Crosstalk of NLRP3 inflammasome and noncoding RNAs in cardiomyopathies

Cardiovascular diseases (CVDs) identified as a serious public health problem. Although there is a lot of evidence that inflammatory processes play a significant role in the progression of CVDs, however, the precise mechanism is not fully understood. Nevertheless, recent studies have focused on inflammation and its related agents. Nucleotide oligomerization domain-, leucine-rich repeat-, and pyrin domain-containing protein 3 (NLRP3) is a type of pattern recognition receptor (PRR) that can recognize pathogen-associated molecular patterns and trigger innate immune response. NLRP3 is a component of the NOD-like receptor (NLR) family and have a pivotal role in detecting damage to cardiovascular tissue. It is suggested that activation of NLRP3 inflammasome leads to initiating and propagating the inflammatory response in cardiomyopathy. So, late investigations have highlighted the NLRP3 inflammasome activation in various forms of cardiomyopathy. On the other side, it was shown that noncoding RNAs (ncRNAs), particularly, microRNAs, lncRNAs, and circRNAs possess a regulatory function in the immune system's inflammatory response, implicating their involvement in various inflammatory disorders. In addition, their role in different cardiomyopathies was indicated in recent studies. This review article provides a summary of recent advancements focusing on the function of the NLRP3 inflammasome in common CVDs, especially cardiomyopathy, while also discussing the therapeutic potential of inhibiting the NLRP3 inflammasome regulated by ncRNAs.

Proteome analysis, bioinformatic prediction and experimental evidence revealed immune response down-regulation function for serum-starved human fibroblasts

Emerging evidence indicates that fibroblasts play pivotal roles in immunoregulation by producing various proteins under health and disease states. In the present study, for the first time, we compared the proteomes of serum-starved human skin fibroblasts and peripheral blood mononuclear cells (PBMCs) using Nano-LC-ESI-tandem mass spectrometry. This analysis contributes to a better understanding of the underlying molecular mechanisms of chronic inflammation and cancer, which are intrinsically accompanied by growth factor deficiency.The proteomes of starved fibroblasts and PBMCs consisted of 307 and 294 proteins, respectively, which are involved in lymphocyte migration, complement activation, inflammation, acute phase response, and immune regulation. Starved fibroblasts predominantly produced extracellular matrix-related proteins such as collagen/collagenase, while PBMCs produced focal adhesion-related proteins like beta-parvin and vinculin which are involved in lymphocyte migration. PBMCs produced a more diverse set of inflammatory molecules like heat shock proteins, while fibroblasts produced human leukocytes antigen-G and -E that are known as main immunomodulatory molecules. Fifty-four proteins were commonly found in both proteomes, including serum albumin, amyloid-beta, heat shock cognate 71 kDa, and complement C3. GeneMANIA bioinformatic tool predicted 418 functions for PBMCs, including reactive oxygen species metabolic processes and 241 functions for starved fibroblasts such as antigen processing and presentation including non-classical MHC -Ib pathway, and negative regulation of the immune response. Protein-protein interactions network analysis indicated the immunosuppressive function for starved fibroblasts-derived human leucocytes antigen-G and -E. Moreover, in an in vitro model of allogeneic transplantation, the immunosuppressive activity of starved fibroblasts was experimentally documented.

Conclusion

Under serum starvation-induced metabolic stress, both PBMCs and fibroblasts produced molecules like heat shock proteins and amyloid-beta, which can have pathogenic roles in auto-inflammatory diseases such as rheumatoid arthritis, type 1 diabetes mellitus, systemic lupus erythematosus, aging, and cancer. However, starved fibroblasts showed immunosuppressive activity in an in vitro model of allogeneic transplantation, suggesting their potential to modify such adverse reactions by down-regulating the immune system.

Spatial patterns and temporal variations of traffic-related air pollutants and estimating its health effects in Isfahan city, Iran

Isfahan as an important industrial city has faced with air pollution recently. Thus, we assessed the spatial and temporal trends of ambient PM_2.5, CO, SO₂, and O₃ and for estimating their health effect on Isfahan citizens between March 2018 and March 2019 through the AirQ+ software. Our results showed that citizens of Isfahan in almost 240, 167, and 134 of the days in the year has exposure to PM_2.5, SO₂, and O₃ higher than the WHO daily guideline, respectively. Daily variations of PM_2.5, CO, and SO₂ concentration showed the increasing trend of pollutants in the morning to evening. The maximum concentrations of O₃ were observed in the noonday. Also, the concentrations of these pollutants on Friday due to the holiday effect were higher than the weekdays. Except for O₃, the PM_2.5, CO, and SO₂ concentrations in the cold months and cold seasons was higher compared with the hot months and hot seasons. The total number of deaths because of lung cancer, natural mortality, ischemic heart disease, chronic obstructive pulmonary disease,, stroke associated with ambient PM_2.5 with the attributable proportion (AP) 11.43%, 11.63%, 15.96%, 15.15%, and 13.1% (95% CI) were 683, 19, 2, 202, and 55 cases, respectively. Therefore, the present study provides additional data for the provincial managers and politicians useful in planning proper strategies of air pollution control to decrease exposure and attributable mortalities.

Downregulation of Stemness Genes and Induction of Necrosis in Rat LA7 Cancer Stem Cells Induced Tumors Treated with Starved Fibroblasts Culture Supernatant

BACKGROUND

Stem cell differentiation therapy is a promising strategy in cancer treatment. we show that protein cocktail prepared from serum starved fibroblasts has therapeutic potential based on this strategy.

METHODS

The condition medium was prepared from foreskin isolated fibroblasts and analyzed by Liquid chromatography electrospray ionization mass spectrometry-mass spectrometry (LC-ESI-MS/MS). LA7 mammary gland cancer stem cells originated tumors were induced in Sprague Dawley rats. The rats treated subcutaneously with DMEM (group A), condition medium (group B), or normal saline (group C) once daily for 7 days. Then the tumors were removed and divided into the two parts, one part was used to quantify gene expression by stem-loop RT-qPCR assay and the other part was used for Hematoxylin & Eosin (H & E), Giemsa, and immunohistochemistry (IHC) staining.

RESULTS

All induced tumors appeared as sarcomatoid carcinoma (SC). Immunohistochemistry staining confirmed this conclusion by recognizing the tumor as Ki67+, cytokeratin+, vimentine+, and estrogen receptor negative SC. RT-qPCR analysis revealed that Oct4-, Sox-2, Nanog- gene expression was much reduced in the condition medium treated tumors versus proper controls (p< 0.05). Tissue necrosis was more prevalent in this group while tumors volume was diminished almost by 40%. The LC-ESI-MS/MS analysis unrevealed the stemness reducing and the cell death inducing proteins such as, pigment epithelium-derived factor (PEDF), insulin like growth factor binding protein-5 (IGFBP-5) and -7 (IGFBP-7) in the condition medium.

CONCLUSION

This study showed that the substances released from starved human fibroblasts were able to down-regulate the stemness-related genes and induce necrosis in LA7 derived tumors.

Reduction in unplanned hospitalizations associated with a physician focused intervention to reduce potentially inappropriate medication use among older adults: a population-based cohort study

Background

A multimodal general practitioner-focused intervention in the Local Health Authority (LHA) of Parma, Italy, substantially reduced the prevalence of potentially inappropriate medication (PIM) use among older adults. Our objective was to estimate changes in hospitalization rates associated with the Parma LHA quality improvement initiative that reduced PIM use.

Methods

This population-based longitudinal cohort study was conducted among older residents (> 65 years) using the Parma LHA administrative healthcare database. Crude and adjusted unplanned hospitalization rates were estimated in 3 periods (pre-intervention: 2005–2008, intervention: 2009–2010, post-intervention: 2011–2014). Multivariable negative binomial models estimated trends in quarterly hospitalization rates among individuals at risk during each period using a piecewise linear spline for time, adjusted for time-dependent and time-fixed covariates.

Results

The pre-intervention, intervention, and post-intervention periods included 117,061, 107,347, and 121,871 older adults and had crude hospitalization rates of 146.2 (95% CI: 142.2–150.3), 146.8 (95% CI: 143.6–150.0), and 140.8 (95% CI: 136.9–144.7) per 1000 persons per year, respectively. The adjusted pre-intervention hospitalization rate was declining by 0.7% per quarter (IRR = 0.993; 95% CI: 0.991–0.995). The hospitalization rate declined more than twice as fast during the intervention period (1.8% per quarter, IRR = 0.982; 95% CI: 0.979–0.985) and was nearly constant post-intervention (IRR: 0.999; 95% CI: 0.997–1.001). Contrasting model predictions for the intervention period (Q1 2009 to Q4 2010), the intervention was associated with 1481 avoided hospitalizations.

Conclusion

In a large population of older adults, a multimodal general practitioner-focused intervention to decrease PIM use was associated with a decline in the unplanned hospitalization rate. Such interventions to reduce high risk medication use among older adults warrant consideration by health systems seeking to improve health outcomes and reduce high-cost acute care utilization.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02172-3.

A novel ternary heterogeneous TiO2/BiVO4/NaY-Zeolite nanocomposite for photocatalytic degradation of microcystin-leucine arginine (MC-LR) under visible light

Microcystin-leucine arginine (MC-LR) is a carcinogenic toxin, produced by cyanobacteria. The release of this toxin into drinking water sources can threaten public health and environmental safety. Therefore, effective MC-LR removal from water resources is necessary. In the present study, the hydrothermal method was used to synthesize a novel ternary BiVO₄/TiO₂/NaY-Zeolite (B/T/N-Z) nanocomposite for MC-LR degradation under visible light. FESEM, FTIR, XRD, and DRS were performed for characterizing the nanocomposite structure. Also, the Response Surface Methodology (RSM) was applied to determine the impact of catalyst dosage, pH, and contact time on the MC-LR removal. High-performance liquid chromatography was performed to measure the MC-LR concentration. Based on the results, independent parameters, including contact time, catalyst dosage, and pH, significantly affected the MC-LR removal (P < 0.05). In other words, increasing the contact time, catalyst dosage, and acidic pH had positive effects on MC-LR removal. Among these variables, the catalyst dosage, with the mean square and F-value of 1041.37 and 162.84, respectively, had the greatest effect on the MC-LR removal efficiency. Apart from the interaction between the catalyst dosage and contact time, the interaction effects of other parameters were not significant. Also, the maximum MC-LR removal efficiency was 99.88% under optimal conditions (contact time = 120 min, catalyst dosage = 1 g/L, and pH = 5). According to the results, the B/T/N-Z nanocomposite, as a novel and effective photocatalyst could be used to degrade MC-LR from polluted water.

Concentrations and mortality due to short- and long-term exposure to PM2.5 in a megacity of Iran (2014-2019)

The present study aimed to survey the spatial and temporal trends of ambient concentration of PM_2.5 and to estimate mortality attributed to short- and long-term exposure to PM_2.5 in Isfahan from March 2014 to March 2019 using the AirQ⁺ software. The hourly concentrations of PM_2.5 were obtained from the Isfahan Department of Environment and Isfahan Air Quality Monitoring Center. Then, the 24-h mean concentration of PM_2.5 for each station was calculated using the Excel software. According to the results, the annual mean concentration of PM_2.5 in 2014-2019 was 29.9-50.9 μg/m³, approximately 3-5 times higher than the WHO guideline (10 μg/m³). The data showed that people of Isfahan in almost 58% to 96% of the days of a year were exposed to PM_2.5 higher than the WHO daily guideline. The concentrations of PM_2.5 in cold months such as October, November, December and January were higher than those in the other months. The zoning of the annual concentrations of PM_2.5 in urban areas showed that the highest PM_2.5 concentrations were related to the northern, northwestern, southern and central areas of the city. On average, from 2014 to 2019, the number of deaths due to natural mortality, lung cancer (LC), chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and stroke associated with ambient PM_2.5 were 948, 16, 18, 281 and 60, respectively. The present study estimated that on average, 14.29% of the total mortality, 17.2% of lung cancer (LC), 15.54% of chronic obstructive pulmonary disease (COPD), 17.12% of ischemic heart disease (IHD) and 14.94% of stroke mortalities were related to long-term exposure to ambient PM_2.5. So provincial managers and politicians must adopt appropriate strategies to control air pollution and reduce the attributable health effects and economic losses.

Optimization and Modeling of Microcystin-LR Degradation by TiO2 Photocatalyst Using Response Surface Methodology

Introduction: Microcystin-leucine arginine (MC-LR) is a toxin with harmful effects on the liver, kidney, heart, and gastrointestinal tract. So, effective removal of MC-LR from water resources is of great importance. The aim of this study was to remove microcystin-LR (MC-LR) from aqueous solution by Titanium Dioxide (TiO2). Materials and Methods: In the present study, TiO2, as a semiconductor, was used for photodegradation of MC-LR under ultraviolet light (UV). The Response Surface Methodology was applied to investigate the effects of operating variables such as pH (A), contact time (B), and catalyst dose (B) on the removal of MC-LR. The MC-LR concentration was measured by high-performance liquid chromatography (HPLC). Results: The results showed that single variables such as A, B, and C had significant effects on MC-LR removal (pvalue < 0.05). In other words, increase of the contact time and catalyst dose had a positive effect on enhancing the removal efficiency of MC-LR, but the effect of pH was negative. The analysis of variance showed that BC, A2, and C2 variables had a significant effect on the MC-LR removal (pvalue < 0.05). Finally, the maximum removal efficiency of MC-LR was 95.1%, which occurred at pH = 5, contact time = 30 minutes, and catalyst dose = 1 g/l. Conclusion: According to the findings, TiO2, as a photocatalyst, had an appropriate effect on degradation of the MC-LR.

Effect of photocatalytic pretreatment on the biodegradation of n-hexane vapours in a biofilter

Hydrophobic volatile organic compounds (VOCs) such as n-hexane are not completely biodegradable by a single biofilter. So, in the present study, a photoreactor system packed with scoria granules coated with TiO2, as a pretreatment unit, was used for increasing the removal efficiency of n-hexane by a biofilter during an operation period of 191 days. The inlet and outlet concentration of n-hexane was analyzed with a gas chromatography coupled with a flame ionization detector (GC/FID). The results indicated that the removal efficiency of the single biofilter with input concentrations of 0.18 - 1 g/m3 at empty bed residence times (EBRTs) of 30, 60, and 120 s was 10.06%, 21.45%, and 46.8%, respectively. When the photoreactor was used as a pretreatment system, the removal efficiency of the combined system in corresponding EBRTs was improved to 39.79%, 63.08%, and 92.60%, respectively. The results proved that the combined system provided higher removal efficiencies than the single biofilter. Thus, the application of the photoreactor as a pretreatment step was much effective in increasing the removal efficiency of n-hexane from the polluted air by the biofilter.

Efficient degradation of microcystin-LR by BiVO4/TiO2 photocatalytic nanocomposite under visible light

Microcystin-Leucine Arginine (MC-LR) is one of the most studied cyanotoxins due to its toxicity and abundant that cause health hazards for humans through of the drinking water. In this study, BiVO₄/TiO₂ nanocomposite was synthesized by hydrothermal method and employed for the removal of MC-LR. The characteristics of the catalysts were determined by FESEM, XRD and FTIR spectra. Response surface methodology (RSM) was applied to assess the effects of operating variables (pH, contact time, and catalyst dose) on the MC-LR removal. The coefficient of determination (R²) was calculated 98.7% for the response. The residual concentration of MC-LR was measured by high-performance liquid chromatography (HPLC). The results show that the highest removal efficiency of MC-LR was 98% under the optimum conditions (pH = 5, contact time = 90 min, and catalyst dose = 0.5 g/l). MC-LR decomposition efficiency by BiVO₄/TiO₂ nanocomposite was enhanced by pH reduction and increasing of contact time and catalyst dose. The prepared BiVO₄/TiO₂ nanocomposite with technological potential can be used directly in environmental preservation, specifically in the decontamination of MC-LR from aqueous solutions.

Protocol for identification of airborne asbestos fibres in the urban areas and spatio-temporal trend

Asbestos is classified as a hazardous pollutants between the airborne particles that cause diseases such as lung fibrosis (asbestosis). This protocol describes an integrated method for determination of asbestos fibres concentration and its temporal-spatial trends in the air of urban areas. To do this, 60 samples were gathered from various areas of Yazd city with low, moderate and high traffic. For analysis of asbestos fibres in the samples scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) were utilized. The spatial and temporal variation of asbestos fibres concentration was carried out by ArcGIS 10 analysis. The Inverse Distance Weighting (IDW) method was used to draw asbestos fibres distribution maps. The interpolation of asbestos fibre by IDW method indicated that the distribution of the fibres in summer and winter were followed almost the similar pattern. However, the distribution of asbestos fibre concentrations in the direction of southeast to the northwest of the city was higher than that in the other areas due to high vehicular traffic.

An innovative approach to attached cultivation of Chlorella vulgaris using different materials

This article investigates the innovative attached cultivation of Chlorella vulgaris (C. vulgaris) using different materials as an alternative to high capital techniques of harvesting such as centrifugation, flocculation, and filtration. A simple attached algal cultivation system was proposed that was equipped by 10 submerged supporting materials which can harvest algal cells, efficiently. The effect of operational parameters such as light intensity, the rate of aeration, and auto-harvesting time was investigated. A chip, durable, and abundant cellulosic material (Kaldnes carriers covered by kenafs, KCCKs) was proposed for auto-harvesting C. vulgaris cells. The results revealed that optimum aeration rate, light intensity, and auto-harvesting of microalgal cells were 3.6 vvm, 10,548 W/m², and 12 days, respectively. Six of these KCCKs had the highest biofilm formation percent up to 33%. In this condition, the rate of cell growth increased to 0.6 mg/cm². Therefore, this system can be used for appropriate auto-harvesting of microalgae in the attached growth systems. C. vulgaris biomass composition is valuable for biodiesel, bioethanol, and animal protein production.

Mortality and Morbidity Due to Exposure to Ambient NO2, SO2, and O3 in Isfahan in 2013-2014

Background

The presence of air pollutants such as CO, NO₂, SO₂, O₃, and PM in the ambient air mainly emitted from fossil fuels combustion has become a major health concern. The aims of this study were to estimate the attribution of NO₂, SO₂, and O₃ in the premature deaths and prevalence of cardiovascular and respiratory diseases in Isfahan in 2013-2014.

Methods

In this study, short-term health effects (total mortality, cardiovascular and respiratory mortality, chronic obstructive pulmonary disease, and acute myocardial infarction) of exposure NO₂, SO₂, and O₃ on the population of Isfahan were assessed using AirQ 2.2.3 software suggested by the World Health Organization (WHO).

Results

The result showed that from nonaccident total mortality in 2013-2014 in Isfahan, the attributable proportion related to NO₂, SO₂, and O₃ were 1.03% (109 cases), 3.46% (365 cases), and 1.29% (136 cases), respectively. The percentage of days that people were exposed to the highest concentration of NO₂ (40-49 μg/m³), SO₂ (60-69 μg/m³), and O₃ (40-49 μg/m³) was 34.46%, 16.85%, and 42.74% of a year, respectively. Total mortality attributed to NO₂, SO₂, and O₃ exposure was 0.36%, 0.79%, and 0.83%, respectively.

Conclusions

The concentrations of NO₂ and SO₂ were upper than the WHO guidelines. The Air-Q software in spite of its limitations can provide useful information regarding the health outcome of the air pollutants. The results estimated in this study were considerable. This information can help the health authorities and policy makers to draw suitable strategies and fulfill effective emission control programs.

The effect of boron dilution transient on the VVER-1000 reactor core using MCNP and COBRA-EN codes

In this paper, the effect of boron dilution transient, as a consequence of the malfunction of the boron control system, was investigated in a VVER-1000 reactor, and then an appropriate setpoint was determined for the actuation of the emergency protection system to the reactor shutdown. In order to simulate the boron dilution, first, the whole reactor core was simulated by MCNPX code to compute the radial and axial power distribution. Then, the COBRA-EN code was employed using calculated power distribution for analyzing the thermal-hydraulic of hot fuel assembly and for extracting the safety parameters. For the safe operation of the reactor, certain parameters must be in defined specified ranges. Comparison between our results and FSARs data shows that the present modeling provides a good prediction of boron dilution transient with the maximum relative difference about 4%.

Cardiovascular, respiratory, and total mortality ascribed to PM10 and PM2.5 exposure in Isfahan, Iran

BACKGROUND

Air pollution is an important environmental issue due to its proven serious impacts on human health. The aim of this study was to estimate the attribution of particulate matter with an aerodynamic diameters of ≤ 2.5 and 10 (PM_2.5 and PM₁₀) in the prevalence of cardiovascular and respiratory diseases and premature deaths in Isfahan in 2013-2014.

MATERIALS AND METHODS

This descriptive, ecological study was conducted to assess health impacts of PM_2.5 and PM₁₀ on the population using Air Q_2.2.3 software, suggested by the World Health Organization (WHO).

RESULTS

The results showed that the annual mean, winter mean, summer mean, and the 98 percentile of PM₁₀ concentration in Isfahan were 108, 100, 116, and 264 μg/m³, respectively. The number of deaths per year related to PM_2.5 was 670 and that for PM₁₀ was 713 cases. The number of annual deaths due to cardiovascular and respiratory diseases attributed to PM₁₀ was 316 and 68 cases, respectively.

CONCLUSION

The results of this study revealed that about 44.3% of total annual death due to cardiovascular diseases and 9.55% of that due to respiratory diseases were attributed to PM₁₀ exposure. In the other word, residents were exposed to PM_2.5 and PM₁₀ concentrations higher than the WHO guidelines which caused a notable increase in the rate of mortality.

Differential effect of long-term drug selection with doxorubicin and vorinostat on neuroblastoma cells with cancer stem cell characteristics

Numerous studies have confirmed that cancer stem cells (CSCs) are more resistant to chemotherapy; however, there is a paucity of data exploring the effect of long-term drug treatment on the CSC sub-population. The purpose of this study was to investigate whether long-term doxorubicin treatment could expand the neuroblastoma cells with CSC characteristics and histone acetylation could affect stemness gene expression during the development of drug resistance. Using n-myc amplified SK-N-Be(2)C and non-n-myc amplified SK-N-SH human neuroblastoma cells, our laboratory generated doxorubicin-resistant cell lines in parallel over 1 year; one cell line intermittently treated with the histone deacetylase inhibitor (HDACi) vorinostat and the other without exposure to HDACi. Cells' sensitivity to chemotherapeutic drugs, the ability to form tumorspheres, and capacity for in vitro invasion were examined. Cell-surface markers and side populations (SPs) were analyzed using flow cytometry. Differentially expressed stemness genes were identified through whole genome analysis and confirmed with real-time PCR. Our results indicated that vorinostat increased the sensitivity of only SK-N-Be(2)C-resistant cells to chemotherapy, made cells lose the ability to form tumorspheres, and reduced in vitro invasion and the SP percentage. CD133 was not enriched in doxorubicin-resistant or vorinostat-treated doxorubicin-resistant cells. Nine stemness-linked genes (ABCB1, ABCC4, LMO2, SOX2, ERCC5, S100A10, IGFBP3, TCF3, and VIM) were downregulated in vorinostat-treated doxorubicin-resistant SK-N-Be(2)C cells relative to doxorubicin-resistant cells. A sub-population of cells with CSC characteristics is enriched during prolonged drug selection of n-myc amplified SK-N-Be(2)C neuroblastoma cells. Vorinostat treatment affects the reversal of drug resistance in SK-N-Be(2)C cells and may be associated with downregulation of stemness gene expression. This work may be valuable for clinicians to design treatment protocols specific for different neuroblastoma patients.

Abstract P2-12-10: Psycho-spiritual therapy for improving the quality of life and spiritual well-being of women with breast cancer

Objective: Psychological distress and morbidity are common consequences of diagnosis and treatment of breast cancer and associated with poor quality of life (QOL). Among several approaches, spirituality has been shown to be significantly associated with improving the quality of life of these patients. The aim of this study was to assess the role of psycho-spiritual therapy intervention in improving the quality of life and spiritual well-being of patients with breast cancer.

Methods: This was a randomized controlled trial study which was conducted in the Breast Cancer Research Center, St. S. Al-Shohada hospital, Isfahan, Iran. Sixty-eight patients with breast cancer were randomized to either psycho-spiritual therapy intervention group or control group who received routine management and educational programs. Before and after 6 weeks of psycho-spiritual therapy sessions, the quality of life was evaluated using Cancer quality-of-life questionnaire (QLQ-C30) and its supplementary breast cancer questionnaire (QLQ-BR23) and Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12). Multivariate, repeated-measures ANOVA, T-test and Paired T-test were used for analysis using Predictive Analytic Soft Ware (PASW, version 18) for windows.

Results: In all sixty five patients actually completed the six-week intervention and were evaluated for the outcomes. The mean Global health status score/QOL reached from 44.37 (SD: 13.03) to 68.63 (SD: 10.86), (p &lt; 0.001), (Cohen's d effect size: 2.16, 95% CI: 1.56–2.78). There was a statistically significant difference in all functional scales of QLQ-C30 (p &lt; 0.05) as well as spiritual well-being after intervention. (p = 0.02)

Conclusions: The results of this trial showed that the psycho-spiritual therapy program can improve the spiritual well-being and QOL of women with breast cancer. This program, with its ease of implementation and home practice, could be adopted in comprehensive care programs for women with breast cancer.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-10.

The role of family physician in case finding, referral, and insurance coverage in the rural areas

BACKGROUND

WHO suggest that family physician is the core in the world efforts for quality improvement, cost effectiveness, and equity in the health care systems. This study evaluates the impact of the program on accessibility of the services, case finding, patient referral, feedback process and insurance coverage in the rural health units.

METHODS

This study was quasi experimental. It compared the function of four health centers and eight health houses in the last three months of year 2004 with 2008. Data extracted from the available documents in the health units. Descriptive and analytical analysis was performed by using SPSS software.

RESULTS

The presence of physicians in health centers were 75 and 100 percent for 2004 and 2008 respectively, this rate for midwives were 50 and 100 percent for the same years respectively. The total referral cases to the hospitals were 2676, the feedback rate was recorded in 36% of the cases. In this case the follow up rate by physicians was 0% in 2004 and 3.17% in 2008. Insurance coverage rate was 27% and 97% for 2004 and 2008 respectively within a meaningful P value range at 95% CI.

CONCLUSION

The findings of this study show that the family physician program has the positive impact on function of health units in terms of availability of physicians and midwives and also insurance coverage at health centers in rural area, No impact on patient follow up and case referral rate was detected.

Regulation of pancreatic islet gene expression in mouse islets by pregnancy

Pancreatic β cells adapt to pregnancy-induced insulin resistance by unclear mechanisms. This study sought to identify genes involved in β cell adaptation during pregnancy. To examine changes in global RNA expression during pregnancy, murine islets were isolated at a time point of increased β cell proliferation (E13.5), and RNA levels were determined by two different assays (global gene expression array and G-protein-coupled receptor (GPCR) array). Follow-up studies confirmed the findings for select genes. Differential expression of 110 genes was identified and follow-up studies confirmed the changes in select genes at both the RNA and protein level. Surfactant protein D (SP-D) mRNA and protein levels exhibited large increases, which were confirmed in murine islets. Cytokine-induced expression of SP-D in islets was also demonstrated, suggesting a possible role as an anti-inflammatory molecule. Complementing these studies, an expression array was performed to define pregnancy-induced changes in expression of GPCRs that are known to impact islet cell function and proliferation. This assay, the results of which were confirmed using real-time reverse transcription-PCR assays, demonstrated that free fatty acid receptor 2 and cholecystokinin receptor A mRNA levels were increased at E13.5. This study has identified multiple novel targets that may be important for the adaptation of islets to pregnancy.

Assessing sources of inconsistencies in genotypes and their effects on genome-wide association studies with HapMap samples

The discordance in results of independent genome-wide association studies (GWAS) indicates the potential for Type I and Type II errors. We assessed the repeatibility of current Affymetrix technologies that support GWAS. Reasonable reproducibility was observed for both raw intensity and the genotypes/copy number variants. We also assessed consistencies between different SNP arrays and between genotype calling algorithms. We observed that the inconsistency in genotypes was generally small at the specimen level. To further examine whether the differences from genotyping and genotype calling are possible sources of variation in GWAS results, an association analysis was applied to compare the associated SNPs. We observed that the inconsistency in genotypes not only propagated to the association analysis, but was amplified in the associated SNPs. Our studies show that inconsistencies between SNP arrays and between genotype calling algorithms are potential sources for the lack of reproducibility in GWAS results.

Callosal lesion predicts future attacks after clinically isolated syndrome

BACKGROUND

Current MRI criteria can help predict a second attack after a clinically isolated syndrome (CIS). Given the known association between corpus callosum lesions (CC) and multiple sclerosis (MS), such lesions on MRI could provide additional predictive information. This study assessed whether the presence of CC lesion on MRI could, next to the modified Barkhof criteria, further enhance prediction of conversion from CIS to MS.

METHODS

Follow-up study of 158 patients with CIS who underwent MRI after CIS was performed. MRI were scored for the Barkhof criteria and CC lesion. Patients were classified as having MS according to Poser criteria. Cox regression models were used for the time to conversion from CIS to MS.

RESULTS

The Barkhof criteria and CC lesion were strongly associated with conversion to MS with hazard ratios (HR), respectively, of 2.6 (95% confidence interval [CI] 1.5-4.3) and 2.7 (95% CI 1.6-4.5). The HRs of CC lesion adjusted for the Barkhof criteria and the Barkhof criteria adjusted for CC lesion were similar (HRs 1.8, not significant). The combined prediction of the Barkhof criteria and CC lesion was 3.3 (95% CI 1.9-5.7). Patients not fulfilling the Barkhof criteria had a fourfold increased risk of MS (HR 3.8, 95% CI 1.5-9.3) when they had a lesion in the CC.

CONCLUSIONS

Corpus callosum (CC) lesion and the Barkhof criteria both predicted conversion to multiple sclerosis (MS). When both variables were combined, the association was stronger. The assessment of CC lesion may be a useful additional tool for predicting conversion to MS in patients with clinically isolated syndrome.

Visfatin genotype may modify the insulin resistance and lipid profile in type 2 diabetes patients

AIM

We investigated the role of the -4689G/T promoter variant of the visfatin gene on serum visfatin concentration and biochemical markers in T2DM patient.

METHODS

In a cross-sectional study we recruited 93 patients with type 2 diabetes. Laboratory and anthropometric measurements were included FBG, OGTT, HbA1C, lipid Profile, fasting serum visfatin, fasting serum insulin, weight, height, Body Mass Index (BMI) and waist hip ratio (WHR). Genotyping for visfatin gene was performed by using the PCR-RFLP method.

RESULTS

Our findings showed significant differences in levels of low density lipoprotein (LDL) cholesterol, total cholesterol, high density lipoprotein (HDL) cholesterol and fasting serum insulin among various types of visfatin genotype (TT, GG, and GT). This study showed a significant correlation between circulating levels of visfatin and weight, BMI, hs-CRP and fasting insulin in TT genotype. But regarding GG genotype only fasting insulin had a significant correlation with circulating visfatin.

CONCLUSIONS

Visfatin genotypes may account for insulin resistance and levels of lipid profile that may cause by different visfatin expression between genotypes.

Postlaparoscopic small bowel obstruction secondary to unrecognized nodular endometriosis of the terminal ileum

Small bowel involvement by endometriosis occurs in about 0.5% of patients, but nodular endometriosis involving the entire wall of the terminal ileum is extremely rare. Endometriotic nodules protruding into the intestinal lumen may lead to chronic, partial, or acute complete small bowel obstruction and associated clinical changes. If obstruction is partial, preoperative diagnosis is difficult and seldom suspected, and no reliable diagnostic tests are available. At laparoscopic surgery, performed typically for associated pelvic endometriosis, bowel lesions may easily be overlooked, especially in women with abdominal adhesions from earlier surgery. Surgical injury, tension tears, or postoperative edema may contribute in such cases to the development of acute, complete small bowel obstruction, which may be difficult to differentiate from postoperative ileus. The patient may deteriorate rapidly and develop abdominal sepsis and multiple organ failure with high risk of mortality. Because of increased production of tumor necrosis factor-alpha by autologous monocytes, endometriosis may predispose to development of severe sepsis and septic shock. (J Am Assoc Gynecol Laparosc 8(1):161-166, 2001)

Chronic DeltaFosB expression and increased AP-1 transcription factor binding are associated with the long term plasticity changes in epilepsy

NMDA receptor activation during status epilepticus (SE) has previously been shown to be required for epileptogenesis as well as the persistent upregulation of serum response factor (SRF) in the in vivo pilocarpine model of epilepsy. SRF is established as a regulator of the FosB gene which expresses FosB and DeltaFosB components of the AP-1 transcription factor complex. Therefore we investigated whether DeltaFosB expression and AP-1 DNA binding were also persistently elevated in pilocarpine-treated rats which chronically displayed spontaneous seizures. Using hippocampal nuclear extracts, DeltaFosB expression and AP-1 DNA binding were significantly elevated for up to one year in the epileptic animals. The expression of other fos and jun proteins was not persistently altered in epilepsy. Neuronal upregulation of DeltaFosB was correlated with regions of the brain that were involved in seizure generation and propagation. The increase in AP-1 DNA binding was shown to be dependent on NMDA receptor activation during SE. Hippocampal DeltaFosB immunostaining was seen predominately in the neuronal nuclei as opposed to other cell types. The data indicate that recurrent seizures which persistently occur in this model were not responsible for the increased DeltaFosB expression. Chronic DeltaFosB expression in epilepsy may be playing a role in the altered expression of other genes in this model and may be involved in some of the neuronal plasticity changes associated with epileptogenesis.

Bone morphogenetic proteins-2 and -4: negative growth regulators in adult retinal pigmented epithelium

PURPOSE

To determine the relative level and localization of bone morphogenetic protein (BMP-4 mRNA in the retina and retinal pigmented epithelium (RPE) under normal and pathologic conditions, to seek clues regarding possible functions.

METHODS

Clones isolated from an RPE cDNA library were sequenced and used as probes for northern blot analysis. Expression in the retina and RPE was investigated in mouse models using reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization. The effect of recombinant proteins on RPE proliferation was investigated by thymidine incorporation.

RESULTS

Bovine clones with high homology to BMP-2 and BMP4 were isolated from a subtracted RPE cDNA library. Northern blot analysis using the clones as probes demonstrated abundant and differential expression in adult bovine RPE, but with RT-PCR and in situ hybridization, expression was also demonstrated in mouse retinal neurons. In mice with oxygen-induced ischemic retinopathy there was a striking decrease in BMP-4 mRNA in the retina within 6 hours of the onset of hypoxia that was maintained for at least 5 days. In mice with inherited photoreceptor degeneration, there was a dramatic decrease in BMP4 mRNA in retina and RPE during and after the degeneration. mRNA for the type II BMP receptor was observed in freshly isolated and cultured RPE cells, isolated retina, and freshly isolated bovine aortic endothelial cells. Thymidine incorporation in early-passage RPE cells showed a 14-fold stimulation above control with 5% serum that was decreased to 322%, 393%, and 313% in the presence of BMP-2 (10 ng/ml), BMP4 (10 ng/ml), and transforming growth factor (TGF)-,1 (2 ng/ml), respectively.

CONCLUSIONS

BMP-2 and BMP-4 may serve as negative growth regulators in the retina and RPE that are downregulated by injury, to allow tissue repair. Modulation of expression of the BMPs may provide a means to control the exaggerated wound repair that occurs in proliferative retinopathies.

Persistent increased DNA-binding and expression of serum response factor occur with epilepsy-associated long-term plasticity changes

We have previously shown that NMDA receptor activation during status epilepticus (SE) is required to produce epilepsy in in vitro and in vivo models. As in human symptomatic epilepsy, the epilepsy in these models is permanent, suggesting that the pathological activation of NMDA receptors causes permanent plasticity changes in the brain. Ca(2+) influx through NMDA receptors is known to transiently activate a key transcription factor, serum response factor (SRF). Thus, we investigated whether this factor, in terms of its expression and ability to bind to the consensus serum response element, was altered long term in the pilocarpine model of epilepsy. In hippocampal nuclear extracts, SRF binding to DNA was significantly increased over saline-injected control rats at 24 hr and at 8 weeks after the onset of SE. This increase was shown to be the result of significantly elevated levels of SRF. DNA binding was also persistently increased in the cortical, but not in the cerebellar, extracts. Hippocampal expression of SRF was localized to neurons using immunohistochemistry. NMDA receptor activation during SE was required for these changes to take place, and the spontaneous seizures seen in epileptic rats did not appear to be responsible for the increase in SRF. The results demonstrate that SRF is persistently elevated after SE in the pilocarpine model of epilepsy and support the theory that long-term gene changes in this model occur and are associated with the long-lasting plasticity changes that are initiated during epileptogenesis.

Video-assisted transportal pericardial window

Pericardial interventions for the diagnosis and treatment of pericardial disease has been evolving since the 17th century. The controversy over opened or closed procedures, the optimal guidance modality, and techniques for the creation of pericardial windows continues to be debated. This report describes two patients who received the endoscopic approach to creating a pericardial window.

Anomalous origin of the left main coronary artery from the right coronary artery ostium-interarterial subtype: angiographic definition and surgical treatment

Coronary artery anomalies occur infrequently compared to atherosclerotic disease; however, when they do occur, they can pose difficulty with coronary visualization and identification. Ectopic origin of the left mainstem coronary artery from the right sinus of Valsalva coursing between the great vessels is the rarest subtype of these anomalies, can be potentially serious, and presents unique problems for surgical treatment.