Cost-performance Analysis Research Articles

97 Comparison of Tulathromycin and Gamithromycin as Metaphylactic Treatment on Growth Performance, Morbidity, and Treatment Cost in High-risk, Newly Received Beef Calves

Abstract Metaphylactic treatments are used in cattle enterprises to mitigate bovine respiratory disease (BRD). Crossbred beef calves (n = 78; BW = 272 ± 25.8 kg) were randomly assigned 1 of 2 metaphylactic treatments. Upon arrival, calves were processed (ear tagged, vaccinated, dewormed, ear notched) and administered either 1.2 mL/50 kg BW of tulathromycin with a 7-d post-metaphylactic interval (PMI) or 2 mL/50 kg BW of gamithromycin with a 5-d PMI. Cattle were observed daily for signs of morbidity and a Clinical Attitude Score (0 [normal] to 5 [morbid]) was recorded. Calves that scored a 1 or greater and PMI eligible were pulled and rectal temperatures were recorded; if temperature exceeded 40°C, calves were given enrofloxacin. If calves were pulled a second time and criteria met, ceftiofur was the final antibiotic administered. Performance data and cost analysis were analyzed using the MIXED procedure of SAS 9.4, with repeated measure of day used for performance data. Morbidity and treatment with second antibiotic data were analyzed using the GLIMMIX procedure of SAS 9.4. There were no differences in morbidity (P = 0.17) or treatment with second antibiotic (P = 0.32). There was no treatment × day interaction or main effect for treatment for BW or ADG, but there was a main effect of day as BW increased (P < 0.001) through the sampling period and gain from days 0 to14 was greater than gain from days 14 to 28 (P = 0.001) and 28 to 42 (P < 0.001). Initial antibiotic costs ($32.73 vs. $21.74) and overall costs ($32.74 vs. $24.16) were greater (P < 0.001) in cattle administered tulathromycin compared to gamithromycin treated calves. While there were no differences between antibiotic treatments for health or performance, these data indicate that gamithromycin was a more cost-effective metaphylactic treatment for newly received, high-risk calves.

The effect of dietary replacement of maize with spent sorghum residue-cassava peel composite meal on growth performance and feed cost analysis in the diet of growing rabbits

Wastes of spent sorghum residues and cassava peels are noticed in burukutu joints and garri/cassava chips processing areas respectively, whereas, reports have it that they have individually been used comparatively to replace maize. Since cassava is relatively low in crude protein, it becomes necessary to combine it with a feedstuff with relatively high crude protein content in order to bring the final product to a protein level as close as possible to that of maize which it seeks to replace in terms of crude protein and metabolizable energy. Therefore, this study was carried out to evaluate the effect of Spent Sorghum Residue and Sundried Cassava Peels as a Composite Meal on Growth Performance and Feed Cost Analysis in the Diet of Growing Rabbits. A total of thirty crossbred weaned rabbits of mixed sexes, aged 4-6 weeks were used for the feeding trial which lasted for twelve weeks (84 days). The experimental animals were randomly allotted to five treatments and each treatment group was replicated six (6) times with one (1) rabbit per replicate in a completely randomized design (CRD). Five experimental diets were formulated using spent sorghum residue-cassava peel (SSR-CP) composite meal at 0, 25, 50, 75 and 100% to replace maize in diets T - T respectively. The mixture of SSR-CP was in the ratio of 1:8 to give crude protein 1 5, of approximately 9% (similar to that of maize). The response criteria at the end of the trial showed that, there were no significant (P>0.05) differences in average daily feed intake, average daily weight gain, feed conversion ratio except protein efficiency ratio. The result on feed cost analysis showed that cost per kg diet decreased progressively from T (80.94) to 1 T (53.09) as the levels of SSR-CP composite meals increased in the diets. The result has 5 shown that maize could be replaced by SSR-CP meal up to 100% without any adverse effect on their performance and better economics of production.
 
 
 
 
 Des déchets de résidus de sorgho usés et d'épluchures de manioc sont observés respectivement dans les zones de transformation des joints de burukutu et des garri/copeaux de manioc, alors que des rapports indiquent qu'ils ont été utilisés individuellement pour remplacer le maïs. Le manioc étant relativement pauvre en protéines brutes, il devient nécessaire de l'associer à un aliment à teneur relativement élevée en protéines brutes afin d'amener le produit final à un taux de protéines aussi proche que possible de celui du maïs qu'il cherche à remplacer en termes de de protéines brutes et d'énergie métabolisable. Par conséquent, cette étude a été réalisée pour évaluer l'effet des résidus de sorgho usé et despelures de manioc séchées au soleil en tant que repas composite sur la performance de croissance et l'analyse du coût de l'alimentation dans le régime alimentaire des lapins en croissance. Un total de trente lapins croisés sevrés de sexes mixtes, âgés de 4 à 6 semaines ont été utilisés pour l'essai d'alimentation qui a duré douze semaines (84 jours). Les animaux expérimentaux ont été répartis au hasard dans cinq traitements et chaque groupe de traitement a été répété six (6) fois avec un (1) lapin par répétition dans une conception entièrement randomisée (CER). Cinq régimes expérimentaux ont été formulés à l'aide d'un repas composé de résidus de sorgho épuisés et d'écorces de manioc (RSE-EM) à 0, 25, 50, 75 et 100 % pour remplacer le maïs dans les régimes T – T , respectivement. Le mélange de 1 5 RSE-EM était dans le rapport de 1:8 pour donner une protéine brute d'environ 9 % (similaire à celle du maïs). Les critères de réponse à la fin de l'essai ont montré qu'il n'y avait pas de différences significatives (P> 0,05) dans l'apport alimentaire quotidien moyen, le gain de poids quotidien moyen, le taux de conversion alimentaire, à l'exception du taux d'efficacité protéique. Le résultat de l'analyse du coût des aliments a montré que le coût par kg de régime diminuait progressivement de T (80,94) à T (53,09) à mesure que les niveaux de repas 1 5 composites RSE-EM augmentaient dans les régimes. Le résultat a montré que le maïs pouvait être remplacé par le tourteau RSE-EM jusqu'à 100% sans aucun effet négatif sur leurs performances et une meilleure économie de production.

Predesign Cost Estimation of a Potential Wastewater Treatment Plant for Jordan Petroleum Refinery-Electrocoagulation

The aim of this paper is to investigate whether simulated Jordan refinery wastewater can be treated through electrocoagulation (EC) to conform to the most stringent Jordanian norms for reusing this wastewater for irrigation of cut flowers and to perform cost analysis for a treatment plant whose core are the EC reactors. The method used for estimating the fixed (capital) costs of the treatment plant is taken from literature and is based on a study estimate (factored estimate) that depends on the knowledge of major items of equipment. Most of the operating costs are estimated based on percentages which are also taken from literature. The best percentage removal of COD, BOD, TSS, fat, oil & grease (FOG), bicarbonate (HCO3−), and phenol from simulated Jordan refinery wastewater, so that it conforms to Jordanian norms, were 84.4%, 82.1%, 27.3%, at least 98.8%, 94.9%, at least 96.7%, respectively, at a current of 10 A, treatment time of 5 min, Al/SS electrodes, and inter-electrode distance 10 mm. Overall treatment costs for the simulated wastewater was found to be 10.75 $/m3 (27 $/kg CODremoved). It is concluded that simulated Jordan refinery wastewater cannot be treated so that it conforms to the most stringent norms for using it for cut flower irrigation but could be treated to conform to the norms for using it for irrigation of cooked vegetables, parks, and playgrounds. Moreover, EC is a suitable technology for the treatment of Jordanian recalcitrant refinery wastewater and the cost for its treatment is affordable. • An affordable overall treatment cost for Jordan refinery wastewater was found. • Optimal pollutant removal efficiencies were achieved in electrocoagulation tests. • During wastewater treatment the most stringent Jordanian norms were not reached.

STEPS \u2013 a patient centric and low-cost solution to ensure standards of TB care to patients reaching private sector in India

BackgroundMore than half of the TB patients in India seek care from the private sector. Two decades of attempts by the National TB Program to improve collaboration between the public and private sectors have not worked except in a few innovative pilots. The System for TB Elimination in Private Sector (STEPS) evolved in 2019 as a solution to ensure standards of TB care to every patient reaching the private sector. We formally evaluated the STEPS to judge the success of the model in achieving its outcomes and to inform decisions about scaling up of the model to other parts of the country.MethodsAn evaluation team was constituted involving all relevant stakeholders. A logic framework for the STEPS model was developed. The evaluation focused on (i) processes - whether the activities are taking place as intended and (ii) proximal outcomes - improvements in quality of care and strengthening of TB surveillance system. We (i) visited 30 randomly selected STEPS centres for assessing infrastructure and process using a checklist, (ii) validated the patient data with management information system of National TB Elimination Program (NTEP) by telephonic interview of 57 TB patients (iii) analysed the quality of patient care indicators over 3 years from the management information system (iv) conducted in-depth interviews (IDI) with 33 beneficiaries and stakeholders to understand their satisfaction and perceived benefits of STEPS and (v) performed cost analysis for the intervention from the perspective of NTEP, private hospital and patients.ResultsEvaluation revealed that STEPS is an acceptable model to all stakeholders. IDIs revealed that all patients were satisfied about the services received. Data in management information system of NTEP were consistent with the hospital records and with the information provided by the patient. Quality of TB care indicators for patients diagnosed in private hospitals showed improvements over years as proportion of TB patients notified from private sector with a microbiological confirmation of diagnosis improved from 25% in 2018 to 38% in 2020 and the documented treatment success rate increased from 33% (2018 cohort) to 88% (2019 cohort). Total additional programmatic cost (deducting cost for patient entitlements) per additional patient with successful treatment outcome was estimated to be 67 USD. Total additional expense/business loss for implementing STEPS for the hospital diagnosing 100 TB patients in a year was estimated to be 573 USD while additional minimum returns for the hospital was estimated to be 1145 USD.ConclusionEvaluation confirmed that STEPS is a low cost and patient-centric strategy. STEPS successfully addressed the gaps in the quality of care for patients seeking care in the private sector and ensured that services are aligned with the standards of TB care. STEPS could be scaled up to similar settings.

CFD Simulation on Improving Water Quality based on Various Aerator Models to Demonstrate Cost Performance Analysis

There are many types of aerator that can be used to perform a water treatment process either from air to water or from water to air approaches. Other than focusing on the performance itself, the usage cost of aerator should be forecasted in detail too to have a sustainable and economical method in remediating the polluted water. Therein, the cost performance analysis was demonstrated by performing a computational fluid dynamics (CFD) simulation on improving water quality based on various aerator models. The simulation was focused in a small-scale aeration tank that consists of a mixing chamber, air duct, and a few of bubble diffusers. The improvement of water quality was assessed by calculating the number of gas bubble particles produced by 4 different configurations of aerator model, namely aerator model A, B, C and D, respectively. Results found that the aerator model D (5 bubble diffuser at 620 L/min) produces the highest number of gas particles up to 72.2%. However, the aerator model C (5 bubble diffuser at 300 L/min) was found to achieve the most efficient and sustainable approach based on energy consuming and cost of aerator configuration when compared to the other aerator models.

Energy Use and Consumption Patterns of Maize Cultivation - A Case Study in Thailand

This study explored energy inputs and consumption patterns to determine energy and economical indices for maize cultivation in Thailand. To assess the energy performance of four used cropping systems, namely, highland cultivation in wet season (HLWS), highland cultivation in dry season (HLDS), plains cultivation in wet season (PLWS), and plains cultivation in dry season (PLDS), data from energy consumed and produced show Net Energy Value (NEV) gains of +77.0, +106.5, +191.6, and +228.5 GJ/ha, respectively. Positive signs indicate that the required energy was less than energy produced which reveals sustainability. Use of fertilizer accounted for the major input energy in all systems, followed by fossil fuels, human labor and seeds. A cost performance analysis demonstrated PLDS production exhibited the highest profit earnings (1,365.2 USD/ha). To establish an alternative way to reduce the amount of energy consumed together with increased profit returns to farmers, the renewable energy from waste manure was used to replace dependence on chemical fertilizers. Scenarios using manure from cows, chickens, and farmyards were considered. Results showed that the use of farmyard manure created greater amounts of energy efficiency and economical return rates. Moreover, the benefits increased with increased amounts of organic material applied.

In-situ assessment of photovoltaic soiling mitigation techniques in northern Nigeria

The photovoltaic (PV) system's performance suffers from intensifying external factors such as soiling, particularly in arid and semi-arid regions with massive solar energy potential. Mitigation techniques are one of the crucial factors to prevent and restore PV performance. Therefore, in this study, five cost-effective mitigation techniques such as natural cleaning, manual cleaning with squeegee/water, manual cleaning with a brush, self-cleaning with a hydrophobic coating, and mechanised cleaning with a wiper using acrylic plastic and low iron glass coupons were executed solar farm based in Nigeria. The finding shows that the self-cleaning technique provides high preventive and restorative performance during the wet season (August) with ~ 99% optical efficiency for a glass. Both manual cleanings with squeegee/water and self-cleaning demonstrated high optical efficiency, with first being the greatest with 96% and the latter 95% during the dry season (January) on a glass coupon. Furthermore, results show that low iron glass is more durable than acrylic plastic when exposed to the harsh condition. Our study envisages the implemented PV soiling mitigation technique's performance and comparative cost analysis of a full pledge PV panel over a longer duration in different regions, considering the factors influencing PV system performance.

Performance, combustion characteristics and economics analysis of a combined thermoelectric and thermophotovoltaic power system

Fast depleting reserves in conservative energy resources are principal motivation for developing highly efficient energy conversion systems. Thermoelectric and thermophotovoltaic devices are rapidly becoming promising solutions and they have revolutionized combustion-driven power generators. A combined thermoelectric and thermophotovoltaic power system was demonstrated experimentally and featured a gravity-fed fuel supply to attain stable combustion. Our aim was to better understand the influence of a fuel − air equivalence ratio on the performance and combustion characteristics of the combined system. The fuel − air equivalence ratio was varied for four types of fuel blends: 100% kerosene, 50%/50% vegetable cooking oil − kerosene, 80%/20% vegetable cooking oil − kerosene, and 95%/5% vegetable cooking oil − kerosene. The electrical power output varied almost linearly in a lean mixture of combustion. The peak values of the electrical power and efficiency skewed slightly rich of the stoichiometry, and these values decayed gradually in the rich mixtures. Detailed temperature profiles revealed efficient transfer of heat from the stabilized porous combustion to the input of both the thermoelectric and thermophotovoltaic cells. The carbon monoxide and nitrogen oxides emissions steeply increased beyond a stoichiometric value, and these emissions were marginally affected by the changes in the vegetable cooking oil contents. The concept appears to be attractive because the pertinent cost-performance analysis indicated a reasonably good similarity compared with other systems reported in the literature. Future advances in the combined power system can be realized by heightening key performance gains as well as effective cost-benefit strategies.

Innovative resilient steel braced frame with Belleville disk and shape memory alloy assemblies

Improving the resiliency of the built environment, particularly against seismic events, has been a crucial matter over the last decade. Changing the structural seismic design strategy and using new structural members has been found to be a solution for achieving a more resilient built environment. In this research the seismic performance of an innovative resilient bracing system based on new structural materials and assemblies using Belleville disks and shape memory alloy was studied. The material models for Belleville disk and shape memory alloy are first verified with the available data, and then the cyclic behavior of the resilient structural assembly built out of Belleville disks and shape memory alloy was studied through finite element analyses. Design equations and procedure were derived and a 5-story building was designed to evaluate the behavior of the resilient system and compare it with a special concentrically braced frame. According to the performed cost analyses, while the cost of structural members would increase by 4% due to the usage of new materials in the resilient system comparing to a special concentrically braced frame, the repair cost was found to decrease 100% at the design base event seismic demand level and 95% at the maximum considered event seismic demand level. Seismic performance of the proposed system was studied through fragility analysis, and the better resiliency of the system could be demonstrated quantitatively based on the available performance assessment tools and mathematical equations.

Cost Comparison of Tibial Distraction Osteogenesis Using External Lengthening and Then Nailing vs Internal Magnetic Lengthening Nails.

Aim and objectiveTibial lengthening can be performed by distraction osteogenesis via lengthening and then nailing (LATN) or by using a magnetic lengthening nail (MLN). MLN avoids the complications of external fixation while providing accurate and easily controlled lengthening. Concerns exist still regarding the high upfront cost of the magnetic nail, which serves to limit its use in resource-poor areas and decrease adoption among cost-conscious surgeons. The purpose of this study was to compare the hospital, surgeon, and total cost between LATN and MLN when used for tibial lengthening.Materials and methodsA retrospective review was performed comparing consecutive tibial lengthening using either LATN (n = 17) or MLN (n = 15). The number of surgical procedures and time to union were compared. Surgeon and hospital payments were used to perform cost analysis after adjusting for inflation using the consumer price index (CPI).ResultsPatients treated with MLN underwent fewer surgeries (3.6 vs 2.8; p < 0.001) but had a longer time to union as compared with patients treated with LATN (19.79 vs 27.84 weeks; p = 0.006). Total costs were similar ($50,345 vs $46,162; p = 0.249) although surgeon fees were lower for MLN as compared with LATN ($6,426 vs $4,428; p < 0.001).ConclusionLATN and MLN had similar overall costs in patients undergoing tibial lengthening. MLN was associated with fewer procedures but a longer time to union as compared with LATN.Clinical significanceDespite an increased upfront cost in MLN, there was no difference in total cost between LATN and MLN when used for tibial lengthening. Thus, in cases where either method is feasible, cost may not be a deciding factor when selecting the appropriate treatment.How to cite this articleDvorzhinskiy A, Zhang DT, Fragomen AT, et al. Cost Comparison of Tibial Distraction Osteogenesis Using External Lengthening and Then Nailing vs Internal Magnetic Lengthening Nails. Strategies Trauma Limb Reconstr 2021;16(1):14–19.

Modelling and simulation for cost optimization and performance analysis of transactional applications in hybrid clouds

In the design process of a hybrid cloud with the purpose of cost optimization, finding the optimal distribution between the resources to be deployed in both private and public clouds is a complex task. To help the cloud designer in this task, optimizer and simulation tools can be used. In the research presented in this paper, a state-of-the-art optimizer tool, designed for the optimal allocation of virtual machines in public clouds for cost optimization, is analyzed for its use in hybrid cloud scenarios. In addition, based on the system and workload model implemented by this tool, a simulator is developed and presented. The simulator provides detailed run-time performance information corresponding to the virtual machine allocations generated by the optimizer tool, offering essential analysis capabilities to the cloud designer. A motivating scenario is used to show how the combined utilization of the optimizer and simulation tools can offer fundamental help in the design and configuration process of hybrid clouds. The research questions posed in the motivating scenario are addressed in a set of experiments, which provide meaningful insights into the capabilities of the tools. The tools and all the experimental data carried out in this research have been made publicly available.

Cost competitive analysis of large-scale gold mines in Ghana from 2007 to 2016

The gold mining industry is a major contributor to the economy of Ghana. However, this contribution has been declining over the past decade. This decline coupled with the importance of the industry to the country’s economy necessitated the need to analyse the performance of companies within the industry. Therefore, a cost performance analysis of Ghana’s major gold mines was done in this paper for the period 2007 to 2016 using industry cost curves. A correlation coefficient analysis was also done to identify the key cost drivers in Ghana. This paper further analysed the cost competitiveness of Ghana’s gold mining industry against other gold producing countries in the world. From the analysis, it was found that Newmont’s Ahafo and Akyem mines were consistent low unit cost producers. Both mines benefited from economies of scale and high metallurgical recovery rates. On the other hand, AngloGold Ashanti’s Obuasi and Golden Star’s Bogoso mines were found to be consistent high unit cost producers due to low-productive and labour-intensive underground mining methods used and very low metallurgical recovery rates, respectively. Finally, the study revealed that Ghana’s gold mining industry was not cost competitive when compared to other gold-producing countries over the analysis period.

Cybersecurity: Risk management framework and investment cost analysis

As organizations accelerate digital transformation with mobile devices, cloud services, social media, and Internet of Things services, cybersecurity has become a key priority in enterprise risk management. While improving cybersecurity leads to higher levels of customer trust and increased revenue opportunities, rapidly evolving data protection and privacy regulations have complicated cybersecurity management. Against the backdrop of rapidly rising cyberbreaches and the emergence of novel cybersecurity technologies such as machine learning and artificial intelligence, this article introduces a cyber risk management framework, discusses a cyber risk assessment process, and illustrates a continuous improvement of cybersecurity performance and cyberinvestment cost analysis with a real-world cybersecurity example.

Markov Model for Fault Tolerant Machining System Operating under Admission Control Policy

In this study, we analyze Markov model for the performance prediction of failure prone machining device that operates under the fault tolerance measures and admission control policy. The threshold-based admission policy is proposed to examine the functioning of designed fault tolerance system. The stationary queue size distribution of failed machines has been established using a recursive approach. The key output metrics and cost function have been designed to analyze the functional efficiency and cost benefit of the system. The numerical implementation of the performance indices and cost analysis have been done to examine the sensitiveness of the system descriptors. Furthermore, harmony search approach has been used to optimize the total cost associated with different activities.

A STUDY ON DRUG UTILIZATION EVALUATION AND POTENTIAL DRUG RELATED PROBLEMS IN TYPE-2 DIABETES MELLITUS PATIENTS WITH CO-MORBIDITIES IN A TERTIARY CARE HOSPITAL

Objective: The objective of this study is to evaluate prescribing pattern, analyze drug-related problems, identify co-morbidities and complications in Type 2 Diabetes Mellitus patients and also to perform cost analysis of Biguanides, Sulfonylureas, Dipeptidyl Peptidase Inhibitors&#x0D; Methods: A Prospective observational study was done in General Medicine and Endocrinology Departments of PSG Hospitals. A total of 200 study subjects, including both inpatients and outpatients, above 18 y of age, prescribed with OHAs (Biguanides, Sulfonylureas and DPP4 inhibitors) were included in the study.&#x0D; Results: Diabetes was more prevalent among males. OHAs were most prescribed in the age group of 51-60 y. Hypertension (71%) was the most common comorbidity and Diabetic neuropathy (23%) was the most common complication found in the patients. Multidrug therapy (72.5%) was most prescribed in diabetic patients, followed by Biguanides. Hypoglycemia was the most prevalent ADR. Cost analysis showed that T. Linagliptin was of high cost and T. Glimepiride being the low cost. Using WHO core indicators prescribing patterns were assessed. Feedback was collected and results were reported to the physicians which showed rational utilization of drugs.&#x0D; Conclusion: The study on drug utilization conducted in a tertiary care hospital helped us to find out that prescribing trends seems to be progressing towards combination therapy, predominantly two-drug therapy

Evaluation of the terminal blend crumb rubber/SBS composite modified asphalt

Terminal Blend rubberized asphalt (TBRA) is a novel application of Crumb Rubber (CR) modified asphalt. Compared with traditional CR modified asphalt, TBRA has good storage stability with a lower viscosity. However, TBRA generally has inferior high temperature performance, thereby SBS polymer is usually incorporated for composite modification. This paper evaluates the performances of TB/SBS composite modified asphalt with various modification formulas. Different rubber contents and SBS polymer contents were considered. Low temperature performance grading test, thermal stress master curve and low temperature Semi-Circular Bend (SCB) test were conducted for low-temperature performance evaluation. Multiple Stress Creep and Recovery (MSCR) and Hamburg Wheel Tracking (HWT) test were conducted for high-temperature performance evaluation. The results show that a 2% SBS addition can enhance the rutting resistance and moisture resistance of TBRA mixture without impairing its low-temperature performances. But more SBS introduction is not putting much extra value. Also, it is observed that with the presence of chemically active SBS polymer, rubber molecules from TB process also take part in the polymer crosslinking networking and strengthen the mixture. Based on both performance evaluation and cost analysis, a 10%TB plus 2%SBS formula is recommended in this study.

National differences in cost analysis of Afirma Genomic sequencing classifier.

Thyroid nodules of indeterminate cytology can be subjected to molecular testing such as the Afirma Genomic Sequencing Classifier (GSC), thereby minimizing the number of unnecessary diagnostic surgeries. This work aimed to evaluate and compare the cost of routine GSC testing of indeterminate thyroid nodules in different countries. The cost of diagnostic hemithyroidectomy of indeterminate thyroid nodules was calculated by performing a Monte Carlo simulation cost analysis on a Markov decision-analytic model and then compared to that of GSC testing in the UK, Australia, USA, and Israel. Assuming that patients are treated by surgical resection and routine GSC testing is performed for all nodules of indeterminate significance, we found the GSC test to be more cost effective compared with diagnostic hemithyroidectomy when malignancy rates of thyroid nodules are less than 22.6%-37.1%, depending on the country where the test is performed. Given the cost of a thyroidectomy in the UK, Australia and Israel, performing routine GSC tests on all Bethesda IV nodules is more expensive than routine diagnostic hemithyroidectomy and becomes cost effective for Bethesda III when the GSC cost is below 3,031-3,087 USD. In comparison, in the USA, higher cost of thyroidectomy makes the GSC test cost effective for Bethesda III nodules at its current cost, but not for Bethesda IV nodules where it becomes cost effective under the price of 3,031 USD. Different molecular testing and surgical costs in different countries should be considered when performing cost analysis. In addition, since different medical centres have different malignancy rates, personalized in-house assessment of cost-effectiveness is warranted.

Medication maths: how to solve pharmacy calculations — concentrations, dilutions and health economics (video)

Calculating dilutions and performing cost analyses is a necessary skill for pharmacists. The ability to do so correctly is assessed by the General Pharmaceutical Council in line with the registration assessment framework. In the following videos, Simon Harris, head of education at Greenlight Campus, provides trainees with a step-by-step walk through of how to solve […]

Impact of office tenants’ electricity use on the cost-optimal solutions in a cold climate

The buildings’ energy performance requirements in Estonia are based on cost-optimality analysis according to the EPBD and pre-defined building performance simulation (BPS) input data from EN 16798-1:2019. Previous studies have shown that the real electricity use of office building tenants differs from the currently used input data in BPS in Estonia – less in total energy use, but more in the shape of the profiles. The aim of this work is to investigate what is the impact of these differences on the cost-optimal solutions, which are identified based on BPS and the self-consumption of the photovoltaic panel (PV) systems. This study describes the energy performance and construction cost analysis of a new office building in Tallinn, Estonia. BPS based on the EN 16798-1 and a model derived from measurements in a real building were conducted and cost-optimal building solutions identified. The variables were building envelope insulation thickness, air handling unit size and effectiveness, electrical lighting control principles and PV system nominal power. The calculated energy use of the building with the two different sets of input data differed significantly. However, the set of cost-optimal solutions identified with EN 16798-1:2019 input data had minor differences from the set of solutions identified with the more realistic model. The decrease of net present value over 20-year period for cost-optimal solution was 11-14 €/m2 compared to the designed building.The realistic office tenants’ electricity model increased the calculated self-consumption of the PV system from 95% to 100%.

The cost performance analysis in public hospitals union: DEA by the comparison of training research hospitals and oral centers

The escalating competitiveness within the healthcare industry and the growing financial burden necessitate public hospitals, which serve as crucial entities in this sector, to enhance the efficiency of their resource utilization. Public hospitals are mandated to determine their levels of activity, utilize cases of inactivity as benchmarks, and formulate strategies to ensure their active engagement. This study focuses on doing a performance and cost analysis of health institutions affiliated with the Turkish Republic Ministry of Health, namely the public hospitals in the Bakirköy area of Istanbul. The evaluation of activity and productivity is practiced to assess the performance and cost-effectiveness of these institutions. According to the data enveloping analysis method, it is evident that approximately 80% of health institutions affiliated with the Istanbul Bakirköy district public hospitals Union general secretary are fully operational and efficient. However, 20% of these institutions face challenges in effectively utilizing their resources. It is well acknowledged that teaching and research hospitals exhibit high levels of productivity and activity since they effectively utilize their resources in a sensible manner.