Understanding the economic burden of cancer care and the utility of health insurance: An exploratory cross-sectional study in a tertiary care hospital in Karnataka, India.

Background: Families and caregivers of cancer patients experience significant financial challenges associated with out-of-pocket (OOP) expenditures. Objectives: This study aims to assess the OOP expenditure and its impact on the livelihood of patients and families, associated with receiving cancer care from a teaching hospital in Karnataka. Materials and Methods: It focuses on understanding health insurance use and its effects on OOP expenses for cancer care based on data obtained from 271 patients receiving treatment for more than 6 months. A structured questionnaire was developed and used for data collection and focused on obtaining direct costs such as consultation fees, surgery costs, and radiotherapy costs and indirect costs such as travel expenses, food costs, and patient income loss, as well as questions that measure the impact of the financial burden on patients and their associated livelihood. Results: In the present study, the median cost of OOP expense incurred for cancer treatment is estimated to be 3.10 lakh Indian rupees. It was also found that patients enrolled in public health insurance schemes, especially Ayushman Bharath-Arogya Karnataka have lesser OOP expenditure than those with either private health insurance or no health insurance. Conclusions: This indicates the need for effective implementation of various public health insurance schemes and their ability to protect patients from huge OOP expenses and related financial risks.

Removal of bisphenol A and methylene blue through persulfate activation by calcinated α-MnO2 nanorods: effect of ultrasonic assistance and toxicity assessment.

This work investigates the efficacy of α-MnO2 nanorods for persulfate-mediated degradation of bisphenol A (BPA) and methylene blue (MB), in silent and ultrasonic-assisted systems. The conversion of α-MnO2 nanoparticle flakes to nanorods occurs upon calcination at a temperature of 400 °C for 3 h under the ramping conditions. The comparative characterization of nanomaterials pre- and post-calcination reveals better physical, chemical, and thermal properties of α-MnO2 nanorods. The impact of various operational parameters such as pH, dosage of nanorods, persulfate dose, selected contaminant concentration, ultrasound frequency and power, scavengers, and landfill leachate medium on the degradation of pollutants is also assessed. The ultrasonic assistance yields higher removal for both BPA and MB than the silent system. This may be attributed to the generation of more radicals as ultrasound activates persulfate. This can be due to acoustic cavitation, which leads to better solute dissociation and excited state. The results obtained through scavenger tests reveal that both OH• and SO4•- can contribute to degradation, but the role of SO4•- is found dominant. Significant removal of BPA and MB ((BPA)silent, 87.12%; (MB)silent, 96.54%; (BPA)ultrasonic, 88.75%; (MB)ultrasonic, 93.86%)) is observed in landfill leachate medium. The degradation pathway for pollutants is also proposed. The toxicity of pollutants and their degradation intermediates are evaluated using Ecological Structure Activity Relationships (ECOSAR) program. The results indicate reduced toxicity of BPA intermediates, while most MB degradation intermediates show higher toxicity. Therefore, it can be affirmed that removing pollutants does not ensure a completely non-toxic process. However, the study proposes a comprehensive toxicity evaluation and eliminating toxic intermediates for completely harmless wastewater treatment.

Removal of micropollutants through bio-based materials as a transition to circular bioeconomy: Treatment processes involved, perspectives and bottlenecks.

The recent increase in micropollutant levels in water bodies is a growing concern globally. The generation of new materials and techniques for wastewater treatment often involves the release of hazardous wastes and the utilization of energy related to it. This can be resolved by the synthesis of bio-based materials through the use of already released wastes and naturally occurring components, adding their value as reusable resources. These bio-based materials find wide applications for micropollutant elimination and energy tapping due to the presence of various functional groups, large surface area, high stability, and reusability. The processes involved in micropollutant elimination through biomaterials generally include adsorption and degradation. These treatment processes are suggested to depend on various operational parameters like pH, temperature, dose, reaction time, presence of other contaminants, ions, etc. in the system, which may influence the process efficiency. Understanding the potential of bio-based materials many steps can be taken towards its large-scale application to upgrade wastewater treatment plants for micropollutant elimination. Furthermore, the recent advances of bio-based materials in energy storage and conversion have widened its scope for implementation in a circular bioeconomy. The bottlenecks towards such a transition and future recommendations are also presented and discussed.