Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.

Economic Viability of Smallholder Agroforestry and Beekeeping Projects in Uluguru Mountains, Tanzania: A Cost Benefit Analysis

Agroforestry and beekeeping are widely promoted as prospective Nature- Based Income Generating Activities (NIGAs) to improve livelihoods while at the same time enhancing biodiversity conservation in degrading agro-ecologies. These activities can diversify and increase famers’ incomes and support instinctive biota and fauna resilience. However, evidence to showcase and compare their long-term benefits is scant. We use the case of Uluguru Mountains in Tanzania to evaluate and compare viability of agroforestry and beekeeping projects using the Cost Benefit Analysis (CBA) approach. The results of analysis yielded positive NPVs for both agroforestry and beekeeping projects at discount rates not higher than 8.2% and 8.5% respectively. Overall, the comparison of economic viability between agroforestry and beekeeping projects revealed that the former was relatively more profitable than the later in terms of both the NPV and Benefit Cost Ratio (BCR) criteria. However, the Internal Rate of Return (IRR) for beekeeping was slightly higher than that of agroforestry. Yet, we underscore the fact that these two projects can jointly be implemented to enhance livelihoods of farmers and support biodiversity conservation in the study area and other parts with similar agro-ecologies in developing countries. However, farmers in these agro-ecologies need to be supported by governments and non-government development partners in terms of training and inspiration to shift from orthodox farming to sustainable NIGAs.

Cost benefit analysis of the use of tranexamic acid in primary lower limb arthroplasty: A retrospective cohort study

AIM: To examine the cost benefit conferred by the perioperative administration of intravenous tranexamic acid(TXA) in lower limb arthroplasty.METHODS: This study evaluates the use of TXA in 200 consecutive lower limb arthroplasties performed in a single surgeon series. The initial 100 patients(control group) underwent surgery without perioperative administration of TXA while the subsequent 100 patients(TXA group) all received 1 g TXA at the time of induction of anaesthesia. Pre- and post-operative haemoglobin, platelet count, haematocrit, the use of blood product post-operatively, length of stay were examined. A financial analysis of both groups was then undertaken. RESULTS: The mean age of patients in both groups was 63 ± 13 years. There were no significant differences between groups in terms of gender(P = 0.47), proportion of total hip replacement to total knee replacement(P = 0.25) or pre-operative haemoglobin(P = 0.43). In the control group, the transfusion rate was 22%. In the TXA group, the transfusion rate dropped to 2%(P < 0.001). The mean post-operative haemoglobin was 10.82 ± 1.55g/dL in the control group vs 11.33 ± 1.27 g/dL in the TXA group(P = 0.01). The total cost of transfused blood products was €11055 and €603 respectively. The mean length of stay in the control group was 6.53 ± 5.93 d vs 5.47 ± 4.26 d in the TXA group(P = 0.15) leading to an estimated financial saving of €114586. There was one pulmonary embolus in the control group and one deep venous thrombosis in the TXA group.CONCLUSION: Intravenous TXA reduces blood loss in lower limb arthroplasty. This leads to lower transfusion rates, shorter length of stay in hospital and significant financial savings.

Cost-benefit analysis of screening for diabetic retinopathy among Chinese type 2 diabetes: decision from different perspectives of a population-based study

The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.

Implementing an Information System Strategy: A Cost, Benefit, and Risk Analysis Framework for Evaluating Viable IT Alternatives in the US Federal Government

In the US Federal government, an analysis of alternatives (AoA) is required for a significant investment of resources. The AoA yields the recommended alternative from a set of viable alternatives for the investment decision. This paper presents an integrated AoA and project management framework for analyzing new or emerging alternatives (e.g., Cloud computing), as may be driven by an information system strategy that incorporates a methodology for analyzing the costs, benefits, and risks of each viable alternative. The case study in this paper, about a business improvement project to provide public health and safety services to citizens in a US Federal agency, is a practical application of this integrated framework and reveals the benefits of this integrated approach for an investment decision. The decision making process in the framework—as an integrated, organized, and adaptable set of management and control practices—offers a defensible recommendation and provides accountability to stakeholders.

Cost-benefit Analysis of Chestnut Production in Xingtai County

On the basis of market demand survey of chestnut,this article carries out cost-benefit analysis of the chestnut production in Xingtai County,to understand the profitability and payback period of local chestnut production.It points out that chestnut production has a high rate of return on investment,and chestnut can be promoted on a large scale in Xingtai County.However,there are still some problems in the production and marketing of chestnut in Xingtai County,such as low level of technology,extensive management,low level of organization,market imperfections and weak brand consciousness.Based on these problems,corresponding recommendations are put forth.

Empirical Analysis of the Typical Breeding Pattern of Clam in Hongdao Town and the Preliminary Estimates of Costs and Benefits

Based on the survey data about clam breeding farmers in Hongdao Town in August 2011,this paper analyzes the production and operation of typical clam breeding pattern,and estimates the costs and benefits. Through the analysis of operation conditions and economic conditions of Hongdao clam breeding,this paper aims to explore a more reasonable and effective breeding pattern so as to reduce breeding costs and market risks,and increase breeding farmers' income.

Comparative Cost Benefit Analysis of Different Solid Waste Management Scenarios in Basrah, Iraq

Solid Waste Management (SWM) system in Basrah has deteriorated recently to the point that only limited waste collection is undertaken in certain urban areas and disposal is largely to uncontrolled dump sites. In this study, the technical, economical, and environmental aspects of three SWM scenarios were investigated aiming to compare the scenarios and select the most appropriate one for implementation. Scenario 1 was to consider waste disposal into a sanitary landfill. Scenario 2 added waste transportation to transfer station before disposal to a sanitary landfill. Scenario 3 considered waste sorting, recycling and composting followed by landfill disposal in an integrated treatment disposal facility. The current open dumping practice was considered as the baseline scenario. According to economic analysis, the benefits from the revenues of selling the produced recyclables and compost did not improve the ranking of scenario 3. However, scenario 3 has gained positive recognition due to the environmental benefits of waste recycling. Therefore, final recommendations were in favour of scenario 3, which has been approved by the UNICEF, as well. Currently the recommended scenario is under implementation in Basrah, Iraq.

Study on Cost of Environmental Degradation Based on Cost-Benefit Analysis

With the rapid economic development of China,the environmental degradation brought by economic development cannot be ignored.In order to measure the cost of environmental degradation brought by land projects in the process of economic development and evaluate a land project,this paper establishes an ecological service evaluation model based on cost-benefit method to analyze the cost and benefit of land development projects from a new perspective,and explore effective strategies to alleviate environmental degradation.

Social Profitability Threshold of High Speed Railway:A Benefit-Cost Analysis

In this study, the benefit-cost analysis technique for projects evaluation is applied to determine the minimum level of demand that makes a high-speed rail project economically viable in Spain. To get this goal, it is nec- essary to take into account not only the costs and benefits of the high speed railway but also the analysis of the costs and benefits linked to other alternative transport modes, such as plane, private car or bus. The re- sults show that the high-speed rail studied is socially profitable from a traffic volume of 6.5 million passen- gers and for a social discount rate of 4%. Given the benefits associated with network effects, which magni- tude grows parallel to the extension of the high-speed network, this threshold could be significantly reduced in subsequent projects.

Evaluating and Improving the Effectiveness of Vehicle Inspection and Maintenance Programs: A Cost-Benefit Analysis Framework

Motor vehicle inspection and maintenance (I/M) programs are designed to identify high-emitting vehicles and mitigate their impacts on air quality and climate. I/M programs have been traditionally ranked superior among various vehicle emission control measures by the results of cost-benefit analysis, based on the assumption that these programs will achieve the targeted emission reduction outcomes. However, the actual effects of I/M programs may be greatly uncertain and when this uncertainty is taken into account, these programs may become suboptimal. This study develops a new a cost-benefit analysis framework that links various program design consideration, such as program participation rate, identification rate and effective repair rate, to the public health benefits as well as costs of the programs. This framework helps decision makers to investigate minimum implementation requirements that at least ensure the benefits are greater than the costs of implementing the programs in order to improve the overall effectiveness of the I/M programs. To illustrate the applications of the framework, it was applied to a particulate matter oriented I/M program targeting all diesel-fueled vehicles in the city of Bangkok, Thailand, a large metropolitan area that has been suffering from severe ambient PM pollution mainly attributable to its wide use of diesel-fueled vehicles and motorcycles. It was found that the health benefits achieved from the program are sensitive to several key program design elements, including participation rate and problem vehicle identification rate, fraction of effective repairs and illegal operation rate. Other variables, such as the testing cut-points and vehicle population growth rate, only have modest effects on the overall emission reduction and consequent health benefits. Overall, the performance of multiple variables associated with I/M program design needs to be improved simultaneous in order to achieve the targeted benefits of the program.

Cost-benefit Analysis of Scale Pig Breeding in Shandong Province Based on Modified Entropy Weight-TOPSIS Model

According to the relevant statistical data in National Agricultural cost-benefit Data Compilation(2001- 2013),we use the modified entropy weight- TOPSIS model to research the cost-benefit status of scale pig breeding in Shandong Province from the perspective of comparing it with that of the entire country and 9 other main pig producing areas. The results show that compared with the national average,the cost-benefit ratio of small scale pig breeding in Shandong Province is lower,while the cost-benefit ratio of medium scale and large scale pig breeding is significantly improved; the cost-benefit ratio of small scale pig breeding in Shandong Province is basically the same as that in 9 other main pig producing areas,while the cost-benefit ratio of medium scale and large scale pig breeding is higher; the output value of main products and the purchase price of piglet are two major bottlenecks restricting the cost-benefit improvement of scale pig breeding in Shandong Province.

Component Analysis and Calculation for Social Benefits of UHV Assessment

With the rapid development of the UHV power grid, evaluation of the economic and social benefits of the UHV power grid is conducive to guiding the planning and construction of UHV power grid. At present economic benefit evaluation system of the UHV power grid is driving to maturity stage on the whole at home and abroad, but it invariably tends to regard social benefits as part of economic benefits, without evaluating social benefit separately. The social benefit evaluation model of UHV power grid is built in case of sufficient investigation. The differentials between social benefit and social cost are calculated respectively by three kinds of solutions according to the constructed social cost evaluation index system and social benefits evaluation index system, conclusion that UHV power grid transmission has better social benefits can be reached by contrastively analyzing the social three kinds of solutions corresponding to benefits. At last, the evaluation model and method are verified and analyzed through the analysis of engineering projects.

Early infant male circumcision:Systematic review,risk-benefit analysis,and progress in policy

AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword "circumcision" together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and "ballooning" during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits.

Benefit analysis of curb parking and study on its optimization model

Curb parking lot is a major part of city parking facility with lots of problems, especially in CCA (citycenter area and it has a lot of advantages and has much effect on dynamic traffic as well. It is therefore necessaryto control the scale of curb parking. Basing the whole benefits of the traffic system and considering the minimumsynthetical cost on curb parking, a optimization model is brought forward of cur. b parking planning in CCAbased on minimum generalized cost. Based on this model, the scale of curb parking can be defined reasonablyto make the whole benefits of traffic system optimum in CCA.

Cyberattack Ramifications, The Hidden Cost of a Security Breach

In this in-depth exploration, I delve into the complex implications and costs of cybersecurity breaches. Venturing beyond just the immediate repercussions, the research unearths both the overt and concealed long-term consequences that businesses encounter. This study integrates findings from various research, including quantitative reports, drawing upon real-world incidents faced by both small and large enterprises. This investigation emphasizes the profound intangible costs, such as trade name devaluation and potential damage to brand reputation, which can persist long after the breach. By collating insights from industry experts and a myriad of research, the study provides a comprehensive perspective on the profound, multi-dimensional impacts of cybersecurity incidents. The overarching aim is to underscore the often-underestimated scope and depth of these breaches, emphasizing the entire timeline post-incident and the urgent need for fortified preventative and reactive measures in the digital domain.

Transradial Versus Transfemoral Approach for Percutaneous Coronary Intervention in Elderly Patients in China： A Retrospective Analysis

在老病人比较在 transradial 干预( TRI )和 transfemoral 干预( TFI )之间的医院费用和临床的结果的目的在我们识别了的 65 years.Methods 上使在 Fuwai 医院里经历了经皮的冠的干预(一种总线标准)的在 65 年变老的 1229 个病人变老，中国北京，在1月1日和2010年12月31日之间。全部的医院费用和在里面医院结果在 TRI 和 TFI 之间被比较。一个反的概率 weighting (IPW ) 模型被介绍控制经历了 TRI 的潜在的 biases.Results 病人更年轻，不太经常女性、更可能为单个容器的损害收到一种总线标准、不太可能为 ostial 损害经历过程。TRI 与一 CNY7495 节省花费被联系(95%CI：CNY4419-10 420 ) 。如此的差别被更低的一种总线标准相关的费用主要驾驶。TRI 病人有停留的更短的长度(1.9 天， 95%CI：1.1-2.7 天) ，更短的 procedural 以后停留(0.7 天， 95%CI：0.3-1.1 天) ，并且更少主要不利心脏的事件(调整机会比率 = 0.47， 95%CI：0.31-0.73 ) 。在在 TRI 和 TFI 之间的一种总线标准以后的流血的发生没有统计意义(P > 0.05 ) 。在在病人的 TRI 的使用在 65 年变老的尖锐心肌的梗塞，急性冠的症候群，和稳定的 angina.Conclusion 的临床上相关的亚群一致的仍然是的如此的差别与显著地减少的医院费用和更多的有利临床的结果被联系。

An Integrated Approach to Evaluate Benefits and Costs of Wastewater and Solid Waste Management to Improve the Living Environment: The Citarum River in West Java, Indonesia

Absence of wastewater and solid waste facilities impacts the quality of life of many people in developing countries. Implementation of these facilities will benefit public health, water quality, livelihoods and property value. Additional benefits may result from the potential recovery of valuable resources from wastewater and solid waste, such as compost, energy, phosphorus, plastics and paper. Improving water quality through implementation of wastewater and solid waste interventions requires, among others, an analysis of i) sources of pollution, ii) mitigating measures and resource recovery potentials and their effect on water quality and health, and iii) benefits and costs of interventions. We present an integrated approach to evaluate costs and benefits of domestic and industrial wastewater and solid waste interventions. To support a policy maker in formulating a cost and environmentally effective approach, we quantified the impact of these interventions on 1) water quality improvement, 2) resource recovery potential, and 3) monetized benefits versus costs. The integration of technical, hydrological, agronomical and socio-economic elements to derive these three tangible outputs in a joint approach is a novelty. The approach is demonstrated using the heavily polluted Indonesian Upper Citarum River in the Bandung region. Domestic interventions, applying simple (anaerobic filter) technologies, were economically most attractive with a benefit cost ratio (BCR) of 3.2, but could not reach target water quality standards. To approach the target water quality, both advanced domestic (nutrient removal systems) and industrial wastewater treatment interventions were required, leading to a BCR of 2. We showed that benefits from selling recovered resources represent here an additional driver for improving water quality and outweigh the additional costs for resource recovery facilities. While included benefits captured some of the major items, these may have been undervalued. Based on these findings, water quality interventions justify their costs and are socially and economically beneficial.