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BACKGROUND: Inflammation is a major cause of kidney injury. The Interleukin (IL)-1 family cytokine IL-33 is released from damaged cells and modulates the immune response through its receptor ST2 expressed on many cell types, including regulatory T-cells (Tregs). While a proinflammatory role of IL-33 has been proposed, exogenous IL-33 expanded Tregs and suppressed renal inflammation. However, the contribution of endogenous IL-33/ST2 for the role of Tregs in the resolution of kidney injury has not been investigated. METHODS: We used murine renal ischemia-reperfusion injury and kidney organoids to delineate the role of the ST2 and amphiregulin (AREG) specifically in Treg cells using targeted deletion. Bulk and single-cell RNA sequencing was performed on flow-sorted Tregs from spleen and CD4 T-cells from post-ischemic kidneys respectively. The protective role of ST2-sufficient Tregs was analyzed using a novel co-culture system of syngeneic kidney organoids and Treg cells under hypoxic conditions. RESULTS: Bulk RNA-sequencing of splenic and single-cell-RNA-sequencing of kidney T-cells showed that ST2+ Tregs are enriched for genes related to Treg proliferation and function. Genes for reparative factors such as AREG were also enriched in ST2+ Tregs. Treg-specific deletion of ST2 or AREG exacerbated kidney injury and fibrosis in the unilateral ischemia reperfusion injury model. In co-culture studies, WT but not ST2-deficient Tregs preserved the hypoxia-induced loss of kidney-organoid viability, which was restored by AREG supplementation. CONCLUSIONS: Our study identified the role of the IL-33/ST2 pathway in Tregs for resolution of kidney injury. The transcriptome of ST2+ Tregs was enriched for reparative factors including AREG. Lack of ST2 or AREG in Tregs worsened kidney injury. Tregs protected kidney organoids from hypoxia in ST2 and AREG-dependent manner. Thus Treg-based approaches could be of benefit for resolution of renal injury.
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Introduction: Takotsubo cardiomyopathy (TCM) features transient left ventricular apical dysfunction or ballooning. The underlying mechanism remains elusive; however, evidence suggests the role of different physical and psychological stressors. We systematically reviewed patients presenting with TCM and autoimmunity to explore the link between the two conditions. Methods: We applied the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to report this review. Using keywords related to autoimmune/immune-mediated diseases and TCM, we searched PubMed, Scopus, and WOS in March 2022. The final results were added to a data extraction sheet. Data were analyzed by SPSS version 26.0. Results: Our search yielded 121 studies, including 155 patients. Females were considerably predominant. Most patients had a history of autoimmune disease, and almost a third had a history of cardiovascular disease. Dyspnea and chest pain were the most common chief complaints. More than 70% of patients had experienced physical stress. Myasthenia gravis, systemic lupus erythematosus, and multiple sclerosis were the most frequently reported autoimmune diseases. Conclusion: There were similarities in age and sex compared to classic TCM. TCM should be considered as a differential diagnosis for ACS, especially in patients with a positive background of autoimmunity. A precise reporting system is required for further studies.
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Enfermedades Autoinmunes , Cardiomiopatía de Takotsubo , Humanos , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/diagnóstico , Dolor en el Pecho , Estrés Psicológico , Cardiomiopatía de Takotsubo/diagnóstico , Estrés FisiológicoRESUMEN
Climate change has significantly altered the characteristics of climate zones, posing considerable challenges to ecosystems and biodiversity, particularly in Borneo, known for its high species density per unit area. This study aimed to classify the region into homogeneous climate groups based on long-term average behavior. The most effective parameters from the high-resolution daily gridded Princeton climate datasets spanning 65 years (1950-2014) were utilized, including rainfall, relative humidity (RH), temperatures (Tavg, Tmin, Tmax, and diurnal temperature range (DTR)), along with elevation data at 0.25° resolution. The FCM clustering method outperformed K-Mean and two Ward's hierarchical methods (WardD and WardD2) in classifying Borneo's climate zones based on multi-criteria assessment, exhibiting the lowest average distance (2.172-2.180) and the highest compromise programming index (CPI)-based correlation ranking among cluster averages across all climate parameters. Borneo's climate zones were categorized into four: 'Wet and cold' (WC) and 'Wet' (W) representing wetter zones, and 'Wet and hot' (WH) and 'Dry and hot' (DH) representing hotter zones, each with clearly defined boundaries. For future projection, EC-Earth3-Veg ranked first for all climate parameters across 961 grid points, emerging as the top-performing model. The linear scaling (LS) bias-corrected EC-Earth3-Veg model, as shown in the Taylor diagram, closely replicated the observed datasets, facilitating future climate zone reclassification. Improved performance across parameters was evident based on MAE (35.8-94.6%), MSE (57.0-99.5%), NRMSE (42.7-92.1%), PBIAS (100-108%), MD (23.0-85.3%), KGE (21.1-78.1%), and VE (5.1-9.1%), with closer replication of empirical probability distribution function (PDF) curves during the validation period. In the future, Borneo's climate zones will shift notably, with WC elongating southward along the mountainous spine, W forming an enclave over the north-central mountains, WH shifting northward and shrinking inland, and DH expanding northward along the western coast. Under SSP5-8.5, WC is expected to expand by 39% and 11% for the mid- and far-future periods, respectively, while W is set to shrink by 46%. WH is projected to expand by 2% and 8% for the mid- and far-future periods, respectively. Conversely, DH is expected to expand by 43% for the far-future period but shrink by 42% for the mid-future period. This study fills a gap by redefining Borneo's climate zones based on an increased number of effective parameters and projecting future shifts, utilizing advanced clustering methods (FCM) under CMIP6 scenarios. Importantly, it contributes by ranking GCMs using RIMs and CPI across multiple climate parameters, addressing a previous gap in GCM assessment. The study's findings can facilitate cross-border collaboration by providing a shared understanding of climate dynamics and informing joint environmental management and disaster response efforts.
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Cambio Climático , Borneo , Temperatura , Ecosistema , Clima , LluviaRESUMEN
COVID-19 emerged in December 2019 in Wuhan, China, spread worldwide rapidly, and caused millions of deaths in a short time. Many preclinical and clinical studies were performed to discover the most efficient therapy to reduce the mortality of COVID-19 patients. Among various approaches for preventing and treating COVID-19, mesenchymal stem cell (MSC) therapy can be regarded as a novel and efficient treatment for managing COVID-19 patients. In this review, we explain the pathogenesis of COVID-19 infection in humans and discuss the role of MSCs in suppressing the inflammation and cytokine storm produced by COVID-19. Then, we reviewed the clinical trial and systematic review studies that investigated the safety and efficacy of MSC therapy in the treatment of COVID-19 infection.
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COVID-19 , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas , Humanos , COVID-19/terapia , Síndrome de Liberación de Citoquinas , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND AND AIM: Dental implantology has revolutionized oral rehabilitation, offering a sophisticated solution for restoring missing teeth. Despite advancements, issues like infection, inflammation, and osseointegration persist. Nano and biomaterials, with their unique properties, present promising opportunities for enhancing dental implant therapies by improving drug delivery systems. This review discussed the current applications of nano and biomaterials in drug delivery for dental implants. METHOD: A literature review examined recent studies and advancements in nano and biomaterials for drug delivery in dental implantology. Various materials, including nanoparticles, biocompatible polymers, and bioactive coatings, were reviewed for their efficacy in controlled drug release, antimicrobial properties, and promotion of osseointegration. RESULTS: Nano and biomaterials exhibit considerable potential in improving drug delivery for dental implants. Nanostructured drug carriers demonstrate enhanced therapeutic efficacy, sustained release profiles, and improved biocompatibility. Furthermore, bioactive coatings contribute to better osseointegration and reduced risks of infections. CONCLUSION: Integrating current nano and biomaterials in drug delivery for dental implants holds promise for advancing clinical outcomes. Enhanced drug delivery systems can mitigate complications associated with dental implant procedures, offering improved infection control, reduced inflammation, and optimized osseointegration.
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Implantes Dentales , Sistemas de Liberación de Medicamentos , Humanos , Anodoncia , Materiales Biocompatibles , InflamaciónRESUMEN
Background: Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) refers to an acute kidney injury (AKI) occurring after exposure to contrast media, commonly used in diagnostic procedures or therapeutic angiographic interventions. Recently, Na/K citrate, used for urine alkalinization, has been assessed for preventing CIN. This experiment evaluated Na/K citrate's efficacy in preventing CIN in high-risk patients undergoing cardiac catheterization. Methods: A prospective randomized clinical trial involved 400 patients with moderate- to high-risk factors for CIN undergoing elective percutaneous coronary intervention (PCI). They were randomly assigned to either the control or Na/K citrate groups. The Na/K citrate group (n = 200) received a 5 g Na/K citrate solution diluted in 200 mL water 2 hours before and 4 hours after the first administration, along with intravenous hydration for 2 hours before and 6 hours after the procedure. In contrast, the control group (n = 200) received only intravenous hydration. Serum creatinine (SCr) levels were measured before contrast exposure and 48 hours afterward. CIN was defined as a 25% increase in serum creatinine (SCr) or > 0.5 mg/dL 48 hours after contrast administration. The significance level was set at P Ë 0.05. Results: CIN was observed in 33 patients (16.5%) in the control group and 6 patients (3%) in the Na/K citrate group. The incidence of CIN was found to have a significant difference between the 2 groups 48 hours after receiving the radiocontrast agent (P < 0.001). Conclusion: Our results show that Na/K citrate is helpful and substantially reduces the incidence of CIN.
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The Three Prime Repair EXonuclease I (TREX1) is critical for degrading post-apoptosis DNA. Mice expressing catalytically inactive TREX1 (TREX1 D18N) develop lupus-like autoimmunity due to chronic sensing of undegraded TREX1 DNA substrates, production of the inflammatory cytokines, and the inappropriate activation of innate and adaptive immunity. This study aimed to investigate Thelper (Th) dysregulation in the TREX1 D18N model system as a potential mechanism for lupus-like autoimmunity. Comparison of immune cells in secondary lymphoid organs, spleen and peripheral lymph nodes (LNs) between TREX1 D18N mice and the TREX1 null mice revealed that the TREX1 D18N mice exhibit a Th1 bias. Additionally, the T-follicular helper cells (Tfh) and the germinal celter (GC) B cells were also elevated in the TREX1 D18N mice. Targeting Bcl6, a lineage-defining transcription factor for Tfh and GC B cells, with a commercially available Bcl6 inhibitor, FX1, attenuated Tfh, GC, and Th1 responses, and rescued TREX1 D18N mice from autoimmunity. The study presents Tfh and GC B-cell responses as potential targets in autoimmunity and that Bcl6 inhibitors may offer therapeutic approach in TREX1-associated or other lupus-like diseases.
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Autoinmunidad , Centro Germinal , Animales , Diferenciación Celular , ADN , Modelos Animales de Enfermedad , Exodesoxirribonucleasas , Ratones , Ratones Noqueados , Fosfoproteínas , Proteínas Proto-Oncogénicas c-bcl-6/genética , Proteínas Proto-Oncogénicas c-bcl-6/metabolismo , Células T Auxiliares Foliculares , Linfocitos T Colaboradores-InductoresRESUMEN
Carcinoma of the lung is among the most common types of cancer globally. Concerning its histology, it is categorized as a non-small cell carcinoma (NSCLC) and a small cell cancer (SCLC) subtype. MicroRNAs (miRNAs) are a member of non-coding RNA whose nucleotides range from 19 to 25. They are known to be critical regulators of cancer via epigenetic control of oncogenes expression and by regulating tumor suppressor genes. miRNAs have an essential function in a tumorous microenvironment via modulating cancer cell growth, metastasis, angiogenesis, metabolism, and apoptosis. Moreover, a wide range of information produced via several investigations indicates their tumor-suppressing, oncogenic, diagnostic assessment, and predictive marker functions in different types of lung malignancy. miRNA mimics or anti-miRNAs can be transferred into a lung cancer cell, with possible curative implications. As a result, miRNAs hold promise as targets for lung cancer treatment and detection. In this study, we investigate the different functions of various miRNAs in different types of lung malignancy, which have been achieved in recent years that show the lung cancer-associated regulation of miRNAs expression, concerning their function in lung cancer beginning, development, and resistance to chemotherapy, also the probability to utilize miRNAs as predictive biomarkers for therapy reaction.
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Recently, copper(II) complexes have been extensively investigated as oxygen-evolution reaction (OER) catalysts through a water-oxidation reaction. Herein, new findings regarding OER in the presence of a Cu(II) complex with 6,6'-dihydroxy-2,2'-bipyridine ligand are reported. Using scanning electron microscopy, energy dispersive spectrometry, X-ray diffraction, Raman spectroscopy, in situ visible microscopy, in situ visible spectroelectrochemistry, X-ray absorption spectroscopy, and electrochemistry, it is hypothesized that the film formed on the electrode's surface in the presence of this complex causes an appropriated matrix to produce Cu (hydr)oxide. The resulting Cu (hydr)oxide could be a candidate for OER catalysis. The formed film could form Cu (hydr)oxide and stabilize it. Thus, OER activity increases in the presence of this complex.
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BACKGROUND: Neonatal sepsis, particularly gram-negative (GN) bacteria-induced, is a significant cause of morbidity and mortality in newborns. Healthcare professionals find this issue challenging because of antibiotic resistance. This study aims to combine findings to identify the prevalence of GN bacteria and their antibiotic resistance in Iranian neonates with sepsis. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The literature search was performed through international databases, including (PubMed/MEDLINE, EMBASE, Scopus, and Web of Science), Iranian local databases (Magiran, Iranmedex, Irandoc, Scimed, and SID), and the first 100 records of Google Scholar. Analytical cross-sectional study checklist from the Joanna Briggs Institute (JBI) was used for the quality assessment of included studies. Comprehensive Meta-Analysis Software Version 2 was used to conduct the meta-analysis. The between-study heterogeneity was investigated by I2 statistics. RESULTS: The prevalence of GN bacteria was estimated to be 53.6% [95% CI: 45.9- 61.1: P = 0.362] in Iranian neonates with sepsis, based on 31 studies with a sample size of 104,566. klebsiella pneumoniae (K.pneumonia) (23.2% [95% CI: 17.5-30.0, P < 0.001]) followed by Escherichia coli (E.coli) (13.5% [95% CI: 9.4-18.9, P < 0.001]) were more prevalent among GN bacteria. The highest resistance in K.pneumoniae was observed in Cefixime (80.6%, [95% CI: 56.3-93.1, P = 0.018]). E.coli showed greater resistance to Ampicillin (61.8%, [95% CI: 44.2-76.5, P = 0.188]. The prevalence of GN bacteria in Iranian neonates with sepsis has a decreasing trend based on the year, as shown by a meta-regression model (P < 0.0004). CONCLUSION: GN pathogens, particularly K.pneumoniae, and E.coli, are the leading cause of neonatal sepsis in Iran. GN bacteria showed the highest resistance to Third-generation cephalosporin and Aminoglycosides.
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Sepsis Neonatal , Humanos , Recién Nacido , Irán/epidemiología , Sepsis Neonatal/tratamiento farmacológico , Sepsis Neonatal/epidemiología , Prevalencia , Estudios Transversales , Bacterias Gramnegativas , Farmacorresistencia Microbiana , Klebsiella pneumoniae , Escherichia coliRESUMEN
The latest advancements in oncology involves the creation of multifunctional nanostructures. The integration of nanoparticles into the realm of cancer therapy has brought about a transformative shift, revolutionizing the approach to addressing existing challenges and limitations in tumor elimination. This is particularly crucial in combating the emergence of resistance, which has significantly undermined the effectiveness of treatments like chemotherapy and radiotherapy. GO stands as a carbon-derived nanoparticle that is increasingly finding utility across diverse domains, notably in the realm of biomedicine. The utilization of GO nanostructures holds promise in the arena of oncology, enabling precise transportation of drugs and genetic material to targeted sites. GO nanomaterials offer the opportunity to enhance the pharmacokinetic behavior and bioavailability of drugs, with documented instances of these nanocarriers elevating drug accumulation at the tumor location. The GO nanostructures encapsulate genes, shielding them from degradation and facilitating their uptake within cancer cells, thereby promoting efficient gene silencing. The capability of GO to facilitate phototherapy has led to notable advancements in reducing tumor progression. By PDT and PTT combination, GO nanomaterials hold the capacity to diminish tumorigenesis. GO nanomaterials have the potential to trigger both cellular and innate immunity, making them promising contenders for vaccine development. Additionally, types of GO nanoparticles that respond to specific stimuli have been applied in cancer eradication, as well as for the purpose of cancer detection and biomarker diagnosis. Endocytosis serves as the mechanism through which GO nanomaterials are internalized. Given these advantages, the utilization of GO nanomaterials for tumor elimination comes highly recommended.
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BACKGROUND: Trichomoniasis is a parasitic infection of the urinary and genital tract, caused by Trichomonas vaginalis. This study aimed to investigate the molecular diagnosis of T. vaginalis infection in liquid-based Papanicolaou samples in Shiraz, southern Iran. MATERIALS AND METHODS: In this cross-sectional study, 534 liquid-based Papanicolaou samples were collected from women referring to the laboratory of Motahari Clinic of Shiraz University of Medical Sciences in 2021. Genomic DNA were extracted from the samples and examined for evidence of T. vaginalis using polymerase chain reaction (PCR) using TVK3 and TVK7 specific primers. RESULTS: The mean age of participants was 39.28 ± 9.89 with a maximum age of 65 and a minimum age of 19 years. T. vaginalis DNA fragments were detected in 4.86% (26/534) of the cases. There was significantly higher prevalence in the age groups of 21 to 30 and 41 to 50 years (46.15%, p = 0.001 and 38.46%, p = 0.015, respectively). Furthermore, the results showed an association between a history of foamy discharge and Trichomonas positivity (p = 0.001). CONCLUSION: T. vaginalis infection is common in liquid-based Papanicolaou samples of women who attended regular health check-ups in the study area. Screening for trichomoniasis in populations, particularly if using highly sensitive methods such as PCR, may lead to increased detection and treatment.
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Tricomoniasis , Vaginitis por Trichomonas , Trichomonas vaginalis , Femenino , Humanos , Adulto Joven , Adulto , Trichomonas vaginalis/genética , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/epidemiología , Vaginitis por Trichomonas/parasitología , Irán/epidemiología , Estudios Transversales , Tricomoniasis/diagnóstico , Tricomoniasis/epidemiologíaRESUMEN
OBJECTIVE: To investigate the trends in hospital admissions and medication prescriptions related to asthma and chronic obstructive pulmonary disease (COPD) in England and Wales. METHODS: An ecological study was conducted between April 1999 and April 2020 using data extracted from the hospital episode statistics database in England and the patient episode database for Wales. The Office of National Statistics mid-year population estimates for 1999 through 2020 were collected, and medication prescription data for 2004-2020 were extracted from the prescription cost analysis database. RESULTS: The total annual number of COPD and asthma hospital admissions for various causes increased by 82.2%, from 210,525 in 1999 to 383,652 in 2020, representing a 59.1% increase in hospital admission rate (from 403.77 in 1999 to 642.42 per 100,000 persons in 2020, p < 0.05). Chronic obstructive pulmonary disease with acute lower respiratory infection accounted for 38.7% of hospital admissions. Around 34.7% of all hospital admissions involved patients aged 75 and older. Around 53.8% of all COPD and asthma hospital admissions were attributable to females. The annual number of prescriptions dispensed for COPD and asthma medications increased by 42.2%. CONCLUSIONS: Throughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups. Hospitalization rates were higher for women. Further observational and epidemiological research is required to identify the factors contributing to increased hospitalization rates.
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Asma , Enfermedad Pulmonar Obstructiva Crónica , Infecciones del Sistema Respiratorio , Humanos , Femenino , Gales/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Hospitalización , Asma/tratamiento farmacológico , Asma/epidemiología , Inglaterra/epidemiología , Hospitales , Prescripciones de Medicamentos , Infecciones del Sistema Respiratorio/tratamiento farmacológicoRESUMEN
OBJECTIVE: To investigate the prevalence of intensive care unit (ICU) admission and its predictors among hospitalized chronic obstructive pulmonary disease (COPD) patients. METHODS: An observational retrospective study was conducted. All patients with a confirmed diagnosis of COPD according to the GOLD guidelines between 28 and 2020 and 1 March 2023 at Al-Noor Specialist Hospital were included in this study. Patients were excluded if a preemptive diagnosis of COPD was made clinically without spirometry evidence of fixed airflow limitation. Descriptive results were presented as frequency (percentage) for categorical variables and mean (SD) for continuous variables and to estimate prevalence of ICU admission. Predictors of ICU admission among hospitalized COPD patients were determined using logistic regression analysis. A SPSS (Statistical Package for the Social Sciences) version 25 was used to perform all statistical analysis. RESULTS: A total of 705 patients with COPD were included in this study. The mean age was 65.4 (25.3) years. Around 12.4% of the hospitalized patients were admitted to the ICD. Logistic regression analysis identified that older age (OR; 1.92, (1.41-2.62)), smoking (OR; 1.60 (1.17-2.19)), and having specific comorbidities (Hypertension (OR; 1.98 (1.45-2.71)), Diabetes mellitus (OR; 1.42 (1.04-1.93)), GERD (OR; 2.81 (1.99-3.96)), Ischemic heart disease (OR; 3.22 (2.19-4.75)), Obstructive sleep apnea syndrome (OR; 2.14 (1.38-3.33)), stroke (OR; 4.51 (2.20-9.26))) were predictors of ICU admissions among patients with COPD. CONCLUSIONS: Our study found that a step-up approach to inpatient COPD management requires admission to the ICU in 12.4%, for which age, smoking status, cardiovascular, and stroke were important predictors. Further clinical research is needed to provide a validated model that can be incorporated into clinical practice to monitor this patient population during their admission and identify at-risk individuals for early transfer to higher acuity settings and intensive care units.
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Enfermedad Pulmonar Obstructiva Crónica , Accidente Cerebrovascular , Humanos , Anciano , Estudios Retrospectivos , Arabia Saudita/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Cuidados Críticos/métodos , Unidades de Cuidados Intensivos , HospitalesRESUMEN
Since genetic factors alone cannot explain most cases of Autism, the environmental factors are worth investigating as they play an essential role in the development of some cases of Autism. This research is a review paper that aims to clarify the role of the macro elements (MEs), Trace elements (TEs) and ultra-trace elements (UTEs) on human health if they are greater or less than the normal range. Aluminium (Al), cadmium Cd), lead (Pb), chromium (Cr), zinc (Zn), copper (Cu), nickel (Ni), arsenic (As), mercury (Hg), manganese (Mn), and iron (Fe) have been reviewed. Exposure to toxicants has a chemical effect that may ultimately lead to autism spectrum disorder (ASD). The Cr, As and Al are found in high concentrations in the blood of an autistic child when compared to normal child reference values. The toxic metals, particularly aluminium, are primarily responsible for difficulties in socialization and language skills disabilities. Zinc and copper are important elements in regulating the gene expression of metallothioneins (MTs), and zinc deficiency may be a risk factor for ASD pathogenesis. Autistics frequently have zinc deficiency combined with copper excess; as part of the treatment protocol, it is critical to monitor zinc and copper levels in autistic people, particularly those with zinc deficiency. Zinc deficiency is linked to epileptic seizures, which are common in autistic patients. Higher serum manganese and copper significantly characterize people who have ASD. Autistic children have significantly decreased lead and cadmium in urine, whereas they have significantly higher urine Cr. A higher level of As and Hg was found in the ASD individual's blood.
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Arsénico , Trastorno del Espectro Autista , Trastorno Autístico , Mercurio , Oligoelementos , Niño , Humanos , Oligoelementos/análisis , Cobre , Trastorno Autístico/inducido químicamente , Manganeso/toxicidad , Cadmio/orina , Trastorno del Espectro Autista/inducido químicamente , Trastorno del Espectro Autista/metabolismo , Aluminio , Zinc , Cromo , Mercurio/toxicidad , Arsénico/toxicidad , Arsénico/análisis , Sustancias PeligrosasRESUMEN
BACKGROUND: In recent years, the world's health system faces with increasing trend of costs. In this regard, Hospital is one of the environments that consumes a large share of the total expenditure of the health system. Medications are one of the most expensive components in hospitals, which require appropriate measurements to control and reduce costs. The present systematic review was conducted to identify strategies and actions for cost containment in hospital. METHOD: Using the PRISMA protocol, a systematic review of the texts was performed to identify strategies and actions for reducing drug cost. In this systematic review, the selected keywords were searched in the following databases: web of sciences, Scopus, PubMed, Google Scholar, and Embase. The inclusion criteria included English-language articles, hospital-level studies, and those studies performed on reducing and controlling hospital costs. The exclusion criteria also included the followings: primary health care studies, non-English language studies, health system studies, and studies solely focussed on the cost-effectiveness of a particular drug. The quality of these articles was investigated using the checklist adapted and modified in the present study. RESULTS: A total of 4696 articles were identified from the reviewed databases and 26 articles were identified from some other sources. After removing duplicate studies and reviewing the title, summary, and full text of articles using reference check and supplemental search, 21 articles were finally included. A number of strategies or managerial actions were extracted from the final articles. According to the qualitative results, qualitative meta-synthesis was used and after eliminating duplicate solutions, the data were classified into five groups: procurement, storage, distribution, prescription, and use. CONCLUSION: According to the increasing cost of medicines, some hospital managers now attempt to reduce hospital costs using drug chain management. Drug cost reduction strategies can be applied for any component of drug chain management such as procurement, storage, distribution, prescription, and use. Also, proper implementation of these strategies and rationalisation of drug use will result in more efficiency of the hospital.
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Costos de los Medicamentos , Hospitales , Humanos , Control de Costos , Personal de Salud , Costos de HospitalRESUMEN
In the last few years, many industrial sectors have generated and discharged large volumes of saline wastewater into the environment. In the present work, the electrochemical removal of nitrogen compounds from synthetic saline wastewater was investigated through a lab-scale experimental reactor. Experiments were carried out to examine the impacts of the operational parameters, such as electrolyte composition and concentration, applied current intensity, and initial ammoniacal nitrogen concentration, on the total nitrogen removal efficiency. Using NaCl as an electrolyte, the NTOT removal was higher than Na2SO4 and NaClO4; however, increasing the initial NaCl concentration over 250 mg·L-1 resulted in no benefits for the NTOT removal efficiency. A rise in the current intensity from 0.05 A to 0.15 A resulted in an improvement in NTOT removal. Nevertheless, a further increase to 0.25 A led to basically no enhancement of the efficiency. A lower initial ammoniacal nitrogen concentration resulted in higher removal efficiency. The highest NTOT removal (about 75%) was achieved after 90 min of treatment operating with a NaCl concentration of 250 mg·L-1 at an applied current intensity of 0.15 A and with an initial ammoniacal nitrogen concentration of 13 mg·L-1. The nitrogen degradation mechanism proposed assumes a series-parallel reaction system, with a first step in which NH4+ is in equilibrium with NH3. Moreover, the nitrogen molar balance showed that the main product of nitrogen oxidation was N2, but NO3- was also detected. Collectively, electrochemical treatment is a promising approach for the removal of nitrogen compounds from impacted saline wastewater.
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In recent years, the discharge of various emerging pollutants, chemicals, and dyes in water and wastewater has represented one of the prominent human problems. Since water pollution is directly related to human health, highly resistant and emerging compounds in aquatic environments will pose many potential risks to the health of all living beings. Therefore, water pollution is a very acute problem that has constantly increased in recent years with the expansion of various industries. Consequently, choosing efficient and innovative wastewater treatment methods to remove contaminants is crucial. Among advanced oxidation processes, electrochemical oxidation (EO) is the most common and effective method for removing persistent pollutants from municipal and industrial wastewater. However, despite the great progress in using EO to treat real wastewater, there are still many gaps. This is due to the lack of comprehensive information on the operating parameters which affect the process and its operating costs. In this paper, among various scientific articles, the impact of operational parameters on the EO performances, a comparison between different electrochemical reactor configurations, and a report on general mechanisms of electrochemical oxidation of organic pollutants have been reported. Moreover, an evaluation of cost analysis and energy consumption requirements have also been discussed. Finally, the combination process between EO and photocatalysis (PC), called photoelectrocatalysis (PEC), has been discussed and reviewed briefly. This article shows that there is a direct relationship between important operating parameters with the amount of costs and the final removal efficiency of emerging pollutants. Optimal operating conditions can be achieved by paying special attention to reactor design, which can lead to higher efficiency and more efficient treatment. The rapid development of EO for removing emerging pollutants from impacted water and its combination with other green methods can result in more efficient approaches to face the pressing water pollution challenge. PEC proved to be a promising pollutants degradation technology, in which renewable energy sources can be adopted as a primer to perform an environmentally friendly water treatment.
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Objective: To evaluate the impact of hepcidin and ferritin in pathogenesis and prognosis of type 2 diabetes mellitus subjects taking only metformin or combined anti-glycaemic agents. METHODS: The observational case-control study was conducted at the Department of Physiology, Baqai Medical University, Karachi, from August 2019 to October 2020, and comprised subjects from both genders who categorised into equal groups as non-diabetic controls, newly-diagnosed type 2 diabetes mellitus patients without any treatment, type 2 diabetes mellitus patients with exposure to metformin only, type 2 diabetes mellitus patients taking oral hypoglycaemic agents along with metformin, type 2 diabetes mellitus patients taking only insulin, and type 2 diabetes mellitus patients taking insulin and oral hypoglycaemic agents. Fasting plasma glucose was determined using glucose oxidase-peroxidase method, glycated haemoglobin by high performance liquid chromatography, high-density lipoprotein and low-density lipoprotein by direct methods, cholesterol by cholesterol oxidase phenol 4-amino antipyrine peroxidase and triglycerides by glycerol phosphate oxidase-phenol 4-amino antipyrine peroxidase method. Serum levels of ferritin, insulin and hepcidin were evaluated using Enzyme-linked immunosorbent assay. Insulin resistance was assessed using homeostasis model assessment for insulin resistance. Data was analysed using SPSS 21. RESULTS: Of the 300 subjects, there were 50(16.66%) in each of the 6 groups. Overall, there were 144(48%) males and 155(51.66%) females. The mean age was significantly lower in the control group 34.72±7.87 compared to all the diabetic groups (p<0.05), and the same was the case with respect to all the parameters (p<0.05) except high-density lipoprotein (p>0.05). Besides, hepcidin level was significantly higher in the control group (p<0.05). Ferritin levels were significantly increased in newly-diagnosed T2DM subjects compared to the controls (p<0.05) while all other groups showed decreased ferritin levels (p<0.05). Hepcidin gave inverse correlation with glycated haemoglobin only in diabetics taking only metformin (r = -0.27, p=0.05). CONCLUSIONS: Anti-diabetes drugs not only addressed type 2 diabetes mellitus, but also reduced levels of ferritin and hepcidin that are found to play a role in diabetes development.
Asunto(s)
Diabetes Mellitus Tipo 2 , Resistencia a la Insulina , Metformina , Humanos , Femenino , Masculino , Metformina/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hepcidinas , Estudios de Casos y Controles , Hemoglobina Glucada , Pakistán , Hipoglucemiantes/uso terapéutico , Insulina , PeroxidasasRESUMEN
The oxygen evolution reaction (OER) can provide electrons for reducing water, carbon dioxide, and ammonia. On the other hand, copper compounds are among the most interesting OER catalysts. In this study, water oxidation of a Cu foil in the presence of K2FeO4, a soluble Fe source, under alkaline conditions (pH ≈ 13) is investigated using electrochemical methods, X-ray diffraction, X-ray photoelectron spectroscopy, in situ visible spectroelectrochemistry, Raman spectroscopy, and scanning electron microscopy. After the reaction of the Fe salt with the Cu foil, a remarkable improvement for OER is recorded, which indicates that either the Fe ions on the copper foil directly participate in OER or these ions are critical for activating copper ions on the surface toward OER. Indeed, a remarkable decrease (130 mV) in the overpotential is recorded for the Cu foil in the presence of [FeO4]2-. Tafel slopes for the Cu foil in the absence and presence of K2FeO4 are 113.2 and 46.4 mV/decade, respectively. X-ray photoelectron spectroscopy shows that there is a strong interaction between Cu(II) and Fe(III) on the surface of the Cu foil. During OER in the presence of Cu(II) (hydr)oxide, Cu(III) is detected. In situ visible spectroelectrochemistry shows that Cu and Fe ions are dynamically active and precipitate on the surface of the counter electrode during cyclic voltammetry (CV). The isotopic experimental data using H218O based on Raman spectroscopy show that there is no change in the lattice oxygen. All of these experiments adopt a new perspective on the role of Fe in OER in the presence of a Cu foil under alkaline conditions.