In recent years, there has been global interest in meeting targets relating to energy affordability and security while taking into account greenhouse gas emissions. This has heightened major interest in potential inve...In recent years, there has been global interest in meeting targets relating to energy affordability and security while taking into account greenhouse gas emissions. This has heightened major interest in potential investigations into the use of supercritical carbon dioxide (sCO2) power cycles. Climate change mitigation is the ultimate driver for this increased interest;other relevant issues include the potential for high cycle efficiency and a circular economy. In this study, a 25 MWe recompression closed Brayton cycle (RCBC) has been assessed, and sCO2 has been proposed as the working fluid for the power plant. The methodology used in this research work comprises thermodynamic and techno-economic analysis for the prospective commercialization of this sCO2 power cycle. An evaluated estimation of capital expenditure, operational expenditure, and cost of electricity has been considered in this study. The ASPEN Plus simulation results have been compared with theoretical and mathematical calculations to assess the performance of the compressors, turbine, and heat exchangers. The results thus reveal that the cycle efficiency for this prospective sCO2 recompression closed Brayton cycle increases (39% - 53.6%) as the temperature progressively increases from 550˚C to 900˚C. Data from the Aspen simulation model was used to aid the cost function calculations to estimate the total capital investment cost of the plant. Also, the techno-economic results have shown less cost for purchasing equipment due to fewer components being required for the cycle configuration as compared to the conventional steam power plant.展开更多
Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of ...Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of the contemporary treatment paradigm for mCRPC.Methods:We devised a treatment protocol consisting of sipuleucel-T,enzalutamide,abiraterone,docetaxel,radium-223,and cabazitaxel.We estimated number and length of treatments for each therapy using dosing schedules or progression free survival data from published clinical trials.We estimated treatment cost using billing data and Medicare reimbursement values and performed a CEA.Our analysis assumed US$100,000 per life year saved(LYS)as the threshold societal willingness to pay.Results:Incremental cost-effectiveness ratios(ICER)for strategies incorporating sipuleucel-T that were not eliminated by extended dominance exceeded the societal threshold willingnessto-pay of US$100,000 per LYS,the lowest of which was sipuleucel-T+enzalutamide+abiraterone+docetaxel at US$207,714 per LYS.Enzalutamide+abiraterone+docetaxel exhibited the most favorable ICER among strategies without sipuleucel-T at US$165,460 per LYS.Conclusion:Based on the available survival data and current costs of treatment,all treatment strategies greatly exceed a commonly assumed societal willingness-to-pay threshold of US$100,000 per LYS.Improvements in this regard can only comewith a reduction in pricing,better tailoring of treatment or significant enhancements in survival with clinical use of treatment combinations or sequences.展开更多
With the advancement of technology and health sciences,health care delivery costs are steadily increasing.This affects both households and governments.Unfortunately,the present truth is that health has become an essen...With the advancement of technology and health sciences,health care delivery costs are steadily increasing.This affects both households and governments.Unfortunately,the present truth is that health has become an essential but unaffordable commodity.This is very concerning.Quality,up-to-date,costeffective health care delivery is one of the prime objectives,and focuses on administration and health care authority.As the per capita spent on health from public/government funds is very poor in developing countries,the responsibility of cost-effective health care delivery falls primarily on the shoulder of the treating physicians.Anesthesiologists are becoming an indispensable part of health care delivery,having a diverse role in the emergency,critical care,pain,and perioperative care of patients.As the population ages,the need for surgical care is also increasing.Therefore,the anesthesiologist can also play a more significant role in delivering cost-effective health care,and minimize the cost without affecting the quality.This brief narrative review analyzes the current practice of anesthesiologists in two prime areas in the context of cost-savings:Preoperative investigation and low/minimal flow anesthesia.展开更多
This study aimed to determine the net energy expenditure(EENET)required for overground walking and running 1200 m in a sample of healthy adolescent boys and girls.A secondary purpose was to describe the effect of body...This study aimed to determine the net energy expenditure(EENET)required for overground walking and running 1200 m in a sample of healthy adolescent boys and girls.A secondary purpose was to describe the effect of body composition on energy expenditure(EE)of walking versus running.Twenty healthy adolescents(9 boys,11 girls)aged 15.85±2.80 years performed 2 field tests in regular outdoor conditions:overground walking(1.64±0.17 m/s)and submaximal running(3.13±0.42 m/s),at a self-selected steady pace.EE was measured via indirect calorimetry.Paired sample t-tests were used to determine if there were differences between walking and running conditions and mean percentage differences were estimated for various physiological parameters.Differences in EENET between conditions were performed for both genders using a two(condition)by two(gender)analysis of variance repeated measures design,with fat free mass as a covariate.Speed increased by 90.43%between the 2 conditions,while the different components of EE increased by almost 20%.Running elicited a significantly greater EENET than walking for both genders;however,boys’and girls’EE did not differ significantly.When EENET was adjusted for fat free mass,there was a statistically significant condition×fat free mass effect.The findings in this study indicate that both adolescent boys and girls expend more energy during running than walking,without being affected by body composition.Body mass and fat free mass significantly correlated with EE only during running.In addition,the trained participants of the study optimized locomotion to minimize EE.展开更多
文摘In recent years, there has been global interest in meeting targets relating to energy affordability and security while taking into account greenhouse gas emissions. This has heightened major interest in potential investigations into the use of supercritical carbon dioxide (sCO2) power cycles. Climate change mitigation is the ultimate driver for this increased interest;other relevant issues include the potential for high cycle efficiency and a circular economy. In this study, a 25 MWe recompression closed Brayton cycle (RCBC) has been assessed, and sCO2 has been proposed as the working fluid for the power plant. The methodology used in this research work comprises thermodynamic and techno-economic analysis for the prospective commercialization of this sCO2 power cycle. An evaluated estimation of capital expenditure, operational expenditure, and cost of electricity has been considered in this study. The ASPEN Plus simulation results have been compared with theoretical and mathematical calculations to assess the performance of the compressors, turbine, and heat exchangers. The results thus reveal that the cycle efficiency for this prospective sCO2 recompression closed Brayton cycle increases (39% - 53.6%) as the temperature progressively increases from 550˚C to 900˚C. Data from the Aspen simulation model was used to aid the cost function calculations to estimate the total capital investment cost of the plant. Also, the techno-economic results have shown less cost for purchasing equipment due to fewer components being required for the cycle configuration as compared to the conventional steam power plant.
文摘Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of the contemporary treatment paradigm for mCRPC.Methods:We devised a treatment protocol consisting of sipuleucel-T,enzalutamide,abiraterone,docetaxel,radium-223,and cabazitaxel.We estimated number and length of treatments for each therapy using dosing schedules or progression free survival data from published clinical trials.We estimated treatment cost using billing data and Medicare reimbursement values and performed a CEA.Our analysis assumed US$100,000 per life year saved(LYS)as the threshold societal willingness to pay.Results:Incremental cost-effectiveness ratios(ICER)for strategies incorporating sipuleucel-T that were not eliminated by extended dominance exceeded the societal threshold willingnessto-pay of US$100,000 per LYS,the lowest of which was sipuleucel-T+enzalutamide+abiraterone+docetaxel at US$207,714 per LYS.Enzalutamide+abiraterone+docetaxel exhibited the most favorable ICER among strategies without sipuleucel-T at US$165,460 per LYS.Conclusion:Based on the available survival data and current costs of treatment,all treatment strategies greatly exceed a commonly assumed societal willingness-to-pay threshold of US$100,000 per LYS.Improvements in this regard can only comewith a reduction in pricing,better tailoring of treatment or significant enhancements in survival with clinical use of treatment combinations or sequences.
文摘With the advancement of technology and health sciences,health care delivery costs are steadily increasing.This affects both households and governments.Unfortunately,the present truth is that health has become an essential but unaffordable commodity.This is very concerning.Quality,up-to-date,costeffective health care delivery is one of the prime objectives,and focuses on administration and health care authority.As the per capita spent on health from public/government funds is very poor in developing countries,the responsibility of cost-effective health care delivery falls primarily on the shoulder of the treating physicians.Anesthesiologists are becoming an indispensable part of health care delivery,having a diverse role in the emergency,critical care,pain,and perioperative care of patients.As the population ages,the need for surgical care is also increasing.Therefore,the anesthesiologist can also play a more significant role in delivering cost-effective health care,and minimize the cost without affecting the quality.This brief narrative review analyzes the current practice of anesthesiologists in two prime areas in the context of cost-savings:Preoperative investigation and low/minimal flow anesthesia.
文摘This study aimed to determine the net energy expenditure(EENET)required for overground walking and running 1200 m in a sample of healthy adolescent boys and girls.A secondary purpose was to describe the effect of body composition on energy expenditure(EE)of walking versus running.Twenty healthy adolescents(9 boys,11 girls)aged 15.85±2.80 years performed 2 field tests in regular outdoor conditions:overground walking(1.64±0.17 m/s)and submaximal running(3.13±0.42 m/s),at a self-selected steady pace.EE was measured via indirect calorimetry.Paired sample t-tests were used to determine if there were differences between walking and running conditions and mean percentage differences were estimated for various physiological parameters.Differences in EENET between conditions were performed for both genders using a two(condition)by two(gender)analysis of variance repeated measures design,with fat free mass as a covariate.Speed increased by 90.43%between the 2 conditions,while the different components of EE increased by almost 20%.Running elicited a significantly greater EENET than walking for both genders;however,boys’and girls’EE did not differ significantly.When EENET was adjusted for fat free mass,there was a statistically significant condition×fat free mass effect.The findings in this study indicate that both adolescent boys and girls expend more energy during running than walking,without being affected by body composition.Body mass and fat free mass significantly correlated with EE only during running.In addition,the trained participants of the study optimized locomotion to minimize EE.
