Societal Costs Research Articles

The impact of energy sector pollution on human development and inequality amidst climate change

Abstract The provision of energy is a primary contributor to climate change and environmental pollution, the latter including air pollution from aerosol emissions and a broad range of other human health effects and ecosystem damages. At the same time, aerosol emissions also reduce radiative forcing, leading to a masking of part of the warming due to rising CO$_2$ concentrations and temporarily reducing the adverse impacts of climate change. Using an energy-economy-climate model linked to atmospheric chemistry, health impact and life cycle assessment models, we show that the societal costs of the health impacts of environmental pollution substantially exceed the economic benefits from masked warming. We further highlight the unequal burden of these issues on developing countries and explore the implications for human development, global inequality and international climate policy.

Housing and supportive services for young mothers experiencing substance use disorder and homelessness: Cost-effectiveness analysis of a randomized trial

BackgroundMothers experiencing homelessness and caring for young children struggle with high rates of substance use and mental health problems. A comprehensive supportive housing intervention was implemented to assist young mothers experiencing substance use disorder (SUD) and homelessness. The cost-effectiveness of this intensive intervention could inform future dissemination. MethodsA cost-effectiveness analysis was conducted alongside a randomized controlled trial that lasted from May 2015 to October 2018. Mothers experiencing homelessness between the ages of 18–24 years with a SUD were randomly assigned to housing+support services (HOU + SS) (n = 80), housing-only (HOU) (n = 80), or services as usual SAU (n = 80). Using incremental cost-effectiveness ratios (ICERs), the study compared the costs of HOU + SS and HOU to SAU for three outcomes: housing stability (percent days of stable housing), substance use (percent days of substance use), and depressive symptoms (Beck Depression Inventory score). Direct intervention costs of HOU + SS and HOU from both payor and societal perspectives were estimated. Cost data were collected from detailed study financial records. Outcomes were taken from 6-month assessments. ResultsThe average societal cost of HOU + SS per participant was $5114 [CI 95 %, $4949-5278], while the average societal cost of HOU was $3248 [CI 95 %, $ 3,140–$3341] (2019 U.S. dollars). The calculated ICERs show that HOU was more cost-effective than HOU + SS and SAU for housing outcome. For illicit drug use, HOU + SS was more cost-effective than HOU. Finally, for depressive symptoms, neither HOU + SS or HOU were more cost effective than SAU. ConclusionWhile HOU is more cost-effective for increasing housing, HOU + SS is more cost-effective for reducing illicit drug use. However, housing without improvements in substance use may not be sustainable, and supportive services are likely essential for improved well-being overall beyond the housing outcome alone.

Health and Economic Benefits of Routine Childhood Immunizations in the Era of the Vaccines for Children Program - United States, 1994-2023.

Since 1994, the U.S. Vaccines for Children (VFC) program has covered the cost of vaccines for children whose families might not otherwise be able to afford vaccines. This report assessed and quantified the health benefits and economic impact of routine U.S. childhood immunizations among both VFC-eligible and non-VFC-eligible children born during 1994-2023. Diphtheria and tetanus toxoids and acellular pertussis vaccine; Haemophilus influenzae type b conjugate vaccine; oral and inactivated poliovirus vaccines; measles, mumps, and rubella vaccine; hepatitis B vaccine; varicella vaccine; pneumococcal conjugate vaccine; hepatitis A vaccine; and rotavirus vaccine were included. Averted illnesses and deaths and associated costs over the lifetimes of 30 annual cohorts of children born during 1994-2023 were estimated using established economic models. Net savings were calculated from the payer and societal perspectives. Among approximately 117 million children born during 1994-2023, routine childhood vaccinations will have prevented approximately 508 million lifetime cases of illness, 32 million hospitalizations, and 1,129,000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs. From both payer and societal perspectives, routine childhood vaccinations among children born during 1994-2023 resulted in substantial cost savings. Childhood immunizations continue to provide substantial health and economic benefits, while promoting health equity.

Impact of Prescription Opioid Detoxification on Quality of Life and Pain Levels.

The aim of this study was to examine the impact of detoxification from prescription opioids on the quality of life (QoL) and pain levels among patients reliant on these medications for chronic pain management. Long-term use of opioids for pain management may lead to a range of adverse effects, including tolerance, dependence, significant societal costs, and a decline in overall quality of life (QoL). Despite these challenges, there is a limited amount of research focusing on the effects of detoxification and its impact on the QoL for patients with chronic pain tolerant to prescription opioids. This prospective study included 45 patients who underwent elective detoxification from prescription opioids. Prescription opioids were discontinued during the detoxification treatment in 44 of the 45 cases. QoL was monitored using SF-36v2™ questionnaires administered before detoxification, on the day of discharge, and at least six months after detoxification. Pain levels were assessed using Visual Analogue Scale (VAS) scores before and after the detoxification process. The study was fully completed by 30 patients. At the third SF-36v2™ evaluation, 25 out of 30 patients (83.3%) reported the detoxification treatment as beneficial to their overall health status compared to that before the treatment, and SF-36v2™ questionnaires after detoxification were significantly higher than before the treatment (p < 0.001). A decreased pain level right after the detoxification was reported by 44 of the 45 patients (97.7%), with a significant average reduction of 4.51 points observed (p < 0.001). The observed enhancement in QoL, significant reduction in pain, and cessation of opioid use in most patients with chronic pain tolerant to prescription opioids following opioid detoxification indicate that this method of treatment can be safely and effectively administered and must be considered for chronic pain patients.

Extending mechanical thrombectomy service provision to 24/7: a break-even analysis

BackgroundComprehensive stroke centres across England have developed investment proposals, showing the estimated increases in mechanical thrombectomy (MT) treatment volume that would justify extending the standard hours to a 24/7 service provision. These investment proposals have been developed taking a financial accounting perspective, that is by considering the financial revenues from tariff income. However, given the pressure put on local health authorities to provide value for money services, an affordability question emerges. That is, at what additional MT treatment volume the additional treatment costs are offset by the additional health economic benefits, that is quality-adjusted life years (QALYs) and societal cost savings, generated by administering MT compared to standard care.MethodsA break-even analysis was conducted to identify the additional MT treatment volume required. The incremental hospital-related costs associated with the 24/7 MT extension were estimated using information and parameters from four relevant business cases. The additional societal cost savings and health benefits were estimated by adapting a previously developed Markov chain-based model.ResultsThe additional hospital-related annual costs for extending MT to a 24/7 service were estimated at a mean of £3,756,818 (range £1,847,387 to £5,092,788). On average, 750 (range 246 to 1,571) additional eligible stroke patients are required to be treated with MT yearly for the proposed 24/7 service extension to be affordable from a health economic perspective. Overall, the additional facility and equipment costs associated with the 24/7 extension would affect this estimate by 20%.ConclusionsThese findings support the ongoing debate regarding the optimal levels of MT treatment required for a 24/7 extension and respective changes in hospital organisational activities. They also highlight a need for a regional-level coordination between local authorities and hospital administrations to ensure equity provision in that stroke patients can benefit from MT and that the optimal MT treatment volume is reached. Future studies should contemplate reproducing the presented analysis for different health service provision settings and decision making contexts.

Functionalized Polymeric Micelles for Targeted Cancer Therapy: Steps from Conceptualization to Clinical Trials.

Cancer is still ranked among the top three causes of death in the 30- to 69-year-old age group in most countries and carries considerable societal and macroeconomic costs that differ depending on the cancer type, geography, and patient gender. Despite advances in several pharmacological approaches, the lack of stability and specificity, dose-related toxicity, and limited bioavailability of chemotherapy (standard therapy) pose major obstacles in cancer treatment, with multidrug resistance being a driving factor in chemotherapy failure. The past three decades have been the stage for intense research activity on the topic of nanomedicine, which has resulted in many nanotherapeutics with reduced toxicity, increased bioavailability, and improved pharmacokinetics and therapeutic efficacy employing smart drug delivery systems (SDDSs). Polymeric micelles (PMs) have become an auspicious DDS for medicinal compounds, being used to encapsulate hydrophobic drugs that also exhibit substantial toxicity. Through preclinical animal testing, PMs improved pharmacokinetic profiles and increased efficacy, resulting in a higher safety profile for therapeutic drugs. This review focuses on PMs that are already in clinical trials, traveling the pathways from preclinical to clinical studies until introduction to the market.

Characterizing Pediatric Patients at Risk for Violence-Related Injuries at a Trauma Center in the Midwest United States

Introduction Hospital-based violence intervention programs (HVIPs) have emerged nationwide to help address the societal and economic costs of violence. Little literature exists regarding selecting those patients most likely to benefit from intensive case management. The study aims to describe the pediatric patient population presenting at a Level 1 ACS trauma center with a chief complaint of violent trauma and identify the characteristics of patients most at risk. Methods This retrospective study examined patients between the ages of eight- and nineteen-years old presenting with traumatic injury during the year 2019. Child abuse and non-accidental trauma patients were excluded. Results A total of 333 patients were included in the analysis. They were predominantly African American and male. The three-group design included those 8–11, 12–13, and 14–19 years. Most patients were over 14 years old (60.2%). “Classmates” was the most common relationship between assailant and victim overall (33.9%) and most prevalent in the youngest age group (8–11 year). The middle age group (12–13 year) were two times more likely to suffer from ADHD, and ADHD was a risk factor for self-harm in this age category. The oldest age group (14–19 year) suffered higher rates of gun violence and were attacked more often by unknown assailants. Conclusions There was a difference in the needs of the older and younger pediatric patients cared for. HVIPs should tailor their interventions to address the different age groups’ needs. HVIPs could also benefit from the integration of targeted mental health services and collaboration with local educational institutions.

Unraveling the Neural Landscape of Mental Disorders using Double Functional Independent Primitives (dFIPs).

Mental illnesses extract a high personal and societal cost, and thus explorations of the links between mental illness and functional connectivity in the brain are critical. Investigating major mental illnesses, believed to arise from disruptions in sophisticated neural connections, allows us to comprehend how these neural network disruptions may be linked to altered cognition, emotional regulation, and social interactions. Although neuroimaging has opened new avenues to explore neural alterations linked to mental illnesses, the field still requires precise and sensitive methodologies to inspect these neural substrates of various psychological disorders. In this study, we employ a hierarchical methodology to derive double functionally independent primitives (dFIPs) from resting state functional magnetic resonance neuroimaging data (rs-fMRI). These dFIPs encapsulate canonical overlapping patterns of functional network connectivity (FNC) within the brain. Our investigation focuses on the examination of how combinations of these dFIPs relate to different mental disorder diagnoses. The central aim is to unravel the complex patterns of FNC that correspond to the diverse manifestations of mental illnesses. To achieve this objective, we used a large brain imaging dataset from multiple sites, comprising 5805 total individuals diagnosed with schizophrenia (SCZ), autism spectrum disorder (ASD), bipolar disorder (BPD), major depressive disorder (MDD), and controls. The key revelations of our study unveil distinct patterns associated with each mental disorder through the combination of dFIPs. Notably, certain individual dFIPs exhibit disorder-specific characteristics, while others demonstrate commonalities across disorders. This approach offers a novel, data-driven synthesis of intricate neuroimaging data, thereby illuminating the functional changes intertwined with various mental illnesses. Our results show distinct signatures associated with psychiatric disorders, revealing unique connectivity patterns such as heightened cerebellar connectivity in SCZ and sensory domain hyperconnectivity in ASD, both contrasted with reduced cerebellar-subcortical connectivity. Utilizing the dFIP concept, we pinpoint specific functional connections that differentiate healthy controls from individuals with mental illness, underscoring its utility in identifying neurobiological markers. In summary, our findings delineate how dFIPs serve as unique fingerprints for different mental disorders.

Cost-effectiveness analysis and return on investment of SunSmart Western Australia to prevent skin cancer.

Each year, malignant melanoma accounts for 57 000 deaths globally. If current rates continue, there will be an estimated 510 000 new cases annually and 96 000 deaths by 2040. Melanoma and keratinocyte cancers (KCs) incur a large societal burden. Using a mathematical population model, we performed an economic evaluation of the SunSmart program in the state of Western Australia (WA), a primary prevention program to reduce the incidence of skin cancer, versus no program. A societal perspective was taken combining costs to the health system, patients and lost productivity. The model combined data from pragmatic trial evidence of sun protection, epidemiological studies and national cost reports. The main outcomes modelled were societal and government costs, skin cancer counts, melanoma deaths, life years and quality-adjusted life years. Over the next 20 years, the model predicted that implementing the WA SunSmart program would prevent 13 728 KCs, 636 melanomas and 46 melanoma deaths per 100 000 population. Furthermore, 251 life years would be saved, 358 quality-adjusted life years gained and AU$2.95 million in cost savings to society per 100 000 population would be achieved. Key drivers of the model were the rate reduction of benign lesions from sunscreen use, the costs of purchasing sunscreen and the effectiveness of reducing KCs in sunscreen users. The likelihood of WA SunSmart being cost-effective was 90.1%. For the WA Government, the estimated return on investment was $8.70 gained for every $1 invested. Primary prevention of skin cancer is a cost-effective strategy for preventing skin cancers.

Partnerships for policy: initiating a Global Burden of Animal Diseases case study in Indonesia.

The Global Burden of Animal Diseases (GBADs) programme aims to quantify the economic and broader societal costs of animal disease, providing information to policy-makers and other stakeholders to inform investments in animal health. Within this context, GBADs'Indonesian case study brings together a multidisciplinary and multi-national team to pilot the GBADs methodology in the Asiaâ€"Pacific region. This article describes the process of building a case study and, based on that experience, summarises key learnings to inform the development of future case studies and similar projects. Recommendations focus on the steps required to build successful partnerships to deliver a complex programme of work; the authors highlight the need to consider the local context in aligning project and country priorities, the importance of early engagement with a range of stakeholders, and the need for regular and clear communication within the project team.

Impact of air pollution on human morality: A multinational perspective

This study aimed to investigate whether global air pollution harms human morals beyond physiological and psychological health. To accomplish this, we conducted an original survey involving over 80,000 individuals across 30 countries, inquiring about their recent perceived unethical behaviors. Through regression analyses, we identified global evidence of a positive correlation between local monthly average concentrations of nitrogen dioxide (NO2) and perceptions of unethical behavior. This finding suggests that air pollution may potentially elicit unethical behavior through a complex response mechanism. It is noteworthy that the impact of air pollution on the inclination to perceive unethical behavior is heterogeneous across categories of unethical behavior and countries. For example, the effects of increasing air pollution concentrations vary even within the same European country: an increase in NO2 concentration in Greece and the Netherlands augments the inclination to perceive fatal unethical behaviors such as murder, terrorism, and suicide, while in Germany, NO2 concentration diminishes the inclination to perceive the same types of unethical behaviors. Overall, the societal costs of air pollution may be even more far-reaching than previously acknowledged, and further research is necessary to unveil the intricate response mechanisms underlying this issue.

Toward a Framework to Assess the Financial and Economic Burden of Cervical Cancer in Low- and Middle-Income Countries: A Systematic Review.

To review the economic burden assessment of cervical cancer in low- and middle-income countries (LMICs) and use the findings to develop a pragmatic, standardized framework for such assessment. We first systematically reviewed articles indexed in scientific databases reporting the methodology for collecting and calculating costs related to the cervical cancer burden in LMICs. Data on study design, costing approach, cost perspective, costing period, and cost type (direct medical costs [DMC], direct nonmedical costs [DNMC], and indirect costs [IC]) were extracted. Finally, we summarized the reported limitations in the methodology and used the solutions to inform our framework. Cervical cancer treatment costs across LMICs vary greatly and can be extremely expensive, up to 70,968 International US dollars. Economic and financial assessment methods also vary greatly across countries. Of the 28 reviewed articles, 25 studies reported DMC for cervical cancer treatment by extracting cost information from billing or insurance databases (eight studies), conducting surveys (five), and estimating the costs (12). Only 11 studies-mainly through surveys-reported DNMC and IC. The economic burden assessment framework includes health care/payer and societal perspectives (DMC, DNMC, IC, and human capital loss) across the cervical cancer screening and treatment continuum. To assess health care/payer costs, we recommend combining the predefined treatment standards with actual local treatment practices, multiplied by unit costs. To assess societal costs, we recommend conducting a cost survey in line with a standardized yet adaptable protocol. Our standardized, pragmatic framework allows assessment of economic and financial burden of cervical cancer in LMICs despite the different levels of available resources across countries. This framework will facilitate global comparisons and monitoring and may also be applied to other cancers.

Approaches for hysterectomy and implementation of robot-assisted surgery in benign gynaecological disease: A cost analysis study in a large university hospital

BackgroundAs a minimally invasive technique, robot-assisted hysterectomy (RAH) offers surgical advantages and significant reduction in morbidity compared to open surgery. Despite the increasing use of RAH in benign gynaecology, there is limited data on its cost-effectiveness, especially in a European context. Our goal is to assess the costs of the different hysterectomy approaches, to describe their clinical outcomes, and to evaluate the impact of introduction of RAH on the rates of different types of hysterectomy. MethodsA retrospective single-centre cost-analysis was performed for patients undergoing a hysterectomy for benign indications. Abdominal hysterectomy (AH), vaginal hysterectomy (VH), laparoscopic hysterectomy (LH), laparoscopically assisted vaginal hysterectomy (LAVH) and RAH were included. We considered the costs of operating room and hospital stay for the different hysterectomy techniques using the “Activity Centre–Care program model”. We report on intra- and postoperative complications for the different approaches as well as their cost relationship. ResultsBetween January 2014 and December 2021, 830 patients were operated; 67 underwent VH (8%), 108 LAVH (13%), 351 LH (42%), 148 RAH (18%) and 156 AH (19%).After the implementation and learning curve of a dedicated program for RAH in 2018, AH declined from 27.3% in 2014–2017, to 22.1% in 2018 and 6.9 % in 2019–2021.The reintervention rate was 3–4% for all surgical techniques. Pharmacological interventions and blood transfusions were performed after AH in 28%, and in 17–22% of the other approaches.AH had the highest hospital stay cost with an average of €2236.40. Mean cost of the hospital stay ranged from €1136.77-€1560.66 for minimally invasive techniques.The average total costs for RAH were €6528.10 compared to €4400.95 for AH. ConclusionImplementation of RAH resulted in a substantial decrease of open surgery rate. However, RAH remains the most expensive technique in our cohort, mainly due to high material and depreciation costs. Therefore, RAH should not be considered for every patient, but for those who would otherwise need more invasive surgery, with higher risk of complications. Future prospective studies should focus on the societal costs and patient reported outcomes, in order to do cost-benefit analysis and further evaluate the exact value of RAH in the current healthcare setting.

An empirical investigation of student online learning continuance intention in the post-COVID-19 pandemic era

PurposeThe purpose of this paper is to investigate students’ viewpoint regarding continuation of using online learning in the post-COVID-19 pandemic world. While during the pandemic years predominantly all formal learning was forced to move online, in the postpandemic environment traditional postsecondary education institutions generally resumed in-person (or face-to-face) learning. Nonetheless, it is possible that some students would like to continue using online learning after using such a system during COVID-19 restrictions. Therefore, it is important for postsecondary institutions to understand students’ views on continuing with online learning so that these institutions can better adapt their offerings to learners’ preferences.Design/methodology/approachThis study uses a cross-sectional online survey-based approach grounded on an innovative theoretical framework blending the unified theory of acceptance and use of technology 2 into the expectation-confirmation model of information systems continuance. Data were collected from 247 students in Canada in Fall 2022 and were analyzed with partial least squares structural equation modeling techniques.FindingsPerceptions of usefulness and of monetary benefits relative to costs together with developing positive habits regarding online learning are the most significant beliefs motivating students to want to continue with online learning. Furthermore, positive disconfirmation of initial expectations and satisfaction relying on previous use together with a favorable attitude with respect to online learning strongly influence the intention to continue with online education.Originality/valueThe study opens the door for similar research in other cultural contexts (e.g. with a different individualistic-collectivistic pattern) and for other domains that moved totally online during the COVID-19 pandemic (e.g. primary health care) to maximize people satisfaction while minimizing societal costs.

Global burden and attributable risk factors of breast cancer in young women: historical trends from 1990 to 2019 and forecasts to 2030 by sociodemographic index regions and countries.

Breast cancer in young women (BCY) is much less common but has significant health sequelae and societal costs. We aimed to evaluate the global and regional burden of breast cancer in women aged 15-39 years from 1990 to 2019. We collected detailed data on breast cancer from the Global Burden of Disease Study 2019 (GBD 2019) Data Resources. The age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR), age-standardised disability-adjusted life years rate (ASDR), and estimated annual percentage change (EAPC) were used to assess the disease burden of BCY. The Bayesian Age-Period-Cohort model was used to forecast disease burden from 2020 to 2030. From 1990 to 2019, significant increases in ASIR were found for BCY (EAPC = 0.59, 95% confidence interval (CI) = 0.5 to 0.68), whereas decreases in ASMR (EAPC = -0.41, 95% CI = -0.53 to -0.3) and ASDR (EAPC = -0.35, 95% CI = -0.46 to -0.24). Across countries with varying sociodemographic indexes (SDI), all regions showed an upward trend in BCY morbidity, except for countries with a high SDI. While mortality and DALYs rates have decreased in countries with high, high-middle, and middle SDI, they have increased in countries with low-middle and low SDI. Countries with lower SDIs are projected to bear the greatest burden of BCY over the next decade, including both low and low-middle categories. Alcohol use was the main risk factor attributed to BCY deaths in most countries, while exposure to second hand smoke was the predominant risk factor for BCY deaths in middle and low-middle SDI countries. The burden of breast cancer in young women is on the rise worldwide, and there are significant regional differences. Countries with a low-middle or low SDI face even more challenges, as they experienced a more significant and increasing BCY burden than countries with higher SDIs.

Potential Impact of Slowing Disease Progression in Early Symptomatic Alzheimer's Disease on Patient Quality of Life, Caregiver Time, and Total Societal Costs: Estimates Based on Findings from GERAS-US Study.

Impact of Alzheimer's disease (AD) progression on patient health-related quality of life (HRQoL), caregiver time, and societal costs is not well characterized in early AD. To assess the association of change in cognition with HRQoL, caregiver time, and societal costs over 36 months, and estimate the impact of slowing disease progression on these outcomes. This post-hoc analysis included patients with amyloid-positive mild cognitive impairment (MCI) and mild AD dementia (MILD AD) from the 36-month GERAS-US study. Disease progression was assessed using the Mini-Mental State Examination score. Change in outcomes associated with slowing AD progression was estimated using coefficients from generalized linear models. At baseline, 300 patients had MCI and 317 had MILD AD. Observed natural progression over 36 months was associated with: 5.1 point decline in the Bath Assessment of Subjective Quality of Life in Dementia (BASQID) score (for HRQoL), increase in 1,050 hours of total caregiver time, and $8,504 total societal costs for MCI; 6.6 point decline in the BASQID score, increase in 1,929 hours of total caregiver time, and $12,795 total societal costs for MILD AD per person. Slowing AD progression by 30% could result in per person savings in HRQoL decline, total caregiver time, and total societal costs: for MCI: 1.5 points, 315 hours, and $2,638; for MILD AD: 2.0 points, 579 hours, and $3,974. Slowing AD progression over 36 months could slow decline in HRQoL and save caregiver time and societal cost in patients with MCI and MILD AD.

Planetary Health and Mental Health Nexus: Least Understood and Embraced in Policy Decisions.

Planetary health influences mental health and a better management of climate, biodiversity and pollution has co-benefits of improving mental health outcomes. The recognition and treatment of mental health, however, has been marginalized within environmental and climate change sciences and a greater understanding of the complex underlying processes and societal costs is required to appropriately manage and motivate policy responses. The paper provides seven recommendations underscoring that public policy developers and implementors need to be aware of the combined costs of inaction - that might accrue from neglecting mental health and environmental sciences- two areas that have been historically marginalized. Improved methodologies in conducting studies on the nature and mental health nexus are needed. The trajectories and models of adaptation and mitigation of climate change and environmental damage can be strengthened through adoption of mental and behavioral sciences approach.

Collaborative optimization of renewable energy power systems integrating electrolytic aluminum load regulation and thermal power deep peak shaving

Addressing renewable energy (RE) curtailment in power systems necessitates a comprehensive strategy leveraging peak regulation resources from both the power and load sides. On the power side, deep peak shaving of thermal power plants can mitigate surplus electricity during periods of high RE production. On the load side, energy-intensive industrial loads, characterized by large capacity and rapid adjustability, can respond effectively to energy deficits when RE is low. To enhance the peak regulation capacity for optimal RE accommodation, this paper proposes a collaborative optimization method combining electrolytic aluminum load (EAL) regulation with thermal power deep peak shaving (DPS). The study is initiated by developing a sophisticated peak regulation model for the electrolytic aluminum load (EAL), considering production characteristics, cost features, and safety constraints. Subsequently, a collaborative optimization model is formulated, integrating EAL regulation with thermal power deep peak shaving (DPS), aiming to minimize societal peak regulation costs (PRC). Applying this model to a practical regional grid in Yunnan Province reveals substantial reductions in RE curtailment rates, effective minimization of total social PRC, and enhanced operational economics of thermal power DPR under varying wind power scenarios. Notably, the proposed approach requires only minor adjustments to the EAL, ensuring production safety is maintained. This research provides valuable insights for the seamless integration of EAL into grid peak regulation services.

The role of peatlands in carbon footprints of countries and products

Global peatland degradation is a major emission source (2 Gt CO2eq/yr), but it is often excluded from product carbon footprints or consumption-based emission inventories. The aim of this study was to analyze the impact of peatlands on the carbon footprints of countries and products. The analysis was performed by combining the updated Global Peatland Assessment emission inventory with the EXIOBASE 3 multiple-region input-output model and propagating the emissions from primary production to final demand of products. The structure of the network of production and consumption was analyzed by identifying the paths and nodes that had the highest embodied peatland emissions. Based on the analysis, the consumption-based emission inventory had hotspots in Indonesia, China, and Russia, where a few key sectors (construction, rice, and other foods) contributed to 31 % of the global peatland emissions. Unlike in many other environmental impact categories, Europe was a net exporter (104 Mt CO2eq/yr) of embodied peatland emissions and Africa & Middle East region was the largest net importer (64 Mt CO2eq/yr). The embodied peatland emissions are focused on agricultural and forestry products in the countries with the largest share of degraded peatlands. Products originating from peatlands can have multiple times higher carbon footprints than non-peatland farmed products. The societal cost of carbon (SCC) of peatland originating products can even be higher than the value of the products. Therefore including peatland emissions into product carbon footprints would create incentives for mitigating emissions. Local emission mitigation will require tailored combinations of rewetting, restoration, and paludiculture. As the current uses of peatlands are emission intensive and have low value added, the potential for cost-effective emission reduction is considerable.

The Acari Hypothesis, IV: revisiting the role of hygiene in allergy.

Allergy and its manifestations were first appreciated in the 1870 s. Today, the mechanism by which specific substances elicit allergic reactions remains poorly understood. This is problematic from a healthcare perspective because the prevalence of allergic disease and its societal costs are substantial. Regarding mechanistic understanding of allergy, a new proposal, The Acari Hypothesis, has been forwarded. The Hypothesis, borne from consideration of alpha-gal syndrome, postulates that acarians, i.e., mites and ticks, are operative agents of allergy. By way of their pathogenic payloads and salivary pattern recognition receptor(s), acarians potentiate in human hosts the generation of IgE against acarian dietary elements. Those elements account for most, if not all, known human allergens. Inasmuch as acarian-human interactions occur on human epithelial surfaces, it is to be expected factors that influence the presence and/or operation of acarians on those surfaces influence the expression of allergic diseases. In this report, it is proposed that two adaptations of catarrhine primates, i.e., Old World monkeys, apes and humans, evolved to deter acarian species: firstly, the expansion of eccrine glands across the entirety of body surface area, and, secondly, the secretion of sweat by those glands. Contemporary hygienic practices that reduce and/or disrupt the operation of eccrine glands are likely responsible for the increase in allergic disease seen today.