Total Net Benefit Research Articles

Estimated lifetime impact of a school-based intervention for mental health: A microsimulation study

Abstract Background The prevalence of childhood mental health problems is increasing. School-based interventions have the potential to reduce poor mental health and mental health inequalities. Our aim was to estimate the long-term costs and benefits of the Incredible Years Teacher® Classroom Management (IY-TCM) intervention in primary schools compared to no intervention. Methods LifeSim, an existing microsimulation model, was used to estimate the lifetime costs and benefits of IY-TCM by linking short-term changes in SDQ based on a previous trial in primary schools (Cluster RCT: 2075 children aged 4-9 years with a 30-month follow-up) to long-term health, social, economic and wellbeing outcomes. Benefits were measured in quality adjusted life years and wellbeing adjusted life years. We examined subgroup based on deprivation, conduct scores and parental depression. Results Microsimulation modelling estimated small gains in lifetime outcomes including reduced conduct disorder in adolescence and depression in adulthood. Estimates indicate IY-TCM could be cost-effective with a large amount of uncertainty (Net monetary benefit (NMB)=£21, Estimated CI = -£195, £240). IY-TCM was estimated to be more cost-effective for those with high deprivation (NMB = £231, Estimation CI - -£99, £231) and high conduct problem scores (NMB=£315, Estimated CI = £45, £483). Total net social benefit for a typical year size group was estimated to be £111m. Conclusions IY-TCM could be cost-effective compared to no intervention with a large estimated social benefit supporting wider implementation of IY-TCM, but results indicate a large amount of uncertainty. Greater benefits and higher certainty of cost-effectiveness for children with conduct problems and those living in a deprived area suggest IY-TCM has the potential to reduce mental health inequalities and may be more cost-effective for schools with higher deprivation and/or a high prevalence of conduct problems. Key messages • The Incredible Years Teacher Classroom Management intervention for mental health in primary schools could be considered cost-effective but there is a large amount of uncertainty. • Greater benefits for children with conduct problems and those living in a deprived area indicates the intervention has the potential to reduce mental health inequalities.

Transcatheter aortic valve replacement and the value of increasing treatment for severe symptomatic aortic stenosis: a plain language summary

Plain Language Summary What is this summary about? This article summarizes an economic evaluation of transcatheter aortic valve replacement (TAVR), a treatment for severe symptomatic aortic stenosis (SSAS). SSAS occurs when the aortic valve, which allows blood to leave the heart, becomes very narrow. This reduces blood flow to the body, causing symptoms like tiredness, chest pain, dizziness, or fainting. Treating SSAS requires replacing the valve. Untreated SSAS results in heart failure and death. Before TAVR, SSAS patients had two options, medical management and surgical aortic valve replacement (SAVR). Medical management helps with symptoms but does not replace the valve, leading patients to eventually die from SSAS. SAVR replaces the valve through open-heart surgery, which is invasive, involving making a large cut through the chest bone. Concerns about this invasiveness led many patients to avoid SAVR, leaving their SSAS untreated. TAVR was introduced in 2010. It is less invasive than SAVR, involving inserting a new valve through a small cut in the leg. TAVR has become popular and twice as many patients now undergo TAVR compared to SAVR. We measure TAVR’s net benefits as the value of its health benefits minus its healthcare costs. We measure these net benefits in three patient groups aged 65 and above in the United States. Group 1 patients are ineligible for SAVR, so TAVR is their only treatment option. Group 2 patients would have received SAVR if TAVR were not available. Group 3 patients are eligible for SAVR but concerned about its invasiveness, and so would have stayed untreated without TAVR. Economic evaluation: A type of study that measures the benefits and costs of a treatment like TAVR and judges whether the benefits are sufficiently large to justify the costs (or put another way, whether the technology represents good value-for-money). Transcatheter aortic valve replacement (TAVR): Replacement of the aortic valve in SSAS patients using a thin tube called a catheter that enters the body through a small cut near the leg and delivers and installs a valve replacement. New treatment option for SSAS from 2010 onwards. A minimally invasive treatment. Aortic stenosis (AS): A heart condition where a heart valve called the aortic valve becomes very narrow, forcing the heart to work harder and limiting blood flow to the rest of the body. Severe Symptomatic Aortic Stenosis (SSAS): Severe form of AS when the narrowing of the aortic valve is significant and accompanied by symptoms like fatigue, chest pain, shortness of breath, dizziness, or fainting. What were the key takeaways? Net benefits per patient are significant in all groups, roughly equal in groups 1 and 2, and over six times larger in group 3. When net benefits are added up across patients, group 3’s total net benefit is 30 times larger than that of groups 1 and 2 combined. What are the main conclusions? Past studies ignored TAVR’s value in helping treat patients who might go untreated because of concerns over SAVR’s invasiveness. But this is TAVR’s largest value to SSAS patients. Our findings support continuing and increasing access to TAVR among SSAS patients, especially those who may go untreated because of concerns about invasive treatment. Aortic valve: One of the four heart valves. It connects the left side of the heart with the aorta, which is the large artery carrying oxygen-rich blood to the body. The aortic valve controls blood flow into the aorta, ensuring it moves in one direction. Medical management (MM): Involves medication and monitoring of SSAS patients but no treatment in the form of valve replacement. Associated with high risk of death. Surgical aortic valve replacement (SAVR): Replacement of the aortic valve in SSAS patients through open heart surgery. The sole treatment option for SSAS before 2010. A highly invasive treatment given its use of open-heart surgery. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text Link to original article here

An empirical predator‒prey model: Examining the interaction of Florida panthers, white‐tailed deer, and cattle in Florida

AbstractIn this article, we present a predator‒prey model for Florida panthers (FL panthers), white‐tailed deer (deer) and cattle in Florida. The model is used to construct the following four policy scenarios: (a) joint management of all three species (Scenario 1); (b) a target population size of FL panthers of 240 individuals (Scenario 2); (c) a target population size of FL panthers equal to the carrying capacity (Scenario 3); and (d) a target population size of FL panthers of zero (Scenario 4) (Scenario 4). We parameterized the model for FL panthers, deer and cattle in Florida, which enables us to obtain empirical results for the population, harvest and net benefit of all three species under each policy scenario. When comparing Scenarios 1 and 2, the total net benefit of all three species is only slightly higher in the former case. Under Scenarios 3 and 4, the net benefit of deer changes significantly compared to Scenario 1, while the effect on the net benefit of cattle is minor. When comparing Scenario 1 and an actual situation, we find that the optimal population of FL panthers is only slightly higher than the actual population.

Efficiency of periodontal treatment to improve type 2 diabetes mellitus outcomes: A systematic review and meta-analysis of economic evaluations.

To assess the efficiency of periodontal treatment (PT) in improving diabetes-related outcomes in adults with type 2 diabetes mellitus (T2DM) and periodontitis, providing an updated and comprehensive synthesis from economic evaluations (EE). Seven databases and one register were independently searched by two reviewers for articles published up to 8 May 2024. Studies that assessed the efficiency of PT versus no treatment or other dental treatments were included. Risk of bias was assessed using the Cochrane RoB 2, ROBINS-I and ECOBIAS tools for the first stage of EE and the CHEERS checklist and NICE quality appraisal tool for overall EE. Qualitative and quantitative syntheses of the articles were conducted and assessed using the GRADE approach. Eleven studies were included. PT reduces total healthcare costs, including inpatient and outpatient, diabetes-related costs and other drug costs (low to moderate certainty). A total incremental net benefit of USD 12 348 (2022 currency, 95% CI 12 195-12 500) was estimated from three high-quality model-based cost-utility analyses (high certainty). The inclusion of PT in the comprehensive treatment of patients with T2DM and periodontitis is cost-effective. Future research is required to ensure the transferability of these findings and inform decision makers from different countries. PROSPERO CRD42023443146.

A Cost-Benefit Analysis of Alternative Management Strategies for Red Deer in Denmark

In this paper, we conduct a cost-benefit analysis (CBA) of five alternative management strategies for red deer in Denmark: free harvest, trophy hunting, maximum harvest and two cases for natural demographic population compositions. To capture the outcome under each strategy we use a biological sex- and age-structured population model. The net benefit function includes meat values, recreational values, browsing damage costs and traffic damage costs and these values and costs are assumed to differ for the various sex and age classes of red deer. We show that the maximum harvest strategy leads to a reasonably high positive total net benefit, while the free harvest strategy yields a small positive net benefit. On the other hand, the trophy hunting strategy generates a high negative net benefit, while small negative net benefits are obtained under the two strategies for natural demographic population compositions.

Effects of vermicompost and mineral fertilizers on soil properties, malt barley (Hordeum distichum L.) yield, and economic benefits

AbstractSoil fertility depletion has significantly reduced the yields of various crops in Ethiopia, mainly the yield of malt barley in the district. To address this issue, integrated applications of vermicompost and mineral nitrogen (N) fertilizers were tested. Therefore, this study aimed to evaluate the effects of vermicompost and mineral nitrogen fertilizers application on malt barley yield (Hordeum distichum L.), soil properties, and economic benefits. The experiment was arranged in a randomized complete block design with three replications. The treatments were nine in various combinations of vermicompost (VC) and N fertilizer (N): (69 kg N; 0.79 t VC + 58.65 kg N; 1.59 t VC + 48.30 kg N; 2.39 t VC + 37.95 kg N; 3.19 t VC + 27.60 kg N; 3.98 t VC + 17.25 kg N; 4.78 t VC + 6.90 kg N; 5.31 t VC ha−1 and control). The highest soil pH was recorded by applying 5.31 t of vermicompost ha−1 alone. The highest total nitrogen (0.34%), available phosphorus (15.58 mg kg−1), grain yield (4950 kg ha−1), and net benefit (4255.74 USD) were recorded from the application of 2.39 t VC plus 37.95 kg N, while the highest soil organic carbon (3.38%) and cation exchange capacity (26.17 cmol (+) kg−1) were recorded from 3.19 t VC plus 27.60 kg N ha−1 compared to the control. This study concludes that applying 2.39 t VC and 37.95 kg N ha−1 in combination improves soil fertility, malt barley yield, and economic benefits for smallholder farmers in the study district and adopts this in similar soil types and agroecologies.

Response of Carrot (Daucus carota L.) to Supplementary Irrigation under Rain-Fed Agriculture at Jimma and Gera, Jimma Zone, South West Ethiopia

Evaluating supplementary irrigation under rain-fed agriculture could help to determine the amount of water depth for water management and increasing productivity. Thus, this study was conducted at the Jimma and Gera to determine the effect of supplementary irrigation (SI) on carrot production. Eight treatments with three replications on a field plot of 9 m2 were used for conducting the experiment. Crop water requirement (ETc) was calculated from reference evapotranspiration (ETo) and crop coefficient (Kc) using CropWat 8.0 software. Yield and yield component data were collected from the field and analyzed using the statistical analysis system (SAS) software 9.0. The result revealed that root shoulder diameter, fresh biomass, and fresh root weight had significant (p <0.05) effects between the treatments, but there was no significant difference (p >0.05) between treatments on plant height and carrot root length at both locations. The highest and lowest plant heights were recorded at 75% SI and at a rain-fed treatment. A root shoulder diameters of 38.37 and 37.86 mm were recorded at Jimma and Gera, respectively, from the application of 75% and two SI at flowering and fruit setting treatment. The application of 75% SI gave the highest root length. A maximum fresh biomass of 3,038.6 kg/ha was obtained at 75% SI, and a minimum fresh biomass of 1,640.00 kg/ha was recorded from the rain-fed treatment at JARC. Application of 75% SI gave the maximum fresh biomass (2,388.9 kg/ha) at Gera, and a minimum fresh biomass of 1,277.8 kg/ha was recorded from rain fed. An application of 75% SI gave the highest fresh root weight of 7,430.6 kg/ha at JARC. In the study, the application of 75% SI gave the highest (6,388.9 kg/ha) fresh root weight, and the lowest was recorded at rain fed (3,883.3 kg/ha). Therefore, for optimum production, 75% SI was recommended for the production of carrots. The total net benefit from the production of carrots was in the range of 36,659–46,950 ETB per hectare at Jimma and from 24,828 up to 39,399 ETB per hectar at Gera. The maximum and minimum marginal return rate (MRR) at Jimma were 300.97%, which is at 75% SI and 43.69%, which is at 25% supplementary irrigation, respectively. At Gera, the maximum and minimum MRR were 490.95%, which were at 25% supplementary irrigation, and the minimum was 23.18%, which was at full supplementary irrigation. Therefore, to get an economic benefit, supplementing carrot crop at 75% irrigation was recommended for both Gera and JARC.

Clinical impact and cost-saving analysis of a comprehensive pharmaceutical care intervention in older patients with cancer.

Hospital admission and discharge are at high risk of drug-related problems (DRPs) in older patients with cancer. This study aimed to assess the clinical and economic impact of a comprehensive pharmaceutical care intervention (RECAP) to optimize drug therapy in patients with cancer ≥75 years admitted to oncology or geriatric wards. RECAP intervention was defined as follows: at admission and discharge, hospital pharmacists conducted comprehensive medication reconciliation and review, identified relevant DRPs and provided optimization recommendations to prescribers; at discharge, pharmacists also provided patient education and shared information with primary care providers. The impact of the intervention was assessed by the rate of implementation of recommendations by the prescribers and the evolution of polypharmacy rate; a peer review of the clinical significance of DRPs was performed by an expert panel of geriatric oncologists and pharmacists. A cost saving analysis compared cost avoided through resolution of DRPs to cost of pharmacist's time. From January 2019 and August 2020, 201 patients were included (median age 80 [75-97] years), 68.7% with solid tumors. DRPs requiring optimization were identified in 70.9% of patients at admission (mean 1.7 DRP/patient) and 47.7% at discharge (0.9 DRP/patient). Most pharmacist recommendations (70.8%) were followed by prescribers, allowing the correction of 1.2 DRP/patient at admission and 0.7 DRP/patient at discharge. Half of resolved DRPs were rated as clinically significant. However, polypharmacy rate was not reduced at discharge. Cost comparison showed $7.2 avoided for $1 invested, with an estimated total net benefit of $354,822 (mean $1766 per patient). The RECAP model significantly reduces DRPs in hospitalized older patients with cancer. The model was cost saving, confirming the value of implementing it in routine practice.

Grid-scale crop dynamic layout optimization model considering stakeholders' cropping preferences and practice behaviours

Rapid population growth has led to an increasing demand for food, accompanied by an increase in the resources invested in producing food, and the extensive food production practices have placed a huge burden on the environment. There is an urgent desire of need to find a sustainable model of food production. Therefore, this study attempted to develop a dynamic regional grid-scale crop layout model (ABCAMODP-Crop) combining agent-based model, multi-objective programming, dynamic programming and cellular automata model to promote more sustainable food production from a supply-side perspective. The model can: (1) take into account the planting preferences and practical behaviours of government and farmer as stakeholders in crop layout; (2) further weigh the conflicts among the various objectives that stakeholders are concerned with from resource, environmental, nutritional and economic dimensions; (3) consider the impact of the previous year's crop layout on the next year's crop placement; and (4) obtain grid-scale accurate crop layout solutions by considering the spatial variability of optimization parameters and the neighborhood effects of crop layout cells. The model was applied to the Shiyang River Basin in China to verify its usefulness. Over the entire planning period, crop layout schemes optimized with the objective of integrating irrigation water productivity, environmental impact, nutrient availability and economic benefits have higher comprehensive benefits than the original scheme, with an increase in average irrigation water productivity per unit area of 14.55%, an increase in total yield of 14.45%, an increase in total carbohydrate availability of 7.39%, an increase in total calcium availability of 18.74%, an increase in total net carbon sequestration of 8.05%, an increase in total net benefit of 20.08%. The model developed allows for a holistic view of crop layout and guides decision-makers in a rational distribution of regional crops, thus promoting more sustainable food production. It can equally be extended to other regions as a generic modelling framework.

Pricing Treatments Cost-Effectively when They Have Multiple Indications: Not Just a Simple Threshold Analysis.

Economic evaluations of treatments increasingly employ price-threshold analyses. When a treatment has multiple indications, standard price-threshold analyses can be overly simplistic. We examine how rules governing indication-specific prices and reimbursement decisions affect value-based price analyses. We analyze a 2-stage game between 2 players: the therapy's manufacturer and the payer purchasing it for patients. First, the manufacturer selects a price(s) that may be indication specific. Then, the payer decides whether to provide reimbursement at the offered price(s). We assume known indication-specific demand. The manufacturer seeks to maximize profit. The payer seeks to maximize total population incremental net monetary benefit and will not pay more than their willingness-to-pay threshold. We consider game variants defined by constraints on the manufacturer's ability to price and payer's ability to provide reimbursement differentially by indication. When both the manufacturer and payer can make indication-specific decisions, the problem simplifies to multiple single-indication price-threshold analyses, and the manufacturer captures all the consumer surplus. When the manufacturer is restricted to one price and the payer must make an all-or-nothing reimbursement decision, the selected price is a weighted average of indication-specific threshold prices such that reimbursement of more valuable indications subsidizes reimbursement of less valuable indications. With a single price and indication-specific coverage decisions, the manufacturer may select a high price where fewer patients receive treatment because the payer restricts reimbursement to the set of indications providing value commensurate with the high price. However, the manufacturer may select a low price, resulting in reimbursement for more indications and positive consumer surplus. When treatments have multiple indications, economic evaluations including price-threshold analyses should carefully consider jurisdiction-specific rules regarding pricing and reimbursement decisions. With treatment prices rising, economic evaluations increasingly employ price-threshold analyses to identify value-based prices. Standard price-threshold analyses can be overly simplistic when treatments have multiple indications.Jurisdiction-specific rules governing indication-specific prices and reimbursement decisions affect value-based price analyses.When the manufacturer is restricted to one price for all indications and the payer must make an all-or-nothing reimbursement decision, the selected price is a weighted average of indication-specific threshold prices such that reimbursement of the more valuable indications subsidize reimbursement of the less valuable indications.With a single price and indication-specific coverage decisions, the manufacturer may select a high price with fewer patients treated than in the first-best solution. There are also cases in which the manufacturer selects a lower price, resulting in reimbursement for more indications and positive consumer surplus.

Technical, economical, and socio-environmental analysis of forest road maintenance using the HDM-4 software

As they do not have a sealant coating, forest roads are more susceptible to degradation and traffic obstruction, requiring better construction and maintenance attention. This study aimed to assess the performance of maintenance carried out on unpaved roads in technical, economic, and socio-environmental scopes by application of the Highway Development & Management Model (HDM-4) and to show the best project proposals. The analyses consisted of inputting the HDM-4 with the characteristic data of roads, of and the maintenance to be adopted and the type of used vehicle. The association of this information made it possible to envision scenarios that consider either the replacement or non-replacement of gravel materials on the roads as a methodology. For management without gravel replacement, the most effective scenario was that of roads with gravel under the bed, located in a tropical climate, with flat features and 90 kilometers in length, initial thickness of 175 mm of gravel, high volume of traffic, and subject high-level maintenance at 30-day intervals. For the management with gravel replacement, the ideal scenario was that of roads with gravel under the bed, located in a temperate climate, on rolling terrain and 30 kilometers long, initial thickness of 175 mm of gravel, high traffic intensity, and subjected to high-level maintenance every 30 days. High-level maintenance was the best option for maximizing the quality of the roads and providing the best total net benefit, lowest gas emission rates, least fuel, and tire consumption, and adequate pavement condition by the end of the project.

Economic valuation from direct use of melaleuca forest at U Minh Ha National Park, Vietnam

This paper investigates the direct use values of melaleuca forests at U Minh Ha National Park. The market price method (MPM) was utilised to estimate the economic value. A semi-structured questionnaire comprising multiple-choice and open-ended questions was administered to 360 families in 2022 to collect data on the various forest products available locally, the quantity of these products collected, as well as their corresponding prices and costs. The results revealed that the total net benefits that the local people derived from the entire melaleuca ecosystem were US$ 73,022,184 per year, or an average worth of US$ 1,723 per person per year. Most of the local annual income was derived from construction pole harvesting (US$ 57,092,223), followed by wood for fishing boats (US$ 5,792,757) and fish (US$ 6,226,995). The melaleuca ecosystem was significant, contributing an average of 75% to the total annual per capita income for the local people. However, the U Minh Ha melaleuca ecosystems are threatened and predicted to disappear in 118 years if the current extraction rate of wood products (2,204 kg/person/year) remains uncontrolled. This suggests an urgent need for an integrated management plan that incorporates melaleuca preservation, as well as the commercial and local use interests in this area.

Visual and quantitative assessment of the effectiveness of non-vascularized bone grafting in osteonecrosis of the femoral head via CT-based radiomics and clinical data

To investigate the value of CT-based radiomics and clinical data in predicting the efficacy of non-vascularized bone grafting (NVBG) in hip preservation, and to construct a visual, quantifiable, and effective method for decision-making of hip preservation. Between June 2009 and June 2019, 153 patients (182 hips) with osteonecrosis of the femoral head (ONFH) who underwent NVBG for hip preservation were included, and the training and testing sets were divided in a 7∶3 ratio to define hip preservation success or failure according to the 3-year postoperative follow-up. The radiomic features of the region of interest in the CT images were extracted, and the radiomics-scores were calculated by the linear weighting and coefficients of the radiomic features after dimensionality reduction. The clinical predictors were screened using univariate and multivariate Cox regression analysis. The radiomics model, clinical model, and clinical-radiomics (C-R) model were constructed respectively. Their predictive performance for the efficacy of hip preservation was compared in the training and testing sets, with evaluation indexes including area under the curve, C-Index, sensitivity, specificity, and calibration curve, etc. The best model was visualised using nomogram, and its clinical utility was assessed by decision curves. At the 3-year postoperative follow-up, the cumulative survival rate of hip preservation was 70.33%. Continued exposure to risk factors postoperative and Japanese Investigation Committee (JIC) staging were clinical predictors of the efficacy of hip preservation, and 13 radiomic features derived from least absolute shrinkage and selection operator downscaling were used to calculate Rad-scores. The C-R model outperformed both the clinical and radiomics models in predicting the efficacy of hip preservation 1, 2, 3 years postoperative in both the training and testing sets ( P<0.05), with good agreement between the predicted and observed values. A nomogram constructed based on the C-R model showed that patients with lower Rad-scores, no further postoperative exposure to risk factors, and B or C1 types of JIC staging had a higher probability of femoral survival at 1, 2, 3 years postoperatively. The decision curve analysis showed that the C-R model had a higher total net benefit than both the clinical and radiomics models with a single predictor, and it could bring more net benefit to patients within a larger probability threshold. The prediction model and nomogram constructed by CT-based radiomics combined with clinical data is a visual, quantifiable, and effective method for decision-making of hip preservation, which can predict the efficacy of NVBG before surgery and has a high value of clinical application.

Net benefits change of waste photovoltaic recycling in China: Projection of waste based on multiple factors

Previous studies on photovoltaic (PV) waste recycling in China have focused on predicting waste volumes and the technical and economic feasibilities of recycling. However, those studies lack an assessment of balance of system (BOS) waste in a PV system and a macro-level assessment of the variation in the net benefits of waste recovery. This paper establishes a multi-factor gray neural network model, combined with the Weibull distribution model, to predict the total PV waste, including modules and BOS. By considering the learning curve of recycling technology and the future projected share of three mainstream technologies (mechanical, chemical, and thermal treatment), we also analyze the changes in net PV recycling benefits across the industry. The results show that total cumulative PV waste is expected to reach about 100 million tons by 2050; of this, 56.13% may be PV modules and 43.87% may be BOS. Three metals, Fe (26%), Al (21%), and Cu (4%), are expected to account for the largest proportion of total metals. Compared with direct landfill disposal, by 2050, the recycling of PV waste could potentially reduce carbon dioxide (CO2) emissions by 1.1E+11 kg, save 1.1E+12 kg of industrial water, and generate 3.6E+11 MJ for primary energy use. The change in net benefits indicates that the benefit could start to generate a positive return by 2026 and total net benefits are expected to reach 90 billion CNY by 2050.

A high level estimation of the net economic benefits to small-scale livestock producers arising from animal health product distribution initiatives.

A fundamental challenge for charities that facilitate distribution of animal health products to small-scale livestock producers (SSPs) in low and middle income countries (LMICs) is identifying the products and market mechanisms that provide the greatest positive impact for SSPs and estimating their associated impact. This paper describes a pragmatic approach to modeling the impact of market-led product distribution initiatives based on estimating the net economic benefit of administration of animal health products. The model estimates the economic impact of diseases at the individual animal level for poultry, small ruminants, and cattle. The economic impact of mortality and growth inhibition associated with disease are then estimated in conjunction with the losses averted or recovered by preventing or treating the disease. Economic benefit is estimated in 2014-2017 values and also adjusted to 2023 values. The flexible model structure allows for addition of new geographies, new products, and increased granularity of modeled production systems. Applied to the Global Alliance for Livestock Veterinary Medicines (GALVmed) product distribution initiatives conducted in Africa and South Asia (SA) between 2014 and 2017, the model estimates an adjusted total net economic benefit of 139.9 million USD from sales of vaccines and poultry anthelminthics in these initiatives. Within SSA, the greatest net economic benefit was realized from East Coast fever and Newcastle disease vaccines, while in SA, peste des petits ruminants and Newcastle disease vaccines had the greatest net economic benefits. This translated to an adjusted $37.97 of net economic benefit on average per SSP customer, many of whom were small poultry producers. While the model currently estimates impacts from mortality and growth inhibition in livestock, there is the potential to extend it to cover impacts of further initiatives, including interventions targeted at diseases that impact production of milk, eggs, and reproduction.

Evaluation of Different Spray Frequency Levels of Fungicides against Ascochyta Blight (Ascochyta fabae S) Diseases of Faba Bean (Vicia faba L) in Northwestern Ethiopia

Ascochyta blight disease is a major problem in faba bean (Vicia faba L) production that causes 90% to 100% yield loss. A field experiment was conducted to evaluate the efficacy of three fungicides with three spray frequency levels against Ascochyta blight disease of faba bean varieties. For the assessment of disease management, a total of 21 treatments were used, which comprised three fungicides, three spray frequencies, two varieties, and control. The field experiment was arranged in a randomized complete block design with factorial combinations of variety, fungicide, and spray frequency levels in three replications. An analysis of variance was performed for disease, yield, and yield related and plant growth parameter data, using the Statistical Analysis System (SAS, 2003) version 9.1.3 software. The economic data obtained from the field experiment was analyzed using the partial budget analysis method. The results showed that area under disease progress curve, percent severity index, disease progress rate, and percent disease incidence had strong mean significant differences ( p &lt; 0.01 ) between treated and untreated plots. Application of fungicide significantly increased plant height, stem girth, pod per plant, grain yield, and harvesting index ( p &lt; 0.01 ) over untreated plots. Greater total return (195,938 Ethiopian birr ha−1), net return (101,761.3 Ethiopian birr ha−1), and net benefit (34,768.17 Ethiopian birr ha−1) were obtained by EH00102-4-1 variety, in two times Mancolaxyl treatment. The linear regression analysis result (R2) indicated that the variation in average grain yield of EH00102-4-1 and local susceptible varieties, due to the mean area under the disease progress curve, was 64.50% and 68.64%, respectively. Therefore, the use of EH00102-4-1 variety, with two times Mancolaxyl spray frequency application, at early growth stage and the onset of the disease is suggested as an agronomic management option, in Northwestern Ethiopia.

Total events and net clinical benefit of rivaroxaban and aspirin in patients with chronic coronary or peripheral artery disease: The COMPASS trial

Low dose rivaroxaban with aspirin reduced major cardiovascular events (MACE) compared to aspirin alone in patients with cardiovascular disease although effects on total events are unknown. The COMPASS clinical trial randomized 27,395 participants with chronic coronary and/or peripheral artery disease to rivaroxaban 2.5 mg twice daily plus aspirin 100 mg daily, rivaroxaban 5 mg twice daily alone, or aspirin 100 mg daily. We analyzed total (first and recurrent) MACE outcomes of cardiovascular death, stroke, or myocardial infarction, and the primary safety outcome of major bleeding. Exploratory analyses included on-treatment and net clinical benefit. Total MACE and safety events were modeled for each treatment. MACE events were lowest in rivaroxaban with aspirin (379 first MACE, 432 total MACE) compared with rivaroxaban (448 first, 508 total) or aspirin alone (496 first, 574 total). Rivaroxaban and aspirin reduced total MACE events compared with aspirin alone [HR 0.75, 95% CI 0.66-0.85, P < .0001, number needed to treat for 2 years (NNT2y) of 63]. Total major bleeding was higher for rivaroxaban with aspirin compared to aspirin, but severe bleeding was not increased. The net clinical benefit of rivaroxaban plus aspirin was 20% higher compared with aspirin alone [HR 0.80 (95% CI 16.3%-31.6%)]. Rivaroxaban alone had no benefit on MACE outcomes compared with aspirin alone. MACE outcomes were similar for those on and off randomized treatment. Low dose rivaroxaban with aspirin significantly reduces first and total cardiovascular events compared with aspirin alone with a NNT2y of 63 and a 20% net clinical benefit. NCT01776424. https://clinicaltrials.gov/ct2/show/NCT01776424.

Use of Urban Open-waterbody to Enhance Fish Production through Cage Culture

The purpose of the experiment was to examine the effect of cage fish culture on the growth and production performances of Shing (Heteropneustes fossilis), Pabda (Ompok pabda) and Gulsha (Mystus cavasius). The stocking density for each fish species was 100 fish/m3. Cages with Shing, Pabda and Gulsha were treated as T1, T2 and T3, respectively. Fishes were fed with artificial diet at the rate of 5-10% of body weight. The experiment was carried out in cages in the Beel from June to November 2019. The study revealed that water quality parameters were not varied significantly (p &gt; 0.05) among the treatments. The growth and production performance were significantly (p &lt; 0.05) higher for Pabda cage culture followed by Gulsha and Shing cultures in cages. Therefore, the total net return (BDT 17,028) and benefit cost ratio (2.48) were significantly (p &lt; 0.05) higher for Pabda fish considering cost benefit analysis. It was concluded that, among the three different fish species, high-valued Pabda is highly acceptable candidate for cage farming in Belai Beel area and cage farming in urban open waterbodies is a promising approach to increase the total fish production to improve the social and economic status of fish farmers.

Nudging to Increase Colorectal Cancer Screening Rates: A Cost-Benefit Analysis of a Medicare Mailed Fecal Immunochemical Test Program

This paper presents a cost-benefit analysis of the implementation of a mailed fecal immunochemical test (FIT) program for Medicare beneficiaries who have fallen behind on recommended colorectal cancer (CRC) screening. An ex-ante cost-benefit analysis was conducted to determine the total net benefits to US society of the implementation of a Medicare Mailed FIT program on one-year and 10-year timelines. Costs and benefits associated with the implementation of such a program were valued using Centers for Medicare and Medicaid Services (CMS) reimbursement rates and results from existing research. Analysis procedures followed Health and Human Services Guidelines for Regulatory Impact Analysis to the maximum extent possible. The base-case net benefits after program year one were estimated to be $9.6 billion with estimated 10-year net benefits of $74.5 billion. Best-case sensitivity analysis outcomes were estimated to be $22.7 billion in net benefits at the end of year one and $202.3 billion in net benefits on a 10-year timeline, while worst-case sensitivity analysis outcomes were estimated to be $1.4 billion in net benefits at the end of year one and $12.5 billion in net benefits on a 10-year timeline. Further sensitivity analyses all yielded positive net benefits on one and 10-year timelines indicating that the implementation of a mailed FIT program for Medicare beneficiaries who have fallen behind on CRC screening offers considerable net benefit to US society.

Deep fertilization improves rice productivity and reduces ammonia emissions from rice fields in China; a meta-analysis

Deep fertilization (DF) has been introduced to rice production systems in China to improve rice productivity with minimum nitrogen (N) losses, however, the effects of DF on rice yield and ammonia (NH 3 ) emissions were never analyzed systematically. In the present study, we evaluated the impact of DF on rice productivity and NH 3 emissions via a meta-analysis based on 1023 observations collected from 144 studies. Data interpretation showed that DF can significantly increase yield by 8.6% (95% confidence interval (CI): 7.3–10.0%), N use efficiency by 16.7% (95% CI: 14.5–18.9%) and reduce NH 3 emissions by 78.1% (95% CI: 71.3–81.3%), respectively compared to broadcast fertilizer (BF). Variation in the effects of DF was mainly due to climate factors, soil properties, and agronomic practices whereas optimization of agronomic practices can improve the rice productivity under DF. The optimal depth of DF ranges between 7 and 13 cm, which coincides with the distribution of the majority of the rice root system. Reducing the fertilizer application rate to the range of 150–250 kg/ha coupled with split fertilization can improve rice yield and reduce NH 3 emissions. Importantly, the DF could significantly increase the total output and net economic benefits compared to the BF. In conclusion, the DF can significantly increase rice productivity and reduce ammonia emissions, however, large-scale adoption of the DF in rice systems are constrained by the availability of well-equipped machinery, good fertilizer products, and skilled farmers and labor. • Effects of deep fertilization (DF) on rice yield and NH 3 emissions were assessed. • Variations in the effects of DF were mainly due to agronomic practices. • Site-specific optimizations are needed to improve the performance of DF.