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With the yearly increasing market penetration of new-energy vehicles in China, the retirement of power batteries has gradually become a scale, and most of the waste batteries have entered informal recycling channels, which has induced a series of environmental problems. Considering this issue, we introduced the system dynamics (SD), stimulus organism response (SOR), and the theory of planned behavior (TPB) in behavioral economics to establish the environmental economic benefit evaluation model of power battery recycling strategies, and we performed a dynamic simulation analysis on the effect of government subsidy policy, policy advocacy, and other recycling strategies. The results show that: (1) the recovery subsidy policy can improve the formal recycling quantity and economic benefits of recovery, but the effect on the degree of environmental pollution is limited. (2) The combination of environmental awareness promotion strategy and subsidy policy can overcome the shortcomings of subsidy policy and has significant environmental and economic performance. (3) Compared with the benchmark scenario, the formal recycling quantity, the CO2 emission reduction, and the economic benefits of recovery in scenario 4 (high subsidy-high policy propaganda strategy) increased by approximately 112 %, 208 %, and 223 %, respectively, and the degree of environmental pollution decreased by approximately 65 %.

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Long-term excessive use of fertilizers and intensive cultivation not only decreases soil organic carbon (SOC) and productivity, but also increases greenhouse gas emissions, which is detrimental to sustainable agricultural development. The purpose of this paper is to identify organic amendments suitable for winter wheat growth in the North China Plain by studying the effects of organic amendments on the economic benefits, carbon emissions, and carbon sequestration for winter wheat fields and to provide a theoretical basis for the wide application of organic amendments in agricultural fields. The two nitrogen rates were N0 (0 kg ha-1) and N240 (240 kg ha-1), and the four organic amendments were straw, manure, mushroom residue (M R), and biochar. The results showed that, compared to N0, N240 significantly increased the yield by 244.1-318.4% and the organic carbon storage by 16.7-30.5%, respectively, but increased the carbon emissions by 29.3-45.5%. In addition, soil carbon stocks increased with all three types of organic amendments compared to the straw amendment, with the biochar treatment being the largest, increasing carbon storage by 13.3-33.6%. In terms of yield and economic benefits, compared to the straw amendment, the manure and biochar amendments increased winter wheat yields by 0.0-1.5% and 4.0-13.3%, respectively, and M R slightly decreased wheat yield; only the economic benefit of the M R amendment was greater than that of the straw amendment, with an increase in economic benefit of 1.3% and 8.2% in the 2021-2022 and 2022-2023 seasons, respectively. Furthermore, according to the net ecosystem productivity (NEP), N0 was the source of CO2, while N240 was a sink of CO2. The TOPSIS results showed that N240 with a mushroom residue amendment could be recommended for increasing soil carbon stocks and economic benefits for winter wheat in the NCP and similar regions. Low-cost M R can increase farmer motivation and improve soil organic carbon, making a big step forward in the spread of organic materials on farmland.

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China is facing severe atmospheric nitrogen (N) deposition. Assessing the economic benefits and damage costs induced by N deposition can help to develop effective mitigation strategies for N emissions. A net economic benefit method was used to assess the economic impact of N deposition in cropland ecosystems in China in 2020. The results showed that atmospheric N deposition gained an economic benefit of $4896.0 million through increased yields of major grain crops and a climate benefit of $1259.3 million through cooling effects. On the other hand, N deposition induced economic losses of $6257.1 and $1063.4 million, respectively to human health and ecosystem health; excessive N deposition induced damages of $137.8 million due to reduced crop yields and $168.4 million due to the increased greenhouse gas emissions. In general, the net economic benefit was -$1471.5 million (-$5324.7 âˆ¼ $921.4 million), indicating that China is suffering economic losses due to N deposition in cropland ecosystems. These results would provide scientific data for the government to enact efficient measures to reduce N pollution.

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In-depth analysis of the factors affecting the transformation of resource-based cities can provide effective support for the transformation and development of resource-dependent regions. How to comprehensively identify the factors affecting the transformation of resource-based cities is a complex problem. This study starts from the total factor productivity model and focuses on the two core basic factors that affect the transformation process of cities reliant on resources. Economic benefits and energy efficiency, respectively, from the economic benefit analysis framework and energy efficiency analysis framework for reconstruction, the two frameworks are combined with the use of distorted prices of resource elements to solve the problem that the synergistic effect of economic benefits and energy efficiency can not be measured. In order to quantitatively analyze the factors that affect the development efficiency of cities reliant on resources under the single or synergistic effect of the comprehensive framework, this study optimizes the directional distance function from three perspectives: exogenous weight, direction vector endogeneity, and absolute distance transformation relative distance, thus achieving an accurate assessment transformation efficiency of cities reliant on resources. Considering the impact of the new coronavirus epidemic, this study only selected the data of resource-based cities from 2003 to 2018, and found through model calculation that the impact on the transformation of cities reliant on resources: (1) Labor mismatch is mainly achieved by affecting the structure about the production of resource-based enterprises and industrial human resources; (2) Capital mismatch is mainly realized by affecting the production of resource-based enterprises; (3) Energy mismatch is mainly achieved by affecting high energy consumption enterprises and low production technology level enterprises. Further research shows that the main objects of these factors are the four parts of production technology level, energy consumption, total factor productivity and industrial structure. Through these contents, they affect environmental efficiency and deeply affect the transformation process of resource-based cities.

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Researchers are now focusing on using the circular economy model to manufacture nanocellulose composites due to growing environmental issues related to waste management. The circular economy model offers a sustainable solution to the problem by optimizing resource efficiency and waste management by reducing waste, maintaining value over time, minimizing the use of primary resources, and creating closed loops for goods, components, and materials. With the use of the circular economy model, waste, such as industrial, agricultural, and textile waste, is used again to produce new products, which can solve waste management issues and improve resource efficiency. In order to encourage the use of circular economy ideas with a specific focus on nanocellulose composites, this review examines the concept of using circular economy, and explores ways to make nanocellulose composites from different types of waste, such as industrial, agricultural, and textile waste. Furthermore, this review investigates the application of nanocellulose composites across multiple industries. In addition, this review provides researchers useful insights of how circular economics can be applied to the development of nanocellulose composites, which have the goal of creating a flexible and environmentally friendly material that can address waste management issues and optimize resource efficiency.

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Rice production is a primary contributor to global greenhouse gas emissions, with unclear pathways towards carbon neutrality. Here, through a comprehensive assessment of direct greenhouse gas (GHG) emission using DNDC model and indirect GHG emission using emission factor methods, we estimated the annual crop yield, GHG emission amount and intensity, and economic benefits of different cropping patterns in the climate-sensitive regions of rice production in China. Through the expansion of single-rice and cropping pattern change from the wheat-rice to wheat-rice-rice in the climate-sensitive regions of single and triple-cropping cultivations, the total grain yield increased by 4.4 % and 4.5 % compared with the current national grain production, the GHG emission would increase by 2.4 % and 5.4 % of the current national GHG emissions from rice and wheat production, the net economic benefits could increase 0.9 % and decrease 2.0 % of the national output value of rice and wheat production. The study takes the entire-life cycle of crop growth as the principal line, and could provide a valuable reference for the regulation of the cropping pattern and the formulation of carbon reduction policies in the climate-sensitive region.

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The expansion of Internet access from urban to rural and coastal areas has changed all aspects of life, including lifestyles and work practices. Although several studies have shown that Internet use is essential in the fisheries sector, more information about the link between Internet usage and subjective well-being among small-scale fishermen is needed. This study is the first attempt to investigate the effect of Internet use on subjective well-being, particularly for small-scale fishers. This study used cross-sectional data from 220 respondents in East Java, Indonesia. Two-stage predictor substitution (2SPS) approaches were used to address the endogeneity issue in the estimation. The results revealed that fishing tools, access to credit, and region positively and significantly influenced small-scale fishers' determination to use the Internet. Savings and off-farm employment significantly and negatively affect adoption decisions. The main findings suggest that Internet use significantly increases small-scale fishermen's subjective well-being (proxied by happiness and life satisfaction). This suggests that improving the Internet infrastructure in coastal areas is needed to support economic activities in the fisheries sector and boost the well-being of small-scale fishers.

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Although straw returning combined with blended controlled-release urea fertilizer (BUFS) has been shown to improve wheat-maize rotation system productivity, their effects on greenhouse gas (GHG) emissions, carbon footprints (CF), and net ecosystem economic benefits (NEEB) are still unknown. Life cycle assessment was used to investigate a long-term (2013-2022) wheat-maize rotation experiment that included straw combined with two N fertilizer types [BUFS and (conventional urea fertilizer) CUFS] and straw-free treatments (BUF and CUF). The results showed that BUFS and CUFS treatments increased the annual yield by 13.8% and 11.5%, respectively, compared to BUF and CUF treatments. The BUFS treatment increased the yearly yield by 13.8% compared to the CUFS treatment. Since BUFS and CUFS treatments increased soil organic carbon (SOC) sink sequestration by 25.0% and 27.0% compared to BUF and CUF treatments, they reduced annual GHG emissions by 7.1% and 4.7% and CF per unit of yield (CFY) by 13.7% and 9.6%, respectively. BUFS treatment also increased SOC sink sequestration by 20.3%, reduced GHG emissions by 10.7% and CFY by 23.0% compared to CUFS treatment. It is worth noting that the BUFS and CUFS treatments increased the annual ecological costs by 41.6%, 26.9%, and health costs by 70.1% and 46.7% compared to the BUF and CUF treatments, but also increased the net yield benefits by 9.8%, 6.8%, and the soil nutrient cycling values by 29.2%, 27.3%, and finally improved the NEEB by 10.1%, 7.3%, respectively. Similar results were obtained for the BUFS treatment compared to the CUFS treatment, ultimately improving the NEEB by 23.1%. Based on assessing yield, GHG emissions, CF, and NEEB indicators, the BUFS treatment is recommended as an ideal agricultural fertilization model to promote sustainable and clean production in the wheat-maize rotation system and to protect the agroecological environment.

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The optimization of production-living-ecology (PLE) space is an important basis for promoting regional high-quality development. Taking the Dongting Lake Eco-economic Zone as an example, from the perspective of improving the comprehensive benefits of the development and protection of the PLE space, we coupled the GMOP-FLUS model, and proposed an optimization method combining the scenario configuration and the bottom line protection of the PLE space. We compared the three optimization scenarios (economic optimization scenario, ecological optimization scenario, and multi-objective optimization scenario), and coordinated the conflict areas of two lines to clarify the comprehensive optimization scheme of the PLE space in the Dongting Lake Eco-economic Zone. The results showed the characteristics of increasing production space and living space and decreasing ecological space from 2010 to 2020, resulting in the partial loss of land ecological and environmental benefits. Under the economic optimization scenario, the ecological optimization scenario promoted the rapid growth of regional economy but damaged regional ecological security. The ecological optimization scenario inhibited regional economic development. The multi-objective optimization scenario led to improvement of economic and ecological benefits of the PLE space, which increased by 2.0% and 1.3%, respectively. The multi-objective optimization scenario was the best optimization scenario among the three scenarios. By superimposing the best scenario and the two-line conflict regional coordination results, we obtained the comprehensive optimization scheme for 2030. The production space, living space, and ecological space areas of the scheme were 25777.18, 2062.94, and 32552.68 km2, respectively. Based on the natural and social conditions, combining the comprehensive optimization scheme, we put forward different control suggestions for each type of PLE space. Our results could provide reference for the rational formulation of territorial spatial planning and the formulation of policies for the coordinated development of ecological environment and social economy in the Dongting Lake Eco-economic Zone.

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Introduction: As a renewable forest resource, bamboo plays a role in sustainable forest development. However, traditional cutting systems, selection cutting (SeC) and clear-cutting (ClC), result in an unsustainable production of bamboo forests due to labor-consuming or bamboo degradation. Recently, a strip clear-cutting (StC) was theoretically proposed to promote the sustainability of bamboo production, while little is known about its application consequence. Methods: Based on a 6-year experiment, we applied the strip clear-cutting system in a typical running bamboo (Phyllostachys glauca McClure) forest to assess its feasibility and sustainability. Using SeC and ClC as controls, we set three treatments with different strip widths (5 m, 10 m, and 20 m) for strip clear-cutting, simplified as StC-5, StC-10, and StC-20, respectively. Then, we investigated leaf physiological traits, bamboo size and productivity, population features, and economic benefits for all treatments. Results: The stands managed by StC had high eco-physiological activities, such as net photosynthetic rate (P n), photosynthetic nitrogen use efficiency (PNUE), and photosynthetic phosphorus use efficiency (PPUE), and thus grew well, achieved a large diameter at breast height (DBH), and were tall. The stand biomass of StC (8.78 t hm-2 year-1) was 1.19-fold and 1.49-fold greater than that of SeC and ClC, respectively, and StC-10 and StC-20 were significantly higher than SeC or ClC (p< 0.05). The income and profit increased with the increase in stand density and biomass, and StC-20 and StC-10 were significantly higher than SeC or ClC (p< 0.05). Using principal components analysis and subordinate function analysis, we constructed a composite index to indicate the sustainability of bamboo forests. For the sustainability assessment, StC-10 had the highest productive sustainability (0.59 ± 0.06) and the second highest economic sustainability (0.59 ± 0.11) in all cutting treatments. StC-10 had the maximum overall sustainability, with a value of 0.53 ± 0.02, which was significantly higher than that of ClC (p< 0.05). Conclusion: The results verified that StC for Phyllostachys glauca forests is feasible and sustainable as its sustainability index outweighs those of traditional cutting systems (SeC and ClC), and 10 m is the optimum distance for the strip width of StC. Our findings provide a new cutting system for managing other running bamboo forests sustainably.

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OBJECTIVE: The objective of the study was to estimate the economic cost benefit of funding influenza vaccination to all Australian adults 50-64 years and predict its effect on sudden cardiac arrest (SCA) deaths and hospitalisation. METHODS: We combined SCA hospitalisation data from the Australian Institute of Health and Welfare (AIHW) with survival, vaccination, and cost parameters from published literature to create a model estimating the cost benefit of universally funded influenza vaccinations to prevent SCA deaths and hospitalisation. Costs were considered from a government perspective and included cost of vaccines and GP consultations, whilst averted deaths were estimated through the age-adjusted value of a statistical life. RESULTS: The target policy was estimated to prevent 278 SCA hospitalisations and 1269 SCA deaths. This would result in cost-savings of almost $4 billion annually, with an incremental benefit-cost ratio (BCR) of 59.94. The majority of savings were associate with averted deaths. When a sensitivity analysis was performed by altering statistical life year values and reducing life years left, the cost-saving remained significant with a minimum BCR of 29.97 derived. CONCLUSIONS: Reducing SCA through extended vaccination including adults 50-64 years is likely to be a cost beneficial policy from a governmental perspective. SCA deaths account for a significant economic loss due to the high mortality rate, which was far greater than the costs saved through averted hospitalisations. More accurate parameters are needed to improve the reliability of these estimate; however, this model can be used as a basis for further research into the economic impact of SCA.

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The one-time application of common urea blended with controlled-release urea (CRU) is considered effective for improving nitrogen use efficiency and grain yield and reducing the greenhouse gas emissions of summer maize in intensive agricultural systems. However, the trade-off between the economic and environmental performances of different blended fertilizer treatments for different maize varieties remains unclear. Therefore, a consecutive two-year field experiment was conducted in the North China Plain to study the effects of different ratios of CRU and common urea on the yield, nitrous oxide (N2O) emissions, yield-scaled total N2O emissions, greenhouse gas intensity (GHGI), and net ecosystem economic benefit (NEEB) in 2021 and 2022. Four N fertilizer treatments with equal rate at 180 kg N ha-1 were applied as N180U (all Urea), N180C1(1/3CRU), N180C2(2/3CRU), and N180C (all CRU), and two maize varieties (JNK728-yellow ripe variety and ZD958-green ripe variety) were used. The N180C1 and N180C2 treatments produced the highest grain yield in varieties JNK728 and ZD958 (9.4-11.5 t ha-1 and 9.0-11.0 t ha-1), respectively. Compared to the N180U treatment (conventional method), the N180C1 treatment reduced the GHGI (24.8 %-25.9 %) and increased the NEEB (33.1 %-33.4 %) in the JNK728 variety, whereas the N180C2 treatment reduced the GHGI (16.9 %-28.8 %) and increased the NEEB (27.2 %-48.1 %) in the ZD958 variety. The study concludes that a one-time application of blended nitrogen fertilizer in suitable varieties can minimize the GHGI and maximize the NEEB, which is an effective strategy for balancing yield and nitrogen efficiency in the summer maize system in the North China Plain.

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BACKGROUND: The positive impact of pharmaceutical care in improving medication safety is considered proven. Little is known about the economic benefit of clinical pharmaceutical services in Germany. OBJECTIVE: In 2020, a pilot project was started at the Ernst von Bergmann Hospital to introduce ward-based clinical pharmacists in intensive care medicine, also in order to determine the economic benefit of the medication management offered. METHODS: By a team of experienced intensive care physicians and clinical pharmacists on the basis of a consensus principle, each pharmaceutical intervention (PI) was assigned a probability score (Nesbit probability score) with which an adverse drug event (ADE) would have occurred. Assuming that each ADE results in an increased length of stay, the costs of intensive care treatment/day were used as potential savings. The model thereby combines the findings of two international publications to enable an economic analysis of pharmaceutical services. RESULTS: During the study period, 177 pharmaceutical interventions were evaluated and corresponding probability scores for the occurrence of ADE were determined. From this, annual savings of €â€¯80,000 through avoided costs were calculated. CONCLUSION: In this project, the economic benefit of pharmaceutical services in intensive care medicine was proven. Ward-based clinical pharmacists are now an integral part of the intensive care treatment team at the Ernst von Bergmann Hospital.

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China accounts for around 50 % of the global vegetable harvested area which is expected to increase continuously. Large cropland areas, including rice paddy, have been converted into vegetable cultivation to feed an increasingly affluent population and increase farmers' incomes. However, little information is available on the balance between economic benefits and environmental impacts upon rice paddy conversion into vegetable fields, especially during the initial conversion period. Herein, the life cycle assessment approach was applied to compare the differences in agricultural input costs, yield incomes, net economic benefits (NEB), carbon (C) and nitrogen (N) footprints and net ecosystem economic benefits (NEEB) between the double rice paddy (Rice) and newly vegetable field (Veg) converted from Rice based on a four-year field experiment. Results showed that yield incomes from Veg increased by 96-135 %, outweighing the increased agricultural input costs due to higher inputs of labor and pesticide, thus significantly increasing NEB by 80-137 %, as compared to Rice. Rice conversion into Veg largely increased C footprints by 2.3-10 folds and N footprints by 1.1-2.6 folds, consequently increasing the environmental damage costs (EDC) by 2.2 folds on average. The magnitudes of increases in C and N footprints and EDC due to conversion strongly declined over time. The NEEB, the trade-offs between NEB and EDC, decreased by 18 % in the first year, while increasing by 63 % in the second year and further to 135 % in the fourth year upon conversion. These results suggested that rice paddy conversion into vegetable cultivation could increase the NEB at the expense of enhanced EDC, particular during the initial conversion years. Overall, these findings highlight the importance of introducing interventions to mitigate C and N footprints from newly converted vegetable field, so as to maximize NEEB and realize the green and sustainable vegetable production.

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The one-time application of blended urea (BU), combining controlled-release urea (CRU) and uncoated urea, has proven to be a promising nitrogen (N) management strategy. However, the long-term sustainability of blending urea remains largely unexplored. To assess whether a single application of blended urea could effectively replace split uncoated urea applications, a long-term field experiment was conducted in the North China Plain (NCP). The results indicated that, when compared to common urea (CU) at the optimal N rate (180 kg N ha-1), BU achieved comparable grain yields, N uptake and NUE (61% vs. 62). BU exhibited a 12% higher 0-20 cm soil organic nitrogen stock and a 9% higher soil organic carbon (C) stock. Additionally, BU reduced life-cycle reactive N (Nr) losses and the N footprint by 10%, and lowered greenhouse gas (GHG) emissions and the C footprint by 7%. From an economic analysis perspective, BU demonstrated comparable private profitability and a 3% greater ecosystem economic benefit. Therefore, BU under the optimal N rate has the potential to substitute split applications of common urea in the long-term and can be regarded as a sustainable N management strategy for wheat and maize production in the NCP.

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Ecotourism, as a means of fostering socio-economic level of local communities and contributing to the conservation of forest resources, is important for development in low-income countries. This work investigates the extent to which local people support the continuation of ecotourism during the COVID-19 pandemic and their attitudes towards resource conservation in Banco National Park in Côte d'Ivoire using social exchange theory (SET) as a foundation. A closed-ended questionnaire was used to conduct a survey with 150 informants selected among residents around the park. The data were analyzed using descriptive, correlational, and Partial Least Squares Structural Equation Modelling (PLS-SEM) approaches. The results showed that residents' perception of the impacts of ecotourism strongly affects their support for tourism development during the COVID-19 pandemic (ß = 0.918, p < 0.05). The socio-cultural (ß = 0.275, p < 0.05) and environmental (ß = 0.309, p < 0.05) benefits of ecotourism are the key determinants of the residents' perception and their support for ecotourism within the park during COVID-19 pandemic. The findings also revealed that economic benefits from ecotourism are linked to residents' perceptions of the qualities of the tourism place (ß = 0.363, p < 0.05). Overall, local people around Banco Park recognize that ecotourism produces more benefits than detriments. The COVID-19 pandemic, a painful and unexpected event, has not blunted their support for the continuation of ecotourism. This study calls for the integration of local residents' opinions in the development of the ecotourism sector in Côte d'Ivoire. It is a first step in determining residents' attitudes towards ecotourism in West Africa in a post-COVID context, and the results constitute a starting point for future studies.

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INTRODUCTION: Outpatient oncology practice is a growing area of opportunity for pharmacists to provide clinical services and evidence-based care. METHODS: This single-center, retrospective chart review analyzed the clinical and economic benefits of a board-certified oncology pharmacist after integration into the ambulatory oncology clinic setting. Primary outcomes were total cost avoidance for pharmacist interventions and impact on Centers for Medicare and Medicaid Services (CMS) OP-35 measures. Pharmacist interventions were characterized into distinct types which were then assigned a cost avoidance value. Cost avoidance was calculated per hour and then extrapolated to a yearly estimate based on a 40-h work week for one year for one full-time equivalent pharmacist. Data collection for the primary clinical outcome was performed by compiling provider-specific emergency department (ED) and inpatient admission rates for diagnoses specified in CMS OP-35 measures within 30 days after receiving outpatient chemotherapy. The rates for the data collection period were compared to the rates six months prior to pharmacist integration to assess pharmacist impact. RESULTS: In six months, 516 total interventions were made by the oncology pharmacist. The incidence of ED visits was 3.34% and 1.72% during the pre- and post-pharmacist intervention periods, respectively. The incidence of inpatient admissions was 2.43% and 0.34% pre- and post-pharmacist intervention, respectively. Total cost avoidance was estimated to be US$375,795 and when accounted for the median pharmacist salary at our institution, total cost savings was US$204,437. CONCLUSION: The presence of an oncology pharmacist specialist in the ambulatory cancer clinic provided clinical and economic benefits to the cancer clinic.

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We investigated the effects of COVID-19 lockdown on air quality and its consequences health and economic benefits in Thailand. The conditional Poisson regression model was applied to examine the association between air pollution and outpatient department (OPD) visits in each province and pooled the province-specific estimates using the random-effects meta-analysis to derive the national estimates. We then applied a random forest model with meteorological normalization approach to predict the concentration of air pollutants by means of business as usual during the lockdown period (April 3-May 3) in 2020 and further calculated the changes in the number of OPD visits and their consequent expenditure attributable to air pollution reduction using the obtained risk function performed earlier. The number of cardiovascular OPD visits attributed to PM10, PM2.5 and NO2 decreased by 4,414 (95% CI 982, 8,401), 4,040 (95% CI 326, 7,770), and 13,917 (95% CI 1,675, 27,278) cases, respectively, leading to reduced medical expenditure by 14,7180.21, 13,4708.31, and 46,4025.04 USD, respectively. The number of respiratory OPD visits attributed to PM10, PM2.5, NO2, and O3 reduction decreased by 2,298 (95% CI 1,223, 3,375), 2,056 (95% CI 740, 3,252), 3,326 (95% CI 542, 6,295), and 1,160 (95% CI 5,26, 1,804) cases, respectively, where the consequent medical expenditure was reduced by 76,618.48, 68,566.36, 11,0908.31, and 38,685.50 USD, respectively. Finding from this study showed that air quality during the lockdown period in Thailand was improved, contributing to the reduction of cardiovascular and respiratory OPD visits, and consequent medical service costs attributable to air pollution.

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Introduction: Due to the shortage of land and water resource, optimization of systems for production in commercial greenhouses is essential for sustainable vegetable supply. The performance of lettuce productivity and the economic benefit in greenhouses using a soil-based system (SBS) and a hydroponic production system (HPS) were compared in this study. Methods: Experiments were conducted in two identical greenhouses over two growth cycles (G1 and G2). Three treatments of irrigation volumes (S1, S2, and S3) were evaluated for SBS while three treatments of nutrient solution concentration (H1, H2, and H3) were evaluated for HPS; the optimal levels from each system were then compared. Results and discussion: HPS was more sensitive to the effects of environmental temperature than SBS because of higher soil buffer capacity. Compared with SBS, higher yield (more than 134%) and higher water productivity (more than 50%) were observed in HPS. We detected significant increases in ascorbic acid by 28.31% and 16.67% and in soluble sugar by 57.84% and 32.23% during G1 and G2, respectively, compared with SBS. However, nitrate accumulated in HPS-grown lettuce. When the nutrient solution was replaced with fresh water 3 days before harvest, the excess nitrate content of harvested lettuce in HPS was removed. The initial investment and total operating cost in HPS were 21.76 times and 47.09% higher than those in SBS, respectively. Consideration of agronomic, quality, and economic indicators showed an overall optimal performance of the H2 treatment. These findings indicated that, in spite of its higher initial investment and requirement of advanced technology and management, HPS was more profitable than SBS for commercial lettuce production.

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BACKGROUND: Breast cancer-related lymphedema (BCRL) imposes a significant economic burden on patients, providers, and society. There is no curative therapy for BCRL, but management through self-care can reduce symptoms and lower the risk of adverse events. MAIN BODY: The economic burden of BCRL stems from related adverse events, reductions in productivity and employment, and the burden placed on non-medical caregivers. Self-care regimens often include manual lymphatic drainage, compression garments, and meticulous skin care, and may incorporate pneumatic compression devices. These regimens can be effective in managing BCRL, but patients cite inconvenience and interference with daily activities as potential barriers to self-care adherence. As a result, adherence is generally poor and often worsens with time. Because self-care is on-going, poor adherence reduces the effectiveness of regimens and leads to costly treatment of BCRL complications. CONCLUSION: Novel self-care solutions that are more convenient and that interfere less with daily activities could increase self-care adherence and ultimately reduce complication-related costs of BCRL.