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High-resolution isotherms of argon and nitrogen adsorption on macroporous silica have been simulated with universal Langmuir and fractal models. A four-parameter, fractal universal Langmuir equation is a good fit to the data at low pressures. Standard Gibbs energy changes calculated from equilibrium adsorption coefficients show a series of broad peaks that indicate adsorbate structural transformations as a function of pressure and coverage. The Freundlich equation or mean fractal model is also a good fit to isotherms at low pressures. Pressure-varying fractals are accurate fits to the data. Fractal exponents provide information on adsorbate coverage and surface access. Broad peaks in pressure-varying exponents are indicators of adsorbate structure. From adsorptive gas amounts, mean and pressure-varying fractal exponents provide details of adsorbate fractal dimensions and surface roughness. Both Ar and N2 adsorption cause increases in mean surface roughness when compared with pure silica. Surface roughness fluctuations from pressure-dependent adsorptive gas fractal dimensions are associated with adsorbate structure. At one trough, the surface is smooth and is linked to close-packed Ar or N2. For Ar adsorption at 87 K, this structure is a complete monolayer (1.00(4)), while for Ar (77 K), 1.15(4) layers and for N2 (87 K), 2.02(10) layers. The universal Langmuir specific area of the silica is 10.1(4) m2 g-1. Pressure- and coverage-dependent adsorbate structures range from filling defects and holes on the surface to cluster formation to adsorbed Ar or N2 evenly distributed or packed across the surface. The Ar (87 K) isotherm is most sensitive to adsorbate structural transformations.
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INTRODUCTION: Chronic fatigue syndrome (CFS) is a neurological disease that is accompanied by excessive fatigue or tiredness. There are several reports confirming the association between human herpesvirus 6 (HHV-6) infection and CFS illness. This systematic review and meta-analysis was performed to integrate the information of published studies with regard to this association until May 2021. METHODS: The literature search was based on keywords including "chronic fatigue syndrome and HHV 6," "chronic fatigue syndrome and HHV-6," "chronic fatigue syndrome and HHV6," "chronic fatigue syndrome and Herpes virus 6," and "chronic fatigue syndrome and Herpesvirus6" in MEDLINE (PubMed), Web of Science, and EMBASE. RESULTS: The literature search identified 17 studies to be included in the systematic review and 11 studies in meta-analysis. The symmetry funnel plot and Egger's test (p value = 0.2) identified no publication bias among studies. Moreover, the low level of I2 revealed homogeneity across studies. DISCUSSION: In conclusion, the association between the HHV-6 infection and CFS incidence was substantiated. However, the results of this study also suggest that further comprehensive studies are needed to solidify the association between HHV-6 and CFS. Future studies should consider additional factors that may have affected the significance of such a correlation.
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Síndrome de Fadiga Crônica , Herpesviridae , Herpesvirus Humano 6 , Síndrome de Fadiga Crônica/epidemiologia , HumanosRESUMO
Background: Most patients suffer from moderate to severe pain after elective laparotomy. They often require opioids to alleviate their pain. Opiates invariably induce certain side effects and, occasionally, dependence. Intraoperative infusion of lidocaine and low-dose ketamine reduces postoperative pain and analgesic requirements. This study aims to evaluate the effects of simultaneous infusion of lidocaine and ketamine during open abdominal surgery on the postoperative pain severity and analgesic consumption. Methods: In this randomized, double-blinded, single-center study that was performed in Iran, 80 patients scheduled for elective open abdominal surgery under general anesthesia were enrolled in two LK and P groups. Group LK (n=40) received lidocaine-ketamine infusion, and group P (n=40) received placebo (normal saline). Both infusions were started thirty minutes after initiation of surgery and were terminated once the surgery was completed. For postoperative pain management, patient-controlled analgesia (PCA), including fentanyl and paracetamol, was administered for both groups. All patients were evaluated for pain visual analogue scale (VAS) and total adjunctive analgesic (diclofenac suppository) consumption within the first 24 hours after the surgery. The data were analyzed using SPSS. P values <0.05 were considered significant. Results: Intraoperative infusion of Lidocaine and Ketamine resulted in desirable postoperative pain control. Patients of LK group demonstrated a significant reduction in the pain score at 1, 6, 12, 18, and 24 hours after termination of surgery (p<0.001). It also resulted in a decreased requirement for postoperative analgesics, as cumulative analgesic consumption was decreased meaningfully in the patients of LK group (p<0.001). Conclusion: Intravenous infusion of lidocaine and ketamine during elective open abdominal surgery reduces pain intensity and analgesic requirements in the first 24 hours postoperatively, without major additional side effects.
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The use of an in situ, one-pot polymerization-induced self-assembly method to synthesize light-responsive pyrene-containing nanoparticles is reported. The strategy is based on the chain extension of a hydrophilic macromolecular chain transfer agent, poly(oligo(ethylene glycol) methyl ether methacrylate), using a light-responsive monomer, 1-pyrenemethyl methacrylate (PyMA), via a reversible addition-fragmentation chain transfer dispersion polymerization; yielding nanoparticles of various morphologies (spherical micelles and worm-like micelles). In this process, addition of comonomers, such as butyl methacrylate (BuMA) or methyl methacrylate (MMA), are required to obtain high PyMA monomer conversion (>80% in 24 h). The addition of comonomers reduces the π-π stacking of the pyrene moieties, which facilitates the diffusion of monomers in the nanoparticle core. The addition of BuMA (as a comonomer) offers P(PyMA-co-BuMA) core-forming chains with high mobility that enables the reorganization of chains and then the evolution of morphology to form vesicles. In contrast, when MMA comonomer is used, kinetically trapped spheres are obtained; this is due to the low mobility of the core-forming chains inhibiting in situ morphological evolution. Finally, the UV-light-induced dissociation of these light-responsive nanoparticles due to the gradual cleavage of the pyrene moieties and the subsequent hydrophobic-to-hydrophilic transitions of the core-forming blocks is demonstrated.
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Técnicas de Química Sintética/métodos , Nanopartículas/química , Polimerização/efeitos da radiação , Polímeros/química , Pirenos/química , Raios Ultravioleta , Interações Hidrofóbicas e Hidrofílicas , Cinética , Metacrilatos/química , Metilmetacrilato/química , Micelas , Microscopia Eletrônica de Transmissão , Modelos Químicos , Estrutura Molecular , Nanopartículas/ultraestrutura , Polímeros/síntese químicaRESUMO
Similar to any modelling technique, system dynamics (SD) modelling should start with the essential step of scoping and identifying the problem of interest before further analysis and modelling. In practice, this first step is a challenging task, especially when wicked issues such as water management are being addressed. There is still a vital need for modelling methods and tools that can support modellers to identify and assemble essential data to inform problem scoping and boundary setting. This article aims to narrow this gap by presenting a methodology for combining a series of conceptual modelling techniques (extending the usually linear Driver-Pressure-State-Impact-Response framework with causal loop diagrams, system archetypes, stock and flow diagrams) towards the development of a quantitative SD model. A case study of the Gorganroud-Gharesu Basin, in Iran, is used to illustrate the benefits of the methodology. Our experience shows that combining multiple conceptual models provides complementary insights into the problem boundaries and model structure, as a basis for developing the SD model.
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Modelos Teóricos , Recursos Hídricos , Irã (Geográfico) , ÁguaRESUMO
The quality of nursing services is one of the challenges of health systems and nurses are responsible for providing quality care to patients. The purpose of this research is to study the relationship between nurses' social responsibility and the quality of nursing delivered services in educational and treatment centers. This study used a descriptive and correlational method. Using stratified random sampling, from 15 December 2015 to 28 September 2016, 150 nurses and 450 patients were selected respectively. The research instruments included Carol Social Responsibility Questionnaire and modified version of SERVQUAL questionnaire. There was a direct relationship between the services delivered to patients and nurses' social responsibility (r= 0.45 and p= 0.04). The planners and nursing authorities take appropriate consideration to increase the quality of nursing services in terms of reliability, responsiveness, assurance, and empathy in order to increase the social responsibility of nurses.
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Cuidados de Enfermagem , Responsabilidade Social , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Irã (Geográfico) , Masculino , Cuidados de Enfermagem/psicologia , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/normas , Qualidade da Assistência à Saúde , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Reversible addition-fragmentation chain-transfer (RAFT) polymerization is a valuable tool for synthesizing macromolecules with controlled topologies and diverse chemical functionalities. However, the application of RAFT polymerization to additive-manufacturing processes has been prevented due to the slow polymerization rates of typical systems. In this work, we developed and optimized a rapid visible (green) light mediated RAFT polymerization process and applied it to an open-air 3D printing system. The reaction components are non-toxic, metal free and environmentally friendly, which tailors these systems toward biomaterial fabrication. The inclusion of RAFT agent in the photosensitive resin provided control over the mechanical properties of 3D printed materials and allowed these materials to be post-functionalized after 3D printing. Additionally, photoinduced spatiotemporal control of the network structure provided a one-pass approach to 4D printed materials. This RAFT-mediated 3D and 4D printing process should provide access to a range of new functional and stimuli-responsive materials.
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In this study, an antimicrobial platform in the form of nitric oxide (NO) gas-releasing polydopamine (PDA)-coated iron oxide nanoparticles (IONPs) is developed for combating bacterial biofilms. NO is bound to the PDA-coated IONPs via the reaction between NO and the secondary amine moieties on PDA to form N-diazeniumdiolate (NONOate) functionality. To impart colloidal stability to the nanoparticles in aqueous solutions (e.g., phosphate buffered saline (PBS) and bacteria cell culture media M9), a polymer bearing hydrophilic and amine pendant groups, P(OEGMA)-b-P(ABA), is synthesized via reversible addition-fragmentation chain transfer (RAFT) polymerization and is subsequently grafted onto the PDA-coated IONPs by employing the Schiff base/Michael addition reaction between o-quinone and a primary amine. These nanoparticles are able to effectively disperse Pseudomonas aeruginosa biofilms (up to 79% dispersal) at submicromolar NO concentrations. In addition, the nanoparticles demonstrate excellent bactericidal activity toward P. aeruginosa planktonic and biofilm cells (up to 5-log10 reduction).
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Biofilmes/efeitos dos fármacos , Materiais Revestidos Biocompatíveis , Portadores de Fármacos , Indóis/química , Nanopartículas/química , Óxido Nítrico , Polímeros/química , Pseudomonas aeruginosa/fisiologia , Biofilmes/crescimento & desenvolvimento , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/farmacologia , Portadores de Fármacos/química , Portadores de Fármacos/farmacologia , Óxido Nítrico/química , Óxido Nítrico/farmacologiaRESUMO
In this study, immunohistochemical analysis was used to evaluate the expression of ALDH1 and NDRG2 in astrocytoma tissue samples and normal brain tissues. ALDH1 protein staining displayed that AlDH1 expression was not detectable in eight astrocytoma tissues (8/36) and in all of normal brain tissues. There was a significant difference between ALDH1 expression and WHO grades (P = 0.03). Furthermore, no correlation was determined between expression levels of ALDH1 and other clinicopathological characteristics including age, sex, and tumor size. Immunohistochemistry showed that a high level of NDRG2 protein expression was markedly detected in normal brain tissues and expression of NDRG2 protein was significantly decreased in astrocytoma tissues. There was a significant association between pathological grading and NDRG2 expression level (P < 0.001, Table 1), but no correlation was determined between expression levels of NDRG2 and other clinicopathological characteristics including age, sex, and tumor size. We also obtained detailed follow-up data and evaluated the association of ALDH1/NDRG2 expressions with overall survival. Kaplan-Meier survival and log-rank analysis indicated that the patients with high proportion of ALDH1-positive cells and low proportion of NDRG2-positive had shorter overall survival (P < 0.001; P = 0.001). Univariate analysis indicated that the high proportion of ALDH1-positive cells (P < 0.001), the low proportion of NDRG2-positive cells (P = 0.009), and the advanced grade (P < 0.005) were markedly linked to the prognosis in patients. Furthermore, in the multivariate analysis, ALDH1 cells' expression (P = 0.012), low proportion of NDRG2-positive cells (P = 0.025), and advanced grade (P < 0.03) were linked to poor overall survival. Our results suggest that NDRG2 expression is related to decreased survival rates and NDRG2 may be a potential marker in the astrocytoma prognosis. NDRG2 may be a potential marker in the astrocytoma prognosis. ALDH1 expression was related to advanced pathological grade and survival rate in astrocytoma patients.
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The polymerization of the photocleavable monomer, o-nitrobenzyl methacrylate (NBMA), is investigated using photoinduced electron/energy transfer reversible addition-fragmentation chain transfer polymerization. The polymerizations under visible red (λ max = 635 nm, 0.7 mW cm(-2) ) and yellow (λ max = 560 nm, 9.7 mW cm(-2) ) light are performed and demonstrate rational evidence of a controlled/living radical polymerization process. Well-defined poly(o-nitrobenzyl methacrylate) (PNBMA) homopolymers with good control over the molecular weight and polymer dispersity are successfully synthesized by varying the irradiation time and/or targeted degree of polymerization. Chain extension of a poly(oligo(ethylene glycol) methyl ether methacrylate) macro-chain transfer agent with NBMA is carried out to fabricate photocleavable amphiphilic block copolymers (BCP). Finally, these self-assembled BCP rapidly dissemble under UV light suggesting the photoresponsive character of NBMA is not altered during the polymerization under yellow or red light. Such photoresponsive polymers can be potentially used for the remote-controlled delivery of therapeutic compounds.
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Luz , Metacrilatos/química , Processos Fotoquímicos , Ácidos Polimetacrílicos/química , Ácidos Polimetacrílicos/síntese química , Preparações de Ação Retardada/síntese química , Preparações de Ação Retardada/químicaRESUMO
Back Cover: Polymers featuring photoresponsive groups have been exploited as promising drug delivery systems. Light as spatially and temporally controllable external stimulus can be readily tuned and focused to trigger changes in the structure of polymer chains to provide "on-command" drug delivery. A benign synthesis route for a novel controlled polymerization, known as photoinduced electron/energy transfer-reversible addition-fragmentation (PET-RAFT) polymerization, is presented. Further details can be found in the article by A. Bagheri, J. Yeow, H. Arandiyan, J. Xu, C. Boyer,* and M. Limon page 905.
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INTRODUCTION: Degenerative spine surgeries often require postoperative immobilization or reduced mobility, predisposing patients to the formation of thrombosis and higher risk of thromboembolic complications. Despite the significance of this issue, there remains a lack of consensus on the optimal anticoagulant agent for postoperative thromboprophylaxis in spinal stenosis and degenerative spine surgeries. Low molecular weight heparins and direct Xa inhibitors represent two anticoagulant groups with high chemoprophylactic potential. METHODS: This study included a prospective cohort of patients undergoing posterior decompressive surgery with or without instrumentation for degenerative spine disease and/or spinal stenosis. Patients receiving postoperative prophylactic Enoxaparin and Apixaban were selected to evaluate the rate of complications, as assessed by Clavien-Dindo classification, thromboembolic events, and 30-day mortality, readmission, and reoperation rate between the two anticoagulants. RESULTS: 130 patients were included in the analysis. 65 patients received Apixaban and Enoxaparin in each group. Mean age of the participants was 57.6±11.0. 83.1% underwent laminectomy and posterior spinal fusion, while 22 patients underwent decompressive surgery only. The incidence of venous thromboembolism (P-value=0.403), deep vein thrombosis (p-value=0.999), hematoma formation (p-value=0.403), surgical site infection (p-value=0.901), readmission (p-value=0.545), reoperation (p=0.510), mortality (p=0.648), and complications rate (p-value=0.232) were not statistically different between Enoxaparin and Apixaban. DISCUSSION: Both Apixaban and Enoxaparin may be viable options for postoperative thromboprophylaxis in spine surgeries with comparable efficacy and safety profile. Future research endeavors should investigate the efficacy of these agents in comparison to placebo in a randomized setting.
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Pirazóis , Piridonas , Estenose Espinal , Tromboembolia Venosa , Humanos , Enoxaparina/efeitos adversos , Anticoagulantes/efeitos adversos , Tromboembolia Venosa/epidemiologia , Estenose Espinal/cirurgia , Estenose Espinal/complicações , Estudos ProspectivosRESUMO
Objectives: This study aimed to develop and validate the OSABSS (Objective Structured Assessment of Basic Surgical Skills), a modified Objective Structured Clinical Examination (OSCE), to assess basic surgical skills in residents. Design: A developmental study conducted in two phases. Basic skills were identified through literature review and gap analysis. The OSABSS was then designed as a modified OSCE. Setting: This study took place at Alborz University of Medical Sciences in Iran. Interventions: The OSABSS was created using Harden's OSCE (Objective Structured Clinical Examination) methodology. Scenarios, checklists, and station configurations were developed through expert panels. The exam was piloted and implemented with residents as participants and faculty as evaluators. Participants: 32 surgical residents in gynecology, general surgery, orthopedics, and neurosurgery participated. 22 faculty members were evaluators. Primary and secondary outcome measures: The primary outcome was OSABSS exam scores. Secondary outcomes were written exam scores, and national residency entrance ranks. Main results: The mean OSABSS score was 16.59 ± 0.19 across all stations. Criterion validity was demonstrated through correlations between OSABSS scores, written scores and entrance ranks. Reliability was high, with a Cronbach's alpha of 0.87. No significant inter-rater score differences were found. Conclusions: The rigorous OSABSS development process produced an exam demonstrating strong validity and reliability for assessing basic surgical skills. The comprehensive station variety evaluates diverse technical and non-technical competencies. Further research should expand participant samples across surgical disciplines.
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BACKGROUND: Appreciating the various dimensions of the coronavirus disease 2019 (COVID-19) pandemic can improve health systems and prepare them to deal better with future pandemics and public health events. This study was conducted to investigate the association between the survival of hospitalized patients with COVID-19 and the epidemic risk stratification of the disease in Golestan province, Iran. METHODS: In this study, all patients with COVID-19 who were hospitalized in the hospitals of Golestan province of Iran from February 20, 2020, to December 19, 2022, and were registered in the Medical Care Monitoring Center (MCMC) system (85,885 individuals) were examined.The community's epidemic risk status (ERS) was determined based on the daily incidence statistics of COVID-19. The survival distribution and compare Survival in different subgroups was investigated using Kaplan-Meier and log-rank test and association between the survival and ERS by multiple Cox regression modeling. RESULTS: Out of 68,983 individuals whose data were correctly recorded, the mean age was 49 (SD = 23.98) years, and 52.8% were women. In total, 11.1% eventually died. The length of hospital stay was varying significantly with age, gender, ERS, underlying diseases, and COVID-19 severity (P < 0.001 for all). The adjusted hazard ratio of death for the ERS at medium, high, and very high-risk status compared to the low-risk status increased by 19%, 26%, and 56%, respectively (P < 0.001 for all). CONCLUSIONS: Enhancing preparedness, facilitating rapid rises in hospital capacities, and developing backup healthcare capacities can prevent excessive hospital referrals during health crises and further deaths.
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BACKGROUND: Given the significant occurrence of skin cancer in the Middle East and the existing research gap concerning its incidence and trends, this research aimed to study the epidemiology and trend changes of skin cancer in the Golestan province, Northeastern Iran. METHODS: The Golestan Population-based Cancer Registry's (GPCR's) data bank was utilized to gather information on confirmed skin cancer cases in the province during 2005-2018. We used Poisson regression analysis for comparing incidence rates between groups. P values less than 0.05 were considered statistically significant. RESULTS: Of 1690 patients (mean age: 62.05±15.83 years), most were male (60.1%) and resided in urban areas (61.5%). The age-standardized rate (ASR) of non-melanoma and melanoma skin cancer was 8.49 and 0.56 per 100000 persons-year, respectively. A notably higher ASR for non-melanoma skin cancer (NMSC) was observed in men (ASR: 10.60; 95% CI: 9.91-11.29) (P<0.01) and urban residents (ASR: 10.19; 95% CI: 9.52-10.82) (P<0.01). There was no significant difference in the ASR of melanoma skin cancer based on gender (P=0.24) and place of residence (P=0.48). The incidence trend of melanoma (estimated annual percent change [EAPC]: -3.28; 95% CI: -18.54 to 14.83) and NMSC (EAPC: 0.39; 95% CI: -3.99 to 4.97) did not differ significantly. CONCLUSION: During the 14-year study period, the ASR of both types of skin cancer exhibited a consistent pattern, except for NMSC, which showed higher rates among men and urban residents. This should be taken into consideration when formulating preventive and control strategies in the study area.
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Melanoma , Sistema de Registros , Neoplasias Cutâneas , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Neoplasias Cutâneas/epidemiologia , Incidência , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Melanoma/epidemiologia , Idoso de 80 Anos ou mais , Distribuição por Sexo , Distribuição por Idade , Adulto Jovem , População Urbana/estatística & dados numéricos , Adolescente , Carcinoma Basocelular/epidemiologiaRESUMO
The Astragalus subgenus Hypoglottis Bunge, which consists of several sections, is one of the taxonomically most complicated groups in the genus. The Astragalus section Stereothrix Bunge belongs to this subgenus and is a significant element of the Irano-Turanian floristic region. A molecular phylogenetic analysis of this section and its closely related taxa using nuclear ribosomal DNA internal transcribed spacers (ITS) and external transcribed spacer (ETS) regions as well as plastid matK sequences were conducted. Parsimony analyses and Bayesian phylogenetic inference revealed that the section is not monophyletic in its current form, as some taxa belonging to closely related sections such as Hypoglottidei DC. and the Malacothrix Bunge group within the sect. Stereothrix render it paraphyletic. Moreover, species groups belonging to sect. Stereothrix are placed in different clades within the phylogenetic tree of subgenus Hypoglottis, which indicates polyphyly, i.e., multiple independent origins of taxa placed in the sect. Stereothrix. Molecular dating of the group estimated an age of 3.62 (1.73-5.62) My for this assemblage with the major diversification events happening during the last 2 My. Many species groups separated only within the last 0.5 to 1 My. Based on morphological and molecular data, we discuss the phylogenetic relationships of the groups and synonymy of species. In addition, the included taxa of sect. Hypoglottidei are not monophyletic and include species belonging to sects. Hololeuce, Koelziana, Malacothrix, Onobrychoideae, and Ornithodpodium group within the sect. Stereothrix taxa. We conclude that only an analysis including all groups and nearly all species of the sections within the Hypoglottis clade can finally result in an new evolutionary-based system for these taxa.
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PURPOSE: Granulation tissue-induced tracheal stenosis (mainly secondary to intubation or lung transplantation) is one of the most common etiologies of benign airway obstructions. Recurrence rates after standard treatment options (surgical resection and/or endobronchial interventions) can inadvertently worsen the stricture through the stimulation of more granulation tissue generation (via increased fibroblast activity and roliferation). Low-dose radiotherapy could be a promising tool to prevent granulation tissue formation after surgery and/or endobronchial interventions regarding its established role in the treatment of keloids or hypertrophic scars, two benign diseases with similar a pathophysiology to tracheal stenosis. This study reviews case reports and small series that used endobronchial brachytherapy (EBBT) or external beam radiotherapy (EBRT) for the management of refractory granulation tissue-induced tracheal stenosis after surgery and/or endobronchial interventions. METHODS AND MATERIALS: Case reports and series (published up to October 2022) that reported outcomes of patients with recurrent granulation tissue-induced tracheal stenosis (after surgery and/or endobronchial interventions) treated by EBBT or EBRT (in definitive or prophylactic settings) were eligible. RESULTS: Sixteen studies (EBBT: nine studies including 69 patients, EBRT: seven studies including 32 patients) were reviewed. The pooled success rate across all studies was 74% and 97% for EBBT and EBRT, respectively. CONCLUSIONS: Radiation therapy appears to be effective in the management of selected patients with recurrent/refractory tracheal stenosis. Response to this treatment is usually good, but further studies with a larger number of patients and long-term followup are necessary to determine the optimal technique, dose, and timing of radiation therapy, late complications, the durability of response, and criteria for patient selection.
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Obstrução das Vias Respiratórias , Braquiterapia , Estenose Traqueal , Humanos , Braquiterapia/métodos , Estenose Traqueal/prevenção & controle , Estenose Traqueal/complicações , Tecido de Granulação/efeitos da radiação , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/radioterapiaRESUMO
BACKGROUND: Epidemiological research on the high-risk population might be helpful in early detection and prevention of biliary tract malignancies. This study assesses the prevalence of biliary tract cancer (BTC) in the Golestan province, northeastern Iran, between 2004 and 2016. METHODS: The current study used information from the Golestan Population-based Cancer Registry (GPCR) to access the epidemiology of BTC across a 13-year period while taking into account temporal and geographic differences. The number of cases, crude rates, age-standardized incidence rates (ASRs) per 100,000 person-years, average annual percent change (AAPC), age-specific incidence rates, and 95% confidence intervals (CI) were reported for each year with respect to gender and place of residence. RESULTS: Totally, 224 instances of BTC overall (54% of whom were females) were reported throughout the research period. The ASR of BTC was 1.7 (95% CI: 1.4â2) for females and 1.4 (95% CI: 1.1â1.6) for men, respectively. Males exhibited a growing time trend in incidence (AAPC: 7.18; CI: 0.06â14.81; P-value:0.048), whereas females had a decreasing trend (AAPC: 0.82; CI: -5.94â4.57; P-value: 0.740). Both sexes saw an increase in age-specific incidence rates starting at the age of 45; however, males experienced a significant increase in incidence in the age group of 75 to 79 while the female rates grew steadily. CONCLUSION: The focus for cancer control in this region may be given to demographic groups with a combination of risk factors, including male gender, older age, and urban residence.
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Neoplasias , Humanos , Masculino , Feminino , Idoso , Irã (Geográfico)/epidemiologia , Sistema de Registros , Neoplasias/epidemiologia , Incidência , Fatores de RiscoRESUMO
Estrogens are a group of sex hormones which have receptors on the skin and lead to increased cells and wound healing. Normally isoflavonoids are present in Astragalus floccosus Boiss. (Leguminosae). Therefore, the present study was conducted to evaluate the presence of isoflavonoids in A. floccosus' rich fraction of flavonoid and evaluate its wound healing effect accordingly. Flavonoids were evaluated by LCMS. Scratch was conducted and the medium culture was treated with the Astragalus' rich fraction of flavonoid (RFF) and was compared with nontreated culture during 48 hours. In addition, in vivo full-thickness wound healing evaluation was performed on rats. The rats were put into four groups and treated on a daily basis for 21 days with a cream containing 1.5% of the RFF (group 1), silver sulfadiazine (group 2), and Vaseline (group 3) separately. The nontreated group (group 4) was created for a better comparison. During the examination, wound size was evaluated and histopathological examination was performed. Herbal analysis detected 11 flavonoids, including 2 isoflavonoids, Calycosin-7-O-beta-D-glucoside and Formononetin, in the RFF. In vitro scratch wound healing showed significant improvement with RFF treatment in comparison to nontreated medium. Furthermore, in vitro drug release of Astragalus ointment showed a stationary line during 24 h and 0.14 mg/ml of flavonoid penetrated the skin. In vivo wound size evaluation showed significant improvement in the group treated with the RFF in comparison to other groups. Histopathological results indicated that congestion, edema, inflammation, necrosis, and angiogenesis decreased during the examination and fibroblast proliferation fibrosis epithelization was increased especially in the RFF group in comparison to the silver sulfadiazine and free groups. In conclusion, A. floccosus showed that wound healing activity in both in vitro and in vivo analyses can be attributed to the presence of isoflavonoids with estrogen-like activity in this plant.
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Methods: The methanolic root extract was prepared by maceration, and flavonoids were evaluated by LC/MS. In silico examination was performed based on the LC/MS results, and the binding affinity of these compounds to estrogen receptors (ERs) α and ß was evaluated. Wound healing evaluation in both in vitro (NHDF cell line, by 500 µg/ml concentration of the extract, 24 h) and in vivo (Wistar rat, topical daily treated with 1.5% of the extract ointment, 21 days) conditions in comparison to control groups was conducted. Rats' control groups included silver sulfadiazine, Vaseline, and the nontreated groups. Results: Eleven flavonoids were detected using LC/MS. The in silico study showed that formononetin, kaempferol-based structures, quercetin-3-O-neohesperidoside, and calycosin-7-O-beta-D-glucoside had a high affinity (<-6.3) to ERs α and ß. Wound closing measurement showed significant improvement in the group treated with the extract in both in vitro and in vivo assays compared to the control groups. Histopathological results confirmed these findings; inflammation factors decreased, and fibroblast proliferation, fibrosis, and epithelization increased, especially in the extract group. Conclusion: This study shows that Astragalus microcephalus has wound healing activity in vitro and in vivo with low toxicity due to the presence of flavonoids, especially isoflavonoids, which show a high affinity to bind to ERs α and ß in the skin tissue.