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Introduction: In recent years, several hospitals have incorporated MRI equipment managed directly by their cardiology departments. The aim of our work is to determine the total cost per test of both CT and MRI in the setting of a Cardiology Department of a tertiary hospital. Materials and Methods: The process followed for estimating the costs of CT and MRI tests consists of three phases: (1) Identification of the phases of the testing process; (2) Identification of the resources consumed in carrying out the tests; (3) Quantification and assessment of inputs. Results: MRI involves higher personnel (EUR 66.03 vs. EUR 49.17) and equipment (EUR 89.98 vs. EUR 33.73) costs, while CT consumes higher expenditures in consumables (EUR 93.28 vs. EUR 22.95) and overheads (EUR 1.64 vs. EUR 1.55). The total cost of performing each test is higher in MRI (EUR 180.60 vs. EUR 177.73). Conclusions: We can conclude that the unit cost of each CT and MRI performed in that unit are EUR 177.73 and EUR 180.60, respectively, attributable to consumables in the case of CT and to amortization of equipment and staff time in the case of MRI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disrupted hospital operations. Anecdotal evidence suggests financial performance likewise suffered, yet little empirical research supports this claim. This study aimed to explore the impact of the pandemic on the financial performance of the most prominent academic hospitals in the United States. Data from the 115 largest major teaching hospitals in the United States were extracted from the American Hospital Directory for three years (2019–2021). We hypothesized that the year and region would moderate the relationship between a hospital's return on assets (financial performance) and specific operational variables. We found evidence through descriptive statistics and multivariate moderated regressions that financial positions rebounded in 2021, mainly through reductions in adjusted full-time employees and liabilities and an increase in non-operating income. Our results also found that the Midwest region significantly outperformed the other three regions, particularly in terms of lower salaries and operational expenses. These findings suggest potential for future initiatives encouraging efficiency and finding alternate sources of income beyond patient income. Hospitals should focus on improving financial reserves, building out non-operational revenue streams, and implementing operational efficiencies to foster better financial resiliency. These suggestions may enable healthcare administrators and facilities to adapt to future pandemics and environmental turbulence. [ABSTRACT FROM AUTHOR]

The increasing growth in the global population has led to a substantial demand for low-carbon energy infrastructure, metals, and minerals. This has put more pressure on land-based deposits, which have been unsustainably exploited over the years. As a result, attention has shifted towards exploring minerals in sea-based environments. Currently, industry and researchers have identified potentially commercially viable locations for the exploration of these nodules. However, significant knowledge gaps remain in the sustainable, efficient, and effective recovery and transportation of the nodules to onshore locations. To address these gaps, the study develops a logistics and cost model embedded in a multiobjective optimization (MOO) approach. This model considers several parameters, such as the production targets, port distance and location, storage capacity, vessel characteristics, transportation options, and cost inputs. By incorporating these parameters, the study analyzes different combinations of vessel classes and onshore locations and provides insights into optimizing offshore–onshore logistics and transportation options. The findings reveal that small and medium-sized vessels require lower storage capacity because they can complete more trips. Furthermore, the analysis reveals the cost of deploying additional vessels outweighs the benefits of reduced storage space for long-distance transport; therefore, smaller and medium-sized vessels are more suitable for locations closer to the offshore production site. Additionally, proximity to the onshore location is important, as it reduces transport costs and simplifies logistics operations. Subsequently, there is a need to have a reasonable buffer rate as this reduces the impact of potential disruptions during transport. From a managerial viewpoint, the study highlights the need to carefully consider vessel types based on transport requirements and journey characteristics. The analysis further identifies the benefits of having an onshore location close to the offshore production site. This will lead to optimized transport and logistics operations. Based on this, the study contributes to the body of knowledge in offshore logistics by developing a multiobjective optimization model for offshore–onshore transport logistics and cost analysis. This model provides a practical tool for informed decision-making and provides insight into vessel size and location considerations. Finally, the study establishes how simultaneous consideration of multiple factors in transport operations can lead to optimized and informed decision-making. [ABSTRACT FROM AUTHOR]

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

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

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

In this paper, we considered one of the problems that arise during drilling automation, namely the automation of lithology identification from drill cuttings images. Usually, this work is performed by experienced geologists, but this is a tedious and subjective process. Drill cuttings are the cheapest source of rock formation samples; therefore, reliable lithology prediction can greatly reduce the cost of analysis during drilling. To predict the lithology content from images of cuttings samples, we used a convolutional neural network (CNN). For training a model with an acceptable generalization ability, we applied dataset-cleaning techniques, which help to reveal bad samples, as well as samples with uncertain labels. It was shown that the model trained on a cleaned dataset performs better in terms of accuracy. Data cleaning was performed using a cross-validation technique, as well as a clustering analysis of embeddings, where it is possible to identify clusters with distinctive visual characteristics and clusters where visually similar samples of rocks are attributed to different lithologies during the labeling process. [ABSTRACT FROM AUTHOR]

This research introduces a cost-effective converter for single-phase machines, aiming to enhance efficiency and reduce energy consumption in retrofit applications. Single-phase motors commonly found in household appliances often suffer from low efficiency, resulting in wasted energy. To tackle this problem, a dedicated converter was proposed to replace the existing capacitors and improve the motor performance. This study presents a proof of concept for retrofit applications, discussing the converter design methodology and prototype evaluation. Additionally, a cost analysis comparing single-phase and three-phase motors is included. It aims to demonstrate the long-term cost savings and improved energy efficiency of the proposed converter. The findings highlight the converter's potential as a promising solution for enhancing energy efficiency and decreasing costs in single-phase motor applications. [ABSTRACT FROM AUTHOR]

Background: Implementation of an anesthesiology-led cardiac implantable electronic device (CIED) service can be viewed to have economic and efficiency challenges. This study evaluates the cost savings of an anesthesiology-led CIED service. Methods: A total of 830 patients presented in the pre-implementation period from 1 March 2016 to 31 December 2017, and 1981 patients presented in the post-implementation period from 1 January 2018 to 31 October 2021. Interrupted time-series analysis for single-group comparisons was used to evaluate the cost savings resulting from reduction in operating room (OR) start delays for patients with CIEDs. Results: OR start-time delay was reduced by 10.6 min (95%CI: −20.5 to −0.83), comparing pre- to post-implementation. For an OR cost of USD 45/min, we estimated the direct cost to the department to be USD 1.68/min. The intervention translated into a total cost reduction during the intervention period of USD 250,000 (USD 18,000 to USD 470,000) per year for the institution and USD 9800 (USD 730 to USD 17,000) per year for the department. The yearly cost of employing a full-time team of CIED specialists would have been USD 135,456. The service triggered electrophysiology consultation on 13 device malfunctions. Conclusions: An anesthesiology-led CIED service resulted in substantial cost savings, increased OR efficiency and patient safety. [ABSTRACT FROM AUTHOR]

The cost of producing one cubic meter of concrete structure, depending on the structure's shape, type, and complexity, can be variously high. The cost of concrete, reinforcement, formwork, and labor ratio varies. But unlike the cost of concrete and reinforcement, which tend to be similar in the terms of the conditions of a particular construction project, the cost of formwork and work with it are different for different contractors. It often depends on the appropriateness of the formwork system used, the optimal placement of the formwork sets, the minimization of downtime, and the efficiency of the carpenters' work. Formwork modeling in the construction preparation phase intervenes in this planning area, where construction sources are defined and quantified, and the time course of their deployment is determined. The current paper deals with optimizing formwork selection and deployment in concrete structure execution. Even if several requirements must be considered when selecting and modeling the formwork (e.g., construction time, quality of concrete structure, etc.), an effort to minimize the cost of formwork, and thus construction cost, plays the most significant role. A dynamic model for effective and optimal planning of formwork in construction projects, including formwork cost analysis, is presented in the paper. The included case study demonstrated the planning of the formwork through a software application developed based on the computational algorithm of the dynamic model presented. A case study is presented in the article as a research method. An office building with five above-ground floors and one underground floor was chosen for the case study. To solve the case study, the formwork for horizontal structures (i.e., beams and slabs) is considered. The goal of the case study is to identify research questions and apply time and cost optimization to a selected specific building. [ABSTRACT FROM AUTHOR]

Genital warts (GWs) caused by the human papilloma virus (HPV) are a significant health problem due to high prevalence and rate of recurrence. Bivalent vaccine has been used since the start of the national vaccination program in 2013, making it feasible to study the GW burden in Finland. There is no national and up-to-date information available on the prevalence and the burden of GWs in the various healthcare sectors in Finland. The present study investigated the prevalence, healthcare resource use, and direct medical costs of the treatment of GWs in Finland in 2018 using data in national healthcare registers. GW cases were identified based on diagnoses in public healthcare and GW-related prescription medications. Cost analysis included public healthcare contacts, procedures in private care, and medications. The study showed that approximately 12,000 GWs cases were treated in Finland in 2018. Since less than half of GW diagnoses were recorded in public healthcare registers, determining the exact costs was challenging. The estimated direct treatment costs in 2018 were 2.6 M€, which is higher than the previous estimation in Finland, yet still likely an underestimation of the true burden. These results provide information for the management of the GW burden in Finland. [ABSTRACT FROM AUTHOR]

Empirical and machine learning models are estimation tools relevant to obtaining scalable solutions to engineering problems. In this study, response surface methodology (RSM) was incorporated to correlate the experimental findings based on mathematical models. Artificial neural networks (ANN) and adaptive neuro-fuzzy inference systems (ANFIS) were the artificial intelligence tools used to create trainable algorithms. Feed data consolidated hydration temperature (50 to 90 °C), hydration time (3 to 7 h), sulphation temperature (120 to 160 °C), diatomite to hydrated lime ratio (0 to 1), and inlet gas concentration (500 to 2500 ppm) were the independent variables mapped against sulphur capture capacity ( Y 1 —5 to 54%) and reagent utilisation ( Y 2 —4 to 42%) as the dependent variables. Statistical error techniques such as root mean square (RMSE), mean square error (MSE), and the coefficient of determination (R2) were used to quantify the model accuracy and cost analysis. The ANN models presented more acceptable and reliable predicted data, with R2 values greater than 99% compared to the RSM and ANFIS models. The ANFIS models showed overfitting deficiencies that affected learning and training. These findings suggest that the ANN models are a more suitable option for accurate and dependable data estimation in similar engineering applications. [ABSTRACT FROM AUTHOR]

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

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

This study aimed to compare the outcomes and cost differences between primary lung cancer (PLC) and second primary lung cancer (SPLC) patients who underwent video-assisted thoracoscopic surgery (VATS). This was a retrospective analysis of 124 patients with lung cancer stages I, II, and III who underwent VATS between January 2018 and January 2023. The patients were divided into two groups based on their cancer status that was matched by age and gender: the PLC group (n = 62) and the SPLC group (n = 62). The results showed that there was no significant difference in the clinical characteristics between the 2 groups, except for the Charlson Comorbidity Index (CCI), with a score above 3 in 62.9% of PLC patients and 80.6% among SPLC patients (p = 0.028). Regarding the surgical outcomes, the operative time for the VATS intervention was significantly higher in the SPLC group, with a median of 300 min, compared with 260 min in the PLC group (p = 0.001), varying by the cancer staging as well. The average duration of hospitalization was significantly longer before and after surgery among patients with SPLC (6.1 days after surgery), compared with 4.2 days after surgery in the PLC group (0.006). Regarding the cost analysis, the total hospitalization cost was significantly higher in the SPLC group (15,400 RON vs. 12,800 RON; p = 0.007). Lastly, there was a significant difference in the survival probability between the two patient groups (log-rank p-value = 0.038). The 2-year survival was 41.9% among PLC patients and only 24.2% among those with SPLC. At the 5-year follow-up, there were only 1.6% survivors in the SPLC group, compared with 11.3% in the PLC group (p-value = 0.028). In conclusion, this study found that VATS is a safe and effective surgical approach for both PLC and SPLC patients. However, SPLC patients have a higher VATS operating time and require more healthcare resources than PLC patients, resulting in higher hospitalization costs. These findings suggest that careful pre-operative evaluation and individualized surgical planning are necessary to optimize the outcomes and cost-effectiveness of VATS for lung cancer patients. Nevertheless, the 5-year survival remains very low and concerning. [ABSTRACT FROM AUTHOR]

In this paper, a conceptual framework for investigating the PPP model as it relates to hospitals is proposed. When the PPP model is applied to healthcare (hospitals), it is possible to discover the path to success by developing a critical assessment and deriving a clear model. It is concluded that most PPP model implementations in hospitals around the world have produced favorable outcomes, both in terms of the performance of healthcare units and in terms of cost-effectiveness. Additionally, a path-to-success model that applies to hospitals is offered, taking into account six PPP model dimensions: (i) Environment; (ii) Potentiate Benefits; (iii) Constant Measure; (iv) Evaluation; (v) Management; and (vi) Enhance Strengths. The PPP model only applies case by case and under specific requirements that should be met cumulatively to provide additional value to healthcare's quality of service. The right conditions are created, the right benefits are amplified, public concerns are frequently assessed, private contributions are carefully considered, and all pressing challenges are managed by enhancing both public and private strengths. Leading decision- and action-making processes in corporate, governmental, and social sectors is the goal of managing PPP models. [ABSTRACT FROM AUTHOR]

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

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

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

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

Public organizations must provide high-quality services at a lower cost. In order to accomplish this goal, they need to apply well accepted cost methods and evaluate the efficiency of their processes using Business Process Management (BPM). However, only a few studies have evaluated the addition of cost information to a process model in a public organization. The aim of the research is to evaluate the combination of cost data to process modeling in an academic library. Our research suggests a new and easy to implement process analysis in three phases. We have combined qualitative (i.e., interviews with the library staff) and quantitative research methods (i.e., estimation of time and cost for each activity and process) to model two important processes of the academic library of the University of Macedonia (UoM). We have modeled the lending and return processes using Business Process Model and Notation (BPMN) in an easy-to-understand format. We have evaluated the costs of each process and sub process with the use of Time-Driven Activity-Based Costing (TDABC) method. The library's managers found our methodology and results very helpful. Our analysis confirmed that the combination of workflow and cost analysis may significantly improve the decision-making procedure and the efficiency of an organization's processes. However, we need to further research and evaluate the appropriateness of the combination of various cost and BPM methods in other public organizations. [ABSTRACT FROM AUTHOR]

The growing number of space objects leads to increases in the potential risks of damage to satellites and generates space debris after colliding. Conjunction assessment analysis is the one of keys to evaluating the collision risk of satellites and satellite operators require the analyzed results as fast as possible to decide and execute collision maneuver planning. However, the computation time to analyze the potential risk of all satellites is proportional to the number of space objects. The conjunction filters and parallel computing techniques can shorten the computation cost of conjunction analysis to provide the analyzed results. Therefore, this paper shows the investigation of the conjunction filter performances (accuracy and computation speed): Smart Sieve, CSieve and CAOS-D (combination of both Smart Sieve and CSieve) in both a single satellite (one vs. all) and all space objects (all vs. all) cases. Then, all the screening filters are developed to implement an algorithm that executes General-purpose computing on graphics processing units (GPGPU) by using NVIDIAs Compute Unified Device Architecture (CUDA). The analyzed results show the comparison results of the accuracy of conjunction screening analysis and computation times of each filter when implemented with the parallel computation techniques. [ABSTRACT FROM AUTHOR]

Background: UAVs (Unmanned Aerial Vehicles) and SUGVs (Sidewalk Unmanned Ground Vehicles) are two prominent options to revolutionize last mile home delivery. However, there is no literature yet addressing a comprehensive assessment of them. To bridge this research gap, this paper aimed to compare UAVs to SUGVs in the context of urban parcel delivery from a practical, conceptual, technological, commercial, and environmental perspective. Methodology: Based on structured literature and web research, this paper provided a comparative status quo review of these two delivery concepts. We introduced a parameter-based cost calculus model to estimate the costs per shipment for each technology. To detect the key cost drivers, we applied a one-way sensitivity analysis, as well as a "full factorial design of experiment" approach. Results: These key cost drivers for both operations are the "number of vehicles per operator" and the "average beeline service radius". From today's commercial point of view, our model indicated better profitability of SUGVs. However, technical and regulatory developments may render different results in the future. As SUGVs emit significantly less noise than UAVs, we assume that SUGVs have an additional advantage for usage in autonomous urban last mile delivery from a resident's perspective. Conclusions: Both key cost drivers will significantly influence the commercial viability of unmanned home delivery services. Safety and security aspects will determine regulatory rules on "number of vehicles per operator". To increase the "average beeline service radius", UAVs could profit from mothership delivery concepts while SUGV delivery may co-use existing public transport infrastructure. [ABSTRACT FROM AUTHOR]

Background: There is significant variability in surgeons' instrumentation patterns for adolescent idiopathic scoliosis surgery. Implant density and costs are difficult to correlate with deformity correction, safety, and quality of life measures. Materials and Methods: Two groups of postoperative adolescents were compared based on exposure to a best practice guidelines program (BPGP) introduced to decrease complications. Hybrid and stainless steel constructs were dropped, and posterior-based osteotomies, screws, and implant density were increased to 66.8 ± 12.03 vs. 57.5 ± 16.7% (p < 0.001). The evaluated outcomes were: initial and final correction, rate of correction loss, complications, OR returns, and SRS-22 scores (minimum two-year follow-up). Results: 34 patients were operated on before BPGP and 48 after. The samples were comparable, with the exceptions of a higher density and longer operative times after BPGP. Initial and final corrections before BPGP were 67.9° ± 22.9 and 64.6° ± 23.7; after BPGP, the corrections were 70.6° ± 17.4 and 66.5° ± 14.9 (sd). A regression analysis did not show a relation between the number of implants and postoperative correction (beta = −0.116, p = 0.307), final correction (beta = −0.065, p = 0.578), or loss of correction (beta= −0.137, p = 0.246). Considering screw constructs only (n = 63), a regression model controlled for flexibility continued to show a slight negative effect of density on initial correction (b = −0.274; p = 0.019). Only with major curve concavity was density relevant in initial correction (b = 0.293; p = 0.038), with significance at 95% not being achieved for final correction despite a similar beta (b = 0.263; p = 0.069). Complications and OR returns dropped from 25.6% to 4.2%. Despite this, no difference was found in SRS-22 (4.30 ± 0.432 vs. 4.42 ± 0.39; sd) or subdomain scores pre- and post-program. Findings: Although it appears counterintuitive that higher density, osteotomies, and operative time may lead to fewer complications, the study shows the value of best practice guidelines in spinal fusions. It also shows that a 66% implant density leads to better safety and efficacy, avoiding higher costs. [ABSTRACT FROM AUTHOR]

Cranioplasty or cranial reconstruction is always a challenging procedure even for experienced surgeons. In this study, two different design techniques for customized cranial prostheses are assessed for cranial reconstruction. Mirror reconstruction is one of the commonly used reconstruction techniques that fails when cranial defects cross the midline of symmetry. Hence, there is a need for a design technique for the reconstruction of cranial defects irrespective of their location on the symmetrical plane. The anatomical reconstruction technique demonstrates its applicability for a wide spectrum of complex skull defects irrespective of the defective position in the anatomical structure. The paper outlines a methodological procedure involving a multi-disciplinary approach involving physicians and engineers in the design and reconstruction of customized cranial implants for asymmetrical skull defects. The proposed methodology is based on five foundation pillars including the multi-disciplinary approach, implant design process, additive-manufactured implant, implant fitting analysis, and cost and time analysis for the customized implant. The patient's computed tomography scan data are utilized to model a customized cranial implant, which is then fabricated using electron beam melting technology. The dimensional validation of the designed and fabricated titanium implant based on the anatomical approach results in a precision of 0.6345 mm, thus indicating a better fit than the standard mirroring method. The results of fitting accuracy also reveal that the manufactured implant's average deviation is very close to the planned reconstruction area with an error less than 1 mm, suggesting that the customized titanium implant fits the skull model quite precisely. The cost and time analysis reports that the cost for producing a customized cranial implant using electron beam melting technology is around USD 217.5 and the time taken to build is approximately 14 h and 27 min, which is low when compared to other studies. The cost and time analysis also demonstrates that the proposed design would be less burdensome to patients when compared to standard practice. Therefore, the new anatomical design process can be used effectively and efficiently to treat a number of diverse cranial abnormalities with the enhanced cranial implant design. [ABSTRACT FROM AUTHOR]

The industrial sector demands 25% of global energy as heat, where one-third is used at temperatures below 150 °C. Nevertheless, the installed solar heating capacity in the industry is only 0.02%, even though the integration of solar heating systems into production processes could significantly reduce fossil fuel consumption at a competitive cost. Among other reasons, this low penetration is due to the final users' lack of knowledge of solar heating technologies. As a result, a free pre-feasibility assessment tool was developed for non-specialised users to evaluate the possibility of integrating solar heat into their processes using basic information. This tool uses transient simulation to estimate a feasible solar heating system through the parametric optimisation of the solar collection area, thermal storage volume, heat exchange capacity, and solar integration schemes at the supply level and costs. A commercial facility in Mexico was analysed using the developed tool as a case study. However, even when this is not a design tool, the calculated solar collector area, storage tank volume, and investment were only 2.1%, 9.0%, and 2.3% higher than reported by the solar designer. Pre-feasibility assessment tools are essential to overcome the certainty gap between end users and solar designers, thus enhancing the possibility of implementing solar heating systems in various commercial and industrial processes. [ABSTRACT FROM AUTHOR]

Globally, floods are a prevalent type of natural disaster. Simulating floods is a critical component in the successful implementation of flood management and mitigation strategies within a river basin or catchment area. Selecting appropriate calibration data to establish a reliable hydrological model is of great importance for flood simulation. Usually, hydrologists select the number of flood events used for calibration depending on the catchment size. Currently, there is no numerical index to help hydrologists quantitatively select flood events for calibrating the hydrological models. The question is, what is the necessary and sufficient amount (e.g., 10 events) of calibration flood events that must be selected? This study analyses the spectral characteristics of flood data in Sequences before model calibration. The absolute best set of calibration data is selected using an entropy-like function called the information cost function (ICF), which is calculated from the discrete wavelet transform (DWT) decomposition results. Given that the validation flood events have already been identified, we presume that the greater the similarity between the calibration dataset and the validation dataset, the higher the performance of the hydrological model should be after calibration. The calibration datasets for the Tunxi catchment in southeast China were derived from 21 hourly flood events, and the calibration datasets were generated by arranging 14 flood events in sequences from 3 to 14 (i.e., a Sequence of 3 with 12 sets (set 1 = flood events 1, 2, 3; set 2 = flood events 2, 3, 4, ..., and so on)), resulting in a total of 12 sequences and 78 sets. With a predetermined validation set of 7 flood events and the hydrological model chosen as the Hydrologic Engineering Center (HEC–HMS) model, the absolute best calibration flood set was selected. The best set from the Sequence of 10 (set 4 = S10′) was found to be the absolute best calibration set of flood events. The potential of the percentile energy entropy was also analyzed for the best calibration sets, but the ICF was the most consistent index to reveal the ranking based on similarity with model performance. The proposed ICF index in this study is helpful for hydrologists to use data efficiently with more hydrological data obtained in the new era of big data. This study also demonstrates the possibility of improving the effectiveness of utilizing calibration data, particularly in catchments with limited data. [ABSTRACT FROM AUTHOR]

During recent years, gasification technology has gained a high potential and attractiveness to convert biomass and other solid wastes into a valuable syngas for energy production or synthesis of new biofuels. The implementation of real gasification facilities implies a good insight of all expenses that are involved, namely investments required in equipment during the project and construction phases (capital expenditures, CapEx) and costs linked to the operation of the plant, or periodic maintenance interventions (operational expenditures, OpEx) or costs related to operations required for an efficient and sustainable performance of a gasification plant (e.g., feedstock pre-treatment and management of by-products). Knowledge of these economic parameters and their corresponding trends over time may help decision-makers to make adequate choices regarding the eligible technologies and to perform comparisons with other conventional scenarios. The present work aims to provide an overview on CapEx associated with gasification technologies devoted to convert biomass or solid waste sources, with a view of reducing the carbon footprint during energy generation or production of new energy carriers. In addition, an analysis of technology cost trends over time using regression methods is also presented, as well as an evaluation of specific capital investments according to the amount of output products generated for different gasification facilities. The novelty of this work is focused on an analysis of CapEx of existing gasification technologies to obtain distinct products (energy and fuels), and to determine mathematical correlations relating technology costs with time and product output. For these purposes, a survey of data and categorization of gasification plants based on the final products was made, and mathematical regression methods were used to obtain the correlations, with a statistical analysis (coefficient of determination) for validation. Specific investments on liquid biofuel production plants exhibited the highest decreasing trend over time, while electricity production became the least attractive solution. Linear correlations of specific investment versus time fitted better for electricity production plants (R2 = 0.67), while those relating the product output were better for liquid biofuel plants through exponential regressions (R2 = 0.65). [ABSTRACT FROM AUTHOR]

This study aims to evaluate the fatigue phenomenon in recycled hot asphalt mixture for an asphalt surface layer. Eight mixtures were evaluated in the laboratory, and the samples were divided into two major groups: four mixtures containing neat binder and RAP from source 1 (RAP with neat binder) and four mixtures containing SBS-modified binder and RAP from source 2 (RAP with SBS-modified binder). The levels of RAP incorporation were 0%, 10%, 20%, and 30% in relation to the total weight of the mixtures. The mixtures followed the Marshall mix design methodology. The results indicate that mixtures with polymer-modified binder presented better performance, whereas the addition of RAP slightly decreased the resistance to fatigue cracking. In terms of economic analysis, the use of RAP, for all cases, leads to a reduction in production costs due to the reduction of the binder and aggregate added, with savings of up to 14.1% in the case of 30% of RAP for the SBS binder. When evaluating the economic impact of inserting RAP and its relationship with fatigue performance in the long term, it can be observed that the type of binder added impacts the results: mixtures with SBS binder present economic gains within acceptable quality parameters up to 30% RAP insertion; for mixtures with neat binder, the percentage of up to 10% RAP is advantageous. [ABSTRACT FROM AUTHOR]

Background and Objectives: Iron deficiency and anemia characterize patients on chronic hemodialysis (HD). Available intravenous iron agents, such as ferric gluconate (FG) and ferric carboxymaltose (FCM), vary in dosing regimens and safety profiles. The aim of the present study was to analyze the modification of the iron status, the correction of anemia, and the economic implications after the shift from FG to FCM therapy in chronic HD patients. We evaluated, during the study, the variations in iron metabolism, assessing ferritin and transferrin saturation, erythropoietin-stimulating agent (ESA) doses and the number of administrations, the effects on anemic status, and consequent costs. Materials and Methods: A retrospective study was performed with a follow-up period of 24 months, enrolling forty-two HD patients. The enrolment phase started in January 2015, when patients were treated with iv FG, and continued until December 2015, when FG was discontinued, and, after a wash-out period, the same patients were treated with FCM. Results: The iron switch reduced the administered dose of ESA by 1610.500 UI (31% of reduction; p < 0.001) during the entire study period and reduced the erythropoietin resistance index (ERI) (10.1 ± 0.4 vs. 14.8 ± 0.5; p < 0.0001). The FCM group had the highest percentage of patients who did not require ESA treatment during the study period. The FCM patients were characterized by higher levels of iron (p = 0.04), ferritin (p < 0.001), and TSAT levels (p < 0.001) compared to the FG patients. The annual cost during FG infusion was estimated at EUR 105,390.2, while one year of treatment with FCM had a total cost of EUR 84,180.7 (a difference of EUR 21,209.51 (20%), saving EUR 42.1 per patient/month (p < 0.0001). Conclusions: FCM was a more effective treatment option than FG, reducing ESA dose requirements, increasing Hb levels, and improving iron status. The reduced ESA doses and the decreased number of patients needing ESA were the main factors for reducing overall costs. [ABSTRACT FROM AUTHOR]

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

Background: Spinal muscular atrophy (SMA) is a debilitating neuromuscular disease resulting in children's mortality and disability. Nusinersen is available to all SMA patients in Poland since 2019. Aim: To compare mortality or disease progression to mechanical ventilation in two patient cohorts before and after the program's introduction. Additionally, to describe the patient population treated with nusinersen and costs incurred by the public payer. Methods: We used the National Health Fund (NHF) database to identify patients born in either 2014 or 2019, who received at least two health services with an ICD10 G12 diagnosis. Outcomes were time to event: death or first mechanical ventilation. We identified all benefits received by nusinersen-treated patients, between 1 January 2019 and 31 May 2022. Results: Children with SMA born in 2019 had significantly lower mortality in the first years of their lives than children born in 2014. Approximately 875 patients (all age groups) were treated with nusinersen in the analysis period. The cost of causal drugs in this period amounted to €51.4 million. The cost of healthcare benefits amounted to €14.9 million. Conclusions: The drug program to treat SMA improved patient care in Poland. The NHF database was a reliable source to monitor resource-intensive therapies' costs, demography, and selected patient outcomes. [ABSTRACT FROM AUTHOR]

The cost-effectiveness of Cerebrolysin as an add-on therapy for moderate–severe acute ischemic stroke is a topic that remains understudied. This study aims to address this gap by performing a comprehensive cost-utility analysis using both deterministic and probabilistic methods from a payer perspective and within the Romanian inpatient care setting. Quality-adjusted life years (QALYs) were calculated using partial individual patient data from the 2016 Cerebrolysin and Recovery After Stroke (CARS) trial, utilizing three different health state valuation models. Cost data was extracted from actual acute care costs reported by Romanian public hospitals for reimbursement purposes for patients included in the CARS study. Incremental cost-effectiveness ratios were calculated for each treatment arm for the duration of the clinical trial. Deterministic analysis based on sample mean values indicates Cerebrolysin would be cost-effective at a threshold between roughly 18.8 and 29.9 thousand EUR, depending on valuation techniques. Probabilistic sensitivity analysis results indicate an 80% chance probability of cost-effectiveness of Cerebrolysin as an add-on therapy for acute ischemic stroke, considering a willingness-to-pay threshold of 50,000 EUR in a 90-day timeframe after stroke. Further economic evaluations of Cerebrolysin are needed to strengthen these findings, covering a timeframe of at least 12 months after the acute incident, which would account for treatment effects spanning beyond the first 90 days after ischemic stroke. These should be conducted to determine its cost-effectiveness under various care settings and patient pathways. Most importantly, modelling techniques are needed to answer important questions such as the estimates of population gain in QALYs after acute administration of Cerebrolysin and the potential offsetting of direct medical costs as a result of administering the intervention. [ABSTRACT FROM AUTHOR]

(1) Background: Identifying hospital-related critical, and excellent, areas represents the main goal of this paper, in both a national and local setting. Information was collected and organized for an internal company's reports, regarding civil litigation that has been affecting the hospital, to relate the obtained results with the phenomenon of medical malpractice on a national scale. This is for the development of targeted improvement strategies, and for investing available resources in a proficient way. (2) Methods: In the present study, data from claims management in Umberto I General Hospital, Agostino Gemelli University Hospital Foundation and Campus Bio-Medico University Hospital Foundation, from 2013 to 2020 were collected. A total of 2098 files were examined, and a set of 13 outcome indicators in the assessment of "quality of care" was proposed. (3) Results: From the total number, only 779 records (37.1%) were attributable to the categories indexable for the present analysis. This data highlights how, following a correct and rigorous categorization of hospital events, it is possible to analyze these medico-legal aspects using a small number of indicators. Furthermore, it is important to consider how a consistent percentage of remaining events was difficult to index, and was also of poor scientific interest. (4) Conclusions: The proposed indicators do not require standards to be compared to, but provide a useful instrument for comparative purposes. In fact, in addition to comparative assessment between different business realities distributed throughout the territory, the use of outcome indicators allows for a longitudinal analysis evaluating the performance of an individual structure over time. [ABSTRACT FROM AUTHOR]

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

A novel solid-phase extraction methodology followed by UHPLC-MS/MS has been developed for Ochratoxin A (OTA) analysis in herbal infusions. For this purpose, a commercial polyurethane foam (PUF) was used as sorbent, and the experimental conditions were fully optimized. The strategy was satisfactory for reducing the matrix effect and allowed for OTA quantification in black tea and herbal infusions, with suitable recoveries and quantitation limits in agreement with those required by the maximum levels allowed by current regulations. The achieved results demonstrated the unprecedented use of polyurethane foam as an effective alternative for OTA retention and quantification in herbal infusions with the advantages of simple preparation, time saving, sustainability, and low cost for routine analysis. [ABSTRACT FROM AUTHOR]

This paper considers a construction procedure of a satellite reference angular motion in the vicinity of an unstable gravitational equilibrium position. The satellite is stabilized on the reference trajectory by the magnetic coils. The problem is solved in several stages. An optimization problem to be solved by the particle swarm optimization method is formulated at each stage. Cost functions are based on the linearized model analysis. The main stage is the construction of a special reference motion, which provides the minimum control torque projection on the geomagnetic induction vector. Optimal geomagnetic field dipole approximation for a given time interval is considered to reduce tracking errors. The paper compares combinations of different cost functions in terms of the terminal attitude accuracy in the presence of perturbations. [ABSTRACT FROM AUTHOR]

Virtual education has been associated, on some occasions, with economic models of scale that strengthen the mercantilist vision of teaching, thereby raising questions on the quality of the service. Some studies on educational costs associated with this modality simplify the analysis based on individual elements, such as the production of courses or the technological infrastructure, offering an incomplete and biased perspective. This study proposes to carry out a complete analysis of the costs of a virtual university using an Activity-Based Costing (ABC) model to determine the percentage of the budget consumed by each of the activities involved in the training process. The results show the significant influence that instructional design and teaching activities have on virtual modalities (62.5% of the set of activities), thus highlighting the importance of human resources in maintaining educational modalities mediated by technology. Understanding the importance of human capital and its contribution to offering a quality and innovative educational service is fundamental to consolidate a model that can improve access to education for populations with major difficulties. [ABSTRACT FROM AUTHOR]

In the Mediterranean area, using organic fertilizers is crucial to maintaining and increasing soil fertility and crop productivity since soil organic matter is being progressively depleted due to climate change effects. Therefore, the aim of this study was to compare two different organic fertilizers (MC1 without and MC2 with an inoculum of selected microorganisms), applied at 100% and 50% doses, with mineral fertilization and an unfertilized control: (i) by assessing the agronomic performance of fennel crop; and (ii) by investigating environmental and economic sustainability, through GHG emissions determination, carbon efficiency, and cost analysis. The results of the MC2 were comparable to the mineral fertilization for crop growing parameters (plants and roots dry weights) and marketable yield, irrespective of the amount applied (50–100%), likely due to the inoculum of selected microorganisms. These may have favored the soil microbial activity, the nutrient availability, and better synchronization of N mineralization with fennel N demand with respect to MC1 (with a higher C/N ratio). The MC2 also achieved lower costs than the other treatments. The highest GHG emission value was found in the mineral fertilization treatment, while the lowest was recorded in the unfertilized control treatment. The two organic treatments at 100% were the most carbon-efficient systems because of the highest carbon stocks/output, considering the difference between C stocked/output and the C loss/input emitted. [ABSTRACT FROM AUTHOR]

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

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

Simple Summary: Lowering the slaughter age of sheep is an indispensable measure to improve the quality of meat reaching the market and to increase the per capita consumption of this type of protein. Sheep meat production systems on pasture are less costly alternatives and associating them with supplementation strategies to reduce costs may be the path to consolidate the productive chain of sheep meat. We assessed intermittent supplementation (every day or every other day) in sheep managed with Masai grass and found no effect of said grass on nutrient intake, performance, intake behavior, carcass characteristics, or meat quality. However, it was seen that the strategy reduces the cost of producing 1 kg of meat by 15%, which encourages us to recommend the application of that nutritional strategy. This study aimed to assess nutrient intake, performance, intake behavior, carcass characteristics, and meat quality of sheep managed on Masai grass pastures along with intermittent concentrate supplementation, in addition to the economic impacts of applying that strategy. A sample of 24 Santa Inês sheep (12 males and 12 females) was kept for 80 days on Panicum maximum cv. Massai pastures and was supplemented daily or every other day. The voluntary intake of dry matter and nutrients was estimated. Mean daily weight gain and total weight gain were calculated and intake behavior parameters were assessed. The males were slaughtered and the weight and yield of the carcasses and meat cuts were assessed. The meat was analyzed for cooking losses, shear force, and color. The gross margin of the system was estimated from the difference between total income and operational cost. No effect was seen of the interaction between supplementation frequency and sex for any parameter assessed (p > 0.05). Intermittent supplementation of Santa Inês sheep managed with Masai grass is recommended since the strategy does not impact nutrient intake, performance, intake behavior, carcass characteristics, or meat quality, but lowers the costs of producing 1 kg of meat by 15%. [ABSTRACT FROM AUTHOR]

The Measurement-Device-Independent-Quantum Key Distribution (MDI-QKD) has the advantage of extending the secure transmission distances. The MDI-QKD combined with the Hybrid-Trusted and Untrusted Relay (HTUR) is used to deploy large-scale QKD networks, which effectively saves deployment cost. We propose an improved scheme for the QKD network architecture and cost analysis, which simplifies the number of QKD transmitters and incorporates the quantum key pool (QKP) in the QKD network. We developed a novel Hybrid-QKD-Network-Cost (HQNC) heuristic algorithm to solve the cost optimization problem. Simulations verified that the scheme in this paper could save the cost by over 50 percent and 90 percent, respectively. [ABSTRACT FROM AUTHOR]

As part of the United Arab Emirates' and the world's aviation goal of reaching net-zero greenhouse gas emissions by 2050, this paper studied the potential of successfully implementing both biofuel "drop-in" alternatives and aerodynamically efficient configurations to decarbonize the aviation industry. By investigating various proposed designs through a PUGH analysis, it was concluded that the optimum design has a Transonic Truss-Braced Wing configuration and runs on 60% biofuel. Although the design stipulates a 1.3% increase in weight, this does not negate the reduction in emissions and fuel consumption. This study also explored the various types of biofuels and found camelina seeds to be the best choice. The effects of biofuels in comparison with Jet-A fuel were further deliberated in a fuel combustion simulation performed on the Ansys-Fluent software. The results of the simulation showed a reduction of 50% in carbon monoxide (CO) and 24% in carbon dioxide (CO2) emissions when burning camelina biofuel rather than Jet-A, making it an ideal alternative to those conventional jet fuels. A primary cost analysis of biofuel applications showed an increase of 453 USD (1653.18 AED) per passenger flying on board 100%-biofuel-powered aircrafts. Yet, considering the trend of the cost increase with the biofuel blend ratio, a solution may exist to the increased cost of biofuel-powered aircrafts. [ABSTRACT FROM AUTHOR]

The CDC's Core Elements of an Antimicrobial Stewardship Program (ASP) lists intravenous (IV) to oral (PO) conversion as an important pharmacy-based intervention. However, despite the existence of a pharmacist-driven IV to PO conversion protocol, conversion rates within our healthcare system remained low. We aimed to evaluate the impact of a revision to the current conversion protocol on conversion rates, using linezolid as a marker due to its high PO bioavailability and high IV cost. This retrospective, observational study was conducted within a healthcare system composed of five adult acute care facilities. The conversion eligibility criteria were evaluated and revised on 30 November 2021. The pre-intervention period started February 2021 and ended November 2021. The post-intervention period was December 2021 to March 2022. The primary objective of this study was to establish if there was a difference in PO linezolid utilization reported as days of therapy per 1000 days present (DOT/1000 DP) between the pre- and post-intervention periods. IV linezolid utilization and cost savings were investigated as secondary objectives. The average DOT/1000 DP for IV linezolid decreased from 52.1 to 35.4 in the pre- and post-intervention periods, respectively (p < 0.01). Inversely, the average DOT/1000 DP for PO linezolid increased from 38.9 in the pre-intervention to 58.8 for the post-intervention period, p < 0.01. This mirrored an increase in the average percentage of PO use from 42.9 to 62.4% for the pre- and post-intervention periods, respectively (p < 0.01). A system-wide cost savings analysis showed projected total annual cost savings of USD 85,096.09 for the system, with monthly post-intervention savings of USD 7091.34. The pre-intervention average monthly spend on IV linezolid at the academic flagship hospital was USD 17,008.10, which decreased to USD 11,623.57 post-intervention; a 32% reduction. PO linezolid spend pre-intervention was USD 664.97 and increased to USD 965.20 post-intervention. The average monthly spend on IV linezolid for the four non-academic hospitals was USD 946.36 pre-intervention, which decreased to USD 348.99 post-intervention; a 63.1% reduction (p < 0.01). Simultaneously, the average monthly spend for PO linezolid was USD 45.66 pre-intervention and increased to USD 71.19 post-intervention (p = 0.03) This study shows the significant impact that an ASP intervention had on IV to PO conversion rates and subsequent spend. By revising criteria for IV to PO conversion, tracking and reporting results, and educating pharmacists, this led to significantly more PO linezolid use and reduced the overall cost in a large healthcare system. [ABSTRACT FROM AUTHOR]

The Voluntary Agreement for Collecting and Recycling Plastic Waste (VA), including polyvinyl chloride (PVC) profiles and flooring materials, will be converted to an Extended Producer Responsibility (EPR) system from 2023. The objective of this study is to calculate the standard recycling cost and the recycling market size for preparing the new system. Among the total recycling companies participating in the VA, a cost analysis was conducted for 11 profile businesses (35% of the total businesses) and seven flooring businesses (58% of the total businesses). As a result, the standard recycling cost was calculated as 0.45 USD/kg for PVC profiles and 0.36 USD/kg for PVC flooring materials. As of 2020, the total market size is 1135 million USD (5.86 million USD for PVC profiles and 5.49 million USD for PVC flooring materials). Our research shows that few countries have nationally managed accurate data regarding PVC profiles and flooring waste. Compared to the European Union (EU), the total amount of recycled PVC products in Korea seems lower, but the recycling rate per capita is higher. This study can provide basic data about the recycling industry for the recycling academia and the manufacturing field. [ABSTRACT FROM AUTHOR]

The estimation of construction costs for shield tunneling projects is typically based on a standard quota, which fails to consider the variation of geological parameters and often results in significant differences in unit cost. To address this issue, we propose a novel model based on a random forest machine learning procedure for analyzing the construction cost of shield tunnelling in complex geological conditions. We focus specifically on the unit consumption of grease, grouting, labor, water, and electricity. Using a dataset of geotechnical parameters and consumption quantities from a shield tunneling project, we employ KNN and correlation analysis to reduce the input dataset dimension from 17 to 6 for improved model accuracy and efficiency. Our proposed approach is applied to a shield tunneling project, with results showing that the compressive strength of geomaterial is the most influential parameter for grease, labor, water, and electricity, while it is the second most influential for grouting quantity. Based on these findings, we calculate the unit consumption and cost of the tunnelling project, which we classify into three geological categories: soil, soft rock, and hard rock. Comparing our results to the standard quota value, it is found that the unit cost of shield tunneling in soil is slightly lower (6%), while that in soft rock is very close to the standard value. However, the cost in the hard rock region is significantly greater (38%), which cannot be ignored in project budgeting. Ultimately, our results support the use of compressive strength as a classification index for shield tunneling in complex geological conditions, representing a valuable contribution to the field of tunneling cost prediction. [ABSTRACT FROM AUTHOR]

This work uses design optimization of a power electronics converter to achieve the best levelized cost of energy in a PV application. The methodology uses detailed models of power electronics' active and passive components to determine the cost and performances of the solid-state energy conversion and connect them to the system-level vision. The deterministic algorithm used for converter sizing allows taking into account a large number of variables and constraints. Methodology, models, and some illustrations of the results are provided in this paper. A sensitivity analysis was also conducted on the cost model. [ABSTRACT FROM AUTHOR]

To mitigate the effects of the lack of IoT standardization, including scalability, reusability, and interoperability, we propose a domain-agnostic monitoring and control framework (MCF) for the design and implementation of Internet of Things (IoT) systems. We created building blocks for the layers of the five-layer IoT architecture and built the MCF's subsystems (monitoring subsystem, control subsystem, and computing subsystem). We demonstrated the utilization of MCF in a real-world use-case in smart agriculture, using off-the-shelf sensors and actuators and an open-source code. As a user guide, we discuss the necessary considerations for each subsystem and evaluate our framework in terms of its scalability, reusability, and interoperability (issues that are often overlooked during development). Aside from the freedom to choose the hardware used to build complete open-source IoT solutions, the MCF use-case was less expensive, as revealed by a cost analysis that compared the cost of implementing the system using the MCF to obtain commercial solutions. Our MCF is shown to cost up to 20 times less than normal solutions, while serving its purpose. We believe that the MCF eliminated the domain restriction found in many IoT frameworks and serves as a first step toward IoT standardization. Our framework was shown to be stable in real-world applications, with the code not incurring a significant increase in power utilization, and could be operated using common rechargeable batteries and a solar panel. In fact, our code consumed so little power that the usual amount of energy was two times higher than what is necessary to keep the batteries full. We also show that the data provided by our framework are reliable through the use of multiple different sensors operating in parallel and sending similar data at a stable rate, without significant differences between the readings. Lastly, the elements of our framework can exchange data in a stable way with very few package losses, being able to read over 1.5 million data points in the course of three months. [ABSTRACT FROM AUTHOR]

The 150 cm tall windows that used as the standard in residential buildings are now being replaced by 220 cm tall windows, which are rapidly becoming widespread. This study examined different window types according to both the type of glass used as well as the type of fill material used in double-glazed windows in order to show the effect of window selection on the energy consumption of the building. A comparison between Antalya and Erzurum was also made in the study. The study was carried out on a building model with seven floors and twenty-four apartments, each of which has five units. The window heights in each unit were assumed to be 150 cm and were defined as Type 0. Five additional building types were defined by increasing the window heights in each unit, respectively. Thermal load values were calculated for all six building types and compared with each other. As a result, a 46.7% increase in the window area causes a maximum heat loss of 9.6% in Erzurum and a maximum heat gain of 45.1% in Antalya. These values bring about an increase in the energy consumption by an average of USD 1465.32 per year in Erzurum and an average of USD 581.08 per year in Antalya. [ABSTRACT FROM AUTHOR]