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1.
J Pak Med Assoc ; 70(Suppl 3)(5): S158-S161, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32515404

RESUMO

Here, we present an overview of the clinical trials that are currently being conducted or have concluded to date on COVID-19 globally. A comprehensive search was conducted to present 16 trial registries from around the world. Collectively, there are 1,528 trials reported for COVID-19 to date. Out of them, 50 studies included paediatric age group from day 0 to less than or equal to 18 years of age. A few 18 studies involve only females and 20 only males. There are 2 trials currently underway in Bangladesh, 4 in Pakistan and 13 in India. Overall, 940 trials are related to medicines and/or interventions. They include standard of care for any viral illness, antivirals, anti-inflammatory and immune altering medications. Two out of 10 vaccine trials are novel vaccines. It is knowledgeable and resourceful to reach out to the concerned sponsor if a physician thinks his patient can benefit from the trials in the region.


Assuntos
Betacoronavirus , Estudos Clínicos como Assunto , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Ásia Ocidental , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
2.
PLoS One ; 15(3): e0229906, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163440

RESUMO

BACKGROUND: Caesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. Since the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,however, the preference for, caesarean delivery and its associated factors are not well understood. OBJECTIVE: To study the caesarean delivery in the South and South-East Asian countries and to determine the factors associated with the preference for caesarean delivery. METHODOLOGY: Demographic and Health Survey Data on from ever-married women of nine developing countries of South and South-East Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh, and Cambodia have been considered. Both bivariate and binary logistic regression models were used to estimate the propensity of a woman undergoing for caesarean delivery and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. RESULTS: Obtained results have shown an inclination of caesarean delivery among urban than rural women and are quite conspicuous, but is found to be underestimated mostly among rural women. Caesarean delivery in general is mostly predisposed among women whose baby sizes are either very large or smaller than average, have a higher level of education and place of delivery is private medical institutions. The logistic regression also revealed the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. Based on nine South and South-East Asian countries an overall C-section prevalence of 13%, but based on institutional births its increase to 19%. The forest plot demonstrated that a significant inclination of C-section among urban than rural regions. In Meta-Analysis, very high and significant heterogeneity among countries is observed, but confirms that in terms of prevalence of C-section all of the countries follow independent pattern. CONCLUSION: Study of seven urban and four rural regions of nine South and South- East Asian countries showed, a significant inclination towards the caesarean delivery above the more recent outdated WHO recommended an optimal range of 10-15%and are associated maternal socioeconomic characteristics. In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery.


Assuntos
Cesárea/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Ásia Sudeste , Ásia Ocidental , Cesárea/tendências , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Modelos Logísticos , Idade Materna , Gravidez , Prevalência , População Rural/estatística & dados numéricos , População Rural/tendências , População Urbana/estatística & dados numéricos , População Urbana/tendências , Adulto Jovem
3.
N Engl J Med ; 382(8): 717-726, 2020 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-32074419

RESUMO

BACKGROUND: The burden of hypertension is escalating, and control rates are poor in low- and middle-income countries. Cardiovascular mortality is high in rural areas. METHODS: We conducted a cluster-randomized, controlled trial in rural districts in Bangladesh, Pakistan, and Sri Lanka. A total of 30 communities were randomly assigned to either a multicomponent intervention (intervention group) or usual care (control group). The intervention involved home visits by trained government community health workers for blood-pressure monitoring and counseling, training of physicians, and care coordination in the public sector. A total of 2645 adults with hypertension were enrolled. The primary outcome was reduction in systolic blood pressure at 24 months. Follow-up at 24 months was completed for more than 90% of the participants. RESULTS: At baseline, the mean systolic blood pressure was 146.7 mm Hg in the intervention group and 144.7 mm Hg in the control group. At 24 months, the mean systolic blood pressure fell by 9.0 mm Hg in the intervention group and by 3.9 mm Hg in the control group; the mean reduction was 5.2 mm Hg greater with the intervention (95% confidence interval [CI], 3.2 to 7.1; P<0.001). The mean reduction in diastolic blood pressure was 2.8 mm Hg greater in the intervention group than in the control group (95% CI, 1.7 to 3.9). Blood-pressure control (<140/90 mm Hg) was achieved in 53.2% of the participants in the intervention group, as compared with 43.7% of those in the control group (relative risk, 1.22; 95% CI, 1.10 to 1.35). All-cause mortality was 2.9% in the intervention group and 4.3% in the control group. CONCLUSIONS: In rural communities in Bangladesh, Pakistan, and Sri Lanka, a multicomponent intervention that was centered on proactive home visits by trained government community health workers who were linked with existing public health care infrastructure led to a greater reduction in blood pressure than usual care among adults with hypertension. (Funded by the Joint Global Health Trials scheme; COBRA-BPS ClinicalTrials.gov number, NCT02657746.).


Assuntos
Anti-Hipertensivos/uso terapêutico , Agentes Comunitários de Saúde , Visita Domiciliar , Hipertensão/terapia , Educação de Pacientes como Assunto , Idoso , Ásia Ocidental , Pressão Sanguínea , Determinação da Pressão Arterial , Lista de Checagem , Países em Desenvolvimento , Educação Médica Continuada , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prática de Saúde Pública , População Rural
4.
J Nerv Ment Dis ; 208(2): 165-168, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977829

RESUMO

Almost no research exists on the relationship between religiosity/spirituality (R/S) and health in the US South Asian population. Using data from the joint Study on Stress, Spirituality, and Health and Mediators of Atherosclerosis Among South Asians Living in America Study (MASALA), this article examined associations between self-rated R/S and self-rated health, emotional functioning, trait anxiety, and trait anger in a community-based sample (n = 933) from the Chicago and San Francisco Bay areas. Ordinary least squares regression was used to analyze categorical differences in levels of R/S and ordinal trends for R/S, adjusting for potential confounders. Being slightly or moderately religious/spiritual was associated with lower levels of self-rated health compared with being very religious/spiritual, and being slightly or moderately religious/spiritual was associated with higher levels of anxiety. In both cases, there was no significant difference between very religious/spiritual individuals and non-religious/spiritual individuals, suggesting a curvilinear relationship. Self-rated R/S was not significantly associated with emotional functioning or anger. In sum, high-R/S and low-R/S individuals had salutary associations with self-rated health and anxiety compared with individuals with slight/moderate levels of R/S. It is important for clinicians and policy makers to recognize the role R/S can play in the health status of South Asians living in the United States.


Assuntos
Nível de Saúde , Espiritualidade , Estresse Psicológico/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia Ocidental/etnologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Estados Unidos
5.
Can J Diabetes ; 43(8): 573-579, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31787243

RESUMO

OBJECTIVES: Gestational diabetes mellitus (GDM) increases the risk of pregnancy complications. South Asian immigrant women have among the highest rates of GDM in Canada and they also have the highest lifelong risk of developing type 2 diabetes after a GDM pregnancy. Diabetes Canada has been developing diabetes education material that accounts for the cultural preferences of South Asians. However, there is uncertainty to whether South Asian immigrants are aware of these resources or trust them, or if other factors influence their uptake of advice. METHODS: In this study, we conducted qualitative interviews to explore, among South Asian immigrant women with GDM: 1) their awareness of diabetes education resources, 2) their attitudes toward information from different resources and varying health-care providers and 3) their barriers and facilitators for GDM management recommendations. Gender theory is embedded in this study, as culturally specific gender roles regarding motherhood have been shown to be important to South Asian immigrant women and their perceptions of health. RESULTS: There was an emergence of 3 main themes. First, awareness of culturally tailored educational resources is low. Second, there is an overabundance of GDM management information, which leads to variability among participants of how they rank accuracy of informational sources. Finally, there is a gender role reversal present, where women are being taken care of by their families instead of being the providers of care. CONCLUSIONS: These results indicate that better dissemination strategies for GDM educational material are needed for health-care providers and patients, and may require additional consideration of family involvement during GDM education sessions.


Assuntos
Diabetes Gestacional , Gerenciamento Clínico , Emigrantes e Imigrantes , Educação em Saúde , Adulto , Ásia Ocidental/etnologia , Feminino , Humanos , Ontário , Gravidez , Pesquisa Qualitativa
6.
Prog Community Health Partnersh ; 13(3): 303-319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564671

RESUMO

BACKGROUND: Building the collective capacity of racialized women to meaningfully lead and engage in research is critical to health equity. To address the silence and stigma related to HIV/sexually transmitted infections (STIs) among South Asian women in Canada, peer leadership and engagement were identified as important strategies to promote open discussion about sexual health. OBJECTIVES: Underpinned by the principle of 'nothing about us without us', the objectives of the Story Sharing for Sexual Health (SSSH) research study included engaging and training South Asian women peer leaders to become an integral part of the study and build community research capacity. To achieve these objectives, it was critical to support the peer leaders in gaining a thorough understanding of the research ethics, protocols and teamwork principles, and to consolidate skills in group facilitation and community engagement. METHODS: The peer leaders attended four full-day training sessions on the social determinants of health and gender equity for racialized populations, HIV/STI and sexual health in the context of South Asian communities, community-based participatory research (CBPR) principles, skills in focus group facilitation, community partnerships building, and storytelling epistemologies. A training manual was developed. Evaluation of the training program included 1) evaluation forms, 2) process evaluations through journal writing and feedback sessions, and 3) implementation outcomes. CONCLUSIONS: The SSSH peer research training program was effective. Peer leaders demonstrated effectiveness in liaising with partner agencies, engaging South Asian women in sexual health discussion, completing CBPR activities and team building. Knowledge generated can be applied in CBPR with other racialized women populations.


Assuntos
Pesquisa Participativa Baseada na Comunidade/organização & administração , Saúde Sexual , Adulto , Ásia Ocidental/etnologia , Canadá , Participação da Comunidade/métodos , Pesquisa Participativa Baseada na Comunidade/métodos , Currículo , Feminino , Grupos Focais , Humanos , Liderança , Grupo Associado , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Saúde Sexual/educação , Saúde Sexual/etnologia
7.
Nat Commun ; 10(1): 4828, 2019 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-31645551

RESUMO

Shigella sonnei increasingly dominates the international epidemiological landscape of shigellosis. Treatment options for S. sonnei are dwindling due to resistance to several key antimicrobials, including the fluoroquinolones. Here we analyse nearly 400 S. sonnei whole genome sequences from both endemic and non-endemic regions to delineate the evolutionary history of the recently emergent fluoroquinolone-resistant S. sonnei. We reaffirm that extant resistant organisms belong to a single clonal expansion event. Our results indicate that sequential accumulation of defining mutations (gyrA-S83L, parC-S80I, and gyrA-D87G) led to the emergence of the fluoroquinolone-resistant S. sonnei population around 2007 in South Asia. This clone was then transmitted globally, resulting in establishments in Southeast Asia and Europe. Mutation analysis suggests that the clone became dominant through enhanced adaptation to oxidative stress. Experimental evolution reveals that under fluoroquinolone exposure in vitro, resistant S. sonnei develops further intolerance to the antimicrobial while the susceptible counterpart fails to attain complete resistance.


Assuntos
Farmacorresistência Bacteriana/genética , Disenteria Bacilar/microbiologia , Fluoroquinolonas , Genoma Bacteriano/genética , Shigella sonnei/genética , Antibacterianos/uso terapêutico , Ásia Sudeste/epidemiologia , Ásia Ocidental/epidemiologia , Teorema de Bayes , Ciprofloxacino/uso terapêutico , DNA Girase/genética , DNA Topoisomerase IV/genética , Evolução Molecular Direcionada , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Europa (Continente)/epidemiologia , Evolução Molecular , Humanos , Epidemiologia Molecular , Mutação , Filogenia , Polimorfismo de Nucleotídeo Único , Shigella sonnei/fisiologia
9.
J Pak Med Assoc ; 69(9): 1349-1354, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31511723

RESUMO

High costs associated with traditional print-based publishing have made open access publishing a popular way to improve research dissemination. Now several options and initiatives are enabling developing-world authors to attain equitable access to the scientific literature. However, little is known about the role of journals and initiatives from low- and middle-income countries in Asia regarding open access and their publication standards. Therefore, this article presents some exemplar y initiatives to promote research dissemination in South Asia through open access and publishing standards of the regional journals. Such initiatives deserve wider recognition, especially when u nder taken by resource -limited cou ntr ies, an d international collaboration schemes hold the potential to build further on current achievements.


Assuntos
Países em Desenvolvimento , Disseminação de Informação , Comunicação Acadêmica , Ásia Ocidental , Bangladesh , Humanos , Índia , Nepal , Publicação de Acesso Aberto , Paquistão , Sri Lanka
10.
Mol Genet Genomics ; 294(6): 1547-1559, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31372716

RESUMO

Distinctive peculiarities of Armenians such as their millennia-long genetic isolation and strong national identity attract a keen interest while studying the demographic history of the West Asia. Here, to examine their fine-scale matrilineal genetic structure, ancestry and relationships with neighboring populations, we analyzed 536 complete mitogenomes (141 of which are novel) from 8 geographically different Armenian populations, covering the whole stretch of historical Armenia. The observed patterns highlight a remarkable degree of matrilineal genetic heterogeneity and weak population structuring of Armenians. Moreover, our phylogeographic analysis reveals common ancestries for some mtDNA lineages shared by West Asians, Transcaucasians, Europeans, Central Asians and Armenians. About third of the mtDNA subhaplogroups found in Armenian gene pool might be considered as Armenian-specific, as these are virtually absent elsewhere in Europe, West Asia and Transcaucasia. Coalescence ages of most of these lineages do not exceed 3.1 kya and coincide well with the population size growth started around 1.8-2.8 kya detectable only in the Bayesian Skyline Plots based on the Armenian-specific mtDNA haplotypes.


Assuntos
Genoma Mitocondrial , Armênia , Ásia Central , Ásia Ocidental , DNA Mitocondrial/química , Europa (Continente) , Variação Genética , Haplótipos , Humanos , Filogenia , Filogeografia
11.
PLoS One ; 14(7): e0218389, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31260474

RESUMO

Polyploidy is one of the major forces of plant evolution and widespread mixed-ploidy species offer an opportunity to evaluate its significance. We therefore selected the cosmopolitan species Urtica dioica (stinging nettle), examined its cytogeography and pattern of absolute genome size, and assessed correlations with bioclimatic and ecogeographic data (latitude, longitude, elevation). We evaluated variation in ploidy level using an extensive dataset of 7012 samples from 1317 populations covering most of the species' distribution area. The widespread tetraploid cytotype (87%) was strongly prevalent over diploids (13%). A subsequent analysis of absolute genome size proved a uniform Cx-value of core U. dioica (except for U. d. subsp. cypria) whereas other closely related species, namely U. bianorii, U. kioviensis and U. simensis, differed significantly. We detected a positive correlation between relative genome size and longitude and latitude in the complete dataset of European populations and a positive correlation between relative genome size and longitude in a reduced dataset of diploid accessions (the complete dataset of diploids excluding U. d. subsp. kurdistanica). In addition, our data indicate an affinity of most diploids to natural and near-natural habitats and that the tetraploid cytotype and a small part of diploids (population from the Po river basin in northern Italy) tend to inhabit synanthropic sites. To sum up, the pattern of ploidy variation revealed by our study is in many aspects unique to the stinging nettle, being most likely first of all driven by the greater ecological plasticity and invasiveness of the tetraploid cytotype.


Assuntos
Evolução Biológica , Genoma de Planta , Ploidias , Urtica dioica/genética , Adaptação Fisiológica/genética , Ásia Ocidental , Ecossistema , Europa (Continente) , Tamanho do Genoma , Geografia , Cariotipagem , Seleção Genética , Urtica dioica/classificação
13.
J Appl Res Intellect Disabil ; 32(6): 1310-1334, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31169955

RESUMO

BACKGROUND: People with from minority ethnic communities face inequalities in health and health care. This systematic review considers the question of what we know about the health and health care of children and adults with intellectual disabilities from ethnic minority communities in the UK. METHOD: Studies published from 1990 to 2018 were identified via electronic literature databases, email requests and cross-citations. Studies were reviewed narratively in relation to identified themes. RESULTS: Twenty-three studies were identified, most commonly focusing on South Asian communities. Very little information was identified on physical health or physical health care, with the identified evidence tending to focus on mental health care, access to specialist intellectual disability services, and inpatient services. CONCLUSION: Little is known about the health status of people with intellectual disabilities from minority ethnic groups in the UK. It is clear that they may experience barriers to accessing specialist intellectual disability services and other forms of health care.


Assuntos
Grupos Étnicos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Deficiência Intelectual , Grupos Minoritários , Grupo com Ancestrais do Continente Africano , Ásia Ocidental , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Nível de Saúde , Humanos , Saúde Mental , Serviços de Saúde Mental/estatística & dados numéricos , Encaminhamento e Consulta , Reino Unido
14.
J Pak Med Assoc ; 69(4): 555-563, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31000862

RESUMO

Sodium-glucose co-transporter type 2 inhibitors (SGLT 2- i)are increasingly being used in the management of type 2 diabetes mellitus (T2DM). With the novel insulinindependent glycosuric action, these agents help to attain glycaemic goals by lowering HbA1c and fasting blood glucose. In addition, these agents improve metabolic control in diabetes and ameliorate comorbidities like obesity and hyper tension. Beneficial effec ts on cardiovascular outcomes have been a key attraction for physicians. These agents are used alone or in combination with oral antidiabetic agents and insulin to attain glycaemic and metabolic targets. A major disadvantagewith these agents is the increased risk for genital andurinary infections. When used in appropriate settings, there is no additional increased risk of hypoglycaemia or volume depletion with these agents. Available evidence suggests good efficacy and safety of these agents in diabetes management. The easy and convenient oncedaily dosing should be customized according to patient needs and glycaemic profiles.


Assuntos
Grupo com Ancestrais do Continente Asiático , Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Ásia Sudeste , Ásia Ocidental , Pressão Sanguínea , Peso Corporal , Colesterol , HDL-Colesterol , LDL-Colesterol , Creatinina , Quimioterapia Combinada , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Metformina/uso terapêutico , Hepatopatia Gordurosa não Alcoólica , Paquistão , Albumina Sérica , Compostos de Sulfonilureia/uso terapêutico
15.
Parasit Vectors ; 12(1): 175, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30999942

RESUMO

BACKGROUND: The zoonotic parasite Taenia saginata transmits between humans, the definitive host (causing taeniosis), and bovines as the intermediate host (causing cysticercosis). Central and western Asia and the Caucasus have large cattle populations and beef consumption is widespread. However, an overview of the extent of human T. saginata infection and bovine cysticercosis is lacking. This review aims to summarize the distribution of T. saginata in this region. METHODS: A systematic review was conducted, that gathered published and grey literature, and official data concerning T. saginata taeniosis and bovine cysticercosis in central and western Asia and the Caucasus published between January 1st, 1990 and December 31st, 2018. Where no data were available for a country within this period, published data from 1985-1990 were also accessed. RESULTS: From 10,786 articles initially scanned, we retrieved 98 full-text articles from which data were extracted. In addition, two unpublished datasets were provided on the incidence of human taeniosis. Data for human taeniosis and bovine cysticercosis were found for all countries except Turkmenistan. Human taeniosis prevalence varied from undetected to over 5.3%, with regional variations. Where bovine cysticercosis was detected, prevalences varied from case reports to 25%. CONCLUSIONS: The public health burden of T. saginata is assumed to be small as the parasite is of low pathogenicity to humans. However, this review indicates that infection continues to be widespread and this may result in a large economic burden, due to the resources utilized in meat inspection and condemnation or processing with subsequent downgrading of infected carcasses.


Assuntos
Doenças dos Bovinos/epidemiologia , Cisticercose/epidemiologia , Taenia saginata , Teníase/epidemiologia , Animais , Ásia Ocidental/epidemiologia , Bovinos , Humanos , Transcaucásia/epidemiologia , Zoonoses/epidemiologia
16.
Ophthalmol Retina ; 3(1): 16-26, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30935655

RESUMO

PURPOSE: A comparison of anti-vascular endothelial growth factor (anti-VEGF) medication use across multiple countries. CLINICAL RELEVANCE: Anti-VEGF medication use is now considered first-line treatment for numerous retinal diseases globally. Exploring medication choices, costs within each healthcare system, policy challenges, emerging treatments, and patient access all provide insight into a newly recognized and major public health issue. METHODS: All data presented in this review are available through the published English literature in PubMed, non-peer-reviewed trade publications, and reported surveys. The following search terms were used: anti-VEGF OR bevacizumab OR ranibizumab OR aflibercept OR pegaptanib OR conbercept AND trends OR survey OR cost OR patterns OR preference. Countries with large populations and available data included the United States, United Kingdom, China, India, Korea, Singapore, and Australia. Population and economic statistics were obtained from published reports from the World Bank, World Health Organization, and Commonwealth Fund. RESULTS: Anti-VEGF medication use and costs are significant aspects of patient and healthcare system expenditures in each nation and may have an especially large potential economic burden in India and China. Bevacizumab use comprises the majority of anti-VEGF medication use in the United States and Singapore, although aflibercept use is growing rapidly. Paradoxically, data demonstrate that there is a significant trend in medication choice toward ranibizumab and aflibercept among practice settings outside of the United States, such as the United Kingdom, China, South Korea, and Australia. The price of anti-VEGF medications ranged from US $30 (ziv-aflibercept) to US $1950 (ranibizumab and aflibercept). Ranibizumab's price ranged from US $240 in India to US $1950 in the United States. Conbercept in China costs approximately US $1150 per dose. CONCLUSIONS: Outside of the United States, many nations are using a majority of more expensive anti-VEGF medications, which may lead to increased costs and decreased access. Increasing the availability of safely compounded anti-VEGF medications will likely improve access, create patient/provider choice, and decrease relative healthcare costs for the growing burden of retinal diseases globally.


Assuntos
Custos de Medicamentos/estatística & dados numéricos , Saúde Pública/economia , Ranibizumab/administração & dosagem , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Doenças Retinianas/tratamento farmacológico , Inibidores da Angiogênese/administração & dosagem , Ásia Ocidental , Análise Custo-Benefício , Humanos , Injeções Intravítreas , Doenças Retinianas/economia , Reino Unido , Estados Unidos , Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
17.
Int J Mol Sci ; 20(6)2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30889809

RESUMO

Tunisia, being part of the secondary center of diversity for durum wheat, has rich unexploited landraces that are being continuously lost and replaced by high yielding modern cultivars. This study aimed to investigate the genetic diversity and population structure of 196 durum wheat lines issued from landraces collected from Tunisia using Diversity Array Technology sequencing (DArTseq) and to understand possible ways of introduction in comparing them to landraces from surrounding countries. A total of 16,148 polymorphic DArTseq markers covering equally the A and B genomes were effective to assess the genetic diversity and to classify the accessions. Cluster analysis and discriminant analysis of principal components (DAPC) allowed us to distinguish five distinct groups that matched well with the farmer's variety nomenclature. Interestingly, Mahmoudi and Biskri landraces constitute the same gene pool while Jenah Zarzoura constitutes a completely different group. Analysis of molecular variance (AMOVA) showed that the genetic variation was among rather than within the landraces. DAPC analysis of the Tunisian, Mediterranean and West Asian landraces confirmed our previous population structure and showed a genetic similarity between the Tunisian and the North African landraces with the exception of Jenah Zarzoura being the most distant. The genomic characterization of the Tunisian collection will enhance their conservation and sustainable use.


Assuntos
Variação Genética , Genética Populacional , Genoma de Planta , Análise de Sequência de DNA/métodos , Triticum/genética , Alelos , Ásia Ocidental , Análise Discriminante , Frequência do Gene/genética , Marcadores Genéticos , Heterozigoto , Região do Mediterrâneo , Filogenia , Análise de Componente Principal , Tunísia
18.
Mol Biol Evol ; 36(5): 875-889, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30861529

RESUMO

The occurrence of parallel speciation strongly implies the action of natural selection. However, it is unclear how general a phenomena parallel speciation is since it was only shown in a small number of animal species. In particular, the adaptive process and mechanisms underlying the process of parallel speciation remain elusive. Here, we used an integrative approach incorporating population genomics, common garden, and crossing experiments to investigate parallel speciation of the wild rice species Oryza nivara from O. rufipogon. We demonstrated that O. nivara originated multiple times from different O. rufipogon populations and revealed that different O. nivara populations have evolved similar phenotypes under divergent selection, a reflection of recurrent local adaptation of ancient O. rufipogon populations to dry habitats. Almost completed premating isolation was detected between O. nivara and O. rufipogon in the absence of any postmating barriers between and within these species. These results suggest that flowering time is a "magic" trait that contributes to both local adaptation and reproductive isolation in the origin of wild rice species. Our study thus demonstrates a convincing case of parallel ecological speciation as a consequence of adaptation to new environments.


Assuntos
Especiação Genética , Oryza/genética , Adaptação Biológica , Ásia Sudeste , Ásia Ocidental , Ecossistema , Fenótipo , Filogeografia , Polimorfismo de Nucleotídeo Único , Isolamento Reprodutivo , Seleção Genética , Sequenciamento Completo do Genoma
19.
Viruses ; 11(3)2019 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-30857374

RESUMO

Bat research networks and viral surveillance are assumed to be at odds due to seemingly conflicting research priorities. Yet human threats that contribute to declines in bat populations globally also lead to increased transmission and spread of bat-associated viruses, which may pose a threat to global health and food security. In this review, we discuss the importance of and opportunities for multidisciplinary collaborations between bat research networks and infectious disease experts to tackle shared threats that jeopardize bat conservation as well as human and animal health. Moreover, we assess research effort on bats and bat-associated viruses globally, and demonstrate that Western Asia has limited published research and represents a gap for coordinated bat research. The lack of bat research in Western Asia severely limits our capacity to identify and mitigate region-specific threats to bat populations and detect interactions between bats and incidental hosts that promote virus spillover. We detail a regional initiative to establish the first bat research network in Western Asia (i.e., the Western Asia Bat Research Network, WAB-Net), with the aim of integrating ecological research on bats with virus surveillance to find "win-win" solutions that promote bat conservation and safeguard public and animal health across the region.


Assuntos
Quirópteros/virologia , Pesquisa/tendências , Comunicação Acadêmica , Vírus/isolamento & purificação , Zoonoses/virologia , Animais , Ásia Ocidental/epidemiologia , Ecologia , Monitoramento Epidemiológico , Humanos , Saúde Única , Filogenia , Vírus/genética , Zoonoses/epidemiologia , Zoonoses/transmissão
20.
Curr Obes Rep ; 8(1): 43-52, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30729382

RESUMO

PURPOSE OF REVIEW: Obesity has increased in South Asian countries that are still grappling with undernutrition. In this review, we highlight the characteristics of obesity, its relation to morbidities, and its management in South Asians. A literature search was conducted using relevant search engines and based on key words focusing on obesity in South Asians. RECENT FINDINGS: The increasing trend in obesity prevalence is caused by imbalanced diets and physical inactivity. South Asians, in general, have higher body fat and lower skeletal muscle mass at the same or lower BMIs compared to white people ("high body fat-normal BMI-low muscle mass" phenotype). In addition, excess abdominal adiposity, typically seen in South Asians, and increased hepatic fat (non-alcoholic fatty liver disease) are associated with an increased risk for type 2 diabetes and cardiovascular disease. Challenges in treatment include lack of awareness regarding correct diets and non-compliance to diet and exercise regimens. Social and cultural issues limit physical activity in South Asian women. Finally, there is a lack of expert health professionals to deal with increased cases of obesity. Aggressive management of obesity is required in South Asians, with more intensive and earlier diet and exercise interventions (i.e., at lower BMI levels than internationally accepted). At a population level, there is no clear policy for tackling obesity in any South Asian country. Prevention strategies focusing on obesity in childhood and the creation of food and activity environments that encourage healthy lifestyles should be firmly applied. Obesity in South Asians should be evaluated with ethnic-specific guidelines and prevention and management strategies should be applied early and aggressively.


Assuntos
Dieta , Exercício Físico , Obesidade/epidemiologia , Ásia Ocidental/epidemiologia , Feminino , Humanos , Masculino , Obesidade/diagnóstico , Obesidade/prevenção & controle , Fenótipo , Prevalência , Fatores Sexuais
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