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Currently, the development of renewable energy products (RES) encourages the search for innovative solutions that take into account key criteria from the point of view of their sustainable development. Despite efforts in this area, there is a lack of approaches and tools to support this process. Therefore, the aim of the research was to develop a decision-making model supporting eco-innovation in products based on the key criteria of sustainable development: quality (customer satisfaction with use), environmental impact in the life cycle (LCA), and the cost of investment incurred in the product development. The functioning of the model was based on the following factors: (i) obtaining the voice of customers (VoC) and processing it into product criteria as part of the development of alternative production solutions (prototypes), (ii) prospective quality assessment and subsequent life cycle assessment of prototypes, (iii) cost analysis taking into account both quality and environmental criteria, (iv) interpretation of results and search for eco-innovative product solutions. Development decision-making is additionally supported by techniques implemented in the model, e.g., the CRITIC method, the LCA method with Ecoinvent database in OpenLCA, the CEA method, and the morphology method. The model was illustrated and tested for photovoltaic (PV) panels, after which a global sensitivity analysis was performed in Statistica. The test results showed that the main factor that influenced the PV development decisions was the investment cost, followed by quality (customer satisfaction) and then environmental impact in LCA. [ABSTRACT FROM AUTHOR]

The strain-hardening geopolymer composite (SHGC) is a new type of fiber concrete with excellent ductility and environmental friendliness. However, the high cost of fibers greatly limits its widespread application. This paper proposes the use of untreated low-cost polyvinyl alcohol (PVA) fibers and polyethylene (PE) fibers to develop a low-cost, high-performance SHGC. Axial compression and axial tension tests were conducted on the SHGC with different PE fiber volume fractions (1%, 1.5%, and 2%) and different PVA fiber replacement ratios (0%, 25%, 50%, 75%, and 100%) to investigate the hybrid effects of fibers with different surface properties and to reveal the mechanism of fiber hybridization on the mechanical behavior of SHGCs. The results show that increasing the PE fiber volume fraction improves the compressive and tensile ductility of the SHGC while increasing the PVA fiber replacement rate impacts the strength indicators positively due to the good interface effect formed between its hydrophilic surface and the matrix. When the PVA fiber replacement ratio is 100%, the compressive strength (93.4 MPa) of the SHGC is the highest, with a 21.1% increase compared to the control group. However, the tensile strength shows a trend of first increasing and then decreasing with the increase in the PVA fiber replacement ratio, reaching the highest at a 25% replacement ratio, with a 12.5% increase compared to the control group. Furthermore, a comprehensive analysis of the economic and environmental performance of the SHGC indicates that a 25% PVA fiber replacement ratio results in the best overall economic benefits and relatively low actual costs, although the effect of fiber hybridization on carbon emission indicators is not significant. This paper provides new ideas and a theoretical basis for designing low-cost SHGCs. [ABSTRACT FROM AUTHOR]

Engineered geopolymer composites (EGCs) exhibit excellent tensile ductility and crack control ability, making them promising for concrete structure repair. However, their widespread use is limited by high costs of reinforcement fiber and a lack of an EGC–concrete interface bonding mechanism. This study investigated a hybrid PE/PVA fiber-reinforced EGC using domestically produced unoiled PVA fibers to replace commonly used PE fibers. The bond performance of the EGC–concrete interface was evaluated through direct tensile and slant shear tests, focusing on the effects of PE fiber content (1%, 2%, and 3%), fiber hybrid ratios (2.0:0.0, 1.5:0.5, 1.0:1.0, 0.5:1.5, and 0.0:2.0), concrete substrate strength (C30, C50, and C70), and the ratio of fly ash (FA) to ground granulated blast furnace slag (GGBS) (6:4, 7:3, and 8:2) on interface bond strength. Results showed that the EGCs' compressive strength ranged from 77.1 to 108.9 MPa, with increased GGBS content significantly enhancing the compressive strength and elastic modulus. Most of the specimens exhibited strain-hardening behavior after initial cracking. Interface bonding tests revealed that a PE/PVA ratio of 1.0 increased tensile bond strength by 8.5% compared with using 2.0% PE fiber alone. Increasing the PE fiber content, PVA/PE ratio, GGBS content, and concrete substrate strength all improved the shear bond strength. This improvement was attributed to the flexible fibers' ability to restrict thermo–hydro damage and deflect and blunt microcracks, enhancing the interface's failure resistance. Cost analysis showed that replacing 50% of the PE fiber in EGC with unoiled PVA fiber reduced costs by 44.2% compared with PE fiber alone, offering the best cost–performance ratio. In summary, hybrid PE/PVA fiber EGC has promising prospects for improving economic efficiency while maintaining tensile ductility and crack-control ability. Future optimization of fiber ratios and interface design could further enhance its potential for concrete repair applications. [ABSTRACT FROM AUTHOR]

The U.S. dairy sector is a significant emitter of methane and nitrous oxide, with the US EPA estimating it produced around 90 Tg CO2 eq. in 2021. This paper reviews the literature on and evaluates various mitigation actions for reducing GHG emissions in the U.S. dairy sector, focusing on both direct and indirect emission sources. We conducted a narrative literature review based on the cradle to gate life-cycle assessment method, covering the entire dairy supply chain up until milk enters retail establishments, including dairy and feed producing farm practices, processing, transportation, and their associated emissions/costs. The papers included were selected over a three year process depending on discussions with experts and issues mentioned in the emerging literature. We review significant opportunities for the U.S. dairy sector to reduce emissions, particularly through improved enteric fermentation and manure management practices. Additionally, we cover the potential for mitigating indirect emissions from feed production, processing, and transportation, areas less frequently covered in existing studies. This review also covers a gap in the literature by integrating economic findings including cost analysis and incentives to mitigate based on the social value of emissions reductions. [ABSTRACT FROM AUTHOR]

Using biopolymers for soil stabilization is favorable compared to more conventional methods because they are more environmentally friendly, cost-effective, and long-lasting. This study analyzes the physical properties of guar gum and laterite soil mixes. A comprehensive engineering study of guar gum-treated soil was conducted with the help of a brief experimental program. This study examined the effects of soil–guar gum interactions on the strengthening behavior of guar gum-treated soil mixtures using a series of laboratory tests. The treated laterite soil's dry density increased marginally, while its optimum moisture content decreased as the guar gum increased. Treatment with guar gum significantly enhanced the strength of laterite soil mixtures. For laterite soil with 2% guar gum, the unsoaked CBR increased by 148% and the soaked CBR increased by 192.36%. The cohesiveness and internal friction angle increased by 93.33% and 31.52%, respectively. These results show that using guar gum dramatically improves the strength of laterite soil, offering a more environmentally friendly and sustainable alternative to traditional soil additives. Using guar gum in T8 subgrade soil requires a 1395 mm pavement depth and costs INR 3.83 crores, 1.52 times more than laterite soil. For T9 subgrade soil, the depth was 1495 mm, costing INR 4.42 crores, 1.72 times more than laterite soil. This study introduces a novel approach to soil stabilization by employing guar gum, a biopolymer, to enhance the physical and mechanical properties of laterite soil. Furthermore, this study provides a detailed cost–benefit analysis for pavement applications, revealing the financial feasibility of using guar gum despite it requiring a marginally higher initial investment. [ABSTRACT FROM AUTHOR]

Background: This study investigated and compared the efficacy, safety, radiation exposure, and financial compensation of two modalities for percutaneous radiologic gastrostomy (PRG): multislice computed tomography biopsy mode (MS-CT BM)-guided and fluoroscopy-guided (FPRG). The aim was to provide insights into optimizing radiologically assisted gastrostomy procedures. Methods: We conducted a retrospective analysis of PRG procedures performed at a single center from January 2018 to January 2024. The procedures were divided into two groups based on the imaging modality used. We compared patient demographics, intervention parameters, complication rates, and procedural times. Financial compensation was evaluated based on the tariff structure for outpatient medical services in Switzerland (TARMED). Statistical differences were determined using Fisher's exact test and the Mann–Whitney U test. Results: The study cohort included 133 patients: 55 with MS-CT BM-PRG and 78 with FPRG. The cohort comprised 35 women and 98 men, with a mean age of 64.59 years (±11.91). Significant differences were observed between the modalities in effective dose (MS-CT BM-PRG: 10.95 mSv ± 11.43 vs. FPRG: 0.169 mSv ± 0.21, p < 0.001) and procedural times (MS-CT BM-PRG: 41.15 min ± 16.14 vs. FPRG: 28.71 min ± 16.03, p < 0.001). Major complications were significantly more frequent with FPRG (10% vs. 0% in MS-CT BM-PRG, p = 0.039, φ = 0.214). A higher single-digit number of MS-CT BM-guided PRG was required initially to reduce procedure duration by 10 min. Financial comparison revealed that only 4% of MS-CT BM-guided PRGs achieved reimbursement equivalent to the most frequent comparable examination, according to TARMED. Conclusions: Based on our experience from a retrospective, single-center study, the execution of a PRG using MS-CT BM, as opposed to FPRG, is currently justified in challenging cases despite a lower incidence of major complications. However, further well-designed prospective multicenter studies are needed to determine the efficacy, safety, and cost-effectiveness of these two modalities. [ABSTRACT FROM AUTHOR]

In mining projects and production operations, energy carrier costs (fuel, electricity) constitute the primary component of variable costs. This study outlines a methodology for projecting operating costs in a surface mine or quarry in order to find the optimal configuration of mining equipment to extract low-grade secondary deposits, taking into account volatile energy prices. For illustration, the operating costs of five variants of mining equipment deployed to mine low-grade products were analysed, with the price of energy and fuels being the key cost component and the main risk factor. There were differences between the initial investment outlays and operating costs involved in all analysed variants, whilst the starting point for estimating the technical and economic parameters involved in the respective solutions was the predefined configuration of the mining equipment. Further, the decision to commence or discontinue mining operations could be supported by the simulation procedure based on the economic model. The results provided valuable insights into the cost-effectiveness of low-grade deposit extraction scenarios, depending on the projected unit costs of fuels and energy. [ABSTRACT FROM AUTHOR]

Meeting Germany's climate targets urgently demands substantial investment in renewable energies such as hydrogen, as well as tackling industrial CO2 emissions with a strong CO2 transport infrastructure. This is particularly crucial for CO2-heavy industries such as steel, cement, lime production, power plants, and chemical plants, given Germany's ban on onshore storage. The CO2 transport network is essential for maintaining a circular economy by capturing, transporting, and either storing or utilizing CO2. This study fills gaps in CO2 pipeline transport research, examining pipeline diameters, costs, and pressure drop, and providing sensitivity analysis. Key findings show that the levelized cost of CO2 transport (LCO2T) ranges from 0.25 €/t to 55.82 €/t based on varying transport masses (1000 t/day to 25,000 t/day) and distances (25 km to 500 km), with compression costs pushing LCO2T to 33.21 €/t to 92.82 €/t. Analyzing eight pipeline diameters (150 mm to 500 mm) and the impact of CO2 flow temperature on pressure loss highlights the importance of selecting optimal pipeline sizes. Precise booster station placement is also crucial, as it significantly affects the total LCO2T. Exploring these areas can offer a more thorough understanding of the best strategies for developing cost-effective, efficient, and sustainable transport infrastructure. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcomas are rare cancers that are complex to treat and can be expensive to manage, especially when considering surgery costs. This research investigates how much sarcoma surgeries cost across three different hospitals in Switzerland and examines what factors might cause these costs to vary. By consistently using the same surgeon for all procedures, the study ensures that differences in surgical expertise do not affect the results, allowing a clear focus on hospital practices and the complexity of tumor impact costs. The findings aim to help hospitals better plan and manage resources, potentially leading to more cost-effective treatments. This study could influence how healthcare systems approach the financial aspects of treating complex cancers, encouraging a shift towards more standardized and economically sustainable practices. Background: Sarcomas present a unique challenge within healthcare systems due to their rarity and complex treatment requirements. This study explores the economic impact of sarcoma surgeries across three Swiss tertiary healthcare institutions, utilizing a consistent surgical approach by a single surgeon to eliminate variability in surgical expertise as a confounding factor. Methods: By analyzing data from 356 surgeries recorded in a real-world-time data warehouse, this study assesses surgical and hospital costs relative to institutional characteristics and surgical complexity. Results: Our findings reveal significant cost variations driven more by institutional resource management and pricing strategies than by surgical techniques. Surgical and total hospitalization costs were analyzed in relation to tumor dignity and complexity scores, showing that higher complexity and malignancy significantly increase costs. Interestingly, it was found that surgical costs accounted for only one-third of the total hospitalization costs, highlighting the substantial impact of non-surgical factors on the overall cost of care. Conclusions: The study underscores the need for standardized cost assessment practices and highlights the potential of predictive models in enhancing resource allocation and surgical planning. By advocating for value-based healthcare models and standardized treatment guidelines, this research contributes to more equitable and sustainable healthcare delivery for sarcoma patients. These insights affirm the necessity of including a full spectrum of care costs in value-based models to truly optimize healthcare delivery. These insights prompt a reevaluation of current policies and encourage further research across diverse geographical settings to refine cost management strategies in sarcoma treatment. [ABSTRACT FROM AUTHOR]

Focused parathyroidectomy is the preferred surgical method for treating primary hyperparathyroidism (pHPT) sustained by the pre-operatively well-localized parathyroid adenoma. We aimed to compare the effectiveness, safety, and short-term clinical outcome of minimally invasive video-assisted parathyroidectomy (MIVAP) in locoregional anaesthesia (LA) vs. general anaesthesia (GA) by means of propensity score matching (PSM) analysis. Retrospective research of patients who underwent MIVAP between January 2014 and December 2022 was carried out. Patients were divided into two groups based on the anaesthesiologic procedure (LA vs. GA). Overall, 553 patients underwent MIVAP. After PSM, 115 patients in the LA group and 230 patients in the GA group were included. MIVAP under LA was associated with shorter median operative time (16 vs. 35 min, p < 0.001), shorter median operative room occupation time (44 vs. 73 min, p < 0.001), and lesser median post-operative visual analogue scale pain, with comparable post-operative hospital stay and complication rate. MIVAP under LA is a safe and feasible procedure with significant advantages over GA in terms of post-operative pain and operative room occupation time. This last step can finally result in more efficient utilisation of the operative room and the health care system's resources. [ABSTRACT FROM AUTHOR]

Simple Summary: Goals-of-care discussions, by promoting mutual understanding between patients and clinicians, supporting decision making and facilitating care planning, have been found to reduce acute care use and cost of care downstream. However, it is not known if goals-of-care discussions have an immediate impact on the cost of the same hospital stay. In this real-world study, we examined the hospitalization cost before and after the implementation of a goals-of-care program. We found that the overall cost in unselected medical patients did not differ significantly before and after program implementation; however, the cost of hospitalization decreased significantly among ICU patients by 17% after program implementation. This study highlights the potential value-based benefit of goals-of-care programs for patients who have serious illnesses. The impact of goals-of-care programs on acute hospitalization costs is unclear. We compared the hospitalization cost in an 8-month period before implementation of a multimodal interdisciplinary goals-of-care program (1 May 2019 to 31 December 2019) to an 8-month period after program implementation (1 May 2020 to 31 December 2020). Propensity score weighting was used to adjust for differences in potential covariates. The primary outcome was total direct cost during the hospital stay for each index hospitalization. This analysis included 6977 patients in 2019 and 5964 patients in 2020. The total direct cost decreased by 3% in 2020 but was not statistically significant (ratio 0.97, 95% CI 0.92, 1.03). Under individual categories, there was a significant decrease in medical oncology (ratio 0.58, 95% CI 0.50, 0.68) and pharmacy costs (ratio 0.86, 95% CI 0.79, 0.96), and an increase in room and board (ratio 1.06, 95% CI 1.01, 1.10). In subgroup analysis, ICU patients had a significant reduction in total direct cost after program implementation (ratio 0.83, 95% CI 0.72, 0.94). After accounting for the length of ICU admission, we found that the total direct cost per hospital day was no longer different between 2019 and 2020 (ratio 0.986, 95% CI 0.92, 1.05), suggesting that shorter ICU admissions likely explained much of the observed cost savings. This study provides real-world data on how "in-the-moment" GOC conversations may contribute to reduced hospitalization costs among ICU patients. [ABSTRACT FROM AUTHOR]

Background: The prevalence of neurological disorders is increasing worldwide. In recent decades, the conventional rehabilitation for people with neurological disorders has been often reinforced with the use of technological devices (robots and virtual reality). The aim of this systematic review was to identify the evidence on the economic cost of rehabilitation with robotic and virtual reality devices for people with neurological disorders through a review of the scientific publications over the last 15 years. Methods: A systematic review was conducted on partial economic evaluations (cost description, cost analysis, description of costs and results) and complete (cost minimization, cost-effectiveness, cost utility and cost benefit) studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The main data sources used were PubMed, Scopus and Web of Science (WOS). Studies published in English over the last 15 years were considered for inclusion in this review, regardless of the type of neurological disorder. The critical appraisal instrument from the Joanna Briggs Institute for economic evaluation and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) were used to analyse the methodological quality of all the included papers. Results: A total of 15 studies were included in this review. Ten papers were focused on robotics and five on virtual reality. Most of the studies were focused on people who experienced a stroke. The robotic device most frequently used in the papers included was InMotion® (Bionik Co., Watertown, MA, USA), and for those focused on virtual reality, all papers included used semi-immersive virtual reality systems, with commercial video game consoles (Nintendo Wii® (Nintendo Co., Ltd., Kyoto, Japan) and Kinect® (Microsoft Inc., Redmond, WA, USA)) being used the most. The included studies mainly presented cost minimization outcomes and a general description of costs per intervention, and there were disparities in terms of population, setting, device, protocol and the economic cost outcomes evaluated. Overall, the methodological quality of the included studies was of a moderate level. Conclusions: There is controversy about using robotics in people with neurological disorders in a rehabilitation context in terms of cost minimization, cost-effectiveness, cost utility and cost benefits. Semi-immersive virtual reality devices could involve savings (mainly derived from the low prices of the systems analysed and transportation services if they are applied through telerehabilitation programmes) compared to in-clinic interventions. [ABSTRACT FROM AUTHOR]

Photosynthetically Active Radiation (PAR) is an important parameter in the plant photosynthesis process, which can relate to plant growth, crop water use, and leaf gas exchange. Previously, many researchers utilized commercially available sensors to monitor PAR. The high cost of the commercially available PAR sensors has limited researchers, agricultural professionals, and farmers to use and expand PAR monitoring in agricultural lands. Thus, this paper focuses on designing an affordable Internet of Things (IoT)-based PAR sensor monitoring system including 3D-printed enclosures (waterproof) for the sensors, performance evaluation of multiple light sensors, solar powering configuration, cloud setup, and cost analysis. Three sensors, including VTB8440BH photodiode, SI 1145, and LI-190R sensors, were evaluated. The 3D-printed waterproof enclosures were designed for the photodiode and SI 1145. Particle Boron was used for recording and sending the sensor data to the IoT webserver. Both the photodiode and SI 1145 were compared to LI-190R, which is the industry standard. In the calibration process, the R2 values of the photodiode and SI 1145 with LI-190R were 0.609 and 0.961, respectively. Field validation data shows that SI 1145 had a strong correlation with LI-190R. In addition, the performance evaluation data shows the photodiode had a weaker correlation with LI-190R than SI 1145. In conclusion, the study successfully developed and designed affordable and reliable IoT-based PAR sensor monitoring systems, including a 3D-printed housing, hardware, programming, and IoT website. SI 1145 with a glass filter is an alternative sensor to monitor PAR at a low cost and has the advantage of being connected to IoT microcontrollers. [ABSTRACT FROM AUTHOR]

Background: This study, using real-world data, assesses the impact of RS testing on treatment pathways and the associated economic consequences of such testing. This paper pertains to lobular breast cancer. Methods: A retrospective, observational study was undertaken between 2011 and 2019 on a cross-section of hormone receptor-positive (HR+), HER2-negative, lymph node-negative, early-stage breast cancer patients. All patients had ILC and had RS testing in Ireland. The patient population is representative of the national population. Patients were classified as low (RS ≤ 25) or high (RS > 25) risk. Patients aged ≤50 were stratified as low (RS 0–15), intermediate (RS 16–25), or high risk (RS > 25). Results: A total of 168 patients were included, most of whom had grade 2 (G2) tumors (n = 154, 92%). Overall, 155 patients (92.3%) had low RS (≤25), 12 (7.1%) had high RS (>25), and 1 (0.6%) had unknown RS status. In 29 (17.5%) patients aged ≤50 at diagnosis, RS was ≤15 in 16 (55%), 16–20 in 6 (21%), 21–25 in 5 (17%), >25 in 1 (3.5%), and unknown in 1 (3.5%). Post RS testing, 126 patients (78%) had a change in chemotherapy recommendation; all to hormone therapy. In total, only 35 patients (22%) received chemotherapy. RS testing achieved a 75% reduction in chemotherapy use, resulting in savings of €921,543.84 in treatment costs, and net savings of €387,283.84. Conclusions: The use of this test resulted in a 75% reduction in chemotherapy and a significant cost savings in our publicly funded health system. [ABSTRACT FROM AUTHOR]

Simple Summary: In practical terms, pet owners' lack of awareness regarding weight reduction protocols, coupled with the high costs of commercial prescription diets, often makes it difficult for them to adhere to such programs in the long term. This study addressed the costs of weight loss per kilogram of metabolic weight in dogs and cats, considering various dietary regimens. The weight reduction protocol, supervised by veterinarians, involved eight dogs and ten cats. The results indicated that the monthly and total cost per kilogram of metabolic weight was significantly lower when using commercial dry foods compared to homemade diets (p < 0.001), reducing costs by 40.88% and 41.01% for dogs and cats, respectively. Despite owners' lack of awareness and associated costs, it is concluded that commercial prescription diets offer greater financial benefit for pet weight reduction protocols, emphasizing the importance of considering economic factors when implementing weight control strategies. These findings underscore the economic challenges associated to pet weight loss and emphasize the necessity for cost-effective solutions to promote sustained owner compliance. In the context of the rising prevalence of obesity among pets, this study aimed to assess the economic aspects of weight reduction protocols for dogs and cats, considering the lack of information and the varying costs of commercial and homemade diets. The results indicated an average weekly weight loss rate of 1.02% for dogs and 0.92% for cats, with a reduction in body fat mass (p < 0.005). The cost analysis included an evaluation of both dry and wet commercial prescription diets as well as homemade diets. The results unveiled higher expenses associated to wet commercial diets, followed by homemade and dry commercial diets (p < 0.001). The study demonstrated that despite the initial investment, the long-term benefits of weight loss, including improved health and reduced financial burdens for owners, justify the expenses incurred. This comprehensive analysis provides veterinarians and pet owners with valuable insights into the economic considerations of weight reduction protocols, facilitating informed decision making and promoting pet well-being. [ABSTRACT FROM AUTHOR]

The outlined methodology for calculating operating costs in open-cast mines and quarries not only facilitates the selection of optimal mining equipment and systems for working lower-grade secondary deposits but also adds significant value in navigating the challenges of fluctuating prices of energy carriers and fuels. Moreover, the study rigorously assesses the impact of mining operations on the performance of deployed mining equipment and the overall viability of the rock mining project. The selection procedure relies on a comprehensive analysis of the technical and economic parameters of selected solutions, providing critical insights to guide decisions regarding the continuation or discontinuation of mining operations. We analyse, based on empirical data, the technical and economic parameters of several variants of mining equipment to be used for the extraction of rocks and stones from secondary deposits in conditions of fluctuation depending on the level of energy prices, in order to find the best configuration in terms of operating costs and potential revenue. In addition to analysing the structure of operating costs, the article presents their correlation with the required profit from the sale of raw materials using the linear correlation method. The results clearly demonstrate the economic viability of mining secondary deposits, taking into account the actual costs incurred by mining companies. [ABSTRACT FROM AUTHOR]

Embolization of de novo pulmonary arteriovenous malformations (PAVMs) using high-volume detachable non-fibered (HVDNF) coils was compared to traditional non-HVDNF coils. Persistent-occlusion rates were evaluated. A total of 272 de novo (previously untreated) PAVM treatments were retrospectively stratified into those treated with non-HVDNF coils only (n = 192) and those treated with HVDNF coils with or without other coils (n = 80). Propensity score matching, followed by survival analysis and cost analysis, was performed. The overall persistent-occlusion rate was 86.0% (234/272). Persistent occlusion was achieved in 81.8% of PAVMs using non-HVDNF coils, compared with 96.3% using HVDNF coils (p = 0.0017). The mean follow-up was 30.7 ± 31.9 months versus 14.7 ± 13.4 months, respectively (p < 0.0001). Propensity-matched survival analysis demonstrated PAVMs treated with HVDNF coils recurred significantly less frequently than PAVMs treated with non-HVNDF coils (p = 0.023). The use of HVDNF coils was more expensive than standard coils, however not significantly different for the treatment of complex PAVMs. The use of high-volume detachable non-fibered coils was associated with higher persistent-occlusion rates when compared with non-HVDNF coils. HVDNF coils were more expensive on average; however, cost was similar between groups for the treatment of complex PAVMs. [ABSTRACT FROM AUTHOR]

This paper presents the cloud vendor lock-in prediction framework (CVL), which aims to address the challenges that arise from vendor lock-in in cloud computing. The framework provides a systematic approach to evaluate the extent of dependency between service providers and consumers and offers predictive risk analysis and detailed cost assessments. At the heart of the CVL framework is the Dependency Module, which enables service consumers to input weighted factors that are critical to their reliance on cloud service providers. These factors include service costs, data transfer expenses, security features, compliance adherence, scalability, and technical integrations. The research delves into the critical factors that are necessary for dependency calculation and cost analysis, providing insights into determining dependency levels and associated financial implications. Experimental results showcase dependency levels among service providers and consumers, highlighting the framework's utility in guiding strategic decision-making processes. The CVL is a powerful tool that empowers service consumers to proactively navigate the complexities of cloud vendor lock-in. By offering valuable insights into dependency levels and financial implications, the CVL aids in risk mitigation and facilitates informed decision-making. [ABSTRACT FROM AUTHOR]

Introduction: The advantages of single-stage treatment of cholecystocholedocholithiasis are well established, but the conditions for carrying out treatment on an outpatient basis require a review of concepts and practices of medical corporations. Objective: To evaluate the practice of treating cholecystocholedocholithiasis by laparoendoscopy on an outpatient basis with cost analysis. Method: A retrospective study was conducted on patients with cholecystocholedocholithiasis treated by combined laparoscopic cholecystectomy and endoscopic choledocholithotomy from January 2015 to January 2019. After collecting data from physical and digital medical records, the patients were divided into two groups—AR (n = 42)—ambulatory regimen and HR (n = 28)—hospitalization regimen—which were compared in terms of demographic, clinical and treatment variables and their results, as well as in terms of costs. Results: The mean age of the AR group was lower than that of the HR group and the physical status of the AR patients was better when assessed according to the American Society of Anesthesiologists (ASA) (p = 0.01). There was no difference between groups regarding the risk of choledocholithiasis (p = 0.99). For the AR group, the length of stay was shorter: 11.29 h × 65.21 h (p = 0.02), as was the incidence of postoperative complications assessed by applying the Clavien–Dindo classification: 3 (7.1%) × 11 (39.2%) (p < 0.01). The total mean costs were higher for the HR group (USD 2489.93) than the AR group (USD 1650.98) (p = 0.02). Conclusion. Outpatient treatment of cholecystocholedocholithiasis by laparoendoscopy is safe and viable for most cases, has a lower cost and can support the reorientation of training and practice of hepatobiliary surgeons. [ABSTRACT FROM AUTHOR]

Simple Summary: Effective, sustainable regional surveillance for the early detection of notifiable swine pathogens has been difficult to achieve. Regional surveillance based on clinical signs (syndromic surveillance) is not diagnostically sensitive and specific. Surveillance based on farm-by-farm testing is burdensome and costly. Borrowing the strengths of each approach, we evaluated an active participatory surveillance design in which regional status was determined by targeted sampling of 10 poor-doing pigs in each participating farm followed by screening in credentialed laboratories. The analysis showed that at 0.1% prevalence (18 infected farms among 17,521 farms) and a farm-level detection probability of 30%, active participatory surveillance would detect ≥ 1 positive farms with 67%, 90%, and 97% probability when producer participation was 20%, 40%, and 60%, respectively. Depending on the specimen collected (serum or swab sample) and test format (nucleic acid or antibody detection), the cost per round of sampling ranged from EUR 0.016 to EUR 0.032 (USD 0.017 to USD 0.034 USD) per pig in the region. The techniques and technologies required for active participatory surveillance are widely available and in common use. Implementation would require coordination among producers, industry groups, and animal health authorities. We evaluated an active participatory design for the regional surveillance of notifiable swine pathogens based on testing 10 samples collected by farm personnel in each participating farm. To evaluate the performance of the design, public domain software was used to simulate the introduction and spread of a pathogen among 17,521 farms in a geographic region of 1,615,246 km2. Using the simulated pathogen spread data, the probability of detecting ≥ 1 positive farms in the region was estimated as a function of the percent of participating farms (20%, 40%, 60%, 80%, 100%), farm-level detection probability (10%, 20%, 30%, 40%, 50%), and regional farm-level prevalence. At 0.1% prevalence (18 positive farms among 17,521 farms) and a farm-level detection probability of 30%, the participatory surveillance design achieved 67%, 90%, and 97% probability of detecting ≥ 1 positive farms in the region when producer participation was 20%, 40%, and 60%, respectively. The cost analysis assumed that 10 individual pig samples per farm would be pooled into 2 samples (5 pigs each) for testing. Depending on the specimen collected (serum or swab sample) and test format (nucleic acid or antibody detection), the cost per round of sampling ranged from EUR 0.017 to EUR 0.032 (USD 0.017 to USD 0.034) per pig in the region. Thus, the analysis suggested that an active regional participatory surveillance design could achieve detection at low prevalence and at a sustainable cost. [ABSTRACT FROM AUTHOR]

The financial implications of long-term restoration projects for cultural heritage, as compared to regular maintenance efforts, often underscore a flawed decision-making process. This can result from years of neglect versus consistent, organized maintenance. Striking a balance between these strategies is paramount for preserving cultural legacies. This research aims to evaluate the trade-offs between the initial expenditures of restoration initiatives and the consistent costs of maintenance activities. We leverage Building Information Modelling (BIM) and its specialized application for heritage preservation, known as Heritage Building Information Modelling (HBIM). This offers a digital depiction of the heritage building's conservation state and associated intervention costs. Specifically, this study taps into the fifth dimension of BIM, cost estimation, to draw a comparative analysis between the financial ramifications of regular maintenance and long-term restoration projects. This assessment is exemplified through a case study on the "Aidkeen Al-Bendqdari Dome" located in historic Cairo, Egypt—a component of the Prince Taz Palace. The analysis integrates cost data to generate insights. The ultimate goal is to devise a comparative framework that can guide authorities in budgetary decisions and resource distribution. [ABSTRACT FROM AUTHOR]

Simple Summary: Recently, robotic-assisted minimally invasive esophagectomy (RAMIE) has become more common for patients with esophageal cancer. However, healthcare providers worried that RAMIE might be more expensive than the traditional minimally invasive esophagectomy (MIE). Therefore, we aimed to compare the results and costs of RAMIE and MIE in 128 patients who underwent surgery between 2017 and 2021. We found that surgical costs of RAMIE were higher. However, total costs were similar between RAMIE and MIE. Fewer cases of postoperative pneumonias were observed after RAMIE. RAMIE also tended to result in shorter hospital stays, which could explain why overall costs were about the same. All in all, our study suggests that RAMIE is not more expensive and might even be a better choice for many patients. In recent decades, robotic-assisted minimally invasive esophagectomy (RAMIE) has been increasingly adopted for patients with esophageal cancer (EC) or cancer of the gastroesophageal junction (GEJ). However, concerns regarding its costs compared to conventional minimally invasive esophagectomy (MIE) have emerged. This study examined outcomes and costs of RAMIE versus total MIE in 128 patients who underwent Ivor Lewis esophagectomy for EC/GEJ at our department between 2017 and 2021. Surgical costs were higher for RAMIE (EUR 12,370 vs. EUR 10,059, p < 0.001). Yet, median daily (EUR 2023 vs. EUR 1818, p = 0.246) and total costs (EUR 30,510 vs. EUR 29,180, p = 0.460) were comparable. RAMIE showed a lower incidence of postoperative pneumonia (8% vs. 25%, p = 0.029) and a trend towards shorter hospital stays (15 vs. 17 days, p = 0.205), which may have equalized total costs. Factors independently associated with higher costs included readmission to the intensive care unit (hazard ratio [HR] = 7.0), length of stay (HR = 13.5), anastomotic leak (HR = 17.0), and postoperative pneumonia (HR = 5.4). In conclusion, RAMIE does not impose an additional financial burden. This suggests that RAMIE may be considered as a valid alternative approach for esophagectomy. Attention to typical cost factors can enhance postoperative care across surgical methods. [ABSTRACT FROM AUTHOR]

In this paper, a bulk arrival and two-phase bulk service with active Bernoulli feedback, vacation, and breakdown is considered. The server provides service in two phases as mandatory according to the general bulk service rule, with minimum bulk size ′ a ′ and maximum bulk size ′ b ′ . In the first essential service (FES) completion epoch, if the server fails, with probability ′ δ ′ , then the renewal of the service station is considered. On the other hand, if there is no server failure, with a probability ′ 1 − δ ′ , then the server switches to a second essential service (SES) in succession. A customer who requires further service as feedback is given priority, and they join the head of the queue with probability β . On the contrary, a customer who does not require feedback leaves the system with a probability ′ 1 − β ′ . If the queue length is less than ′ a ′ after SES, the server may leave for a single vacation with probability ′ 1 − β ′ . When the server finds an inadequate number of customers in the queue after vacation completion, the server becomes dormant. After vacation completion, the server requires some time to start service, which is attained by including setup time. The setup time is initiated only when the queue length is at least ′ a ′ . Even after setup time completion, the service process begins only with a queue length 'N' (N > b). The novelty of this paper is that it introduces an essential two-phase bulk service, immediate Bernoulli feedback for customers, and renewal service time of the first essential service for the bulk arrival and bulk service queueing model. We aim to develop a model that investigates the probability-generating function of the queue size at any time. Additionally, we analyzed various performance characteristics using numerical examples to demonstrate the model's effectiveness. An optimum cost analysis was also carried out to minimize the total average cost with appropriate practical applications in existing data transmission and data processing in LTE-A networks using the DRX mechanism. [ABSTRACT FROM AUTHOR]

Unmanned Aerial Vehicles (UAVs) are a novel up-and-coming technology with wide applicability and great potential to be used in agricultural systems for spraying applications. However, the cost-effectiveness of this application is still rather uncertain. The present study utilized actual data from field applications to analyze the critical components and parameters in the potential case of using UAV sprayers for the control of olive fruit flies in order to assess the operational costs. The results are compared with the costs of two traditional spraying methods: manual spaying by workers using backpack sprayers and manual spraying assisted by a tractor. The case of the olive fruit fly was selected because it involves costly, time consuming, and laborious manual spraying. Furthermore, the bait character of spraying in these applications does not require full canopy coverage, making it ideal for UAV applications. A parameterized computational model was developed to assess the costs of labor, capital spending, repair and maintenance, energy, licensees, fees and taxes, and storage for each of the three methods. In addition, the cost for surveillance was also accounted for with the UAV method. Consequently, a sensitivity analysis was performed to examine the impact of the most crucial parameters. The results showed that the cost of spraying with a UAV was 1.45 to 2 times higher than the traditional methods, mainly due to the high capital spending resulting from a low economic life. There are opportunities, however, of improving the economic performance, making it compatible to the traditional methods, by using a smaller UAV with longer lasting batteries and by expanding its annual use beyond the needs of olive fruit fly control. [ABSTRACT FROM AUTHOR]

Cage-free (CF) layer houses tend to have high particulate matter (PM) levels because of bedding/litter floor and the birds' activities, such as perching, dustbathing, and foraging on it. It has been reported that optimizing bedding management can potentially suppress PM levels in CF houses. The objectives of this study were to (1) test the effect of the top application of new bedding materials (BMs) on PM levels and (2) compare different BM PM reduction efficiencies. Small flake shavings (SFS), large flake shavings (LFS), and aspen wood chips (AWC) were top-dressed on the surface of the original litter (33-week-old litter) evenly in each of the BM treatment rooms at 20% volume of the original litter floor. The initial litter depths in the control, SFS, LFS, and AWC rooms were 4.6 ± 0.6, 4.8 ± 0.8 cm, 4.8 ± 0.8 cm, and 4.6 ± 0.9 cm, respectively. One room was used as a control without adding new BM. The results indicate that the top application of new bedding suppressed PM levels in all treatment rooms (p < 0.01). The PM2.5 reductions in the SFS, AWC, and LFS treatment rooms were 36.5%, 34.6%, and 28.9% greater than in the control room, respectively. The mitigation efficiencies were different between PM sizes. For instance, PM2.5, PM10, and TSP in the SFS room were lower than in the control room by 36.5%, 39.4%, and 38.7%, respectively. For litter quality, the moisture content was 18.0 ± 2.8, 20.0 ± 3.1, 20.6 ± 2.4, and 19.7 ± 4.2% in the control, SFS, LFS, and AWC rooms, respectively. Treatment rooms with 20% new BM had 10% higher litter moisture than the control room. The findings of this study reveal that the top application of new bedding on old litter is a potential strategy for reducing PM generation in CF houses. Further studies are warranted, such as regarding the effect of different ratios of new bedding on PM reduction, cost analysis, and verification tests in commercial CF houses. [ABSTRACT FROM AUTHOR]

As the largest carbon emitter in China's manufacturing sector, the low-carbon transition of the steel industry is urgent. CO2 capture, utilization, and storage (CCUS) technology is one of the effective measures to reduce carbon emissions in steel industry. In this paper, a comprehensive assessment model of source–sink matching-levelized cost in China's steel industry is constructed to evaluate the potential, economy, and spatial distribution of CCUS retrofits of blast furnaces in the BF-BOF steel industry. The results show that, if no extra incentive policy is included, the levelized cost of carbon dioxide (LCOCD) of 111 steel plants with a 420.07 Mt/a CO2 abatement potential ranges from −134.87 to 142.95 USD/t. The levelized cost of crude steel (LCOS) range of steel plants after the CCUS retrofits of blast furnaces is 341.81 to 541.41 USD/t. The incentives such as carbon market and government subsidies will all contribute to the early deployment of CCUS projects. The CCUS technology could be prioritized for deployment in North China, Northwest China, and East China's Shandong Province, but more powerful incentives are still needed for current large-scale deployment. The research results can provide references for the early deployment and policy formulation of CCUS in China's steel industry. [ABSTRACT FROM AUTHOR]

European Society for Blood and Marrow Transplantation (EBMT) hematologic response categories comprehensively assess complement inhibitor responses in patients with paroxysmal nocturnal hemoglobinuria (PNH). Using data from the 16-week randomized controlled period of the phase 3 PEGASUS trial (N = 80), we estimated the treatment cost per responder by the EBMT response category for pegcetacoplan and eculizumab in adults with PNH and a suboptimal response to eculizumab. Average drug costs per responder, number needed to treat, and incremental drug costs per responder were estimated using dosages administered during the trial (base case). A US payer perspective (2020 US dollars) was used. Scenario analyses were conducted for various costs, dosages, treatment durations, patient populations, and settings. In total, 30 of 41 (73%) who switched to pegcetacoplan and 2 of 39 (5%) patients who continued eculizumab had a good, major, or complete response (good-to-complete responders) at Week 16. Average weekly drug costs per good-to-complete responder were USD 15,923 with pegcetacoplan and USD 216,100 with eculizumab; average weekly drug costs per patient were USD 11,651 and USD 11,082, respectively. Average drug costs per good-to-complete responder with pegcetacoplan were similar across complement inhibitor-naïve populations and were consistently lower than with eculizumab. Switching from eculizumab to pegcetacoplan allowed more patients with a suboptimal response to attain a good-tocomplete response at lower costs. These results apply to patients with a suboptimal response to prior eculizumab treatment only. [ABSTRACT FROM AUTHOR]

Simple Summary: This review aims to highlight the usage of circulating tumour DNA and circulating tumour cells in various manners for the care of cancer patients. The different technologies that are currently employed using these biomarkers are mentioned and contrasted with another whilst also discussing their limitations such as affordability and scalability. The review also aims to bring light to newer emerging technologies in the space of liquid biopsy that have yet to be approved by a regulatory board but have been developed with the notion of affordability and scalability in mind. These factors of technology are found to be important in order to provide cutting edge diagnostic and monitoring regimes as they can lead to personalised treatments and patient stratification for all. Cancer remains a leading cause of death worldwide, despite many advances in diagnosis and treatment. Precision medicine has been a key area of focus, with research providing insights and progress in helping to lower cancer mortality through better patient stratification for therapies and more precise diagnostic techniques. However, unequal access to cancer care is still a global concern, with many patients having limited access to diagnostic tests and treatment regimens. Noninvasive liquid biopsy (LB) technology can determine tumour-specific molecular alterations in peripheral samples. This allows clinicians to infer knowledge at a DNA or cellular level, which can be used to screen individuals with high cancer risk, personalize treatments, monitor treatment response, and detect metastasis early. As scientific understanding of cancer pathology increases, LB technologies that utilize circulating tumour DNA (ctDNA) and circulating tumour cells (CTCs) have evolved over the course of research. These technologies incorporate tumour-specific markers into molecular testing platforms. For clinical translation and maximum patient benefit at a wider scale, the accuracy, accessibility, and affordability of LB tests need to be prioritized and compared with gold standard methodologies in current use. In this review, we highlight the range of technologies in LB diagnostics and discuss the future prospects of LB through the anticipated evolution of current technologies and the integration of emerging and novel ones. This could potentially allow a more cost-effective model of cancer care to be widely adopted. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we examined the prescription patterns and pharmaceutical costs for treatments of multiple myeloma (MM) in Catalonia's public healthcare system over the past decade. MM is a complex and costly disease for which substantial pharmacological innovation has recently been introduced, and we aimed to understand how treatment choices and expenses have evolved. We analyzed data from 4556 MM patients and found that the number of treated patients increased annually. Drugs like lenalidomide and daratumumab showed significant utilization rises, impacting overall costs. Our findings shed light on the economic burden of MM treatment, emphasizing the importance of monitoring and optimizing healthcare resources allocation for better healthcare decision making. (1) Background: Our understanding of and treatment for multiple myeloma (MM) has advanced significantly, and new pharmacological treatments have promising benefits but high price tags. This study analyzes prescription patterns and pharmaceutical expenditure for MM treatments in Catalonia's public healthcare system over eight years. (2) Methods: A retrospective observational study examined MM treatment data from 2015 to 2022 in Catalonia, using healthcare registries from the Catalan Health Service to collect information on patients, medicines used, and treatment costs. (3) Results: A total of 4556 MM patients received treatment, with a rising trend in the number of treated patients each year from 902 in 2015 to 1899 in 2022. The mean age was 68.9 years, and patients were almost evenly distributed by gender (51.5% male). Most patients were treated with bortezomib (3338 patients), lenalidomide (2952), and/or daratumumab (1093). Most drugs showed increased utilization annually, most significantly for lenalidomide and daratumumab. The total pharmacological treatment cost throughout the entire study period was EUR 321,811,249, with lenalidomide leading with the highest total cost (EUR 157,236,784), and daratumumab exhibiting the highest increase in annual expenditure. (5) Conclusions: The study reveals a progressive increase in the number of MM patients treated and rising pharmaceutical costs. Lenalidomide and daratumumab incurred the highest costs. The findings highlight MM treatment's economic impact and the need to monitor prescription patterns and expenditures to optimize healthcare resources and decision making. Understanding these trends can guide resource allocation effectively. [ABSTRACT FROM AUTHOR]

Perovskite solar cells are an emerging technology that exploits the self-assembly and highly tunable bandgap properties of perovskite materials. Because of their low manufacturing cost, thin films of perovskites have attracted enormous interest and witnessed great progress. The power conversion efficiency of these devices has improved from 3.8% to 25.8%, which is a significant step forward. The formulation of innovative materials with the proper replacement of lead in perovskites is essential to reduce lead toxicity. Here, we examine the difficulties encountered in the commercialization of perovskite devices, such as material and structural stability, device stability under high temperature and humidity conditions, lifetime, and manufacturing cost. This review addresses issues such as device engineering, performance stability against the harsh environment, cost-effectiveness, recombination, optical, and resistance losses, large-area solar cell module issues, material cost analysis, module cost reduction strategy, and environmental concerns, which are important for the widespread acceptance of perovskite-based solar devices. The applications and market growth prospects of perovskite cells are also studied. In summary, we believe there is a great opportunity to research high-performance, long-lived perovskites and cells for energy applications. [ABSTRACT FROM AUTHOR]

Since, according to many scientific studies, price is a very important factor when buying fruits and vegetables, it is interesting to study whether price differences between them occur in retail markets. Because of the discussion regarding sustainability, we performed an observational, orienting study on the retail prices of frequently bought packaged and unpackaged fruits and vegetables (apples, tomatoes, and bell peppers) in the Munich area in February and March 2022. We also differentiated between organic and non-organic produce. The relationship between the type of packaging (packaged versus unpackaged) and the retail price (EUR/kg) was determined by means of correlation coefficients, and we examined whether unpackaged products were more expensive than the packaged variants. The results differed for the organic and non-organic variants of the products, as well as among the individual fruit and vegetable varieties. We found a tendency towards unpackaged products being more expensive than packaged fruits and vegetables, in three out of four cases for the non-organic and two out of three cases for the organic products. For all cases, single products and single cost values were observed where the opposite was found. [ABSTRACT FROM AUTHOR]

The growing interest in deploying photovoltaic systems and achieving their benefits as sustainable energy supplier raises the need to seek reliable medium-term and long-term operations with optimal performance and efficient use of economic resources. Cleaning scheduling is one of the activities that can positively impact performance. This work proposes a methodological framework to define the optimal scheduling of the cleaning activities of photovoltaic systems. The framework integrates a forecast model of the performance ratio, including the environmental variables' effect. In addition, an economic analysis involving the economic losses and maintenance costs of cleaning is used. This framework is applied to a case study of a photovoltaic system located in Yumbo, Colombia. Based on the historical data on irradiance, active energy, temperature, rainfall, and wind speed, the obtained forecast model of the photovoltaic system's performance ratio in a 60-day horizon has a mean absolute percentage error lesser of than 11%. The next cleaning date is forecasted to be beyond the horizon in a 19-day range, which will decrease as time goes by. This framework was applied to historical data and compared to actual cleaning dates performed by the utility company. The results show a loss of USD 33.616 due to unnecessary, early, or late cleaning activities. [ABSTRACT FROM AUTHOR]

A cost analysis of thiopurine treatment was carried out in 257 patients, with 153 preemptively genotyped for TPMT and 104 retrospectively genotyped in a Spanish setting. The healthcare cost was significantly higher in patients retrospectively genotyped compared to those who were preemptively genotyped (p < 0.001). TPMT intermediate metabolizers (IMs) (n = 23) showed a 3.3-fold higher healthcare cost when compared to normal metabolizers (NMs) (p < 0.001). The healthcare cost in patients with a TPMT IM phenotype whose physician adhered to the genotype-informed recommendation was similar than the cost in TPMT NMs and was significantly lower than IMs whose physician did not adhere to the therapeutic recommendation (3.8-fold, p = 0.016). Myelotoxicity occurrence was significantly lower in patients preemptively vs. retrospectively genotyped (2.0% and 21.2%, respectively, p < 0.001). Patients who developed myelotoxicity showed a significantly higher healthcare cost than those who did not (4.10-fold, p < 0.001). Overall, 87% of patients whose dose was not adjusted despite being TPMT IMs suffered myelotoxicity, while only one of the eight patients (13%) whose dose was adjusted suffered myelotoxicity (p < 0.001). In conclusion, TPMT preemptive genotyping and physician adherence to genotype-informed therapeutic recommendations prevents myelotoxicity and significantly reduces the healthcare cost, and it is therefore essential for the sustainability of the Spanish healthcare system. [ABSTRACT FROM AUTHOR]

Simple Summary: This research study aims to understand whether the Medicare Advantage program, which provides healthcare to a significant portion of Medicare beneficiaries, including cancer survivors, is effectively improving access to care, healthcare outcomes, and affordability. The study highlights the need for the ongoing evaluation and re-evaluation of the role of Medicare Advantage in promoting equity among beneficiaries with cancer. It provides valuable insights for policymakers and healthcare professionals involved in decision-making processes related to Medicare Advantage and its impact on healthcare access, affordability, and financial well-being for cancer survivors. This research informs discussions on potential improvements in the Medicare program to ensure that the needs of cancer survivors are adequately addressed. Background: The Medicare Advantage program provides care to nearly half of Medicare beneficiaries, including a rapidly growing population of cancer survivors. Despite its increased adoption, it is still unknown whether or not the program improves healthcare access, outcomes, and affordability for cancer survivors. Methods: We performed a cross-sectional study of Medicare beneficiaries aged ≥ 65 years with a self-reported history of cancer from the 2019 National Health Interview Survey. We used multivariable logistic regression to evaluate the association between Medicare program type (Medicare Advantage vs. traditional Medicare) and measures of healthcare access, acute care utilization, and affordability. Results: We identified 4451 beneficiaries with a history of cancer, corresponding to 26.6 million weighted cancer survivors in 2019. Of the beneficiaries, 35.8% were enrolled in Medicare Advantage, whereas 64.2% were enrolled in traditional Medicare. The age, sex, racial and ethnic composition, household income, primary site of cancer, and comorbidity burden of Medicare Advantage and traditional Medicare beneficiaries were similar. In the adjusted analysis, there were no differences in healthcare access or acute care utilization between traditional Medicare and Medicare Advantage beneficiaries. However, cancer survivors enrolled in Medicare Advantage were more likely to worry about (34.3% vs. 29.4%; aOR, 1.3 (95% CI, 1.1–1.5)) or have problems paying (13.6% vs. 11.1%; aOR, 1.4 (95% CI, 1.1–1.8)) medical bills. Conclusions: We found no evidence that Medicare Advantage beneficiaries with cancer had better healthcare access, affordability, or acute care utilization than traditional Medicare beneficiaries did. Furthermore, Medicare Advantage beneficiaries were more likely to report financial strain and have difficulty paying for their medical bills than were those with traditional Medicare. Despite the generous benefits and attractive incentives, Medicare Advantage plans may not be more cost-effective than traditional Medicare is for cancer survivors. Our study informs ongoing congressional deliberations to re-evaluate the role of Medicare Advantage in promoting equity among beneficiaries with cancer. [ABSTRACT FROM AUTHOR]

The Alaska Railbelt transmission system runs from Fairbanks to Anchorage to Homer and supplies 75% of the state's population with power. In the near future, this system will experience significant increases in load due to electrification of the transportation and heating sectors. To account for this, several state organizations are working towards the creation of an integrated resource plan and reliability standards.This work encompasses the efforts of researching the operations, cost, and locations of desirable hydropower and pumped storage hydropower (PSH) resources in the areas surrounding the Railbelt transmission system. The aspects of conventional hydropower and PSH as well as adjustable-speed and ternary PSH were analyzed. With Alaska's diverse and rugged landscape, QGIS was utilized to delineate the positions of energy resources within a reasonable distance from the Railbelt. By incorporating Digital Terrain Models and the QGIS processing toolbox, a least cost path analysis was completed to filter out resources within the designated distance of the Railbelt. Applying existing cost models to the data in this work helped to decide the energy resources that would be studied further. The future of this project includes modeling the selected energy sources in the PSS/e Railbelt model to examine their effects on the reliability and stability. [ABSTRACT FROM AUTHOR]

Simple Summary: Despite being in use for almost 50 years, monoclonal antibodies face limitations in their implementation in clinical practice, particularly in pediatrics and pediatric cancer. Although technological advancements and research into new therapeutic targets have led to the development of sophisticated and effective molecules, translational barriers still exist. Integrating monoclonal antibodies (mAbs) into current treatment protocols and ensuring accessibility for all children with cancer globally remains a challenge. This review examines the biological, clinical, economic, and social limitations hindering the global implementation of mAbs in pediatric cancer, with a particular focus on anti-GD2 mAbs. Monoclonal antibodies (mAbs), as the name implies, are clonal antibodies that bind to the same antigen. mAbs are broadly used as diagnostic or therapeutic tools for neoplasms, autoimmune diseases, allergic conditions, and infections. Although most mAbs are approved for treating adult cancers, few are applicable to childhood malignancies, limited mostly to hematological cancers. As for solid tumors, only anti-disialoganglioside (GD2) mAbs are approved specifically for neuroblastoma. Inequities of drug access have continued, affecting most therapeutic mAbs globally. To understand these challenges, a deeper dive into the complex transition from basic research to the clinic, or between marketing and regulatory agencies, is timely. This review focuses on current mAbs approved or under investigation in pediatric cancer, with special attention on solid tumors and anti-GD2 mAbs, and the hurdles that limit their broad global access. Beyond understanding the mechanisms of drug resistance, the continual discovery of next generation drugs safer for children and easier to administer, the discovery of predictive biomarkers to avoid futility should ease the acceptance by patient, health care professionals and regulatory agencies, in order to expand clinical utility. With a better integration into the multimodal treatment for each disease, protocols that align with the regional clinical practice should also improve acceptance and cost-effectiveness. Communication and collaboration between academic institutions, pharmaceutical companies, and regulatory agencies should help to ensure accessible, affordable, and sustainable health care for all. [ABSTRACT FROM AUTHOR]

Invasive neuromonitoring is a bedrock procedure in neurosurgery and neurocritical care. Intracranial hypertension is a recognized emergency that can potentially lead to herniation, ischemia, and neurological decline. Over 50,000 external ventricular drains (EVDs) are performed in the United States annually for traumatic brain injuries (TBI), tumors, cerebrovascular hemorrhaging, and other causes. The technical challenge of a bedside ventriculostomy and/or parenchymal monitor placement may be increased by complex craniofacial trauma or brain swelling, which will decrease the tolerance of brain parenchyma to applied procedural force during a craniostomy. Herein, we report on the implementation and safety of a disposable power drill for bedside neurosurgical practices compared with the manual twist drill that is the current gold standard. Mechanical testing of the drill's stop extension (n = 8) was conducted through a calibrated tensile tester, simulating an axial plunging of 22.68 kilogram (kg) or 50 pounds of force (lbf) and measuring the strength-responsive displacement. The mean displacement following compression was 0.18 ± 0.11 mm (range of 0.03 mm to 0.34 mm). An overall cost analysis was calculated based on the annual institutional pricing, with an estimated $64.90 per unit increase in the cost of the disposable electric drill. Power drill craniostomies were utilized in a total of 34 adult patients, with a median Glasgow Coma Scale (GCS) score of six. Twenty-seven patients were male, with a mean age of 50.7 years old. The two most common injury mechanisms were falls and motor vehicle/motorcycle accidents. EVDs were placed in all subjects, and additional quad-lumen neuromonitoring was applied to 23 patients, with no incidents of plunging events or malfunctions. One patient developed an intracranial infection and another had intraparenchymal tract hemorrhaging. Two illustrative TBI cases with concomitant craniofacial trauma were provided. The disposable power drill was successfully implemented as an option for bedside ventriculostomies and had an acceptable safety profile. [ABSTRACT FROM AUTHOR]

The most practical way of storing hydrogen gas for fuel cell vehicles is to use a composite overwrapped pressure vessel. Depending on the driving distance range and power requirement of the vehicles, there can be various operational pressure and volume capacity of the tanks, ranging from passenger vehicles to heavy-duty trucks. The current commercial hydrogen storage method for vehicles involves storing compressed hydrogen gas in high-pressure tanks at pressures of 700 bar for passenger vehicles and 350 bar to 700 bar for heavy-duty trucks. In particular, hydrogen is stored in rapidly refillable onboard tanks, meeting the driving range needs of heavy-duty applications, such as regional and line-haul trucking. One of the most important factors for fuel cell vehicles to be successful is their cost-effectiveness. So, in this review, the cost analysis including the process analysis, raw materials, and manufacturing processes is reviewed. It aims to contribute to the optimization of both the cost and performance of compressed hydrogen storage tanks for various applications. [ABSTRACT FROM AUTHOR]

The integration of photovoltaic panels and heat pumps in domestic environments is a topic that has been studied extensively. Due to their electrical nature and the presence of elements that add thermal inertia to the system (water tanks and the building itself), the functioning of compression heat pumps can be manipulated to try to fulfill a certain objective. In this paper, following a rule-based control concept that has been identified in commercial solutions and whose objective is to improve the self-consumption of the system by actively modulating the heat pump compressor, a parametric analysis is presented. By making use of a lab-tested model, the performance of the implemented control algorithm is analyzed. The main objective of this analysis is to identify and quantify the effects of the main parameters in the performance of the system, namely the climate (conditioning both heating and cooling demands), the photovoltaic installation size, the thermal insulation of the building and the control activation criteria. A total of 168 yearly simulations have been carried out. The results show that the average improvement in self-consumption is around 13%, while the cost is reduced by 2.5%. On the other hand, the heat from the heat pump and the power consumed increase by 3.7% and 5.2%, respectively. Finally, a linear equation to estimate the performance of the controller is proposed. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aims to determine the income level of contracted broiler breeders in terms of earnings and to calculate the profitability, cost, and return of contracted production. In broiler production, the contracted production model between the breeder and the integrated broiler business that supplies the product to the market is applied in Turkey as well as in the world. Broiler production is completed in 5–7 weeks in the normal process. This process may vary depending on slaughter weight, market conditions, carcass broiler weight demands of consumers, feed prices, broiler sales price, and operating conditions. However, in some periods, integrated broiler enterprises make the broiler slaughter earlier in order not to experience disruptions in product supply in the supply chain. In such cases, to determine whether broiler breeders suffer from income loss, breeding parameters were calculated as cost and net income gain in the study. The results show that the entrepreneurs generated a net income of $9.197 per m2 and $0.541 per broiler during the rearing period from broiler breeding. Despite the low earnings in contracted broiler breeding, it is continued because it allows the on-site evaluation of the workforce of family businesses engaged in breeding. Integrated broiler enterprises can procure products regularly throughout the year through contracted production. This study uses the data obtained from 63 broiler farms engaged in contract farming in Akhisar, Turkey. The average feed conversion ratio in the broiler farms is 1.75, the average live weight 2.25 kg, and the mean market age 38.9 days. The feed conversion rate and the income generated are highly correlated (r = −0.76). The production index is 313.4. According to this production index value, 47.6% of the enterprises are below the average production index. It is highest when the marketing age is greater than 38 days, less than and equal to 40. In other words, it is the optimum market age range where carcass yield is at maximum. The average mortality rate is 4.68%. In 52.4% of the enterprises, the mortality rate is above 5%. There is a low level of correlation between the mortality rate and income (r = −0.26). In broiler farming, mortality rate, and feed conversion ratio are factors that directly affect the success and income of the breeder. In broiler farming, the heating cost has the largest share of the total cost, followed by the litter cost. They are followed by labor, electricity, and pesticide costs. Variable costs account for three-quarters of the total operating costs. The farms have a mean gross value of production of $23.797 per m2 and $1.400 per broiler in a breeding period. The profit margin is 0.572 $/kg per broiler. The mean enterprise net income in the breeding period is $9.197 per m2 and $0.541 per broiler. These findings suggest that broiler farming is a profitable venture. [ABSTRACT FROM AUTHOR]

The article analyzes the impact of different filling materials for a seasonal heat storage stack that can be used to heat an innovative plus-energy house in Poland. The storage medium is of the sensible heat type. Twelve filling materials and nine thermal insulation materials readily available in the local market were analyzed. Seven variants comprising a combination of the stack's filling and thermal insulation materials were selected and then grouped into three classes: advanced, medium, and simple technology. Using a mathematical model, energy analysis of the year-round operation of the HVAC installation in the analyzed building was performed for each of the seven variants. The conducted analyses revealed that for each combination of filling and thermal insulation material, there is an optimal maximum temperature of the stack, at which the volume of the stack is the smallest or its costs are the lowest. The obtained results were evaluated to determine the ideal variant combination, and two solutions were recommended: clinker brick and fireplace wool, for which the stack volume is 23 m3 and the total cost is EUR 12,500; and concrete block and glass wool, for which the stack volume is 27 m3 and the total cost is EUR 1700. [ABSTRACT FROM AUTHOR]

Remote sensing coupled with hyperspectral technology has become increasingly popular to investigate plant traits, showcasing its advantages in studying plant growth, health, and productivity. The quality of the collected hyperspectral images is crucial for subsequent data analysis and plant phenotyping studies. However, diurnal variations in spectral characteristics introduce more data variance in canopy reflectance spectra, raising the cost of subsequent analyses and compromising the performance of trait estimation models. In this study, a fixed gantry platform in a cornfield was used to capture visible and near-infrared (VNIR) hyperspectral images of corn canopies at consecutive time intervals. By applying reference board calibration and locally weighted scatterplot smoothing to minimize the effects of ambient light and daily growth, diurnal spectral changes across all involved VNIR wavelengths were investigated. Several distinct diurnal patterns were observed to have close connections with the plants' physiological effects. Diurnal calibration models were established at every wavelength by employing the least squares polynomial algorithm, with the highest coefficient of determination reaching 0.84. Moreover, by employing diurnal calibration in canopy spectra processing, the reduction in spectral variance brought about by varying imaging time was evidently exhibited. This study not only reveals the diurnal spectral variation pattern at VNIR bands but also offers a reliable, straightforward, and low-cost approach to improve the quality of remote sensing data and reduce the inherent variance brought about via the different imaging times ensuring that comparable spectral analysis can be performed under relatively fair conditions. [ABSTRACT FROM AUTHOR]

Studies have shown negative short-term effects of early weaning (EW) in finfish larvae but information on long-term effects of EW on growth and subsequent economic loss is lacking. We evaluated the short- and long-term effects of EW and late weaning (LW) on Atlantic cod. Cod larvae were fed with enriched rotifers from 2 to 35 days post-hatch (dph) and weaning carried out from 21 to 35 dph (EW) or with enriched rotifers from 2 to 29 dph followed by enriched Artemia nauplii from 25 to 56 dph and weaning carried out from 45 to 56 dph (LW). At 190 dph, 50 fish from each tank were tagged with an electronic tag and were transferred to sea cages at 10 months old. At the end of 30 months post-hatch, the weight of the fish was recorded. Our results showed a significant short-term effect of the weaning method on the growth of Atlantic cod at 65 dph, but no significant difference at 90 and 190 dph. However, fish from LW showed a significantly higher body weight compared to fish from EW at 30 months post-hatch. A cost analysis indicated substantial benefit for commercial cod farming by using LW and we recommend using LW to gain sizable financial benefit. [ABSTRACT FROM AUTHOR]

Background: Preterm labor and delivery remain a major problem in obstetrics accounting for perinatal morbidity and mortality. The challenge is to identify those with true preterm labor to avoid unnecessary hospital admissions. The fetal fibronectin (FFN) test is a strong predictor of preterm birth and can help identify women with true preterm labor. However, its cost-effectiveness as a strategy for triaging women with threatened preterm labor is still debatable. Objective: To evaluate the effect of FFN test implementation on hospital resources by reducing the admission rate of threatened preterm labor in a tertiary hospital, Latifa Hospital, UAE. Methods: A retrospective cohort study of singleton pregnancies between 24 and 34 weeks of gestation who attended Latifa Hospital in the period of September 2015–December 2016, complaining of threatened preterm labor after the availability of an FFN test, and a historical cohort study for those who attended with threatened preterm labor before the availability of an FFN test. Data analysis was performed using a Kruskal–Wallis test, Kaplan–Meier, Fischer exact chi-square and cost analysis. The significance was set at p-value < 0.05. Results: In total, 840 women met the inclusion criteria and were enrolled. The relative risk of FFN for delivery at term was 4.35 times higher among the negative-tested compared to preterm delivery (p-value < 0.001). A total of 134 (15.9%) women were unnecessarily admitted (FFN tested negative, delivered at term) which yielded $107,000 in extra costs. After the introduction of an FFN test, a 7% reduction of threatened preterm labor admissions was recorded. [ABSTRACT FROM AUTHOR]

In this study, we develop a data-driven heuristic method to solve the irregular flight recovery problem. Based on operational data from China South Airlines, Beijing, China, we evaluate the importance of a flight in the flight network and the influence of a delay on a flight and its subsequent flights. Then, we classify historical states into three scenarios according to their delay reasons and investigate the recovery patterns for each scenario. Inspired by the results of the data analysis, we develop a heuristic algorithm that imitates dispatcher actions. The algorithm is based on two basic operations: swapping the tail numbers of two flights and resetting their flight departure times. The algorithm can provide multiple recovery plans in real time for different scenarios, and we continue to refine and validate the algorithm for more robust and general solutions through a cost analysis. Finally, we test the efficiency and effectiveness of the recovery method based on the flight schedule, with real and simulated delays, and compare it with two other methods and the recovery actions of dispatchers. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review and explore the impact of study methods on the cost of managing adverse drug reactions (ADRs) among hospitalized patients to guide policymakers and researchers. A literature search was conducted in MEDLINE, EMBASE, CINAHL, Cochrane Library, and Google Scholar. The search was restricted to studies from 2000 to 2017. Two authors independently reviewed the studies, assessed their risk of bias, and extracted information for analysis. Data abstraction was based on the study design, ADR reporting, and costing approaches. Of 677 studies identified, 12 were included for analysis. All studies defined ADR according to WHO classifications. The percentage of admission due to ADR ranged from 0.03% to 17.11%. All studies adopted a healthcare provider perspective, using either a micro-costing (n = 7), case-mix group costing (n = 3), or average-per-diem costing (n = 2) approach. The cost per ADR widely fluctuated from USD 65.00 to USD 12,129.90 based on various factors. The micro-costing approach generally had a lower cost compared to other approaches. The cost per ADR in high-income countries was also 10 times higher than in lower- or middle-income countries. This study evidenced that the methodological heterogeneity across studies has resulted in a wide range of cost estimations for ADR management. [ABSTRACT FROM AUTHOR]

Solar power occupies a significant position among global renewable energy sources due to its abundant energy potential. Consequently, its contribution to electricity generation is steadily increasing. However, obtaining peak efficiency from fixed solar photovoltaic (PV) panels is a formidable task due to their limited ability to consistently tap into solar energy. To tackle this issue and mitigate energy efficiency losses, the utilization of solar tracking systems has emerged as an exceptionally effective solution. These systems enable continuous adjustment of the panels' position to align with the sun's trajectory, optimizing energy absorption and enhancing overall performance. This paper presents the performance and cost analysis of three distinct solar panel tracking systems, namely, a fixed system, a single-axis system, and a dual-axis system. The systems are operated under identical coordinates and conditions. The production data are collected over a period of 15 days for comparative analysis. The tracking movements of the systems are controlled using Arduino. The mechanical components are specifically designed for the establishment of each system. The findings of this study indicate that both single-axis and dual-axis solar tracking systems outperformed fixed systems in terms of power generation. The single-axis system demonstrated a 24.367% increase in power production, while the dual-axis system showed a 32.247% increase compared to the fixed system. Moreover, a cost analysis was carried out considering the installation expenses and power production data of the three systems. It was determined that the single-axis tracking system achieved payback in 0.39 years less compared to the fixed system, while the dual-axis system achieved payback in 1.48 years less compared to the fixed system. Overall, this study underscores the advantages of implementing solar tracking systems, particularly in the single-axis and dual-axis configurations, as they contribute to higher power generation and cost-effectiveness compared to fixed systems. [ABSTRACT FROM AUTHOR]

Consider a set of k identical asynchronous mobile agents located in an anonymous ring of n nodes. The classical Gather (or Rendezvous) problem requires all agents to meet at the same node, not a priori decided, within a finite amount of time. This problem has been studied assuming that the network is safe for the agents. In this paper, we consider the presence in the ring of a stationary process located at a node that disables any incoming agent without leaving any trace. Such a dangerous node is known in the literature as a black hole, and the determination of its location has been extensively investigated. The presence of the black hole makes it deterministically unfeasible for all agents to gather. So, the research concern is to determine how many agents can gather and under what conditions. In this paper we establish a complete characterization of the conditions under which the problem can be solved. In particular, we determine the maximum number of agents that can be guaranteed to gather in the same location depending on whether k or n is unknown (at least one must be known). These results are tight: in each case, gathering with one more agent is deterministically unfeasible. All our possibility proofs are constructive: we provide mobile agent algorithms that allow the agents to gather within a predefined distance under the specified conditions. The analysis of the time costs of these algorithms show that they are optimal. Our gathering algorithm for the case of unknown k is also a solution for the black hole location problem. Interestingly, its bounded time complexity is Θ (n) ; this is a significant improvement over the existing O (n log n) bounded time complexity. [ABSTRACT FROM AUTHOR]

Simple Summary: As robotic surgery is less invasive and patients recover faster compared to open surgery, the postoperative nursing effort should be lower. However, this potential cost savings mechanism for the otherwise more expensive robotic surgery has not been investigated yet. Therefore, we compared 198 robotic and 61 open partial kidney resections performed within two years at an experienced center. Indeed, the median total nursing time and daily nursing effort were significantly lower after robotic surgery, which resulted in mean savings of EUR 186.48 in nursing costs per robotic surgery. However, this cost savings mechanism alone did not amortize the overall increased costs of the robotic system. Despite perioperative advantages, robot-assisted surgery is associated with high costs. However, the lower morbidity of robotic surgery could lead to a lower nursing workload and cost savings. In this comparative cost analysis of open retroperitoneal versus robot-assisted transperitoneal partial nephrectomies (PN), these possible cost savings, including other cost factors, were quantified. Therefore, patient, tumor characteristics, and surgical results of all PN within two years at a tertiary referral center were retrospectively analyzed. The nursing effort was quantified by the local nursing staff regulation and INPULS® intensive care and performance-recording system. Out of 259 procedures, 76.4% were performed robotically. After propensity score matching, the median total nursing time (2407.8 vs. 1126.8 min, p < 0.001) and daily nursing effort (245.7 vs. 222.6 min, p = 0.025) were significantly lower after robotic surgery. This resulted in mean savings of EUR 186.48 in nursing costs per robotic case, in addition to savings of EUR 61.76 due to less frequent administrations of erythrocyte concentrates. These savings did not amortize the higher material costs for the robotic system, causing additional expenses of EUR 1311.98 per case. To conclude, the nursing effort after a robotic partial nephrectomy was significantly lower compared to open surgery; however, this previously unnoticed savings mechanism alone could not amortize the overall increased costs. [ABSTRACT FROM AUTHOR]

Background: Collateral damage to surrounding healthy tissues has been reported in patients who undergo radiation therapy for pelvic malignancies. This study aimed to evaluate the safety, efficacy and cost efficiency of endoscopic diode laser therapy in patients diagnosed with chronic radiation proctitis (CRP). Methods: The data of 24 patients (median age 78, range 67–90 years) who presented rectal bleeding and were diagnosed with CRP after undergoing high-dose radiotherapy for prostatic cancer and underwent diode laser therapy were evaluated retrospectively. Non-contact fibers were used in the patients who underwent the procedure without sedation in an outpatient setting. Results: The patients underwent a median of two sessions; overall, a mean of 1591 J of laser energy per session was used. No complications were noted during or after the procedures. Bleeding was completely resolved in 21/24 (88%) patients, and two patients showed improvement (96%). It was not necessary to suspend antiplatelet (six patients) or anticoagulant (four patients) therapy during the treatment course. The mean cost per session was EUR 473.4. Conclusions: The study findings demonstrated that endoscopic non-contact diode laser treatment in CRP patients is safe, effective and cost efficient. For this procedure, antiplatelet and anticoagulant therapy suspension, intraprocedural sedation and hospital admission are not required. [ABSTRACT FROM AUTHOR]