Cost Savings Research Articles

Performance and economic assessment of a wing-integrated hybrid laminar flow control system

Abstract The energy efficiency of emerging aircraft designs plays a key role, not only in reducing environmental impact, but also in reducing operating costs in the anticipated rise in fuel prices. The European Clean Sky 2 project HLFC-Win is investigating the feasibility of hybrid laminar flow control (HLFC) technology integrated into the outer wing leading edge for a long-haul aircraft. HLFC technology reduces aerodynamic friction drag by means of suction of the boundary layer through a micro-perforated skin to achieve laminarity and thereby improving aircraft performance. However, integrating such a system is not without its drawbacks, as the integration has an impact on the geometry, mass, aerodynamics and engine offtakes that need to be considered. Therefore, the aim of this current work is to assess the HLFC system based on a fair, objective and transparent comparison between the HLFC aircraft and an aircraft of the same technology level without HLFC. The assessment of the HLFC system is twofold, firstly estimating the mission-based performance at the overall aircraft level and secondly performing a lifecycle simulation with three scenarios to determine realistic fuel and cost savings. The mission-based performance assessment indicates a block fuel reduction of over 3 % for the design mission which averages 1.6 to 2.5 % considering a realistic route scenario and expected degradation. The economic assessment suggests a dependency on the scenario chosen, ranging from a 0.7 % increase in total cost (in an unfavourable scenario) to almost a 1 % reduction in total cost (in a favourable scenario), equivalent to $15 million saved per HLFC aircraft over its lifetime. These results support the commercial viability of HLFC technology, which offers significant aerodynamic and fuel efficiency improvements and operating cost savings to the aviation industry. Importantly, no critical barriers were identified for the integration of HLFC technology, further underscoring its potential to improve aircraft performance.

Development of battery-operated automated sugarcane single bud sett cutter with image processing technology

Sugarcane is a vital commercial crop in India. In conventional sugarcane cultivation, around 6 to 8 tonnes of sugarcane setts are used as planting seeds. The substantial planting material creates significant transportation, handling and storage challenges, leading to quick deterioration. Additionally, it requires significant labour and negatively impacts germination rates. To overcome this problem, a battery-operated automated sugarcane bud sett cutter was developed with the components of key components of the main frame, sugarcane stacker, conveyors, serrated disc, cam, battery, DC motors, Raspberry Pi board, Arduino board, ultrasonic sensor, infrared sensor, relay and web camera. The developed machine is designed to reduce the mass of sugarcane setts, with the leftover material being utilized for producing juice, sugar and jaggery. The performance of the sugarcane sett cutter was tested by varying the rotational speeds of two rotary blades, which were mounted on a single shaft with adjustable spacers. The machine could cut 2670 setts per hour at 7000 rpm. The cost of cutting whole sugarcane into setts for planting using the automatic single- bud sugarcane sett cutter is ? 115 per 1000 setts, compared to Rs. 150 per 1000 setts for manual cutting with chopper knives. Using the sett cutter gives a 35 % savings in labour costs and doubled efficiency, with no fissures in the setts. The machine is priced at ? 42000/-.

An Economic Model to Assess the Cost Impact of Using Xpert Carba-R to Screen Carbapenemase-Producing Enterobacterales in Comparison with Standard of Care, in a National Health Service Setting.

Carbapenemase-producing Enterobacterales (CPE) are bacteria that produce carbapenemases, enzymes that destroy carbapenem antibiotics and result in carbapenem resistance. Early identification of individuals who have been colonised or infected is important to correctly implement infection prevention and control procedures. Chromogenic media culture is traditionally the most common method of screening for high-risk patients. However, there is a long wait for results, which has substantial cost and operational implications. Xpert Carba-R is a rapid molecular test that provides CPE screening results in 50min. This study aimed to assess the cost impact of high-risk CPE screening with Xpert Carba-R compared with media culture. An economic model was developed using a probabilistic cost-comparison approach to estimate the costs associated with Xpert Carba-R, from a National Health Service and personal social services perspective. The model cohort was individuals at high risk of CPE colonisation and used an 8.30-day mean time horizon for all patients to cover hospitalisation time, with an extra 5.80days added for patients that were truly colonised to cover the time they would spend in isolation (14.10-day time horizon overall). Deterministic sensitivity analysis and scenario analysis were used to determine the robustness of the findings. The model found that Xpert Carba-R is cost saving compared with media culture, with incremental cost savings of £818.28 per person. Despite greater technology costs, there are cost savings associated with preventing unnecessary isolation. The analysis found Xpert Carba-R to be cost saving compared with media culture for CPE screening in high-risk patients. The model did not explore onwards transmission or the opportunity cost of releasing isolation spaces, so the cost savings are likely to be far greater than those demonstrated in this study.

The contribution of home gardens to sustainable community development from the perspectives of residents in Northern Ghana

In sub-Saharan Africa (SSA), home gardening supports approximately 20% of household food needs, highlighting its significance in addressing food insecurity. This practice has emerged as a vital strategy for promoting sustainable community development in diverse ways. Using Bolgatanga, Ghana, as a case study, this study explores the socioecological and economic benefits of home gardening and their associations with socioeconomic characteristics. In total, 370 residents were interviewed, and the data was analyzed using descriptive and inferential statistics. The study revealed that home gardening provides environmental benefits, such as reducing temperature and erosion; social benefits, including enhanced well-being and cohesion; and economic benefits, such as reduced food costs and increased profits. The findings indicated statistically significant associations between environmental benefits, such as soil fertility enrichment (p < 0.01) and natural cooling (p < 0.01); social benefits, including stress reduction (p < 0.01); and economic benefits, such as sustainable living through composting (p < 0.01), and socioeconomic characteristics of respondents. The Relative Importance Index (RII) analysis identified biodiversity enhancement as the most significant environmental benefit, cost savings from homegrown food as the most important economic benefit, and stress reduction as the most significant social benefit. The study concludes that home gardening significantly contributes to sustainable community development through its environmental, social, and economic benefits, therefore it is essential for the Municipal Agriculture Department, non-profit organisations to collaborate with communities in terms of training programmes and resources for home gardening practices to maximize these benefits.

Analysis of Tirzepatide Acquisition Costs and Weight Reduction Outcomes in the United Kingdom: Insights from the SURMOUNT-1 Study.

Tirzepatide, an anti-obesity medication, demonstrated significant weight loss efficacy in the SURMOUNT-1 randomized controlled trial. This analysis evaluates the cost-efficiency of tirzepatide in the UK by linking clinical outcomes to drug acquisition costs. Data from SURMOUNT-1 (2539 participants across global sites) were used to assess tirzepatide's (5, 10, and 15mg) impact on weight reduction over 72weeks (72W), with a focus on drug acquisition costs and cost/weight loss outcome. Cost needed to treat and cost-to-target analyses were performed to determine the economic value of achieving specific weight loss goals and improvements in body mass index (BMI). Tirzepatide demonstrated significant weight loss, with greater reductions at higher doses. Cost/kilogram of weight loss at 72W was £102.86, £85.41, and £89.24 for 5, 10, and 15mg, respectively. Average per-patient costs at 72W for 5% weight loss were £1852, £1971, and £2186 (5, 10, and 15mg, respectively; average 28-day costs: £102.90, £109.52, and £121.47). Average per-patient costs for 10% weight loss were £2258, £2209, and £2338 (28-day costs: £125.43, £122.69, and £129.88). The 15mg dose was the most cost-efficient for achieving higher weight loss targets (15% and 20%). In the SURMOUNT-1 study, tirzepatide was cost-efficient in the UK for weight management, demonstrating favourable economic outcomes relative to its efficacy in reducing body weight and improving BMI. It provided additional health benefits, including reduced risks for type 2 diabetes and cardiovascular events and improved mental health. Tirzepatide contributed to cost savings and improved efficiency within the healthcare system by decreasing the burden of obesity-related conditions, thus enhancing overall healthcare resource allocation. These findings support its inclusion in clinical practice guidelines and healthcare formularies. Further research is needed to explore real-world adherence, patient-centred outcomes, and the long-term sustainability of weight loss with tirzepatide.

Service evaluation of having an additional CT scan for motor neurone disease patients undergoing a gastrostomy.

several patients had failed percutaneous endoscopic gastrostomy (PEG) placements. A CT scan was introduced to identify if it would be possible to place a PEG or another gastrostomy such as a radiologically inserted gastrostomy (RIG). To assess cost-effectiveness of adding a CT scan to the pathway and evaluate if it was improving patient experience. Data from 1 February 2024 to 1 August 2024 indicated when the PEG was planned, CT outcomes and whether the gastrostomy was successful. Results from patients (n=19) showed changes from the CT scan for 4 patients; 18 patients had a successful gastrostomy. There were cost savings from the implementation of the CT scan. There were minimal differences reported by patients in post-procedural complications. Incorporating a CT scan before gastrostomy procedures for patients with MND can enhance planning, reduce failures, and improve patient outcomes. Cost savings were evident.

Why do patients with ischemic heart disease modify their lifestyle? a qualitative study

ObjectiveIschemic Heart Disease (IHD) is a major cause of death worldwide, particularly in low- to middle-income nations, such as Iran. Lifestyle modification (LSM) (e.g., healthy nutritional patterns, regular physical activity, smoking cessation, and stress management) can prevent the development of IHD. This study aimed to identify the motivations behind LSM in patients with IHD.ResultsThis qualitative study employed traditional content analysis and purposive sampling from cardiac rehabilitation (CR) centers in Iran. Data were collected through semi-structured interviews, analyzed using Graneheim and Lundman steps, conducted from October 2023 to September 2024. The participants included 15 IHD patients with LSM experience, one patient’s son, and 4 healthcare professionals (nurses, clinical psychologists, cardiologists, and nutritionists). The patients had an average age of 63 years and varied in sex, occupation, education, and marital status. Interviews averaged 69 min, ranging from 50 to 100 min. The analysis revealed a theme of “seeking wise survival,” with 10 subcategories and three categories: interest and fear (e.g., family interest, fear of death), comprehensive recommendations, and individual and social benefits (e.g., time and cost savings). The findings of this study provide scientific evidence for HCPs to encourage and educate patients and their families regarding the LSM.

A societal cost-benefit analysis of falls prevention in community-dwelling older people in the Netherlands.

A societal cost-benefit analysis of falls prevention in community-dwelling older people in the Netherlands.

Impact of centralised reconstitution of biological medicines on the amount and costs of medicine waste

ObjectivesTo evaluate the impact of centralising the reconstitution of biological medicines from hospital wards to a hospital pharmacy aseptic facility on the amount and costs of medicine waste.MethodsData from 1...

Cost-Effectiveness of Hospital-at-Home and Fecal Microbiota Transplantation in Treating Older Patients With Clostridioides difficile.

Clostridioides difficile infection (CDI) primarily affects older patients with comorbid conditions and has a high mortality rate. Fecal microbiota transplantation (FMT) is effective and cost-effective for CDI. In a recent study, we demonstrated the clinical benefits of combining hospital-at-home care with FMT for older patients with CDI, but its cost-effectiveness remains unknown. The current study aimed to evaluate the cost-effectiveness of the intervention in patients aged ≥70 years with CDI, compared with standard treatment. The cost-utility analysis was conducted using data from a randomized clinical trial enrolling 217 patients, assessing the cost-effectiveness of the intervention over 90 days. Resource use was assessed from a healthcare sector perspective. Missing data were handled with proxy replacement and multiple imputation. Sensitivity analyses included probabilistic analysis, complete case analysis, adjustment of key unit prices, and a hospital perspective. A willingness-to-pay threshold was set to €22 994 or $24 863 per quality-adjusted life year (QALY). In the base case analysis, the intervention was dominant, with mean cost savings of €2556 ($2764) and a mean gain of 0.004 QALY. Although resource use was higher, the intervention resulted in an average reduction of 6 hospital admission days per patient and increased odds of clinical resolution. The results remained robust across different perspectives, the exclusion of patients with missing data, and variations in hospital admission costs. In patients aged ≥70 years with CDI, an intervention combining hospital-at-home care and FMT is cost-effective compared with standard treatment. The cost-effectiveness is mainly driven by fewer hospital admission days.

Impact of Deep tech on Supply Chain Management

The integration of deep technology tools like Artificial Intelligence (AI), the Internet of Things (IoT), and predictive analytics is transforming how businesses approach supply chain management. Traditional methods are increasingly being replaced by AI-driven models that can process large volumes of real-time data, allowing companies to better predict market changes, streamline inventory, and enhance operational efficiency. This study examines the effects of these technologies across different industries, emphasizing their ability to minimize waste, improve supply chain responsiveness, and generate cost savings. By presenting case studies from sectors such as retail, automotive, food, and fashion, this research highlights the significant impact of deep technologies on the future of demand forecasting and supply chain management.

Flexural response of patch repaired composite cantilever beams loaded in Flapwise direction

AbstractRepairing damaged composite beams can significantly extend their lifespan, resulting in substantial cost savings over time. In general, repairing involves three steps: locating damage, damage removal, and then patching the resulting hole. Hence, it becomes imperative to understand the effectiveness of the repair process. To this end, a series of experiments were conducted to study the effect of different parameters like hole size, hole location, filler material, and repair techniques on the damage response of the undamaged, damaged, and repaired specimens. From the experiments on damaged specimens with different hole diameters (‘D’) and hole location (‘L’), visible cracks are found to appear for those specimens with an L/D ratio less than 10% of D. The specimen with critical hole size and location, thus identified, is used to study the effectiveness of different repair techniques. The patch repair technique is found effective in restoring the load carrying capacity of the repaired beams subjected to flapwise bending, but the effectiveness is dependent on the filler type being used in the plug to repair the damage. In particular, the specimens repaired using a plug made from part of the parent laminate and from impregnated fabric layers are found to be the promising repair technique.Highlights Critical combination of hole size and location for specimen is identified. Study focuses on the effectiveness of repair on flapwise bending. Effect of different filler materials on the effectiveness of repairs is studied. Effect of plug configuration on effectiveness of repairs is studied.

Impact of a New Program of Care for Work-Related Mild Traumatic Brain Injury on Recovery and Return to Work.

The Workplace Safety and Insurance Board (WSIB) in Ontario, Canada, launched a new community-based mild traumatic brain injury (mTBI) program of care (POC) in November 2020. The new program included graded exercise therapy and vestibular rehabilitation (where required). The objective of this study was to assess the impact of the new mTBI POC on recovery and return to work among patients who suffered a work-related mTBI. We identified WSIB claims that accessed the previous and new mTBI POC over a 4-year timeframe (October 1, 2017, to September 30, 2019, and July 1, 2021, to June 30, 2023). A quasi-experimental pre-post study, propensity score matching design with a difference-in-difference modelling component was applied to approximate estimation of causal effects on loss of earnings (LOE) benefit duration at 3-, 6-, and 12-months and HC costs for patients treated in the previous and new programs. Over the 4-year timeframe, 5625 patients accessed the previous and new mTBI POC. The new program achieved improved 3-, 6-, and 12-month disability durations (incremental percentage difference of -11.7%, -9.3%, and -9.0%, respectively), and shorter durations of disability, reflected by decreased LOE benefit costs (incremental percentage difference of -32.6%) and decreased HC costs (incremental percentage difference of -5.6%). The overall combined savings in LOE and HC costs was 21%. This analysis indicates that the implementation of this new evidence based mTBI POC resulted in improved outcomes (decreased disability duration and lower health care utilization) on a per patient basis for people with work-related mTBI.

Maternal-fetal medicine fellow experience in the first year of training compared to interview expectations based on interview modality

BackgroundVirtual interviews for Maternal-Fetal Medicine (MFM) fellowship have been feasible and successful with significant cost and time savings. However, there are concerns about an applicant’s ability to accurately evaluate a program virtually. The objective of this study was to evaluate MFM fellows’ experience in their fellowship training program at the completion of their first year compared to their expectations of the program based on their interview, comparing fellows who interviewed in-person to those who interviewed virtually.MethodsA novel cross-sectional online survey was distributed to all first-year MFM fellows in the final class to undergo in-person interviews (2021), as well as those who were the first to interview virtually (2022) at accredited programs in the United States. Participants were asked whether their interview experience provided an accurate representation of their program, whether their interview experience allowed them to accurately assess their “fit,” how their expectation of the program prior to starting compared to their actual experience in their first year of training, and their overall satisfaction. Descriptive statistics and bivariate analysis were performed to compare groups.ResultsWe received 48 responses in 2021, (37.5% response rate) and 48 responses in 2022 (36.1% response rate). There was no difference between the in-person and virtual groups in agreement that the interview experience provided an accurate representation of the program (p = 0.41). While there was a trend toward more fellows from the in-person group strongly agreeing that their interview experience allowed them to accurately assess their “fit” with the program as compared to the virtual group, there was no significant difference in ability to assess fit between groups (p = 0.06). There was no difference in expectation of the program prior to starting compared to the actual experience in the first year of fellowship (p = 0.18) or overall satisfaction with the fellowship program (p = 0.95).ConclusionsMFM fellows’ expectations of their fellowship program matched their experience in the first year of training whether the fellow interviewed virtually or in person. These data suggest that virtual interviews are as effective as in-person interviews in providing realistic expectations of the program and thus support ongoing exclusive virtual interviews in our subspecialty.

How Should e-Product OEMs Invest in Design for Remanufacturing Under the Take-Back Regulation in a Competitive Environment?

This study investigates the effects of take-back regulations and remanufacturing competition on e-product OEM design for remanufacturing (DfR) strategies and remanufacturing decisions within a closed-loop supply chain. Considering the monopolistic remanufacturing scenario where the remanufacturer does not enter the remanufacturing market as a benchmark model, we establish a Stackelberg game model involving an OEM and a remanufacturer to explore the OEM’s optimal DfR decisions under take-back regulations and in a competitive environment. The Lagrangian function and Karush–Kuhn–Tucker conditions are formulated to identify the optimal solutions. The findings reveal the following: (i) Whether the remanufacturer engages in remanufacturing activity or not, take-back regulation consistently prompts OEMs to increase DfR investment. (ii) DfR investment level is lower in competitive markets compared to monopolistic scenarios, while remanufactured product output is higher. (iii) While consumer welfare improves with remanufacturer entry, environmental benefits deteriorate due to potential increased competition. Notably, competitive remanufacturing is advantageous for OEMs only when take-back regulation is stringent and the cost savings of remanufactured products are relatively low.

Optimal Sizing and Techno-Economic Feasibility of Hybrid Microgrid

This study explores the energy demand planning for university loads at the new Sohag University campus in Sohag Al Gadida City, Egypt. It assesses the feasibility of establishing a microgrid on a section of the campus to determine its practicality and potential benefits. The existing power distribution system is analyzed, and the suitability of various distributed generation sources, including photovoltaic, battery, and hydrogen-based microgrid, is evaluated. A techno-economic analysis is conducted to optimize microgrid sizing, using MATLAB R2023a (Optimization Toolbox) to implement a sizing algorithm for a hybrid microgrid system and HOMER Pro 3.14 for component sizing. The optimal microgrid configuration is verified based on the intended power supply potential while minimizing costs. The results demonstrate that the energy costs of the proposed hybrid microgrid system align with previously published values, confirming its feasibility. Additionally, economic analysis reveals that the proposed system not only reduces carbon emissions but also achieves cost savings of 20–30% over 20 years compared to conventional grid supply, with a payback period of 8–10 years.

Case-only analysis in small studies of predictive biomarkers

Characteristics of tumors and patients can be used as predictive biomarkers to guide treatment choice. Although many potential biomarkers are evaluated each year, only few will eventually be used since evidence is usually based on small studies leading to inconclusive results. Such data are often analyzed with Cox proportional hazards regression using a multiplicative interaction term between biomarker and treatment, with insufficient power and possibly biased results. Instead of analyzing patients who do (cases) and do not experience (non-cases) the survival event of interest, case-only analysis with logistic regression has been proposed, however with unknown small sample properties. We evaluated the performance of case-only analysis with bias-eliminating Firth correction and confidence intervals obtained with a profile likelihood method in a simulation study tailored to breast cancer. Our results show that this approach is generally inferior to the full cohort analysis but has acceptable properties when the marker is protective or null among patients treated with the standard treatment, the event rate is low (e.g., a rare event and a protective marker) and treatment assignment is independent of the marker level (e.g., in randomized studies). In such situations, the case-only design offers substantial cost savings. However, the model is sensitive to these assumptions.

Used Lubricating Oil Treatment and Reuse for Sustainable Production Processes in Cement Industry

Used lubricating oil is one type of hazardous waste produced in the chemical industry, including the cement industry. PT ITP Unit Palimanan has obtained a permit to process hazardous waste in the form of used lubricant oil since February 21, 2023. Therefore, starting from March 2023, PT. ITP Unit Palimanan has been utilizing used lubricant oil for open chain lubrication. The used lubricant oil, which is dark in color and contains a high number of particles, is reprocessed through a filtration process before being used. In this process, the contaminating particles are reduced, and the used lubricant oil can be reused as lubrication material for open chains within PT. ITP Unit Palimanan itself. In 2019-2021, the average total generation of used lubricant oil was around 125 tons per year. Of this amount, approximately 90% was suitable for reuse as it contained metal and water levels below the threshold limits. Through this reuse process, the substitution of lubricant oil for open chain equipment can be reduced by 95.5%, equivalent to Rp 1,514,556,289 per year or Rp 4,207,101 per day. Besides the cost savings, PT ITP Unit Palimanan can significantly reduce the burden of used lubricant oil waste on the environment through this innovation.

Outpatient Management of Bispecific Related Toxicities: An Observational Study of Safety Outcomes and Resource Utilization.

Cytokine release syndrome (CRS) of any grade occurs in 56%-80% of bispecific antibodies (BsAbs) used in multiple myeloma (MM). Risk mitigation strategies are required to expedite escalation of care if toxicities develop. The rarity of grade 3 or 4 CRS compels protocolized outpatient management of BsAbs as outpatient practice may avoid hospital admissions and costly resource utilization without compromising safety. Patients with MM who received BsAb step-up dosing (SUD) from August 23, 2023, to March 29, 2024, were enrolled. Baseline demographics, patient outcomes, and CRS management were reviewed to assess the safety of outpatient practice. Resource utilization was also analyzed. In this study, 34 patients received outpatient SUD of BsAbs (teclistamab n = 17, talequetamab n = 17) with 16 remaining outpatient throughout the entire SUD period. CRS occurred in seven patients who did not require hospitalization, demonstrating the safety of outpatient management of BsAb toxicity, regardless of low-grade CRS. CRS was observed in 24 patients (maximum grade 2) and immune effector cell-associated neurotoxicity syndrome in four patients (maximum grade 3). All patients with CRS received steroids, including 12 patients at home when instructed. Tocilizumab was given to 13 patients, accounting for 18 doses. If all doses of BsAbs and tocilizumab were given outpatient, the medication margin would be $115,004 in US dollars (USD). An outpatient-based practice for BsAb administration demonstrated safety and cost savings. The description of our practice and results of this study provide valuable insights into the safety, feasibility, and resource stewardship of outpatient management of BsAbs. Future research should attempt to predict and stratify CRS risk to deliver a tailored supportive strategy and continued increase of outpatient management.

Migrating On-Premise HR Systems to SaaS - A Focus on Workday: Benefits, Challenges &amp; Strategies

Traditional on-premises HR systems are struggling to keep up with the demands of a modern workforce. The shift to SaaS HR solutions has become a game-changer, offering flexibility, efficiency, and enhanced employee experiences. Among the leading SaaS HR platforms, Workday stands out for its ability to streamline HR processes, automate workflows, and provide real-time insights. This white paper explores the benefits, challenges, and best practices of migrating from legacy on-premise HR systems to Workday’s cloud-based HR solution. It highlights key advantages such as improved accessibility, scalability, and cost savings while addressing common challenges like data migration, system compatibility, and change management. The paper emphasizes the need for organizations to embrace digital transformation in HR and leverage platforms like Workday. It serves as a guide to understanding the impact of SaaS HR solutions and how Workday can help future-proof HR operations for long-term success.