Cost Benefits Research Articles

A Framework for Considering the Value of Race and Ethnicity in Estimating Disease Risk.

Accounting for race and ethnicity in estimating disease risk may improve the accuracy of predictions but may also encourage a racialized view of medicine. To present a decision analytic framework for considering the potential benefits of race-aware over race-unaware risk predictions, using cardiovascular disease, breast cancer, and lung cancer as case studies. Cross-sectional study. NHANES (National Health and Nutrition Examination Survey), 2011 to 2018, and NLST (National Lung Screening Trial), 2002 to 2004. U.S. adults. Starting with risk predictions from clinically recommended race-aware models, the researchers generated race-unaware predictions via statistical marginalization. They then estimated the utility gains of the race-aware over the race-unaware models, based on a simple utility function that assumes constant costs of screening and constant benefits of disease detection. The race-unaware predictions were substantially miscalibrated across racial and ethnic groups compared with the race-aware predictions as the benchmark. However, the clinical net benefit at the population level of race-aware predictions over race-unaware predictions was smaller than expected. This result stems from 2 empirical patterns: First, across all 3 diseases, 95% or more of individuals would receive the same decision regardless of whether race and ethnicity are included in risk models; second, for those who receive different decisions, the net benefit of screening or treatment is relatively small because these patients have disease risks close to the decision threshold (that is, the theoretical "point of indifference"). When used to inform rationing, race-aware models may have a more substantial net benefit. For illustrative purposes, the race-aware models were assumed to yield accurate estimates of risk given the input variables. The researchers used a simplified approach to generate race-unaware risk predictions from the race-aware models and a simple utility function to compare models. The analysis highlights the importance of foregrounding changes in decisions and utility when evaluating the potential benefit of using race and ethnicity to estimate disease risk. The Greenwall Foundation.

Building energy efficiency evaluation based on fusion weight method and grey clustering method

The renovation and evaluation of building energy-saving projects can provide important support for building an energy-saving society. The study proposes using the contract energy management model to analyze building energy-saving projects and construct an evaluation index system. We also innovatively integrated the Analytic Hierarchy Process and Entropy Weight Method to calculate the weights of indicators, in order to leverage the effective influence of subjective and objective factors. Finally, we used Grey Cluster Analysis to obtain the evaluation effect of building energy-saving projects. Through weight calculation and evaluation analysis, it was found that the energy-saving rates of year-end electricity consumption and air conditioning electricity consumption in buildings after energy-saving renovation were 59.80% and 54.95%, respectively. The overall effectiveness of energy-saving buildings was above 50%, indicating a significant energy-saving effect. In the indicator evaluation system, the weight results of energy-saving service company indicators were relatively high, with values of 0.52, 0.48, and 0.51, respectively. The transformation effect was relatively good. The building energy-saving cost and economic benefits obtained from a 65% energy-saving rate were 3 million yuan and 530,000 yuan, respectively, which were significantly better than the simulation results of other energy-saving rates. The contract energy management model based on the fusion weight method and grey clustering method has superiority, which is effective for evaluating building energy-saving projects. It also provides technical reference and scientific suggestions for building energy-saving renovation.

Low-emission hydrogen supply chain for oil refining: Assessment of large-scale production via electrolysis and gasification

The refining industry is a major hydrogen consumer, mainly relying on fossil fuel-derived hydrogen. While recent literature has focused on the production of hydrogen from water electrolysis, (waste) biomass gasification is another effective method for low-emission hydrogen production, and the refining industry is well positioned for its rapid adoption. This study conducts a techno-economic assessment of the whole supply chain of hydrogen for oil refining and analyses the LCA-climate change for residual biomass gasification and water electrolysis pathways. The potential economic and environmental benefits of combining both production methods are also analyzed. A real case study featuring four different scenarios, using data from a refinery, coupled with local data and future projections for potential curtailment and electricity prices, is included. The hourly hydrogen generation and demand profiles of the refinery were analyzed to accurately assess storage requirements. Results indicate that combining both technologies does not result in clear environmental or cost benefits, with residual biomass gasification emerging as the most advantageous configuration for the base case. Sensitivity analysis reveals that hydrogen produced via electrolysis may become more cost-effective if residual biomass prices are high enough. The importance of underground storage (salt cavern) is highlighted due to its low investment, while other storage methods can significantly increase the Levelized Cost of Hydrogen (LCOH). This study demonstrates that hydrogen production through gasification can be less carbon-intensive and more cost-competitive than electrolysis. Achieving low LCOH values and greenhouse gas emissions is feasible in all scenarios, indicating that both water electrolysis and residual biomass gasification are economically viable options for contributing to a low-emission global energy system.

Incorporation of polyvinyl alcohol in bacterial cellulose/polypyrrole flexible conductive films to enhance the mechanical and conductive performance

The integration of polypyrrole (PPy) into bacterial cellulose (BC) has provided significant conductivity and cost benefits. However, this combination has led to a reduction in mechanical properties, particularly in terms of elongation at break and tensile strength. This study investigated the enhancement of BC/PPy composite films by incorporating polyvinyl alcohol (PVA). The resulting BC/PPy/PVA films demonstrated improvements in flexibility, tensile strength and thermal stability. Specifically, with 7 % PVA, the flexible films exhibited remarkable enhancements: tensile strength increased from 11.01 MPa (for BC/PPy) to 25.27 MPa and elongation at break rose from 5.81 % to 11.54 %. Additionally, the electrical conductivity of the BC/PPy/PVA films with a resistance of 38.5 Ω, surpassed that of the BC/PPy films. Furthermore, the equilibrium swelling water absorption rates of BC/PPy and BC/PPy/PVA films were 30.6 % and 81.4 %, respectively, with corresponding resistances of 530 Ω and 540 Ω. The variation in resistance between the dry and swollen states of the BC/PPy/PVA flexible conductive film resulted in differences in the brightness of the small light bulb. These findings highlighted the synergistic effects of PVA within the BC/PPy matrix, presenting a promising avenue for developing high-performance conductive materials suitable for flexible electronics and wearable devices.

Enhancing the efficiency of novel PCNF demulsifier for oil-contaminated wastewater treatment through numerical simulation optimization of demulsification mechanism

This study used COMSOL simulation software to simulate the aggregation behavior of oil droplets under the action of a direct current electric field. Moreover, in-depth research was conducted on the aggregation process of oil droplets and the dynamic changes of the water oil micro interface. Research has found that the interfacial tension between water and oil is an important factor affecting the deformation of oil droplets. In this work, a new type of magnetic demulsifier (PCNF) was prepared using nano-Fe3O4 as the condensed core, sodium carboxymethyl cellulose (CMC-Na) as the binder, and polyferric sulfate (PFS), and this demulsifier was coupled with an electroflocculation process. The results indicate that the addition of PCNF can effectively reduce the interfacial tension between water and oil, promoting the demulsification process. Compared with traditional flocculants, the combination of electrochemical action and the optimal 2 g/L PCNF dosage provides higher purification efficiency. By introducing calcium chloride, the dosage of PCNF can be reduced. When the dosage is adjusted to 1.5 g PCNF + 0.5 g calcium chloride, the electrolysis time can be shortened from 180 min to 90 min. Under these treatment conditions, the COD in the emulsified oil wastewater is reduced to 46 mg/L and the oil content is reduced to 5.08 mg/L. Economic calculations show that compared to using PCNF alone, this reduction method can reduce operating costs by 39.83 %. This strategy achieves efficient demulsification and oil removal, lowers economic costs, and provides a solid foundation for guiding the development of practical technology.

Do we need group and save for trans-urethral resection of bladder tumour and trans-urethral resection of the prostate procedures?

Background: Trans-urethral resection of the prostate (TURP) and trans-urethral resection of bladder tumour (TURBT) are urological procedures essential for treating benign prostatic hyperplasia (BPH) and non-muscle invasive bladder cancer, respectively, these procedures may result in post-operative bleeding. In our hospital, pre-operative blood group and save is a routine to enhance patient safety. This study aims to evaluate transfusion rates and the potential cost benefits of limiting routine blood group and save. Methods: We conducted a retrospective audit of patients undergoing TURP and TURBT between October 2018 and October 2020. Data was collected using theatre system records and blood bank information regarding transfusions. Results: Out of 233 patients (average age 74), 141 underwent TURBT, 89 underwent TURP, and 3 underwent both simultaneously. Historical group and save were found in 214 (91.84%) patients, and 162 (69.5%) had same-day group and save. Only 2 patients (0.85%) necessitated transfusions. Conclusions: The necessity for blood transfusion after TURP and TURBT is low, indicating that routine pre-operative group and save may not be essential for all patients. Tailoring this practice to high-risk individuals may reduce costs and relieve workloads. Enhanced surgical techniques and tools are likely contributors to these improved outcomes.

Numerical study on cooling performance of the L-shaped crushed-rock embankment in permafrost regions

In permafrost regions, crushed-rock embankments are favored for their environmental compatibility and thermal efficiency. This study introduces the innovative L-shaped crushed-rock embankment (LCRE), which features a crushed-rock layer exclusively at the base and on the sunny slope, providing a cost-effective alternative to the conventional U-shaped design. Using numerical methods, we assessed the cooling performance of the LCRE compared to other crushed-rock embankments, focusing on the impact of its geometric parameters. The findings indicate that the overall cooling performance of the LCRE is situated between that of the crushed-rock interlayer embankment and the U-shaped crushed-rock embankment, and its ability to mitigate the shady and sunny slope effect is superior to that of the U-shaped crushed-rock embankment. Additionally, our analysis reveals that increasing the horizontal width of the revetment to enhance cooling is not a cost-effective approach. The LCREs is more suitable for higher embankments than U-shaped counterparts. Despite the LCRE's advantageous thermal performance and cost benefits, its asymmetric load distribution could lead to exacerbated differential settlement, highlighting the need for further research. This study offers pivotal insights into the design and development of innovative crushed-rock embankments in permafrost regions.

Exploring properties and hydration mechanisms in clinker-free cement formulated from steel industry solid waste using the extreme vertices method

The development of clinker-free cementitious binders (CFCB) using industrial solid waste has attracted widespread attention due to their environmental and cost benefits. This study developed a CFCB using ground blast furnace slag (GBFS), steel slag (SS), and flue gas desulfurization gypsum (FGDG) as raw materials, utilizing an extreme vertex design method. The study systematically assessed the effects of each component on the CFCB's properties, hydration behavior, and microstructure, and based on these findings, further elucidated its hydration mechanism using thermodynamic simulations. Results indicated that FGDG played a critical role in regulating the fluidity of the fresh pastes and the compressive strength of the hardened pastes. GBFS enhanced the development of compressive strength, while the high-activity aluminates in SS enhanced the early-stage compressive strength. Thermodynamic simulations and experimental results confirmed that reactive aluminates and sulfates led to the formation of expansive hydration products AFt and AFm, with volume expansion peaking around 10 d. As the hydration reaction progressed, the number of aluminates participating in the reaction gradually increased, promoting the formation of C-A-S-H, hydrogarnet, and hydrotalcite, as well as the transformation of AFt into AFm. Comprehensive analysis suggested that within the GBFS–SS–FGDG system, the proportion of FGDG should not be less than 10 %, the content of GBFS should be controlled between 50 and 57.5 %, and the content of SS should not exceed 37.5 %. This study revealed the hydration mechanisms within the GBFS–SS–FGDG system, emphasizing the critical roles of each component.

Influence of quenching and tempering heat treatment on heat flux to the workpiece in dry milling of AISI 1045 steel

Dry machining offers cost and environmental benefits in metal cutting, but the absence of cutting fluid can elevate workpiece temperature, impacting surface quality and dimensional accuracy. This study explores and quantifies the impact of quenching and tempering heat treatment on the heat flux to the work material in dry milling AISI 1045 steel. Inverse heat transfer analysis determines the maximum magnitude of a moving Gaussian heat source corresponding to the heat load into the milled part. The inverse estimates are obtained from temperature measurements taken when machining samples subject to different heat treatment conditions. The estimated heat flux and the measured temperature are discussed in the context of the metallo-thermomechanical connection with microstructural aspects, hardness, and thermal properties. The results reveal a substantial increase in thermal energy transferred to the milled steel when quenched and tempered, with a 33 % higher heat input compared to normalized conditions. This condition is mainly attributed to the increased hardness and reduced thermal conductivity of the tempered martensitic structure obtained through hardening. The estimates show deviations of less than ±5 %, according to uncertainty calculations based on thermal sensitivity and sensor accuracy.

Content delivery network solutions for the CMS experiment: The evolution towards HL-LHC

The Large Hadron Collider at CERN in Geneva is poised for a transformative upgrade, preparing to enhance both its accelerator and particle detectors. This strategic initiative is driven by the tenfold increase in proton-proton collisions anticipated for the forthcoming high-luminosity phase scheduled to start by 2029. The vital role played by the underlying computational infrastructure, the World-Wide LHC Computing Grid, in processing the data generated during these collisions underlines the need for its expansion and adaptation to meet the demands of the new accelerator phase. The provision of these computational resources by the worldwide community remains essential, all within a constant budgetary framework. While technological advancements offer some relief for the expected increase, numerous research and development projects are underway. Their aim is to bring future resources to manageable levels and provide cost-effective solutions to effectively handle the expanding volume of generated data. In the quest for optimized data access and resource utilization, the LHC community is actively investigating Content Delivery Network (CDN) techniques. These techniques serve as a mechanism for the cost-effective deployment of lightweight storage systems that support both, traditional and opportunistic compute resources. Furthermore, they aim to enhance the performance of executing tasks by facilitating the efficient reading of input data via caching content near the end user. A comprehensive study is presented to assess the benefits of implementing data cache solutions for the Compact Muon Solenoid (CMS) experiment. This in-depth examination serves as a use-case study specifically conducted for the Spanish compute facilities, playing a crucial role in supporting CMS activities. Data access patterns and popularity studies suggest that user analysis tasks benefit the most from CDN techniques. Consequently, a data cache has been introduced in the region to acquire a deeper understanding of these effects. In this paper, the details of the implementation of a data cache system in the PIC Tier-1 compute facility are presented. It includes insights into the developed monitoring tools and discusses the positive impact on CPU usage for analysis tasks executed in the region. The study is augmented by simulations of data caches, with the objective of discerning the most optimal requirements in both size and network connectivity for a data cache serving the Spanish region. Additionally, the study delves into the cost benefits associated with deploying such a solution in a production environment. Furthermore, it investigates the potential impact of incorporating this solution into other regions of the CMS computing infrastructure.

Reusability of Ti-6Al-4V powder in laser powder bed fusion: Influence on powder morphology, oxygen uptake, and mechanical properties

The reusability of Ti-6Al-4V powder in laser powder bed fusion (L-PBF) processes is essential for achieving economic efficiency and maintaining consistent product quality. While powder reuse offers clear cost benefits, it also raises concerns about preserving material quality and consistency across multiple build cycles. This study, therefore, investigates the effects of repeated powder reuse on key parameters, including powder morphology, oxygen uptake, and mechanical properties. The results demonstrate that the repeated reuse of the powder results in a decrease in satellite particles and an increase in particle deformation. Oxygen content progressively increases with each cycle; however, smooth particles maintain relatively stable oxygen levels, whereas rough particles exhibit a more pronounced rise in oxygen content. Mechanical testing shows that as oxygen levels increase, tensile strength improves, yet elongation decreases. This observed increase in strength can be partially attributed to oxygen-induced phase transformations, where localized oxygen enrichment promotes the formation of the face-centered cubic (FCC) β phase, contributing to material strengthening. These findings emphasize the importance of optimizing powder reuse strategies, particularly in controlling oxygen levels, to achieve the optimal balance between strength and ductility in high-quality material properties.

Techno-Economic Feasibility Study of a Combined Cycle Power Plant Utilizing Natural Gas and Biogas from Cattle Manure Co-firing in South Central Timor

The low electrification ratio in East Nusa Tenggara, particularly in South Central Timor Regency, poses a significant issue. Despite reaching an electrification rate of 92.33%, efforts to achieve 100% are ongoing. South Central Timor as one of the largest cattle farming areas in Indonesia, with its large grasslands and dry climate ideal for cattle farming, has substantial biogas potential from beef cattle manure through anaerobic digestion. Biogas from beef cattle manure has a net calorific value of 18.36 MJ/kg. Based on projections for 2027 using best fit regression, the average daily manure production capacity from 260,217 cattle in South Central Timor is 7.55 kilotons, which is equivalent to approximately 301,852 m3 of biogas. A small-scale combined cycle power plant (CCPP) is proposed to capitalize on this, with a capacity of 20.73 MW and a net thermal efficiency of 55.33%. The plant’s fuel mix will consist of 30% biogas and 70% natural gas by mass, with a fuel mass flow rate of 1 kg/s. The levelized cost of electricity (LCOE), internal rate of return (IRR), and net present value (NPV) obtained from the economic calculations are Rp1,126.76/kWh, 9.62%, and 222 billion IDR with assumptions of a 20-year plant lifetime, an electricity selling price of Rp1,352/kWh, and a discount rate of 6%. The plant is expected to reduce carbon emissions by 61 kilotons annually, while creating new job opportunities in the energy, livestock, and logistics sectors.

HPB SO23 - Implementation and Outcomes of Index Admission Management of Acute Gallstone Pancreatitis on a Specialist Biliary Unit

Abstract Background While the management of acute gallstone pancreatitis (AP) has recognised guidelines, there are wide variations in compliance with these in various institutions for different reasons. The primary objective of this review was to evaluate the effects of implementing proactive management strategies on a specialist biliary firm receiving most biliary emergency admissions by protocol on the incidence of index admission laparoscopic cholecystectomy (LC) for AP. The secondary aims were to study the admission to LC interval, if such policy was safe and how it can help the optimisation of outcomes of AP. Method Analysis of prospectively collected data from AP patients treated by a specialist biliary unit dedicated to index admission LC and single session laparoscopic management of bile duct stones. Almost all patients were referred to the unit as soon as the diagnosis of AP was made. Only patients with severe pancreatitis on imaging or requiring intensive care were not included in the index admission pathway and subsequently underwent delayed surgery. Routine MRCP and ERCP were not part of the management protocol. Following clinical optimisation patients had LC with routine cholangiography (IOC). and if necessary bile duct exploration. Results 495/6140 patients were identified (8%), 70% females. Median age was 55 years. 92.3% had suspected ductal stones, half with jaundice. 11.9% had previous episodes. Only 6.2% had MRCPs and 2% ERCPs. Admission to LC interval was 5 days. 33.2% required bile duct explorations. LC difficulty grade was III to V in 37.2%. The median operative time was 62 minutes with no conversions, ductal injuries or mortality. Complications occurred in 9.2%, including 14 persistent pancreatitis/collections resulting in 6 of 25 readmissions. Two re-operations resulted from t-tube complications. Median hospital stay was 7 days, 72% having had only one admission. Conclusion Index admission LC on all AP patients fit for surgery is perfectly safe in the specialist setting. It optimises preoperative radiological investigations and endoscopic interventions and ,subsequently, a third of the patients require bile duct exploration. Implementing definitive surgical interventions during the index admission for AP offers a substantial reduction in hospital stay, re-admission rates and an overall decrease in hospital attendances. This not only yields significant cost benefits for the health service but also enhances the quality of life for patients.

HPB SO59 - How do Previous Biliary Interventions Affect the Operative and Postoperative Outcomes Of Patients Undergoing Laparoscopic Cholecystectomy (LC) and Bile Duct Exploration (LCBDE)?

Abstract Background Laparoscopic biliary surgery is perceived to be difficult in patients who had undergone previous biliary interventions; ERCP, cholecystostomy or cholecystectomy. Our objective was to evaluate the referral pattern, the preoperative characteristics and operative and postoperative outcomes in such patients. Method Analysis of prospectively collected data from patients treated by a specialist biliary unit dedicated to index admission LC and single session laparoscopic management of bile duct stones. In spite of a policy of no preoperative endoscopic clearance of bile duct stones the unit inevitably received some patients who had had previous ERCP at other hospitals prior to referral or were initially unfit when admitted to the base hospital and required ERCP. In a series of 6140 LC and LCBDE 158 patients (2.57%) had already undergone ERCP and 31 (0.5%) had undergone cholecystectomies (18), cholecystostomies (9) or attempted cholecystectomy. Results Of 158 pre-referral ERCPs, 130 (82.3%) were referred from other hospitals, 36 (22.8%) having had more than one ERCP. 83.5% had suspected CBD stones. LC difficulty grade was IV to V in 48.7%. 112 patients (70.9%) required LCBDE. There were 10.1% biliary related complications, 3 re-operations, one conversion and one mortality. of 31 patients with previous biliary interventions, 58% came from other units or hospitals. A third had already undergone ERCP. 61.3% had LC difficulty grades IV or V. The 18 un-cholecystectomised patients needed LCBDE with no conversions or bile duct injuries. There were only 2 (6.5%) biliary related complications. Conclusion While previous biliary interventions understandably increased the difficulty of LC they did not adversely affect operative and postoperative outcomes. Such surgery should be undertaken in the specialist setting as 70.9% of those with previous endoscopic and 58.1% of those with previous surgical or radiologically guided biliary interventions require LCBDE. Implementing definitive surgical interventions during the index admission can achieve a substantial reduction in re-admission rates, and overall decrease in hospital episodes without significant morbidity, re-interventions or mortality. This enhances the quality of life for patients who would otherwise be subjected to multiple repeat ERCPs and yields significant cost benefits.

Strategic selection of wind turbines for low wind speed regions: Impact on cost and environmental benefits

ABSTRACT Integrating renewable energy sources into the power system is essential for rapid and cost-effective decarbonization. This study evaluates the potential of a wind farm by analyzing three turbine models – VESTAS, GAMESA, and W2E – with power capacities from 2.5 MW to 8 MW. The analysis focuses on Region III, characterized by wind speeds below 7.5 m/s. Using the RETScreen model, the study identifies an optimized wind-rated power (OWRP) that balances financial viability, technical performance, and capacity factors. Monte Carlo simulations and sensitivity analyses assess financial indicators such as the levelized cost of energy, net present value, and equity payback period. The framework also considers greenhouse gas (GHG) credits. Results show that turbines with 4.5 MW power, rotor diameters of 105–128 m, and hub heights of 150 m are the most feasible. The project would reduce annual CO2 emissions by 187,097 tons and avoid 82,031 tons of fossil fuel consumption, equivalent to 17,559 hectares of forest CO2 absorption or 190,915 people cutting energy use by 20%. Without GHG credits, the equity payback period is 6.2 years; with a €50/tCO2 credit, it drops to 2.7 years. These findings offer policymakers in Albania and similar low-wind regions a guide to meeting 2050 energy and climate targets.

To act or wait: The impact of disruption duration estimates on manufacturer’s response strategies

In the event of a disruption at a primary supplier, the manufacturer’s sourcing and production operations are inevitably affected, necessitating a response strategy based on the estimated disruption duration. This article derives the optimal production policy for each response strategy, aiming to minimize total costs over a planning horizon within a dynamic programming framework. We characterize these production policies across various model parameters, particularly focusing on the estimated disruption duration and initial inventory level. Our analysis identifies when the passive acceptance strategy and the backup strategy each hold an advantage, and how the cost benefits of each strategy vary with different model parameters. Additionally, we examine the consequences of overestimating or underestimating the disruption duration, providing insights into how the chosen response strategy and production policy, based on the estimated duration, diverge from the true optimal ones as the actual duration unfolds. We also highlight the cost implications of these discrepancies. Finally, in scenarios where the true duration follows a probabilistic distribution, our numerical experiments demonstrate how strategy selection and the cost of misestimation are influenced by the mean of the true disruption duration and the initial inventory level. These analyses offer decision-makers valuable guidance on when to act or wait in the face of disruptions.

Comparison of suckling and artificial rearing on calf growth and milk requirements in pastoral dairy systems

Context Dairy calf-rearing practises have the potential to influence profitability through milk requirements at rearing, and affect lifetime productivity and market access from an animal-welfare perspective. Aims The aim of this research was to compare calf growth and milk requirements by using conventional artificial rearing (AR) and restricted milk allocation with AR and high milk allocation or suckled calves. Methods Forty-five Friesian × Jersey calves were allocated to be either AR on 6 L/calf.day, (ARC) or 12 L/calf.day, (ARH), or suckled with dams in a cow–calf contact system using partial contact (15 h/day, CCC). AR calves were fed, and intake measured, using an automatic feeder, whereas CCC calves had access to their dams between 1500 hours and 0600 hours. Calves were transitioned off milk, once they reached at least 75 kg liveweight (LW), by gradually reducing their milk allocation (AR) or reducing access to their dam (CCC). Key results Milk consumption for ARH was greater than for ARC calves (382 vs 450 L/calf, P < 0.05), whereas for CCC calves milk-yield difference between dams for the control and suckling groups during the suckling period and over the full season was 706 and 1048 L/cow respectively. There was no difference in weaning weight of calves (87 ± 1.7 kg LW), but, owing to differences in pre-weaning growth rate, age to weaning was youngest (P < 0.05) for CCC (55 days), followed by ARH (62 days) and ARC (73 days). Respective growth rates between birth and weaning (P < 0.001) for CCC, ARH and ARC calves were 0.955, 0.873 and 0.755 ± 0.028 kg/day. Although there was a growth check among CCC calves during the weaning period, there were no post-weaning differences in growth rate among the groups. Conclusions Increasing milk allowance had the benefit of improving calf pre-weaning growth rate, giving the option of weaning calves either earlier or when heavier. However, milk yield losses under suckling systems may be too high to warrant the elevated pre-weaning growth of calves. Implications The costs–benefits of high milk allocation or suckling systems need to be ascertained over the lifetime of the animals to assess long-term survival and productivity outcomes.

A prospective cost analysis model for financial impact of Connected Care interventions on hospitals’ budget

ObjectivesTo present a prospective cost analysis (PCA) model for estimating the financial impact of Connected Care interventions in hospitals to support managerial decision-making, and describe its application to three different care pathways. MethodsInput of the developed PCA model consisted of standard of care input and intervention-specific input. The output of the model included: capacity benefits, costs, and reimbursements. The model was applied to three types of interventions in a large Dutch teaching hospital: 1) home telemonitoring for chronic patients (case (COPD), 2) remote aftercare for patients with acute illnesses (case: stroke), and 3) parenteral medication administration at home (case: prosthetic hip or knee joint infections). ResultsOutput of the PCA model showed that the cost savings can exceed the intervention costs if an intervention decreases the length of stay of patients. For COPD telemonitoring 10.1 % of the healthcare utilization should be reduced to reach break-even, and for antibiotic treatment at home break-even is reached if 4.6 % of the length of stay is reduced. The cost savings of remote aftercare for stroke patients is focused on reducing outpatient visits, and in the current Dutch reimbursement system this does not completely cover the costs. ConclusionsThe PCA model is an easy to implement and useful tool for assessing the financial impact of CC interventions from a hospital perspective. It supports decision makers to prospectively assess the cost and capacity benefits of interventions and to inform decisions on implementation. Further studies are needed to extend the model across the entire healthcare continuum. Public interest summaryWe present a prospective cost analysis (PCA) model for estimating the financial impact of Connected Care interventions in hospitals to support managerial decision-making. Connected Care interventions are based on an integrated care approach utilizing digital health technologies to enhance patient-centred, collaborative care, where patients receive care at home. Examples are telemonitoring of chronic obstructive pulmonary disease (COPD) patients, remote aftercare for stroke patients and infusion treatment at home for orthopaedic patients with an infection. These interventions have additional costs, but also save part of the costs of the conventional care, and have benefits in terms of a decrease in outpatient visits or hospitalizations. We provide a model where a hospital can calculate the impact in costs and benefits of Connected Care interventions and test this on these three examples. We show that the cost savings are able to exceed the intervention costs if an intervention has impact on the hospitalization.

Improving the efficiency and reliability of India’s power grid through targeted EHV transmission line investments: a case of UPPCL

This study analyzes the optimization of Extra High Voltage (EHV) transmission line design parameters by Uttar Pradesh Power Corporation Limited (UPPCL) in India to improve power grid efficiency and reliability. UPPCL reduced insulation specifications for 400 kV lines from 27 to 21 disc insulators and decreased live metal clearance from 2600 to 2400 mm, resulting in 7–9% cost savings per line and reduced right-of-way requirements. While initial test lines performed satisfactorily for over 5 years, longer lines experienced operational challenges related to insulator quality, bird activity, and design margins. Tripping issues emerged during adverse weather conditions, particularly in foggy winter periods. Root cause analysis revealed the need for stringent insulator quality control, regular cleaning to mitigate bird dropping contamination, and potential corona ring design improvements. This case study demonstrates how targeted EHV transmission line optimization can yield significant cost and environmental benefits, while highlighting the importance of balancing economic gains with reliability and safety considerations. The findings provide valuable insights for future EHV transmission line designs and upgrades across India’s power grid.

Economic-ecological assessment of multi-crop small-scale model farms in the Republic of Armenia (piloting results from Gegharqunik region)

Background: Biogenic elements such as nitrogen (N), phosphorus (P), and potassium (K) are major pollutants of Lake Sevan's water, causing eutrophication and deterioration of water quality. Untreated wastewater, sewage, agriculture, fish farming, and other activities are significant sources of these pollutants. Vegetable cultivation, heavily reliant on mineral fertilizers and chemicals, and livestock breeding contribute substantially to nitrogen pollution in the lake. However, improved vegetable growing practices, including small-scale agriculture using organic fertilizers, natural soil improvers, and eco-friendly bio-liquids as growth stimulants, can enhance the socio-economic conditions for farmers in the Lake Sevan basin. These practices promote environmentally friendly, water-saving land-use methods, reducing nitrogen leaching into the lake. Objective: This study aims to demonstrate the socio-economic and environmental benefits of applying innovative agro-technology to small-scale farming in the Lake Sevan watershed (Gegharkunik region). Specifically, the study objectives are to determine the quality characteristics of crops grown in small-scale farms and compare these quality indicators between yields obtained through the proposed technology and traditional cultivation methods. Methods: Field trials of multi-crop systems were conducted on 0.25 ha land plots in four variations across four different locations in the Lake Sevan watershed. The trials were evaluated for various parameters. Nitrate content, dry matter, starch, vitamin C, and sugar levels were determined in potatoes, cabbage, broccoli, beets, and green beans, while fat content was measured in green beans and green peas. Results: Economic efficiency calculations revealed that utilizing the proposed innovative agro-technology in a multi-crop small-scale farm (0.25 ha) yielded a 20-25% increase compared to traditional cultivation with synthetic fertilizers, accompanied by notable environmental benefits. Conclusions: The study demonstrates that small-scale agricultural practices employing the proposed agro-technology have significant socioeconomic and environmental impacts on local farmers. Keywords: Cultivation of non-traditional crops, organic farming, small-scale farming, activities, economic and ecological evaluation, and food quality characteristics.