Improving small-scale fishermen's subjective well-being in Indonesia: Does the internet use play a role?

The expansion of Internet access from urban to rural and coastal areas has changed all aspects of life, including lifestyles and work practices. Although several studies have shown that Internet use is essential in the fisheries sector, more information about the link between Internet usage and subjective well-being among small-scale fishermen is needed. This study is the first attempt to investigate the effect of Internet use on subjective well-being, particularly for small-scale fishers. This study used cross-sectional data from 220 respondents in East Java, Indonesia. Two-stage predictor substitution (2SPS) approaches were used to address the endogeneity issue in the estimation. The results revealed that fishing tools, access to credit, and region positively and significantly influenced small-scale fishers' determination to use the Internet. Savings and off-farm employment significantly and negatively affect adoption decisions. The main findings suggest that Internet use significantly increases small-scale fishermen's subjective well-being (proxied by happiness and life satisfaction). This suggests that improving the Internet infrastructure in coastal areas is needed to support economic activities in the fisheries sector and boost the well-being of small-scale fishers.

Effects of straw returning combined with blended controlled-release urea fertilizer on crop yields, greenhouse gas emissions, and net ecosystem economic benefits: A nine-year field trial

Although straw returning combined with blended controlled-release urea fertilizer (BUFS) has been shown to improve wheat-maize rotation system productivity, their effects on greenhouse gas (GHG) emissions, carbon footprints (CF), and net ecosystem economic benefits (NEEB) are still unknown. Life cycle assessment was used to investigate a long-term (2013-2022) wheat-maize rotation experiment that included straw combined with two N fertilizer types [BUFS and (conventional urea fertilizer) CUFS] and straw-free treatments (BUF and CUF). The results showed that BUFS and CUFS treatments increased the annual yield by 13.8% and 11.5%, respectively, compared to BUF and CUF treatments. The BUFS treatment increased the yearly yield by 13.8% compared to the CUFS treatment. Since BUFS and CUFS treatments increased soil organic carbon (SOC) sink sequestration by 25.0% and 27.0% compared to BUF and CUF treatments, they reduced annual GHG emissions by 7.1% and 4.7% and CF per unit of yield (CFY) by 13.7% and 9.6%, respectively. BUFS treatment also increased SOC sink sequestration by 20.3%, reduced GHG emissions by 10.7% and CFY by 23.0% compared to CUFS treatment. It is worth noting that the BUFS and CUFS treatments increased the annual ecological costs by 41.6%, 26.9%, and health costs by 70.1% and 46.7% compared to the BUF and CUF treatments, but also increased the net yield benefits by 9.8%, 6.8%, and the soil nutrient cycling values by 29.2%, 27.3%, and finally improved the NEEB by 10.1%, 7.3%, respectively. Similar results were obtained for the BUFS treatment compared to the CUFS treatment, ultimately improving the NEEB by 23.1%. Based on assessing yield, GHG emissions, CF, and NEEB indicators, the BUFS treatment is recommended as an ideal agricultural fertilization model to promote sustainable and clean production in the wheat-maize rotation system and to protect the agroecological environment.

Cost-benefit of influenza vaccination in preventing sudden cardiac arrest amongst Australian adults

OBJECTIVE

The objective of the study was to estimate the economic cost benefit of funding influenza vaccination to all Australian adults 50-64 years and predict its effect on sudden cardiac arrest (SCA) deaths and hospitalisation.

METHODS

We combined SCA hospitalisation data from the Australian Institute of Health and Welfare (AIHW) with survival, vaccination, and cost parameters from published literature to create a model estimating the cost benefit of universally funded influenza vaccinations to prevent SCA deaths and hospitalisation. Costs were considered from a government perspective and included cost of vaccines and GP consultations, whilst averted deaths were estimated through the age-adjusted value of a statistical life.

RESULTS

The target policy was estimated to prevent 278 SCA hospitalisations and 1269 SCA deaths. This would result in cost-savings of almost $4 billion annually, with an incremental benefit-cost ratio (BCR) of 59.94. The majority of savings were associate with averted deaths. When a sensitivity analysis was performed by altering statistical life year values and reducing life years left, the cost-saving remained significant with a minimum BCR of 29.97 derived.

CONCLUSIONS

Reducing SCA through extended vaccination including adults 50-64 years is likely to be a cost beneficial policy from a governmental perspective. SCA deaths account for a significant economic loss due to the high mortality rate, which was far greater than the costs saved through averted hospitalisations. More accurate parameters are needed to improve the reliability of these estimate; however, this model can be used as a basis for further research into the economic impact of SCA.

[Ward-based clinical pharmacists in intensive care medicine: an economic evaluation]

BACKGROUND

The positive impact of pharmaceutical care in improving medication safety is considered proven. Little is known about the economic benefit of clinical pharmaceutical services in Germany.

OBJECTIVE

In 2020, a pilot project was started at the Ernst von Bergmann Hospital to introduce ward-based clinical pharmacists in intensive care medicine, also in order to determine the economic benefit of the medication management offered.

METHODS

By a team of experienced intensive care physicians and clinical pharmacists on the basis of a consensus principle, each pharmaceutical intervention (PI) was assigned a probability score (Nesbit probability score) with which an adverse drug event (ADE) would have occurred. Assuming that each ADE results in an increased length of stay, the costs of intensive care treatment/day were used as potential savings. The model thereby combines the findings of two international publications to enable an economic analysis of pharmaceutical services.

RESULTS

During the study period, 177 pharmaceutical interventions were evaluated and corresponding probability scores for the occurrence of ADE were determined. From this, annual savings of € 80,000 through avoided costs were calculated.

CONCLUSION

In this project, the economic benefit of pharmaceutical services in intensive care medicine was proven. Ward-based clinical pharmacists are now an integral part of the intensive care treatment team at the Ernst von Bergmann Hospital.

Optimizing maize planting density based on soil organic matter to achieve synergistic improvements of yield, economic benefits, and resource use efficiency

With the development of the economy, the contradiction between population, resources, and the environment has become more and more prominent. How to make full use of limited cultivated land resources to increase food production while reducing damage to the environment is an important issue facing agricultural production. Maize plays an essential role in ensuring global food security. Furthermore, planting density is a key agronomic factor affecting maize yield. Although soil organic matter (SOM) is an important indicator of soil fertility. Whether there are different agronomic optimal planting densities of maize under varying SOM contents remains unknown. Furthermore, there is limited understanding on whether optimizing maize planting density based on SOM further improves grain yield and resource use efficiency. Therefore, this study investigates the influence of SOM and planting density on maize grain yield. We also determine the relationship between SOM and agronomic optimal planting density (AOPD) and compare the grain yield, economic benefits, and resource use efficiency of sowing under uniform conventional planting density (SUD) versus optimized planting density based on SOM (SOD). The results showed that AOPD and its corresponding yield increased linearly with the increase in SOM. Compared with SUD, the yield of the two experimental sites under SOD increased by 2.3 % and 5.5 %, respectively, and the economic benefits increased by 0.5 % and 4.9 %, respectively. The average energy use efficiency, energy mass productivity, and energy economic productivity of the two experimental sites under SOD were all higher than those of SUD. These results demonstrate that it is theoretically feasible to optimize maize planting density based on the spatial heterogeneity of SOM. SOD is a potentially sustainable maize production method that can fully utilize the resources of cultivated land to increase grain yield and economic benefits.

Effects of the lockdown measure amid COVID-19 pandemic on outpatient department visits associated with air pollution reduction in Thailand

We investigated the effects of COVID-19 lockdown on air quality and its consequences health and economic benefits in Thailand. The conditional Poisson regression model was applied to examine the association between air pollution and outpatient department (OPD) visits in each province and pooled the province-specific estimates using the random-effects meta-analysis to derive the national estimates. We then applied a random forest model with meteorological normalization approach to predict the concentration of air pollutants by means of business as usual during the lockdown period (April 3-May 3) in 2020 and further calculated the changes in the number of OPD visits and their consequent expenditure attributable to air pollution reduction using the obtained risk function performed earlier. The number of cardiovascular OPD visits attributed to PM10, PM2.5 and NO2 decreased by 4,414 (95% CI 982, 8,401), 4,040 (95% CI 326, 7,770), and 13,917 (95% CI 1,675, 27,278) cases, respectively, leading to reduced medical expenditure by 14,7180.21, 13,4708.31, and 46,4025.04 USD, respectively. The number of respiratory OPD visits attributed to PM10, PM2.5, NO2, and O3 reduction decreased by 2,298 (95% CI 1,223, 3,375), 2,056 (95% CI 740, 3,252), 3,326 (95% CI 542, 6,295), and 1,160 (95% CI 5,26, 1,804) cases, respectively, where the consequent medical expenditure was reduced by 76,618.48, 68,566.36, 11,0908.31, and 38,685.50 USD, respectively. Finding from this study showed that air quality during the lockdown period in Thailand was improved, contributing to the reduction of cardiovascular and respiratory OPD visits, and consequent medical service costs attributable to air pollution.

Lymphedema self-care: economic cost savings and opportunities to improve adherence

BACKGROUND

Breast cancer-related lymphedema (BCRL) imposes a significant economic burden on patients, providers, and society. There is no curative therapy for BCRL, but management through self-care can reduce symptoms and lower the risk of adverse events.

MAIN BODY

The economic burden of BCRL stems from related adverse events, reductions in productivity and employment, and the burden placed on non-medical caregivers. Self-care regimens often include manual lymphatic drainage, compression garments, and meticulous skin care, and may incorporate pneumatic compression devices. These regimens can be effective in managing BCRL, but patients cite inconvenience and interference with daily activities as potential barriers to self-care adherence. As a result, adherence is generally poor and often worsens with time. Because self-care is on-going, poor adherence reduces the effectiveness of regimens and leads to costly treatment of BCRL complications.

CONCLUSION

Novel self-care solutions that are more convenient and that interfere less with daily activities could increase self-care adherence and ultimately reduce complication-related costs of BCRL.

How does Internet use affect farmers' low-carbon agricultural technologies in southern China?

Agricultural low-carbon emission reduction is an essential part of China's ecological civilization construction. Farmers' low-carbon agricultural technology (LCAT) adoption has become an important means to achieve agricultural low-carbon emission reduction. Based on the survey data of 1080 farmers in Sichuan Province, farmers' LCAT adoption has been empirically studied using the combined estimate conditional mixed treatment model (CMP). The results show that the use of the Internet will substantially promote farmers' low-carbon tillage technology adoption and low-carbon fertilization technology adoption but has no significant impact on farmers' low-carbon pharmaceutical application technology adoption, low-carbon irrigation technology adoption, low-carbon agricultural film recycling technology adoption, and straw recycling technology adoption. Mechanism analysis shows that Internet use mainly affects farmers' low-carbon fertilization technology adoption through economic benefit cognition and affects farmers' low-carbon tillage technology adoption through ecological benefit cognition. This study can enhance our understanding of the relationship between Internet use and LCAT adoption and serve as a resource for rural digital infrastructure development and LCAT adoption-related policy design.

Sustainable strategies related to soil fertility, economic benefit, and environmental impact on pear orchards at the farmer scale in the Yangtze River Basin, China

Pears are an important income source in China, and unreasonable management practices have had a negative impact on the sustainability of pear orchards. However, multi-objective synergistic strategies are unclear on a farmer scale. In this study, we quantified indicators of soil fertility (soil organic matter (SOM)), environmental impact (global warming potentials (GWP)), and economic benefit (ratio of benefit and cost (BCR)) and analysed the synergetic strategies based on survey data from 230 smallholders in the Yangtze River Basin (Shanghai City, Chongqing City, Zhejiang province, and Jiangxi province). The average SOM, GWP, and BCR were 28.9 g kg^-1, 17.3 t CO₂-eq ha^-1, and 3.63, respectively. Furthermore, optimised solutions using the Pareto multiple-objective optimisation model can reduce the GWP by 44.6% and improve the SOM and BCR by 34.4% and 43.9%, respectively, when fertiliser N rate and density are both decreased and the ratio of organic fertiliser application is increased compared to farmer management practices. The structural equation model indicated that planting density and fertiliser N rate can directly influence GWP and indirectly increase SOM and BCR; organic fertiliser application directly affects the GWP, SOM, and BCR. Our research provides a bottom-up approach based on the farmer scale, which can improve the sustainability of pear systems, and these findings can be used as guidelines for policymakers and pear orchard managers.

Economic benefits of preventing bird collisions in South Korea: findings from a choice experiment survey

Bird deaths due to collisions with artificial structures, such as glass windows of buildings and transparent noise barriers, are continuing to occur in South Korea. The government is trying to prevent bird collisions by increasing the attachment of specially designed tapes to help birds avoid windows. This article estimates the economic benefits arising from the prevention of collisions by applying a choice experiment (CE). For this purpose, a CE survey of 1000 South Korean interviewees was conducted. The four attributes to be attached with the tapes for the CE application were a transparent soundproof wall window on an expressway, a transparent soundproof wall window on a general road, a glass window in a public building, and a glass window in a private building. The unit was the percentage of each structure with the tapes attached to the window. The marginal values of a one-unit (1%p) increase in each attribute were computed to be KRW 534 (USD 0.46), KRW 233 (USD 0.20), KRW 1,318 (USD 1.13), and KRW 12,930 (USD 11.05), respectively. This quantitative information will be an important reference for implementing the prevention policy. For example, based on the collision prevention of 1000 birds per structure, the priority for attaching tapes can be placed in the order of expressways, public buildings, private buildings, and general roads.

The development of a derelict crab trap removal incentive program for commercial shrimpers

Due to fishery-tailored gear, shrimpers are often affected by benthic marine debris, specifically derelict crab traps. To alleviate the impacts on the commercial shrimping industry in the Mississippi Sound, a team of natural resource professionals and stakeholders developed a derelict crab trap removal incentive program for commercial shrimpers. In three years, this program led to the removal of 2904 derelict crab traps from the north-central Gulf of Mexico at a total average cost of $35,595 per year to implement the program, or $53 per derelict crab trap. Results from this study showed the cost of the program could further be reduced while covering the same shrimping area, through the inclusion of fewer disposal locations and targeting active and engaged shrimpers. This program led to the removal of crab traps by non-registered shrimpers, indicating that the existence of the program and associated outreach could lead to improved environmental stewardship without an incentive.

Climate-smart planting for potato to balance economic return and environmental impact across China

Potato production plays an important role in safeguarding food security in China since the central government implemented the 'Potato-as-Staple-Food' policy in 2015. However, a key challenge facing China's potato production is to realize a tradeoff between economic return and environmental impact. Effective strategies for reducing carbon emission without compromising potato yield remain to be developed. This study conducted a comprehensive assessment by integrating climate, soil, crop, and agricultural input data, crop model and life cycle impact assessment model to quantify potato yields, GHG emission amounts and intensities (GHGI), and economic benefits under the conventional planting pattern (CPP), the lowest GHG emission pattern (LEP), and the highest yield pattern (HYP) across China's potato planting regions including four sub-regions, i.e., North Single planting region (NS), Central Double planting region (CD), South Winter planting region (SW), and Southwest Mixed planting region (SWM). Averaged fresh potato yield, GHG emission amount, and GHGI under the CPP were 21.7 t ha^-1, 2815.1 kg CO₂eq ha^-1, and 137.3 kg CO₂eq t^-1, respectively, in China's potato planting region. Compared with the CPP, averaged GHG emission amount and GHGI under the LEP could be decreased by 48.2 % and 51.5 % respectively while the fresh potato yield and economic benefit could be enhanced by 8.1 % and 18.5 %, respectively. For the HYP, averaged GHG emission amount and GHGI could be decreased by 24.2 % and 39.8 % respectively while the fresh potato yield and economic benefit could be enhanced by 18.7 % and 39.6 %, respectively, compared with the CPP. Across the four potato planting regions, SW had the largest potential in reducing GHG emissions owing to a high reduction amount of nitrogen application rate. Our study demonstrates that optimizing agronomic management could reduce environmental impact without compromising economic benefit and provides a scientific method for assessing crop potential to realize the climate-smart planting.

Integrating optimization and damage estimation to increase economic benefit and ensure food security under seasonal land variability

Rapidly increasing population and rising food demand necessitates expansion of agricultural mainland. However, with accelerated urbanization, agricultural land resources are difficult to expand. The riverine sandbars offer a vast fertile terrain that is conducive to agricultural food production and could support the global food demands despite urbanization. Nevertheless, hydroclimatic factors like streamflow and precipitation have an impact on the availability of agricultural land and potential crop damage in riverine ecosystems. The present study determines the agricultural economic benefits from cultivation in riverine sandbars through optimization framework under stochastic streamflow. A damage estimation model was developed to evaluate the economic losses an optimally planned riverine agricultural area would suffer, if the flow variation exceeds a certain threshold. The findings showed that economic benefit of ∼130 million rupees could be achieved with ∼22 million rupees of additional benefit from the proposed optimization approach. This additional benefit was in reference to the selective cropping approaches, which the farmers did not account. Furthermore, the damage estimation model could comprehend the losses under fluctuating streamflow in subsequent years that was found to vary between 5 and 34 percent. Therefore, this framework of integrating optimization and damage estimation approaches contribute to a better understanding of optimally utilizing the riverine sandbars, thereby improving the socio-economic status of marginalized communities and providing potential additional land resources to sustain food security and production. The study also highlighted the need of crop insurance facilities to assess and manage risks that could provide financial support to farmers, cover crop loss and damage arising from hydroclimatic variabilities.

Environmental impacts and nutrient distribution routes for food waste separated disposal on large-scale anaerobic digestion/ composting plants

Centralized biological treatments, i.e., anaerobic digestion (AD) and in-vessel composting (IVC), were supposed to be the promising processes for the disposal of food waste (FW) after source separation, while the systematic benefits were unclear for FW with high water content, salt and oil and thus influenced the selection by the local decision-makers. In this study, two large-scale working AD and IVC plants were compared for environmental impacts, nutrient recovery and economic benefits. For unit amount of FW, 89.26 kg CO₂-eq was released in IVC mainly due to 47.89 kWh electricity consumption, and 57.02 kg CO₂-eq was produced in AD. With the application of compost and energy recovery, 26.88 and 93.55 kg CO₂-eq savings were obtained in IVC and AD, respectively. NH₃ emissions were the main contributor to acidification (0.35 kg SO₂-eq) in IVC, while AD exerted less impact on acidification (0.09 kg SO₂-eq) and nutrient enrichment (0.25 kg NO₃-eq) attributed to the counteract of energy recovery. 2029 would be the inflection point for global warming potential in AD with more clean energy applied in electricity mix in China. For nutrient recovery, more C (8.3%), N (37.9%) and P (66.7%) could be recovered in compost, while those were discharged via leachate and biogas residue in AD. The cost of IVC was 16 CNY/t (2.40 USD/t) lower than AD. Combing the three key indexes and the sale routes of products, IVC was recommended to be used in areas dominated by agriculture and forestry industries, and AD was more suitable for large cities.

Effects of organic amendments and ridge-furrow mulching system on soil properties and economic benefits of wolfberry orchards on the Tibetan Plateau

Water scarcity and low soil fertility severely constrain crop growth and sustainable agricultural productivity on the Tibetan Plateau. Organic amendments and ridge-furrow mulching system (RFMS) are widely used to improve soil moisture, soil structure, and crop production in arid and semi-arid areas. However, their combined effects on soil physicochemical properties and economic benefits of wolfberry (Lycium barbarum L.) on the Tibetan Plateau remain unclear. A two-year field experiment was undertaken to evaluate the combined effects of organic amendments and RFMS on soil water, soil structure, soil saturated hydraulic conductivity, soil organic carbon (SOC), total nitrogen (TN), and economic benefits on wolfberry. Four cultivation practices were established: traditional flat plot with mulching (FP), traditional flat plot with mulching and organic amendment (FPOA), ridge-furrow planting with mulching (RF), and ridge-furrow planting with mulching and organic amendment (RFOA). The organic amendment and RFMS treatments had higher soil water storage (SWS) and soil desiccation index (SDI) than the FP treatment in both growing seasons, especially at 20-60 cm soil depth. In addition, organic amendment significantly decreased soil bulk density by 6.4% and increased soil saturated hydraulic conductivity by 16.8% in the 0-60 cm soil layer, respectively, and improved the proportion of larger soil aggregates (0.02-2 mm) by 10.8% in the 0-40 cm soil layer. Furthermore, the RFOA treatment significantly improved SOC and TN contents at 0-60 cm soil depth by 47.7% and 19.4%, respectively, relative to FP. The measured soil properties were highly correlated with wolfberry yield and water use efficiency over 2 years. In particular, the RFOA treatment had higher crop yield and economic benefit than the other treatments due to the more favorable soil environment. Therefore, the RFOA treatment could be a sustainable and efficient cultivation practice for alleviating drought stress, improving soil properties, and increasing economic benefit on the Tibetan Plateau.

Conversion from double-season rice to ratoon rice paddy fields reduces carbon footprint and enhances net ecosystem economic benefit

Ratoon rice (RR) system is an alternative to the double-season rice (DR) system in central China due to its high annual yield and relatively lower cost and labor requirement. However, the effect of conversion from DR to RR on the carbon footprint (CF) and net ecosystem economic benefit (NEEB) remains largely unknown. Here, we elucidated the effect by using two early-season rice varieties (ZJZ17, LY287) and two late-season rice varieties (WY103, TY390) for the DR system, and two RR varieties (YLY911, LY6326) for the RR system. The six varieties constituted four cropping systems, including DR1 (ZJZ17 + WY103), DR2 (LY287 + TY390), RR1 (YLY911) and RR2 (LY6326). The two-year experiment demonstrated that RR had 27.37% lower annual CF than DR, which could be attributed to the significantly lower annual CF (by 87.27%) of ratoon crop in RR relative to that of the late-season rice in DR. Direct greenhouse gas (GHG) emissions contributed the most to annual CF in both systems, accounting for 43.28% and 35.39% in DR and RR, respectively. Furthermore, conversion from DR to RR system significantly increased annual NEEB by 30.95%. This increase could be attributed to the 20.25% higher annual grain yield of main crop in RR relative to early-season rice in DR, and 75.32% and 87.27% lower annual costs for agricultural inputs and CF of ratoon crop than late-season rice in DR, respectively. Rice variety also showed certain effects on the yields and GHG emissions in different RR systems. Compared with RR1, RR2 significantly increased annual yield and annual NEEB, while decreased annual CF and annual yield-scaled CF (CF_y). These findings suggest that the conversion of the DR system to LY6326 RR system may be a highly promising strategy to simultaneously reduce CF, promote NEEB and maintain high grain yield in central China.

Environmental and economic benefits of electric, hybrid and conventional vehicle treatment: A case study of Lithuania

Reuse, recovery, and recycling of end-of-life vehicles (ELVs) are encouraged owing to various economic and environmental benefits. Automotive remanufacturing serves as a specific circular marketing system for the reuse of recovered parts that can bring economic benefits for both dismantling companies and consumers. This study aimed to reveal the economic and environmental benefits of the end-of-life treatment of electric, hybrid, and conventional passenger cars. This research presents an economic assessment of the reuse of ELV parts based on a material flow analysis (MFA) and a practical analysis of the prices of these parts in the Lithuanian market. The environmental assessment of the reuse of ELV parts was performed using an MFA, the CO₂ equivalents for the production of different materials, and a life cycle assessment methodology. The results showed that 38% of all electric and hybrid ELV parts, and 27% and 28% of diesel- and petrol-powered ELV parts, respectively, can be sold (reused). The economic benefit across all four types of ELVs could amount to savings of up to 12,739 Eur and 51,281 Eur for the dismantlers and passenger car consumers, respectively. The greatest CO₂ savings result from reusing the parts of electric ELVs, whilst the lowest savings come from petrol ELVs.

Advanced composting technologies promotes environmental benefits and eco-efficiency: A life cycle assessment

Growing demand for intensive animal farms and increased public awareness of environmental friendliness, have led to continuous iteration and refinement of the initially crude composting technology. However, the impact of the composting facility and energy input on eco-efficiency is limited. In this study, a LCA approach was conducted to investigate the eco-efficiency of four widely applied composting strategies: static heaps (SH), windrow composting (WC), membrane-covered composting (MC) and reactor composting (RC). The results showed that the environmental benefits of RC's were decreased by 11.3%, 21.7%, and 6.5% compared to SH, WC, and MC, respectively. Advanced composting technologies didn't substantially reduce direct economic costs, however, the eco-efficiency of RC was increased by 296.9%, 54.7%, and 87.6% compared to SH, WC, and MC, respectively. Overall, the results demonstrate that RC is a promising solution with high ecological efficiency that can contribute to the sustainable development of intensified livestock production.

Value of Remission in Patients with Rheumatoid Arthritis: A Targeted Review

The treat-to-target strategy, which defines clinical remission as the primary therapeutic goal for rheumatoid arthritis (RA), is a widely recommended treatment approach in clinical guidelines. Achieving remission has been associated with improved clinical outcomes, quality of life, and productivity. These benefits are likely to translate to reduced economic burden in terms of lower healthcare costs and resource utilization. As such, a literature review was conducted to better understand the economic value of remission. Despite the large heterogeneity found in RA-related economic outcomes across studies, patients in remission consistently had lower direct medical and indirect costs, less healthcare resource utilization, and greater productivity compared to those without remission. Remission was associated with 19–52% savings in direct medical costs and 37–75% savings in indirect costs. The economic value of remission should thus be considered in economic analyses of RA therapies to inform treatment and reimbursement decisions.

Comparing rice production systems in China: Economic output and carbon footprint

In recent years, many rotational and integrated rice production systems coupled with several greenhouse gas (GHG) emissions mitigation practices have been developed and adopted for demand of low carbon production. However, there have been only few studies about comparisons on the balance between high production and mitigation of GHG emissions in different rice production systems. We therefore aimed to evaluate economic output and carbon footprint of different rice production systems, based on several long-term experiments conducted by our lab. CH₄ and N₂O emission were measured by the same static chamber/gas chromatogram measurement procedure in different rice production systems, including rice-fallow, rice-rapeseed, rice-wheat, double rice, and integrated rice-crayfish production system. Then, we applied the DeNitrification DeComposition model to simulate CH₄ and N₂O emission over different years under the same condition for comparison. Carbon footprint was calculated following the process-based life cycle assessment (PLCA) methodology. The economic benefit of rice production systems was assessed by cost-benefit analysis. According to the analysis, the double-rice production system exhibited the highest intensity of carbon footprint (ICF = 4.14 kg CO₂-eq yuan^-1), rain-fed treatment in the rice-rapeseed system had the lowest (ICF = 0.68 kg CO₂-eq yuan^-1). The intensity of carbon footprint in different treatments in the integrated rice-crayfish production system was around 0.8 kg CO₂-eq yuan^-1. Overall, the results of this case study suggest: (1) the proposed practices in different rice production systems are no straw returning (rice-fallow), no-tillage without straw returning (rice-wheat), rain-fed farming (rice-rapeseed), no insect and no inoculation (double rice), and feeding with straw returning (rice-crayfish); (2) rotational and integrated systems can achieve high net output with low carbon emission; (3) reducing the amount of nitrogenous fertilizer application is the most important and effective GHG mitigation practice for rotational systems.

Healthcare Resource Utilization Among Patients with Focal Seizures Treated with Eslicarbazepine Acetate in the US Long-Term Care Setting: A Retrospective Claims Database Analysis

Introduction

The aim of this study was to compare healthcare resource utilization (HCRU) before and after initiation of eslicarbazepine acetate (ESL) in the long-term care (LTC) setting (rehabilitation center, mental health center, LTC non-skilled nursing facility/assisted-living facility, home health, assisted living, nursing home, other/unknown).

Methods

This retrospective analysis used IQVIA’s New Data Warehouse, which includes deterministically linked LTC, prescription, and professional fee claims data and IQVIA Hospital Charge Data Master database. The study period was 1 April 2013 to 31 December 2019. The index date was the date of ESL initiation in the LTC setting. Inclusion criteria were: (1) ≥ 1 new ESL prescription between 1 April 2014 and 31 December 2018; (2) diagnosis of focal seizure (FS) during the 12 months pre-index date; and (3) no ESL prescription during the 12-month period pre-index. A 12-month pre-post analysis compared epilepsy-specific and all-cause HCRU before and after ESL initiation. Categorical variables were compared with McNemar’s tests.

Results

A total of 307 patients (mean age 52.2 years, 57.7% male) with FS were included, of whom 24.8% were in nursing homes. Patients used a mean of 3.1 antiseizure drugs prior to initiation of ESL, and 87.9% of patients initiated ESL as adjunctive treatment. There were significant reductions in proportion of patients with epilepsy specific physician office visits, emergency department (ED) visits, hospitalizations, and all-cause physician office visits and hospitalizations in the post-index period compared to the pre-index period (P < 0.05). Similar results were observed in sensitivity (patients with an epilepsy diagnosis) and subgroup analyses [presence or absence of intellectual developmental disorders or age (≥ 65 and < 65 years)].

Conclusion

Proportion of patients with epilepsy-specific physician office visits, ED visits, hospitalizations, and all-cause physician office visits and hospitalizations were significantly reduced following initiation of ESL in patients with FS in LTC.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40120-021-00244-5.

Estimation of economic benefits associated with the reduction in the CO2 emission due to COVID-19

Since World War-II, the COVID-19 pandemic is considered the most serious challenge faced by the mankind. This pandemic has not only adversely affected the health systems but has also disrupted the manufacturing and industrial sectors and thus leading to low CO2 emissions. Reduction in the carbon dioxide (CO2) gas emission has been noticed nearly everywhere in the world due to shutdown of industries and lockdown imposed by governments as a consequence of the COVID-19 pandemic. In the year 2019, around 37 billion tons of CO2 emitted globally that has been reduced by 9% in the same period (January to July) for the year 2020 as consequence of COVID-19 pandemic. The Social Cost of Carbon (SCC) of a country reflects the economic damages caused by per ton increase in the CO2 emissions. Economic and environmental benefits are associated with the reduction of CO2 emissions as a result of COVID-19 and their estimation is the main theme of the study. Coupling reduction in the CO2 emissions to the Social Cost of Carbon gives economic benefit for a country. The research presented investigates the long term economic and environmental benefits associated with the reduction in the CO2 emissions for various regions of the world. The economic benefit due to the reduction in the of the CO2 emissions as consequence of the COVID-19 to global economy is estimated as 650 billion US Dollars for the period of 6 months (from January to July). The study mainly focuses on the countries that contribute the high percentage of CO2 emissions to the atmosphere. The first half of year 2020 (from January 2020 to July 2020) is taken into consideration because lockdown was mainly followed in that period. Further, within the country the sectors that contribute the high percentage of CO2 emissions are also taken into account.

Export trade, embodied carbon emissions, and environmental pollution: An empirical analysis of China's high- and new-technology industries

China's export trade has been expanding steadily in recent years, significantly increasing resource consumption and environmental pollution. High- and new-technology industries are essential for achieving sustainable economic development and improving environmental quality. This study employs a multi-regional input-output model to estimate the economic benefits and environmental costs of export trade in high- and new-technology industries. Then, it analyzes the impact of economic benefits and technological levels on environmental pollution using the Stochastic Impacts by Regression on Population, Affluence, and Technology model. An input-output multi-objective linear programming model and a non-dominated sorting genetic algorithm II are adopted to combine economic development with environmental pollution and determine the optimal path for export trade. The results show that technological progress in China's high- and new-technology industries is conducive to reducing embodied carbon emissions in developed countries while increasing emissions in developing countries. Moreover, a nonlinear three-stage accompanying relationship exists between the economic benefits and environmental costs of high- and new-technology exports; this is because exports with low economic benefits generate fewer carbon emissions whereas exports with high economic benefits generate significant carbon emissions. An increase in exports with ultra-high economic benefits will generate excessive embodied carbon emissions that hinder coordinated economic-environmental development. Lastly, technological progress in the electrical and optical equipment sector can effectively promote pollution reduction; thus, it should be further developed to improve the comprehensive benefits of exports.

Plastic mulching reduces nitrogen footprint of food crops in China: A meta-analysis

Sustainably feeding the growing population amid rising global temperatures and dwindling resources is a grand challenge facing mankind. Plastic mulching (PM) is widely used in China aiming to the increase of crop productivity. However, the impact of PM on reactive nitrogen (Nr) emissions and nitrogen (N) footprint has not been explicitly described. In this study, we collected 4051 observations from 394 published papers for potato (Solanum tuberosum L.), maize (Zea mays L.), and wheat (Triticum aestivum L.), and used meta-analysis to investigate how PM affected crop yield, net economic return, Nr emissions, and N footprints including nitrogen footprint per unit of output energy (NFo) and nitrogen footprint per unit of net economic return (NFe) at regional scale and across a range of precipitation and N fertilization gradients in China. The meta-analysis showed that compared to non-PM practice, PM increased grain yield by 25, 27, and 20% in potato, maize, and wheat, respectively, and enhanced net economic return by 19, 29, and 22%, respectively, with corresponding reduction in NFo of 24, 36, and 18% and NFe of 19, 37, and 19%, respectively. Potato and maize had greater energy output and net economic return than wheat. Plastic mulching was more effective in improving net economic return (or energy output) and reducing N footprints (i.e., NFe and NFo) in the semiarid region (i.e., annual precipitation <600 mm) when N was applied at 100-200 kg N ha^-1, especially in potato and maize. Our analysis suggests that the use of PM enhanced grain yield and net economic return while lowering the N footprint without increasing Nr emission. Therefore, PM has great potential to mitigate Nr loss in China when crop species, N fertilization rate, and local environmental factors (i.e., growing region and annual precipitation) are appropriately considered.

Integration of Pleurotus tuoliensis cultivation and biogas production for utilization of lignocellulosic biomass as well as its benefit evaluation

The present study was to assess the economic benefit of integrated P. tuoliensis cultivation and biogas production based on the utilization of lignocellulosic biomass. Among the five evaluated cultivation substrates, that consisting of 55% cottonseed hull, 25% corncob, 10% wheat bran, 5% corn flour, 4% lime, and 1% gypsum was demonstrated to be optimal for the simultaneous production of P. tuoliensis mushrooms and biogas fuel. Preliminary estimation shows that, for the consumption of dry substrate per unit mass (calculated in per kg), a total of 561 g fresh mushroom product was harvested and 189.88 L biogas was generated. Accordingly, the production costs were abolished and an economic benefit of approximately $0.592 was obtained, with the high-value mushroom product being the main contributor to profit. Moreover, this integrated process also exhibited positive ecological and social benefits and as such, is worthy of promotion and further application.

Impact of Early Initiation of Eslicarbazepine Acetate on Economic Outcomes Among Patients with Focal Seizure: Results from Retrospective Database Analyses

INTRODUCTION

This study assessed the association between early initiation of eslicarbazepine acetate (ESL) as first-line therapy (1L cohort) or as first adjunctive regimen to either levetiracetam (LEV) or lamotrigine (LTG) (add-on cohort), and healthcare resource utilization (HCRU) and charges among adults with treated focal seizures (FS).

METHODS

This retrospective, longitudinal cohort analysis used Symphony Health's Integrated Dataverse (IDV®) claims data to identify patients aged ≥ 18 years with a diagnosis of FS who had a new prescription for ESL between April 2015 and June 2018. Baseline was the 90-day period immediately prior to the date of the first-dispensed claim for ESL (index date) with a follow-up of 1-4 consecutive 90-day periods. Linear regression models were estimated to assess changes in HCRU and charge outcomes.

RESULTS

There were 274 and 153 patients who received ESL in the 1L cohort and add-on cohort, respectively. The 1L cohort experienced significant reductions from baseline during follow-up in all-cause inpatient (IP; P < 0.0001), emergency room (ER; P < 0.0001), and outpatient (OP; P < 0.0001) visits; FS-related IP (P = 0.006) and OP (P < 0.0001) visits; total, medical, all-cause ER and OP, and FS-related medical charges (P < 0.05); and significant increases in total prescription and anti-seizure drug (ASD)-related prescription (P < 0.001) charges. The add-on cohort experienced significant reductions in all-cause IP (P = 0.009) and all-cause and FS-related OP visits (P < 0.0001 for both) and significant increases in total prescription and ASD-related prescription (P < 0.001) charges during the follow-up period. In both cohorts, the increases in prescription charges were smaller than the reduction in total medical charges.

CONCLUSION

Early initiation of ESL as 1L or add-on therapy was associated with statistically significant reductions in all-cause IP and all-cause and FS-related OP visits during follow-up compared to baseline. The 1L cohort also had statistically significant reductions in all-cause ER visits, FS-related IP visits, and total, medical, all-cause ER and OP, and FS-related medical charges. Knowledge of healthcare resource utilization (HCRU) and costs of care in patients taking anti-seizure drugs (ASDs) is required to inform prescribing and formulary decision-making. Levetiracetam (LEV) and lamotrigine (LTG) are the most widely used first-line (1L) ASDs in the USA. Eslicarbazepine acetate (ESL), a third-generation ASD with sodium channel-modulating activity, is typically used in later lines of therapy. Sodium channel-blocking anti-seizure drugs may represent an effective treatment option for patients with epilepsy in the 1L setting. This study assessed the association between early initiation of ESL as 1L therapy (1L cohort) or as first adjunctive therapy to either LEV or LTG (add-on cohort), and HCRU and charges among adults with treated focal seizures (FS). The results showed that following ESL initiation the 1L cohort experienced significant reductions in all-cause inpatient (IP), emergency room (ER), and outpatient (OP) visits; FS-related IP and OP visits; and total, medical, all-cause ER and OP, and FS-related medical charges, and significant increases in total prescription and ASD-related prescription charges. The add-on cohort showed significant reductions in all-cause IP and all-cause and FS-related OP visits and significant increases in total prescription and ASD-related prescription charges. In both cohorts, the increases in prescription charges were smaller than the reduction in total medical charges. These data imply that use of ESL as 1L therapy in adult patients with FS could help conserve scarce healthcare resources and reduce the burden on healthcare budgets. These findings may inform selection of ASD therapy in this patient population.

Assessment of productivity, nutrient uptake and economic benefits of rice under different nitrogen management strategies

Background

Integrating a chemical nitrogen (N) fertilizer with an organic fertilizer and using slow-release mechanism are important N management strategies to increase the N utilization efficiency (NUE) and grain yield of rice. However, the performances of both N management strategies on the productivity, the nutrient absorption and utilization efficiency, and the economic benefits of rice have not yet been comprehensively evaluated.

Methods

A 2-year field experiment was conducted with seven N management strategies without fertilizer (control), 100% conventional N fertilizer (conventional compound fertilizer and urea) (N₁₀₀), 75% conventional N fertilizer with 25% organic-inorganic compound fertilizer (N₇₅+OICF₂₅), 50% conventional N fertilizer with 50% organic-inorganic compound fertilizer (N₅₀+OICF₅₀), 100% organic-inorganic compound fertilizer (OICF₁₀₀), slow-release compound fertilizer with urea (SRCF+U), compound fertilizer with sulfur-coated urea (CF+SCU). The responses of the productivity, the nutrient absorption and utilization efficiency, and the economic benefits of rice to the different N management strategies were evaluated.

Results

CF+SCU performed comparably or better than N₁₀₀, judging by the grain yield (GY), the N, phosphate (P) and potassium (K) agronomic efficiency (NAE, PAE and KAE), and the apparent N, P and K recovery efficiency (ANRE, APRE and AKRE). SRCF+U significantly increased the GY by an average of 7.7%, the NAE and the ANRE by 23.8 and 26.7%, the PAE and the APRE by 90.6 and 109.3%, and the KAE and the AKRE by 74.2 and 57.7%. The higher GY and nutrient utilization efficiency when using SRCF+U were attributed to the higher total biomass and total nutrient absorption. N₇₅+OICF₂₅ and N₅₀+OICF₅₀ produced a comparable grain yield than N₁₀₀, whereas a significant yield reduction was observed when using OICF₁₀₀. Compared with N₁₀₀, N₇₅+OICF₂₅ resulted in a comparable or higher fertilizer use efficiency (0.3 and 4.7% for NAE and ANRE, 0.3 and 3.2% for PAE and APRE, 0.3 and -2.8% for KAE and AKRE). However, the fertilizer use efficiency when using N₅₀+OICF₅₀ and OICF₁₀₀ were lower than with N₁₀₀. The highest net return (NR) (5,845.03 yuan ha^-1) and benefit to cost (B:C) ratio (0.34) were obtained when using SRCF+U. The NR and the B:C ratio when using N₇₅+OICF₂₅ were slightly higher than when using N_100. However, N₅₀+OICF₅₀ and OICF₁₀₀ significantly decreased the NR and the B:C ratio compared with N₁₀₀ by 14.5 and 12.1% and by 35.1 and 29.0%, respectively.

Conclusions

SRCF+U and CF+SCU enhanced the crop productivity, the nutrient uptake and utilization efficiency, and the economic benefits compared with N_100. The comprehensive performance of SRCF+U was better than that of CF+SCU. N₇₅+OICF₂₅ produced almost similar productivity, nutrient uptake and use efficiency compared with N₁₀₀. It demonstrated that N₇₅+OICF₂₅ stabilized the grain yield production of rice and reduced the input of chemical N fertilizer.

Quantifying welfare gains of coastal and estuarine ecosystem rehabilitation for recreational fisheries

Coastal and estuarine ecosystems, such as mangroves, tidal marshes and seagrass meadows, provide a range of ecosystem services, but have seen extensive degradation and decline. Effective protection and rehabilitation of coastal ecosystems requires an understanding of how efforts may improve associated ecosystem services. In this study, we present a spatially-explicit angler catch function to predict boat-based recreational catch as a function of ecosystem and angler characteristics. We developed a choice model to investigate where recreational anglers launch their boats and fish in southeast Australia. By linking the recreational catch models with a choice model, we were able to quantify welfare gains of ecosystem rehabilitation. We found welfare gains across fishing locations varied widely due to heterogeneous coverage of seagrass. The welfare gains of different fishing locations ranged from near-zero in areas of low seagrass coverage, to AU $19.18 (10% increase in seagrass area) and to AU $85.55 (30% increase) per trip in location of high seagrass coverage. Given two million fishing trips occurring per year in Port Phillip Bay, and one million in Western Port, the aggregated welfare gain could scale up to AU $6.2 million with a 10% increase in seagrass coverage, and AU $22 million per annum with a 30% increase in seagrass. We also calculated the welfare loss associated with total loss of seagrass ecosystem in each fishing location to represent the current value, which varied significantly, ranging from near-zero in some locations to AU $87.47 per trip in other locations. Over the past several decades, the bay-wide seagrass ecosystem has dropped by 36.7% in Western Port, resulting in potential welfare loss of an estimated AU $ 86.7 million per annum. Our analyses provide insightful spatial policy implications for coastal and marine ecosystem rehabilitation in the region.

Recycling of iron and titanium resources from early tailings: From fundamental work to industrial application

The comprehensive recovery of iron and titanium resources from early tailings were systematically attempted from fundamental work to industrial application. Geochemical characterization of the tailings was first conducted, followed by the iron recovery and titanium recovery. Iron recovery was mainly achieved through a series of magnetic separation, and titanium recovery was on the combination of magnetic pre-concentration and flotation separation. Special for titanium recovery, different pretreatment methods including ultrasonic cleaning and attrition-scrubbing were studied to reduce the influence of serious surface pollution of early tailings on ilmenite floatability, and attrition-scrubbing proved to be the best one. Associated mechanisms of flocculants influence on ilmenite floatability and the attrition-scrubbing effects were explored using micro-flotation and XPS tests. After a series of fundamental studies, the industrial production of iron and ilmenite concentrate went into operation and the industrial debugging results were roughly satisfactory. At last, a brief economic analysis was given for the present work.

Assessment of the FilmArray® multiplex PCR system and associated meningitis/encephalitis panel in the diagnostic service of a tertiary hospital

Rapid and accurate diagnosis of meningitis/encephalitis (M/E) is essential for successful patient outcomes. The FilmArray® meningitis/encephalitis Panel (MEP) is a multiplexed PCR test for simultaneous, rapid detection of pathogens directly from cerebrospinal fluid (CSF) samples. 94 prospectively collected CSF specimens from patients with clinical suspicion of infective M/E underwent testing for 14 pathogens simultaneously, including Escherichia coli, Haemophilus influenzae, Neisseria meningitidis, and Varicella zoster. MEP demonstrated 95% agreement with current PCR methods, resulting in 16 diagnosed cases of M/E. Typically, the FilmArray® MEP results were delivered within approximately one hour, contrasting with current practices taking up to 5.6 days. Given the significant morbidity and mortality associated with delayed diagnosis of central nervous system infections, the FilmArray® MEP is a useful addition to the diagnostic capabilities of a clinical microbiology department.

Estimation of health and economic benefits based on ozone exposure level with high spatial-temporal resolution by fusing satellite and station observations

In recent years, ozone pollution has become more and more serious in China. Several epidemiological studies have demonstrated the correlation between short-term ozone exposure and several health risks including all-cause mortality, cardiovascular mortality, and respiratory mortality. In this study, the daily ozone exposure levels with 10 km × 10 km resolution were estimated based on satellite data derived from Ozone Monitoring Instrument (OMI) and the monitoring data. The health impacts for potential decrease in the daily ozone concentration and the corresponding economic benefits in 2016 were estimated by applying the environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. By reducing the daily maximum 8-h average concentration of ozone to 100 μg/m³, the estimated avoided all-cause mortalities were 120 × 10³ (95% confidence interval (CI): 67 × 10³, 160 × 10³) cases and the correspondingly economic benefits ranged from 36 to 64 billion CNY using amended human capital (AHC) and willingness to pay (WTP) method in 2016. If the daily maximum 8-h average concentration of ozone were rolled back to 70 μg/m³, the estimated avoided all-cause mortalities were 160 × 10³ (95% CI: 98 × 10³, 230 × 10³) cases and economic benefits ranged from 54 to 95 billion CNY based on AHC and WTP methods.

A two-stage water allocation strategy for developing regional economic-environment sustainability

In this study, a new two-stage stochastic interval-parameter fuzzy programming strategy model is developed for regional economic-environment sustainability, considering the planning and management of water-resources and water-environment systems under uncertainty. The model is capable in addressing the complexity and uncertainties of the water system，which contains the concepts of economics and environment within an optimization framework. The objective of this research is to develop a participatory integrated assessment model, based on the water benefit and water environment security, with an application in the Sanjiang Plain area, China. The methodology intendeds to capture the complexity and scarcity of water management problems, incorporating the relevant sectors, as well as the different levels of water involved in water management decision. The model is applied through maximizing the benefits of water during livelihood, production and ecology. In addition, the model considers the constraints of water quantity and water quality. Then, a variety of decision results are calculated under different conditions of water shortage. The developed method is applied to plan resources management and develop regional environment sustainability. The generated results can assist the decision makers in not only making resources allocation strategies but also gaining insights into the benefit between economic and environment objective.

Estimation of health benefits from air quality improvement using the MODIS AOD dataset in Seoul, Korea

BACKGROUND

Exposure to fine particles in the atmosphere can adversely affect health and even lead to premature death. Recently, South Korea has attracted attention because of its rapid increase in the concentration of Particulate Matter (PM).

OBJECTIVES

We estimated the economic benefits of reducing PM₁₀ in Seoul, South Korea, based on MODerate-resolution Imaging Spectroradiometer (MODIS) Aerosol Optical Depth (AOD). Based on the retrieved PM₁₀ data, we estimated its effects on overall health in each district of Seoul, Korea between 2014 and 2015.

METHODS

The relationships between MODIS AOD and ground-based PM₁₀ data were identified in different seasons in South Korea between 2012 and 2013 using the linear regression model. The health benefits were estimated by the Benefits Mapping and Analysis Program (Benmap) using the scenarios from the World Health Organization (WHO).

RESULTS

The correlation between MODIS AOD and PM₁₀ concentration differed with the season. There was a higher correlation between MODIS AOD and PM₁₀ concentration in winter (R = 0.57) than there was in other seasons. Based on the MODIS AOD, the average annual PM₁₀ concentration in Seoul was higher in 2014 than it was in 2015, at values of 45.7 μg/m³, and 41.6 μg/m³, respectively. The greatest economic benefit of reducing PM₁₀ concentration (WHO annual standard of 20 μg/m³) was in 2014. This benefit was estimated to be 7022 (95% CI: 599, 20496), 2617 (95% CI: 216, 7750), and 1328 (95% CI: -159, 4679) billion KRW for all-cause, cardiovascular, and respiratory mortalities in 2014 and 2015, respectively.

CONCLUSIONS

These results demonstrate that, despite considerable improvements in air quality in recent decades, there is still a need for countermeasures to prevent economic loss due to air pollution in Seoul.

An optimum treatment for waste electronic home appliance in remote area: The case of Kinmen, Taiwan

An optimum treatment system for the waste electronic home appliance in remote area by local pre-processing and outsourcing post-processing is proposed. The cost reduction potential of the proposed treatment system is presented for main four types of electronic home appliances by the case study of Kinmen, Taiwan. Implementation of local pre-processing in Kinmen, Taiwan can provide 42, 54, 32, and 41 TWD unit cost reduction for television, washing machine, refrigerator, and air conditioner, respectively, comparing to the current treatment system. The different treatment characteristics according to the type of the appliances are the major factors for the applicability and cost reduction potential of the local pre-processing system. The application of this system to other cases is presented by sensitivity analysis with relative labor cost and transportation distance as the parameters. The results and the analysis process can be applied to the domestic systems with regions without recycling facilities, and also the international systems under the extended producer responsibility concept to take back the products for recycling.

Air quality improvement and health benefit of PM2.5 reduction from the coal cap policy in the Beijing-Tianjin-Hebei (BTH) region, China

Large amounts of air pollutants emitted from massive coal combustion result in the air quality deterioration and threaten public health in China. To improve air quality, the Chinese government released the coal cap policy to reduce coal consumption. So it is important and necessary to understand the possible environmental impact and relevant health benefits from the coal cap policy. The purpose of this paper is to quantify the air quality improvement and to evaluate the health benefits from the implementation of the coal cap policy, with the Beijing-Tianjin-Hebei (BTH) region as the study area. The results showed that the emissions of SO₂, NOx, CO, VOCs, PM₁₀, and PM_2.5 could be reduced by 20-40% in the BTH region in 2020 and all pollutants from industrial boilers notably decreased. Under the coal cap policy, the PM_2.5 concentration in the whole region would fall by 11.27%, and the total economic benefit from health impacts could achieve 26.61 (13.29 to 39.14) billion RMB (3.9 billion USD) in the BTH region in 2020, accounting for 0.43% (0.21 to 0.63%) of regional GDP in 2013. This study demonstrated the quantification of environmental effect and health benefit from the coal cap policy, which could be used for the complete cost-benefit analysis and provide the sufficient support for policy makers to implement the coal cap policy in the BTH region and other areas of China.

Economic valuation of noise pollution control policy: does the type of noise matter?

As the average noise level and number of noise sources have increased, governments have taken various measures to make soundscapes sustainable. Wise policy decisions require information about the monetary value of noise-control policies. This study elicited people's willingness to pay (WTP) for noise policies, separating traffic noise from residential noise to compare the value of controlling different types of noise. The contingent valuation method was used for the empirical analysis, with data from South Korea. The results show that the monthly mean WTP of respondents was KRW 3392.3 for residential noise reduction and KRW 3507.1 for transport noise reduction; thus, the WTP for the latter is slightly higher than that for the former. Moreover, about 80% of people are unwilling to pay for a noise policy at all, and that high ratio of people with zero WTP must be taken into consideration in the process of policy formulation and implementation. Respondents' experiential and psychological factors were found to be more important than their demographics in explaining their WTP for a noise policy. Potential policy implications based on the analysis results are provided.

Estimating short-term mortality and economic benefit attributable to PM10 exposure in China based on BenMAP

With the rapidly booming economy, China has been suffering from serious particulate matter (PM) pollution in recent years. In order to improve the air quality, Chinese government issued a new China National Ambient Air Quality Standard (No. GB3095-2012) in 2012. In this study, PM₁₀ exposure level was simulated based on the data of 912 newly constructed monitoring sites and Voronoi Neighborhood Averaging (VNA) interpolation method. It is widely accepted that PM₁₀ can cause short-term health effects. We calculated the short-term health benefit due to decreasing PM₁₀ concentration to the levels of China National Ambient Air Quality Standard based on Environmental Benefits Mapping and Analysis Program (BenMAP). Our results indicated that if the daily average concentration of PM₁₀ reduced to the daily Grade II standard (150 μg/m³), the avoided deaths for all cause, cardiovascular disease, and respiratory disease would be 82,000 (95%CI: 49,000-120,000), 56,000 (95%CI: 34,000-78,000), and 16,000 (95%CI: 10,000-22,000) in 2014, respectively. The economic benefits of avoiding deaths due to all cause for rolling back the concentration of PM₁₀ to the level of 50 μg/m³ were estimated to be 240 billion CNY and 16 billion CNY using willingness to pay (WTP) and human capital (HC) methods, respectively, which accounted for 0.38% (95%CI: 0.11-0.64%) and 0.03% (95%CI: 0.02-0.03%) of the total annual gross domestic product (GDP) of China in 2014.

Performance of small and large scales rainwater harvesting systems in commercial buildings under different reliability and future water tariff scenarios

A rainwater harvesting system (RWHS) was proposed for small and large commercial buildings in Malaysia as an alternative water supply for non-potable water consumption. The selected small and large commercial buildings are AEON Taman Universiti and AEON Bukit Indah, respectively. Daily rainfall data employed in this work were obtained from the nearest rainfall station at Senai International Airport, which has the longest and reliable rainfall record (29 years). Water consumption at both buildings were monitored daily and combined with the secondary data obtained from the AEON's offices. The mass balance model was adopted as the simulation approach. In addition, the economic benefits of RWHS in terms of percentage of reliability (R), net present value (NPV), return on investment (ROI), benefit-cost ratio (BCR), and payback period (PBP) were examined. Effects of rainwater tank sizes and water tariffs on the economic indicators were also evaluated. The results revealed that the percentages of reliability of the RWHS for the small and large commercial buildings were up to 93 and 100%, respectively, depending on the size of rainwater tank use. The economic benefits of the proposed RWHS were highly influenced by the tank size and water tariff. At different water tariffs between RM3.0/m³ and RM4.7/m³, the optimum PBPs for small system range from 6.5 to 10.0 years whereas for the large system from 3.0 to 4.5 years. Interestingly, the large commercial RWHS offers better NPV, ROI, BCR, and PBP compared to the small system, suggesting more economic benefits for the larger system.

Health and economic benefits of building ventilation interventions for reducing indoor PM2.5 exposure from both indoor and outdoor origins in urban Beijing, China

China is confronted with serious PM_2.5 pollution, especially in the capital city of Beijing. Exposure to PM_2.5 could lead to various negative health impacts including premature mortality. As people spend most of their time indoors, the indoor exposure to PM_2.5 from both indoor and outdoor origins constitutes the majority of personal exposure to PM_2.5 pollution. Different building interventions have been introduced to mitigate indoor PM_2.5 exposure, but always at the cost of energy expenditure. In this study, the health and economic benefits of different ventilation intervention strategies for reducing indoor PM_2.5 exposure are modeled using a representative urban residence in Beijing, with consideration of different indoor PM_2.5 emission strengths and outdoor pollution. Our modeling results show that the increase of envelope air-tightness can achieve significant economic benefits when indoor PM_2.5 emissions are absent; however, if an indoor PM_2.5 source is present, the benefits only increase slightly in mechanically ventilated buildings, but may show negative benefit without mechanical ventilation. Installing mechanical ventilation in Beijing can achieve annual economic benefits ranging from 200yuan/capita to 800yuan/capita if indoor PM_2.5 sources exist. If there is no indoor emission, the annual benefits above 200yuan/capita can be achieved only when the PM_2.5 filtration efficiency is no <90% and the envelope air-tightness is above Chinese National Standard Level 7. Introducing mechanical ventilation with low PM_2.5 filtration efficiency to current residences in urban Beijing will increase the indoor PM_2.5 exposure and result in excess costs to the residents.

Impacts of plastic film mulching on crop yields, soil water, nitrate, and organic carbon in Northwestern China: A meta-analysis

In order to increase crop yield in semi-arid and arid areas, plastic film mulching (PFM) is widely used in Northwestern China. To date, many studies have addressed the effects of PFM on soil physical and biochemical properties in rain-fed agriculture in Northwestern China, but the findings of different studies are often contradictory. Therefore, a comprehensive review of the impacts of PFM on soil water content, soil nutrients and food production is needed. We compiled the results of 1278 observations to evaluate the overall effects of PFM on soil water content, the distribution of nitrate and soil organic carbon, and crop yield in rain-fed agriculture in Northwestern China. Our results showed that PFM increased soil moisture and nitrate concentration in topsoils (0-20 cm) by 12.9% and 28.2%, respectively, but slightly decreased (1.8%) soil organic carbon (SOC) content in the 0-10 cm soil layer. PFM significantly increased grain yields by 43.1%, with greatest effect in spring maize (79.4%). When related to cumulative precipitation during the crop growing season, yield increase from PFM was greatest (72.8%) at 200-300 mm, which was attributed to the large increase for spring maize and potato, implying that crop zoning would be beneficial for PFM in this region. When related to N application rate, crop yields benefited most from PFM (80.2%) at 200-300 kg/ha. A cost-benefit analysis indicated that PFM increased economic return by an average of 29.5%, with the best improvement for spring maize (71.1%) and no increase for spring wheat. In conclusion, PFM can significantly increase crop yield and economic return (especially for spring maize) in rain-fed agriculture areas of Northwestern China. Crop zoning is recommended for PFM to achieve the largest economic benefit. However, full account needs to be taken of the environmental impacts relating to N loss, SOC depletion and film pollution to evaluate the sustainability of PFM systems and further research is required to quantify and mitigate these impacts.

Enhancing recovery and sensitivity studies in an unconventional tight gas condensate reservoir

The recovery factor from tight gas reservoirs is typically less than 15%, even with multistage hydraulic fracturing stimulation. Such low recovery is exacerbated in tight gas condensate reservoirs, where the depletion of gas leaves the valuable condensate behind. In this paper, three enhanced gas recovery (EGR) methods including produced gas injection, CO₂ injection and water injection are investigated to increase the well productivity for a tight gas condensate reservoir in the Montney Formation, Canada. The production performance of the three EGR methods is compared and their economic feasibility is evaluated. Sensitivity analysis of the key factors such as primary production duration, bottom-hole pressures, and fracture conductivity is conducted and their effects on the well production performance are analyzed. Results show that, compared with the simple depletion method, both the cumulative gas and condensate production increase with fluids injected. Produced gas injection leads to both a higher gas and condensate production compared with those of the CO₂ injection, while waterflooding suffers from injection difficulty and the corresponding low sweep efficiency. Meanwhile, the injection cost is lower for the produced gas injection due to the on-site available gas source and minimal transport costs, gaining more economic benefits than the other EGR methods.

Assessing the economic advantage of laparoscopic vs. open approaches for colorectal cancer by a propensity score matching analysis

PURPOSES

This study investigated the surgical outcomes and potential economic advantage of open vs. laparoscopic surgery for colorectal cancer using a propensity score matching analysis.

METHODS

We examined the surgical and economic outcomes of patients undergoing laparoscopic (N = 127) and open surgery (N = 253) for colorectal cancer and then compared these outcomes in two groups (N = 103 each) using a propensity score matching analysis.

RESULTS

Compared to open surgery, the laparoscopic approach was associated with a significantly lower overall morbidity rate (14 vs. 40%; P < 0.001) and shorter mean (± standard deviation) postoperative hospital stay (12.6 ± 8.3 vs. 16.8 ± 9.9 days, respectively; P = 0.001). Despite generating higher mean surgical costs (Japanese yen) (985,000 ± 215,000 vs. 812,000 ± 222,000 yen; P < 0.001), utilizing a laparoscopic approach significantly reduced the non-surgical costs (773,000 ± 440,000 vs. 1075,000 ± 508,000 yen; P < 0.001). The mean total cost of laparoscopic-assisted surgery (1758,000 ± 576,000 yen) was decreased by approximately 130,000 yen compared with open surgery (1886,000 ± 619,000 yen), although the difference was not statistically significant (P = 0.125).

CONCLUSIONS

Laparoscopic surgery for colorectal cancer is advantageous in reducing morbidity and facilitating an early discharge and does not increase hospital costs. These findings are consistent with the general consensus supporting the benefits of laparoscopic surgery as a minimally invasive approach.

Assessment of population exposure to PM2.5 for mortality in China and its public health benefit based on BenMAP

Along with the rapid socioeconomic development, air pollution in China has become a severe problem. One component of air pollution, in particular, PM_2.5 has aroused wide public concern because of its high concentration. In this study, data were collected from over 900 monitoring sites of the newly constructed PM_2.5 monitoring network in China. The interpolation methods were used to simulate the PM_2.5 exposure level of China especially in rural areas, thus reflecting the spatial variation of PM_2.5 pollution. We calculated the health benefit caused by PM_2.5 in China in 2014 based on Environmental Benefits Mapping and Analysis Program (BenMAP), assuming achievement of China National Ambient Air Quality Standard (No. GB3095-2012). By reducing the annual average concentration of PM_2.5 to the annual Grade II standard (35 μg/m³), the avoided deaths for cardiovascular disease, respiratory disease and lung cancer could reach 89,000 (95% CI, 8000-170,000), 47,000 (95% CI, 3000-91,000) and 32,000 (95% CI, 6000-58,000) per year using long term health function, respectively. The attributable fractions of cardiovascular disease, respiratory disease and lung cancer to all cause were 42%, 22% and 15%, respectively. The total economic benefits for rolling back the concentration of PM_2.5 to the level of 35 μg/m³ were estimated to be 260 (95%CI: (73, 440) billion RMB and 72 (95%CI: (45, 99) billion RMB using willingness to pay (WTP) and human capital (HC) methods, respectively, which account for 0.40% (95%CI: (0.11%, 0.69%) and 0.11% (95%CI: (0.07%, 0.15%) of the total annual Gross Domestic Product (GDP) of China in 2014.

[Interest of optical coherence tomography performed immediately before intravitreal injection of anti-VEGF in exudative AMD]

INTRODUCTION

Two or three systematic intravitreal injections (IVT) may be prescribed in a PRN approach to treat an exudative recurrence of neovascular age-related macular degeneration (AMD), according to the phenotype. Optical coherence tomography (OCT) may be performed immediately before the 2nd or the 3rd scheduled IVT, making it possible to cancel the procedure in the absence of exudation. The aim of the study was to evaluate the usefulness of this OCT examination and to assess the percentage of IVT cancelled, in order to evaluate a potential medico-economic benefit.

METHODS

Monocentric retrospective study, in which were included 292 consecutive eyes with exudative recurrence of AMD, for which 2 or 3 IVT were scheduled between January 1st and April 30th, 2014. All patients received a first systematic IVT in the seven days following the diagnosis. Then, on the days of the 2nd and 3rd scheduled IVT, each patient had a visual acuity measurement and a Spectral domain-OCT (Spectralis, HRA Heidelberg Engineering). This measurement allowed for the IVT to be either performed as scheduled or cancelled. Both ranibizumab and aflibercept were used. A Chi(2) test was used to compare the qualitative variables and an adjusted Wilcoxon test for the quantitative values.

RESULTS

Two hundred and ninety-two consecutive eyes were included; 172 in the "2 scheduled IVT" group (group A) and 120 in the "3 scheduled IVT" group (group B). At the first follow-up, 37.6% of scheduled IVT were cancelled after the OCT (44.1% in group A and 28.3% in group B). At the second follow-up, 33.3% of IVT were cancelled in group B. Overall, 150/412 (36.4%) IVT were avoided in this series. Presence of serous retinal detachment, retinal edema and increased central macular thickness were statistically correlated with confirmation of the scheduled IVT at the two follow-ups (P<0.001, P<0.001 and P=0.002, respectively). A savings of 429.80 € per patient was calculated during this short period of follow-up.

CONCLUSION

An average non-injection rate of 36.4% of scheduled IVT was found in this protocol of management of recurrences with OCT performed the day of IVT. This protocol allowed to avoid unnecessary IVT one-third of the time and appeared highly cost-effective.