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Microbially induced carbonate precipitation (MICP) is a promising technology for solidifying sandy soil, ground improvement, repairing concrete cracks, and remediation of polluted land. By solidifying sand into soil capable of growing shrubs, MICP can facilitate peak and neutralization of CO2 emissions because each square meter of shrub can absorb 253.1 grams of CO2 per year. In this paper, based on the critical review of the microbial sources of solidified sandy soil, models used to predict the process of sand solidification and factors controlling the MICP process, current problems in microbial sand solidification are analyzed and future research directions, ideas and suggestions for the further study and application of MICP are provided. The following topics are considered worthy of study: (1) MICP methods for evenly distributing CaCO3 deposit; (2) minimizing NH4+ production during MICP; (3) mixed fermentation and interaction of internal and exogenous urea-producing bacteria; (4) MICP technology for field application under harsh conditions; (5) a hybrid solidification method by combining MICP with traditional sand barrier and chemical sand consolidation; and (6) numerical model to simulate the erosion resistance of sand treated by MICP.

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BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn’s disease (MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy (IMT) for MS-CD relative to conventional maintenance therapy remained unclarified. AIM To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer. METHODS A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy (CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs. RESULTS Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications (odds ratio: 0.527, P = 0.010), higher utility value for quality of life (coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management (coefficient -0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers ¥55260 to gain one quality-adjusted life year (QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita (GDPPC)] was 86.4%. CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.