To segregate imaging expenditures from claims data by resource utilization bands (RUBs) and underlying conditions to create an “expenditure map” of pediatric imaging costs.
A Claims data for children ...enrolled in a commercial value-based plan were categorized by RUB 0 non-user, 1 healthy user, 2 low morbidity, 3 moderate morbidity, 4 high morbidity, & 5 very high morbidity. The per member per year (PMPY) expense, total imaging spend, and imaging modality with the highest spend were assessed for each RUB. Diagnosis categories associated with high imaging costs were also evaluated.
There were 40,022 pediatric plan members. 14% had imaging-related claims accounting for approximately $2.8 million in expenditures. Member distribution and mean PMPY expenditure RUB was respectively: RUB 0 (3,037, $0), RUB 1 (6,604, $7), RUB 2 – 13,698, $27), RUB 3 – 13,341, $87), RUB 4 (2,810, $268), RUB 5 (532, $841). RUB 3 had the largest total imaging costs at $1,159,523. The imaging modality with the greatest mean PMPY expense varied by RUB with radiography highest in lower RUBs and MRI highest in higher RUBs. The top 3 diagnoses associated with the highest total imaging costs were developmental disorders ($443,980), asthma ($388,797), and congenital heart disease ($294,977) and greatest mean PMPY imaging expenditures malignancy/leukemia ($3,100), transplant ($2,639), and tracheostomy ($1,661).
Expense mapping using claims data allows for a better understanding of the distribution of imaging costs across a covered pediatric population. This tool may assist organizations in planning effective cost-reduction initiatives and learning how imaging utilization varies by patient complexity in their system.
Decarbonisation goals have triggered photovoltaic (PV) sector expansion and cost reductions in PV technologies. Thin film (TF) PV technologies are currently the cheapest to manufacture and offer the ...possibility of attaining lower costs. However, scarcity of key component materials has been highlighted as a potential barrier to both large scale deployment and reductions in technology cost. This paper explores this claim for cadmium telluride (CdTe) and copper indium gallium (di)selenide (CIGS) TF technologies and their potentially constraining materials, tellurium and indium. It reviews key literature, highlighting the high uncertainty in the estimates of the resource constrained TF PV potential as well as in data and methodologies used to assess future availability of the targeted materials. The reviewed evidence does not support the contention that the availability of tellurium and indium will necessarily constrain CdTe and CIGS technologies respectively in their ability to supply expected future PV market growth. However, future escalation in indium and tellurium price resulting from demand–supply imbalances could have a negative impact on CdTe and CIGS cost reduction ambitions. Factors influencing indium and tellurium price and their relative contribution to TF PV module production cost need further investigation.
Abstract
This paper aims to recognize the effect of material waste on cost increase in Palestinian construction projects. The study used questionnaire survey to achieve its objectives. The target ...population of the study are constructors and consultants involved in construction projects. The study also predicts the effect of cost overrun on material waste in some construction activities, namely: ceramic and brick works. The collected data were analyzed using statistical analyses. The study has established that among the various factors that affect cost overrun, experience in the line of work, conflicts among project participants, payments delay, and political situation are the key factors. While the analysis revealed that the main material waste factors are: poor site management, using untrained labors, rework due to workers' mistakes, selecting the lowest bidder contractor/subcontractor, and frequent change orders. Data from 55 building projects constructed in the West Bank between 2015 and 2020 were collected to test the relation between material waste and cost increase. Two mathematical models were developed: Model (l) links cost increase and waste in ceramic works. It indicates that if waste increases by 1%, the cost will increase by 1.07%. Model (2) links between cost increase and material waste in brick works. It tells that if waste increases by 1%, cost will increase by 1.25%.
R
square of value >0.7, for both models, indicates a strong linear relation between cost increase and material waste. This is the first study that predicts the effect of material waste on cost increase in Palestinian construction sector. The study encourages different parties related to construction projects to manage factors of cost overrun and material waste to enhance the sector of construction.
Water electrolysis is a promising technology for storing surplus energy from intermittent renewable energy sources in the form of hydrogen. The future investment costs of water electrolysis represent ...one key challenge for a hydrogen-based energy system. In this work, a literature review was conducted to evaluate the published data on investment costs and learning rates for PEM and alkaline electrolyzers from the 1990s until 2017 and the years beyond. The collected data are adjusted for inflation and specified in €2017 per kW-output using the higher heating value (HHV). R&D efforts have led to impressive cost reductions in the observed period, especially for PEM technology, while cost reductions for alkaline technology have also been decent. The overall spread of the cost estimations in the 1990s was in a range between 306 and 4748 €2017/kWHHV-Output. Today's estimations for future investment costs (through 2030) for both technologies are narrowed towards values of 397 and 955 €2017/kWHHV-Output. Higher automation, mass production, larger cell areas, market penetration and technology development will all have a further impact on the investment costs.
•Development of cost projections for PEM and alkaline was investigated.•Future cost estimates for PEM are approaching those of the alkaline.•More transparent cost projections studies for electrolysis are needed.•Usage of existing approaches for future projections is proposed.•Clear definition of manufacturing boundaries for future cost projection is proposed.
Future low-temperature district heating systems (LTDH) require supply and return temperatures as low as 55 °C and 25 °C, respectively. In this direction, the use of night setbacks in heating of ...office buildings is a problem. This article investigated in a typical office building with large distribution system by tests and simulations the energy and cost savings by changing the control of the heating system from a continuous high-temperature operation either to a high-temperature intermittent heating or to a continuous low-temperature operation. Both strategies secured thermal comfort and resulted in similar energy savings of approximately 11% in the specific building. The reduction of the return temperature was higher under continuous low-temperature operation, resulting in additional cost savings due to a motivation tariff for low-temperature operation used in Denmark. As a result continuous low-temperature operation can achieve the highest total cost reduction for heating of 23.1%. Even if the results refer to the specific building, continuous low-temperature heating may result in significant energy savings in other buildings with large distribution systems. Moreover, implementing motivation tariffs towards LTDH may provide additional economic incentives. Therefore, it is interesting to investigate continuous low-temperature heating in each building and quantify the cost and energy savings towards LTDH.
•A comparison between night-setback and low-temperature continuous heating in an office building.•Both strategies can secure thermal comfort in the offices according to tests.•Both strategies can result in similar energy savings of 11% in the specific office building.•Low-temperature continuous heating results in lower return temperature by 5 °C.•Low-temperature continuous heating results in cost reduction of 23% due to motivation tariff.
Selective removal of arsenic (As) is the key challenge for any of As removal mechanisms as this not only increases the efficiency of removal of the main As species (neutral As(III) and As(V) ...hydroxyl-anions) but also allows for a significant reduction of waste as it does not co-remove other solutes. Selective removal has a number of benefits: it increases the capacity and lifetime of units while lowering the cost of the process. Therefore, a sustainable selective mitigation method should be considered concerning the economic resources available, the ability of infrastructure to sustain water treatment, and the options for reuse and/or safe disposal of treatment residuals. Several methods of selective As removal have been developed, such as precipitation, adsorption and modified iron and ligand exchange. The biggest challenge in selective removal of As is the presence of phosphate in water which is chemically comparable with As(V). There are two types of mechanisms involved with As removal: Coulombic or ion exchange; and Lewis acid-base interaction. Solution pH is one of the major controlling factors limiting removal efficiency since most of the above-mentioned methods depend on complexation through electrostatic effects. The different features of two different As species make the selective removal process more difficult, especially under natural conditions. Most of the selective As removal methods involve hydrated Fe(III) oxides through Lewis acid-base interaction. Microbiological methods have been studied recently for selective removal of As, and although there have been only a small number of studies, the method shows remarkable results and indicates positive prospects for the future.
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•Selective arsenic (As) removal increase removal units' lifetime, decrease waste, costs.•Phosphate is the principal competitor for all selective As removal approaches.•Simultaneous selective removal of As(V) and As(III) requires composite approaches.•Lewis acid-base interaction & ion-exchange are the major mechanisms involved.•Microbial methods have potential in selective As removal as an economical method.
This paper, which is a contribution to the UNEP series on Eco-Efficient Cements, examines the role of material-based solutions to reducing CO2 emissions from cement production considering factors ...that could influence implementation. Global urbanization has led to an increase in demand for cement and cement-based materials. With its growth in consumption, the associated CO2 emissions from its production are raising concern. However, the role of mitigation strategies in a global context that account for regional material availability and degree of market adoption have yet to be considered. This work shows that the 2°C scenario targets for 2050 can be met through increased use of calcined clay and engineered filler with dispersants. The introduction of new Portland clinker-based cement alternatives, use of alkali-activated materials, and improvement of efficiency of cement use could further contribute to reduction goals. There are currently-available technologies for reduction that could be rapidly implemented.
Abstract
Introduction
There is a strong incentive to reduce the costs associated with processing urine specimens, since tests involving urine specimens are often the most frequently ordered culture ...studies. Multiple analyses have demonstrated that approximately two-thirds of urine specimens sent to culture yield a negative result.
Methods
Using the laboratory records of urinalysis and urine culture results for one week (October 20–27, 2016), data were collected on the number of urinalysis and cultures ordered in total and the results of each test for 45 patients. A total of 345 urine cultures and 859 urinalysis tests were ordered in that time. Fifty urine cultures and those patients’ corresponding urinalysis were also analyzed.
Conclusion and Results
Of the 50 cultures performed, five were repeat urine cultures, making it a total of 45 patients included in the analyses. Of these, 64 urinalyses were performed. Urinalysis and urine culture were concurrently ordered tests in 40/45 patients (88%). It was found that 11 of 50 cultures resulted in a positive result (22%), making the majority of cultures negative (78%). Due to the high negative result of culture, and the immense cost to the laboratory to process these specimens, a way to reduce costs and to speed up result turnaround time was identified. One solution for our lab is the use an instrument that is already utilized for urinalysis, the IRIS iQ200, as a urine culture screening method to screen out negative urines unnecessarily sent for culture. This intervention aids clinicians by providing faster presumptive culture results, which can shorten empiric antibiotic treatment time with the added benefit of reducing costs to the laboratory and patients.
During the past decade, the development of offshore wind energy has transitioned from near shore with shallow water to offshore middle-depth water regions. Consequently, the energy conversion ...technology has shifted from bottom-fixed wind turbines to floating offshore wind turbines. Floating offshore wind turbines are considered more suitable, but their cost is still very high. One of the main reasons for this is that the system dynamics control method is not well-adapted, thereby affecting the performance and reliability of the wind turbine system. The additional motion of the platform tends to compromise the system’s performance in terms of power maximization, power regulation, and load mitigation. To provide a recommendation based on the advantages and disadvantages of different control methods, we systematically analyze feasible control methods for existing floating offshore wind turbine designs. Based on a brief overview of floating offshore wind turbine system dynamics, we present several promising control methods by classifying them as blade-pitch-based and mass–spring–damper-based. Furthermore, we emphasize on the incoming wind and wave forecasting associated with the control methods. We then compare different methods by evaluating a matrix involving platform motion minimization, load mitigation, and power regulation and identify the advantages and disadvantages. Finally, recommendations and suggestions for further research are provided by integrating the advantageous control algorithm and forecasting technologies to reduce costs.
•Various control methods of floating offshore wind turbine systematic dynamics are reviewed.•Incoming wind and wave forecasting techniques are presented.•Advantages and disadvantages of different methods with respect to platform design is discussed.•Incident disturbance-based control method improvement is proposed with machine learning.
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