresponding increases in community based postnatal care. Simply reducing staffing in proportion to the length of stay increases the workload for each staff member resulting in poorer quality of care and increased staff stress. Many policy debates, such as that about the length of postnatal hospital-stay, demand consideration of multiple dimensions. This paper demonstrates how diverse data sources and techniques can be integrated to provide a more holistic analysis. Our study suggests that while earlier discharge from the postnatal ward may achievable, it may not generate all of the anticipated cost savings. Some useful savings may be realised but if staff and bed capacity are simply reduced in proportion to the length of stay, care quality may be compromised.

Cone penetrometer testing and discrete-depth ground water sampling techniques: A cost-effective method of site characterization in a multiple-aquifer setting

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

Zemo, D.A.; Pierce, Y.G.; Gallinatti, J.D.

Cone penetrometer testing (CPT), combined with discrete-depth ground water sampling methods, can significantly reduce the time and expense required to characterize large sites that have multiple aquifers. Results from the screening site characterization can then be used to design and install a cost-effective monitoring well network. At a site in northern California, it was necessary to characterize the stratigraphy and the distribution of volatile organic compounds (VOCs). To expedite characterization, a five-week field screening program was implemented that consisted of a shallow ground water survey, CPT soundings and pore-pressure measurements, and discrete-depth ground water sampling. Based on continuous lithologic informationmore » provided by the CPT soundings, four predominantly coarse-grained, water yielding stratigraphic packages were identified. Seventy-nine discrete-depth ground water samples were collected using either shallow ground water survey techniques, the BAT Enviroprobe, or the QED HydroPunch I, depending on subsurface conditions. Using results from these efforts, a 20-well monitoring network was designed and installed to monitor critical points within each stratigraphic package. Good correlation was found for hydraulic head and chemical results between discrete-depth screening data and monitoring well data. Understanding the vertical VOC distribution and concentrations produced substantial time and cost savings by minimizing the number of permanent monitoring wells and reducing the number of costly conductor casings that had to be installed. Additionally, significant long-term cost savings will result from reduced sampling costs, because fewer wells comprise the monitoring network. The authors estimate these savings to be 50% for site characterization costs, 65% for site characterization time, and 60% for long-term monitoring costs.« less

Estimating the Value of Life, Injury, and Travel Time Saved Using a Stated Preference Framework.

PubMed

Niroomand, Naghmeh; Jenkins, Glenn P

2016-06-01

The incidence of fatality over the period 2010-2014 from automobile accidents in North Cyprus is 2.75 times greater than the average for the EU. With the prospect of North Cyprus entering the EU, many investments will need to be undertaken to improve road safety in order to reach EU benchmarks. The objective of this study is to provide local estimates of the value of a statistical life and injury along with the value of time savings. These are among the parameter values needed for the evaluation of the change in the expected incidence of automotive accidents and time savings brought about by such projects. In this study we conducted a stated choice experiment to identify the preferences and tradeoffs of automobile drivers in North Cyprus for improved travel times, travel costs, and safety. The choice of route was examined using mixed logit models to obtain the marginal utilities associated with each attribute of the routes that consumers choose. These estimates were used to assess the individuals' willingness to pay (WTP) to avoid fatalities and injuries and to save travel time. We then used the results to obtain community-wide estimates of the value of a statistical life (VSL) saved, the value of injury (VI) prevented, and the value per hour of travel time saved. The estimates for the VSL range from €315,293 to €1,117,856 and the estimates of VI from € 5,603 to € 28,186. These values are consistent, after adjusting for differences in incomes, with the median results of similar studies done for EU countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy

PubMed Central

Borrero, Sonya; Zite, Nikki; Potter, Joseph E.; Trussell, James; Smith, Kenneth

2013-01-01

Objective Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly-funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. Study design We constructed a cost effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a post-partum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. Results With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. Conclusion A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies, and save a significant amount of public funds. Implication Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly-funded, post-partum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to a cost savings of $215 million each year. PMID:24028751

Saving can save from death anxiety: mortality salience and financial decision-making.

PubMed

Zaleskiewicz, Tomasz; Gasiorowska, Agata; Kesebir, Pelin

2013-01-01

Four studies tested the idea that saving money can buffer death anxiety and constitute a more effective buffer than spending money. Saving can relieve future-related anxiety and provide people with a sense of control over their fate, thereby rendering death thoughts less threatening. Study 1 found that participants primed with both saving and spending reported lower death fear than controls. Saving primes, however, were associated with significantly lower death fear than spending primes. Study 2 demonstrated that mortality primes increase the attractiveness of more frugal behaviors in save-or-spend dilemmas. Studies 3 and 4 found, in two different cultures (Polish and American), that the activation of death thoughts prompts people to allocate money to saving as opposed to spending. Overall, these studies provided evidence that saving protects from existential anxiety, and probably more so than spending.

Incorporating indirect costs into a cost-benefit analysis of laparoscopic adjustable gastric banding.

PubMed

Finkelstein, Eric A; Allaire, Benjamin T; Dibonaventura, Marco Dacosta; Burgess, Somali M

2012-01-01

The objective of this study was to estimate the time to breakeven and 5-year net costs of laparoscopic adjustable gastric banding (LAGB) taking both direct and indirect costs and cost savings into account. Estimates of direct cost savings from LAGB were available from the literature. Although longitudinal data on indirect cost savings were not available, these estimates were generated by quantifying the relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and combining these elasticity estimates with estimates of the direct cost savings to generate total savings. These savings were then combined with the direct and indirect costs of the procedure to quantify net savings. By including indirect costs, the time to breakeven was reduced by half a year, from 16 to 14 quarters. After 5 years, net savings in medical expenditures from a gastric banding procedure were estimated to be $4970 (±$3090). Including absenteeism increased savings to $6180 (±$3550). Savings were further increased to $10,960 (±$5864) when both absenteeism and presenteeism estimates were included. This study presented a novel approach for including absenteeism and presenteeism estimates in cost-benefit analyses. Application of the approach to gastric banding among surgery-eligible obese employees revealed that the inclusion of indirect costs and cost savings improves the business case for the procedure. This approach can easily be extended to other populations and treatments. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Time-saving and fail-safe dissection method for vestibulocochlear organs in gross anatomy classes.

PubMed

Suzuki, Ryoji; Konno, Naoaki; Ishizawa, Akimitsu; Kanatsu, Yoshinori; Funakoshi, Kodai; Akashi, Hideo; Zhou, Ming; Abe, Hiroshi

2017-09-01

Because the vestibulocochlear organs are tiny and complex, and are covered by the petrous part of the temporal bone, they are very difficult for medical students to dissect and visualize during gross anatomy classes. Here, we report a time-saving and fail-safe procedure we have devised, using a hand-held hobby router. Nine en bloc temporal bone samples from donated human cadavers were used as trial materials for devising an appropriate procedure for dissecting the vestibulocochlear organs. A hand-held hobby router was used to cut through the temporal bone. After trials, the most time-saving and fail-safe method was selected. The performance of the selected method was assessed by a survey of 242 sides of 121 cadavers during gross anatomy classes for vestibulocochlear dissection. The assessment was based on the observation ratio. The best procedure appeared to be removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof. The whole procedure was completed within two dissection classes, each lasting 4.5 hr. The ratio of surveillance for the chorda tympani and three semicircular canals by students was significantly improved during 2013 through 2016. In our dissection class, "removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof" was the best procedure for students in the limited time available. Clin. Anat. 30:703-710, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Cost analysis of nursing home registered nurse staffing times.

PubMed

Dorr, David A; Horn, Susan D; Smout, Randall J

2005-05-01

To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.

A Study on the Optimal Duration of Daylight Saving Time (DST) in Korea

NASA Astrophysics Data System (ADS)

Mihn, Byeong-Hee; Ahn, Young Sook; Kim, Dong-Bin; Yang, Hong-Jin

2009-09-01

Daylight saving time aims at spending effective daylight in summer season. Korea had enforced daylight saving time twelve times from 1948 to 1988. Since 1988, it is not executed, but it is recently discussed the resumption of DST. In this paper, we investigate the trend of DST in other countries, review the history of DST in Korea, and suggest the optimal DST duration in terms of astronomical aspects (times of sunrise and sunset). We find that the starting day of DST in Korea is apt for the second Sunday in May or the second Sunday in April according to the time of sunrise or to the difference between Korean standard meridian and observer's, respectively. We also discuss time friction that might be caused by time difference between DST and Korea Standard Time (KST).

Non-tables look-up search algorithm for efficient H.264/AVC context-based adaptive variable length coding decoding

NASA Astrophysics Data System (ADS)

Han, Yishi; Luo, Zhixiao; Wang, Jianhua; Min, Zhixuan; Qin, Xinyu; Sun, Yunlong

2014-09-01

In general, context-based adaptive variable length coding (CAVLC) decoding in H.264/AVC standard requires frequent access to the unstructured variable length coding tables (VLCTs) and significant memory accesses are consumed. Heavy memory accesses will cause high power consumption and time delays, which are serious problems for applications in portable multimedia devices. We propose a method for high-efficiency CAVLC decoding by using a program instead of all the VLCTs. The decoded codeword from VLCTs can be obtained without any table look-up and memory access. The experimental results show that the proposed algorithm achieves 100% memory access saving and 40% decoding time saving without degrading video quality. Additionally, the proposed algorithm shows a better performance compared with conventional CAVLC decoding, such as table look-up by sequential search, table look-up by binary search, Moon's method, and Kim's method.

Method and System For an Automated Tool for En Route Traffic Controllers

NASA Technical Reports Server (NTRS)

Erzberger, Heinz (Inventor); McNally, B. David (Inventor)

2001-01-01

A method and system for a new automation tool for en route air traffic controllers first finds all aircraft flying on inefficient routes, then determines whether it is possible to save time by bypassing some route segments, and finally whether the improved route is free of conflicts with other aircraft. The method displays all direct-to eligible aircraft to an air traffic controller in a list sorted by highest time savings. By allowing the air traffic controller to easily identify and work with the highest pay-off aircraft, the method of the present invention contributes to a significant increase in both air traffic controller and aircraft productivity. A graphical computer interface (GUI) is used to enable the air traffic controller to send the aircraft direct to a waypoint or fix closer to the destination airport by a simple point and click action.

Energy conservation in ad hoc multimedia networks using traffic-shaping mechanisms

NASA Astrophysics Data System (ADS)

Chandra, Surendar

2003-12-01

In this work, we explore network traffic shaping mechanisms that deliver packets at pre-determined intervals; allowing the network interface to transition to a lower power consuming sleep state. We focus our efforts on commodity devices, IEEE 802.11b ad hoc mode and popular streaming formats. We argue that factors such as the lack of scheduling clock phase synchronization among the participants and scheduling delays introduced by back ground tasks affect the potential energy savings. Increasing the periodic transmission delays to transmit data infrequently can offset some of these effects at the expense of flooding the wireless channel for longer periods of time; potentially increasing the time to acquire the channel for non-multimedia traffic. Buffering mechanisms built into media browsers can mitigate the effects of these added delays from being mis-interpreted as network congestion. We show that practical implementations of such traffic shaping mechanisms can offer significant energy savings.

Method and system for an automated tool for en route traffic controllers

NASA Technical Reports Server (NTRS)

Erzberger, Heinz (Inventor); McNally, B. David (Inventor)

2001-01-01

A method and system for a new automation tool for en route air traffic controllers first finds all aircraft flying on inefficient routes, then determines whether it is possible to save time by bypassing some route segments, and finally whether the improved route is free of conflicts with other aircraft. The method displays all direct-to eligible aircraft to an air traffic controller in a list sorted by highest time savings. By allowing the air traffic controller to easily identify and work with the highest pay-off aircraft, the method of the present invention contributes to a significant increase in both air traffic controller and aircraft productivity. A graphical computer interface (GUI) is used to enable the air traffic controller to send the aircraft direct to a waypoint or fix closer to the destination airport by a simple point and click action.

Calibrated energy simulations of potential energy savings in actual retail buildings

NASA Astrophysics Data System (ADS)

Alhafi, Zuhaira

Retail stores are commercial buildings with high energy consumption due to their typically large volumes and long hours of operation. This dissertation assesses heating, ventilating and air conditioning saving strategies based on energy simulations with input parameters from actual retail buildings. The dissertation hypothesis is that "Retail store buildings will save a significant amount of energy by (1) modifying ventilation rates, and/or (2) resetting set point temperatures. These strategies have shown to be beneficial in previous studies. As presented in the literature review, potential energy savings ranged from 0.5% to 30% without compromising indoor thermal comfort and indoor air quality. The retail store buildings can be ventilated at rates significantly lower than rates called for in the ASHRAE Standard 62.1-2010 while maintaining acceptable indoor air quality. Therefore, two dissertation objectives are addressed: (1) Investigate opportunities to reduce ventilation rates that do not compromise indoor air quality in retail stores located in Central Pennsylvania, (2) Investigate opportunities to increase (in summer) and decrease (in winter) set point temperatures that do not compromise thermal comfort. This study conducted experimental measurements of ventilation rates required to maintain acceptable air quality and indoor environmental conditions requirements for two retail stores using ASHRAE Standard 62.1_2012. More specifically, among other parameters, occupancy density, indoor and outdoor pollutant concentrations, and indoor temperatures were measured continuously for one week interval. One of these retail stores were tested four times for a yearlong time period. Pollutants monitored were formaldehyde, carbon dioxide, particle size distributions and concentrations, as well as total volatile organic compounds. As a part of the base protocol, the number of occupants in each store was hourly counted during the test, and the results reveal that the occupant densities were approximately 20% to 30% of that called by ASHRAE 62.1. Formaldehyde was the most important contaminant of concern in retail stores investigated. Both stores exceeded the most conservative health guideline for formaldehyde (OEHHA TWA REL = 7.3 ppb). This study found that source removal and reducing the emission rate, as demonstrated in retail stores sampled in this study, is a viable strategy to meet the health guideline. Total volatile compound were present in retail stores at low concentrations well below health guidelines suggested by Molhave (1700microg /m 2) and Bridges (1000 microg /m2). Based on these results and through mass--balance modeling, different ventilation rate reduction scenarios were proposed, and for these scenarios the differences in energy consumption were estimated. Findings of all phases of this desertion have contributed to understanding (a) the trade-off between energy savings and ventilation rates that do not compromise indoor air quality, and (b) the trade-off between energy savings and resets of indoor air temperature that do not compromise thermal comfort. Two models for retail stores were built and calibrated and validated against actual utility bills. Energy simulation results indicated that by lowering the ventilation rates from measured and minimum references would reduce natural gas energy use by estimated values of 6% to 19%. Also, this study found that the electrical cooling energy consumption was not significantly sensitive to different ventilation rates. However, increasing indoor air temperature by 3°C in summer had a significant effect on the energy savings. In winter, both energy savings strategies, ventilation reduction and decrease in set points, had a significant effect on natural gas consumption. Specially, when the indoor air temperature 21°C was decreased to 19.4°C with the same amount of ventilation rate of Molhaves guideline for both cases. Interestingly, the temperature of 23.8°C (75°F), which is the lowest value of ASHRAE 55 thermal comfort for sedentary people (cashiers) and the highest value for thermal comfort adjustments due to activity level (customers and workers) that are calculated by using empirical equation, was the optimum temperature for sedentary and active people in Retail store buildings.

Lineaments on Skylab photographs: Detection, mapping, and hydrologic significance in central Tennessee

NASA Technical Reports Server (NTRS)

Moore, G. K.

1976-01-01

An investigation was carried out to determine the feasibility of mapping lineaments on SKYLAB photographs of central Tennessee and to determine the hydrologic significance of these lineaments, particularly as concerns the occurrence and productivity of ground water. Sixty-nine percent more lineaments were found on SKYLAB photographs by stereo viewing than by projection viewing, but longer lineaments were detected by projection viewing. Most SKYLAB lineaments consisted of topographic depressions and they followed or paralleled the streams. The remainder were found by vegetation alinements and the straight sides of ridges. Test drilling showed that the median yield of wells located on SKYLAB lineaments were about six times the median yield of wells located by random drilling. The best single detection method, in terms of potential savings, was stereo viewing. Larger savings might be achieved by locating wells on lineaments detected by both stereo viewing and projection.

Spaceborne GPS Current Status and Future Visions

NASA Technical Reports Server (NTRS)

Bauer, Frank H.; Hartman, Kate; Lightsey, E. Glenn

1998-01-01

The Global Positioning System (GPS), developed by the Department of Defense, is quickly revolutionizing the architecture of future spacecraft and spacecraft systems. Significant savings in spacecraft life cycle cost, in power, and in mass can be realized by exploiting Global Positioning System (GPS) technology in spaceborne vehicles. These savings are realized because GPS is a systems sensor-it combines the ability to sense space vehicle trajectory, attitude, time, and relative ranging between vehicles into one package. As a result, a reduced spacecraft sensor complement can be employed on spacecraft and significant reductions in space vehicle operations cost can be realized through enhanced on- board autonomy. This paper provides an overview of the current status of spaceborne GPS, a description of spaceborne GPS receivers available now and in the near future, a description of the 1997-1999 GPS flight experiments and the spaceborne GPS team's vision for the future.

Defense.gov Special Report: The Virtual Worlds of DOD

Science.gov Websites

for training, research and a growing number of other activities to save money, time and lives. May 9 Defense Department will save money, time, and ultimately, lives, he said, and it's his job to make that

Pharmaceutical high profits: the value of R&D, or oligopolistic rents?

PubMed

Spitz, Janet; Wickham, Mark

2012-01-01

Pharmaceutical firms attribute high prices and high profits to costs associated with researching and developing the next generation of life-saving drugs. Using data from annual reports, this article tests the validity of this claim. We find that while pharmaceutical firms do invest in R&D, they also enjoy strong rents; between 1988 and 2009, pharmaceuticals enjoyed profits of 3 to 37 times the all-industry average, depending on the years, while investing proportionately less in R&D than other high-R&D firms. Costs of pharmaceutical drugs have successfully flown below the radar in much of the current health care debate, with producers managing to obstruct alternative sourcing as well as payment cuts. While health care is examined for savings in other areas, sustained high pharmaceutical profits suggest that as a new health care policy develops in the U.S., the pharmaceutical industry should not be excluded from examination for significant savings in health care costs.

An Audit of Repeat Testing at an Academic Medical Center: Consistency of Order Patterns With Recommendations and Potential Cost Savings.

PubMed

Hueth, Kyle D; Jackson, Brian R; Schmidt, Robert L

2018-05-31

To evaluate the prevalence of potentially unnecessary repeat testing (PURT) and the associated economic burden for an inpatient population at a large academic medical facility. We evaluated all inpatient test orders during 2016 for PURT by comparing the intertest times to published recommendations. Potential cost savings were estimated using the Centers for Medicare & Medicaid Services maximum allowable reimbursement rate. We evaluated result positivity as a determinant of PURT through logistic regression. Of the evaluated 4,242 repeated target tests, 1,849 (44%) were identified as PURT, representing an estimated cost-savings opportunity of $37,376. Collectively, the association of result positivity and PURT was statistically significant (relative risk, 1.2; 95% confidence interval, 1.1-1.3; P < .001). PURT contributes to unnecessary health care costs. We found that a small percentage of providers account for the majority of PURT, and PURT is positively associated with result positivity.

Single-Use Energy Sources and Operating Room Time for Laparoscopic Hysterectomy: A Randomized Controlled Trial.

PubMed

Holloran-Schwartz, M Brigid; Gavard, Jeffrey A; Martin, Jared C; Blaskiewicz, Robert J; Yeung, Patrick P

2016-01-01

To compare the intraoperative direct costs of a single-use energy device with reusable energy devices during laparoscopic hysterectomy. A randomized controlled trial (Canadian Task Force Classification I). An academic hospital. Forty-six women who underwent laparoscopic hysterectomy from March 2013 to September 2013. Each patient served as her own control. One side of the uterine attachments was desiccated and transected with the single-use device (Ligasure 5-mm Blunt Tip LF1537 with the Force Triad generator). The other side was desiccated and transected with reusable bipolar forceps (RoBi 5 mm), and transected with monopolar scissors using the same Covidien Force Triad generator. The instrument approach used was randomized to the attending physician who was always on the patient's left side. Resident physicians always operated on the patient's right side and used the converse instruments of the attending physician. Start time was recorded at the utero-ovarian pedicle and end time was recorded after transection of the uterine artery on the same side. Costs included the single-use device; amortized costs of the generator, reusable instruments, and cords; cleaning and packaging of reusable instruments; and disposal of the single-use device. Operating room time was $94.14/min. We estimated that our single use-device cost $630.14 and had a total time savings of 6.7 min per case, or 3.35 min per side, which could justify the expense of the device. The single-use energy device had significant median time savings (-4.7 min per side, p < .001) and total intraoperative direct cost savings ($254.16 per case). A single-use energy device that both desiccates and cuts significantly reduced operating room time to justify its own cost, and it also reduced total intraoperative direct costs during laparoscopic hysterectomy in our institution. Operating room cost per minute varies between institutions and must be considered before generalizing our results. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Clinical impact and value of workstation single sign-on.

PubMed

Gellert, George A; Crouch, John F; Gibson, Lynn A; Conklin, George S; Webster, S Luke; Gillean, John A

2017-05-01

CHRISTUS Health began implementation of computer workstation single sign-on (SSO) in 2015. SSO technology utilizes a badge reader placed at each workstation where clinicians swipe or "tap" their identification badges. To assess the impact of SSO implementation in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations. Following implementation of SSO, a total of 65,202 logins were sampled systematically during a 7day period among 2256 active clinical end users for time saved in 6 facilities when compared to pre-implementation. Dollar values were assigned to the time saved by 3 groups of clinical end users: physicians, nurses and ancillary service providers. The reduction of total clinician login time over the 7day period showed a net gain of 168.3h per week of clinician time - 28.1h (2.3 shifts) per facility per week. Annualized, 1461.2h of mixed physician and nursing time is liberated per facility per annum (121.8 shifts of 12h per year). The annual dollar cost savings of this reduction of time expended logging in is $92,146 per hospital per annum and $1,658,745 per annum in the first phase implementation of 18 hospitals. Computer hardware equipment savings due to desktop virtualization increases annual savings to $2,333,745. Qualitative value contributions to clinician satisfaction, reduction in staff turnover, facilitation of adoption of EHR applications, and other benefits of SSO are discussed. SSO had a positive impact on clinician efficiency and productivity in the 6 hospitals evaluated, and is an effective and cost-effective method to liberate clinician time from repetitive and time consuming logins to clinical software applications. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Saving Can Save from Death Anxiety: Mortality Salience and Financial Decision-Making

PubMed Central

Zaleskiewicz, Tomasz; Gasiorowska, Agata; Kesebir, Pelin

2013-01-01

Four studies tested the idea that saving money can buffer death anxiety and constitute a more effective buffer than spending money. Saving can relieve future-related anxiety and provide people with a sense of control over their fate, thereby rendering death thoughts less threatening. Study 1 found that participants primed with both saving and spending reported lower death fear than controls. Saving primes, however, were associated with significantly lower death fear than spending primes. Study 2 demonstrated that mortality primes increase the attractiveness of more frugal behaviors in save-or-spend dilemmas. Studies 3 and 4 found, in two different cultures (Polish and American), that the activation of death thoughts prompts people to allocate money to saving as opposed to spending. Overall, these studies provided evidence that saving protects from existential anxiety, and probably more so than spending. PMID:24244497

Atlanta congestion reduction demonstration. National evaluation : cost benefit analysis test plan.

DOT National Transportation Integrated Search

2001-01-01

Initiatives to evaluate the impact of Advanced Traveler Information Services (ATIS) over the last ten years have returned what appears to be contradictory results with respect to the time savings of ATIS users: large perceived time savings reported b...

Help!

ERIC Educational Resources Information Center

Adams, Caralee

2006-01-01

This article presents ten time-saving ideas for teachers. One great time-saving tip is to come in an hour early once or twice a week for grading papers. It is also a great idea if teachers will not give tests on Friday in order to reduce their weekend work.

Colorado's Alternative School Calendar Program.

ERIC Educational Resources Information Center

Stiverson, C. L.

1982-01-01

Colorado's 22 school districts on a four-day week schedule, as authorized by Colorado Senate Bill 78, show comparable student achievement levels as those on a five-day schedule; support from parents, teachers; and students; improved energy savings and/or time savings; and cost savings. Five other possible benefits are listed. (LC)

31 CFR 315.10 - Limitations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... applicable to each series of bonds and savings notes for each specific year, which has varied from time to..., DEPARTMENT OF THE TREASURY BUREAU OF THE FISCAL SERVICE REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B... Limitations. Specific limitations have been placed on the amounts of bonds of each series and savings notes...

The MMPI-2 Computerized Adaptive Version (MMPI-2-CA) in a Veterans Administration Medical Outpatient Facility

ERIC Educational Resources Information Center

Forbey, Johnathan D.; Ben-Porath, Yossef S.; Arbisi, Paul A.

2012-01-01

The ability to screen quickly and thoroughly for psychological difficulties in existing and returning combat veterans who are seeking treatment for physical ailments would be of significant benefit. In the current study, item and time savings, as well as extratest correlations, associated with an audio-augmented version of the computerized…

Materials and Process Design for High-Temperature Carburizing: Integrating Processing and Performance

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

D. Apelian

2007-07-23

The objective of the project is to develop an integrated process for fast, high-temperature carburizing. The new process results in an order of magnitude reduction in cycle time compared to conventional carburizing and represents significant energy savings in addition to a corresponding reduction of scrap associated with distortion free carburizing steels.

Five Smart Ways Educators Can Save Money on Benefit Costs

ERIC Educational Resources Information Center

McCullough, Pat

2012-01-01

State and local governments today face significant financial stress from the most recent recession, which makes their need to control benefit costs even greater. Revenues declined 22% from 2008 to 2009, mostly because of reduced tax income. At the same time, state and local government spending on unemployment compensation jumped 86%. It is no…

7 Questions to Ask Open Source Vendors

ERIC Educational Resources Information Center

Raths, David

2012-01-01

With their budgets under increasing pressure, many campus IT directors are considering open source projects for the first time. On the face of it, the savings can be significant. Commercial emergency-planning software can cost upward of six figures, for example, whereas the open source Kuali Ready might run as little as $15,000 per year when…

Char binder for fluidized beds

DOEpatents

Borio, Richard W.; Accortt, Joseph I.

1981-01-01

An arrangement that utilizes agglomerating coal as a binder to bond coal fines and recycled char into an agglomerate mass that will have suitable retention time when introduced into a fluidized bed 14 for combustion. The simultaneous use of coal for a primary fuel and as a binder effects significant savings in the elimination of non-essential materials and processing steps.

Energetics of hibernating yellow-bellied marmots (Marmota flaviventris).

PubMed

Armitage, Kenneth B; Blumstein, Daniel T; Woods, Brett C

2003-01-01

Yellow-bellied marmots (Rodentia: Sciuridae) typically hibernate for eight months. This study explored energetic costs of hibernation in young and adults at 10 and 6 degrees C. Age significantly affected the percent time torpid, total and mass-specific VO(2), use of energy during torpor, and daily mass loss at 6 degrees C. Thus young had a higher mass-specific VO(2) during a torpor bout, which was attributed to higher metabolism during deep torpor. Total VO(2) during a bout was higher in young and there were significant temperature/age interactions; young had a higher VO(2) during torpor and deep torpor at 6 degrees C than at 10 degrees C. VO(2) increased at T(E)s below 6 degrees C. Young had a higher daily mass loss than adults at 6 degrees C. Euthermy increased energetic costs 19.3 times over those of torpor and 23.5 times over those of deep torpor. Energy costs are minimized by spending 88.6% of the hibernation period in torpor, by the rapid decline of VO(2) from euthermy to torpor and by allowing T(B) to decline at low T(E). Torpidity results in average energy savings during winter of 83.3% of the costs of maintaining euthermy. Energy savings are greater than those reported for Marmota marmota and M. monax.

Testing simulation and structural models with applications to energy demand

NASA Astrophysics Data System (ADS)

Wolff, Hendrik

2007-12-01

This dissertation deals with energy demand and consists of two parts. Part one proposes a unified econometric framework for modeling energy demand and examples illustrate the benefits of the technique by estimating the elasticity of substitution between energy and capital. Part two assesses the energy conservation policy of Daylight Saving Time and empirically tests the performance of electricity simulation. In particular, the chapter "Imposing Monotonicity and Curvature on Flexible Functional Forms" proposes an estimator for inference using structural models derived from economic theory. This is motivated by the fact that in many areas of economic analysis theory restricts the shape as well as other characteristics of functions used to represent economic constructs. Specific contributions are (a) to increase the computational speed and tractability of imposing regularity conditions, (b) to provide regularity preserving point estimates, (c) to avoid biases existent in previous applications, and (d) to illustrate the benefits of our approach via numerical simulation results. The chapter "Can We Close the Gap between the Empirical Model and Economic Theory" discusses the more fundamental question of whether the imposition of a particular theory to a dataset is justified. I propose a hypothesis test to examine whether the estimated empirical model is consistent with the assumed economic theory. Although the proposed methodology could be applied to a wide set of economic models, this is particularly relevant for estimating policy parameters that affect energy markets. This is demonstrated by estimating the Slutsky matrix and the elasticity of substitution between energy and capital, which are crucial parameters used in computable general equilibrium models analyzing energy demand and the impacts of environmental regulations. Using the Berndt and Wood dataset, I find that capital and energy are complements and that the data are significantly consistent with duality theory. Both results would not necessarily be achieved using standard econometric methods. The final chapter "Daylight Time and Energy" uses a quasi-experiment to evaluate a popular energy conservation policy: we challenge the conventional wisdom that extending Daylight Saving Time (DST) reduces energy demand. Using detailed panel data on half-hourly electricity consumption, prices, and weather conditions from four Australian states we employ a novel 'triple-difference' technique to test the electricity-saving hypothesis. We show that the extension failed to reduce electricity demand and instead increased electricity prices. We also apply the most sophisticated electricity simulation model available in the literature to the Australian data. We find that prior simulation models significantly overstate electricity savings. Our results suggest that extending DST will fail as an instrument to save energy resources.

Prescription Program Provides Significant Savings

ERIC Educational Resources Information Center

Rowan, James M.

2010-01-01

Most school districts today are looking for ways to save money without decreasing services to its staff. Retired pharmacist Tim Sylvester, a lifelong resident of Alpena Public Schools in Alpena, Michigan, presented the district with a pharmaceuticals plan that would save the district money without raising employee co-pays for prescriptions. The…

A framework for quantifying the impact of occupant behavior on energy savings of energy conservation measures

DOE PAGES

Sun, K; Hong, T

2017-07-01

© 2017 Elsevier B.V. To improve energy efficiency—during new buildings design or during a building retrofit—evaluating the energy savings potential of energy conservation measures (ECMs) is a critical task. In building retrofits, occupant behavior significantly impacts building energy use and is a leading factor in uncertainty when determining the effectiveness of retrofit ECMs. Current simulation-based assessment methods simplify the representation of occupant behavior by using a standard or representative set of static and homogeneous assumptions ignoring the dynamics, stochastics, and diversity of occupant's energy-related behavior in buildings. The simplification contributes to significant gaps between the simulated and measured actual energymore » performance of buildings. This study presents a framework for quantifying the impact of occupant behaviors on ECM energy savings using building performance simulation. During the first step of the study, three occupant behavior styles (austerity, normal, and wasteful) were defined to represent different levels of energy consciousness of occupants regarding their interactions with building energy systems (HVAC, windows, lights and plug-in equipment). Next, a simulation workflow was introduced to determine a range of the ECM energy savings. Then, guidance was provided to interpret the range of ECM savings to support ECM decision making. Finally, a pilot study was performed in a real building to demonstrate the application of the framework. Simulation results show that the impact of occupant behaviors on ECM savings vary with the type of ECM. Occupant behavior minimally affects energy savings for ECMs that are technology-driven (the relative savings differ by less than 2%) and have little interaction with the occupants; for ECMs with strong occupant interaction, such as the use of zonal control variable refrigerant flow system and natural ventilation, energy savings are significantly affected by occupant behavior (the relative savings differ by up to 20%). The study framework provides a novel, holistic approach to assessing the uncertainty of ECM energy savings related to occupant behavior, enabling stakeholders to understand and assess the risk of adopting energy efficiency technologies for new and existing buildings.« less

A framework for quantifying the impact of occupant behavior on energy savings of energy conservation measures

DOE PAGES

Sun, Kaiyu; Hong, Tianzhen

2017-04-27

To improve energy efficiency—during new buildings design or during a building retrofit—evaluating the energy savings potential of energy conservation measures (ECMs) is a critical task. In building retrofits, occupant behavior significantly impacts building energy use and is a leading factor in uncertainty when determining the effectiveness of retrofit ECMs. Current simulation-based assessment methods simplify the representation of occupant behavior by using a standard or representative set of static and homogeneous assumptions ignoring the dynamics, stochastics, and diversity of occupant's energy-related behavior in buildings. The simplification contributes to significant gaps between the simulated and measured actual energy performance of buildings. Thismore » paper presents a framework for quantifying the impact of occupant behaviors on ECM energy savings using building performance simulation. During the first step of the study, three occupant behavior styles (austerity, normal, and wasteful) were defined to represent different levels of energy consciousness of occupants regarding their interactions with building energy systems (HVAC, windows, lights and plug-in equipment). Next, a simulation workflow was introduced to determine a range of the ECM energy savings. Then, guidance was provided to interpret the range of ECM savings to support ECM decision making. Finally, a pilot study was performed in a real building to demonstrate the application of the framework. Simulation results show that the impact of occupant behaviors on ECM savings vary with the type of ECM. Occupant behavior minimally affects energy savings for ECMs that are technology-driven (the relative savings differ by less than 2%) and have little interaction with the occupants; for ECMs with strong occupant interaction, such as the use of zonal control variable refrigerant flow system and natural ventilation, energy savings are significantly affected by occupant behavior (the relative savings differ by up to 20%). Finally, the study framework provides a novel, holistic approach to assessing the uncertainty of ECM energy savings related to occupant behavior, enabling stakeholders to understand and assess the risk of adopting energy efficiency technologies for new and existing buildings.« less

A framework for quantifying the impact of occupant behavior on energy savings of energy conservation measures

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

Sun, Kaiyu; Hong, Tianzhen

To improve energy efficiency—during new buildings design or during a building retrofit—evaluating the energy savings potential of energy conservation measures (ECMs) is a critical task. In building retrofits, occupant behavior significantly impacts building energy use and is a leading factor in uncertainty when determining the effectiveness of retrofit ECMs. Current simulation-based assessment methods simplify the representation of occupant behavior by using a standard or representative set of static and homogeneous assumptions ignoring the dynamics, stochastics, and diversity of occupant's energy-related behavior in buildings. The simplification contributes to significant gaps between the simulated and measured actual energy performance of buildings. Thismore » paper presents a framework for quantifying the impact of occupant behaviors on ECM energy savings using building performance simulation. During the first step of the study, three occupant behavior styles (austerity, normal, and wasteful) were defined to represent different levels of energy consciousness of occupants regarding their interactions with building energy systems (HVAC, windows, lights and plug-in equipment). Next, a simulation workflow was introduced to determine a range of the ECM energy savings. Then, guidance was provided to interpret the range of ECM savings to support ECM decision making. Finally, a pilot study was performed in a real building to demonstrate the application of the framework. Simulation results show that the impact of occupant behaviors on ECM savings vary with the type of ECM. Occupant behavior minimally affects energy savings for ECMs that are technology-driven (the relative savings differ by less than 2%) and have little interaction with the occupants; for ECMs with strong occupant interaction, such as the use of zonal control variable refrigerant flow system and natural ventilation, energy savings are significantly affected by occupant behavior (the relative savings differ by up to 20%). Finally, the study framework provides a novel, holistic approach to assessing the uncertainty of ECM energy savings related to occupant behavior, enabling stakeholders to understand and assess the risk of adopting energy efficiency technologies for new and existing buildings.« less

Clinical evaluation of atlas and deep learning based automatic contouring for lung cancer.

PubMed

Lustberg, Tim; van Soest, Johan; Gooding, Mark; Peressutti, Devis; Aljabar, Paul; van der Stoep, Judith; van Elmpt, Wouter; Dekker, Andre

2018-02-01

Contouring of organs at risk (OARs) is an important but time consuming part of radiotherapy treatment planning. The aim of this study was to investigate whether using institutional created software-generated contouring will save time if used as a starting point for manual OAR contouring for lung cancer patients. Twenty CT scans of stage I-III NSCLC patients were used to compare user adjusted contours after an atlas-based and deep learning contour, against manual delineation. The lungs, esophagus, spinal cord, heart and mediastinum were contoured for this study. The time to perform the manual tasks was recorded. With a median time of 20 min for manual contouring, the total median time saved was 7.8 min when using atlas-based contouring and 10 min for deep learning contouring. Both atlas based and deep learning adjustment times were significantly lower than manual contouring time for all OARs except for the left lung and esophagus of the atlas based contouring. User adjustment of software generated contours is a viable strategy to reduce contouring time of OARs for lung radiotherapy while conforming to local clinical standards. In addition, deep learning contouring shows promising results compared to existing solutions. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Case studies identify savings of up to $40,000 for academic research laboratories with the use of video journals

NASA Astrophysics Data System (ADS)

Pritsker, Moshe

2015-04-01

Recent studies indicate that 70% to 90% of results published in science journals are not reproducible, which presents troubling uncertainty about the future of scientific research. In contrast to the text format of traditional journals, novel video-based journals allow for systematic, step-by-step visualized demonstrations of research experiments. Video articles produce a more efficient transfer of knowledge between laboratories and therefore offer a viable solution to the issue of reproducibility. To quantify the savings of time and money generated by this alternative mode of scientific communication, we conducted a number of case studies among academic laboratories who use the peer-reviewed video journal JoVE. One study determined that using video as a guide to learn a new dissection technique saved a bioengineering lab at the University of Washington 40,000. A second case study found that a laboratory at Cornell University studying muscular dystrophy eliminated 6 months of experimentation by learning a new complex stem cell injection technique from the video journal. Results from a third study indicated that a laboratory at the University of Helsinki shortened the time to learn a surgical technique from 1 year to 2 weeks. Together, these studies indicate that video publication significantly enhances the reproducibility and productivity of scientific research.

Clinical and economic impact of infliximab one-hour infusion protocol in patients with inflammatory bowel diseases: A multicenter study

PubMed Central

Viola, Anna; Costantino, Giuseppe; Privitera, Antonino Carlo; Bossa, Fabrizio; Lauria, Angelo; Grossi, Laurino; Principi, Maria Beatrice; Della Valle, Nicola; Cappello, Maria

2017-01-01

AIM To assess the impact of short infliximab (IFX) infusion on hospital resource utilization and costs. METHODS All inflammatory bowel diseases (IBD) patients who received IFX 1 h infusion from March 2007 to September 2014 in eight centers from Southern Italy were included in the analysis. Demographic, clinical and infusion related data were collected. The potential benefits related to the short infusion protocol were assessed both in terms of time saving and increased infusion unit capacity. In addition, indirect patient-related cost savings were evaluated. RESULTS One hundred and twenty-five patients were recruited (64 with ulcerative colitis and 61 with Crohn’s disease). Median duration of disease was of 53 mo and mean age of pts at diagnosis was of 34 years (SD: ± 13). Adverse infusion reactions were reported in less than 4% both before and after short infusion. The total number of infusions across the selected centers was of 2501 (30.5% short infusions). In the analyzed cohort, 1143 h were saved (762 in the infusion and 381 in observation phases) through the rapid IFX infusion protocol. This time saving (-15% compared to the standard protocol in infusion phase) represents, from the hospital perspective, an opportunity to optimize infusion unit capacity by allocating the saved time in alternative cost-effective treatments. This is the case of opportunity cost that represents the value of forgone benefit which could be obtained from a resource in its next-best alternative use. Hence, an extra hour of infusion in the case of standard 2-h IFX represents a loss in opportunity to provide other cost effective services. The analysis showed that the short infusion increased the infusion units capacity up to 50% on days when the IFX infusions were scheduled (infusion phase). Furthermore, the analysis showed that the short IFX infusion protocol leads to time savings also in the post-infusion phase (observation) leading to a time saving of 10% on average among the analyzed centers. Finally, the short infusion protocol has been demonstrated to lead to indirect cost savings of €138/patient (average -€17.300 on the whole cohort). CONCLUSION A short IFX infusion protocol can be considered time and cost saving in comparison to the standard infusion protocol both from the hospital’s perspective, as it contributes to increase infusion units capacity, and the patients’ perspective, as it reduces indirect costs and the impact of treatment on everyday life and work productivity. PMID:28533923

Time- and cost-saving apparatus for analytical sample filtration

Treesearch

William R. Kenealy; Joseph C. Destree

2005-01-01

Simple and cost-effective protocols were developed for removing particulates from samples prior to analysis by high performance liquid chromatography and gas chromatography. A filter and vial holder were developed for use with a 96-well filtration plate. The device saves preparation time and costs.

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

Engelmeier, R.L.

A technique has been described for fabrication of a radiation therapy stent that can help to stabilize the head when adjustable alignment devices are used to position a patient during radiation therapy. The technique can save time for the radiotherapist, enhance accuracy in treatment, increase patient comfort, and save the dentist time in stent fabrication.

Spectral Analysis of the Effects of Daylight Saving Time on Motor Vehicle Fatal Traffic Accidents

DOT National Transportation Integrated Search

1977-04-01

This report shows that Daylight Saving Time (DST) reduces the number of persons killed in motor vehicle fatal traffic accidents by about one percent. This estimate is based on a spectral (Fourier) analysis of these fatalities which utilizes a filteri...

Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

PubMed

Howe, Lynn

2008-06-01

This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

The effectiveness of the 55 MPH national maximum speed limit as a life saving benefit : executive summary

DOT National Transportation Integrated Search

1981-01-01

The following report contains an analysis of the life saving benefits resulting from the 55 mph NMSL from 1974-1979. Monthly fatality data from 1970-1979 was used in a time series model to arrive at the estimated safety benefits (lives saved). The ti...

Energy Savings Forecast of SSL in General Illumination Report Summary

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

None

2016-09-30

Summary of the DOE report Energy Savings Forecast of Solid-State Lighting in General Illumination Applications, a biannual report that models the adoption of LEDs in the U.S. general-lighting market, along with associated energy savings, based on the full potential DOE has determined to be technically feasible over time.

31 CFR 363.171 - How do I redeem a converted savings bond?

Code of Federal Regulations, 2014 CFR

2014-07-01

... converted savings bond? (a) Before final maturity—(1) Savings bond of any series registered in the single... bond of any series registered either in the single owner, owner with beneficiary, or entity form of registration any time prior to final maturity after the minimum holding period through your TreasuryDirect...

31 CFR 363.171 - How do I redeem a converted savings bond?

Code of Federal Regulations, 2011 CFR

2011-07-01

... converted savings bond? (a) Before final maturity—(1) Savings bond of any series registered in the single... bond of any series registered either in the single owner, owner with beneficiary, or entity form of registration any time prior to final maturity after the minimum holding period through your TreasuryDirect...

31 CFR 359.72 - May the United States supplement or amend the offering of Series I savings bonds?

Code of Federal Regulations, 2010 CFR

2010-07-01

... terms of this offering of Series I bonds at any time. ... amend the offering of Series I savings bonds? 359.72 Section 359.72 Money and Finance: Treasury... PUBLIC DEBT OFFERING OF UNITED STATES SAVINGS BONDS, SERIES I Miscellaneous Provisions § 359.72 May the...

31 CFR 359.72 - May the United States supplement or amend the offering of Series I savings bonds?

Code of Federal Regulations, 2011 CFR

2011-07-01

... terms of this offering of Series I bonds at any time. ... amend the offering of Series I savings bonds? 359.72 Section 359.72 Money and Finance: Treasury... PUBLIC DEBT OFFERING OF UNITED STATES SAVINGS BONDS, SERIES I Miscellaneous Provisions § 359.72 May the...

31 CFR 321.12 - Redemption value of securities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... value of each savings security is determined by the terms of its offering and the length of time it has been outstanding. The Bureau of the Fiscal Service determines redemption values for Series A-E bonds, eligible Series EE and I bonds, and savings notes, that should be used in redeeming savings securities. [63...

31 CFR 359.72 - May the United States supplement or amend the offering of Series I savings bonds?

Code of Federal Regulations, 2013 CFR

2013-07-01

... terms of this offering of Series I bonds at any time. ... amend the offering of Series I savings bonds? 359.72 Section 359.72 Money and Finance: Treasury... PUBLIC DEBT OFFERING OF UNITED STATES SAVINGS BONDS, SERIES I Miscellaneous Provisions § 359.72 May the...

31 CFR 363.171 - How do I redeem a converted savings bond?

Code of Federal Regulations, 2010 CFR

2010-07-01

... converted savings bond? (a) Before final maturity—(1) Savings bond of any series registered in the single... bond of any series registered either in the single owner, owner with beneficiary, or entity form of registration any time prior to final maturity after the minimum holding period through your TreasuryDirect...

31 CFR 363.171 - How do I redeem a converted savings bond?

Code of Federal Regulations, 2013 CFR

2013-07-01

... converted savings bond? (a) Before final maturity—(1) Savings bond of any series registered in the single... bond of any series registered either in the single owner, owner with beneficiary, or entity form of registration any time prior to final maturity after the minimum holding period through your TreasuryDirect...

31 CFR 363.171 - How do I redeem a converted savings bond?

Code of Federal Regulations, 2012 CFR

2012-07-01

... converted savings bond? (a) Before final maturity—(1) Savings bond of any series registered in the single... bond of any series registered either in the single owner, owner with beneficiary, or entity form of registration any time prior to final maturity after the minimum holding period through your TreasuryDirect...

31 CFR 359.72 - May the United States supplement or amend the offering of Series I savings bonds?

Code of Federal Regulations, 2012 CFR

2012-07-01

... terms of this offering of Series I bonds at any time. ... amend the offering of Series I savings bonds? 359.72 Section 359.72 Money and Finance: Treasury... PUBLIC DEBT OFFERING OF UNITED STATES SAVINGS BONDS, SERIES I Miscellaneous Provisions § 359.72 May the...

77 FR 42489 - Notice of Submission for OMB Review; Office of Postsecondary Education; Application for Gaining...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-19

... with the collection results from a program change to run this one-time college savings account...; Application for Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) College Savings... pairing federally supported college savings accounts with GEAR UP activities as part of an overall college...

Fibroblast Viability after Storage at 20 °C in Milk, Hank's Balanced Salt Solution and Coconut Water.

PubMed

Souza, Beatriz Dulcineia Mendes de; Alves, Ana Maria Hecke; Santos, Luciane Geanini Pena Dos; Simões, Claudia Maria de Oliveira; Felippe, Wilson Tadeu; Felippe, Mara Cristina Santos

2016-01-01

The objective of this study was to evaluate the effectiveness of various storage media at 20 °C in maintaining the viability of human periodontal ligament fibroblasts (HPLF) over time. HPLF were maintained at 20 °C in skim milk (SM), whole milk (WM), freshly prepared Hank's balanced salt solution (HBSS), Save-A-Tooth(r), natural coconut water (NCW), coconut water industrialized (ICW) and tap water (negative control) for 3, 6, 24, 48, 72, 96 and 120 h. Cells maintained in Minimal Essential Medium (MEM-37) at 37 °C served as a positive control. Cell viability was determined by MTT assay. Statistical analysis was performed by Kruskal-Wallis test and Scheffe test (α = 5%). From 24 h, NCW was significantly better in maintaining cell viability than all other tested storage media (p<0.05). SM and WM were significantly better than HBSS for up to 72 h. Save-A-Tooth(r) and ICW were the worst conservation storage media. In conclusion, the effectiveness of the tested storage media to maintain the viability of the periodontal ligament cells was as follows, in a descending order: NCW > MEM-37> SM and IM> HBSS> ICW > Save-A-Tooth(r)> tap water.

Cloud field classification based upon high spatial resolution textural features. II - Simplified vector approaches

NASA Technical Reports Server (NTRS)

Chen, D. W.; Sengupta, S. K.; Welch, R. M.

1989-01-01

This paper compares the results of cloud-field classification derived from two simplified vector approaches, the Sum and Difference Histogram (SADH) and the Gray Level Difference Vector (GLDV), with the results produced by the Gray Level Cooccurrence Matrix (GLCM) approach described by Welch et al. (1988). It is shown that the SADH method produces accuracies equivalent to those obtained using the GLCM method, while the GLDV method fails to resolve error clusters. Compared to the GLCM method, the SADH method leads to a 31 percent saving in run time and a 50 percent saving in storage requirements, while the GLVD approach leads to a 40 percent saving in run time and an 87 percent saving in storage requirements.

Energy Savings in Cellular Networks Based on Space-Time Structure of Traffic Loads

NASA Astrophysics Data System (ADS)

Sun, Jingbo; Wang, Yue; Yuan, Jian; Shan, Xiuming

Since most of energy consumed by the telecommunication infrastructure is due to the Base Transceiver Station (BTS), switching off BTSs when traffic load is low has been recognized as an effective way of saving energy. In this letter, an energy saving scheme is proposed to minimize the number of active BTSs based on the space-time structure of traffic loads as determined by principal component analysis. Compared to existing methods, our approach models traffic loads more accurately, and has a much smaller input size. As it is implemented in an off-line manner, our scheme also avoids excessive communications and computing overheads. Simulation results show that the proposed method has a comparable performance in energy savings.

Household water saving: Evidence from Spain

NASA Astrophysics Data System (ADS)

Aisa, Rosa; Larramona, Gemma

2012-12-01

This article focuses on household water use in Spain by analyzing the influence of a detailed set of factors. We find that, although the presence of both water-saving equipment and water-conservation habits leads to water savings, the factors that influence each are not the same. In particular, our results show that those individuals most committed to the adoption of water-saving equipment and, at the same time, less committed to water-conservation habits tend to have higher incomes.

Cost analysis of the CTLB Study, a multitherapy antenatal education programme to reduce routine interventions in labour

PubMed Central

Dahlen, Hannah G; Smith, Caroline A; Finlayson, Kenneth William; Downe, Soo

2018-01-01

Objective To assess whether the multitherapy antenatal education ‘CTLB’ (Complementary Therapies for Labour and Birth) Study programme leads to net cost savings. Design Cost analysis of the CTLB Study, using analysis of outcomes and hospital funding data. Methods We take a payer perspective and use Australian Refined Diagnosis-Related Group (AR-DRG) cost data to estimate the potential savings per woman to the payer (government or private insurer). We consider scenarios in which the intervention cost is either borne by the woman or by the payer. Savings are computed as the difference in total cost between the control group and the study group. Results If the cost of the intervention is not borne by the payer, the average saving to the payer was calculated to be $A808 per woman. If the payer covers the cost of the programme, this figure reduces to $A659 since the average cost of delivering the programme was $A149 per woman. All these findings are significant at the 95% confidence level. Significantly more women in the study group experienced a normal vaginal birth, and significantly fewer women in the study group experienced a caesarean section. The main cost saving resulted from the reduced rate of caesarean section in the study group. Conclusion The CTLB antenatal education programme leads to significant savings to payers that come from reduced use of hospital resources. Depending on which perspective is considered, and who is responsible for covering the cost of the programme, the net savings vary from $A659 to $A808 per woman. Compared with the average cost of birth in the control group, we conclude that the programme could lead to a reduction in birth-related healthcare costs of approximately 9%. Trial registration number ACTRN12611001126909. PMID:29439002

Building America Case Study: Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test, Minneapolis, Minnesota

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

High performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiencymore » water heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.« less

Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test

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

Schoenbauer, Ben

High-performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiency watermore » heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.« less

Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test

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

Schoenbauer, Ben

High performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiencymore » water heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.« less

Comparing fixation used for calcaneal displacement osteotomies: a look at removal rates and cost.

PubMed

Lucas, Douglas E; Simpson, G Alex; Philbin, Terrence M

2015-02-01

The calcaneal displacement osteotomy is a procedure frequently used by foot and ankle surgeons for hindfoot angular deformity. Traditional techniques use compression screw fixation that can result in prominent hardware. While the results of the procedure are generally good, a common concern is the development of plantar heel pain related to prominent hardware. The primary purpose of this study is to retrospectively compare clinical outcomes of 2 fixation methods for the osteotomy. Secondarily a cost analysis will compare implant costs to hardware removal costs. Records were reviewed for patients who had undergone a calcaneal displacement osteotomy fixated with either lag screw or a locked lateral compression plate (LLCP). Neuropathy, previous ipsilateral calcaneus surgery, heel pad trauma, or incomplete radiographic follow-up were exclusionary. Thirty-two patients (19.4%) required hardware removal from the screw fixation group compared to 1 (1.6%) of the LLCP group, which is significant (P < .05). Time to radiographic healing was not significantly different (P = .87). The screw fixation group required more follow-up visits over a longer period of time (P < .05). Implant cost was remarkably different with screw fixation costing on average $247.12, compared to the LLCP costing $1175.59. Although the LLCP cost was significantly higher, cost savings were identified when the cost of removal and removal rates were included. This study demonstrates that this device provides adequate stabilization for healing in equivalent time to screw fixation. The LLCP required decreased rates of hardware removal with fewer postoperative visits over a shorter period of time. Significant savings were demonstrated in the LLCP group despite the higher implant cost. Therapeutic, Level III, Retrospective Comparative Study. © 2014 The Author(s).

Cost-benefit analysis of Xpert MTB/RIF for tuberculosis suspects in German hospitals.

PubMed

Diel, Roland; Nienhaus, Albert; Hillemann, Doris; Richter, Elvira

2016-02-01

Our objective was to assess the cost-benefit of enhancing or replacing the conventional sputum smear with the real-time PCR Xpert MTB/RIF method in the inpatient diagnostic schema for tuberculosis (TB).Recent data from published per-case cost studies for TB/multidrug-resistant (MDR)-TB and from comparative analyses of sputum microscopy, mycobacterial culture, Xpert MTB/RIF and drug susceptibility testing, performed at the German National Reference Center for Mycobacteria, were used. Potential cost savings of Xpert MTB/RIF, based on test accuracy and multiple cost drivers, were calculated for diagnosing TB/MDR-TB suspects from the hospital perspective.Implementing Xpert MTB/RIF as an add-on in smear-positive and smear-negative TB suspects saves on average €48.72 and €503, respectively, per admitted patient as compared with the conventional approach. In smear-positive and smear-negative MDR-TB suspects, cost savings amount to €189.56 and €515.25 per person, respectively. Full replacement of microscopy by Xpert MTB/RIF saves €449.98. In probabilistic Monte-Carlo simulation, adding Xpert MTB/RIF is less costly in 46.4% and 76.2% of smear-positive TB and MDR-TB suspects, respectively, but 100% less expensive in all smear-negative suspects. Full replacement by Xpert MTB/RIF is also consistently cost-saving.Using Xpert MTB/RIF as an add-on to and even as a replacement for sputum smear examination may significantly reduce expenditures in TB suspects. Copyright ©ERS 2016.

Saving-enhanced memory: the benefits of saving on the learning and remembering of new information.

PubMed

Storm, Benjamin C; Stone, Sean M

2015-02-01

With the continued integration of technology into people's lives, saving digital information has become an everyday facet of human behavior. In the present research, we examined the consequences of saving certain information on the ability to learn and remember other information. Results from three experiments showed that saving one file before studying a new file significantly improved memory for the contents of the new file. Notably, this effect was not observed when the saving process was deemed unreliable or when the contents of the to-be-saved file were not substantial enough to interfere with memory for the new file. These results suggest that saving provides a means to strategically off-load memory onto the environment in order to reduce the extent to which currently unneeded to-be-remembered information interferes with the learning and remembering of other information. © The Author(s) 2014.

Transpyloric Feeding Tube Placement Using Electromagnetic Placement Device in Children.

PubMed

Goggans, Margaret; Pickard, Sharon; West, Alina Nico; Shah, Samir; Kimura, Dai

2017-04-01

Transpyloric feeding tubes (TPT) are often recommended in critically ill children. Blind tube placement, however, can be difficult, be time-consuming, and incur multiple radiation exposures. An electromagnetic device (EMD) is available for confirmation of successful placement of TPTs. We conducted a retrospective cohort study to evaluate the efficacy of an EMD for TPT placement in children and determine its impact on placement success, radiation exposure, confirmation time, and cost for tube placement compared with traditional blind TPT placement. Retrospective data were collected in patients receiving a TPT before (pre-EMD group) and after implementation of an EMD (EMD group). Need for radiographic exposure decreased significantly in the EMD group (n = 40) compared with the pre-EMD group (n = 38) (0.6 vs 1.6 x-rays, P < .001). TPTs were placed and confirmed without abdominal x-ray in 21 of 40 patients in the EMD group. There were no serious adverse events such as misplacement into the lung or pneumothorax or perforation injury of the stomach. Successful tube confirmation took a significantly shorter time in the EMD group than in the pre-EMD group (1.45 vs 4.59 hours, P < .0001). There was an estimated cost savings of $245.10 per placement associated with decreased x-ray and fluoroscopy. The use of an EMD in children significantly decreased radiation exposure and confirmation time while maintaining TPT placement success. The use of an EMD can potentially offer large cost savings. Elimination of abdominal x-ray with EMD during TPT placement was achieved without any serious complications in approximately half of the children.

Using reconfigurable hardware to accelerate multiple sequence alignment with ClustalW.

PubMed

Oliver, Tim; Schmidt, Bertil; Nathan, Darran; Clemens, Ralf; Maskell, Douglas

2005-08-15

Aligning hundreds of sequences using progressive alignment tools such as ClustalW requires several hours on state-of-the-art workstations. We present a new approach to compute multiple sequence alignments in far shorter time using reconfigurable hardware. This results in an implementation of ClustalW with significant runtime savings on a standard off-the-shelf FPGA.

Community biomass handbook. Volume I: thermal wood energy

Treesearch

D. Becker; E. Lowell; D. Bihn; R. Anderson; S. Taff

2014-01-01

This handbook and financial app is a guide to help communities quickly determine if biomass energy projects might work for them so that this option is not overlooked. Its purpose is as a screening tool designed to save significant time, resources, and investment by weeding out those wood energy projects that may never come to fruition from those that have a chance of...

Even in E-Learning Is Important to Do Your Own Notes!

ERIC Educational Resources Information Center

Magdin, Martin

2016-01-01

In the last decade, e-learning has been a standard part of the educational process at all types of schools--primary, secondary, and high schools. When used, e-learning can achieve significant savings not only in terms of time as well as operating costs. However, e-learning is also often criticized. This is mainly due to direct absence of teachers…

A Critical Discourse Analysis of ELT Materials in Gender Representation: A Comparison of "Summit" and "Top Notch"

ERIC Educational Resources Information Center

Samadikhah, Mehran; Shahrokhi, Mohsen

2015-01-01

In spite of the crucial importance of textbooks, their increasing development day by day, and their significant effects on saving time, energy, and budgets, only few studies have been done on textbooks evaluation from a critical discourse analysis perspective. This study aimed to analyze and compare the gender representation in "Top…

Conquering Cancer in the 21st Century: Leading a Movement to Save More Lives Worldwide

ERIC Educational Resources Information Center

Seffrin, John R.

2011-01-01

This article examines the current state of the global fight against cancer and of noncommunicable disease in general, the progress to date against cancer, and postulates that there has never been a more challenging--nor more ideal--time to succeed in making significant headway against the disease worldwide. Based on progress made particularly in…

A Strategy for American Power: Energy, Climate and National Security

DTIC Science & Technology

2008-06-01

principle applies to the suppliers of energy, particularly oil, since the United States gets...outlined four principles : • Human-induced climate change is real; • The consequences of climate change will be significant and will hit the poor...savings, in terms of higher macroeconomic output in times of energy price volatility, associated with the development of nuclear capacity in Japan.

31 CFR 359.72 - May the United States supplement or amend the offering of Series I savings bonds?

Code of Federal Regulations, 2014 CFR

2014-07-01

... amend the terms of this offering of Series I bonds at any time. ... amend the offering of Series I savings bonds? 359.72 Section 359.72 Money and Finance: Treasury... FISCAL SERVICE OFFERING OF UNITED STATES SAVINGS BONDS, SERIES I Miscellaneous Provisions § 359.72 May...

Improving Operational Acceptability of Dynamic Weather Routes Through Analysis of Commonly Use Routings

NASA Technical Reports Server (NTRS)

Evans, Antony D.; Sridhar, Banavar; McNally, David

2016-01-01

The Dynamic Weather Routes (DWR) tool is a ground-based trajectory automation system that continuously and automatically analyzes active in-flight aircraft in en route airspace to find simple modifications to flight plan routes that can save significant flying time, while avoiding weather and considering traffic conflicts, airspace sector congestion, special use airspace, and FAA routing restrictions. Trials of the DWR system have shown that significant delay savings are possible. However, some DWR advised routes are also rejected by dispatchers or modified before being accepted. Similarly, of those sent by dispatchers to flight crews as proposed route change requests, many are not accepted by air traffic control, or are modified before implementation as Center route amendments. Such actions suggest that the operational acceptability of DWR advised route corrections could be improved, which may reduce workload and increase delay savings. This paper analyzes the historical usage of different flight routings, varying from simple waypoint pairs to lengthy strings of waypoints incorporating jet routes, in order to improve DWR route acceptability. An approach is developed that can be incorporated into DWR, advising routings with high historical usage and savings potential similar to that of the nominal DWR advisory. It is hypothesized that modifying a nominal DWR routing to one that is commonly used, and nearby, will result in more actual savings since common routings are generally familiar and operationally acceptable to air traffic control. The approach allows routing segments with high historical usage to be concatenated to form routes that meet all DWR constraints. The relevance of a route's historical usage to its acceptance by dispatchers and air traffic control is quantified by analyzing historical DWR data. Results indicate that while historical usage may be less of a concern to flight dispatchers accepting or rejecting DWR advised route corrections, it may be important to air traffic control acceptance of DWR routes.

A Comparison of Two Fat Grafting Methods on Operating Room Efficiency and Costs.

PubMed

Gabriel, Allen; Maxwell, G Patrick; Griffin, Leah; Champaneria, Manish C; Parekh, Mousam; Macarios, David

2017-02-01

Centrifugation (Cf) is a common method of fat processing but may be time consuming, especially when processing large volumes. To determine the effects on fat grafting time, volume efficiency, reoperations, and complication rates of Cf vs an autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit. We performed a retrospective cohort study of consecutive patients who underwent autologous fat grafting during reconstructive breast surgery with Rv or Cf. Endpoints measured were volume of fat harvested (lipoaspirate) and volume injected after processing, time to complete processing, reoperations, and complications. A budget impact model was used to estimate cost of Rv vs Cf. Ninety-eight patients underwent fat grafting with Rv, and 96 patients received Cf. Mean volumes of lipoaspirate (506.0 vs 126.1 mL) and fat injected (177.3 vs 79.2 mL) were significantly higher (P < .0001) in the Rv vs Cf group, respectively. Mean time to complete fat grafting was significantly shorter in the Rv vs Cf group (34.6 vs 90.1 minutes, respectively; P < .0001). Proportions of patients with nodule and cyst formation and/or who received reoperations were significantly less in the Rv vs Cf group. Based on these outcomes and an assumed per minute operating room cost, an average per patient cost savings of $2,870.08 was estimated with Rv vs Cf. Compared to Cf, the Rv fat processing system allowed for a larger volume of fat to be processed for injection and decreased operative time in these patients, potentially translating to cost savings. LEVEL OF EVIDENCE 3. © 2016 The American Society for Aesthetic Plastic Surgery, Inc.

Saving billions of dollars--and physicians' time--by streamlining billing practices.

PubMed

Blanchfield, Bonnie B; Heffernan, James L; Osgood, Bradford; Sheehan, Rosemary R; Meyer, Gregg S

2010-06-01

The U.S. system of billing third parties for health care services is complex, expensive, and inefficient. Physicians end up using nearly 12 percent of their net patient service revenue to cover the costs of excessive administrative complexity. A single transparent set of payment rules for multiple payers, a single claim form, and standard rules of submission, among other innovations, would reduce the burden on the billing offices of physician organizations. On a national scale, our hypothetical modeling of these changes would translate into $7 billion of savings annually for physician and clinical services. Four hours of professional time per physician and five hours of practice support staff time could be saved each week.

Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting.

PubMed

Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D

2018-02-08

To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.

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

NASA Technical Reports Server (NTRS)

Shiokari, T.

1975-01-01

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

Uncertainties in the Value of Bill Savings from Behind-the-Meter, Residential Photovoltaic Systems: The Roles of Electricity Market Conditions, Retail Rate Design, and Net Metering

NASA Astrophysics Data System (ADS)

Darghouth, Naim Richard

Net metering has become a widespread policy mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), allowing customers with PV systems to reduce their electric bills by offsetting their consumption with PV generation, independent of the timing of the generation relative to consumption. Although net metering is one of the principal drivers for the residential PV market in the U.S., the academic literature on this policy has been sparse and this dissertation contributes to this emerging body of literature. This dissertation explores the linkages between the availability of net metering, wholesale electricity market conditions, retail rates, and the residential bill savings from behind-the-meter PV systems. First, I examine the value of the bill savings that customers receive under net metering and alternatives to net metering, and the associated role of retail rate design, based on current rates and a sample of approximately two hundred residential customers of California's two largest electric utilities. I find that the bill savings per kWh of PV electricity generated varies greatly, largely attributable to the increasing block structure of the California utilities' residential retail rates. I also find that net metering provides significantly greater bill savings than alternative compensation mechanisms based on avoided costs. However, retail electricity rates may shift as wholesale electricity market conditions change. I then investigate a potential change in market conditions -- increased solar PV penetrations -- on wholesale prices in the short-term based on the merit-order effect. This demonstrates the potential price effects of changes in market conditions, but also points to a number of methodological shortcomings of this method, motivating my usage of a long-term capacity investment and economic dispatch model to examine wholesale price effects of various wholesale market scenarios in the subsequent analysis. By developing three types of retail rates (a flat rate, a time-of-use rate, and real-time pricing) from these wholesale price profiles, I examine bill savings from PV generation for the ten wholesale market scenarios under net metering and an alternative to net metering where hourly excess PV generation is compensated at the wholesale price. Most generally, I challenge the common assertion that PV compensation is likely to stay constant (or rise) due to constant (or rising) retail rates, and find that future electricity market scenarios can drive substantial changes in residential retail rates and that these changes, in concert with variations in retail rate structures and PV compensation mechanisms, interact to place substantial uncertainty on the future value of bill savings from residential PV.

Outsourcing of Domestic Tasks and Time-Saving Effects

ERIC Educational Resources Information Center

van der Lippe, Tanja; Tijdens, Kea; de Ruijter, Esther

2004-01-01

The increased participation of women in paid labor has changed the organization of domestic work. This article deals with a strategy to cope with remaining domestic duties; to what extent are domestic tasks outsourced, what are the main determinants, and does it indeed save time spent on housework? Five outsourcing options are investigated:…

Differences in Household Saving between Non-Hispanic White and Hispanic Households

ERIC Educational Resources Information Center

Fisher, Patti J.; Hsu, Chungwen

2012-01-01

This study uses the 2007 Survey of Consumer Finances to empirically explore differences in saving behavior between Hispanic (N = 533) and non-Hispanic White (N = 2,473) households. The results of the logistic regression model show that self-employed Hispanics were more likely to save, while self-employment was not significant for Whites. Being…

An assessment of time involved in pre-test case review and counseling for a whole genome sequencing clinical research program.

PubMed

Williams, Janet L; Faucett, W Andrew; Smith-Packard, Bethanny; Wagner, Monisa; Williams, Marc S

2014-08-01

Whole genome sequencing (WGS) is being used for evaluation of individuals with undiagnosed disease of suspected genetic origin. Implementing WGS into clinical practice will place an increased burden upon care teams with regard to pre-test patient education and counseling about results. To quantitate the time needed for appropriate pre-test evaluation of participants in WGS testing, we documented the time spent by our clinical research group on various activities related to program preparation, participant screening, and consent prior to WGS. Participants were children or young adults with autism, intellectual or developmental disability, and/or congenital anomalies, who have remained undiagnosed despite previous evaluation, and their biologic parents. Results showed that significant time was spent in securing allocation of clinical research space to counsel participants and families, and in acquisition and review of participant's medical records. Pre-enrollment chart review identified two individuals with existing diagnoses resulting in savings of $30,000 for the genome sequencing alone, as well as saving hours of personnel time for genome interpretation and communication of WGS results. New WGS programs should plan for costs associated with additional pre-test administrative planning and patient evaluation time that will be required to provide high quality care.

A cost/benefit analysis of commercial fusion-fission hybrid reactor development

NASA Astrophysics Data System (ADS)

Kostoff, Ronald N.

1983-04-01

A simple algorithm was developed that allows rapid computation of the ratio, R, of present worth of benefits to present worth of hybrid R&D program costs as a function of potential hybrid unit electricity cost savings, discount rate, electricity demand growth rate, total hybrid R&D program cost, and time to complete a demonstration reactor. In the sensitivity study, these variables were assigned nominal values (unit electricity cost savings of 4 mills/kW-hr, discount rate of 4%/year, growth rate of 2.25%/year, total R&D program cost of 20 billion, and time to complete a demonstration reactor of 30 years), and the variable of interest was varied about its nominal value. Results show that R increases with decreasing discount rate and increasing unit electricity savings and ranges from 4 to 94 as discount rate ranges from 5 to 3%/year and unit electricity savings range from 2 to 6 mills/kW-hr. R increases with increasing growth rate and ranges from 3 to 187 as growth rate ranges from 1 to 3.5%/year and unit electricity cost savings range from 2 to 6 mills/kW-hr. R attains a maximum value when plotted against time to complete a demonstration reactor. The location of this maximum value occurs at shorter completion times as discount rate increases, and this optimal completion time ranges from 20 years for a discount rate of 4%/year to 45 years for a discount rate of 3%/year.

Does a simple syringe applicator enhance bone cement set up time in knee arthroplasty?

PubMed Central

Sodhi, Nipun; Dalton, Sarah E.; Khlopas, Anton; Sultan, Assem A.; Curtis, Gannon L.; Harb, Matthew A.; Naziri, Qais; Barrington, John W.; Mont, Michael A.

2017-01-01

Background The time required for polymethylmethacrylate (PMMA) cement curing or hardening can be modified by a number of variables including the mixing technique, and the temperature and pressure at which the process is taking place. Therefore, the purpose of this study was to evaluate two different methods of PMMA application in terms of set up time. Specifically, we (I) compared the PMMA set up time of cement that remained in the mixing bowl to cement that was placed in a syringe and (II) extrapolated the associated annual cost difference on the national and individual surgeon levels. Methods The cement set up time was measured for a total of 146 consecutive patients who underwent either unicompartmental knee arthroplasty (n=136) or patellofemoral arthroplasty (n=10) between January 2016 and April 2017. One pack of PMMA powder and monomer were mixed, placed in a 300 mL small plastic bowl, and mixed with a tongue depressor. Then, 50 mL of the mixed PMMA was placed in a sterile 60 mL syringe with the tip cut to a 6-mm opening, and the syringe was used to apply the cement to the bone and the prosthesis surface. The remaining unused cement in the syringe (syringe group) and the remaining unused cement in the plastic bowl (bowl group) were removed and formed into a two separate 2 cm diameter cubes that were allowed to cure at room temperature on a sterile set of osteotomes. The two cubes of cement were timed for complete PMMA curing. A two-tailed student’s t-test was used to compare the curing time for the two groups. Annual cost differences were calculated on the national and individual surgeon level. The total number of daily cases performed and the operative time savings using the syringe applicator was used to find daily and annual cost savings. Results The mean time for the cement to set up in the bowl group was 16.8±2.1 minutes, and the mean time for cement set up in the syringe group was 15.1±1.7 minutes. Compared to the bowl group cement set up time, the syringe group set up time was significantly lower (P<0.0001). An estimated 350,000 cemented knee arthroplasties are performed each year in the United States. With 1.7 minutes saved per case, 595,000 operating room minutes per year could be saved, resulting in a nearly $71,000,000 national and $110,000 individual surgeon annual cost savings. Conclusions The results of the present study demonstrated that the utilization of a simple, inexpensive syringe applicator enhanced the cement set up time by over one and a half minutes. This may be a result of the pressure differences in the syringe applicator. In addition to the control of and precision of where the cement is placed, the syringe applicator could provide an important potential time advantage to the arthroplasty surgeon. PMID:29299472

Looking at IT through a New Lens: Achieving Cost Savings in a Fiscally Challenging Time

ERIC Educational Resources Information Center

Claffey, George F., Jr.

2009-01-01

Information technology (IT) departments must cut costs and justify expenditures in the face of shrinking budgets. To promote greater cost savings, it is important to look at IT through a new "lens." This article discusses four broad categories that can be evaluated to determine if IT resource alignment is appropriate and if savings can…

12 CFR 391.13 - Issuance of orders to correct deficiencies and to take or refrain from taking other actions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... general. The FDIC shall provide a State savings association prior written notice of the FDIC's intention to issue an order requiring the State savings association to correct a safety and soundness... savings association shall have such time to respond to a proposed order as provided by the FDIC under...

12 CFR 391.13 - Issuance of orders to correct deficiencies and to take or refrain from taking other actions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... general. The FDIC shall provide a State savings association prior written notice of the FDIC's intention to issue an order requiring the State savings association to correct a safety and soundness... savings association shall have such time to respond to a proposed order as provided by the FDIC under...

12 CFR 391.13 - Issuance of orders to correct deficiencies and to take or refrain from taking other actions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... general. The FDIC shall provide a State savings association prior written notice of the FDIC's intention to issue an order requiring the State savings association to correct a safety and soundness... savings association shall have such time to respond to a proposed order as provided by the FDIC under...

Applications of high thermal conductivity composites to electronics and spacecraft thermal design

NASA Technical Reports Server (NTRS)

Sharp, G. Richard; Loftin, Timothy A.

1990-01-01

Recently, high thermal conductivity continuous graphite fiber reinforced metal matrix composites (MMC's) have become available that can save much weight over present methods of heat conduction. These materials have two or three times higher thermal conductivity in the fiber direction than the pure metals when compared on a thermal conductivity to weight basis. Use of these materials for heat conduction purposes can result in weight savings of from 50 to 70 percent over structural aluminum. Another significant advantage is that these materials can be used without the plumbing and testing complexities that accompany the use of liquid heat pipes. A spinoff of this research was the development of other MMC's as electronic device heat sinks. These use particulates rather than fibers and are formulated to match the coefficient of thermal expansion of electronic substrates in order to alleviate thermally induced stresses. The development of both types of these materials as viable weight saving substitutes for traditional methods of thermal control for electronics packaging and also for spacecraft thermal control applications are the subject of this report.

Energy Impacts of Wide Band Gap Semiconductors in U.S. Light-Duty Electric Vehicle Fleet.

PubMed

Warren, Joshua A; Riddle, Matthew E; Graziano, Diane J; Das, Sujit; Upadhyayula, Venkata K K; Masanet, Eric; Cresko, Joe

2015-09-01

Silicon carbide and gallium nitride, two leading wide band gap semiconductors with significant potential in electric vehicle power electronics, are examined from a life cycle energy perspective and compared with incumbent silicon in U.S. light-duty electric vehicle fleet. Cradle-to-gate, silicon carbide is estimated to require more than twice the energy as silicon. However, the magnitude of vehicle use phase fuel savings potential is comparatively several orders of magnitude higher than the marginal increase in cradle-to-gate energy. Gallium nitride cradle-to-gate energy requirements are estimated to be similar to silicon, with use phase savings potential similar to or exceeding that of silicon carbide. Potential energy reductions in the United States vehicle fleet are examined through several scenarios that consider the market adoption potential of electric vehicles themselves, as well as the market adoption potential of wide band gap semiconductors in electric vehicles. For the 2015-2050 time frame, cumulative energy savings associated with the deployment of wide band gap semiconductors are estimated to range from 2-20 billion GJ depending on market adoption dynamics.

Avoiding Medical Identity Theft

MedlinePlus

... was not received, even when there is no money owed Maintain copies of your healthcare records Beware ... learned that a PHR saves time, energy, and money. And it saved my life! A woman's Facebook ...

[Is Herceptin(®) (trastuzumab) by subcutaneous a mini revolution? Pharmaco-economic study].

PubMed

Lieutenant, Vincent; Toulza, Émilie; Pommier, Martine; Lortal-Canguilhem, Barbara

2015-03-01

Herceptin(®) injected by intravenous (IV) is one of the key treatment of breast cancer HER2+. The improvement of galenic form allowed a new way of administration, the sub-cutaneous way (SC), authorized by EMEA in 2013. This new way enables a 5-minute infusion, a fixed dose and a fixed volume of preparation. On 2012, saving-time and financial impacts were calculated by extrapolation of the IV way in a cancer treatment center. The study showed a preparing time-saving of 7.5min/loading dose and of 6.5min/maintenance dose, and a nurse time-saving of 4.5min/loading dose and 4.25min/maintenance dose. Moreover, it can be added a saving of consumable of 13,31€ per injection in case of monotherapy. The SC leads to a new adaptation and reorganization in the preparation of monoclonal antibodies and day hospitals. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

The Spin Move: A Reliable and Cost-Effective Gowning Technique for the 21st Century.

PubMed

Ochiai, Derek H; Adib, Farshad

2015-04-01

Operating room efficiency (ORE) and utilization are considered one of the most crucial components of quality improvement in every hospital. We introduced a new gowning technique that could optimize ORE. The Spin Move quickly and efficiently wraps a surgical gown around the surgeon's body. This saves the operative time expended through the traditional gowning techniques. In the Spin Move, while the surgeon is approaching the scrub nurse, he or she uses the left heel as the fulcrum. The torque, which is generated by twisting the right leg around the left leg, helps the surgeon to close the gown as quickly and safely as possible. From 2003 to 2012, the Spin Move was performed in 1,725 consecutive procedures with no complication. The estimated average time was 5.3 and 7.8 seconds for the Spin Move and traditional gowning, respectively. The estimated time saving for the senior author during this period was 71.875 minutes. Approximately 20,000 orthopaedic surgeons practice in the United States. If this technique had been used, 23,958 hours could have been saved. The money saving could have been $14,374,800.00 (23,958 hours × $600/operating room hour) during the past 10 years. The Spin Move is easy to perform and reproducible. It saves operating room time and increases ORE.

The Spin Move: A Reliable and Cost-Effective Gowning Technique for the 21st Century

PubMed Central

Ochiai, Derek H.; Adib, Farshad

2015-01-01

Operating room efficiency (ORE) and utilization are considered one of the most crucial components of quality improvement in every hospital. We introduced a new gowning technique that could optimize ORE. The Spin Move quickly and efficiently wraps a surgical gown around the surgeon's body. This saves the operative time expended through the traditional gowning techniques. In the Spin Move, while the surgeon is approaching the scrub nurse, he or she uses the left heel as the fulcrum. The torque, which is generated by twisting the right leg around the left leg, helps the surgeon to close the gown as quickly and safely as possible. From 2003 to 2012, the Spin Move was performed in 1,725 consecutive procedures with no complication. The estimated average time was 5.3 and 7.8 seconds for the Spin Move and traditional gowning, respectively. The estimated time saving for the senior author during this period was 71.875 minutes. Approximately 20,000 orthopaedic surgeons practice in the United States. If this technique had been used, 23,958 hours could have been saved. The money saving could have been $14,374,800.00 (23,958 hours × $600/operating room hour) during the past 10 years. The Spin Move is easy to perform and reproducible. It saves operating room time and increases ORE. PMID:26052490

Effects of work participation, intergenerational transfers and savings on life satisfaction of older Malaysians.

PubMed

Ng, Sor-Tho; Hamid, Tengku-Aizan

2013-12-01

To examine the effects of work participation, intergenerational transfers and savings on the life satisfaction of older community-dwelling Malaysians. Data from the 1999 Survey on Perceptions of Needs and Problems of the Elderly on people aged 60 and over were used. The life satisfaction score was constructed from 10 questions adopted from the Life Satisfaction Inventory-A by Neugarten, Havighurst and Tobin. Multiple regression analysis was used to estimate the expected level of life satisfaction. Controlling for other variables in the model, respondents who provided assistance to and received assistance from children with savings had significantly higher life satisfaction than their counterparts, while work participation did not have any significant effect on life satisfaction. Intergenerational transfers and savings are important predictors of life satisfaction. The interdependence between generations should remain and savings habits need to be cultivated to ensure a higher life satisfaction in old age. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

Will health fund rationalisation lead to significant premium reductions?

PubMed

Hanning, Brian

2003-01-01

It has been suggested that rationalisation of health funds will generate significant albeit unquantified cost savings and thus hold or reduce health fund premiums. 2001-2 Private Health Industry Administration Council (PHIAC) data has been used to analyse these suggestions. Payments by funds for clinical services will not vary after fund rationalisation. The savings after rationalisation will arise from reductions in management expenses, which form 10.9% of total fund expenditure. A number of rationalisation scenarios are considered. The highest theoretical industry wide saving found in any plausible scenario is 2.5%, and it is uncertain whether this level of saving could be achieved in practice. If a one off saving of this order were achieved, it would have no medium and long term impact on fund premiums increases given funds are facing cost increases of 4% to 5% per annum due to demographic changes and age standardised utilization increases. It is suggested discussions on fund amalgamation divert attention from the major factors increasing fund costs, which are substantially beyond fund control.

ENERGY EFFICIENCY UPGRADES FOR SANITATION FACILITIES IN SELAWIK, AK FINAL REPORT

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

POLLIS, REBECCA

2014-10-17

The Native Village of Selawik is a federally recognized Alaskan tribe, located at the mouth of the Selawik River, about 90 miles east of Kotzebue in northwest Alaska. Due to the community’s rural location and cold climate, it is common for electric rates to be four times higher than the cost urban residents pay. These high energy costs were the driving factor for Selawik pursuing funding from the Department of Energy in order to achieve significant energy cost savings. The main objective of the project was to improve the overall energy efficiency of the water treatment/distribution and sewer collection systemsmore » in Selawik by implementing the retrofit measures identified in a previously conducted utility energy audit. One purpose for the proposed improvements was to enable the community to realize significant savings associated with the cost of energy. Another purpose of the upgrades was to repair the vacuum sewer system on the west side of Selawik to prevent future freeze-up problems during winter months.« less

Three-Catheter Technique for Ablation of Left-Sided Accessory Pathways in Wolff-Parkinson-White is Less Expensive and Equally Successful When Compared to a Five-Catheter Technique.

PubMed

Capone, Christine A; Ceresnak, Scott R; Nappo, Lynn; Gates, Gregory J; Schechter, Clyde B; Pass, Robert H

2015-12-01

To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed. The three-catheter group was compared to a control group who underwent a standard five-catheter (ablation, RV apical, CS decapolar, His catheter, and right atrial catheter) ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes, and costs were compared between groups. Twenty-eight patients met inclusion criteria with 28 control patients. The groups did not differ in gender, age, weight, or body surface area. Locations of the AP on the mitral annulus were similar between the groups. All patients were ablated via transseptal approach. Note that 28 of 28 in the three-catheter group (100%) and 27 of 28 (96%) controls were acutely successfully ablated (P = 0.31). No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or number of RF applications. Use of the three-catheter technique resulted in a total savings of $2,465/case, which includes the $680 savings from using fewer catheters as well as the savings from a shortened procedure time. Ablation in patients with WPW and a left-sided AP can be performed using three catheters with similar efficacy and safety while offering significant cost savings compared to a conventional five-catheter approach. © 2015 Wiley Periodicals, Inc.

Rice Performance and Water Use Efficiency under Plastic Mulching with Drip Irrigation

PubMed Central

He, Haibing; Ma, Fuyu; Yang, Ru; Chen, Lin; Jia, Biao; Cui, Jing; Fan, Hua; Wang, Xin; Li, Li

2013-01-01

Plastic mulching with drip irrigation is a new water-saving rice cultivation technology, but little is known on its productivity and water-saving capacity. This study aimed to assess the production potential, performance, and water use efficiency (WUE) of rice under plastic mulching with drip irrigation. Field experiments were conducted over 2 years with two rice cultivars under different cultivation systems: conventional flooding (CF), non-flooded irrigation incorporating plastic mulching with furrow irrigation (FIM), non-mulching with furrow irrigation (FIN), and plastic mulching with drip irrigation (DI). Compared with the CF treatment, grain yields were reduced by 31.76–52.19% under the DI treatment, by 57.16–61.02% under the FIM treatment, by 74.40–75.73% under the FIN treatment, which were mainly from source limitation, especially a low dry matter accumulation during post-anthesis, in non-flooded irrigation. WUE was the highest in the DI treatment, being 1.52–2.12 times higher than with the CF treatment, 1.35–1.89 times higher than with the FIM treatment, and 2.37–3.78 times higher than with the FIN treatment. The yield contribution from tillers (YCFTs) was 50.65–62.47% for the CF treatment and 12.07–20.62% for the non-flooded irrigation treatments. These low YCFTs values were attributed to the poor performance in tiller panicles rather than the total tiller number. Under non-flooded irrigation, root length was significantly reduced with more roots distributed in deep soil layers compared with the CF treatment; the DI treatment had more roots in the topsoil layer than the FIM and FIN treatments. The experiment demonstrates that the DI treatment has greater water saving capacity and lower yield and economic benefit gaps than the FIM and FIN treatments compared with the CF treatment, and would therefore be a better water-saving technology in areas of water scarcity. PMID:24340087

77 FR 319 - Culturally Significant Objects Imported for Exhibition Determinations: “Put Your Freedom in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-04

... DEPARTMENT OF STATE [Public Notice 7748] Culturally Significant Objects Imported for Exhibition Determinations: ``Put Your Freedom in the Corner, Save it for a Rainy Day'' by Martin Kippenberger SUMMARY... object ``Put Your Freedom in the Corner, Save it for a Rainy Day'' by Martin Kippenberger, imported from...

Information for Caregivers

MedlinePlus

... learned that a PHR saves time, energy, and money. And it saved my life! A woman's Facebook ... Doctor’s Visit A Reference Guide Blue Button Resources Mobile PHRs Blog FAQ © 2018 AHIMA, All Rights Reserved | ...

Common Privacy Myths

MedlinePlus

... learned that a PHR saves time, energy, and money. And it saved my life! A woman's Facebook ... Doctor’s Visit A Reference Guide Blue Button Resources Mobile PHRs Blog FAQ © 2018 AHIMA, All Rights Reserved | ...

Up Close and Personal: The Value of Feedback in Implementing an Individual Energy-Saving Adaptation

ERIC Educational Resources Information Center

Pollard, Carol Elaine

2016-01-01

Purpose: The purpose of this research is to explore the drivers of computer-related sustainability behavior at a medium-sized US university and the extent to which an inexpensive energy-saving device installed on 146 administrator, faculty and general staff workstations achieved significant savings in kWh, CO[subscript 2] kg and dollars.…

Save the World on Your Own Time

ERIC Educational Resources Information Center

Fish, Stanley

2008-01-01

What should be the role of our institutions of higher education? To promote good moral character? To bring an end to racism, sexism, economic oppression, and other social ills? To foster diversity and democracy and produce responsible citizens? In "Save the World On Your Own Time", Stanley Fish argues that, however laudable these goals might be,…

Impact of pharmacist interventions on rational prophylactic antibiotic use and cost saving in elective cesarean section.

PubMed

Wang, Jingwen; Dong, Mohan; Lu, Yang; Zhao, Xian; Li, Xin; Wen, Aidong

2015-08-01

To assess the impact of pharmacist interventions on rational use of prophylactic antibiotics and cost saving in elective cesarean section and the economic outcomes of implementing pharmacist interventions. A pre-to-post intervention design was applied to the practices of prophylactic antibiotic use in the department of gynecology and obstetrics in a Chinese tertiary hospital. Patients admitted during a 3-month period from June to August 2012 and during that from October to December 2012 undergoing elective cesarean section were assigned to the pre-intervention and the post-intervention group, respectively. Pharmacist interventions were performed in the post-intervention group, including obstetrician education, realtime monitoring of clinical records and making recommendations to obstetricians on prophylactic antibiotic prescription based on the criteria set at the beginning of the study. Data from the two groups were then compared to evaluate the outcomes of pharmacist interventions. Cost-outcome analysis was performed to determine the economic effect of implementing pharmacist interventions in preoperative antibiotic prophylaxis. Pharmacist interventions led to significant reductions in antibiotic usage cost/patient-day (p < 0.001), mean antibiotic cost (p < 0.001), mean total drug cost (p < 0.001), mean total hospitalization cost (p < 0.001), the duration of prophylaxis antibiotics (p < 0.001) and a significant increase by 19.29% in the percentage of cases adhering to all of the four criteria (p < 0.001). The ratio of the saving in antibiotic use to the cost of pharmacist time was 27.23 : 1 and the net cost benefit was $65,255.84. This study provides evidence that pharmacist interventions promoted rational use of prophylactic antibiotics and substantial cost saving in elective cesarean section.

76 FR 71437 - Mutual Savings Association Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... the public interest in order for the OCC to study the needs of and challenges facing mutual savings... for their time, but are eligible for reimbursement of travel expenses in accordance with applicable...

What goes on behind closed doors? How college dormitory residents change to save energy during a competition-based energy reduction intervention

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

Sintov, Nicole; Dux, Ellen; Tran, Agassi

Here, the aim of our study was to evaluate the impact of a competition-based intervention combining high resolution electricity feedback, incentives, information, and prompts on college dormitory residents’ energy consumption and participation in demand response (DR) events. We also investigated changes in individual-level pro-environmental behaviors and examined psycho-social correlates of behavior change. Residents of 39 suites in a freshman residence hall competed against one another to reduce energy consumption and win prizes as part of a 3-week competition. Feedback was provided in near real time at the suite-level via an interactive touch-screen kiosk. Participants also completed baseline and followup surveys.more » Findings have indicated that electricity use among all suites was approximately 6.4% lower during the competition period compared to baseline, a significant reduction. Additionally, participants reported engaging in various pro-environmental behaviors significantly more frequently during the competition relative to baseline. Changes in pro-environmental behavior were associated with changes in level of group identification and perceived social norms. In three weeks, dormitory residents saved 3, 158 kWh of electricity compared to baseline – the equivalent of more than 3, 470 pounds of carbon dioxide emissions. Our findings provide evidence that real-time feedback, combined with incentives, information, and prompts, can motivate on-campus residents to reduce energy consumption. We contribute to a limited body of evidence supporting the effectiveness of dorm energy competitions in motivating college students to save energy. In addition, we identified individual-level behavioral and psycho-social changes made during such an intervention. University residential life planners may also use the results of this research to inform student programming.« less

What goes on behind closed doors? How college dormitory residents change to save energy during a competition-based energy reduction intervention

DOE PAGES

Sintov, Nicole; Dux, Ellen; Tran, Agassi; ...

2016-07-04

Here, the aim of our study was to evaluate the impact of a competition-based intervention combining high resolution electricity feedback, incentives, information, and prompts on college dormitory residents’ energy consumption and participation in demand response (DR) events. We also investigated changes in individual-level pro-environmental behaviors and examined psycho-social correlates of behavior change. Residents of 39 suites in a freshman residence hall competed against one another to reduce energy consumption and win prizes as part of a 3-week competition. Feedback was provided in near real time at the suite-level via an interactive touch-screen kiosk. Participants also completed baseline and followup surveys.more » Findings have indicated that electricity use among all suites was approximately 6.4% lower during the competition period compared to baseline, a significant reduction. Additionally, participants reported engaging in various pro-environmental behaviors significantly more frequently during the competition relative to baseline. Changes in pro-environmental behavior were associated with changes in level of group identification and perceived social norms. In three weeks, dormitory residents saved 3, 158 kWh of electricity compared to baseline – the equivalent of more than 3, 470 pounds of carbon dioxide emissions. Our findings provide evidence that real-time feedback, combined with incentives, information, and prompts, can motivate on-campus residents to reduce energy consumption. We contribute to a limited body of evidence supporting the effectiveness of dorm energy competitions in motivating college students to save energy. In addition, we identified individual-level behavioral and psycho-social changes made during such an intervention. University residential life planners may also use the results of this research to inform student programming.« less

Baker-Barry Tunnel Lighting: Evaluation of a Potential GATEWAY Demonstrations Project

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

Tuenge, Jason R.

2011-06-28

The U.S. Department of Energy is evaluating the Baker-Barry Tunnel as a potential GATEWAY Demonstrations project for deployment of solid-state lighting (SSL) technology. The National Park Service views this project as a possible proving ground and template for implementation of light-emitting diode (LED) luminaires in other tunnels, thereby expanding the estimated 40% energy savings from 132 MWh/yr to a much larger figure nationally. Most of the energy savings in this application is attributable to the instant-restrike capability of LED products and to their high tolerance for frequent on/off switching, used here to separately control either end of the tunnel duringmore » daytime hours. Some LED luminaires rival or outperform their high-intensity discharge (HID) counterparts in terms of efficacy, but options are limited, and smaller lumen packages preclude true one-for-one equivalence. However, LED products continue to improve in efficacy and affordability at a rate unmatched by other light source technologies; the estimated simple payback period of eight years (excluding installation costs and maintenance savings) can be expected to improve with time. The proposed revisions to the existing high-pressure sodium (HPS) lighting system would require slightly increased controls complexity and significantly increased luminaire types and quantities. In exchange, substantial annual savings (from reduced maintenance and energy use) would be complemented by improved quantity and quality of illumination. Although advanced lighting controls could offer additional savings, it is unclear whether such a system would prove cost-effective; this topic may be explored in future work.« less

Enhanced identification of eligibility for depression research using an electronic medical record search engine.

PubMed

Seyfried, Lisa; Hanauer, David A; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C

2009-12-01

Electronic medical records (EMRs) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and clinical accuracy of a medical record search engine vs. manual review of the EMR. Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic medical record search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving clinical accuracy. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information.

Enhanced Identification of Eligibility for Depression Research Using an Electronic Medical Record Search Engine

PubMed Central

Seyfried, Lisa; Hanauer, David; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C.

2009-01-01

Purpose Electronic medical records (EMR) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and accuracy of electronic search engine vs. manual review of the EMR. Methods Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Results Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Conclusions Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving reliability. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information. PMID:19560962

An adaptive two-stage energy-efficiency mechanism for the doze mode in EPON

NASA Astrophysics Data System (ADS)

Nikoukar, AliAkbar; Hwang, I.-Shyan; Su, Yu-Min; Liem, Andrew Tanny

2016-07-01

Sleep and doze power-saving modes are the common ways to reduce power consumption of optical network units (ONUs) in Ethernet passive optical network (EPON). The doze mode turns off the ONU transmitter when there is no traffic in the upstream direction while the sleep mode turns off the ONU transmitter and receiver. As the result, the sleep mode is more efficient compared to the doze mode, but it introduces additional complexity of scheduling and signaling, losses the clock synchronization and requires long clock recovery time; furthermore, it requires the cooperation of the optical line terminal (OLT) in the downstream direction to queue frames. To improve the energy-saving in the doze mode, a new two-stage mechanism is introduced that the doze sleep duration is extended for longer time with acceptable quality-of-services (QoS) metrics when ONU is idle in the current cycle. By this way the ONU enters the doze mode even in the high load traffic; moreover, the green dynamic bandwidth allocation (GBA) is proposed to calculate the doze sleep duration based on the ONU queue state and incoming traffic ratio. Simulation results show that the proposed mechanism significantly improves the energy-saving 74% and 54% when traffic load is from the light load to the high load in different traffic situations, and also promises the QoS performance.

Small Body Hopper Mobility Concepts

NASA Technical Reports Server (NTRS)

Howe, A. Scott; Gernhardt, Michael L.; Lee, Dave E.; Crues, E. Zack; Dexter, Dan E.; Abercromby, Andrew F. J.; Chappell, Steve P.; Nguyen, Hung T.

2015-01-01

A propellant-saving hopper mobility system was studied that could help facilitate the exploration of small bodies such as Phobos for long-duration human missions. The NASA Evolvable Mars Campaign (EMC) has proposed a mission to the moons of Mars as a transitional step for eventual Mars surface exploration. While a Mars transit habitat would be parked in High-Mars Orbit (HMO), crew members would visit the surface of Phobos multiple times for up to 14 days duration (up to 50 days at a time with logistics support). This paper describes a small body surface mobility concept that is capable of transporting a small, two-person Pressurized Exploration Vehicle (PEV) cabin to various sites of interest in the low-gravity environment. Using stored kinetic energy between bounces, a propellant-saving hopper mobility system can release the energy to vector the vehicle away from the surface in a specified direction. Alternatively, the stored energy can be retained for later use while the vehicle is stationary in respect to the surface. The hopper actuation was modeled using a variety of launch velocities, and the hopper mobility was evaluated using NASA Exploration Systems Simulations (NExSyS) for transit between surface sites of interest. A hopper system with linear electromagnetic motors and mechanical spring actuators coupled with Control Moment Gyroscope (CMG) for attitude control will use renewable electrical power, resulting in a significant propellant savings.

Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings.

PubMed

Theilen, Ulf; Fraser, Laura; Jones, Patricia; Leonard, Paul; Simpson, Dave

2017-06-01

The introduction of a paediatric Medical Emergency Team (pMET) was accompanied by weekly in-situ simulation team training. Key ward staff participated in team training, focusing on recognition of the deteriorating child, teamwork and early involvement of senior staff. Following an earlier study [1], this investigation aimed to evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications. Prospective cohort study of all deteriorating in-patients in a tertiary paediatric hospital requiring admission to paediatric intensive care (PICU) the year before, 1year after and 3 years after the introduction of pMET and team training. Deteriorating patients were recognised more promptly (before/1year after/3years after pMET; median time 4/1.5/0.5h, p<0.001), more often reviewed by consultants (45%/76%/81%, p<0.001) and more rapidly escalated to PICU (median time 10.5/5/3.5h, p=0.02). There was a significant reduction in associated PICU admissions (56/51/32, p=0.02) and PICU bed days (527/336/193, p<0.001). The total annual cost of training (£74,250) was more than offset by savings from reduced PICU bed days (£801,600 per annum). Introduction of pMET coincided with significantly reduced hospital mortality (p<0.001). These results indicate that lessons learnt by ward staff during team training led to sustained improvements in the hospital response to critically deteriorating in-patients, significantly improved patient outcomes and substantial savings. Integration of regular in-situ simulation training of medical emergency teams, including key ward staff, in routine clinical care has potential application in all acute specialties. Copyright © 2017. Published by Elsevier B.V.

12 CFR 170.4 - Issuance of orders to correct deficiencies and to take or refrain from taking other actions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Notice of intent to issue order—(1) In general. The OCC shall provide a Federal savings association prior written notice of the OCC's intention to issue an order requiring the savings association to correct a... the FDI Act. The savings association shall have such time to respond to a proposed order as provided...

12 CFR 170.4 - Issuance of orders to correct deficiencies and to take or refrain from taking other actions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Notice of intent to issue order—(1) In general. The OCC shall provide a Federal savings association prior written notice of the OCC's intention to issue an order requiring the savings association to correct a... the FDI Act. The savings association shall have such time to respond to a proposed order as provided...

12 CFR 170.4 - Issuance of orders to correct deficiencies and to take or refrain from taking other actions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Notice of intent to issue order—(1) In general. The OCC shall provide a Federal savings association prior written notice of the OCC's intention to issue an order requiring the savings association to correct a... the FDI Act. The savings association shall have such time to respond to a proposed order as provided...

Social Security and Saving: A Time-Series Econometrics Pedagogical Example (With "R" Code)

ERIC Educational Resources Information Center

Wassell, Charles S., Jr.

2018-01-01

In 1974, and then again in 1996, Martin Feldstein published studies of the impact of the Social Security system on private saving in the U.S. economy. He found that Social Security depressed personal saving by a substantial amount--up to 50 percent. The author uses the Feldstein data and empirical models in this article to illustrate the steps in…

Ideas To Save Electricity

ERIC Educational Resources Information Center

Gardner, John C.

1974-01-01

Significant energy savings can be effected through stopping obvious waste of water, electricity, and heat; purchasing equipment with the correct voltage and horsepower; equipment maintenance; and redesigning or replacing obsolete or inefficient equipment. (Author/MF)

A review on waste heat recovery from exhaust in the ceramics industry

NASA Astrophysics Data System (ADS)

Delpech, Bertrand; Axcell, Brian; Jouhara, Hussam

2017-11-01

Following the energy crisis in 1980, many saving technologies have been investigated with attempts to implement them into various industries, one of them is the field of ceramic production. In order to comply with energy saving trends and environmental issues, the European ceramic industry sector has developed energy efficient systems which reduced significantly production time and costs and reduced total energy consumption. The last achievement is of great importance as the energy consumption of the ceramic process accounts for a significant percentage of the total production costs. More precisely, the firing stage consumes the highest amount of energy during the whole ceramic production process. The use of roller kilns, fired by natural gas, involves a loss of 50% of the input energy via the flue gas and the cooling gas exhausts. This review paper briefly describes the production process of the different ceramic products, with a focus on the ceramic sector in Europe. Due to the limited on waste heat recovery in the ceramic industry, other high temperature waste heat recovery applications are considered in the paper, such as in concrete and steel production, which could have a potential use in the ceramic industry. The state of the art technologies used in the ceramics industry are reviewed with a special interest in waste heat recovery from the ceramic process exhaust stacks and energy saving technologies.

Economic Feasibility of Staffing the Intensive Care Unit with a Communication Facilitator.

PubMed

Khandelwal, Nita; Benkeser, David; Coe, Norma B; Engelberg, Ruth A; Curtis, J Randall

2016-12-01

In the intensive care unit (ICU), complex decision making by clinicians and families requires good communication to ensure that care is consistent with the patients' values and goals. To assess the economic feasibility of staffing ICUs with a communication facilitator. Data were from a randomized trial of an "ICU communication facilitator" linked to hospital financial records; eligible patients (n = 135) were admitted to the ICU at a single hospital with predicted mortality ≥30% and a surrogate decision maker. Adjusted regression analyses assessed differences in ICU total and direct variable costs between intervention and control patients. A bootstrap-based simulation assessed the cost efficiency of a facilitator while varying the full-time equivalent of the facilitator and the ICU mortality risk. Total ICU costs (mean 22.8k; 95% CI, -42.0k to -3.6k; P = 0.02) and average daily ICU costs (mean, -0.38k; 95% CI, -0.65k to -0.11k; P = 0.006)] were reduced significantly with the intervention. Despite more contacts, families of survivors spent less time per encounter with facilitators than did families of decedents (mean, 25 [SD, 11] min vs. 36 [SD, 14] min). Simulation demonstrated maximal weekly savings with a 1.0 full-time equivalent facilitator and a predicted ICU mortality of 15% (total weekly ICU cost savings, $58.4k [95% CI, $57.7k-59.2k]; weekly direct variable savings, $5.7k [95% CI, $5.5k-5.8k]) after incorporating facilitator costs. Adding a full-time trained communication facilitator in the ICU may improve the quality of care while simultaneously reducing short-term (direct variable) and long-term (total) health care costs. This intervention is likely to be more cost effective in a lower-mortality population.

Adverse Effects of Daylight Saving Time on Adolescents' Sleep and Vigilance

PubMed Central

Medina, Diana; Ebben, Matthew; Milrad, Sara; Atkinson, Brianna; Krieger, Ana C.

2015-01-01

Study Objectives: Daylight saving time (DST) has been established with the intent to reduce energy expenditure, however unintentional effects on sleep and vigilance have not been consistently measured. The objective of this study was to test the hypothesis that DST adversely affects high school students' sleep and vigilance on the school days following its implementation. Methods: A natural experiment design was used to assess baseline and post-DST differences in objective and subjective measures of sleep and vigilance by actigraphy, sleep diary, sleepiness scale, and psychomotor vigilance testing (PVT). Students were tested during school days immediately preceding and following DST. Results: A total of 40 high school students were enrolled in this study; 35 completed the protocol. Sleep duration declined by an average of 32 minutes on the weeknights post-DST, reflecting a cumulative sleep loss of 2 h 42 min as compared to the baseline week (p = 0.001). This finding was confirmed by sleep diary analyses, reflecting an average sleep loss of 27 min/night (p = 0.004) post-DST. Vigilance significantly deteriorated, with a decline in PVT performance post-DST, resulting in longer reaction times (p < 0.001) and increased lapses (p < 0.001). Increased daytime sleepiness was also demonstrated (p < 0.001). Conclusions: The early March DST onset adversely affected sleep and vigilance in high school students resulting in increased daytime sleepiness. Larger scale evaluations of sleep impairments related to DST are needed to further quantify this problem in the population. If confirmed, measures to attenuate sleep loss post-DST should be implemented. Citation: Medina D, Ebben M, Milrad S, Atkinson B, Krieger AC. Adverse effects of daylight saving time on adolescents' sleep and vigilance. J Clin Sleep Med 2015;11(8):879–884. PMID:25979095

First performance evaluation of software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine at CT.

PubMed

Scholtz, Jan-Erik; Wichmann, Julian L; Kaup, Moritz; Fischer, Sebastian; Kerl, J Matthias; Lehnert, Thomas; Vogl, Thomas J; Bauer, Ralf W

2015-03-01

To evaluate software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine on CT in terms of accuracy, potential for time savings and workflow improvement. 77 patients (28 women, 49 men, mean age 65.3±14.4 years) with known or suspected spinal disorders (degenerative spine disease n=32; disc herniation n=36; traumatic vertebral fractures n=9) underwent 64-slice MDCT with thin-slab reconstruction. Time for automatic labeling of the thoracolumbar spine and reconstruction of double-angulated axial images of the pathological vertebrae was compared with manually performed reconstruction of anatomical aligned axial images. Reformatted images of both reconstruction methods were assessed by two observers regarding accuracy of symmetric depiction of anatomical structures. In 33 cases double-angulated axial images were created in 1 vertebra, in 28 cases in 2 vertebrae and in 16 cases in 3 vertebrae. Correct automatic labeling was achieved in 72 of 77 patients (93.5%). Errors could be manually corrected in 4 cases. Automatic labeling required 1min in average. In cases where anatomical aligned axial images of 1 vertebra were created, reconstructions made by hand were significantly faster (p<0.05). Automatic reconstruction was time-saving in cases of 2 and more vertebrae (p<0.05). Both reconstruction methods revealed good image quality with excellent inter-observer agreement. The evaluated software for automatic labeling and anatomically aligned, double-angulated axial image reconstruction of the thoracolumbar spine on CT is time-saving when reconstructions of 2 and more vertebrae are performed. Checking results of automatic labeling is necessary to prevent errors in labeling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Navigation API Route Fuel Saving Opportunity Assessment on Large-Scale Real-World Travel Data for Conventional Vehicles and Hybrid Electric Vehicles: Preprint

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

Zhu, Lei; Holden, Jacob; Gonder, Jeffrey D

The green routing strategy instructing a vehicle to select a fuel-efficient route benefits the current transportation system with fuel-saving opportunities. This paper introduces a navigation API route fuel-saving evaluation framework for estimating fuel advantages of alternative API routes based on large-scale, real-world travel data for conventional vehicles (CVs) and hybrid electric vehicles (HEVs). The navigation APIs, such Google Directions API, integrate traffic conditions and provide feasible alternative routes for origin-destination pairs. This paper develops two link-based fuel-consumption models stratified by link-level speed, road grade, and functional class (local/non-local), one for CVs and the other for HEVs. The link-based fuel-consumption modelsmore » are built by assigning travel from a large number of GPS driving traces to the links in TomTom MultiNet as the underlying road network layer and road grade data from a U.S. Geological Survey elevation data set. Fuel consumption on a link is calculated by the proposed fuel consumption model. This paper envisions two kinds of applications: 1) identifying alternate routes that save fuel, and 2) quantifying the potential fuel savings for large amounts of travel. An experiment based on a large-scale California Household Travel Survey GPS trajectory data set is conducted. The fuel consumption and savings of CVs and HEVs are investigated. At the same time, the trade-off between fuel saving and time saving for choosing different routes is also examined for both powertrains.« less

How to Create a Personal Health Record

MedlinePlus

... learned that a PHR saves time, energy, and money. And it saved my life! A woman's Facebook ... Doctor’s Visit A Reference Guide Blue Button Resources Mobile PHRs Blog FAQ © 2018 AHIMA, All Rights Reserved | ...

A properly adjusted forage harvester can save time and money

USDA-ARS?s Scientific Manuscript database

A properly adjusted forage harvester can save fuel and increase the realizable milk per ton of your silage. This article details the adjustments necessary to minimize energy while maximizing productivity and forage quality....

31 CFR 360.12 - Disposition of excess.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATES SAVINGS BONDS, SERIES I Limitations on Annual Purchases § 360.12 Disposition of excess. If any person at any time has savings bonds issued during any one calendar year in excess of the prescribed...

31 CFR 360.12 - Disposition of excess.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STATES SAVINGS BONDS, SERIES I Limitations on Annual Purchases § 360.12 Disposition of excess. If any person at any time has savings bonds issued during any one calendar year in excess of the prescribed...

31 CFR 353.12 - Disposition of excess.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STATES SAVINGS BONDS, SERIES EE AND HH Limitations on Annual Purchases § 353.12 Disposition of excess. If any person at any time has savings bonds issued during any one calendar year in excess of the...

31 CFR 353.12 - Disposition of excess.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STATES SAVINGS BONDS, SERIES EE AND HH Limitations on Annual Purchases § 353.12 Disposition of excess. If any person at any time has savings bonds issued during any one calendar year in excess of the...

31 CFR 353.12 - Disposition of excess.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATES SAVINGS BONDS, SERIES EE AND HH Limitations on Annual Purchases § 353.12 Disposition of excess. If any person at any time has savings bonds issued during any one calendar year in excess of the...

31 CFR 360.12 - Disposition of excess.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STATES SAVINGS BONDS, SERIES I Limitations on Annual Purchases § 360.12 Disposition of excess. If any person at any time has savings bonds issued during any one calendar year in excess of the prescribed...

An adaptive time-stepping strategy for solving the phase field crystal model

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

Zhang, Zhengru, E-mail: zrzhang@bnu.edu.cn; Ma, Yuan, E-mail: yuner1022@gmail.com; Qiao, Zhonghua, E-mail: zqiao@polyu.edu.hk

2013-09-15

In this work, we will propose an adaptive time step method for simulating the dynamics of the phase field crystal (PFC) model. The numerical simulation of the PFC model needs long time to reach steady state, and then large time-stepping method is necessary. Unconditionally energy stable schemes are used to solve the PFC model. The time steps are adaptively determined based on the time derivative of the corresponding energy. It is found that the use of the proposed time step adaptivity cannot only resolve the steady state solution, but also the dynamical development of the solution efficiently and accurately. Themore » numerical experiments demonstrate that the CPU time is significantly saved for long time simulations.« less

An analysis of 6 decades of hygiene-related advertising: 1940-2000.

PubMed

Aiello, A E; Larson, E L

2001-12-01

To describe and analyze trends in hygiene-related advertisements and examine potential social and regulatory changes that might be associated with these trends. From 1940 to 2000, advertisements in January issues of 2 widely read magazines were analyzed every fifth year, and 2 additional magazines only available from 1960 to 2000 were also analyzed every fifth year. In a content analysis, the total number of advertisements were determined and specific advertisements were grouped into categories (personal hygiene, dishwashing, laundry, and house cleaning) and further examined for the presence of 4 key claims (aesthetics, health effects, time-saving, and microbial effects). From 1940 to 2000 for all magazines combined, 10.4% of the advertisements were devoted to hygiene products. After 1960 there were significantly fewer hygiene advertisements as compared with 1940 to 1955, and there was a significant increase after 1980 (P <.00001). Throughout all 6 decades, most advertisements related to personal hygiene. There were no significant differences over time in the proportion of advertisements that made claims related to health, microbial effects, or aesthetics, but significantly more advertisements before 1960 made time-savings claims (P =.009). This content analysis reflects a cyclical attention in consumer advertising to personal and home hygiene products during the past 6 decades, with a waning of interest in the decades from 1960 to 1980 and an apparent resurgence of advertisements from 1985 to 2000. The potential contributions of federal regulatory bodies and societal changes (e.g., new marketing strategies and options, product development, new and re-emerging infectious diseases, increasing concern about antimicrobial resistance, and increasing recognition that infectious diseases are unlikely to be eradicated) to these marketing trends are discussed.

QuickView video preview software of colon capsule endoscopy: reliability in presenting colorectal polyps as compared to normal mode reading.

PubMed

Farnbacher, Michael J; Krause, Horst H; Hagel, Alexander F; Raithel, Martin; Neurath, Markus F; Schneider, Thomas

2014-03-01

OBJECTIVE. Colon capsule endoscopy (CCE) proved to be highly sensitive in detection of colorectal polyps (CP). Major limitation is the time-consuming video reading. The aim of this prospective, double-center study was to assess the theoretical time-saving potential and its possible impact on the reliability of "QuickView" (QV), in the presentation of CP as compared to normal mode (NM). METHODS. During NM reading of 65 CCE videos (mean patient´s age 56 years), all frames showing CPs were collected and compared to the number of frames presented by QV at increasing QV settings (10, 20, ... 80%). Reliability of QV in presenting polyps <6 mm and ≥6 mm (significant polyp), and identifying patients for subsequent therapeutic colonoscopy, capsule egestion rate, cleansing level, and estimated time-saving potential were assessed. RESULTS. At a 30% QV setting, the QV video presented 89% of the significant polyps and 86% of any polyps with ≥1 frame (per-polyp analysis) identified in NM before. At a 10% QV setting, 98% of the 52 patients with significant polyps could be identified (per-patient analysis) by QV video analysis. Capsule excretion rate was 74% and colon cleanliness was adequate in 85%. QV´s presentation rate correlates to the QV setting, the polyp size, and the number of frames per finding. CONCLUSIONS. Depending on its setting, the reliability of QV in presenting CP as compared to NM reading is notable. However, if no significant polyp is presented by QV, NM reading must be performed afterwards. The reduction of frames to be analyzed in QV might speed up identification of candidates for therapeutic colonoscopy.

Estimating the Energy, Demand and Cost Savings from a Geothermal Heat Pump ESPC Project at Fort Polk, LA Through Utility Bill Analysis.

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

Shonder, John A; Hughes, Patrick

2006-01-01

Energy savings performance contracts (ESPCs) are a method of financing energy conservation projects using the energy cost savings generated by the conservation measures themselves. Ideally, reduced energy costs are visible as reduced utility bills, but in fact this is not always the case. On large military bases, for example, a single electric meter typically covers hundreds of individual buildings. Savings from an ESPC involving only a small number of these buildings will have little effect on the overall utility bill. In fact, changes in mission, occupancy, and energy prices could cause substantial increases in utility bills. For this reason, other,more » more practical, methods have been developed to measure and verify savings in ESPC projects. Nevertheless, increasing utility bills--when ESPCs are expected to be reducing them--are problematic and can lead some observers to question whether savings are actually being achieved. In this paper, the authors use utility bill analysis to determine energy, demand, and cost savings from an ESPC project that installed geothermal heat pumps in the family housing areas of the military base at Fort Polk, Louisiana. The savings estimates for the first year after the retrofits were found to be in substantial agreement with previous estimates that were based on submetered data. However, the utility bills also show that electrical use tended to increase as time went on. Since other data show that the energy use in family housing has remained about the same over the period, the authors conclude that the savings from the ESPC have persisted, and increases in electrical use must be due to loads unassociated with family housing. This shows that under certain circumstances, and with the proper analysis, utility bills can be used to estimate savings from ESPC projects. However, these circumstances are rare and over time the comparison may be invalidated by increases in energy use in areas unaffected by the ESPC.« less

Architectural Analysis of Complex Evolving Systems of Systems

NASA Technical Reports Server (NTRS)

Lindvall, Mikael; Stratton, William C.; Sibol, Deane E.; Ray, Arnab; Ackemann, Chris; Yonkwa, Lyly; Ganesan, Dharma

2009-01-01

The goal of this collaborative project between FC-MD, APL, and GSFC and supported by NASA IV&V Software Assurance Research Program (SARP), was to develop a tool, Dynamic SAVE, or Dyn-SAVE for short, for analyzing architectures of systems of systems. The project team was comprised of the principal investigator (PI) from FC-MD and four other FC-MD scientists (part time) and several FC-MD students (full time), as well as, two APL software architects (part time), and one NASA POC (part time). The PI and FC-MD scientists together with APL architects were responsible for requirements analysis, and for applying and evaluating the Dyn-SAVE tool and method. The PI and a group of FC-MD scientists were responsible for improving the method and conducting outreach activities, while another group of FC-MD scientists were responsible for development and improvement of the tool. Oversight and reporting was conducted by the PI and NASA POC. The project team produced many results including several prototypes of the Dyn-SAVE tool and method, several case studies documenting how the tool and method was applied to APL s software systems, and several published papers in highly respected conferences and journals. Dyn-SAVE as developed and enhanced throughout this research period, is a software tool intended for software developers and architects, software integration testers, and persons who need to analyze software systems from the point of view of how it communicates with other systems. Using the tool, the user specifies the planned communication behavior of the system modeled as a sequence diagram. The user then captures and imports the actual communication behavior of the system, which is then converted and visualized as a sequence diagram by Dyn-SAVE. After mapping the planned to the actual and specifying parameter and timing constraints, Dyn-SAVE detects and highlights deviations between the planned and the actual behavior. Requirements based on the need to analyze two inter-system communication protocols that are representative of protocols used in the Aerospace industry have been specified. The protocols are related: APL s Common Ground System (CGS) as used in the MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) and the Radiation Belt Space Probes (RBSP) missions. The analyzed communications were implementations of the Telemetry protocol and the CCSDS File Delivery Protocol (CFDP) protocol. Based on these requirements, three prototypes of Dyn-SAVE were developed and applied to these protocols. The application of Dyn-SAVE to these protocols resulted in the detection of several issues. Dyn-SAVE was also applied to several Testbeds that have previously been used for experimentation earlier on this project, as well as, to other protocols and logs for testing its broader applicability. For example, Dyn-SAVE was used to analyze 1) the communication pattern between a web browser and a web server, 2) the system log of a computer in order to detect offnominal computer shut-down behavior, and 3) the actual test cases of NASA Goddard s Core Flight System (CFS) and automatically generated test cases in order to determine the overlap between the two sets of test cases. In all cases, Dyn-SAVE assisted in providing insightful conclusions about each of the cases identified above.

Chinese hotel general managers' perspectives on energy-saving practices

NASA Astrophysics Data System (ADS)

Zhu, Yidan

As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

The impact of the 'Better Care Better Value' prescribing policy on the utilisation of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for treating hypertension in the UK primary care setting: longitudinal quasi-experimental design.

PubMed

Baker, Amanj; Chen, Li-Chia; Elliott, Rachel A; Godman, Brian

2015-09-10

In April/2009, the UK National Health Service initiated four Better Care Better Value (BCBV) prescribing indicators, one of which encouraged the prescribing of cheaper angiotensin-converting enzyme inhibitors (ACEIs) instead of expensive angiotensin receptor blockers (ARBs), with 80 % ACEIs/20 % ARBs as a proposed, and achievable target. The policy was intended to save costs without affecting patient outcomes. However, little is known about the actual impact of the BCBV indicator on ACEIs/ARBs utilisation and cost-savings. Therefore, this study aimed to evaluate the impact of BCBV policy on ACEIs/ARBs utilisation and cost-savings, including exploration of regional variations of the policy's impact. This cross-sectional study used data from the UK Clinical Practice Research Datalink. Segmented time-series analysis was applied to monthly ACEIs prescription proportion, adjusted number of ACEIs/ARBs prescriptions and costs. Overall, the proportion of ACEIs prescription decreased during the study period from 71.2% in April/2006 to 70.7% in March/2012, with a small but a statistically significant pre-policy reduction in its monthly trend of 0.02% (p < 0.001). Instantly after its initiation, the policy was associated with a sudden reduction in the proportion of ACEIs prescription; however, it resulted in a statistically significant increase in the post-policy monthly trend of ACEIs prescription proportion of 0.013% (p < 0.001), resulting in an overall post-policy slope of -0.007%. Despite this post-policy induced increment, the policy failed to achieve the 80% target, which resulted in missing a potential cost-saving opportunity. The pre-policy trend of the adjusted number of ACEIs/ARBs prescriptions was increasing; however, their trends declined after the policy implementation. The policy affected neither total ACEIs/ARBs cost nor individual ACEIs or ARBs costs. ACEIs/ARBs utilisation was not affected by the BCBV policy. The small increase in post-policy ACEIs prescription proportion was not associated with any savings. This study represents a case study of a failed or ineffective policy and thus provides key learning lessons for other healthcare authorities. Given the existing opportunity of potential cost-savings from achieving the 80 % target, specific measures would be needed to enhance the policy implementation and uptake; however, this must be balanced against other cost-saving policies in other high-priority areas.

Urban Telemedicine: The Applicability of Teleburns in the Rehabilitative Phase.

PubMed

Liu, Yuk Ming; Mathews, Katie; Vardanian, Andrew; Bozkurt, Taylan; Schneider, Jeffrey C; Hefner, Jaye; Schulz, John T; Fagan, Shawn P; Goverman, Jeremy

Telemedicine has been successfully used in many areas of medicine, including triage and evaluation of the acute burn patient. The utility of telemedicine during the rehabilitative phase of burn care has yet to be evaluated; therefore, we expanded our telemedicine program to link our burn center with a rehabilitation facility. The goal of this project was to demonstrate cost-effective improvements in the transition and quality of care. A retrospective review was performed on all patients enrolled in our telemedicine/rehabilitation program between March 2013 and March 2014. Data collected included total number of encounters, visits, type of visit, physician time, and readmissions. Transportation costs were based on local ambulance rates between the two facilities. The impact of telemedicine was evaluated with respect to the time saved for the physician, burn center, and burn clinic, as well as rehabilitative days saved. A patient satisfaction survey was also administered. A total of 29 patients participated in 73 virtual visits through the telemedicine project. Virtual visits included new consults, preoperative evaluations, and postoperative follow-ups. A total of 146 ambulance transports were averted during the study period, totaling $101,110. Virtual visits saved 6.8 outpatient burn clinic days, or 73 clinic appointments of 30-min duration. The ability to perform more outpatient surgery resulted in 80 inpatient bed days saved at the burn hospital. The rehabilitation hospital saved an average of 2 to 3 patient days secondary to unnecessary travel. Satisfaction surveys demonstrated patient satisfaction with the encounters, primarily related to time saved. The decrease in travel time for the patient from the rehabilitation hospital to outpatient burn clinic improved adherence to the rehabilitation care plan and resulted in increased throughput at the rehabilitation facility. Videoconferencing between a burn center and rehabilitation hospital streamlined patient care and reduced health care costs, while maintaining quality of care and patient satisfaction. This program has improved inpatient burn rehabilitation by maximizing time spent in therapy and avoiding unnecessary patient travel to offsite appointments.

[Global MED-NET].

PubMed

Slatina, E

2000-01-01

This poster will show a concept as well as some practical solutions for the database which is intended to be used by all members and institutions of the Emergency Medical Care international institutions network. This poster shows how data is automatically processed in a rapid and good quality way, while in the same time the lives are saved and time and money are saved too.

Assessing Your Assets: Systems for Tracking and Managing IT Assets Can Save Time and Dollars

ERIC Educational Resources Information Center

Holub, Patricia A.

2007-01-01

The average school district loses more than $80,000 per year because of lost or damaged IT assets, according to a QED survey cosponsored by Follett Software Company. And many districts--59 percent--still use manual systems to track assets. Enter asset management systems. Software for managing assets, when implemented properly, can save time,…

31 CFR 315.35 - Payment (redemption).

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Savings Notes. A Series E bond will be paid at any time after two months from issue date at the... time after six (6) months from issue date. In any case where Series H bonds are surrendered to a..., SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.35...

Low-Emissivity, Energy-Control, Retrofit Window Film: Final Report

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

Winckler, Lisa

Solutia Performance Films, utilizing funding from the U.S. Department of Energy's Buildings Technologies Program, completed research to develop, validate, and commercialize a range of cost-effective, low-emissivity energy-control retrofit window films with significantly improved emissivity over current technology. These films, sold under the EnerLogic® trade name, offer the energy-saving properties of modern low-e windows, with several advantages over replacement windows, such as: lower initial installation cost, a significantly lower product carbon footprint, and an ability to provide a much faster return on investment. EnerLogic® window films also offer significantly greater energy savings than previously available with window films with similar visiblemore » light transmissions. EnerLogic® window films offer these energy-saving advantages over other window films due to its ability to offer both summer cooling and winter heating savings. Unlike most window films, that produce savings only during the cooling season, EnerLogic® window film is an all-season, low-emissivity (low-e) film that produces both cooling and heating season savings. This paper will present technical information on the development hurdles as well as details regarding the following claims being made about EnerLogic® window film, which can be found at www.EnerLogicfilm.com: 1. Other window film technologies save energy. EnerLogic® window film's patent-pending coating delivers excellent energy efficiency in every season, so no other film can match its annual dollar or energy consumption savings. 2. EnerLogic® window film is a low-cost, high-return technology that compares favorably to other popular energy-saving measures both in terms of energy efficiency and cost savings. In fact, EnerLogic® window film typically outperforms most of the alternatives in terms of simple payback. 3. EnerLogic® window film provides unparalleled glass insulating capabilities for window film products. With its patent-pending low-e technology, EnerLogic® window film has the best insulating performance of any film product available. The insulating power of EnerLogic® window film gives single-pane windows the annual insulating performance of double-pane windows - and gives double-pane windows the annual insulating performance of triple-pane windows.« less

Social factors of mental disorder and suicide in Japan-for understanding circumstance of suicides in each prefecture-.

PubMed

Motohashi, Hideyuki; Fujimoto, Atsuko; Sakane, Toshiyasu; Yamamoto, Akira; Yano, Yoshitaka

2013-01-01

In recent years there have been over 30000 suicides annually in Japan. This is one of the most serious problems for Japanese society. Because mental disorder is closely associated with suicide, factors related to the increase in mental disorders and suicides should be clarified. In this study, various data regarding social factors were evaluated to assess the correlation of the number of patients with mental disorders and suicides among the 47 prefectures of Japan. Various data regarding social factors, such as income, savings, or rate of divorce, were obtained from the database of the Ministry of Health, Labour and Welfare of Japan. Among the factors, the annual income and the amount of savings were significantly correlated with the number of patients with mental disorder. On the other hand, while the annual income did not have a significant correlation with suicides, the amount of savings had a significant correlation with suicides. In conclusion, the annual income and amount of savings may both be one of the important factors involved in mental disorders, and the savings may also be a factor affecting suicides. These analyses are valuable in helping to clarify the causes of mental disease, and can hopefully contribute to the health and welfare of Japanese.

Energy Savings Performance Contract Energy Sales Agreement Toolkit

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

None

FEMP developed the Energy Savings Performance Contracting Energy Sales Agreement (ESPC ESA) Toolkit to provide federal agency contracting officers and other acquisition team members with information that will facilitate the timely execution of ESPC ESA projects.

Web-based management of diabetes through glucose uploads: has the time come for telemedicine?

PubMed

Azar, Madona; Gabbay, Robert

2009-01-01

This review focuses on the burgeoning use of web-based systems allowing patient-initiated glucometer uploads to facilitate provider treatment intensification. Studies in type 1 diabetes tended to show equivalent HbA1c improvements in both intervention and control groups without statistically significant difference. In contrast, type 2 patients seemed to do better than controls with significant differences in HbA1c. Patients were the beneficiaries of web-based diabetes management both through savings in time and cost. Major obstacles to wider implementation are patient computer skills, adherence to the technology, architectural and technical design, and the need to reimburse providers for their care.

Pan Am gets big savings at no cost

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

Tanz, D.

Pan American World Airways' contract with an energy management control systems distributor enabled the company's terminal and maintenance facilities at JFK airport in New York to shift from housekeeping to major savings without additional cost. Energy savings from a pneumatic control system were split almost equally between Pan Am and Thomas S. Brown Associates (TSBA) Inc., and further savings are expected from a planned computer-controlled system. A full-time energy manager, able to give top priority to energy-consumption problems, was considered crucial to the program's success. Early efforts in light-level reduction and equipment scheduling required extensive persuasion and policing, but successfulmore » energy savings allowed the manager to progress to the more-extensive plants with TSBA.« less

A CLS-based survivable and energy-saving WDM-PON architecture

NASA Astrophysics Data System (ADS)

Zhu, Min; Zhong, Wen-De; Zhang, Zhenrong; Luan, Feng

2013-11-01

We propose and demonstrate an improved survivable and energy-saving WDM-PON with colorless ONUs. It incorporates both energy-saving and self-healing operations. A simple effective energy-saving scheme is proposed by including an energy-saving control unit in the OLT and a control unit at each ONU. The energy-saving scheme realizes both dozing and sleep (offline) modes, which greatly improves the energy-saving efficiency for WDM-PONs. An intelligent protection switching scheme is designed in the OLT, which can distinguish if an ONU is in dozing/sleep (offline) state or a fiber is faulty. Moreover, by monitoring the optical power of each channel on both working and protection paths, the OLT can know the connection status of every fiber path, thus facilitating an effective protection switching and a faster failure recovery. The improved WDM-PON architecture not only significantly reduces energy consumption, but also performs self-healing operation in practical operation scenarios. The scheme feasibility is experimentally verified with 10 Gbit/s downstream and 1.25 Gbit/s upstream transmissions. We also examine the energy-saving efficiency of our proposed energy-saving scheme by simulation, which reveals that energy saving mainly arises from the dozing mode, not from the sleep mode when the ONU is in the online state.

A Feasibility Study to Determine the Possibility of Teaching Freshman Composition and Rhetoric with a Programmed Text. Final Report.

ERIC Educational Resources Information Center

Lutz, William D.

The question of whether a significant amount of time could be saved if freshman composition were taught with a programed text was studied. Two sections of English I were randomly selected from the regular class schedule. Class A was taught using the usual syllabus and texts. Class B was taught using the same syllabus and texts with one exception.…

Numerical Solutions for a Cylindrical Laser Diffuser Flowfield

DTIC Science & Technology

1990-06-01

exhaust conditions with minimum losses to optimize performance of the system. Thus, the handling of the system of shock waves to decelerate the flow...requirement for exhaustive experimental work will result in significant savings of both time and resources. As more advanced computers are developed, the...Mach number (ɚ.5) flows. Recent interest in hypersonic engine inlet performance has resulted in an extension of the methodology to high Mach number

Treatment of severe poison ivy: a randomized, controlled trial of long versus short course oral prednisone.

PubMed

Curtis, Gabrielle; Lewis, Amy C

2014-12-01

Toxidendron (poison ivy, oak, and sumac) contact dermatitis is a common complaint in the outpatient primary care setting with little evidence-based guidance on best treatment duration. This randomized, controlled trial examined the efficacy and side effects of a 5-day regimen of 40 mg oral prednisone daily (short course) compared to the same 5-day regimen followed by a prednisone taper of 30 mg daily for 2 days, 20 mg daily for 2 days, 10 mg daily for 2 days, and 5 mg daily for 4 days over a total of 15 days (long course) in patients with severe poison ivy dermatitis. In 49 patients with severe poison ivy, non-adherence rates, rash return, medication side effects, and time to improvement and complete healing of the rash were not significantly different between the two groups. Patients receiving the long course regimen were significantly less likely to utilize other medications (22.7% vs. 55.6%, P = 0.02, number needed to treat 3.05). This study suggests that a longer course prescription may save patients' time and exposure to excess medication in the treatment of severe poison ivy. Application of this information to clinical practice will save return visits and reduce excess non-prescription medication administration to individual patients.

Treatment of Severe Poison Ivy: A Randomized, Controlled Trial of Long Versus Short Course Oral Prednisone

PubMed Central

Curtis, Gabrielle; Lewis, Amy C.

2014-01-01

Background Toxidendron (poison ivy, oak, and sumac) contact dermatitis is a common complaint in the outpatient primary care setting with little evidence-based guidance on best treatment duration. Methods This randomized, controlled trial examined the efficacy and side effects of a 5-day regimen of 40 mg oral prednisone daily (short course) compared to the same 5-day regimen followed by a prednisone taper of 30 mg daily for 2 days, 20 mg daily for 2 days, 10 mg daily for 2 days, and 5 mg daily for 4 days over a total of 15 days (long course) in patients with severe poison ivy dermatitis. Results In 49 patients with severe poison ivy, non-adherence rates, rash return, medication side effects, and time to improvement and complete healing of the rash were not significantly different between the two groups. Patients receiving the long course regimen were significantly less likely to utilize other medications (22.7% vs. 55.6%, P = 0.02, number needed to treat 3.05). Conclusions This study suggests that a longer course prescription may save patients’ time and exposure to excess medication in the treatment of severe poison ivy. Application of this information to clinical practice will save return visits and reduce excess non-prescription medication administration to individual patients. PMID:25247016

The presentation of expert testimony via live audio-visual communication.

PubMed

Miller, R D

1991-01-01

As part of a national effort to improve efficiency in court procedures, the American Bar Association has recommended, on the basis of a number of pilot studies, increased use of current audio-visual technology, such as telephone and live video communication, to eliminate delays caused by unavailability of participants in both civil and criminal procedures. Although these recommendations were made to facilitate court proceedings, and for the convenience of attorneys and judges, they also have the potential to save significant time for clinical expert witnesses as well. The author reviews the studies of telephone testimony that were done by the American Bar Association and other legal research groups, as well as the experience in one state forensic evaluation and treatment center. He also reviewed the case law on the issue of remote testimony. He then presents data from a national survey of state attorneys general concerning the admissibility of testimony via audio-visual means, including video depositions. Finally, he concludes that the option to testify by telephone provides a significant savings in precious clinical time for forensic clinicians in public facilities, and urges that such clinicians work actively to convince courts and/or legislatures in states that do not permit such testimony (currently the majority), to consider accepting it, to improve the effective use of scarce clinical resources in public facilities.

Identifying barriers to emergency care services.

PubMed

Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

2012-01-01

This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

Effects of a behaviour change intervention for Girl Scouts on child and parent energy-saving behaviours

NASA Astrophysics Data System (ADS)

Boudet, Hilary; Ardoin, Nicole M.; Flora, June; Armel, K. Carrie; Desai, Manisha; Robinson, Thomas N.

2016-08-01

Energy education programmes for children are hypothesized to have great potential to save energy. Such interventions are often assumed to impact child and family behaviours. Here, using a cluster-randomized controlled trial with 30 Girl Scout troops in Northern California, we assess the efficacy of two social cognitive theory-based interventions focused on residential and food-and-transportation energy-related behaviours of Girl Scouts and their families. We show that Girl Scouts and parents in troops randomly assigned to the residential energy intervention significantly increased their self-reported residential energy-saving behaviours immediately following the intervention and after more than seven months of follow-up, compared with controls. Girl Scouts in troops randomly assigned to the food-and-transportation energy intervention significantly increased their self-reported food-and-transportation energy-saving behaviours immediately following the intervention, compared with controls, but not at follow-up. The results demonstrate that theory-based, child-focused energy interventions have the potential to increase energy-saving behaviours among both children and their parents.

Fast approach for toner saving

NASA Astrophysics Data System (ADS)

Safonov, Ilia V.; Kurilin, Ilya V.; Rychagov, Michael N.; Lee, Hokeun; Kim, Sangho; Choi, Donchul

2011-01-01

Reducing toner consumption is an important task in modern printing devices and has a significant positive ecological impact. Existing toner saving approaches have two main drawbacks: appearance of hardcopy in toner saving mode is worse in comparison with normal mode; processing of whole rendered page bitmap requires significant computational costs. We propose to add small holes of various shapes and sizes to random places inside a character bitmap stored in font cache. Such random perforation scheme is based on processing pipeline in RIP of standard printer languages Postscript and PCL. Processing of text characters only, and moreover, processing of each character for given font and size alone, is an extremely fast procedure. The approach does not deteriorate halftoned bitmap and business graphics and provide toner saving for typical office documents up to 15-20%. Rate of toner saving is adjustable. Alteration of resulted characters' appearance is almost indistinguishable in comparison with solid black text due to random placement of small holes inside the character regions. The suggested method automatically skips small fonts to preserve its quality. Readability of text processed by proposed method is fine. OCR programs process that scanned hardcopy successfully too.

Moral Hypocrisy on the Basis of Construal Level: To Be a Utilitarian Personal Decision Maker or to Be a Moral Advisor?

PubMed Central

Xiao, Wei; Wu, Qing; Yang, Qun; Zhou, Liang; Jiang, Yuan; Zhang, Jiaxi; Miao, Danmin; Peng, Jiaxi

2015-01-01

Background People encounter various moral issues that involve making decisions for others by giving advice. Objective This study investigated the characteristics of providing suggestions for oneself versus providing suggestions for others in ethical decision-making and the differences between them based on Construal Level Theory (CLT). Methods A total of 768 undergraduate students from three universities in China were randomly assigned to eight groups on the basis of a grid of two Construal Levels (self or others) by two different numbers of people saved (5 people or 15 people) by two problem situations (trolley problem vs. footbridge problem). The investigation examined participants’ decisions to opt to take action or refrain from action that would have the consequence of saving more people. Results The main effects of Construal Level (F1, 752 = 6.46, p = .011), saving number (F1, 752 = 35.81, p < .001), and problem situation type (F1, 752 = 330.55, p < .001) were all significant. The interaction of the problem situation and saving number (F1, 752 = 1.01, p = .31), and social distance and saving number (F1, 752 = 0.85, p = .36), and interaction of the three independent factors (F1, 752 = 0.47, p = .49) were not significant. However, the interaction of social distance and problem situation (F1, 752 = 9.46, p = .002) was significant. Results indicated the participants utilized a component of utilitarian reasoning in the decision-making, and their behaviors appeared more utilitarian at low Construal Levels (CLs) compared to high. Conclusion CLs, saving numbers, and problem situation significantly affected moral decision-making and exhibited significant interaction. Making decisions for oneself (low-construal) rather than giving advice to others (high-construal) was one important factor that determined whether the people were utilitarian or not. Utilitarian considerations are more relevant in impersonal dilemmas. PMID:25689521

Realtime mitigation of GPS SA errors using Loran-C

NASA Technical Reports Server (NTRS)

Braasch, Soo Y.

1994-01-01

The hybrid use of Loran-C with the Global Positioning System (GPS) was shown capable of providing a sole-means of enroute air radionavigation. By allowing pilots to fly direct to their destinations, use of this system is resulting in significant time savings and therefore fuel savings as well. However, a major error source limiting the accuracy of GPS is the intentional degradation of the GPS signal known as Selective Availability (SA). SA-induced position errors are highly correlated and far exceed all other error sources (horizontal position error: 100 meters, 95 percent). Realtime mitigation of SA errors from the position solution is highly desirable. How that can be achieved is discussed. The stability of Loran-C signals is exploited to reduce SA errors. The theory behind this technique is discussed and results using bench and flight data are given.

What are the potential benefits of including latent storage in common wallboard?

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

Stovall, T.K.; Tomlinson, J.J.

1995-11-01

Previous work has shown that wallboard can be successfully manufactured to contain up to 30% phase-change material (PCM), or wax, thus enabling this common building material to serve as a thermal energy storage device. The PCM wallboard was analyzed for passive solar applications and found to save energy with a reasonable payback time period of five years. Further evaluations of the wallboard are reported in this paper. This analysis looks at potential applications of PCM wallboard as a load management device and as a comfort enhancer. Results show that the wallboard is ineffective in modifying the comfort level but canmore » provide significant load management relief. In some applications the load management strategy also serves to save a small amount of energy, in others there is a small energy penalty.« less

On the economic growth theory with Kadiyala production function

NASA Astrophysics Data System (ADS)

Grassetti, Francesca; Hunanyan, Gevorg

2018-05-01

We study the discrete time neoclassical one-sector growth model with differential savings while assuming Kadiyala production function which shows a variable elasticity of substitution symmetric with respect to capital and labor. We show that, if workers save more than shareholders, then the growth path is bounded from above and the boundary is independent from the savings rate of shareholders. Moreover, the growth path for non-developed countries is influenced only by the savings rate of shareholders while level of capital per capita of developed economies is influenced by the savings rate of workers. We also show that multistability phenomena may occur so that the model is able to explain co-existence of under-developed, developing and developed economies. We prove that fluctuations and complex dynamics may arise when the elasticity of substitution between production factors is lower than one and shareholders save more than workers.

Subjective cognitive function in hoarding disorder.

PubMed

Tolin, David F; Hallion, Lauren S; Wootton, Bethany M; Levy, Hannah C; Billingsley, Amber L; Das, Akanksha; Katz, Benjamin W; Stevens, Michael C

2018-07-01

The aim of the present study was to examine subjective cognitive impairment among adult patients with hoarding disorder (HD). Eighty-three patients with HD and 46 age- and gender-matched healthy control (HC) participants received a diagnostic interview and completed measures of subjective cognitive functioning and motivations for saving behavior, as well as measures of hoarding severity, depression, anxiety, stress, and obsessive-compulsive disorder (OCD) symptoms. The HD group reported more impairment than did the HC group in domains of memory, distractibility, blunders, memory for names, and inattention. These differences generally remained significant when controlling for comorbid symptoms. In the HD group, the degree of cognitive impairment was significantly correlated with severity of saving and acquiring behaviors, although results were attenuated when controlling for comorbid symptoms (overall HD severity, but not saving behavior specifically, remained significantly correlated with cognitive impairment). Subjective cognitive impairment was further associated with a desire to save possessions in order to avoid forgetting, and these results remained significant when controlling for comorbid symptoms. These results comport with current behavioral models of HD that emphasize decision-making deficits, as well as clinician observations suggestive of impaired cognitive function, and complement a growing body of neuropsychological testing studies. Copyright © 2018. Published by Elsevier B.V.

Time perspective and attitude-behaviour consistency in future-oriented behaviours.

PubMed

Rabinovich, Anna; Morton, Thomas; Postmes, Tom

2010-03-01

The authors propose that the salience of a distant-future time perspective, compared to a near-future time perspective, should increase attitude-behaviour and attitude-intention consistency for future-oriented behaviours. To test this prediction, time perspective was experimentally manipulated in three studies. Across studies, participants in the distant-future time perspective condition demonstrated a strong positive relationship between attitudes towards future-oriented behaviours (saving and environmental protection) and corresponding intentions, as well as between attitudes and behaviour. In the near-future time perspective condition, the relationship between attitudes and intentions and attitudes and behaviour was significantly weaker than in the distant-future time perspective condition. The theoretical implications of these results and suggestions for future research are discussed.

Why Nations Become Wealthy: The Effects of Adult Longevity on Saving

PubMed Central

Kinugasa, Tomoko; Mason, Andrew

2007-01-01

We analyze steady state and out-of-steady-state effects of the transition in adult longevity on the national saving rate using historical data and international panel data. The rise in adult life expectancy has a large and statistically significant effect on aggregate saving. The effects have been especially pronounced in East Asia because its mortality transition was very rapid. Gains in life expectancy are much more important than declines in child dependency. Population aging may not lead to lower saving rates in the future if life expectancy and the duration of retirement continue to increase. PMID:18167514

Saving Time, Saving Money: The Economics of Unclogging America's Worst Bottlenecks

DOT National Transportation Integrated Search

2000-01-01

A 1999 study by the American Highway Users Alliance entitled "Unclogging America's Arteries: Prescriptions for Healthier Highways" identified the 166 worst bottlenecks in the country and evaluated the benefits of removing them. By assigning monetary ...

Residential solar hot water system--Tempe, Arizona

NASA Technical Reports Server (NTRS)

1981-01-01

Domestic hot water for single story home is heated by two 4 by 8 foot solar collectors. Solar energy saved 5.54 million Btu in six month period; savings with increased water consumption would be significantly higher.

Determinants of residential water consumption: Evidence and analysis from a 10-country household survey

NASA Astrophysics Data System (ADS)

Grafton, R. Quentin; Ward, Michael B.; To, Hang; Kompas, Tom

2011-08-01

Household survey data for 10 countries are used to quantify and test the importance of price and nonprice factors on residential water demand and investigate complementarities between household water-saving behaviors and the average volumetric price of water. Results show (1) the average volumetric price of water is an important predictor of differences in residential consumption in models that include household characteristics, water-saving devices, attitudinal characteristics and environmental concerns as explanatory variables; (2) of all water-saving devices, only a low volume/dual-flush toilet has a statistically significant and negative effect on water consumption; and (3) environmental concerns have a statistically significant effect on some self-reported water-saving behaviors. While price-based approaches are espoused to promote economic efficiency, our findings stress that volumetric water pricing is also one of the most effective policy levers available to regulate household water consumption.

Building a Thriving Nation: 21st-Century Vision and Practice to Advance Health and Equity

ERIC Educational Resources Information Center

Cohen, Larry

2016-01-01

It is a great time for prevention. As the United States explores what health in our country should look like, it is an extraordinary time to highlight the role of prevention in improving health, saving lives, and saving money. The Affordable Care Act's investment in prevention has spurred innovation by communities and states to keep people healthy…

31 CFR 315.35 - Payment (redemption).

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Savings Notes. A Series E bond will be paid at any time after two months from issue date at the... interest is $6.90 per $500. (e) Series H. A Series H bond will be redeemed at face value at any time after..., SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.35...

31 CFR 315.35 - Payment (redemption).

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Savings Notes. A Series E bond will be paid at any time after two months from issue date at the... interest is $6.90 per $500. (e) Series H. A Series H bond will be redeemed at face value at any time after..., SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.35...

31 CFR 315.35 - Payment (redemption).

Code of Federal Regulations, 2012 CFR

2012-07-01

... and Savings Notes. A Series E bond will be paid at any time after two months from issue date at the... interest is $6.90 per $500. (e) Series H. A Series H bond will be redeemed at face value at any time after..., SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.35...

31 CFR 315.35 - Payment (redemption).

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Savings Notes. A Series E bond will be paid at any time after two months from issue date at the... interest is $6.90 per $500. (e) Series H. A Series H bond will be redeemed at face value at any time after..., SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.35...

U.S. Navy Advanced Receiving: A Better Approach to the Basics.

DTIC Science & Technology

1987-04-01

the Navy and DLA should begin now to plan for electronic interchange of data between their inventory management systems. This would eliminate the...labor savings from work simplification, improved material handling, and better work load planning 0 Material savings from reduced packaging and use of... planning purposes, source distribution managers use the following equa- tion to determine maximum consolidation time: Maximum consolidation time = 21

Hospital steam sterilizer usage: could we switch off to save electricity and water?

PubMed

McGain, Forbes; Moore, Graham; Black, Jim

2016-07-01

Steam sterilization in hospitals is an energy and water intensive process. Our aim was to identify opportunities to improve electricity and water use. The objectives were to find: the time sterilizers spent active, idle and off; the variability in sterilizer use with the time of day and day of the week; and opportunities to switch off sterilizers instead of idling when no loads were waiting, and the resultant electricity and water savings. Analyses of routine data for one year of the activity of the four steam sterilizers in one hospital in Melbourne, Australia. We examined active sterilizer cycles, routine sterilizer switch-offs, and when sterilizers were active, idle and off. Several switch-off strategies were examined to identify electricity and water savings: switch off idle sterilizers when no loads are waiting and switch off one sterilizer after 10:00 h and a second sterilizer after midnight on all days. Sterilizers were active for 13,430 (38%) sterilizer-hours, off for 4822 (14%) sterilizer-hours, and idle for 16,788 (48%) sterilizer-hours. All four sterilizers were simultaneously active 9% of the time, and two or more sterilizers were idle for 69% of the time. A sterilizer was idle for two hours or less 13% of the time and idle for more than 2 h 87% of the time. A strategy to switch off idle sterilizers would reduce electricity use by 66 MWh and water use by 1004 kl per year, saving 26% electricity use and 13% of water use, resulting in financial savings of AUD$13,867 (UK£6,517) and a reduction in 79 tonnes of CO2 emissions per year. An alternative switch-off strategy of one sterilizer from 10:00 h onwards and a second from midnight would have saved 30 MWh and 456 kl of water. The methodology used of how hospital sterilizer use could be improved could be applied to all hospitals and more broadly to other equipment used in hospitals. © The Author(s) 2016.

Cost-minimization analysis favors outpatient quick diagnosis unit over hospitalization for the diagnosis of potentially serious diseases.

PubMed

Sanclemente-Ansó, Carmen; Bosch, Xavier; Salazar, Albert; Moreno, Ramón; Capdevila, Cristina; Rosón, Beatriz; Corbella, Xavier

2016-05-01

Quick diagnosis units (QDUs) are a promising alternative to conventional hospitalization for the diagnosis of suspected serious diseases, most commonly cancer and severe anemia. Although QDUs are as effective as hospitalization in reaching a timely diagnosis, a full economic evaluation comparing both approaches has not been reported. To evaluate the costs of QDU vs. conventional hospitalization for the diagnosis of cancer and anemia using a cost-minimization analysis on the proven assumption that health outcomes of both approaches were equivalent. Patients referred to the QDU of Bellvitge University Hospital of Barcelona over 51 months with a final diagnosis of severe anemia (unrelated to malignancy), lymphoma, and lung cancer were compared with patients hospitalized for workup with the same diagnoses. The total cost per patient until diagnosis was analyzed. Direct and non-direct costs of QDU and hospitalization were compared. Time to diagnosis in QDU patients (n=195) and length-of-stay in hospitalized patients (n=237) were equivalent. There were considerable costs savings from hospitalization. Highest savings for the three groups were related to fixed direct costs of hospital stays (66% of total savings). Savings related to fixed non-direct costs of structural and general functioning were 33% of total savings. Savings related to variable direct costs of investigations were 1% of total savings. Overall savings from hospitalization of all patients were €867,719.31. QDUs appear to be a cost-effective resource for avoiding unnecessary hospitalization in patients with anemia and cancer. Internists, hospital executives, and healthcare authorities should consider establishing this model elsewhere. Copyright © 2015. Published by Elsevier B.V.

Early Impact Of CareFirst's Patient-Centered Medical Home With Strong Financial Incentives.

PubMed

Afendulis, Christopher C; Hatfield, Laura A; Landon, Bruce E; Gruber, Jonathan; Landrum, Mary Beth; Mechanic, Robert E; Zinner, Darren E; Chernew, Michael E

2017-03-01

In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years. Our quantitative analyses used spending and utilization data for 2010-13 to compare enrollees who received care from participating physician groups to similar enrollees cared for by nonparticipating groups. Savings were small and fully shared with providers, which suggests no significant effect on total spending (including bonuses). Our qualitative analysis suggested that early in the program, many physicians were not fully engaged with the initiative and did not make full use of its tools. These findings imply that this and similar payment reforms may require greater time to realize significant savings than many stakeholders had expected. Patience may be necessary if payer-led reform is going to lead to system transformation. Project HOPE—The People-to-People Health Foundation, Inc.

Energy Efficient Engine Program: Technology Benefit/Cost Study, Volume II

NASA Technical Reports Server (NTRS)

Gray, D. E.; Gardner, W. B.

1983-01-01

The Benefit/Cost Study portion of the NASA-sponsored Energy Efficient Engine Component Development and Integration program was successful in achieving its objectives: identification of air transport propulsion system technology requirements for the years 2000 and 2010, and formulation of programs for developing these technologies. It is projected that the advanced technologies identified, when developed to a state of readiness, will provide future commercial and military turbofan engines with significant savings in fuel consumption and related operating costs. These benefits are significant and far from exhausted. The potential savings translate into billions of dollars in annual savings for the airlines. Analyses indicate that a significant portion of the overall savings is attributed to aerodynamic and structure advancements. Another important consideration in acquiring these benefits is developing a viable reference technology base that will permit engines to operate at substantially higher overall pressure ratios and bypass ratios. Results have pointed the direction for future research and a comprehensive program plan for achieving this was formulated. The next major step is initiating the program effort that will convert the advanced technologies into the expected benefits.

Neural Predictors of Visuomotor Adaptation Rate and Multi-Day Savings

NASA Technical Reports Server (NTRS)

Cassady, Kaitlin; Ruitenberg, Marit; Koppelmans, Vincent; Reuter-Lorenz, Patricia; De Dios, Yiri; Gadd, Nichole; Wood, Scott; Riascos Castenada, Roy; Kofman, Igor; Bloomberg, Jacob;

Medialization thyroplasty versus injection laryngoplasty: a cost minimization analysis.

PubMed

Tam, Samantha; Sun, Hongmei; Sarma, Sisira; Siu, Jennifer; Fung, Kevin; Sowerby, Leigh

2017-02-20

Medialization thyroplasty and injection laryngoplasty are widely accepted treatment options for unilateral vocal fold paralysis. Although both procedures result in similar clinical outcomes, little is known about the corresponding medical care costs. Medialization thyroplasty requires expensive operating room resources while injection laryngoplasty utilizes outpatient resources but may require repeated procedures. The purpose of this study, therefore, is to quantify the cost differences in adult patients with unilateral vocal fold paralysis undergoing medialization thyroplasty versus injection laryngoplasty. Cost minimization analysis conducted using a decision tree model. A decision tree model was constructed to capture clinical scenarios for medialization thyroplasty and injection laryngoplasty. Probabilities for various events were obtained from a retrospective cohort from the London Health Sciences Centre, Canada. Costs were derived from the published literature and the London Health Science Centre. All costs were reported in 2014 Canadian dollars. Time horizon was 5 years. The study was conducted from an academic hospital perspective in Canada. Various sensitivity analyses were conducted to assess differences in procedure-specific costs and probabilities of key events. Sixty-three patients underwent medialization thyroplasty and 41 underwent injection laryngoplasty. Cost of medialization thyroplasty was C$2499.10 per patient whereas those treated with injection laryngoplasty cost C$943.19. Results showed that cost savings with IL were C$1555.91. Deterministic and probabilistic sensitivity analyses suggested cost savings ranged from C$596 to C$3626. Treatment with injection laryngoplasty results in cost savings of C$1555.91 per patient. Our extensive sensitivity analyses suggest that switching from medialization thyroplasty to injection laryngoplasty will lead to a minimum cost savings of C$596 per patient. Considering the significant cost savings and similar effectiveness, injection laryngoplasty should be strongly considered as a preferred treatment option for patients diagnosed with unilateral vocal fold paralysis.

Building an Energy-efficient Uplink and Downlink Delay Aware TDM-PON System

NASA Astrophysics Data System (ADS)

Newaz, S. H. Shah; Jang, Min Seok; Alaelddin, Fuad Yousif Mohammed; Lee, Gyu Myoung; Choi, Jun Kyun

2016-05-01

With the increasing concern over the energy expenditure due to rapid ICT expansion and growth of Internet traffic volume, there is a growing trend towards developing energy-efficient ICT solutions. Passive Optical Network (PON), which is regarded as a key enabler to facilitate high speed broadband connection to individual subscribers, is considered as one of the energy-efficient access network technologies. However, an immense amount of research effort can be noticed in academia and industries to make PON more energy-efficient. In this paper, we aim at improving energy saving performance of Time Division Multiplexing (TDM)-PON, which is the most widely deployed PON technology throughout the world. A commonly used approach to make TDM-PON energy-efficient is to use sleep mode in Optical Network Units (ONUs), which are the customer premises equipment of a TDM-PON system. However, there is a strong trade-off relationship between traffic delay performance of an ONU and its energy saving (the longer the sleep interval length of an ONU, the lower its energy consumption, but the higher the traffic delay, and vice versa). In this paper, we propose an Energy-efficient Uplink and Downlink Delay Aware (EUDDA) scheme for TDM-PON system. The prime object of EUDDA is to meet both downlink and uplink traffic delay requirement while maximizing energy saving performance of ONUs as much as possible. In EUDDA, traffic delay requirement is given more priority over energy saving. Even so, it still can improve energy saving of ONUs noticeably. We evaluate performance of EUDDA in front of two existing solutions in terms of traffic delay, jitter, and ONU energy consumption. The performance results show that EUDDA significantly outperforms the other existing solutions.

Real-World Cost Savings Demonstrated by Switching Patients with Refractory Diabetic Macular Edema to Intravitreal Fluocinolone Acetonide (Iluvien): A Retrospective Cost Analysis Study.

PubMed

Ch'ng, Soon W; Brent, Alexander J; Empeslidis, Theodoros; Konidaris, Vasileios; Banerjee, Somnath

2018-06-01

It is hypothesized that using fluocinolone acetonide (FAc) implants such as Iluvien for the treatment of diabetic macular edema (DME) may reduce the total number of intravitreal injections and clinic visits, resulting in an overall treatment cost reduction. The primary aim of this study is to identify the real-world cost savings achievable in a tertiary National Health Service (NHS) hospital. A retrospective cost analysis study was conducted. The inclusion criteria were patients with refractory DME who were switched to Iluvien. The average yearly costs were calculated both before and after the switch to Iluvien. All costs including medicines, investigations, clinics, and management of raised intraocular pressure (IOP) were calculated. The cost differences over the 3 years' worth of Iluvien treatment were calculated and analyzed. To ensure non-inferiority of this treatment intervention, the best corrected visual acuity (BCVA) and central retinal thickness (CRT) were also analyzed. Statistical analysis was conducted with a Student t test where appropriate and statistical significance is identified where p < 0.05. Fourteen eyes of 13 patients met the inclusion criteria. Switching patients to Iluvien achieved on average a saving of £2606.17 per patient (p = 0.33) over the 3 years. However, seven cases (50%) had a rise in IOP after Iluvien that warranted medical treatment and two cases (14.3%) required glaucoma surgery. Incorporating the costs of glaucoma management reduced the overall savings over 3 years to £1064.66 per patient. The BCVA and CRT analysis showed a non-inferiority relationship between Iluvien and any previous treatment. The use of Iluvien in refractory DME patients represents a cost- and time-saving procedure, while showing non-inferiority in terms of efficacy.

Quantifying Adoption Rates and Energy Savings Over Time for Advanced Manufacturing Technologies

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

Hanes, Rebecca; Carpenter Petri, Alberta C; Riddle, Matt

Energy-efficient manufacturing technologies can reduce energy consumption and lower operating costs for an individual manufacturing facility, but increased process complexity and the resulting risk of disruption means that manufacturers may be reluctant to adopt such technologies. In order to quantify potential energy savings at scales larger than a single facility, it is necessary to account for how quickly and how widely the technology will be adopted by manufacturers. This work develops a methodology for estimating energy-efficient manufacturing technology adoption rates using quantitative, objectively measurable technology characteristics, including energetic, economic and technical criteria. Twelve technology characteristics are considered, and each characteristicmore » is assigned an importance weight that reflects its impact on the overall technology adoption rate. Technology characteristic data and importance weights are used to calculate the adoption score, a number between 0 and 1 that represents how quickly the technology is likely to be adopted. The adoption score is then used to estimate parameters for the Bass diffusion curve, which quantifies the change in the number of new technology adopters in a population over time. Finally, energy savings at the sector level are calculated over time by multiplying the number of new technology adopters at each time step with the technology's facility-level energy savings. The proposed methodology will be applied to five state-of-the-art energy-efficient technologies in the carbon fiber composites sector, with technology data obtained from the Department of Energy's 2016 bandwidth study. Because the importance weights used in estimating the Bass curve parameters are subjective, a sensitivity analysis will be performed on the weights to obtain a range of parameters for each technology. The potential energy savings for each technology and the rate at which each technology is adopted in the sector are quantified and used to identify the technologies which offer the greatest cumulative sector-level energy savings over a period of 20 years. Preliminary analysis indicates that relatively simple technologies, such as efficient furnaces, will be adopted more quickly and result in greater cumulative energy savings compared to more complex technologies that require process retrofitting, such as advanced control systems.« less

Soft-copy sonography: cost reduction sensitivity analysis in a pediatric hospital.

PubMed

Don, S; Albertina, M J; Ammann, D

1998-03-01

Our objective was to determine whether interpreting sonograms of pediatric patients using soft-copy (computer workstation) instead of laser-printed film could reduce costs for a pediatric radiology department. We used theoretic models of growth to analyze costs. The costs of a sonographic picture archiving and communication system (three interface devices, two workstations, a network server, maintenance expenses, and storage media costs) were compared with the potential savings of eliminating film and increasing technologist efficiency or reducing the number of technologists. The model was based on historic trends and future capitation estimates that will reduce fee-for-service reimbursement. The effects of varying the study volume and reducing technologists' work hours were analyzed. By converting to soft-copy interpretation, we saved 6 min 32 sec per examination by eliminating film processing waiting time, thus reducing examination time from 30 min to 24 min. During an average day of 27 examinations, 176 min were saved. However, 33 min a day were spent retrieving prior studies from long-term storage; thus, 143 extra minutes a day were available for scanning. This improved efficiency could result in five more sonograms a day obtained by converting to soft-copy interpretation, using existing staff and equipment. Alternatively, five examinations a day would equate to one half of a full-time equivalent technologists position. Our analysis of costs considered that the hospital's anticipated growth of sonography and the depreciation of equipment during 5 years resulted in a savings of more than $606,000. Increasing the examinations by just 200 sonograms in the first year and no further growth resulted in a savings of more than $96,000. If the number of sonograms stayed constant, elimination of film printing alone resulted in a loss of approximately $157,000; reduction of one half of a full-time equivalent technologist's position would recuperate approximately $134,000 of that loss. Soft-copy sonography can save money through improved technologist efficiency, thereby increasing the number of sonograms obtained and revenue generated. If the number of sonograms does not increase, elimination of printing costs and reduction of staff technologists will not result in a savings.

Program Helps Decompose Complicated Design Problems

NASA Technical Reports Server (NTRS)

Rogers, James L., Jr.

1993-01-01

Time saved by intelligent decomposition into smaller, interrelated problems. DeMAID is knowledge-based software system for ordering sequence of modules and identifying possible multilevel structure for design problem. Displays modules in N x N matrix format. Requires investment of time to generate and refine list of modules for input, it saves considerable amount of money and time in total design process, particularly new design problems in which ordering of modules has not been defined. Program also implemented to examine assembly-line process or ordering of tasks and milestones.

DOD Civilian and Contractor Workforces: Additional Cost Savings Data and Efficiencies Plan are Needed

DTIC Science & Technology

2016-10-01

reductions reported in average strength bNumber of reductions reported in full-time equivalents Note: DOD costs savings provided for the prior FY are...comparing costs from FY 2012 to FY 2017, and not each year in between. Further, officials stated that DOD did not include full- time equivalents ...Application FTE Full-time Equivalent NDAA National Defense Authorization Act This is a work of the U.S. government and is not subject to copyright

The Regulation of a Spatially Heterogeneous Externality: Tradable Groundwater Permits to Protect Streams

NASA Astrophysics Data System (ADS)

Kuwayama, Y.; Brozovic, N.

2012-12-01

Groundwater pumping from aquifers can reduce the flow of surface water in nearby streams through a process known as stream depletion. In the United States, recent awareness of this externality has led to intra- and inter-state conflict and rapidly-changing water management policies and institutions. A factor that complicates the design of groundwater management policies to protect streams is the spatial heterogeneity of the stream depletion externality; the marginal damage of groundwater use on stream flows depends crucially on the location of pumping relative to streams. Under these circumstances, economic theory predicts that spatially differentiated policies can achieve an aggregate reduction in stream depletion cost effectively. However, whether spatially differentiated policies offer significant abatement cost savings and environmental improvements over simpler, alternative policies is an empirical question. In this paper, we analyze whether adopting a spatially differentiated groundwater permit system can lead to significant savings in compliance costs while meeting targets on stream protection. Using a population data set of active groundwater wells in the Nebraska portion of the Republican River Basin, we implement an optimization model of each well owner's crop choice, land use, and irrigation decisions to determine the distribution of regulatory costs. We model the externality of pumping on streams by employing an analytical solution from the hydrology literature that determines reductions in stream flow caused by groundwater pumping over space and time. The economic and hydrologic model components are then combined into one optimization framework, which allows us to measure farmer abatement costs and stream flow benefits under a constrained optimal market that features spatially differentiated, tradable groundwater permits. We compare this outcome to the efficiency of alternative second-best policies, including spatially uniform permit markets and pumping restrictions based on geographic zones. Our analysis considers static policies for which abatement is fixed over time, as well as dynamic policies that allow abatement to vary over time and future compliance costs to be subject to a discount rate. We find that if current levels of stream flow in the Republican River Basin are held fixed, regulators can generate most of the potential abatement cost savings by establishing a one-to-one tradable permit system that does not account for spatial heterogeneity. We obtain this surprising result because the agronomic and climatic parameters in our data set that determine farmer abatement costs are spatially correlated with hydrologic parameters that determine the marginal damage of groundwater use on streams. However, we also find that if future legal or ecological circumstances require regulators to increase significantly the protection of streams from current levels, spatially differentiated policies will generate sizable cost savings compared to policies that ignore spatial heterogeneity.

Year-Round Daylight Saving Time Study : Volume 2. Supporting Studies

DOT National Transportation Integrated Search

1975-06-01

This volume contains detailed background material in support of findings of the Interim Report. It includes the findings of a survey of attifudes towards daylight saving conducted by the National Opinion Research Center; description of sunrise and su...

Predictive Optimal Control of Active and Passive Building Thermal Storage Inventory

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

Gregor P. Henze; Moncef Krarti

2005-09-30

Cooling of commercial buildings contributes significantly to the peak demand placed on an electrical utility grid. Time-of-use electricity rates encourage shifting of electrical loads to off-peak periods at night and weekends. Buildings can respond to these pricing signals by shifting cooling-related thermal loads either by precooling the building's massive structure or the use of active thermal energy storage systems such as ice storage. While these two thermal batteries have been engaged separately in the past, this project investigated the merits of harnessing both storage media concurrently in the context of predictive optimal control. To pursue the analysis, modeling, and simulationmore » research of Phase 1, two separate simulation environments were developed. Based on the new dynamic building simulation program EnergyPlus, a utility rate module, two thermal energy storage models were added. Also, a sequential optimization approach to the cost minimization problem using direct search, gradient-based, and dynamic programming methods was incorporated. The objective function was the total utility bill including the cost of reheat and a time-of-use electricity rate either with or without demand charges. An alternative simulation environment based on TRNSYS and Matlab was developed to allow for comparison and cross-validation with EnergyPlus. The initial evaluation of the theoretical potential of the combined optimal control assumed perfect weather prediction and match between the building model and the actual building counterpart. The analysis showed that the combined utilization leads to cost savings that is significantly greater than either storage but less than the sum of the individual savings. The findings reveal that the cooling-related on-peak electrical demand of commercial buildings can be considerably reduced. A subsequent analysis of the impact of forecasting uncertainty in the required short-term weather forecasts determined that it takes only very simple short-term prediction models to realize almost all of the theoretical potential of this control strategy. Further work evaluated the impact of modeling accuracy on the model-based closed-loop predictive optimal controller to minimize utility cost. The following guidelines have been derived: For an internal heat gain dominated commercial building, reasonable geometry simplifications are acceptable without a loss of cost savings potential. In fact, zoning simplification may improve optimizer performance and save computation time. The mass of the internal structure did not show a strong effect on the optimization. Building construction characteristics were found to impact building passive thermal storage capacity. It is thus advisable to make sure the construction material is well modeled. Zone temperature setpoint profiles and TES performance are strongly affected by mismatches in internal heat gains, especially when they are underestimated. Since they are a key factor in determining the building cooling load, efforts should be made to keep the internal gain mismatch as small as possible. Efficiencies of the building energy systems affect both zone temperature setpoints and active TES operation because of the coupling of the base chiller for building precooling and the icemaking TES chiller. Relative efficiencies of the base and TES chillers will determine the balance of operation of the two chillers. The impact of mismatch in this category may be significant. Next, a parametric analysis was conducted to assess the effects of building mass, utility rate, building location and season, thermal comfort, central plant capacities, and an economizer on the cost saving performance of optimal control for active and passive building thermal storage inventory. The key findings are: (1) Heavy-mass buildings, strong-incentive time-of-use electrical utility rates, and large on-peak cooling loads will likely lead to attractive savings resulting from optimal combined thermal storage control. (2) By using economizer to take advantage of the cool fresh air during the night, the building electrical cost can be reduced by using less mechanical cooling. (3) Larger base chiller and active thermal storage capacities have the potential of shifting more cooling loads to off-peak hours and thus higher savings can be achieved. (4) Optimal combined thermal storage control with a thermal comfort penalty included in the objective function can improve the thermal comfort levels of building occupants when compared to the non-optimized base case. Lab testing conducted in the Larson HVAC Laboratory during Phase 2 showed that the EnergyPlus-based simulation was a surprisingly accurate prediction of the experiment. Therefore, actual savings of building energy costs can be expected by applying optimal controls from simulation results.« less

Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim.

PubMed

Grewal, Simrun; Ramsey, Scott; Balu, Sanjeev; Carlson, Josh J

2018-05-18

Biosimilars can directly reduce the cost of treating patients for whom a reference biologic is indicated by offering a highly similar, lower priced alternative. We examine factors related to biosimilar regulatory approval, uptake, pricing, and financing and the potential impact on drug expenditures in the U.S. We developed a framework to illustrate how key factors including regulatory policies, provider and patient perception, pricing, and payer policies impact biosimilar cost-savings. Further, we developed a budget impact cost model to estimate savings from filgrastim biosimilars under various scenarios. The model uses publicly available data on disease incidence, treatment patterns, market share, and drug prices to estimate the cost-savings over a 5-year time horizon. We estimate five-year cost savings of $256 million, of which 18% ($47 million) are from reduced patient out-of-pocket costs, 34% ($86 million) are savings to commercial payers, and 48% ($123 million) are savings for Medicare. Additional scenarios demonstrate the impact of uncertain factors, including price, uptake, and financing policies. A variety or interrelated factors influence the development, uptake, and cost-savings for Biosimilars use in the U.S. The filgrastim case is a useful example that illustrates these factors and the potential magnitude of costs savings.

Significant savings with a stepped care model for treatment of patients with intermittent claudication.

PubMed

Fokkenrood, H J P; Scheltinga, M R M; Koelemay, M J W; Breek, J C; Hasaart, F; Vahl, A C; Teijink, J A W

2014-10-01

International guidelines recommend supervised exercise therapy (SET) as primary treatment for intermittent claudication (IC). The aim of this study was to calculate treatment costs in patients with IC and to estimate nationwide annual savings if a stepped care model (SCM, primary SET treatment followed by revascularization in case of SET failure) was followed. Invoice data of all patients with IC in 2009 were obtained from a Dutch health insurance company (3.4 million members). Patients were divided into three groups based on initial treatment after diagnosis (t0). The SET group received SET initiated at any time between 12 months before and up to 3 months after t0. The intervention group (INT) underwent endovascular or open revascularization between t0 and t+3 months. The third group (REST) received neither SET nor any intervention. All peripheral arterial disease related invoices were recorded during 2 years and average costs per patient were calculated. Savings following use of a SCM were calculated for three scenarios. Data on 4954 patients were analyzed. Initial treatment was SET (n = 701, 14.1%), INT (n = 1363, 27.5%), or REST (n = 2890, 58.3%). Within 2 years from t0, invasive revascularization in the SET group was performed in 45 patients (6.4%). Additional interventions (primary at other location and/or re-interventions) were performed in 480 INT patients (35.2%). Some 431 REST patients received additional SET (n = 299, 10.3%) or an intervention (n = 132, 4.5%). Mean total IC related costs per patient were €2,191, €9851 and €824 for SET, INT, and REST, respectively. Based on a hypothetical worst, moderate, and best case scenario, some 3.8, 20.6, or 33.0 million euros would have been saved per annum if SCM was implemented in the Dutch healthcare system. Implementation of a SCM treatment for patients with IC may lead to significant savings of health care resources. Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Life-cycle models of saving and the effect of the timing of divorce on retirement economic well-being.

PubMed

Fethke, C C

1989-05-01

The long-term effect of the current high rate of divorce upon the future economic status of individuals has not been thoroughly analyzed. This study reviews the retirement, precautionary, and bequest motives for saving, then evaluates how marriage dissolution may (a) decrease the family's savings rate, (b) cause shifts in the family's portfolio to assets with lower rates of return, and (c) destroy or deplete existing family assets. Whether divorce interrupts the savings process or destroys assets, it is unlikely that most individuals will be able to save enough in later life to overcome the loss. The long-term effect may well be that, in future years, we will recognize a new category of elderly poor, those who have experienced the dissolution of their marriage.

The impact of generic reference pricing interventions in the statin market.

PubMed

Puig-Junoy, Jaume

2007-11-01

The objective of this study was to evaluate the intended and unintended impact on pharmaceutical use and sales of three public reimbursement reforms applied to the prescription of statins: a Spanish generic reference pricing system, and two competing policies introduced by the Andalusian Public Health Service. This study is designed as an interrupted time series analysis with comparison series of 46 monthly drug use and sales figures from January 2001 to October 2004 for each active ingredient. The mean monthly saving for the year after the introduction of reference pricing was 16.7% of total lovastatin sales, representing only 1.1% of total statins sales. Mean monthly savings for the 10 months after reference pricing being applied to simvastatin were 51.8% of simvastatin sales, and 13.9% of statin sales. Over the 46 months of the study, all analysed public interventions resulted in a 2.2% average monthly decrease in statin sales in the rest of Spain and savings non-significantly different from zero in Andalusia. RP has been effective at reducing the volume of sales growth of the off-patent statins, yet its overall impact on sales of all statins has been relatively modest.

Microlith Based Sorber for Removal of Environmental Contaminants

NASA Technical Reports Server (NTRS)

Roychoudhury, S.; Perry, J.

2004-01-01

The development of energy efficient, lightweight sorption systems for removal of environmental contaminants in space flight applications is an area of continuing interest to NASA. The current CO2 removal system on the International Space Station employs two pellet bed canisters of 5A molecular sieve that alternate between regeneration and sorption. A separate disposable charcoal bed removes trace contaminants. An alternative technology has been demonstrated using a sorption bed consisting of metal meshes coated with a sorbent, trademarked and patented as Microlith by Precision Combustion, Inc. (PCI); thesemeshes have the potential for direct electrical heating for this application. This allows the bed to be regenerable via resistive heating and offers the potential for shorter regeneration times, reduced power requirement, and net energy savings vs. conventional systems. The capability of removing both CO2 and trace contaminants within the same bed has also been demonstrated. Thus, the need for a separate trace contaminant unit is eliminated resulting in an opportunity for significant weight savings. Unlike the charcoal bed, zeolites for trace contaminant removal are amenable to periodic regeneration. This paper describes the design and performance of a prototype sorber device for simultaneous CO2 and trace contarninant removal and its attendant weight and energy savings.

Energy Impacts of Wide Band Gap Semiconductors in U.S. Light-Duty Electric Vehicle Fleet

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

Warren, Joshua A.; Riddle, Matthew E.; Graziano, Diane J.

2015-08-12

Silicon carbide and gallium nitride, two leading wide band gap semiconductors with significant potential in electric vehicle power electronics, are examined from a life cycle energy perspective and compared with incumbent silicon in U.S. light-duty electric vehicle fleet. Cradle-to-gate, silicon carbide is estimated to require more than twice the energy as silicon. However, the magnitude of vehicle use phase fuel savings potential is comparatively several orders of magnitude higher than the marginal increase in cradle-to-gate energy. Gallium nitride cradle-to-gate energy requirements are estimated to be similar to silicon, with use phase savings potential similar to or exceeding that of siliconmore » carbide. Potential energy reductions in the United States vehicle fleet are examined through several scenarios that consider the market adoption potential of electric vehicles themselves, as well as the market adoption potential of wide band gap semiconductors in electric vehicles. For the 2015–2050 time frame, cumulative energy savings associated with the deployment of wide band gap semiconductors are estimated to range from 2–20 billion GJ depending on market adoption dynamics.« less

Performance of MIMO-OFDM using convolution codes with QAM modulation

NASA Astrophysics Data System (ADS)

Astawa, I. Gede Puja; Moegiharto, Yoedy; Zainudin, Ahmad; Salim, Imam Dui Agus; Anggraeni, Nur Annisa

2014-04-01

Performance of Orthogonal Frequency Division Multiplexing (OFDM) system can be improved by adding channel coding (error correction code) to detect and correct errors that occur during data transmission. One can use the convolution code. This paper present performance of OFDM using Space Time Block Codes (STBC) diversity technique use QAM modulation with code rate ½. The evaluation is done by analyzing the value of Bit Error Rate (BER) vs Energy per Bit to Noise Power Spectral Density Ratio (Eb/No). This scheme is conducted 256 subcarrier which transmits Rayleigh multipath fading channel in OFDM system. To achieve a BER of 10-3 is required 10dB SNR in SISO-OFDM scheme. For 2×2 MIMO-OFDM scheme requires 10 dB to achieve a BER of 10-3. For 4×4 MIMO-OFDM scheme requires 5 dB while adding convolution in a 4x4 MIMO-OFDM can improve performance up to 0 dB to achieve the same BER. This proves the existence of saving power by 3 dB of 4×4 MIMO-OFDM system without coding, power saving 7 dB of 2×2 MIMO-OFDM and significant power savings from SISO-OFDM system.

Optimization of a novel enzyme treatment process for early-stage processing of sheepskins.

PubMed

Lim, Y F; Bronlund, J E; Allsop, T F; Shilton, A N; Edmonds, R L

2010-01-01

An enzyme treatment process for early-stage processing of sheepskins has been previously reported by the Leather and Shoe Research Association of New Zealand (LASRA) as an alternative to current industry operations. The newly developed process had marked benefits over conventional processing in terms of a lowered energy usage (73%), processing time (47%) as well as water use (49%), but had been developed as a "proof of principle''. The objective of this work was to develop the process further to a stage ready for adoption by industry. Mass balancing was used to investigate potential modifications for the process based on the understanding developed from a detailed analysis of preliminary design trials. Results showed that a configuration utilising a 2 stage counter-current system for the washing stages and segregation and recycling of enzyme float prior to dilution in the neutralization stage was a significant improvement. Benefits over conventional processing include a reduction of residual TDS by 50% at the washing stages and 70% savings on water use overall. Benefits over the un-optimized LASRA process are reduction of solids in product after enzyme treatment and neutralization stages by 30%, additional water savings of 21%, as well as 10% savings of enzyme usage.

Chapter 2: Commercial and Industrial Lighting Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Gowans, Dakers; Telarico, Chad

The Commercial and Industrial Lighting Evaluation Protocol (the protocol) describes methods to account for gross energy savings resulting from the programmatic installation of efficient lighting equipment in large populations of commercial, industrial, and other nonresidential facilities. This protocol does not address savings resulting from changes in codes and standards, or from education and training activities. A separate Uniform Methods Project (UMP) protocol, Chapter 3: Commercial and Industrial Lighting Controls Evaluation Protocol, addresses methods for evaluating savings resulting from lighting control measures such as adding time clocks, tuning energy management system commands, and adding occupancy sensors.

Evaluating Acoustic Emission Signals as an in situ process monitoring technique for Selective Laser Melting (SLM)

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

Fisher, Karl A.; Candy, Jim V.; Guss, Gabe

2016-10-14

In situ real-time monitoring of the Selective Laser Melting (SLM) process has significant implications for the AM community. The ability to adjust the SLM process parameters during a build (in real-time) can save time, money and eliminate expensive material waste. Having a feedback loop in the process would allow the system to potentially ‘fix’ problem regions before a next powder layer is added. In this study we have investigated acoustic emission (AE) phenomena generated during the SLM process, and evaluated the results in terms of a single process parameter, of an in situ process monitoring technique.

Significant clinical practice cost savings through downsizing office supply inventory and just in time ordering.

PubMed

Gonzalez, Chris M; Jang, Tom; Raines, Melanie; Lys, Thomas Z; Schaeffer, Anthony J

2006-07-01

Cost containment in the office is becoming more important secondary to increasing overhead costs and lower reimbursement. In an attempt to limit these particular expenditures we analyzed and restructured our methods of ordering, storing and distributing office supply inventory. In a large academic practice with 11 urologists and approximately 20,000 annual patient visits an attempt was made to decrease overhead costs using the principle of just in time inventory popularized by large manufacturing companies. We initially issued a return of excess and/or unused supplies from our office inventory stock room. Our main supply room was then centralized to contain office supplies for up to 4 weeks. The 12 individual clinic rooms were stocked with appropriate supplies to last 1 week. Limited access to the main supply room was established and a supply manager was established to log all input and output. The initial credit for the return of unused/overstocked supplies was $10,107 in January 2004. Annual office supply charges in calendar year 2004 were $87,444 compared to charges in calendar year 2003 of $175,340. No stock outs occurred during year 2004 and all standing delivery orders were terminated. The total number of patient visits in calendar year 2004 was 20,170 compared to 19,455 in calendar year 2003. Decreasing overall inventory through accurate demand forecasting, judicious accounting, office supply centralization and just in time ordering is a potential area for significant overhead cost savings in a clinical practice.

A cost-consequences analysis of a primary care librarian question and answering service.

PubMed

McGowan, Jessie; Hogg, William; Zhong, Jianwei; Zhao, Xue

2012-01-01

Cost consequences analysis was completed from randomized controlled trial (RCT) data for the Just-in-time (JIT) librarian consultation service in primary care that ran from October 2005 to April 2006. The service was aimed at providing answers to clinical questions arising during the clinical encounter while the patient waits. Cost saving and cost avoidance were also analyzed. The data comes from eighty-eight primary care providers in the Ottawa area working in Family Health Networks (FHNs) and Family Health Groups (FHGs). We conducted a cost consequences analysis based on data from the JIT project. We also estimated the potential economic benefit of JIT librarian consultation service to the health care system. The results show that the cost per question for the JIT service was $38.20. The cost could be as low as $5.70 per question for a regular service. Nationally, if this service was implemented and if family physicians saw additional patients when the JIT service saved them time, up to 61,100 extra patients could be seen annually. A conservative estimate of the cost savings and cost avoidance per question for JIT was $11.55. The cost per question, if the librarian service was used at full capacity, is quite low. Financial savings to the health care system might exceed the cost of the service. Saving physician's time during their day could potentially lead to better access to family physicians by patients. Implementing a librarian consultation service can happen quickly as the time required to train professional librarians to do this service is short.

Impact of rivastigmine on costs and on time spent in caregiving for families of patients with Alzheimer's disease.

PubMed

Marin, Deborah; Amaya, Karine; Casciano, Roman; Puder, Katherine L; Casciano, Julian; Chang, Sobin; Snyder, Edward H; Cheng, Isaac; Cuccia, Anthony J

2003-12-01

Alzheimer's disease (AD) places a significant burden on health care systems worldwide. As new treatments are developed, their cost-effectiveness is often assessed to help health care professionals make informed decisions. In addition to the more common practice of assessing direct medical costs, indirect costs, including time spent in caregiving, should be evaluated. This study examined the potential effects of the dual cholinesterase inhibitor rivastigmine (Exelon) on caregivers of patients with AD. Results from two 26-week, placebo-controlled trials have demonstrated the clinically relevant and statistically significant efficacy of rivastigmine (6-12 mg/day) compared to placebo, on cognition, activities of daily living, and global functioning. By delaying progression of AD, significant savings in caregiver burden are anticipated, as measured by time spent caregiving and its related costs. Data collected in a prospective, observational study of AD patients and their caregivers were used to establish the relationship between disease severity (based on Mini-Mental State Examination [MMSE] score) and time spent caregiving (according to the 5-item Caregivers Activity Survey score). A significant correlation was observed between the two scores (N = 43, r = -.56, p < .0001), demonstrating that more time for supervision from caregivers is required as the disease progresses. This finding was used to estimate the reduced caregiver burden resulting from the delay in disease progression that was demonstrated with use of rivastigmine. Over a 2-year period, the reduction in time spent in caregiving reached 691 hours for caregivers of patients with mild AD (MMSE score 21-30), resulting in a total savings of approximately 11,253 dollars. Treatment of patients with moderately severe AD was also evaluated. The trend was similar but the impact was less, suggesting an economic benefit to early therapy. Early diagnosis and a pharmacologic intervention that allows the patients to remain at home longer by delaying disease progression would have a beneficial impact on patients, caregivers, and payers, and should therefore be encouraged through initiatives designed to identify and treat patients early in the course of disease.

Referral Finder: Saving Time and Improving The Quality of In-hospital Referrals.

PubMed

Cathcart, Jennifer; Cowan, Neil; Tully, Vicki

2016-01-01

Making referrals to other hospital specialties is one of the key duties of the foundation doctor, which can be difficult and time consuming. In Ninewells hospital, Scotland, in our experience the effectiveness of referrals is limited by contact details not being readily accessible and foundation doctors not knowing what information is relevant to each specialty. We surveyed foundation doctors on their experience of the existing referral process to identify where we needed to focus to improve the process. The doctors reported significant delays in obtaining contact details from the operator, and found they did not know the specific information needed in each referral. To increase the information available to foundation doctors, we set up a page on the staff intranet called 'Referral Finder'. This page includes contact details, guidelines for referral, and links to relevant protocols for each specialty. By making this information readily accessible our objective was to increase the speed and quality of referrals. When surveyed two months after the web page was established, foundation doctors reported a reduction in calls to operator from baseline and reported achieving more effective referrals. When asked to comment, many doctors asked if the page could include details for other hospitals in our health board and provide more specialty specific information. This feedback prompted us to extend the scope of the page to include the district general hospital in our region, and update many of the existing details. Doctors were then surveyed after the updates, 100% agreed that the website saved time and there was a 49.3% reduction in doctors who reported not knowing the specific information needed for a referral. Having adequate information improved referrals and resulted in time saved. This would allow more time for patient care. The quality improvement project was praised among doctors as a useful, innovative and replicable project.

Referral Finder: Saving Time and Improving The Quality of In-hospital Referrals

PubMed Central

Cathcart, Jennifer; Cowan, Neil; Tully, Vicki

2016-01-01

Making referrals to other hospital specialties is one of the key duties of the foundation doctor, which can be difficult and time consuming. In Ninewells hospital, Scotland, in our experience the effectiveness of referrals is limited by contact details not being readily accessible and foundation doctors not knowing what information is relevant to each specialty. We surveyed foundation doctors on their experience of the existing referral process to identify where we needed to focus to improve the process. The doctors reported significant delays in obtaining contact details from the operator, and found they did not know the specific information needed in each referral. To increase the information available to foundation doctors, we set up a page on the staff intranet called ‘Referral Finder’. This page includes contact details, guidelines for referral, and links to relevant protocols for each specialty. By making this information readily accessible our objective was to increase the speed and quality of referrals. When surveyed two months after the web page was established, foundation doctors reported a reduction in calls to operator from baseline and reported achieving more effective referrals. When asked to comment, many doctors asked if the page could include details for other hospitals in our health board and provide more specialty specific information. This feedback prompted us to extend the scope of the page to include the district general hospital in our region, and update many of the existing details. Doctors were then surveyed after the updates, 100% agreed that the website saved time and there was a 49.3% reduction in doctors who reported not knowing the specific information needed for a referral. Having adequate information improved referrals and resulted in time saved. This would allow more time for patient care. The quality improvement project was praised among doctors as a useful, innovative and replicable project. PMID:27158494

Outplacement Services in Support of BRAC and Competitive Sourcing Task Group

DTIC Science & Technology

2003-07-30

Management(SM) is an automated Web-based solution that streamlines workforce adjustment initiatives and exit processing, saving time and money by getting...effected during FY02 – almost 7,000. o Over 160,000 employees have been saved from involuntary separation since program inception in 1993. Buyouts...monetary incentive, up to $25,000, for employee to retire, either optional or early, or resign. Payment of the incentive must save another DoD employee

Buying time promotes happiness.

PubMed

Whillans, Ashley V; Dunn, Elizabeth W; Smeets, Paul; Bekkers, Rene; Norton, Michael I

2017-08-08

Around the world, increases in wealth have produced an unintended consequence: a rising sense of time scarcity. We provide evidence that using money to buy time can provide a buffer against this time famine, thereby promoting happiness. Using large, diverse samples from the United States, Canada, Denmark, and The Netherlands ( n = 6,271), we show that individuals who spend money on time-saving services report greater life satisfaction. A field experiment provides causal evidence that working adults report greater happiness after spending money on a time-saving purchase than on a material purchase. Together, these results suggest that using money to buy time can protect people from the detrimental effects of time pressure on life satisfaction.

Buying time promotes happiness

PubMed Central

Whillans, Ashley V.; Dunn, Elizabeth W.; Smeets, Paul; Bekkers, Rene; Norton, Michael I.

2017-01-01

Around the world, increases in wealth have produced an unintended consequence: a rising sense of time scarcity. We provide evidence that using money to buy time can provide a buffer against this time famine, thereby promoting happiness. Using large, diverse samples from the United States, Canada, Denmark, and The Netherlands (n = 6,271), we show that individuals who spend money on time-saving services report greater life satisfaction. A field experiment provides causal evidence that working adults report greater happiness after spending money on a time-saving purchase than on a material purchase. Together, these results suggest that using money to buy time can protect people from the detrimental effects of time pressure on life satisfaction. PMID:28739889

Analysis of Application Power and Schedule Composition in a High Performance Computing Environment

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

Elmore, Ryan; Gruchalla, Kenny; Phillips, Caleb

As the capacity of high performance computing (HPC) systems continues to grow, small changes in energy management have the potential to produce significant energy savings. In this paper, we employ an extensive informatics system for aggregating and analyzing real-time performance and power use data to evaluate energy footprints of jobs running in an HPC data center. We look at the effects of algorithmic choices for a given job on the resulting energy footprints, and analyze application-specific power consumption, and summarize average power use in the aggregate. All of these views reveal meaningful power variance between classes of applications as wellmore » as chosen methods for a given job. Using these data, we discuss energy-aware cost-saving strategies based on reordering the HPC job schedule. Using historical job and power data, we present a hypothetical job schedule reordering that: (1) reduces the facility's peak power draw and (2) manages power in conjunction with a large-scale photovoltaic array. Lastly, we leverage this data to understand the practical limits on predicting key power use metrics at the time of submission.« less

Motivating people to learn cardiopulmonary resuscitation and use of automated external defibrillators.

PubMed

McDonald, Deborah Dillon; Martin, Deborah; Foley, Diane; Baker, Lee; Hintz, Deborah; Faure, Lauren; Erman, Nancy; Palozie, Jessica; Lundquist, Kathleen; O'Brien, Kara; Prior, Laura; Songco, Narra; Muscillo, Gwyn; Graziani, Denise; Tomczyk, Michael; Price, Sheryl

2010-01-01

The purpose of this study was to test the effect of a motivational message on the intention of laypersons to learn cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. A pretest-posttest, double-blind, randomized design was used with 220 community-dwelling adults. Participants were randomly assigned to the treatment group reading the CPR and AED pamphlet emphasizing learning CPR and AED use to save someone they love and the 3-minute window for response time; or to the comparison group reading the identical pamphlet without the 2 motivational statements. Intention to learn CPR and AED use and to look for AEDs in public areas was measured before and after reading the respective pamphlet. No significant difference emerged between the groups for the number of participants planning to learn CPR and AED use. A significant number of participants in both groups increased intention to learn CPR and AED use. Significantly more treatment participants than comparison participants planned to routinely look for AEDs in public areas after reading the pamphlet, however. Teaching critical facts such as the low survival rate for out-of-hospital cardiac arrest might encourage laypersons to learn CPR and AED use. Routinely teaching family members of people at risk for a cardiac arrest about the short window of time in which CPR and AED use must begin and encouraging them to learn about CPR and AEDs to save someone they love may encourage family members to identify the location of AEDs in public places.

Parametric Modeling in the CAE Process: Creating a Family of Models

NASA Technical Reports Server (NTRS)

Brown, Christopher J.

2011-01-01

This Presentation meant as an example - Give ideas of approaches to use - The significant benefit of PARAMETRIC geometry based modeling The importance of planning before you build Showcase some NX capabilities - Mesh Controls - Associativity - Divide Face - Offset Surface Reminder - This only had to be done once! - Can be used for any cabinet in that "family" Saves a lot of time if pre-planned Allows re-use in the future

Auto Design

NASA Technical Reports Server (NTRS)

1988-01-01

The 1987 Honda Acura Legend Coupe was designed with aid of the NASA-developed NASTRAN computer program. NASTRAN takes an electronic look at a computerized design and predicts how the structure will react under a great many different conditions. Quick and inexpensive, it minimizes trial and error in the design process and makes possible better, lighter, safer structures while affording significant savings in development time. All Honda auto products designed in the 1980's have been analyzed by the NASTRAN program.

Observations on SOFIA Observation Scheduling: Search and Inference in the Face of Discrete and Continuous Constraints

NASA Technical Reports Server (NTRS)

Frank, Jeremy; Gross, Michael; Kuerklu, Elif

2003-01-01

We did cool stuff to reduce the number of IVPs and BVPs needed to schedule SOFIA by restricting the problem. The restriction costs us little in terms of the value of the flight plans we can build. The restriction allowed us to reformulate part of the search problem as a zero-finding problem. The result is a simplified planning model and significant savings in computation time.

Analysis of data for LANDSAT (ERTS) follow-on

NASA Technical Reports Server (NTRS)

Sizer, J. E. (Principal Investigator)

1976-01-01

The author has identified the following significant results. Daily weather service satellite photographs of the midwest were found to be of great assistance before ordering EROS Data Center products. These weather satellite images are a quick and inexpensive record of the location of cloud masses, which supplements the percent of cloud catalogues. Savings of time and money were made because the location of cloud cover was known before any imagery was ordered.

Monitoring Churn in Wireless Networks

NASA Astrophysics Data System (ADS)

Holzer, Stephan; Pignolet, Yvonne Anne; Smula, Jasmin; Wattenhofer, Roger

Wireless networks often experience a significant amount of churn, the arrival and departure of nodes. In this paper we propose a distributed algorithm for single-hop networks that detects churn and is resilient to a worst-case adversary. The nodes of the network are notified about changes quickly, in asymptotically optimal time up to an additive logarithmic overhead. We establish a trade-off between saving energy and minimizing the delay until notification for single- and multi-channel networks.

Value drivers: an approach for estimating health and disease management program savings.

PubMed

Phillips, V L; Becker, Edmund R; Howard, David H

2013-12-01

Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

On the use of inexact, pruned hardware in atmospheric modelling

PubMed Central

Düben, Peter D.; Joven, Jaume; Lingamneni, Avinash; McNamara, Hugh; De Micheli, Giovanni; Palem, Krishna V.; Palmer, T. N.

2014-01-01

Inexact hardware design, which advocates trading the accuracy of computations in exchange for significant savings in area, power and/or performance of computing hardware, has received increasing prominence in several error-tolerant application domains, particularly those involving perceptual or statistical end-users. In this paper, we evaluate inexact hardware for its applicability in weather and climate modelling. We expand previous studies on inexact techniques, in particular probabilistic pruning, to floating point arithmetic units and derive several simulated set-ups of pruned hardware with reasonable levels of error for applications in atmospheric modelling. The set-up is tested on the Lorenz ‘96 model, a toy model for atmospheric dynamics, using software emulation for the proposed hardware. The results show that large parts of the computation tolerate the use of pruned hardware blocks without major changes in the quality of short- and long-time diagnostics, such as forecast errors and probability density functions. This could open the door to significant savings in computational cost and to higher resolution simulations with weather and climate models. PMID:24842031

Ownership of individual retirement accounts – an empirical analysis based on SHARE

PubMed Central

Garcia, Maria Teresa Medeiros; Marques, Pedro Deslandes Correia Vasconcelos

2017-01-01

This paper examines the household retirement saving decisions in what concerns to the ownership of Individual Retirement Accounts (IRAs) in eight European Union (EU) countries. IRAs are more and more seen as an alternative to public pension benefits, which are decreasing. Therefore, understanding the enrolment in IRAs, both the socio-economic factors and over time, is most important. Detailed empirical analysis of the factors that might influence the ownership of IRAs is presented based on Survey of Health Ageing and Retirement in Europe (SHARE), using data from Wave 2 (2006-2007) and Wave 4 (2010-2011). Further, to analyse the impact of legal retirement age in the ownership of IRAs, two subsamples are considered: people aged between 50 and 64 years old (50-64 years) and people aged 65 or over (≥ 65 years). The results suggest that age, years of education, income and ownership of dwelling influence positively and significantly household saving, while number of children, marital status and risk aversion have a negative effect. Marital status and income are not statistically significant for retired people. Policy implications are derived. PMID:28983144

Streetlight Control System Based on Wireless Communication over DALI Protocol

PubMed Central

Bellido-Outeiriño, Francisco José; Quiles-Latorre, Francisco Javier; Moreno-Moreno, Carlos Diego; Flores-Arias, José María; Moreno-García, Isabel; Ortiz-López, Manuel

2016-01-01

Public lighting represents a large part of the energy consumption of towns and cities. Efficient management of public lighting can entail significant energy savings. This work presents a smart system for managing public lighting networks based on wireless communication and the DALI protocol. Wireless communication entails significant economic savings, as there is no need to install new wiring and visual impacts and damage to the facades of historical buildings in city centers are avoided. The DALI protocol uses bidirectional communication with the ballast, which allows its status to be controlled and monitored at all times. The novelty of this work is that it tackles all aspects related to the management of public lighting: a standard protocol, DALI, was selected to control the ballast, a wireless node based on the IEEE 802.15.4 standard with a DALI interface was designed, a network layer that considers the topology of the lighting network has been developed, and lastly, some user-friendly applications for the control and maintenance of the system by the technical crews of the different towns and cities have been developed. PMID:27128923

Evolution of the global virtual water trade network.

PubMed

Dalin, Carole; Konar, Megan; Hanasaki, Naota; Rinaldo, Andrea; Rodriguez-Iturbe, Ignacio

2012-04-17

Global freshwater resources are under increasing pressure from economic development, population growth, and climate change. The international trade of water-intensive products (e.g., agricultural commodities) or virtual water trade has been suggested as a way to save water globally. We focus on the virtual water trade network associated with international food trade built with annual trade data and annual modeled virtual water content. The evolution of this network from 1986 to 2007 is analyzed and linked to trade policies, socioeconomic circumstances, and agricultural efficiency. We find that the number of trade connections and the volume of water associated with global food trade more than doubled in 22 years. Despite this growth, constant organizational features were observed in the network. However, both regional and national virtual water trade patterns significantly changed. Indeed, Asia increased its virtual water imports by more than 170%, switching from North America to South America as its main partner, whereas North America oriented to a growing intraregional trade. A dramatic rise in China's virtual water imports is associated with its increased soy imports after a domestic policy shift in 2000. Significantly, this shift has led the global soy market to save water on a global scale, but it also relies on expanding soy production in Brazil, which contributes to deforestation in the Amazon. We find that the international food trade has led to enhanced savings in global water resources over time, indicating its growing efficiency in terms of global water use.

Cost-effectiveness of traffic enforcement: case study from Uganda.

PubMed

Bishai, D; Asiimwe, B; Abbas, S; Hyder, A A; Bazeyo, W

2008-08-01

In October 2004, the Ugandan Police department deployed enhanced traffic safety patrols on the four major roads to the capital Kampala. To assess the costs and potential effectiveness of increasing traffic enforcement in Uganda. Record review and key informant interviews were conducted at 10 police stations along the highways that were patrolled. Monthly data on traffic citations and casualties were reviewed for January 2001 to December 2005; time series (ARIMA) regression was used to assess for a statistically significant change in traffic deaths. Costs were computed from the perspective of the police department in $US 2005. Cost offsets from savings to the health sector were not included. The annual cost of deploying the four squads of traffic patrols (20 officers, four vehicles, equipment, administration) is estimated at $72,000. Since deployment, the number of citations has increased substantially with a value of $327 311 annually. Monthly crash data pre- and post-intervention show a statistically significant 17% drop in road deaths after the intervention. The average cost-effectiveness of better road safety enforcement in Uganda is $603 per death averted or $27 per life year saved discounted at 3% (equivalent to 9% of Uganda's $300 GDP per capita). The costs of traffic safety enforcement are low in comparison to the potential number of lives saved and revenue generated. Increasing enforcement of existing traffic safety norms can prove to be an extremely cost-effective public health intervention in low-income countries, even from a government perspective.

Gold Medal Forum Winner. Unfractionated heparin three times a day versus enoxaparin in the prevention of deep vein thrombosis in trauma patients.

PubMed

Arnold, Joshua D; Dart, Benjamin W; Barker, Donald E; Maxwell, Robert A; Burkholder, Hans C; Mejia, Vicente A; Smith, Philip W; Longley, Joy M

2010-06-01

Venous thromboembolic disease is a significant source of morbidity and mortality in hospitalized trauma patients. Multiple drugs and dosing regimens have been suggested for pharmacoprophylaxis. In this study, we compared efficacy, complications, and cost of unfractionated heparin administered subcutaneously three times a day with standard-dosed enoxaparin for prophylaxis of deep venous thrombosis (DVT) in adult trauma patients over 1 year. Patients admitted for greater than 72 hours who received pharmacoprophylaxis as part of a comprehensive DVT protocol were included. A change was made in the protocol from enoxaparin (30 mg twice a day or 40 mg per day) to heparin (5000 U three times a day) at midyear. Surveillance lower extremity venous ultrasound was performed according to established institutional guidelines. Data, including demographics, associated injuries, complications, and cost, were collected and analyzed. Four hundred seventy-six patients met inclusion criteria. Two hundred thirty-seven (49.8%) patients received enoxaparin and 239 (50.2%) received heparin. Proximal lower extremity DVTs were detected in 16 (6.75%) patients in the enoxaparin group and 17 (7.11%) in the heparin group (P = 0.999). Risk factors for DVT in these patients included spinal cord injury (P = 0.001) and closed head injury (P = 0.031). There was no difference between the incidence of pulmonary emboli and bleeding. There was an estimated yearly pharmacy cost savings of $135,606. In trauma patients, subcutaneous heparin dosed three times a day may be as effective as standard-dosed enoxaparin for prophylaxis of venous thromboembolism without increased complications. Heparin three times a day for venous thromboembolism prophylaxis was associated with significant pharmaceutical cost savings.

Orphan therapies: making best use of postmarket data.

PubMed

Maro, Judith C; Brown, Jeffrey S; Dal Pan, Gerald J; Li, Lingling

2014-08-01

Postmarket surveillance of the comparative safety and efficacy of orphan therapeutics is challenging, particularly when multiple therapeutics are licensed for the same orphan indication. To make best use of product-specific registry data collected to fulfill regulatory requirements, we propose the creation of a distributed electronic health data network among registries. Such a network could support sequential statistical analyses designed to detect early warnings of excess risks. We use a simulated example to explore the circumstances under which a distributed network may prove advantageous. We perform sample size calculations for sequential and non-sequential statistical studies aimed at comparing the incidence of hepatotoxicity following initiation of two newly licensed therapies for homozygous familial hypercholesterolemia. We calculate the sample size savings ratio, or the proportion of sample size saved if one conducted a sequential study as compared to a non-sequential study. Then, using models to describe the adoption and utilization of these therapies, we simulate when these sample sizes are attainable in calendar years. We then calculate the analytic calendar time savings ratio, analogous to the sample size savings ratio. We repeat these analyses for numerous scenarios. Sequential analyses detect effect sizes earlier or at the same time as non-sequential analyses. The most substantial potential savings occur when the market share is more imbalanced (i.e., 90% for therapy A) and the effect size is closest to the null hypothesis. However, due to low exposure prevalence, these savings are difficult to realize within the 30-year time frame of this simulation for scenarios in which the outcome of interest occurs at or more frequently than one event/100 person-years. We illustrate a process to assess whether sequential statistical analyses of registry data performed via distributed networks may prove a worthwhile infrastructure investment for pharmacovigilance.

The shift to and from daylight savings time and motor vehicle crashes.

PubMed

Lambe, M; Cummings, P

2000-07-01

The objective of the study was to examine whether the shifts to and from daylight savings time in Sweden have short-term effects on the incidence of traffic crashes. A database maintained by the Swedish National Road Administration was used to examine crashes from 1984 through 1995, that occurred on state roads the Monday preceding, the Monday immediately after (index Monday), and the Monday 1 week after the change to daylight savings time in the spring and for the corresponding three Mondays in the autumn. The Mondays 1 week before and after the time changes were taken as representing the expected incidence of crashes. Crash incidence was calculated per 1000 person-years using population estimates for each year of the study. The association between 1 h of possible sleep loss and crash incidence was estimated by the incidence rate ratio from negative binomial regression. The incidence rate ratio was 1.04 (95% CI, 0.92-1.16) for a Monday on which drivers were expected to have had 1 h less sleep, compared with other Mondays. In the spring, the incidence rate ratio for crashes was 1.11 (95% CI, 0.93-1.31) for Mondays after the time change compared to other spring Mondays. The corresponding rate ratio for the fall was 0.98 (95% CI, 0.84-1.15) It was concluded that the shift to and from daylight savings time did not have measurable important immediate effects on crash incidence in Sweden.

Cost savings using a protocol approach to manage anemia in a hemodialysis unit.

PubMed

Charlesworth, Emily C; Richardson, Robert M; Battistella, Marisa

2014-01-01

National guidelines recommend using anemia management protocols to guide treatment. The objective of this study was to determine if an anemia management protocol would improve hemoglobin (Hgb) indices in hemodialysis patients and to measure whether the protocol would reduce the use and cost of darbepoetin alfa (DBO) and intravenous (IV) iron in hemodialysis patients. An anemia management protocol was created and implemented for hemodialysis patients at our institution. A retrospective observational review of the use of DBO and IV iron as well as changes in Hgb, transferrin saturation and ferritin in 174 patients was conducted 6 months before and after implementation of the anemia protocol. The number of Hgb measurements in the target range increased from 44.3 to 46.0% (p = 0.48) after protocol implementation. The mean weekly dose of DBO was reduced from 34.56 ± 31.12 to 31.11 ± 28.64 μg post-protocol implementation (p = 0.011), which translated to a cost savings of USD 41,649 over 6 months. The mean monthly IV iron dose also decreased from 139.56 ± 98.83 to 97.65 ± 79.05 mg (p < 0.005), a cost savings of USD 18,594 over the same time period. The use of an anemia management protocol resulted in the deprescribing of DBO and iron agents while increasing the number of patients in the target Hgb range, which led to significant cost savings in the treatment of anemia.

Advanced Imaging Utilization and Cost Savings Among Medicare Shared Savings Program Accountable Care Organizations: An Initial Exploratory Analysis.

PubMed

Rosenkrantz, Andrew B; Duszak, Richard

2018-03-01

The purpose of this study was to explore associations between CT and MRI utilization and cost savings achieved by Medicare Shared Savings Program (MSSP)-participating accountable care organizations (ACOs). Summary data were obtained for all MSSP-participating ACOs (n = 214 in 2013; n = 333 in 2014). Multivariable regressions were performed to assess associations of CT and MRI utilization with ACOs' total savings and reaching minimum savings rates to share in Medicare savings. In 2014, 54.4% of ACOs achieved savings, meeting minimum rates to share in savings in 27.6%. Independent positive predictors of total savings included beneficiary risk scores (β = +20,265,720, P = .003) and MRI events (β = +19,964, P = .018) but not CT events (β = +2,084, P = .635). Independent positive predictors of meeting minimum savings rates included beneficiary risk scores (odds ratio = 2108, P = .001) and MRI events (odds ratio = 1.008, P = .002), but not CT events (odds ratio = 1.002, P = .289). Measures not independently associated with savings were total beneficiaries; beneficiaries' gender, age, race or ethnicity; and Medicare enrollment type (P > .05). For ACOs with 2013 and 2014 data, neither increases nor decreases in CT and MRI events between years were associated with 2014 total savings or meeting savings thresholds (P ≥ .466). Higher MRI utilization rates were independently associated with small but significant MSSP ACO savings. The value of MRI might relate to the favorable impact of appropriate advanced imaging utilization on downstream outcomes and other resource utilization. Because MSSP ACOs represent a highly select group of sophisticated organizations subject to rigorous quality and care coordination standards, further research will be necessary to determine if these associations are generalizable to other health care settings. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Unified Communications for Space Inventory Management

NASA Technical Reports Server (NTRS)

Gifford, Kevin K.; Fink, Patrick W.; Barton, Richard; Ngo, Phong H.

2009-01-01

To help assure mission success for long-duration exploration activities, NASA is actively pursuing wireless technologies that promote situational awareness and autonomy. Wireless technologies are typically extensible, offer freedom from wire tethers, readily support redundancy, offer potential for decreased wire weight, and can represent dissimilar implementation for increased reliability. In addition, wireless technologies can enable additional situational awareness that otherwise would be infeasible. For example, addition of wired sensors, the need for which might not have been apparent at the outset of a program, night be extremely costly due in part to the necessary routing of cables through the vehicle. RFID, or radio frequency identification, is a wireless technology with the potential for significant savings and increased reliability and safety in space operations. Perhaps the most obvious savings relate to the application of inventory management. A fully automated inventory management system is highly desirable for long-term sustaining operations in space environments. This assertion is evidenced by inventory activities on the International Space Station, which represents the most extensive inventory tracking experience base in the history of space operations. In the short tern, handheld RFID readers offer substantial savings owing to reduced crew time for inventory audits. Over the long term, a combination of improved RFID technology and operational concepts modified to fully utilize the technology should result in space based inventory management that is highly reliable and requires very little crew time. In addition to inventory management, RFID is likely to find space applications in real-time location and tracking systems. These could vary from coarse-resolution RFID portals to the high resolution afforded by ultra-wideband (UWB) RFID. Longer range RFID technologies that leverage passive surface acoustic wave (SAW) devices are being investigated to track assets on a lunar or planetary surface.

Stroke thrombolysis: save a minute, save a day.

PubMed

Meretoja, Atte; Keshtkaran, Mahsa; Saver, Jeffrey L; Tatlisumak, Turgut; Parsons, Mark W; Kaste, Markku; Davis, Stephen M; Donnan, Geoffrey A; Churilov, Leonid

2014-04-01

Stroke thrombolysis is highly time-critical, but data on long-term effects of small reductions in treatment delays have not been available. Our objective was to quantify patient lifetime benefits gained from faster treatment. Observational prospective data of consecutive stroke patients treated with intravenous thrombolysis in Australian and Finnish centers (1998-2011; n=2258) provided distributions of age, sex, stroke severity, onset-to-treatment times, and 3-month modified Rankin Scale in daily clinical practice. Treatment effects derived from a pooled analysis of thrombolysis trials were used to model the shift in 3-month modified Rankin Scale distributions with reducing treatment delays, from which we derived the expected lifetime and level of long-term disability with faster treatment. Each minute of onset-to-treatment time saved granted on average 1.8 days of extra healthy life (95% prediction interval, 0.9-2.7). Benefit was observed in all groups: each minute provided 0.6 day in old severe (age, 80 years; National Institutes of Health Stroke Scale [NIHSS] score, 20) patients, 0.9 day in old mild (age, 80 years; NIHSS score, 4) patients, 2.7 days in young mild (age, 50 years; NIHSS score, 4) patients, and 3.5 days in young severe (age, 50 years; NIHSS score, 20) patients. Women gained slightly more than men over their longer lifetimes. In the whole cohort, each 15 minute decrease in treatment delay provided an average equivalent of 1 month of additional disability-free life. Realistically achievable small reductions in stroke thrombolysis delays would result in significant and robust average health benefits over patients' lifetimes. The awareness of concrete importance of speed could promote practice change.

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

Baxter, Van D.; Munk, Jeffrey D.; Gehl, Anthony C.

The field study is planned to continue through the 2016 cooling season with the draft final project report due by September 30, 2016. This report provides a description of both installations and preliminary 2015 cooling and fall season performance results for the Knoxville site. For the August 18 through December 14 period, the Knoxville site GS-IHP provided 53.6% total source energy savings compared to a baseline electric RTU/heat pump and electric WH. Peak demand savings ranged from 33% to 59% per month. Energy cost savings of 53.1% have been achieved to date with more than half of that coming frommore » reduced demand charges. Data on installation and maintenance costs are being collected and will be combined with total test period energy savings data for a payback analysis to be included in the project final report. The GS-IHP also saved a significant amount of carbon emissions. The total emission savings for the Knoxville site for the August-December 2015 period were ~0.8 metric tons. If trading for carbon credits ever becomes a reality, additional cost savings would be realized.« less

Freight Wing Trailer Aerodynamics

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

Graham, Sean; Bigatel, Patrick

2004-10-17

Freight Wing Incorporated utilized the opportunity presented by this DOE category one Inventions and Innovations grant to successfully research, develop, test, patent, market, and sell innovative fuel and emissions saving aerodynamic attachments for the trucking industry. A great deal of past scientific research has demonstrated that streamlining box shaped semi-trailers can significantly reduce a truck's fuel consumption. However, significant design challenges have prevented past concepts from meeting industry needs. Market research early in this project revealed the demands of truck fleet operators regarding aerodynamic attachments. Products must not only save fuel, but cannot interfere with the operation of the truck,more » require significant maintenance, add significant weight, and must be extremely durable. Furthermore, SAE/TMC J1321 tests performed by a respected independent laboratory are necessary for large fleets to even consider purchase. Freight Wing used this information to create a system of three practical aerodynamic attachments for the front, rear and undercarriage of standard semi trailers. SAE/TMC J1321 Type II tests preformed by the Transportation Research Center (TRC) demonstrated a 7% improvement to fuel economy with all three products. If Freight Wing is successful in its continued efforts to gain market penetration, the energy and environmental savings would be considerable. Each truck outfitted saves approximately 1,100 gallons of fuel every 100,000 miles, which prevents over 12 tons of CO2 from entering the atmosphere. If all applicable trailers used the technology, the country could save approximately 1.8 billion gallons of diesel fuel, 18 million tons of emissions and 3.6 billion dollars annually.« less

Cost comparison and economic implications of commonly used originator and generic chemotherapy drugs in India.

PubMed

Lopes, G de L

2013-09-01

Cancer treatments have improved outcomes but access to medications is an issue around the world and especially so in low- and middle-income countries, such as India. Generic substitution may lead to significant cost savings. The author aimed to compare the cost and estimate potential cost savings per cycle, per patient, and for the country as a whole with generic substitution of frequently used chemotherapy drugs in the treatment of common cancers in India. Generic paclitaxel (Taxol), docetaxel (Taxotere), gemcitabine, oxaliplatin and irinotecan cost from 8.9% to 36% of their equivalent branded originator drug, resulting in cost savings of ~ Indian Rupees (INR) 11,000 to >INR 90,000 (USD 200-1600, Euro 160-1300) per cycle; and ~INR 50,000 to >INR 240,000 (USD 900-4300, Euro 700-3400) per patient. Overall, potential yearly savings for health systems in India were nearly INR 47 billion (~USD 843 million, Euro 670 million). In conclusion, generic substitution for frequently used chemotherapy drugs in the treatment of common cancers has an enormous potential to generate significant cost savings and increase access to cancer treatments in India and other low- and middle-income countries.

Cool Shelter

ERIC Educational Resources Information Center

Praeger, Charles E.

2005-01-01

Amid climbing energy costs and tightening budgets, administrators at school districts, colleges and universities are looking for all avenues of potential savings while promoting sustainable communities. Cool metal roofing can save schools money and promote sustainable design at the same time. Cool metal roofing keeps the sun's heat from collecting…

Direct and indirect costs and potential cost savings of laparoscopic adjustable gastric banding among obese patients with diabetes.

PubMed

Finkelstein, Eric A; Allaire, Benjamin T; DiBonaventura, Marco DaCosta; Burgess, Somali M

2011-09-01

To estimate the time to breakeven and 5-year net costs for laparoscopic adjustable gastric banding among obese patients with diabetes taking direct and indirect costs into account. Indirect cost savings were generated by quantifying the cross-sectional relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and simulating indirect cost savings based on these multipliers and reductions in direct medical costs available in the literature. Time to breakeven was estimated to be nine quarters with and without the inclusion of indirect costs. After 5 years, net savings increase from $26570 (±$9000) to $34160 (±$10 380) when indirect costs are included. This study presented a novel approach for incorporating indirect costs into cost-benefit analyses. Application to gastric banding revealed that inclusion of indirect costs improves the financial outlook for the procedure. (C)2011The American College of Occupational and Environmental Medicine

High-content screening in microfluidic devices.

PubMed

Cheong, Raymond; Paliwal, Saurabh; Levchenko, Andre

2010-08-01

Miniaturization is the key to advancing the state of the art in high-content screening (HCS) in order to enable dramatic cost savings through reduced usage of expensive biochemical reagents and to enable large-scale screening on primary cells. Microfluidic technology offers the potential to enable HCS to be performed with an unprecedented degree of miniaturization. This perspective highlights a real-world example from the authors’ work of HCS assays implemented in a highly miniaturized microfluidic format. The advantages of this technology are discussed, including cost savings, high-throughput screening on primary cells, improved accuracy, the ability to study complex time-varying stimuli, and ease of automation, integration and scaling. The reader will understand the capabilities of anew microfluidics-based platform for HCS and the advantages it provides over conventional plate-based HCS. Microfluidics technology will drive significant advancements and broader usage and applicability of HCS in drug discovery.

Airline flight planning: The weather connection

NASA Technical Reports Server (NTRS)

Steinberg, R.

1981-01-01

Airline flight planning has shown little improvement in accuracy since the introduction of computerized techniques in 1964. This has primarily been, because both the type of weather product utilized by the carriers and the way they have employed it has remained unchanged over the past 15 years. The airlines now have an opportunity to make a significant advance in this area with attendant benefits in fuel savings. Most the technological ingredients are in place, but it will take increased cooperation between government and the private sector if cost effective improvements are to be made on a reasonable time scale. This paper reviews the meteorological basis for the present method of flight planning and analyzes its impact on current flight operations. A new approach is suggested for developing a weather data base, for flight planning, which has the potential of providing a fuel savings of between 2 and 3 percent on long distance flights.

Eco-efficiency evaluation of a smart window prototype.

PubMed

Syrrakou, E; Papaefthimiou, S; Yianoulis, P

2006-04-15

An eco-efficiency analysis was conducted using indicators suitably defined to evaluate the performance of an electrochromic window acting as an energy saving component in buildings. Combining the indicators for various parameters (control scenario, expected lifetime, climatic type, purchase cost) significant conclusions are drawn for the development and the potential applications of the device compared to other commercial fenestration products. The reduction of the purchase cost (to 200 euros/m2) and the increase of the lifetime (above 15 years) are the two main targets for achieving both cost and environmental efficiency. An electrochromic device, implemented in cooling dominated areas and operated with an optimum control strategy for the maximum expected lifetime (25 years), can reduce the building energy requirements by 52%. Furthermore, the total energy savings provided will be 33 times more than the energy required for its production while the emission of 615 kg CO2 equivalent per electrochromic glazing unit can be avoided.

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.

The Benefits of Streamlined Hip Fracture Management in a Regional Hospital.

PubMed

Mow, T C; Lukeis, Jen; Sutherland, A G

2017-06-01

Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment. A hip fracture working group was created to examine closely the process of hip fracture care, and a single key performance indicator (KPI) of "surgery within 48 hours" was adopted. This allowed identification of processes that could be clarified and streamlined, with the agreement of relevant stakeholders, in the creation of a new hip fracture pathway. In the first 3 months of the pathway's implementation, 16 of 18 patients had surgery within 48 hours of presentation. In a 6-month follow-up audit after 2 years of implementation, 36 of 39 patients were treated within 48 hours. This was significantly different to the time to surgery seen in the 12 months prior to the redesign ( P < .001, Student t test). The mean time to surgery was reduced from 72 hours to 36 hours, a saving in an annual acute bed stay cost of A$152 000. Decreased time to the operating room, the cost savings inherent to this, can be achieved with the introduction of the best standard of care. A redesign that mandates collaboration in achieving a single KPI has allowed a significant culture shift in the treatment of hip fractures in our institution in the months following its institution. Collaborative, multidisciplinary collaboration has facilitated a higher standard of care and demonstrated significant cost benefit.

Mathematical model of marine diesel engine simulator for a new methodology of self propulsion tests

NASA Astrophysics Data System (ADS)

Izzuddin, Nur; Sunarsih, Priyanto, Agoes

2015-05-01

As a vessel operates in the open seas, a marine diesel engine simulator whose engine rotation is controlled to transmit through propeller shaft is a new methodology for the self propulsion tests to track the fuel saving in a real time. Considering the circumstance, this paper presents the real time of marine diesel engine simulator system to track the real performance of a ship through a computer-simulated model. A mathematical model of marine diesel engine and the propeller are used in the simulation to estimate fuel rate, engine rotating speed, thrust and torque of the propeller thus achieve the target vessel's speed. The input and output are a real time control system of fuel saving rate and propeller rotating speed representing the marine diesel engine characteristics. The self-propulsion tests in calm waters were conducted using a vessel model to validate the marine diesel engine simulator. The simulator then was used to evaluate the fuel saving by employing a new mathematical model of turbochargers for the marine diesel engine simulator. The control system developed will be beneficial for users as to analyze different condition of vessel's speed to obtain better characteristics and hence optimize the fuel saving rate.

Evaluating the fair market value of pay for performance.

PubMed

Johnson, Jen; Higgins, Alexandra

2014-04-01

When assessing a pay-for-performance arrangement, the following factors should be considered: Existence and/or size of minimum savings threshold before savings are allocated. Savings allocation percentage available to physicians. Benchmarks used to measure quality against past performance and/or medical evidence. Ways in which quality outcomes are measured and paid for. Per member per month payments for patient management. Physician investment (participation fee, time, or capital). Existence of downside risk to physicians. Employed compensation structure (if applicable).

Disaster Relief and Emergency Medical Services Project (DREAMS TM): Digital EMS

DTIC Science & Technology

2000-10-01

exchanges between the hospital and the EMS vehicle. By creating the virtual presence of a physician at or near the emergency scene, more lives will be saved ...address, cross street, zip code etc. The map can be saved to the clipboard or to an EMF graphics file for use by other applications in the system. 29...section can be found in Appendix B. The EMS personnel on board the ambulance can benefit greatly from technology integration. Several time- saving

Design of electric vehicle charging station based on wind and solar complementary power supply

NASA Astrophysics Data System (ADS)

Wang, Li

2018-05-01

Electric vehicles have become a major trend in the development of the automobile industry. Green energy saving is an important feature of their development. At the same time, the related charging facilities construction is also critical. If we improve the charging measures to adapt to its green energy-saving features, it will be to a greater extent to promote its further development. This article will propose a highly efficient green energy-saving charging station designed for the electric vehicles.

Are virtual planning and guided surgery for head and neck reconstruction economically viable?

PubMed

Zweifel, Daniel Fritz; Simon, Christian; Hoarau, Remy; Pasche, Philippe; Broome, Martin

2015-01-01

Virtual planning and guided surgery with or without prebent or milled plates are becoming more and more common for mandibular reconstruction with fibular free flaps (FFFs). Although this excellent surgical option is being used more widely, the question of the additional cost of planning and cutting-guide production has to be discussed. In capped payment systems such additional costs have to be offset by other savings if there are no special provisions for extra funding. Our study was designed to determine whether using virtual planning and guided surgery resulted in time saved during surgery and whether this time gain resulted in self-funding of such planning through the time saved. All consecutive cases of FFF surgery were evaluated during a 2-year period. Institutional data were used to determine the price of 1 minute of operative time. The time for fibula molding, plate adaptation, and insetting was recorded. During the defined period, we performed 20 mandibular reconstructions using FFFs, 9 with virtual planning and guided surgery and 11 freehand cases. One minute of operative time was calculated to cost US $47.50. Multiplying this number by the time saved, we found that the additional cost of virtual planning was reduced from US $5,098 to US $1,231.50 with a prebent plate and from US $6,980 to US $3,113.50 for a milled plate. Even in capped health care systems, virtual planning and guided surgery including prebent or milled plates are financially viable. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Rayyan-a web and mobile app for systematic reviews.

PubMed

Ouzzani, Mourad; Hammady, Hossam; Fedorowicz, Zbys; Elmagarmid, Ahmed

2016-12-05

Synthesis of multiple randomized controlled trials (RCTs) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions. Filtering of searches is time consuming, and no single method fulfills the principal requirements of speed with accuracy. Automation of systematic reviews is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making. We developed Rayyan ( http://rayyan.qcri.org ), a free web and mobile app, that helps expedite the initial screening of abstracts and titles using a process of semi-automation while incorporating a high level of usability. For the beta testing phase, we used two published Cochrane reviews in which included studies had been selected manually. Their searches, with 1030 records and 273 records, were uploaded to Rayyan. Different features of Rayyan were tested using these two reviews. We also conducted a survey of Rayyan's users and collected feedback through a built-in feature. Pilot testing of Rayyan focused on usability, accuracy against manual methods, and the added value of the prediction feature. The "taster" review (273 records) allowed a quick overview of Rayyan for early comments on usability. The second review (1030 records) required several iterations to identify the previously identified 11 trials. The "suggestions" and "hints," based on the "prediction model," appeared as testing progressed beyond five included studies. Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements. The survey respondents reported 40% average time savings when using Rayyan compared to others tools, with 34% of the respondents reporting more than 50% time savings. In addition, around 75% of the respondents mentioned that screening and labeling studies as well as collaborating on reviews to be the two most important features of Rayyan. As of November 2016, Rayyan users exceed 2000 from over 60 countries conducting hundreds of reviews totaling more than 1.6M citations. Feedback from users, obtained mostly through the app web site and a recent survey, has highlighted the ease in exploration of searches, the time saved, and simplicity in sharing and comparing include-exclude decisions. The strongest features of the app, identified and reported in user feedback, were its ability to help in screening and collaboration as well as the time savings it affords to users. Rayyan is responsive and intuitive in use with significant potential to lighten the load of reviewers.

Improved Surgery Planning Using 3-D Printing: a Case Study.

PubMed

Singhal, A J; Shetty, V; Bhagavan, K R; Ragothaman, Ananthan; Shetty, V; Koneru, Ganesh; Agarwala, M

2016-04-01

The role of 3-D printing is presented for improved patient-specific surgery planning. Key benefits are time saved and surgery outcome. Two hard-tissue surgery models were 3-D printed, for orthopedic, pelvic surgery, and craniofacial surgery. We discuss software data conversion in computed tomography (CT)/magnetic resonance (MR) medical image for 3-D printing. 3-D printed models save time in surgery planning and help visualize complex pre-operative anatomy. Time saved in surgery planning can be as much as two thirds. In addition to improved surgery accuracy, 3-D printing presents opportunity in materials research. Other hard-tissue and soft-tissue cases in maxillofacial, abdominal, thoracic, cardiac, orthodontics, and neurosurgery are considered. We recommend using 3-D printing as standard protocol for surgery planning and for teaching surgery practices. A quick turnaround time of a 3-D printed surgery model, in improved accuracy in surgery planning, is helpful for the surgery team. It is recommended that these costs be within 20 % of the total surgery budget.

Illumina Unamplified Indexed Library Construction: An Automated Approach

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

Hack, Christopher A.; Sczyrba, Alexander; Cheng, Jan-Fang

Manual library construction is a limiting factor in Illumina sequencing. Constructing libraries by hand is costly, time-consuming, low-throughput, and ergonomically hazardous, and constructing multiple libraries introduces risk of library failure due to pipetting errors. The ability to construct multiple libraries simultaneously in automated fashion represents significant cost and time savings. Here we present a strategy to construct up to 96 unamplified indexed libraries using Illumina TruSeq reagents and a Biomek FX robotic platform. We also present data to indicate that this library construction method has little or no risk of cross-contamination between samples.

How Do I Find the Evidence? Find Your Librarian-Stat!

PubMed

Eresuma, Emily; Lake, Erica

Clinical nurses often struggle with a lack of time and proficiency when it comes to finding and reviewing research. Knowing where to start, and discerning which search terms will retrieve the best results, can be arduous. As expert searchers, medical librarians have the skills and knowledge to make significant contributions to the clinical team, helping nurses navigate information resources and research from start to finish. When there is not direct access to a librarian, the toolbox of resources outlined in the article can save nurses' time and effort when they require quality, evidence-based information.

Global ablation techniques.

PubMed

Woods, Sarah; Taylor, Betsy

2013-12-01

Global endometrial ablation techniques are a relatively new surgical technology for the treatment of heavy menstrual bleeding that can now be used even in an outpatient clinic setting. A comparison of global ablation versus earlier ablation technologies notes no significant differences in success rates and some improvement in patient satisfaction. The advantages of the newer global endometrial ablation systems include less operative time, improved recovery time, and decreased anesthetic risk. Ablation procedures performed in an outpatient surgical or clinic setting provide advantages both of potential cost savings for patients and the health care system and improved patient convenience. Copyright © 2013. Published by Elsevier Inc.

Evaluating health information technology: provider satisfaction with an HIV-specific, electronic clinical management and reporting system.

PubMed

Magnus, Manya; Herwehe, Jane; Andrews, Laura; Gibson, Laura; Daigrepont, Nathan; De Leon, Jordana M; Hyslop, Newton E; Styron, Steven; Wilcox, Ronald; Kaiser, Michael; Butler, Michael K

2009-02-01

Health information technology (HIT) offers the potential to improve care for persons living with HIV. Provider satisfaction with HIT is essential to realize benefits, yet its evaluation presents challenges. An HIV-specific, electronic clinical management and reporting system was implemented in Louisiana's eight HIV clinics, serving over 7500. A serial cross-sectional survey was administered at three points between April 2002 and July 2005; qualitative methods were used to augment quantitative. Multivariable methods were used to characterize provider satisfaction. The majority of the sample (n = 196; T1 = 105; T2 = 46; T3 = 45) was female (80.0%), between ages of 25 and 50 years (68.3%), frequent providers at that clinic (53.7% more than 4 days per week), and had been at the same clinic for a year or more (85.0%). Improvements in satisfaction were observed in patient tracking ( p < 0.05), distribution of educational materials ( p < 0.04), and belief that electronic systems improve care ( p < 0.05). Provider self-reports of time to complete critical functions decreased for all tasks, two significantly so. Time (in minutes) to find current CD4 count decreased at each time point (mean 3.9 [standard deviation {SD} 5.8], 2.9 [2.3], 2.1 [2.6], p>0.05), current viral load decreased at each time point (mean 4.0 [SD 5.6], 2.9 [2.5], 1.8 [2.6], p = 0.08], current antiretroviral status decreased at each time point (mean 3.9 [SD 4.7], 2.9 [3.7], 1.5 [1.1], p < 0.04), history of antiretroviral use decreased at each time point (mean 15.1 [SD 21.9], 6.0 [5.4], 5.4 [7.2], p < 0.04]. Time savings were realized, averaging 16.1 minutes per visit ( p < 0.04). Providers were satisfied with HIT in multiple domains, and significant time savings were realized.

Goal clarity and financial planning activities as determinants of retirement savings contributions.

PubMed

Stawski, Robert S; Hershey, Douglas A; Jacobs-Lawson, Joy M

2007-01-01

Retirement counselors, financial service professionals, and retirement intervention specialists routinely emphasize the importance of developing clear goals for the future; however, few empirical studies have focused on the benefits of retirement goal setting. In the present study, the extent to which goal clarity and financial planning activities predict retirement savings practices was examined among 100 working adults. Path analysis techniques were used to test two competing models, both of which were designed to predict savings contributions. Findings provide support for the model in which retirement goal clarity is a significant predictor of planning practices, and planning, in turn, predicts savings tendencies. Two demographic variables-income and age-were also revealed to be important elements of the model, with income accounting for roughly half of the explained variance in savings contributions. The results of this study have implications for the development of age-based models of planning, as well as implications for retirement counselors and financial planners who advise workers on long-term saving strategies.

Dedicated Orthogeriatric Service Saves the HSE a Million Euro.

PubMed

Shanahan, E; Henderson, C; Butler, A; Lenehan, B; Sheehy, T; Costelloe, A; Carew, S; Peters, C; O'Connor, M; Lyons, D; Ryan, J

2016-04-11

Hip fracture is common in older adults and is associated with high morbidity, mortality and significant health care costs. A pilot orthogeriatrics service was established in an acute hospital. We aimed to establish the cost effectiveness of this service. Length of hospital stay, discharge destination and rehabilitation requirements were analysed for a one year period and compared to patients who received usual care prior to the service. We calculated the costs incurred and savings produced by the orthogeriatric service. Median length of stay was reduced by 3 days (p < 0.001) saving €266,976. There was a 19% reduction in rehabilitation requirements saving €192,600. Median rehabilitation length of stay was reduced by 6.5 days saving €171,093. Reductions in long term care requirements led to savings of €10,934 per week. Costs to establish such a service amount to €171,564. The introduction of this service led to improved patient outcomes in a cost effective manner.

Existing Whole-House Solutions Case Study: Cascade Apartments - Deep Energy Multifamily Retrofit

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

None

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington, which resulted in annual energy cost savings of 22%, improved comfort and air quality for residents, and increased durability of the units. This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary Building America research questions: 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings comparemore » with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio of the retrofit package after considering utility window incentives and KCHA capital improvement funding.« less

Standardization: Hardware and Software Standardization Can Reduce Costs and Save Time

ERIC Educational Resources Information Center

Brooks-Young, Susan

2005-01-01

Sadly, technical support doesn't come cheap. One money-saving strategy that's gained popularity among school technicians is equipment and software standardization. When it works, standardization can be very effective. However, standardization has its drawbacks. This article discusses the advantages and disadvantages of standardization.

Do You Automate? Saving Time and Dollars

ERIC Educational Resources Information Center

Carmichael, Christine H.

2010-01-01

An automated workforce management strategy can help schools save jobs, improve the job satisfaction of teachers and staff, and free up precious budget dollars for investments in critical learning resources. Automated workforce management systems can help schools control labor costs, minimize compliance risk, and improve employee satisfaction.…

Printed Circuit Board Design (PCB) with HDL Designer

NASA Technical Reports Server (NTRS)

Winkert, Thomas K.; LaFourcade, Teresa

2004-01-01

Contents include the following: PCB design with HDL designer, design process and schematic capture - symbols and diagrams: 1. Motivation: time savings, money savings, simplicity. 2. Approach: use single tool PCB for FPGA design, more FPGA designs than PCB designers. 3. Use HDL designer for schematic capture.

Rising College Costs.

ERIC Educational Resources Information Center

USA Today, 1981

1981-01-01

Focuses on ways in which parents of school-age children can offset the rising costs of college, including encouraging students to get summer and part-time jobs, putting savings toward students' education in accounts in students' names to save taxes, investigating cooperative work/education plans, and investing in mutual funds. (DB)

Performance Contracting: Taking School Technology Green

ERIC Educational Resources Information Center

Taival, Dane

2009-01-01

Energy efficiency makes fiscal and environmental sense, and so does energy savings performance contracting. Because an energy savings performance contract can create a self-funding package of products and services that reduce energy and operating costs, over time, school districts' sometimes-large initial investment in emerging technologies saves…

How Dollars Make Cents. Teacher's Guide [and] Student Materials.

ERIC Educational Resources Information Center

Auman, L. Charles

This unit provides secondary school students with methods for comparison shopping of savings institutions. It contains both student materials and teacher's guide and is designed for individualized instruction. Approximate time for the unit is six hours. Activities include analyzing cartoons, defining the terms "savings" and…

Health belief model and reasoned action theory in predicting water saving behaviors in yazd, iran.

PubMed

Morowatisharifabad, Mohammad Ali; Momayyezi, Mahdieh; Ghaneian, Mohammad Taghi

2012-01-01

People's behaviors and intentions about healthy behaviors depend on their beliefs, values, and knowledge about the issue. Various models of health education are used in deter¬mining predictors of different healthy behaviors but their efficacy in cultural behaviors, such as water saving behaviors, are not studied. The study was conducted to explain water saving beha¬viors in Yazd, Iran on the basis of Health Belief Model and Reasoned Action Theory. The cross-sectional study used random cluster sampling to recruit 200 heads of households to collect the data. The survey questionnaire was tested for its content validity and reliability. Analysis of data included descriptive statistics, simple correlation, hierarchical multiple regression. Simple correlations between water saving behaviors and Reasoned Action Theory and Health Belief Model constructs were statistically significant. Health Belief Model and Reasoned Action Theory constructs explained 20.80% and 8.40% of the variances in water saving beha-viors, respectively. Perceived barriers were the strongest Predictor. Additionally, there was a sta¬tistically positive correlation between water saving behaviors and intention. In designing interventions aimed at water waste prevention, barriers of water saving behaviors should be addressed first, followed by people's attitude towards water saving. Health Belief Model constructs, with the exception of perceived severity and benefits, is more powerful than is Reasoned Action Theory in predicting water saving behavior and may be used as a framework for educational interventions aimed at improving water saving behaviors.

Health Belief Model and Reasoned Action Theory in Predicting Water Saving Behaviors in Yazd, Iran

PubMed Central

Morowatisharifabad, Mohammad Ali; Momayyezi, Mahdieh; Ghaneian, Mohammad Taghi

2012-01-01

Background: People's behaviors and intentions about healthy behaviors depend on their beliefs, values, and knowledge about the issue. Various models of health education are used in deter¬mining predictors of different healthy behaviors but their efficacy in cultural behaviors, such as water saving behaviors, are not studied. The study was conducted to explain water saving beha¬viors in Yazd, Iran on the basis of Health Belief Model and Reasoned Action Theory. Methods: The cross-sectional study used random cluster sampling to recruit 200 heads of households to collect the data. The survey questionnaire was tested for its content validity and reliability. Analysis of data included descriptive statistics, simple correlation, hierarchical multiple regression. Results: Simple correlations between water saving behaviors and Reasoned Action Theory and Health Belief Model constructs were statistically significant. Health Belief Model and Reasoned Action Theory constructs explained 20.80% and 8.40% of the variances in water saving beha-viors, respectively. Perceived barriers were the strongest Predictor. Additionally, there was a sta¬tistically positive correlation between water saving behaviors and intention. Conclusion: In designing interventions aimed at water waste prevention, barriers of water saving behaviors should be addressed first, followed by people's attitude towards water saving. Health Belief Model constructs, with the exception of perceived severity and benefits, is more powerful than is Reasoned Action Theory in predicting water saving behavior and may be used as a framework for educational interventions aimed at improving water saving behaviors. PMID:24688927

12 CFR 3.201 - Purpose, applicability, and reservation of authority.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CAPITAL ADEQUACY STANDARDS Risk-Weighted Assets-Market Risk § 3.201 Purpose, applicability, and... banks or Federal savings associations with significant exposure to market risk, provides methods for these national banks or Federal savings associations to calculate their standardized measure for market...

Framing Effect in the Trolley Problem and Footbridge Dilemma.

PubMed

Cao, Fei; Zhang, Jiaxi; Song, Lei; Wang, Shoupeng; Miao, Danmin; Peng, Jiaxi

2017-02-01

The present study investigated the effect of dilemma type, framing, and number of saved lives on moral decision making. A total of 591 undergraduates, with a mean age of 20.56 (SD = 1.37) were randomly assigned to 12 groups on the basis of a grid of two dilemma types (the trolley problem or the footbridge dilemma) by three frames (positive, neutral, or negative frame) by two different numbers of workers (5 or 15 people). The main effects of dilemma type, frame, and number of saved workers were all significant. The interaction of dilemma type and number of saved workers and the interaction of the three independent factors were significant. Results indicated that moral judgment is affected by framing. Specifically, people were more inclined to utilitarianism in the positive or neutral frame and more inclined to intuitionism in the negative frame. Furthermore, this effect can be moderated by dilemma type and number of saved lives. Implications of our results are discussed.

Do hospital mergers reduce costs?

PubMed

Schmitt, Matt

2017-03-01

Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition. These results are robust to a variety of different control strategies, and do not appear to be easily explained by post-merger changes in service and/or patient mix. I then explore several extensions of the results to examine (a) whether the acquiring hospital/system realizes cost savings post-merger and (b) if cost savings depend on the size of the acquirer and/or the geographic overlap of the merging hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

Interpretative Guidelines and Possible Indications for Indocyanine Green Fluorescence Imaging in Robot-Assisted Sphincter-Saving Operations.

PubMed

Kim, Jin Cheon; Lee, Jong Lyul; Park, Seong Ho

2017-04-01

Since the introduction of indocyanine green angiography more than 25 years ago, few studies have presented interpretative guidelines for indocyanine green fluorescent imaging. We aimed to provide interpretative guidelines for indocyanine green fluorescent imaging through quantitative analysis and to suggest possible indications for indocyanine green fluorescent imaging during robot-assisted sphincter-saving operations. This is a retrospective observational study. This study was conducted at a single center. A cohort of 657 patients with rectal cancer who consecutively underwent curative robot-assisted sphincter-saving operations was enrolled between 2010 and 2016, including 310 patients with indocyanine green imaging (indocyanine green fluorescent imaging+ group) and 347 patients without indocyanine green imaging (indocyanine green fluorescent imaging- group). We tried to quantitatively define the indocyanine green fluorescent imaging findings based on perfusion (mesocolic and colic) time and perfusion intensity (5 grades) to provide probable indications. The anastomotic leakage rate was significantly lower in the indocyanine green fluorescent imaging+ group than in the indocyanine green fluorescent imaging- group (0.6% vs 5.2%) (OR, 0.123; 95% CI, 0.028-0.544; p = 0.006). Anastomotic stricture was closely correlated with anastomotic leakage (p = 0.002) and a short descending mesocolon (p = 0.003). Delayed perfusion (>60 s) and low perfusion intensity (1-2) were more frequently detected in patients with anastomotic stricture and marginal artery defects than in those without these factors (p ≤ 0.001). In addition, perfusion times greater than the mean were more frequently observed in patients aged >58 years, whereas low perfusion intensity was seen more in patients with short descending mesocolon and high ASA classes (≥3). The 300 patients in the indocyanine green fluorescent imaging- group underwent operations 3 years before indocyanine green fluorescent imaging. Quantitative analysis of indocyanine green fluorescent imaging may help prevent anastomotic complications during robot-assisted sphincter-saving operations, and may be of particular value in high-class ASA patients, older patients, and patients with a short descending mesocolon.

Business Intelligence in Hospital Management.

PubMed

Escher, Achim; Hainc, Nicolin; Boll, Daniel

2016-01-01

Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.

Improving a data-acquisition software system with abstract data type components

NASA Technical Reports Server (NTRS)

Howard, S. D.

1990-01-01

Abstract data types and object-oriented design are active research areas in computer science and software engineering. Much of the interest is aimed at new software development. Abstract data type packages developed for a discontinued software project were used to improve a real-time data-acquisition system under maintenance. The result saved effort and contributed to a significant improvement in the performance, maintainability, and reliability of the Goldstone Solar System Radar Data Acquisition System.

Adobe Mining grows during tough times

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

Scott, F.E.

1983-05-01

This article describes how a mining company produces coal at its 10 surface operations 24 hrs. a day, 7 days a week, and runs its 3 preparation plants 24 hrs. a day, 5 days a week. In 1982 Adobe topped 2 million tons per year in coal production. A significant savings is realized because Adobe has its own shop to rebuild all major engines and power train components when necessary. Adobe origins and safety and reclamation are discussed.

The personal and national costs of lost labour force participation due to arthritis: an economic study

PubMed Central

2013-01-01

Background The costs of arthritis to the individuals and the state are considerable. Methods Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model of 45 to 64 year old Australians built on data from the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. Results Individuals aged 45 to 64 years who had retired early due to arthritis had a median value of AU$260 in total weekly income whereas those who were employed full time were likely to average more than five times this. The large national aggregate impact of early retirement due to arthritis includes AU$9.4 billion in lost GDP, attributable to arthritis through its impact on labour force participation. When looking at the ongoing impact of being out of the labour force those who retired from the labour force early due to arthritis were estimated to have a median value of total savings by the time they are 65 of as little as $300 (for males aged 45–54). This is far lower than the median value of savings for those males aged 45–54 who remained in the labour force full time, who would have an estimated $339 100 of savings at age 65. Conclusions The costs of arthritis to the individuals and the state are considerable. The impacts on the state include loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments – in addition to direct health care costs. Individuals bear the economic costs of lost income and the reduction of their savings over the long term. PMID:23452565

Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

PubMed Central

Hex, Nick; Setters, Jo; Little, Stuart

2016-01-01

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers. Educational aims Provide update for oxygen prescribers on options for home oxygen provision. Provide update on the evidence base for available self-fill oxygen technologies. Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems. PMID:27408629

Low rank approximation methods for MR fingerprinting with large scale dictionaries.

PubMed

Yang, Mingrui; Ma, Dan; Jiang, Yun; Hamilton, Jesse; Seiberlich, Nicole; Griswold, Mark A; McGivney, Debra

2018-04-01

This work proposes new low rank approximation approaches with significant memory savings for large scale MR fingerprinting (MRF) problems. We introduce a compressed MRF with randomized singular value decomposition method to significantly reduce the memory requirement for calculating a low rank approximation of large sized MRF dictionaries. We further relax this requirement by exploiting the structures of MRF dictionaries in the randomized singular value decomposition space and fitting them to low-degree polynomials to generate high resolution MRF parameter maps. In vivo 1.5T and 3T brain scan data are used to validate the approaches. T 1 , T 2 , and off-resonance maps are in good agreement with that of the standard MRF approach. Moreover, the memory savings is up to 1000 times for the MRF-fast imaging with steady-state precession sequence and more than 15 times for the MRF-balanced, steady-state free precession sequence. The proposed compressed MRF with randomized singular value decomposition and dictionary fitting methods are memory efficient low rank approximation methods, which can benefit the usage of MRF in clinical settings. They also have great potentials in large scale MRF problems, such as problems considering multi-component MRF parameters or high resolution in the parameter space. Magn Reson Med 79:2392-2400, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Preliminary Study of Perception and Consumer Behaviour Towards Energy Saving for Household Appliances: A Case of Makassar

NASA Astrophysics Data System (ADS)

Syam Akil, Yusri; Mangngenre, Saiful; Mawar, Sri; Amar, Kifayah

2018-03-01

Electricity load has tendency to increase over the time. Therefore, efforts to maintain a balance between electricity supply and demand such as increasing energy saving related to the use of home electricity appliances are urgently needed. In general, one of the household appliances which consumes relatively high electricity energy is refrigerator. The purpose of this study is to analyze residential consumers perceptions and their behaviours about electricity energy saving in relation to the usage of household appliances in Makassar, Indonesia particularly for refrigerator. Moreover, typical relationship between perceptions and consumers behaviours is also analyzed by composed two regression models, namely model for usage behaviour (UREFm model) and model for habitual behaviour (HREFm model) by using general perception, specific perception, and external factors as explanation variables. To collect data, a questionnaire was designed for survey which involved 40 respondents as a preliminary study and then statistical tests including regression analysis were applied to analyze usable data. The target of respondent was an owner of a house in Makassar with installed power capacity at least 900 VA. Reliability test shown that all items in the developed questionnaire can be used for main survey as obtained Cronbach’s alpha values were above 0.6. Evaluation for consumers perceptions on energy saving in relation to demographic aspect using mean and Standard Deviation values indicated some significant differences. Other results regarding regression analysis shown that both composed models were well validated and had quite good fitness degree with adjusted R-squared values around 49.31% for UREFm model and 80.90% for HREFm model. Among considered variables, specific perception, and external factors were found have significant influence to the usage and habitual behaviours of consumers as confirmed by their p-values in each model below 0.05. Findings of this research can be used as a reference in developing programs for residential consumers such as electricity energy conservation program.

The relationships between OHS prevention costs, safety performance, employee satisfaction and accident costs.

PubMed

Bayram, Metin; Ünğan, Mustafa C; Ardıç, Kadir

2017-06-01

Little is known about the costs of safety. A literature review conducted for this study indicates there is a lack of survey-based research dealing with the effects of occupational health and safety (OHS) prevention costs. To close this gap in the literature, this study investigates the interwoven relationships between OHS prevention costs, employee satisfaction, OHS performance and accident costs. Data were collected from 159 OHS management system 18001-certified firms operating in Turkey and analyzed through structural equation modeling. The findings indicate that OHS prevention costs have a significant positive effect on safety performance, employee satisfaction and accident costs savings; employee satisfaction has a significant positive effect on accident costs savings; and occupational safety performance has a significant positive effect on employee satisfaction and accident costs savings. Also, the results indicate that safety performance and employee satisfaction leverage the relationship between prevention costs and accident costs.

Cascade Apartments: Deep Energy Multifamily Retrofit

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

Gordon, A.; Mattheis, L.; Kunkle, R.

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington (marine climate.)This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary BA research questions : 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings compare with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio (SIR) of the retrofitmore » package after considering utility window incentives and KCHA capitol improvement funding.« less

Cascade Apartments - Deep Energy Multifamily Retrofit , Kent, Washington (Fact Sheet)

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

None, None

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington (marine climate.)This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary BA research questions : 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings compare with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio (SIR) of the retrofitmore » package after considering utility window incentives and KCHA capitol improvement funding.« less

Cascade Apartments: Deep Energy Multifamily Retrofit

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

Gordon, A.; Mattheis, L.; Kunkle, R.

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington (marine climate.)This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary BA research questions: 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings compare with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio (SIR) of the retrofit packagemore » after considering utility window incentives and KCHA capitol improvement funding.« less

Michigan Energy and Cost Savings for New Single- and Multifamily Homes: 2012 IECC as Compared to the Michigan Uniform Energy Code

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

Lucas, Robert G.; Taylor, Zachary T.; Mendon, Vrushali V.

2012-07-03

The 2012 International Energy Conservation Code (IECC) yields positive benefits for Michigan homeowners. Moving to the 2012 IECC from the Michigan Uniform Energy Code is cost-effective over a 30-year life cycle. On average, Michigan homeowners will save $10,081 with the 2012 IECC. Each year, the reduction to energy bills will significantly exceed increased mortgage costs. After accounting for up-front costs and additional costs financed in the mortgage, homeowners should see net positive cash flows (i.e., cumulative savings exceeding cumulative cash outlays) in 1 year for the 2012 IECC. Average annual energy savings are $604 for the 2012 IECC.

Ohio Energy and Cost Savings for New Single- and Multifamily Homes: 2012 IECC as Compared to the 2009 IECC

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

Lucas, Robert G.; Taylor, Zachary T.; Mendon, Vrushali V.

2012-07-03

The 2012 International Energy Conservation Code (IECC) yields positive benefits for Ohio homeowners. Moving to the 2012 IECC from the 2009 IECC is cost-effective over a 30-year life cycle. On average, Ohio homeowners will save $5,151 with the 2012 IECC. Each year, the reduction to energy bills will significantly exceed increased mortgage costs. After accounting for up-front costs and additional costs financed in the mortgage, homeowners should see net positive cash flows (i.e., cumulative savings exceeding cumulative cash outlays) in 1 year for the 2012 IECC. Average annual energy savings are $330 for the 2012 IECC.

Relative roles of emissions and meteorology in the diurnal pattern of urban PM10: analysis of the daylight saving time effect.

PubMed

Muñoz, Ricardo C

2012-06-01

Daylight saving time (DST) is a common practice in many countries, in which Official Time (OT) is abruptly shifted 1 hour with respect to solar time on two occasions every year (in fall and spring). All anthropogenic emitting processes tied to OT like job and school commuting traffic, abruptly change in this moment their timing with respect to solar time, inducing a sudden shift between emissions and the meteorological factors that control the dispersion and transport of air pollutants. Analyzing 13 years of hourly particulate matter (PM10) concentrations measured in Santiago, Chile, we demonstrate that the DST practice has observable non-trivial effects in the PM10 diurnal cycle. The clearest impact is in the morning peak of PM10 during the fall DST change, which occurs later and has on average a significant smaller magnitude in the days after the DST change as compared to the days before it. This decrease in magnitude is most remarkable because it occurs in a period of the year when overall PM10 concentrations increase due to generally worsening of the dispersion conditions. Results are shown for seven monitoring stations around the city, and for the fall and spring DST changes. They show clearly the interplay of emissions and meteorology in conditioning urban air pollution problems, highlighting the role of the morning and evening transitions of the atmospheric boundary layer in shaping the diurnal pattern of urban air pollutant concentrations.

Relationship of saving habit determinants among undergraduate students: A case study of UiTM Negeri Sembilan, Kampus Seremban

NASA Astrophysics Data System (ADS)

Syahrom, N. S.; Nasrudin, N. S.; Mohamad Yasin, N.; Azlan, N.; Manap, N.

2017-08-01

It has been reported that students are already accumulating substantial debt from higher education fees and their spending habit are at a critical stage. These situations cause the youngsters facing bankruptcy if they cannot improve their saving habit. Many researches have acknowledged that the determinants of saving habit include financial management, parental socialization, peer influence, and self-control. However, there remains a need for investigating the relationship between these determinants in order to avoid bankruptcy among youngsters. The objectives of this study are to investigate the relationship between saving habit determinants and to generate a statistical model based on the determinants of saving habit. Data collection method used is questionnaire and its scope is undergraduate students of UiTM Negeri Sembilan, Kampus Seremban. Samples are chosen by using stratified probability sampling technique and cross-sectional method is used as the research design. The results are then analysed by using descriptive analysis, reliability test, Pearson Correlation, and Multiple Linear Regression analysis. It shows that saving habit and self-control has no relationship. It means that students with less self-control tend to save less. A statistical model has been generated that incorporated this relationship. This study is significant to help the students save more by having high self-control.

31 CFR 353.13 - Employee plans-Conditions of eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... plans—Conditions of eligibility. (a) Definition of plan. Employee thrift, savings, vacation and similar... any account at any time for that purpose is equal to the purchase price of a bond or bonds in an... establish the plan's eligibility. (e) Vacation plans. Savings bonds may be purchased under certain vacation...

31 CFR 353.13 - Employee plans-Conditions of eligibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... plans—Conditions of eligibility. (a) Definition of plan. Employee thrift, savings, vacation and similar... any account at any time for that purpose is equal to the purchase price of a bond or bonds in an... establish the plan's eligibility. (e) Vacation plans. Savings bonds may be purchased under certain vacation...

Paperless Payroll: Implementation of a Paperless Payroll Certification.

ERIC Educational Resources Information Center

Reese, Larry D.

1991-01-01

The University of Florida has implemented an online payroll certification system that exemplifies how computer applications can result in higher quality information and provide real cost savings. In this case, the combined personnel savings exceeded 6.5 full-time-equivalent positions, more than twice the computing costs incurred. (MSE)

12 CFR 575.11 - Operating restrictions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... stockholders other than its parent mutual holding company may repurchase any share of stock within one year of its date of issuance (which may include the time period the shares issued by the savings association were outstanding if the subsidiary holding company was formed after the initial issuance by the savings...

101 Ways to Save Money in Small Schools.

ERIC Educational Resources Information Center

Bratlie, Ron

This paper is a checklist on ways to save money targeted to administrators of small rural schools but appropriate to schools of any size. Tips concerning staff include salary issues, early retirement, time management techniques, involving staff in budget and facilities planning, and utilizing limited-experience teachers, teacher-administrators,…

Finding Savings in Community Use of Schools

ERIC Educational Resources Information Center

Gandy, Julia

2013-01-01

This article reports on the growing challenge of managing community groups using educational facilities for meetings, athletics, and special events. It describes how, by using an online scheduling software program, one school district was able to track payments and save time and money with its event and facility scheduling process.

75 FR 10993 - Save Your Vision Week, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

... Your Vision Week, 2010 By the President of the United States of America A Proclamation While many Americans are fortunate to have healthy eyes, millions are affected by low vision or blindness. Maintaining good vision requires early diagnosis and timely treatment of eye conditions. Save Your Vision Week is a...

Consortium Purchases: Case Study for a Cost-Benefit Analysis.

ERIC Educational Resources Information Center

Scigliano, Marisa

2002-01-01

Discusses library cooperation and academic library consortia and presents a case study of a Canadian consortia that conducted a cost-benefit analysis for purchasing an electronic resource. Reports on member library subscription costs, external economic factors, value of patron time saved, costs and benefits for patrons, and net savings. (LRW)