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BACKGROUND: The Federal Ministry of National Health Services, Regulations and Coordination (MNHSR&C) in Pakistan has committed to progress towards universal health coverage (UHC) by 2030 by providing an Essential Package of Health Services (EPHS). Starting in 2019, the Disease Control Priorities 3rd edition (DCP3) evidence framework was used to guide the development of Pakistan's EPHS. In this paper, we describe the methods and results of a rapid costing approach used to inform the EPHS design process. METHODS: A total of 167 unit costs were calculated through a context-specific, normative, ingredients-based, and bottom-up economic costing approach. Costs were constructed by determining resource use from descriptions provided by MNHSR&C and validated by technical experts. Price data from publicly available sources were used. Deterministic univariate sensitivity analyses were carried out. RESULTS: Unit costs ranged from 2019 US$ 0.27 to 2019 US$ 1478. Interventions in the cancer package of services had the highest average cost (2019 US$ 837) while interventions in the environmental package of services had the lowest (2019 US$ 0.68). Cost drivers varied by platform; the two largest drivers were drug regimens and surgery-related costs. Sensitivity analyses suggest our results are not sensitive to changes in staff salary but are sensitive to changes in medicine pricing. CONCLUSION: We estimated a large number of context-specific unit costs, over a six-month period, demonstrating a rapid costing method suitable for EPHS design.
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Cobertura Universal del Seguro de Salud , Pakistán , Humanos , Cobertura Universal del Seguro de Salud/economía , Costos y Análisis de Costo/métodos , Atención a la Salud/economía , Costos de la Atención en Salud/estadística & datos numéricos , Servicios de Salud/economíaRESUMEN
AIMS AND BACKGROUND: Whole-genome sequencing (WGS) is increasingly applied in clinical practice and expected to replace standard-of-care (SoC) genetic diagnostics in hematological malignancies. This study aims to assess and compare the fully burdened cost ('micro-costing') per patient for Swedish laboratories using WGS and SoC, respectively, in pediatric and adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). METHODS: The resource use and cost details associated with SoC, e.g. chromosome banding analysis, fluorescent in situ hybridization, and targeted sequencing analysis, were collected via activity-based costing methods from four diagnostic laboratories. For WGS, corresponding data was collected from two of the centers. A simulation-based scenario model was developed for analyzing the WGS cost based on different annual sample throughput to evaluate economy of scale. RESULTS: The average SoC total cost per patient was 2,465 for pediatric AML and 2,201 for pediatric ALL, while in adults, the corresponding cost was 2,458 for AML and 1,207 for ALL. The average WGS cost (90x tumor/30x normal; sequenced on the Illumina NovaSeq 6000 platform) was estimated to 3,472 based on an annual throughput of 2,500 analyses, however, with an annual volume of 7,500 analyses the average cost would decrease by 23% to 2,671. CONCLUSION: In summary, WGS is currently more costly than SoC, however the cost can be reduced by utilizing laboratories with higher throughput and by the expected decline in cost of reagents. Our data provides guidance to decision-makers for the resource allocation needed when implementing WGS in diagnostics of hematological malignancies.
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Pruebas Genéticas , Leucemia Mieloide Aguda , Leucemia-Linfoma Linfoblástico de Células Precursoras , Secuenciación Completa del Genoma , Humanos , Suecia , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/diagnóstico , Secuenciación Completa del Genoma/economía , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Pruebas Genéticas/economía , Pruebas Genéticas/métodos , Adulto , Niño , Masculino , Femenino , Costos y Análisis de CostoRESUMEN
The past decade has witnessed a significant evolution in the role of the Internet, transitioning from individual connectivity to an integral aspect of various domains. This shift has prompted a move in IP paradigms from hierarchical to distributed architectures characterized by decentralized structures. This transition empowers efficient data routing and management across diverse networks. However, traditional distributed mobility management (DMM) protocols, reliant on tunneling mechanisms, incur overheads, costs, and delays, exacerbating challenges in managing the exponential growth of mobile data traffic. This research proposes Tunnel-Free Mobility for IPv6 (TFMIPv6) as a solution to address the shortcomings of existing DMM protocols. TFMIPv6 eliminates the need for tunneling, simplifying routing processes and reducing latency. A comprehensive cost analysis and performance evaluation are conducted, comparing TFMIPv6 with traditional protocols such as MIPv6, PMIPv6, FMIPv6, and HMIPv6. The study reveals significant improvements with TFMIPv6. Signaling costs are reduced by 50%, packet delivery costs by 23%, and tunneling costs are completely eliminated (100%). Real-world network traffic datasets are used for simulation, providing statistical evidence of TFMIPv6's efficacy in supporting an uninterrupted movement of IPv6 data across networks.
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Costos y Análisis de Costo , Redes de Comunicación de Computadores/economía , Internet , Humanos , AlgoritmosRESUMEN
Robotic surgery has been increasingly adopted in various surgical fields, but the cost-effectiveness of this technology remains controversial due to its high cost and limited improvements in clinical outcomes. This study aims to explore the health economic implications of robotic pancreatic surgery, to investigate its impact on hospitalization costs and consumption of various medical resources. Data of patients who underwent pancreatic surgery at our institution were collected and divided into robotic and traditional groups. Statistical analyses of hospitalization costs, length of stay, costs across different service categories, and subgroup cost analyses based on age, BMI class, and procedure received were performed using t tests and linear regression. Although the total hospitalization cost for the robotic group was significantly higher than that for the traditional group, there was a notable reduction in the cost of medical consumables. The reduction was more prominent among elderly patients, obese patients, and those undergoing pancreaticoduodenectomy, which could be attributed to the technological advantages of the robotic surgery platform that largely facilitate blood control, tissue protection, and suturing. The study concluded that despite higher overall costs, robotic pancreatic surgery offers significant savings in medical consumables, particularly benefiting certain patient subgroups. The findings provide valuable insights into the economic viability of robotic surgery, supporting its adoption from a health economics perspective.
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Pancreatectomía , Procedimientos Quirúrgicos Robotizados , Centros de Atención Terciaria , Procedimientos Quirúrgicos Robotizados/economía , Procedimientos Quirúrgicos Robotizados/estadística & datos numéricos , Procedimientos Quirúrgicos Robotizados/métodos , Humanos , China , Centros de Atención Terciaria/economía , Persona de Mediana Edad , Femenino , Masculino , Anciano , Pancreatectomía/economía , Pancreatectomía/métodos , Pancreaticoduodenectomía/economía , Pancreaticoduodenectomía/métodos , Pancreaticoduodenectomía/estadística & datos numéricos , Tiempo de Internación/economía , Tiempo de Internación/estadística & datos numéricos , Análisis Costo-Beneficio , Adulto , Costos y Análisis de Costo , Páncreas/cirugía , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Costos de Hospital/estadística & datos numéricosRESUMEN
BACKGROUND: In 2018, Scotland became the second country to implement minimum unit pricing (MUP) for all types of alcoholic beverages. The aim of this study was to examine the effect of the policy. METHOD: Three national household-level surveys were used: Scottish Health Surveys (2008-2021), Health Surveys in England (2011-2019), and Northern Ireland Continuous Household Survey (2011-2015). First, a generalized ordered logistic model examined patterns of drinking solely in Scotland from 2008-2021 covering current drinking, drinking categories and the weekly consumption (in alcohol units). Secondly, difference-in-difference (DID) analysis was employed to examine changes in "social drinking" behaviours in Scotland after the announcement in 2012 (2011-2015, Northern Ireland and England as comparators) and after the adoption of the policy in 2018 (England as a comparator, with two timeframes 2016-2019 and 2013-2019). RESULTS: Overall, drinking in Scotland began to decline prior to 2012 and dropped further with the enactment of MUP in 2018. In response to MUP, the likelihood of abstention increased along with a slight decrease in the prevalence of heavy drinking. The overall amount of drinking fell by about 8% after 2012 and 12% after 2018 (as compared to 2008-2011 level), with a significant decline seen in moderate drinkers but not of those who drank at hazardous or harmful levels. The DID analyses confirmed the reduction in current drinking in Scotland starting since 2012 and continued post-MUP in 2018. CONCLUSION: This study points to the impact of MUP in Scotland with a potential role for 'policy signalling' by the Scottish Government's with a multiple-buy discount ban and MUP's announcement since 2011-2012. Indications of impact include a clear decline in alcohol consumption levels and a small but noteworthy change in prevalence of overall drinking and heavy drinking.
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Consumo de Bebidas Alcohólicas , Bebidas Alcohólicas , Escocia/epidemiología , Humanos , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/economía , Masculino , Femenino , Adulto , Bebidas Alcohólicas/economía , Persona de Mediana Edad , Adulto Joven , Adolescente , Costos y Análisis de Costo , Prevalencia , Anciano , Encuestas EpidemiológicasRESUMEN
BACKGROUND: Breastfeeding is the biological norm for feeding infants and young children. When mothers' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam. METHODS: An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation. RESULTS: The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021. CONCLUSION: Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs.
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Costos y Análisis de Costo , Bancos de Leche Humana , Leche Humana , Humanos , Vietnam , Bancos de Leche Humana/economía , Femenino , Recién Nacido , Lactante , Lactancia Materna/economíaAsunto(s)
Mano , Clase Social , Humanos , Mano/cirugía , Costos y Análisis de Costo , Estados UnidosRESUMEN
BACKGROUND: While healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets. METHODS: Data from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios. RESULTS: We observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5) than the CBD (BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8) and the EAT-Lancet diet (BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL$0.48 in the cost of the CBD, similar to standardized WF (BRL$0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL$0.20; WF: BRL$0.33) and EAT-Lancet (CF: BRL$0.04; WF: BRL$0.18) was found, but with a less pronounced effect. CONCLUSIONS: The BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.
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Dieta Saludable , Dieta , Ambiente , Brasil , Humanos , Dieta Saludable/economía , Dieta/economía , Huella de Carbono , Política Nutricional , Valor Nutritivo , Costos y Análisis de CostoRESUMEN
Shared manufacturing is a new business form that focuses on all aspects of production and manufacturing, mainly relying on the shared manufacturing platform to achieve the optimal allocation of idle resources. For enterprises, in the process of deciding to lease idle resources, the pricing and advertising investment efficiency of the shared manufacturing platform is a valuable research issue. The shared manufacturing model in this paper consists of one manufacturer and one shared manufacturing platform, which will invest in cooperative advertising while the shared manufacturing process is completed. The cooperative advertising involves four models: the traditional cooperation model, the cost-sharing contract model, the revenue-sharing contract model, and the bilateral cost-sharing contract model. We investigate the impact of some key parameters on the prices and profits of the manufacturer and the shared manufacturing platform based on the differential game. The numerical examples demonstrate the viability of the model. Finally, we provide suggestions based on the decision-making of the manufacturer and the shared manufacturing platform under different cooperative advertising models.
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Publicidad , Publicidad/economía , Publicidad/métodos , Conducta Cooperativa , Costos y Análisis de Costo , Modelos Económicos , Teoría del Juego , Humanos , Comercio/economíaRESUMEN
Within the framework of the study, conditions are analyzed, cost estimates and other characteristics of large construction projects in the medical field are presented. The article analyzes investment projects of construction medical facilities in the Russian Federation. Plans for the development of some large medical networks are also briefly highlighted. A review of literature sources on health development programs of the subjects of the Russian Federation was conducted, federal target programs were considered, investment projects for the construction of medical facilities planned for completion in 2023-2025 were studied. Some analytical results of monitoring for 2020-2023 on the activity of the investment market in the direction of the Russian strategic and institutional design of the construction of medical facilities in the Russian Federation are presented.
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Inversiones en Salud , Federación de Rusia , Humanos , Inversiones en Salud/economía , Costos y Análisis de Costo , Arquitectura y Construcción de Instituciones de Salud/economíaRESUMEN
Severe acute malnutrition (SAM) is a high-fatality condition that affected 13.7 million children under five years of age worldwide in 2022, with complicated cases requiring extensive inpatient stay with an accompanying caregiver. Our objective was to assess the costs of inpatient treatment for complicated SAM in children aged 6 to 59 months in Northern Senegal and identify cost predictors. We performed a retrospective cost analysis, including 140 children hospitalized from January to December 2020 in five SAM inpatient treatment facilities. We adopted a societal perspective, including direct medical and non-medical costs and indirect costs. We extracted patients' sociodemographic and clinical data from medical records and conducted semi-structured interviews with healthcare staff to capture information on time allocation and care management. A multivariable generalized linear model with gamma family and a log link was used to investigate the factors associated with direct costs. Costs are expressed in 2020 international USD using purchasing power parity. Mean length of stay was 5.3 (SD = 3.2) days and diarrhoea was the cause of the admission in 55.7% of cases. Mean total cost was USD 431.9 (SD = 203.9), with personnel being the largest cost item (33% of the total). Households' out-of-pocket expenses represented 45.3% of total costs and amounted to USD 195.6 (SD = 103.6). Costs were significantly associated with gender (20.3% lower in boys), diarrhoea (27% increase), anaemia (49.4% increase), inpatient death (44.9% decrease), and type of facility (26% higher in hospitals vs. health centre). Our study highlights the financial burden of complicated SAM in Senegal in particular for families. This underscores the need for tailored prevention and social policies to protect families from the disease's financial burden and improve treatment adherence, both in Senegal and similar contexts.
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Costo de Enfermedad , Desnutrición Aguda Severa , Humanos , Senegal , Lactante , Masculino , Femenino , Preescolar , Desnutrición Aguda Severa/economía , Desnutrición Aguda Severa/terapia , Estudios Retrospectivos , Hospitalización/economía , Tiempo de Internación/economía , Pacientes Internos/estadística & datos numéricos , Costos y Análisis de Costo , Costos de la Atención en Salud/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Diarrea/economía , Diarrea/terapiaRESUMEN
OBJECTIVES: To determine the actual cost and drivers of the cost of an extracorporeal cardiopulmonary resuscitation (E-CPR) care cycle. PERSPECTIVE: A time-driven activity-based costing study conducted from a healthcare provider perspective. SETTING: A quaternary care ICU providing around-the-clock E-CPR service for out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) in Australia. METHODS: The E-CPR care cycle was defined as the time from initiating E-CPR to hospital discharge or death of the patient. Detailed process maps with discrete steps and probabilistic decision nodes accounting for the complex trajectories of E-CPR patients were developed. Data about clinical and nonclinical resources and timing of activities was collected multiple times for each process . Total direct costs were calculated using the time estimates and unit costs per resource for all clinical and nonclinical resources. The total direct costs were combined with indirect costs to obtain the total cost of E-CPR. RESULTS: From 10 E-CPR care cycles observed during the study period, a minimum of 3 observations were obtained per process. The E-CPR care cycle's mean (95% CI) cost was $75,014 ($66,209-83,222). Initiation of extracorporeal membrane oxygenation (ECMO) and ECMO management constituted 18% of costs. The ICU management (35%) and surgical costs (20%) were the primary cost determinants. IHCA had a higher mean (95% CI) cost than OHCA ($87,940 [75,372-100,570] vs. 62,595 [53,994-71,890], p < 0.01), mainly because of the increased survival and ICU length of stay of patients with IHCA. The mean cost for each E-CPR survivor was $129,503 ($112,422-147,224). CONCLUSIONS: Significant costs are associated with E-CPR for refractory cardiac arrest. The cost of E-CPR for IHCA was higher compared with the cost of E-CPR for OHCA. The major determinants of the E-CPR costs were ICU and surgical costs. These data can inform the cost-effectiveness analysis of E-CPR in the future.
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Reanimación Cardiopulmonar , Oxigenación por Membrana Extracorpórea , Paro Cardíaco Extrahospitalario , Humanos , Reanimación Cardiopulmonar/economía , Oxigenación por Membrana Extracorpórea/economía , Paro Cardíaco Extrahospitalario/terapia , Paro Cardíaco Extrahospitalario/economía , Paro Cardíaco Extrahospitalario/mortalidad , Australia , Unidades de Cuidados Intensivos/economía , Factores de Tiempo , Masculino , Femenino , Persona de Mediana Edad , Paro Cardíaco/terapia , Paro Cardíaco/economía , Paro Cardíaco/mortalidad , Costos de la Atención en Salud/estadística & datos numéricos , Costos y Análisis de CostoRESUMEN
While studies have theoretically discussed the impact of carbon pricing on renewable energy, the practical implementation and effectiveness of these policies remain uncertain. This study empirically examines the role of carbon emissions trading and carbon tax in global renewable energy development using panel data from 196 countries and regions and employing the staggered difference-in-differences (DID) model and Bacon decomposition method. The results suggest that: (1) From the perspective of policy shocks, carbon trading has increased non-hydro renewable electricity generation by 73.32%, while carbon tax has increased it by 31.79%. This indicates that the overall impact of carbon trading on renewable energy is greater than that of carbon tax. However, the elasticity coefficients of renewable energy to carbon trading prices and carbon tax rates are 0.1801 and 0.1845, respectively, suggesting a slightly greater marginal effect of carbon tax on renewable energy compared to carbon trading. (2) Both carbon tax and carbon trading have mitigated the growth of fossil electricity and encouraged public investment in renewable energy, thereby fostering its development. (3) The influence of carbon pricing on renewable energy varies by income level; notably, the implementation of these policies in high-income countries has diminished their promotional effect on renewable energy. (4) The contribution of technological innovation to renewable energy development is smaller than that of policies including carbon trading and carbon tax, indicating that renewable energy development during the sample period was predominantly driven by policy measures. The findings indicate that the application of carbon pricing policies should be further promoted to accelerate the energy mix transition.
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Carbono , Energía Renovable , Energía Renovable/economía , Impuestos , Costos y Análisis de CostoRESUMEN
BACKGROUND: Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. Published data have shown that potassium-binding polymer patiromer (Veltassa) is associated with reduced rates of severe edema and hospitalization for heart failure compared with sodium zirconium cyclosilicate (SZC, Lokelma) when treating hyperkalemia. The aim of this study was to evaluate the possible costs associated with these interventions in the Spanish and UK settings. METHODS: A cost-analysis model was developed in Microsoft Excel to compare the costs associated with patiromer and SZC for the management of hyperkalemia. Clinical event rates were taken from a published real-world comparative study, with the base case capturing the statistically significant reduction in severe edema with patiromer vs SZC and a sensitivity analysis also including the non-statistically significant reduction in hospitalization for heart failure. Country-specific costs, expressed in 2022 Euros (EUR) and British pounds sterling (GBP), were evaluated from a healthcare payer perspective and included pharmacy costs and costs of clinical events. RESULTS: Patiromer may be associated with cost savings of EUR 107 and GBP 630 per patient-year of treatment vs SZC in Spain and the UK, respectively. The majority of cost savings were due to the possible lower daily cost of patiromer compared with SZC. Including the difference in heart failure hospitalization rates in a sensitivity analysis led to greater cost savings with patiromer over SZC, increasing to EUR 460 and GBP 902 in Spain and the UK, respectively. Extrapolation of patient-level economic outcomes to a population level found that patiromer was associated with annual cost savings of EUR 30.6 million in Spain, and GBP 801.7 million in the UK vs SZC. CONCLUSIONS: Patiromer has the potential to be cost saving vs SZC for the treatment of hyperkalemia in Spain and the UK based on the results of a real-world evidence analysis.
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Hiperpotasemia , Polímeros , Silicatos , Hiperpotasemia/tratamiento farmacológico , Hiperpotasemia/economía , Humanos , España , Reino Unido , Polímeros/uso terapéutico , Silicatos/uso terapéutico , Silicatos/economía , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/economía , Análisis Costo-Beneficio , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Costos y Análisis de Costo , Modelos EconométricosRESUMEN
Despite significant capital and operating costs, mechanical vapor compression (MVC) remains the preferred technology for challenging brine concentration applications. This work seeks to assess the dependence of MVC costs on feedwater salinity and desired water recovery and to quantify the value of improved component performance or reduced component costs for reducing the levelized cost of water (LCOW) of MVC. We built a cost optimization model coupling thermophysical, heat and mass transfer, and technoeconomic models to optimize and identify low cost MVC system designs as a function of feedwater salinity and water recovery. The LCOW ranges over 3.6 to 6.1 $/m3 for seawater feed salinities of 25-150 g/kg and water recoveries of 40-80 %. We then perform sensitivity analysis on parameter inputs to isolate irreducible costs and determine high value component innovation targets. The LCOW was most sensitive to evaporator material costs and performance, including the overall heat transfer coefficient in the evaporator. Process and material innovations such as polymer-composite evaporator tubes that reduce evaporator costs by 25 % without reducing heat transfer performance by more than 10 % would result in MVC cost reductions of 8 %.
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Salinidad , Modelos Teóricos , Sales (Química) , Agua de Mar , Costos y Análisis de CostoRESUMEN
Infertility affects millions worldwide, with significant medical, financial, and emotional challenges, particularly in low- and middle-income countries (LMICs). Cultural, religious, financial, and gender-related barriers hinder access to treatment, exacerbating social and economic consequences, especially for women. Despite its prevalence, infertility often remains overlooked due to competing health priorities. However, global initiatives recognise infertility as a reproductive health concern, advocating for universal access to high-quality fertility care. In LMICs, limited resources and infrastructure impede access to treatment, prompting people to turn to alternative, often ineffective, non-biomedical solutions. Addressing these challenges requires implementing affordable fertility care services tailored to local contexts, supported by political commitment and community engagement. Emerging technologies offer promising solutions, but comprehensive education and training programs are essential for their effective implementation. By integrating fertility care into broader health policies and fostering partnerships, we can ensure equitable access to infertility treatment and support reproductive health worldwide.
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Países en Desarrollo , Infertilidad , Servicios de Salud Reproductiva , Infertilidad/terapia , Preservación de la Fertilidad , Servicios de Salud Reproductiva/economía , Servicios de Salud Reproductiva/normas , Accesibilidad a los Servicios de Salud , Factores Socioeconómicos , Religión , Costos y Análisis de Costo , HumanosAsunto(s)
Sepsis , Humanos , Sepsis/diagnóstico , Metagenómica/métodos , Adulto , Costos y Análisis de Costo , Masculino , Femenino , Persona de Mediana EdadRESUMEN
Clean water is an integral part of industries, agricultural activities and human life, but water contamination by toxic dyes, heavy metals, and oil spills is increasingly serious in the world. Aerogels with unique properties such as highly porous and extremely low density, tunable surface modification, excellent reusability, and thermal stability can contribute to addressing these issues. Thanks to high purity, biocompatibility and biodegradability, bacterial cellulose can be an ideal precursor source to produce aerogels. Here, we review the modification, regeneration, and applications of bacterial cellulose-based aerogels for water treatment. The modification of bacterial cellulose-based aerogels undergoes coating of hydrophobic agents, carbonization, and incorporation with other materials, e.g., ZIF-67, graphene oxide, nanoparticles, polyaniline. We emphasized features of modified aerogels on porosity, hydrophobicity, density, surface chemistry, and regeneration. Although major limits are relevant to the use of toxic coating agents, difficulty in bacterial culture, and production cost, the bacterial cellulose aerogels can obtain high performance for water treatment, particularly, catastrophic oil spills.
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Bacterias , Celulosa , Geles , Purificación del Agua , Celulosa/química , Purificación del Agua/métodos , Geles/química , Costos y Análisis de Costo , Contaminantes Químicos del Agua/química , Porosidad , Biodegradación Ambiental , Interacciones Hidrofóbicas e HidrofílicasRESUMEN
AIMS: Alcohol pricing policies may reduce alcohol-related harms, yet little work has been done to model their effectiveness beyond health outcomes especially in Australia. We aim to estimate the impacts of four taxation and minimum unit pricing (MUP) interventions on selected social harms across sex and age subgroups in Australia. METHODS: We used econometrics and epidemiologic simulations using demand elasticity and risk measures. We modelled four policies including (A) uniform excise rates (UER) (based on alcohol units) (B) MUP $1.30 on all alcoholic beverages (C) UER + 10 % (D) MUP$ 1.50. People who consumed alcohol were classified as (a) moderate (≤ 14 Australian standard drinks (SDs) per week) (b) Hazardous (15-42 SDs per week for men and 14-35 ASDs for women) and (c) Harmful (> 42 SDs per week for men and > 35 ASDs for women). Outcomes were sickness absence, sickness presenteeism, unemployment, antisocial behaviours, and police-reported crimes. We used relative risk functions from meta-analysis, cohort study, cross-sectional survey, or attributable fractions from routine criminal records. We applied the potential impact fraction to estimate the reduction in social harms by age group and sex after implementation of pricing policies. RESULTS: All four modelled pricing policies resulted in a decrease in the overall mean baseline of current alcohol consumption, primarily due to fewer people drinking harmful amounts. These policies also reduced the total number of crimes and workplace harms compared to the current taxation system. These reductions were consistent across all age and sex subgroups. Specifically, sickness absence decreased by 0.2-0.4 %, alcohol-related sickness presenteeism by 7-9 %, unemployment by 0.5-0.7 %, alcohol-related antisocial behaviours by 7.3-11.1 %, and crimes by 4-6 %. Of all the policies, the implementation of a $1.50 MUP resulted in the largest reductions across most outcome measures. CONCLUSION: Our results highlight that alcohol pricing policies can address the burden of social harms in Australia. However, pricing policies should just form part of a comprehensive alcohol policy approach along with other proven policy measures such as bans on aggressive marketing of alcoholic products and enforcing the restrictions on the availability of alcohol through outlet density regulation or reduced hours of sale to have a more impact on social harms.