Cost Of Individual Components Research Articles

Circular economy: Extending end-of-life strategies

The transition from linear economy to circular economy (CE) has gained mainstream status in recent times, not only at product and process levels, but also at component level. In order to adopt the CE as common practice, there is a need to reimagine the product end-of-life (EoL) phase to include assessment of individual component health status. Implementation of EoL strategies on products designed based on wear and tear, robustness, and safety concerns is, however, complex. The purpose of this study is to explore the potential of designing for CE by applying a visual health-based analysis (VHA) at the component level at the EoL stage. The application of this diagnostic tool is exemplified in a case at a large Swedish outdoor power product manufacturer by analyzing components for reuse, remanufacture, refurbishment, recycling, and recovery strategies. The VHA results in the calculation of a CE potential at the component-product level based on individual component's cost, complexity, health, and diagnostic approach. This study presents a diagnostic tool for practitioners to understand circularity at the component-level in the effort to identify EoL strategies. Furthermore, in supporting the CE principle of maximizing resource recovery, the study potentially contributes to the EU's CE action plan and the UN-SDGs 8, 9, 12, and 13.

Assessment of regulatory ecosystem services of green plants in urban ecosystems

The article presents the results of research on the assessment of ecosystem services of green tree stands on the territory of the first academic campus of the National University of Kyiv-Mohyla Academy using the MyTree tool. It is a part of the i-Tree tool set developed by the Forest Service of the United States Department of Agriculture (USDA) of the comprehensive program, designed to assess the ecosystem services provided by individual trees or small groups of trees. Research has established that the most important regulatory services were carbon dioxide absorption, microclimate regulation, energy saving, air purification from ozone and sulfur dioxide. Calculations by the MyTree tool show the annual cost of tree planting services on campus and its projected cumulative growth after 20 years. According to the calculations of the MyTree tool, this year’s cost of tree plantation services of the first academic campus of the National University of Kyiv-Mohyla Academy was $847.29, and according to forecasts, after 20 years it will cumulatively increase to $18,895.36. Estimates of the cost of individual components of regulatory ecosystem services are provided. The cumulative estimate over the next 20 years for CO2 sequestration was $4,129.15, which includes the sequestration of 21,963.55 kg of carbon. Air purification for 20 years is estimated at $1,342.66, which includes absorption and neutralization of 656.24 kg of O3, 117.47 kg of SO2, 54.45 kg of NO2, and 34.26 kg of solid dust particles PM2.5. Energy savings are estimated at $10,791.14, which includes energy savings of 100,448.21 kW. The tree species Aesculus hippocastanum (Bitter chestnut), Picea abies (European spruce), Picea pungens (Blue spruce), Betula pendula (Hanging birch) and Ulmus laevis (Smooth elm) provide the highest value of services. The results of this study can be used in the future to improve the planning and management of green areas of the university campus, taking into account the value of their ecosystem services.In general, the study confirmed the importance of monitoring and evaluating the ecosystem services of green spaces in urban ecosystems for making sustainable decisions regarding the development of urban areas, supporting the well-being and health of the population.

Development of a Methane Detection System by a Household Gas Detector

Software has been developed for the correct operation of the air monitoring sensor, which allows real-time information on the concentration of the detected gas in the air. Implemented the ability to notify the user in real time by means of a temporary email address server. The gas detector model presented in this paper has the following advantages: strength; ease of use, which allows it to be used by a wide range of users; low cost of individual components and the model as a whole; portability, allowing installation in small rooms, ventilation shafts, technical openings or ceilings.

Challenges of reaching high renewable fractions in hybrid renewable energy systems

This study evaluates the techno-economic feasibility of hybrid renewable energy systems (HRES) for providing electricity in four example localities in the United States: western New York; San Diego, California; Milwaukee, WI; and the entire state of Texas. The Hybrid Optimization of Multiple Energy Resources (HOMER) Pro Microgrid Tool was used to simulate and assess a grid model relying on solar and wind electric generation with utility-scale battery storage as back-up to serve the load on an hourly basis, when renewable resources are not available. A total of 495 HOMER trials were modeled to determine the levelized cost of electricity (LCOE) and societal cost of electricity (SCOE) for each of these locations assuming varying levels of carbon taxes, the economic value of health benefits from emissions savings, and a renewable fraction (RF) ranging from 0% to 100%. Technical and financial properties for the model, such as individual component cost, life-time, and efficiency, were obtained from the U.S. Energy Information Administration (EIA). Emission rates for various generation sources were obtained from the U.S. Environmental Protection Agency (EPA) and health benefits were analyzed using the Co-Benefit Risk Assessment (COBRA) tool. Finally, the ideal renewable fraction resulting in the lowest LCOEs were obtained for each of the four locations studied. For carbon tax values of $0/tonne and $130/tonne, this was determined to be 34% to 48% for New York; 0% to 34% for San Diego; 55% to 75% for Milwaukee; and 21% to 65% for Texas. Applying health benefits can shift the optimal RF of HRESs to higher amounts by 5.26% on average.

The protein translation machinery is expressed for maximal efficiency in Escherichia coli

Protein synthesis is the most expensive process in fast-growing bacteria. Experimentally observed growth rate dependencies of the translation machinery form the basis of powerful phenomenological growth laws; however, a quantitative theory on the basis of biochemical and biophysical constraints is lacking. Here, we show that the growth rate-dependence of the concentrations of ribosomes, tRNAs, mRNA, and elongation factors observed in Escherichia coli can be predicted accurately from a minimization of cellular costs in a mechanistic model of protein translation. The model is constrained only by the physicochemical properties of the molecules and has no adjustable parameters. The costs of individual components (made of protein and RNA parts) can be approximated through molecular masses, which correlate strongly with alternative cost measures such as the molecules’ carbon content or the requirement of energy or enzymes for their biosynthesis. Analogous cost minimization approaches may facilitate similar quantitative insights also for other cellular subsystems.

Resource requirements for essential universal health coverage: a modelling study based on findings from Disease Control Priorities, 3rd edition

SummaryBackgroundDisease Control Priorities, 3rd edition (DCP3), published two model health benefits packages (HBPs). This study estimates the overall costs and individual component costs of these packages in low-income countries (LICs) and lower-middle-income countries (lower-MICs).MethodsThis study reports on our Disease Control Priorities Cost Model (DCP-CM), developed as part of the DCP3 project to determine the overall costs of the 218 health sector interventions recommended in the model HBP termed essential universal health coverage (EUHC). Model inputs included data on intervention unit costs, demographic and epidemiological data to quantify the populations in need of specific interventions, baseline coverage indicators, and estimates of required health system costs to support direct service delivery. The DCP-CM was informed primarily by published estimates of economic costs of interventions measured from the health system perspective. We estimated counterfactual annual costs for the year 2015. We disaggregated costs according to intervention characteristics (delivery platform, delivery timing, and health system objective) and did one-way and probabilistic sensitivity analyses with determination of 95% credible intervals (Crls).FindingsAt 80% population coverage, the annual cost of EUHC would be US$79 (95% Crl 60–110) per capita (in 2016 US dollars) in LICs and US$130 (100–180) per capita in lower-MICs. As a share of 2015 gross national income (GNI), additional investments would require 8·0% (95% Crl 5·7–11·3) in LICs and 4·2% (2·9–5·9) in lower-MICs. A highest priority subpackage comprising 115 of the EUHC interventions would cost approximately half of these amounts (3·7% [2·6–5·3] of 2015 GNI in LICs and 2·0% [1·4–2·8] in lower-MICs). Mortality-reducing interventions would require around two-thirds of the overall package costs, with interventions to reduce mortality at age 5–69 years from non-communicable disease and injury comprising the highest share of total EUHC costs in both income groups (37·6% [37·2–37·9] in LICs and 43·0% [42·6–43·4] in lower-MICs). Interventions addressing chronic health conditions (requiring 45·5% [44·8–46·4] 2015 GNI for LICs and lower-MICs combined) and interventions delivered in health centres (requiring 49·8% [49·5–50·2] 2015 GNI for LICs and lower-MICs combined) would each comprise the plurality of costs.InterpretationImplementation of EUHC would require costly investment, especially in LICs. DCP-CM is available as an online tool that can inform local HBP deliberation and support efficient investment in UHC, especially as countries pivot towards non-communicable disease and injury care.FundingBill & Melinda Gates Foundation, Trond Mohn Foundation, and Norwegian Agency for Development Cooperation.

OP37 Impact On Uncertainty Of Disaggregating Cost Data

IntroductionEconomic models contain several parameters ordinarily subject to uncertainty. Unlike most other model parameters, costs can constitute numerous distinct components. For example, a surgical intervention can require a variety of disposables and reusable equipment. A micro-costing output may be disaggregated or presented as a total cost. Uncertainty could be applied to individual cost components or to total cost. We aimed to explore how disaggregation of cost data may impact on uncertainty using a case study.MethodsA set of simulations using hypothetical scenarios were developed with uncertainty set at ± 20 percent. The simulations investigated the impact of number of cost components, balance between components, and correlation between them. A cost-utility model from an assessment of robot-assisted radical prostatectomy was analyzed; procedure cost was divided into 32 individual cost components or treated as a total cost.ResultsBased on five equal cost components, uncertainty reduces from ± 20 percent for correlated variables to ± 9 percent for uncorrelated variables. With increasing numbers of uncorrelated cost components, the uncertainty in the total cost decreases markedly. The uncertainty around total robot-assisted surgery procedure equipment costs was ± 19.7 percent when components were correlated and ± 9.4 percent when uncorrelated. The impact on uncertainty in the incremental cost effectiveness ratio (ICER) was negligible but the ranking of parameters in the univariate sensitivity analysis changed.ConclusionsAnalyzing uncertainty by aggregated or disaggregated costs can have implications for presenting uncertainty in costs to decision makers. Applying uncertainty to aggregated costs essentially implies that variation in the cost of individual components is perfectly correlated. By disaggregating cost components they are being treated as uncorrelated, which can substantially reduce uncertainty in the total cost. In this case study we found that although the reduction in uncertainty could be clearly seen in the cost parameter, it had a negligible impact on uncertainty in the ICER.

Obesity and healthcare resource utilization: results from Clinical Practice Research Database (CPRD).

SummaryBackground/ObjectivesThe economic burden of obesity and type 2 diabetes (T2D) rises with increasing prevalence. This study estimates the association between obesity, healthcare resource utilization (HCRU) and associated costs in individuals with/without T2D.Subjects/MethodsThis observational cohort study used the United Kingdom Clinical Practice Research Datalink data. Between 1 January 2011 and 31 December 2015, total HCRU costs and individual component costs (hospitalizations, general practitioner contacts, prescriptions) were calculated for individuals linked to the Hospital Episodes Statistics database with/without T2D with normal weight, overweight, class I, II, III obesity.ResultsA total of 396,091 individuals were included. Increasing body mass index (BMI) was associated with increased HCRU costs. At each BMI category, costs were greater for individuals with than without T2D. Relative to normal BMI, increasing BMI was positively associated with increased HCRU costs, with similar magnitude regardless of T2D. The total HCRU cost for an individual with class III obesity was 1.4‐fold (£3,695) greater than for normal weight.ConclusionIn the United Kingdom, HCRU costs were positively associated with increasing BMI, irrespective of T2D status. The combination of T2D and obesity was associated with higher HCRU costs compared with individuals of the same BMI, without T2D. These findings suggest that prioritizing weight management programmes focused specifically on individuals with obesity and T2D may be more cost‐effective than for those with obesity alone.

Development of a high flow rate piston pump for rocket engines

There is a need for cheaper small satellite rocket launchers. One way of reducing costs is to reduce the cost of individual components. We describe here the development of an inexpensive piston pump for rocket engine applications. It demonstrates that it can deal with the combined requirements of high flow rate and operating speed at cryogenic temperatures without incurring the costs normally associated with such performance.

A novel diagnostic prognostic approach for rehabilitated RC structures based on integrated probabilistic deterioration models

The task of maintaining the huge stock of structures provides both owners and engineers with financial and technical challenges. Building managers are increasingly faced with having to maintain their building assets more efficiently whilst reducing the short and long-term cost of rehabilitation. Several approaches employing a Markovian model have been adapted to the bridge structure domain; fewer in the domain of concrete buildings. The present paper describes a parallel approach to maintenance management used in bridge structures, but adapted to the maintenance of reinforced concrete buildings. The maintenance of several components of a concrete structural system is considered in the context of both yearly and longer-term maintenance planning. The significance of different components in relation to others in the system is determined by first conducting a failure mode effect and criticality analysis (FMECA) on all structural/non-structural elements. The FMECA permits developing a component criticality index from which their relative importance is assigned amongst the different building components. An optimisation of different possible maintenance actions is considered in relation to the cost of specified actions or replacement of components based on a multi-objective index (MOI). This index provides a means of relating competing maintenance objectives; that of controlling maintenance intervention costs and maintaining component condition ratings. It provides yearly maintenance costs of individual components for a given structural system over a long-term horizon that spans the life of the building.

Assessment of Durability of the Toothed Segment Based on FEM Analysis and Low Fatigue Cycle Test

Abstract The development of a novel design for the toothed segment of drive transmission in longwall shearer is expected to significantly reduce the cost of individual components of the feed system and the related work of repair and renovations, increasing at the same time the safety of mine repair teams. The conducted experimental and numerical analysis of the state of stress and strain in the innovative design of the toothed segment has enabled estimating the maximum effort of the developed structure. Based on the results of fundamental mechanical studies of the cast L20HGSNM steel and fatigue tests combined with the numerical stress/strain analysis, the fatigue life curve was plotted for the examined casting of the rack.

Evaluation of Selected Anode and Cathode Gas Diffusion Layers for Use in PEM Water Electrolysis with Focus on Compatibility with 3M's Ir-Nstf Based Electrolyzer Catalyst Coated Membranes

The interest in harnessing energy from renewable sources to achieve environmental cleanliness in the energy industry keeps gaining momentum. The need to be able to convert and store all that renewable energy has rekindled interest in hydrogen as a clean and environmentally benign energy carrier. Likewise, the rising star of hydrogen enabled mobility (motive fuel cells) ads further impetus to addressing needs for economical means to generate hydrogen - the ultimate key to success for hydrogen as fuel in societal everyday transportation solutions. Polymer Electrolyte Membrane (PEM) water electrolysis emerged recently as one of the better choice today to address the need for hydrogen fuel by virtue of being compatible with highly variable and unpredictable nature of the renewable energy generation. Even though PEM has in fact been used for quite a few years now without undergoing substantial improvements over those years now, however, with the new focus on hydrogen as the energy carrier there is much more interest in low cost/high efficiency H2 production. There are two main ways to lower the cost of hydrogen production via PEM water electrolysis: to lower the capital expenses (CAPEX) and/or to lower the operating expenses (OPEX). We at 3M have recently demonstrated a way to address reducing the high CAPEX by widening the range of current densities where electrolyzers can operate from a maximum of about 2.0 A/cm2, as used today in commercial electrolyzers, to as much as 20 A/cm2 by employing a novel 3M’s proprietary Nano Structured Thin Film (NSTF) catalyst and more conductive 3M PFSA based electrolytes in the electrolyzer MEA1-3. What the cited work does not touch upon is the need to further address high electrolyzer CAPEX by lowering costs of individual components of electrolyzer cells. This could be done independently of the operational cost savings and in addition to them. One such area where improvements can still be made is in the use of more economical Gas Diffusion Layers. These differ in function from fuel cell GDLs by the fact that reactants move through them in different directions, the requirements for performance, durability and mechanical robustness are also much more stringent. The standard materials in use as GDLs today are based on sintered titanium plates and although they work well and perform satisfactory such GDLs are neither inexpensive nor are they compatible with high speed/low cost roll-to-roll manufacturing – a necessary requirement for substantial cost reductons. In this work, we intend to present results of our attempts to investigate materials available in the fuel cell realm for compatibility and performance in electrolyzer cathodes as possible replacement for Ti sinters. We will also present data evaluating alternatives to rigid Ti sinters for electrolyzer anodes. All materials are selected such that compatibility of these candidate GDL materials with high speed/low cost roll-to-roll manufacturing process is not negatively affected by their properties and/or modifications. Krzysztof A. Lewinski, Sean M. Luopa, (invited) “High Power Water Electrolysis as a New Paradigm for Operation of PEM Electrolyzer” (abstract 1948), Spring ECS Meeting, Chicago, IL, May 2015. Krzysztof A. Lewinski, Dennis van der Vliet, and Sean M. Luopa, “NSTF Advances for PEM Electrolysis - the Effect of Alloying on Activity of NSTF Electrolyzer Catalysts and Performance of NSTF Based PEM Electrolyzers” ( 1457), Fall ECS Meeting, Phoenix, AZ, Oct 2015. Krzysztof A. Lewinski, Dennis van der Vliet, and Sean M. Luopa, “NSTF Advances for PEM Electrolysis - the Effect of Alloying on Activity of NSTF Electrolyzer Catalysts and Performance of NSTF Based PEM Electrolyzers”, (10.1149/06917.0893ecst), ECS Transactions, 69 (17) , p. 893-917 (2015).

Building integrated photovoltaics (BIPV): costs, benefits, risks, barriers and improvement strategy

Building integrated photovoltaics (BIPV) refers to photovoltaic or solar cells that are integrated into the building envelope (such as facade or roof) to generate ‘free’ energy from sunshine, and it is one of the fastest growing industries worldwide. However, up until now, there have been limited studies that analysed cost‒benefit and risk factors/barriers of BIPV from a supply chain perspective; and there have also been limited studies that provide strategies to industry and academics in order to encourage BIPV diffusion and application. The aim of this research is to identify the costs, benefits and risks of BIPV and propose suggestions for greater BIPV application, from a stakeholder perspective, through a comprehensive review of current literature. The results of this research show that whilst BIPV have high initial investment capital costs, there are significant long-term benefits to be achieved for clients, end users and the entire society. Further, the results also show that BIPV costs decrease and government policy support and incentives are required in order to promote wider BIPV application. In addition, this research has identified the fact that there was a lack of detailed BIPV cost data (including individual component costs) and lack of methods for BIPV cost‒benefit analysis, and there are risks and barriers in BIPV applications. Following this, this research provides a strategic framework and a number of suggestions to industry stakeholders for integration and collaboration within the BIPV supply chain in order to facilitate the cost reduction of BIPV. Finally, this study proposes several topics for future research. It is anticipated that the results presented in this paper have implications not only for government policy and product development and application, but also for academic research.

Levelized cost of energy and sensitivity analysis for the hydrogen–bromine flow battery

The technoeconomics of the hydrogen–bromine flow battery are investigated. Using existing performance data the operating conditions were optimized to minimize the levelized cost of electricity using individual component costs for the flow battery stack and other system units. Several different configurations were evaluated including use of a bromine complexing agent to reduce membrane requirements. Sensitivity analysis of cost is used to identify the system elements most strongly influencing the economics. The stack lifetime and round-trip efficiency of the cell are identified as major factors on the levelized cost of electricity, along with capital components related to hydrogen storage, the bipolar plate, and the membrane. Assuming that an electrocatalyst and membrane with a lifetime of 2000 cycles can be identified, the lowest cost market entry system capital is 220 $ kWh−1 for a 4 h discharge system and for a charging energy cost of 0.04 $ kWh−1 the levelized cost of the electricity delivered is 0.40 $ kWh−1. With systems manufactured at large scales these costs are expected to be lower.

Dive behaviour can predict metabolic expenditure in Steller sea lions.

Quantification of costs associated with foraging contributes to understanding the energetic impact that changes in prey availability have on the energy balance of an animal and the fitness of populations. However, estimating the costs of foraging is difficult for breath-hold divers, such as Steller sea lions, that feed underwater. We developed models parameterized with data from free-diving captive Steller sea lions to estimate the costs incurred by wild animals while foraging. We measured diving metabolic rate of trained sea lions performing four types of dives to 10 and 40 m in the open ocean and estimated the separate costs of different dive components: surface time; bottom time; and transiting to and from depth. We found that the sea lions' diving metabolic rates were higher while transiting (20.5 ± 13.0 ml O2 min(-1) kg(-1)) than while swimming at depth (13.5 ± 4.1 ml O2 min(-1) kg(-1)), and both were higher than metabolism at the surface (9.2 ± 1.6 ml O2 min(-1) kg(-1)). These values were incorporated into an energetic model that accurately predicted oxygen consumption for dives only (within 9.5%) and dive cycles (within 7.7%), although it consistently overestimated costs by 5.9% for dives and 21.8% for dive cycles. Differences in the costs of individual components of dives also explained differences in the efficiency of different dive strategies. Single dives were energetically less costly than bout dives; however, sea lions were more efficient at replenishing oxygen stores after bout dives and could therefore spend a greater portion of their time foraging than when undertaking single dives. The metabolic rates we measured for the different behavioural components of diving can be applied to time-depth recordings from wild Steller sea lions to estimate the energy expended while foraging. In turn, this can be used to understand how changes in prey availability affect energy balance and the health of individuals in declining populations.

Labor Resource Use for Endoscopic Gastric Cancer Screening in Japanese Primary Care Settings: A Work Sampling Study

ObjectiveEndoscopic gastric cancer is screened in primary care settings, but how much resources are required to deliver this service remains unknown. This study determines how much time and human resources are used for endoscopic gastric cancer and for each component of the procedure.Materials and MethodsUpper endoscopic procedures were prospectively observed using a work sampling technique. This study analyzed data from patients who underwent upper endoscopic gastric cancer screening at primary care clinics that provide this service. The main outcome measurements were time intervals and total time intervals that considered the numbers of simultaneously engaged workers and were calculated as the product of time intervals and the number of workers, and the labor cost of individual components of each procedure.ResultsWe observed 44 upper endoscopic procedures at four outpatient clinics. Pre-procedure (preparation and pre-medication), procedure (from intubation to extubation) and post-procedure (recovery and cleaning) accounted for 34.1%, 10.6% and 54.4% of the total time, respectively. Of the overall total time intervals (mean: 4453 person-seconds), 29.3%, 14.4% and 55.7% of the total time was devoted to pre-procedure, procedure and post-procedure, respectively. The post-procedure was the most time- and labor-consuming component from the viewpoints of both total time and labor cost.ConclusionsMost of the time taken to complete endoscopic gastric cancer screening is consumed by preparation, pre-medication and post-procedures in which nurses play key roles.

Cost Benefit Analysis Of a Sickle Cell Infusion Center For The Treatment Of Vaso-Occlusive Crises

IntroductionThe most common reason for acute care utilization for individuals with sickle cell disease (SCD) is Vaso-Occlusive crisis (VOC). Patients typically seek out care through the emergency department (ED) At these locations patients often have long waits to get care and often receive sub optimal pain management, which Results in over 40% of patients requiring hospital admission. Johns Hopkins Hospital has implemented a new model of service for people with SCD; an outpatient Sickle Cell Infusion Clinic (SCIC) that was opened in 2008 as an alternative source of urgent care for patients having VOC. The purpose of this study is to determine the net financial benefit of implementing the sickle cell infusion clinic model. MethodsA cost-benefit analysis is conducted from the payer's perspective focusing on direct medical cost (procedures, drugs, tests, etc.) of SCD patients and excludes indirect medical costs (patients' productive changes). Health care costs and utilization data was available for the last 3 out of 5 years that the SCIC was opened. A literature review was conducted to determine the costs of individual components of the total costs for SCD patients: inpatient hospitalization, ED visit, primary care and secondary care visits, and other healthcare costs for patients with SCD. The overall and average visit cost of the SCIC was determined from the 2012-2013 budget and visits. The billing data for a subset of patients seen in the SCIC that were insured by one of the Medicaid's MCO was used to determine utilization and costs of healthcare services for 2010, 2011, and 2012. The baseline utilization of healthcare services before the SCIC was implemented was estimated from the literature. As we did not have baseline data we estimated that the 2010 utilization of healthcare services reflected a 20% decrease in hospitalizations and a 40% decrease in ED visits. The overall cost of care for patients with SCD was determined from the above-mentioned sample of billing claims data and utilization estimates. The costs of running the SCIC was added to the overall costs of care. Finally, net savings for the SCIC was determined by calculating the difference in overall cost and savings per beneficiary per month (PBPM). All values are reported in 2012 inflation-adjusted dollars. ResultsFor the subset of patients covered by the Medicaid MCO, the SCIC model resulted in a 7.6% ($676 PBPM) cost savings in the first year (estimated baseline compared to 2010) with savings of 29.2% ($2598 PBPM) when comparing estimated baseline to 2012. The total medical costs for the subset of patients using the SCIC in 2010 was $3,492,339 with an average cost of $94,388 per patient. The SCIC had 1,428 visits by 246 unique patients in FY2012 with an average cost per visit of $434 or $203 PBPM. Other costs in this patient population include: inpatient hospitalization ($3,985 PBPM), ED visits ($326 PBPM), primary and secondary care visits ($26 PBPM), and pharmacy ($493 PBPM). The total cost of care for the same number of sickle cell patients as in our sample who did not utilize the SCIC would have been $3,779,588, with an average cost of $102,151per patient. The SCIC model resulted in cost savings primarily due to a decrease in hospitalizations and ED visits. The number of hospitalization decreased 52.0% (2.88 HPY) and the number of ED visits decreased 48.4% (2.32 visits VPY) in the fifth year of operating the infusion clinic model (2012). The average cost of a hospitalization and an ED visit was $10,797 and $1,024 respectively. These values did not change with the implementation of the SCIC. If we extrapolate the cost savings seen in the subset of patients using the more conservative 7.6% cost savings, to the entire patient cohort this would result in a cost savings of $1.9 million. DiscussionPreliminary cost-benefit analysis shows that the SCIC model resulted in significant cost savings that increased significantly in successive years. Cost savings was driven by two major factors: 1) decrease in inpatient hospitalizations and 2) decrease in ED visits. Additional analysis to include actual baseline data is planned along with a sensitivity analysis to identify if there is a certain threshold population density for which this model would be most cost effective. Disclosures:Lanzkron: GlycoMimetics, Inc.: Research Funding.

A $70/tCO2 greenhouse gas mitigation backstop for China's industrial and electric power sectors: Insights from a comprehensive CCS cost curve

As one of the world's fastest growing economies with abundant coal reserves, China's carbon dioxide (CO2) emissions have doubled in the last decade and are expected to continue growing for the foreseeable future. While the Central Government has been promoting development and growth of cleaner and more efficient energy systems, efforts to reduce carbon emissions from the heavily coal-based economy may require continued and increased development and deployment of carbon dioxide capture and storage (CCS) technologies. This paper presents the first detailed, national-scale assessment of CCS potential across the diverse geographic, geologic, and industrial landscape of China, through the lens of an integrated CCS cost curve. It summarizes the development of a cost curve representing the full chain of components necessary for the capture and geologic storage of CO2 from China's power generation and industrial sectors. Individual component cost estimates are described, along with the optimized source–sink matching of over 1600 large stationary CO2 sources and 2300gigatons of CO2 storage capacity within 90 major deep geologic onshore sedimentary sub-basins, to develop a cost curve incorporating CO2 capture, compression, transport, and storage. Results suggest that CCS can provide an important greenhouse gas mitigation option for most regions and industrial sectors in China, able to store more than 80% of emissions from these large CO2 sources (2900million tons of CO2 annually) at costs less than $70/tCO2 for perhaps a century or more.

Highest Reliability-based Optimum Maintenance Scheduling Model for Traction Substations in Railways

Optimum maintenance scheduling for traction substations guarantees reliable and efficient operation of electrical railways. Reliability-based optimum scheduling models are respectively proposed through the analysis of the structure and maintenance cost of individual components in traction substations in this study. An individual components-based heuristic algorithm for solving the proposed models is developed considering the structural complexity of traction substations. Furthermore, a reliability evaluation-based co-ordination method is devised for optimum scheduling of traction substations. Case studies from field data are implemented to verify the validity and practicability of the proposed methods by their solutions.

Modeling the Cost-Effectiveness for Cement-Less and Hybrid Prosthesis in Total Hip Replacement in Emilia Romagna, Italy

The aim of the present study was to assess the cost-effectiveness of cement-less versus hybrid prostheses in total hip replacement (THR) in patients diagnosed with primary osteoarthritis. Effectiveness data were obtained from the Emilia-Romagna Regional Registry on Orthopaedic Prosthesis (RIPO), which collects information on all orthopaedic intervention performed in Emilia-Romagna (41,199 total hip replacements performed from 2000 to 2007), and from which we obtained survival curves and transition probabilities for the cement-less and hybrid prostheses, respectively. Conversely, costs were derived from regional databases through a specific procedure, which allowed us to register individual component's costs for both primary and subsequent revision interventions. A specific Markov transition model was constructed in order to consider the 3 types of revisions that an implant could possibly undergo through its life-span: total, cup or stem, head insert or neck. The cost-effectiveness was expressed in terms of cost per "revision-free" life year. Considering a 70-y old patient undergoing THR, the cementless strategy resulted more effective but more costly than the hybrid solution, with an incremental cost effectiveness ratio of 2401.63 € per revision-free life year. Following a deterministic sensitivity analysis, hybrid and cementless fixation showed, respectively, a dominance profile for patients older than 83 y and younger than 43 y, whereas for all ages in between, we report a progressive increase in the ICER of cementless prostheses. Our results proved to be robust, as underlined by the probabilistic sensitivity analysis performed using cost distributions.