To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of ment...To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.展开更多
BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences b...BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.展开更多
Life Cycle Cost Analysis (LCCA) provides a systematic approach to assess the total cost associated with owning, operating, and maintaining assets throughout their entire life. BIM empowers architects and designers to ...Life Cycle Cost Analysis (LCCA) provides a systematic approach to assess the total cost associated with owning, operating, and maintaining assets throughout their entire life. BIM empowers architects and designers to perform real-time evaluations to explore various design options. However, when integrated with LCCA, BIM provides a comprehensive economic perspective that helps stakeholders understand the long-term financial implications of design decisions. This study presents a methodology for developing a model that seamlessly integrates BIM and LCCA during the conceptual design stage of buildings. This integration allows for a comprehensive evaluation and analysis of the design process, ensuring that the development aligns with the principles of low carbon emissions by employing modular construction, 3D concrete printing methods, and different building design alternatives. The model considers the initial construction costs in addition to all the long-term operational, maintenance, and salvage values. It combines various tools and data through different modules, including energy analysis, Life Cycle Assessment (LCA), and Life Cycle Cost Analysis (LCCA) to execute a comprehensive assessment of the financial implications of a specific design option throughout the lifecycle of building projects. The development of the said model and its implementation involves the creation of a new plug-in for the BIM tool (i.e., Autodesk Revit) to enhance its functionalities and capabilities in forecasting the life-cycle costs of buildings in addition to generating associated cash flows, creating scenarios, and sensitivity analyses in an automatic manner. This model empowers designers to evaluate and justify their initial investments while designing and selecting potential construction methods for buildings, and enabling stakeholders to make informed decisions by assessing different design alternatives based on long-term financial considerations during the early stages of design.展开更多
AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quanti...AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction($/mm Hg) at 1y postoperatively.RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.CONCLUSION: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.展开更多
For probabilistic programs,there is some work for qualitative and quantitative analysis about expec-tation or mean,such as expected termination time,and expected cost analysis.However,another non-trivial issue is abou...For probabilistic programs,there is some work for qualitative and quantitative analysis about expec-tation or mean,such as expected termination time,and expected cost analysis.However,another non-trivial issue is about tail bounds(i.e.,upper bounds of tail probabilities),which can provide high-probability guarantees to extreme events.In this work,we focus on the problem of tail-bound cost analysis over nondeterministic proba-bilistic programs,which aims to automatically obtain the tail bound of resource usages over such programs.To achieve this goal,we present a novel approach,combined with a suitable concentration inequality,to derive the tail bound of accumulated cost until program termination.Our approach can handle both positive and negative costs.Moreover,our approach enables an automated template-based synthesis of supermartingales and leads to an efficient polynomial-time algorithm.To show the effectiveness of our approach,we present experimental results on various programs and make a comparison with state-of-the-art tools.展开更多
This paper systematically generalizes relevant theories and methods regarding mining cost control and constitutes the model for the mining cost analysis. It also comes up with the sensitivity factor analysis to conduc...This paper systematically generalizes relevant theories and methods regarding mining cost control and constitutes the model for the mining cost analysis. It also comes up with the sensitivity factor analysis to conduct mining cost control. The theories and methods have been experimented with Jiangsu Chuanshan Mining Joint-Stock Company Ltd. Case studies have been undertaken on mining cost of the company and the most sensitive factor which affects mining cost has been found accordingly. Finally the paper concludes that the focus concerning the cost control of the company should be directed at output and material costs.展开更多
The paper analyzes the external economy of pollution, Two different cost models of enterprises are established From the point of enterprises and the government, the measures of eliminating the externalily are discusse...The paper analyzes the external economy of pollution, Two different cost models of enterprises are established From the point of enterprises and the government, the measures of eliminating the externalily are discussed, and the limits the measures are analyzed.展开更多
Inverted pavements have proven performance across the world,and there is a need to opti-mize the layer thickness and material properties of the pavement addressing the critical failures in the mechanistic-empirical pa...Inverted pavements have proven performance across the world,and there is a need to opti-mize the layer thickness and material properties of the pavement addressing the critical failures in the mechanistic-empirical pavement design.The present study is made on bituminous concrete(BC)pavement with traffic up to 50 samples per second(MSA)and studying the critical factors affecting the pavement performance.The Minitab’s response surface methodology(RSM)box behnken method,was used for the design of experi-ments which includes critical factors and responses obtained from ANSYS finite element modeling of the inverted pavement.The critical factors and responses are normally dis-tributed and indicate a linear relationship with the least error.The composite desirability for minimum stress and strains in the pavement layers was found to be 0.89.The optimized pavement thickness and layer material properties were validated with two pavement field cross sections of different Indian national highways,and it is observed that the optimized cross-section is safe.Further,this research paper carried out life cycle cost analysis(LCCA)and life cycle assessment(LCA)of inverted pavement with optimized pavement cross-section obtained including the carbon footprint during the vehicle operation phase.The study demonstrated the benefits of inverted pavement with reduced costs and carbon emissions.Thus,this approach paves the way towards sustainable and long-lasting pavements.展开更多
Pavement performance and economic efficiency are researched on the perpetual test pavement of Yijiang-Suzhou Express Highway in Jiangsu province, China. Test sections were continuously monitored. The conditions and de...Pavement performance and economic efficiency are researched on the perpetual test pavement of Yijiang-Suzhou Express Highway in Jiangsu province, China. Test sections were continuously monitored. The conditions and developing laws of deflection, rutting and cracking are compared among the perpetual pavement with the rich binder layer （RBL）, the perpetual pavement without the RBL, and the conventional semi-rigid asphalt pavement in the past eight years after opening for traffic. Economical evaluation is conducted via life cycle cost analysis （LCCA）. Based on the performance comparison and LCCA analysis, sections with the RBL have good crack resistance, but they are not very satisfactory in the aspect of permanent deformation; the conventional semi-rigid asphalt pavement is the least economic one due to requiring more frequent maintenance. Research results show that the perpetual pavement without RBL is a more appropriate structure for the test site.展开更多
Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of ...Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of the contemporary treatment paradigm for mCRPC.Methods:We devised a treatment protocol consisting of sipuleucel-T,enzalutamide,abiraterone,docetaxel,radium-223,and cabazitaxel.We estimated number and length of treatments for each therapy using dosing schedules or progression free survival data from published clinical trials.We estimated treatment cost using billing data and Medicare reimbursement values and performed a CEA.Our analysis assumed US$100,000 per life year saved(LYS)as the threshold societal willingness to pay.Results:Incremental cost-effectiveness ratios(ICER)for strategies incorporating sipuleucel-T that were not eliminated by extended dominance exceeded the societal threshold willingnessto-pay of US$100,000 per LYS,the lowest of which was sipuleucel-T+enzalutamide+abiraterone+docetaxel at US$207,714 per LYS.Enzalutamide+abiraterone+docetaxel exhibited the most favorable ICER among strategies without sipuleucel-T at US$165,460 per LYS.Conclusion:Based on the available survival data and current costs of treatment,all treatment strategies greatly exceed a commonly assumed societal willingness-to-pay threshold of US$100,000 per LYS.Improvements in this regard can only comewith a reduction in pricing,better tailoring of treatment or significant enhancements in survival with clinical use of treatment combinations or sequences.展开更多
Background： Cervical cancer shows a growing incidence and medical cost in recent years that has increased severe financial pressure on patients and medical insurance institutions. This study aimed to investigate the ...Background： Cervical cancer shows a growing incidence and medical cost in recent years that has increased severe financial pressure on patients and medical insurance institutions. This study aimed to investigate the medical economic characteristics of cervical cancer patients with different payment modes within a Grade A tertiary hospital to provide evidence and suggestions for inpatient cost control and to verily the application of Gamma model in medical cost analysis. Methods： The basic and cost information of cervical cancer cases within a Grade A tertiary hospital in the year 2011-2016 were collected. The Gamma model was adopted to analyze the differences in each cost item between medical insured patient and uninsured patients. Meanwhile, the marginal means of different cost items were calculated to estimate the influence of payment modes toward different medical cost items among cervical cancer patients in the study. Results： A total of 1321 inpatients with cervical cancer between the 2011 and 2016 were collected through the medical records system. Of the 1321 cases~ 65.9% accounted for medical insured patients and 34.1% were uninsured patients. The total inpatient medical expenditure of insured patients was RMB 29,509.1 Yuan and uninsured patients was RMB 22,114.3 Yuan, respectively. Payment modes, therapeutic options as well as the recurrence and metastasis of tumor toward the inpatient medical expenditures between the two groups were statistically significant. To the specifics, drug costs accounted for 37.7% and 33.8% of the total, surgery costs accounted for 21.5% and 25.5%, treatment costs accounted for 18.7% and 16.4%, whereas the costs of imaging and laboratory examinations accounted for 16.4% and 15.2% for the insured patient and uninsured patients, respectively. As the effects of covariates were controlled, the total hospitalization costs, drug costs, treatment costs as well as imaging and laboratory exainination costs showed statistical significance. The total hospitalization costs, drug costs, treatment costs as well as imaging and laboratory examination costs of insured patient were 1.33, 1.42, 1.52, and 1.44 times of uninsured patients. Conclusions： The analysis of different payment modes toward the medical economic characteristics based on Gamma model is basically rational. Medical payment modes are having certain influence toward the hospitalization expenses of cervical cancer patients in an extent, as drug costs, treatment costs, and examination costs appear to be the main causes.展开更多
Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of ...Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.Methods:A number of study sites(eight counties in five provinces)were selected from the malaria endemic area in China,representing the different levels of malaria incidence,risk classification,economic development.A number of households with malaria cases(n=923)were surveyed during the May to December in 2012 to collect information on malaria economic burden.Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender,age group,occupation and malaria type.The malaria economic costs were evaluated by direct and indirect costs.Comparisons were carried out by using the chi-square test(or Z-test)and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients,hospitalized/out patients,and treatment hospitals.Results:The average cost of malaria per case was 1691.23 CNY(direct cost was 735.41 CNY and indirect cost was 955.82 CNY),which accounted for 11.1%of a household’s total income.The average costs per case for local and imported malaria were 1087.58 CNY and 4271.93 CNY,respectively.The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above(3975.43 CNY)was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital(938.80 CNY).Conclusion:This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs.There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria,especially of imported infections,in order to eliminate the disease in China.展开更多
Optimal application of pavement preservation or preventive maintenance is critical for highway agencies to allocate the limited budget for different treatments. This study developed an integrated life-cycle cost analy...Optimal application of pavement preservation or preventive maintenance is critical for highway agencies to allocate the limited budget for different treatments. This study developed an integrated life-cycle cost analysis （LCCA） model to quantify the impact of pavement preservation on agency cost and vehicle operation cost （VOC） and analyzed the optimal timing of preservation treatments. The international roughness index （IRI） data were extracted from the long-term pavement performance （LTPP） program specific pavement studies 3 （SPS-3） to determine the long-term effectiveness of preservation treatments on IRI deterioration. The traffic loading and the initial IRI value significantly affects life extension and the benefit of agency cost caused by pavement preservation. The benefit in VOC is one to two orders greater in magnitude as compared to the benefit in agency cost. The optimal timing calculated based on VOC is always earlier than the optimal timing calculated based on agency cost. There are considerable differences among the optimal timing of three preservation treatments.展开更多
A conceptual mathematical model was used to evaluate the design parameters of a combined ultraviolet （UV）-biofilter system, and perform a cost analysis. Results showed that the UV light source strength and the gas r...A conceptual mathematical model was used to evaluate the design parameters of a combined ultraviolet （UV）-biofilter system, and perform a cost analysis. Results showed that the UV light source strength and the gas residence times in the UV system （UVRT） and biofilter （EBRT） had positive effects on the overall chlorobenzene removal efficiency of the system. High ratio of UVRT to EBRT improved the removal efficiency, suggesting that the UV system has a greater effect on the overall performance of the system compared with the biofilter. Analysis of the capital and operating costs showed that the capital costs of the standalone biofilter system were much higher than those of the standalone UV system. However, the biofilter operating costs were lower than those of the UV system. The operating costs of the combined UV-biofilter system increased with increasing UVRT/EBRT ratio, whereas its capital costs decreased.展开更多
Bio-gasification is a new technology and considered as a more efficient way to utilize bioenergy.The economic feasibility becomes one of the greatest issues when we apply this new technology.Evaluation of economic fea...Bio-gasification is a new technology and considered as a more efficient way to utilize bioenergy.The economic feasibility becomes one of the greatest issues when we apply this new technology.Evaluation of economic feasibility of a bio-gasification facility needs better understanding of its production unit cost under different capacities and different working shift modes.The objective of this study was to evaluate the unit cost of biofuel products(Liquid HCs,Light HCs and Oxygenates CxHyOz)under different capacities using a modeling method.The cost analysis model was developed using Visual Basic Microsoft 2008,computer programming language and mathematical equations.The modeling results showed that the unit costs of biofuel product from bio-gasification facility were significantly affected by production capacities of facilities.As the facility capacity increased from 65 to 10,000 N m^3 h^-1,the biofuel production unit cost of gas(Light HCs),oil(Liquid HCs),and aqueous(Oxygenates CxHyOz)decreased from$38.92 per MMBTU,$30.89 per gallon and$25.74 per gallon to$2.01 per MMBTU,$1.59 per gallon,and$1.33 per gallon,respectively.The results of the sensitivity analysis showed that feedstock cost was the most sensitive cost factor on unit costs for all biofuel products at high capacity.The cost analysis model developed in this study could be used to optimize production unit costs of bio-fuel products from bio-gasification facility.展开更多
Excessive consumption of refined grains harms human health and ecosystem viability.Whole grains,as a healthy and sustainable alternative to refined grains,can benefit individual health by providing dietary fiber,B vit...Excessive consumption of refined grains harms human health and ecosystem viability.Whole grains,as a healthy and sustainable alternative to refined grains,can benefit individual health by providing dietary fiber,B vitamins,and bioactive substances.Additionally,they aid in improving the environment due to their higher extraction rate and lower carbon emission during the processing stage.However,few studies have attempted to evaluate the economic and social benefits of increasing the amount of whole grain in grain intake.This paper estimates the potential savings in healthcare costs and reduced food carbon footprints(CFs)that could result from a shift toward whole grain consumption following the Chinese Dietary Guidelines(CDG).We investigate hypothetical scenarios where a certain proportion(5–100%)of Chinese adults could increase their whole grain intakes as proposed by CDG to meet the average shortfall of 30.2 g.In that case,the healthcare costs for associated diseases(e.g.,type2 diabetes mellitus(T2DM),cardiovascular disease(CVD),and colorectal cancer(CRC))are expected to reduce by a substantial amount,from USD 2.82 to 56.37 billion;the carbon emission levels are also projected to decrease by0.24–5.72 million tons.This study provides compelling evidence that advocating for the transition towards greater consumption of whole grain products could benefit individual health,the environment,and society,by reducing both healthcare costs and carbon emissions.展开更多
BACKGROUND Laparoscopic Heller myotomy(LHM)has been the traditional surgical treatment for achalasia.Recently,peroral endoscopic myotomy(POEM)has demonstrated similar clinical outcomes with shorter procedure times.Stu...BACKGROUND Laparoscopic Heller myotomy(LHM)has been the traditional surgical treatment for achalasia.Recently,peroral endoscopic myotomy(POEM)has demonstrated similar clinical outcomes with shorter procedure times.Studies comparing the direct cost-effectiveness of POEM vs LHM are limited.AIM To compare costs of POEM vs LHM.METHODS Haider SA et al.Comparing costs:POEM vs Heller myotomy WJGE https://www.wjgnet.com 594 October 16,2023 Volume 15 Issue 10 This retrospective chart review aimed to compare the outcomes and cost of clinical care between patients who underwent POEM and LHM procedures for achalasia.The study was conducted at a tertiary academic center from January 2019 to December 2020.Clinical outcomes,including post-operative Eckardt scores and adverse events,were assessed and compared between the two groups.Direct cost variance analysis was utilized to evaluate the cost of clinical care incurred by patients undergoing POEM in the year preceding the procedure,during the index admission,and one year post-procedure,in comparison to patients undergoing LHM.RESULTS Of 30 patients were included(15 POEM and 15 LHM)in the study.Patients in the POEM group had a mean Eckardt score of 0.5±0.5 post-procedure,which was no different from patients in the LHM group(0.7±0.6,P=0.17)indicating comparative efficacy.However,the total costs of the admission for the procedure in the LHM group were on average$1827 more expensive than in the POEM group(P<0.01).Total healthcare costs one year prior to index procedure were$7777 higher in the LHM group,but not statistically different(P=0.34).The patients in the LHM group one year after the index procedure had accrued$19730.24 larger total cost,although this was not statistically different from POEM group(P=0.68).CONCLUSION Despite similar clinical outcomes,the cost of the index procedure admission for POEM was significantly lower than for LHM.The difference was primarily related to shorter time increments utilized in the operating room during the index procedure,and shorter length of hospital stay following POEM.展开更多
Textile dyes are dramatic sources of pollution and non-aesthetic disturbance of aquatic life and therefore represent a potential risk of bioaccumulation that can affect living species.It is imperative to reduce or eli...Textile dyes are dramatic sources of pollution and non-aesthetic disturbance of aquatic life and therefore represent a potential risk of bioaccumulation that can affect living species.It is imperative to reduce or eliminate these dyes from liquid effluents with innovative biomaterials and methods.Therefore,this research aims to highlight the performance of Capparis spinosa L waste-activated carbon(CSLW-AC)adsorbent to remove crystal violet(CV)from an aqueous solution.The mechanism of CV adsorption on CSLW-AC was evaluated based on the coupling of experimental data and different characterization techniques.The efficiency of the CSLW-AC material reflected by the equilibrium adsorption capacity of CV could reach more than 195.671 mg·g^(–1) when 0.5 g·L^(–1) of CSLW-AC(Particle size≤250μm)is introduced into the CV of initial concentration of 100 mg·L^(–1) at pH 6 and temperature 65℃ and in the presence of potassium ions after 60 min of contact time according to the one parameter at a time studies.The adsorption behavior of CV on CSLW-AC was found to be consistent with the pseudo-second-order kinetic model and Frumkin's linear isothermal model.The thermodynamic aspects indicate that the process is physical,spontaneous,and endothermic.The optimization of the process by the Box Behnken design of experiments resulted in an adsorption capacity approaching 183.544 mg·g^(–1)([CV]=100 mg·L^(–1) and[CSLW-AC]=0.5 g·L^(–1) at 35 min).The results of the Lactuca sativa seeds germination in treated CV(70%),adsorbent solvent and thermal regeneration(more than 5 cycles),and process cost analysis(1.0484 USD·L^(–1))tests are encouraging and promising for future exploitations of the CSLW-AC material in different industrial fields.展开更多
A combination of solar hot water system with the economizer for heating the water that circulates in the hot water storage tank is presented with the objective to reduce and analyze the cost of investment. The solar c...A combination of solar hot water system with the economizer for heating the water that circulates in the hot water storage tank is presented with the objective to reduce and analyze the cost of investment. The solar collector area will be affected to the investment cost of the solar hot water system. A combined system can be reduced the cost of solar collector by using the waste heat from the economizer to produce the hot water for reaching the requirement of the industry. In this paper the economizer installs in the boiler stack of the industry and produces hot water at 60 ℃ of 5,400 liter per day and the solar hot water system produces the hot water at the same temperature of 6,100 liter per day. The analysis is proposed by determining the solar collector plate area from the data and calculation. Investment cost of the system is 151,000 baht for the solar hot water system of 110,000 baht and the economizer of 410,000 baht for producing the total hot water of 115,000 liter per day.展开更多
基金funded by National Institute for Health Research(NIHR)(RP-PG-1212-20019)。
文摘To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.
文摘BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.
文摘Life Cycle Cost Analysis (LCCA) provides a systematic approach to assess the total cost associated with owning, operating, and maintaining assets throughout their entire life. BIM empowers architects and designers to perform real-time evaluations to explore various design options. However, when integrated with LCCA, BIM provides a comprehensive economic perspective that helps stakeholders understand the long-term financial implications of design decisions. This study presents a methodology for developing a model that seamlessly integrates BIM and LCCA during the conceptual design stage of buildings. This integration allows for a comprehensive evaluation and analysis of the design process, ensuring that the development aligns with the principles of low carbon emissions by employing modular construction, 3D concrete printing methods, and different building design alternatives. The model considers the initial construction costs in addition to all the long-term operational, maintenance, and salvage values. It combines various tools and data through different modules, including energy analysis, Life Cycle Assessment (LCA), and Life Cycle Cost Analysis (LCCA) to execute a comprehensive assessment of the financial implications of a specific design option throughout the lifecycle of building projects. The development of the said model and its implementation involves the creation of a new plug-in for the BIM tool (i.e., Autodesk Revit) to enhance its functionalities and capabilities in forecasting the life-cycle costs of buildings in addition to generating associated cash flows, creating scenarios, and sensitivity analyses in an automatic manner. This model empowers designers to evaluate and justify their initial investments while designing and selecting potential construction methods for buildings, and enabling stakeholders to make informed decisions by assessing different design alternatives based on long-term financial considerations during the early stages of design.
文摘AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction($/mm Hg) at 1y postoperatively.RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.CONCLUSION: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.
基金the National Natural Science Foundation of China(Nos.61802254,62072299,and 61772336)。
文摘For probabilistic programs,there is some work for qualitative and quantitative analysis about expec-tation or mean,such as expected termination time,and expected cost analysis.However,another non-trivial issue is about tail bounds(i.e.,upper bounds of tail probabilities),which can provide high-probability guarantees to extreme events.In this work,we focus on the problem of tail-bound cost analysis over nondeterministic proba-bilistic programs,which aims to automatically obtain the tail bound of resource usages over such programs.To achieve this goal,we present a novel approach,combined with a suitable concentration inequality,to derive the tail bound of accumulated cost until program termination.Our approach can handle both positive and negative costs.Moreover,our approach enables an automated template-based synthesis of supermartingales and leads to an efficient polynomial-time algorithm.To show the effectiveness of our approach,we present experimental results on various programs and make a comparison with state-of-the-art tools.
文摘This paper systematically generalizes relevant theories and methods regarding mining cost control and constitutes the model for the mining cost analysis. It also comes up with the sensitivity factor analysis to conduct mining cost control. The theories and methods have been experimented with Jiangsu Chuanshan Mining Joint-Stock Company Ltd. Case studies have been undertaken on mining cost of the company and the most sensitive factor which affects mining cost has been found accordingly. Finally the paper concludes that the focus concerning the cost control of the company should be directed at output and material costs.
文摘The paper analyzes the external economy of pollution, Two different cost models of enterprises are established From the point of enterprises and the government, the measures of eliminating the externalily are discussed, and the limits the measures are analyzed.
文摘Inverted pavements have proven performance across the world,and there is a need to opti-mize the layer thickness and material properties of the pavement addressing the critical failures in the mechanistic-empirical pavement design.The present study is made on bituminous concrete(BC)pavement with traffic up to 50 samples per second(MSA)and studying the critical factors affecting the pavement performance.The Minitab’s response surface methodology(RSM)box behnken method,was used for the design of experi-ments which includes critical factors and responses obtained from ANSYS finite element modeling of the inverted pavement.The critical factors and responses are normally dis-tributed and indicate a linear relationship with the least error.The composite desirability for minimum stress and strains in the pavement layers was found to be 0.89.The optimized pavement thickness and layer material properties were validated with two pavement field cross sections of different Indian national highways,and it is observed that the optimized cross-section is safe.Further,this research paper carried out life cycle cost analysis(LCCA)and life cycle assessment(LCA)of inverted pavement with optimized pavement cross-section obtained including the carbon footprint during the vehicle operation phase.The study demonstrated the benefits of inverted pavement with reduced costs and carbon emissions.Thus,this approach paves the way towards sustainable and long-lasting pavements.
基金The Science and Technology Project of Jiangsu Provincial Communications Department(No.7621000078)
文摘Pavement performance and economic efficiency are researched on the perpetual test pavement of Yijiang-Suzhou Express Highway in Jiangsu province, China. Test sections were continuously monitored. The conditions and developing laws of deflection, rutting and cracking are compared among the perpetual pavement with the rich binder layer （RBL）, the perpetual pavement without the RBL, and the conventional semi-rigid asphalt pavement in the past eight years after opening for traffic. Economical evaluation is conducted via life cycle cost analysis （LCCA）. Based on the performance comparison and LCCA analysis, sections with the RBL have good crack resistance, but they are not very satisfactory in the aspect of permanent deformation; the conventional semi-rigid asphalt pavement is the least economic one due to requiring more frequent maintenance. Research results show that the perpetual pavement without RBL is a more appropriate structure for the test site.
文摘Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of the contemporary treatment paradigm for mCRPC.Methods:We devised a treatment protocol consisting of sipuleucel-T,enzalutamide,abiraterone,docetaxel,radium-223,and cabazitaxel.We estimated number and length of treatments for each therapy using dosing schedules or progression free survival data from published clinical trials.We estimated treatment cost using billing data and Medicare reimbursement values and performed a CEA.Our analysis assumed US$100,000 per life year saved(LYS)as the threshold societal willingness to pay.Results:Incremental cost-effectiveness ratios(ICER)for strategies incorporating sipuleucel-T that were not eliminated by extended dominance exceeded the societal threshold willingnessto-pay of US$100,000 per LYS,the lowest of which was sipuleucel-T+enzalutamide+abiraterone+docetaxel at US$207,714 per LYS.Enzalutamide+abiraterone+docetaxel exhibited the most favorable ICER among strategies without sipuleucel-T at US$165,460 per LYS.Conclusion:Based on the available survival data and current costs of treatment,all treatment strategies greatly exceed a commonly assumed societal willingness-to-pay threshold of US$100,000 per LYS.Improvements in this regard can only comewith a reduction in pricing,better tailoring of treatment or significant enhancements in survival with clinical use of treatment combinations or sequences.
文摘Background： Cervical cancer shows a growing incidence and medical cost in recent years that has increased severe financial pressure on patients and medical insurance institutions. This study aimed to investigate the medical economic characteristics of cervical cancer patients with different payment modes within a Grade A tertiary hospital to provide evidence and suggestions for inpatient cost control and to verily the application of Gamma model in medical cost analysis. Methods： The basic and cost information of cervical cancer cases within a Grade A tertiary hospital in the year 2011-2016 were collected. The Gamma model was adopted to analyze the differences in each cost item between medical insured patient and uninsured patients. Meanwhile, the marginal means of different cost items were calculated to estimate the influence of payment modes toward different medical cost items among cervical cancer patients in the study. Results： A total of 1321 inpatients with cervical cancer between the 2011 and 2016 were collected through the medical records system. Of the 1321 cases~ 65.9% accounted for medical insured patients and 34.1% were uninsured patients. The total inpatient medical expenditure of insured patients was RMB 29,509.1 Yuan and uninsured patients was RMB 22,114.3 Yuan, respectively. Payment modes, therapeutic options as well as the recurrence and metastasis of tumor toward the inpatient medical expenditures between the two groups were statistically significant. To the specifics, drug costs accounted for 37.7% and 33.8% of the total, surgery costs accounted for 21.5% and 25.5%, treatment costs accounted for 18.7% and 16.4%, whereas the costs of imaging and laboratory examinations accounted for 16.4% and 15.2% for the insured patient and uninsured patients, respectively. As the effects of covariates were controlled, the total hospitalization costs, drug costs, treatment costs as well as imaging and laboratory exainination costs showed statistical significance. The total hospitalization costs, drug costs, treatment costs as well as imaging and laboratory examination costs of insured patient were 1.33, 1.42, 1.52, and 1.44 times of uninsured patients. Conclusions： The analysis of different payment modes toward the medical economic characteristics based on Gamma model is basically rational. Medical payment modes are having certain influence toward the hospitalization expenses of cervical cancer patients in an extent, as drug costs, treatment costs, and examination costs appear to be the main causes.
基金supported by the National Natural Science Foundation of China(No.81101280)the National Special Science and Technology Project for Major Infectious Diseases of China(Grant Nos.2012ZX10004-220,2008ZX10004-011,and 2012ZX10004-201)+1 种基金the China UK Global Health Support Programme(GHSP-CS-OP101)-China’s Experiences in Control of Malaria and Schistosomiasis:Relevant to LMICs through Distillation,Synthesis and Dissemination Approaches,the Public Health Overseas Fund,the Bureau of Health,Shanghai(Grant No.GWHW201216)the Shanghai Public Health Improvement Action Plan 2015–2017,and the Global Fund Project in China.The funders had no role in the study design,data collection and analysis,decision to publish,or preparation of the paper.
文摘Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.Methods:A number of study sites(eight counties in five provinces)were selected from the malaria endemic area in China,representing the different levels of malaria incidence,risk classification,economic development.A number of households with malaria cases(n=923)were surveyed during the May to December in 2012 to collect information on malaria economic burden.Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender,age group,occupation and malaria type.The malaria economic costs were evaluated by direct and indirect costs.Comparisons were carried out by using the chi-square test(or Z-test)and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients,hospitalized/out patients,and treatment hospitals.Results:The average cost of malaria per case was 1691.23 CNY(direct cost was 735.41 CNY and indirect cost was 955.82 CNY),which accounted for 11.1%of a household’s total income.The average costs per case for local and imported malaria were 1087.58 CNY and 4271.93 CNY,respectively.The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above(3975.43 CNY)was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital(938.80 CNY).Conclusion:This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs.There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria,especially of imported infections,in order to eliminate the disease in China.
文摘Optimal application of pavement preservation or preventive maintenance is critical for highway agencies to allocate the limited budget for different treatments. This study developed an integrated life-cycle cost analysis （LCCA） model to quantify the impact of pavement preservation on agency cost and vehicle operation cost （VOC） and analyzed the optimal timing of preservation treatments. The international roughness index （IRI） data were extracted from the long-term pavement performance （LTPP） program specific pavement studies 3 （SPS-3） to determine the long-term effectiveness of preservation treatments on IRI deterioration. The traffic loading and the initial IRI value significantly affects life extension and the benefit of agency cost caused by pavement preservation. The benefit in VOC is one to two orders greater in magnitude as compared to the benefit in agency cost. The optimal timing calculated based on VOC is always earlier than the optimal timing calculated based on agency cost. There are considerable differences among the optimal timing of three preservation treatments.
文摘A conceptual mathematical model was used to evaluate the design parameters of a combined ultraviolet （UV）-biofilter system, and perform a cost analysis. Results showed that the UV light source strength and the gas residence times in the UV system （UVRT） and biofilter （EBRT） had positive effects on the overall chlorobenzene removal efficiency of the system. High ratio of UVRT to EBRT improved the removal efficiency, suggesting that the UV system has a greater effect on the overall performance of the system compared with the biofilter. Analysis of the capital and operating costs showed that the capital costs of the standalone biofilter system were much higher than those of the standalone UV system. However, the biofilter operating costs were lower than those of the UV system. The operating costs of the combined UV-biofilter system increased with increasing UVRT/EBRT ratio, whereas its capital costs decreased.
基金This material is based upon work performed through the Sustainable Energy Research Center at Mississippi State University,and is supported by the Department of Energy under Award Number DE-FG3606GO86025Micro CHP and Biofuel Center.
文摘Bio-gasification is a new technology and considered as a more efficient way to utilize bioenergy.The economic feasibility becomes one of the greatest issues when we apply this new technology.Evaluation of economic feasibility of a bio-gasification facility needs better understanding of its production unit cost under different capacities and different working shift modes.The objective of this study was to evaluate the unit cost of biofuel products(Liquid HCs,Light HCs and Oxygenates CxHyOz)under different capacities using a modeling method.The cost analysis model was developed using Visual Basic Microsoft 2008,computer programming language and mathematical equations.The modeling results showed that the unit costs of biofuel product from bio-gasification facility were significantly affected by production capacities of facilities.As the facility capacity increased from 65 to 10,000 N m^3 h^-1,the biofuel production unit cost of gas(Light HCs),oil(Liquid HCs),and aqueous(Oxygenates CxHyOz)decreased from$38.92 per MMBTU,$30.89 per gallon and$25.74 per gallon to$2.01 per MMBTU,$1.59 per gallon,and$1.33 per gallon,respectively.The results of the sensitivity analysis showed that feedstock cost was the most sensitive cost factor on unit costs for all biofuel products at high capacity.The cost analysis model developed in this study could be used to optimize production unit costs of bio-fuel products from bio-gasification facility.
基金the National Natural Science Foundation of China(72203214 and 72061147002)China Scholarship Council(CSC)(201913043)。
文摘Excessive consumption of refined grains harms human health and ecosystem viability.Whole grains,as a healthy and sustainable alternative to refined grains,can benefit individual health by providing dietary fiber,B vitamins,and bioactive substances.Additionally,they aid in improving the environment due to their higher extraction rate and lower carbon emission during the processing stage.However,few studies have attempted to evaluate the economic and social benefits of increasing the amount of whole grain in grain intake.This paper estimates the potential savings in healthcare costs and reduced food carbon footprints(CFs)that could result from a shift toward whole grain consumption following the Chinese Dietary Guidelines(CDG).We investigate hypothetical scenarios where a certain proportion(5–100%)of Chinese adults could increase their whole grain intakes as proposed by CDG to meet the average shortfall of 30.2 g.In that case,the healthcare costs for associated diseases(e.g.,type2 diabetes mellitus(T2DM),cardiovascular disease(CVD),and colorectal cancer(CRC))are expected to reduce by a substantial amount,from USD 2.82 to 56.37 billion;the carbon emission levels are also projected to decrease by0.24–5.72 million tons.This study provides compelling evidence that advocating for the transition towards greater consumption of whole grain products could benefit individual health,the environment,and society,by reducing both healthcare costs and carbon emissions.
文摘BACKGROUND Laparoscopic Heller myotomy(LHM)has been the traditional surgical treatment for achalasia.Recently,peroral endoscopic myotomy(POEM)has demonstrated similar clinical outcomes with shorter procedure times.Studies comparing the direct cost-effectiveness of POEM vs LHM are limited.AIM To compare costs of POEM vs LHM.METHODS Haider SA et al.Comparing costs:POEM vs Heller myotomy WJGE https://www.wjgnet.com 594 October 16,2023 Volume 15 Issue 10 This retrospective chart review aimed to compare the outcomes and cost of clinical care between patients who underwent POEM and LHM procedures for achalasia.The study was conducted at a tertiary academic center from January 2019 to December 2020.Clinical outcomes,including post-operative Eckardt scores and adverse events,were assessed and compared between the two groups.Direct cost variance analysis was utilized to evaluate the cost of clinical care incurred by patients undergoing POEM in the year preceding the procedure,during the index admission,and one year post-procedure,in comparison to patients undergoing LHM.RESULTS Of 30 patients were included(15 POEM and 15 LHM)in the study.Patients in the POEM group had a mean Eckardt score of 0.5±0.5 post-procedure,which was no different from patients in the LHM group(0.7±0.6,P=0.17)indicating comparative efficacy.However,the total costs of the admission for the procedure in the LHM group were on average$1827 more expensive than in the POEM group(P<0.01).Total healthcare costs one year prior to index procedure were$7777 higher in the LHM group,but not statistically different(P=0.34).The patients in the LHM group one year after the index procedure had accrued$19730.24 larger total cost,although this was not statistically different from POEM group(P=0.68).CONCLUSION Despite similar clinical outcomes,the cost of the index procedure admission for POEM was significantly lower than for LHM.The difference was primarily related to shorter time increments utilized in the operating room during the index procedure,and shorter length of hospital stay following POEM.
文摘Textile dyes are dramatic sources of pollution and non-aesthetic disturbance of aquatic life and therefore represent a potential risk of bioaccumulation that can affect living species.It is imperative to reduce or eliminate these dyes from liquid effluents with innovative biomaterials and methods.Therefore,this research aims to highlight the performance of Capparis spinosa L waste-activated carbon(CSLW-AC)adsorbent to remove crystal violet(CV)from an aqueous solution.The mechanism of CV adsorption on CSLW-AC was evaluated based on the coupling of experimental data and different characterization techniques.The efficiency of the CSLW-AC material reflected by the equilibrium adsorption capacity of CV could reach more than 195.671 mg·g^(–1) when 0.5 g·L^(–1) of CSLW-AC(Particle size≤250μm)is introduced into the CV of initial concentration of 100 mg·L^(–1) at pH 6 and temperature 65℃ and in the presence of potassium ions after 60 min of contact time according to the one parameter at a time studies.The adsorption behavior of CV on CSLW-AC was found to be consistent with the pseudo-second-order kinetic model and Frumkin's linear isothermal model.The thermodynamic aspects indicate that the process is physical,spontaneous,and endothermic.The optimization of the process by the Box Behnken design of experiments resulted in an adsorption capacity approaching 183.544 mg·g^(–1)([CV]=100 mg·L^(–1) and[CSLW-AC]=0.5 g·L^(–1) at 35 min).The results of the Lactuca sativa seeds germination in treated CV(70%),adsorbent solvent and thermal regeneration(more than 5 cycles),and process cost analysis(1.0484 USD·L^(–1))tests are encouraging and promising for future exploitations of the CSLW-AC material in different industrial fields.
文摘A combination of solar hot water system with the economizer for heating the water that circulates in the hot water storage tank is presented with the objective to reduce and analyze the cost of investment. The solar collector area will be affected to the investment cost of the solar hot water system. A combined system can be reduced the cost of solar collector by using the waste heat from the economizer to produce the hot water for reaching the requirement of the industry. In this paper the economizer installs in the boiler stack of the industry and produces hot water at 60 ℃ of 5,400 liter per day and the solar hot water system produces the hot water at the same temperature of 6,100 liter per day. The analysis is proposed by determining the solar collector plate area from the data and calculation. Investment cost of the system is 151,000 baht for the solar hot water system of 110,000 baht and the economizer of 410,000 baht for producing the total hot water of 115,000 liter per day.
