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When are solar refrigerators less costly than on-grid refrigerators: A simulation modeling study.

ABSTRACT: Gavi recommends solar refrigerators for vaccine storage in areas with less than eight hours of electricity per day, and WHO guidelines are more conservative. The question remains: Can solar refrigerators provide value where electrical outages are less frequent?Using a HERMES-generated computational model of the Mozambique routine immunization supply chain, we simulated the use of solar versus electric mains-powered refrigerators (hereafter referred to as "electric refrigerators") at different locations in the supply chain under various circumstances.At their current price premium, the annual cost of each solar refrigerator is 132% more than each electric refrigerator at the district level and 241% more at health facilities. Solar refrigerators provided savings over electric refrigerators when one-day electrical outages occurred more than five times per year at either the district level or the health facilities, even when the electric refrigerator holdover time exceeded the duration of the outage. Two-day outages occurring more than three times per year at the district level or more than twice per year at the health facilities also caused solar refrigerators to be cost saving. Lowering the annual cost of a solar refrigerator to 75% more than an electric refrigerator allowed solar refrigerators to be cost saving at either level when one-day outages occurred more than once per year, or when two-day outages occurred more than once per year at the district level or even once per year at the health facilities.Our study supports WHO and Gavi guidelines. In fact, solar refrigerators may provide savings in total cost per dose administered over electrical refrigerators when electrical outages are less frequent. Our study identified the frequency and duration at which electrical outages need to occur for solar refrigerators to provide savings in total cost per dose administered over electric refrigerators at different solar refrigerator prices.

SUBMITTER: Haidari LA

PROVIDER: S-EPMC5548121 | biostudies-other | 2017 Apr

REPOSITORIES: biostudies-other

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Project description:BackgroundComputed tomography (CT) colonography's effectiveness, its associated patient advantages, and its potential role to increase colorectal cancer (CRC) screening rates have been demonstrated in previous research, but whether CT colonography has a cost advantage relative to optical colonoscopy for the commercially insured US population has not been assessed.ObjectiveTo compare the costs of CRC screening using CT colonography or optical colonoscopy for commercially insured people in the United States.MethodsUsing retrospective commercial healthcare claims data and peer-reviewed studies, we performed a simulated multiyear, matched-case comparison of the costs of CT and optical colonoscopies for CRC screening. We estimated commercial optical colonoscopy costs per screening based on the 2016 Truven Health MarketScan Commercial Database and ancillary services, such as bowel preparation, anesthesia, pathology, and complication costs. We developed 4 scenarios for CT colonography cost per screening using the ratio of commercial to Medicare fees, and calculated ancillary service and follow-up costs from payers' costs for these services when associated with optical colonoscopies. For comparison, we converted the costs per screening to the costs per screening year per person using real-world screening intervals that were obtained from peer-reviewed studies.ResultsIn 2016, the average optical colonoscopy screening cost for commercial payers was $2033 (N = 406,068), or $340 per screening year per person. With our highest-cost CT colonography scenario, CT colonography costs 22% less, or $265 per screening year, than optical colonoscopy, mostly because of the advantages for patients of no anesthesia and the greatly reduced use of pathology services.ConclusionsThe use of CT colonography for CRC testing offers effective screening, patient-centered advantages, and lower costs compared with optical colonoscopy, and may be particularly appealing to the currently unscreened population with commercial health insurance. If the availability of CT colonography expands to meet the increased demand for it, CT colonography could cost up to 50% less than optical colonoscopy per screening year.

Project description:Grid cells are a special class of spatial cells found in the medial entorhinal cortex (MEC) characterized by their strikingly regular hexagonal firing fields. This spatially periodic firing pattern is originally considered to be independent of the geometric properties of the environment. However, this notion was contested by examining the grid cell periodicity in environments with different polarity (Krupic et al., 2015) and in connected environments (Carpenter et al., 2015). Aforementioned experimental results demonstrated the dependence of grid cell activity on environmental geometry. Analysis of grid cell periodicity on practically infinite variations of environmental geometry imposes a limitation on the experimental study. Hence we analyze the dependence of grid cell periodicity on the environmental geometry purely from a computational point of view. We use a hierarchical oscillatory network model where velocity inputs are presented to a layer of Head Direction cells, outputs of which are projected to a Path Integration layer. The Lateral Anti-Hebbian Network (LAHN) is used to perform feature extraction from the Path Integration neurons thereby producing a spectrum of spatial cell responses. We simulated the model in five types of environmental geometries such as: (1) connected environments, (2) convex shapes, (3) concave shapes, (4) regular polygons with varying number of sides, and (5) transforming environment. Simulation results point to a greater function for grid cells than what was believed hitherto. Grid cells in the model encode not just the local position but also more global information like the shape of the environment. Furthermore, the model is able to capture the invariant attributes of the physical space ingrained in its LAHN layer, thereby revealing its ability to classify an environment using this information. The proposed model is interesting not only because it is able to capture the experimental results but, more importantly, it is able to make many important predictions on the effect of the environmental geometry on the grid cell periodicity and suggesting the possibility of grid cells encoding the invariant properties of an environment.

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When are solar refrigerators less costly than on-grid refrigerators: A simulation modeling study.

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