An economic evaluation of a primary care-based technology-enabled intervention for stroke secondary prevention and management in rural China : a study protocol

Introduction: Secondary prevention of stroke is a leading challenge globally and only a few strategies have been tested to be effective in supporting stroke survivors. The system-integrated and technology-enabled model of care (SINEMA) intervention, a primary care-based and technology-enabled model of care, has been proven effective in strengthening the secondary prevention of stroke in rural China. The aim of this protocol is to outline the methods for the cost-effectiveness evaluation of the SINEMA intervention to better understand its potential economic benefits. Methods: The economic evaluation will be a nested study based on the SINEMA trial; a cluster-randomized controlled trial implemented in 50 villages in rural China. The effectiveness of the intervention will be estimated using quality-adjusted life years for the cost-utility analysis and reduction in systolic blood pressure for the cost-effectiveness analysis. Health resource and service use and program costs will be identified, measured, and valued at the individual level based on medication use, hospital visits, and inpatients' records. The economic evaluation will be conducted from the perspective of the healthcare system. Conclusion: The economic evaluation will be used to establish the value of the SINEMA intervention in the Chinese rural setting, which has great potential to be adapted and implemented in other resource-limited settings

Response Surface Optimization of the Preparation Process of Compound Yogurt with Cistanche deserticola and Jujube and Evaluation of the Antioxidant Activity of Compound Yogurt with Biosensors

The preparation process of compound yogurt with added cistanche and jujube was optimized using single-factor experiments and response surface curve analysis by applying evaluation indicators including taste, texture, odor, and color. Besides, a rapid evaluation of the antioxidant activity of the compound yogurt was performed by employing the DPPH free radical scavenging system and electrochemical biosensors. Results of the single-factor experiments and response surface analysis indicated that the quality of the compound yogurt was optimal when the percentages of jujube juice, cistanche juice, and honey were 18%, 8%, and 5%, respectively. This composition achieved a sensory score of 92.2, which was close to the predicted score of 92.5. Under the same optimized conditions, the evaluation of the antioxidant activity with the preparation of DNA/CS-N-G/GCE biosensor obtained through the layer-by-layer modified glassy carbon electrode assembly of DNA, chitosan, and nitrogen-doped graphene indicated that L-ascorbic acid, compound yogurt, and plain yogurt present peak current values of 6.5×10−5、8.5×10−5 and 1.05×10−4 A, respectively. This represented a decreasing trend in antioxidant activity. Further validation of DPPH free radical scavenging experiments showed that the IC50 value of L-ascorbic acid, compound yogurt and plain yogurt were 4.54, 15.65 and 22.94 mg/mL, respectively. This was consistent with the results of the evaluation of the compound yogurt using the biosensor, and there was no significant difference between the two methods. Therefore, the addition of cistanche and jujube extracts into plain yogurt significantly enhanced the inhibition of damage to DNA by free radicals, thus improving the antioxidant activity in the compound yogurt. The constructed sensor could be used for the rapid evaluation of antioxidant activity of compound yogurt

Cost Drivers and Financial Burden for Cancer-Affected Families in China: A Systematic Review

This systematic review examined cancer care costs, the financial burden for patients, and their economic coping strategies in mainland China. We included 38 quantitative studies that reported out-of-pocket payment for cancer care and patients’ coping strategies in English or Chinese (PROSPERO: CRD42021273989). We searched PubMed, Embase, Ovid, Web of Science, Cochrane, CNKI, and Wanfang Data from 1 January 2009 to 10 August 2022. We referred to the standards for reporting observational studies to assess the methodological quality and transparent reporting of the included studies and reported the costs narratively. Annual mean medical costs (including inpatient and outpatient costs and fees for self-purchasing drugs) ranged from USD 7421 to USD 10,297 per patient. One study investigated medical costs for 5 years and indicated that inpatient costs accounted for 51.6% of the total medical costs, followed by self-purchasing drugs (43.9%). Annual medical costs as a percentage of annual household income ranged from 36.0% to 63.1% with a metaproportion of 51.0%. The common coping strategies included borrowing money and reduction of household expenses and expenses from basic health services. Costs of inpatient care and self-purchasing drugs are major drivers of medical costs for cancer care, and many affected households shoulder a very heavy financial burden

CdSe/ZnS Quantum Dots Impaired the First Two Generations of Placenta Growth in an Animal Model, Based on the Shh Signaling Pathway

The toxicity, especially the transgenerational toxicity of quantum dots (QDs) in vivo, is still scarcely understood in spite of great promising applications of QDs in biomedicine. In this study, the maternal status, pregnancy outcome, and fetus development of parental generation (P0) to offspring in three generations (F3) were investigated after Kunming mice perinatal (GD 13-PND 5) exposure to Cd containing QDs (CdSe/ZnS QDs) and CdCl2. The results show CdSe/ZnS QDs induced placenta injuries in P0 and diminished placenta diameters in F1 and F2. Bodyweight growth decreased in the CdSe/ZnS QDs treatment group in the F1 and F2 generation. Additionally, CdSe/ZnS QDs significantly altered the expression of key genes in the Shh signal pathway. Overall, this study exhibited that the CdSe/ZnS QDs exposure during perinatal period impaired placenta growth in the first two generations, but not on the third generation. The toxicological actions of the CdSe/ZnS QDs might be through the effects on the Shh signal pathway

Nano Zinc Oxide Induced Fetal Mice Growth Restriction, Based on Oxide Stress and Endoplasmic Reticulum Stress

ZnO NPs have been assessed to show adverse effects on reproductive organs, but the molecular mechanisms of reproductive toxicity have not been sufficiently studied. In this research, the dosage effects from the oral exposure of ZnO NPs (30 nm) to pregnant mice in gestation day 10.5 to 17.5 was analyzed. Pregnant mice exposed to ZnO NPs induced dam injury, mice fetal growth restriction, and the fetus number decreased. The pathological evaluation showed that ZnO NPs exposure caused placental spongiotrophoblast area decease and structural damage. The RT-qPCR and immunocytochemistry data indicated that ZnO NPs could induce placenta oxide stress, endoplasmic reticulum stress responses, apoptosis, and altered placental function. These findings indicated that ZnO NPs could induce dam injury and fetal growth restriction. Reproductive toxicity of ZnO NPs may be due to placental injury and function alteration caused by apoptosis, oxide stress, and endoplasmic reticulum stress after ZnO NPs exposure