973 resultados para Cost comparison
Resumo:
The widespread use of ³H and 14C in research has generated a large volume of waste mixed with scintillation liquid, requiring an effective control and appropriate storage of liquid radioactive waste. In the present study, we compared the efficacy of three commercially available scintillation liquids, Optiphase HiSafe 3, Ultima-Gold™ AB (biodegradable) and Insta-Gel-XF (non-biodegradable), in terms of [14C]-glucose and [³H]-thymidine counting efficiency. We also analyzed the effect of the relative amount of water (1.6 to 50%), radioisotope concentration (0.1 to 100 nCi/ml), pH (2 to 10) and color of the solutions (samples containing 0.1 to 1.0 mg/ml of Trypan blue) on the counting efficiency in the presence of these scintillation liquids. There were few significant differences in the efficiency of 14C and ³H counting obtained with biodegradable or non-biodegradable scintillation liquids. However, there was an 83 and 94% reduction in the efficiency of 14C and ³H counting, respectively, in samples colored with 1 mg/ml Trypan blue, but not with 0.1 mg/ml, independent of the scintillation liquid used. Considering the low cost of biodegradable scintillation cocktails and their efficacy, these results show that traditional hazardous scintillation fluids may be replaced with the new safe biodegradable fluids without impairment of ³H and 14C counting efficiency. The use of biodegradable scintillation cocktails minimizes both human and environmental exposure to hazardous solvents. In addition, some biodegradable scintillation liquids can be 40% less expensive than the traditional hazardous cocktails.
Resumo:
Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled). Uncontrolled asthmatics accounted for higher health care expenditures than controlled patients, US$125.45 and US$15.58, respectively [emergency room visits (US$39.15 vs US$2.70) and hospitalization (US$86.30 vs US$12.88)], per patient over 6 months. The costs with medications in the last month for patients with mild, moderate and severe asthma were US$1.60, 9.60, and 25.00 in the uncontrolled patients, respectively, and US$6.50, 19.00 and 49.00 in the controlled patients. In view of the small proportion of uncontrolled subjects receiving regular maintenance medication (22.2%) and their lack of resources, providing free medication for uncontrolled patients might be a cost-effective strategy for the public health system.
Resumo:
Whole blood samples (N = 295) were obtained from different locations in Amazonas and Sucre States, in Venezuela. Malaria was diagnosed by microscopy, OptiMAL™ and polymerase chain reaction (PCR), with Plasmodium vivax, P. falciparum, and P. malariae being detected when possible. We identified 93 infections, 66 of which were caused by P. vivax, 26 by P. falciparum, and 1 was a mixed infection. No infection caused by P. malariae was detected. The sensitivity and specificity of each diagnostic method were high: 95.7 and 97.9% for microscopy, 87.0 and 97.9% for OptiMAL, and 98.0 and 100% for PCR, respectively. Most samples (72.2%) showed more than 5000 parasites/µL blood. The sensitivity of the diagnosis by microscopy and OptiMAL decreased with lower parasitemia. All samples showing disagreement among the methods were reevaluated, but the first result was used for the calculations. Parasites were detected in the 6 false-negative samples by microscopy after the second examination. The mixed infection was only detected by PCR, while the other methods diagnosed it as P. falciparum (microscopy) or P. vivax (OptiMAL) infection. Most of the false results obtained with the OptiMAL strip were related to the P. falciparum-specific band, including 3 species misdiagnoses, which could be related to the test itself or to genetic variation of the Venezuelan strains. The use of the microscopic method for malaria detection is recommended for its low cost but is very difficult to implement in large scale, population-based studies; thus, we report here more efficient methods suitable for this purpose.
Resumo:
Allogeneic hematopoietic stem cell transplantation (AHSCT) is the treatment of choice for young patients with severe aplastic anemia (SAA). The association of antithymocyte globulin (ATG) and cyclophosphamide (CY) is the most frequently used conditioning regimen for this disease. We performed this retrospective study in order to compare the outcomes of HLA-matched sibling donor AHSCT in 41 patients with SAA receiving cyclophosphamide plus ATG (ATG-CY, N = 17) or cyclophosphamide plus busulfan (BU-CY, N = 24). The substitution of BU for ATG was motivated by the high cost of ATG. There were no differences in the clinical features between the two groups, including age, gender, cytomegalovirus status, ABO match, interval between diagnosis and transplant, and number of total nucleated cells infused. No differences were observed in the time to neutrophil and platelet engraftment, or in the risk of veno-occlusive disease and hemorrhage. However, there was a higher risk of mucositis in the BU-CY group (71 vs 24%, P = 0.004). There were no differences in the incidence of neutrophil and platelet engraftment, acute and chronic graft-versus-host disease, and transplant-related mortality. There was a higher incidence of late rejection in the ATG-CY group (41 vs 4%, P = 0.009). Although the ATG-CY group had a longer follow-up (101 months) than the BU-CY group (67 months, P = 0.04), overall survival was similar between the groups (69 vs 58%, respectively, P = 0.32). We conclude that the association BU-CY is a feasible option to the conventional ATG-CY regimen in this population.
Resumo:
In this paper, we provide both qualitative and quantitative measures of the cost of measuring the integrated volatility by the realized volatility when the frequency of observation is fixed. We start by characterizing for a general diffusion the difference between the realized and the integrated volatilities for a given frequency of observations. Then, we compute the mean and variance of this noise and the correlation between the noise and the integrated volatility in the Eigenfunction Stochastic Volatility model of Meddahi (2001a). This model has, as special examples, log-normal, affine, and GARCH diffusion models. Using some previous empirical works, we show that the standard deviation of the noise is not negligible with respect to the mean and the standard deviation of the integrated volatility, even if one considers returns at five minutes. We also propose a simple approach to capture the information about the integrated volatility contained in the returns through the leverage effect.
Resumo:
With the great advancement of computer technologies, electronic information starts to play a more and more important role in modern business transactions. Therefore, electronic data, such as e-mail, is frequently required in the process of litigation. Companies, on the one hand, have the legal obligations to produce this kind of e-mail evidence. On the other hand, they also undertake a high cost of e-mail evidence preservation due to the great volume on a daily basis. This Article firstly analyzed features of e-mail evidence with the comparison of paper evidence. Then, it discussed about how e-mail is authenticated and admitted into evidence. By using the case laws in different legal aspects and current Canadian legislations, the Author demonstrated the importance of e-mail evidence preservation in ordinary business course. After that, the Article focused on the practical dilemma of the companies between their legal obligation and the expensive cost to preserve e-mail evidence. Finally, the Author proposed suggestions to both companies and courts on how to coordinate the obligation and cost. More specifically, while companies should adopt a document management policy to implement e-mail evidence preservation, courts need to take into consideration of the high cost of e-mail evidence preservation in electronic discovery.
Resumo:
Introduction : La force d’adhésion à l'interface métal-céramique avec les résines auto-polymérisantes destinées au collage indirect des boîtiers orthodontiques n'a pas été évaluée à ce jour et un protocole clinique basé sur la littérature scientifique est inexistant. Objectifs : 1) Comparer la force de cisaillement maximale entre des boîtiers métalliques et des surfaces en porcelaine préparées selon différentes méthodes; 2) Suggérer un protocole clinique efficace et prévisible. Matériel et méthodes : Quatre-vingt-dix disques en leucite (6 groupes; n = 15/groupe) ont été préparés selon 6 combinaisons de traitements de surface : mécaniques (+ / - fraisage pour créer les rugosités) et chimiques (acide fluorhydrique, apprêt, silane). Des bases en résine composite Transbond XT (3M Unitek, Monrovia, California) faites sur mesure ont été collées avec le système de résine adhésive auto-polymérisante Sondhi A + B Rapid Set (3M Unitek, Monrovia, California). Les échantillons ont été préservés (H2O/24hrs), thermocyclés (500 cycles) et testés en cisaillement (Instron, Norwood, Massachusetts). Des mesures d’Index d’adhésif résiduel (IAR) ont été compilées. Des tests ANOVAs ont été réalisés sur les rangs étant donné que les données suivaient une distribution anormale et ont été ajustés selon Tukey. Un Kruskall-Wallis, U-Mann Whitney par comparaison pairée et une analyse de Weibull ont aussi été réalisés. Résultats : Les médianes des groupes varient entre 17.0 MPa (- fraisage + acide fluorhydrique) à 26.7 MPa (- fraisage + acide fluorhydrique + silane). Le fraisage en surface ne semble pas affecter l’adhésion. La combinaison chimique (- fraisage + silane + apprêt) a démontré des forces de cisaillement significativement plus élevées que le traitement avec (- fraisage + acide fluorhydrique), p<0,05, tout en possédant des forces similaires au protocole typiquement suggéré à l’acide fluorhydrique suivi d’une application de silane, l’équivalence de (- fraisage + acide fluorhydrique + silane). Les mesures d’IAR sont significativement plus basses dans le groupe (- fraisage + acide fluorhydrique) en comparaison avec celles des 5 autres groupes, avec p<0,05. Malheureusement, ces 5 groupes ont des taux de fracture élévés de 80 à 100% suite à la décimentation des boîtiers. Conclusion : Toutes les combinaisons de traitement de surface testées offrent une force d’adhésion cliniquement suffisante pour accomplir les mouvements dentaires en orthodontie. Une application de silane suivie d’un apprêt est forte intéressante, car elle est simple à appliquer cliniquement tout en permettant une excellente adhésion. Il faut cependant avertir les patients qu’il y a un risque de fracture des restorations en céramique lorsque vient le moment d’enlever les broches. Si la priorité est de diminuer le risque d’endommager la porcelaine, un mordançage seul à l’acide hydrofluorique sera suffisant.
Resumo:
Wavelength division multiplexing (WDM) networks have been adopted as a near-future solution for the broadband Internet. In previous work we proposed a new architecture, named enhanced grooming (G+), that extends the capabilities of traditional optical routes (lightpaths). In this paper, we compare the operational expenditures incurred by routing a set of demands using lightpaths with that of lighttours. The comparison is done by solving an integer linear programming (ILP) problem based on a path formulation. Results show that, under the assumption of single-hop routing, almost 15% of the operational cost can be reduced with our architecture. In multi-hop routing the operation cost is reduced in 7.1% and at the same time the ratio of operational cost to number of optical-electro-optical conversions is reduced for our architecture. This means that ISPs could provide the same satisfaction in terms of delay to the end-user with a lower investment in the network architecture
Resumo:
In an attempt to focus clients' minds on the importance of considering the construction and maintenance costs of a commercial office building (both as a factor in staff productivity and as a fraction of lifetime staff costs) there is an often-quoted ratio of costs of 1:5:200, where for every one pound spent on construction cost, five are spent on maintenance and building operating costs and 200 on staffing and business operating costs. This seems to stem from a paper published by the Royal Academy of Engineering, in which no data is given and no derivation or defence of the ratio appears. The accompanying belief that higher quality design and construction increases staff productivity, and simultaneously reduces maintenance costs, how ever laudable, appears unsupported by research, and carries all the hallmarks of an "urban myth". In tracking down data about real buildings, a more realistic ratio appears to depend on a huge variety of variables, as well as the definition of the number of "lifetime" years. The ill-defined origins of the original ratio (1:5:200) describing these variables have made replication impossible. However, by using published sources of data, we have found that for three office buildings, a more realistic ratio is 1:0.4:12. As there is nothing in the public domain about what comprised the original research that gave rise to 1:5:200, it is not possible to make a true comparison between these new calculations and the originals. Clients and construction professionals stand to be misled because the popularity and widespread use of the wrong ratio appears to be mis-informing important investment and policy decisions.
Resumo:
Berberine has been shown to have hypoglycaemic activity in several in vitro and in vivo models, although the mechanism of action is not fully known. Berberis lyceum Royle root produces high concentrations of berberine, and in traditional medicine, the whole extract of this plant is used widely to treat diabetes. The antidiabetic activity of the ethanol root extract of Berberis lyceum was compared with pure berberine in normal and alloxan-diabetic rats using similar doses of each. The concentration of berberine in the extract was determined to be 80% dry weight with only trace amounts of other alkaloids present. The purpose of the study was to investigate the effects of berberine and a whole extract of Berberis lyceum on blood glucose and other parameters associated with diabetes, to compare the effects of the crude extract with those of pure berberine and thus validate its use as a therapeutic agent, and finally to identify any contribution of the other components of the extract to these effects. Oral administration of 50 mg/kg of Berberis extract and berberine to normal and experimental diabetic rats produced a significant (p < 0.05) reduction in blood glucose levels from days 3-7 days of treatment. Significant effects were also observed on the glucose tolerance, glycosylated haemoglobin, serum lipid profiles and body weight of experimental animals. Berberis extract and berberine demonstrated similar effects on all parameters measured, and although the extract was comparable in efficacy to berberine, it did not produce any effects additional to those shown by pure berberine. The results support the use of the extract in traditional medicine, and demonstrate that apart from being a highly cost-effective means of treating with berberine, the total extract does not appear to confer any additional benefits or disadvantages compared with the pure compound. Copyright (c) 2008 John Wiley & Sons, Ltd.
Resumo:
Sensitive methods that are currently used to monitor proteolysis by plasmin in milk are limited due to 7 their high cost and lack of standardisation for quality assurance in the various dairy laboratories. In 8 this study, four methods, trinitrobenzene sulphonic acid (TNBS), reverse phase high pressure liquid 9 chromatography (RP-HPLC), gel electrophoresis and fluorescamine, were selected to assess their 10 suitability for the detection of proteolysis in milk by plasmin. Commercial UHT milk was incubated 11 with plasmin at 37 °C for one week. Clarification was achieved by isoelectric precipitation (pH 4·6 12 soluble extracts)or 6% (final concentration) trichloroacetic acid (TCA). The pH 4·6 and 6% TCA 13 soluble extracts of milk showed high correlations (R2 > 0·93) by the TNBS, fluorescamine and 14 RP-HPLC methods, confirming increased proteolysis during storage. For gel electrophoresis,15 extensive proteolysis was confirmed by the disappearance of α- and β-casein bands on the seventh 16 day, which was more evident in the highest plasmin concentration. This was accompanied by the 17 appearance of α- and β-casein proteolysis products with higher intensities than on previous days, 18 implying that more products had been formed as a result of casein breakdown. The fluorescamine 19 method had a lower detection limit compared with the other methods, whereas gel electrophoresis 20 was the best qualitative method for monitoring β-casein proteolysis products. Although HPLC was the 21 most sensitive, the TNBS method is recommended for use in routine laboratory analysis on the basis 22 of its accuracy, reliability and simplicity.
Resumo:
Background: Medication errors in general practice are an important source of potentially preventable morbidity and mortality. Building on previous descriptive, qualitative and pilot work, we sought to investigate the effectiveness, cost-effectiveness and likely generalisability of a complex pharm acist-led IT-based intervention aiming to improve prescribing safety in general practice. Objectives: We sought to: • Test the hypothesis that a pharmacist-led IT-based complex intervention using educational outreach and practical support is more effective than simple feedback in reducing the proportion of patients at risk from errors in prescribing and medicines management in general practice. • Conduct an economic evaluation of the cost per error avoided, from the perspective of the National Health Service (NHS). • Analyse data recorded by pharmacists, summarising the proportions of patients judged to be at clinical risk, the actions recommended by pharmacists, and actions completed in the practices. • Explore the views and experiences of healthcare professionals and NHS managers concerning the intervention; investigate potential explanations for the observed effects, and inform decisions on the future roll-out of the pharmacist-led intervention • Examine secular trends in the outcome measures of interest allowing for informal comparison between trial practices and practices that did not participate in the trial contributing to the QRESEARCH database. Methods Two-arm cluster randomised controlled trial of 72 English general practices with embedded economic analysis and longitudinal descriptive and qualitative analysis. Informal comparison of the trial findings with a national descriptive study investigating secular trends undertaken using data from practices contributing to the QRESEARCH database. The main outcomes of interest were prescribing errors and medication monitoring errors at six- and 12-months following the intervention. Results: Participants in the pharmacist intervention arm practices were significantly less likely to have been prescribed a non-selective NSAID without a proton pump inhibitor (PPI) if they had a history of peptic ulcer (OR 0.58, 95%CI 0.38, 0.89), to have been prescribed a beta-blocker if they had asthma (OR 0.73, 95% CI 0.58, 0.91) or (in those aged 75 years and older) to have been prescribed an ACE inhibitor or diuretic without a measurement of urea and electrolytes in the last 15 months (OR 0.51, 95% CI 0.34, 0.78). The economic analysis suggests that the PINCER pharmacist intervention has 95% probability of being cost effective if the decision-maker’s ceiling willingness to pay reaches £75 (6 months) or £85 (12 months) per error avoided. The intervention addressed an issue that was important to professionals and their teams and was delivered in a way that was acceptable to practices with minimum disruption of normal work processes. Comparison of the trial findings with changes seen in QRESEARCH practices indicated that any reductions achieved in the simple feedback arm were likely, in the main, to have been related to secular trends rather than the intervention. Conclusions Compared with simple feedback, the pharmacist-led intervention resulted in reductions in proportions of patients at risk of prescribing and monitoring errors for the primary outcome measures and the composite secondary outcome measures at six-months and (with the exception of the NSAID/peptic ulcer outcome measure) 12-months post-intervention. The intervention is acceptable to pharmacists and practices, and is likely to be seen as costeffective by decision makers.
Resumo:
Khartoum like many cities in least developing countries (LDCs) still witnesses huge influx of people. Accommodation of the new comers leads to encroachment on the cultivation land leads to sprawl expansion of Greater Khartoum. The city expanded in diameter from 16.8 km in 1955 to 802.5 km in 1998. Most of this horizontal expansion was residential. In 2008 Khartoum accommodated 29% of the urban population of Sudan. Today Khartoum is considered as one of 43 major cities in Africa that accommodates more than 1 million inhabitants. Most of new comers live in the outskirts of the city e.g. Dar El-Salam and Mayo neighbourhoods. The majority of those new comers built their houses especially the walls from mud, wood, straw and sacks. Selection of building materials usually depends on its price regardless of the environmental impact, quality, thermal performance and life of the material. Most of the time, this results in increasing the cost with variables of impacts over the environment during the life of the building. Therefore, consideration of the environmental impacts, social impacts and economic impacts is crucial in the selection of any building material. Decreasing such impacts could lead to more sustainable housing. Comparing the sustainability of the available wall building materials for low cost housing in Khartoum is carried out through the life cycle assessment (LCA) technique. The purpose of this paper is to compare the most available local building materials for walls for the urban poor of Khartoum from a sustainability point of view by going through the manufacturing of the materials, the use of these materials and then the disposal of the materials after their life comes to an end. Findings reveal that traditional red bricks couldn’t be considered as a sustainable wall building material that will draw the future of the low cost housing in Greater Khartoum. On the other hand, results of the comparison lead to draw attention to the wide range of the soil techniques and to its potentials to be a promising sustainable wall material for urban low cost housing in Khartoum.
Resumo:
Health monitoring technologies such as Body Area Network (BAN) systems has gathered a lot of attention during the past few years. Largely encouraged by the rapid increase in the cost of healthcare services and driven by the latest technological advances in Micro-Electro-Mechanical Systems (MEMS) and wireless communications. BAN technology comprises of a network of body worn or implanted sensors that continuously capture and measure the vital parameters such as heart rate, blood pressure, glucose levels and movement. The collected data must be transferred to a local base station in order to be further processed. Thus, wireless connectivity plays a vital role in such systems. However, wireless connectivity comes at a cost of increased power usage, mainly due to the high energy consumption during data transmission. Unfortunately, battery-operated devices are unable to operate for ultra-long duration of time and are expected to be recharged or replaced once they run out of energy. This is not a simple task especially in the case of implanted devices such as pacemakers. Therefore, prolonging the network lifetime in BAN systems is one of the greatest challenges. In order to achieve this goal, BAN systems take advantage of low-power in-body and on-body/off-body wireless communication technologies. This paper compares some of the existing and emerging low-power communication protocols that can potentially be employed to support the rapid development and deployment of BAN systems.
Resumo:
In this thesis the solar part of a large grid-connected photovoltaic system design has been done. The main purpose was to size and optimize the system and to present figures helping to evaluate the prospective project rationality, which can potentially be constructed on a contaminated area in Falun. The methodology consisted in PV market study and component selection, site analysis and defining suitable area for solar installation; and system configuration optimization based on PVsyst simulations and Levelized Cost of Energy calculations. The procedure was mainly divided on two parts, preliminary and detailed sizing. In the first part the objective was complex, which included the investigation of the most profitable component combination and system optimization due to tilt and row distance. It was done by simulating systems with different components and orientations, which were sized for the same 100kW inverter in order to make a fair comparison. For each simulated result a simplified LCOE calculation procedure was applied. The main results of this part show that with the price of 0.43 €/Wp thin-film modules were the most cost effective solution for the case with a great advantage over crystalline type in terms of financial attractiveness. From the results of the preliminary study it was possible to select the optimal system configuration, which was used in the detailed sizing as a starting point. In this part the PVsyst simulations were run, which included full scale system design considering near shadings created by factory buildings. Additionally, more complex procedure of LCOE calculation has been used here considered insurances, maintenance, time value of money and possible cost reduction due to the system size. Two system options were proposed in final results; both cover the same area of 66000 m2. The first one represents an ordinary South faced design with 1.1 MW nominal power, which was optimized for the highest performance. According to PVsyst simulations, this system should produce 1108 MWh/year with the initial investment of 835,000 € and 0.056 €/kWh LCOE. The second option has an alternative East-West orientation, which allows to cover 80% of occupied ground and consequently have 6.6 MW PV nominal power. The system produces 5388 MWh/year costs about 4500,000 € and delivers electricity with the same price of 0.056 €/kWh. Even though the EW solution has 20% lower specific energy production, it benefits mainly from lower relative costs for inverters, mounting and annual maintenance expenses. After analyzing the performance results, among the two alternatives none of the systems showed a clear superiority so there was no optimal system proposed. Both, South and East-West solutions have own advantages and disadvantages in terms of energy production profile, configuration, installation and maintenance. Furthermore, the uncertainty due to cost figures assumptions restricted the results veracity.