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Wang T, Zhi J, Pan B, Jiang H. The impact of national health insurance on the cost of auricular reconstruction with skin expansion for microtia in China: A single-center retrospective study based on 1290 surgeries. J Plast Reconstr Aesthet Surg 2024; 94:62-71. [PMID: 38763056 DOI: 10.1016/j.bjps.2024.04.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Congenital microtia presents challenges that encompass physical disabilities and psychosocial distress. It is reported that people with low income have a higher possibility of giving birth to babies with congenital malformations. At the end of June 2023, auricular reconstruction was partially incorporated into national health insurance in our hospital. METHODS Briefly, 1290 surgeries, including stage-I and stage-II auricular reconstruction with tissue expansion were performed in 2023, involving 779 patients. Patient data, including age, sex, length of stay, residence, and costs, were retrieved from the electronic medical record system. The final cost before and after health insurance coverage, as well as the medical insurance reimbursement ratio in each province and municipality were statistically analyzed. RESULTS Following insurance coverage, a significant increase in the number of surgeries was observed (514 [39.84%] vs. 776 [60.16%], χ2 = 45.99, p = 0.000), with notable reductions in out-of-pocket costs for unilateral and bilateral stage-I and -II auricular reconstructions ($3915.01 vs. $6645.28, p < 0.05; $11546.80 vs. $5198.08, p < 0.05). Disparities in reimbursement rates across regions were evident, but showed no correlation to the local GDP per capita. There was a positive correlation between the length of stay and inpatient cost. Patient's age was not related to the inpatient cost, but to the length of stay. CONCLUSION The health insurance coverage for microtia treatment significantly alleviated financial burdens on the patients' family and increased the number of auricular reconstruction surgeries. These findings underscore the critical role of insurance coverage in enhancing healthcare accessibility and affordability for patients with congenital microtia.
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Affiliation(s)
- Tiange Wang
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, People's Republic of China
| | - Jiajun Zhi
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, People's Republic of China
| | - Bo Pan
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, People's Republic of China.
| | - Haiyue Jiang
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, People's Republic of China
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Wang J, Kimura E, Mongan M, Xia Y. Genetic Control of MAP3K1 in Eye Development and Sex Differentiation. Cells 2021; 11:cells11010034. [PMID: 35011600 PMCID: PMC8750206 DOI: 10.3390/cells11010034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/03/2021] [Accepted: 12/21/2021] [Indexed: 01/11/2023] Open
Abstract
The MAP3K1 is responsible for transmitting signals to activate specific MAP2K-MAPK cascades. Following the initial biochemical characterization, genetic mouse models have taken center stage to elucidate how MAP3K1 regulates biological functions. To that end, mice were generated with the ablation of the entire Map3k1 gene, the kinase domain coding sequences, or ubiquitin ligase domain mutations. Analyses of the mutants identify diverse roles that MAP3K1 plays in embryonic survival, maturation of T/B cells, and development of sensory organs, including eye and ear. Specifically in eye development, Map3k1 loss-of-function was found to be autosomal recessive for congenital eye abnormalities, but became autosomal dominant in combination with Jnk and RhoA mutations. Additionally, Map3k1 mutation increased eye defects with an exposure to environmental agents such as dioxin. Data from eye developmental models reveal the nexus role of MAP3K1 in integrating genetic and environmental signals to control developmental activities. Here, we focus the discussions on recent advances in understanding the signaling mechanisms of MAP3K1 in eye development in mice and in sex differentiation from human genomics findings. The research works featured here lead to a deeper understanding of the in vivo signaling network, the mechanisms of gene-environment interactions, and the relevance of this multifaceted protein kinase in disease etiology and pathogenesis.
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Affiliation(s)
| | | | | | - Ying Xia
- Correspondence: ; Tel.: +1-513-558-0371
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Manyilizu WB, Mdegela RH, Helleve A, Skjerve E, Kazwala R, Nonga H, Muller MHB, Lie E, Lyche J. Self-Reported Symptoms and Pesticide Use among Farm Workers in Arusha, Northern Tanzania: A Cross Sectional Study. TOXICS 2017; 5:toxics5040024. [PMID: 29051456 PMCID: PMC5750552 DOI: 10.3390/toxics5040024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/18/2017] [Accepted: 09/20/2017] [Indexed: 11/16/2022]
Abstract
The objective of the study was to describe self-reported health symptoms, the use of personal protective gear and clothing and poor safety procedures when applying pesticides among farm workers. A total of 128 adult farm workers were interviewed using a structured questionnaire during the farming season. The commonly used pesticides included profenofos, mancozeb, chlorpyrifos, cypermethrin, deltamethrin, permethrin, lambda-cyhalothrin, endosulfan and carbosulfan. The majority (>90%) of farm workers used no personal protective clothing while handling pesticides. More than one-third of farm workers ate and drank without washing their hands following pesticide handling, while a smaller number smoked or chewed gum. Wearing special boots during pesticide application was found to reduce the risk of skin rash (OR = 0.2, 95% CI: 0.06-0.66), whereas smoking when applying pesticides increased the risk of chest pain occurrence (OR = 4.0, 95% CI: 1.14-15.43), as well as forgetfulness (OR = 4.0, 95% CI: 1.30-14.02). Chewing gum and eating when applying pesticides was associated with diarrhoea (OR = 11.0, 95% CI: 1.80-6.84 and OR = 7.0, 95% CI: 1.27-3.67 respectively). The increased self-reported prevalence of post-exposure adverse health effects among farm workers was associated with poor use of personal protective clothing and poor safety practices during pesticide use and handling. These data indicate the need for improved availability and use of protective equipment, and training in crop and pest management practices to prevent risky behavioursand for safer and sustainable vegetable production.
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Affiliation(s)
- Wilbert Bunini Manyilizu
- Health Systems Department, School of Public Administration and Management, Mzumbe University, P.O. Box 101, Morogoro 023, Tanzania.
- Departmentt of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro 023, Tanzania.
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, P.O. Box 8146, 454 Oslo, Norway.
| | - Robbinson Hammerton Mdegela
- Departmentt of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro 023, Tanzania.
| | - Arnfinn Helleve
- Institute of Health and Society, University of Oslo, International Community Health, P.O. Box 1130 Blindern, N-0318, 454 Oslo, Norway.
| | - Eystein Skjerve
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, P.O. Box 8146, 454 Oslo, Norway.
| | - Rudovick Kazwala
- Departmentt of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro 023, Tanzania.
| | - Hezron Nonga
- Departmentt of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro 023, Tanzania.
| | - Mette Hellen Bjorge Muller
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, P.O. Box 8146, 454 Oslo, Norway.
| | - Elisabeth Lie
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, P.O. Box 8146, 454 Oslo, Norway.
| | - Jan Lyche
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, P.O. Box 8146, 454 Oslo, Norway.
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Carmichael SL, Yang W, Roberts E, Kegley SE, Brown TJ, English PB, Lammer EJ, Shaw GM. Residential agricultural pesticide exposures and risks of selected birth defects among offspring in the San Joaquin Valley of California. ACTA ACUST UNITED AC 2015; 106:27-35. [PMID: 26689858 DOI: 10.1002/bdra.23459] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND We examined associations of birth defects with residential proximity to commercial agricultural pesticide applications in California. Subjects included 367 cases representing five types of birth defects and 785 nonmalformed controls born 1997 to 2006. METHODS Associations with any versus no exposure to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for covariates. Overall, 46% of cases and 38% of controls were classified as exposed to pesticides within a 500 m radius of mother's address during a 3-month periconceptional window. RESULTS We estimated odds ratios (ORs) for 85 groups and 95 chemicals with five or more exposed cases and control mothers. Ninety-five percent confidence intervals (CI) excluded 1.0 for 11 ORs for groups and 22 ORs for chemicals, ranging from 1.9 to 3.1 for groups and 1.8 to 4.9 for chemicals except for two that were <1 (noted below). CONCLUSION For groups, these ORs were for anotia/microtia (n = 95 cases) and dichlorophenoxy acids/esters and neonicotinoids; anorectal atresia/stenosis (n = 77) and alcohol/ethers and organophosphates (these ORs were < 1.0); transverse limb deficiencies (n = 59) and dichlorophenoxy acids/esters, petroleum derivatives, and triazines; and craniosynostosis (n = 79) and alcohol/ethers, avermectins, neonicotinoids, and organophosphates. For chemicals, ORs were: anotia/microtia and five pesticides from the groups dichlorophenoxy acids/esters, copper-containing compounds, neonicotinoids, organophosphates, and triazines; transverse limb deficiency and six pesticides - oxyfluorfen and pesticides from the groups copper-containing compounds, 2,6-dinitroanilines, neonicotinoids, petroleum derivatives and polyalkyloxy compounds; craniosynostosis and 10 pesticides - oxyfluorfen and pesticides from the groups alcohol/ethers, avermectins, n-methyl-carbamates, neonicotinoids, ogranophosphates (two chemicals), polyalkyloxy compounds (two chemicals), and pyrethroids; and congenital diaphragmatic hernia (n = 62) and a copper-containing compound.
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Affiliation(s)
- Suzan L Carmichael
- Department of Pediatrics, Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Wei Yang
- Department of Pediatrics, Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Eric Roberts
- Public Health Institute, Oakland, California, USA
| | | | | | - Paul B English
- California Department of Public Health, Richmond, California, USA
| | - Edward J Lammer
- UCSF Benioff Children's Hospital Oakland, Oakland, California, USA
| | - Gary M Shaw
- Department of Pediatrics, Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, California, USA
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Nurulain SM, Shafiullah M. TERATOGENICITY AND EMBRYOTOXICITY OF ORGANOPHOSPHORUS COMPOUNDS IN ANIMAL MODELS - A SHORT REVIEW. ACTA ACUST UNITED AC 2012. [DOI: 10.31482/mmsl.2012.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Snijder CA, Vlot IJ, Burdorf A, Obermann-Borst SA, Helbing WA, Wildhagen MF, Steegers EAP, Steegers-Theunissen RPM. Congenital heart defects and parental occupational exposure to chemicals. Hum Reprod 2012; 27:1510-7. [DOI: 10.1093/humrep/des043] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Giri A, Giri S, Sharma GD. Malathion and fenvalerate induce micronuclei in mouse bone marrow cells. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2011; 52:607-613. [PMID: 21538555 DOI: 10.1002/em.20649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 01/25/2011] [Accepted: 01/25/2011] [Indexed: 05/30/2023]
Abstract
Health effects of pesticides are a major public health concern. In this study, the genotoxic effects of two commonly-used pesticides, malathion, and fenvalerate, were investigated in mice in vivo. Induction of micronuclei in bone marrow cells was used as the test parameter following exposure to 2.5, 5 or 10 mg/kg malathion by intraperitoneal (i.p.) or per oral (p.o.) exposure. Exposure by both routes was found to cause a significant increase in micronucleated polychromatic erythrocytes (PCEs) in a dose-dependent manner (r = 0.9769; P < 0.05). The highest dose (10 mg/kg) induced significant (P < 0.05) cytotoxicity. In contrast, fenvalerate caused an increase in micronucleated PCEs only at higher doses (10 and 20 mg/kg) via i.p. injection, and was not associated with cytotoxicity. A significant dose-response correlation was not observed in the dose ranges tested for fenvalerate (r = 0.8704; P > 0.05). The results suggest that technical grade malathion is a genotoxic agent. In contrast, technical grade fenvalerate appears to be a potent genotoxic agent, but this observation should be confirmed with further investigation(s).
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Affiliation(s)
- A Giri
- Environmental Toxicology Laboratory, Department of Life Science & Bioinformatics, Assam University, Silchar, India
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Maternal Pesticide Exposure and Neural Tube Defects in Mexican Americans. Ann Epidemiol 2010; 20:16-22. [DOI: 10.1016/j.annepidem.2009.09.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 09/25/2009] [Accepted: 09/30/2009] [Indexed: 11/21/2022]
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