Published Performance Data Research Articles

Importance of FDA-Integrated Continuous Glucose Monitors to Ensure Accuracy of Continuous Glucose Monitoring.

Continuous glucose monitoring (CGM) has been shown to improve glycemic control and self-monitoring, as well as to reduce the risk of hypoglycemia. Integrated CGM (iCGM) FDA-cleared systems with published performance data are established nonadjunctive and accurate CGM tools that can directly inform decision-making in the treatment of diabetes (i.e., insulin dosing). Studies have assessed accuracy and safety data of CGMs that were eventually cleared for iCGM by the FDA and that informed the recommendation for their nonadjunctive use. Subsequent robust clinical trials and real-world studies demonstrated clinical effectiveness with improvements in a range of patient outcomes. In recent years, a number of non-iCGM-approved CGM devices have entered the market outside the United States worldwide. Some of these non-iCGM-approved CGM devices require additional user verification of blood glucose levels to be performed for making treatment decisions, termed adjunctive. Moreover, in many non-iCGM-approved CGM devices, accuracy studies published in peer-reviewed journals are scarce or have many limitations. Consequently, non-iCGM-approved CGM devices cannot be automatically perceived as having the same performance or quality standards than those approved for iCGM by the FDA. As a result, although these devices tend to cost less than iCGMs that carry FDA clearance and could therefore be attractive from the point of view of a health care payer, it must be emphasized that evaluation of costs should not be limited to the device (such as the usability preference that patients have for nonadjunctive sensors compared to adjunctive sensors) but to the wider value of the total benefit that the product provides to the patient.

Evaluation of disposable protective garments against epoxy resin permeation and penetration from anti-corrosion coatings.

Epoxy-based resin formulations are a frequent cause of allergic and irritant contact dermatitis in the construction and painting industries. Cases of epoxy resin contact dermatitis continue to persist across many sectors and are likely attributable to the growing use of epoxy products, including epoxy-based anti-corrosion coatings and inadequate skin protection. There are no published performance data against epoxy resins for garment materials and gloves to guide proper material selection in the workplace. The objective of this study was to evaluate the resistance of 5 protective garment materials against permeation and penetration by bisphenol A diglycidyl ether and its higher oligomers found commonly in epoxy-based anti-corrosion coatings. Five disposable garment materials were evaluated for resistance to bisphenol A diglycidyl ether monomers and oligomers during contact with epoxy-based anti-corrosion coatings, including latex gloves, nitrile gloves, Tyvek coveralls, polypropylene/polyethylene (PP/PE) coveralls, and a cotton T-shirt. A permeation test cell system was used to evaluate each garment material against an epoxy-based zinc-rich primer and an epoxy-based intermediate coating using a realistic application method. Glass fiber filters were used to collect permeating and penetrating epoxy resin during a 120-min test period. Bisphenol A diglycidyl ether quantification was performed with high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry. Paint loading, coating thickness, and homogeneity were assessed on polytetrafluoroethylene filters sprayed in series in permeation test cells. Latex gloves provided the least resistance to permeation by BADGE in coating formulations, with a maximum cumulative permeation over the 2-h test interval of 21.7 ng cm-2 with the primer and 513.8 ng cm-2 with the intermediate coating product. Nitrile gloves were not permeated by either coating formulation. The Tyvek coveralls provided greater protection as compared to the PP/PE coveralls. The cotton T-shirt was penetrated by bisphenol A diglycidyl ether more frequently than any of the tested garment materials and resulted in a maximum cumulative penetration of 128 ng cm-2 with the primer and 28.0 ng cm-2 with the intermediate coating. Although all the garment materials evaluated during this study provided sufficient protection to prevent cumulative permeation in excess of the established acceptable permeation thresholds, the use of nitrile gloves and Tyvek coverall is highly recommended to minimize skin exposure to bisphenol A diglycidyl ether. We recommend cotton T-shirts to be used under Tyvek coveralls as a secondary layer of skin protection and for added comfort, but not as a primary protection layer.

(Invited) The Need for Standardized Benchmarking of Solid Oxide Cells

Solid Oxide Cells (SOC) have been the subject of intense scientific research in the past few decades, and significant progress has been achieved to increase the power output. While promising efforts to further industrialize the technology are underway, an increase in the performance of SOCs is still the scope of many scientific publications. However, progress in cell performance is increasingly hard to gauge due to a lack of comprehensive testing standards. Furthermore, many researchers publish performance data without providing all the necessary information about the testing conditions, or use metrics that do not allow comparison to other works.In particular, the “peak power density” (PPD) is often used to characterize cell performance. The PPD is unsuitable as a performance indicator since it is far removed from a relevant working point for an SOFC, and depends to a large extend on the experimental conditions. To make matters worse, the PPD of high-performance cells is located at very high current densities, exacerbating the influence of the experimental conditions (which are often not described in detail or at all) and experimental artifacts on the measured performance. As a result, claims of increased cell performance may not hold up when applying standardized testing criteria.This contribution summarizes the most important aspects that are relevant for performance evaluation of SOCs, focusing on those with the highest impact on apparent cell performance. Furthermore, the limitations of performance indicators on the cell level will be illustrated by comparing them to stack-level performance, and additional losses incurred under application-oriented operation conditions will be discussed. Since cell testing is often the key test to assess performance of novel materials and processing routes, comparability of the results is critical to scientific progress and therefore relevant for the community as a whole.

Risk stratification of HPV-positive results using extended genotyping and cytology: Data from the baseline phase of the Onclarity trial

BackgroundOptimizing the balance between colposcopy referrals and the detection of high-grade cervical intraepithelial neoplasia (CIN) during cervical cancer screening requires robust triage strategies. We evaluated the performance of extended HPV genotyping (xGT), in combination with cytology triage, and compared it to previously published performance data for high-grade CIN detection by HPV16/18 primary screening in combination with p16/Ki-67 dual staining (DS). Methods and materialsThe baseline phase of the Onclarity trial enrolled 33,858 individuals, yielding 2978 HPV-positive participants. Risk values for ≥CIN3 were determined for Onclarity result groupings corresponding to HPV16, not HPV16 but HPV18 or 31, not HPV16/18/31 but HPV33/58 or 52, not HPV16/18/31/33/58/52 but HPV35/39/68 or 45 or 51 or 56/59/66 across all cytology categories. Published data from the IMPACT trial for HPV16/18 plus DS was utilized as a comparator during ROC analyses. ResultsThere were 163 ≥ CIN3 cases detected. The ≥CIN3 risk stratum hierarchy (% risk of ≥CIN3) that resulted from this analysis included: >LSIL (39.4%); HPV16, ≤LSIL (13.3%); HPV18/31, ≤LSIL (5.9%); HPV33/58/52/45, ASC-US/LSIL (2.4%); HPV33/58/52, NILM (2.1%); HPV35/39/68/51/56/59/66, ASC-US/LSIL (0.9%); and HPV45/35/39/68/51/56/59/66, NILM (0.6%). For ≥CIN3 ROC analysis, the optimal cutoff for sensitivity versus specificity was approximated between not HPV16 but HPV18 or 31, any cytology (≥CIN3 sensitivity = 85.9% and colposcopy-to- ≥ CIN3 = 7.4) and not HPV16/18/31 but HPV33/58/52, NILM (≥CIN3 sensitivity = 94.5% and colposcopy-to- ≥CIN3 = 10.8). HPV16/18 with DS triage showed a sensitivity of 94.3%, with a colposcopy-to- ≥ CIN3 ratio of 11.4. ConclusionsxGT performed similarly compared to HPV primary screening plus DS for detection of high-grade CIN. xGT provides results that stratify risk in a flexible and reliable manner for colposcopy risk thresholds set by different guidelines or organizations.

Modeling and experiments for a CO2 ground-source heat pump with subcritical and transcritical operation

CO2-based ground-source heat pumps (GSHPs) have the potential to be very environmentally friendly, since GSHPs operate with high energy efficiency, and CO2 has no ozone depletion potential (ODP) and a low global warming potential (GWP). We developed a prototype CO2 liquid-to-air GSHP to investigate its performance potential in residential applications. Further, we developed a detailed model of the system that simulates both cooling and heating operation; the model is the primary focus of this report. The model simulates both subcritical and transcritical operation since the system regularly operates near and above the critical temperature of CO2 (30.98 °C) during heating and cooling operation. The model considered both the refrigerant-side thermodynamic and transport processes in the cycle, as well as the air-side heat transfer and moisture removal.We performed cooling tests for the prototype CO2 GSHP that included those from the International Standards Organization (ISO) 13256-1 standard for liquid-to-air heat pumps, as well as extended tests at additional entering liquid temperatures (ELTs). The model predicted the measurements within 0.5% to 6.7% for COP, 1.0% to 3.6% for total capacity, and 3.3% to 4.9% for sensible capacity. We compared the measured cooling performance to published performance data for a commercially-available R410A GSHP and found that for ELTs below 20 °C, the CO2 GSHP has a higher cooling COP and total capacity than the R410A GSHP. At the ‘standard’ cooling rating condition (ELT 25 °C), the CO2 GSHP COP was 4.14 and the R410A GSHP COP was 4.43. At ‘part-load’ conditions (ELT 20 °C) the CO2 GSHP COP was 4.92 and the R410A GSHP COP was 4.99. In the future, the model can be used to investigate methods to improve the CO2 GSHP performance to meet or exceed that of the R410A system over a wider range of ELTs; possible studies include replacing the electronic expansion valve (EEV) with an ejector, optimizing the charge, and optimizing the heat exchanger geometry and circuiting.

Sensitivity and Specificity of Treponemal-specific Tests for the Diagnosis of Syphilis.

We conducted a systematic review of relevant syphilis diagnostic literature to address the question, “What is the sensitivity and specificity of the treponemal tests currently approved by the Food and Drug Administration (FDA) for the diagnosis of syphilis (by stage)?” There were 16 treponemal assays evaluated: 13 immunoassays and 3 manual assays (fluorescent treponemal antibody absorbed test [FTA-ABS], microhemagglutination assay for Treponema pallidum antibodies [MHA-TP], Treponema pallidum particle agglutination assay [TP-PA]). MHA-TP and FTA-ABS were less sensitive in primary and secondary syphilis than TP-PA; TP-PA is the most specific manual treponemal assay. There is insufficient evidence to recommend one particular treponemal immunoassay (eg, enzyme immunoassays, chemiluminescence immunoassays, microbead immunoassays) over another based on published performance data. For diagnosis of neurosyphilis, cerebrospinal fluid (CSF) TP-PA has similar performance to CSF FTA-ABS in studies with patients with definitive or presumptive neurosyphilis. However, CSF treponemal testing has limitations in its sensitivity and specificity and should be interpreted within the context of the clinical scenario, additional CSF test results and syphilis prevalence.

Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department.

BackgroundEarly identification of acute infections and sepsis remains an unmet medical need. While early detection and initiation of treatment reduces mortality, inappropriate treatment leads to adverse events and the development of antimicrobial resistance. Current diagnostic and prognostic solutions, including procalcitonin, lack required accuracy. A novel blood-based host response test, HostDx™ Sepsis by Inflammatix, Inc., assesses the likelihood of a bacterial infection, the likelihood of a viral infection, and the severity of the condition.ObjectivesWe estimated the economic impact of adopting HostDx Sepsis testing among patients with suspected acute respiratory tract infection (ARTI) in the emergency department (ED).MethodsOur cost impact model estimated costs for adult ED patients with suspected ARTI under the standard of care versus with the adoption of HostDx Sepsis from the perspective of US payers. Included costs were those assumed to be associated with an episode of sepsis diagnosis, management, and treatment. Projected accuracies for test predictions, disease prevalence, and clinical parameters was derived from patient-level meta-analysis data of randomized trials, supplemented with published performance data for HostDx Sepsis. One-way sensitivity analysis was performed on key input parameters.ResultsCompared to standard of care including procalcitonin, the superior test characteristics of HostDx Sepsis resulted in an average cost savings of approximately US$1974 per patient (−31.3%) exclusive of the cost of HostDx Sepsis. Reductions in hospital days (−0.80 days, −36.7%), antibiotic days (−1.49 days, −29.5%), and percent 30-day mortality (−1.67%, −13.64%) were driven by HostDx Sepsis providing fewer “noninformative” moderate risk predictions and more “certain” low- or high-risk predictions compared to standard of care, especially for patients who were not severely ill. These results were robust to changes in key parameters, including disease prevalence.ConclusionsOur model shows substantial savings associated with introduction of HostDx Sepsis among patients with ARTIs in EDs. These results need confirmation in interventional trials.

Abstract TP247: A Comparison of Time to Treatment Between an Emergency Department-Focused Stroke Protocol and Mobile Stroke Units

Background: San Francisco is a relatively compact city with a population of 884,000 and nine stroke centers within a 47 square mile area. Emergency medical services (EMS) transport distances and times are short and there are currently no mobile stroke units (MSUs). Methods: We evaluated EMS activation to CT (EMS-CT) and EMS activation to thrombolysis (EMS-TPA) times for acute stroke in the first two years after implementation of an emergency department (ED)-focused, direct EMS-to-CT protocol entitled “Mission Protocol” (MP) at a safety net hospital in San Francisco and compared our performance to published reports from MSUs. EMS times were abstracted from ambulance records. Geometric means were calculated for MP data and pooled means were similarly calculated from published MSU data. Results: From July 2017 through June 2019, a total of 423 patients with suspected stroke were evaluated under the MP, and 166 of these patients were ultimately diagnosed with ischemic stroke. EMS and treatment time data were available for 129 of these patients with 60 patients (47%) receiving IV-tPA with mean EMS-CT and EMS-TPA times of 41 minutes (95% CI 39-43) and 64 minutes (95% CI 58-70), respectively. The pooled estimates for MSUs suggested a mean EMS-CT time of 35 minutes (95% CI 27-45) and a mean EMS-TPA time of 48 minutes (95% CI 39-60). MSUs achieved faster EMS-CT and EMS-TPA times (p<0.0001 for both). Conclusions: In moderate-sized, urban settings with high population densities, our protocol was able to achieve EMS activation to treatment times that were comparable but ultimately slightly slower than published performance data from MSUs.

Information content of the voltage vs. current curve of a solid oxide fuel cell

Relationships are derived by means of which data on the ionic and electronic conductivity of the electrolyte employed in a fuel cell can be calculated from the U-I curves of the cell, provided that certain conditions in regard to the extent of electrode polarization are met. The capability and limitations of the resulting equations are demonstrated on the basis of known data on the ionic conductivity of gadolinia doped ceria. By applying the relationships to recently published performance data of fuel cells with CuFeO2 as electrolyte or as part of a composite electrolyte, the partial conductivities of this oxide are quantified for the first time. The results prove that CuFeO2, known to be a good mixed ionic-electronic conductor, exhibits unexpectedly high oxygen-ion conductivity under the operating conditions of a fuel cell.

Performance indicators in club level Gaelic football

ABSTRACTOver 2000 Gaelic Football clubs compete annually for the honour of playing in the All-Ireland club finals in Croke Park in front of up to 30,000 people. There are no published performance data for club level Gaelic football, despite evidence of considerable performance analysis activity. This study aims to establish benchmark profiles for Senior, Intermediate and Junior grade club Gaelic football and investigate which variables are most closely associated with winning.Data from all tiers of the Ulster club football championship of 2015 and 2016 (n = 48) were analysed using a range of validated operational definitions measuring 17 variables. Differences between winning and losing performance were tested using a Mann-Whitney U test.Across all grades, six variables proved significant (p < 0.05), three were directly related to scoring (points, number of scores and total score), the others related to the effective use of possession (possession: scores ratio; turnover rate and productivity (scores per possession)). Several others are specific to certain grades, and are directly linked to successful performance at that level.Our findings can be used by club coaches and analysts as comparable profiles for measuring team performance and targeting improvements associated with successful performance.

A methodology for predicting hybrid solar panel performance in different operating modes

Abstract When a hybrid solar panel produces thermal energy, it can operate in either hybrid mode, or thermal-only mode. In hybrid mode, the panel produces both electrical power and thermal power, and in thermal-only mode, only thermal power is produced. It has been shown that the thermal performance of a hybrid panel can vary by 15% on average between these two modes, but panel manufacturers are only required to publish performance data for one mode. Other studies in the literature have found a difference in panel thermal performance between these two modes, but they do not discuss a methodology to estimate alternate mode performance using manufacturer-supplied data. To alleviate this gap in the literature, this study presents a novel methodology to estimate alternate mode thermal performance of a hybrid solar panel only using manufacturer-supplied data. To match the panel information that is typically available, the second-order thermal efficiency model is used to estimate thermal performance, and temperature dependent electrical characteristics are used to estimate electrical performance. Indoor testing using a solar simulator was carried out, and the detailed test results are included. Results show that using the proposed modification technique can estimate thermal performance within 4% of actual values on average.

How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis.

ObjectivesInternationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care.MethodsWe conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts.ResultsThree programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact.ConclusionsAlthough there is only limited research evidence to support some widely held theories of how aggregated patient-reported outcome measures data stimulate quality improvement, several lessons emerge from interventions sharing the same programme theories to help guide the increasing use of these measures.

A Noninvasive Body Setup Method for Radiotherapy by Using a Multimodal Image Fusion Technique.

Purpose:To minimize the mismatch error between patient surface and immobilization system for tumor location by a noninvasive patient setup method.Materials and Methods:The method, based on a point set registration, proposes a shift for patient positioning by integrating information of the computed tomography scans and that of optical surface landmarks. An evaluation of the method included 3 areas: (1) a validation on a phantom by estimating 100 known mismatch errors between patient surface and immobilization system. (2) Five patients with pelvic tumors were considered. The tumor location errors of the method were measured using the difference between the proposal shift of cone-beam computed tomography and that of our method. (3) The collected setup data from the evaluation of patients were compared with the published performance data of other 2 similar systems.Results:The phantom verification results showed that the method was capable of estimating mismatch error between patient surface and immobilization system in a precision of <0.22 mm. For the pelvic tumor, the method had an average tumor location error of 1.303, 2.602, and 1.684 mm in left–right, anterior–posterior, and superior–inferior directions, respectively. The performance comparison with other 2 similar systems suggested that the method had a better positioning accuracy for pelvic tumor location.Conclusion:By effectively decreasing an interfraction uncertainty source (mismatch error between patient surface and immobilization system) in radiotherapy, the method can improve patient positioning precision for pelvic tumor.

Prenatal screening costs at a large military treatment facility

Objective: Prenatal screening with cell-free DNA (cfDNA) offers improved detection of Down syndrome (T21) compared to conventional screening. These tests are expensive and have fewer detectable anomalies. Our objective was to investigate potential costs and test performance of screening algorithms when accounting for detectable aneuploidies.Methods: This is a cost analysis for a large military treatment facility. Using a theoretical delivery cohort and published performance data, universal screening with cfDNA was compared to sequential screening, comparing T21 to all detectable aneuploidies. Predicted test performance and costs were calculated.Results: A cohort of 3000 deliveries was used. For T21, universal cfDNA is more expensive ($1,346,064) than sequential screening ($244,885), but has a lower false positive rate and avoids 101 invasive diagnostic tests. An additional case of T21 is detected with a marginal cost of $1,101,179. For all detectable aneuploidies, cfDNA is more expensive ($1,353,660) than sequential screening ($239,189), and 59 invasive diagnostic tests are avoided. Sequential screening detects an additional case of aneuploidy, with a cost savings of $1,114,471.Conclusions: Although cfDNA is superior in detecting T21 cases, sequential screening is superior when considering all aneuploidies detectable. The cost increase with universal cfDNA is significant, and is not justified with small improvements in the performance.

Beyond Li-Ion: Utilization of the High Energy Density of Silver-Zinc in Secondary Button and Coin Cell Miniature Battery Sizes

The performance data for rechargeable silver-zinc (AgZn) button cells are compared with the published performance data for commercially available rechargeable Li-ion and Li-polymer cells. The results show that silver-zinc cells offer greater capacity and energy densities over the equivalently sized rechargeable Li-ion and Li-polymer batteries. Additionally, for the two smallest sized silver-zinc batteries, there are no equivalently sized Li-ion solutions currently available. In comparison with the smallest Li-ion available, the silver-zinc cell has a 57% greater energy density, while the largest silver-zinc cell is shown to be greater by 20% over the best performing Li-ion option available. How the subcomponents and the construction of the AgZn cell affect this enhanced performance will be discussed.

PheKB: a catalog and workflow for creating electronic phenotype algorithms for transportability.

Health care generated data have become an important source for clinical and genomic research. Often, investigators create and iteratively refine phenotype algorithms to achieve high positive predictive values (PPVs) or sensitivity, thereby identifying valid cases and controls. These algorithms achieve the greatest utility when validated and shared by multiple health care systems.Materials and Methods We report the current status and impact of the Phenotype KnowledgeBase (PheKB, http://phekb.org), an online environment supporting the workflow of building, sharing, and validating electronic phenotype algorithms. We analyze the most frequent components used in algorithms and their performance at authoring institutions and secondary implementation sites. As of June 2015, PheKB contained 30 finalized phenotype algorithms and 62 algorithms in development spanning a range of traits and diseases. Phenotypes have had over 3500 unique views in a 6-month period and have been reused by other institutions. International Classification of Disease codes were the most frequently used component, followed by medications and natural language processing. Among algorithms with published performance data, the median PPV was nearly identical when evaluated at the authoring institutions (n = 44; case 96.0%, control 100%) compared to implementation sites (n = 40; case 97.5%, control 100%). These results demonstrate that a broad range of algorithms to mine electronic health record data from different health systems can be developed with high PPV, and algorithms developed at one site are generally transportable to others. By providing a central repository, PheKB enables improved development, transportability, and validity of algorithms for research-grade phenotypes using health care generated data.

What Have 25 Years of Performance Data Taught Us About Private Equity Real Estate?

Executive SummaryNCREIF has published performance data covering a 25-year historical period for institutional investments following core, value-add, and opportunistic strategies in private equity real estate assets. In this paper, I summarize salient observations regarding capital appreciation, income, fees and expenses, the income share of total return, the effects of cash reserves and leverage, net total returns, systematic risk, and risk-adjusted performance during five informative market periods: two severe real estate market downturns, one complete real estate bull market, and two incomplete bull market periods. The available data challenge several points of conventional wisdom regarding private equity real estate returns.

A comparative analysis on experimental performance of CO2 trans-critical cycle

A performance comparison of experimental results for CO2 trans-critical cycle is presented for an overview of the current level of technology. The published performance data were collected as research objects through comprehensive literature review on experimental research. The methods for data processing, error analysis, and performance evaluation are introduced in the research methodology section. Through the proposed research method, 28 groups of performance results from developed prototypes or test rigs are compared and analyzed using the coefficient of performance and the second law efficiency of thermodynamics. A discussion of the performance comparison between developed CO2 devices and commercial products of synthetic working fluid is also presented based on China's national standards (General Administration of Quality Supervision, Insection and Quarantine of the People's Republic of China 2001, 2003). Based on the comparison results, the state-of-art and possible research directions for CO2 trans-critical cycle technology are summarized and presented.

Classification Index and Grade Levels for Energy Efficiency Classification of Agricultural Dryers in Korea

Purpose: This study was carried out to develop a classification index and grade levels to rate agricultural heaters for energy efficiency classification. Methods: The classification index was developed mainly by taking simplicity of calculation and easy access to relevant data into consideration. The grade levels were developed on the basis of a 5-grade classification system in which graded heaters are to be normally distributed over the grades. The value of each grade level were determined in terms of the classification index values calculated using the published performance data of agricultural heaters tested at the FACT in Korea over the past 12 years. Results: The thermal efficiency of agricultural heaters based on the enthalpy method was proposed as a reasonable classification index. The grade levels were proposed in equation form for three types of agricultural heaters: fossil fuel heaters, wood pellet heaters and wood pellet boilers. A reasonable energy efficiency classification of agricultural heaters could be performed using the proposed classification index and grade levels. Conclusions: It is expected that energy saving programs will be extended to agricultural machines in the near future. The classification index and grade levels to rate agricultural heaters for energy efficiency classification were developed and proposed for such near future to come.

Support for All in the UK Work Programme? Differential Payments, Same Old Problem.

The UK has been a high profile policy innovator in welfare-to-work provision which has led in the Coalition government's Work Programme to a fully outsourced, ‘black box’ model with payments based overwhelmingly on job outcome results. A perennial fear in such programmes is providers' incentives to ‘cream’ and ‘park’ claimants, and the Department for Work and Pensions has sought to mitigate such provider behaviours through Work Programme design, particularly via the use of claimant groups and differential pricing. In this article, we draw on a qualitative study of providers in the programme alongside quantitative analysis of published performance data to explore evidence around creaming and parking. The combination of the quantitative and qualitative evidence suggest that creaming and parking are widespread, seem systematically embedded within the Work Programme, and are driven by a combination of intense cost-pressures and extremely ambitious performance targets alongside overly diverse claimant groups and inadequately calibrated differentiated payment levels.