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Hiremath, Mitavachan, Peter Viebahn, and Sascha Samadi. "An Integrated Comparative Assessment of Coal-Based Carbon Capture and Storage (CCS) Vis-à-Vis Renewable Energies in India’s Low Carbon Electricity Transition Scenarios." Energies 14, no. 2 (January 6, 2021): 262. http://dx.doi.org/10.3390/en14020262.
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Roadmaps for India’s energy future foresee that coal power will continue to play a considerable role until the middle of the 21st century. Among other options, carbon capture and storage (CCS) is being considered as a potential technology for decarbonising the power sector. Consequently, it is important to quantify the relative benefits and trade-offs of coal-CCS in comparison to its competing renewable power sources from multiple sustainability perspectives. In this paper, we assess coal-CCS pathways in India up to 2050 and compare coal-CCS with conventional coal, solar PV and wind power sources through an integrated assessment approach coupled with a nexus perspective (energy-cost-climate-water nexus). Our levelized costs assessment reveals that coal-CCS is expensive and significant cost reductions would be needed for CCS to compete in the Indian power market. In addition, although carbon pricing could make coal-CCS competitive in relation to conventional coal power plants, it cannot influence the lack of competitiveness of coal-CCS with respect to renewables. From a climate perspective, CCS can significantly reduce the life cycle GHG emissions of conventional coal power plants, but renewables are better positioned than coal-CCS if the goal is ambitious climate change mitigation. Our water footprint assessment reveals that coal-CCS consumes an enormous volume of water resources in comparison to conventional coal and, in particular, to renewables. To conclude, our findings highlight that coal-CCS not only suffers from typical new technology development related challenges—such as a lack of technical potential assessments and necessary support infrastructure, and high costs—but also from severe resource constraints (especially water) in an era of global warming and the competition from outperforming renewable power sources. Our study, therefore, adds a considerable level of techno-economic and environmental nexus specificity to the current debate about coal-based large-scale CCS and the low carbon energy transition in emerging and developing economies in the Global South.
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Li, Jiaquan, Yunbing Hou, Pengtao Wang, and Bo Yang. "A Review of Carbon Capture and Storage Project Investment and Operational Decision-Making Based on Bibliometrics." Energies 12, no. 1 (December 21, 2018): 23. http://dx.doi.org/10.3390/en12010023.
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The research on carbon capture and storage (CCS) project planning and investment and operational decision-making can provide a reference for enterprises to invest in CCS and for policy-makers to formulate policies to promote CCS development. So what are the current research hotspots in this field and the gaps that still need to be further studied in the future? This paper reviews the research in the field by a bibliometric analysis. The results show that the research in this field first focus on cost analysis, followed by project investment evaluation, project planning (cost curve and pipeline network), and project operation. In particular, fossil fuel power plants, pipeline transportation, and oil fields are the most crucial objects in the three technical links of CCS projects, respectively. Policies, carbon pricing, and uncertainty in cost and benefits are factors that are mainly discussed in this field. The methods used for CCS project planning are cost curve model and optimization model. The real option approach is suitable for the evaluation of investment decision-making. The evaluation of operational decision is mostly based on optimization model. The future research directions can be summarized as five points: (1) continuously and systematically update the calculated costs in the current research to the unified price of the latest year; (2) calculate the cost curve from the perspective of emission sources; (3) expand the planning region of pipeline network to the country, continent, and even the entire world; (4) pay more attention to the investment assessment of the CCS project that may be implemented with low cost and high return; and (5) analyze the optimal operation mode of CCS in the low-load power system.
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Szima, Szabolcs, Carlos Arnaiz del Pozo, Schalk Cloete, Szabolcs Fogarasi, Ángel Jiménez Álvaro, Ana-Maria Cormos, Calin-Cristian Cormos, and Shahriar Amini. "Techno-Economic Assessment of IGCC Power Plants Using Gas Switching Technology to Minimize the Energy Penalty of CO2 Capture." Clean Technologies 3, no. 3 (August 10, 2021): 594–617. http://dx.doi.org/10.3390/cleantechnol3030036.
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Cost-effective CO2 capture and storage (CCS) is critical for the rapid global decarbonization effort recommended by climate science. The increase in levelized cost of electricity (LCOE) of plants with CCS is primarily associated to the large energy penalty involved in CO2 capture. This study therefore evaluates three high-efficiency CCS concepts based on integrated gasification combined cycles (IGCC): (1) gas switching combustion (GSC), (2) GSC with added natural gas firing (GSC-AF) to increase the turbine inlet temperature, and (3) oxygen production pre-combustion (OPPC) that replaces the air separation unit (ASU) with more efficient gas switching oxygen production (GSOP) reactors. Relative to a supercritical pulverized coal benchmark, these options returned CO2 avoidance costs of 37.8, 22.4 and 37.5 €/ton (including CO2 transport and storage), respectively. Thus, despite the higher fuel cost and emissions associated with added natural gas firing, the GSC-AF configuration emerged as the most promising solution. This advantage is maintained even at CO2 prices of 100 €/ton, after which hydrogen firing can be used to avoid further CO2 cost escalations. The GSC-AF case also shows lower sensitivity to uncertain economic parameters such as discount rate and capacity factor, outperforms other clean energy benchmarks, offers flexibility benefits for balancing wind and solar power, and can achieve significant further performance gains from the use of more advanced gas turbine technology. Based on all these insights, the GSC-AF configuration is identified as a promising solution for further development.
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Slavu, Nela, and Cristian Dinca. "Economical aspects of the CCS technology integration in the conventional power plant." Proceedings of the International Conference on Business Excellence 11, no. 1 (July 1, 2017): 168–80. http://dx.doi.org/10.1515/picbe-2017-0018.
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Abstract One of the way to reduce the greenhouses gases emissions generated by the fossil fuels combustion consists in the Carbon Capture, Transport and Storage (CCS) technologies utilization. The integration of CCS technologies in the coal fired power plants increases the cost of the energy generation. The CCS technology could be a feasible solution in the case of a high value of a CO2 certificate but for the present value an optimization of the CCS technology integration in the power plants is expected. However, for reducing the cost of the energy generated in the case of CCS integration in the power plants, a parametrical study optimization of the CO2 capture process is required. In this study, the chemical absorption process was used and the monoethanolamine with 30 wt. %. The objective of this paper is to analyze the effects of the package type used in the absorption column on the size of the equipment used and, on the energy cost of the power plant with CO2 capture process consequently. The packages types analyzed in this paper are metal Pall rings with different sizes and the rings are made of different metals: aluminum, nickel, cooper, and brass. In the case of metal Pall rings, the utilization of different material has an impact on the absorption column weight. Also, Pall rings made of plastics (polypropylene and polyethylene) were analyzed. The comparative assessment was achieved for a coal fired power plant with an installed power of 100 MW and considering the CO2 capture process efficiency of 90 %.
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Hooper, B., B. Koppe, and L. Murray. "COMMERCIAL AND TECHNICAL ISSUES FOR LARGE-SCALE CARBON CAPTURE AND STORAGE PROJECTS—A GIPPSLAND BASIN STUDY." APPEA Journal 46, no. 1 (2006): 435. http://dx.doi.org/10.1071/aj05025.
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The Latrobe Valley in Victoria’s Gippsland Basin is the location of one of Australia’s most important energy resources—extremely thick, shallow brown coal seams constituting total useable reserves of more than 50,000 million tonnes. Brown coal has a higher moisture content than black coal and generates more CO2 emissions per unit of useful energy when combusted. Consequently, while the Latrobe Valley’s power stations provide Australia’s lowest- cost bulk electricity, they are also responsible for over 60 million tonnes of CO2 emissions per year—over half of the Victorian total. In an increasingly carbon constrained world the ongoing development of the Latrobe Valley brown coal resource is likely to require a drastic reduction in the CO2 emissions from new coal use projects—and carbon capture and storage (CCS) has the potential to meet such deep cuts. The offshore Gippsland Basin, the site of major producing oil and gas fields, has the essential geological characteristics to provide a high-volume, low-cost site for CCS. The importance of this potential to assist the continuing use of the nation’s lowest-cost energy source prompted the Australian Government to fund the Latrobe Valley CO2 Storage Assessment (LVCSA).The LVCSA proposal was initiated by Monash Energy (formerly APEL, and now a 100% subsidiary of Anglo American)—the proponent of a major brown coal-to-liquids plant in the Latrobe Valley. Monash Energy’s plans for the 60,000 BBL per day plant include CCS to store about 13 million tonnes of CO2 per year. The LVCSA, undertaken for Monash Energy by the Cooperative Research Centre for Greenhouse Gas Technologies (CO2CRC), provides a medium to high-level technical and economic characterisation of the volume and cost potential for secure geosequestration of CO2 produced by the use of Latrobe Valley brown coal (Hooper et al, 2005a). The assessment’s scope includes consideration of the interaction between CO2 injection and oil and gas production, and its findings have been publicly released for use by CCS proponents, oil and gas producers and all other interested parties as an executive summary, (Hooper et al, 2005b), a fact sheet (Hooper et al, 2005c) and a presentation (Hooper et al, 2005d)).The LVCSA identifies the key issues and challenges for implementing CCS in the Latrobe Valley and provides a reference framework for the engagement of stakeholders. In effect the LVCSA constitutes a pre-feasibility study for the implementation of geosequestration in support of the continuing development of Victoria’s brown coal resources.The LVCSA findings indicate that the Gippsland Basin has sufficient capacity to safely and securely store large volumes of CO2 and may provide a viable means of substantially reducing greenhouse gas emissions from coal-fired power plants and other projects using brown coal in the Latrobe Valley. The assessment also indicates that CO2 injection could well be designed to avoid any adverse impact on adjacent oil and gas production, so that CO2 injection can begin near fields that have not yet come to the end of their productive lives. However, CCS proposals involving adjacent injection and production will require more detailed risk management strategies and continuing cooperation between prospective injectors and existing producers.
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Payton, Ryan L., Mark Fellgett, Brett L. Clark, Domenico Chiarella, Andrew Kingdon, and Saswata Hier-Majumder. "Pore-scale assessment of subsurface carbon storage potential: implications for the UK Geoenergy Observatories project." Petroleum Geoscience 27, no. 2 (January 13, 2021): petgeo2020–092. http://dx.doi.org/10.1144/petgeo2020-092.
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The growing importance of subsurface carbon storage for tackling anthropogenic carbon emissions requires new ideas to improve the rate and cost of carbon capture and storage (CCS) project development and implementation. We assessed sandstones from the UK Geoenergy Observatories (UKGEOS) site in Glasgow, UK and the Wilmslow Sandstone Formation (WSF) in Cumbria, UK at the pore scale to indicate suitability for further assessment as CCS reservoirs. We measured porosity, permeability and other pore geometry characteristics using digital rock physics techniques on microcomputed tomographic images of core material from each site. We found the Glasgow material to be unsuitable for CCS due to very low porosity (up to 1.65%), whereas the WSF material showed connected porosity up to 26.3% and permeabilities up to 6040 mD. Our results support the presence of a percolation threshold at 10% total porosity, introducing near full connectivity. We found total porosity varies with permeability with an exponent of 3.19. This provides a reason to assume near full connectivity in sedimentary samples showing porosities above this threshold without the need for expensive and time-consuming analyses.Supplementary material: Information about the boreholes sampled in this study, additional well logs of boreholes and a summary of the supporting data plotted throughout this article from literature are available at https://doi.org/10.6084/m9.figshare.c.5260074Thematic collection: This article is part of the Geoscience for CO2 storage collection available at: https://www.lyellcollection.org/cc/geoscience-for-co2-storage
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Cao, Cheng, Hejuan Liu, Zhengmeng Hou, Faisal Mehmood, Jianxing Liao, and Wentao Feng. "A Review of CO2 Storage in View of Safety and Cost-Effectiveness." Energies 13, no. 3 (January 29, 2020): 600. http://dx.doi.org/10.3390/en13030600.
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The emissions of greenhouse gases, especially CO2, have been identified as the main contributor for global warming and climate change. Carbon capture and storage (CCS) is considered to be the most promising strategy to mitigate the anthropogenic CO2 emissions. This review aims to provide the latest developments of CO2 storage from the perspective of improving safety and economics. The mechanisms and strategies of CO2 storage, focusing on their characteristics and current status, are discussed firstly. In the second section, the strategies for assessing and ensuring the security of CO2 storage operations, including the risks assessment approach and monitoring technology associated with CO2 storage, are outlined. In addition, the engineering methods to accelerate CO2 dissolution and mineral carbonation for fixing the mobile CO2 are also compared within the second section. The third part focuses on the strategies for improving economics of CO2 storage operations, namely enhanced industrial production with CO2 storage to generate additional profit, and co-injection of CO2 with impurities to reduce the cost. Moreover, the role of multiple CCS technologies and their distribution on the mitigation of CO2 emissions in the future are summarized. This review demonstrates that CO2 storage in depleted oil and gas reservoirs could play an important role in reducing CO2 emission in the near future and CO2 storage in saline aquifers may make the biggest contribution due to its huge storage capacity. Comparing the various available strategies, CO2-enhanced oil recovery (CO2-EOR) operations are supposed to play the most important role for CO2 mitigation in the next few years, followed by CO2-enhanced gas recovery (CO2-EGR). The direct mineralization of flue gas by coal fly ash and the pH swing mineralization would be the most promising technology for the mineral sequestration of CO2. Furthermore, by accelerating the deployment of CCS projects on large scale, the government can also play its role in reducing the CO2 emissions.
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Sanchez, Daniel L., Nils Johnson, Sean T. McCoy, Peter A. Turner, and Katharine J. Mach. "Near-term deployment of carbon capture and sequestration from biorefineries in the United States." Proceedings of the National Academy of Sciences 115, no. 19 (April 23, 2018): 4875–80. http://dx.doi.org/10.1073/pnas.1719695115.
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Capture and permanent geologic sequestration of biogenic CO2 emissions may provide critical flexibility in ambitious climate change mitigation. However, most bioenergy with carbon capture and sequestration (BECCS) technologies are technically immature or commercially unavailable. Here, we evaluate low-cost, commercially ready CO2 capture opportunities for existing ethanol biorefineries in the United States. The analysis combines process engineering, spatial optimization, and lifecycle assessment to consider the technical, economic, and institutional feasibility of near-term carbon capture and sequestration (CCS). Our modeling framework evaluates least cost source–sink relationships and aggregation opportunities for pipeline transport, which can cost-effectively transport small CO2 volumes to suitable sequestration sites; 216 existing US biorefineries emit 45 Mt CO2 annually from fermentation, of which 60% could be captured and compressed for pipeline transport for under $25/tCO2. A sequestration credit, analogous to existing CCS tax credits, of $60/tCO2 could incent 30 Mt of sequestration and 6,900 km of pipeline infrastructure across the United States. Similarly, a carbon abatement credit, analogous to existing tradeable CO2 credits, of $90/tCO2 can incent 38 Mt of abatement. Aggregation of CO2 sources enables cost-effective long-distance pipeline transport to distant sequestration sites. Financial incentives under the low-carbon fuel standard in California and recent revisions to existing federal tax credits suggest a substantial near-term opportunity to permanently sequester biogenic CO2. This financial opportunity could catalyze the growth of carbon capture, transport, and sequestration; improve the lifecycle impacts of conventional biofuels; support development of carbon-negative fuels; and help fulfill the mandates of low-carbon fuel policies across the United States.
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Pelitari, Stavroula, Charlotte Hathaway, Dean Gritton, Andrea Smith, David Bush, Shyam Menon, and Brian McKaig. "Impact and cost-effectiveness of formal gastroenterology outpatient referral Clinical Assessment Service." Frontline Gastroenterology 9, no. 2 (September 23, 2017): 159–65. http://dx.doi.org/10.1136/flgastro-2017-100853.
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ObjectiveThe aim was to assess the financial and operational impact of our new gastroenterology referral pathway model on our services.DesignAn electronic ‘Clinical Assessment Service’ (CAS) proforma and an information platform were developed, and all data were analysed retrospectively.SettingRoyal Wolverhampton NHS Trust.Patients14 245 general practitioner (GP) referrals were received during January 2014–December 2016 with 9773 of them being triaged via our CAS.Main outcome measuresWe looked into patients’ clinical outcome along with departmental performance and finances.ResultsA new outpatient appointment was offered to 60.1% (n=5873) of the CAS referred patients. Endoscopic or radiological investigations were requested for 29.2% (n=2854) of patients prior to deciding on further management plan. Out of those, 27% (n=765) went on to receive another gastroenterology (GI) clinic appointment. The remaining 21.3% (n=2089) of the CAS patients were discharged back to their GP following initial investigations. 5.5% (n=538) were discharged back to primary care with a letter of advice, whereas 5.2% (n=509) were deemed inappropriate for GI clinic and were redirected to other specialists. Overall, 32% (n=3127) of patients were managed without a face to face consultation in the GI clinic. This corresponds to 3136 less outpatient appointments with estimated reduced expenditure by the Clinical Commissioning Group (CCG) of £481K. The 18-week performance and waiting times remained stable despite the increasing referral population. The DNA rate dropped from 14% pre to 8.5%.ConclusionsOur clinical assessment model has, in addition to the clinical benefits, a considerable positive financial impact to the health economy.
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Adu, Emmanuel, Y. D. Zhang, Dehua Liu, and Paitoon Tontiwachwuthikul. "Parametric Process Design and Economic Analysis of Post-Combustion CO2 Capture and Compression for Coal- and Natural Gas-Fired Power Plants." Energies 13, no. 10 (May 15, 2020): 2519. http://dx.doi.org/10.3390/en13102519.
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For the envisaged large number of commercial-scale carbon capture and storage (CCS) projects that are to be implemented in the near future, a number of issues still need to be resolved, the most prominent being the large capital and operational costs incurred for the CO2 capture and compression process. An economic assessment of the capture and compression system based on optimal design data is important for CCS deployment. In this paper, the parametric process design approach is used to optimally design coal and natural gas monoethanolamine (MEA)-based post-combustion CO2 absorption–desorption capture (PCC) and compression plants that can be integrated into large-scale 550 MW coal-fired and 555 MW natural gas combined cycle (NGCC) power plants, respectively, for capturing CO2 from their flue gases. The study then comparatively assesses the energy performance and economic viabilities of both plants to ascertain their operational feasibilities and relative costs. The parametric processes are presented and discussed. The results indicate that, at 90% CO2 capture efficiency, for the coal PCC plant, with 13.5 mol.% CO2 in the inlet flue gas, at an optimum liquid/gas ratio of 2.87 kg/kg and CO2 lean loading of 0.2082 mol CO2/mol MEA, the CO2 avoidance cost is about $72/tCO2, and, for the NGCC PCC plant, with 4.04 mol.% CO2 in the inlet flue gas, at an optimum liquid/gas ratio of 0.98 kg/kg and CO2 lean loading of 0.2307 mol CO2/mol MEA, the CO2 avoidance cost is about $94/tCO2.
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Xu, Mao, Xian Zhang, Shuo Shen, Shijie Wei, and Jing-Li Fan. "Assessment of potential, cost, and environmental benefits of CCS-EWR technology for coal-fired power plants in Yellow River Basin of China." Journal of Environmental Management 292 (August 2021): 112717. http://dx.doi.org/10.1016/j.jenvman.2021.112717.
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Cinar, Yildiray, Peter R. Neal, William G. Allinson, and Jacques Sayers. "Geoengineering and Economic Assessment of a Potential Carbon Capture and Storage Site in Southeast Queensland, Australia." SPE Reservoir Evaluation & Engineering 12, no. 05 (October 27, 2009): 660–70. http://dx.doi.org/10.2118/108924-pa.
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Summary This paper presents geoengineering and economic sensitivity analyses and assessments of the Wunger Ridge flank carbon capture and storage (CCS) site. Both geoengineering and economics are needed to derive the number of wells required to inject a certain amount of CO2 for a given period. A numerical reservoir simulation examines injection rates ranging from 0.5 to 1.5 million tonnes of CO2 year for 25 years of injection. Primary factors affecting the ability to inject CO2 include permeability, formation fracture gradient, aquifer strength, and multiphase flow functions. Secondary factors include the solubility of CO2 in the formation brine, injection well location with respect to the flow barriers/low-permeability aquifers, model geometry including faults, grid size and refinement, and injection well type. Less significant factors include hydrodynamic effects. The economics are assessed using an internally developed technoeconomic model. The model optimizes the CO2 injection cost on the basis of geoengineering data and recent equipment costs. The overall costs depend on the initial costs of CO2 separation and source-to-sink distances and their associated pipeline costs. Secondary cost variations are highly dependent on fracture gradient, permeability, and CO2 injection rates. Depending on the injection characteristics, the specific cost of CO2 avoided is between AUS 62 and 80 per tonne. Introduction Australia's fossil-fuel fired power plants emit 194 million tonnes of CO2 each year (Mt CO2/yr), and approximately 26 Mt/yr of this comes from southeast Queensland. A multidisciplinary study has recently identified the onshore Bowen basin as having potential for geological storage of CO2 (Sayers et al. 2006a). In that paper, geological containment and injectivity and reservoir engineering simulation sensitivities showed that a target injection rate of 1.2 Mt CO2/yr over a 25-year project life span could be achieved (i.e., equivalent to injecting the emissions from a 400 MW gas based power station). This study further examines reservoir engineering and economics sensitivities.
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Zhang, Nian Mu, Fu Lai Luo, Lei Bi, and Lian Xing Hu. "Cost Risk Assessment for Large Hydropower Project Based on the Probability Distribution." Applied Mechanics and Materials 212-213 (October 2012): 1015–19. http://dx.doi.org/10.4028/www.scientific.net/amm.212-213.1015.
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Probability distribution is adopted to evaluate the cost risk of large hydropower project. Risk factors are firstly identified through Work Breakdown Structure(WBS), Cost Breakdown Structure(CBS) and Risk Breakdown Structure(RBS), and then individual risk factor probability distribution is measured by method combined Monte Carlo simulation model and the controlled interval memory (CIM) model. By superimposing individual ones, probability distribution of cost under the influence of a number of risk factors is achieved, which provides effective information for investment decision and cost control.
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Scouse, Adam A., Steven S. Kelley, Richard A. Venditti, and T. Eric McConnell. "Evaluating sustainable product alternatives by combining life cycle assessment with full-cost accounting: A highway guardrail case study." BioResources 15, no. 4 (October 16, 2020): 9103–27. http://dx.doi.org/10.15376/biores.15.4.9103-9127.
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Full-cost accounting techniques incorporate the environmental and societal burdens a product generates through its manufacture, use, and disposal into that product’s price. This research generates full-cost prices for functionally equivalent chromated copper arsenate (CCA) treated wood and galvanized steel guardrail posts by combining previously conducted life cycle inventory analyses results with secondary emission valuation data. Based on the analysis, both CCA-treated posts and galvanized steel posts have environmental damage costs associated with emissions generated through the product’s manufacturing, use, and disposal stages. After developing full-cost prices for product alternatives, CCA-treated wood guardrail posts were found to be a more economical and environmentally responsible alternative to galvanized steel. In addition to generating full-cost prices, this research uses Monte Carlo simulation to provide estimates of variability around CCA-treated wood and galvanized steel damage costs.
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Dong, Hengjin, and Martin Buxton. "Early assessment of the likely cost-effectiveness of a new technology: A Markov model with probabilistic sensitivity analysis of computer-assisted total knee replacement." International Journal of Technology Assessment in Health Care 22, no. 2 (March 28, 2006): 191–202. http://dx.doi.org/10.1017/s0266462306051014.
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Objectives:The objective of this study is to apply a Markov model to compare cost-effectiveness of total knee replacement (TKR) using computer-assisted surgery (CAS) with that of TKR using a conventional manual method in the absence of formal clinical trial evidence.Methods:A structured search was carried out to identify evidence relating to the clinical outcome, cost, and effectiveness of TKR. Nine Markov states were identified based on the progress of the disease after TKR. Effectiveness was expressed by quality-adjusted life years (QALYs). The simulation was carried out initially for 120 cycles of a month each, starting with 1,000 TKRs. A discount rate of 3.5 percent was used for both cost and effectiveness in the incremental cost-effectiveness analysis. Then, a probabilistic sensitivity analysis was carried out using a Monte Carlo approach with 10,000 iterations.Results:Computer-assisted TKR was a long-term cost-effective technology, but the QALYs gained were small. After the first 2 years, the incremental cost per QALY of computer-assisted TKR was dominant because of cheaper and more QALYs. The incremental cost-effectiveness ratio (ICER) was sensitive to the “effect of CAS,” to the CAS extra cost, and to the utility of the state “Normal health after primary TKR,” but it was not sensitive to utilities of other Markov states. Both probabilistic and deterministic analyses produced similar cumulative serious or minor complication rates and complex or simple revision rates. They also produced similar ICERs.Conclusions:Compared with conventional TKR, computer-assisted TKR is a cost-saving technology in the long-term and may offer small additional QALYs. The “effect of CAS” is to reduce revision rates and complications through more accurate and precise alignment, and although the conclusions from the model, even when allowing for a full probabilistic analysis of uncertainty, are clear, the “effect of CAS” on the rate of revisions awaits long-term clinical evidence.
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Schrefler, Lorna, Giacomo Luchetta, and Felice Simonelli. "A New Tool in the Box?" European Journal of Risk Regulation 6, no. 1 (March 2015): 68–78. http://dx.doi.org/10.1017/s1867299x00004293.
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The year 2013 has witnessed a new entry in the EU “better regulation” toolbox: the Cumulated Cost Assessment (CCA). The CCA is set to answer an apparently simple question: what is the cumulative cost imposed by a selection of EU rules and policies on a given economic sector? In this contribution we present the CCA methodology and its building blocks, as well as the results of the first two empirical applications of this tool. More importantly, we elaborate on two key features that make the CCA a valuable addition to the better regulation toolbox: it creates a methodological bridge between the policy and competitiveness assessment instruments, and it clarifies empirically how a wide array of policies interact with one another when and after they are actually implemented, an element that is often a weak link in policy–appraisal. We conclude with some remarks on how the CCA opens the avenue for a set of challenging and interesting methodological and policy considerations.
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Xu, Bing, and Qinling Zeng. "Research on the Whole Process Cost Risk Evaluation Index System of Real Estate Park." E3S Web of Conferences 233 (2021): 03060. http://dx.doi.org/10.1051/e3sconf/202123303060.
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The development focus of real estate enterprises has shifted from traditional buildings to industrial park construction. After summarizing and analyzing the risk factors of the traditional construction cost, the WBS-CBS-RBS method is used to classify and identify the whole process cost of the industrial park. Finally, eight first level evaluation indexes and 37 second level evaluation indexes are established to form the whole process cost risk evaluation index system of the industrial park construction, which provides the basis for the whole process cost risk assessment of the subsequent industrial park construction.
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Cannone, Salvatore F., Andrea Lanzini, and Massimo Santarelli. "A Review on CO2 Capture Technologies with Focus on CO2-Enhanced Methane Recovery from Hydrates." Energies 14, no. 2 (January 12, 2021): 387. http://dx.doi.org/10.3390/en14020387.
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Natural gas is considered a helpful transition fuel in order to reduce the greenhouse gas emissions of other conventional power plants burning coal or liquid fossil fuels. Natural Gas Hydrates (NGHs) constitute the largest reservoir of natural gas in the world. Methane contained within the crystalline structure can be replaced by carbon dioxide to enhance gas recovery from hydrates. This technical review presents a techno-economic analysis of the full pathway, which begins with the capture of CO2 from power and process industries and ends with its transportation to a geological sequestration site consisting of clathrate hydrates. Since extracted methane is still rich in CO2, on-site separation is required. Focus is thus placed on membrane-based gas separation technologies widely used for gas purification and CO2 removal from raw natural gas and exhaust gas. Nevertheless, the other carbon capture processes (i.e., oxy-fuel combustion, pre-combustion and post-combustion) are briefly discussed and their carbon capture costs are compared with membrane separation technology. Since a large-scale Carbon Capture and Storage (CCS) facility requires CO2 transportation and storage infrastructure, a technical, cost and safety assessment of CO2 transportation over long distances is carried out. Finally, this paper provides an overview of the storage solutions developed around the world, principally studying the geological NGH formation for CO2 sinks.
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Staiger, Roxane D., Matteo Cimino, Ammar Javed, Sebastiano Biondo, Constantino Fondevila, Julie Périnel, Ana Carolina Aragão, et al. "The Comprehensive Complication Index (CCI®) is a Novel Cost Assessment Tool for Surgical Procedures." Annals of Surgery 268, no. 5 (November 2018): 784–91. http://dx.doi.org/10.1097/sla.0000000000002902.
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Ćmielewski, Kazimierz, Krzysztof Karsznia, Janusz Kuchmister, Piotr Gołuch, and Izabela Wilczyńska. "Accuracy and functional assessment of an original low-cost fibre-based inclinometer designed for structural monitoring." Open Geosciences 12, no. 1 (October 17, 2020): 1052–59. http://dx.doi.org/10.1515/geo-2020-0171.
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AbstractSafe exploitation of a building requires constant monitoring of both the object itself as well as its surrounding through the monitoring system. These tasks find particular applications when operating large construction projects, especially in urbanised areas. Besides the warning function and undertaking reactions, the monitoring system allows for recording changes in object geometries to assess their stability. To conduct monitoring, various sensors and instruments that work within the applied measuring systems can be used. As an example, one can mention precise inclinometers (‘electronic bubbles’) allowing for accurate determination of inclination angles. The paper discusses the precision and functional aspect of the original inclinometer developed and improved by the authors. The working principle of the device is based on optical fibres, light projection and its detection on a CCD camera objective. The presented issue is a low-cost solution offering high measurement accuracy, which may be used in structural monitoring of objects located in the impact zone of a deep excavation or other nearby ongoing investments.
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Tolley, Keith, Brenda Leese, Ken Wright, Sue Hennessy, Corinne Rowley, Janet Stowe, and Ann Chamberlain. "Communication AIDS for the Speech Impaired: Cost and Quality-of-Life Outcomes of Assessment Programs Provided by Speciaiist Communication Aids Centers in the United Kingdom." International Journal of Technology Assessment in Health Care 11, no. 2 (1995): 196–213. http://dx.doi.org/10.1017/s0266462300006838.
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AbstarctAn evaluation was conducted of the approaches, costs, and quality-of-life outcomes associated with communication aid assessment programs for the speech-impaired provided by specialist Communication Aids Centres (CACs) in the United Kingdom. The average costs of CAC assessment programs was £410 per client, which is not excessive. There was evidence of moderate quality-of-life benefits from clients' use of the recommended aids.
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Rachev, Boris T. "The economics of health service transformation." Clinical Governance: An International Journal 20, no. 3 (July 6, 2015): 113–22. http://dx.doi.org/10.1108/cgij-07-2015-0024.
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Purpose – This is a report on a recent development of an innovative coordinated care solution named the Care Coordination Centre (CCC), which targets coordinated care arrangements for a populations expected to benefit the most. The purpose of this paper is to identify the patients who might comprise this group, and to assess the best ways to meet their health, community, and social care needs before and after introducing the coordinated care solution across care settings. Design/methodology/approach – This is a summary of the author’s experience in the design and development of a care coordination business model for US providers and UK Clinical Commissioning Groups (CCGs) using coordinated care not only as a cost-cutting tool, but as a mechanism for creating a flexible and responsive patient-centered care. The author makes an assessment of the economic benefits of coordinated care resulting from: the shift to less costly interventions; reduction in readmissions; reduced unplanned admissions; increased time allocation efficiency of healthcare staff; and the overall reduction in per-patient costs. Findings – The health and social care systems in the USA and the UK are facing the biggest challenges in their history. Payers, providers, governments, and communities need to work to build better coordination and integration mechanisms to manage the increasing demand on health and social care in a period of stagnant health and social care budgets. New innovative models of coordinated care have been developed in both countries, at the local economy level, as the health service systems are undergoing crucial transformation from a supply to a demand-based model. In the UK, the Trafford CCG has commissioned a new CCC, responsible for the delivery of high-quality coordinated care. The CCC is designed to function at clinical, service, and community levels across multiple providers to cover, among other tasks, chronic condition patient case management, risk stratification of preventative, elective, and unscheduled care for the whole region. Originality/value – Insights from the work with Trafford CCG would be of considerable methodological and practical interest to researchers, policy makers, commissioners, healthcare professionals, and innovators.
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Qin, Li-Xuan, Jian Zou, Jiejun Shi, Ann Lee, Aleksandra Mihailovic, Thalia A. Farazi, Thomas Tuschl, and Samuel Singer. "Statistical Assessment of Depth Normalization for Small RNA Sequencing." JCO Clinical Cancer Informatics, no. 4 (September 2020): 567–82. http://dx.doi.org/10.1200/cci.19.00118.
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PURPOSE Methods for depth normalization have been assessed primarily with simulated data or cell-line–mixture data. There is a pressing need for benchmark data enabling a more realistic and objective assessment, especially in the context of small RNA sequencing. METHODS We collected a unique pair of microRNA sequencing data sets for the same set of tumor samples; one data set was collected with and the other without uniform handling and balanced design. The former provided a benchmark for evaluating evidence of differential expression and the latter served as a test bed for normalization. Next, we developed a data perturbation algorithm to simulate additional data set pairs. Last, we assembled a set of computational tools to visualize and quantify the assessment. RESULTS We validated the quality of the benchmark data and showed the need for normalization of the test data. For illustration, we applied the data and tools to assess the performance of 9 existing normalization methods. Among them, trimmed mean of M-values was a better scaling method, whereas the median and the upper quartiles were consistently the worst performers; one variation of remove unwanted variation had the best chance of capturing true positives but at the cost of increased false positives. In general, these methods were, at best, moderately helpful when the level of differential expression was extensive and asymmetric. CONCLUSION Our study (1) provides the much-needed benchmark data and computational tools for assessing depth normalization, (2) shows the dependence of normalization performance on the underlying pattern of differential expression, and (3) calls for continued research efforts to develop more effective normalization methods.
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SØNDERGAARD, M. S. R., M. H. JOSEFSEN, C. LÖFSTRÖM, L. S. CHRISTENSEN, K. WIECZOREK, J. OSEK, and J. HOORFAR. "Low-Cost Monitoring of Campylobacter in Poultry Houses by Air Sampling and Quantitative PCR." Journal of Food Protection 77, no. 2 (February 1, 2014): 325–30. http://dx.doi.org/10.4315/0362-028x.jfp-13-268.
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The present study describes the evaluation of a method for the quantification of Campylobacter by air sampling in poultry houses. Sampling was carried out in conventional chicken houses in Poland, in addition to a preliminary sampling in Denmark. Each measurement consisted of three air samples, two standard boot swab fecal samples, and one airborne particle count. Sampling was conducted over an 8-week period in three flocks, assessing the presence and levels of Campylobacter in boot swabs and air samples using quantitative real-time PCR. The detection limit for air sampling was approximately 100 Campylobacter cell equivalents (CCE)/m3. Airborne particle counts were used to analyze the size distribution of airborne particles (0.3 to 10 μm) in the chicken houses in relation to the level of airborne Campylobacter. No correlation was found. Using air sampling, Campylobacter was detected in the flocks right away, while boot swab samples were positive after 2 weeks. All samples collected were positive for Campylobacter from week 2 through the rest of the rearing period for both sampling techniques, although levels 1- to 2-log CCE higher were found with air sampling. At week 8, the levels were approximately 104 and 105 CCE per sample for boot swabs and air, respectively. In conclusion, using air samples combined with quantitative real-time PCR, Campylobacter contamination could be detected earlier than by boot swabs and was found to be a more convenient technique for monitoring and/or to obtain enumeration data useful for quantitative risk assessment of Campylobacter.
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Ika Rinawati, Dyah, Diana Puspita Sari, Darminto Pujotomo, and Puji Handayani Kasih. "Natural Dyes Product Design Using Green Quality Function Deployment II Method To Support Batik Sustainable Production." E3S Web of Conferences 73 (2018): 04014. http://dx.doi.org/10.1051/e3sconf/20187304014.
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Using synthetic dyes causes bad impact on the environment. But using natural dyes has several problems such as fade, slight colour variations and takes longer time. In order to solve that problems, it is needed to develop instant natural dyes. This study aims to design instant natural dyes to fulfill needs of batik artisans that having minimal environmental impact as well as having minimal cost. This study use green quality function deployment II method. This study involve voice of customer identification, calculation gap, the determination of characteristic of technical, making the house of quality (HOQ), life cycle assessment (formulation of green house & green the matrix), life cycle cost (formulation of cost house, the preparation of cost the matrix) and concept comparison house (CCH). Based on voice of customer, natural dyes that will be developed is red colour. Red natural dyes extracted from root of Morinda citrifolia and Ceriops candolleana. In this research, there are two alternatives of natural dyes namely powders and liquid natural dyes. The result of this study is powder natural dyes selected because of lower environmental impact and user operational cost.
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Doolin, Jim W., Jonathan L. Berry, Natalia S. Forbath, Noah X. Tocci, Tenzin Dechen, Stephanie Li, Rebekah A. Hartwell, et al. "Implementing Electronic Patient-Reported Outcomes for Patients With New Oral Chemotherapy Prescriptions at an Academic Site and a Community Site." JCO Clinical Cancer Informatics, no. 5 (June 2021): 631–40. http://dx.doi.org/10.1200/cci.20.00191.
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PURPOSE Oral chemotherapy challenges providers' abilities to safely monitor patients' symptoms, adherence, and financial toxicity. COVID-19 has increased the urgency of caring for patients remotely. Collection of electronic patient-reported outcomes (ePROs) has demonstrated efficacy for patients on intravenous chemotherapy, but limited data support their use in oral chemotherapy. We undertook a pilot project to assess the feasibility of implementing an ePRO system for patients starting oral chemotherapy at our cancer center, which includes both an academic site and a community site. METHODS Patients initiating oral chemotherapy were asked to participate. A five-question tool was built in REDCap. Concerning responses triggered outreach within one business day. The primary outcome was time to first symptom assessment. For comparison, we used a historical cohort of patients who had been prescribed oral chemotherapies by providers in the same disease groups at the cancer center. RESULTS Twenty-five of 62 (40%) patients completed ePRO assessments. Fifty historical charts were reviewed. Time to first symptom assessment was 7 days (IQR, 4-14 days) in the historical group compared with 3 days (IQR, 2-4 days) in the ePRO group. Time to clinical action was 14 days (7-35 days) in the historical group compared with 8 days (4-19 days) in the ePRO group. No statistically significant differences were detected in 30-day emergency department visit or hospitalization (12% for both groups) or 90-day emergency department visit or hospitalization rates (historical 28% and ePRO 20%). CONCLUSION An ePRO tool monitoring patient concerns about adherence, cost, and toxicities for patients with new oral chemotherapy regimens is feasible and improves time to symptom assessment. Further investigation is needed to improve patient engagement with ePROs and evaluate the long-term impacts for patients on oral chemotherapy.
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Markham, Jessica L., Matt Hall, Jennifer L. Goldman, Jessica L. Bettenhausen, James C. Gay, James Feinstein, Julia Simmons, Stephanie K. Doupnik, and Jay G. Berry. "Readmissions Following Hospitalization for Infection in Children With or Without Medical Complexity." Journal of Hospital Medicine 16, no. 3 (February 17, 2021): 134–41. http://dx.doi.org/10.12788/jhm.3505.
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OBJECTIVE: To describe the prevalence and characteristics of infection-related readmissions in children and to identify opportunities for readmission reduction and estimate associated cost savings. STUDY DESIGN: Retrospective analysis of 380,067 nationally representative index hospitalizations for children using the 2014 Nationwide Readmissions Database. We compared 30-day, all-cause unplanned readmissions and costs across 22 infection categories. We used the Inpatient Essentials database to measure hospital-level readmission rates and to establish readmission benchmarks for individual infections. We then estimated the number of readmissions avoided and costs saved if hospitals achieved the 10th percentile of hospitals’ readmission rates (ie, readmission benchmark). All analyses were stratified by the presence/absence of a complex chronic condition (CCC). RESULTS: The overall 30-day readmission rate was 4.9%. Readmission rates varied substantially across infections and by presence/absence of a CCC (CCC: range, 0%-21.6%; no CCC: range, 1.5%-8.6%). Approximately 42.6% of readmissions (n = 3,576) for children with a CCC and 54.7% of readmissions (n = 5,507) for children without a CCC could have been potentially avoided if hospitals achieved infection-specific benchmark readmission rates, which could result in an estimated savings of $70.8 million and $44.5 million, respectively. Bronchiolitis, pneumonia, and upper respiratory tract infections were among infections with the greatest number of potentially avoidable readmissions and cost savings for children with and without a CCC. CONCLUSION: Readmissions following hospitalizations for infection in children vary significantly by infection type. To improve hospital resource use for infections, future preventative measures may prioritize children with complex chronic conditions and those with specific diagnoses (eg, respiratory illnesses).
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Konka, Anita, Jeremy Weedon, and Nira A. Goldstein. "Cost-benefit Analysis of Polysomnography versus Clinical Assessment Score-15 (CAS-15) for Treatment of Pediatric Sleep-disordered Breathing." Otolaryngology–Head and Neck Surgery 151, no. 3 (June 16, 2014): 484–88. http://dx.doi.org/10.1177/0194599814536844.
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Konka, Anita, Jeremy Weedon, and Nira A. Goldstein. "Cost-Benefit Analysis of Polysomnography versus Clinical Assessment Score-15 (CAS-15) for Treatment of Pediatric Sleep-Disordered Breathing." Otolaryngology–Head and Neck Surgery 149, no. 2_suppl (August 23, 2013): P242. http://dx.doi.org/10.1177/0194599813496044a303.
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Sevillano-Marco, Eva, Alfonso Fernández-Manso, Carmen Quintano, and Marcela Poulain. "CCD CBERS and ASTER data in dasometric characterization of Pinus radiata D. Don (North-western Spain)." CERNE 19, no. 1 (March 2013): 103–10. http://dx.doi.org/10.1590/s0104-77602013000100013.
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A Chinese-Brazilian Earth Resources Satellite (CBERS) and an Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) scenes coupled with ancillary georeferenced data and field survey were employed to examine the potential of the remote sensing data in stand basal area, volume and aboveground biomass assessment over large areas of Pinus radiata D. Don plantations in Northwestern Spain. Statistical analysis proved that the near infrared band and the shade fraction image showed significant correlation coefficients with all stand variables considered. Predictive models were accordingly selected and utilized to undertake the spatial distribution of stand variables in radiata stands delimited by the National Forestry Map. The study reinforces the potentiality of remote sensing techniques in a cost-effective assessment of forest systems.
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Jones, Jay Pendell, Ronald E. Wambles, Charles K. Mann, and Thomas J. Vickers. "Effect on Noise of Intensity-Axis Correction of Spectra Recorded with Charge-Coupled Device Detectors." Applied Spectroscopy 56, no. 5 (May 2002): 564–69. http://dx.doi.org/10.1366/0003702021955321.
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We have examined the effect of intensity-axis correction on noise in white light spectra recorded with charge-coupled device (CCD) detectors. Measurements were made with five detectors in Raman spectrometers. Detectors were both liquid-nitrogen and thermoelectrically cooled devices and one room temperature device. Both random and pattern noise have been considered. We used cross-correlation of noise sets to provide an indicator of a fixed pattern in the spectra and an assessment of the efficacy of the correction procedure in removing this pattern. For four of the five detectors intensity-axis correction provided a significant improvement in signal-to-noise ratio. Correction was particularly important for measurements made with lower-cost CCD detectors of the kind proposed for process control instruments.
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Featherstone, Roland L., Joanna Dobson, Jörg Ederle, David Doig, Leo H. Bonati, Stephen Morris, Nishma V. Patel, and Martin M. Brown. "Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): a randomised controlled trial with cost-effectiveness analysis." Health Technology Assessment 20, no. 20 (March 2016): 1–94. http://dx.doi.org/10.3310/hta20200.
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BackgroundCarotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for the treatment of carotid stenosis, but safety and long-term efficacy were uncertain.ObjectiveTo compare the risks, benefits and cost-effectiveness of CAS versus CEA for symptomatic carotid stenosis.DesignInternational, multicentre, randomised controlled, open, prospective clinical trial.SettingHospitals at 50 centres worldwide.ParticipantsPatients older than 40 years of age with symptomatic atheromatous carotid artery stenosis.InterventionsPatients were randomly allocated stenting or endarterectomy using a computerised service and followed for up to 10 years.Main outcome measuresThe primary outcome measure was the long-term rate of fatal or disabling stroke, analysed by intention to treat (ITT). Disability was assessed using the modified Rankin Scale (mRS). A cost–utility analysis estimating mean costs and quality-adjusted life-years (QALYs) was calculated over a 5-year time horizon.ResultsA total of 1713 patients were randomised but three withdrew consent immediately, leaving 1710 for ITT analysis (853 were assigned to stenting and 857 were assigned to endarterectomy). The incidence of stroke, death or procedural myocardial infarction (MI) within 120 days of treatment was 8.5% in the CAS group versus 5.2% in the CEA group (72 vs. 44 events) [hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.16 to 2.45;p = 0.006]. In the analysis restricted to patients who completed stenting, age independently predicted the risk of stroke, death or MI within 30 days of CAS (relative risk increase 1.17% per 5 years of age, 95% CI 1.01% to 1.37%). Use of an open-cell stent conferred higher risk than a closed-cell stent (relative risk 1.92, 95% CI 1.11 to 3.33), but use of a cerebral protection device did not modify the risk. CAS was associated with a higher risk of stroke in patients with an age-related white-matter changes score of 7 or more (HR 2.98, 95% CI 1.29 to 6.93;p = 0.011). After completion of follow-up with a median of 4.2 years, the number of patients with fatal or disabling stroke in the CAS and CEA groups (52 vs. 49), and the cumulative 5-year risk did not differ significantly (6.4% vs. 6.5%) (HR 1.06, 95% CI 0.72 to 1.57;p = 0.776). Stroke of any severity was more frequent in the CAS group (15.2% vs. 9.4% in the CEA group) (HR 1.712, 95% CI 1.280 to 2.300;p < 0.001). There was no significant difference in long-term rates of severe carotid restenosis or occlusion (10.8% in the CAS group vs. 8.6% in the CEA group) (HR 1.25, 95% CI 0.89 to 1.75;p = 0.20). There was no difference in the distribution of mRS scores at 1-year, 5-year or final follow-up. There were no differences in costs or QALYs between the treatments.LimitationsPatients and investigators were not blinded to treatment allocation. Interventionists’ experience of stenting was less than that of surgeons with endarterectomy. Data on costs of managing strokes were not collected.ConclusionsThe functional outcome after stenting is similar to endarterectomy, but stenting is associated with a small increase in the risk of non-disabling stroke. The choice between stenting and endarterectomy should take into account the procedural risks related to individual patient characteristics. Future studies should include measurement of cognitive function, assessment of carotid plaque morphology and identification of clinical characteristics that determine benefit from revascularisation.Trial registrationCurrent Controlled Trials ISRCTN25337470.FundingThis project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 20. See the NIHR Journal Library website for further project information. Further funding was provided by the Medical Research Council, Stroke Association, Sanofi-Synthélabo and the European Union.
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Marcatti, Michela, Jamal Saada, Ikenna Okereke, Charles E. Wade, Stefan H. Bossmann, Massoud Motamedi, and Bartosz Szczesny. "Quantification of Circulating Cell Free Mitochondrial DNA in Extracellular Vesicles with PicoGreen™ in Liquid Biopsies: Fast Assessment of Disease/Trauma Severity." Cells 10, no. 4 (April 6, 2021): 819. http://dx.doi.org/10.3390/cells10040819.
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The analysis of circulating cell free DNA (ccf-DNA) is an emerging diagnostic tool for the detection and monitoring of tissue injury, disease progression, and potential treatment effects. Currently, most of ccf-DNA in tissue and liquid biopsies is analysed with real-time quantitative PCR (qPCR) that is primer- and template-specific, labour intensive and cost-inefficient. In this report we directly compare the amounts of ccf-DNA in serum of healthy volunteers, and subjects presenting with various stages of lung adenocarcinoma, and survivors of traumatic brain injury using qPCR and quantitative PicoGreen™ fluorescence assay. A significant increase of ccf-DNA in lung adenocarcinoma and traumatic brain injury patients, in comparison to the group of healthy human subjects, was found using both analytical methods. However, the direct correlation between PicoGreen™ fluorescence and qPCR was found only when mitochondrial DNA (mtDNA)-specific primers were used. Further analysis of the location of ccf-DNA indicated that the majority of DNA is located within lumen of extracellular vesicles (EVs) and is easily detected with mtDNA-specific primers. We have concluded that due to the presence of active DNases in the blood, the analysis of DNA within EVs has the potential of providing rapid diagnostic outcomes. Moreover, we speculate that accurate and rapid quantification of ccf-DNA with PicoGreen™ fluorescent probe used as a point of care approach could facilitate immediate assessment and treatment of critically ill patients.
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Mount, Cristin A., Patricia A. Short, George R. Mount, and Christina M. Schofield. "An End-of-Year Oral Examination for Internal Medicine Residents: An Assessment Tool for the Clinical Competency Committee." Journal of Graduate Medical Education 6, no. 3 (September 1, 2014): 551–54. http://dx.doi.org/10.4300/jgme-d-13-00365.1.
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Abstract Background Comprehensive evaluations of clinical competency consume a large amount of time and resources. An oral examination is a unique evaluation tool that can augment a global performance assessment by the Clinical Competency Committee (CCC). Objective We developed an oral examination to aid our CCC in evaluating resident performance. Methods We reviewed tools used in our internal medicine residency program and other training programs in our institution. A literature search failed to identify reports of a similar evaluation tool used in internal medicine programs. We developed and administered an internal medicine oral examination (IMOE) to our postgraduate year–1 and postgraduate year–2 internal medicine residents annually over a 3-year period. The results were used to enhance our CCC's discussion of overall resident performance. We estimated the costs in terms of faculty time away from patient care activities. Results Of the 54 residents, 46 (86%) passed the IMOE on their first attempt. Of the 8 (14%) residents who failed, all but 1 successfully passed after a mentored study period and retest. Less than 0.1 annual full-time equivalent per faculty member was committed by most faculty involved, and the time spent on the IMOE replaced regular resident daily conference activities. Conclusions The results of the IMOE were added to other assessment tools and used by the CCC for a global assessment of resident performance. An oral examination is feasible in terms of cost and can be easily modified to fit the needs of various competency committees.
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Gregori, Dario, and Daniele Chiffi. "Editorial - Evaluating Impact of High-Cost Cancer Drugs at Regional Level: The Case of Veneto (Italy)." Open Pharmacology Journal 7, no. 1 (April 19, 2013): 1. http://dx.doi.org/10.2174/1874143601307010001.
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In Italy, the National Health System (NHS) costs are controlled by the regional governments (which are financially accountable for health care expenditure, including hospital drug budgets), but agreements regarding price and discounts are decided in AIFA (Italian Medicine Agency). For this reason, some regional governments ask the pharmaceutical companies to produce a "Health Technology Assessment" before deciding to introduce a drug in the regional hospital list of accepted drugs. Thus, in terms of public policy maker and its decision process, the choice of well-specified points of view is an essential ingredient in the critical assessment of economic evaluation, which becomes more effective when information is presented in the general terms of a cost of illness analysis (COI), or, in a disaggregated way by means of a list of the costs and the outcomes or consequences of the intervention, namely as a cost consequence analysis (CCA). Furthermore, while it has been observed that economic evaluations are usually performed in different countries at national level, in local health care decision making there is lack of health economic data and evaluations, disconnecting economic evaluations from the types of decision that local institutions must normally face. The University of Padova financed a composite and interdisciplinary group of researchers to develop a proof-of-concept like program aimed at serving the Veneto region as a template for the evaluation of the impact of (high-cost) drugs. The program, financed as “Progetti di Ateneo” 2009, (Code CPDA093183/09, "Modello per la valutazione dell'impatto economico, sociale e di salute derivante dall'utilizzo dei nuovi farmaci oncologici nella regione Veneto") has come now to its end and this report represents the outcome of a two-year intense research work. Gratefully, the leading investigators acknowledge the contribution of the entire EIHCD-VeRo Research Project Agreement for their help and cooperation at the various stages of the project development.
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Kheshgi, Haroon S., Hans Thomann, Nazeer A. Bhore, Robert B. Hirsch, Michael E. Parker, and Gary Teletzke. "Perspectives on CCS Cost and Economics." SPE Economics & Management 4, no. 01 (January 1, 2012): 24–31. http://dx.doi.org/10.2118/139716-pa.
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Kayuni, S. A., P. L. A. M. Corstjens, E. J. LaCourse, K. E. Bartlett, J. Fawcett, A. Shaw, P. Makaula, et al. "How can schistosome circulating antigen assays be best applied for diagnosing male genital schistosomiasis (MGS): an appraisal using exemplar MGS cases from a longitudinal cohort study among fishermen on the south shoreline of Lake Malawi." Parasitology 146, no. 14 (August 27, 2019): 1785–95. http://dx.doi.org/10.1017/s0031182019000969.
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AbstractWe provide an update on diagnostic methods for the detection of urogenital schistosomiasis (UGS) in men and highlight that satisfactory urine-antigen diagnostics for UGS lag much behind that for intestinal schistosomiasis, where application of a urine-based point-of-care strip assay, the circulating cathodic antigen (CCA) test, is now advocated. Making specific reference to male genital schistosomiasis (MGS), we place greater emphasis on parasitological detection methods and clinical assessment of internal genitalia with ultrasonography. Unlike the advances made in defining a clinical standard protocol for female genital schistosomiasis, MGS remains inadequately defined. Whilst urine filtration with microscopic examination for ova of Schistosoma haematobium is a convenient but error-prone proxy of MGS, we describe a novel low-cost sampling and direct visualization method for the enumeration of ova in semen. Using exemplar clinical cases of MGS from our longitudinal cohort study among fishermen along the shoreline of Lake Malawi, the portfolio of diagnostic needs is appraised including: the use of symptomatology questionnaires, urine analysis (egg count and CCA measurement), semen analysis (egg count, circulating anodic antigen measurement and real-time polymerase chain reaction analysis) alongside clinical assessment with portable ultrasonography.
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Keene, David J., Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, et al. "The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years." Health Technology Assessment 20, no. 75 (October 2016): 1–158. http://dx.doi.org/10.3310/hta20750.
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BackgroundClose contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults.ObjectivesWe aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences.DesignA pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study.SettingTrauma and orthopaedic departments of 24 NHS hospitals.ParticipantsAdults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded.InterventionsCCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern.Main outcome measuresFollow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud–Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol.ResultsWe recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later converted to ORIF because of loss of fracture reduction. CCC resulted in equivalent ankle function compared with ORIF at 6 months {OMAS 64.5 points [standard deviation (SD) 22.4 points] vs. OMAS 66.0 points (SD 21.1 points); mean difference –0.65 points, 95% confidence interval (CI) –3.98 to 2.68 points; standardised effect size –0.04, 95% CI –0.23 to 0.15}. There were no differences in quality of life, ankle motion, pain, mobility and patient satisfaction. Infection and/or wound problems were more common with ORIF [29/298 (10%) vs. 4/275 (1%)], as were additional operating theatre procedures [17/298 (6%) vs. 3/275 (1%)]. Malunion was more common with CCC [38/249 (15%) vs. 8/274 (3%);p < 0.001]. Malleolar non-union was lower in the ORIF group [lateral: 0/274 (0%) vs. 8/248 (3%);p = 0.002; medial: 3/274 (1%) vs. 18/248 (7%);p < 0.001]. During the trial, CCC showed modest mean cost savings [NHS mean difference –£644 (95% CI –£1390 to £76); society mean difference –£683 (95% CI –£1851 to £536)]. Estimates showed some imprecision. Incremental quality-adjusted life-years following CCC were no different from ORIF. Over common willingness-to-pay thresholds, the probability that CCC was cost-effective was very high (> 95% from NHS perspective and 85% from societal perspective). Experiences of treatments were similar; both groups endured the impact of fracture, uncertainty regarding future function and the need for further interventions.LimitationsAssessors at 6 weeks were necessarily not blinded. The learning-effect analysis was inconclusive because of limited CCC applications per surgeon.ConclusionsCCC provides a clinically equivalent outcome to ORIF at reduced cost to the NHS and to society at 6 months.Future workLonger-term follow-up of trial participants is under way to address concerns over potential later complications or additional procedures and their potential to impact on ankle function. Further study of the patient factors, radiological fracture patterns and outcomes, treatment responses and prognosis would also contribute to understanding the treatment pathway.Trial registrationCurrent Controlled Trials ISRCTN04180738.FundingThe National Institute for Health Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 75. See the NIHR Journals Library website for further project information. This report was developed in association with the National Institute for Health Research Oxford Biomedical Research Unit funding scheme. The pilot phase was funded by the AO Research Foundation.
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Gerstenberger, M. C., A. Christophersen, R. Buxton, G. Allinson, W. Hou, G. Leamon, and A. Nicol. "Integrated Risk Assessment for CCS." Energy Procedia 37 (2013): 2775–82. http://dx.doi.org/10.1016/j.egypro.2013.06.162.
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Shrestha, Archana Bade. "Assessment of the Socio-Economic Status of Apartments in Kathmandu Valley." Journal of Science and Engineering 6 (May 3, 2019): 9–19. http://dx.doi.org/10.3126/jsce.v6i0.23961.
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Nepal is urbanising at a rapid pace. According to CBS 2011 the urban population accounts for 17% and Kathmandu valley shares the highest urban population. The growing population has put immense pressure on land and housing situation in Kathmandu Valley. Apartments came into picture to accommodate the growing population in the less horizontal space of land but all income groups of people could not afford and access to the facilities and space provided in the apartments.
The current scenario in Kathmandu valley depicts that the developers make investments in construction of apartments as a commercial activity rather than to upgrade housing scenario. Despite, due to the high interest rate, formal collateral in the form of land and house and high income of people to repay loans preferred by commercial banks, the economically weaker section and lower income group of people are not eligible to proceed for the loan. The high cost of Apartment units is beyond affordability of EWS and LIG.
The rapid increment of population concentration on primate cities like Kathmandu has led to scarcity of land to accommodate the increasing migrants and not only that, it has resulted in the unhygienic condition of living, suffocating and deteriorating urban environment. As a result, the high income group are moving in the urban fringe and it’s always the poor who are trapped in the vulnerable core cities of Kathmandu. The residential shift of rich people to urban fringe has led to the adhoc development with social disparity and inequity amongst the people living in the same areas.
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Rubin, Edward S. "Understanding the pitfalls of CCS cost estimates." International Journal of Greenhouse Gas Control 10 (September 2012): 181–90. http://dx.doi.org/10.1016/j.ijggc.2012.06.004.
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Gini, Andrea, Reinier G. S. Meester, Homa Keshavarz, Kevin C. Oeffinger, Sameera Ahmed, David C. Hodgson, and Iris Lansdorp-Vogelaar. "Cost-Effectiveness of Colonoscopy-Based Colorectal Cancer Screening in Childhood Cancer Survivors." JNCI: Journal of the National Cancer Institute 111, no. 11 (April 13, 2019): 1161–69. http://dx.doi.org/10.1093/jnci/djz060.
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Abstract Background Childhood cancer survivors (CCS) are at increased risk of developing colorectal cancer (CRC) compared to the general population, especially those previously exposed to abdominal or pelvic radiation therapy (APRT). However, the benefits and costs of CRC screening in CCS are unclear. In this study, we evaluated the cost-effectiveness of early-initiated colonoscopy screening in CCS. Methods We adjusted a previously validated model of CRC screening in the US population (MISCAN-Colon) to reflect CRC and other-cause mortality risk in CCS. We evaluated 91 colonoscopy screening strategies varying in screening interval, age to start, and age to stop screening for all CCS combined and for those treated with or without APRT. Primary outcomes were CRC deaths averted (compared to no screening) and incremental cost-effectiveness ratios (ICERs). A willingness-to-pay threshold of $100 000 per life-years gained (LYG) was used to determine the optimal screening strategy. Results Compared to no screening, the US Preventive Services Task Force’s average risk screening schedule prevented up to 73.2% of CRC deaths in CCS. The optimal strategy of screening every 10 years from age 40 to 60 years averted 79.2% of deaths, with ICER of $67 000/LYG. Among CCS treated with APRT, colonoscopy every 10 years from age 35 to 65 years was optimal (CRC deaths averted: 82.3%; ICER: $92 000/LYG), whereas among those not previously treated with APRT, screening from age 45 to 55 years every 10 years was optimal (CRC deaths averted: 72.7%; ICER: $57 000/LYG). Conclusions Early initiation of colonoscopy screening for CCS is cost-effective, especially among those treated with APRT.
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Wong, F. Lennie, Smita Bhatia, Seira Kurian, Wendy Landier, Liton Francisco, Wendy M. Leisenring, Melissa M. Hudson, et al. "Efficacy of the Children's Oncology Group (COG) long-term follow-up (LTFU) guidelines in reducing risk of congestive heart failure (CHF) in childhood cancer survivors (CCS)." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 9505. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.9505.
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9505 Background: CCS are at risk for left ventricular dysfunction (LVD) and subsequent CHF due to exposure to anthracyclines and chest radiation (RT). COG LTFU guidelines recommend screening for LVD using echocardiograms (ECHOs) every 1-5y depending on anthracycline dose, RT, and age at cancer diagnosis. The relevance and cost-effectiveness of these consensus-based guidelines are unknown. Methods: Life expectancy and age at onset of CHF were projected in a simulated cohort (>1 million) of CCS undergoing screening ECHO per COG guidelines. Intervention for LVD was modeled to reduce annual CHF risk by 30%. Quality-adjusted life-years (QALYs) and lifetime costs with and without ECHO screening were calculated. Non-CHF mortality was estimated from the Childhood Cancer Survivor Study and US population rates. Costs and QOL adjustments were obtained from the Healthcare Cost and Utilization Project and medical literature. Screening was considered cost-effective if it resulted in a >6 month delay in onset of CHF and <$50,000/QALY gained. Results: Recommended screening strategies (Table) were cost-effective in: i) CCS exposed to ≥300mg/m² of anthracycline regardless of RT or age; and ii) CCS diagnosed at age 1-4y, exposed to RT and <300mg/m² of anthracycline. Screening was most cost-effective for CCS diagnosed at age 1-4y exposed to RT + ≥300 mg/m² of anthracycline (1.4y delay in CHF onset; $15,821/QALY gained). Screening as currently proposed was not cost-effective for other age/anthracycline/RT combinations. Conclusions: Recommended ECHO screening strategies are cost-effective for all CCS exposed to ≥300 mg/m² of anthracycline; screening was also cost-effective for those 1-4y at diagnosis, exposed to anthracycline <300 mg/m² + RT. Alternate screening strategies are needed for CCS with other exposure conditions. [Table: see text]
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Dahowski, R. T., C. L. Davidson, X. C. Li, and N. Wei. "Examining CCS Deployment Potential in China Via Application of an Integrated CCS Cost Curve." Energy Procedia 37 (2013): 2487–94. http://dx.doi.org/10.1016/j.egypro.2013.06.130.
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Liu, Ji Yong, Xiao Feng Zhang, Ji Fa Zhang, Huan Liu, and Fang Qin Li. "Development Status and Energy Penalty of Carbon Dioxide Capture Technologies." Advanced Materials Research 864-867 (December 2013): 1598–601. http://dx.doi.org/10.4028/www.scientific.net/amr.864-867.1598.
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Carbon dioxide is claimed to be responsible for 60 percent of the global warming caused by greenhouse gases. CCS is important for reducing CO2emissions. Most technologies are in demonstration stage. Carbon capture accounts for two thirds of total cost of CCS. The trend of CCS is also described.
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Harker Steele, Amanda, Travis Warner, Derek Vikara, Allison Guinan, and Peter Balash. "Comparative Analysis of Carbon Capture and Storage Finance Gaps and the Social Cost of Carbon." Energies 14, no. 11 (May 21, 2021): 2987. http://dx.doi.org/10.3390/en14112987.
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This paper evaluates how changes in economic market and policy conditions, including the establishment of a per-unit tax on unabated emissions of carbon dioxide (CO2) set equal to estimates of the social cost of carbon (SCC), influence the economics of carbon capture and storage (CCS) for two hypothetical power generation facilities located in the United States. Data are provided from modified versions of models and resources created and managed by the National Energy Technology Laboratory. Changes in economic market and policy conditions are evaluated over a series of scenarios in which differences in the levelized cost of electricity (LCOE) provide estimates of the financial gap necessary to overcome for CCS to be considered the cost-minimizing choice for each power generation facility type considered. Results suggest that for the coal and natural gas power generation facilities considered, a per-unit tax set equal to an SCC exceeding $123 per metric ton of CO2 (/tCO2) emitted (2018 dollars) and $167/tCO2 emitted, respectively, in combination with current Section 45Q tax credits, yields investment in CCS as the cost-minimizing choice; SCC values as low as $58/tCO2 and $98/tCO2 can make CCS the cost-minimizing choice with additional support policies (e.g., free transportation and storage options).
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Raj, Sarth, and Larry H. Hollier. "Review of “The Comprehensive Complication Index (CCI) is a Novel Cost Assessment Tool for Surgical Procedures” by Roxanne S et al in Ann Surg 268." Journal of Craniofacial Surgery 30, no. 6 (September 2019): 1920. http://dx.doi.org/10.1097/scs.0000000000005290.
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Oraee-Mirzamani, Behdeen, Tim Cockerill, and Zen Makuch. "Risk Assessment and Management Associated with CCS." Energy Procedia 37 (2013): 4757–64. http://dx.doi.org/10.1016/j.egypro.2013.06.385.
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Feng, Yaoyu, Xukun Zhao, Jiaxu Chen, Wei Jin, Xiaonong Zhou, Na Li, Lin Wang, and Lihua Xiao. "Occurrence, Source, and Human Infection Potential of Cryptosporidium and Giardia spp. in Source and Tap Water in Shanghai, China." Applied and Environmental Microbiology 77, no. 11 (April 15, 2011): 3609–16. http://dx.doi.org/10.1128/aem.00146-11.
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ABSTRACTGenotyping studies on the source and human infection potential ofCryptosporidiumoocysts in water have been almost exclusively conducted in industrialized nations. In this study, 50 source water samples and 30 tap water samples were collected in Shanghai, China, and analyzed by the U.S. Environmental Protection Agency (EPA) Method 1623. To find a cost-effective method to replace the filtration procedure, the water samples were also concentrated by calcium carbonate flocculation (CCF). Of the 50 source water samples, 32% were positive forCryptosporidiumand 18% forGiardiaby Method 1623, whereas 22% were positive forCryptosporidiumand 10% forGiardiaby microscopy of CCF concentrates. When CCF was combined with PCR for detection, the occurrence ofCryptosporidium(28%) was similar to that obtained by Method 1623. Genotyping ofCryptosporidiumin 17 water samples identified the presence ofC. andersoniin 14 water samples,C. suisin 7 water samples,C. baileyiin 2 water samples,C. meleagridisin 1 water sample, andC. hominisin 1 water sample. Therefore, farm animals, especially cattle and pigs, were the major sources of water contamination in Shanghai source water, and most oocysts found in source water in the area were not infectious to humans.Cryptosporidiumoocysts were found in 2 of 30 tap water samples. The combined use of CCF for concentration and PCR for detection and genotyping provides a less expensive alternative to filtration and fluorescence microscopy for accurate assessment ofCryptosporidiumcontamination in water, although the results from this method are semiquantitative.
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Groenenberg, Heleen, Todd Flach, Gudmundur Sigurthorsson, Paul Curnow, Jason Anderson, Heleen de Coninck, David Reiner, Simon Shackley, and Christopher Norton. "Is CO2 capture and storage ready to roll?" Journal for European Environmental & Planning Law 4, no. 5 (2007): 402–14. http://dx.doi.org/10.1163/187601007x00334.
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AbstractWithin the context of rising overall awareness of the climate change problem, CO2 capture and storage has risen rapidly on the policy agenda. Some Stakeholders have suggested that technology, cost and legal questions around CCS are all but solved. However, while policymakers embark on the agreement of national, European and international legislation on CCS, a number of challenges arise. This paper reviews the progress of CCS towards a legally embedded mitigation option, and identifies three major conditions for the acceptability of CCS deployment: social acceptance by stakeholders and the lay public, robustness of economic and cost data, and legal and regulatory consistency. Technical maturity and reliability are important crosscutting issues that need to be fully addressed before any of the other areas can be solved. It is concluded that, although legal and regulatory issues are close to being resolved, the role that CCS may play in the global energy system has likely been overestimated in system models, which is partly due to transparency and information problems. In addition, resistance from environmental organisations may have to be reckoned with and social acceptance of CCS remains one of its most prominent unknowns.