Care cost for pregnant and parturient women with diabetes and mild hyperglycemia

OBJETIVO: Comparar custos de hospitalização e de atenção ambulatorial em gestantes/parturientes diabéticas e com hiperglicemia leve. MÉTODOS: Estudo observacional, prospectivo, quantitativo descritivo realizado em centro de diabete perinatal em Botucatu, SP, entre 2007 e 2008. Foram estimados os custos por absorção diretos e indiretos disponíveis na instituição e os custos específicos para a doença (medicamentos e exames). As 30 gestantes diabéticas tratadas com dieta foram acompanhadas em ambulatório e 20 tratadas com dieta mais insulina foram hospitalizadas. RESULTADOS: O custo da doença diabete (para a assistência pré-natal e parto) foi de US$ 3,311.84 para as gestantes hospitalizadas e de US$ 1,366.04 para as acompanhadas em ambulatório. CONCLUSÕES: Os custos diretos e indiretos e o custo total da assistência pré-natal foram mais elevados nas gestantes diabéticas hospitalizadas enquanto os custos da assistência ao parto e hospitalização para parto e puerpério foram semelhantes. Os custos da assistência pré-natal como no parto/puerpério foram superiores aos valores pagos pelo Sistema Único de Saúde.

Cost-benefit of hospitalization compared with outpatient care for pregnant women with pregestational and gestational diabetes or with mild hyperglycemia, in Brazil

CONTEXTO E OBJETIVO: Gestações complicadas pelo diabetes estão associadas com aumento de complicações maternas e neonatais. Os custos hospitalares aumentam de acordo com a assistência prestada. O objetivo foi calcular o custo-benefício e a taxa de rentabilidade social da hospitalização comparada ao atendimento ambulatorial em gestantes com diabetes ou com hiperglicemia leve. DESENHO do ESTUDO: Estudo prospectivo, observacional, quantitativo, realizado em hospital universitário, sendo incluídas todas as gestantes com diabetes pregestacional e gestacional ou com hiperglicemia leve que não desenvolveram intercorrências clínicas na gestação e que tiveram parto no Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (HC-FMB-Unesp). MÉTODOS: Trinta gestantes tratadas com dieta foram acompanhadas em ambulatório e 20 tratadas com dieta e insulina foram abordadas com hospitalizações curtas e frequentes. Foram obtidos custos diretos (pessoal, material e exames) e indiretos (despesas gerais) a partir de dados contidos no prontuário e no sistema de custo por absorção do hospital e posteriormente calculado o custo-benefício. RESULTADOS: O sucesso do tratamento das gestantes diabéticas evitou o gasto de US$ 1.517,97 e US$ 1.127,43 para pacientes hospitalizadas e ambulatoriais, respectivamente. O custo-benefício da atenção hospitalizada foi US$ 143.719,16 e ambulatorial, US$ 253.267,22, com rentabilidade social 1,87 e 5,35 respectivamente. CONCLUSÃO: A análise árvore de decisão confirma que o sucesso dos tratamentos elimina custos no hospital. A relação custo-benefício indicou que o tratamento ambulatorial é economicamente mais vantajoso do que a hospitalização. A rentabilidade social de ambos os tratamentos foi maior que 1, indicando que ambos os tipos de atendimento à gestante diabética têm benefício positivo.

Energy system contributions in indoor rock climbing

The present study cross-sectionally investigated the influence of training status, route difficulty and upper body aerobic and anaerobic performance of climbers on the energetics of indoor rock climbing. Six elite climbers (EC) and seven recreational climbers ( RC) were submitted to the following laboratory tests: ( a) anthropometry, (b) upper body aerobic power, and ( c) upper body Wingate test. on another occasion, EC subjects climbed an easy, a moderate, and a difficult route, whereas RC subjects climbed only the easy route. The fractions of the aerobic (WAER), anaerobic alactic (W-PCR) and anaerobic lactic (W-[La(])-) systems were calculated based on oxygen uptake, the fast component of excess post-exercise oxygen uptake, and changes in net blood lactate, respectively. on the easy route, the metabolic cost was significantly lower in EC [ 40.3 ( 6.5) kJ] than in RC [60.1 ( 8.8) kJ] ( P < 0.05). The respective contributions of the WAER, WPCR, and W-[La(])- systems in EC were: easy route = 41.5 (8.1), 41.1 (11.4) and 17.4% (5.4), moderate route = 45.8 (8.4), 34.6 (7.1) and 21.9% (6.3), and difficult route = 41.9 (7.4), 35.8 (6.7) and 22.3% (7.2). The contributions of the WAER, WPCR, and W-[La(])- systems in RC subjects climbing an easy route were 39.7 (5.0), 34.0 (5.8), and 26.3% (3.8), respectively. These results indicate that the main energy systems required during indoor rock climbing are the aerobic and anaerobic alactic systems. In addition, climbing economy seems to be more important for the performance of these athletes than improved energy metabolism.

Development of a simple and versatile ultrafiltration system for the fractionation of aquatic humic substances

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Designing a modified Hopfield network to solve an Economic Dispatch problem with nonlinear cost function

Economic Dispatch (ED) problems have recently been solved by artificial neural networks approaches. In most of these dispatch models, the cost function must be linear or quadratic. Therefore, functions that have several minimum points represent a problem to the simulation since these approaches have not accepted nonlinear cost function. Another drawback pointed out in the literature is that some of these neural approaches fail to converge efficiently towards feasible equilibrium points. This paper discusses the application of a modified Hopfield architecture for solving ED problems defined by nonlinear cost function. The internal parameters of the neural network adopted here are computed using the valid-subspace technique, which guarantees convergence to equilibrium points that represent a solution for the ED problem. Simulation results and a comparative analysis involving a 3-bus test system are presented to illustrate efficiency of the proposed approach.

Z(bus) transmission network cost allocation

This paper addresses the problem of allocating the cost of the transmission network to generators and demands. A physically-based network usage procedure is proposed. This procedure exhibits desirable apportioning properties and is easy to implement and understand. A case study based on the IEEE 24-bus system is used to illustrate the working of the proposed technique. Some relevant conclusions are finally drawn.

Thermodynamic analysis of the cogeneration system expansion in a sugar-alcohol factory

In this work it was performed energetic and exergetic analyses of three thermal plants to assessment a cogeneration system in expansion of a sugar-alcohol factory. The initial configuration considered is constituted by a low pressure steam generator, single stage steam turbines for electricity generation and crusher, shredder and mills with mechanical driving. In the intermediary configuration, the low pressure steam generator was substituted by another which generates steam at higher pressure and higher temperature, the steam turbines for electricity generation were substituted by a multiple stages extraction-condensation turbine and the other steam turbines were maintained. The final configuration consists in the substitution of these last turbines by electrical motors. Thermodynamic analyses were performed to evaluate the equipment and the overall plants efficiencies to permit a comparison among the plants. Besides of this, some important parameters of the sugar-alcohol factories were calculated.

A cost optimization-based design of precast concrete floors using genetic algorithms

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

An overview on network cost allocation methods

This work is devoted to Study and discuss the main methods to solve the network cost allocation problem both for generators and demands. From the presented, compared and discussed methods, the first one is based on power injections, the second deals with proportional sharing factors, the third is based upon Equivalent Bilateral Exchanges, the fourth analyzes the power How sensitivity in relation to the power injected, and the last one is based on Z(bus) network matrix. All the methods are initially illustrated using a 4-bus system. In addition, the IEEE 24-bus RTS system is presented for further comparisons and analysis. Appropriate conclusions are finally drawn. (C) 2008 Elsevier B.V. All rights reserved.

In vitro conservation and low cost micropropagation of Cochlospermum regium (Mart. Ex. Scharank)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Thermoeconomic analysis of a cogeneration system of a university campus

In this paper, a thermoeconomic analysis method based on the First and the Second Law of Thermodynamics and applied to analyse the replacement of an equipment of a cogeneration system is presented. The cogeneration system consists of a gas turbine linked to a waste boiler. The electrical demand of the campus is approximately 9 MW but the cogen system generates approximately one third of the university requirement as well as 1.764 kg/s of saturated steam (at 0.861 MPa), approximately, from a single fuel source. The energy-economic study showed that the best system, based on pay-back period and based on the maximum savings (in 10 years), was the system that used the gas turbine M1T-06 of Kawasaki Heavy Industries and the system that used the gas turbine CCS7 of Hitachi Zosen, respectively. The exergy-economic study showed that the best system, which has the lowest EMC, was the system that used the gas turbine ASE50 of Allied Signal. © 2002 Elsevier Science Ltd. All rights reserved.

Allocation of the cost of transmission losses in a multimarket framework

The paper addresses the issue of apportioning of the cost of transmission losses to generators and demands in a multimarket framework. Line flows are unbundled using equivalent bilateral exchanges on a DC-network model and allocated to generators and demands. Losses are then calculated based on unbundled flows and straightforwardly apportioned to generators and demands. The proposed technique is particularly useful in a multimarket framework, where all markets have a common grid operator with complete knowledge of all network data, as is the case of the Brazilian electric-energy system. The methodology proposed is illustrated using the IEEE Reliability Test System and compared numerically with an alternative technique. Appropriate conclusions are drawn. © The Institution of Engineering and Technology 2006.

A mechatronic system applied to wear particle analysis

This paper describes the development of a mechatronic system for a predictive maintenance grounded on wear particle analysis. The reckoning of wear particles containing in lubricating industrial oils brings the image acquisition system into being. The ISO 4406:1999 standard is a guide to establish the counting and evaluation processes of particles. The system applied to the acquisition and analysis of the data consists of a digital camera, a monocular microscope and an oil filtering system. A computational program was developed with the application of Visual Microsoft C++ in a way to detain the oil sample image from the microscope slide to the computer screen. Quantitative analyses of the wear debris particles bulk are exploited applying a graphical interface that was developed to render the image processing of the sample test. The implemented system has a reachable cost thus it can be applied for schooling goals and for bolstering laboratories of minor industries and medium size companies.

Construction and test of low cost X-ray tomography scanner for physical-chemical analysis and nondestructive inspections

X-ray computed tomography (CT) refers to the cross-sectional imaging of an object measuring the transmitted radiation at different directions. In this work, we describe the development of a low cost micro-CT X-ray scanner that is being developed for nondestructive testing. This tomograph operates using a microfocus X-ray source and contains a silicon photodiode as detectors. The performance of the system, by its spatial resolution, has been estimated through its Modulation Transfer Function - MTF and the obtained value at 10% of MTF is 661 μm. It was built as a general purpose nondestructive testing device. © 2009 American Institute of Physics.

The Owner Share scheduler for a distributed system

In large distributed systems, where shared resources are owned by distinct entities, there is a need to reflect resource ownership in resource allocation. An appropriate resource management system should guarantee that resource's owners have access to a share of resources proportional to the share they provide. In order to achieve that some policies can be used for revoking access to resources currently used by other users. In this paper, a scheduling policy based in the concept of distributed ownership is introduced called Owner Share Enforcement Policy (OSEP). OSEP goal is to guarantee that owner do not have their jobs postponed for longer periods of time. We evaluate the results achieved with the application of this policy using metrics that describe policy violation, loss of capacity, policy cost and user satisfaction in environments with and without job checkpointing. We also evaluate and compare the OSEP policy with the Fair-Share policy, and from these results it is possible to capture the trade-offs from different ways to achieve fairness based on the user satisfaction. © 2009 IEEE.