Indoxyl |A-D-galactopyranoside/3-O-angeloylingenol/2-Butenoic acid, 2-methyl-, (1aR,2R,5R,5aS,6S,8aS,9R,10aR)-1a,2,5,5a,6,9,10,10a-octahydro-5,5a-dihydroxy-4-(hydroxymethyl)-1,1,7,9-tetramethyl-11-oxo-1H-2,8a-methanocyclopenta[a]cyclopropa[e]cyclodecen-6-yl ester, (2Z)-/Ingenol 3-angelate/3-Indolyl-b-D-galactopyranoside/(1S,4S,5S,6R,9R,10R,12R,14R)-5,6-Dihydroxy-7-(hydroxymethyl)-3,11,11,14-tetramethyl-15-oxotetracyclo[7.5.1.01,5.010,12]pentadeca-2,7-dien-4-yl (2Z)-2-methyl-2-butenoate/indican (glucoside)/Picato/Ingenol mebutate/(1S,4S,5S,6R,9R,10R,12R,14R)-5,6-Dihydroxy-7-(hydroxymethyl)-3,11,11,14-tetramethyl-15-oxotetracyclo[22.214.171.124.0]pentadeca-2,7-dien-4-yl (2Z)-2-methyl-2-butenoate/Ingenol-3-angelate/3-Ingenyl angelate/3-Angeloylingenol
Soluble to 2 mM in DMSO
576.9±50.0 °C at 760 mmHg
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The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.
We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan (CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup (hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.
A total of 2356 patients with a mean age of 57.4 years were included, 57.1% of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY. The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage I, II, III, and IV disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3% of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more, whereas those with a lower household income and those who underwent surgery spent less (all P < 0.05). Conclusions For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic, and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.
Colorectal neoplasms, Direct expenditure, Financial burden, China
Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey
Hui-Yao Huang,1 Ju-Fang Shi,corresponding author1 Lan-Wei Guo,1,2 Ya-Na Bai,3 Xian-Zhen Liao,4 Guo-Xiang Liu,5 A-Yan Mao,6 Jian-Song Ren,1 Xiao-Jie Sun,7 Xin-Yu Zhu,1,3 Le Wang,1 Bing-Bing Song,8 Ling-Bin Du,9 Lin Zhu,10 Ji-Yong Gong,11 Qi Zhou,12 Yu-Qin Liu,13 Rong Cao,14 Ling Mai,15 Li Lan,16 Xiao-Hua Sun,17 Ying Ren,18 Jin-Yi Zhou,19 Yuan-Zheng Wang,20 Xiao Qi,21 Pei-An Lou,22 Dian Shi,1,3 Ni Li,1 Kai Zhang,1 Jie He,1 and Min Daicorresponding author
2017 Apr 28
In the United States, the mortality burden of injury is higher among American Indians and Alaska Natives (AI/AN) than any other racial/ethnic group, and injury contributes to considerable medical costs, years of potential life lost (YPLL), and productivity loss among AI/AN.
This study assessed the economic burden of injuries for AI/AN who are eligible for services through Indian Health Service, analyzing direct medical costs of injury for Indian Health Service’s users and years of potential life lost (YPLL) and the value of productivity losses from injury deaths for AI/AN in the Indian Health Service population.
Injury-related lifetime medical costs were estimated for Indian Health Service users with medically treated injuries using data from the 2011-2015 National Data Warehouse. Productivity costs and YPLL were estimated using data on injury-related deaths among AI/AN in Indian Health Service’s 2008-2010 service population. Costs were reported in 2017 U.S. dollars.
The total estimated costs of injuries per year, including injuries among Indian Health Service users and productivity losses from injury-related deaths, were estimated at $4.5 billion. Lifetime medical costs to treat annual injuries among Indian Health Service users were estimated at $549 million, with the largest share ($131 million) going toward falls, the most frequent injury cause. Total estimated YPLL from AI/AN injury deaths in Indian Health Service’s service population were 106,400. YPLL from injury deaths for men (74,000) were 2.2 times YPLL for women (33,000). Productivity losses from all injury-related deaths were $3.9 billion per year. The highest combined lifetime medical and mortality costs were for motor vehicle/traffic injuries, with an estimated cost of $1.6 billion per year.
Findings suggest that targeted injury prevention efforts by Indian Health Service likely contributed to lower rates of injury among AI/AN, particularly for motor vehicle/traffic injuries. However, because of remaining disparities in injury-related outcomes between AI/AN and all races in the United States, Indian Health Service should continue to monitor changes in injury incidence and costs over time, evaluate the impacts of previous injury prevention investments on current incidence and costs, and identify additional injury prevention investment needs.
American Indian, Alaska native, Indian Health Service, injury, Costs, Prevention
Incidence, deaths, and lifetime costs of injury among American Indians and Alaska Natives
Amanda A. Honeycutt,corresponding author1 Olga Khavjou,1 Simon J. Neuwahl,1 Grant A. King,1 Meredith Anderson,2 Andrea Lorden,3 and Michael Reed4
2019 Nov 11
We describe 22 new species in the genus Hyphantrophaga Townsend, 1892 (Diptera: Tachinidae) from Area de Conservacion Guanacaste (ACG) in north-western Costa Rica. All species were reared from an ongoing inventory of wild-caught caterpillars spanning a variety of families (Lepidoptera: Bombycidae, Crambidae, Depressariidae, Doidae, Erebidae, Euteliidae, Gelechiidae, Geometridae, Hedylidae, Hesperiidae, Immidae, Lasiocampidae, Limacodidae, Megalopygidae, Mimaloniidae, Noctuidae, Nolidae, Notodontidae, Nymphalidae, Papilionidae, Pieridae, Phiditiidae, Pterophoridae, Pyralidae, Riodinidae, Saturniidae, Sphingidae, Thyrididae, Tortricidae and Zygaenidae). We provide a morphological description of each species together with information on life history, molecular data and photographic documentation. In addition to the new species, we provide a redescription of the genus, as well as the redescription of three previously described species, which were also collected within ACG during this study: Hyphantrophaga angustata (van der Wulp), Hyphantrophaga myersi (Aldrich) and Hyphantrophaga virilis (Aldrich & Webber).
The following 22 new species of Hyphantrophaga are described: Hyphantrophaga adrianguadamuzi Fleming & Wood sp. n., Hyphantrophaga albopilosa Fleming & Wood sp. n., Hyphantrophaga anacordobae Fleming & Wood sp. n., Hyphantrophaga calixtomoragai Fleming & Wood sp. n., Hyphantrophaga calva Fleming & Wood sp. n.., Hyphantrophaga ciriloumanai Fleming & Wood sp. n., Hyphantrophaga danausophaga Fleming & Wood sp. n., Hyphantrophaga diniamartinezae Fleming & Wood sp. n., Hyphantrophaga duniagarciae Fleming & Wood sp. n., Hyphantrophaga edwinapui Fleming & Wood sp. n., Hyphantrophaga eldaarayae Fleming & Wood sp. n., Hyphantrophaga eliethcantillanoe Fleming & Wood sp. n., Hyphantrophaga gilberthampiei Fleming & Wood sp. n., Hyphantrophaga guillermopereirai Fleming & Wood sp. n., Hyphantrophaga hazelcambroneroae Fleming & Wood sp. n., Hyphantrophaga luciariosae Fleming & Wood sp. n., Hyphantrophaga manuelriosi Fleming & Wood sp. n., Hyphantrophaga morphophaga Fleming & Wood sp. n., Hyphantrophaga nigricauda Fleming & Wood sp. n., Hyphantrophaga osvaldoespinozai Fleming & Wood sp. n., Hyphantrophaga pabloumanai Fleming & Wood sp. n. and Hyphantrophaga similis Fleming & Wood sp. n.
The following are proposed by Wood as new synonyms of Hyphantrophaga Townsend, 1892: Brachymasicera Townsend, 1911 syn. n., Ommasicera Townsend, 1911 syn. n., Ophirosturmia Townsend, 1911 syn. n., Patillalia Curran, 1934 syn. n. and Ypophaemyiops Townsend, 1935 syn. n.
The following nine new combinations are proposed as a result of the new synonymies: Hyphantrophaga adamsoni (Thompson, 1963), comb. n., Hyphantrophaga fasciata (Curran, 1934), comb. n., Hyphantrophaga glauca (Giglio-Tos, 1893), comb. n., Hyphantrophaga gowdeyi (Curran, 1926), comb. n., Hyphantrophaga myersi (Aldrich, 1933), comb. n., Hyphantrophaga nigripes (Townsend, 1928), comb. n., Hyphantrophaga optica (Schiner, 1868), comb. n., Hyphantrophaga polita (Townsend, 1911), comb. n., Hyphantrophaga subpolita (Townsend, 1912), comb. n.
caterpillar, tropical, Goniini , parasitoid, fly, rain forest, dry forest, cloud forest, ACG
Twenty-two new species in the genus Hyphantrophaga Townsend (Diptera: Tachinidae) from Area de Conservacion Guanacaste, with a key to the species of Mesoamerica
AJ Fleming,corresponding author1 D. Monty Wood,1 M. Alex Smith,2 Tanya Dapkey,3 Winnie Hallwachs,3 and Daniel Janzen3
2019 Jun 28
Ingenol Mebutate is an active ingredient in Euphorbia peplus, acts as a potent PKC modulator, with Kis of 0.3, 0.105, 0.162, 0.376, and 0.171 nM for PKC-α, PKC-β, PKC-γ, PKC-δ, and PKC-ε, respectively, and has antiinflammatory and antitumor activity.