Impact of E-cigarettes on Physician Recommendations of Tobacco Use Cessation Pharmacotherapy

Introduction: E-cigarettes have been marketed as smoking cessation aids and harm reduction strategies. Prior regional surveys found that physicians are recommending them to patients despite the lack of evidence supporting these industry claims. Yet, little is known about physicians’ beliefs regarding e-cigarettes and whether these beliefs are associated with them recommending e-cigarette use in clinical practice. Methods: This three-manuscript dissertation used a mixed-methods approach including both qualitative and quantitative research methods. The aims were to: (1) Uncover the factors associated with primary care physicians’ (PCPs) decisions to recommend e-cigarettes to their patients for tobacco use cessation; (2) Estimate the prevalence of PCPs who recommend e-cigarettes to their patients as a tobacco use cessation aid; (3) Estimate the influence of factors identified in Aim 1 on PCPs’ decisions to recommend e-cigarettes to their patients for tobacco use cessation; (4) Evaluate the conceptual model which demonstrates the factors contributing to PCPs’ decisions to recommend e-cigarettes to their patients for tobacco use cessation. Results: Study 1 found that PCPs expressed a lack of information about e-cigarette safety and efficacy along with skepticism about the role of e-cigarettes in tobacco control in general and in smoking cessation in particular. However, once a patient initiates a discussion with them, PCPs seem to be endorsing patients’ interests in using e-cigarettes, as well as recommending e-cigarettes to particular types of patients who smoke for both smoking cessation and as a harm reduction strategy. Study 2 found that over three-quarters (82.7%, n=220) of PCPs reported previously discussing e-cigarettes with their patients. Overall, 57.8% (n=155) reported previously recommending e-cigarettes to an adult patient who smoked. Among those recommending e-cigarettes, the majority reported recommending them for smoking cessation and harm reduction (71.6%, n=111), 18.8% for smoking cessation only, and 9.6% for harm reduction only. The likelihood of recommending e-cigarettes to patients was associated with considering their patients’ interest in using e-cigarettes, PCP’s belief that e-cigarettes can help in quitting smoking, and PCP’s belief that e-cigarettes limit secondhand smoke exposure for others. Study 3 found that PCPs intend to recommend e-cigarettes for smokers with prior unsuccessful quit attempts (mean=3.63, ±2.1), followed by heavy smokers wanting to quit (3.57, ±2.2), and heavy smokers refusing to quit (mean=3.50, ±2.2). The mean for PCPs’ recommendation intentions was 3.04 (±2.0) for light smokers wanting to quit, and 3.01 (±1.9) for light smokers refusing to quit. Nevertheless, these recommendation intentions were driven by PCPs’ beliefs and perceptions of e-cigarette benefit and harm; however, these intentions varied by patients’ tobacco use profile. Discussion: Findings across the three studies highlight the significance of PCPs’ beliefs in driving their recommendations of e-cigarettes versus evidence based knowledge, as well as, the importance of patients’ factors and interest in using e-cigarettes for PCPs’ recommendations for e-cigarette use

The compensatory effect of glutathione on alleviating salinity–induced modulations in growth and biochemical traits in maize irrigated with diluted seawater

Salinity stress has recently received much attention as an object worthy of research and interest. It is a great challenge for the future global agricultural production that aspires to a large-scale conversion of raw seawater to irrigation use. Our study aims to investigate the antioxidant and free radical scavenging effect of glutathione (GSH) that would enhance maize tolerance to the destructive effect of salinity. A greenhouse trail was conducted in this context during the summer season of 2015 using two salinity (Mediterranean seawater: 3000 and 6000 ppm) and GSH (100 and 200 pm) levels. Tap water was used as a control. Individually, saline water acted in a distinctly different manner than GSH. Irrigation with diluted seawater caused morphological alterations consistent with chemical imbalance. The weight, stem diameter and longitudinal growth of maize were substantially reduced, while enzymatic and non-enzymatic antioxidant components were positively enhanced. Amino acid composition was significantly higher only among plants received low salt concentration (3000 ppm). Glutathione application alone had a strong impact in promoting maize growth. However, lower response was noted at the level of antioxidant-related substances and amino acids content in comparison with salinity treatments. In stressed plants, glutathione mitigated the detrimental effects imposed by salinity, both at the morphological and biochemical levels. Concurrently, the alleviative effect increased as GSH concentration increased. In view of the results obtained irrigation maize with diluted seawater is possible, yet the cumulative adverse effects of salt on land safety should be considered. Our results suggest that using GSH enhances maize tolerance to salinity, and promotes plant recovery from the stress

Eco-genetic study on water hyacinth, Eichhornia crassipes (Mart.) Solms, the world's most invasive aquatic plant

Water hyacinth is a complicated, multifaceted problem disturbs all interested and concerned entities in aquatic weed management. Water hyacinth, which is the world's most aggressive and destructive aquatic freshwater species, extends over vast areas of the world creating serious ecological and cultural problems. So far, water quality does not represent a dilemma against water hyacinth growth. The objective of the current work is to study the potential genetic differences between water hyacinth populations growing under different aquatic ecosystems in Egypt. Water and plant samples were collected from three different sites namely irrigation water, drainage water and sewage water at Al-Buhayrah Governorate, Damanhour District. The physicochemical properties and heavy metal content of selected waters were estimated. Heavy metals in roots and shoots coupled with the patterns of genetic structure within each type were also evaluated. Poor quality of sewage water was prominent with relatively small concentrations of trace elements. Plants from the different regions absorbed and accumulated heavy metals to varying degrees. Relatively high concentrations were estimated in sewage water plants if compared with the plants of the other sources. Root and shoot tissues of the same plant also exhibited various degrees of heavy metal accumulation. Overall, roots showed a high affinity for the different elements, an exception is Zn. The genetic variation between plants was expected. DNA analysis of the plants using ISSR–PCR technique showed different genetic regions with an increasing number of molecular markers in sewage water plants. This fact surely indicates that water hyacinth has an innate ability to tolerate harsh growth conditions with high genetic potential which enables it to live sustainably

Assessment of cognitive dysfunction in kidney disease

Background: Cognitive dysfunction, include reducedmental alertness, intellectual impairment, decreasedattention and concentration, memory deficits anddiminished perceptual-motor coordination. Both CKDand chronic dialysis patients are thought to be associatedwith cognitive impairment. Cognitive impairment maydecrease an individual's quality of life, increase resourceutilization and result in suboptimal medical care.Neurophysiologic tests using imaging techniques areused to evaluate structural and functional abnormalities.Neuropsychological testing uses validated questions andscreening tests to evaluate cognition.Setting and participants: This study was carried out on120 patients with different stages of CKD fromnephrology outpatient clinic and hemodialysis unit inAin Shams University Hospitals. Group I: 50 CKDpatients, stage ? and stage IV. Group II: 50 ESRDpatients on regular hemodialysis with K t/v > 1.1. GroupIII: 20 acute kidney injury patients, followed up till theirrenal functions stabilized. Group ?V: 20 healthy subjectsmatched with patients. All patients underwent laboratoryinvestigations and psychometric tests which include trialmaking test part B, digit span test, digit symbol test,mini-mental state examination.Results: There were highly significant differences ofmean values of cognitive function tests between (groupsI,II and III as compared with group IV (control group),stage III CKD and stage IV CKD, CKD andhemodialysis patients, AKI patient at the insult and afterrecovery) and finally between hemoglobin and cognitivefunction tests score.Conclusions: There were significant differences of cognitive function tests results between CKD, III,IV,V, AKI patients as compared with healthy group, suggesting that kidney disease affects cognitive performance, there were significant differences of cognitive function tests results between stage III CKD and stage IV CKD, suggesting that the degree of cognitive impairment is associated with the severity of CKD, also significant differences of cognitive function tests results between CKD and ESRD on hemodialysis, suggesting that dialysis improves cognitive performance. Our results showed significant differences of cognitive function tests results between AKI patients at the insult and after recovery, suggesting that AKI also impair cognitive function. Finally cognitive performance is affected by hemoglobin level in CKD stage III, IV, V on hemodialysis and AKI patients, suggesting that treatment of anemia in AKI, CKD and ESRD patients improve cognitive performance

Smoking Behaviors among Adolescents in Foster Care: A Gender-Based Analysis

Background and objectives: Adolescents in foster care are at high risk for cigarette smoking. However, it is not clear how their smoking behaviors vary by gender. The present study examined lifetime and current smoking among males and females, and explored gender-specific risk factors for engagement in smoking behaviors. Method: Data from the Multi Site Evaluation of Foster Youth Programs was used to evaluate patterns of smoking among adolescents aged 12–18 years (N = 1121; 489 males, 632 females). Results: Males and females did not differ significantly in rates of lifetime and current smoking, or in the age of smoking initiation and number of cigarettes smoked on a typical day. Gender-based analyses revealed that older age and placement in group homes or residential treatment facilities were associated with heightened risk of smoking among males. In contrast, sexual minority status (i.e., nonheterosexual orientation) and increased childhood victimization were associated with heightened risk of smoking among females. A history of running away was linked to smoking in both genders. Conclusion: Gender should be considered when designing intervention programs to address cigarette smoking among foster youth, as the stressors associated with smoking may differ for males and females

Assessment of Knowledge, Attitude and Practice of Molar-Incisor Hypomineralisation among a Group of Egyptian Dentists (Observational Cross-Sectional Study)

Abstract: Introduction: Molar Incisor Hypomineralisation (MIH) is one of qualitative DED. MIH is increasing dramatically in the new generations, which is considered to be challenging for the majority of dentists. MIH was found to be prevalent in 14.2% of the world\u27s population, with the high incidence 18% in South America and the least (10.9%) in Africa. This study was carried out to assess the knowledge, attitude, and practice of graduated Egyptian dentists\u27 group regarding MIH condition and compare the outcome information among different dental specialists. Material and methods: A google based questionnaire based on previously validated published papers distributed electronically through different social media by direct message or public social media link. Eligibility criteria including Graduated Egyptian licensed dentists excluding students, interns and other medical specialties. Model answer prepared by researchers in 3 rounds based on most recent published papers. Results: 416 participants enrolled in this study with response rate reach to 16.7% for direct message and 1.4% for public share link. 79.1% of PDs, 45.8% of GPs and 45.0% of other specialties are familiar with both MIH condition and terminology. A prevalence of 10-20 % was notice by participants during their practice (21.9% PDs, 22.0% GPs and 22.2 other specialties). Most of participants believe that there is a lack of information regarding MIH between Egyptian dentists. The majority of the participant used Full coverage for posterior teeth and composite resin for anterior teeth as treatment choice. 53.1% of PDs are encountered MIH in monthly bases. Conclusion: MIH is a clinical problem that Egyptian dentists well recognize and frequently encounter in clinical practice. There is a need to include MIH in academic curriculum to increase the awareness regarding the condition and clinical management

Effect of SPIO Nanoparticle Concentrations on Temperature Changes for Hyperthermia via MRI

Magnetic nanoparticles (MNPs) are being developed for a wide range of biomedical applications. In particular, hyperthermia involves heating the MNPs through exposure to an alternating magnetic field (AMF). These materials offer the potential for selectively by heating cancer tissue locally and at the cellular level. This may be a successful method if there are enough particles in a tumor possessing sufficiently high specific absorption rate (SAR) to deposit heat quickly while minimizing thermal damage to surrounding tissue. The current research aim is to study the influence of super paramagnetic iron oxides Fe3O4 (SPIO) NPs concentration on the total heat energy dose and the rate of temperature change in AMF to induce hyperthermia in Ehrlich carcinoma cells implanted in female mice. The results demonstrated a linearly increasing trend between these two factors

Laser and radiofrequency-induced hyperthermia treatment via gold-coated magnetic nanocomposites

Alsayed AM Elsherbini1, Mahmoud Saber2, Mohamed Aggag2, Ahmed El-Shahawy2, Hesham AA Shokier11National Institute of Laser Enhanced Science, 2Children's Cancer Hospital, Cairo, EgyptIntroduction: The current radiofrequency ablation technique requires invasive needle placement. On the other hand, most of the common photothermal therapeutic methods are limited by lack of accuracy of targeting. Gold and magnetic nanoparticles offer the potential to heat tumor tissue selectively at the cellular level by noninvasive interaction with laser and radiofrequency.Methods: Gold nanospheres and gold-coated magnetic nanocomposites were used for inducing hyperthermia to treat subcutaneous Ehrlich carcinoma implanted in female mice.Results: In mice treated with gold nanospheres, tumors continued to grow but at a slow rate. In contrast, more than 50% of the tumors treated with gold-coated magnetic nanocomposites completely disappeared.Conclusion: This simple and noninvasive method shows great promise as a technique for selective magnetic photothermal treatment.Keywords: laser, hyperthermia, gold magnetic nanocomposites, Ehrlich carcinom