Supply Costs Research Articles

Recent Advances of PtCu Alloy in Electrocatalysis: Innovations and Applications

Developing highly active and durable platinum-based catalysts is crucial for electrochemical renewable energy conversion technologies but the limited supply and high cost of platinum have hindered their widespread implementation. The incorporation of non-noble metals, particularly copper, into Pt catalysts has been demonstrated as an effective solution to reduce Pt consumption while further promoting their performance, making them promising for various electrocatalytic reactions. This review summarizes the latest advances in PtCu-based alloy catalysts over the past several years from both synthetic and applied perspectives. In the synthesis section, the selection of support and reagents, synthesis routes, as well as post-treatment methods at high temperatures are reviewed. The application section focuses not only on newly proposed electrochemical reactions such as nitrogen-related reactions and O2 reduction but also extends to device-level applications. The discussion in this review aims to provide further insights and guidance for the development of PtCu electrocatalysts for practical applications.

Trade-offs between grain supply and soil conservation in the Grain for Green Program under changing climate: A case study in the Three Gorges Reservoir region

Understanding the trade-offs between ecological benefits and cost of grain supply caused by ecosystem restoration is essential for decision-making. Nevertheless, due to climate change, the benefits of ecosystem restoration and cost of grain supply change across various spatial locations, thereby complicating the trade-offs. Taking one of China's largest scale ecosystem restorations, the Grain for Green Program (GGP), as an example, this study used the Three Gorges Reservoir (TGR) region as the case study area and combined the crop environment resource synthesis (CERES)-Crop model, future land-use simulation (FLUS), and the revised universal soil loss equation (RUSLE) to simulate future grain supply and soil erosion during 2021–2050 under three climate change and socioeconomic development scenarios (SSP1-2.6, SSP2-4.5, SSP5-8.5) in the TGR region. The results showed that: (1) Until 2050, the implementation of GGP would bring a large soil conservation benefit by reducing soil erosion of 2.47–5.68 million tons, at the cost of 130,277–660,279 tons decrease in grain production in the TGR region. (2) Under SSP5-8.5 climate change scenario with the highest rainfall in the future, the GGP would maintain the greatest soil conservation benefits, resulting in a total amount of soil erosion decrease by 2.55 to 5.68 million tons. (3) Trade-offs between benefit of reducing soil erosion and cost of grain supply vary considerably across income. Specifically, GGP benefits are greater under low-income and higher-emission scenarios, with significant gains in soil erosion control and less impact on grain supply. In contrast, in high-income and low-emission scenarios, the GGP results in less soil erosion control and greater impact on grain supply.

Economics of primary healthcare: cost estimation of clinical services at primary care facilities in the six countries of the Gulf Cooperation Council

ObjectiveWhile the Gulf Cooperation Council (GCC) countries have demonstrated a strong commitment to strengthening primary healthcare (PHC), the costs of delivering these services in this region remain relatively unexplored. Understanding...

Digital Preoperative Huddle Platform Use Leads to Decreased Surgical Cost.

Communication has a well-established effect on improving outcomes. The current study evaluated the effect of multidisciplinary preoperative team communication using a digital huddle software platform on operating room costs. A digital huddle software platform was implemented in March 2022 for neurosurgical procedures performed at a single tertiary care center. Surgeons were encouraged, but not required, to participate. General linear models were used to test the association between participation and the difference in supply-related cost and case length, using intergroup comparison and historical controls. A total of 29626 cases (performed by 97 surgeons), conducted between March 2021 and June 2023, were included in our analysis. Cases from participating neurosurgeons (12 surgeons, 4064 cases) were compared with cases from nonparticipating neurosurgeons (6 surgeons, 2452 cases), non-neurosurgery cases carried out by the same operating room staff (20 orthopedic spine surgeons, 6073 cases), and non-neurosurgery cases performed in a different operating room unit (59 surgeons, 21 996 cases). In aggregate, operating room (OR) costs increased by 7.3% (95% CI: 0.9-14.1, P = .025) in the postintervention period. In the same period, participation in the digital huddle platform was associated with an OR utilization and supply-related cost decrease of 16.3% (95% CI: 8.3%-23.6%, P < .001). Among neurosurgeons specifically, participation was associated with a supply-related cost decrease of 17.5% (95% CI: 6.0%-27.5%, P = .0037). There was no change in case length (median case length 171 minutes, change: +2.7% increase, 95% CI:-2.2%-7.9%, P = .28). The implementation of a digital huddle software platform resulted in an OR utilization and supply cost decrease among participants during a period when the overall nonparticipating control cohort experienced an increase in cost.

Second-best electricity pricing in France: Effectiveness of existing rates in evolving power markets

The adoption of time-varying pricing in the French electricity market has been historically low despite their availability to consumers well before the deployment of smart metering. However, as the share of variable renewable electricity increases and carbon prices grow, the demand-side response will become increasingly important to achieve efficiency gains. Relying on the historical hourly consumption of French electricity consumers and multiple prospective weather years, we study the gain allowed by the broader adoption of time-varying electricity retail rates in low-carbon power systems. We develop a four-stage methodology to assess the efficiency and stability of the electricity supply cost component of the electricity bill in France for historical and prospective years. Our analysis demonstrates that peak pricing schemes have increasing interest in the context of further deployment of renewable capacity, capturing 25% to 50% of the welfare gain reached by real-time pricing schemes. The corresponding deadweight loss of peak pricing schemes represents 0.4 to 1 bn EUR per year in 2030 compared to real-time prices (RTP) schemes. Conversely, deadweight loss of current time-of-use (ToU) rates represents 1 to 1.2 bn EUR per year in 2025 and increases over time. The current design of TOU rates does not provide adequate incentives in future power systems. Besides the tariff efficiency, the results underlined an increasing price difference between on-peak and off-peak rates. This questions the social acceptance of time-varying retail rates for consumers unable to hedge against peak prices. By analysing the effectiveness and limitations of time-varying rates, our findings underline the importance and value of price-based DR in future power systems in general. Our results highlight the need to revise the end-user tariff design in the French power system, notably with regard to the conveyed price signals.

Paradox of GPO size and a hospital’s relative power for purchasing efficiency and the moderating role of system membership

PurposeExtant research documents the cost benefits of group purchasing organizations (GPOs) to member hospitals, but understudies concerns about the market dominance of a few large GPOs and the relatively weakened buyer power of hospitals in the US healthcare product supply chain. To fill the gap in the literature, this study investigates whether GPO size and a hospital’s relative power to its GPO affect the hospital’s supply expenses, and whether and how system membership moderates the power–performance link.Design/methodology/approachFor this study, we collect the panel data from various secondary sources on GPO–hospital dyads, which include the seven largest GPOs and their 2,590 unique acute care hospital members in 51 states over the period of 2009–2017. To address the endogeneity issue associated with simultaneity, we establish a one-year time lag between dependent and independent variables and analyzed the 15,527 hospital-year observations using the time-series regression with fixed-effect.FindingsWe find that a hospital’s relative power to its GPO is the most critical factor to reduce its supply cost while GPO size has no effects. We also find that a nonsystem hospital achieves greater cost savings by leveraging its relative power to its GPO while a system hospital gains no benefits.Originality/valueTo the best of our knowledge, this study is the first to address the paradox of GPO size and a hospital’s relative power and the moderating role of system membership for the hospital’s purchasing efficiency using a large nation-wide dataset of US hospitals–GPO dyads.

Deployment of Lean Manufacturing in Palm Oil Mill for Maximum Yield: A Case Study of Leading Palm Oil Producer in Nigeria

The deployment of lean manufacturing in the palm oil mill companyaimed at maximizing yield, was thoroughly investigated. The company has been experiencing a decline in palm oil production, adversely affecting productivity and customer satisfaction. The methodology employed for optimization encompassed a comprehensive system description, detailing the case study company's history, operational modalities, production machinery, and system challenges. To gather a holistic understanding of the company's current situation, data was meticulously collected through questionnaires, examination of company records, and other relevant sources. Microsoft excel software was then utilized to analyze the acquired data. The implementation of lean manufacturing tools, such as the fishbone diagram, identification of eight deadly wastesand takt-timeplayed a pivotal role in streamlining operations. In addition, a quantitative model of the supply chain was applied, utilizing critical path method (network analysis) to determine the optimal route. The results derived from the application of lean manufacturing tools and the supply chain quantitative model exhibited a remarkable improvement between (2012-2016) and (2018-2022). The average oil palm extraction increased substantially from 8.67% (2012-2016) to an impressive 30.52% (2018-2022). Furthermore, the management tools led to a significant reduction in machine downtimes, decreasing from an annual average of 5,498.6 hours to 2,472.4 hours. This improvement resulted in a considerable reduction in the annual total average cost of machine maintenance, plummeting from #1,899,578.6 to #261,853.8. The optimization efforts also extended to the supply chain, where selecting Path-2, exhibiting the least total supply time of 11 hours, significantly reduced the cost of supply from an average of #2,168,402 to #1,893,186. Overall, the net revenue of the company witnessed a remarkable surge of 71.99% post-implementation of these management tools. This comprehensive approach not only addressed production challenges but also had a substantial positive impact on the company’s financial performance. The strategic deployment of lean manufacturing emerged as a catalyst for sustainable growth and enhanced operational efficiency.

Weighing the Impact: The Influence of Body Mass Index on Facility Costs in Total Joint Arthroplasty

BackgroundUsing time-driven activity-based costing (TDABC), a novel cost calculation method that more accurately reflects true resource utilization in health care, we sought to compare the total facility costs across different body mass index (BMI) groups following total joint arthroplasty (TJA). MethodsThe study consisted of 13,806 TJAs (7,340 total knee arthroplasties [TKAs] and 6,466 total hip arthroplasties [THAs]) performed between 2019 and 2023. The TDABC data from an analytics platform was employed to depict total facility costs, comprising personnel and supply costs. For the analysis, patients were stratified into four BMI categories: <30, 30 to <35, 35 to <40, and ≥40. Multivariable regression was used to determine the independent effect of BMI on facility costs. ResultsWhen indexed to patients who had BMI <30, elevated BMI categories (30 to <35, 35 to <40, and ≥40) were associated with higher total personnel costs (TKA 1.03x versus 1.07x versus 1.13x, P < .001; THA 1.00x versus 1.08x versus 1.08x, P < .001), and total supply costs (TKA 1.01x versus 1.04x versus 1.04x, P < .001; THA 1.01x versus 1.02x versus 1.03x, P = .007). Total facility costs in TJAs were significantly greater in higher BMI categories (TKA 1.02x versus 1.05x versus 1.08x, P < .001; THA 1.01x versus 1.05x versus 1.05x, P < .001). Notably, when incorporating adjustments for demographics and comorbidities, BMI values of 35, 40, and 45 relative to BMI of 25, exhibit a significant association with a 2, 3, and 5% increase in total facility cost for TKAs and a 3, 5, and 7% increase for THAs. ConclusionsUsing TDABC methodology, this study found that overall facility costs of TJAs increase with BMI. The present study provides patient-level cost insights, indicating the potential need for reassessment of physician compensation models in this population. Further studies may facilitate the development of risk-adjusted procedural codes and compensation models for public and private payors. Level of EvidenceLevel IV, economic and decision analyses.

Improved fuzzy multi-objective transportation problem with Triangular fuzzy numbers

The present study investigates a Multi-Objective Transportation Problem within a fuzzy environment. The cost of transportation, supply, and demand data are assumed to be inaccurate due to market variations. As a result, the parameters are imprecise or fuzzy data. We offer a multi-objective, balanced transportation problem during this work, where all the parameters are fuzzy numbers. Following a mathematical formulation, fuzzy arithmetic will be used to divide the Fuzzy MOTP into three levels MOTP (lower, medium, upper). After reducing the problem to a crisp MOTP and applying a harmonic mean to each objective function, a suggested solution procedure is presented. Determining the optimal solutions for the FMOTP under unknown situations is, thus, the most important objective of this research.

Costs and access barriers to ondansetron: A national analysis of Medicare part D and Medicare Advantage plans.

e23126 Background: Seniors living with cancer and receiving prescription drug benefits through Medicare Part D Prescription Drug Plans (PDPs) can face cost and access barriers in the forms of prior authorization and quantity limit policies. While over half of Medicare beneficiaries are now insured with drug benefits through Medicare Advantage, it remains unclear how costs and access barriers compare between PDPs and MA drug plans (MADPs). This study compared plan-level costs and prevalence of prior authorization or quantity limit policies between PDPs and MADPs for oral ondansetron, an essential and widely used antiemetic for patients with cancer. Methods: We used 2023 Q3 MA and PDP data from the Center for Medicare and Medicaid Services, excluding employer-sponsored and Supplemental Need Plans (including dual-eligible plans) and plans with &lt; 10 enrollees. We focused on the four most common generic ondansetron forms: 4mg and 8mg tablets, and 4mg and 8mg orally disintegrating tablets (ODT). To compare medication quantities, we calculated the median (IQR) cost of 30-day supply (90 dosage units), defining plan-level price as the average unit cost for each formulation. Price benchmarks were defined using Mark Cuban Cost-plus Drug Company cash prices, which reflect fixed markup to negotiated wholesale prices. T-test and Chi-square tests were used for comparison. Results: Across 813 PDPs and 3512 MADPs, MAPDs had lower median costs for a 30-day supply of ondansetron than PDP plans (4mg tab: $16.1 vs $29.2; 4mg ODT: $38.0 vs $56.4; 8mg tab: $24.7 vs $35.6; 8mg ODT: $37.2 vs $54.4, all p &lt; 0.01). Median costs for both PDPs and MAPDs were higher than benchmarks (66-155% across formulations; all p &lt; 0.01). PDPs and MAPDs had similarly high prior authorization rates (83.6% vs 83.4%, p = 0.89), but MAPDs used quantity limits more frequently (22.5% vs 16.5%, p &lt; 0.01). There was little variation in prior authorization and quantity limit policies across formulations. Conclusions: Ondansetron costs in both PDPs and MAPDs were higher than benchmarks. Compared to PDPs, MAPDs offered ondansetron at lower costs but used policies creating access barriers for patients either at similar (prior authorization) or higher (quantity limit) frequency, burdening patients, physicians, health systems, and pharmacies. [Table: see text]

Access barriers and cost of varenicline for smoking cessation: A national comparative analysis of Medicare standalone part D and Medicare Advantage plan.

11080 Background: Smoking cessation is a critical part of cancer prevention and control. Oral varenicline is the most cost-effective medication for smoking cessation, yet seniors enrolled in Medicare Part D Prescription Drug Plans (PDPs) can potentially face costs and access barriers to varenicline in the forms of prior authorization and quantity limits. Although over half of Medicare beneficiaries are now insured and receiving drug benefits through Medicare Advantage, it remains unclear how costs and access barriers compare between PDPs and MA drug plans (MADPs). This study compared plan-level costs and prevalence of prior authorization and quantity limit policies between PDPs and MADPs for oral varenicline. Methods: We used 2023 Q3 MA and PDP data from the Center for Medicare and Medicaid Services, excluding employer-sponsored and Supplemental Need Plans (including dual-eligible plans) and plans with &lt;10 enrollees. We focused on two generic varenicline forms: 0.5mg and 1mg tablets. To compare medication quantities, we calculated the plan-level median (IQR) cost for 30-day supply, based on the average unit cost. Price benchmarks were defined based on average wholesale acquisition cost (WAC) from Micromedex Red Book. T-test and Chi-squared tests were used to compare costs and prevalence of prior authorization and quantity limits. Results: Across 3512 MADPs and 813 PDPs, median costs for a 30-day supply of varenicline were similar (0.5mg tab: $375.32 vs. $376.87, p=0.64; 1mg: $371.88 vs. $376.87, p=0.49, respectively). Median costs for both PDPs and MAPDs were higher than benchmarks; p&lt;0.01 for all). For both varenicline dosages, MAPDs had higher rates of prior authorization (27.1% vs 16.2%, p&lt;0.01) and quantity limits (48.0% vs 30.4%, p&lt;0.01) than PDPs. Conclusions: Varenicline prices in both PDPs and MAPDs were much higher than benchmarks. Compared to PDPs, MAPDs used more prior authorization and quantity limit to control cost. This can create access barriers to this cost-effective medication, burdening patients, physicians, health systems, and pharmacies. [Table: see text]

A study on the effects of replacing fishmeal with soybean meal in the feed of Procambarus clarkii: Assessing growth performance, immunity, and gut microbiota

The unstable supply and high cost of fishmeal have led to increased interest in low fish meal feed. As such, the present study aimed to investigate the effects of replacing fishmeal in feeds with soybean meal (SM) on the growth, immunity, and gut microbiota of crayfish. A total of 750 crayfish (4.00 g) were randomly divided into five groups (SS0, SS25, SS50, SS75, and SS100) with three replicates, and were fed diets with different levels of soybean meal substituted for fishmeal for six weeks. The results revealed that crayfish subjected to high SM diets experienced a significant decrease in the final body weight, weight gain rate, and specific growth rate (p<0.05), together with enzyme activities related to nutrient digestion and absorption. Of note, the groups with 25–50 % SM replacement exhibited decreased final body weight without significance compared to that in the SS0 group (p>0.05). Moreover, increasing SM inclusion exhibited the potential to impair the intestine, characterized by the increase in hemolymph LD content, decrease in the levels of TC content, T-AOC, and AKP, along with the observed edema of the lamina propria, and up-regulated mRNA expression levels of nfkb, alf, and tlr. Furthermore, high SM diets resulted in the emergence of new species and a shift in Firmicutes, Bacteroidota, Proteobacteria, and Fusobacteriota. Specifically, the abundance of lower Firmicutes and higher Proteobacteria was observed in the SS100 group, which was closely correlated with genus-level Candidatus Bacilloplasma, and RsaHf231 abundance alterations. MENAs demonstrated that the high SM diets led to a more complex, yet fragile and unstable microbial network. The global network further indicated that the microbes contributing more to crayfish were in module eigen 4, in which 9 OTUs were identified as major biomarkers and mainly classified into Proteobacteria. Taken above, SM could replace 25 % of fishmeal in crayfish diets without negatively affecting growth performance, nutrient utilization, immunity, and antioxidant capacity. Excessive SM levels contributed to gut dysfunction and weakened the immune system of crayfish.

The hospital costs of high emergency department pediatric readiness.

We estimate annual hospital expenditures to achieve high emergency department (ED) pediatric readiness (HPR), that is, weighted Pediatric Readiness Score (wPRS)≥88 (0-100 scale) across EDs with different pediatric volumes of children, overall and after accounting for current levels of readiness. We calculated the annual hospital costs of HPR based on two components: (1) ED pediatric equipment and supplies and (2) labor costs required for a Pediatric Emergency Care Coordinator (PECC) to perform pediatric readiness tasks. Data sources to generate labor cost estimates included: 2021 national salary information from U.S. Bureau of Labor Statistics, detailed patient and readiness data from 983 EDs in 11 states, the 2021 National Pediatric Readiness Project assessment; a national PECC survey; and a regional PECC survey. Data sources for equipment and supply costs included: purchasing costs from seven healthcare organizations and equipment usage per ED pediatric volume. We excluded costs of day-to-day ED operations (ie, direct clinical care and routine ED supplies). The total annual hospital costs for HPR ranged from $77,712 (95% CI 54,719-100,694) for low volume EDs to $279,134 (95% CI 196,487-362,179) for very high volume EDs; equipment costs accounted for 0.9-5.0% of expenses. The total annual cost-per-patient ranged from $3/child (95% CI 2-4/child) to $222/child (95% CI 156-288/child). After accounting for current readiness levels, the cost to reach HPR ranged from $23,775 among low volume EDs to $145,521 among high volume EDs, with costs per patient of $4/child to $48/child. Annual hospital costs for HPR are modest, particularly when considered per child.

Energy scheduling method for island micro-grid system based on prediction model

Abstract Renewable energy, due to its characteristics such as volatility and intermittency, brings difficulties to the energy scheduling of renewable energy power generation systems. The main way of island power generation is to use renewable energy power generation. This chapter proposes a hierarchical energy scheduling method based on the prediction model through the research on the energy scheduling method of the island microgrid system to realize the energy optimization between the microgrid sub-systems, to achieve the maximum consumption of renewable energy for power supply, and to reduce the power supply cost and improve user satisfaction. The effectiveness of this method in improving the energy supply-demand balance of the microgrid sub-systems is verified through experiments.

Reframing water demand management: a new co-governance framework coupling supply-side and demand-side solutions toward sustainability

Abstract. Water demand management adopts economic and non-economic measures to reduce human water use. However, it is argued in this study that water use changes may cause idle water supply facilities and revenue losses, thereby challenging the sustainability of water supply systems in the context of climate change. A co-governance framework was established to inspire practical strategies of sustaining water supply systems by re-evaluating the long-term impacts of water demand changes. This framework adopts a broader view of water demand management by integrating the political, financial, and consumptive needs of the government, the market, and the users in the form of a collaborative strategy coupling both supply-side and demand-side solutions. The proposed framework was applied to the analysis of the sustainability of China's South-to-North Water Diversion Project. It is found that the South-to-North Water Diversion Project is not a simple water supply infrastructure but rather a synthesis of supply-side and demand-side water management solutions. Actively releasing water for ecological and cultural purposes is suggested in this study to maintain the socio-ecological benefits of the project in the context of human water use decline. The economic cost of the water supply could be recovered by ongoing revenues that include not only the water fees charged to users but also the benefits gained from cooperative investment in broader water-related businesses by both the state-owned water transfer company and local governments in water-receiving areas. The proposed framework and strategies are valuable for other water utilities around the world, especially those challenged by reduced water demand caused by climate change, high water prices, and economic depression.

Variation in the Cost of Hip Arthroscopy for Labral Pathological Conditions: A Time-Driven Activity-Based Costing Analysis.

Despite growing interest in delivering high-value orthopaedic care, the costs associated with hip arthroscopy remain poorly understood. By employing time-driven activity-based costing (TDABC), we aimed to characterize the cost composition of hip arthroscopy for labral pathological conditions and to identify factors that drive variation in cost. Using TDABC, we measured the costs of 890 outpatient hip arthroscopy procedures for labral pathological conditions across 5 surgeons at 4 surgery centers from 2015 to 2022. All patients were ≥18 years old and were treated by surgeons who each performed ≥20 surgeries during the study period. Costs were normalized to protect the confidentiality of internal hospital cost data. Descriptive analyses and multivariable linear regression were performed to identify factors underlying cost variation. The study sample consisted of 515 women (57.9%) and 375 men (42.1%), with a mean age (and standard deviation) of 37.1 ± 12.7 years. Most of the procedures were performed in patients who were White (90.6%) or not Hispanic (93.4%). The normalized total cost of hip arthroscopy per procedure ranged from 43.4 to 203.7 (mean, 100 ± 24.2). Of the 3 phases of the care cycle, the intraoperative phase was identified as the largest generator of cost (>90%). On average, supply costs accounted for 48.8% of total costs, whereas labor costs accounted for 51.2%. A 2.5-fold variation between the 10th and 90th percentiles for total cost was attributed to supplies, which was greater than the 1.8-fold variation attributed to labor. Variation in total costs was most effectively explained by the labral management method (partial R2 = 0.332), operating surgeon (partial R2 = 0.326), osteoplasty type (partial R2 = 0.087), and surgery center (partial R2 = 0.086). Male gender (p < 0.001) and younger age (p = 0.032) were also associated with significantly increased costs. Finally, data trends revealed a shift toward labral preservation techniques over debridement during the study period (with the rate of such techniques increasing from 77.8% to 93.2%; Ptrend = 0.0039) and a strong correlation between later operative year and increased supply costs, labor costs, and operative time (p < 0.001 for each). By applying TDABC to outpatient hip arthroscopy, we identified wide patient-to-patient cost variation that was most effectively explained by the method of labral management, the operating surgeon, the osteoplasty type, and the surgery center. Given current procedural coding trends, declining reimbursements, and rising health-care costs, these insights may enable stakeholders to design bundled payment structures that better align reimbursements with costs. Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.

Analisis Strategi Persediaan Bahan Baku Buah Pala Untuk Meningkatkan Efisiensi Rantai Pasok CV Cielofood Pratama di Kota Bogor

CV Cielofood Pratama is a beverage processing business with nutmeg raw materials, located in Bogor City, West Java. The company produces syrups with varying sizes of packaging. The multi-stage production process does not rule out the possibility of irregularities that could cause the product to no longer meet the quality standards we set. In general, business units have a profit goal for business sustainability, by seeking efficiency in operations in order to obtain profitable profits. Analysis of the data shows the difference between corporate policy and the results of the EOQ method. The company usually orders 25 kg of raw materials with a frequency of 120 times per year. However, the EOQ method recommends ordering 144 kg with a frequency of 36 times per year. In addition, there is a significant difference in the total cost of supplies, which is IDR 30,900,000 according to company policy and IDR 10,392,000 according to EOQ method. This study aims to analyze strategies in raw material supply as an effort for supply chain efficiency. Using the Economic Orders Quantity (EOQ) method Reduce storage costs, save space on both storage and workspaces, resolve problems and reduce the risk that raw material supplies may pose.

Handmade Loop Versus Hem-o-Lok Clip in Closure of Appendiceal Stump During Laparoscopic Appendectomy: Limited Setting in a Peripheral University Hospital.

Background: Today, laparoscopy is frequently used in abdominal emergencies such as acute appendicitis. There are several techniques used to close the appendiceal stump during laparoscopic appendectomy. We aimed to compare the use of handmade loop and Hem-o-lok used to close the appendiceal stump in public hospitals where resources are limited, in terms of surgical outcomes and cost. Methods: Between January 2020 and December 2022, patients for whom handmade loops and Hem-o-loks were used to close the appendiceal stump during laparoscopic appendectomy in our clinic were included in the study. There were a total of 638 patients (mean age: 33 ± 13.5 years, 325 females and 313 males) in the patient cohort. Demographic and clinical data, duration of surgery, complications, hospital stay, pathology reports, mortality, and cost of supplies were compared between the two groups. Results: There were 308 patients in the handmade loop group (160 females, 148 males, mean age: 33.7 years, range: 18-85 years) and 330 patients in the Hem-o-lok group (166 females, 164 males, mean age: 32.5 years, range: 18-89 years). There was no significant difference between the two groups for American Society of Anesthesiologists score, duration of symptom, hospital stay, intensive care unit stay, preoperative laboratory values, histopathological results, mortality, and morbidity (P > .05). The mean operation time was 48.76 ± 16.16 minutes in the handmade loop group and 40.53 ± 11.63 minutes in the Hem-o-lok group (p = 0.001). In terms of cost, the cost per case of Hem-o-lok group was about 25.8 times as much as the group that used sutures ($31 versus $1.2). Conclusions: Both methods can be used safely in laparoscopic appendectomy. The use of Hem-o-lok has no advantage other than shortening the operation time. However, it is costlier. Especially in peripheral hospitals where resources are limited, closing the appendiceal stump using a handmade loop is an easy, safe, and cost-effective method.

Investment Strategy and Benefit Analysis of Power and Heat Hybrid Energy Storage in Industrial Parks Based on Energy Performance Contracting

To solve the problems of a single mode of energy supply and high energy cost in the park, the investment strategy of power and heat hybrid energy storage in the park based on contract energy management is proposed. Firstly, the concept of energy performance contracting (EPC) and the advantages and disadvantages of its main modes are analyzed, and the basic scheme of EPC for parks is proposed combined with the actual demand. Furthermore, the multiple energy storage model for power and heat storage in parks is established, which includes lithium batteries and heat storage tanks. Based on this, minimizing the annual operation cost of parks is taken as the optimization goal, and the capacity optimization model for power and heat storage is constructed, which considers the investment costs, operation and maintenance costs, purchased energy costs, peak-shaving subsidy, and environmental subsidy. Finally, an industrial park is selected as an example of EPC to verify the effectiveness of our proposed investment strategy. The results show that compared with the situation before the energy-saving renovation, the park can save 35.14 ten thousand CNY in annual cost expenses. When the unit power price of the lithium battery exceeds 3900 CNY/kW, the unit capacity price exceeds 5460 CNY/kWh, the unit power price of the heat storage tank (HST) exceeds 6000 CNY/kW, and the unit capacity price exceeds 1000 CNY/kWh, the configuration of the lithium battery and HST in the park is no longer the optimal choice to perform the energy-saving renovation.

Aviation fuels of the future − A techno-economic assessment of distribution, fueling and utilizing electricity-based LH2, LCH4 and kerosene (SAF)

This paper investigates the techno-economic implications on air travel when fossil-based kerosene is phased out of the market, specifically focusing on the comparison between liquid hydrogen, liquid methane and renewable kerosene for ten exemplary flight routes to estimate the cost of air travel per passenger and 100 km distance travelled €2020PAX100km for every fuel type. By considering the entire supply chain, including hydrogen production from renewable sources, synthesis, oversea transport, domestic distribution, and utilization, this study addresses the overarching question of whether it is more economical to change the fuel source or the fuel itself to reduce fossil kerosene usage in the aviation industry. It is demonstrated that aircraft acquisition costs play a minor role compared to fuel supply costs and specific fuel demand. The study shows that for electricity-based fuels, liquid hydrogen is the most economic option, even with a potential energy penalty, followed by liquid methane and renewable kerosene. The results for an aircraft with a capacity 180 passengers are 3.08, 4.57 and 5.11 €PAX100km for liquid hydrogen, liquid methane and renewable kerosene, respectively. Challenges regarding storage and isolation requirements for cryogenic fuels in aviation are discussed, with assumptions made that these obstacles can be overcome to realize economic benefits. Additionally, the study suggests potential shifts in aircraft size selection by airlines to mitigate rising fuel prices in the future. The study advocates for the aviation industry's openness to new fuels like liquid hydrogen and liquid methane to alleviate the cost increase associated with phasing out fossil kerosene.