Salvage Cost Research Articles

SP4.5 - Cost estimates of intra-operative cell salvage in patients undergoing major liver surgery: a retrospective cohort study

Abstract Aims Major liver surgery is associated with a high risk of blood loss. Autologous transfusion of blood salvaged intra-operatively (cell salvage) reduces the requirement for post-operative allogenic transfusion. Allogenic transfusion is associated with risks, and blood is a scarce and costly resource. However, the cost of cell salvage in liver resection has not been previously estimated. Objective To estimate the cost of cell salvage in patients undergoing major liver surgery. Methods We analysed a cohort of 243 patients who underwent major liver surgery between 2015 and 2022 at a large tertiary referral hospital in England. Cost of cell salvage was calculated as an average price for consumables and operator time. Cost of admission including cell salvage was assessed per year. Results The average cost of cell salvage per patient was £433. On average, consumables costed £240 and costs associated with operating cell salvage machinery were £193. The average cost for an index admission for this cohort of patients undergoing major liver surgery with cell salvage was £24,694. When comparing the required units of allogeneic blood required to replace the red cells lost during surgery, cell salvage led to cost-savings in one of the years under analysis. Conclusions Our findings suggest that cell salvage has the potential to be cost-effective in patients undergoing major liver surgery. These findings should be assessed in an economic evaluation conducted alongside a randomised controlled trial.

Analysis of Feasible Pathway of Marinefishing Net Recycling of China-Case Study of Sanya City,Hainan Province

As single-use plastics, abandoned fishing nets cause pollution and damage to the ocean and biodiversity. This is a hot topic in international environmental and plastic governance. Fishing net materials are mainly composed of thermoplastics, including polyamide (nylon, PA) , polyethylene terephthalate (PET) and polypropylene (PP) . The real solution to pollution is to bring back waste fishing nets for recycling and use them in high-value recycled products. The research team conducted on-site research in Sanya City in April 2023. The survey found that the main fishing gear used by fishermen in Sanya is gillnets. Due to reasons such as low recycling value and high salvage costs, the local area has not yet formed a closed-loop industrial chain for waste net high-value recycling. The survey also found that Sanya fishermen have a positive attitude towards increasing fishing net recycling, but their actual actions are also restricted by factors such as the price of fishing net recycling and the convenience of recycling. Based on the survey results of this fishing net recycling, the research team provides four feasible suggestions for high-value utilization of fishing net recycling and regeneration. The first is to introduce upstream and downstream enterprises and terminal brand enterprises to regenerate fishing nets to produce high-value recycled products, thereby increasing the initial recycling price of fishing nets. The second is to establish a “centralized recycling demonstration site” to improve the efficiency of fishing net recycling through differential price subsidy recycling models. The third is to establish the traceability of fishing net recycling and the quantitative evaluation system of recycled carbon emission reduction to give full play to the commercial value and carbon market value of recycled fishing nets. The fourth is to strengthen the publicity of the environmental benefits of fishing net recycling and promote community environmental sustainability through capacity building and training. Continuous development.

Wavelet Analysis and Forecasting using Open-Access Lumber Market Indices for Assessing the Impact of Hurricanes on Southern US Stumpage Prices

Abstract In the aftermath of events such as hurricanes, the economic impact of downed timber can reach billions of dollars. Accurate forecasting of stumpage prices after such events is crucial for maximizing recovery value while minimizing salvage costs. However, this poses challenges because of the inherent nature of the data. This study addresses these challenges by exploring the application of wavelet analysis, a novel approach in the field of forestry economic analysis. Wavelet analysis offers a unique framework for studying periodic phenomena in time series data, particularly when frequency changes over time are present. By leveraging wavelet analysis, this study uncovers relationships between timber market indices and hurricane seasons. The combination of traditional correlation analysis and wavelet coherence analysis enhances the statistical analysis in this study, offering a comprehensive examination of the relationship between the Timber Market Survey data and market indices. This innovative analytical approach enables a deeper understanding of the dynamics of the timber market and the potential effects of hurricanes on timber prices. Furthermore, this research highlights the recent advancements in wavelet methodology and the availability of open-source packages in the programming language R, such as WaveletComp and WaveletArima, that facilitate wavelet analysis and time series forecasting. The Wavelet-ARIMA model used in this study demonstrates its effectiveness in reducing noise and improving prediction accuracy. The study incorporates an extensive data set consisting of 10 Consumer Price Indices, 7 Producer Price Indices, 30 state-wide Timber Market Survey indices, 54 TMS subregions, and 6 open market series.

RECYCLED AGGREGATE CONCRETE (RAC): A viable solution for sustainable construction

Construction activities are booming in and around the cities with development and modernization. As a result of these constructions, natural aggregates are being extracted. Simultaneously, there is a significant amount of construction and demolition waste (CDW) generated due to the demolition of structures either due to the structure attaining service life or fashion and the ongoing trend of reconstruction. Therefore, recycling coarse aggregate from CDW in concrete is one of the sustainable solutions to prevent a serious threat to the environment due to the extraction of virgin aggregates and landfilling. This paper presents the results of a study undertaken to examine the influence of recycled concrete aggregate on the properties of new concrete and its life cycle cost (LCC) analysis. It is clear from the test that the strength of RAC is much lowered than natural aggregate concrete (NAC). In order to achieve the optimum strength, the natural aggregate is replaced by recycled aggregate within a range of 0% to 100%, in intervals of 10%. Additionally, to enhance its strength further, reinforcing RAC with new and recycled polypropylene (PP) fiber is done in percentages ranging from 0.25% to 2% by weight of cement with an interval of 0.25%. For analysis, compression, and split tensile strength tests were performed at the end of 28 days of the curing period. The result revealed that 40% replacement of natural aggregate with recycled aggregate achieves the ideal percentage replacement without compromising the strength. Moreover, incorporating 1.5% of new PP fiber or 1.25% of recycled PP fiber in the RAC provides optimum strength. For LCC analysis, the initial investment cost, operations, and maintenance cost, and salvage cost of all the alternatives are compared. Through this analysis, it was determined that the LCC of concrete manufactured using recycled aggregate as concrete ingredients is the lowest. Consequently, incorporating recycled aggregates in concrete production reduces the LCC compared to using natural aggregates.

Investigation of the Economic and Life Cycle Cost Benefits of Concrete Pavement over Asphalt Pavement: Case Study of Isieke Road, Ebonyi State

Comparative economic analysis using present net worth method was carried for 1 km of rigid and flexible pavement of Isieke Road, Ebonyi State. Information on the initial construction cost of the given length of the road, the maintenance cost, the rehabilitation cost, the salvage cost and the user cost which were obtained from the Ministry of Works, Ebonyi State, were used to assess the life cycle cost of the each alternative using the present net worth method. Comparisons between the various costs used to determine the life cycle cost for both rigid and flexible pavement showed that except the initial cost of construction where the rigid pavement is considerably higher than the flexible pavement, the other costs show the flexible pavement being on the high side. The summary cost showed that the for the period of 40 years which was the period of study in this work, the life cycle cost (LCC) of rigid pavement is 8.52% lower than that of the flexible pavement. Considering economy, this savings in LCC makes it a more viable alternative to flexible pavement.

Technoeconomic Analysis and Optimization of Hybrid Solar-Wind-Hydrodiesel Renewable Energy Systems Using Two Dispatch Strategies

Sustainable generation is impacted by the adoption of renewable energy, the growth of energy markets, and economic strategies. This paper offers a sustainable strategy and a technoeconomic analysis of off-grid hybrid energy systems (HES) in remote islands of Iran, including Lavan, Larak, and Failaka, utilizing PV module, wind turbine, and hydrokinetic turbines. Hourly wind speed, solar irradiation, and hydrovelocity have been implemented under load following (LF) and cycle charging (CC) dispatch strategies in order to ascertain the most appropriate systems. Lavan Island achieves the winning HES with a CC dispatch strategy, which consists of 3 hydroelectric turbines, 1 wind turbine, 349 kW of solar power, 150 kW of generator power, 316 kWh of batteries, and 287 kW of the converter. This ideal HES, which generates a consistent generation profile and reasonable net present cost (NPC) and cost of energy (COE) of M0.160$ and $0.013 kWh, respectively, can be practically attained in these areas. LF-controlled optimal solutions use less fuel than CC-based ones, leading to a higher share of renewable energy. Compared to Larak and Lavan, the CC- and LF-controlled options on Failaka Island generate cleaner electricity with emissions that are 57% and 44% lower. Regarding the ability to recoup the project’s initial investment costs, long-term energy production would be more financially viable than short-term. Short-term projects with higher financial uncertainty due to the salvage cost should use the CC method.

Utilization and cost of cell salvage in minimally invasive myomectomy

ObjectiveTo assess the utilization and cost of intraoperative cell salvage (ICS) in minimally invasive myomectomy. Study DesignRetrospective cohort study of patients who underwent minimally invasive myomectomy at a quaternary care academic hospital. Patients were classified into: ICS setup vs no ICS setup, ICS setup with reinfusion vs ICS setup without reinfusion. ResultsOf 382 patients who underwent minimally invasive myomectomy, 67 (17.5 %) had ICS setup, 30 (44.8 %) of those patients reinfused. Median volume of reinfusion per patient was 300 mL (range 125–1000 mL). Patients who ultimately underwent ICS reinfusion, compared to those with ICS setup only, had significantly larger mean maximum fibroid size (9.8 cm vs 8.0 cm, p = 0.02), higher median total specimen weight (367 vs 304 g, p = 0.03), higher median estimated blood loss (575 vs 300 mL, p < 0.0001), longer mean operative time (261 vs 215 min, p = 0.04). No perioperative complications were associated with ICS. Higher costs are associated with universal use or complete lack of ICS; lowest cost is associated with ICS setup only for those ultimately reinfused. ConclusionICS might reduce requirements for allogeneic blood transfusions in patients undergoing minimally invasive myomectomy, and may contribute to cost savings. Uterine and maximum fibroid sizes are possible preoperative indicators for patients who require cell salvage reinfusion.

Single item periodic review inventory control with sales dependent stochastic return flows

Retailers have to deal with increasing levels of product returns as the shares of e-commerce sales soars. With this increase, it is no longer feasible to dispatch returned products to outlets or landfills, hence retailers must re-evaluate them both to maximize profit and to minimize their environmental impact. Our objective is to study a retailer’s optimal inventory control policy under product returns to maximize expected profit which is the sales revenue minus the procurement, backorder, holding, and salvage costs incurred in a finite horizon. We model a period’s returns to be stochastically dependent on the previous period’s sales quantity. Using dynamic programming formulation, we solve for the optimal periodic review inventory policy and provide structural results on the optimal policy of the final period. Through numerical studies, we show that incorporating detailed sales-dependent returns could increase a retailer’s expected profit by 23%. Ignoring this dependency in determining the optimal inventory policy results with increased order frequency, higher levels of backorders and more leftovers which could eventually end up in a landfill, but above all could lead to a significant overestimation of the resulting profit.

Decision on risk share to maximize the supply chain expected profit

There are many agents in a supply chain, each of which has its uncertainty and risk. A contract between agents could reduce the risk. In this paper, an insurance contract with three parameters; retailer’s risk share, supplier’s risk share, and the premium transferred between them is considered to maximize the profit for all agents. Three mathematical models were developed for different types of a supply chains, and one thousand initial scenarios were generated in this stochastic programming. A new algorithm was proposed to reduce the number of scenarios. Three models are programmed and solved in MATLAB software. From the numerical examples solved, the results show that when the retailer gives 0.75 of losses from over and under stock, keeping, and salvage costs, the insurance contract has its best performance, and the supply chain has 2.4% extra benefit using it, almost near the maximum profit that is possible.

Life cycle cost analysis of wastewater treatment technologies

With the ever-increasing population, volumes of wastewater treatment are a major concern in our country. The Activated Sludge Process (ASP), Biological Filtration and Oxygenated Reactor (BIOFOR), Upflow Anaerobic Sludge Blanket (UASB), and Moving Bed Bio Reactor (MBBR) are all monetarily investigated in the present study using the Life Cycle Cost Assessment (LCCA) tool. In this study, life cycle costing is done using the present value method, which involves discounting the costs for a 20-year economic life. The costs of treating wastewater per million litres per day (MLD) of wastewater treatment technology are obtained from the literature. Moreover, this study takes into account the capital, annual operation, energy, salvage, and replacement costs to compare the life cycle costs of ASP, UASB, BIOFOR, and MBBR to make the best guess of an economical technology. The LCCA demonstrates that the MBBR has the highest costs of treatment, resulting in the highest Life Cycle Cost (LCC). BIOFOR has the largest energy requirement making LCC the second-highest among the technologies. In India, ASP is one of the most widely used technologies, whose LCC is the third most advanced of the four technologies. Because of its lower energy and operating costs, UASB has the lowest LCC.

Optimal sizing and feasibility analysis of grid-isolated renewable hybrid microgrids: Effects of energy management controllers

Renewable energy dispatching strategy is considered a crucial step to control hybrid energy systems. Achieving a profitable and reliable energy configuration that satisfies continuous operation at minimum cost is necessary due to the high cost of renewable energy technologies. This paper offers a sustainable framework and techno-feasibility evaluation of stand-alone hybrid power options for electrification in Persian Gulf Islands, namely, Larak, Failaka, and Lavan. The real-time hourly irradiation, wind speed, and wave velocity are used to explore new patterns in renewable behavior, using cycle charging (CC) and load following (LF) strategies. Integration of CC-controlled 150 kW generator, 349 kW photovoltaic system, 3 hydrokinetic turbines, 1 wind turbine, 316 kWh battery pack, and 287 kW converter in Lavan Island is found as an optimal solution. The followed NPC, COE, and the renewable fraction of the winning solution are estimated to be M0.160$, $0.013 kWh, and 26% higher than LF mode. The CC-based energy systems, on average, consume more fuel than LF-based options and, followingly, have a lower renewable fraction. The COE rises by $0.001/kWh to $0.004/kWh under CC mode and $0.004/kWh to $0.01 kWh under LF control per each 5% increase in SOCmin values. Although the capital cost under LF is $300 k higher than the CC one, the salvage cost of this controller is estimated to be slightly lower than the CC mode.

A Replenishment Inventory Model with a Stock-Dependent Demand and Age–Stock-Dependent Cost Functions in a Random Environment

This paper investigates an [Formula: see text] continuous-review perishable inventory model with a stock-dependent Poisson demand process, full backordering (with an extension for lost sales) and uncertainty in lead time and shelf life. Four types of costs are considered: a fixed cost of an order and each outdated item; age-dependent costs of an item (i.e., holding and salvage costs), given by a function of its remaining shelf life; and a delay cost of a backlogged demand unit, which is a function of its delay duration. Applying the supplementary variable technique, we obtain the joint probability-density function of the number of items in the system and the remaining time and thereby obtain the optimal parameters minimizing the long-run average total cost. Numerical experiments show that supply chain profits are enhanced by integrating the age components into replenishment decisions, and ignoring the shelf age- and delay-dependent costs may result in a substantial loss (up to 25%). It further appeared that estimating the lead-time distribution by an exponential one is significantly more costly, in particular as the c.v. differs from 1. In contrast, an exponential shelf life may provide a good heuristic for other shelf-life distributions.

Renewable energy integration/techno-economic feasibility analysis, cost/benefit impact on islanded and grid-connected operations: A case study

On-grid and off-grid renewable energy sources have emerged as a more efficient way to meet large-scale urban and rural needs. The integration of renewables into the utilities/island mode as well as into the techno-economic feasibility studies determines the financial viability, technical and operational viability of the project. This study was conducted to integrate renewables and techno-economic feasibility analysis using the utility grid-connected and islanded mode to meet the demand for community and commercial loads with these strategic objectives. Three main analytical tasks have been performed, including: optimization, simulation, and sensitivity analysis. We selected four sensitivity cases and further divided each sensitivity case into four sensitivity loops, including different combinations of renewable energy sources, e.g., photovoltaics, wind turbines, battery banks, power grids, converters, and diesel generators. The following parameters were used to conduct a techno-economic feasibility analysis: capital costs, replacement costs, operating and maintenance costs, salvage costs, fuel costs, real-time commercial/community load, and climate data. The best results of sensitivity case-2 were selected for the techno-economic feasibility analysis of the remaining four sensitivity cases. The islanded mode net present and annualized sensitivity loop-1 costs in sensitivity case-2 were noted at $1381080.42 and $106832.62, respectively. Net present and annualized sensitivity loop-1 costs in sensitivity case-2 of the grid-connected utility mode were noted at $512792.1 and $39,666.71, respectively. The proposed utility grid-connected mode cost is two times lower than that of the islanded mode, so we have chosen sensitive case-2 for hourly, seasonal, and annual electrical load flow and techno-economic feasibility analysis to meet the community and commercial load demand.

Safety, efficacy and cost of intra-operative cell salvage during open radical prostatectomy.

BackgroundWe aim to examine the safety and efficacy of intra-operative cell salvage (ICS) in radical prostatectomy.MethodsA retrospective cohort study was performed, enrolling consecutive patients undergoing open radical prostatectomy at two institutions during 01/01/18–31/12/19. Patients were grouped by ICS use. Primary outcomes were allogeneic transfusion rates, and biochemical recurrence (prostate specific antigen >0.2 mg/mL). Secondary outcomes were use of adjuvant therapies, Clavien-Dindo complications and transfusion-related cost (allogeneic transfusion + ICS setup + ICS reinfusion).ResultsIn total, 168 men were enrolled. Patients were grouped based on whether they received no blood conservation technique (126 men) or ICS (42 men). Groups were similar in median age, pre- and post-operative haemoglobin and length of stay. They also had similar post-operative tumour Gleason score, TNM-stage and positive surgical margin rates. Compared with controls, the ICS group had shorter follow up (336 vs. 225 days; P=0.003). The groups had similar rates of biochemical recurrence (17% vs. 14%; P=0.90), adjuvant therapy use (30% vs. 29%; P=0.85) and complications (14% vs. 19% patients; P=0.46). There was no metastatic progression or cancer-specific mortality in either group. Although a similar proportion of patients received allogenic transfusion (2.4% vs. 4.8%; P=0.33) and units of packed red blood cells (PRBC) (9 vs. 5 units), transfusion-related costs were higher amongst the ICS group (AUD $11,422 vs. $43,227).ConclusionsICS use in radical prostatectomy was not associated with altered rates of allogeneic transfusion, complications, biochemical recurrence or adjuvant or salvage therapies. Transfusion related costs were higher in the ICS group.

Life-Cycle Cost Analysis (LCCA) comparison of pavements (Flexible, rigid and rigid-admixed with cow bone ASH)

Life Cycle Cost Analysis (LCCA) acts as a decision support tool in economic evaluation of cost (agency and user) during pavement type selection, maintenance and rehabilitation strategy. The Life cycle cost analysis was done using the Present worth of Cost method. Technical Recommendations for Highway (TRH) 12 (pavement rehabilitation investigation and design) analysis was used for calculating the agency cost which entailed the initial rehabilitation, maintenance, future and salvage cost. The LCCA analysis period for this study was taken as 40 years as the analysis period have to be sufficiently long to reflect long-term cost differences associated with reasonable design strategies. The result of the study shows that the present worth cost for the varying Pavement presents the options available for decision making. The result revealed that the initial cost of Rigid pavement is the highest followed by the initial cost of Rigid pavement with 15% CBA while flexible Pavement has the lowest initial cost. However, considering the result showing the present worth cost for the varying pavement types present worth cost of flexible pavement is the highest followed by Rigid pavement and Rigid pavement with 15% CBA has the lowest life cycle cost. The study recommended that Rigid pavement with 15% CBA should be considered because it gives the lowest life cycle cost and the initial cost is relatively low.

Optimal Cost-Aware Paradigm for Off-Grid Green Cellular Networks in Oman

Green wireless networks or energy-efficient wireless networks have gained popularity as a research topic due to the ecological and economic concerns of cellular operators. The specific power supply requirements for the cellular base station, such as cost-effectiveness, efficiency, sustainability, and reliability, can be met by utilizing the technological advances in renewable energy. There are numerous drivers for the deployment of renewable energy technologies and the transition towards green energy. Renewable energy is free, clean, and abundant in most locations throughout the year. Accordingly, this work proposes a novel framework for energy-efficient solar-powered base stations for the Oman site, specifically for off-grid locations where fuel transportation for diesel generator (DG) is a serious concern. To demonstrate the effectiveness of the proposed system for off-grid sites, the Hybrid Optimization Model for Electric Renewables optimization software is adapted by considering real-time conditions and its technical feasibility. Different cost factors such as capital cost, salvage cost, replacement cost, operational, and maintenance cost of PV panels, inverters, and batteries also undergo extensive analysis. From the observed results, the total net present cost (NPC) of the proposed system is $27,887, while the net NPC of the DG is estimated at $32,900. Remarkably, the proposed scheme can potentially achieve considerable savings in the operational expenditure at approximately 15.24%. Indeed, these outcomes can provide profound economic, technical, and ecological benefits to the cellular operators of Oman. It also ensures a sizeable reduction in greenhouse gas that supports sustainable green wireless network deployment in remote areas.

Design of a wreck removal method considering safety and economy

ABSTRACT Selecting a proper lifting method for wreck removal is one of the most important procedures when planning a salvage operation. For this, both the safety and economy should be considered to prevent accidents and reduce time and cost. We propose an evaluation and verification method considering the safety and economy. A simulation based on multibody dynamics is used to assess the safety of the lifting method. In particular, we implemented a model to calculate the contact and friction of the wire when lifting the ship to simulate the wire-wrapping method. Next, we proposed a method of estimating the total salvage cost and an economic evaluation was obtained by comparing the results of various lifting methods. We attempted to estimate the time and cost of salvage quantitatively using expert consultation results and calculations. Finally, the proposed safety assessment and economic evaluation method were applied to various lifting methods.

Obstetric intra-operative cell salvage: a review of an established cell salvage service with 1170 re-infused cases.

The use of cell salvage during caesarean section has been increasing steadily, although there are concerns relating to cost, a perceived risk of amniotic fluid embolism, and fetal red cell sensitisation. We present observational data from almost a decade of use of intra-operative cell salvage in obstetrics. By the end of this period, we set up cell salvage collection for >98% of all caesarean sections. From 2008 to 2017, 1170 women have had a re-infusion of cell salvaged blood with no clinical safety concerns; the median (IQR [range]) volume was 231 (154-306 [80-1690]) ml. During this time there has been a marked reduction in the number of women who were transfused allogeneic blood, as well as the amount of blood transfused. In total, 647 (55%) women have had alloimmunisation testing, with two positive cases. Quality control data indicate that the quality of blood processed from partial first bowls is no worse than that from full bowls. We discuss the costs of providing this service with regard to: staffing costs; single suction; leucodepletion filters; selectivity in the processing of collected blood; and the use of partial first bowls.

Cell salvage cost effective during caesarean section?

Cell salvage cost effective during caesarean section?

Analysis of the drivers of cost of management when patients with brain metastases are treated with upfront radiosurgery

ObjectivesWe aimed to assess the driving factors for increased cost of brain metastasis management when using upfront stereotactic radiosurgery (SRS). Patient and Methods737 patients treated with upfront SRS without whole brain radiotherapy (WBRT). Patients were evaluated for use of craniotomy, length of hospital stay, need for rehabilitation or facility placement, and use of salvage SRS or salvage WBRT. Costs of care of these interventions were estimated based on 2013 Medicare reimbursements. Multiple linear regression was performed to determine factors that predicted for higher cost of treatment per month of life, as well as highest cumulative cost of care for brain metastasis. ResultsMean cost of brain metastasis management per patient was $42,658, and $4673 per month of life. Upfront SRS represented the greatest contributor of total cost of brain metastasis management over a lifetime (49%), followed by use of any salvage SRS (21%), use of initial surgery (14%), use of salvage surgery (10%), hospitalization (3%) and cost of salvage WBRT (3%). Multiple linear regression identified brain metastasis velocity (BMV) (p < 0.001), use of cavity-directed SRS (<0.001), and CNS symptoms at time of presentation (p = 0.005) as factors that increased costs of care per month of survival. Use of salvage WBRT decreased per month cost of care in patients requiring salvage (p < 0.001). ConclusionThe cost of upfront SRS is the greatest contributor to cost of brain metastasis management when using upfront SRS. Higher BMV, progressive systemic disease and presence of symptoms are associated with increased cost of care.