Decision-making under uncertainty for species introductions into ecological networks.

Ecological communities are increasingly subject to natural and human-induced additions of species, as species shift their ranges under climate change, are introduced for conservation and are unintentionally moved by humans. As such, decisions about how to manage ecosystems subject to species introductions and considering multiple management objectives need to be made. However, the impacts of gaining new species on ecological communities are difficult to predict due to uncertainty in introduced species characteristics, the novel interactions that will be produced by that species, and the recipient ecosystem structure. Drawing on ecological and conservation decision theory, we synthesise literature into a conceptual framework for species introduction decision-making based on ecological networks in high-uncertainty contexts. We demonstrate the application of this framework to a theoretical decision surrounding assisted migration considering both biodiversity and ecosystem service objectives. We show that this framework can be used to evaluate trade-offs between outcomes, predict worst-case scenarios, suggest when one should collect additional data, and allow for improving knowledge of the system over time.

Model-Based Systems Engineering Applied to Trade-Off Analysis of Wireless Power Transfer Technologies for Implanted Biomedical Microdevices.

Decision-making is an important part of human life and particularly in any engineering process related to a complex product. New sensors and actuators based on MEMS technologies are increasingly complex and quickly evolving into products. New biomedical implanted devices may benefit from system engineering approaches, previously reserved to very large projects, and it is expected that this need will increase in the future. Here, we propose the application of Model Based Systems Engineering (MBSE) to systematize and optimize the trade-off analysis process. The criteria, their utility functions and the weighting factors are applied in a systematic way for the selection of the best alternative. Combining trade-off with MBSE allow us to identify the more suitable technology to be implemented to transfer energy to an implanted biomedical micro device.

The overlooked spatial dimension of climate-smart agriculture.

Climate-smart agriculture (CSA) and sustainable intensification (SI) are widely claimed to be high-potential solutions to address the interlinked challenges of food security and climate change. Operationalization of these promising concepts is still lacking and potential trade-offs are often not considered in the current continental- to global-scale assessments. Here we discuss the effect of spatial variability in the context of the implementation of climate-smart practices on two central indicators, namely yield development and carbon sequestration, considering biophysical limitations of suggested benefits, socioeconomic and institutional barriers to adoption, and feedback mechanisms across scales. We substantiate our arguments by an illustrative analysis using the example of a hypothetical large-scale adoption of conservation agriculture (CA) in sub-Saharan Africa. We argue that, up to now, large-scale assessments widely neglect the spatially variable effects of climate-smart practices, leading to inflated statements about co-benefits of agricultural production and climate change mitigation potentials. There is an urgent need to account for spatial variability in assessments of climate-smart practices and target those locations where synergies in land functions can be maximized in order to meet the global targets. Therefore, we call for more attention toward spatial planning and landscape optimization approaches in the operationalization of CSA and SI to navigate potential trade-offs.

Upstream solutions to coral reef conservation: The payoffs of smart and cooperative decision-making.

Land-based source pollutants (LBSP) actively threaten coral reef ecosystems globally. To achieve the greatest conservation outcome at the lowest cost, managers could benefit from appropriate tools that evaluate the benefits (in terms of LBSP reduction) and costs of implementing alternative land management strategies. Here we use a spatially explicit predictive model (InVEST-SDR) that quantifies change in sediment reaching the coast for evaluating the costs and benefits of alternative threat-abatement scenarios. We specifically use the model to examine trade-offs among possible agricultural road repair management actions (water bars to divert runoff and gravel to protect the road surface) across the landscape in West Maui, Hawaii, USA. We investigated changes in sediment delivery to coasts and costs incurred from management decision-making that is (1) cooperative or independent among landowners, and focused on (2) minimizing costs, reducing sediment, or both. The results illuminate which management scenarios most effectively minimize sediment while also minimizing the cost of mitigation efforts. We find targeting specific "hotspots" within all individual parcels is more cost-effective than targeting all road segments. The best outcomes are achieved when landowners cooperate and target cost-effective road repairs, however, a cooperative strategy can be counter-productive in some instances when cost-effectiveness is ignored. Simple models, such as the one developed here, have the potential to help managers make better choices about how to use limited resources.

Modeling the influence of alternative forest management scenarios on wood production and carbon storage: A case study in the Mediterranean region.

Forest ecosystems are fundamental for the terrestrial biosphere as they deliver multiple essential ecosystem services (ES). In environmental management, understanding ES distribution and interactions and assessing the economic value of forest ES represent future challenges. In this study, we developed a spatially explicit method based on a multi-scale approach (MiMoSe-Multiscale Mapping of ecoSystem services) to assess the current and future potential of a given forest area to provide ES. To do this we modified and improved the InVEST model in order to adapt input data and simulations to the context of Mediterranean forest ecosystems. Specifically, we integrated a GIS-based model, scenario model, and economic valuation to investigate two ES (wood production and carbon sequestration) and their trade-offs in a test area located in Molise region (Central Italy). Spatial information and trade-off analyses were used to assess the influence of alternative forest management scenarios on investigated services. Scenario A was designed to describe the current Business as Usual approach. Two alternative scenarios were designed to describe management approaches oriented towards nature protection (scenario B) or wood production (scenario C) and compared to scenario A. Management scenarios were simulated at the scale of forest management units over a 20-year time period. Our results show that forest management influenced ES provision and associated benefits at the regional scale. In the test area, the Total Ecosystem Services Value of the investigated ES increases 85% in scenario B and decreases 82% in scenario C, when compared to scenario A. Our study contributes to the ongoing debate about trade-offs and synergies between carbon sequestration and wood production benefits associated with socio-ecological systems. The MiMoSe approach can be replicated in other contexts with similar characteristics, thus providing a useful basis for the projection of benefits from forest ecosystems over the future.

Trade-off analysis between gm/ID and fT of GNR-FETs with single-gate and double-gate device structure.

This study examines the operational parameters of field-effect transistors (FETs) using single-gate (SG) and double-gate (DG) graphene nanoribbons (GNRs) within the analog/RF domain. A detailed exploration is conducted through an atomistic pz orbital model, derived from the Hamiltonian of graphene nanoribbons, employing the nonequilibrium Green's function formalism (NEGF) for analysis. The atomic characteristics of the GNRFETs channel are accurately described by utilizing a tight-binding Hamiltonian with an atomistic pz orbital basis set. The primary focus of the analysis revolves around essential analog/RF parameters such as transconductance, transconductance generation factor (TGF), output resistance, early voltage, intrinsic gain, gate capacitance, cut-off frequency, and transit time. Furthermore, the study assesses the gain frequency product (GFP), transfer frequency product (TFP), and gain transfer frequency product (GTFP) to evaluate the balance between transistor efficiency, gain, and cut-off frequency. The research outcomes indicate that double-gate GNRFETs exhibit superior analog/RF performance in comparison to their single-gate counterparts. However, both types of devices demonstrate cut-off frequencies in the gigahertz range. The extensive data presented in this study provides valuable insights into the characteristics of SG and DG GNRFETs, particularly in terms of the figure-of-merit (FoM) for analog/RF performance, offering a comprehensive analysis of the trade-offs in analog applications. In addition, the analysis has been extended be performing a high-performance hybrid 6T static random-access memory (SRAM) to get the impact in their circuit level variation as well as improvement in their circuit performance.

Trade-offs between economic benefits and environmental impacts in non-grain expansion: a case study in the eastern plain of China.

China has experienced a boom expansion of non-grain production in recent years. While the non-grain production can increase the economic benefits of farmers, its expansion has significant impacts on the ecological environment and agricultural sustainability. This study attempted to assess the trade-offs between the economic benefits and environmental costs of non-grain production and to provide reference for future land use management. Focusing on the non-grain expansion in Tongxiang City, eastern China, empirical models and field surveys were used to evaluate its environmental impacts and monetary analysis was used to assess the trade-offs between the economic benefits and environmental costs. The results showed that the area of non-grain production increased by 2464.74 ha from 2005 to 2020, and pond fish farming accounted for the largest proportion. The economic benefits and environmental costs of non-grain production increased continuously during 2005-2020, and the net economic-environmental benefits gradually expanded after 2010. Trade-off analysis indicates that the economic benefits of duck rearing did not compensate for the environmental costs, while the other non-grain productions did. Nevertheless, the potential impact of non-grain conversion on the local environment is still underestimated. Some suggestions are proposed to achieve a win-win situation between cultivated land utilization and ecological protection.

Evaluating the Effect of Deficit Irrigation on Yield and Water Use Efficiency of Drip Irrigation Cotton under Film in Xinjiang Based on Meta-Analysis.

Water scarcity constrains the sustainable development of Chinese agriculture, and deficit irrigation as a new irrigation technology can effectively alleviate the problems of water scarcity and water use inefficiency in agriculture. In this study, the drip irrigation cotton field under film in Xinjiang was taken as the research object. Meta-analysis and machine learning were used to quantitatively analyze the effects of different farm management practices, climate, and soil conditions on cotton yield and water use efficiency under deficit irrigation, to investigate the importance of the effects of different factors on cotton yield and water use efficiency, and to formulate appropriate optimization strategies. The results showed that deficit irrigation significantly increased cotton water use efficiency (7.39%) but decreased cotton yield (-15.00%) compared with full irrigation. All three deficit irrigation levels (80~100% FI, 60~80% FI, and 40~60% FI; FI: full irrigation) showed a significant decrease in cotton yield and a significant increase in water use efficiency. Under deficit irrigation, cotton yield reduction was the smallest and cotton water use efficiency increased the most when planted with one film, two tubes, a six-row cropping pattern, an irrigation frequency ≥10 times, a nitrogen application of 300~400 kg·ha-1, and a crop density ≥240,000 per hectare, and planted with the Xinluzhong series of cotton varieties; deficit irrigation in areas with average annual temperature >10 °C, annual evapotranspiration >2000 mm, annual precipitation <60 mm, and with loam, sandy soil had the least inhibition of cotton yield and the greatest increase in cotton water use efficiency. The results of the random forest showed that the irrigation amount and nitrogen application had the greatest influence on cotton yield and water use efficiency. Rational irrigation based on optimal management practices under conditions of irrigation not less than 90% FI is expected to achieve a win-win situation for both cotton yield and water use efficiency. The above results can provide the best strategy for deficit irrigation and efficient water use in drip irrigation cotton under film in arid areas.

Spatial identification and multilevel zoning of land use functions improve sustainable regional management: a case study of the Yangtze River Economic Belt, China.

The quantitative identification and zoning management of land use functions (LUFs) are important starting points for solving the problems of resource allocation and sustainable development. In this study, with the Yangtze River Economic Belt (YREB) as the case study area, LUFs were grouped into three primary categories: economic function (ENF), social function (SCF), and ecological function (ELF). The least square error model was adopted to identify the morphological changes of LUFs. A two-dimensional discriminant matrix of the dynamic degree of LUF change and terrain niche index was constructed to explain the terrain gradient effect of LUFs. Bivariate local spatial autocorrelation was used to analyze the trade-offs in 2018 between ELF and ENF, and ELF and SCF. Finally, a new multilevel zoning scheme for LUFs was proposed. The results showed that from 1990 to 2018, ENF increased rapidly in cities along the Yangtze River, the overall level of SCF declined, and ELF in the south of the Yangtze River was better than that in the north. LUFs' morphological zoning exhibited significant regional differences. SCF-ELF combination areas and ELF dominance areas were mainly optimized in the second-level zoning. The areas with weak ELF were concentrated in the east of the YREB. Based on these results, nine kinds of LUF zonings and six kinds of major functional zonings were devised, and policy allocation was arranged for each zoning to improve the efficiency of spatial zoning management. Our research provides a reference for large-scale regional sustainable development and land use zoning management.

Different biomass production and soil water patterns between natural and artificial vegetation along an environmental gradient on the Loess Plateau.

Loess Plateau (LP) is a vulnerable and climate-sensitive ecoregion. With the implementation of "Grain for Green" project (GGP), the vegetation cover has largely improved, while the contradiction between overconsumption of soil water and sustainability of restored vegetation is increasingly prominent, and further threatening the ecosystem sustainability and socioeconomic development. Understanding the different responses of relations of biomass production and soil water regimes between natural and artificial vegetation along environmental gradient will be crucial for sustainability of restored vegetation on the LP. Here, aboveground biomass (AGB) and soil water content (SWC) of natural and artificial vegetation were measured in steppe, forest-steppe and forest zone from 2008 to 2017 on the Yanhe River catchment. The results showed that artificial vegetation consumed more soil water than natural vegetation in steppe and forest-steppe zone, while it did not over consume soil water in forest zone. The AGB of natural vegetation in forest zone was significantly higher than that in steppe and forest-steppe zone. Steppe zone had serious overload of artificial vegetation (overload ratio: 5.35), while no overload occurred in forest zone. So, we suggest a cessation of artificial vegetation expansion in steppe zone. In steppe zone, planting artificial vegetation increased competition intensity between AGB and SWC, and the relative benefit tended to be AGB, their competition intensity was the highest. In forest zone, the trade-off relationship between AGB and SWC had no significant difference between natural and artificial vegetation, and the competition intensity between the AGB and SWC was the weakest. Optimal vegetation restoration approach would maintain the balance between vegetation restoration and soil water. To obtain social and ecological sustainability on the LP, vegetation suitability and suitable management along different environmental gradients should be considered and identified in the future revegetation project.

Quantifying trade-offs between ecological gains, economic costs, and landowners' preferences in boreal mire protection.

Private land often encompasses biodiversity features of high conservation value, but its protection is not straightforward. Commonly, landowners' perspectives are rightfully allowed to influence conservation actions. This unlikely comes without consequences on biodiversity or other aspects such as economic considerations, but these consequences are rarely quantitatively considered in decision-making. In the context of boreal mire protection in Finland, we report how acknowledging landowners' resistance to protection changes the combination of mires selected to conservation compared to ignoring landowners' opinions. Using spatial prioritization, we quantify trade-offs arising between the amount of landowners' resistance, protected biodiversity, and financial costs in different conservation scenarios. Results show that the trade-offs cannot be fully avoided. Nevertheless, we show that the systematic examination of the trade-offs opens up options to alleviate them. This can promote the evaluation of different conservation policy outcomes, enabling better-informed conservation decisions and more effective and socially sustainable allocation of conservation resources.

Tradeoff for water resources allocation based on updated probabilistic assessment of matching degree between water demand and water availability.

Water resources allocation is very important for water resources management. However, it is subject to the uncertainty in water availability (WA) or water demand (WD), as well as the pressure exerted by multi-stakeholders. Therefore, we propose a general framework as following: (i) applying Bayes theorem to develop a forecasting model for WA and WD probability distributions; (ii) constructing the matching matrix showing matching degree between WA and WD and assessing the probabilistic behavior of water resources allocation solutions based on the matching matrices; and (iii) performing the trade-off analysis among the solutions under different stakeholders' objectives to meet requirements of multi-stakeholders. Longgang River basin is selected as a case study area to demonstrate the proposed framework. Results show that, the forecast probability distributions of WA and WD may be updated timely with newly introduced data, and reflect their statistical characters well. Furthermore, the matching matrices illustrate the probabilities of the possible outcomes of each allocation solution clearly. From the probabilistic assessment; the results suggest: 21160×104 m3 diverted water are required to surely satisfy the current water demands, which is exactly the amount currently diverted for the study area. The proposed framework provides the updated probabilistic assessment for the possible outcomes, contributing to stakeholders to perform the tradeoff with each other. It makes significant contributions to address water allocation issues under uncertainty and is worthy to be applied broadly.

Net clinical benefit of antithrombotic therapy in patients with heart failure and sinus rhythm: A network meta-analysis from 5 clinical trials.

BACKGROUND: Heart failure (HF) is associated with an increased incidence of thromboembolic events. Antithrombotic treatment could reduce the stroke risk, whereas increase the bleeding risk. Whether antithrombotic treatment should be a routine therapy for HF and sinus rhythm (SR) patients remains unanswered. METHODS: We systematically searched Medline, Embase, Cochrane Library databases, and ClinicalTrials.gov Website for randomized controlled trials (RCTs) studying antithrombotic therapy in HF and SR patients. The primary outcomes of efficacy and safety were defined as stroke and major bleeding, respectively. The network meta-analysis was conducted. The results were expressed as relative risks (RRs) with 95% confidence intervals (95% CIs), and pooled using a random-effects model. The surface under the cumulative ranking curves (SUCRA) was calculated and trade-off analysis of net clinical benefit (NCB) was estimated. RESULTS: Five studies totally involving 9390 patients were included. A significantly decreased risk of stroke was found for patients with HF and SR, when rivaroxaban was compared with placebo (RR: 0.67, 95%CI: 0.47-0.96) and warfarin was compared with antiplatelets (RR: 0.49, 95%CI: 0.33-0.73). Warfarin (RR: 7.96, 95%CI: 1.06-59.88) and rivaroxaban (RR: 1.65, 95%CI: 1.16-2.33) were associated with a significant increase in the risk of major bleeding when compared with placebo. Considering the ranking of each antithrombotic therapy for primary outcomes, warfarin (SUCRA: 78.2) emerged with the highest cumulative ranking probability for stroke, with rivaroxaban (SUCRA: 73.9) and antiplatelet agents (SUCRA: 19.6) ranked behind. In terms of major bleeding, rivaroxaban (SUCRA: 57.6) was the safer intervention compared with antiplatelet agents (SUCRA: 43.5) or warfarin (SUCRA: 2.9). No difference was observed considering all-cause death, MI and hospitalization of HF among all different antithrombotic regimens. Rivaroxaban was considered as a reasonably effective and the safe antithrombotic agent for HF and SR patients. CONCLUSIONS: Rivaroxaban might the optimal antithrombotic regimen balancing stroke and major bleeding for HF patients with SR. The results might support the attempt to anticoagulation on HF and SR patients. However, further specialized designs of RCTs are necessary to draw a robust conclusion.

Net Clinical Benefit of Direct Oral Anticoagulants in Patients With Cancer and Venous Thromboembolism: A Systematic Review and Trade-Off Analysis.

Background: Venous thromboembolism (VTE) is highly prevalent in cancer patients. Recent guidelines recommend considering direct oral anticoagulants (DOACs) for the treatment of cancer-associated thrombosis (CAT). However, direct head-to-head comparisons among DOACs are lacking, and almost no net clinical benefit (NCB) analysis has been performed in patients with CAT. Methods: We systematically searched PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) reporting on recurrent VTE, major bleeding, or clinically relevant bleeding events in patients with CAT who received DOACs and low-molecular-weight heparins. Relative risks (RRs) and 95% confidence intervals (95% CIs) were calculated using a random-effect model. Surface under the cumulative ranking curve (SUCRA) values were calculated, and a trade-off analysis was performed to estimate the NCB. Results: Overall, four RCTs involving 2,894 patients were enrolled. DOACs were more effective than dalteparin in reducing the risk of recurrent VTE (RR: 0.62, 95% CI: 0.44-0.87), with a comparative risk of major bleeding (RR: 1.33, 95% CI: 0.84-2.11) and an increased risk of clinically relevant bleeding (RR: 1.45, 95% CI: 1.05-1.99). No significant difference was observed among individual anticoagulants in terms of recurrent VTE and major bleeding. With respect to the ranking of each anticoagulant for the primary outcome, edoxaban (SUCRA: 69.2) was more effective than dalteparin (SUCRA: 60.7), rivaroxaban (SUCRA: 60.7), and apixaban (SUCRA: 25.5) in reducing VTE recurrence. For major bleeding, apixaban (SUCRA: 76.3) had the highest cumulative ranking probability, followed by edoxaban (SUCRA: 66.4), dalteparin (SUCRA: 28.8), and rivaroxaban (SUCRA: 28.5). Similar results were observed for clinically relevant bleeding. In terms of both benefit and safety outcomes, DOACs, especially edoxaban, seemed to confer a better NCB profile than dalteparin. Conclusions: DOACs are a safe and effective alternative therapy to dalteparin in patients with CAT. Among them, edoxaban might provide a good risk-to-benefit balance. However, because of the lack of head-to-head studies, further investigations are needed to confirm our findings.

ESPRES: A web application for interactive analysis of multiple pressures in aquatic ecosystems.

ESPRES (Efficient Strategies for anthropogenic Pressure Reduction in European waterSheds) is a web-based Decision Support System (DSS) designed to explore management options for achieving environmental targets in European freshwaters. The tool integrates multi-objective optimization (MOO) algorithms for selecting the best management options in a river basin and models assessing the consequent changes in the water quantity (water flow) and quality (nutrient concentration). The MOO engine identifies Pareto front strategies that are trade-offs between environmental objectives for water bodies and the effort required for reducing the pressures. The web interface provides tools to set the effort perceived by different river basin stakeholders considering technical feasibility, political difficulty, and social acceptability of the alternative options. The environmental impact of management options (scenarios) is assessed with models developed at the European scale. ESPRES enables comparison of management solutions and allows quantifying environmental and socio-economic trade-offs inherent to the decision making process.

Using a system thinking approach to assess the contribution of nature based solutions to sustainable development goals.

Climate change and the overexploitation of natural resources increase the need to integrate sustainable development policies at both national and international levels to fit the demands of a growing population. In 2015 the United Nations (UN) established the 2030 Agenda for sustainable development with the aim of eradicating extreme poverty, reducing inequality and protecting the planet. The Agenda 2030 highlights the importance of biodiversity and the functioning of ecosystems to maintain economic activities and the well-being of local communities. Nature Based Solutions (NBS) support biodiversity conservation and the functioning of ecosystems. NBS are increasingly seen as innovative solutions to manage water-related risks while transforming natural capital into a source of green growth and sustainable development. In this context, NBS could potentially contribute to the achievement of several Sustainable Development Goals (SDGs) by promoting the delivery of bundles of ecosystem services together generating various social, economic and environmental co-benefits. However, to achieve the full potential of NBS, it is necessary to recognize the trade-offs and synergies of the co-benefits associated with their implementation. To this aim, we have adopted a system perspective and a multi-sectoral approach to analyse the potential of NBS to deliver co-benefits while at the same time reducing the negative effects of water-related hazards. Using the case study of Copenhagen, we have analysed the relationships between the co-benefits associated with the scenario of the restoration of the Ladegaardsaa urban river. Our hypothesis is that enhancing the understanding of the social, economic and environmental factors of the system, including mutual influences and trade-offs, could improve the decision-making process and thereby enhance the capability of NBS to contribute to the achievement of the SDGs.

Quantifying stakeholder understanding of an ecosystem service trade-off.

Sustainable management of global natural resources is challenged by social and environmental drivers, adding pressure to ecosystem service provision in many regions of the world where there are competing demands on environmental resources. Understanding trade-offs between ecosystem services and how they are valued by different stakeholder groups is therefore critical to maximise benefits and avoid conflict between competing uses. In this study we developed a novel participatory trade-off experiment to elicit the perception of 43 participants, from across four key stakeholder groups, working in land and water management (Environmental Regulators, Farming Advisors, Water Industry Staff and Catchment Scientists). Using the Production Possibility Frontier (PPF) concept, we quantified stakeholder assessment of both the shape and the uncertainty around the PPF in a trade-off between agricultural intensity and the ecological health of freshwater systems. The majority of stakeholder groups selected threshold and logistic decay trade-off curves to describe the relationship of the trade-off, and estimated the uncertainty around the curves to be intermediate or large. The views of the four stakeholder groups differed significantly regarding how they estimated stakeholder trade-off prioritisation; the largest difference in perspectives was identified between Environmental Regulators and Farm Advisors. The methodology considered the cultural, socio-economic and institutional specificities of an ecosystem service interaction and identified potential sources of conflict but also possible solutions for win-win opportunities to explore and share understanding between stakeholders. Valuing stakeholder knowledge as a form of expert data and integrating this into participatory decision-making processes for land and water management thus contributes considerable value beyond traditional approaches to ecosystem service assessments.

Selecting sustainable alternatives for cruise ships in Venice using multi-criteria decision analysis.

The rapid growth of cruise ship tourism increases the use of historic port cities as strategic hubs for cruise ship operators. Benefits derived from increased tourism for the municipality and cruise ships are often at odds with the environmental and social impacts associated with continued historical port use. This study illustrates the use of Multi-Criteria Decision Analysis (MCDA) for weighing of various criteria and metrics related to the environment, economy, and social sustainability for the selection of a sustainable cruise line route. Specifically, MCDA methodology was employed in Venice, Italy to illustrate its application. First, the four most representative navigational route projects among those presented to local authorities were assessed based on social, economic, and environmental considerations. Second, a pool of experts representing the local authority, private port businesses, and cruise line industry were consulted to evaluate the validity and weight assignments for the selected criteria. Finally, a sensitivity analysis was employed to assess the robustness of the recommendations using an evaluation of weight changes and their effects on the ranking of alternative navigational routes. The results were presented and discussed in a multi-stakeholder meeting to further the route selection process.

A Renal Function Based Trade-Off Analysis of Non-vitamin K Antagonist Oral Anticoagulants in Nonvalvular Atrial Fibrillation.

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) depend on some degree of renal excretion, and no head-to-head comparisons based on renal function is available. This study mainly investigated the trade-off property of NOACs in nonvalvular atrial fibrillation (NVAF) with varying degrees of renal function. Methods: A comprehensive search of Medline, Embase, Cochrane Library, and Clinical Trials.gov Website was performed for eligible randomized controlled trials (RCTs) that reported the efficacy and safety outcomes according to renal function of NOACs. Primary efficacy outcome was any Stroke or systemic embolism (S/SE). Major bleeding was considered as a primary safety outcome. Risk ratios (RRs) with their confidence intervals (CIs), the surface under the cumulative ranking curve (SUCRA), and trade-off analysis were conducted by renal function. Results: Finally, 5 phase III Clinical Trials (72961 NVAF patients) comparing NOACs with warfarin in NVAF patients were included. In terms of normal renal function, dabigatran-150 mg was ranked first for efficacy (SUCRA: 90.3), and edoxaban-30 mg was ranked first for safety (SUCRA: 93.3). Dabigatran-110 mg/150 mg, and apixaban-5 mg were regarded as the most effective and reasonably safe interventions in the trade-off analysis. Regarding mild renal impairment, edoxaban-60 mg was ranked first for efficacy (SUCRA: 97.8), and edoxaban-30 mg was ranked first for safety (SUCRA: 99.5). Edoxaban-60 mg and dabigatran-150 mg were accounted as the most effective and reasonably safe interventions. With regards to moderate renal impairment, dabigatran-150 mg was ranked first for efficacy (SUCRA: 95.1), and edoxaban-15 mg was ranked first for safety (SUCRA: 98.2). Apixaban-2.5 mg and Edoxaban-30 mg was considered as the reasonably effective and the safest interventions. Conclusions: Dabigatran-150 mg seems the most effective therapy in patients with normal renal function and moderate renal impairment, and edoxaban-60 mg in patients with mild renal impairment. Low dose edoxaban (15 and 30 mg) seems the safest intervention. Apixaban-2.5 mg and edoxaban-30 mg might be the best trade-off property in moderate renal insufficiency. HIGHLIGHTS  Dabigatran-150 mg seems the most effective therapy for normal renal function and moderate renal impairment patients, edoxaban-60 mg for mild renal impairment patients.Low-dose edoxaban can be considered as a good choice in NVAF patients at high risk of bleeding.Apixaban-2.5 mg and edoxaban-30 mg might be the balanced option in NVAF patients with moderate renal insufficiency.STUDY REGISTRATION:  PROSPERO Identifier, CRD42017054235.

Trade-Off Analysis in High-Throughput Materials Exploration.

This Research Article presents a strategy to identify the optimum compositions in metal alloys with certain desired properties in a high-throughput screening environment, using a multiobjective optimization approach. In addition to the identification of the optimum compositions in a primary screening, the strategy also allows pointing to regions in the compositional space where further exploration in a secondary screening could be carried out. The strategy for the primary screening is a combination of two multiobjective optimization approaches namely Pareto optimality and desirability functions. The experimental data used in the present study have been collected from over 200 different compositions belonging to four different alloy systems. The metal alloys (comprising Fe, Ti, Al, Nb, Hf, Zr) are synthesized and screened using high-throughput technologies. The advantages of such a kind of approach compared to the limitations of the traditional and comparatively simpler approaches like ranking and calculating figures of merit are discussed.