Search Results (1,414)

Background and aim: Advanced Therapy Medicinal Products (ATMPs) are innovative drugs based on genes, tissues, or cells that target rare and severe diseases. ATMPs have shown promising clinical outcomes but are associated with high costs, raising questions about cost-effectiveness. Hence, this systematic review aims to analyze the cost-effectiveness and cost-utility profiles of the European Medicines Agency-authorized ATMPs for treating rare diseases. Methods: A systematic review was conducted following PRISMA guidelines. Studies were identified by searching PubMed, Embase, Web of Science, and ProQuest scientific databases. Economic evaluations reporting incremental cost-effectiveness/utility ratios (ICERs/ICURs) for ATMPs were included. Costs were standardized to 2023 Euros, and a cost-effectiveness plane was constructed to evaluate the results against willingness-to-pay (WTP) thresholds of EUR 50,000, EUR 100,000, and EUR 150,000 per QALY, as part of a sensitivity analysis. Results: A total of 61 studies met the inclusion criteria. ATMPs for rare blood diseases, such as tisagenlecleucel and axicabtagene ciloleucel, were found to be cost-effective in a majority of studies, with incremental QALYs ranging from 1.5 to 10 per patient over lifetime horizon. Tisagenlecleucel demonstrated a positive cost-effectiveness profile in the treatment of acute lymphoblastic leukemia (58%), while axicabtagene ciloleucel showed a positive profile in the treatment of diffuse large B-cell lymphoma (85%). Onasemnogene abeparvovec for spinal muscular atrophy (SMA) showed uncertain cost-effectiveness results, and voretigene neparvovec for retinal diseases was not cost-effective in 40% of studies, with incremental QALYs around 1.3 and high costs exceeding the WTP threshold set. Conclusions: ATMPs in treating rare diseases show promising economic potential, but cost-effectiveness varies across indications. Policymakers must balance innovation with system sustainability, using refined models and the long-term impact on patient outcomes. Full article

We need to educate students and the public about addressing natural resource challenges to maintain civilization moving into a sustainable future. Because US mineral and energy resources are found in its continental crust and sedimentary basins, introductory geology students need to be well-informed about US crust and basins. We think that creating effective videos about these topics is the best way to engage students to want to learn more. In preparation for making these videos, we researched what introductory geology students are taught and what they learn about these topics. Student interviews informed us about learned curriculum, and taught curriculum was analyzed using a novel keyword-counting method applied to textbook indices. We found that geophysics is stressed twice as much as geology, radiometric dating, and sedimentary basins. We expected that students would have learned more about geophysics and less about the other topics; however, this was not the case. Students knew more about geology, and less about geophysics, radiometric dating, and sedimentary basins. To make effective videos on these topics, we need to explain the following threshold concepts: seismic refraction to scaffold student understanding of crustal geophysics, as well as radiometric dating and deep time to understand crustal geology and the economic importance of sedimentary basins. Full article

Silvopastoral systems, though ecologically beneficial, remain underrepresented in the European Union’s Common Agricultural Policy and are seldom studied in Mediterranean contexts. The current study assesses both the environmental and economic aspects of five typical silvopastoral systems in central Greece, encompassing cattle, sheep, and goat farming. A Life Cycle Assessment approach was implemented to quantify greenhouse gas emissions using economic allocation, distributing impacts between milk and meat outputs. Enteric fermentation was the major emission source, accounting for up to 65.14% of total emissions in beef-based systems, while feeding and soil emissions were more prominent in mixed and small ruminant systems. Total farm-level emissions ranged from 60,609 to 273,579 kg CO₂eq per year. Economically, only beef-integrated systems achieved an average annual profitability above EUR 20,000 per farm, based on financial data averaged over the last five years (2020–2024) from selected case studies in central Greece, while the remaining systems fell below the national poverty threshold for an average household, underscoring concerns about their economic viability. The findings underline the dual challenges of economic viability and policy neglect, stressing the need for targeted support if these multifunctional systems are to add value to EU climate goals and rural sustainability. Full article

Soil salinization severely limits plant growth and productivity. Mulberry (Morus alba L.), an economically and ecologically important tree, is widely cultivated, yet its salt-tolerance mechanisms at the seedling stage remain insufficiently understood. This study investigated the physiological and biochemical responses of two-year-old mulberry (‘Tailai Sang’) seedlings subjected to six NaCl treatments (0, 50, 100, 150, 200, and 300 mmol L⁻¹) for 28 days. Results showed that growth parameters and photosynthetic gas exchange exhibited dose-dependent declines. The reduction in net photosynthetic rate (Pn) was attributed to both stomatal limitations (decreased stomatal conductance) and non-stomatal limitations, as evidenced by a significant decrease in the maximum quantum efficiency of photosystem II (Fv/Fm) under high salinity. To cope with osmotic stress, seedlings accumulated compatible solutes, including soluble sugars, proteins, and proline. Critically, mulberry seedlings demonstrated effective ion homeostasis by sequestering Na⁺ in the roots to maintain a high K⁺/Na⁺ ratio in leaves, a mechanism that was compromised above 150 mmol L⁻¹. Concurrently, indicators of oxidative stress—malondialdehyde (MDA) and H₂O₂—rose significantly with salinity, inducing the activities of antioxidant enzymes (SOD, CAT, APX, and GR), which peaked at 150 mmol L⁻¹ before declining under extreme stress. A biomass-based LC₅₀ of 179 mmol L⁻¹ NaCl was determined. These findings elucidate that mulberry salt tolerance is a coordinated process involving three key mechanisms: osmotic adjustment, selective ion distribution, and a robust antioxidant defense system. This study establishes an indicative tolerance threshold under controlled conditions and provides a physiological basis for further field-based evaluations of ‘Tailai Sang’ mulberry for cultivation on saline soils. Full article

China’s economy is shifting from an era of rapid expansion to one focused on high-quality development, making it imperative to tackle environmental degradation linked to energy use. Understanding how New Quality Productive Forces (NQPF) interact with energy efficiency, along with the mechanisms driving this relationship, is essential for economic transformation and long-term sustainability. This study establishes an evaluation framework for NQPF, integrating technological, green, and digital dimensions. We apply fixed-effects models, the spatial Durbin model (SDM), a moderation model, and a threshold model to analyze the influence of NQPF on Green Total Factor Energy Efficiency (GTFEE) and its spatial implications. This underscores the necessity of distinguishing it from traditional productivity frameworks and adopting a new analytical perspective. Furthermore, by considering dimensions such as input, application, innovation capability, and market efficiency, we reveal the moderating role and heterogeneous effects of artificial intelligence (AI). The findings are as follows: The development of NQPF significantly enhances GTFEE, and the conclusion remains robust after tail reduction and endogeneity tests. NQPF has a positive spatial spillover effect on GTFEE; that is, while improving the local GTFEE, it also improves neighboring regions GTFEE. The advancement of AI significantly strengthens the positive impact of NQPF on GTFEE. AI exhibits a significant U-shaped threshold effect: as AI levels increase, its moderating effect transitions from suppression to facilitation, with marginal benefits gradually increasing over time. Full article

Achieving the construction sector’s dual carbon objectives necessitates scaling green energy adoption in new residential buildings. The current literature critically overlooks four unresolved problems: oversimplified penalty mechanisms, ignoring escalating regulatory costs; static subsidies misaligned with market maturity evolution; systematic exclusion of innovation feedback from energy suppliers; and underexplored behavioral evolution of building owners. This study establishes a government–suppliers–owners evolutionary game framework with dynamically calibrated policies, simulated using MATLAB multi-scenario analysis. Novel findings demonstrate: (1) A dual-threshold penalty effect where excessive fines diminish policy returns due to regulatory costs, requiring dynamic calibration distinct from fixed-penalty approaches; (2) Market-maturity-phased subsidies increasing owner adoption probability by 30% through staged progression; (3) Energy suppliers’ cost-reducing innovations as pivotal feedback drivers resolving coordination failures, overlooked in prior tripartite models; (4) Owners’ adoption motivation shifts from short-term economic incentives to environmentally driven decisions under policy guidance. The framework resolves these gaps through integrated dynamic mechanisms, providing policymakers with evidence-based regulatory thresholds, energy suppliers with cost-reduction targets, and academia with replicable modeling tools. Full article

Beech forests in the Italian peninsula are actively managed and they also support a high level of biodiversity. Hence, biodiversity conservation can be synergistic with timber production and carbon sequestration, enhancing the overall economic benefits of forest management. This study aimed to evaluate the effect of forest management regimes on bird communities in the Italian Peninsula during 2022 through audio recordings. We studied the structure, composition, and specialization of the breeding bird community in four managed beech stands (three even-aged beech stands aged 20, 60, and 100 years old, managed by a uniform shelterwood system; one uneven-aged stand, managed by a single-tree selection system) and one uneven-aged, unmanaged beech stand in the northern Apennines (Tuscany region, Italy). Between April and June 2022, data were collected through four 1-hour audio recording sessions per site, analyzing 5 min sequences. The unmanaged stand hosted a richer (a higher number of species, p < 0.001) and more specialized (a higher number of cavity-nesting species, p < 0.001; higher Woodland Bird Community Index (WBCI) values, p < 0.001; and eight characteristic species, including at least four highly specialized ones) bird community, compared to all the managed forests; moreover, the latter were homogeneous (similar to each other). Our study suggests that the unmanaged beech forests should be a priority option for conservation, while in terms of the managed beech forests, greater attention should be paid to defining the thresholds for snags, deadwood, and large trees to be retained to enhance their biodiversity value. Studies in additional sites, conducted over more years and including multi-taxon communities, are recommended for a deeper understanding and generalizable results. Full article

Landslides are among the most hazardous natural phenomena affecting Greater Abidjan, causing significant economic and social damage. Strategic planning supported by geographic information systems (GIS) can help mitigate potential losses and enhance disaster resilience. This study evaluates landslide susceptibility using logistic regression and frequency ratio models. The analysis is based on a dataset comprising 54 mapped landslide scarps collected from June 2015 to July 2023, along with 16 thematic predictor variables, including altitude, slope, aspect, profile curvature, plan curvature, drainage area, distance to the drainage network, normalized difference vegetation index (NDVI), and an urban-related layer. A high-resolution (5-m) digital elevation model (DEM), derived from multiple data sources, supports the spatial analysis. The landslide inventory was randomly divided into two subsets: 80% for model calibration and 20% for validation. After optimization and statistical testing, the selected thematic layers were integrated to produce a susceptibility map. The results indicate that 6.3% (0.7 km²) of the study area is classified as very highly susceptible. The proportion of the sample (61.2%) in this class had a frequency ratio estimated to be 20.2. Among the predictive indicators, altitude, slope, SE, S, NW, and NDVI were found to have a positive impact on landslide occurrence. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), demonstrating strong predictive capability. These findings can support informed land-use planning and risk reduction strategies in urban areas. Furthermore, the prediction model should be communicated to and understood by local authorities to facilitate disaster management. The cost function was adopted as a novel approach to delineate hazardous zones. Considering the landslide inventory period, the increasing hazard due to climate change, and the intensification of human activities, a reasoned choice of sample size was made. This informed decision enabled the production of an updated prediction map. Optimal thresholds were then derived to classify areas into high- and low-susceptibility categories. The prediction map will be useful to planners in helping them make decisions and implement protective measures. Full article

Improving the green innovation quality (GIQ) of center cities is crucial to achieve sustainable urban agglomeration development. Utilizing data on green patent citations and economic indicators across cities in the Yangtze River Delta urban agglomeration (YRD) from 2003 to 2022, this research examines the influence of center cities’ GIQ on the economic performance of peripheral municipalities. The results show the following: (1) Center cities’ GIQ exerts a significant suppressive effect on peripheral cities’ economic growth overall. Heterogeneity analysis uncovers a distance-dependent duality. GIQ stimulates growth in proximate cities (within 300 km) but suppresses it beyond this threshold. This spatial siphoning effect is notably amplified in national-level center cities. (2) Mechanisms suggest that GIQ accelerates the outflow of skilled labor in peripheral cities through factor agglomeration and industry transfer mechanisms. Concurrently, it impedes the gradient diffusion of urban services, collectively hindering peripheral development. (3) Increased government green attention (GGA) and industry–university–research cooperation (IURC) in centers can mitigate these negative impacts. This paper contributes to the theoretical discourse on center cities’ spatial externalities within agglomerations and offers empirical support and policy insights for the exertion of spillover effects of high-quality green innovation from center cities and the sustainable development of urban agglomeration. Full article

Radio Frequency Identification (RFID) technology is widely applied in various scenarios, including logistics tracking, supply chain management, and target monitoring. In these contexts, the malicious cloning of legitimate tag information can lead to sensitive data leakage and disrupt the normal acquisition of tag information by readers, thereby threatening personal privacy and corporate security and incurring significant economic losses. Although some efforts have been made to detect cloning attacks, the presence of missing tags in RFID systems can obscure cloned ones, resulting in a significant reduction in identification efficiency and accuracy. To address these problems, we propose the block-based cloned tag identification (BCTI) protocol for identifying cloning attacks in the presence of missing tags. First, we introduce a block indicator to sort all tags systematically and design a block mechanism that enables tags to respond repeatedly within a block with minimal time overhead. Then, we design a superposition strategy to further reduce the number of verification times, thereby decreasing the execution overhead. Through an in-depth analysis of potential tag response patterns, we develop a precise method to identify cloning attacks and mitigate interference from missing tags in probabilistic cloning attack scenarios. Moreover, we perform parameter optimization of the BCTI protocol and validate its performance across diverse operational scenarios. Extensive simulation results demonstrate that the BCTI protocol meets the required identification reliability threshold and achieves an average improvement of $24.01\%$ in identification efficiency compared to state-of-the-art solutions. Full article

In the wake of the continuous development of the international strategic petroleum reserve system, the tonnage and quantity of oil tankers have been increasing. This trend has driven the expansion of offshore oil exploration and transportation, resulting in frequent incidents of ship oil spills. Catastrophic impacts have been exerted on the marine environment by these accidents, posing a serious threat to economic development and ecological security. Therefore, there is an urgent need for efficient and reliable methods to detect oil spills in a timely manner and minimize potential losses as much as possible. In response to this challenge, a marine radar oil film segmentation method based on feature fusion and the artificial bee colony (ABC) algorithm is proposed in this study. Initially, the raw experimental data are preprocessed to obtain denoised radar images. Subsequently, grayscale adjustment and local contrast enhancement operations are carried out on the denoised images. Next, the gray level co-occurrence matrix (GLCM) features and Tamura features are extracted from the locally contrast-enhanced images. Then, the generalized least squares (GLS) method is employed to fuse the extracted texture features, yielding a new feature fusion map. Afterwards, the optimal processing threshold is determined to obtain effective wave regions by using the bimodal graph direct method. Finally, the ABC algorithm is utilized to segment the oil films. This method can provide data support for oil spill detection in marine radar images. Full article

Background/Objectives: Laboratory tests conducted in community settings are occasionally repeated within hours of presentation to pediatric emergency departments (PEDs). Reducing unnecessary repetitions can ease child discomfort and alleviate the healthcare burden without compromising the diagnostic process or quality of care. The aim of this study was to develop a decision tree (DT) model to guide physicians in minimizing unnecessary repeat blood tests in PEDs. The minimal decision tree (MDT) algorithm was selected for its interpretability and capacity to generate optimally pruned classification trees. Methods: Children aged 3 months to 18 years with community-based complete blood count (CBC), electrolyte (ELE), and C-reactive protein (CRP) measurements obtained between 2016 and 2023 were included. Repeat tests performed in the pediatric emergency department within 12 h were evaluated by comparing paired measurements, with tests considered justified when values transitioned from normal to abnormal ranges or changed by ≥20%. Additionally, sensitivity analyses were conducted for absolute change thresholds of 10% and 30% and for repeat intervals of 6, 18, and 24 h. Results: Among 7813 children visits in this study, 6044, 1941, and 2771 underwent repeated CBC, ELE, and CRP tests, respectively. The mean ages of patients undergoing CRP, ELE, and CBC testing were 6.33 ± 5.38, 7.91 ± 5.71, and 5.08 ± 5.28 years, respectively. The majority were of middle socio-economic class, with 66.61–71.24% living in urban areas. Pain was the predominant presented complaint (83.69–85.99%), and in most cases (83.69–85.99%), the examination was conducted by a pediatrician. The DT model was developed and evaluated on training and validation cohorts, and it demonstrated high accuracy in predicting the need for repeat CBC and ELE tests but not CRP. Performance of the DT model significantly exceeded that of the logistic regression model. Conclusions: The data-driven guide derived from the DT model provides clinicians with a practical, interpretable tool to minimize unnecessary repeat laboratory testing, thereby enhancing patient care and optimizing healthcare resource utilization. Full article

Polymer flooding is a widely used enhanced oil recovery (EOR) method for improving energy efficiency and reducing the carbon footprint of oil production. Optimizing polymer concentration is critical for maximizing recovery while minimizing economic and environmental costs. Here, we present a systematic experimental study which shows that even very low concentrations of polymers yield relatively high recovery rates at adverse mobility ratios (230 cP oil). A series of core flood experiments were conducted on Bentheimer sandstone rock, with polymer concentrations ranging from 40 ppm (1.35 cP) to 600 ppm (10.0 cP). Beyond a mobility ratio threshold, increasing polymer concentration did not significantly enhance recovery. This plateau in performance was attributed to the persistence of viscous fingering and oil crossflow into pre-established water channels. The study suggests that low concentrations of polymer may mobilize oil at high mobility ratios by making use of the pre-established water channels as transport paths for the oil and that the rheology of the polymer enhances this effect. These findings enable reductions in the polymer concentration in fields with adverse mobility ratios, leading to substantial reductions in chemical usage, energy consumption, and environmental impact of the extraction process. Full article

This study focuses on the impact of China’s digital economy on sustainable modernization from 2011 to 2021, using provincial panel data for empirical analysis. By applying threshold and mediation models, we find that the digital economy promotes modernization through industrial upgrading (with a mediating effect of 38%) and trade openness (coefficient = 0.234). The research reveals “U-shaped” nonlinear threshold effects at specific levels of digital development (2.218), market efficiency (9.212), and technological progress (12.224). Eastern provinces benefit significantly (coefficient ranging from 0.12 to 0.15 ***), while western regions initially experience some inhibition (coefficient = −0.08 *). Industrial digitalization (coefficient = 0.13 ***) and innovation ecosystems (coefficient = 0.09 ***) play crucial roles in driving eco-efficiency and equity, in line with Sustainable Development Goals 9 and 13. Meanwhile, the impacts of infrastructure (coefficient = 0.07) and industrialization (coefficient = 0.085) are delayed. Economic modernization improves (coefficient = 0.37 ***), yet social modernization declines (coefficient = −0.12 *). This study not only enriches economic theory but also extends the environmental Kuznets curve to the digital economy domain. We propose tiered policy recommendations, including the construction of green digital infrastructure, carbon pricing, and rural digital transformation, which are applicable to China and offer valuable references for emerging economies aiming to achieve inclusive low-carbon growth in the digital era. Future research could further explore the differentiated mechanisms of various digital technologies in the modernization process across different regions and how to optimize policy combinations to better balance digital innovation with sustainable development goals. Full article

This study investigates the impact and mechanisms of digital inclusive finance (DIF) on high-quality economic development in China. Drawing on panel data from 281 prefecture-level cities between 2011 and 2021, we employ a Spatial Durbin Model (SDM) to analyze both the direct effects and spatial spillovers of DIF. The results indicate that (1) DIF has a significantly positive effect on high-quality development, which remains robust after conducting various stability and endogeneity tests; (2) DIF strongly contributes to economic upgrading in eastern regions, while its impact is weaker or even negative in central and western regions, revealing notable regional disparities exist; (3) a key finding is the identification of a double-threshold effect, suggesting that the positive influence of DIF only emerges when financial and industrial development surpass certain thresholds; (4) results from the two-regime SDM further show that spillover effects are more prominent in non-central cities than in central ones; and (5) mechanism analysis reveals that DIF facilitates high-quality growth primarily by promoting industrial structure upgrading. These findings underscore the importance of region-specific policy strategies to enhance the role of DIF and reduce spatial disparities in development across China. Full article