Treatment Effect Model Research Articles

The impact of market-oriented cooperation on food production performance in small-scale farms in rural China

IntroductionSmall-scale farmers in developing countries can significantly contribute to sustainable food production through market-oriented cooperation (MOC). MOC allows farmers to access machinery services and specialized labor, but it also carries economic costs that may impact food production performance in small-scale farms. This study attempts to uncover the association between farmers' MOC participation and food production performance in small-scale farms in rural China, using a sample of 650 rice farmers in Jiangsu province.MethodsWe applied the stochastic frontier analysis to calculate the technical efficiency that indicates the production performance of small-scale farms. The treatment effect model is employed to detect the effect of farmers' MOC participation on technical efficiency, and the multivalued treatment effects model is used to explore the relationship between farmers' intensity of MOC and technical efficiency.ResultsThe results show that farmers' MOC participation significantly increases technical efficiency of small-scale farms, with an inverted U-shaped correlation between MOC participation intensity and technical efficiency. A heterogeneity analysis based on production phases reveals that farmers tend to adopt MOC in machinery-driven phases with higher priority than in labor-driven phases. MOC in labor-driven phases, such as seedling and spraying, presents negative effect on technical efficiency.DiscussionThese findings highlight the crucial role of MOC in food production performance in small-scale farms, and provide insights for designing MOC strategies in different production phases in order to facilitate sustainable food production in developing regions. This research addresses the need for solutions to improve food production sustainability under agricultural transformation in developing countries. It also touches on the challenges and opportunities that producers face in adopting new practices and participating in the modern food supply chain.

Marginal returns on Chinese agricultural technology transfer in Nigeria: Who benefits more?

Agricultural technology transfers are generally considered an effective means of solving persistently low yields in sub-Saharan Africa. This study assesses the impact of the Chinese agricultural training program on farmers' productivity and income using ex-post non-experimental data from Ogun State, Nigeria. Our empirical approach is based on marginal treatment effect models. We find that the returns for individuals who participated in Chinese agricultural technology training indicated a 68.5% increase in yield and a 45.3% increase in agricultural income. Furthermore, we show that the program targets farmers from advantaged backgrounds, who may benefit less from attending the program than disadvantaged farmers, who experience a lower incentive to participate. Finally, we suggest sufficient awareness and incentives to encourage highly resistant farmers to participate in such programmes.

Risk of Underlying Diseases and Effectiveness of Drugs on COVID-19 Inpatients Assessed Using Medical Claims in Japan: Retrospective Observational Study.

Results of earlier studies have demonstrated underlying diseases such as cancer, diabetes mellitus, immunodeficiency, hypertension and heart failure to be risk factors for severe outcomes and mortality. Furthermore, clinical trials have shown that drugs such as antiviral drugs, antibody cocktails, steroids and anti-inflammatory drugs can be expected to prevent severe COVID-19 outcomes and death. This study, using inpatient records from the Medical Information Analysis Databank covering national hospital organizations in Japan, was conducted to evaluate the effects of underlying diseases and/or administered drugs on mortality. Subjects were all inpatients receiving oxygen administration and inpatients using respiratory ventilators, categorized by three age classes: all ages, patients 65 years old or older, and patients younger than 65 years old. We used logistic regression to analyze outcomes for underlying diseases, administered drugs, age, sex, the proportion of the mutated strains, and vaccine coverage. Patients with hypertension, except for younger inpatients, have a lower risk of mortality (estimated coefficient 0.67 among all inpatients (p < 0.01): 0.77 among inpatients with oxygen therapy (p = 0.02) and 0.57 among inpatients with respiratory ventilation w (p = 0.01)). Except for younger inpatients, antibody cocktail (casirivimab/imdevimab or sotrovimab) administration was associated with a higher probability of survival (estimated coefficient 0.27 among all inpatients (p < 0.01)). It raised the survival probability consistently, although other drugs might have reduced the probability of survival. These findings suggest that antiviral drugs (remdesivir, estimated coefficient 1.44 (p < 0.01)), steroids (dexamethasone, estimated coefficient 1.85 (p < 0.01)), and anti-inflammatory drugs (baricitinib, estimated coefficient 1.62 (p < 0.01), and tocilizumab, estimated coefficient 2.73 (p < 0.01)) might not contribute to survival. These results have not been reported from earlier studies. More sophisticated estimation procedures, such as treatment effect models, are necessary to obtain conclusive results.

Does Row Planting Enhance Farm Productivity and Reduce Risk Exposure? Insights From Ethiopia

AbstractThis study examines the impact of the row planting method on maize productivity and risk exposure using panel datasets from Ethiopia. A flexible moment-based production function is fitted to capture the expected yield, yield variance, and exposure to downside risk. A Mundlak–Chamberlain approach is combined with a switching regression treatment effects model to account for unobserved heterogeneity and endogeneity. The study shows that adopters of the row planting method significantly reduced exposure to downside risk while increasing expected yield. The analysis also identified some household and environmental conditions that affect the gain from the row planting method.

The Contract Design of Employee Stock Ownership Plan and Enterprise Innovation Investment: Evidence from China

Enterprise innovation is a key driver of national economic growth. How to stimulate employees’ innovation vitality to improve the company’s innovation input and output has always been a hot topic. Employee Stock Ownership Plan (ESOP) is one of the effective means to stimulate employees’ innovation vitality by linking employee wealth with firm value. The purpose of this paper is to examine the effect of ESOP implementation and contract design on enterprise innovation investment in the context of the recent booming development of ESOP in China. First, we use a treatment effect model to examine the impact of ESOP implementation on innovation investment, taking firms that implement ESOPs as the treatment group and firms that do not implement ESOPs as the control group. Second, we use multivariate regression models to test the impact of ESOP contract design (including fund source, stock source, lockup period, duration, shareholding scale, executive subscription ratio, participation degree, and management mode) on innovation investment using the treatment group. The results indicate that the implementation of ESOP is helpful in increasing enterprise innovation investment, and the impact of ESOP on innovation investment varies significantly with the design of incentive contracts.

Climate change adaption strategies in urban communities: new evidence from Islamabad, Pakistan.

Pakistan is urbanizing at the fastest pace in South Asia, and if left unplanned, it will not only reduce adaptive capacity of its residents rather it will be a chaos for its residents. The aim of this study is to answer the question on how urbanites of Pakistan are coping with climate change and which part of the society required support to cope with changing climate? To answer this questions, this study conducted survey through a structured questionnaire, from the urban residents of Islamabad, to explore their coping mechanisms towards climate change. Survey collected information on demographic, social, economic, and physical aspects, using Hackman's Treatment effect model. The sample selection equation is conditional on the adaptations to climate change in the outcome equation. Main independent variables are income, age, education, and occupation. Selection equation is based on perceptions of individuals about climate change which contains dependent variables of changes in temperature of summers and winters, changes in rain fall pattern, fog, hailstorm, and information received from social media and peer groups. With the result of 57.55, the Wald test shows that overall, there exists goodness of fit at the 99 percent confidence level. The value of rho in the Heckman model is 0.40 which implies the Heckman model provides more consistent and more efficient estimates. The results are suggesting that increasing age enhances the likelihood of adaptations as the positive and significant coefficient of age implies that age has probability to adapt to climate change. The positive and significant coefficient of income, education, and occupation implies that urbanites have higher probability to adapt to climate change. Perception is the essential foundation of adaptation, and differences in perception can be transferred to the adapted strategies. Households that experience a greater variation in annual mean temperature are more likely to adopt any adaptation strategy to cope with climate change. Essentially, poverty encompasses the majority of the characteristics that reduce respondents' adaptation capacity and increase their susceptibility to climate change. The major contextual disparities were discovered across union councils in the form of financial, personal, social, physical, and natural capitals of families. Therefore, obligation is on government to offer greater support for individuals who are less affluent in terms of these assets. For this city, officials must offer subsidy schemes to less privileged and marginalized people of urban dwellers to enhance their adaptive capacity.

Inference for Large‐Scale Linear Systems With Known Coefficients

This paper considers the problem of testing whether there exists a non‐negative solution to a possibly under‐determined system of linear equations with known coefficients. This hypothesis testing problem arises naturally in a number of settings, including random coefficient, treatment effect, and discrete choice models, as well as a class of linear programming problems. As a first contribution, we obtain a novel geometric characterization of the null hypothesis in terms of identified parameters satisfying an infinite set of inequality restrictions. Using this characterization, we devise a test that requires solving only linear programs for its implementation, and thus remains computationally feasible in the high‐dimensional applications that motivate our analysis. The asymptotic size of the proposed test is shown to equal at most the nominal level uniformly over a large class of distributions that permits the number of linear equations to grow with the sample size.

EMPIRICAL ANALYSES OF FINANCIAL CREDIT ON SMALLHOLDER FARMER’S PRODUCTIVITY MODELLING FARMERS CREDIT ALLOCATION FROM RURAL BANKS IN SIERRA LEONE

Sierra Leone has experienced an increase in farmers’ accessibility to financial credit facilities in recent time. Financial credit plays a significant role in enhancing productivity and efficiency within the agricultural sector of emerging nations, and Sierra Leone is not exempt from this trend. The present study investigates the allocation of financial credit among farmers and its impact on technical efficiency. A three-stage sampling methodology was employed to gather cross-sectional data from a sample of 500 agricultural producers in Sierra Leone. The objective of this study was to evaluate the influence of financial support on agricultural productivity, with the ultimate goal of enhancing economic and technical efficiency. The evaluation of the effect of allocation techniques on technical efficiency is conducted through the utilization of the random frontiers truncated-normal with the conditional average model. The present study employed the Heckman treatment effect model and stochastic frontier analysis (SFA) to examine the production efficiency of smallholder farmers. The study’s empirical findings indicate that the provision of financial assistance by community banks has a notable and favorable impact on the technical efficiency of farmers. Despite the presence of many constraints, farmers’ access to financial financing remains limited. This is reflected in the total technical efficiency of farmers, which was measured at 0.81 (81%). This indicates that none of the farmers were able to achieve a production threshold of 1 (100%). Nevertheless, it is worth noting that the average disparity in efficiency between individuals who borrowed and those who did not borrow was 0.09, equivalent to a 9% variation. This finding provides further evidence supporting the notion that access to financial credit has a beneficial effect on the efficiency of farmers. This, in turn, leads to a reduction in the severity of poverty and extreme poverty. Despite facing challenges such as pest and disease infestations, financial constraints, and unpredictable weather conditions, the inefficiency model demonstrated that factors such as education, membership in a farmer-based organization, experience, access to credit, and participation in a government-sponsored mass spraying program had a notable and favorable influence on efficiency scores. Hence, it is advisable to propose a policy aimed at enhancing the accessibility of financial services from community and rural banking institutions that includes every group of smallholder farmers in Sierra Leone.

Distributive impacts of non-farm income on output and farm income of cassava farmers in Southwestern Nigeria

Non-farm income is a major source of income, along with farming for most rural households, that seems to offer a pathway out of poverty. It has gained prominence in recent times as an alternative strategy. However, it is often not clear how non-farm income can contribute to farm output and income because empirical results from existing literature remain somewhat ambiguous. Therefore, more robust research is needed to understand what conditions lead to what outcomes and to identify appropriate policy responses. We extend the previous literature in the direction of understanding more finely the potential impact of non-farm income on output and farm income distributions, applying a novel approach, IVQTEs, for the first time in this context. In this paper, we analyzed the drivers of non-farm income as an alternative strategy, and its distributive impacts on cassava farmers' output and farm income in Southwestern Nigeria. A multistage sampling procedure was employed to select 300 cassava farmers for the study. Data were analysed using the novel nehurdle estimation procedure of the double hurdle model. Our methodology of using an instrumental variable quantile treatment effect model (IVQTE) explicitly demonstrates the impact of non-farm income on farm output and income distribution at different levels. The first hurdle (Probit regression) of nehurdle results show that age, household size, years of education, years of experience, farm size, and access to credit may likely influence the decision to participate in non-farm income works; while, in the second hurdle, household size, age, years of education, farm size, gender, asset ownership, cooperative membership are the significant factors that may likely influence the amount realized from non-farm income works. Our results reveal a positive marginal impact of non-farm income at all quantiles of the conditional distribution of cassava farmers’ output and farm income, with the impact being the lowest at the lowest quantile (25th quantile) and increased across the other quantiles. In this regard, the study suggests that the creation of job opportunities outside farming will supplement on-farm works and enhance household's income. This study also suggests that measures such as education, extension services and cooperative societies, to enhance participation in non-farm income works, will spur the rural economy in Nigeria and other developing countries.

Impact of Farm Households’ Adaptations to Climate Change on Food Security: Evidence from Different Agro-ecologies of Pakistan

The study used data from 3298 food crop growers in Pakistan. Potential outcome treatment effects model was applied to evaluate the impact of adaptations on household food security. A household Food Security Index (FSI) was constructed applying Principle Component Analysis (PCA). Adaptation strategies employed by the farmers in response to climate change were categorised into four groups namely: changes in sowing time (C1); input intensification (C2); water and soil conservation (C3); and changes in varieties (C4). Out of 15 mutually exclusive combinations constructed for evaluation, only 7 combinations were considered for estimating the treatment effects models because of limited number of observations in other cases. Results of only two of the 7 are discussed in the paper, as the other 5 had very small number of adapters and the impact measures shown either insignificant results or had opposite signs. The first (C1234) combined all the four, while the second (C234) combined the last three strategies. The results suggest that the households which adapted to climate changes were statistically significantly more food secure as compared to those who did not adapt. The results further show that education of the male and female heads, livestock ownership, the structure of house—both bricked and having electricity facility, crops diversification, and non-farm income are among the factors, which raise the food security of farm households and their impacts are statistically significant. The variables which are significantly negatively associated with the food security levels include age of the head of household, food expenditure management, households having less than 12.5 acres of land— defined as marginal (cultivate 6.25 to 12.5 acres). Farmers of cotton-wheat, rice-wheat, and rain-fed cropping systems are found to be more food secure as compared to the farmers working in the mixed cropping systems where farm holdings are relatively small and high use of tube-well water adding to salinity of soils. It is crucial to invest in the development of agricultural technological packages, addressing issues of climate change relevant to different ecologies and farming systems; improve research-extension-farmer linkages; enhance farmers‘ access to new technologies; improve rural infrastructure; development of weather information system linking meteorological department, extension and farmers; and establishment of targeted food safety nets as well as farm subsidy programs for marginal farm households.

A Tale of two cities – A comparative study of land conveyance decisions upon national policies and their impacts on land transaction prices in Beijing and Shanghai

Although urban land leasing is supposedly a local government matter, local leaderships' proactive pursual of economic growth for their career advancements can sometimes be at odds with national policies. Yet, how land conveyance decisions are made in midst of the implementation of national policies and land financing has been a rather overlooked aspect in the studies of China's land market. Hence, this paper explores this issue through a study of land conveyance decisions in Beijing and Shanghai's residential and commercial land markets from 2007 to 2018, and their subsequent land price effects. Deploying endogenous treatment effect models, it is revealed that land conveyance decisions in Beijing were highly subject to national policies and the status of its City Party Secretary, but not in Shanghai. Also, the use of Guapai resulted in higher residential and commercial land prices in Shanghai, but lower prices for Beijing's commercial land parcels. The findings indicate that Beijing, due to its closer proximity to the Central Government, appears to have stringently followed the national policy directions, whereas land officials in Shanghai seem to have had a higher degree of autonomy in their decisions. Additionally, the contrasting price effect of Guapai on land prices for residential and commercial land parcels enabled Beijing's government to compensate for the latent losses in land revenue when leasing residential land parcels, due to Nation #10, by leasing commercial parcels at higher prices via tender.

Off-Farm Income Effect on Farmer Response to Climate Change in the Northern Region of Ghana

This study assessed the effect of off-farm income on maize farmers' responses to climate change in the Tolon district of Northern Region of Ghana. Using multi-stage sampling technique and semi-structured questionnaires, 150 maize farmers from five communities were interviewed. Heckman's treatment effect model was used. The result showed that majority had off-farm income that they received from trading. Furthermore, off-farm income has a significant effect on adoption of adaptation strategies. The majority of the farmers had perceived changes in the climate over the past decades and adaptation strategies practiced included changing planting date, changing crop variety, diversifying crop type, mixed cropping, and keeping animals alongside crop cultivation. Based on the findings from this study, government should provide enabling environment that will create and increase opportunities for farmers to engage in other income-generating activities that will provide them with additional income to procure necessary inputs and tools for appropriate response to the ongoing climate change problem.

A treatment-effect model to quantify human dimensions of disaster impacts: the case of Hurricane Maria in Puerto Rico

A treatment-effect model to quantify human dimensions of disaster impacts: the case of Hurricane Maria in Puerto Rico

Explanation of the Phenomenon “Different Prices on the Same Land” in the Farmland Transfer Market—Evidence from China’s Farmland Transfer Market

The purpose of this study was to investigate the differences in farmland rent prices between land transferors and different transferees when considering the quality supervision cost of the transferred farmland. Moreover, the impact of the intervention of township governments, village committees, and other intermediary organizations on the rent price differences is also taken into consideration. The treatment effect model (TEM) and grouping regression model were used. The results showed that: (1) Owing to the different transaction costs, when leasing to village transferees, the land rent was significantly lower than when leasing to non-village transferees. (2) With the intervention of intermediary organizations, such as township governments and village committees, the constraints of the reputation mechanism between acquaintances were weakened, and the cost of information identification when land transferors searched for out-of-town transferees was reduced. As a result, the differences in land rent when transferring to the village and non-village transferees were narrowed. This study presents a different view to explain the transaction characteristics of the rural land transfer market in China. Further, it is of paramount importance to implement an effective public intervention, including strengthening the intermediary role of township governments and village committees, which is conducive to improving the rural land transfer market of most developing countries, including China.

Interceding Role of Agricultural Extension Services in Adoption of Climate-Smart Agricultural Technologies in Northern Ghana

As a result of the effect of climate change on food security and rural livelihoods, the promotion and adoption of climate-smart agricultural practices have become very crucial. The role of agricultural extension in the adoption decision process is an important factor. However, extension delivery systems in most developing countries face numerous challenges that raise concerns about their ability to bring about the desired impact on farm households’ decisions. Relying on data from a cross-section of smallholder farmers in Ghana’s northern savanna area, specifically the Tolon district, the study assessed the determinants of farmers’ decision to adopt climate-smart agriculture (CSA) practices as well as the intensity of adoption and the role agricultural extension plays in CSA adoption. Using a Poisson regression with endogenous treatment effects model to account for selectivity bias, the study observed that farmers adopt multiple CSA practices, with adoption being influenced by farmer group membership, size of herd and participation in off-farm work. Intensity of adoption, on the other hand, increased with access to agricultural extension, farm credit and input subsidy, but decreased with farm size and participation in off-farm work. Furthermore, an impact assessment indicated that participants in agricultural extension had 1.27 more adoption of CSA practices than they would if they had not participated in agricultural extension. The study concludes that there is a strong association between adoption intensity and access to agricultural support services such as extension, input subsidy and agricultural credit. The interceding role of extension in the adoption of CSA practices calls for more resources to be channeled towards extension service provision as a means to mitigate the effects of climate change and promote sustainable production at the farm level. The positive externalities from CSA adoption will go a long way to protect the environment, promote food security and rural livelihoods.

Understating emerging value chains and business performance: evidence from dairy industry in India

PurposeThe purpose of the study is to identify the factors affecting the entrepreneur's choice of the dairy value chain and evaluate the impact of the value chain on farm performance (profit).Design/methodology/approachPrimary data were collected from dairy entrepreneurs in India, covering nine states. A multinomial treatment effect model (controlling for selection bias and endogeneity) was used to evaluate the impact of the choice of the value chain on entrepreneurs' profit.FindingsDairy entrepreneurs operating in any recognized value chain other than the value chain driven by the consumer household realize a comparatively lesser profit. Dairy farmers have established direct linkages with customers in urban areas – who could pay premium prices for safe and quality milk. Food safety compliance is positively associated with profit and entrepreneurs (who have undergone formal training in dairying) preferred partnerships with a formal value chain. The prospects of starting a dairy enterprise are slightly higher in villages compared to urban areas.Research limitations/implicationsDairy entrepreneurs can make a shift in accordance with the study's findings and boost their profitability. It aids in comprehending how trainees (who obtained advice and training for raising dairy animals from R&D organizations) and non-trainee dairy farmers make value chain selections, which ultimately affect profitability. However, purposive sampling and a small sample size limit the universal implications of the study.Social implicationsDeveloping entrepreneurial behavior and startup culture is at the center of policymaking in India. The findings imply that the emerging value chain not only enhances the profit of dairy farmers by resolving consumer concerns about food safety and the quality of milk and milk products but also builds consumer trust.Originality/valueThis paper offers insight into how the benefits of dairy entrepreneurs vary with their participation in the different value chains. The impact of skill development/training programs on value chain selection and farm profitability has not yet been fully understood. Here is an attempt to fill this gap. This paper through light on how trained and educated dairy entrepreneurs are able to establish a territorial market by approaching premium customers – this is an addition to the existing literature.

Understanding the determinants and impact of the adoption of technologies for sustainable farming systems in water-scarce areas of Bangladesh

IntroductionBangladesh's quest to achieve sustainable development goals has highlighted the need to enhance resilience against the challenges that interconnected food, energy, and water (FEW) nexus systems faces to support human well-being. The government has decided to promote the adoption of competent and cutting-edge technologies that can significantly contribute to balancing energy and water resource utilization in achieving a more sustainable and climate-smart food production system. Hence, scaled-up adoption of solar-powered irrigation systems and recommended fertilizer dose (SIRFD) applications were proposed. This study, to provide practical policy implications, attempts to identify the determinants and impact of SIRFD adoption in water-scarce areas of Bangladesh.MethodsDeterminants of adoption were analyzed using multinomial logistic regression, and the adoption impact was analyzed using treatment effect models.ResultsThe results revealed that land typology, soil fertility perception, soil water retention, knowledge, environmental awareness, secondary income, close acquaintance adoption, and cash availability significantly influenced adoption decisions. The treatment effect model result indicated that farmers who adopted both technologies could reduce production costs by 1.36% and obtain an 8.92% higher ROI than non-adopters.ConclusionThe study findings suggest that policy interventions on scaling up SIRFD adoption require focusing on knowledge development village-based demonstration activities, group farming models backed by micro-finance, and avoiding launching conflicting schemes.

Impact of the Momentum pilot project on male involvement in maternal health and newborn care in Kinshasa, Democratic Republic of the Congo: a quasi-experimental study

BackgroundThe World Health Organization recommends that programs that seek to improve maternal and newborn health outcomes actively involve men during pregnancy, childbirth, and postpartum. However, there is little evidence on what strategies work to increase male knowledge of and involvement in antenatal and postnatal care. This study assessed the impact of the Momentum project on male involvement in maternal health and newborn care. The project involved monthly home visits to a cohort of first-time mothers aged 15–24 recruited at six-months gestation and group education sessions for their male partners using the Program P toolkit. Participants were followed-up for 16 months.MethodsThe study used a quasi-experimental design with three intervention and three comparison health zones. Baseline data were collected in 2018 and endline data in 2020. Exploratory factor analysis was used to develop scales of male involvement. We measured the causal influence of Momentum using an intent-to-treat analysis at the health-zone level and a dose–response analysis at the individual level. We used random-effects probit and linear models for outcomes measured at baseline and endline, and treatment effects models with inverse-probability weighting for outcomes measured only at endline. The impact analysis involved 1,204 male partners of first-time mothers with live births.ResultsIntervention health zones were associated with an 18.1 percentage point (95% CI [(10.6, 25.6]) increase in knowledge of three or more obstetric danger signs and a 13.9 percentage point (95% CI [6.3, 21.6]) increase in knowledge of newborn danger signs. Significant increases in male involvement in antenatal care (average treatment effect (ATE) = 0.728, 95% CI [0.445, 1.010]), birth planning (ATE = 0.407, 95% CI [0.157, 0.657]), and newborn care (ATE = 0.690, 95% CI [0.359, 1.021]) were found. The magnitude of Momentum’s impact increased steadily with the number of prenatal home visits and was statistically significant for all behavioral outcomes except shared decision making. Exposure to both home visits and group education sessions during the prenatal period had a significant impact on all outcomes relative to no exposure.ConclusionsThe study demonstrated the effectiveness of Momentum on male involvement in maternal health and newborn care.

Effects of second-line antihyperglycemic drugs on the risk of chronic kidney disease: applying a target trial approach to a hospital-based cohort of Thai patients with type 2 diabetes

BackgroundThe reno-protective effect of second-line treatments in type 2 diabetes has been assessed by clinical trials but generalizability to routine clinical practice is still uncertain. We aimed to assess the effectiveness of these treatments, when added to metformin, on the risk of chronic kidney disease (CKD).MethodsA real-world, hospital-based, type 2 diabetes cohort was retrospectively assembled at Ramathibodi Hospital from 2010 to 2019. Patients who received sulfonylureas (SU), thiazolidinediones (TZD), dipeptidyl peptidase-4 inhibitors (DPP4i), or sodium-glucose cotransporter-2 inhibitors (SGLT2i), as second-line antihyperglycemic treatment were included. Treatment effect models with inverse probability weighting and regression adjustment were used to estimate CKD risk according to treatment.ResultsCKD was identified in 4,132 of the 24,777 patients with type 2 diabetes (16.7%). The CKD incidence (95% CI) was 4.1% (2.2%, 6.9%), 13.5% (12.5%, 14.6%), 14.8% (13.5%, 16.1%), and 18.0% (17.4%, 18.5%) for patients receiving SGLT2i, DPP4i, TZD, and SU treatment, respectively. The average treatment effects (i.e., the difference in CKD risk) for SGLT2i, DPP4i, and TZD compared to SU were − 0.142 (− 0.167, − 0.116), − 0.046 (− 0.059, − 0.034), and − 0.004 (− 0.023, 0.014), respectively, indicating a significant reduction in CKD risk of 14.2% and 4.6% in the SGLT2i and DPP4i groups, respectively, compared to the SU group. Furthermore, SGLT2i significantly reduced CKD risk by 13.7% (10.6%, 16.8%) and 9.5% (6.8%, 12.2%) when compared to TZD and DPP4i, respectively.ConclusionsOur study identified 14.2%, 13.7%, and 9.5% reduced CKD risk in Thai patients with type 2 diabetes who were treated with SGLT2i compared to those treated with SU, TZD, and DPP4i, respectively, in real-world clinical data. Previous evidence of a reno-protective effect of SGLT2i reported in other populations is consistent with our observations in this Southeast Asian cohort.

Assessing the ecological effectiveness of Sloping Land Conversion Programme to identify vegetation restoration types: A case study of Northern Shaanxi Loess Plateau, China

China's Sloping Land Conversion Programme (SLCP) improves the vegetation at the expense of a lot of water and aggravates the drought in arid and semi-arid regions. Identifying vegetation restoration types based on their ecological effectiveness is important for alleviating the conflicting demands for water between the ecosystem and humans. This study used the treatment effect model to estimate the marginal contribution of SLCP towards vegetation restoration in the Northern Shaanxi Loess Plateau. Additionally, we built a relative advantage index (RAI) for identifying vegetation restoration types based on the assessment of SLCP's ecological effectiveness. After implementing the SLCP, land use experienced significant transitions, and the vegetation was extensively improved in the Northern Shaanxi Loess Plateau. The farmland changed into forestland and grassland extended to over 985.608 km2 and 3021.526 km2 respectively, and the average normalized differential vegetation index (NDVI) increased by 35.818 % from 2000 to 2015. The SLCP has a large positive effect on vegetation, and the marginal contribution of conversion farmland to forest (CFF) is higher than that of conversion farmland to grassland (CFG). Furthermore, the RAI can effectively distinguish vegetation restoration types in forest-grass transition zones. The suitable afforestation areas with a RAI of more than 1 account for 14.101 %, and are mainly distributed in the south of the Northern Shaanxi Plateau while others are more suitable for grass-planting. The government should improve schemes to guide farmers to choose the appropriate vegetation restoration types in different areas for gaining more ecological profits.