In order to effectively utilize woody biomass, which has a low abundance density, it is necessary to develop a power generation system that can convert it with high efficiency even with a small capacity as less than 2 MW. For electricity generation, it is reasonable to use a small reciprocating engine. In the case of a naturally aspirated spark ignition reciprocating engine (SIRE), the amount of aspirated gas in one cycle is determined almost entirely by the displacement. The thermal efficiency of the SIRE generally increases with the power. Therefore, to improve the thermal efficiency, it is effective to make the low heating value (LHV) of the fuel higher to increase the power of the naturally aspirated SIRE. In this paper, three methods are used to increase the LHV of the bio-syngas: 1) reducing the nitrogen density of the bio-syngas (upgrade bio-syngas), 2) adding hydrogen to the bio-syngas, and 3) adding methane to the bio-syngas. Using these fuels, 1) the conditions for high power, and 2) the costs assumed for each condition, are evaluated through experiments and estimates. The results showed that the upgrade bio-syngas, obtained by gasification with oxygen-enriched air, had the highest power and the best cost-effectiveness.

Optimizing the operation of photovoltaic (PV) storage systems is crucial for meeting the load demands of parks while minimizing curtailment and enhancing economic efficiency. This paper proposes a multi-scenario collaborative optimization strategy for PV storage systems based on a master-slave game model. Three types of energy storage system (ESS) application scenarios are designed to comprehensively stabilize PV fluctuations, compensate for load transfers, and participate in the frequency regulation (FR) market, thereby optimizing the overall operational strategy of PV storage systems in parks. The upper-level objective is to maximize the park operators\' profit, while the lower-level objective is to minimize the user\'s power supply costs. Case studies demonstrate that this strategy can significantly increase the economic benefits for park operators by 25.8%, reduce user electricity expenditures by 5.27%, and lower curtailment through a load response mechanism, thereby promoting the development and construction of PV storage parks.

3D-printed vascular models can enhance flap harvesting efficiency in abdominal free flap breast reconstruction, reducing the use of operating room time. However, no economic analyses with respect to model use in this context have been conducted to date. As such, this study examines model cost-benefit tradeoffs for use in abdominal free flap breast reconstruction.

OBJECTIVE: To analyse factors influencing the American public\'s preferences for changes to teenage driver licensing requirements.
METHODS: We employed a discrete choice experiment (DCE) with 808 participants from National Opinion Research Center\'s AmeriSpeak panel to assess preferences for two existing elements (on-road testing and intermediate licensure period) and a new feature (driver monitoring with telematics during the intermediate licensure period) of licensing system. Multinomial and mixed logit models were used to estimate preference weights, marginal rates of substitution and the relative importance of each attribute.
RESULTS: Among 730 respondents who completed all DCE choice tasks, we found robust support for changes to teenage driver licensing requirements, with preferences varying by individual characteristics. Respondents expressed a high baseline support for changes to teen driving licensure policies. They favoured testing, prioritising easy tests and opposed prolonged driver monitoring and extended intermediate licensure periods. Baseline preference weights exhibited substantial heterogeneity, emphasising the diversity of public preferences. The marginal rates of substitution revealed a preference for extended driver monitoring over an extended intermediate licensure period. An easy test was valued at 2.85 times more than a hard one. The most influential attributes were the length of intermediate licence period and testing requirements, with the former twice as important.
CONCLUSIONS: Our study found robust support for reforms to teenage driver licensing requirements, favouring easier on-road driving tests over an extended period of intermediate licensure and driver monitoring. Public preferences for licensing systems need to be balanced with the broader policy objectives including optimising mobility and maximising safety.

Bangladesh is blessed with an extensive range of solar energy generation possibilities; however, the primary impediment to attaining its full potential in the solar energy industry is the inadequate budget in the energy sector. As a result, determining the most economical and efficient solar module configuration for each specific scenario has become a critical necessity. This study offers a comprehensive techno-economic analysis and environmental impact assessment of four distinct solar modules: monofacial, bifacial, dual-axis solar tracker, and seasonal tilt solar module, in an open area of South Sakucia Union, Bhola district, in the southwest part of Bangladesh. By integrating energy-generation capabilities, financial metrics, and environmental benefits, this research provides a holistic evaluation framework to ensure optimal economic performance and minimal adverse environmental effects for sustainable solar solutions in Bangladesh. Utilizing PV*SOL, PVsyst, and System Advisor Model (SAM) software, this study assesses energy-generation capabilities and economic viability. Despite the dual-axis solar tracker exhibiting the highest average energy generation (149,070.3 kWh/year), its higher initial cost renders it less financially viable compared to other configurations. Financial metrics reveal that the seasonal tilt configuration is the most cost-efficient, with the lowest Levelized Cost of Electricity (LCOE) at $0.0452/kWh and the highest Net Present Value (NPV) of $52,887.70. Additionally, it has the shortest Discounted Payback Period (DPBP) at 12.69 years, a favorable Internal Rate of Return (IRR) of 9.460 %, and a Profitability Index (PI) of 1.459, indicating robust returns on investment. These findings emphasize the importance of considering both energy-generation capabilities and financial metrics when evaluating solar module configurations in the southern part of Bangladesh, serving as a valuable reference for policymakers. Moreover, meticulous environmental impact assessments assist in choosing configurations with minimal adverse effects on the environment.

UNASSIGNED: Parkinson\'s disease is a brain condition causing a progressive loss of co ordination and movement problems. Around 145,500 people have Parkinson\'s disease in the United Kingdom. Levodopa is the most prescribed treatment for managing motor symptoms in the early stages. Patients should be monitored by a specialist every 6-12 months for disease progression and treatment of adverse effects. Wearable devices may provide a novel approach to management by directly monitoring patients for bradykinesia, dyskinesia, tremor and other symptoms. They are intended to be used alongside clinical judgement.
UNASSIGNED: To determine the clinical and cost-effectiveness of five devices for monitoring Parkinson\'s disease: Personal KinetiGraph, Kinesia 360, KinesiaU, PDMonitor and STAT-ON.
UNASSIGNED: We performed systematic reviews of all evidence on the five devices, outcomes included: diagnostic accuracy, impact on decision-making, clinical outcomes, patient and clinician opinions and economic outcomes. We searched MEDLINE and 12 other databases/trial registries to February 2022. Risk of bias was assessed. Narrative synthesis was used to summarise all identified evidence, as the evidence was insufficient for meta-analysis. One included trial provided individual-level data, which was re-analysed. A de novo decision-analytic model was developed to estimate the cost-effectiveness of Personal KinetiGraph and Kinesia 360 compared to standard of care in the UK NHS over a 5-year time horizon. The base-case analysis considered two alternative monitoring strategies: one-time use and routine use of the device.
UNASSIGNED: Fifty-seven studies of Personal KinetiGraph, 15 of STAT-ON, 3 of Kinesia 360, 1 of KinesiaU and 1 of PDMonitor were included. There was some evidence to suggest that Personal KinetiGraph can accurately measure bradykinesia and dyskinesia, leading to treatment modification in some patients, and a possible improvement in clinical outcomes when measured using the Unified Parkinson\'s Disease Rating Scale. The evidence for STAT-ON suggested it may be of value for diagnosing symptoms, but there is currently no evidence on its clinical impact. The evidence for Kinesia 360, KinesiaU and PDMonitor is insufficient to draw any conclusions on their value in clinical practice. The base-case results for Personal KinetiGraph compared to standard of care for one-time and routine use resulted in incremental cost-effectiveness ratios of £67,856 and £57,877 per quality-adjusted life-year gained, respectively, with a beneficial impact of the Personal KinetiGraph on Unified Parkinson\'s Disease Rating Scale domains III and IV. The incremental cost-effectiveness ratio results for Kinesia 360 compared to standard of care for one-time and routine use were £38,828 and £67,203 per quality-adjusted life-year gained, respectively.
UNASSIGNED: The evidence was limited in extent and often low quality. For all devices, except Personal KinetiGraph, there was little to no evidence on the clinical impact of the technology.
UNASSIGNED: Personal KinetiGraph could reasonably be used in practice to monitor patient symptoms and modify treatment where required. There is too little evidence on STAT-ON, Kinesia 360, KinesiaU or PDMonitor to be confident that they are clinically useful. The cost-effectiveness of remote monitoring appears to be largely unfavourable with incremental cost-effectiveness ratios in excess of £30,000 per quality-adjusted life-year across a range of alternative assumptions. The main driver of cost-effectiveness was the durability of improvements in patient symptoms.
UNASSIGNED: This study is registered as PROSPERO CRD42022308597.
UNASSIGNED: This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135437) and is published in full in Health Technology Assessment; Vol. 28, No. 30. See the NIHR Funding and Awards website for further award information.
Parkinson’s disease is a brain condition causing loss of co-ordination and movement problems. Levodopa is the most prescribed treatment for early disease. Patients should be seen by a specialist every 6–12 months to assess their treatment needs. Wearable devices (like smart watches) may aid management by directly monitoring patients for disease symptoms including tremor and slowness of movement (bradykinesia), or side effects of treatment like involuntary movement (dyskinesia). This assessment considered the clinical and economic value of five wearable devices: Personal KinetiGraph, STAT-ON, Kinesia 360, KinesiaU and PDMonitor. We searched medical databases to find all studies of the five devices. We assessed the quality of these studies and reviewed their results. We found 77 studies of the devices. There was some evidence to suggest that Personal KinetiGraph can accurately measure bradykinesia and dyskinesia, leading to treatment modification in some patients, and a possible improvement in symptoms. The evidence for STAT-ON suggested it may be of value for diagnosing symptoms, but there is currently no evidence on its clinical value. There was insufficient evidence for Kinesia 360, KinesiaU and PDMonitor to draw any conclusions. An economic analysis was conducted to investigate whether using any of these technologies is economically viable. The economic analysis found that the quality-of-life benefits generated by remote monitoring devices were small relative to the additional costs of implementing them in the NHS. As such, none of the remote monitoring devices were good value for money when compared with the current standard of care.

The production of coconut tree seedlings is an important step in the production process, as it substantially affects the productive performance of the adult plant, and the way of obtaining seedlings directly reflects the added costs. To minimize costs, the introduction of biostimulants can be considered a viable and sustainable technology. This study aimed to evaluate the effects of applying Bacillus cereus in promoting growth and reducing the costs of producing Brazilgreen dwarf coconut seedlings. The study has two stages, the first was an experiment carried out in a commercial nursery in the state of Pará-Brazil. The design was completely randomized, with two treatments: control with water (100% mineral fertilization) and B. cereus inoculation (50% mineral fertilization), with 10 replicates each. Biometric parameters and the quality of seedlings were evaluated. In the second stage, the production of stimulated seedlings was compared to that of commercial seedlings, and the effective operating cost (COE) and the total operating cost (TOC) were determined. Biostimulation with B. cereus promotes the growth of coconut tree seedlings, increases seedling quality, and reduces nursery time. In addition, the cost of production is reduced by 10%. Thus, microbial technology is a positive strategy for the production of Brazilian green dwarf coconut seedlings. Using B. cereus can guarantee obtaining seedlings with high performance and at a lower cost. These results may favor obtaining adult plants with high productivity.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12088-023-01163-9.

This work evaluates the effects of economic conditions\' variations on the costs and viability of floating photovoltaics, a novel solution where modules are installed on or above water. A sensitivity analysis of key economic criteria is conducted across multiple European countries, first generating country-specific baseline scenarios and then introducing systematic variations into the input parameters. The results show that capital expenditure and electricity prices, which have both experienced significant variations in recent years, have the largest influence on the net present value and the internal rate of return. Similarly, capital expenditure and discount rate are found to be the most influencing factors for the levelized cost of electricity. Overall, this study contributes to the literature by identifying the correlations between the economic variables and the viability of floating photovoltaics. The findings can be used to assess the effectiveness of potential government policies and support mechanisms and to evaluate the viability of this technology under varying national and international economic conditions.

This study investigates the synthesize of activated carbon for carbon dioxide adsorption using palm kernel shell (PKS), a by-product of oil palm industry. The adsorbent synthesis involved a simple two-step carbonization method. Firstly, PKS was activated with potassium oxide (KOH), followed by functionalization with magnesium oxide (MgO). Surface analysis revealed that KOH activated PKS has resulted in a high specific surface area of 1086 m2/g compared to untreated PKS (435 m2/g). However, impregnation of MgO resulted in the reduction of surface area due to blockage of pores by MgO. Thermogravimetric analysis (TGA) demonstrated that PKS-based adsorbents exhibited minimal weight loss of less than 30% up to 500 °C, indicating their suitability for high-temperature applications. CO2 adsorption experiments revealed that PKS-AC-MgO has achieved a higher adsorption capacity of 155.35 mg/g compared to PKS-AC (149.63 mg/g) at 25 °C and 5 bars. The adsorption behaviour of PKS-AC-MgO was well fitted by both the Sips and Langmuir isotherms, suggesting a combination of both heterogeneous and homogeneous adsorption and indicating a chemical reaction between MgO and CO2. Thermodynamic analysis indicated a spontaneous and thermodynamically favourable process for CO2 capture by PKS-AC-MgO, with negative change in enthalpy (- 0.21 kJ/mol), positive change in entropy (2.44 kJ/mol), and negative change in Gibbs free energy (- 729.61 J/mol, - 790.79 J/mol, and - 851.98 J/mol) across tested temperature. Economic assessment revealed that the cost of PKS-AC-MgO is 21% lower than the current market price of commercial activated carbon, indicating its potential for industrial application. Environmental assessment shows a significant reduction in greenhouse gas emissions (381.9 tCO2) through the utilization of PKS-AC-MgO, underscoring its environmental benefits. In summary, the use of activated carbon produced from PKS and functionalised with MgO shows great potential for absorbing CO2. This aligns with the ideas of a circular economy and sustainable development.

UNASSIGNED: In the SVR (Single Ventricle Reconstruction) Trial, 1-year survival in recipients of right ventricle to pulmonary artery shunts (RVPAS) was superior to that in those receiving modified Blalock-Taussig-Thomas shunts (MBTTS), but not in subsequent follow-up. Cost analysis is an expedient means of evaluating value and morbidity.
UNASSIGNED: The purpose of this study was to evaluate differences in cumulative hospital costs between RVPAS and MBTTS.
UNASSIGNED: Clinical data from SVR and costs from Pediatric Health Information Systems database were combined. Cumulative hospital costs and cost-per-day-alive were compared serially at 1, 3, and 5 years between RVPAS and MBTTS. Potential associations between patient-level factors and cost were explored with multivariable models.
UNASSIGNED: In total, 303 participants (55% of the SVR cohort) from 9 of 15 sites were studied (48% MBTTS). Observed total costs at 1 year were lower for MBTTS ($701,260 ± 442,081) than those for RVPAS ($804,062 ± 615,068), a difference that was not statistically significant (P = 0.10). Total costs were also not significantly different at 3 and 5 years (P = 0.21 and 0.32). Similarly, cost-per-day-alive did not differ significantly for either group at 1, 3, and 5 years (all P > 0.05). In analyses of transplant-free survivors, total costs and cost-per-day-alive were higher for RVPAS at 1 year (P = 0.05 for both) but not at 3 and 5 years (P > 0.05 for all). In multivariable models, aortic atresia and prematurity were associated with increased cost-per-day-alive across follow-up (P < 0.05).
UNASSIGNED: Total costs do not differ significantly between MBTTS and RVPAS. The magnitude of longitudinal costs underscores the importance of efforts to improve outcomes in this vulnerable population.