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The hypoxic environment is prominently witnessed in most solid tumors and is associated with the promotion of cell proliferation, epithelial-mesenchymal transition (EMT), angiogenesis, metabolic reprogramming, therapeutic resistance, and metastasis of tumor cells. All the effects are mediated by the expression of a transcription factor hypoxia-inducible factor-1α (HIF-1α). HIF-1α transcriptionally modulates the expression of genes responsible for all the aforementioned functions. The stability of HIF-1α is regulated by many proteins and non-coding RNAs (ncRNAs). In this article, we have critically discussed the crucial role of ncRNAs [such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs), Piwi-interacting RNAs (piRNAs), and transfer RNA (tRNA)-derived small RNAs (tsRNAs)] in the regulation of stability and expression of HIF-1α. We have comprehensively discussed the molecular mechanisms and relationship of HIF-1α with each type of ncRNA in either promotion or repression of human cancers and therapeutic resistance. We have also elaborated on ncRNAs that are in clinical examination for the treatment of cancers. Overall, the majority of aspects concerning the relationship between HIF-1α and ncRNAs have been discussed in this article.
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MicroRNAs , Neoplasias , Humanos , Proliferação de Células/genética , Resistencia a Medicamentos Antineoplásicos/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , MicroRNAs/genética , MicroRNAs/metabolismo , Neoplasias/tratamento farmacológico , Neoplasias/genética , RNA não Traduzido/genéticaRESUMO
This study explores the critical role of inhibitors targeting the mammalian target of rapamycin (mTOR) signaling pathway in breast cancer research and treatment. The mTOR pathway, a central regulator of cellular processes, has been identified as a crucial factor in the development and progression of breast cancer. The essay explains the complex molecular mechanisms through which mTOR inhibitors, such as rapamycin and its analogs, exert their anticancer effects. These inhibitors can stop cell growth, proliferation, and survival in breast cancer cells by blocking critical signaling pathways within the mTOR pathway. Furthermore, the essay discusses the implications of using mTOR inhibitors as a comprehensive therapeutic strategy. It emphasizes the potential benefits of combining mTOR inhibitors with other treatment approaches to enhance the effectiveness of breast cancer treatment. The evolving landscape of breast cancer research underscores the significance of mTOR as a therapeutic target and highlights ongoing efforts to improve and optimize mTOR inhibitors for clinical use. In conclusion, the essay asserts that inhibitors of the mTOR signaling pathway offer a promising approach in the fight against breast cancer. These inhibitors provide a focused and effective intervention targeting specific dysregulations within the mTOR pathway. As research advances, the integration of mTOR inhibitors into customized combination therapies holds excellent potential for shaping a more effective and personalized approach to breast cancer treatment, ultimately leading to improved outcomes for individuals affected by this complex and diverse disease.
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Nuclear paraspeckle assembly transcript 1 (NEAT1) is a long noncoding RNA (lncRNA) that is widely expressed in a variety of mammalian cell types. Altered expression levels of the lncRNA NEAT1 have been reported in liver-related disorders including cancer, fatty liver disease, liver fibrosis, viral hepatitis, and hepatic ischemia. lncRNA NEAT1 mostly acts as a competing endogenous RNA (ceRNA) to sponge various miRNAs (miRs) to regulate different functions. In regard to hepatic cancers, the elevated expression of NEAT1 has been reported to have a relation with the proliferation, migration, angiogenesis, apoptosis, as well as epithelial-mesenchymal transition (EMT) of cancer cells. Furthermore, NEAT1 upregulation has contributed to the pathogenesis of other liver diseases such as fibrosis. In this review, we summarize and discuss the molecular mechanisms by which NEAT1 contributes to liver-related disorders including acute liver failure, nonalcoholic fatty liver disease (NAFLD), liver fibrosis, and liver carcinoma, providing novel insights and introducing NEAT1 as a potential therapeutic target in these diseases.
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MicroRNAs , Hepatopatia Gordurosa não Alcoólica , RNA Longo não Codificante , Animais , Humanos , Proliferação de Células/genética , Fibrose , Cirrose Hepática/genética , Mamíferos/genética , Mamíferos/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Hepatopatia Gordurosa não Alcoólica/genética , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismoRESUMO
Nucleic acid vaccines (NAVs) have the potential to be economical, safe, and efficacious. Furthermore, just the chosen antigen in the pathogen is the target of the immune responses brought on by NAVs. Triple-negative breast cancer (TNBC) treatment shows great promise for nucleic acid-based vaccines, such as DNA (as plasmids) and RNA (as messenger RNA [mRNA]). Moreover, cancer vaccines offer a compelling approach that can elicit targeted and long-lasting immune responses against tumor antigens. Bacterial plasmids that encode antigens and immunostimulatory molecules serve as the foundation for DNA vaccines. In the 1990s, plasmid DNA encoding the influenza A nucleoprotein triggered a protective and targeted cytotoxic T lymphocyte (CTL) response, marking the first instance of DNA vaccine-mediated immunity. Similarly, in vitro transcribed mRNA was first successfully used in animals in 1990. At that point, mice were given an injection of the gene encoding the mRNA sequence, and the researchers saw the production of a protein. We begin this review by summarizing our existing knowledge of NAVs. Next, we addressed NAV delivery, emphasizing the need to increase efficacy in TNBC.
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Neoplasias de Mama Triplo Negativas , Vacinas de DNA , Humanos , Camundongos , Animais , Vacinas Baseadas em Ácido Nucleico , Neoplasias de Mama Triplo Negativas/terapia , Neoplasias de Mama Triplo Negativas/patologia , Imunoterapia , DNA , RNA Mensageiro/genéticaRESUMO
The escalating global health challenge posed by infections prompts the exploration of innovative solutions utilizing MXene-based nanostructures. Societally, the need for effective antimicrobial strategies is crucial for public health, while scientifically, MXenes present promising properties for therapeutic applications, necessitating scalable production and comprehensive characterization techniques. Here we review the versatile physicochemical properties of MXene materials for combatting microbial threats and their various synthesis methods, including etching and top-down or bottom-up techniques. Crucial characterization techniques such as XRD, Raman spectroscopy, SEM/TEM, FTIR, XPS, and BET analysis provide insightful structural and functional attributes. The review highlights MXenes' diverse antimicrobial mechanisms, spanning membrane disruption and oxidative stress induction, demonstrating efficacy against bacterial, viral, and fungal infections. Despite translational hurdles, MXene-based nanostructures offer broad-spectrum antimicrobial potential, with applications in drug delivery and diagnostics, presenting a promising path for advancing infection control in global healthcare.
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Anti-Infecciosos , Nanoestruturas , Nanoestruturas/química , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , Anti-Infecciosos/síntese química , Humanos , Testes de Sensibilidade Microbiana , Bactérias/efeitos dos fármacos , Controle de Infecções , Antibacterianos/farmacologia , Antibacterianos/química , Antibacterianos/síntese químicaRESUMO
This systematic review and meta-analysis aimed to evaluate the relationship between body mass index (BMI) and mortality of burn patients. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Body mass index", "Burns" and "Mortality" from the earliest to the April 1, 2023. The quality of the studies included in this systematic review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). Finally, six articles were included in this systematic review and meta-analysis. A total of 16 154 burn patients participated in six studies. Their mean age was 46.32 (SD = 1.99). Of the participants, 71.7% were males. The mean length of hospitalization was 18.80 (SD = 8.08) days, and the average TBSA in burn patients was 38.32 (SD = 2.79) %. Also, the average BMI in burn patients was 27.10 (SD = 1.75). Results found mortality in patients with abnormal BMI (overweight to morbidity BMI) was 0.19 more than normal BMI (ES: 1.19, 95%CI: 0.76-1.87, Z = 0.75, I2 : 71.8%, p = 0.45). Results of linear dose-response showed each 5 kg/m2 increase in BMI was associated with a 5% increase in mortality that was marginally significant (ES: 1.05, 95%CI: 1.00-1.11, Z = 1.99, I2 : 22.2%, p = 0.047). There was a non-linear relationship between levels of BMI and mortality (Prob > χ2 = 0.02). There was an increase in mortality from percentile 10 to 50, although it was not significant (Correlational coefficient: 0.01, p = 0.85). Also, there was an increase in mortality rate from percentile 50 to 90 that was statistically significant (correlational coefficient: 0.06, p = 0.047). Finally, the results of the study indicated BMI can increase the chance of mortality by 0.19, although it was not significant. As a result, more studies are needed to better judge the relationship between BMI and mortality in burn victims.
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Queimaduras , Sobrepeso , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Índice de Massa Corporal , Estudos Transversais , Queimaduras/terapiaRESUMO
Fractures in bone, a tissue critical in protecting other organs, affect patients' quality of life and have a heavy economic burden on societies. Based on regenerative medicine and bone tissue engineering approaches, stem cells have become a promising and attractive strategy for repairing bone fractures via differentiation into bone-forming cells and production of favorable mediators. Recent evidence suggests that stem cell-derived exosomes could mediate the therapeutic effects of their counterpart cells and provide a cell-free therapeutic strategy in bone repair. Since bone is a highly vascularized tissue, coupling angiogenesis and osteogenesis is critical in bone fracture healing; thus, developing therapeutic strategies to promote angiogenesis will facilitate bone regeneration and healing. To this end, stem cell-derived exosomes with angiogenic potency have been developed to improve fracture healing. This review summarizes the effects of stem cell-derived exosomes on the repair of bone tissue, focusing on the angiogenesis process.
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Exossomos , Células-Tronco Mesenquimais , Humanos , Qualidade de Vida , Neovascularização Fisiológica , Células-Tronco , Regeneração Óssea , OsteogêneseRESUMO
Oncolytic viruses (OVs) infect, multiply, and finally remove tumor cells selectively, causing no damage to normal cells in the process. Because of their specific features, such as, the ability to induce immunogenic cell death and to contain curative transgenes in their genomes, OVs have attracted attention as candidates to be utilized in cooperation with immunotherapies for cancer treatment. This treatment takes advantage of most tumor cells' inherent tendency to be infected by certain OVs and both innate and adaptive immune responses are elicited by OV infection and oncolysis. OVs can also modulate tumor microenvironment and boost anti-tumor immune responses. Mesenchymal stem cells (MSC) are gathering interest as promising anti-cancer treatments with the ability to address a wide range of cancers. MSCs exhibit tumor-trophic migration characteristics, allowing them to be used as delivery vehicles for successful, targeted treatment of isolated tumors and metastatic malignancies. Preclinical and clinical research were reviewed in this study to discuss using MSC-released OVs as a novel method for the treatment of cancer. Video Abstract.
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Células-Tronco Mesenquimais , Neoplasias , Terapia Viral Oncolítica , Vírus Oncolíticos , Humanos , Vírus Oncolíticos/fisiologia , Terapia Viral Oncolítica/métodos , Neoplasias/patologia , Imunoterapia , Células-Tronco Mesenquimais/patologia , Microambiente TumoralRESUMO
The metabolism of cancer has been an interesting hallmark and metabolic reprogramming, especially the change from oxidative phosphorylation in mitochondria to glucose metabolism known as glycolysis occurs in cancer. The molecular profile of glycolysis, related molecular pathways and enzymes involved in this mechanism such as hexokinase have been fully understood. The glycolysis inhibition can significantly decrease tumorigenesis. On the other hand, circRNAs are new emerging non-coding RNA (ncRNA) molecules with potential biological functions and aberrant expression in cancer cells which have received high attention in recent years. CircRNAs have a unique covalently closed loop structure which makes them highly stable and reliable biomarkers in cancer. CircRNAs are regulators of molecular mechanisms including glycolysis. The enzymes involved in the glycolysis mechanism such as hexokinase are regulated by circRNAs to modulate tumor progression. Induction of glycolysis by circRNAs can significantly increase proliferation rate of cancer cells given access to energy and enhance metastasis. CircRNAs regulating glycolysis can influence drug resistance in cancers because of theirimpact on malignancy of tumor cells upon glycolysis induction. TRIM44, CDCA3, SKA2 and ROCK1 are among the downstream targets of circRNAs in regulating glycolysis in cancer. Additionally, microRNAs are key regulators of glycolysis mechanism in cancer cells and can affect related molecular pathways and enzymes. CircRNAs sponge miRNAs to regulate glycolysis as a main upstream mediator. Moreover, nanoparticles have been emerged as new tools in tumorigenesis suppression and in addition to drug and gene delivery, then mediate cancer immunotherapy and can be used for vaccine development. The nanoparticles can delivery circRNAs in cancer therapy and they are promising candidates in regulation of glycolysis, its suppression and inhibition of related pathways such as HIF-1α. The stimuli-responsive nanoparticles and ligand-functionalized ones have been developed for selective targeting of glycolysis and cancer cells, and mediating carcinogenesis inhibition.
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MicroRNAs , Neoplasias , Humanos , RNA Circular/metabolismo , Hexoquinase/genética , Hexoquinase/metabolismo , Neoplasias/terapia , Neoplasias/genética , MicroRNAs/genética , MicroRNAs/metabolismo , Carcinogênese , Transformação Celular Neoplásica , Glicólise , Proteínas de Ciclo Celular/metabolismo , Quinases Associadas a rho/metabolismo , Proteínas com Motivo Tripartido/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismoRESUMO
BACKGROUND: Waterpipe tobacco smoking rates in the Eastern Mediterranean region are among the highest worldwide, yet little evidence exists on its economics. Estimates of demand elasticities for tobacco products are largely limited to cigarettes. This study aimed to estimate own-price and cross-price elasticities of demand for cigarettes and waterpipe tobacco products in Lebanon, Jordan and Palestine. METHODS: A volumetric choice experiment was conducted using nationally representative household surveys. The choice experiment elicited respondents' stated purchases of eight cigarette and waterpipe tobacco product varieties by hypothetically varying prices. Data were analysed using zero-inflated Poisson models that yielded demand elasticity estimates of cigarette and waterpipe tobacco consumption. RESULTS: The study included 1680 participants in Lebanon (50% female), 1925 in Jordan (44.6% female) and 1679 in Palestine (50% female). We found the demand for premium cigarettes to be price elastic (range, -1.0 to -1.2) across all three countries, whereas the demand for discount cigarettes was less elastic than premium cigarettes in Lebanon (-0.6) and Jordan (-0.7) and more elastic in Palestine (-1.2). The demand for premium waterpipe tobacco was highly elastic in Lebanon (-1.9), moderately elastic in Jordan (-0.6) and inelastic in Palestine (0.2). The cross-price elasticity between cigarettes and waterpipe tobacco was near zero, suggesting that the two products are not considered to be close substitutes by consumers. CONCLUSIONS: These results serve as a strong evidence base for developing and implementing fiscal policies for tobacco control in the Eastern Mediterranean region that address cigarettes and waterpipe tobacco products.
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Cachimbos de Água , Produtos do Tabaco , Tabaco para Cachimbos de Água , Feminino , Humanos , Masculino , Comércio , Elasticidade , ImpostosRESUMO
The incidence of cancer has been growing worldwide. Better survival rates following the administration of novel drugs and new combination therapies may concomitantly cause concern regarding the long-term adverse effects of cancer therapy, for example, second primary malignancies. Moreover, overcoming tumour resistance to anticancer agents has been long considered as a critical challenge in cancer research. Some low toxic adjuvants such as herb-derived molecules may be of interest for chemoprevention and overcoming the resistance of malignancies to cancer therapy. Apigenin is a plant-derived molecule with attractive properties for chemoprevention, for instance, promising anti-tumour effects, which may make it a desirable adjuvant to reduce genomic instability and the risks of second malignancies among normal tissues. Moreover, it may improve the efficiency of anticancer modalities. This paper aims to review various effects of apigenin in both normal tissues and malignancies. In addition, we explain how apigenin may have the ability to protect usual cells against the genotoxic repercussions following radiotherapy and chemotherapy. Furthermore, the inhibitory effects of apigenin on tumours will be discussed.
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Apigenina , Neoplasias , Humanos , Apigenina/farmacologia , Apigenina/uso terapêutico , Neoplasias/tratamento farmacológico , Neoplasias/genética , Neoplasias/prevenção & controleRESUMO
This study evaluated the impacts of the probiotic, Lactobacillus sakei (L. sakei), and the extract of hawthorn, Crataegus elbursensis, on growth and immunity of the common carp exposed to acetamiprid. Fish (mean ± SE: 11.48 ± 0.1 g) feeding was done with formulated diets (T 1 (control): no supplementation, T 2: 1 × 106 CFU/g LS (Lactobacillus sakei), T3: 1 × 108 CFU/g LS, T 4: 0.5% hawthorn extract (HWE), and T 5: 1% HWE) for 60 days and then exposed to acetamiprid for 14 days. The growth performance improved in the fish fed LS at dietary level of 1 × 108 CFU/g, even after exposure to acetamiprid (P < 0.05). Intestinal Lactobacillus sakei (CFU/g) load increased (P < 0.05), following supplementation with the probiotic-enriched diet. The LS-treated fish had increases in the activity of digestive enzymes (P < 0.05). Both LS and HWE stimulated antioxidant enzymes and immune system components in serum and mucus (alkaline phosphatase (ALP), protease, total Ig, and lysozyme) (P < 0.05). However, the changes were different depending on the kind of the supplement. The malondialdehyde (MDA) levels decreased in HWE-treated fish after acetamiprid exposure (P < 0.05). Both LS and HWE reduced the liver metabolic enzymes (LDH, ALP, AST, ALT, and LDH) in serum both before and after exposure to the pesticide (P < 0.05). However, each enzyme exhibited a different change trend depending on the type of the supplement. HWE showed a stress-ameliorating effect, as glucose and cortisol levels declined in the HWE-treated fish (P < 0.05). This study indicated the immunomodulatory impacts of LS (1 × 108 CFU/g) and HWE (at dietary levels of 0.5-1%). The probiotic showed more performance compared to HWE. However, the HWE mitigated oxidative stress more efficiently than the probiotic.
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In this study, we investigate the potentials of dietary curcumin and resveratrol on blood biochemistry, immune responses and resistance to the toxicity of the pesticide, abamectin. 540 common carps (30.78 ± 0.17 g) were randomly distributed into 18 tanks (30 fish per tank), as six experimental groups (T1: non-supplemented and on-exposed fish, T2: 300 mg/kg curcumin, T3: 300 mg/kg resveratrol, T4: 12.5% LC50 of abamectin, T5: 300 mg/kg curcumin +12.5% LC50 of abamectin, T6: 300 mg/kg resveratrol + 12.5% LC50 of abamectin). Use of 300 mg/kg resveratrol in the diet of non-abamectin exposed fish improved the growth performance (P < 0.05), while such effects were not observed for curcumin (P > 0.05). There were no differences in the final weight (FW), feed conversion ratio (FCR) and weight gain (WG) between control and fish of the treatments, resveratrol + abamectin and curcumin + abamectin (P < 0.05). The immune components in blood [lysozyme, complement activity, Total immunoglobulin (total Ig), protease, myeloperoxidase (MPO), nitro-blue-tetrazolium (NBT), peroxidase, albumin] and mucus [acid phosphatase (ACP), alkaline phosphatase (ALP), esterase, antiprotease)] and antioxidant enzymes [(superoxide dismutase (SOD), glutathione peroxidase (GPx)] exhibited various change patterns compared to the control group, however, these components were almost all higher in fish supplemented with curcumin and resveratrol in an abamectin-free medium than in control and other groups (P < 0.05). In most cases, the levels of immune and antioxidant components in the control did not show significant difference with the treatments, resveratrol + abamectin and curcumin + abamectin (P > 0.05). Abamectin induced oxidative stress in fish, as the malondialdehyde (MDA) levels significantly increased in the exposed fish compared to non-exposed groups (P < 0.05). It appears that neither curcumin nor resveratrol were as effective in preventing oxidative stress, because MDA levels were higher in exposed fish (abamectin, curcumin + abamectin, resveratrol + abamectin) than in control and non-exposed individuals (P < 0.05). Curcumin and resveratrol also showed protective effects on liver, since the levels of liver metabolic enzymes [aspartate transaminase (AST), ALP, lactate dehydrogenase (LDH)] were lower in the supplemented fish in a abamectin-free medium than in control (P < 0.05). Curcumin and resveratrol also mitigated the stress responses in the exposed fish, as cortisol and glucose levels showed significant decreases in the supplemented fish (P < 0.05). In conclusion, this study revealed that abamectin can depress the growth and immunity in the common carp. Although, both resveratrol and curcumin were mitigated the toxic effects of abamectin, it seems that resveratrol be more effective than curcumin.
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Carpas , Curcumina , Praguicidas , Fosfatase Ácida , Albuminas , Fosfatase Alcalina , Ração Animal/análise , Animais , Antioxidantes/metabolismo , Aspartato Aminotransferases , Carpas/metabolismo , Curcumina/farmacologia , Dieta/veterinária , Suplementos Nutricionais/análise , Glucose , Glutationa Peroxidase , Hidrocortisona , Imunoglobulinas , Lactato Desidrogenases , Malondialdeído , Muco/metabolismo , Muramidase , Peptídeo Hidrolases , Peroxidase , Inibidores de Proteases , Resveratrol , Superóxido DismutaseRESUMO
INTRODUCTION: Despite the high prevalence of waterpipe tobacco smoking in the Eastern Mediterranean region, evidence supporting its fiscal measures is limited. We modelled the impact of waterpipe tobacco-specific excise taxes on consumption, government revenue and premature deaths averted in Jordan, Lebanon and Palestine. METHODS: We developed a simulation model using country-specific and market share-specific price, consumption and price elasticity data from WHO, UN Comtrade and nationally representative surveys. We modelled increases to specific excise taxes to meet a 35.9% tax burden on 20 g of waterpipe tobacco in Lebanon and Jordan, in line with the global average, and to double government revenues from excise duties in Palestine, which has surpassed this average. RESULTS: Specific excise tax was raised by $1.14 ($0.18-$1.32) in Jordan, $2.41 ($0.03-$2.44) in Lebanon (alongside removal of ad valorem taxes) and $2.39 ($1.72-$4.11) in Palestine per 20 g of waterpipe tobacco. Government revenue increased by $126.3 million in Jordan, $53.8 million in Lebanon and $162.4 million in Palestine while waterpipes smoked decreased by 32.4% in Jordan, 71.0% in Lebanon and 16.3% in Palestine. The corresponding numbers of premature deaths averted annually were approximately 162 000; 1 000 000; and 52 000. DISCUSSION: Increases in waterpipe tobacco-specific excise taxes substantially reduce smoking and increase government revenue and averted premature deaths in Jordan, Lebanon and Palestine. This has positive implications for both public health and financing and should be considered a policy priority.
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Economic evaluation of tobacco control policies is common in high-income settings and mainly focuses on cigarette smoking. Evidence suggests that increasing the excise tax of tobacco products is a consistently effective tool for reducing tobacco use and is an efficient mechanism for increasing government revenues. However, less research has been conducted in low/middle-income countries where other tobacco forms are common. This paper presents insights from our work on the economics of waterpipe tobacco smoking conducted in the Eastern Mediterranean Region where waterpipe smoking originated and is highly prevalent. The specific areas related to economics of waterpipe smoking considered herein are: price elasticity, taxation, government revenue, expenditure and healthcare costs. This paper aims to provide practical guidance for researchers investigating the economics of waterpipe tobacco with potential implications for other novel tobacco products. We present lessons learnt across five thematic areas: data, demand, taxes, equity and health modelling. We also highlight knowledge gaps to be addressed in future research. Research implications include designing comprehensive assessment tools that investigate heterogeneity in waterpipe smoking patterns; accounting for cross-price elasticity of demand with other tobacco products; exploring the change in waterpipe tobacco smoking in response to a tax increase and analysing the equity impact of waterpipe tobacco control interventions.
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BACKGROUND: Atrial fibrillation (AF) is the most common form of dysrhythmia observed in the clinical field, causing multiple morbidities, such as thromboembolic complications. Hence, the maintenance of sinus rhythm is superior to rate control. This study tests the efficacy of single- and low-dose amiodarone on the persistence of AF after surgery before transfer to the intensive care unit. METHODS: A double-blinded, randomized controlled trial assessed 113 patients who underwent mitral valve surgery with preoperative chronic AF. Patients were divided into two groups: the control group (N = 55) who received 50 mL of 5% dextrose over 10 min after general anesthesia induction, and the amiodarone group (N = 58) who received 1 mg/kg of amiodarone diluted in 50 mL of 5% dextrose over 10 min shortly after anesthesia induction. RESULTS: The amiodarone group had a statistically significant successful conversion of preoperative AF to normal sinus rhythm in 40 patients (72.73%). The control group demonstrated spontaneous conversion from AF to a normal sinus rhythm in seven patients (12.73%). The sinus rhythm was maintained in 60% of patients (36), as four patients reverted to AF during the hospital stay despite the initial normal sinus rhythm after the operation. In contrast, 53 (96.36%) patients in the control group were discharged from the hospital with a controlled rate of AF. In addition, low-dose amiodarone caused a statistically significant reduction in heart rates at 10, 30, and 60 min after declamping, extended throughout the first 24 h with mean heart rates of 97.233±7.311, 99.509±8.482, and 97.940±7.715 bpm, respectively. In comparison, the control group had heart rates of 115.382±7.547, 115.055±13.919, and 113.618±8.765 bpm at these times. The mean postoperative heart rate at the end of the first 24 h was 97.793±7.189 bpm in the amiodarone group and 113.036±9.737 bpm in the control group. No mortality or need for mechanical support was recorded in either group. CONCLUSIONS: Single and low-dose intraoperative intravenous amiodarone during mitral valve surgery may be practical to aid in pharmacological cardioversion of patients with preoperative chronic AF presenting for mitral valve surgery.
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Amiodarona , Fibrilação Atrial , Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Cardioversão Elétrica , Glucose/uso terapêutico , Humanos , Valva Mitral/cirurgia , Resultado do TratamentoRESUMO
In this study, blend nanofibrous scaffolds were electrospun from polycaprolactone/gelatin (PCL/Gel) blend solutions reinforced by bone morphogenetic protein (BMP)-modified graphene oxide (GO). SEM results showed that uniform and bead-less nanofibers with 270 nm average diameter were obtained from electrospun of PCL/Gel blend solutions. Tensile strength test and contact angle measurement demonstrated that addition of PCL led to higher mechanical and physical properties of the resulting nanofibers. The addition of PCL as well as GO in the blend supports the suitable mechanical strength in the body media. The loading of BMP-modified graphene in the Gel/PCL structure caused the formation of nanofibrous substrate with great resemblance to bone tissue. Gel/PCL-G hybrid nanofibers revealed good biocompatibility in the presence of human osteosarcoma cells, and no trace of cellular toxicity was observed. The cells grown on the scaffolds exhibited a spindle-like and broad morphology and almost uniformly covered the entire nanofiber scaffold. Gel/PCL nanofibers reinforced by graphene oxide-immobilized bone morphogenetic protein was prepared as a promising safe and biocompatible nanofiber with high antibacterial activity for bone tissue engineering.
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Grafite , Nanofibras , Proteínas Morfogenéticas Ósseas , Osso e Ossos , Gelatina/química , Humanos , Nanofibras/química , Poliésteres/química , Engenharia Tecidual/métodos , Alicerces Teciduais/químicaRESUMO
OBJECTIVE: The aim: The present study was carried out on patients recovered from COVID-19, including those patients who have taken vaccine and those who have not. PATIENTS AND METHODS: Materials and methods: The patients were recruited via an online panel and surveyed at different regions of Iraq from June 1, 2021, to August 30, 2021. RESULTS: Results: Our results demonstrated that the highest percentage of people recommended Pfizer vaccine followed by Sinopharm, while AstraZeneca vaccine was least recommended. CONCLUSION: Conclusions: The efficacy of different vaccines differed significantly; the highest effectiveness was observed with Pfizer vaccine followed by AstraZeneca and Sinopharm with effectiveness ranging from 94%, 89%, and 74%, respectively. Further, the highest percentage of re-infected patients was observed with Sinopharm vaccine followed by Astra Zeneca and Pfizer vaccine, respectively. Also, the highest percent of re-infection with masking used was seen in the case of Sinopharm vaccine followed by AstraZeneca and Pfizer vaccine. Although, we observed that post-vaccination symptoms were lowest than pre-vaccination symptoms, the percent of asymptomatic cases post-vaccination was highest than pre-vaccination cases for all vaccines.
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COVID-19 , Vacinas , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Humanos , Iraque , VacinaçãoRESUMO
OBJECTIVE: The aim: In this study, we looked into the possible link between the G196A polymorphism in the BDNF gene and DM in Iraqi patients. PATIENTS AND METHODS: Materials and methods: By using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) approach, 100 subjects were genotyped for the G196A SNP of the BDNF gene, 50 as DM and 50 as controls, age-sex and ethnically matched healthy controls. Analysis of covariance (ANCOVA) was used to assess the association of this polymorphism, and genotype frequencies were compared between patients and healthy controls. RESULTS: Results: Our result show that patient with the AG (Val-Met) genotype had a 40%of total DM patients than those and GG (Val-Val) genotypes. Therefore, we concluded that as a future aspect of the report the work can be further extended on proteomic level wherein the corresponding change occurred due to the mutation in the protein can be further detected at structural and functional level. CONCLUSION: Conclusions: conclusion of our result was any patient with covid-19 must need to follow up for at least 1 month after recovery to notified of the post-Covid symptoms especially the male gender.
Assuntos
Fator Neurotrófico Derivado do Encéfalo , Diabetes Mellitus Tipo 2 , Fator Neurotrófico Derivado do Encéfalo/genética , COVID-19/complicações , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/genética , Humanos , Iraque , Masculino , ProteômicaRESUMO
BACKGROUND: Armed conflicts have major indirect health impacts in addition to the direct harms from violence. They create enduring political instability, destabilise health systems, and foster negative socioeconomic and environmental conditions-all of which constrain efforts to reduce maternal and child mortality. The detrimental impacts of conflict on global maternal and child health are not robustly quantified. This study assesses the association between conflict and maternal and child health globally. METHODS AND FINDINGS: Data for 181 countries (2000-2019) from the Uppsala Conflict Data Program and World Bank were analysed using panel regression models. Primary outcomes were maternal, under-5, infant, and neonatal mortality rates. Secondary outcomes were delivery by a skilled birth attendant and diphtheria, pertussis, and tetanus (DPT) and measles vaccination coverage. Models were adjusted for 10 confounders, country and year fixed effects, and conflict lagged by 1 year. Further lagged associations up to 10 years post-conflict were tested. The number of excess deaths due to conflict was estimated. Out of 3,718 country-year observations, 522 (14.0%) had minor conflicts and 148 (4.0%) had wars. In adjusted models, conflicts classified as wars were associated with an increase in maternal mortality of 36.9 maternal deaths per 100,000 live births (95% CI 1.9-72.0; 0.3 million excess deaths [95% CI 0.2 million-0.4 million] over the study period), an increase in infant mortality of 2.8 per 1,000 live births (95% CI 0.1-5.5; 2.0 million excess deaths [95% CI 1.6 million-2.5 million]), a decrease in DPT vaccination coverage of 4.9% (95% CI 1.5%-8.3%), and a decrease in measles vaccination coverage of 7.3% (95% CI 2.7%-11.8%). The long-term impacts of war were demonstrated by associated increases in maternal mortality observed for up to 7 years, in under-5 mortality for 3-5 years, in infant mortality for up to 8 years, in DPT vaccination coverage for up to 3 years, and in measles vaccination coverage for up to 2 years. No evidence of association between armed conflict and neonatal mortality or delivery by a skilled birth attendant was found. Study limitations include the ecological study design, which may mask sub-national variation in conflict intensity, and the quality of the underlying data. CONCLUSIONS: Our analysis indicates that armed conflict is associated with substantial and persistent excess maternal and child deaths globally, and with reductions in key measures that indicate reduced availability of organised healthcare. These findings highlight the importance of protecting women and children from the indirect harms of conflict, including those relating to health system deterioration and worsening socioeconomic conditions.