The Future of the Louisiana Waterways Transport System: A System Analysis and Plan to Move Commerce by Water

LTRC Project Number: 20-1SSSIO Number: DOTLT1000330Moving commerce by water represents 25 percent of all goods movements within the state of Louisiana and is a critical component of the multimodal transportation system in the state [1]. To be best positioned for future development and investment, the Louisiana Department of Transportation and Development's (DOTD) Office of Multimodal Commerce (OMC) requested a comprehensive, statewide waterways transportation system plan. The plan would be capable of dovetailing into, and be a complement for, the Louisiana Statewide Transportation Plan. In doing so, it will provide the OMC the ability to identify potential chokepoints in the multimodal commerce network and ultimately assist in the development of strategies and capital investment programs to relieve these chokepoints through running \u201cwhat-if\u201d scenarios of the impacts of potential modal shifts on localized congestion

Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis (NASH) in the United Kingdom (UK) in 2018.

BACKGROUND AND AIMS Non-alcoholic steatohepatitis (NASH) - a progressive subset of non-alcoholic fatty liver disease (NAFLD) - is a chronic liver disease that can progress to advanced fibrosis, cirrhosis, and end-stage liver disease (ESLD) if left untreated. Early-stage NASH is usually asymptomatic, meaning a large proportion of the prevalent population are undiagnosed. Receiving a NASH diagnosis increases the probability that a patient will receive interventions for the purpose of managing their condition. The purpose of this study was to estimate the disease burden and economic impact of diagnosed NASH in the United Kingdom (UK) adult population in 2018. METHODS The socioeconomic burden of diagnosed NASH from a societal perspective was estimated using cost-of-illness methodology applying a prevalence approach. This involved estimating the number of adults with diagnosed NASH in the UK in a base period (2018) and the economic and wellbeing costs attributable to diagnosed NASH in that period. The analysis was based on a targeted review of the scientific literature, existing databases and consultation with clinical experts, health economists and patient groups. RESULTS Of the prevalent NASH population in the UK in 2018, an estimated 79.8% were not diagnosed. In particular, of the prevalent population in disease stages F0 to F2, only 2.0% (F0), 2.0% (F1) and 16.5% (F2), respectively, were diagnosed. Total economic costs of diagnosed NASH in the UK ranged from £2.3 billion (lower prevalence scenario, base probability of diagnosis scenario) to £4.2 billion (higher prevalence scenario, base probability of diagnosis scenario). In 2018, people with NASH in the UK were estimated to experience 94,094 to 174,564 disability-adjusted life years (DALYs) overall. Total wellbeing costs associated with NASH in 2018 were estimated to range between £5.6 to £10.5 billion. CONCLUSION The prevention and appropriate management of adult NASH patients could result in reduced economic costs and improvements in wellbeing