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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]

Wastewater reuse is a proven strategy to mitigate water stress in drought-prone regions. However, this practice is still limited due to high implementation costs, regulatory hurdles, and limited public acceptance. In regions with low reclaim rates, a thorough evaluation of the potential for reuse is needed to support decision-making, focusing on opportunities that address both low-hanging fruit and high-leverage projects. This paper introduces a streamlined, data-centric methodology for assessing wastewater reuse potential, adaptable to various regional contexts. The methodology involves comprehensive data collection and processing to evaluate wastewater treatment plant (WWTP) capabilities and identify potential users, allowing the prioritisation of case studies based on demand alignment. Different treatment and distribution systems are analysed to match WWTP capabilities with user needs, considering volume, quality, and infrastructure requirements. Cost analysis incorporates capital expenditure (CAPEX), operational expenditure (OPEX) and unit costs using novel cost functions for treatment and distribution. Risk analysis adheres to WHO methodology to ensure safety and sustainability. A case study in the Lisbon and Oeste areas in Portugal validates this approach, revealing key insights into the potential and economic viability of water reuse. By comparing tariffs and costs associated with different reuse scenarios, this paper offers benchmarks for the economic feasibility of reuse projects. [ABSTRACT FROM AUTHOR]

Gait dysfunction (GD) is a common impairment of Parkinson's disease (PD), which negatively impacts patients' quality of life. Among the most recent rehabilitation technologies, a lower-limb powered exoskeleton (LLEXO) arises as a useful instrument for gait training in several neurological conditions, including PD. However, some questions relating to methods of use, achievable results, and usefulness compared to traditional rehabilitation methodologies still require clear answers. Therefore, in this review, we aim to summarise and analyse all the studies that have applied an LLEXO to train gait in PD patients. Literature research on PubMed and Scopus retrieved five articles, comprising 46 PD participants stable on medications (age: 71.7 ± 3.7 years, 24 males, Hoehn and Yahr: 2.1 ± 0.6). Compared to traditional rehabilitation, low-profile lower-limb exoskeleton (lp-LLEXO) training brought major improvements towards walking capacity and gait speed, while there are no clear major benefits regarding the dual-task gait cost index and freezing of gait symptoms. Importantly, the results suggest that lp-LLEXO training is more beneficial for patients with an intermediate-to-severe level of disease severity (Hoehn and Yahr > 2.5). This review could provide a novel framework for implementing LLEXO in clinical practise, highlighting its benefits and limitations towards gait training. [ABSTRACT FROM AUTHOR]

There is a large disparity in Pre-exposure Prophylaxis (PrEP) utilization among communities of color compared to White Americans. There is also a lack of theory-based survey instruments to measure the underlying reasons for the disparity among communities of color. The purpose of this study was to create an instrument based on a qualitative approach involving community interviews. Semi-structured interviews guided by the Multi-theory Model (MTM) of health behavior change were performed in a sample of 12 members from communities of color. The analysis entailed a directed content analysis along the themes of MTM constructs to develop a survey instrument. The barriers to PrEP that emerged included the cost of PrEP, lack of protection from other sexually transmitted diseases, reduced trust between partners, and the stigma associated with PrEP. The perceived disadvantages included the potential cost of PrEP, partner mistrust when taking PrEP, discussion of sexual behaviors with a provider, and unclear process of acquiring the PrEP prescription. The results guided the development of a survey tool to further investigate aspects of cost, partner relations, stigma, reassurance of safety, and other factors. The tool can be used for future studies as part of guided interventions to increase PrEP uptake. [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]

Many manufacturing firms face considerable difficulties in building export capacity and selling their products in international markets. These firms often struggle with unpredictable cost changes, logistical problems along the supply chain, and rising labor expenses that could threaten the competitive edge of manufacturing operations. As there is also a clear absence of practical export models tailored to the unique needs of industrial firms, our study aims to offer a more holistic approach to assessing the impact of cost components on enhancing export-oriented production capacity (EOPC), a perspective not comprehensively provided by the comparative advantage theory, the Heckscher–Ohlin model, or the resource-based theory. While offering a comprehensive analysis of cost components in production, we argue that adjusting the resources, managing the costs, and enhancing production efficiency can significantly improve the EOPC of the manufacturing firms. Using primary data collected from 200 manufacturing firms in Oman during the period 2012–2016, multiple regression analysis followed by descriptive statistical analysis together with a correlation matrix indicates strong positive relationships between the EOPC and factors such as the raw material cost (RMC), labor wages (LW), labor force (LF), and R&D costs (RND). Multicollinearity assessment shows VIF values below the threshold, suggesting reliable estimates. Interaction terms and market conditions were integrated into the model, enhancing its predictive accuracy. Preliminary multiple regression analysis confirms the significant impact of the RMC, LW, LF, and R&D on the EOPC, while highlighting the importance of market conditions in moderating these effects. The model's adjusted R2 value indicates a strong fit, showing that the independent variables account for a substantial proportion of the variance in the EOPC. Each variable's importance is reflected in its coefficient, while p-values assess the statistical significance, highlighting which factors are crucial for enhancing export capabilities. Specifically, low p-values for cost components, labor force size, and wages confirm their significant influence, and varying market conditions further modulate these effects, demonstrating the accurate interplay between internal and external factors. Adjustments in cost components under varying market scenarios were analyzed, indicating optimal strategies for increasing the EOPC. Of the five scenarios proposed to distribute the cost either among some variables while keeping others constant or among all the factors, the best-case scenario adjusted all variables together, resulting in a 20% increment in exports. We conclude with some practical and policy implications for governments to support industries in accessing cheap resources through tax reductions on imported raw materials and efficient supply chains, while promoting innovation, technology adoption, and R&D investment at the firm level. [ABSTRACT FROM AUTHOR]

Five different biomass wastes—orange peel, coffee grounds, cork, almond shell, and peanut shell—were transformed into biochars (BCs) or activated carbons (ACs) to serve as adsorbents and/or ozone catalysts for the removal of recalcitrant water treatment products. Oxalic acid (OXL) was used as a model pollutant due to its known refractory character towards ozone. The obtained materials were characterized by different techniques, namely thermogravimetric analysis, specific surface area measurement by nitrogen adsorption, and elemental analysis. In adsorption experiments, BCs generally outperformed ACs, except for cork-derived materials. Orange peel BC revealed the highest adsorption capacity (Qe = 40 mg g−1), while almond shell BC showed the best cost–benefit ratio at €0.0096 per mg of OXL adsorbed. In terms of catalytic ozonation, only ACs made from cork and coffee grounds presented significant catalytic activity, achieving pollutant removal rates of 72 and 64%, respectively. Among these materials, ACs made from coffee grounds reveal the best cost/benefit ratio with €0.02 per mg of OXL degraded. Despite the cost analysis showing that these materials are not the cheapest options, other aspects rather than the price alone must be considered in the decision-making process for implementation. This study highlights the promising role of biomass wastes as precursors for efficient and eco-friendly water treatment processes, whether as adsorbents following ozone water treatment or as catalysts in the ozonation reaction itself. [ABSTRACT FROM AUTHOR]

This study addresses the critical global challenge of climate adaptation by assessing the inadequacies in current methodologies for estimating adaptation costs. Broad assessments reveal a significant investment shortfall in adaptation strategies, highlighting the necessity for precise cost analysis to guide effective policy-making. By employing the PRISMA 2020 protocol and enhancing it with the prismAId tool, this review systematically analyzes the recent evolution of cost assessment methodologies using state-of-the-art generative AI. The AI-enhanced approach facilitates rapid and replicable research extensions. The analysis reveals a significant geographical and sectoral disparity in research on climate adaptation costs, with notable underrepresentation of crucial areas and sectors that are most vulnerable to climate impacts. The study also highlights a predominant reliance on secondary data and a lack of comprehensive uncertainty quantification in economic assessments, suggesting an urgent need for methodological enhancements. It concludes that extending analyses beyond merely verifying that benefits exceed costs is crucial for supporting effective climate adaptation. By assessing the profitability of adaptation investments, it becomes possible to prioritize these investments not only against similar interventions but also across the broader spectrum of public spending. [ABSTRACT FROM AUTHOR]

The selection of an appropriate construction method stands as a pivotal decision in ensuring the success of any building project. This paper undertakes a comprehensive comparative analysis of cost and timeline implications between the top-down and bottom-up construction methodologies. The research focuses on ten distinct underground structure models, each characterized by varying depths and base areas. Through rigorous design and analysis, the cost and projected duration for each model are meticulously evaluated under the lens of both top-down and bottom-up construction techniques. The findings reveal that while the bottom-up approach emerges as the most cost-effective alternative at a depth of 8 m, the top-down method exhibits superior cost efficiency with increasing depth. Interestingly, alterations in the structure's base area exert a minimal influence on the cost differentials between the two methodologies. Moreover, the top-down construction method consistently outshines its counterpart in terms of project duration across all ten models examined, with the percentage increase in base area yielding insignificant impacts on project timeline discrepancies. This study furnishes construction project managers with invaluable insights to navigate the complexities of method selection. By judiciously considering parameters such as project scale, depth, and base area, managers can strategically optimize both cost and timeline outcomes, thereby facilitating the seamless execution of construction projects. [ABSTRACT FROM AUTHOR]

This research envisages a system composed of three subsystems connected in series. Each subsystem comprises three units connected in parallel. For the system to function, at least one unit per subsystem must remain operational. Unit failure is governed by an exponential distribution, while unit repair is governed by either a general distribution or a Gumbel–Hougaard family copula distribution. The primary goal of this research is to compare the overall performance of our system under these two different regimes for performing repairs. Laplace transforms and supplementary variable methods are employed in solving the system. Our metrics for evaluating system performance are the availability, reliability, mean time to failure, and cost. The second goal of this research is to showcase a strategy for reduction that enhances the overall efficiency and availability of our system. [ABSTRACT FROM AUTHOR]

Wastewater pollution is severe, with various refractory compounds extensively used and discharged into sewage, posing risks to the environment and human health. Electrocatalytic technologies including direct and indirect electrocatalytic oxidation, electrocatalytic reduction, and electro-Fenton processes offer advantages such as high efficiency, ease of control, and minimal secondary pollution. This review aims to systematically introduce the principles, current research status, advantages, and disadvantages of various electrocatalytic processes used for wastewater treatment, with a focus on the electrode materials, operational parameters, and cost analysis of various electrocatalytic technologies. It also provides new insights into efficient electrode materials for future electrocatalytic technologies in treating refractory wastewater. [ABSTRACT FROM AUTHOR]

The major problems related to environmental pollution are increasingly present among us. The uncontrolled use and incorrect disposal of products means that these problems are increasing at frightening rates. In this context, a major related problem is the incorrect disposal of dishwasher sponges that are no longer useful; their material being made up of petroleum derivatives causes this problem to be leveraged in the environment. In the present work, we evaluated and carried out tests in which these dirty sponges that would be discarded were used for the purpose of developing new sustainable adsorbent materials. These materials were washed and dried, crushed and made available for use, by which they were kept in contact with a paracetamol solution, evaluating the effect of mass, pH, kinetics, equilibrium, thermodynamic parameters, and cost analyses. The results demonstrated an adsorptive capacity of approximately 40 mg g−1 and its cost was relatively viable, since this material would otherwise be discarded incorrectly. In conclusion, this material achieved the good removal of this studied contaminant and became an economical, viable, and ecologically viable material. [ABSTRACT FROM AUTHOR]

In the early stages of developing wave energy converter (WEC) projects, a quantitative assessment of component failure consequence costs is essential. The WEC types, deployment site features, and accessibility should all be carefully considered. This study introduces an operation and maintenance failure consequence cost (O&M-FC) model, distinct from conventional O&M models. The model is illustrated with case studies at three energetic Atlantic sites, each of which considers two types of generic floating WECs: a 300 kW point absorber (PA) with a hydraulic power-take-off (PTO) and a 1000 kW oscillating water column (OWC) with an air-wells-turbine PTO. This study compares 39 failure modes for PA and 27 for OWC in terms of direct repair costs and indirect lost production costs, examining the impact of location accessibility, capacity factors, and the mean annual energy production. The discussion revolves around the sensitive parameters. Recommendations for failure mitigations are presented, and the impact of planned maintenance (PM) during the operational phase is examined for 20 MW PA and OWC WEC projects. For a given WEC type, the method thoroughly evaluates how the location affects performance metrics. It offers a decision-making tool for determining optimal PM intervals to meet targets such as O&M costs, operating profit, or availability. [ABSTRACT FROM AUTHOR]

Microbial keratitis (MK) is the fourth leading cause of blindness globally, imposing a substantial burden on the healthcare system. This study aims to determine the cost composition of MK patients and explore factors influencing these expenses. We analyzed the demographics, clinical features, and costs of 602 MK patients treated at Beijing Tongren Hospital from June 2021 to October 2023. The analysis revealed the average total cost of treating MK was USD 1646.8, with a median of USD 550.3 (IQR: 333.3–1239.1). Patients with Acanthamoeba keratitis (AK) incurred the highest median total costs at USD 706.2 (IQR: 399.2–3370.2). Additionally, AK patients faced the highest costs for ophthalmic exams and laboratory tests (both p < 0.001), while patients with fungal keratitis (FK) and viral keratitis (VK) experienced higher medication costs. Costs varied significantly with the severity of MK, especially for outpatients at severity level 4, which was markedly higher than levels 1–3 (USD 1520.1 vs. USD 401.0, p < 0.001). Delayed presentation also resulted in increased costs (USD 385.2 vs. USD 600.3, p < 0.001). Our study highlights the financial burden associated with MK treatment and underscores the importance of timely and accurate diagnosis and intervention. [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]

Aging is an imperative issue in Korean society, and a healthy life is important for a better quality of life for older adults. Therefore, the purpose of this research was to investigate the determinants of subjective health and depression in middle-aged and elderly Korean individuals. This study used three attributes as the determinants of subjective health and depression, including the curve linear effect of medical expenses and eating-out expenses and the linear impact of regular exercise. We utilized the Korean Longitudinal Study of Aging (KLOSA) to determine the associations between five attributes: subjective health, depression, medical expenses, eating-out expenses, and regular exercise. Research panel data were employed as the data source. The study period was between 2018 and 2020. This research implemented various multiple linear panel regression econometric analysis instruments: ordinary least squares, random effects, and fixed effects. The mean age of survey participants was 72.10 years, and 35 percent of participants were female. The number of observations for data analysis was 7197. The results revealed that medical and eating-out expenses had a curved linear effect on subjective health and depression. Moreover, regular exercise positively affected subjective health and resulted in less depression. These findings may inform policy decisions that promote regular exercise and manage medical and eating-out expenses, thereby enhancing subjective health and mitigating depression. [ABSTRACT FROM AUTHOR]

Severe acute malnutrition (SAM) is a high-fatality condition that affected 13.7 million children under five years of age worldwide in 2022, with complicated cases requiring extensive inpatient stay with an accompanying caregiver. Our objective was to assess the costs of inpatient treatment for complicated SAM in children aged 6 to 59 months in Northern Senegal and identify cost predictors. We performed a retrospective cost analysis, including 140 children hospitalized from January to December 2020 in five SAM inpatient treatment facilities. We adopted a societal perspective, including direct medical and non-medical costs and indirect costs. We extracted patients' sociodemographic and clinical data from medical records and conducted semi-structured interviews with healthcare staff to capture information on time allocation and care management. A multivariable generalized linear model with gamma family and a log link was used to investigate the factors associated with direct costs. Costs are expressed in 2020 international USD using purchasing power parity. Mean length of stay was 5.3 (SD = 3.2) days and diarrhoea was the cause of the admission in 55.7% of cases. Mean total cost was USD 431.9 (SD = 203.9), with personnel being the largest cost item (33% of the total). Households' out-of-pocket expenses represented 45.3% of total costs and amounted to USD 195.6 (SD = 103.6). Costs were significantly associated with gender (20.3% lower in boys), diarrhoea (27% increase), anaemia (49.4% increase), inpatient death (44.9% decrease), and type of facility (26% higher in hospitals vs. health centre). Our study highlights the financial burden of complicated SAM in Senegal in particular for families. This underscores the need for tailored prevention and social policies to protect families from the disease's financial burden and improve treatment adherence, both in Senegal and similar contexts. [ABSTRACT FROM AUTHOR]

(1) Background: Antibiotic surveillance data are crucial to map out strategies to promote their optimal use at hospital and community levels. We conducted a comprehensive analysis of longitudinal trends in antibiotic consumption over 7 years at a core "National Antimicrobial Consumption Network" site in North India. (2) Methods: In-patient antibiotic consumption data (2017–2023) were obtained from the hospital's central drug store and organised as follows: defined daily dose per 100 bed-days; antibiotic consumption as per the WHO access, watch and reserve classification; trends in overall and different antibiotic classes' consumption; paediatric formulations of antibiotics; and hospital's annual expenditure on antibiotics. (3) Results: During the 7-year study period, no significant trend could be observed in the overall antibiotic consumption (average annual percent change, AAPC: 9.22; 95% CI: −16.46, 34.9) and cost (AAPC: 13.55; −13.2, 40.3). There was a higher proportion of the consumption of antibiotics in the "reserve" group from 2021 onwards compared to previous years, but the overall trend over 7 years was not significant (AAPC: 319.75; −137.6, 777.1). Antibiotic combinations, classified under the WHO "not recommended" category, comprised a significant proportion of antibiotics consumed. A remarkably increased consumption of azithromycin and doxycycline was recorded during 2020 and 2021, coinciding with the COVID-19 pandemic. (4) Conclusions: Some recommendations to optimise antibiotic use are promoting the use of narrow spectrum "access" group agents; linking antimicrobial resistance and consumption data to formulate effective therapeutic and prophylactic antibiotic use guidelines; and the adoption of restrictive antibiotic policy. [ABSTRACT FROM AUTHOR]

Korean medicine (KM) is used to treat anxiety disorders, but there is limited research on its effects. This study aimed to examine the associations between improved QoL and reduced clinical symptoms and KM in patients with anxiety disorders. The medical records of patients with anxiety who were treated with KM (acupuncture, psychotherapy, Chuna therapy, aromatherapy, or herbal medicine) for at least 4 weeks were retrospectively analyzed. Clinical, QoL, and cost outcomes were measured at baseline and at weeks 4 and 12 (Anxiety: State-Trait Anxiety Inventory [STAI X-1 (state), X-2 (trait)], Beck Anxiety Inventory [BAI]; anger: State-Trait Anger Expression Inventory State [STAXI-S (state), T (trait)], Anger Expression Inventory [AXI-K-I (anger-in), AXI-K-O (anger-out), AXI-K-C (anger-control); depression: Beck Depression Inventory-II [BDI II], QoL: QoL-related instruments Euro Quality of Life 5 Dimensions utility score [EQ-5D], Euro QoL Visual Analog Scale [EQ-VAS]). The total costs for each item were calculated in terms of NHIS-covered costs and patients' out-of-pocket costs from the perspective of the healthcare system. The medical records of 67 patients were evaluated. The KM treatments were found to be associated with decreased anxiety (STAI X-1; STAI X-2; BAI, p < 0.0001), depression (BDI-II, p < 0.0001), and anger (AKI-K-I; AKI-K-O, p < 0.05) and increased QoL (EQ-5D; EQ-VAS, p < 0.0001). An average of USD 1360 was paid for the KM treatments for 4 weeks. The study findings suggested that KM may improve clinical symptoms and QoL outcomes in patients with anxiety disorders. [ABSTRACT FROM AUTHOR]

Ensuring accountability and integrity in MQTT communications is important for enabling several IoT applications. This paper presents a novel approach that combines blockchain technology and the interplanetary file system (IPFS) to achieve non-repudiation and data integrity in the MQTT protocol. Our solution operates in discrete temporal rounds, during which the broker constructs a Merkle hash tree (MHT) from the messages received. Then the broker publishes the root on the blockchain and the MHT itself on IPFS. This mechanism guarantees that both publishers and subscribers can verify the integrity of the message exchanged. Furthermore, the interactions with the blockchain made by the publishers and the broker ensure they cannot deny having sent the exchanged messages. We provide a detailed security analysis, showing that under standard assumptions, the proposed solution achieves both data integrity and accountability. Additionally, we provided an experimental campaign to study the scalability and the throughput of the system. Our results show that our solution scales well with the number of clients. Furthermore, from our results, it emerges that the throughput reduction depends on the integrity check operations. However, since the frequency of these checks can be freely chosen, we can set it so that the throughput reduction is negligible. Finally, we provided a detailed analysis of the costs of our solution showing that, overall, the execution costs are relatively low, especially given the critical security and accountability benefits it guarantees. Furthermore, our analysis shows that the higher the number of subscribers in the system, the lower the costs per client in our solution. Again, this confirms that our solution does not present any scalability issues. [ABSTRACT FROM AUTHOR]

Construction projects are complexity, multidisciplinary, have thousands of activities and details, and involve many participants. This intricate and fragmented nature of construction projects coupled with tight budgets and limited resources makes them good candidates for failure and promotes the emergence of risks. These risks must be addressed in the decision-making process and properly managed to mitigate their effect. However, risk management is one of the most difficult tasks and the assessment and analysis of the cost and schedule risks of construction activities are considered the most challenging tasks in the whole risk management process and require careful considerations throughout the life cycle of a project. Despite the high cost associated with managing risk in construction projects, the outcome of this task normally provides fruitful benefits. To address this crucial issue, this study employs a mixed methodology approach utilizing both qualitative and quantitative methods to gather feedback from construction experts and identify schedule and cost risk events associated with construction activities, prioritize their likelihood of occurrence, and suggest responses to mitigate them. The Program Evaluation and Review Technique (PERT) and earned value (EV) analysis are then used to estimate the expected cost at completion and the risk associated with it. A spreadsheet framework is then developed to help construction practitioners identify the most severe risks and measure their effect on the project's duration and cost. The framework also suggests risk responses for each of the risk events. The study then provides recommendations to mitigate risks with high impact and severity. [ABSTRACT FROM AUTHOR]

This work presents an innovative application of optimal control theory to the strategic scheduling of battery storage in the day-ahead electricity market, focusing on enhancing profitability while factoring in battery degradation. This study incorporates the effects of battery degradation on the dynamics in the optimisation framework. Considering this cost in economic analysis and operational strategies is essential to optimise long-term performance and economic viability. Neglecting degradation costs can lead to suboptimal operation and dispatch strategies. We employ a continuous-time representation of the dynamics, in contrast with many other studies that use a discrete-time approximation with rather coarse intervals. We adopt an equivalent circuit model coupled with empirical degradation parameters to simulate a battery cell's behaviour and degradation mechanisms with good support from experimental data. Utilising direct collocation methods with mesh refinement allows for precise numerical solutions to the complex, nonlinear dynamics involved. Through a detailed case study of Belgium's day-ahead electricity market, we determine the optimal charging and discharging schedules under varying objectives: maximising net revenues, maximising profits considering capacity degradation, and maximising profits considering both capacity degradation and internal resistance increase due to degradation. The results demonstrate the viability of our approach and underscore the significance of integrating degradation costs into the market strategy for battery operators, alongside its effects on the battery's dynamic behaviour. Our methodology extends previous work by offering a more comprehensive model that empirically captures the intricacies of battery degradation, including a fine and adaptive time domain representation, focusing on the day-ahead market, and utilising accurate direct methods for optimal control. This paper concludes with insights into the potential of optimal control applications in energy markets and suggestions for future research avenues. [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]

This paper presents a new layered plaster-based material for building purposes. First, a new manufacturing machine was designed to make the elaboration process easier. This manufacturing machine and the way it works are described. In this study, perlite and recycled glass wool (RGW) were added to traditional plaster with the aim of improving the performance of this material. Two series (with and without perlite) and three different layer configurations were developed and assessed. Recycled glass wool layered materials were subjected to both physical and mechanical characterisation to determine their suitability for precast elaboration. The addition of perlite resulted in a significant improvement in flexural strength. Moreover, the addition of RGW also gave rise to extra flexural strength when added. The two-layered samples performed better than the one-layered samples. Mechanical properties increased up to 75% when both the perlite and RGW layers were added. Potential Global Warming Potential (GWP 100) savings were also analysed, reporting up to 49% savings. A complementary cost analysis was performed, aimed at establishing potential savings in production costs; thus, 13–57% potential cost savings were reported. After that, a comparative analysis within the literature was conducted to contextualise the results obtained in this study. [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]

The efficient planning and control of timber harvesting operations is crucial to growth productivity and reducing costs, and different systems or methods are applied to obtain elevated performance. In particular, cable yarding is a highly appreciated and very efficient wood extraction method in areas that are difficult to access with ground-based extraction machines. Combined logging systems are not diffuse and not often implemented. For this reason, the use and the application of innovative methods are limited. However, some combinations have recently been observed in forest operations. This study, conducted in a deciduous stand in Bulgaria, paid attention to the combination of a tractor-mounted tower yarder (Valentini V400) with a clambunk skidder (Timberjack 1010D), aiming to examine the viability and develop the operational efficiency of the two-stage extraction system and to define the time, log volume extracted per unit by the yarder and the clambunk, and the yarding and skidding costs. The researchers carried out a time-motion study and performed a regression analysis to identify those variables that are most likely to affect the duration of work elements and productivity. For cost analysis, the COST model was used. The mean productivity of the tower yarder was 10.34 m3/PMH and 8.11 m3/SMH, while for the clambunk skidder, the productivity was 6.23 m3/PMH and 4.93 m3/SMH. The net costs for the combined logging system were calculated as 120.87 €/PMH and 14.93 €/m3. This study adds new data about the correct use of both machines, supporting their application in beech forests. [ABSTRACT FROM AUTHOR]

Electric vehicles (EVs) play a crucial role in tertiary sectors due to their eco-friendliness and sustainability when powered by clean energy. Integrating EV charging stations with renewable energy systems is essential to alleviate energy issues and grid pressure. Exploring this integration's feasibility is imperative for sustainable transportation. This study aims to provide a clear approach and methodology for examining the potential of integrating renewable energy technologies with EV charging stations at the district level. Additionally, the study investigates the energy, economic, and environmental benefits of an integrated system comprising photovoltaic/wind turbines (PV/WTs) connected to the electricity grid to meet the energy demand of a tertiary district consisting of five hotels in Egypt. Through the development of a simulation model, the paper verifies whether the proposed energy system can meet the district's energy demand. In addition, the simulation model has been employed to conduct a sensitivity analysis for investigating the impact of different charging rates on economic feasibility. The results indicate that a hybrid renewable energy system (HRES) integrated with an EV charging station can effectively relieve pressure on the electricity grid and provide electricity at competitive prices compared to the national grid. Moreover, the proposed energy system significantly reduces environmental emissions by up to 510 tons of CO2 per year and has the potential to decrease fossil fuel usage by 248 tons per year. Sensitivity analysis highlights the significant impact of charging prices on project profitability. [ABSTRACT FROM AUTHOR]

Energy supply on high mountains remains an open issue since grid connection is not feasible. In the past, diesel generators with lead–acid battery energy storage systems (ESSs) were applied in most cases. Recently, photovoltaic (PV) systems with lithium-ion (Li-ion) battery ESSs have become suitable for solving this problem in a greener way. In 2016, an off-grid PV system with a Li-ion battery ESS was installed in Paiyun Lodge on Mt. Jade (the highest lodge in Taiwan). After operating for more than 7 years, the aging of the whole electric power system became a critical issue for its long-term usage. In this work, a method is established for analyzing the massive energy data (over 7 million rows), such as daily operation patterns, as well as the C-rate, temperature, and accumulated energy distributions, and estimating the health of the Li-ion battery system. A completed electric power improvement project dealing with power system aging is reported. Based on the long-term usage experience, a simple cost analysis model comparing lead–acid and Li-ion battery systems is built, revealing that expensive Li-ion batteries can compete with cheap lead–acid batteries for long-term usage on high mountains. This case study can provide engineers and researchers with a fundamental understanding of the long-term usage of off-grid PV ESSs and engineering on high mountains. [ABSTRACT FROM AUTHOR]

Determining the residual value of tractors is imperative for comprehensive cost analyses within the agricultural machinery sector. Despite numerous studies offering various models and independent variables, the double square root regression approach, originally developed by Cross and Perry and adapted by ASABE for North American contexts, has been widely utilized. However, factors such as the complexity of OEM portfolios, steep price increases due to compliance with diesel emission regulations, and limited data availability in Europe and its market specificities necessitate improvements in predictive accuracy. This study evaluates different tractor cohort alternatives beyond engine horsepower to enhance predictive robustness. Incorporating brand and powertrain type alongside engine power significantly improved model performance and exhibited the strongest robustness, as evidenced by reduced the root mean square error (RMSE) and increased R-squared values. These findings contribute to the refinement of tractor residual value estimation models, offering valuable insights for stakeholders in the agricultural machinery industry. [ABSTRACT FROM AUTHOR]

Enhancing energy efficiency in buildings plays a pivotal role in realizing the ambitious objective of achieving carbon neutrality by 2050, as outlined in the European Green Deal. Roofs represent the technical element most affected by energy phenomena related to heat transfer: in winter, roofing can lose up to 35% of heat, and the summer heat flux can even be higher. This paper provides a catalogue of optimized and sustainable solutions, with a specific focus on standardization and prefabrication principles, for enhancing the energy efficiency of the most prevalent types of roofs that characterize the national residential building heritage. The methodological approach that guided the research presented in this article was based on the identification and study of the most common roofings in the diverse national residential building heritage, followed by their classification according to their construction era. In the context of essential energy retrofitting of deteriorated residential building stock, 21 optimized standardized solutions have been identified. The outcome of performance evaluations of the proposed solutions allowed the implementation of a matrix that can be a valuable support for designers in selecting the most efficient precalculated and prefabricated solutions for the national residential building heritage based on energy performance and sustainability criteria. [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]

In the context of emissions, carbon dioxide constitutes a predominant portion of greenhouse gases (GHGs), leading to the use of the term "carbon" interchangeably with these gases in climate-related discussions. The carbon market has emerged as a pivotal mechanism for emission regulation, allowing industries that struggle to meet emission reduction targets to acquire credits from those who have successfully curbed their emissions below stipulated levels. Thermoeconomics serves as a tool for analyzing multiproduct systems prevalent in diverse sectors, including sugarcane and alcohol mills, paper and pulp industries, steel mills, and cogeneration plants. These systems necessitate frameworks for equitable cost/emission allocation. This study is motivated by the need to expand the scope of thermoeconomic modeling to encompass expenses or revenues linked with the carbon market. By utilizing a cogeneration system as a representative case, this research aims to demonstrate how such modeling can facilitate the allocation of carbon market costs to final products. Moreover, it underscores the adaptability of this approach for internalizing other pertinent costs, encompassing expenses associated with environmental control devices, licenses, and permits. Although certain exergy disaggregation models depict an environmental component within diagrams, which is integral for addressing environmental burdens, even models without explicit environmental devices can effectively internalize carbon credits and allocate them to final products. The integration of carbon credits within thermoeconomic modeling introduces the capability to assess both the financial and environmental implications of emissions. This integration further incentivizes the reduction in GHGs and supports optimization endeavors concerning system design and operation. In summary, this study delves into the incorporation of carbon market dynamics into thermoeconomic modeling. It demonstrates the potential to allocate carbon-related costs, facilitates comprehensive cost analysis, encourages emission reduction, and provides a platform for enhancing system efficiency across industrial sectors. [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]

Elephant apple, a fruit with numerous bioactive compounds, is rich in therapeutic qualities. However, its use in processed products is limited due to insufficient postharvest processing methods. To address this issue, an automatic core cutter (ACC) was developed to handle the hard nature of the fruit while cutting. The physical characteristics of the elephant apple were considered for designing and development of the cutter. The cutter is divided into four main sections, including a frame, collecting tray, movable coring unit, and cutting base with five fruit holders. The parts that directly contact the fruit are made of food-grade stainless steel. The efficiency of the cutter was analyzed based on cutting/coring capacity, machine efficiency, loss percentage, and other factors, and was compared to traditional cutting methods (TCM) and a foot-operated core cutter (FOCC). The ACC had an average cutting/coring capacity of 270–300 kg/h, which was significantly higher than TCM's capacity of 12–15 kg/h and comparable to FOCC's capacity of 115–130 kg/h. The ACC offered a higher sepal yield of 85.68 ± 1.80% compared to TCM's yield of 65.76 ± 1.35%, which was equivalent to the yield obtained by FOCC. Therefore, the ACC outperforms TCM in terms of quality, quantity, and stress associated and is superior to FOCC in terms of higher efficiency of machine and labor. [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]

Electric buses have been vigorously promoted and implemented in major countries worldwide and have generated a huge demand for charging stations. Optimizing the daily charging experience of electric buses, adapting the daily operation scheduling, improving the utilization rate of charging stations, reducing the load on the power grid, and improving the operation efficiency of electric bus line networks require the reasonable layout of the charging stations. In this study, public transportation charging station layout and siting is the research object. We summarize the progress of analysis methods from the charging station and vehicle sides; introduce related research on the planning and layout of charging stations based on optimization models, including cost analysis and siting and layout for electric bus systems; summarize the data-driven station planning and siting research; and provide an overview of the current charging demand estimation, accuracy, and charging efficiency. Finally, we address the problems of the charging demand estimation accuracy, the mismatch between the charging station layouts for electric buses, and the charging demand on a long time scale. We suggest that research be conducted on data fusion for the temporal and spatial refinement of charging demand prediction in the context of the electrification of public transportation systems and the big data of telematics. [ABSTRACT FROM AUTHOR]

Psycholeptic and specifically antipsychotic prescribing is increasing worldwide each year. This study aims to investigate the prevalence and cost of antipsychotic prescribing, within the wider frame of psycholeptic prescribing, in the Irish context. Quantitative analysis of a dataset from the Primary Care Reimbursement Service relating to cost and prescribing frequency of ATC Class N05 psycholeptic drugs from January 2020–August 2022 inclusive was conducted using Microsoft® Excel® for Microsoft 365 MSO (Version 2311) and STATA 18. Descriptive statistics and time-trend regression analysis were used to investigate the prescribing prevalence of psycholeptics and antipsychotics licensed for use in the Republic of Ireland, and the total cost per funding scheme. The prevalence of psycholeptic prescribing increased yearly from 2020–2022, peaking at 328,572 prescriptions in December 2020 with a total cost of psycholeptic drugs to the State in 2021 of €57,886,250, which was 0.5% of an increase on 2020. Over the 32-month time period, the average monthly cost of psycholeptic drugs was €4,436,469 on the General Medical Services (GMS) scheme and €369,154 on the Drug Payment Scheme (DPS). In 2021, quetiapine, olanzapine, and risperidone were the most prescribed antipsychotics, accounting for 66.58% of antipsychotics prescribed on the GMS scheme. This study identified the large expenditure on psycholeptics and antipsychotics in Ireland, with a higher proportion of the Irish healthcare budget spent on antipsychotics than that of the UK and the USA. The development of Irish antipsychotic prescribing guidelines may allow for structured, cost-effective prescribing. [ABSTRACT FROM AUTHOR]

The increase in population and need for shelter demand a huge amount of concrete production. These construction activities cause environmental problems and global warming continues to threaten the world. In this study, the properties of cement paste composites containing high proportions of fly ash are intended for use as sustainable ecological products in various civil engineering applications to minimize the worse effects of building construction. The physical, mechanical, and durability properties of pure cement paste composed of fly ash were investigated. New insight is presented in this study to show how to use fly ash in the paste for a wide range of workability with better optimization of physical and mechanical characterization with cost performance and to design the composites to achieve specific engineering properties. The proposed approach can help researchers model the pastes for various ranges of workability and strength. This modeling approach can potentially be used to construct mixture design criteria for such composites. The unconfined compressive strength (UCS) showed very good results with the porosity of the paste, UCS = a × (1 − porosity)b; thus, this equation can be used for the strength determination of pastes at various workability ranges. [ABSTRACT FROM AUTHOR]

The urgent need for sustainable construction that corresponds to the three pillars of sustainable development is obvious and continuously requires innovative solutions. Cementitious composites with TiO2 nanoparticles (NT) addition show potential due to their improved durability, physico–mechanical characteristics, and self-cleaning capacity. This study aimed to evaluate the influence of NT on cementitious composites by comparing those with 2%–5% nanoparticles with a similar control sample without nanoparticles, as well as an analysis of cost growth. The experimental results showed an increase in bulk density of the material (4.7%–7.4%), reduction in large pore sizes by min. 12.5%, together with an increase in cumulative volume and cumulative specific surface area of small pore sizes, indicating densification of the material, also supported by SEM, EDS, and XRD analyses indicating acceleration of cement hydration processes with formation of specific products. The changes at microstructural level support the experimental results obtained at macrostructural level, i.e., modest but existent increases in flexural strength (0.6%–7.9%) and compressive strength (0.2%–2.6%) or more significant improvements in abrasion resistance (8.2%–58%) and reduction in water absorption coefficient (37.5%–81.3%). Following the cost–benefit analysis, it was concluded that, for the example case considered of a pedestrian pavement with a surface area of 100 m2, using 100 mm thick slabs, if these slabs were to be made with two layers, the lower layer made of cementitious composite as a reference and the upper layer with a thickness of 10 mm made of cementitious composite with 3% NT or 4% NT, the increase in cost would be acceptable, representing less than 15% compared to the cost for the exclusive use of cementitious composite without NT. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) is a virtual technology that integrates virtual information and objects into real environments, offering unprecedented possibilities in such fields such as architecture, education, and healthcare. Real-time communication and security protocols are critical to the successful deployment of AR applications to ensure user immersion, prevent motion sickness, and address security problems. This paper proposes a secure user-to-user (U2U) and user-to-infrastructure (U2I) authentication protocol suitable for edge computing-based AR environments. We also employ extended Chebyshev chaotic maps and physical unclonable functions to ensure security and efficiency during the authentication process. The proposed protocol initiates session keys after U2I authentication when an AR user enters the edge node area, facilitating secure U2U authentication for sharing data with nearby users. We conduct comprehensive studies of the security robustness of the proposed protocol using formal and informal analyses, including "Burrows–Abadi–Needham logic", "Real-Or-Random model", the "Scyther tool" and informal security analyses. Furthermore, we measure the performance of cryptographic primitives using the "Multiprecision Integer and Rational Arithmetic Cryptographic Library" Cryptographic SDK. We perform a comparative analysis of security features and functionality, and we conduct a computational and communication cost analysis. The results reveal that the proposed protocol can provide security and efficiency for edge computing-based AR environments, presenting the methods for seamless and secure real-time AR data exchanges for U2I and U2U communications. [ABSTRACT FROM AUTHOR]