How health risk factors affect inpatient costs among adults with stroke in China: the mediating role of length of stay.

BACKGROUND: As stroke has become the leading cause of death and disability in China, it has induced a heavy disease burden on society, families, and patients. Despite much attention within the literature, the effect of multiple risk factors on length of stay (LOS) and inpatient costs in China is still not fully understood. AIM: To analyse the association between the number of risk factors combined and inpatient costs among adults with stroke and explore the mediating effect of LOS on inpatient costs. METHODS: A retrospective cross-sectional study was conducted among stroke patients in a tertiary hospital in Nantong City from January 2018 to December 2019. Lifestyle factors (smoking status, exercise), personal disease history (overweight, hypertension, dyslipidemia, diabetes mellitus, atrial fibrillation), family history of stroke, and demographic characteristics were interviewed by trained nurses. Inpatient costs and LOS were extracted from electronic medical records. Hierarchical multiple linear regression models and mediation analysis were used to examine the direct and indirect effects of the number of risk factors combined for stroke on inpatient costs. RESULTS: A total of 620 individuals were included, comprising 391 ischaemic stroke patients and 229 haemorrhagic stroke patients, and the mean age was 63.2 years, with 60.32% being male. The overall mean cost for stroke inpatients was 30730.78 CNY ($ 4444.91), and the average length of stay (LOS) was 12.50 days. Mediation analysis indicated that the greater number of risk factors was not only directly related to higher inpatient costs (direct effect = 0.16, 95%CI:[0.11,0.22]), but also indirectly associated with inpatient cost through longer LOS (indirect effect = 0.08, 95% CI: [0.04,0.11]). Furthermore, patients with high risk of stroke had longer LOS than those in low-risk patients, which in turn led to heavier hospitalization expenses. CONCLUSIONS: Both the greater number of risk factors and high-risk rating among stroke patients increased the length of stay and inpatient costs. Preventing and controlling risk behaviors of stroke should be strengthened.

Global, regional, and national burden of cervical cancer for 195 countries and territories, 2007-2017: findings from the Global Burden of Disease Study 2017.

BACKGROUND: Cervical cancer is one of the most common cancers among women worldwide. The formulation or evaluation on prevention strategies all require an accurate understanding of the burden for cervical cancer burden. We aimed to report the up-to-date estimates of cervical cancer burden at global, regional, and national levels. METHODS: Data were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 study. The counts, age-standardized rates, and percentage changes of incidence, disability-adjusted life-years (DALYs), and death attributed to cervical cancer at the global, regional, and national levels in all 195 countries and territories from 21 regions during 2007 to 2017 by age and by Socio-demographic Index (SDI) were measured. All estimates were reported with 95% uncertainty intervals (UIs). RESULTS: In 2017, 601,186 (95% UI 554,455 to 625,402) incident cases of cervical cancer were reported worldwide, which caused 8,061,667 (7,527,014 to 8,401,647) DALYs and 259,671 (241,128 to 269,214) deaths. The age-standardized rates for incidence, DALYs and death decreased by - 2.8% (- 7.8% to 0.6%), - 7.1% [- 11.8% to - 3.9%] and - 6.9% [- 11.5% to - 3.7%] from 2007 to 2017, respectively. The highest age-standardized incidence, DALYs and death rates in 2017 were observed in the low SDI quintile, Oceania, Central and Eastern Sub-Saharan Africa. During 2007 to 2017, only East Asia showed increase in these rates despite not significant. At the national level, the highest age-standardized rates for incidence, DALYs, and death in 2017 were observed in Kiribati, Somalia, Eritrea, and Central African Republic; and Georgia showed the largest increases in all these rates during 2007 to 2017. CONCLUSION: Although the age-standardized rates for incidence, DALYs, and death of cervical cancer have decreased in most parts of the world from 2007 to 2017, cervical cancer remains a major public health concern in view of the absolute number of cervical cancer cases, DALYs, and deaths increased during this period. The challenge is more prone to in the low SDI quintile, Oceania, Central and Eastern Sub-Saharan Africa, East Asia, and some countries, suggesting an urgent to promote human papillomavirus vaccination in these regions.

[Trends and forecast of hepatocellular carcinoma in Nantong, China: mortality rates from 1999 to 2011].

OBJECTIVE: To investigate the mortality rates of hepatocellular carcinoma (HCC) in Nantong,China from 1999 to 2011, in order to uncover dynamic trends and provide reasoned advice on intervention strategies to decrease HCC incidence and mortality in Nantong in the future. METHODS: Versions 10 and 9 of the WHO International Classification of Diseases (ICD-10 and ICD-9) were used to determine the number of HCC deaths in Nantong,China for the study's range of years. Thex2 test was applied to compare the HCC mortality rates according to sex and age. The Grey system GM(1,1) model was used to predict the next-5-year HCC mortality for Nantong. RESULTS: Analysis of the standardized mortality in Nantong showed a slight decreasing trend from 1999 to 2011 (x2=57 545.98, P less than 0.001),with males showing a steeper decrease than females. The total mortality of HCC during these years was 53.41 per 100,000 people,with mortality among males being significantly higher than that among females (80.81 per 100,000 people vs. 26.94 per 100,000 people; x2=13 625.42, P less than 0.001). In general, HCC mortality increased with increase in age (general trend:x2=57 545.98, P less than 0.001; male trend: x2=39 878.8, P less than 0.001; female trend: x2=20 105.3, P less than 0.001). However,HCC mortality increased significantly in women after the age of 40 and in men after the age of 35. The GM(1,1) equation was: Yt=-1265.28e(-0.0375t)+1315.5, which predicted that the HCC mortality will decrease to 25.56 per 100,000 people in 2016. CONCLUSION: Although HCC mortality generally decreased from 1999 to 2011, the rate remained high. Public health intervention strategies may be more effective if they focus on males over the age of 35 and females over the age of 40.

"Red-to-blue" colorimetric detection of cysteine via anti-etching of silver nanoprisms.

The reported strategies for cysteine (Cys) colorimetric detection based on noble metal nanomaterials include triggering aggregation, etching or fluorescence quenching of nanomaterials by Cys. In this study, we propose a new strategy for Cys colorimetric detection, i.e. anti-etching of silver nanoprisms (AgNPRs). In the absence of Cys, iodide ions (I(-)) could etch the corners and edges of AgNPRs and induce the morphology transition from nanoprism to nanodisk, which results in color change of the AgNPR dispersion from blue to red. In its presence, however, Cys can prevent the AgNPRs from I(-) attack. In that case, the color of the AgNPR dispersion containing I(-) and Cys remains blue. The mechanism is confirmed by using UV-vis spectra, TEM, DLS, Raman spectra and XPS spectra. According to the sensing effect of the Cys detection system, the concentration of I(-) incubated with AgNPRs, incubation time of AgNPRs and I(-), and pH of AgNPR dispersions are optimized to 5.0 µM, 10 min, and pH 6.2, respectively. Under the optimized conditions, the proposed Cys detection system has excellent selectivity and high sensitivity. The limit of detection (LOD) of our Cys detection system is 25 nM by the naked eye, which is much better than the reported lowest LOD by eye-vision (100 nM), and 10 nM by UV-vis spectroscopy. The results of Cys detection in rabbit urine or plasma samples reinforce that our Cys detection system is applicable for rapid colorimetric detection of Cys in real body fluid samples.

A new rapid colorimetric detection method of Al³âº with high sensitivity and excellent selectivity based on a new mechanism of aggregation of smaller etched silver nanoparticles.

As a pathogenic factor of the Alzheimer׳s disease, aluminum has been associated with the damage of the central nervous system in humans. In this study, we propose a new facile and rapid colorimetric detection method of Al(3+) with excellent selectivity and high sensitivity based on silver nanoparticles (AgNPs) stabilized by reduced glutathione (GSH) in the presence of l-cysteine (Cys). The new mechanism of our Al(3+) detection system based on GSH-AgNPs, i.e., aggregation of smaller etched GSH-AgNPs, are confirmed by TEM, EDS and DLS. The aggregation of smaller etched GSH-AgNPs results in obvious color change of the nanoparticle dispersion from yellow to reddish brown, and red shift and intensity decrease of the surface plasmon resonance (SPR) absorption. The GSH concentration, Cys concentration and pH value of the GSH-AgNPRs-based detection system are respectively optimized to be 10.0 mM, 50.0 mM and 6.0 according to the sensing effect of Al(3+). At the optimized conditions, the selectivity of the GSH-AgNPs detection system for Al(3+) is excellent compared with other ions including K(+), Mg(2+), Fe(3+), Co(2+), Mn(2+), Zn(2+), Cd(2+), Pb(2+), Ca(2+), Ba(2+), Cu(2+), Cr(3+), Hg(2+), Ni(2+), [Formula: see text] , [Formula: see text] , [Formula: see text] , [Formula: see text] and [Formula: see text] . Furthermore, this detection system is very sensitive for Al(3+). The limit of detection (LOD) is 1.2 µM by the naked eyes and 0.16 µM by UV-vis spectra, which are both much lower than the national drinking water standards (7.4 µM). Furthermore, the UV-vis detection offers a good linear detection range from 0.4 to 4.0 µM (R(2)=0.9924), which indicates that our developed detection system can also be used for the quantitative analysis of Al(3+). The detection results of real water samples indicate that this method can be used for real water detection.

Biocompatible composite nanoparticles with large longitudinal relaxivity for targeted imaging and early diagnosis of cancer.

Early diagnosis of cancer greatly increases the chances of successful treatment by radical resection. The sensitivity of magnetic resonance imaging (MRI) techniques for detecting early stage tumors can be increased with the assistance of a positive MRI contrast agent. However, the traditional positive MRI contrast agents, such as Gd-chelates and Gd-based inorganic nanoparticles, are often limited by their cytotoxicity and low specificity. Here, we propose a new design of MRI contrast agent based on gadolinium oxide nanocrystals (GON) for targeted imaging and cancer early diagnosis with good biocompatibility. The GON were prepared using a polyol method and then encapsulated into albumin nanoparticles (AN), which were cross-linked with glutaraldehyde and found to exhibit bright and stable autofluorescence without conjugation to any fluorescent agent. After that, a target molecule, folic acid (FA), was conjugated onto the surface of the GON-loaded AN (GON-AN) to construct a GON-AN-FA composite. The as-prepared nanoparticles are biocompatible and stable in serum. The results of MRI relaxation studies show that the longitudinal relaxivities (r1) of GON-AN (11.6 mM-1 s-1) and GON-AN-FA (10.8 mM-1 s-1) are much larger than those of traditional positive MRI contrast agents, such as Magnevist (3.8 mM-1 s-1). The results of cell viability assays indicate that GON-AN and GON-AN-FA are almost non-cytotoxic. Furthermore, the specificities of GON-AN and GON-AN-FA were evaluated with two kinds of cancer cells which overexpress folate receptor alpha (FRα). The results reinforce that the autofluorescent GON-AN-FA is able to target cancer cells via recognition of the ligand FA and the receptor FRα. Therefore, our autofluorescent GON-AN-FA possessing a large longitudinal relaxivity and good biocompatibility represents a significant advance for the targeted imaging and early diagnosis of cancer.