Net Cost Research Articles

Estimating the economic impact of blister-packaging on medication adherence and health care costs for a Medicare Advantage health plan.

Medication nonadherence is a persistent challenge in the United States, leading to increased health care resource utilization (HCRU) and health care costs and worsened health outcomes. Medicare Star Ratings is a program developed by the Centers for Medicare and Medicaid Services (CMS) to evaluate Medicare health plan quality and performance. Three of the Medicare Part D Star Ratings quality measures assess medication adherence, showing the importance CMS places on improving medication adherence in older adults. Although a variety of medication adherence-enhancing interventions are available to help promote adherence among patients, one intervention that has shown success historically is blister-packaging. To model the potential impact of blister-packaging chronic medications on HCRU and health care costs in the Medicare population. An economic model was developed to assess the potential impact of blister-packaging the 3 Medicare Star Ratings adherence measure medication classes: renin-angiotensin system antagonists (RASAs), statins, and noninsulin antidiabetics. The model perspective was that of a hypothetical Medicare Advantage health plan with a plan size of 100,000 members. A 12-month time horizon was used in the model. The dichotomous adherence threshold in the model was set at 80% or greater of the proportion of days covered (PDC). Literature-based references were used to inform both the impact of blister-packaging on the number of patients who become adherent as well as the impact of medication adherence on HCRU and health care costs for each of the medication classes. One-way sensitivity analyses and several scenario analyses were conducted to assess model uncertainty. Owing to increased adherence from the blister-packaging intervention, the hypothetical health plan in the analysis saw 776 additional members adherent to RASAs, 1,651 additional members adherent to statins, and 414 additional members adherent to oral antidiabetics. Although medication expenditure increased for all 3 medication classes (RASAs: $274,963; statins: $730,083; oral antidiabetics: $100,529), medical costs decreased across all classes (RASAs: -$4,098,848; statins: -$5,549,699; oral antidiabetics: -$917,968). Total net health care costs decreased by $3,823,885 for RASAs (-$3.19 per member per month [PMPM]), $4,819,616 for statins (-$4.02 PMPM), and $817,438 for oral antidiabetics (-$0.68 PMPM). The entire Medicare Advantage population scenario analysis saw reductions in total health care costs of $1,081,394,737 for RASAs, $1,362,987,376 for statins, and $231,171,496 for oral antidiabetics. Dispensing chronic medications with blister-packaging for Medicare Advantage health plan patients was modeled to reduce HCRU and health care costs. Future studies are needed to assess whether the impact of blister-packaging medications is tied to reductions in HCRU and health care costs in real-world settings.

The Private Health Insurance Underwriting Cycle, Economic Profits and Their Determinants

The underwriting cycle in private health insurance refers to fluctuations in profit margin over time. This research, a novel effort, aims to understand the peak-to-trough magnitudes and determinants of the industry-wide underwriting cycle. Historical industry-wide profits and losses have not been previously estimated, making this study a significant contribution to the field. Based on the reports of the Centers for Medicare and Medicaid Services (national health expenditures reports), this study begins by constructing the underwriting cycle of private health insurance performance over the last six decades, from which profit margins can be estimated. Expressing the net cost of private health insurance and personal health expenditures as a fraction of the premium facilitates the analysis, which employs standard methods. The results show, over a 62-year period from 1960 through 2022, that there are 12 underwriting cycles. The capacity to generate profits is influenced by the cost of personal healthcare expenditures, competition for enrollment, and the availability of substitutes. Evidence of reduced capacity for profitability is a finding that additional enrollment does not contribute to profits and that private health insurance enrollment is generally declining. Cumulative profits due to the sales of private health insurance only over the 62 years assessed are negative.

Effects of minute oscillation stretching training on muscle and tendon stiffness and walking capability in people with type 2 diabetes.

we investigated the effects of a 10week training program (i.e., minute oscillatory stretching; MOS) on the mechanical responses and walking capability in people with type 2 diabetes (T2D). seventeen T2D patients performed maximum voluntary contractions of the plantar flexor muscles during which Achilles tendon stiffness (kT) and muscle-tendon stiffness (kM) were evaluated at different percentages of the maximum voluntary force (MVC). In addition, each participant was requested to walk at different walking speeds (i.e. 2, 3, 4, 5, and 6kmh-1) while their net energy cost of walking (Cnet), cumulative EMG activity per distance travelled (CMAPD) and kinematic parameters (step length, step frequency, the ankle/knee range of motion) were evaluated. maximum tendon elongation increased after MOS training, and kT significantly decreased (between 0 and 20% of MVC). No differences were observed for muscle elongation or kM after training. Cnet decreased after training (at the slowest tested speeds) while no changes in CMAPD were observed. Step length and ankle ROM during walking increased after training at the slowest tested speeds, while step frequency decreased; no significant effects were observed for knee ROM. these results indicate the effectiveness of 10weeks of MOS training in reducing tendon stiffness and the energy cost during walking in people with T2D. This training protocol requires no specific instrumentation, can be easily performed at home, and has a high adherence (92 ± 9%). It could, thus, be useful to mitigate mechanical tendon deterioration and improve physical behaviour in this population.

Optimal Hybrid Renewable Energy System to Accelerate a Sustainable Energy Transition in Johor, Malaysia

As the world’s second-largest palm oil producer, Malaysia heavily depends on its extensive oil palm cultivation, which accounts for nearly 90% of the country’s lignocellulosic biomass waste. Approximately 20–22 tonnes of empty fruit bunches (EFBs) can be derived from an initial yield of 100 tonnes of fresh fruit bunches (FFBs) from oil palm trees. The average annual amount of EFBs produced in Johor is 3233 tonnes per day. Recognising that urban areas contribute significantly to anthropogenic greenhouse gas emissions, and to support Malaysia’s transition from fossil fuel-based energy to a low-carbon energy system, this research employed HOMER Pro software 3.18.3 to develop an optimal hybrid renewable energy system integrating solar and biomass (EFB) energy sources in Johor, Malaysia. The most cost-effective system (solar–biomass) consists of 4075 kW solar photovoltaics, a 2100 kW biomass gasifier, 9363 battery units and 1939 kW converters. This configuration results in a total net present cost (NPC) of USD 44,596,990 and a levelised cost of energy (LCOE) of USD 0.2364/kWh. This system satisfies the residential load demand via 6,020,427 kWh (64.7%) of solar-based and 3,286,257 kWh (35.3%) of biomass-based electricity production, with an annual surplus of 2,613,329 kWh (28.1%). The minimal percentages of unmet electric load and capacity shortage, both <0.1%, indicate that all systems can meet the power demand. In conclusion, this research provides valuable insights into the economic viability and technical feasibility of powering the Kulai district with a solar–biomass system.

Optimization of Residential Hydrogen Facilities with Waste Heat Recovery: Economic Feasibility across Various European Cities

The European Union has established ambitious targets for lowering carbon dioxide emissions in the residential sector, aiming for all new buildings to be “zero-emission” by 2030. Integrating solar generators with hydrogen storage systems is emerging as a viable solution for achieving these goals in homes. This paper introduces a linear programming optimization algorithm aimed at improving the installation capacity of residential solar–hydrogen systems, which also utilize waste heat recovery from electrolyzers and fuel cells to increase the overall efficiency of the system. Analyzing six European cities with diverse climate conditions, our techno-economic assessments show that optimized configurations of these systems can lead to significant net present cost savings for electricity and heat over a 20-year period, with potential savings up to EUR 63,000, which amounts to a 26% cost reduction, especially in Southern Europe due to its abundant solar resources. Furthermore, these systems enhance sustainability and viability in the residential sector by significantly reducing carbon emissions. Our study does not account for the potential economic benefits from EU subsidies. Instead, we propose a novel incentive policy that allows owners of solar–hydrogen systems to inject up to 20% of their total solar power output directly into the grid, bypassing hydrogen storage. This strategy provides two key advantages: first, it enables owners to profit by selling the excess photovoltaic power during peak midday hours, rather than curtailing production; second, it facilitates a reduction in the size—and therefore cost—of the electrolyzer.

STUDI KELAYAKAN USAHA INDUSTRI PEMINDANGAN IKAN DI LINGKUNGAN MAPAK BELATUNG KELURAHAN JEMPONG BARU KECAMATAN SEKARBELA KOTA MATARAM

The potential of fish in Indonesian waters has two seasons, the first is the fishing season which usually occurs between April and November, the lean season occurs between December and March. During the fishing season, fishermen can get catches that exceed the catch capacity for each time they go sailing. The Mapak Belatung Community is a coastal community where most of the population depends on marine products and aquatic animal cultivation, one of which is fish. This is what finally gave birth to fish smoking activities. Unsold fresh fish are processed into pindang fish by fisherwomen in a simple way and then marketed in traditional markets around Mataram City. The purpose of this study was to determine the feasibility of developing a fish smoking industry in the Mapak Belatung Environment, Sekar Bela District, Mataram City when viewed from the investment criteria of Net Present Value (NPV), Net Benefit Cost Ratio (Net B / C), Gross Benefit Cost Ratio (Gross B / C), Profitability Ratio (PR) and Internal Rate of Return (IRR). Based on the calculation of Net Present Value, it shows that the total NPV is Rp. 5,722,264, this means that the palm oil industry business at the research location is feasible to continue because the NPV result is positive (+). The calculation of Net B/C shows that the result is greater than 1 or 1.75, this means that the benefit obtained is 1.75 times the cost or expenses incurred. Based on the calculation of Gross Benefit Cost Ratio, it has a value greater than 1 (> 1), which is 1.233, meaning that the palm oil industry business at the research location is feasible to run, likewise the calculation result of Profitability ratio has a value greater than 1 (> 1), which is 1.97, meaning that the palm oil industry business at the research location is feasible to run. The Internal Rate of Return (IRR) of the palm oil industry at the research location has a value of 17.8 percent or greater than the applicable interest rate

Assessing the impact of taxation on the effective tax rate and operational risk of capital investment projects under optimal capital structures

This paper proposes two metrics to correctly measure under optimal capital structures the impact of corporate statutory tax rates (a) on the effective tax rate, and (b) on the operational risk of capital investment projects and their parent firm's project portfolio. For illustrative and explanatory purposes as well as for ensuring a realistic coverage of a wide spectrum of risky capital investment projects, both metrics are applied to a stationary in mean and variance stochastic NPVτ model under the Canadian open-class corporate taxation system. The Marshallian partial equilibrium adjustment mechanism is brought into play to ensure through efficient financial markets that firms operating within any domestic economic sector are concomitantly subjected to financial equilibrium conditions, thereby enabling firms to converge in the very short run to an optimal after-tax leveraged net cost of capital. This paper concludes that current macroeconomic neo-classical rate-based marginal effective tax rate (METR) metrics systematically and significantly underestimate business organizations' microeconomic NPVτ-based corporate effective tax rates. Furthermore, increasing both the corporate statutory tax rate and the cross-correlation coefficient between portfolio projects will markedly increase a parent firm's project portfolio operational risk while impeding its capacity to reduce it.

Mega-scale solar-wind complementarity assessment for large-scale hydrogen production and storage (H2PS) in Algeria: A techno-economic analysis

Green hydrogen (GH2) is produced using renewable energy resources (RERs) such as solar photovoltaic (PV) and wind energy. However, relying solely on a single source, H2 production systems may encounter challenges due to the intermittent nature, time-of-day variability, and seasonal changes associated with these energies. This paper addresses the assessment of mega-scale solar-wind complementarity and the economic viability of large-scale H2 production and storage in Algeria, considering various climatic conditions. A techno-economic feasibility analysis is conducted by examining various factors, including resource complementarity, electricity and hydrogen productivity, solar and wind contributions, capacity factors (CFs), total net present cost (TNPC), the levelized cost of hydrogen (LCOH) production, and storage (LCOS). The findings reveal that among the studied locations (Tamanrasset, M'sila, Hassi R'mel, and Adrar), Tindouf ranked first in H2 production, with the highest amount at 11,267 kg and the lowest LCOH at 2.999 $/kg. Wind energy accounted for 69% (3,846,922 kWh) of the total (5,572,571 kWh), while solar energy contributed 31% (1,738,171 kWh). Economically, the LCOH-TNPC for the various locations ranged from 2.99 $/kg-77,042,696 $ to 3.70 $/kg-99,000,488 $. The total electricity-hydrogen generated is estimated at 25,840.251 MWh-529,395 kg. Wind power makes the major contribution, accounting for 63%–70%, compared to the PV system's share, ranging from 31% to 37%. Compared to relying on a single source, leveraging solar-wind complementarity presents opportunities for more consistent energy utilization and reliable hydrogen production. The obtained results are essential for decision-makers and policymakers in Algeria, indicating that the country can successfully achieve energy diversification and transition for future sustainability, and become a major player in the international hydrogen market.

Quantitative Monitoring Maximizes Cost-Saving Strategies When Antagonizing Neuromuscular Block With Sugammadex.

Introduction Weight-based dosing combined with variable patient weights in pediatric anesthesia can lead to significant medication excess and waste from single-use medication vials packaged for dosing in adults. Medication aliquots have been proposed as a strategy to decrease waste and therefore expense when using high-cost medications such as sugammadex. Appropriate dosing of sugammadex to antagonize neuromuscular block is based on the results of quantitative monitoring, though the use of these monitors is not routine. In this quality improvement project, we demonstrate cost savings from aliquoting sugammadex from large, single-use vials and using quantitative monitoring to guide accurate and appropriate dosing. Methods After institutional review and approval, patients receiving rocuronium neuromuscular block during their anesthetic care between October 10 and December 9, 2022, were included for analysis. Sugammadex aliquots were prepared under sterile conditions in the operating room pharmacy according to current compounding guidelines. Quantitative neuromuscular monitoring with electromyography-based monitors was used to guide accurate sugammadex dosing. Cost analysis included the actual savings achieved when aliquots were used instead of single-use vials, the potential savings if aliquots had been used as opposed to single-use vials, and the actual savings achieved when quantitative monitoring indicated that adequate spontaneous recovery was reached and sugammadex administration was not needed. Results A total of 200 patients were included in the analysis. In 73 patients, a 200 mg/2 ml vial of sugammadex was utilized, while 86 patients received sugammadex from pre-filled aliquot syringes of 50 mg/0.5 ml. Forty-one patients did not require sugammadex antagonism as they achieved spontaneous recovery to a train-of-four ratio ≥90%. Conclusion Administration of sugammadex from aliquots rather than manufacturer-packaged single-use vials, with dosing guided by quantitative neuromuscular monitoring, produced a net cost savings of approximately $46 per case and projected net annual cost savings of nearly $370,000 in our institution. Forty percent of the net cost savings came from confirmation by quantitative monitoring of adequate spontaneous recovery to a train-of-four ratio ≥90%.

Techno-economic Analysis of Hybrid Renewable Energy System for Hydrogen Production in the Demnate Region of Morocco

This paper investigates the techno-economic feasibility of producing electrical energy for three villages in the mountains in the Demnate region. The community needs were determined based on the site visit to identify the electrical load demand in reality. In addition, a site description was done to evaluate the suitable system to produce the electrical energy. Using the Homer software, two systems were selected to produce electricity and hydrogen which are described as follows: The first system is constituted of a PV-Generator with 3759 kW, an Autosize Genset generating 300 kW, a DC/ AC converter supplying 317 kw, 800 kW produced by the electrolyzer, and a hydrogen storage tank with 900 Kg as a capacity. The second system is composed of PV modules with 3743 kw, seven G3 wind turbines with 3kW, an Autosize Genset generating 300 kw, 323 kW of power converters, a generic electrolyzer with an output power of 800 kW, and a hydrogen tank with 900 Kg as capacity. In addition, the financial analysis gives 1.56$/kWh and 1.57$/kWh as the Levelized Cost of Energy and 15.6 M$ and 15.7 M$ as the Net Present Cost for the first and second systems respectively.

Battery energy storage with renewable energy sources integration in unbalanced distribution network considering time of use pricing

The increasing demand for sustainable energy solutions and the escalating energy demand have facilitated the emergence of renewable energy sources (RES), such as photovoltaic (PV) sources. Combining RES with battery energy storage system (BESS) technology reduces peak hour demand and allows for economical charging and discharging for time-based energy pricing. Integrating PV and BESS in an unbalanced system with multiple RES sources is a challenging task. It requires a robust algorithm to minimise power loss in the distribution system and decrease the voltage unbalance factor (VUF). This paper presents a new multi-objective Pelican optimisation algorithm (MOPOA) for the optimal allocation of PV and BESS. The MOPOA helps find the best placement of PV and BESS in an IEEE-33 bus unbalanced radial distribution system (URDS). The proposed algorithm combines multiple benefits from a lower net present cost (NPC) and a higher voltage profile enhancement index (VPEI). The case studies and simulation results show that the proposed method places PV and BESS in IEEE 33-bus URDS optimally, satisfying all of the system’s requirements. The results indicate an improvement in the minimum VUF factor of 4.4% in a winter day and 4.3% in a summer day; a reduction in active power loss of 16% in a winter day and 7.1% in a summer day; and a reduction in reactive power loss of 7.5% in a winter day and 7.2% in a summer day. Thus, the recommended strategy effortlessly accelerates to a suboptimal solution.

Efficacy of Various Insecticides against Leaf Folder Cnaphalocrocis medinalis (Guenee) in Rice and the Calculation of the Benefit-cost Ratio

The present investigation was conducted at Heera Puri research field, Institute of Agriculture and Natural Sciences, Deen Dayal Upadhyaya Gorakhpur University, Gorakhpur during Kharif, 2023. The relative effectiveness of six insecticides viz., Flubendiamide 39.35 % SC, Chlorpyriphos 20 EC, Acephate 95 SC, Chlorantraniliprole 18.5 SC, Fipronil 5 SC, Cartap hydrochloride 50% SP and Control. The study revealed that the treatment Flubendiamide 39.35% SC was found most effective followed by Chlorantraniliprole 18.5 SC, and Fipronil 5 SC whereas the highest infestation was recorded in the control plot. The significantly higher grain yield was obtained in Flubendiamide 39.35% SC treated plots which are followed by Chlorantraniliprole 18.5 SC, Fipronil 5 SC, Cartap hydrochloride 50% SP, Acephate 95 SC and Chlorpyriphos 20 EC. The highest increase in yield over control was reported in the plot treated with Flubendiamide 39.35% SC followed by Chlorantraniliprole 18.5 SC, Fipronil 5 SC, Cartap hydrochloride 50% SP, Acephate 95 SC, and Chlorpyriphos 20 EC. The economics of various treatments based on net profit and cost of plant protection revealed that. the highest cost: benefit ratio of Chlorpyriphos 20 EC was followed by Chlorantraniliprole 18.5 SC, followed by Acephate 95 SC, Fipronil 5 SC and the lowest benefit-cost ratio was reported in plots treated with Cartap hydrochloride 50% SP.

Techno-Economic analysis of A Stand-Alone hybrid renewable energy system (Solar/Fuel Cell/Battery) and grid extension for two residential Districts

This study investigates the technical and economic aspects of grid extension and stand-alone hybrid renewable energy systems (HRES) for Loughborough-England and Afyonkarahisar-Türkiye. For the HRES, the primary energy source is solar panels. Fuel cells and batteries are available as auxiliary sources. In addition, electrolysers and batteries are considered to store excess energy for a sustainable system. All calculations of the HRES are performed by HOMER Pro® software. The results are compared considering the cost of energy and net present cost. The cost of energy is 95.30 and 61.39 $/MWh, respectively. The net present cost of HRES is $298,644 and $1,478,892, respectively. The grid extension is also evaluated for both locations. The minimum cost of energy is calculated at 94.31 and 90.65 $/MWh, respectively. The minimum net present cost of the grid extension is $275,750 and $1,943,175, respectively. The break-even distance is 3.59 km for Loughborough-England. However, it is not available for Afyonkarahisar-Türkiye.

Financial impact of low pathogenic avian influenza virus subtype H9N2 on commercial broiler chicken and egg layer production systems in Pakistan

Low Pathogenic Avian Influenza (LPAI) subtype H9N2 is endemic in Pakistan and impacts poultry farming through disease related mortality, poor weight gain and reduced egg production. This study aims to estimate the farm-level financial impact of LPAI H9N2 infection on commercial broiler and layer production systems in Pakistan.A questionnaire based cross-sectional survey of 138 broiler farms and 136 layer farms in Pakistan was conducted in 2019. Primary data collected by cross-sectional survey along with expert opinion and published literature were used to parameterize five stochastic production and gross margin models for three broiler and two layer production systems: fully integrated production (FIP), partially integrated production (PIP) and independent farming production (IP) systems. Partial budget analysis were then carried out to estimate the financial impact of LPAI H9N2.Results indicate that in broiler production systems, starting with 35,000 day old chicks (DOC) per batch, the net cost of disease (million PKR/production cycle) was estimated at 4.10 (14,862 USD), 4.62 (16,747 USD) and 2.46 (8917 USD) for IP, PIP and FIP systems, respectively. The disease produced a negative gross margin (defined here as revenue minus replacement and variable costs) in IP (-53 PKR (-0.19 USD)/DOC bought) and PI (-25 PKR (-0.091 USD)/DOC bought) systems, while remained positive for FIP systems (87 PKR (0.32 USD)/DOC bought). For layer production systems, (mean flock size as 48,000 DOCs) the net cost (million PKR/production cycle) was 29.75 (107,095.21 USD) and 29.51 (106,223.45 USD) IP and PIP systems, respectively, and produced negative gross margin in both systems.The outcomes of the study highlight the vulnerability of independent and partially integrated production systems to the disease. These findings also offer a decision-making tool to the farmers and policy makers to evaluate avian influenza surveillance systems and control interventions in Pakistan.

Abstract P333: Predicted Nationwide Health and Economic Impacts of the AMA MAP TM Hypertension Program to Improve Hypertension Control

Introduction: Lack of actionable blood pressure (BP) measurements, therapeutic inertia, and suboptimal patient self-management are three key barriers to better BP control. To help address these barriers, the American Medical Association developed the Measure Accurately, Act Rapidly, and Partner with Patients Hypertension (MAP TM HTN) quality improvement program. Methods: To estimate the 10-year health and economic outcomes achieved when healthcare delivery systems adopt MAP HTN, HealthPartners Institute's ModelHealth™: Cardiovascular disease (CVD) microsimulation model was applied to conduct “what if” analyses for adopting MAP HTN nationwide and in care delivery systems of varying size. MAP HTN targets patients aged 18 to 85 years with diagnosed hypertension. To account for newly diagnosed hypertensive patients over time and outcomes that follow exposure to the program after age 85, the simulation model predicted outcomes for a dynamic cross-section of U.S. adults aged 18 to 100 years. This study was conducted from the health care sector perspective, including that of the payers for medical services and the health care delivery system that provides these services. Risk equations to predict the incidence of CVD events were derived from Framingham Heart Study data and are based upon the following risk factors: age, sex, body mass index, systolic BP (SBP), lipid levels, smoking status, diabetes status, and CVD history. Modeled outcomes over 10 years included prevalence of SBP ≥140 mmHg; incidence of cardiovascular disease (CVD) events and CVD-related mortality; averted medical costs in 2021 U.S. dollars; and net costs. Results: Nationwide adoption of MAP HTN was predicted to improve mean BP control by 4.3% and prevent 601000 CVD events, with 85000 fewer myocardial infarctions, 164000 fewer strokes and 120000 fewer CVD deaths over 10 years as compared to usual care. The majority (93%) of the estimated $17.9 billion in averted costs were among Medicare beneficiaries. Total costs of implementing MAP HTN was $12.6 billion, resulting in a predicted $5.3 billion in net savings to the health care sector over 10 years. Small and large care delivery organizations could economically benefit from implementing MAP HTN at varying levels (5-50%) of shared cost savings from payers. Conclusions: The model demonstrates that AMA’s MAP HTN has the potential to improve population health and provide a positive business case by averting future myocardial infarctions, strokes, and CVD deaths.

FEASIBILITY ANALYSIS OF ORGANIC WASTE MANAGEMENT PROGRAM AT IPB UNIVERSITY, INDONESIA

More than half of the waste produced at IPB University is organic waste and is routinely generated every day. The waste could have economic value if it has proper management. On the other hand, waste management costs money for investment and operation. Therefore, a proper project plan is needed so the management can generate profits. This research aims to (1) estimate the potential of organic waste from IPB University that can be used optimally to produce economic value and (2) analyze the economic feasibility of organic waste at IPB University. The result of this research shows that the number of potential organic waste from IPB University that can give economic value is 506,496 kg each year. Economic value and feasibility were analyzed using three criteria, which are Net Present Value (NPV), Internal Rate of Return (IRR), and Net Benefit Cost Ratio (Net B/C). In economic analysis with a project life cycle of 20 years, the organic waste management obtained an NPV value of 915,056,415 rupiahs, 1.29 for Net B/C, and 10.35% for IRR. In financial analysis with a project life cycle of 20 years, the organic waste management obtained NPV value by -695,114,013 rupiahs, 0.78 for Net B/C, and 0.12%for IRR. Based on the description above, it can be concluded that the project IPB campus organic waste management is economically feasible but not feasible financially.

Sustainable rural electrification: Energy-economic feasibility analysis of autonomous hydrogen-based hybrid energy system

Pakistan has endured a severe power shortage for the past decade, with an installed capacity insufficient to meet the escalating demand. This dire situation results in catastrophic power breakdowns lasting 12 h in cities and 18 h in rural areas daily, and unfortunately, the outlook indicates it may worsen over time. The energy deficit is taking a toll on the country's overall economy, causing significant damage. This study focuses on designing a rural hybrid renewable energy system (HRES) to provide stable power to a remote village in Pakistan's Bannu district. The proposed HRES includes photovoltaic panels (PV), fuel cells (FC), and a biogas generator (BG). This paper addresses Pakistan's power shortage crisis and offers an economically viable solution through the rural HRES design, ensuring a sustainable and resilient energy future. Robustness, sensitivity, and breakeven analyses confirm the system's viability and ability to provide the community with uninterrupted electricity. The research demonstrates a cost of energy (COE) of $0.41/kWh and a total net present cost (TNPC) of $199,081 for the HRES. Additionally, the study compares the performance of the proposed system with state-of-the-art alternatives.

An extensive qualitative and quantitative multi criteria analysis for a hybrid renewable energy system applied to tribal zone - based primary health centres, and maximizing the societal parameters

Remote electrification enhances the quality of life quality of people in remote areas, with no access to electricity through distributed coverage of electricity. Due to the irregular and unbalanced fuel cost and impracticable expansion of the grid, hybrid integrated renewable energy sources become dependable substitute for remote electrification. The necessity of uninterrupted power dispatch is a prime factor for primary health centres, located in tribal and remote areas. This article proposes an integrated primary analysis like financial, production, quantity and environmental, applied to an optimum sizing of a hybrid standalone renewable energy source, which might be carried out in eight primary health centres, situated in the Gudalur Zone in Nilgiris District, Tamil Nadu, India. Four different criteria were inspected in this study, as standard loading, boost up loading, step down loading and complete renewable loading. In addition, every criterion was assessed with four kinds of PV tracking arrangements. The peak load requirement of power and energy, for eight primary health centres, was around 121.08 kW and 907.96 kWh/day respectively. HOMER Pro Micro-grid Analysis Tool was used, to analyze the different primary parameters of this study. The foremost financial parameters like COE (Cost of Energy) and NPC (Net Present Cost), could range from 0.102 to 0.118 $ per kWh and from 0.4047 to 0.5708 Million $ respectively. Annual energy production of solar PV could vary from 318.5 to 427.65 MWh. The main quantity parameter like percentage of excess electricity was obtained from 13.3 to 21.5% annually. The leading emission parameters like CO2 and CO were reported to range from 1700 to 4502 and from 7.98 to 28.1 kg per year respectively. Generator and fuel parameters, key properties of energy storage and converter, were also analyzed extensively. In addition, sensitivity analysis and social parameters were also discussed in this study. The result of this work gives a conceptual and flexible design of structure, to make possible the continuous power supply to the remote tribal area - based primary health centres, under in all situations.

Cost-effectiveness of a primary care-based Healthy Weight Clinic compared with usual care.

The objective of this study was to project the cost-effectiveness of implementing the Healthy Weight Clinic (HWC), a primary care-based intervention for 6- to 12-year-old children with overweight or obesity, at federally qualified health centers (FQHCs) nationally. We estimated intervention costs from a health care sector and societal perspective and used BMI change estimates from the HWC trial. Our microsimulation of national HWC implementation among all FQHCs from 2023 to 2032 estimated cost per child and per quality-adjusted life year (QALY) gained and projected impact on obesity prevalence by race and ethnicity. Probabilistic sensitivity analyses assessed uncertainty around estimates. National implementation is projected to reach 888,000 children over 10 years, with a mean intervention cost of $456 (95% uncertainty interval [UI]: $409-$506) per child to the health care sector and $211 (95% UI: $175-$251) to families (e.g., time participating). Assuming effect maintenance, national implementation could result in 2070 (95% UI: 859-3220) QALYs gained and save $14.6 million (95% UI: $5.6-$23.5 million) in health care costs over 10 years, yielding a net cost of $278,000 (95% CI: $177,000-$679,000) per QALY gained. We project greater reductions in obesity prevalence among Hispanic/Latino and Black versus White populations. The HWC is relatively low-cost per child and projected to reduce obesity disparities if implemented nationally in FQHCs.

Optimal design and techno-economic analysis of a solar-wind hybrid power system for laayoune city electrification with hydrogen and batteries as a storage device

The pressing environmental concerns associated with fossil fuels have propelled renewable energy sources, particularly solar and wind energy, into a more prominent position. This article aims to explore an optimal configuration and conduct a technical and economic analysis of a hybrid solar-wind energy system tailored for electrifying Laayoune city. This system, equipped with hydrogen tank and batteries as storage devices, aims to meet the annual energy requirements of residential areas estimated at 310.87 GWh/year. In addition to addressing energy needs, the study tackles significant challenges such as reducing dependence on traditional energy sources, curbing greenhouse gas emissions, and bolstering energy security in the region. Utilizing HOMER Pro software, the research evaluates various combinations of renewable resources, including solar and wind, alongside storage solutions such as batteries, fuel cells, and hydrogen storage, to find the most viable solution in terms of electricity generation, cost, and environmental impact. The findings highlight a hybrid configuration comprising solar, wind, battery, grid, and converter components as the most cost-effective approach for Laayoune's renewable energy system. This integrated system not only yields an energy cost of 0.0477 $/kWh and a net present cost (NPC) of 336 M$ but also generates 627.69 GWh/year of energy. Furthermore, it achieves a 100% renewable energy ratio while completely eliminating CO2 emissions.