SmartMicro Grid Energy System Management Based on Optimum Running Cost for Rural Communities in Rwanda

The governmental electric utility and the private sector are joining hands to meet the target of electrifying all households by 2024.However,the aforementioned goal is challenged by households that are scattered in remote areas.So far,Solar Home Systems(SHS)have mostly been applied to increase electricity access in rural areas.SHSs have continuous constraints to meet electricity demands and cannot run income-generating activities.The current research presents the feasibility study of electrifying Remera village with the smart microgrid as a case study.The renewable energy resources available in Remera are the key sources of electricity in that village.The generation capacity is estimated based on the load profile.The microgrid configurations are simulated with HOMER,and the genetic algorithm is used to analyze the optimum cost.By analyzing the impact of operation and maintenance costs,the results show that the absence of subsidies increases the levelized cost of electricity(COE)five times greater than the electricity price from the public utility.The microgrid made up of PV,diesel generator,and batteries proved to be the most viable solution and ensured continuous power supply to customers.By considering the subsidies,COE reaches 0.186$/kWh,a competitive price with electricity from public utilities in Rwanda.

The Innovative Practice of Traditional Printmaking Art in the Teaching of Costume Design

Costume is not only an important carrier of human civilization,but also reflects the development level of material and spiritual civilization.In modern costume design,we have incorporated colorful cultural elements,which are not only the embodiment of aesthetics but also the aesthetic expression based on culture.Printmaking art,as a kind of traditional art,has its unique style and characteristics.In teaching practice,we instruct students to integrate the creative spirit and formal elements of printmaking into costume design,to realize the inheritance and innovation of traditional culture.Under the background of globalization,we should be more committed to inheriting and carrying forward the excellent Chinese national culture and promoting the popularization and dissemination of traditional culture.Exploring the application of printmaking art in costume design through teaching practice aims to construct a new teaching mode,which provides a reference for the application of other traditional arts in modern design teaching.

Interest of D-dimer level,severity of COVID-19 and cost of management in Gabon

BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.

“liberal arts”的源与流——古今之变中的审视

“古今之变”是审视liberal arts流变的中心线索。古典liberal arts是具有内在统一性并指向完满品格的整全性知识体系。欧洲三次文艺复兴对liberal arts的再造展现了其历史流变中的不变逻辑,即为特定时代的受教育者提供共同价值。德国古典大学赋予了liberal arts在古典意义上的完美形态,而新人文主义的自我塑造观念孕育了博雅教育的现代转向。科学革命终结了古典学术的内在统一性与道德理想,瓦解了古典liberal arts。美国现代大学则借助古典资源,经由三次改革浪潮重建了liberal arts。然而,古典教育凝聚文明精华的共同价值、塑造意义与学术整合力量,同现代科学的智识自由、价值分殊与学科分化特性相冲突,这是古今之变为现代大学再造liberal arts所深植的困境,liberal arts只能在钟摆的两端之间不断权衡。

An estimation method for direct maintenance cost of aircraft components based on particle swarm optimization with immunity algorithm

A particle swarm optimization (PSO) algorithm improved by immunity algorithm (IA) was presented. Memory and self-regulation mechanisms of IA were used to avoid PSO plunging into local optima. Vaccination and immune selection mechanisms were used to prevent the undulate phenomenon during the evolutionary process. The algorithm was introduced through an application in the direct maintenance cost (DMC) estimation of aircraft components. Experiments results show that the algorithm can compute simply and run quickly. It resolves the combinatorial optimization problem of component DMC estimation with simple and available parameters. And it has higher accuracy than individual methods, such as PLS, BP and v-SVM, and also has better performance than other combined methods, such as basic PSO and BP neural network.

High loading FeS2 nanoparticles anchored on biomass-derived carbon tube as low cost and long cycle anode for sodium-ion batteries

In recent years, the sodium storage mechanism and performance optimization of FeS2 have been studied intensively. However, before the commercial application of FeS2, preconditions of low-cost, simple craft and scale production of nanoscale FeS2 are also essential. Based on above challenges, mesh-like FeS2/carbon tube/FeS2 composites are prepared simply from green, low-cost and renewable natural herb in this work. With the assistance of protogenetic interconnected carbon tube network(only 5.3 wt%), FeS2/carbon tube/FeS2 composites show high capacity(542.2 mA h g^-1), good stability(< 0.005% per cycle over 1000 cycles), and excellent rate performance(426.2 mA h g^-1 at 2 A g^-1).The outstanding electrochemical performance of FeS2/carbon tube/FeS2 composites may be attributed to the unique interconnected reticular structure, meaning that FeS2 nanoparticles are effectively immobilized by carbon tube network via physical encapsulation and chemical bonding.More importantly, this work may provide green and low cost preparation method for specially structured metal sulfides/carbon composites,which promotes their commercial utilization in environmentally friendly energy storage system.

Solving resource availability cost problem in project scheduling by pseudo particle swarm optimization

This paper considers a project scheduling problem with the objective of minimizing resource availability costs appealed to finish al activities before the deadline. There are finish-start type precedence relations among the activities which require some kinds of renewable resources. We predigest the process of sol-ving the resource availability cost problem （RACP） by using start time of each activity to code the schedule. Then, a novel heuris-tic algorithm is proposed to make the process of looking for the best solution efficiently. And then pseudo particle swarm optimiza-tion （PPSO） combined with PSO and path relinking procedure is presented to solve the RACP. Final y, comparative computational experiments are designed and the computational results show that the proposed method is very effective to solve RACP.

Empirical Studies of Effects of High Blood Pressure on Medical Costs and Heart Disease: Is the 2017 ACC/AHA Guideline Supported by Enough Evidence?

Background: The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline in November 2017. However, previous studies have pointed out that this new guideline might lack sufficient evidence to justify its use. Data and Methods: The effects of blood pressure (BP) on medical costs and on the probability of having heart disease as anamnesis are analyzed. We used a dataset containing 175,123 medical checkups and 6,312,125 receipts from 88,211 individuals obtained from three health insurance societies from April 2013 to March 2016. The dataset was divided into subgroups based on whether the patients had diabetes and took hypertension medications. The power transformation and probit models were used in the study. Results: We observed negative effects of systolic BP (SBP) on medical costs in most subgroups. We could not find evidence that higher SBP made the medical costs and probability of having heart diseases higher. The results raise uncertainty about the reliability of the new guideline, at least for SBP. Conclusion: The results of this study did not support the new 2017 ACC/AHA guideline, at least for SBP. The new guideline must be more carefully reevaluated by additional studies. Limitations: The dataset was observatory, the sample period was only 3 years, and we could not complete a time-series analysis of individuals.

Design and Implementation of a Novel HomePlug-Based Solution for Low Cost and High Performance Smart Home Networking

As the smart home is the end-point power consumer, it is the major part to be controlled in a smart micro grid. There are so many challenges for implementing a smart home system in which the most important ones are the cost and simplicity of the implementation method. It is clear that the major share of the total cost is referred to the internal controlling system network; although there are too many methods proposed but still there is not any satisfying method at the consumers＇ point of view. In this paper, a novel solution for this demand is proposed, which not only minimizes the implementation cost, but also provides a high level of reliability and simplicity of operation; feasibility, extendibility, and flexibility are other leading properties of the design.

Probabilistic remote preparation of a high-dimensional equatorial multiqubit with four-party and classical communication cost

This paper presents a protocol for probabilistic remote preparation of a high-dimensional equatorial multiqubit with four-party, consisting of a sender and three receivers. The quantum channel is composed of a partial entangled high-dimensional four-particle state. We calculate the successful total probability and the total classical communication cost required for this scheme. It is shown that both the entangled resources and classical communication cost are greatly reduced.

医护-社会组织一体化模式对HIV/AIDS患者ART及自我管理能力的影响

探究接受高效抗反转录病毒治疗确诊HIV/AIDS患者接受医护-社会组织一体化模式干预价值。方法 从2022年1月至2022年12月南昌市某定点医院接受抗病毒治疗及随访管理的新确诊HIV/AIDS患者100例,50例接受传统医护合作模式对照组、50例接受医护-社会组织一体化模式观察组,两组各项临床指标差异进行分析对比(从HIV抗体初筛阳性到启动ART治疗时间、抗病毒治疗一年后HIV病毒载量的指标及病毒抑制率、抗病毒治疗一年后自我管理能力)。结果 干预后与对照组比较,观察组HIV抗体初筛阳性到启动ART治疗时间显著偏低,HIV病毒载量指标水平显著偏低,病毒抑制率显著偏高,一年后自我管理能力评分显著偏高,用药依从性显著偏高(P<0.05)。结论 接受抗病毒治疗及随访管理的确诊HIV/AIDS患者接受医护-社会组织一体化模式干预后,可显著提高患者自我管理能力。此外,还能保障高病毒抑制率,缩短患者治疗时间,提升患者用药依从性。

Classical Communication Cost and Remote Preparation of Multi-qubit with Three-Party

We present a scheme for probabilistic remote preparation of multi-qubit with three-party from a sender to either of two receivers. The quantum channel is composed of a partial entangled tripartite GHZ state. We obtain the successful totM probability of the scheme in the general case and special case, respectively. We also calculate total classical communication cost required in the RSP process with three-party in the general case and special case, respectively.

A comparison of perspectives on costs in emergency care among emergency department patients and residents

BACKGROUND: Costs of care are increasingly important in healthcare policy and, more recently, in clinical care in the emergency department(ED). We compare ED resident and patient perspectives surrounding costs in emergency care.METHODS: We conducted a mixed methods study using surveys and qualitative interviews at a single, academic ED in the United States. The two study populations were a convenience sample of adult ED patients(>17 years of age) and ED residents training at the same institution. Participants answered open- and closed-ended questions on costs, medical decision making, cost-related compliance, and communication about costs. Closed-ended data were tabulated and described using standard statistics while open-ended responses were analyzed using grounded theory.RESULTS: Thirty ED patients and 24 ED residents participated in the study. Both patients and residents generally did not have knowledge of medical costs. Patients were comfortable discussing costs while residents were less comfortable. Residents agreed that doctors should consider costs when making medical decisions whereas patients somewhat disagreed. Additionally, residents generally took costs into consideration during clinical decision-making, yet nearly all residents agreed that they had too little education on costs.CONCLUSION: There were several notable differences in ED patient and resident perspectives on costs in this U.S. sample. While patients somewhat disagree that cost should factor into decision making, generally they are comfortable discussing costs yet report having insuf? cient knowledge of what care costs. Conversely, ED residents view costs as important and agree that cost should factor into decision making but lack education on what emergency care costs.

Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes

Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes.

Environmental and Cost Advantages of Using Polyethylene Terephthalate Fibre Reinforced Concrete with Fly Ash as a Partial Cement Replacement

Solid waste disposal is an alarming problem in most African countries. Plastic wastes like Polyethylene Terephthalate (PET) bottles and powdered wastes like fly ash are severely persisting environmental hazards. They are brutally polluting the water bodies, landfills, as well as the atmosphere. The construction industry has been working towards improving concrete quality by developing alternative methods like partial cement replacement with different pozzolanic elements as well as using waste fibrous materials. Fly ash and PET bottle fibres are two common waste materials that can be used. This article is a part of a research that studied the combined effects of the addition of PET bottle fibres and fly ash (as a partial cement replacement) on the structural performance of concrete. From a purely engineering point of view, the research results indicate that the utilization and incorporation of PET and fly ash wastes in the construction industry are a viable solution to make concrete quality better. This article presents, beyond the engineering properties and experimental works, the economic and environmental advantages of the addition of these waste materials to the conventional concrete mixture. The addition of PET bottle fibres and fly ash resulted in positive cost implications providing a production cost reduction of 19% over the conventional concrete mixture. The removal of these materials from the environment also showed reduction of the emission of toxic elements to landfills and water bodies that put human, animal and plant lives in danger.

Effects of Preoperative Risk Stratification on Direct In-hospital Costs for Chinese Patients with Coronary Artery Bypass Graft:A Single Center Analysis

The purpose of this study was to analyze the components of inpatient costs for coronary artery bypass graft(CABG)according to preoperative risk stratification and to provide evidence for improvement of diagnosis-related groups(DRGs)payment.All patients(n=458)receiving an isolated CABG between January 2014 and December 2016 in a tertiary referral center,in southwest China,were analyzed.Hospital mortality was predicted by the EuroSCORE Ⅱ for each patient. The patients were subdivided into two groups according to the observed mortality(1.97%,9/458):a high-risk group(group H,predicted mortality≥1.97%)and a low-risk group(group L,predicted mortality<1.97%).Clinical outcomes,resource use,in-hospital direct costs,and reimbursement expenses were compared between the two groups.Significant differences existed between group L and group H in postoperative mortality(0.4% vs.3.4%;P=0.02),postoperative complications(10.6% vs.45.7%;P<0.001),postoperative length of hospital stay(17.5±4.9 days vs.18.8±6.5 days,P=0.01),in-hospital costs($20 256±3096vs.$23 334±6332;P<0.001),and reimbursement expenses($7775±2627 vs.$9639±3917;P<0.001).In general,a higher EuroSCORE Ⅱ was significantly associated with a worse clinical outcome and increased costs.The CABG cost data provide evidence for improvement of DRGs payment. Key words:coronary artery bypass graft;risk stratification;hospital costs;medical insurance

Cost of Stroke Care at Public Hospitals in Brazzaville and Implication of Third Parties in Stroke Care Expenditure

Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talanga&#239; Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of stroke care. Patient families are the main financial assistance system for stroke care expenditure. To minimize the heavy financial burden induced by stroke on patients, households and families, it is important to implement a health insurance system and strengthen the stroke prevention program.

Reducing costly falls after total knee arthroplasty

AIM To investigate whether adductor canal nerve block(ACB) reduces patient falls when compared to femoral nerve block(FNB) after total knee arthroplasty(TKA). METHODS We conducted an institutional review of all-cause falls after TKA from January 2013 to August 2016 using a quality improvement database. Our inclusion criteria were patients with diagnosis of primary knee osteoarthritis who underwent primary unilateral TKA with either a FNB or an ACB and sustained a fall during their hospitalization. We excluded patients who had revision TKA and extensor mechanism reconstruction. We also excluded patients with a history of post-traumatic arthritis, prior history of lower extremity fracture, history of neurological disease, or cerebrovascular disease. RESULTS A total of 834 patients had TKA with femoral nerve block and knee immobilizer(FNB + KI). Of those patients, 11(1.3%) experienced a fall during their hospital stay. In contrast, 791 patients had TKA with ACB. Of those patients, only one(0.13%) patient fall was recorded within this group. We used the Fisher's exact test to compare the differences between the two groups. The difference between the two groups achieves statistical significance(P = 0.006). We also found that 11 out of the 12 patients that fell had a right TKA procedure while one patient had a left TKA procedure. Nine out of twelve patients that fell were female, while only three patients were male.CONCLUSION Given the reduction in the number of falls with ACB, it is recommended that ACB be considered the preferred analgesia for patients undergoing a TKA procedure.

Health care service usage and costs for high-needs elderly patients with heart failure

Heart failure(HF)has been defined as global disease of pandemic proportions,since it affects around 26 million people worldwide.[1]According to a recent study,age is the most important factor influencing the prevalence of HF,as it is for most other chronic conditions.[2]This means that,with the predicted aging of the population(the proportion of the world’s population aged 60 years and over will nearly double from 2015 to 2050),[3]there will be a growth in the total burden of HF,and a rise in the number of comorbidities in HF patients.According to a recent study,almost 86%of adults with HF have two or more comorbid conditions.[4]Comorbidity,defined as the co-existence of one or more additional conditions in individuals with a specified index medical condition,[5]adds to the complexity of treating elderly patients with HF.

Cost control for real estate development projects in China - Part 1: Literature review

The background and purpose, and the current situation of the cost control theory of real estate development project are disscussed in the paper. Problems of cost control for real estate development projects in China are analyzed and summarized. According to the real estate development project cost control problems and related factors, a cost control index system of real estate development enterprise, and a cost control factors index system of real estate projects are constructed respectively. Cost control in the five stages of a real estate development project is introduced and summarized respectively. The five stages include: the investment decision-making, planning and design stage, the bidding phase, project implementation stage, and rental or sale.