Assessment Of Benefits Research Articles

The assessment of adjuvant chemotherapy benefits after D3 lymphadenectomy in patients with colon cancer: a propensity score matching study

The assessment of adjuvant chemotherapy benefits after D3 lymphadenectomy in patients with colon cancer: a propensity score matching study

Hormone replacement therapy in surgical menopause after gynecological malignancies

This review examines hormone replacement therapy (HRT) in cases of surgical menopause following gynecological malignancies. It aims to capture current knowledge, summarize recent findings, and provide recommendations for clinical settings. Unlike natural menopause, surgical menopause occurs abruptly, without an adjustment period, and is associated with a notably higher risk of fractures, arthritis, cognitive decline, dementia, Parkinson’s disease, and various metabolic disorders affecting glucose and lipid levels—all of which contribute to an increased risk of major cardiovascular events. In 2017, The North American Menopause Society recommended that, barring contraindications, HRT should be initiated in women who enter surgical menopause before age 45. If these women do not experience vasomotor symptoms or other issues, HRT should be maintained consistently at least until age 52. This guideline reflects contemporary knowledge and is the result of a multidisciplinary consensus, based on a review of existing literature and several randomized clinical trials focusing on women who have survived gynecological cancers and whose quality of life is significantly impacted by surgical or early menopause. Estrogen supplementation is particularly beneficial, as it is linked to marked improvements in quality of life, including delayed onset of chronic cardiovascular issues, reduced fracture risk, enhanced cognitive function, reduced inflammation, and improved self-esteem, as well as better social and work performance. Clinical implementation of HRT, however, requires a highly individualized approach. This approach must consider the type and stage of malignancy, histopathological characteristics, risk factors for recurrence (such as diet, concurrent medications, medical history, and genetic predispositions), and a thorough assessment of the potential benefits and risks of HRT, as well as the patient’s personal wishes and expectations.

Intravenous and intracranial GD2-CAR T cells for H3K27M+ diffuse midline gliomas.

H3K27M-mutant diffuse midline gliomas (DMGs) express high levels of the disialoganglioside GD2(ref. 1). Chimeric antigen receptor-modified T cells targeting GD2 (GD2-CART) eradicated DMGs in preclinical models2. Arm A of Phase I trial no. NCT04196413 (ref.3) administered one intravenous (IV) dose of autologous GD2-CART to patients with H3K27M-mutant pontine (DIPG) or spinal DMG (sDMG) at two dose levels (DL1, 1 × 106 kg-1; DL2, 3 × 106 kg-1) following lymphodepleting chemotherapy. Patients with clinical or imaging benefit were eligible for subsequent intracerebroventricular (ICV) intracranial infusions (10-30 × 106 GD2-CART). Primary objectives were manufacturing feasibility, tolerability and the identification of maximally tolerated IV dose. Secondary objectives included preliminary assessments of benefit. Thirteen patients enroled, with 11 receiving IV GD2-CART on study (n = 3 DL1 (3 DIPG); n = 8 DL2 (6 DIPG, 2 sDMG)). GD2-CART manufacture was successful for all patients. No dose-limiting toxicities occurred on DL1, but three patients experienced dose-limiting cytokine release syndrome on DL2, establishing DL1 as the maximally tolerated IV dose. Nine patients received ICV infusions, with no dose-limiting toxicities. All patients exhibited tumour inflammation-associated neurotoxicity, safely managed with intensive monitoring and care. Four patients demonstrated major volumetric tumour reductions (52, 54, 91 and 100%), with a further three patients exhibiting smaller reductions. One patient exhibited a complete response ongoing for over 30 months since enrolment. Nine patients demonstrated neurological benefit, as measured by a protocol-directed clinical improvement score. Sequential IV, followed by ICV GD2-CART, induced tumour regressions and neurological improvements in patients with DIPG and those with sDMG.

The metabolic burden associated with plasmid acquisition: An assessment of the unrecognized benefits to host cells.

Bacterial conjugation, wherein DNA is transferred between cells through direct contact, is highly prevalent in complex microbial communities and is responsible for spreading myriad genes related to human and environmental health. Despite their importance, much remains unknown regarding the mechanisms driving the spread and persistence of these plasmids in situ. Studies have demonstrated that transferring, acquiring, and maintaining a plasmid imposes a significant metabolic burden on the host. Simultaneously, emerging evidence suggests that the presence of a conjugative plasmid can also provide both obvious and unexpected benefits to their host and local community. Combined, this highlights a continuous cost-benefit tradeoff at the population level, likely contributing to overall plasmid abundance and long-term persistence. Yet, while the metabolic burdens of plasmid conjugation, and their causes, are widely studied, their attendant potential advantages are less clear. Here, we summarize current perspectives on conjugative plasmids' metabolic burden and then highlight the lesser-appreciated yet critical benefits that plasmid-mediated metabolic burdens may provide. We argue that this largely unexplored tradeoff is critical to both a fundamental theory of microbial populations and engineering applications and therefore warrants further detailed study.

Development and validation of a nomogram for predicting the risk of developing gastric cancer based on a questionnaire: a cross–sectional study

BackgroundDetection of gastric cancer (GC) at early stages is an effective strategy for decreasing mortality. This study aimed to construct a prediction nomogram based on a questionnaire to assess the risk of developing GC.MethodsOur study comprised a total of 4379 participants (2326 participants from outpatient at Fengqing People’s Hospital were considered for model development and internal validation, and 2053 participants from outpatients at the endoscopy center at the Seventh Affiliated Hospital of Sun Yat-Sen University were considered for independent external validation) and gastric mucosa status was determined by endoscopy and biopsies. The eligible participants in development cohort from Fengqing people’s Hospital were randomly separated into a training cohort (n=1629, 70.0%) and an internal validation cohort (n=697, 30.0%). The relevant features were selected by a least absolute shrinkage and selection operator (LASSO), and the ensuing features were evaluated through multivariable logistic regression analysis. Subsequently, the variables were selected to construct a prediction nomogram. The discriminative ability and predictive accuracy of the nomogram were evaluated by the C-index and calibration plot, respectively. Decision curve analysis (DCA) curves were used for the assessment of clinical benefit of the model. This model was developed to estimate the risk of developing neoplastic lesions according to the “transparent reporting of a multivariable prediction model for individual prognosis or diagnosis” (TRIPOD) statement.ResultsSix variables, including age, sex, alcohol consumption, cigarette smoking, education level, and Hp infection status, were independent risk factors for the development of neoplastic lesions. Thus, these variables were incorporated into the final nomogram. The AUC of the nomogram were 0.701, 0.657 and 0.699 in the training, internal validation, and external validation cohorts, respectively. The calibration curve showed that the nomogram was in good agreement with the observed outcomes. Compared to treatment of all patients or none, our nomogram showed a notably higher clinical benefit.ConclusionThis nomogram proved to be a convenient, cost-effective tool to effectively predict an individual’s risk of developing neoplastic lesions, and it can act as a prescreening tool before gastroscopy.

Spatial benefit assessment and marine climate response of coastal zone in Fujian Province under cross-system influence.

To gain a scientific understanding of the cross-system impact of coastal zones and promote the sustainable development and protection of coastal areas, we constructed a spatial benefit evaluation system that encompassed both terrestrial and marine systems, focusing on the ecological, economic, and social dimensions. We employed the entropy method, moving average method, and Mann-Kendall trend test to quantitatively characterize the spatial benefits of the coastal zone in Fujian Province, China, and the evolution of the marine climate from 2005 to 2020. Building on this, the grey relational analysis method was applied to investigate the correlation between spatial benefits and marine climate and to explore the trends and magnitude of the impact of marine climate on spatial benefits. During the study period, the spatial benefits of the coastal zone in Fujian Province exhibited a fluctuating pattern of an initial increase followed by a decrease, with spatial benefits varying among cities. The role of the economic system in enhancing spatial benefits was not considerable. Changes in the marine climate aligned with the global warming trend, with the most considerable changes observed in sea level and tropical cyclone frequency and intensity, which are sensitive to human activities. There was a high degree of correlation between coastal zone spatial benefits and marine climate, with seawater salinity being most closely related to spatial benefits, while tropical cyclones showed the weakest correlation. The results of this study support sustainable development efforts in coastal zones.

Construction and Validation of a Nomogram for Predicting the Adding-on Phenomenon Postoperatively for Adolescent Idiopathic Scoliosis: A Retrospective Study

To develop and validate a nomogram predicting the postoperative adding-on (AO) phenomenon in Lenke 1/2 adolescent idiopathic scoliosis (AIS) patients, providing a quantitative tool for therapeutic benefit assessment and personalized risk prediction. A retrospective analysis was conducted using clinical data from 213 patients. The least absolute shrinkage selection operator (Lasso) was applied to identify the best predictors. Multivariate logistic regression was used to construct a nomogram with a training set (80%), while a validation set (20%) was used for internal validation. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) assessed the model's clinical utility. The model was constructed using the four best predictor variables: the number of vertebrae in the main thoracic curve (NV-MTC), apical vertebra translation (AVT), last instrumented vertebra rotation (LIVR), and Risser sign (RS). The model's C-index was 0.932 (95% confidence interval, 0.8858-0.9775). DCA indicated a clinically meaningful high-risk threshold between 0 and 1, and the calibration curve demonstrated satisfactory accuracy. The model proved useful for predicting the occurrence of AO in Lenke 1/2 AIS patients after surgery.

Selection for agronomic traits in intermediate wheatgrass increases responsiveness to arbuscular mycorrhizal fungi

Societal Impact StatementAgricultural practices have had a negative impact on the physical, chemical, and biological components of soil. Perennial cropping systems that facilitate positive soil microbial interactions could not only rebuild soils but also sustain productivity through expected variations in environmental conditions. Here, we show the presence of arbuscular mycorrhizal (AM) fungi, soil symbionts that can improve host performance and soil health, increased the growth of intermediate wheatgrass, a novel perennial grain crop, in populations that have been increasingly bred for desirable agricultural characteristics. The right pairing of intermediate wheatgrass and a beneficial AM fungal community could lead to more sustainable agroecosystems.Summary Intermediate wheatgrass (IWG) is a novel perennial grain that can provide many soil health benefits in agroecosystems; however, little is known about how selection for agronomic traits has impacted interactions with soil biota. Here, we assess how the selection for agronomic traits in IWG has impacted its relationship with arbuscular mycorrhizal (AM) fungi. First, growth response to AM fungi was compared across five generations of IWG with varying degrees of selection. Second, variation in AM fungal responsiveness was compared among genets of IWG individuals within a more advanced generation. Finally, a meta‐analysis was performed on all published studies exploring AM fungal inocula effects on IWG performance to increase understanding of selection effects. AM fungal responsiveness increased with selection for agronomic traits, responsiveness varied among genets in the advanced generation, and a majority of genets performed better in the presence of AM fungi. The meta‐analysis supported the findings that AM fungal responsiveness has increased with selection in IWG. Further studies are needed to realize the combined potential soil health and sustainability benefits of IWG and AM fungi, including assessment of symbiotic benefits beyond biomass production, identification of IWG traits correlated with responsiveness, and characterization of AM fungal community response to IWG.

Hematopoietic Stem Cell Transplantation for C1q Deficiency: A Study on Behalf of the EBMT Inborn Errors Working Party

C1q deficiency is a rare inborn error of immunity characterized by increased susceptibility to infections and autoimmune manifestations mimicking SLE, with an associated morbidity and mortality. Because C1q is synthesized by monocytes, to date, four patients treated with allogeneic HSCT have been reported, with a positive outcome in three. We conducted an international retrospective study to assess the outcome of HSCT in C1q deficiency. Eighteen patients, fourteen previously unreported, from eleven referral centres, were included. Two patients had two HSCTs, thus 20 HSCTs were performed in total, at a median age of 10 years (range 0.9—19). Indications for HSCT were autoimmune manifestations not controlled by ongoing treatment in seventeen, and early development of MALT lymphoma in one patient. Overall survival (OS) was 71% and event-free survival was 59% at two years (considering an event as acute GvHD ≥ grade III, disease recurrence and death). In eleven patients HSCT led to resolution of autoimmune features and discontinuation of immunosuppressive treatments (follow-up time range 3–84 months). Five patients died due to transplant-related complications. Patients with a severe autoimmune phenotype, defined as neurological and/or renal involvement, had the worst OS (40% vs 84%; p = 0.034). Reviewing data of 69 genetically confirmed C1q deficient patients, we found that anti-Ro antibodies are associated with neurologic involvement, and anti-RNP and anti-DNA antibodies with renal involvement. In conclusion, HSCT may be a valid curative option for C1q deficiency, but careful selection of patients, with an accurate assessment of risk and benefit, is mandatory.

Integrating Forest Ecosystem Services into Health Strategies to Improve Human Well-Being

As the largest terrestrial ecosystem covering extensive expanses of the Earth’s surface, forests offer crucial health benefits to humans, both directly and indirectly. Presently, health services derived from forest resources have presented significant opportunities for enhancing human well-being. Nonetheless, the absence of a comprehensive understanding regarding the mechanisms by which forests impact human health jeopardizes the potential gains in health. Regrettably, there remains a dearth of scholarly work elucidating these pathways. This paper aims to furnish a thorough examination of how forests influence human health. We initiate by formulating a conceptual framework upon which we delineate the various pathways through which forests impact human health. These encompass the provisioning of resources, preventive services, and forest therapies. Concurrently, we outline the moderating influence of social, economic, and individual characteristics as mediators within this pathway. These characteristics are classified into two overarching dimensions: accessibility and behavioral choices, which notably affect marginalized demographics such as those with lower socioeconomic status, women, the elderly, individuals with disabilities, and children in developing nations. Consequently, we build upon these foundational insights to propose six strategies aimed at perpetuating the positive impact of forests on human health in the foreseeable future. In the future, the development of forest management policies, the assessment of long-term health benefits, social practices, and international cooperation must be considered holistically to attain the dual objective of sustainable forest management and the advancement of human well-being.

Investment Feasibility Analysis Using Discounted Cash Flow Valuation Method (Case Study: Gold Mine in Pit A PT XYZ)

Investment in the mining sector carries a high risk, so a comprehensive financial evaluation is required to ensure project feasibility. This study assesses the financial feasibility of gold mining investment in Pit A, PT XYZ, for the period 2025 to 2036. The purpose of this study is to evaluate the feasibility of the project through the analysis of key financial indicators such as Net Present Value (NPV), Internal Rate of Return (IRR), and Payback Period (PBP) using the Discounted Cash Flow (DCF) method. The DCF method was chosen due to its ability to project future cash flows and incorporate them into a comprehensive assessment of the potential benefits and risks of the project. In addition, sensitivity analysis was conducted to see the effect of changes in important variables such as revenue, cost of goods sold (COGS), and capital expenditure (capex) on the financial results of the project. The results show that the project is financially viable, with a positive NPV of US$404.16 million, an IRR of 52.10%, and a PBP of 3.32 years, all of which indicate a strong return on investment. Further sensitivity analysis shows that the project remains robust under various scenarios of changes in key variables. This study contributes to the investment evaluation literature in the mining sector by offering a more integrated approach to addressing investment uncertainty and risk through the combined use of the DCF method and sensitivity analysis.

The assessment of environmental effect and economic benefit for apple orchard under different stand ages in the Loess Plateau, China

The assessment of environmental effect and economic benefit for apple orchard under different stand ages in the Loess Plateau, China

Quantifying the unseen benefits: an innovative economic valuation of the social and cultural values of trees, woods, and forests at risk

ABSTRACT Trees, woods, and forests in England are associated with a wide range of social and cultural values (S&CV). However, these treescapes (i.e. trees in any location) face increasing risks from pests, diseases, climate change, and biosecurity threats. This study addresses the urgent need for comprehensive estimates of S&CV related to England’s treescapes. Current UK policies and resource allocations are based on limited “value at risk” estimates. The study proposes a novel anchor value method for holistic S&CV valuation, resulting in an annual benefits flow ranging from £7 to £10 billion. This estimate surpasses the current natural capital accounts for England’s woodlands and underscores the importance of including S&CV in total ecosystem benefits assessments. The study also applies traditional methods, namely Willingness to Pay (WTP) and Travel Cost Method (TCM), to economically value S&CV of trees at risk from pests and diseases. These methods, focusing on local use values, yield similar estimates of just under £1 billion per year. This preliminary valuation invites further debate and scrutiny.

Incorporation of Phase Change Materials in Buildings

This review paper explores the integration of phase change materials (PCMs) in building insulation systems to enhance energy efficiency and thermal comfort. Through an extensive analysis of existing literature, the thermal performance of PCM-enhanced building envelopes is evaluated under diverse environmental conditions. This review highlights that PCMs effectively moderate indoor temperatures by absorbing and releasing heat during phase transitions, maintaining a stable indoor climate. This paper also delves into the detailed concepts of PCMs, including their classification and various applications within building insulation. It is noted that different types of PCMs have unique thermal properties and potential uses, which can be tailored to specific building requirements and climatic conditions. Furthermore, cost–benefit and environmental assessments presented in the reviewed studies suggest that incorporating PCMs into building materials offers significant potential for reducing energy consumption and mitigating environmental impacts. These assessments indicate that PCMs can lead to substantial energy savings by decreasing the reliance on heating and cooling systems, thereby lowering overall energy costs and carbon emissions. However, despite the promising outlook, this review identifies a need for further research to optimize PCM formulations and integration methods. This optimization is essential for overcoming current challenges and facilitating the widespread adoption of PCMs in the construction industry. Addressing issues such as long-term durability, compatibility with existing building materials, and cost-effectiveness will be crucial for maximizing the benefits of PCMs in enhancing energy efficiency and sustainability in buildings. Overall, this review underscores the transformative potential of PCMs in building insulation practices. By providing a comprehensive overview of PCM classifications, applications, and their impacts on energy efficiency and environmental sustainability, this paper lays the groundwork for future advancements and research directions in the field of PCM-enhanced building technologies.

Locating the suitable large-scale solar farms in China's deserts with environmental considerations

Desert areas offer rich solar resources and low land use costs, ideal for large-scale new energy development. However, desert ecosystems are fragile, and large-scale photovoltaic (PV) power facilities pose ecological risks. Current assessments of PV plant sites in deserts lack consideration of wind-sand hazards and ecological impacts. In this study, we have developed a new large-scale photovoltaic (PV) site selection model that integrates the analytic hierarchy process with geographic information system technology, and applies it to the desert regions of China. The results show that the potential for large-scale PV power plants in China's deserts is significant, with 69.4 % of the region assessed as medium or higher. The most suitable area is 12.7 × 104 km2 (7.6 % of the overall study area), mainly centered in the Tibetan Plateau's Qaidam Basin Desert and the deserts of northern China, characterized by favorable solar resources, climate, and terrain. Across all regions, gravel deserts are recognized as more suitable for the construction of large-scale PV power projects than sandy deserts. Considering varying PV installation density scenarios with an installed capacity potential of 36.4–84.9 TW and system costs ranging from 10.0 to 33.5 trillion USD, the study estimates an annual solar power generation potential of 47–110 PWh which is 1.7–3.9 times the global electricity demand. Carbon emissions could be reduced by 26.8–62.6 gigatons annually, offsetting 73–170 % of global emissions. Covering just 4.8–11.5 % of China's desert area (8 × 104–19.4 × 104 km2) would meet the projected 2025 electricity needs of the country. This study lays the groundwork for spatial planning and benefit assessment of large-scale PV projects in desert regions, and reduces conflicts between PV plant construction and local ecosystem.

Climate Benefit Assessment of Doubling the Extent of Windbreak Plantations in Hungary

Climate Benefit Assessment of Doubling the Extent of Windbreak Plantations in Hungary

Assessment of Ventilation Potential and Construction of Wind Corridors in Chengdu City Based on Multi-Source Data and Multi-Model Analysis

The establishment of urban ventilation corridors (UVCs) aims to mitigate the urban heat island effect. While most studies focus on the construction and assessment of the environmental benefit of UVCs, they often overlook the analysis of UVCs’ topological features. This research integrates multi-source data including 3D urban buildings, historical meteorological observations, high-resolution remote sensing, and land use planning, combined with multiple models, including geographic information system spatial analysis, circuit theory, and complex networks. Based on an assessment of urban ventilation potential, the circuit model was applied to extract UVCs aligned with the prevailing wind direction for both summer and winter seasons. Complex network modeling was employed to analyze the topological features of the ventilation network. From the analytical results, a multi-level wind corridor system for Chengdu was quantitatively developed. The results indicate that the city’s overall ventilation resistance is high, with notable spatial clustering, and the southeastern region faces substantial ventilation obstructions. A total of 143 critical ventilation nodes were identified, with the number of air inlets and outlets in summer being significantly fewer than in winter. However, the cooling effect of ventilation corridors in the prevailing summer wind direction is superior to that in winter. The ventilation network comprises 16 communities with distinct ventilation characteristics, exhibiting moderate connectivity, lacking small-world properties, and showing congestion and instability.

Non-invasive vagus nerve stimulation to reduce ileus after colorectal surgery: randomized feasibility trial and efficacy assessment (IDEAL Stage 2B).

Ileus is characterized by a period of intestinal dysmotility after surgery, leading to vomiting and constipation. In preclinical models, vagus nerve stimulation reduces intestinal inflammation and prevents smooth muscle dysfunction, accelerating the return of gut function. This study explored the feasibility of a definitive trial of non-invasive vagus nerve stimulation (nVNS) along with an early assessment of efficacy. A multicentre, randomized feasibility trial (IDEAL Stage 2B) of self-administered nVNS was performed. Patients undergoing colorectal surgery were randomized to nVNS or sham before and after surgery. Feasibility outcomes comprised assessments of recruitment, compliance, blinding and attrition. Clinical outcomes were measures of intestinal function and adverse events. All participants were followed up for 30 days. Interviews with patients and health professionals explored barriers to feasibility and perspectives around implementation. In all, 125 patients were approached about the study and 97 (77.6%) took part. Across all randomized groups, the median compliance to treatment was 19 out of 20 stimulations (interquartile range 17-20). The incidence of adverse events was similar across groups. In this unpowered feasibility study, the time taken for the return of gut function (such as first passage of stool) was similar between nVNS and sham treatments. According to interviews, patients were highly motivated to use the device because it provided them with an opportunity to engage actively in their care. Health professionals were highly driven to tackle the problem of ileus. Powered assessments of clinical efficacy are required to confirm or refute the promise of nVNS, as already demonstrated in preclinical models. This feasibility study concludes that a definitive randomized assessment of the clinical benefits of nVNS is desired and feasible.

The Development and Content Validation of the Sjögren's Related Quality of Life Instrument (SRQoL).

Several clinical outcome assessment (COA) instruments assess Sjögren's disease (Sjögren's) symptoms, but do not provide comprehensive assessment of the health-related quality of life (HRQoL) impact of Sjögren's. This study aimed to develop a patient-reported outcome (PRO) instrument for the assessment of HRQoL, intended for use in clinical trials and clinical practice in the assessment of treatment benefit. Review of study sponsor proprietary data and qualitative interviews informed the development of a conceptual model, the Sjögren's Related Quality of Life (SRQoL) and patient global impression of severity (PGI-S) and change (PGI-C) items. Combined concept elicitation and cognitive debriefing interviews with patients with Sjögren's explored their HRQoL impact experience and content validity of the SRQoL and PGI items. Twenty participants were interviewed about their Sjögren's experience. Following inductive analysis of interviews, concepts were categorized into eight domains: emotional well-being (e.g., worry and stress; n = 20/20; 100%), sleep (e.g., daytime sleepiness and waking up during the night; n = 20/20; 100%), activities of daily living (e.g., difficulty looking at screens and difficulty driving; n = 20/20; 100%), cognition (e.g., concentration difficulties and word finding difficulties; n = 19/20; 95.0%), physical functioning (e.g., difficulty walking and difficulty exercising; n = 19/20; 95.0%), social and family functioning (e.g., dependent on others and relationship difficulties; n = 17/20; 85.0%), work (n = 15/20; 75.0%), and sexual functioning (n = 12/20; 60.0%). SRQoL and PGI items, instructions, response options, and recall period were well understood and relevant to participants. The SRQoL is a new PRO instrument to assess Sjögren's impact on HRQoL, developed in accordance with regulatory guidance. This study provides considerable insight into the patient experience of Sjögren's and evidence to support the content validity of the SRQoL. Future research should evaluate the psychometric properties of the SRQoL to support its use in clinical trials and clinical practice and further validate its use as an assessment of treatment benefit.

Optimizing soil conservation through comprehensive benefit assessment in river basins

Land degradation from water erosion poses a significant threat to water security and ecosystem stability, driving global efforts in soil conservation. Quantitative assessment of soil conservation benefits—both on-site and off-site—is crucial for guiding effective conservation strategies. However, existing methodologies often fall short in quantifying the value of these combined benefits. Here, we present a comprehensive framework for quantifying soil conservation service flows in monetary terms, evaluating the effectiveness of both on-site and off-site measures. Applying this framework to the Yellow River Basin (YRB), we employ cost-avoidance algorithms related to soil fertility maintenance, dredging cost reduction, and mitigation of nonpoint source pollution. Our results reveal that while many areas contribute to both on-site and off-site benefits, over half of the YRB relies predominantly on off-site services. By strategically enhancing key regions—which constitute 30% of the basin—we demonstrate that the overall soil conservation service supply can increase by 64.2% over the multi-year average from 2001 to 2020 compared to a consideration of on-site only. These findings underscore the essential role of off-site services in fully understanding soil conservation needs, particularly in large river basins, and the identified priority areas can offer valuable insights for optimizing soil conservation efforts.