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.

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.

Clinical and economic impact of oncology-trained pharmacist integration in an ambulatory cancer clinic.

INTRODUCTION: Outpatient oncology practice is a growing area of opportunity for pharmacists to provide clinical services and evidence-based care. METHODS: This single-center, retrospective chart review analyzed the clinical and economic benefits of a board-certified oncology pharmacist after integration into the ambulatory oncology clinic setting. Primary outcomes were total cost avoidance for pharmacist interventions and impact on Centers for Medicare and Medicaid Services (CMS) OP-35 measures. Pharmacist interventions were characterized into distinct types which were then assigned a cost avoidance value. Cost avoidance was calculated per hour and then extrapolated to a yearly estimate based on a 40-h work week for one year for one full-time equivalent pharmacist. Data collection for the primary clinical outcome was performed by compiling provider-specific emergency department (ED) and inpatient admission rates for diagnoses specified in CMS OP-35 measures within 30 days after receiving outpatient chemotherapy. The rates for the data collection period were compared to the rates six months prior to pharmacist integration to assess pharmacist impact. RESULTS: In six months, 516 total interventions were made by the oncology pharmacist. The incidence of ED visits was 3.34% and 1.72% during the pre- and post-pharmacist intervention periods, respectively. The incidence of inpatient admissions was 2.43% and 0.34% pre- and post-pharmacist intervention, respectively. Total cost avoidance was estimated to be US$375,795 and when accounted for the median pharmacist salary at our institution, total cost savings was US$204,437. CONCLUSION: The presence of an oncology pharmacist specialist in the ambulatory cancer clinic provided clinical and economic benefits to the cancer clinic.

Planting and mowing cover crops as livestock feed to synergistically optimize soil properties, economic profit, and environmental burden on pear orchards in the Yangtze River Basin.

BACKGROUND: Pears, as an important cash crop, are currently facing great issues due to unsustainable management practices. Cover cropping is a sustainable management strategy that can improve soil fertility and increase fruit yield, while it may also stimulate greenhouse gas emissions. Therefore, synergizing multiple indicators to achieve sustainable development is critical. This study introduces a new management system, namely the planting and mowing of ryegrass as a livestock feed system (PRSS), and analyzes its impact on soil quality, economic benefits, and environmental burdens. RESULTS: Our results indicated that PRSS could increase soil pH from 5.08 to 5.48 and decrease the content of soil alkali-hydrolyzable nitrogen, total phosphate, and available phosphate (26.96-59.89%) while also enhancing yield (+38.51%) compared with the traditional natural grass management system (TMS). The average soil methane fluxes in PRSS were 72.67 µg m-2 day-1 , higher than those of TMS (61.28 µg m-2 day-1 ). However, the gross primary production was lower than TMS (-37.24%), and no significant difference was observed in soil nitrous oxide fluxes. In different scenarios, the total profit of PRSS mode 1 (mowing ryegrass and selling to a livestock company) and PRSS mode 2 (mowing ryegrass and feeding own sheep) were 10 706.21 $ ha-1 and 26 592.87 $ ha-1 respectively. These values are respectively2.36 times and 5.85 times higher than that of TMS. The total global warming potential of TMS (18.19 t CO2 -eq ha-1 ) was 1.29 t CO2 -eq ha-1 higher and 2.89 t CO2 -eq ha-1 lower than that of PRSS mode 1 and mode 2 respectively. CONCLUSION: Compared with traditional natural grass, planting and mowing ryegrass in pear orchards can optimize soil properties, increase fruit yield, and reduce global warming potential. Different modes can greatly increase revenue but have varying impacts on environmental burdens. These findings can help rebuild the links between farmland and specialized livestock production, contributing to sustainable development in the pear industries. © 2023 Society of Chemical Industry.

Mixed cropping with duck co-culture: an agroecological system to improve grain quality and farm profitability.

BACKGROUND: Previous studies found that mixed cropping combined with duck co-culture (MCDC) system could improve the efficiency of grain production and positively affect soil nutrient contents. However, the effects on grain quality, and profitable income have not been evaluated yet. In this study, a field experiment with four combinations of different rice varieties and ducks was conducted during both the early and late rice growing seasons. RESULTS: The field survey demonstrated that MCDC system significantly decreased the grain appearance of chalky rice rate and the chalkiness degree with an average of 56.82%, and 54.28%, respectively. Leaf SPAD value, photosynthetic rate, and aboveground dry weight were all improved in the MCDC and mixed-cropping systems, relative to the mono-cropping system. The net income obtained from the mono-cropping, mixed cropping (no ducks), and MCDC (with ducks) systems (from grain and ducks' meat) was 581.2 USD ha-1 yr-1 , 1001.8 USD ha-1 yr-1 , and 5242.1 USD ha-1 yr-1 in both growing seasons, respectively. CONCLUSION: Planting genetically diverse rice varieties and co-culture with ducks increased rice growth rates, productivity and grain quality. The MCDC system would provide more ecological and economic benefits compared with the conventional mono-cropping system. © 2022 Society of Chemical Industry.

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.

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.

Optimizing organic amendment applications to enhance carbon sequestration and economic benefits in an infertile sandy soil.

A thorough understanding of the agricultural, ecological, and economic benefits of organic amendment (OA) application in infertile soils is crucial for facilitating agricultural sustainability. We conducted a three-year field study to evaluate the effects of OA application on soil organic carbon (SOC) sequestration, crop yields, and the net ecosystem economic benefit (NEEB) in a typical infertile sandy soil (with an initial SOC content of 2.56 g kg-1) of the ancient Yellow River alluvial plain. In addition to the control (CK; non-OA application), two types of OAs, namely, manure-based organic fertilizer (M) and spent mushroom residue (MR), were each applied at 12, 24, and 36 Mg ha-1 yr-1. Two scenarios of OA application practices, namely, conventional manual OA application (AMA) and mechanical OA application (AME), were considered in the economic evaluation. An increase of 1 g kg-1 SOC content could improve the crop yield by 2.25 Mg ha-1 yr-1. Compared with the CK, the application of OAs enhanced the SOC content and SOC stock by 14.6%-39.8% and 8.5%-28.2%, respectively. However, the SOC sequestration efficiency of the OAs tended to decrease under high rates of OA application. MR was observed to have greater potential than M in sequestering SOC and promoting soil aggregates. OA-induced SOC sequestration could neutralize 36.6%-97.8% of greenhouse gas emissions, which resulted in a reduction in the global warming potential and its cost by 0.62-2.68 Mg CO2-eq ha-1 yr-1 and 15.46-65.78 CNY ha-1 yr-1, respectively. Nevertheless, in terms of the NEEB, the benefits of OA application on crop yield and SOC sequestration were largely offset by the increased material and labor costs. Compared with AMA, AME could save 10%-27% of agricultural costs. The AME of MR at a rate of 24 Mg ha-1 yr-1 achieved the highest NEEB. The results of this study suggest that a strategy involving the appropriate OA, optimal application rate, and cheapest incorporation cost for a specific individual soil should be adopted to achieve a sustainable solution for promoting crop productivity, enhancing SOC sequestration, and ensuring farmer income in infertile farming regions.

Efficacy and economics evaluation of seed rhizome treatment combined with preplant soil fumigation on ginger soilborne disease, plant growth, and yield promotion.

BACKGROUND: Ginger (Zingiber officinale Roscoe) is widely planted around the world. Owing to continuous planting, ginger is seriously affected by soilborne fungi, bacteria, and nematodes. Although preplant soil fumigation is an effective prevention strategy of soilborne diseases, individual fumigant and technology could not provide effective control of ginger soilborne disease. In our research, different combinations of soil fumigants and seed rhizome treatments were evaluated by monitoring the soil pathogens population, ginger growth, yield, and estimation of economic benefits. RESULTS: Soil fumigation effectively reduced the population of soilborne pathogens, and chloropicrin had a better control effect on soilborne pathogens than dazomet did. Preplant soil fumigation and seed rhizome treatment not only provide good control of soilborne disease, but also reduced the incidence of plant foliar pest and disease. Average yield increase rate of seed rhizome treatment was 12.0%; the highest yield increase was 24.4%. The average cost of seed rhizome treatment only increased by about 2.86%, but the rate of net revenue increase for the seed rhizome treatment reached up to 19.1%. CONCLUSION: Seed rhizome treatment is a very cost-effective soilborne disease control technology. In the management of soilborne diseases, the combined application of soil fumigation and seed rhizome treatment can reduce the risk of crops infected by soilborne diseases and ensure high and stable crop yields. © 2021 Society of Chemical Industry.

Environmental-economic approach to optimization of transport communication in megacities.

The paper presents the results of the study on the transport systems in metropolises by stating the interdisciplinary problems and prospects of applying the environmental and economic approach to the optimization of transport communication in megacities. The main problems of transport communications in large cities have been considered. The world experience in managing transport systems is analyzed. Priority directions for the implementation of environmental and economic tasks of transport industry management using the economic and mathematical approach have been established. It has been established that the performance indicators of the functioning of the megalopolis transport system depend on the work of the service provider. The most effective solution is to ensure that vehicles are working properly, that the vehicles are fully loaded and that they are on schedule. Performance indicators of the functioning of the megalopolis transport system on the part of the consumer of services: the coefficient of determination was 0.9493, the static probability p = 0.2067 standard deviation was 7.9428, the variance did not exceed 0.1015. The correlation of actual and planned results exceeded r2>0.7051; and was described by the equation y = 1.6746 + 0.844x. Logistic models for performance improvement of the transportation system were offered.

[Analysis of economic benefits of Chinese medicine eco-agriculture based on multiple stakeholders].

As the most advanced environment-friendly production model in the international society, ecological agriculture of Chinese materia medica(CMM) is the only way for the development of modern agriculture. With the proposal of the declaration on ecolo-gical agriculture of CMM, "Don't grab land from farmland, don't be enemies of grass and insects, don't be afraid of barren slopes and forests, and live up to the green and green mountains", the ecological planting of CMM has blossomed all over the country, and formed a scientific theory, technology and model. Based on the theory and method of economics, this paper expounds the comprehensive benefits and development advantages of ecological agriculture of CMM from the perspectives of farmers(producers), patients(consumers) and the country. From the perspective of medicinal farmers, the input and output income of conventional agriculture and ecological agriculture of CMM such as Panax ginseng, Astragalus propinquus, Atractylodes lancea, and Bupleurum chinense were compared, and it was found that ecological agriculture of CMM had obvious advantages in net income, average annual income and input-output ratio, which could better promote farmers' income. From the perspective of patients, according to the same dose, the content of active ingredients in ecologically planted CMMs is significantly higher than that in conventionally-planted herbs, and the amount of effective substances taken by patients is also higher, so as to achieve better therapeutic effect. At the national level, ecological planting of CMM is the key to ensuring the high-quality development of CMM industry, increasing farmers' income, ensuring the safety of people's drug use and promoting the sustainable development of agriculture. It is also an important part of realizing the harmonious development of economy, society and environment and promoting ecological civilization. In general, the declaration on ecological agriculture of CMM embo-dies the core characteristics and goals of ecological agriculture, and also points of the path and vision of ecological agriculture of CMM in the future. The declaration will guide production practice, promote the benefit of farmers, and lay the foundation for the sustainable development of CMM industry.

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.

The effects of different types of mulch on soil properties and tea production and quality.

BACKGROUND: Tea is an important economic crop in China. Mulching, a modern agricultural practice, can modify the soil microenvironment and maintain the crop yield. RESULTS: To investigate the effect of different mulching modes on tea plant growth, filed experiments were conducted in a Shizipu tea plantation located in Langxi Country (Xuanchen City, Anhui Province, China). Five treatments were carried out in a randomized complete block arrangement: (i) clean tillage (control); (ii) black plastic film; (iii) weed barrier fabric; (iv) rice straw mulch; and (v) intercropping with Vulpia myuros. The effects of different mulch modes on soil temperature, water moisture, soil compactness, root activity, soil enzyme activity and nutrition status on tea yield, quality and economic benefits were compared at the harvest stage. In the present study, compared with other mulch treatments, intercropping with V. myuros significantly reduced the topsoil temperature (to an optimum temperature) and soil compactness, and increased the water holding capacity in the deep soil layer, which contributed to increased tea root activity and respiration. Furthermore, intercropping with V. myuros significantly increased soil enzymes activity, soil organic matter, and the available nitrogen and phosphorus concentrations in the main root zone. Therefore, the stronger tea root activity accelerated nutrition uptake and increased the tea yield and quality-related components of the tea, thus resulting in a larger average net income. CONCLUSION: Intercropping with V. myuros could serve as a profitable agricultural method for tea production. © 2020 Society of Chemical Industry.

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.

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.

Economic benefit of carpal tunnel release in the Medicare patient population.

OBJECTIVE The epidemiology of carpal tunnel syndrome (CTS) has been extensively researched. However, data describing the economic burden of CTS is limited. The purpose of this study was to quantify the disease burden of CTS and determine the economic benefit of its surgical management. METHODS The authors utilized the PearlDiver database to identify the number of individuals with CTS in the Medicare patient population, and then utilized CPT codes to identify which individuals underwent surgical management. These data were used to calculate the total number of disability-adjusted life years (DALYs) associated with CTS. A human capital approach was employed and gross national income per capita was used to calculate the economic burden. RESULTS From 2005 to 2012 there were 1,500,603 individuals identified in the Medicare patient population with the diagnosis of CTS. Without conservative or surgical management, this results in 804,113 DALYs without age weighting and discounting, and 450,235 DALYs with age weighting and a discount rate of 3%. This amounts to between $21.8 and $39 billion in total economic burden, or $2.7-$4.8 billion per year. Surgical management of CTS has resulted in the aversion of 173,000-309,000 DALYs. This has yielded between $780 million and $1.6 billion in economic benefit per year. Endoscopic carpal tunnel release provided between $11,683 and $23,186 per patient at 100% success while open carpal tunnel release provided between $10,711 and $22,132 per patient at 100% success. The benefit-cost ratio at its most conservative is 2.7:1, yet could be as high as 6.9:1. CONCLUSIONS CTS is prevalent in the Medicare patient population, and is associated with a large amount of economic burden. The surgical management of CTS leads to a large reduction in this burden, yielding extraordinary economic benefit.

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.

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.

Appropriate level of alfalfa hay in diets for rearing Simmental crossbred calves in dryland China.

OBJECTIVE: In dryland areas of China, alfalfa hay (AH) is a possible substitute for concentrate feed for beef cattle. To evaluate the potential benefits of this substitution, we studied the effect of the ratio of AH intake to total dry matter (DM) intake on average daily body-weight gain (ADG), dietary energy utilization status, and economic benefit in Gansu province. METHODS: In each of two feeding trials in 2016 (trial 1 [T1], July 3 to 17; trial 2 [T2], August 15 to September 23), crossbred male Simmental calves were allocated to low AH (LA), medium AH (MA), and high AH (HA) feeding groups (n = 4 per group). The target ADG was set as 1 kg for both trials. In a one-way-layout design based on conventional feeding practices in the province, calves received diets containing the different AH amounts, with a constant ratio of corn stover:total DM and decreasing rations of concentrate feed proportional to the increase in AH. Calves in T1 received AH at 15% (T1-LA), 23% (T1-MA), or 31% (T1-HA) of their dietary DM allowances; those in T2 received 9% (T2-LA), 24% (T2-MA), or 34% (T2-HA) AH. RESULTS: Among the T1 groups, both ADG and economic benefit were highest in T1-LA; whereas in T2, they were higher in the T2-LA and T2-MA groups than in T2-HA. Energy digestibility did not significantly differ among the groups in either trial. The dietary AH inclusion ratios of 14% in the warm season and 8% to 21% in the cool season appeared to yield optimal ADG, metabolizable energy intake, and economic benefit. CONCLUSION: Low-level inclusion of AH, ranging from 8% to 21%, is a practical approach for beef cattle feeding. This modified feeding regimen likely will promote increased growth performance during the fattening stage of beef steers in dryland areas of Gansu province, China.