A systematic review and meta-analysis of health utility values among patients with ischemic stroke

PurposeIschemic stroke (IS) has a considerable impact on the health-related quality of life (HRQoL) of patients. A systematic review was conducted to summarize and synthesize the HRQoL reported from IS patients.MethodsAn electronic search was performed in PubMed, Web of Science, ScienceDirect, Embase, and Cochrane Library databases from inception to February 2022 for studies measuring utility values in IS patients. Basic information about the studies, patient characteristics, measurement of the utility values, and utility values were extracted and summarized. Utility values were pooled according to the time of evaluation, and disease severity was classified with modified Rankin Scale (mRS) scores. The quality of the studies was assessed according to key criteria recommended by the National Institute for Health and Care Excellence.ResultsA total of 39 studies comprising 30,853 participants were included in the study. Measured with EQ-5D-3L, the pooled utility values were 0.42 [95% confidential interval (CI): 0.13 to 0.71], 0.55 (95% CI: 0.43 to 0.68), 0.65 (95% CI: 0.52 to 0.78), 0.60 (95% CI: 0.43 to 0.78), and 0.67 (95% CI: 0.60 to 0.74) for patients diagnosed with IS within 1, 3, 6, 12, and 24 months or above among poststroke patients. Four studies reported utility values classified by mRS scores where synthesized estimates stratified by mRS scores ranged from 0.91 (95% CI: 0.85 to 0.97) for patients with an mRS score of 1 to−0.04 (95% CI:−0.18 to 0.11) for those with an mRS score of 5. As for the health dimension profiles, usual activity was the most impacted dimension, while self-care was the least impacted one.ConclusionThis study indicated that the utility values in IS patients kept increasing from stroke onset and became relatively stabilized at 6 months poststroke. Health utility values decreased significantly as mRS scores increased. These results facilitate economic evaluations in utility retrieval and selection. Further exploration was required regarding the factors that affect the HRQoL of IS patients

Outstanding Thermal Conductivity of Single Atomic Layer Isotope-Modified Boron Nitride

Materials with high thermal conductivities (k) is valuable to solve the challenge of waste heat dissipation in highly integrated and miniaturized modern devices. Herein, we report the first synthesis of atomically thin isotopically pure hexagonal boron nitride (BN) and its one of the highest k among all semiconductors and electric insulators. Single atomic layer (1L) BN enriched with 11B has a k up to 1009 W/mK at room temperature. We find that the isotope engineering mainly suppresses the out-of-plane optical (ZO) phonon scatterings in BN, which subsequently reduces acoustic-optical scatterings between ZO and transverse acoustic (TA) and longitudinal acoustic (LA) phonons. On the other hand, reducing the thickness to single atomic layer diminishes the interlayer interactions and hence Umklapp scatterings of the out-of-plane acoustic (ZA) phonons, though this thickness-induced k enhancement is not as dramatic as that in naturally occurring BN. With many of its unique properties, atomically thin monoisotopic BN is promising on heat management in van der Waals (vdW) devices and future flexible electronics. The isotope engineering of atomically thin BN may also open up other appealing applications and opportunities in 2D materials yet to be explored

The impact of Internet access on household dietary quality: Evidence from rural China

Over the past few decades, the Internet has rapidly diffused across China. The spread of the Internet has had a profound economic and social impact on Chinese rural areas. Existing research shows that Internet access significantly impacts agricultural production and improves smallholder farmers’ income. Beyond these, the Internet can affect other dimensions of social welfare. However, research about the impact of Internet access on dietary quality in rural China remains scarce. This study utilizes multi-period panel data from Fixed Observation Point in rural China from 2009 to 2015 to estimate the impact of Internet access on dietary quality and food consumption of rural households and conducts a causal analysis. Regression models with time and household fixed effects allow robust estimation while reducing potential issues of unobserved heterogeneity. The estimates show that Internet access has significantly increased rural household dietary quality (measured by the Chinese Diet Balance Index). Further research finds that Internet access has increased the consumption of animal products, such as aquatic and dairy products. We also examine the underlying mechanisms. Internet access improves dietary quality and food consumption mainly through increasing household income and food expenditure. These results encourage the promotion of Internet access as a valuable tool for nutritional improvements, especially in rural areas

Alcohol Consumption and Mild Cognitive Impairment: A Mendelian Randomization Study from Rural China

Alcohol consumption has been associated with the risk of mild cognitive impairment (MCI) in observational studies. The result is inconsistent and whether the association is causal remains unknown. To examine the causal effect of alcohol consumption on MCI in rural China, this study used a cross-sectional dataset that included 1966 observations collected in rural China, of which 235 observations’ genotyping were collected. All participants accepted the MCI evaluation using Mini-Cog and were asked about the participants’ alcohol consumption behavior. The causal effect of alcohol consumption on MCI was investigated by Mendelian randomization (MR) of genetic variation in the aldehyde dehydrogenase 2 (ALDH2 rs671) gene. The risk of MCI in Chinese rural areas was 43%. Alcohol consumption was causally associated with a higher risk of MCI under MR design. Parameter estimates of drinking or not (b = 0.271, p = 0.007, 95% CI = 0.073 to 0.469), drinking frequency during the past 30 days (b = 0.016, p = 0.003, 95% CI = 0.005 to 0.027), and the weekly ethanol consumption (b = 0.132, p = 0.004, 95% CI = 0.042 to 0.223) were all positive and statistically significant at the 5% level. In conclusion, there was a high risk of MCI in rural China, and alcohol consumption was causally associated with a higher risk of MCI