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The past decade has witnessed a significant evolution in the role of the Internet, transitioning from individual connectivity to an integral aspect of various domains. This shift has prompted a move in IP paradigms from hierarchical to distributed architectures characterized by decentralized structures. This transition empowers efficient data routing and management across diverse networks. However, traditional distributed mobility management (DMM) protocols, reliant on tunneling mechanisms, incur overheads, costs, and delays, exacerbating challenges in managing the exponential growth of mobile data traffic. This research proposes Tunnel-Free Mobility for IPv6 (TFMIPv6) as a solution to address the shortcomings of existing DMM protocols. TFMIPv6 eliminates the need for tunneling, simplifying routing processes and reducing latency. A comprehensive cost analysis and performance evaluation are conducted, comparing TFMIPv6 with traditional protocols such as MIPv6, PMIPv6, FMIPv6, and HMIPv6. The study reveals significant improvements with TFMIPv6. Signaling costs are reduced by 50%, packet delivery costs by 23%, and tunneling costs are completely eliminated (100%). Real-world network traffic datasets are used for simulation, providing statistical evidence of TFMIPv6's efficacy in supporting an uninterrupted movement of IPv6 data across networks. [ABSTRACT FROM AUTHOR]

Background: To improve patient outcomes and provider team practice, the California Perinatal Quality Care Collaborative (CPQCC) created the Simulating Success quality improvement program to assist hospitals in implementing a neonatal resuscitation training curriculum. This study aimed to examine the costs associated with the design and implementation of the Simulating Success program. Methods: From 2017–2020, a total of 14 sites participated in the Simulating Success program and 4 of them systematically collected resource utilization data. Using a micro-costing approach, we examined costs for the design and implementation of the program occurring at CPQCC and the 4 study sites. Data collection forms were used to track personnel time, equipment/supplies, space use, and travel (including transportation, food, and lodging). Cost analysis was conducted from the healthcare sector perspective. Costs incurred by CPQCC were allocated to participant sites and then combined with site-specific costs to estimate the mean cost per site, along with its 95% confidence interval (CI). Cost estimates were inflation-adjusted to 2022 U.S. dollars. Results: Designing and implementing the Simulating Success program cost $228,148.36 at CPQCC, with personnel cost accounting for the largest share (92.2%), followed by program-related travel (6.1%), equipment/supplies (1.5%), and space use (0.2%). Allocating these costs across participant sites and accounting for site-specific resource utilizations resulted in a mean cost of $39,210.69 per participant site (95% CI: $34,094.52-$44,326.86). In sensitivity analysis varying several study assumptions (e.g., number of participant sites, exclusion of design costs, and useful life span of manikins), the mean cost per site changed from $35,645.22 to $39,935.73. At all four sites, monthly cost of other neonatal resuscitation training was lower during the program implementation period (mean = $1,112.52 per site) than pre-implementation period (mean = $2,504.01 per site). In the 3 months after the Simulating Success program ended, monthly cost of neonatal resuscitation training was also lower than the pre-implementation period at two of the four sites. Conclusions: Establishing a multi-site neonatal in situ simulation program requires investment of sufficient resources. However, such programs may have financial and non-financial benefits in the long run by offsetting the need for other neonatal resuscitation training and improving practice. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is a global concern, with Peru experiencing a high incidence and mortality. Trastuzumab, a crucial treatment for human epidermal growth factor receptor 2-positive BC, is administered intravenously or subcutaneously (SC). This study evaluates the costs associated with both methods at Peru's Instituto Nacional de Enfermedades Neoplásicas. Real data indicate that SC administration reduces treatment costs by approximately S/15,049.09. Cross-continental comparisons highlight a global trend favouring SC administration for efficiency and cost-effectiveness. The analysis provides insights for informed decision-making in resource-constrained healthcare settings like Peru, emphasising the need to consider local contexts in optimising oncology care. [ABSTRACT FROM AUTHOR]

A rare disease is that with a low prevalence in the population. However, it is estimated that there are between 6,000 and 8,000 different types of rare diseases in the world and, generally, they are incurable and deadly. Machado-Joseph's disease (MJD) is one of these cases; of genetic origin, autosomal dominant, with a high chance of transmission between generations and without curative treatment. Given the specificities of MJD and the lack of economic studies associated with it, this article aims to estimate the direct and indirect health-related costs of lost productivity attributable to Machado-Joseph's Disease. The data used were primarily collected at the Hospital de Clínicas de Porto Alegre (HCPA), during the period between October 2019 and March 2020. The bottom-up cost methodology was used, that is to say, to estimate costs across a sample of patients to produce an annual cost per patient. Among the main results, it was found that 90.8% of the sample does not work and of these, 72.73% reported that the reason they had stopped working was due to Machado-Joseph's disease. The average age of men when they stopped working was 39.05 years of age and for women it was 39.64 years of age. In relation to direct non-medical costs, with rehabilitation and transport, it was found that these items affect about 32% of men's income and 36% of women's income, as well as medication and diapers costs affect about 15% of women's income and 14% of the income of men who are no longer able to work. The study also showed that 50% of caregivers, who are generally close relatives of the patient, do not work. Of these, 33.3% reported having left the labor market to provide assistance to the patient, which means that the cost for families is even higher than that estimated for the patient. [ABSTRACT FROM AUTHOR]

The technical and economic challenges are enormous in developing gas wells with a high CO2 content (> 50 mol %), such as the East Natuna gas field, which has 71 mol % (86 mass %). Carbon capture technology in gas wells with high CO2 content is studied to find a more economical one. In this study, the technology for capturing high concentrations of CO2 is varied from gas wells, Controlled Freeze Zone (CFZ), and cryogenic distillation which will be analyzed based on cost. Variations in the CO2 content of gas wells are 75 %, 80 %, 85 %, 90 %, and 95 % in mass fraction simulated using Aspen Plus V.11.0. Based on this research, CFZ technology and cryogenic distillation can obtain purity up to 99 % and recovery above 78 %. However, the total annual cost (annual capital and operating costs) of CFZ technology is lower than cryogenic distillation technology, so CFZ technology is suitable for capturing CO2 in gas wells with high CO2 content. [ABSTRACT FROM AUTHOR]

Background: The organisational care needs involved in accessing kidney transplant have not been described in the literature and therefore a detailed analysis thereof could help to establish a framework (including appropriate timing, investment, and costs) for the management of this population. The main objective of this study is to analyse the profile and care needs of kidney transplant candidates in a tertiary hospital and the direct costs of studying them. Methods: A descriptive, cross-sectional study was conducted using data on a range of variables (sociodemographic and clinical characteristics, study duration, and investment in visits and supplementary tests) from 489 kidney transplant candidates evaluated in 2020. Results: The comorbidity index was high (> 4 in 64.3%), with a mean of 5.6 ± 2.4. Part of the study population had certain characteristics that could hinder their access a kidney transplant: physical dependence (9.4%), emotional distress (33.5%), non-adherent behaviours (25.2%), or language barriers (9.4%). The median study duration was 6.6[3.4;14] months. The ratio of required visits to patients was 5.97:1, meaning an investment of €237.10 per patient, and the ratio of supplementary tests to patients was 3.5:1, meaning an investment of €402.96 per patient. Conclusions: The study population can be characterised as complex due to their profile and their investment in terms of time, visits, supplementary tests, and direct costs. Management based on our results involves designing work-adaptation strategies to the needs of the study population, which can lead to increased patient satisfaction, shorter waiting times, and reduced costs. [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]

Background and Aims: Multiple sources of medical oxygen, namely liquid medical oxygen (LMO) tanks, pressure swing adsorption (PSA) plants, concentrators, and gaseous cylinders, are available at different healthcare facilities. These sources of oxygen have varying installation and operational costs. In low-resource settings, it is imperative to utilise these assets optimally. This study investigated the operational costs of multiple oxygen sources available at a healthcare facility. Methods: A Microsoft (MS) Excel-based model was developed to analyse and compare the oxygen manufacturing costs (in ₹/m³) using PSA plants and procurement costs (in ₹/m³) of LMO and third-party vendor-refilled cylinders. Results: The oxygen manufacturing costs for PSA plants of different capacities and running times on electricity and diesel generators (DGs) as a power source were calculated. This study highlights the cost-benefit of using PSA plants over LMO and third-party vendor-refilled cylinders as a source of oxygen. PSA plants are most economical when they are of higher capacity and used to their maximum capacity on electricity as the power source. On the contrary, they are most expensive when used on a DG set as a power source. Furthermore, this study provides evidence of PSA plants being more cost-effective for refilling cylinders using a booster compressor unit when compared to third-party vendor-cylinder refilling. Conclusion: Given their cost-effectiveness and low third-party dependence, they should be utilised to their maximum capacity as medical oxygen sources at healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: The onset of the COVID-19 pandemic has had an adverse impact on children, youth, and families with eating disorders (EDs). The COVID-19 pandemic exacerbated pre-existing personal and financial costs to youth, caregivers, and health professionals accessing or delivering ED services. The objectives of this mixed methods study were to (1) understand the indirect, direct medical and non-medical costs reported by youth, caregivers, and clinicians; (2) understand how the COVID-19 pandemic may have impacted these costs, and (3) explore implications of these costs with regards to barriers and resources to inform future decisions for the ED system of care. Methods: Youth (aged 16–25 years) with lived/living experience, primary caregivers, clinicians, and decision-makers were recruited with support from various partners across Canada to complete group specific surveys. A total of 117 participants responded to the survey. From those respondents, 21 individuals volunteered to further participate in either a discussion group or individual interview to provide additional insights on costs. Results: Youth and primary caregivers reported costs relating to private services, transportation and impacts of not attending school or work. Additionally, primary caregivers reported the top direct medical cost being special food or nutritional supplements (82.8%). In discussion groups, youth and caregivers elaborated further on the challenges with long waitlists and cancelled services, impact on siblings and effect on family dynamics. Clinicians and decision-makers reported increased work expectations (64.3%) and fear/isolation due to COVID-19 in the workplace (58.9%). Through discussion groups, clinicians expanded further on the toll these expectations took on their personal life. Approximately 1 in 3 health professionals reported contemplating leaving their position in 1–2 years, with greater than 60% of this group stating this is directly related to working during the pandemic. Conclusions: Findings demonstrate the need for increased support for youth and caregivers when accessing ED services both during crisis and non-crisis times. Additionally, attention must be given to acknowledging the experience of health professionals to support better retention and resource management as they continue to navigate challenges in the health care system. Plain English summary: The COVID-19 pandemic has had significant impacts for children, youth and families with eating disorders (EDs) and those who care for them. The objective of this study was to understand the impacts on financial and personal costs to youth, caregivers and clinicians when either accessing or delivering ED services during the pandemic. This study consisted of an online survey and discussion groups with youth (16-25 years old) with lived experience of an ED, primary caregivers, clinicians and decision-makers delivering ED services to understand the costs they experienced. Although many reported costs were financial, including direct medical costs (i.e. private therapy) and direct non-medical costs (i.e. transportation, accommodation costs), there were also significant personal costs to individuals and their families. Healthcare professionals also reported extensive challenges with resources and increased work expectations due to the pandemic context. Acknowledging the costs experienced by young people, families and healthcare professionals during the pandemic allows for the discussion of how we can better support those accessing or delivering ED services in times of crisis and non-crisis. [ABSTRACT FROM AUTHOR]

The standard care for burns is tangential surgical debridement and subsequent covering, but recently enzymatic debridement has appeared as an alternative. The objective of this study, using an individualised cost-per-patient information system, is to compare the cost per patient of these two alternatives and identify their main determining factors. A non-randomised, retrospective, observational study was carried out with 79 patients, 39 of whom were treated with surgical debridement. The average cost per patient for enzymatic debridement is lower, particularly due to a shorter length of stay of critical hospitalisation (13.7 vs. 18.9 days; €26,101 vs. €33,919), a decreased need for surgical procedures (0.45 vs. 1.28) and a shorter use of operating theatres (53 vs. 202 minutes; €904 vs. €3,000). Age, aetiology, evolution length and percentage TBSA are robust determinants of the cost of care for burn patients. The type of procedure does not appear to significantly affect the cost per patient. [ABSTRACT FROM AUTHOR]

• Dalbavancin has been shown to be a safe option in the therapy of infective endocarditis. • A lower hospital stay was observed in patients who received dalbavancin. • Dalbavancin use was associated with a reduction in costs and hospital stay. Due to its long half-life, dalbavancin offers benefits for long-duration treatments, especially osteoarticular and infective endocarditis (IE). We evaluated the efficacy and costs of IE treatment, comparing dalbavancin with standard of care (SOC). Retrospective multicenter cohort study of adult patients with Gram-positive cocci definite IE. Dalbavancin was used as a sequential therapy before discharge. Efficacy was a combined variable of clinical cure and absence of recurrence in 12-month follow-up. Length of hospital stay and the associated costs were analyzed in both groups of treatment. Twenty-two patients received dalbavancin and 47 SOC. The efficacy was similar between the groups (dalbavancin 18 [72%] vs SOC 44 [94%], P = 0.198). Hospital stay was shorter in the dalbavancin group (dalbavancin 22 days [16-34] vs SOC 37 days [23-49], P = 0.001), especially in those with E. faecalis IE (dalbavancin 30 days [20-36] vs SOC 65 days [46-74], P <0.001). A reduction of cost was observed between both groups (dalbavancin, 12,206 € [8998-17,283] vs SOC 16,249 € [11,496-22,367], P = 0.032). Dalbavancin could be a safe and effective option in the sequential treatment of patients with IE. Also, a cost reduction was detected, due to a significant shortness of hospital stay. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis is a highly prevalent disease. Patients undergo various medical and pharmacological treatments, which have an economic impact on hospitals. The aim of this study was to estimate the direct economic costs of Mexican Social Security Institute (IMSS) resources used to provide healthcare to adult patients with rheumatoid arthritis in 2016–2017. Methods: Data of patients aged > 18 years with Rheumatoid Arthritis (RA) were obtained from databases and public information sources to estimate the use of IMSS resources for the target population. Total costs were estimated by means of the macro-costing method, employing the diagnosis-related group (DRG). Each DRG of the IMSS was constructed with one of the diagnoses and the respective combination of clinical characteristics included in the ICD-9. This study was conducted from the national perspective of IMSS, the largest healthcare service administrator in the country. As such, it can be considered representative of the broader healthcare landscape in Mexico. Results: The total cost per year of furnishing inpatient care to RA patients was found to be $170,099,794 MXN ($9,096,245.67 USD) for 2016 and $167,039,481 MXN ($8,932,592.57 USD) for 2017, implying an enormous economic impact on the government budget for Mexican public health services. Conclusions: Our results demonstrate that the direct costs of musculoskeletal and cardiovascular surgery represented the highest costs of RA in-hospital care at IMSS (the largest health institution in Mexico) in 2016 and 2017. Further studies are needed that include the cost of drugs and other indirect costs in addition to our results to get the most accurate approximation of the cost of living with RA. [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]

Background: Breastfeeding is the biological norm for feeding infants and young children. When mothers' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam. Methods: An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation. Results: The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021. Conclusion: Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs. [ABSTRACT FROM AUTHOR]

This study investigates the lifetime costs associated with concrete barriers and steel guardrails. We introduce a cost analysis methodology that incorporates critical factors such as construction costs, maintenance costs, exposure risks during maintenance activities, and the costs imposed to traveling public through the increased traffic and the crash outcomes. We integrate various parameters including economic factors, road geometry, general weather condition, and traffic mix to estimate a location-dependent cost for each type of barrier accurately. A software tool, named CalBarrier, was developed during this study to carry out the calculations and the comparison of lifetime cost of aforementioned barriers. An inherent strength of this research is its reliance on recent real data extracted from various databases of California Department of Transportation (Caltrans), ensuring precision and relevance in accounting for various influential factors. Drawing insights from Caltrans practices and interviews with their personnel, this study emphasizes the intricate decision-making process involved in mitigating safety risks and reducing operational expenses. Although our data originates from California, the methodology for life cycle cost analysis, and our software are applicable for regions with different socio-economic conditions by deploying user input costs, making our findings a valuable resource for other areas facing comparable challenges. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is the biological norm for feeding infants and young children. When mothers' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam. Methods: An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation. Results: The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021. Conclusion: Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs. [ABSTRACT FROM AUTHOR]

Introduction: Vaccine stockout is a severe problem in Africa, including Nigeria, which could have an adverse effect on vaccination coverage and even health outcomes among the population. The Vaccine Direct Delivery (VDD) program was introduced to manage vaccine stockouts using eHealth technology. This study conducts a cost analysis of the VDD program and calculates the incremental costs of reaching an additional child for vaccination through the VDD program. Methods: We used the expense reports from eHealth Africa, an NGO which implemented the VDD program, to calculate the VDD program's overall operating costs. We also used the findings from the literature to translate the effect of VDD on the reduction of vaccine stockouts into its effect on the increase in vaccination coverage. We calculated the incremental costs of reaching an additional child for vaccination through the VDD program. Results: We calculated that implementing the VDD program cost USD10,555 monthly for the 42 months that the VDD program was operating in Bauchi state. This figure translates to an incremental cost of USD20.6 to reach one additional child for vaccination. Discussion/Conclusions: Our study is one of the first to conduct a cost analysis of eHealth technology in Africa. The incremental cost of USD20.6 was within the range of other interventions that intended to increase vaccine uptake in low- and middle-income countries. The VDD program is a promising technology to substantially reduce vaccine stockout, leading to a reduction of over 55% at a reasonable cost, representing 26% of the total budget for routine immunization activities in Bauchi state. However, there is no comparable costing study that evaluates the cost of a supply chain strengthening intervention. Future studies should investigate further the feasibility of eHealth technology, as well as how to minimize its costs of implementation while keeping the efficacy of the program. [ABSTRACT FROM AUTHOR]

Carbon-based nanodots have garnered recent interest for their simple synthesis and versatile utility, ranging from biomedical to (opto) electronic applications, evolving into a tunable and biocompatible material. Here, for the first time, a biochar (lotus leaf) derived carbon nanodots was synthesized through hydrothermal carbonization. The synthesized hollow spherical biochar was engineered via functionalization by grafting –SO3H active sites. The attained catalyst was broadly analyzed by XRD, FTIR, TGA, BET, SEM–EDX, TEM, and XPS analysis after which it was applied for the acetalization reaction of crude glycerol (a biodiesel by-product) to form solketal, a potential fuel additive to valorize the large waste stream generated from biodiesel industry. Employing the RSM-CCD methodology, the experimental matrix was executed, and subsequent data were scrutinized through multiple regressions to model a quadratic equation. Under specific reaction parameters—a reaction duration of 14 min, a molar ratio of 7.5:1, and a catalyst loading of 5.7 wt.%, maximum solketal yield (95.7%) was attained through the ultrasonication method. Finally, to conclude, life cycle cost analysis (LCCA) for solketal production was studied here which determined the overall cost of solketal production per kilogram to be 0.719 USD ($), indicating high commercial applicability. [ABSTRACT FROM AUTHOR]

The development of the vehicle-road cooperative intelligence can effectively resolve the current technical impediment and cost quandary associated with high-level autonomous driving. Nevertheless, the intelligent infrastructure entails initial deployment costs and ongoing energy consumption and maintenance costs, necessitating a comprehensive and quantitative analysis of the costs of intelligent infrastructure and the corresponding changes in comprehensive costs. The cost evaluation model for the cooperative intelligent system is designed in this paper, considering the corresponding intelligent infrastructure layout scheme for different road types within the technical framework. The intelligent configuration and corresponding cost transfer from roadside to vehicle side under the synergy effect is also analyzed. Using Beijing as a case study, the results indicate that the deployment of intelligent infrastructure will effectively reduce acquisition and usage costs of high-level intelligent vehicles and achieve a greater "reuse" effect by serving more intelligent connected vehicles (ICVs). Compared to the vehicle intelligence, collaborative intelligence will reduce cumulative total costs by more than ¥200 billion from 2023 to 2050, even with the inclusion of intelligent infrastructure's costs. [ABSTRACT FROM AUTHOR]

This study evaluates the logistics cost associated with transporting Wood Pellets (WP) and Torrefied Biomass Pellets (TBP) from Aveiro, Portugal's principal WP exporting port, to Northern European destinations. With increasing emphasis on sustainable energy, understanding the cost dynamics between WP and TBP becomes crucial for market competitiveness. Using data sourced from the Argus Biomass Markets report, we compared the energy in gigajoules per ton of both WP and TBP. Torrefaction results in pellets with superior energy and bulk densities, influencing their transportation logistics costs. The main metrics for comparison were cost per energy unit and the implications of energy and bulk densities on transport costs. Preliminary findings indicate that although torrefied pellets undergo more significant mass loss than energy loss, their enhanced energy and bulk densities present logistical advantages. These advantages manifest as more tons per volume unit and heightened energy per ton, which ultimately lead to reduced transportation cost per energy unit. The insights from this analysis provide valuable input for the biofuel sector. By understanding the cost benefits associated with TBP transportation in contrast to WP, stakeholders can make strategic decisions, bolstering the competitiveness of Portuguese biofuel products in the European domain. [ABSTRACT FROM AUTHOR]

Managing tibial fractures requires substantial health resources, which costs the health system. This study aimed to describe the costs of photobiomodulation (PBM) with LEDs in the healing process of soft tissue lesions associated with tibial fracture compared to a placebo. Economic analysis was performed based on a randomized controlled clinical trial, with a simulation of the cost-effectiveness and incremental cost model. Adults (n = 27) hospitalized with tibia fracture awaiting definitive surgery were randomized into two distinct groups: the PBM Group (n = 13) and the Control Group with simulated phototherapy (n = 14). To simulate the cost-effectiveness and incremental cost model, the outcome was the evolution of wound resolution by the BATES-JENSEN scale and time of wound resolution in days. The total cost of treatment for the Control group was R$21,164.56, and a difference of R$7,527.10 more was observed when compared to the treatment of the PBM group. The proposed intervention did not present incremental cost since the difference in the costs to reduce measures between the groups was smaller for the PBM group. When analyzing the ICER (Incremental cost-effectiveness ratio), it would be possible to save R$3,500.98 with PBM and decrease by 2.15 points in the daily average on the BATES-JENSEN scale. It is concluded, therefore, that PBM can be a supportive therapy of clinical and economic interest in a hospital setting. [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]

Cotton (Gossypium spp) remains a significant source of income in Africa. However, production is limited by high input costs that reduce profit margins. This study aimed to conduct cost analysis on field trials that were conducted to evaluate the effect of chemical insecticides, Chlorpyrifos® 480 EC, Karate® EC, and Bandit® 350 SC compared with biopesticides, Eco-Bb®, Bolldex®, Delfin®, NOMU-PROTEC® and Bb endophyte on the control of cotton insect pests. Delfin® (US$602) was the most expensive pesticide, followed by Bolldex® (US$495.74), while the cheapest pesticide was Chlorpyrifos® (US$28). Other input costs were US$1 396.50 per hectare, with the highest labor cost of US$544. The minimal cost of production from the bollworm trial was recorded from the application of Karate® (US$1 455), while Delfin® (US$1 999) was the highest. Maximum average seed cotton yield was recorded with Bolldex® (6 402 kg ha-1); however, the maximum net profit of up to US$1 445.26 per hectare was registered with Karate® with the highest cost-benefit ratio of 1.8. The average highest seed cotton yield was obtained with Bandit® (6 394 kg ha-1) followed by Bb endophyte (6 297 kg ha-1) in the leafhopper trial. Bandit® and Karate® had the highest net profits of US$ 1,712 and US$ 1,253, respectively. The Bandit® treatment had the highest costbenefit ratio of 2. Generally, biopesticide application was found to be more expensive than chemical insecticides; however, they were all profitable. [ABSTRACT FROM AUTHOR]

In the present study, the effect of high-volume fly ash blending in the concentration of 15%, 25%, 35%, 45%, and 55% with different effective water-to-cement (W/C) ratios has been investigated for rheology, compressive strength (CS), and durability of self-compacting mortar (SC-mortar). The rheology of SC-mortar was evaluated in terms of slump flow diameter, v-funnel flow time, and developed yield stress and plastic viscosity. The CS of SC-mortar was evaluated at 7 and 28 days of curing, whereas the water permeability and rapid chloride penetration tests were performed to evaluate the durability of SC-mortar at 28, 90, and 180 days. The consumption of ordinary portland cement was reduced using the k-factor or cementing efficiency factor in mix design, where the value of the k-factor decreases with increasing fly ash content. The experimental study revealed that the addition of a high volume of fly ash has a significant impact on rheology and durability, whereas CS of SC-mortar was affected marginally. Scanning electron microscopic (SEM) examination revealed that the fly ash blending has improved the packing and reduced the pore density to compensate for the loss of CS on account of lower cement content. An increase in W/C has increased the porosity, causing a negative impact on CS and durability. The durability of SC-mortar has increased with increasing fly ash content, and there was an exceptional increment in water ingression time (T25) with an increase in fly ash content from 25% to 35%, but with higher content of fly ash (above 35%) and low value of W/C, SC-mortar become very sticky, thus reduced the workability significantly. Compared with the control mix, there is a significant reduction in the cost of SC-mortar with fly ash blending of 15%, thereafter, the cost reduction is marginal with a further increase in fly ash dosage which is due to the rise in admixture dosage. Based on the rheology (within EFNARC limits), CS, and durability of SC-mortar, the optimized dosage of fly ash has been recommended in the range of 25%–40% with different W/C. [ABSTRACT FROM AUTHOR]

Objective: To analyze the clinical and cost outcomes of transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) in heart failure (HF) patients. Methods: All 162 HF patients undergoing TEER for MR between January 2019 and March 2023 were included. A propensity-adjusted analysis was used to compare 32 systolic vs. 97 diastolic vs. 33 mixed (systolic + diastolic) HF patients. Systolic, diastolic, and mixed HF patients were defined according to AHA guidelines. The primary outcome was the long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events (MACCEs, all-cause mortality + stroke + myocardial infarction + repeat intervention). Results: The mean age was 76.3 vs. 80.9 vs. 76 years old, and the mean ejection fraction (EF) was 39.5% vs. 59.8% vs. 39.7% in systolic vs. diastolic vs. mixed HF, respectively. Postoperatively, the diastolic vs. systolic HF group had a higher intensive care unit stay (21 vs. 0 h; HR 67.5 (23.7, 111.4)]; lower ventilation time [2 vs. 2.3 h; HR 49.4 (8.6, 90.2)]; lower EF [38% vs. 58.5%; HR 9.9 (3.7, 16.1)]. In addition, the diastolic vs. mixed HF groups had a lower incidence of EF < 50% (11 vs. 27 patients; HR 6.6 (1.6, 27.3) and a lower use of dialysis (one vs. three patients; HR 18.1 (1.1, 287.3), respectively. At a mean 1.6 years follow-up, all-cause death [HR 39.8 (26.2, 60.5)], MACCEs [HR 50.3 (33.7–75.1)], and new pacemaker implantations [HR 17.3 (8.7, 34.6)] were higher in the mixed group. There was no significant total hospital cost difference among the systolic (USD 106,859) vs. diastolic (USD 91,731) vs. mixed (USD 120,522) HF groups (p = 0.08). Conclusions: TEER for MR evidenced the worst postoperative and follow-up clinical outcomes in the mixed HF group compared to diastolic and systolic HF groups. No total hospital cost differences were observed. [ABSTRACT FROM AUTHOR]

Municipal solid waste (MSW) management poses significant challenges due to the generation of organic waste materials, including the under-sieve fraction (USF), which contains high moisture and organic content. Hydrothermal carbonization (HTC) has emerged as a promising technology for converting USF into hydrochar (HC), a valuable energy-rich material with improved combustible properties. Despite the potential of HTC for waste valorization, comprehensive studies on the thermoecological cost (TEC) and environmental implications of applying HTC to USF are limited. In this study, a detailed analysis of the TEC associated with the HTC process applied to USF from MSW was conducted. The TEC assessment was conducted considering varying dilution ratios (DS/W), operational temperatures (180–220 °C), and reaction times (1–8 h) to evaluate the energy efficiency, resource utilization, and environmental impact of the HTC process. Comparative assessments were made with alternative USF treatment methods, such as bio-stabilization, landfilling, and wastewater treatment. The results indicate that the optimal conditions for minimizing TEC are a temperature of 180 °C, a reaction time of 1 h, and a dilution ratio of 0.15, achieving a TEC value of approximately 9.25 GJ per ton of USF. This represents a significant reduction compared to the conventional treatment methods, which showed a TEC of 14.9 GJ/ton of USF. This study provides a comprehensive comparison of HTC with alternative USF treatment methods, such as bio-stabilization and landfilling, highlighting HTC's superior energy efficiency and environmental sustainability. These findings offer valuable insights into the energy consumption, resource utilization, and environmental impact of HTC, emphasizing its potential for sustainable waste valorization. [ABSTRACT FROM AUTHOR]

In this paper, the reliability characteristics of a parallel system are investigated. The parallel system under consideration is made up of three active units that run in parallel, with two of them having to be operational in order for the system to work. The main purpose of this study is to quantify/examine the effect of online and offline preventive maintenance. Preventive maintenance is carried out on the systems in two ways: online and offline preventive maintenance. After the first unit of each system fails, online preventive maintenance is performed. Following the failure of the second unit of each system, offline preventive maintenance is performed. Partial and complete failures are the two types of failures that may occur. Both systems can undergo exponential failure and repair. Using supplementary variable technique, Laplace transform, and Copula repair approach, the system of first-order differential equations associated with system effectiveness, which are crucial to this research, is established and resolved. Tables and graphs are used to illustrate the important findings based on assumed numerical values. System designers, programmers, and maintenance supervisors will be able to create and maintain more crucial systems with the assistance of this research paper. [ABSTRACT FROM AUTHOR]

Background: Electronic early warning systems have been used in adults for many years to prevent critical deterioration events (CDEs). However, implementation of similar technologies for monitoring children across the entire hospital poses additional challenges. While the concept of such technologies is promising, their cost-effectiveness is not established for use in children. In this study we investigate the potential for direct cost savings arising from the implementation of the DETECT surveillance system. Methods: Data were collected at a tertiary children's hospital in the United Kingdom. We rely on the comparison between patients in the baseline period (March 2018 to February 2019) and patients in the post-intervention period (March 2020 to July 2021). These provided a matched cohort of 19,562 hospital admissions for each group. From these admissions, 324 and 286 CDEs were observed in the baseline and post-intervention period, respectively. Hospital reported costs and Health Related Group (HRG) National Costs were used to estimate overall expenditure associated with CDEs for both groups of patients. Results: Comparing post-intervention with baseline data we found a reduction in the total number of critical care days, driven by an overall reduction in the number of CDEs, however without statistical significance. Using hospital reported costs adjusted for the Covid-19 impact, we estimate a non-significant reduction of total expenditure from £16.0 million to £14.3 million (corresponding to £1.7 million of savings – 11%). Additionally, using HRG average costs, we estimated a non-significant reduction of total expenditure from £8.2 million to £ 7.2 million (corresponding to £1.1 million of savings – 13%). Discussion and conclusion: Unplanned critical care admissions for children not only impose a substantial burden on patients and families but are also costly for hospitals. Interventions aimed at reducing emergency critical care admissions can be crucial to contribute to the reduction of these episodes' costs. Even though cost reductions were identified in our sample, our results do not support the hypothesis that reducing CDEs using technology leads to a significant reduction on hospital costs. Trial registration: Current Controlled Trials ISRCTN61279068, date of registration 07/06/2019, retrospectively registered. [ABSTRACT FROM AUTHOR]

Objective: MR‐guided laser interstitial thermal therapy (LITT) is used increasingly for refractory epilepsy. The goal of this investigation is to directly compare cost and short‐term adverse outcomes for adult refractory epilepsy treated with temporal lobectomy and LITT, as well as to identify risk factors for increased costs and adverse outcomes. Methods: The National Inpatient Sample (NIS) was queried for patients who received LITT between 2012 and 2019. Patients with adult refractory epilepsy were identified. Multivariable mixed‐effects models were used to analyze predictors of cost, length of stay (LOS), and complications. Results: LITT was associated with reduced LOS and overall cost relative to temporal lobectomy, with a statistical trend toward lower incidence of postoperative complications. High‐volume surgical epilepsy centers had lower LOS overall. Longer LOS was a significant driver of increased cost for LITT, and higher comorbidity was associated with non‐routine discharge. Significance: LITT is an affordable alternative to temporal lobectomy for adult refractory epilepsy with an insignificant reduction in inpatient complications. Patients may benefit from expanded access to this treatment modality for both its reduced LOS and lower cost. [ABSTRACT FROM AUTHOR]

This study analyzed the structure and determined the factors affecting the cost of treatment of severe burns patients. The results showed that the average total costs for a patient was 3275.9 USD. The daily cost of hospitalization was 113.3 USD, the treatment cost for 1% burn surface area was 109.5 USD with the highest proportion for medication and consumable medical equipment (43.2%), followed by surgery and procedures (30.2%). The treatment costs increased with increasing age, burn extent and deep burn area (p < .05) and were significantly higher in the group of patients with inhalation injury, electrical burns and in non-survivors (p < .01). Multivariate regression analysis found that burn extent, deep burn area and inhalation injury independently influenced the treatment cost of burn patients. [ABSTRACT FROM AUTHOR]

A bottom-up cost analysis for delivering utility-scale PV-generated electricity as hydrogen through pipelines and as electricity through power is undertaken. Techno-economic, generation, and demand data for California are used to calculate the levelized cost of transmitting (LCOT) energy and the levelized cost of electricity (LCOE) prior to distribution. High-voltage levels of 230 kV and 500 kV and 24-inch and 36-inch pipelines for 100 to 700 miles of transmission are considered. At 100 miles of transmission, the cost of transmission between each medium is comparable. At longer distances, the pipeline scenarios become increasingly cheaper at low utilization levels. The all-electric pathways utilizing battery energy storage systems can meet 95% of the load for as low as 356 USD/MWh, whereas when meeting 100% of load with the hydrogen gas turbine and fuel cell pathways, the costs are 278 and 322 USD/MWh, respectively. [ABSTRACT FROM AUTHOR]

Background: Advanced practice physiotherapy (APP) models of care where physiotherapists are primary contact emergency department (ED) providers are promising models of care to improve access, alleviate physicians' burden, and offer efficient centered patient care for patients with minor musculoskeletal disorders (MSKD). Objectives: To compare the effectiveness of an advanced practice physiotherapist (APPT)-led model of care with usual ED physician care for persons presenting with a minor MSKD, in terms of patient-related outcomes, health care resources utilization, and health care costs. Methods: This trial is a multicenter stepped-wedge cluster randomized controlled trial (RCT) with a cost analysis. Six Canadian EDs (clusters) will be randomized to a treatment sequence where patients will either be managed by an ED APPT or receive usual ED physician care. Seven hundred forty-four adults with a minor MSKD will be recruited. The main outcome measure will be the Brief Pain Inventory Questionnaire. Secondary measures will include validated self-reported disability questionnaires, the EQ-5D-5L, and other health care utilization outcomes such as prescription of imaging tests and medication. Adverse events and re-visits to the ED for the same complaint will also be monitored. Health care costs will be measured from the perspective of the public health care system using time-driven activity-based costing. Outcomes will be collected at inclusion, at ED discharge, and at 4, 12, and 26 weeks following the initial ED visit. Per-protocol and intention-to-treat analyses will be performed using linear mixed models with a random effect for cluster and fixed effect for time. Discussion: MSKD have a significant impact on health care systems. By providing innovative efficient pathways to access care, APP models of care could help relieve pressure in EDs while providing efficient care for adults with MSKD. Trial registration: ClinicalTrials.govNCT05545917. Registered on September 19, 2022 [ABSTRACT FROM AUTHOR]

Garlic is a very significant crop that is grown all over the world, especially in Ethiopia. Garlic is widely used as a clove, for consumption and medicinal purposes. Despite wide use, many problems are not solved in the production system, among which planting technique seems the first. Due to the lack of a garlic planter system farmers still use traditional methods for planting garlic cloves this traditional method is inefficient, tiresome, labour-intensive, and timeconsuming. So by providing planting machines the above problems was eliminated and improve planting efficiency and garlic productivity. The main aim of this study was to design and development of a tractor-drawn multi row garlic planter capable of planting garlic clove. The following method was used, studying physical properties of garlic clove, design all of machine component construction process, laboratory test and cost analysis. The developed tractor drawn garlic planter consists of hopper, feed cup, clove metering mechanism, furrow opener, ground wheel, three-point hitch and furrow covering device. The clove rate for seeds at different hopper filling and they were recorded were 122.86, 116.01 and 111.23 kg respectively. The meter clove were observed average mechanical damage at different hopper filling level (¼ fill, ½ fill and full fill) were 0.803%, 0.91% and 1.124% in of garlic clove respectively. The production cost of garlic planter is $ 854.46. Therefore garlic planting machine can assist the farmers to save time, reduce planting operation cost and prevent drudgery of labour. Creating a good platform for the farmers to adopt and use the garlic planter effectively and efficiently should be considered by the policy makers. [ABSTRACT FROM AUTHOR]

Wind energy is widely deployed and will likely grow in service of reducing the world's dependency on fossil fuels. The first generation of wind turbines are now coming to the end of their service lives, and there are limited options for the reuse or recycling of the composite materials they are made of. Current literature has verified that there is no existing recycling pathway (i.e., mechanical, chemical, thermal methods of recovery, etc.) for end-of-life materials in wind blades that can meet cost parity with landfilling in the US. However, to the authors' knowledge there is no study to date that uncovers the cost structures associated with repurposing wind turbine blades in the US. Repurposing could offer a cost-competitive advantage through displacement of higher-value products, rather than materials or chemical constituents alone. This study implements life cycle assessment (LCA) and life cycle cost analysis (LCC) to assess the environmental and financial implications at each stage of repurposing wind turbine blades as the primary load-carrying elements for high-voltage transmission line structures in the United States. This case study contribution to knowledge is based on the successful management of construction waste by analyzing an application for repurposing construction demolition waste. Specifically, this study presents an environmental and financial analysis of repurposing wind turbine blades as transmission line poles. Under this case study, our results show that BladePoles have lower greenhouse gas emissions than steel poles, and we anticipate BladePoles will be less costly than steel poles. Overall emissions are most sensitive to combustion emissions, driven primarily by transportation distance and hours of required crane operations during the installation process. Compared to other evaluated recycling methods, repurposing wind blades as BladePoles has the least overall global warming potential. As renewable energy production grows, managing infrastructure at its end-of-life is increasingly relevant—for example, wind turbine blades. This case study presents a financial and environmental analysis of repurposing decommissioned wind turbine blades as transmission poles, called BladePoles. This paper presents the cost and associated greenhouse gas emissions at each stage of the process. The case study also compares this reuse application to typical steel pole deployment, finding that for the same 60-year life span and 161 kV, 230 kV, and 345 kV transmission line poles, the BladePole cost is lower than the steel pole. Greenhouse gas emissions are most sensitive to transportation distance from the wind farm to the transmission project and the time of crane use for installation are key parameters in this case study and reducing them directly reduces the total greenhouse emissions overall. [ABSTRACT FROM AUTHOR]

Background: This study investigated the clinical value of adding the sFlt-1/PlGF ratio to the spot urine protein/creatinine ratio (PCr) in women with suspected pre-eclampsia. Methods: This was a prospective cohort study performed in a tertiary referral centre. Based on the combination of PCr (< 30) and sFlt-1/PlGF (≤38) results, four groups were described: a double negative result, group A−/−; a negative PCr and positive sFlt-1/PlGF, group B−/+; a positive PCr and negative sFlt-1/PlGF, group C+/−; and a double positive result, group D+/+. The primary outcome was the proportion of false negatives of the combined tests in comparison with PCr alone in the first week after baseline. Secondary, a cost analysis comparing the costs and savings of adding the sFlt-1/PlGF ratio was performed for different follow-up scenarios. Results: A total of 199 women were included. Pre-eclampsia in the first week was observed in 2 women (2%) in group A−/−, 12 (26%) in group B−/+, 4 (27%) in group C+/−, and 12 (92%) in group D+/+. The proportion of false negatives of 8.2% [95% CI 4.9–13.3] with the PCr alone was significantly reduced to 1.6% [0.4–5.7] by adding a negative sFlt-1/PlGF ratio. Furthermore, the addition of the sFlt-1/PlGF ratio to the spot urine PCr, with telemonitoring of women at risk, could result in a reduction of 41% admissions and 36% outpatient visits, leading to a cost reduction of €46,- per patient. Conclusions: Implementation of the sFlt-1/PlGF ratio in addition to the spot urine PCr, may lead to improved selection of women at low risk and a reduction of hospital care for women with suspected pre-eclampsia. Trial registration: Netherlands Trial Register (NL8308). [ABSTRACT FROM AUTHOR]

Offshore wind farms are great options for addressing the world's energy and climate change challenges, as well as meeting rising energy demand while taking environmental and economic impacts into account. Floating wind turbines, in specific, depict the next horizon in the sustainable renewable energy industry. In this study, a life-cycle cost analysis for floating offshore wind turbines is developed by combining the most recent data and parametric formulas from databases and relevant papers. The cost analysis models focused on cost minimization with special emphasis on Operation and Maintenance Cost (OPEX), Decommissioning Cost (DECOM), and Levelized Cost of Energy (LCOE), which are important factors in wind power economy. Given that floating wind energy is still developing, the presented scenarios should be beneficial in making future decisions. The cost analysis scenarios include on-site and off-site maintenance scenarios for OPEX. In addition, four alternative scenarios for DECOM have been examined: mechanical recycling, mechanical-incineration, incineration processes, and landfill. According to the findings of these scenarios, OPEX varies from 16.89 to 19.93 £/MWh and DECOM between 3.47 and 3.65 £/MWh, whilst the total LCOE varied from 50.67 to 66.73 £/MWh. [ABSTRACT FROM AUTHOR]

Background: Indoor residual spraying (IRS) is one of the most effective malaria control tools. However, its application has become limited to specific contexts due to the increased costs of IRS products and implementation programmes. Selective spraying—selective spray targeted to particular areas/surfaces of dwellings—has been proposed to maintain the malaria control and resistance-management benefits of IRS while decreasing the costs of the intervention. Methods: A literature search was conducted to find (1) studies that assessed the resting behaviour of Anopheles mosquitoes and (2) studies that evaluated the impact of selective spraying on entomological and malaria outcomes. Additional articles were identified through hand searches of all references cited in articles identified through the initial search. A cost model was developed from PMI VectorLink IRS country programmes, and comparative cost analysis reports to describe the overall cost benefits of selective IRS. Results: In some studies, there appeared to be a clear resting preference for certain Anopheles species in terms of the height at which they rested. However, for other species, and particularly the major African malaria vectors, a clear resting pattern was not detected. Furthermore, resting behaviour was not measured in a standardized way. For the selective spray studies that were assessed, there was a wide range of spray configurations, which complicates the comparison of methods. Many of these spray techniques were effective and resulted in reported 25–68% cost savings and reduced use of insecticide. The reported cost savings in the literature do not always consider all of the IRS implementation costs. Using the IRS cost model, these savings ranged from 17 to 29% for programs that targeted Anopheles spp. and 18–41% for programmes that targeted Aedes aegypti. Conclusions: Resting behaviour is generally measured in a simplistic way; noting the resting spot of mosquitoes in the morning. This is likely an oversimplification, and there is a need for better monitoring of resting mosquitoes. This may improve the target surface for selective spray techniques, which could reduce the cost of IRS while maintaining its effectiveness. Reporting of cost savings should be calculated considering the entire implementation costs, and a cost model was provided for future calculations. [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]

Introduction: Preterm birth is a leading cause of under-5 mortality, with the greatest burden in lower-resource settings. Strategies to improve preterm survival have been tested, but strategy costs are less understood. We estimate costs of a highly effective Preterm Birth Initiative (PTBi) intrapartum intervention package (data strengthening, WHO Safe Childbirth Checklist, simulation and team training, quality improvement collaboratives) and active control (data strengthening, Safe Childbirth Checklist). Methods: In our analysis, we estimated costs incremental to current cost of intrapartum care (in 2020 $US) for the PTBi intervention package and active control in Kenya and Uganda. We costed the intervention package and control in two scenarios: 1) non-research implementation costs as observed in the PTBi study (Scenario 1, mix of public and private inputs), and 2) hypothetical costs for a model of implementation into Ministry of Health programming (Scenario 2, mostly public inputs). Using a healthcare system perspective, we employed micro-costing of personnel, supplies, physical space, and travel, including 3 sequential phases: program planning/adaptation (9 months); high-intensity implementation (15 months); lower-intensity maintenance (annual). One-way sensitivity analyses explored the effects of uncertainty in Scenario 2. Results: Scenario 1 PTBi package total costs were $1.11M in Kenya ($48.13/birth) and $0.74M in Uganda ($17.19/birtth). Scenario 2 total costs were $0.86M in Kenya ($23.91/birth) and $0.28M in Uganda ($5.47/birth); annual maintenance phase costs per birth were $16.36 in Kenya and $3.47 in Uganda. In each scenario and country, personnel made up at least 72% of total PTBi package costs. Total Scenario 2 costs in Uganda were consistently one-third those of Kenya, largely driven by differences in facility delivery volume and personnel salaries. Conclusions: If taken up and implemented, the PTBi package has the potential to save preterm lives, with potential steady-state (maintenance) costs that would be roughly 5–15% of total per-birth healthcare costs in Uganda and Kenya. [ABSTRACT FROM AUTHOR]

Research on collaborative manufacturing process modelling and simulation is of great significance in improving production efficiency and product quality, reducing costs, promoting collaborative work, and supporting decision-making. However, current studies have not offered the optimal costs of node enterprises participating in collaborative manufacturing, and ignored the impact of demand uncertainty of suppliers, manufacturers and customers on costs and economic benefits. Therefore, this paper aimed to study the collaborative manufacturing process modelling and simulation of production cost and economic benefit accounting analysis. First, this paper summarized three cost types, conducted cost accounting for the collaborative manufacturing process, and analysed its economic benefits. Second, based on the basic timed automata (TA) model, this paper used a timed input/output automata with port labels (Lp-TIOA) for modelling test cases of the simulation system. Finally, the experimental results verified the effectiveness of the constructed simulation model. [ABSTRACT FROM AUTHOR]

Background: Although breastfeeding is recommended as the optimal form of nutrition in the first six months, it is not sustained as the predominant mode of feeding infants in Scotland. This study estimated the impact of infant feeding choices on primary and secondary healthcare service costs in a 13-year birth cohort. Method: Using linked administrative datasets, in a retrospective cohort design of 502,948 singletons born in Scotland between 1997 and 2009, we estimated the cost of GP consultations and hospital admissions by area deprivation and mode of infant feeding up to 6–8 weeks for ten common childhood conditions from birth to 27 months. Additionally, we calculated the potential healthcare savings if all infants in the cohort had been exclusively breastfed at 6–8 weeks. Discounting of 1.5% was applied following current health economic conventions and 2009/10 used as the base year. Results: Over the study period, the estimated cost of hospital admissions in the cohort was £111 million and £2 million for the 2% subset of the cohort with primary care records. Within each quintile of deprivation, exclusively breastfed infants used fewer healthcare services and incurred lower costs compared to infants fed (any) formula milk. At least £10 million of healthcare costs may have been avoided if formula-fed infants had been exclusively breastfed within the first 6–8 weeks of birth. Conclusions: This study using a representative birth cohort demonstrates how breastmilk can promote equitable child health by reducing childhood illness and healthcare utilisation in the early years. [ABSTRACT FROM AUTHOR]

In this trial, the effects of early qualitative feed restriction and barrier perch access on some meat quality traits, growth performance, and diet cost analysis of broiler chickens were investigated. A total of 504 1-d-old male chicks (Ross 308) were randomly allocated to four treatments (qualitative feed restriction − QFR; absence-/presence+ and barrier perch − BP; absence-/presence+) with three replicate pens in a completely randomised design involving a 2 × 2 factorial arrangement of treatments. Broiler chickens in the treatment of QFR- were fed with a corn-soybean meal diet containing protein and energy at the level specified in the commercial hybrid catalogue during d 0−42. The treatment of QFR+ was fed with a corn-soybean meal diet containing lower energy (10%) and protein (20%) for the first 21 d, and then between d 22 and 42, they were fed with a diet specified in the commercial hybrid catalogue. In the treatment of BP+, the barrier perch was placed between the feeder and the drinker. Meat quality traits (pH, lightness − L*, redness − a*, yellowness − b*, chroma, hue angle, and cooking loss − CL), growth performance (body weight − BW, body weight gain − BWG, feed intake − FI, and feed conversion ratio − FCR), and diet cost analysis (total diet cost and diet cost per unit weight gain) were recorded. Except for the a* value and hue angle measured at 24-h post-slaughter, the effect of QFR treatments on meat quality traits was insignificant in all measurements. During d 0−42, in the treatments of QFR+, BW, BWG, and FI were lower (P<0.0001, and P=0.005, respectively), and FCR was worse (P=0.014). The QFR treatments did not differ significantly in dietary cost per unit weight gained during d 0−42. As a result, it can be said that early qualitative feed restriction did not significantly affect meat quality traits. The treatment of QFR+ resulted in reduced growth performance. However, diet cost per unit weight gain showed similar values in both QFR treatments (QFR+ €0.75, QFR- €0.76, P=0.511). [ABSTRACT FROM AUTHOR]

Objectives: Open surgical tracheostomy (OST) is a common procedure performed on intensive care unit (ICU) patients. The procedure can be performed bedside in the ICU (bedside open surgical tracheostomy, BeOST) or in the operating room (operating room open surgical tracheostomy, OROST), with comparable safety and long-term complication rates. We aimed to perform a cost analysis and evaluate the use of human resources and the total time used for both BeOSTs and OROSTs. Methods: All OSTs performed in 2017 at 5 different ICUs at Oslo University Hospital Ullevål were retrospectively evaluated. The salaries of the personnel involved in the 2 procedures were obtained from the hospital's finance department. The time taken and the number of procedures performed were extracted from annual reports and from the electronic patient record system, and the annual expenditures were calculated. Results: Altogether, 142 OSTs were performed, of which 122 (86%) and 20 (14%) were BeOSTs and OROSTs, respectively. A BeOST cost 343 EUR (95% CI: 241.4-444.6) less than an OROST. Bedside open surgical tracheostomies resulted in an annual cost efficiency of 41.818 EUR. In addition, BeOSTs freed 279 hours of operating room occupancy during the study year. Choosing BeOST instead of OROST made 1 nurse, 2 surgical nurses, and 1 anesthetic nurse redundant. Conclusion: Bedside open surgical tracheostomy appears to be cost-, time-, and resource-effective than OROST. In the absence of contraindications, BeOSTs should be performed in ICU patients whenever possible. [ABSTRACT FROM AUTHOR]

The Preventive Controls for Human Food Rule regulation under the Food Safety Modernization Act sets new food safety standards. Both food safety educators and small and medium sized food processing businesses that manufacture certain value-added or processed foods lack knowledge regarding costs to prepare, implement, and manage ongoing food safety practices under the new standards. Current food safety training materials do not acknowledge costs or provide content addressing potential costs, and food safety educators do not have information needed to guide development of relevant materials that address costs. We combine economics and food science principles and use mixed methods to identify and estimate cost barriers for food processing businesses through an interdisciplinary research and extension project in the Northeast U.S. We first modify Preventive Controls extension programming to acknowledge costs and test how modified programming improves self-reported knowledge about costs. Materials that acknowledge that costs are associated with meeting standards significantly increases participants' self-reported perceived knowledge of costs by 1.3 points on a 1-to-5-point Likert scale. Compared with programming areas in which detailed content is provided, however, improvements in knowledge of costs lags behind overall knowledge gains (3.2 for costs versus 4.1 for food safety content). To fill this content gap, we next conduct semi-structured group interviews with a subset of participants (N = 10), develop a costs analysis framework, and measure actual costs associated with Preventive Controls. We find that initial costs average $20,000 per business to plan, implement, and manage standards, and almost $8,000 in every subsequent year to manage. We demonstrate that even modest interventions can reduce cost barriers for businesses seeking to meet compliance standards. We provide food safety educators with concrete cost information to support businesses to pursue Preventive Controls standards. Study results imply that low-cost methods could improve food safety in mid-scale supply chains. [ABSTRACT FROM AUTHOR]

The ongoing expansion of wolf (Canis lupus) populations in Europe has led to a growing demand for up‐to‐date abundance estimates. Non‐invasive genetic sampling (NGS) is now widely used to monitor wolves, as it allows individual identification and abundance estimation without physically capturing individuals. However, NGS is resource‐intensive, partly due to the elusive behaviour and wide distribution of wolves, as well as the cost of DNA analyses. Optimisation of sampling strategies is therefore a requirement for the long‐term sustainability of wolf monitoring programs. Using data from the 2020–2021 Italian Alpine wolf monitoring, we investigate how (i) reducing the number of samples genotyped, (ii) reducing the number of transects, and (iii) reducing the number of repetitions of each search transect impacted spatial capture‐recapture population size estimates. Our study revealed that a 25% reduction in the number of transects or, alternatively, a 50% reduction in the maximum number of repetitions yielded abundance estimates comparable to those obtained using the entire dataset. These modifications would result in a 2046 km reduction in total transect length and 19,628 km reduction in total distance searched. Further reducing the number of transects resulted in up to 15% lower and up to 17% less precise abundance estimates. Reducing only the number of genotyped samples led to higher (5%) and less precise (20%) abundance estimates. Randomly subsampling genotyped samples reduced the number of detections per individual, whereas subsampling search transects resulted in a less pronounced decrease in both the total number of detections and individuals detected. Our work shows how it is possible to optimise wolf monitoring by reducing search effort while maintaining the quality of abundance estimates, by adopting a modelling framework that uses a first survey dataset. We further provide general guidelines on how to optimise sampling effort when using spatial capture‐recapture in large‐scale monitoring programmes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs. MATERIALS AND METHODS: Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range). RESULTS: Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593-3104) and for non-NLEM was INR 5343 (2964-14364). It was INR 806 (243-2132) for generic and INR 3809 (1968-14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5-22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins (P < 0.0001). CONCLUSION: The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines. [ABSTRACT FROM AUTHOR]

Introduction: Neuropathic pain is prevalent among people after lower limb fracture surgery and is associated with lower health-related quality of life and greater disability. This study estimates the financial cost and pain medication use associated with neuropathic pain in this group. Methods: A secondary analysis using pain data collected over six postoperative months from participants randomised in the Wound Healing in Surgery for Trauma (WHiST) trial. Pain states were classified as pain-free, chronic non-neuropathic pain (NNP) or chronic neuropathic pain (NP). Cost associated with each pain state from a UK National Health Service (NHS) and personal social services (PSS) perspective were estimated by multivariate models based on multiple imputed data. Pain medication usage was analysed by pain state. Results: A total of 934 participants who provided either 3- or 6-months pain data were included. Compared to participants with NP, those with NNP (adjusted mean difference -£730, p = 0.38, 95% CI −2368 to 908) or were pain-free (adjusted mean difference -£716, p = 0.53, 95% CI −2929 to 1497) had lower costs from the NHS and PSS perspective in the first three postoperative months. Over the first three postoperative months, almost a third of participants with NP were prescribed opioids and 8% were prescribed NP medications. Similar trends were observed by 6 months postoperatively. Conclusion: This study found healthcare costs were higher amongst those with chronic NP compared to those who were pain-free or had chronic NNP. Opioids, rather than neuropathic pain medications, were commonly prescribed for NP over the first six postoperative months, contrary to clinical guidelines. [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]

The superior mechanical characteristics of ultra-high-performance concrete (UHPC) have attracted the interest of many researchers worldwide. Researchers have attempted to perform comparative analyses on the behavior of UHPC versus conventional and high-strength concrete, with their aim being to gain more insights into the difference between different types of concrete. However, the current state-of-the-art revealed no direct comprehensive comparisons between their behaviors in ductile coupled shear walls under seismic loading. This paper explores a comprehensive side-by-side comparison in terms of seismic behavior and cost analysis for four 60-story archetype buildings. The reference building was designed using high-strength concrete with a strength of 60 MPa. The other three archetype variations incorporated three different UHPC grades: 150 MPa, 185 MPa, and 220 MPa. The plan configuration and the lateral force-resisting system (LFRS) were chosen according to the most common practice in the UAE. The main objective is to report the effect of UHPC on the LFRS (ductile coupled shear walls). Moreover, a simplified initial cost analysis (materials and labor) design was performed. The findings of this paper indicate that the use of UHPC is capable of improving the seismic performance behavior of the lateral system as well as reducing the total initial costs. [ABSTRACT FROM AUTHOR]