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An accurate estimate of a capital expenditure (CAPEX) is foundational to timely and profitable implementation of a new or proven technology. In industries ranging from renewable energy production and petroleum refining to semiconductor and consumer product manufacturing, detailed cost estimating methodologies can be used to quantify the cost of design and construction operations, as well as the overall investment. Capital cost estimates are designated by phases that progress until the technology is commercialized.

The Williams discuss that early-stage capital cost estimates are critical to determining the financial feasibility of a project. Thoughtful decisions about capital investment expenditures (CAPEX) can ensure the success of operations and the ability to reliably supply products to customers. In industries such as renewable energy production, petroleum refining, semiconductor manufacturing, and consumer product manufacturing, early-stage cost estimation enables selection of profitable investment opportunities. The author defines five types of capital cost estimates, but focuses on early-stage cost correlations, and unit cost estimates.

In November 2016, an unprecedented epidemic thunderstorm asthma event in Victoria, Australia, resulted in many thousands of people developing breathing difficulties in a very short period of time, including 10 deaths, and created extreme demand across the Victorian health services. To better prepare for future events, a pilot forecasting system for epidemic thunderstorm asthma (ETSA) risk has been developed for Victoria. The system uses a categorical risk-based approach, combining operational forecasting of gusty winds in severe thunderstorms with statistical forecasts of high ambient grass pollen concentrations, which together generate the risk of epidemic thunderstorm asthma. This pilot system provides the first routine daily epidemic thunderstorm asthma risk forecasting service in the world that covers a wide area, and integrates into the health, ambulance, and emergency management sector. Epidemic thunderstorm asthma events have historically occurred infrequently, and no event of similar magnitude has impacted the Victorian health system since. However, during the first three years of the pilot, 2017–19, two high asthma presentation events and four moderate asthma presentation events were identified from public hospital emergency department records. The ETSA risk forecasts showed skill in discriminating between days with and without health impacts. However, even with hindsight of the actual weather and airborne grass pollen conditions, some high asthma presentation events occurred in districts that were assessed as low risk for ETSA, reflecting the challenge of predicting this unusual phenomenon.

BackgroundTardive dyskinesia (TD) is a movement disorder associated with prolonged exposure to antipsychotics. The current study was designed to describe demographics and comorbidities for patients with a dyskinesia diagnosis as probable TD (cohort 1), patients likely to have undiagnosed/uncoded TD (cohort 2), and a control population.MethodsThis retrospective study analyzed Medicaid claims data from July 2013-March 2017. For a pool of patients with a history of 3 months or more of taking an antipsychotic, three cohorts were evaluated: cohort 1 (ICD-9/10 codes for dyskinesia); cohort 2 (propensity score matching to cohort 1); and cohort 3 (patients withschizophrenia, major depressive disorder [MDD], and/or bipolar disorder [BD] and history of ≤2 antipsychotic medications). Outcomes included patient characteristics, Charlson Comorbity Index (CCI) and healthcare utilization (pre-and post [12-month] period).ResultsCohort sizes and characteristics were: cohort 1 (n=1,887; female, 68%; mean age, 42 years; MDD, 17%; BD, 48%); cohort 2 (n=1,572; female, 58%; mean age, 39 years; MDD, 22%; BD, 48%); cohort 3 (n=25,949; female, 67%; mean age, 40 years; MDD, 11%; BD, 49%). Cohorts 1 and 2 had higher comorbidity burden than cohort 3 (mean pre-index CCIs: 0.68, 0.79, and 0.47, respectively; p<0.001 for each cohort). After 12 months, mean per member per year healthcare costs were higher in cohort 1 and2 compared to cohort 3 ( $21,293, $ 18,988, and $11,522, respectively), as were mean claims per member per year (185, 138, and 109, respectively).ConclusionIn the study population, patients likely suffering from TD, ICD-9/10 code-confirmed or unconfirmed, have a higher overall comorbidity burden and healthcareutilization than those who probably do not have TD.Funding AcknowledgementsThis study was funded by Neurocrine Biosciences, Inc.

According to Pew Research, the labor participation rate of individuals ages 15 to 64 has settled to just 61.5 percent, while retirement has doubled in the past two years. Typical time-wasting tasks include: * Missing parts or procedures on the repair order * Incorrect, damaged, or missing parts * Ease of access to needed materials * In-process quality issues * Production reprioritization Creating a process Whenever the technician is off-task, time and money is lost. How do we address this? * Accurate and complete damage analysis before a vehicle enters production * Parts availability, accuracy, and verification prior to production * Needed materials accessable within the workspace * Real-time quality validation and verification processes * Visible production management based on schedule Doing all of these steps requires an investment of time and resources, but the return is much greater than the investment.

[...]multiply that number by sales per hour in the previous formula. Among the best practices to do this include: * Scheduling to production capacity rather than grabbing the keys * Completing the damage assessment before production rather than tearing down in production * Verifying critical parts are on hand before the vehicle enters production, rather than starting on it and having to stop * Verifying parts for accuracy and quality before production * Verifying and validating quality electronically during the repair phases to eliminate redos rather than a postrepair inspection * Reducing wasted movement by having materials readily available at the vehicle rather than centralized supply cabinets * Communicating electronically to focus on task(s) rather than chasing people and parts around the shop Labor optimization is critical to the survival of the industry and ultimately, to the survival of your shop. Ted is a secondgeneration collision repairer and former multiple-time Skills USA/VICA Collision Repair Champion.