Cost Comparison Research Articles

Assessing the state of obesity care: Quality, access, guidelines, and standards.

An international panel of obesity medicine experts from multiple professional organizations examined patterns of obesity care and current obesity treatment guidelines to identify areas requiring updating in response to emerging science and clinical evidence. The panel focused on multiple medical health and societal issues influencing effective treatment of obesity and identified several unmet needs in the definition, assessment, and care of obesity. The panel was held in Leesburg, Virginia in September 2019. The panelists recommended addressing these unmet needs in obesity medicine through research, education, evaluation of delivery and payment of care, and updating clinical practice guidelines (CPG) to better reflect obesity's pathophysiological basis and heterogeneity, as well as the disease's health, sociocultural, and economic complications; effects on quality of life; need for standards for quantitative comparison of treatment benefits, risks, and costs; and the need to more effectively integrate obesity treatment guidelines into routine clinical practice and to facilitate more direct clinician participation to improve public understanding of obesity as a disease with a pathophysiological basis. The panel also recommended that professional organizations working to improve the care of people with obesity collaborate via a working group to develop an updated, patient-focused, comprehensive CPG establishing standards of care, addressing identified needs, and providing for routine, periodic review and updating. Unmet needs in the definition, assessment and treatment of obesity were identified and a blueprint to address these needs developed via a clinical practice guideline that can be utilized worldwide to respond to the increasing prevalence of obesity.

Seismic performance and cost comparison of RC moment resisting and dual frames using UBC 97 and IBC 2021

The transition from the Uniform Building Code (UBC-97) to the International Building Code (IBC-21) marked a major shift in the definition of seismic hazard. The term “seismic hazard” in the form of peak ground acceleration (PGA) is replaced by spectral acceleration. This paper investigates the effect of using new seismic hazards on the structural performance of reinforced concrete (RC) buildings. It also looks into the financial impact on the capital costs of new buildings. Useful insights are made to understand the structural performance and financial impact of adopting IBC 21 for structural design in contrast to UBC 97. This study was carried out from the perspective of a developing country, Pakistan. Reinforced concrete moment resisting and dual frames are used as the main structural system of a typical 7-story residential building to investigate the aforementioned effect. The frames are assumed to be located in two locations with high and low seismic hazards. The effect on structural performance is investigated via nonlinear pushover analysis. Financial impact is judged mainly through cost estimation for steel and concrete. A detailed discussion is also presented on the seismic design guidelines in both codes.

Active surveillance versus immediate surgery in the management of low-risk papillary thyroid microcarcinoma: comparison of long-term costs in Brazil.

To compare the long-term medical costs of active surveillance (AS), partial thyroidectomy (PT), and total thyroidectomy (TT) in patients with low-risk papillary thyroid microcarcinoma (PTMC) receiving care covered by the Brazilian Public Health System. After reviewing AS cohorts and our own data, we created a model of AS, PT, and TT flow care for low-risk PTMC over 10, 20, and 30 years. The medical costs included those associated with diagnosis, surgery, and follow-up. We considered that 13.3% of the patients on AS would require surgery after a mean of 21.3 months, 4% undergoing TT would develop permanent hypoparathyroidism, and 43% undergoing PT would develop hypothyroidism. The most economical alternative was AS. The costs of TT per patient were higher than those of AS by 182.8% over 10 years (866.89 versus 306.49 US dollars [USD], respectively), by 152.9% over 20 years (1,023.66 versus 404.73 USD, respectively), and by 134.7% over 30 years (1,180.42 versus 502.96 USD, respectively). The costs of PT per patient were higher than those of AS by 16.0% over 10 years (355.66 versus 306.49 USD, respectively), by 16.9% over 20 years (473.41 versus 404.73 USD, respectively), and by 17.5% over 30 years (591.17 versus 502.96 USD, respectively). The AS approach was less costly than immediate surgery throughout 30 years of follow-up. Hence, the implementation of AS in Brazil should not be hindered by cost considerations.

A retrospective cohort study to evaluate disease burden, health care resource utilization, and costs in patients with breast cancer in Dubai, UAE

BackgroundThe current study evaluated the disease burden, health care resource utilization and analyzed the cost burden due to events of special interest among patients with breast cancer (BC) diagnosed and treated in Dubai, United Arab Emirates (UAE), in general and in the subset of patients treated with cyclin-dependent kinase (CDK) 4/6 inhibitors.MethodsThis retrospective cohort study, using insurance e-claims data from Dubai Real-World Database, was conducted from 01 January 2014 to 30 September 2021. Female patients aged ≥ 18 years with at least 1 diagnosis claim for BC and with continuous enrollment during the index period were included.ResultsOverall, 8,031 patients were diagnosed with BC (median age: 49.0 years), with the majority (68.1%) being in 41–60-year age group. During the post-index period, BC-specific costs contributed to 84% of the overall disease burden among patients with BC. Inpatient costs (USD 16,956.2) and medication costs (USD 10,251.3) contributed significantly to BC-specific costs. In the subgroup of patients in whom CDK4/6 inhibitors were part of the treatment regimen (n = 174), CDK4/6 inhibitors were commonly prescribed in combination with aromatase inhibitors (41.4%) and estrogen receptor antagonists (17.9%). In patients with BC, health care costs due to events of special interest (n = 1,843) contributed to 17% of the overall disease cost burden.ConclusionThe study highlights the significant cost burden among patients with BC, with BC-specific costs contributing to 84% of the overall disease cost burden. Despite few limitations such as study population predominantly comprising of privately insured expatriate patients and only direct healthcare costs being assessed in the current study, most indicative costs have been captured in the study, by careful patient selection and cost comparisons, as applicable. The findings can guide key health care stakeholders (payers and providers) on future policy measures aiming to reduce the cost burden among patients with BC.

Financial Reporting, Tracking, and Analysis Practices Effect on Financial Performance of Commercial State Corporations in Kenya

In Kenya, legislative acts by parliament establish state corporations to promote social and economic progress. The state corporations advisory committee has identified eight distinct categories of these entities, which include financial, commercial, industrial, regulatory, public universities, training and research, service, regional development authorities, as well as tertiary education corporations. Out of the 33 state corporations in commercial and manufacturing category, 18 fall under manufacturing while 15 are commercial-oriented and therefore by their operational nature expected to make profits or operating surplus. The study focused on the fifteen (15) profit-making state corporations. Most commercial state corporations are in a state of perennial loss-making. Their financial performance trend between 2016-2020, shows that out of the 15 corporations in the commercial sector, only four (26.67%) are sustainable from their operations. This leaves over 73.33% of them struggling to survive and have to depend on government funding to address their liquidity challenges. This study sought to assess the impact of financial reporting and analysis on the financial performance of commercial state corporations in Kenya. The study assumed a descriptive study design. The study used a census procedure since all fifteen State Corporations under the commercial category were studied. Data was analysed using descriptive and inferential statistics. The inferential statistics results indicate that financial reporting and analysis have a positive and statistically significant effect on financial performance of commercial SOEs. The study found that improved financial performance was observed upon conducting periodical operational budget estimations, capital project estimations, periodical cash flow projections, and comparison of actual costs and budget variance analysis. The management and finance department to ensure that financial reporting processes are strengthened to enhance accuracy, openness, and compliance with governing requirements.

Comparative Cost Analysis of Hypercholesterolemia Treatment: Allopathic Medicine and Ayurveda Medicine

The cost of treatment is very high for CVD and the prevalence of hypercholesterolemia is also very high in developing countries. Many Indian people do not have basic amenities and medical facilities are also not accessible. So alternative medicine can play an important role in the treatment of high cholesterol. Arjuna and Kutki are effective medicines in treating high cholesterol. Methodology: Comparative cross sectional study was planned to determine the socio-economic, and demographic status and comparison of treatment costs of high cholesterol patients in SS Hospital, IMS, BHU, Varanasi. Result: The overall expenditure for Group B is significantly high (3670.06) compared to Group A (1341.10). Medicine costs form the largest portion of expenses in Group B (1:4.8), while laboratory costs are the largest in Group A. Discussion: The economic burden poses a significant challenge in the treatment of any illness. Elevated cholesterol levels pose a significant problem in the current state of affairs in India. Developing countries face significant challenges in managing their financial issues.

Lifetime cost analysis of concrete barriers and steel guardrails

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

Energy, environmental, and economic analysis of novel R744/R290 cascade refrigeration systems designed for warm ambient conditions utilizing ejector

There is a growing global awareness about the need to reduce total carbon equivalent emissions and other environmental problems caused due to synthetic refrigerants. The study utilizes cascade refrigeration systems (CRS) with R744 in the low-temperature circuit (LTC) and R290 in the high-temperature circuit (HTC). Two evaporators are present in the LTC; one is direct expansion (DX) type at −40 °C with a cooling load of 70 kW, and other is gravity-fed evaporator at −25 °C with 60 kW cooling load. The study aims to enhance the performance and economic and environmental impact of CRS by incorporating parallel compression (PC) in LTC, a gravity-fed evaporator, and an ejector in HTC. The performance is compared to a baseline CRS system using a flash-gas bypass arrangement (FGB) in the LTC, bypassing generated flash gas to compressor suction. PC in LTC removes flash gas from receiver pressure to cascade condenser pressure in the first suggested CRS. While the second proposed CRS (PCEJ) employs an ejector in HTC over and above PC in LTC. The CRSs demonstrate significant higher COP of 1.43, 1.58 and 1.65, leading to an improvement upto 62.4 %, 79 %, and 86 % over the reference HFC-404A system at 45 °C ambient temperature. SEER analysis also establishes higher year-round efficiency compared to reference HFC-404A by 22 %, 36 %, and 44 %. The total TEWI of FGB, PC, and PCEJ is 43.1 %, 53.2 %, and 53.5 % lower compared to the reference system, indicating substantial potential for lowering global warming when implemented. Economic analysis brings out relative cost comparisons under various measures.

RESEARCH ON LOGISTIC COSTS IN TRANSPORTATION OF AGRICULTURAL CARGO BY ROAD AND RAIL TRANSPORT MODES

Goal. Starting with the full-scale invasion on February 24, 2022, the aggressor country began to make it difficult to access major ports in southern Ukraine, limiting the importation, transportation, and export of grain. This forced shippers to look for alternative routes for transporting grain to foreign seaports. A large share of the transportation of grain cargo fell on railway transport and on western terminals, which caused long queues at crossing points. Restrictions also affected the capacity of internal railway lines. To restore the transportation of agricultural goods and increase the efficiency of the organization of grain transportation, it is necessary to conduct a study of the logistics costs of road and rail transportation, considering such factors as the type of shipment, the volume of cargo, time costs, the cost of transportation, and the capacity of border crossings and terminals. Method. The research was carried out based on statistical analysis, methods of operational work for calculating the norms of mass and length of route trains, a comprehensive analysis of logistics costs when transporting various types of shipments by rail and road modes of transport, considering the technical equipment of terminals and the capacity of crossing points, the train formation plan (TFP). The results. Based on calculations, the conditional lengths of route trains are determined, with their further bringing them to the current PFP on the railways of Ukraine; the cost of delivery of grain cargoes when transported by rail was calculated for various types of shipments, and a comparison was made with road transport; terms of cargo delivery, main advantages and disadvantages of each type of transportation are determined; analysed and selected the best method of transportation of agricultural cargo, taking into account the weight of the cargo being transported, the time spent on transportation along the tracking routes; a comparison of financial costs per ton of cargo was made; proposed options for increasing the throughput of border railway stations. The work also identifies the busiest terminals that carry out a significant share of cargo processing at border railway stations with a relatively large capacity and technical support for the transhipment of grain depending on the types of shipments, namely: railway stations and their transitions - Chop - Chierna-nad-Tysoy, Mostyska II-Medyka and Izov - Hrebushiv. Practical significance. The obtained results can be applied in decision-making systems for shippers, which will help in choosing the optimal route and type of rolling stock for cargo transportation. The rational choice of types of shipments and transfer stations makes it possible to use technical means for cargo transhipment as effectively as possible, to reduce the waiting time of wagons at border stations while waiting for technological operations and to reduce the time for these operations, to reduce the total costs of transporting agricultural goods. Options for increasing the throughput capacity of border stations will make it possible to speed up the delivery of cargo by speeding up the execution of mandatory operations performed at transhipment points or by removing part of such operations altogether.

Influence of rapid heat treatment on the photocatalytic activity and stability of calcium titanates against a broad range of pollutants

Calcium titanate (CTO) photocatalysts were synthesized using a sol–gel method by adopting a cost-efficient, rapid calcination technique. The CTOs were characterized by X-ray diffractometry, X-ray photoelectron spectroscopy, infrared spectroscopy, nitrogen adsorption, porosimetry measurements, scanning/transmission electron microscopy, and diffuse reflectance spectroscopy. Their photocatalytic activity was assessed through the photocatalytic degradation of phenol, oxalic acid, and chlorophenol under UV light exposure, using a commercial CTO as a reference. The stability of the samples was evaluated using compounds with –OH, –COOH, and –Cl functional groups. Characterization results showed that CTO composites containing anatase, rutile, and brookite titania were obtained. Increasing the calcination temperature led to various crystalline compositions, higher crystallinity, larger primary crystallite sizes, and smaller specific surface areas. The photocatalytic activity of all CTO/TiO2 composites was superior compared to the commercial CTO we used as a reference. The high photocatalytic activity of the best-performing composites was attributed to their higher specific surface areas and the synergistic effect between the crystal phases. A cost comparison was also made between our unique calcination technique and conventional calcination, and it was found that our method is approximately 35% more cost-effective, while retaining the photocatalytic activity.

Cost analysis of anticancer chemotherapy and chemoirradiation regimens considering the drugs marketed through Jan Aushadhi (People's Medicine) stores and their branded counterparts: First cost comparison study.

Chemotherapy in an integral part of cancer treatment, either administered alone or in combination with radiation. However, the cost of these drugs is often prohibitively high for most patients. To address this issue, the Government of India has established Jan Aushadhi (JAS) stores across the country, where affordable generic medicines are available. In the current study, we performed a cost minimization analysis comparing JAS drugs with branded chemotherapeutic drugs used in various cancer treatment regimens. This study was to conduct a cost-minimization analysis by comparing the costs of different regimens when using JAS drugs, the most expensive branded drugs, and the least expensive branded drugs in the treatment of cancer in India. The study focused on conducting a cost minimization analysis of various chemotherapy drugs used in the treatment of different cancers, considering the availability of anticancer drugs at JAS stores. The costs for different chemotherapy regimens, including both anticancer and supportive drugs, were calculated for single and complete cycles. The costs of the most expensive and least expensive branded drugs were noted from the Current Index of Medical Stores. The cost difference (CD) was calculated by subtracting the cost of the cheaper drug from that of the costliest brand. The cost ratio (CR) and the percentage of cost variation (PCV) were calculated for India-specific conditions. The study analyzed the CD for various regimens using JAS drugs for chemotherapy treatment of breast, esophagus, rectal, colon, stomach, prostate, ovary, endometrial, cervical, head and neck, lung, multiple myeloma, testicular, and lymphoma cancers. It also considered chemoirradiation regimens for brain, head and neck, anorectal, esophageal, and uterine cervical cancers. Significant CDs were observed when both anticancer and supportive drugs were obtained from JAS stores. To the best of the authors' knowledge, this is the first study to consider the CD, CR, and PCV for various regimens using JAS drugs, as well as the costliest and cheapest branded drugs in standard cancer treatment regimens. The results of this study are expected to assist healthcare professionals and pharmacists in understanding the cost-saving benefits of substituting expensive branded drugs with more affordable chemotherapeutic drugs for the treatment of cancer. This substitution can provide financial benefit for socioeconomically marginalized population.

Comparison of Operating Costs and LOS of Cesarean Section Patients Using ERACS and Non-ERACS Method

The rate of births with cesarean section delivery in Indonesia is increasing. Along with the increasing rate, various clinical methods are used to reduce maternal morbidity and mortality, one of which is the Enhanced Recovery After Cesarean Section (ERACS). ERACS aims to speed up recovery, reduce postoperative complications, shorten length of stay (LOS) and lower patient care operational costs of cesarean section. The purpose of this study is to compare operational costs and LOS of cesarean section patients with ERACS and non-ERACS methods.The reseach used was case-control study which was carried out at RSUD dr. Rehatta Kelet from October-December 2022. This study involved 71 patients who met the inclusion criteria. Data were obtained from the patients’ medical records. The data were analyzed by mann Whitney Test using SPSS software. The result shows that the difference in LOS and operational costs using ERACS and non-ERACS was statistically significant at P=0.0001. The study concludes that ERACS method reduces LOS and operational costs compared to non-ERACS methods. The authors recommend that the association of obstetricians and gynaecologists should encourage its members to apply EARCS whenever possible.

Cost Comparison Analysis Between Maritime Intermodal and Road Mode Freight Transport in Java Island, Indonesia

Cost Comparison Analysis Between Maritime Intermodal and Road Mode Freight Transport in Java Island, Indonesia

Exploring the Potential of Deep Learning and Blockchain for Intrusion Detection Systems: A Comprehensive Review

Detecting intrusions in real-time within cloud networks presents a multifaceted challenge involving intricate processes such as feature representation, intrusion type classification and post-processing procedures. Distributed Intrusion Detection Systems (DIDSs) constitute a complex landscape characterized by diverse contextual nuances, distinct functional advantages and limitations specific to deployment scenarios. Despite these challenges, DIDS offers immense potential for addressing evolving intrusion detection challenges through tailored contextual adaptations and unique functional advantages. Moreover, exploring the limitations associated with different deployment contexts facilitates targeted improvements and refinements, unlocking new avenues for innovation in intrusion detection technologies. Notably, deep learning (DL) integrated with blockchain technology emerges as a superior approach in terms of security, while bioinspired models excel in Quality of Service (QoS). These models demonstrate higher accuracy across various network scenarios, underscoring their efficacy in intrusion detection. Additionally, edge-based models exhibit high accuracy and scalability with reduced delay, complexity and cost in real-time network environments. The fusion of these models holds promise for enhancing classification performance across diverse attack types, offering avenues for future research exploration. This text conducts a comprehensive comparison of performance metrics, including accuracy, response delay, computational complexity, scalability and deployment costs. The proposed Novel DIDS Rank (NDR) streamlines model selection by considering these metrics, enabling users to make well-informed decisions based on multiple performance aspects simultaneously. This unified ranking approach facilitates the identification of DIDS that achieves high accuracy and scalability while minimizing response delay, cost and complexity across varied deployment scenarios.

Enhanced DC Building Distribution Performance Using a Modular Grid-Tied Converter Design

This work quantifies the techno-economic performance of AC and DC residential building distribution. Two methods, utilising software and hardware configurations, are showcased to improve DC distribution: (i) a novel rule-based battery dual-objective operation (DOO) and (ii) a modular Master/Slave design of the grid-tied converter (GC). Both methods use the GC’s load-dependent efficiency characteristic, eliminating partial-load operation and enhancing energy efficiency. The work uses measured annual PV and load data to evaluate the performance of the methods compared to AC and DC references. The techno-economic analysis includes the annual net electricity bill and monetised battery degradation. The results show that the DOO eliminates GC partial-load operation at the cost of increased battery usage, resulting in marginal net savings. In contrast, the modular converter design significantly reduces losses: −157 kWh/a (−31%) and −121 kWh/a (−26%), respectively, relative to the DC and AC references. For a parametric sweep of electricity price and discount rate, the Lifetime Operating Cost (LOC) comparison shows savings from DC of up to USD 575 compared to AC.

The Effectiveness Of Using Column Formwork In A Multi-Story Building Construction Project

Building the structural components is crucial for constructing a multi-story building. In the process of creating these components, which is commonly done through casting, a tool called formwork is required. Formwork is a tool used to mold the necessary concrete structures, ensuring that their shape and dimensions align with the concrete material's planning. Formwork tasks for concrete work significantly impact costs. Different formwork options, including traditional, semi-system, and full-system forms, are available. This research aims to assess cost-effectiveness through value engineering, specifically focusing on column formwork, by comparing their utilization in a multi-story construction project. The study begins by collecting primary data, namely working drawings, so that the volume of conventional formwork can be calculated. Then, budget planning calculations are made to analyze the cost comparison of each formwork alternative. The selection of the appropriate formwork affects the speed of execution and the costs incurredIn this construction project for the building, the conventional column formwork results in expenses amounting to IDR 587,749,263.04 and requires 28 days for completion, while semi-system column formwork achieves a 37% cost saving with the same duration of 28 days, and full-system column formwork becomes 64% more cost-effective with a construction period of 10 days.

Comprehensive Review of Geotechnical Engineering Properties of Recycled Polyethylene Terephthalate Fibers and Strips for Soil Stabilization.

The waste management of plastic has become a pressing environmental issue, with polyethylene terephthalate (PET) being one of the major contributors. To address this challenge, the utilization of recycled PET fibers and strips in geotechnical engineering applications for soil stabilization has gained considerable attention. This review aims to provide a comprehensive study of the geotechnical engineering properties of recycled-PET-reinforced soils. The review examines various factors influencing the performance of PET-reinforced soils, including PET percent content, fiber length, and aspect ratio. It evaluates the mechanical properties, like shear strength, compressibility, bearing capacity, hydraulic behavior, and durability of recycled-PET-reinforced soils. The findings reveal PET reinforcement enhances shear strength, reduces settlement, and increases the bearing capacity and stability of the soil. However, it is observed that the incorporation of recycled PET fibers and strips does not lead to a significant impact on the dry density of the soil. Finally, an environmental and cost comparison analysis of recycled PET fibers and strips was conducted. This review serves as a valuable resource for researchers, engineers, and practitioners involved in the field, offering insights into the geotechnical properties of PET-reinforced soils and outlining future research directions to maximize their effectiveness and sustainability.

Feasibility and effectiveness of replacing bow truss bridge members with concrete-filled sections

A comparative study of a conventional bow truss bridge, proposed in Rishikesh, India with a composite bow truss bridge (new construction technique) was conducted. First, the bridge was designed by considering conventional steel sections. Then, adopting a modified construction technique, the top chord members of the bridge were replaced with concrete-filled steel box sections and the bottom girders, diagonals and cross-girders (tension members) were replaced with hollow steel box sections. To analyse these replacements, a finite-element model was created and validated with experimental data. A 200 × 200 × 8 mm steel section (fy = 374 MPa) filled with concrete (fck = 42.5 MPa) was found to be suitable for the top chord members. Buckling and plate yielding analyses of the box sections were also investigated and it was found that, due to the higher stress concentration, only two opposite sides of the plate yielded. A cost comparison revealed that the composite section reduced the overall cost by up to 51% when assuming pin connections and by up to 13% when assuming fixed connections. Furthermore, the effects of joints (hinge and fixed) were analysed to check the critical connection and end failure of the bridge members.

Operation and maintenance cost comparison between 15 MW direct-drive and medium-speed offshore wind turbines

Abstract. Determining offshore wind energy operational expenditures relies on acquiring reliability data, particularly as turbine power ratings increase. The uncertainty surrounding operational costs and optimal drivetrain configurations for larger turbines persists. While previous research has addressed reliability data for 3 MW offshore wind turbines, this study reviews and collates updated failure data for 15 MW turbines, comparing direct-drive and medium-speed configurations. It employs an operation and maintenance (O&M) modelling tool to calculate total operational costs. The study concurs with existing literature, showing that direct-drive turbines have lower operational costs than medium-speed turbines in three case studies. However, the cost and availability differences between configurations are smaller than previously suggested. For 15 MW turbines, the analysis reveals that the cost disparity between direct-drive and medium-speed turbines is significantly smaller than for smaller-rated turbines, with percentages of 1.59 %, 1.58 %, and 5.78 % for the three ScotWind sites selected. Previously, the absolute percentage difference in cost between direct-drive and medium-speed turbines was estimated to be 29.79 %. Sensitivity analyses explore the influence of three factors – failure rates, accessibility limits, and major replacement times – on total operational costs. These analyses demonstrate that medium-speed configurations exhibit more significant cost fluctuations, and the cost gap between configurations is reduced if failure rates are lowered at the same rate for each configuration, accessibility increases, or the major replacement time is reduced for the larger wind turbine components.

Comparison of Long-Term Clinical Outcomes and Costs Between Transesophageal Echocardiography-Guided and X-ray-Guided Percutaneous Atrial Septal Defect Closure in Children.

This study aimed to compare the long-term clinical outcomes and costs between using either transesophageal echocardiography (TEE) or X-ray fluoroscopy for Percutaneous atrial septal defect (ASD) closure in children. An analysis was conducted on clinical data from children undergoing TEE-guided (n = 168) and X-ray-guided (n = 139) percutaneous ASD closure. Demographic characteristics, technical indices, acute complications, follow-up outcomes, and costs were compared between the groups. The results are that TEE-guided closure demonstrated shorter surgical times (20.3 ± 7.6min vs. 32.8 ± 7.9min, P < 0.001) and lower procedural costs ($3093.3 ± 451.5 vs. $3589.1 ± 219.4, P < 0.001) compared to X-ray guidance. Initial successful closure rates were similar between the groups (TEE: 98.2%, XR: 97.1%, P = 0.691). TEE guidance also resulted in fewer acute complications and reduced radiation exposure. TEE-guided percutaneous ASD closure offers advantages in terms of shorter surgical times, lower procedural costs, and reduced radiation exposure compared to X-ray guidance. These findings support the preference for TEE guidance in pediatric ASD closure procedures, with potential implications for improving patient outcomes and reducing healthcare costs.