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1.
Environ Res ; 251(Pt 2): 118740, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38521356

RESUMO

Magnetite mining is a significant contributor to land deterioration as well as HM-based soil contamination. The characteristics of magnetite mine tailing were examined in the present study, in addition to the positive and sustainable restoration strategy with Bougainvillaea glabra under the influence of Thiobacillus ferroxidance. The traits of test soil analysis findings demonstrated that the majority of the parameters exceeded the allowable limits (For instance: HMs such as Cr, Cu, Zn, Pb, Fe, and Co were found to be 208 ± 2.3, 131.43 ± 1.6, 185.41 ± 3.3, 312 ± 5.11, 956 ± 5.3, and 26.89 ± 2.43 mg kg-1 respectively). T. ferroxidance exhibited impressive HMs tolerance for as much as 800 g mL-1 concentrations of Cr, Cu, Zn, Pb, Fe, and Co. To prevent HMs toxic effects, the HMs contents in test soil were decreased by diluting with normal soil in the ratios of Ex-3 and Ex-2. A typical greenhouse study was carried out to assess the phytoremediation ability of B. glabra across six setups for experiments (Ex-1 to Ex-6). According to the findings of this research, the HMs tolerant T. ferroxidance from Ex-3 and Ex-2 had an outstanding impact on the growth, biomolecules level (such as chlorophylls: 65.84 & 41.1 mg g-1, proteins: 165.1 & 151.1 mg g-1, as well as carbohydrates: 227.4 & 159.3 mg g-1) as well as phytoremediation potential of B. glabra on magnetite mine soil. These findings indicated that a mixture of B. glabra as well as T. ferroxidance might serve as a valuable sustainable agent for removing HMs from contaminated soil.


Assuntos
Biodegradação Ambiental , Mineração , Poluentes do Solo , Poluentes do Solo/análise , Poluentes do Solo/metabolismo , Óxido Ferroso-Férrico/química , Solo/química , Metais Pesados/análise , Metais Pesados/metabolismo , Bacillaceae/metabolismo
2.
Chaos ; 33(12)2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38154041

RESUMO

This study investigates the emergence of extreme events in two different coupled systems: the FitzHugh-Nagumo neuron model and the forced Liénard system, both based on time-varying interactions. The time-varying coupling function between the systems determines the duration and frequency of their interaction. Extreme events in the coupled system arise as a result of the influence of time-varying interactions within various parameter regions. We specifically focus on elucidating how the transition point between extreme events and regular events shifts in response to the duration of interaction time between the systems. By selecting the appropriate interaction time, we can effectively mitigate extreme events, which is highly advantageous for controlling undesired fluctuations in engineering applications. Furthermore, we extend our investigation to networks of oscillators, where the interactions among network elements are also time dependent. The proposed approach for coupled systems holds wide applicability to oscillator networks.

3.
Phys Rev E ; 108(2-1): 024217, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37723774

RESUMO

The numerical, analytical, and experimental analyses are presented for synchronizing two rotors under the Yukawa interaction. We report that the rotors exhibit in-phase and mixed-phase measure synchronizations for a pair of coupled rotors. Here, the analytical condition for synchronization is derived, tested numerically, and confirmed experimentally using coupled camphor infused rotors as a test bed. Moreover, the concept of measure synchronization is discussed. We report that, in conservative systems, not only the critical coupling parameter but initial conditions also play an essential role for estimating the measure synchronization region.

4.
Chaos ; 33(9)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37748481

RESUMO

In the present study, we investigate the dynamic behavior of the fractional-order Bonhoeffer-van der Pol (BVP) oscillator. Previous studies on the integer-order BVP have shown that it exhibits mixed-mode oscillations (MMOs) with respect to the frequency of external forcing. We explore the effect of fractional-order on these MMOs and observe interesting phenomena. For fractional-order q1, we find that as we vary the frequency of external forcing, the system exhibits increasingly small amplitude oscillations. Eventually, as q1 decreases, the MMOs disappear entirely, indicating that lower fractional orders eliminate the presence of MMOs in the BVP oscillator. On the other hand, for the fractional-order q2, we observe more complex MMOs compared to q1. However, we find that the elimination of MMOs occurs with less variation from the integer order 1. Intriguingly, as we change q2, the fractional-order BVP oscillator undergoes a phenomenon known as a crisis, where the attractor expands and extreme events occur. Overall, our study highlights the rich dynamics of the fractional-order BVP oscillator and its ability to display various modes of oscillations and crises as the order is changed.

5.
Phys Rev E ; 108(1-1): 014209, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37583223

RESUMO

Phase slips are a typical dynamical behavior in coupled oscillator systems: the route to phase synchrony is characterized by intervals of constant phase difference interrupted by abrupt changes in the phase difference. Qualitatively similar to stick-slip phenomena, analysis of phase slip has mainly relied on identifying remnants of saddle-nodes or "ghosts." We study sets of phase oscillators and by examining the dynamics in detail, offer a more precise, quantitative description of the phenomenon. Phase shifts and phase sticks, namely, the temporary locking of phases required for phase slips, occur at stationary points of phase velocities. In networks of coupled phase oscillators, we show that phase slips between pairs of individual oscillators do not occur simultaneously, in general. We consider additional systems that show phase synchrony: one where saddle-node ghosts are absent, one where the coupling is similarity dependent, and two cases of coupled chaotic oscillators.

6.
Opt Express ; 31(14): 22817-22836, 2023 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-37475384

RESUMO

In this study, we report a rich variety of large-intensity pulses exhibited by a Zeeman laser model. The instabilities in the system occur via three different dynamical processes, such as quasiperiodic intermittency, Pomeau-Manneville intermittency, and the breakdown of quasiperiodic motion to chaos followed by an interior crisis. This Zeeman laser model is more capable of exploring the major possible types of instabilities when changing a specific system's parameter in a particular range. We exemplified distinct dynamical transitions of the Zeeman laser model. The statistical measures reveal the appearance of the low probability of large-intensity pulses above the qualifier threshold value. Moreover, they seem to follow an exponential decay that shows a Poisson-like distribution. The impact of noise and time delay effects have been analyzed near the transition point of the system.

7.
Prev Med Rep ; 35: 102291, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37455756

RESUMO

The COVID-19 pandemic has exacerbated the existing challenges to achieving the WHO target of eliminating cervical cancer as a public health problem by working towards the target of fewer than four cases per 100 000 women. We reviewed the literature to identify potential recovery strategies to support cervical cancer prevention programs in lower-and middle-income countries (LMICs) following COVID-19 disruptions and the extent to which strategies have been implemented. Utilising the WHO health systems framework, we mapped these recovery strategies against the six building blocks to examine their reach across the health system. Most recovery strategies were focused on service delivery, while leadership and governance played a pivotal role in the continuity of cervical cancer prevention programs during the pandemic. Leadership and governance were the drivers for outcomes in the building blocks of health information systems, financing and critical support in operationalising service delivery strategies. In the aftermath of the COVID-19 pandemic with strained health resources and economies, stakeholders would significantly influence the coverage and sustainability of cervical cancer prevention programs. The support from multisectoral stakeholders would accelerate the recovery of cervical cancer prevention programs. To achieve the WHO target by 2030, we call for future studies to understand the barriers and facilitators from the perspectives of stakeholders in order to support the decision-making processes and information required to implement recovery strategies in LMICs.

8.
Food Sci Nutr ; 11(7): 4191-4210, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37457145

RESUMO

This systematic review identified various bioactive compounds which have the potential to serve as novel drugs or leads against acute myeloid leukemia. Acute myeloid leukemia (AML) is a heterogeneous hematopoietic malignancy that arises from the dysregulation of cell differentiation, proliferation, and cell death. The risk factors associated with the onset of AML include long-term exposure to radiation and chemicals such as benzene, smoking, genetic disorders, blood disorders, advancement in age, and others. Although novel strategies to manage AML, including a refinement of the conventional chemotherapy regimens, hypomethylating agents, and molecular targeted drugs, have been developed in recent years, resistance and relapse remain the main clinical problems. In this study, three databases, PubMed/MEDLINE, ScienceDirect, and Google Scholar, were systematically searched to identify various bioactive compounds with antileukemic properties. A total of 518 articles were identified, out of which 59 were viewed as eligible for the current report. From the data extracted, over 60 bioactive compounds were identified and divided into five major groups: flavonoids, alkaloids, organosulfur compounds, terpenes, and terpenoids, and other known and emerging bioactive compounds. The mechanism of actions of the analyzed individual bioactive molecules differs remarkably and includes disrupting chromatin structure, upregulating the synthesis of certain DNA repair proteins, inducing cell cycle arrest and apoptosis, and inhibiting/regulating Hsp90 activities, DNA methyltransferase 1, and histone deacetylase 1.

9.
Phys Rev E ; 107(5): L052201, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37328971

RESUMO

Hidden attractors are present in many nonlinear dynamical systems and are not associated with equilibria, making them difficult to locate. Recent studies have demonstrated methods of locating hidden attractors, but the route to these attractors is still not fully understood. In this Research Letter, we present the route to hidden attractors in systems with stable equilibrium points and in systems without any equilibrium points. We show that hidden attractors emerge as a result of the saddle-node bifurcation of stable and unstable periodic orbits. Real-time hardware experiments were performed to demonstrate the existence of hidden attractors in these systems. Despite the difficulties in identifying suitable initial conditions from the appropriate basin of attraction, we performed experiments to detect hidden attractors in nonlinear electronic circuits. Our results provide insights into the generation of hidden attractors in nonlinear dynamical systems.

10.
Environ Res ; 231(Pt 2): 116130, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37201702

RESUMO

Studies have investigating the detoxification and antioxidant enzymes with melatonin under pesticide stress in many vertebrates, whereas no reports produced in invertebrates. In this study possible role of melatonin and luzindole effect on fipronil toxicity and the detoxification, antioxidant enzymes in H. armigera has been reported. Result showed high toxicity of fipronil treatment (LC50 4.24 ppm), followed by increased LC50 value with melatonin pretreatment (6.44 ppm). Whereas decreased toxicity was observed with melatonin and luzindole combination (3.72 ppm). The detoxification enzymes AChE, esterase and P450 were increased in larval head and whole body with exogenous melatonin level compared to control 1-1.5 µmol/mg of protein. The antioxidant levels of CAT, SOD and GST in whole body and head tissue had been increased by melatonin and fipronil combination 1.1-1.4 unit/mg of protein followed by GPx and GR in larval head (1-1.2 µmol/mg of protein). Mean while the luzindole antagonist inhibits CAT, SOD, GST and GR oxidative enzyme level (1-1.5 fold) in most of the tissue compared to melatonin and fipronil treatment (p < 0.01). Hence this study concludes that the melatonin pretreatment can reduce the fipronil toxicity by enhanced detoxification and antioxidant enzyme system in H. armigera.


Assuntos
Melatonina , Mariposas , Animais , Antioxidantes/farmacologia , Melatonina/farmacologia , Larva/metabolismo , Mariposas/metabolismo , Superóxido Dismutase/metabolismo
11.
Environ Res ; 231(Pt 1): 116079, 2023 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-37156353

RESUMO

The tobacco cutworm, Spodoptera litura and cotton bollworm, Helicoverpa armigera (Lepidoptera: Noctuidae) are important pests of various agricultural crops that cause sevier economic loses throughout the world. Indiscriminate and frequent use of insecticide may lead to development of resistance in these pests. Nanotechnology has given an alternative to manage and overcome insecticide resistance for pest management strategies. In the present study the iron nanoparticles derived from Trigonella foenum-graecum leaf extract (FeNPs) was investigated for its ecofriendly management of pyrethroid resistance in two lepidopteron pest species at 24 h, 48 h and 72 h post treatment. The result showed high mortality (92.83% and 91.41%) of S. litura and H. armigera at 72 h treatment upon FeNPs and fenvalerate (Fen + FeNPs) teratment. Probit analysis revealed high LC50 upon Fen + FeNPs treatment (130.31 and 89.32 mg/L) with a synergism ratio of 1.38 and 1.36. Antifeedant activity of six dofferent concentration of FeNPs revelaed increased antifeedant activity with respect to increasing concentration of nanoparticles ranging from 10 to 90% and 20-95% againt both insects (p<0.05). Detoxification activity of carboxylesterase was elevated at 630 µmol/mg protein/min (p<0.05) in fenvalerate treatment, whereas decreased activity was found (392umole/mg protein/min) in FeNPs and Fen + FeNPs treatment (P<0.001). GST and P450 activity was also increased in fenvalerate treatment, whereas decreased activity was observed in FeNPs and Fen + FeNPs. Esterase isoenzyme banding pattern revealed four bands in fenvalerate treatment and two bans (E3 and E4) in Fen + FeNPs combination. Hence the present study concludes that T. foenum-graecum synthesized iron nanoparticles could be an effective alternate for ecofriendly management of S. litura and H. armigera.


Assuntos
Inseticidas , Mariposas , Nanopartículas , Trigonella , Animais , Spodoptera , Larva
12.
Phys Rev E ; 107(2): L022201, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36932627

RESUMO

Extreme events are unusual and rare large-amplitude fluctuations can occur unexpectedly in nonlinear dynamical systems. Events above the extreme event threshold of the probability distribution of a nonlinear process characterize extreme events. Different mechanisms for the generation of extreme events and their prediction measures have been reported in the literature. Based on the properties of extreme events, such as those that are rare in the frequency of occurrence and extreme in amplitude, various studies have shown that extreme events are both linear and nonlinear in nature. Interestingly, in this Letter, we report on a special class of extreme events which are nonchaotic and nonperiodic. These nonchaotic extreme events appear in between the quasiperiodic and chaotic dynamics of the system. We report the existence of such extreme events with various statistical measures and characterization techniques.

13.
J Obstet Gynaecol Res ; 49(4): 1230-1243, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36726190

RESUMO

BACKGROUND: Despite the introduction of cervical cancer screening and human papillomavirus (HPV) vaccines, the utilization pattern was not standardized. The aim of this study was to elicit the current prevention care in Asia-Oceania. METHODS: An online questionnaire was circulated to different countries/cities in Asia-Oceania. The primary objective was to evaluate the coverage of HPV vaccination and cervical screening programs. The secondary objectives were to study the structures of these programs. Five case scenarios were set to understand how the respondents manage the abnormal screening results. RESULTS: Fourteen respondents from 10 countries/cities had participated. Cervical cancer ranked the first in Myanmar and Nepal. About 10%-15% did not have national vaccination or screening program. The estimated coverage rate for vaccination and screening varied from less than 1% to 70%, which the coverage ran in parallel with the incidence and mortality rates of cervical cancer. All regions approved HPV vaccines, although only four provided free or subsidized programs for nonavalent vaccine. Cervical cytology remained the most common screening tool, and 20%-30% relied heavily on visual inspection using acetic acid. The screening age groups varied in different regions. From the case scenarios, it was noted that some respondents tended to offer more frequent screening tests or colposcopy than recommended by international guidelines. CONCLUSION: This study revealed discrepancy in the practice of cervical cancer prevention in Asia-Oceania especially access to HPV vaccines. There is an urgent need for a global collaboration to eliminate cervical cancer by public education, reforming services, and medical training.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Ásia/epidemiologia , Detecção Precoce de Câncer/métodos , Programas de Rastreamento , Oceania , Infecções por Papillomavirus/complicações , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Disparidades em Assistência à Saúde
14.
J Biomol Struct Dyn ; 41(7): 2772-2788, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35139758

RESUMO

Coronaviruses have caused enough devastation in the last two decades. These viruses have some rare features while sharing some common features. Novel coronavirus disease (nCoV-19) caused an outbreak with a fatality rate of 5%. It emerged from China and spread into many countries. The present research focused on genome analysis of Indian nCoV-19 Isolate and its translational product subjected to homology modeling and its subsequent molecular simulations to find out potent FDA approved drug for treating COVID-19. Phylogenetic analysis of SARS-CoV-2 Indian isolate shows close resemblance with 17 countries SARS-CoV-2 isolates. Homology modeling of four non-structural proteins translational product of Indian SARS-CoV-2 genome shows high similarity and allowed regions with the existing PDB deposited SARS-CoV-2 target proteins. Finally, these four generated proteins show more affinity with cobicistat, remdesivir and indinavir out of 14 screened FDA approved drugs in molecular docking which is further proven by molecular dynamics simulation and MMGBSA analysis of target ligand complex with best simulation trajectories. Overall our present research findings is that three proposed drugs namely cobicistat, remdesivir and indinavir showed higher interaction with the model SARS-CoV-2 viral target proteins from the Indian nCoV-19 isolate. These compounds could be used as a starting point for the creation of active antiviral drugs to combat the deadly COVID-19 virus during global pandemic and its subsequent viral infection waves across the globe.Communicated by Ramaswamy H. Sarma.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Indinavir , Simulação de Dinâmica Molecular , Simulação de Acoplamento Molecular , Filogenia , Cobicistat
15.
Chaos ; 32(11): 113138, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36456346

RESUMO

We consider a system of coupled nonlinear oscillators in which the interaction is modulated by a measure of the similarity between the oscillators. Such a coupling is common in treating spatially mobile dynamical systems where the interaction is distance dependent or in resonance-enhanced interactions, for instance. For a system of Stuart-Landau oscillators coupled in this manner, we observe a novel route to oscillation death via a Hopf bifurcation. The individual oscillators are confined to inhomogeneous limit cycles initially and are damped to different fixed points after the bifurcation. Analytical and numerical results are presented for this case, while numerical results are presented for coupled Rössler and Sprott oscillators.


Assuntos
Vibração
16.
Phys Rev E ; 106(2-1): 024201, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36109890

RESUMO

We present numerical and experimental results for the generation of aperiodic motion in coupled active rotators. The numerical analysis is presented for two point particles constrained to move on a unit circle under the Yukawa-like interaction. Simulations exhibit that the collision among the rotors results in chaotic motion of the rotating point particles. Furthermore, the numerical model predicts a route to chaotic motion. Subsequently, we explore the effect of separation between the rotors on their chaotic dynamics. The numerically calculated fraction of initial conditions which led to chaotic motion shed light on the observed effects. We reproduce a subset of the numerical observations with two self-propelled ribbons rotating at the air-water interface. A pinned camphor rotor moves at the interface due to the Marangoni forces generated by surface tension imbalance around it. The camphor layer present at the common water surface acts as chemical coupling between two ribbons. The separation distance of ribbons (L) determines the nature of coupled dynamics. Below a critical distance (L_{T}), rotors can potentially, by virtue of collisions, exhibit aperiodic oscillations characterized via a mixture of co- and counterrotating oscillations. These aperiodic dynamics qualitatively matched the chaotic motion observed in the numerical model.

17.
Chaos ; 32(7): 073106, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35907724

RESUMO

We report the appearance of strange nonchaotic attractors in a discrete FitzHugh-Nagumo neuron model with discontinuous resetting. The well-known strange nonchaotic attractors appear in quasiperiodically forced continuous-time dynamical systems as well as in a discrete map with a small intensity of noise. Interestingly, we show that a discrete FitzHugh-Nagumo neuron model with a sigmoidal recovery variable and discontinuous resetting generates strange nonchaotic attractors without external force. These strange nonchaotic attractors occur as intermittency behavior (locally unstable behavior in laminar flow) in the periodic dynamics. We use various characterization techniques to validate the existence of strange nonchaotic attractors in the considered system.


Assuntos
Neurônios , Neurônios/fisiologia
18.
Environ Pollut ; 300: 118922, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35114308

RESUMO

Contamination of aquatic systems with pharmaceuticals, personal care products, steroid hormones, and agrochemicals has been an immense problem for the earth's ecosystem and health impacts. The environmental issues of well-known persistence pollutants, their metabolites, and other micro-pollutants in diverse aquatic systems around the world were collated and exposed in this review assessment. Waste Water Treatment Plant (WWTP) influents and effluents, as well as industrial, hospital, and residential effluents, include detectable concentrations of known and undiscovered persistence pollutants and metabolites. These components have been found in surface water, groundwater, drinking water, and natural water reservoirs receiving treated and untreated effluents. Several studies have found that these persistence pollutants, and also similar recalcitrant pollutants, are hazardous to a variety of non-targeted creatures in the environment. In human and animals, they can also have severe and persistent harmful consequences. Because these pollutants are harmful to aquatic organisms, microbial degradation of these persistence pollutants had the least efficiency. Fortunately, only a few wild and Genetically Modified (GMOs) microbial species have the ability to degrade these PPCPs contaminants. Hence, researchers have been studying the degradation competence of microbial communities in persistence pollutants of Pharmaceutical and Personal Care Products (PPCPs) and respective metabolites for decades, as well as possible degradation processes in various aquatic systems. As a result, this review provides comprehensive information about environmental issues and the degradation of PPCPs and their metabolites, as well as other micro-pollutants, in aquatic systems.


Assuntos
Cosméticos , Poluentes Ambientais , Poluentes Químicos da Água , Animais , Cosméticos/análise , Ecossistema , Monitoramento Ambiental , Preparações Farmacêuticas , Águas Residuárias/química , Poluentes Químicos da Água/análise
19.
J Biomol Struct Dyn ; 40(13): 5769-5784, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-33491580

RESUMO

The unavailability of vaccine and medicines raised serious issues during COVID-19 pandemic and peoples from different parts of world relied on traditional medicine for their immediate recovery from COVID-19 and it found effective also. The current research aims to target COVID-19 immunological human host receptors i.e. angiotensin-converting enzyme (ACE)-2, interleukin (IL)-1ß, IL-6, tumor necrosis factor-alpha (TNF-α) and protease-activated receptor (PAR)-1 using curcumin derivatives to prevent viral infection and control overproduction of early clinical responses of COVID-19. Targeting these host proteins will mitigate the infection and will filter out many complications caused by these proteins in COVID-19 patients. It is proven through computer-aided computational modeling approaches, total 30 compounds of curcumin and its derivatives were chosen. Drug-likeness parameters were calculated for curcumin and its derivatives and 20 curcumin analogs were selected for docking analysis. From docking analysis of 20 curcumin analogs against five chosen human host receptor targets reveals 11 curcumin analogs possess least binding affinity and best interaction at active sites subjected to absorption, distribution, metabolism, excretion (ADME) analysis. Density functional theory (DFT) analysis of five final shortlisted curcumin derivatives was done to show least binding affinity toward chosen host target protein. Molecular dynamics simulation (MDS) was performed to observe behavior and interaction of potential drug hydrazinocurcumin against target proteins ACE-2 and PAR-1. It was performed at 100 nanoseconds and showed satisfactory results. Finally, our investigation reveals that hydrazinocurcumin possesses immunomodulatory and anti-cytokine therapeutic potential against COVID-19 and it can act as COVID-19 warrior drug molecule and promising choice of drug for COVID-19 treatment, however, it needs further in vivo clinical evaluation to commercialize as COVID-19 drug.Communicated by Ramaswamy H. Sarma.


Assuntos
Tratamento Farmacológico da COVID-19 , Curcumina , Curcumina/química , Curcumina/farmacologia , Curcumina/uso terapêutico , Citocinas , Humanos , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Pandemias
20.
J Med Genet ; 59(3): 220-229, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33526602

RESUMO

BACKGROUND: Identifying patients with BRCA mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming. METHODS: The Mainstreaming Genetic Counselling for Ovarian Cancer Patients (MaGiC) study is a prospective, two-arm observational study comparing oncologist-led and genetics-led counselling. This study included 790 multiethnic patients with ovarian cancer from 23 sites in Malaysia. We compared the impact of different method of delivery of genetic counselling on the uptake of genetic testing and assessed the feasibility, knowledge and satisfaction of patients with ovarian cancer. RESULTS: Oncologists were satisfied with the mainstreaming experience, with 95% indicating a desire to incorporate testing into their clinical practice. The uptake of genetic testing was similar in the mainstreaming and genetics arm (80% and 79%, respectively). Patient satisfaction was high, whereas decision conflict and psychological impact were low in both arms of the study. Notably, decisional conflict, although lower than threshold, was higher for the mainstreaming group compared with the genetics arm. Overall, 13.5% of patients had a pathogenic variant in BRCA1 or BRCA2, and there was no difference between psychosocial measures for carriers in both arms. CONCLUSION: The MaGiC study demonstrates that mainstreaming cancer genetics is feasible in low-resource and middle-resource Asian setting and increased coverage for genetic testing.


Assuntos
Oncologistas , Neoplasias Ovarianas , Proteína BRCA1/genética , Proteína BRCA2/genética , Aconselhamento , Feminino , Aconselhamento Genético , Testes Genéticos/métodos , Humanos , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Estudos Prospectivos
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