Efficacy and safety of ipratropium bromide/albuterol compared with albuterol in patients with moderate-to-severe asthma: a randomized controlled trial

Abstract Background Many patients with asthma require frequent rescue medication for acute symptoms despite appropriate controller therapies. Thus, determining the most effective relief regimen is important in the management of more severe asthma. This study’s objective was to evaluate whether ipratropium bromide/albuterol metered-dose inhaler (CVT-MDI) provides more effective acute relief of bronchospasm in moderate-to-severe asthma than albuterol hydrofluoroalkaline (ALB-HFA) alone after 4 weeks. Methods In this double-blind, crossover study, patients who had been diagnosed with asthma for ≥1 year were randomized to two sequences of study medication “as needed” for symptom relief (1–7 day washout before second 4-week treatment period): CVT-MDI/ALB-HFA or ALB-HFA/CVT-MDI. On days 1 and 29 of each sequence, 6-hour serial spirometry was performed after administration of the study drug. Co-primary endpoints were FEV 1 area under the curve (AUC 0–6 ) and peak (post-dose) forced expiratory volume in 1 s (FEV 1 ) response (change from test day baseline) after 4 weeks. The effects of “as needed” treatment with ALB-HFA/CVT-MDI were analyzed using mixed effect model repeated measures (MMRM). Results A total of 226 patients, ≥18 years old, with inadequately controlled, moderate-to-severe asthma were randomized. The study met both co-primary endpoints demonstrating a statistically significant treatment benefit of CVT-MDI versus ALB-HFA. FEV 1 AUC 0-6h response was 167 ml for ALB-HFA, 252 ml for CVT-MDI (p <0.0001); peak FEV 1 response was 357 ml for ALB-HFA, 434 ml for CVT-MDI (p <0.0001). Adverse events were comparable across groups. Conclusions CVT-MDI significantly improved acute bronchodilation over ALB-HFA alone after 4 weeks of “as-needed” use for symptom relief, with a similar safety profile. This suggests additive bronchodilator effects of β 2 -agonist and anticholinergic treatment in moderate-to-severe, symptomatic asthma. Trial registration ClinicalTrials.gov No.: NCT00818454; Registered November 16, 2009

The emerging role of non-coding RNAs in the regulation of PI3K/AKT pathway in the carcinogenesis process

The PI3K/AKT pathway is an intracellular signaling pathway with an indispensable impact on cell cycle control. This pathway is functionally related with cell proliferation, cell survival, metabolism, and quiescence. The crucial role of this pathway in the development of cancer has offered this pathway as a target of novel anti-cancer treatments. Recent researches have demonstrated the role of microRNAs (miRNAs) and long noncoding RNAs (lncRNAs) in controlling the PI3K/AKT pathway. Some miRNAs such as miR-155-5p, miR-328-3p, miR-125b-5p, miR-126, miR-331-3p and miR-16 inactivate this pathway, while miR-182, miR-106a, miR-193, miR-214, miR-106b, miR-93, miR-21 and miR-103/107 enhance activity of this pathway. Expression levels of PI3K/AKT-associated miRNAs could be used to envisage the survival of cancer patients. Numerous lncRNAs such as GAS5, FER1L4, LINC00628, PICART1, LOC101928316, ADAMTS9-AS2, SLC25A5-AS1, MEG3, AB073614 and SNHG6 interplay with this pathway. Identification of the impact of miRNAs and lncRNAs in the control of the activity of PI3K/AKT pathway would enhance the efficacy of targeted therapies against this pathway. Moreover, each of the mentioned miRNAs and lncRNAs could be used as a putative therapeutic candidate for the interfering with the carcinogenesis. In the current study, we review the role of miRNAs and lncRNAs in controlling the PI3K/AKT pathway and their contribution to carcinogenesis. © 2021 The Author(s

Strengthening livelihood resilience in upper catchments of dry areas by integrated natural resources management

The Livelihood Resilience project evolved around the hypothesis that better integrated management can improve the livelihoods of poor farming communities and increase the environmental integrity and water productivity of upstream watersheds in dry areas. This hypothesis was tested by researchers from different Iranian research and executive organizations and farming communities in two benchmark research watersheds in upper Karkheh River Basin in Iran, under the guidance of the ICARDA scientists. Participatory technology development, water, soil, erosion, land degradation and vegetation assessments, livelihood, gender and policy analyses, and integrated workshops delivered a set of principles for watershed management in dry areas

Serological Survey of Avian Influenza (H9N2) in Commercial Ostrich Farms in Iran, 2015

The aim of this study was to determine the seroprevalence of avian influenzaH9N2 subtype in the industrial ostrich farms and its geographical distribution. This cross-sectional study was conducted from January to June 2015. A total of 40 farms were selected from different provinces of Iran, from each of which 11 ostriches (n=440) were sampled. The sera samples were examined using 4 hemagglutination units of H9N2 antigens. A frequency distribution was used to describe the responses to the survey questions. The mean titers between provinces were compared using one-way analysis of variance. According to the results, 21 (47.5%) out of 40 farms and 108 (24.5%) out of 440 ostriches tested positive in the HI-H9N2 test. There were statistically significant differences between the mean titers of samples in different provinces (

Effect of omega-3 fatty acids supplementation on cardio-metabolic and oxidative stress parameters in patients with chronic kidney disease: a systematic review and meta-analysis

Background: Omega-3 fatty acids (FAs) have been suggested as a beneficial supplement in chronic kidney disease (CKD) patients, but the results of randomized clinical trials (RCTs) are controversial. We conducted a systematic review and meta-analysis to evaluate all the RCTs about the impact of omega-3 FAs supplementation on cardiometabolic outcomes and oxidative stress parameters in patients with CKD. Methods: We performed a systematic database search in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central, up to May 2020. We included all placebo-controlled randomized trials that assessed the effect of omega-3 FAs supplementation on any cardiometabolic outcomes: blood pressure, total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) or triglycerides (TG) and oxidative stress parameters. Data were pooled using DerSimonian�Laird�s random-effects model. Results: Finally, thirteen articles met the inclusion criteria for this review omega-3 FAs supplementation significantly decrease TC (SMD: -0.26; 95 CI: � 0.51, � 0.02; I2 = 52.7), TG (SMD: -0.22; 95 CI: � 0.43, � 0.02; I2 = 36.0) and Malondialdehyde (MDA) levels (SMD: -0.91; 95 CI: � 1.29, � 0.54; I2 = 00.0) and also significantly increase superoxide dismutase (SOD) (SMD: 0.58; 95 CI: 0.27, 0.90; I2 = 00.0) and Glutathione peroxidase (GPx) (SMD: 0.50; 95 CI: 0.14, 0.86; I2 = 00.0) activities. However our results show that omega-3 FAs supplementation have no significant effects on HDL, LDL and blood pressure. Conclusion This systematic review and meta-analysis supports current evidence for the clinical benefit of omega-3 FAs intake to improve cardiometabolic parameters in CKD patients. However, well-designed RCTs still needed to provide a conclusive picture in this field. © 2021, The Author(s)

在后冠状病毒（COVID-19）环境下的伊朗健身俱乐部行业发展创业商业模式

The purpose of this study was to investigate the COVID-19 and the challenges facing the club industry in developing countries. In this qualitative-analytical study, 17 sports experts, sports club managers, and sports entrepreneurs were interviewed based on purposive and triangular sampling methods. The data analysis was also performed by open and axial coding, of which 6 concepts and 42 categories were classified under 6 general themes. The main concepts include government support, financial issues, club activity, sponsorship, mental consequences, and social media. This study highlights the role of sports entrepreneurship in overcoming problems. Managers must use the ability of entrepreneurship because entrepreneurship is considered essential in the economy and provides the impetus for economic growth. Sports entrepreneurship can overcome the coronavirus crisis and solve the problems that have arisen.Целью настоящего исследования было изучить COVID-19 и проблемы, стоящие перед клубной индустрией в развивающихся странах. В этом качественно-аналитическом исследовании были опрошены 17 спортивных экспертов, менеджеров спортивных клубов и предпринимателей в области спорта на основе методов целевой и трехчастной выборки. Анализ данных также проводился с помощью открытого и осевого кодирования; 6 подходов и 42 категории были классифицированы по шести общим темам: государственная поддержка, финансовые вопросы, деятельность клубов, спонсорство, психологические последствия и социальные сети. В работе подчеркивается роль предпринимательства в спортивной индустрии в преодолении проблем. Менеджеры должны использовать способность к предпринимательству, поскольку оно дает импульс для экономического роста. Предпринимательство в спортивной индустрии может преодолеть кризис как последствие коронавируса и решить возникшие проблемы.本研究的目的是探讨发展中国家的健身俱乐部行业面临的与COVID-19有关的挑战。在这项定性与分析研究中，基于目的性和三部分抽样法，采访了17位体育专家、体育俱乐部经理和体育企业家。数据分析也采用了开放式和主轴性编码的方式进行：6种方法和42个类别被划分了为6个共同主题。关键概念包括：政府支持、财务问题、俱乐部活动、赞助、心理健康影响和社会网络。这项研究强调了体育企业家精神在克服问题方面的作用。管理者应该利用创业的能力，因为它对经济很重要，能推动经济增长。体育创业将有助于克服冠状病毒影响等危机，解决经济中出现的问题

The Multifunctional Host Defense Peptide SPLUNC1 Is Critical for Homeostasis of the Mammalian Upper Airway

Otitis media (OM) is a highly prevalent pediatric disease caused by normal flora of the nasopharynx that ascend the Eustachian tube and enter the middle ear. As OM is a disease of opportunity, it is critical to gain an increased understanding of immune system components that are operational in the upper airway and aid in prevention of this disease. SPLUNC1 is an antimicrobial host defense peptide that is hypothesized to contribute to the health of the airway both through bactericidal and non-bactericidal mechanisms. We used small interfering RNA (siRNA) technology to knock down expression of the chinchilla ortholog of human SPLUNC1 (cSPLUNC1) to begin to determine the role that this protein played in prevention of OM. We showed that knock down of cSPLUNC1 expression did not impact survival of nontypeable Haemophilus influenzae, a predominant causative agent of OM, in the chinchilla middle ear under the conditions tested. In contrast, expression of cSPLUNC1 was essential for maintenance of middle ear pressure and efficient mucociliary clearance, key defense mechanisms of the tubotympanum. Collectively, our data have provided the first in vivo evidence that cSPLUNC1 functions to maintain homeostasis of the upper airway and, thereby, is critical for protection of the middle ear

The effects of acute interval exercise and strawberry intake on postprandial lipemia

YesPurpose: Raised postprandial triglycerides (TAG) and related oxidative stresses are strongly associated with increased cardiovascular disease (CVD) risk. Acute exercise and strawberry ingestion independently ameliorate postprandial lipid excursions and oxidative stress. However, the combined effects of these lifestyle interventions is unknown. We investigated whether acute exercise and strawberry consumption improved postprandial responses to an oral fat tolerance test (OFTT) in overweight/obese males. Methods: Overweight/obese adult males underwent four separate OFTT (73g fat, 33g carbohydrate) with blood sampled at baseline and hourly for 4 h after OFTT. Two OFTT contained 25g freeze-dried strawberries and two contained strawberry flavouring (placebo). Participants performed 40 minutes of submaximal high intensity interval cycling exercise (HIIE) 16 h before one strawberry and one placebo OFTT, and rested before the remaining two OFTT. Serum TAG was analysed and TAG area under curve (AUC) and incremental AUC (iAUC) were calculated. Oxidative stress markers were measured at baseline and 4 h. Differences between conditions (strawberry/placebo and exercise/rest) were assessed using repeated measures ANOVA. Results: Ten males (Age, 31.5 IQR 17.8 years; BMI, 29.9 ±1.8 kg.m-2) completed the study. TAG AUC was 1.5 mmol.4h-1.L-1 lower for the exercise conditions compared to the rest conditions (95% confidence interval [CI]= -2.3 to 0.8, p= 0.001). TAG AUC was not different between the strawberry and placebo conditions (CI= -1.3 to 0.6, p= 0.475). TAG iAUC was 0.5 mmol.4h-1.L-1 greater for the strawberry compared to the placebo conditions (CI= 0.1 to 1.0, p= 0.021). There were no changes in markers of lipid related oxidative stress (P> 0.05). Conclusion: Acute submaximal HIIE appears effective in reducing postprandial lipaemia in overweight/obese adult males. However, strawberry ingestion did not improve postprandial TAG

Psoriasin, one of several new proteins identified in nasal lavage fluid from allergic and non-allergic individuals using 2-dimensional gel electrophoresis and mass spectrometry

BACKGROUND: Extravasation and luminal entry of plasma occurs continuously in the nose. This process is markedly facilitated in patients with symptomatic allergic rhinitis, resulting in an increased secretion of proteins. Identification of these proteins is an important step in the understanding of the pathological mechanisms in allergic diseases. DNA microarrays have recently made it possible to compare mRNA profiles of lavage fluids from healthy and diseased patients, whereas information on the protein level is still lacking. METHODS: Nasal lavage fluid was collected from 11 patients with symptomatic allergic rhinitis and 11 healthy volunteers. 2-dimensional gel electrophoresis was used to separate proteins in the lavage fluids. Protein spots were picked from the gels and identified using mass spectrometry and database search. Selected proteins were confirmed with western blot. RESULTS: 61 spots were identified, of which 21 were separate proteins. 6 of these proteins (psoriasin, galectin-3, alpha enolase, intersectin-2, Wnt-2B and hypothetical protein MGC33648) had not previously been described in nasal lavage fluids. The levels of psoriasin were markedly down-regulated in allergic individuals. Prolactin-inducible protein was also found to be down-regulated, whereas different fragments of albumin together with Ig gamma 2 chain c region, transthyretin and splice isoform 1 of Wnt-2B were up-regulated among the allergic patients. CONCLUSION: The identification of proteins in nasal lavage fluid with 2-dimensional gelelectrophoresis in combination with mass spectrometry is a novel tool to profile protein expression in allergic rhinitis and it might prove useful in the hunt for new therapeutic targets or diagnostic markers for allergic diseases. Psoriasin is a potent chemotactic factor and its down-regulation during inflammation might be of importance for the outcome of the disease

Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use

<p>Abstract</p> <p>Background</p> <p>In recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population.</p> <p>Results</p> <p>Out of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively). The majority of waterpipe smokers (75.5%) indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6%) while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, <it>p </it>= 0.002), energizing (48.5% vs. 11.4%, <it>p </it>= 0.001), a part of their culture (58.8% vs. 34.1%, <it>p </it>= 0.04), and the healthiest way to use tobacco (40.6% vs. 11.1%, <it>p </it>= 0.005).</p> <p>Conclusions</p> <p>Social and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of waterpipes among university students in Iran must consider the equal gender distribution and its perception by many waterpipe smokers as being a healthier and non-addictive way to use tobacco.</p