Household expenditure on cigarettes and tobacco in Syria

The study uses average data from Household Income and Expenditure Survey 2004 in Syria to examine monthly household expenditure on cigarettes and tobacco and its relationships with a group of socioeconomic variables. It is found that this expenditure increases by average household income. This increase, however, is relatively small; the percent of total expenditure allocated to smoking is much higher among the poor compared to the rich. Expenditure on smoking is negatively affected by the improvements in educational conditions. Household expenditure on domestic cigarettes does not vary by household income; it is positively correlated with characteristics of the place of residence, particularly with illiteracy, polygamy; and negatively with developed educational structure. Expenditure on foreign cigarettes is spread mostly in governorate centers and among rich households. The study deduces that people with low income cannot smoke unless they decrease their monthly expenditure on basic requirements. In order to decrease smoking, two recommendations are made, developing the educational structure and eradicating illiteracy and launching concentrated campaigns to raise awareness against smoking

Dark Matter Constraints from the Eccentric Supermassive Black Hole Binary OJ 287

OJ 287 is a blazar thought to be a binary system containing a ~ 18 billion solar mass primary black hole accompanied by a ~ 150 million solar mass secondary black hole in an eccentric orbit, which triggers electromagnetic flares twice in every ~ 12 year orbital period when it traverses the accretion disk of the primary. The times of these emissions are consistent with the predictions of general relativity calculated to the 4.5th post-Newtonian order. The orbit of the secondary black hole samples the gravitational field at distances between O(10) and O(50) Schwarzschild radii around the primary, and hence is sensitive to the possible presence of a dark matter spike around it. We find that the agreement of general-relativistic calculations with the measured timings of flares from OJ 287 constrains the mass of such a spike to < 3% of the primary mass.Comment: Matches version accepted for publicatio

Traditional Medicine in Syria: Folk Medicine in Aleppo Governorate:

The use of Traditional Arabic Medicine (TAM) for various diseases has been popular but scarcely studied in Syria. In the present study, we carried out ethnobotanical and ethnopharmacological research on the plants traditionally used to cure various diseases in northern Syria. The information was collected from the city and villages of the Aleppo governorate "Mohaafazah" in the north of Syria, collecting data directly on the basis of a detailed survey of inhabitants and herbalists. In this survey, we found that hundreds of plant species are still in use in TAM for the treatment of various diseases. We selected the most common 100 species, used in the treatment of more than 25 diseases. Among these plants, 53 are used for treating gastrointestinal disorders, 38 for respiratory system diseases, including asthma, bronchitis and cough, 34 for skin diseases, 21 for diabetes, 17 for kidney and urinary disorders, 16 for cardiac disorders, 14 for infertility and sexual impotency, 13 for treating liver diseases, 13 for several types of cancer, 9 for enhancing breast milk excretion, 8 for weight loss, 5 for reducing cholesterol, and three for weight gain. Plants were collected and identified: scientific Latin names, local names, the used parts of the plant, the herbal preparations and the local medical uses are described. Scientific literature concerning the activity of the investigated species is also reported and discussed according to their traditional uses

Application of recommended therapies among patients with heart failure during the Syrian conflict : reality and barriers

Aims Lower socio-economic status may delay and even prevent the application of guideline-directed heart failure (HF) therapy for most patients. This study aims to evaluate the feasibility and possible difficulties facing the application of this treatment during the current Syrian conflict. Methods and results A questionnaire on HF management and feasibility of recommended HF therapy was addressed to physicians practising cardiology in Syria. The questionnaire consisted of 30 questions and focused on the quality of HF management and awareness of recommended drug and device therapy for HF among physicians practising cardiology in Syria. A total of 228 physicians participated in the survey. Awareness of recommended medical and device therapy of HF was very high among participants (98% and 95%, respectively). The majority of participants (>75%) believe that more than half of HF patients do not receive optimal medical HF therapy. Ninety per cent of participants believe that <10% of patients with an appropriate indication for device therapy receive it. More than 75% of participants believe that the cost of medications, alone or in combination with other medical causes, represents the major problem facing the application of optimal HF medical therapy. More than 95% of participants reported that cost alone, or in combination with unavailability, is the primary reason why patients with appropriate indications are not offered device therapy. Conclusions Despite the high level of awareness of recommended HF therapies among Syrian cardiologists, the majority of HF patients are still undertreated. Financial difficulties and lack of resources are the main causes of this problem

Genetic determinants of risk in pulmonary arterial hypertension: international genome-wide association studies and meta-analysis

Background Rare genetic variants cause pulmonary arterial hypertension, but the contribution of common genetic variation to disease risk and natural history is poorly characterised. We tested for genome-wide association for pulmonary arterial hypertension in large international cohorts and assessed the contribution of associated regions to outcomes. Methods We did two separate genome-wide association studies (GWAS) and a meta-analysis of pulmonary arterial hypertension. These GWAS used data from four international case-control studies across 11744 individuals with European ancestry (including 2085 patients). One GWAS used genotypes from 5895 whole-genome sequences and the other GWAS used genotyping array data from an additional 5849 individuals. Cross-validation of loci reaching genome-wide significance was sought by meta-analysis. Conditional analysis corrected for the most significant variants at each locus was used to resolve signals for multiple associations. We functionally annotated associated variants and tested associations with duration of survival. All-cause mortality was the primary endpoint in survival analyses. Findings A locus near SOX17 (rs10103692, odds ratio 1·80 [95% CI 1·55–2·08], p=5·13×10– ¹⁵) and a second locus in HLA-DPA1 and HLA-DPB1 (collectively referred to as HLA-DPA1/DPB1 here; rs2856830, 1·56 [1·42–1·71], p=7·65×10– ²⁰) within the class II MHC region were associated with pulmonary arterial hypertension. The SOX17 locus had two independent signals associated with pulmonary arterial hypertension (rs13266183, 1·36 [1·25–1·48], p=1·69×10– ¹²; and rs10103692). Functional and epigenomic data indicate that the risk variants near SOX17 alter gene regulation via an enhancer active in endothelial cells. Pulmonary arterial hypertension risk variants determined haplotype-specific enhancer activity, and CRISPR-mediated inhibition of the enhancer reduced SOX17 expression. The HLA-DPA1/DPB1 rs2856830 genotype was strongly associated with survival. Median survival from diagnosis in patients with pulmonary arterial hypertension with the C/C homozygous genotype was double (13·50 years [95% CI 12·07 to >13·50]) that of those with the T/T genotype (6·97 years [6·02–8·05]), despite similar baseline disease severity. Interpretation This is the first study to report that common genetic variation at loci in an enhancer near SOX17 and in HLA-DPA1/DPB1 is associated with pulmonary arterial hypertension. Impairment of SOX17 function might be more common in pulmonary arterial hypertension than suggested by rare mutations in SOX17. Further studies are needed to confirm the association between HLA typing or rs2856830 genotyping and survival, and to determine whether HLA typing or rs2856830 genotyping improves risk stratification in clinical practice or trials. Funding UK NIHR, BHF, UK MRC, Dinosaur Trust, NIH/NHLBI, ERS, EMBO, Wellcome Trust, EU, AHA, ACClinPharm, Netherlands CVRI, Dutch Heart Foundation, Dutch Federation of UMC, Netherlands OHRD and RNAS, German DFG, German BMBF, APH Paris, INSERM, Université Paris-Sud, and French ANR

Household Expenditure on Cigarettes and Tobacco in Syria

The study uses average data from Household Income and Expenditure Survey 2004 in Syria to examine monthly household expenditure on cigarettes and tobacco and its relationships with a group of socioeconomic variables. It is found that this expenditure increases by average household income. This increase, however, is relatively small; the percent of total expenditure allocated to smoking is much higher among the poor compared to the rich. Expenditure on smoking is negatively affected by the improvements in educational conditions. Household expenditure on domestic cigarettes does not vary by household income; it is positively correlated with characteristics of the place of residence, particularly with illiteracy, polygamy; and negatively with developed educational structure. Expenditure on foreign cigarettes is spread mostly in governorate centers and among rich households. The study deduces that people with low income cannot smoke unless they decrease their monthly expenditure on basic requirements. In order to decrease smoking, two recommendations are made, developing the educational structure and eradicating illiteracy and launching concentrated campaigns to raise awareness against smoking.Household Economics; Social Policy; Poverty