A study of pain and anxiety/ depression severity on patients with nonspecific chronic low back pain

Background and aims: Patients with low back pain like other chronic diseases, may experience psychological symptoms in addition to physical symptoms which leads to the exacerbation of the condition of these patients and reduce their quality of life. Due to lack of clinical studies in this field, this study was conducted to investigate the relationship between pain and severity of depression and anxiety in patients with nonspecific chronic low back pain. Methods: This analytic- descriptive study was performed on 250 patients with nonspecific low back pain referring to the orthopedic clinic in Shahrekord selected by convenience sampling. Demographic questionnaire, visual analogue scale of pain, Beck Depression Inventory and Beck Anxiety Inventory were used to collect the patient’s information, pain severity, anxiety and depression. Stata software 14 was used for data analysis. Results: Mean ± SD of pain in women was 4.6±1.21 and higher than in men (4.1±1.25). Pain severity showed a significant difference between the groups of patients with different levels of anxiety and depression (P<0.01). There was a significant difference among non-smokers for pain rate between the groups, according to the levels of depression (P<0.05). Conclusion: Patients with nonspecific chronic low back pain experience higher level of pain with increasing severity of depression and anxiety. It is necessary in treatment of patients with nonspecific low back pain to pay attention to their psychological dimensions in addition to treating physical problems to reduce pain, and take action to relieve for the modulation of anxiety, depression and quality of life in these patients

Homing and mobilization of hematopoietic stem cells

Hematopoietic stem and progenitor cells (HSPCs) are non-stop travelers throughout body in both time and space. Understanding the mechanism of HSPCs homing and mobilization is important to enhance the efficacy at bone marrow transplantation and cellular therapy. Mobilized HSPCs has largely replaced than the use of bone marrow as a source of stem cells for both allogeneic and autologous stem cell transplantation. This review describes the specific factors which play a key role in homing and mobilization of HSPCs, includes SDF-1 and its receptor CXCR4, proteases (MMPs and CPM). Moreover, chemokines inducing rapid HPSCs mobilization would be discussed. In this article we showed that many factors such as adhesion molecules and SDF-1/CXCR4 have critical roles in homing hematopoietic stem cells and G.CSF, MMPs, adhesion molecules and ROS involvement in mobilization of stem cells. According to above, we can be rich the peripheral blood of HSPCS using of this factors and antagonist for this receptors on the osteoblastic cells or/and HSPCs to bone marrow transplant

The Role of BCR-ABL P190 in Diagnosis and Prognosis of ALL patients

Acute lymphoblastic leukemia(ALL) is due to early stage arrest of lymphoblast development. The translocation of Philadelphia (Ph) chromosome occurs as a result of the BCR-ABL fusion gene, which constitutively produced activated tyrosine kinase. This gene fusion is an important indicator for prognosis in ALL and is associated with poor overall survival and remission duration. BCR-ABL could interfere in establishment of ALL. Therefore, in this study, we will try to investigate most pathological aspects involved in BCR-ABL fusion. Strategies for genetic alterations in B-ALL pathogenesis are discussed. Then, the main cytogenetic changes and genetic subtypes for ALL are highlighted. Moreover, intermediate reactions between cancer stem cells (CSC) related to ALL, its niche and microenvironment is discussed. The main objective in this review is to understand the principle prognosis in ALL to introduce new approaches and treatment alternatives

Why INR is outside the therapeutic range in patients with acuteischemic stroke and atrial fibrillation

Introduction: Warfarin is still the primary drug used to prevent vascular events in patientswith atrial fibrillation (AF), especially in low-income countries. Therapeutic failure and non-adherenceare common causes of recurrent embolic events. The aim of this study was toinvestigate possible reasons why INR was outside the therapeutic range in patients presentingwith acute ischemic stroke and AF. Methods: This prospective study was performed over a ten-month period and all patientsadmitted with acute ischemic stroke were enrolled. Patients with AF who did not have INRwithin the therapeutic range (INR = 2-3) at the time of admission were identified. During a face-to-face interview, the reasons for INR being outside the therapeutic range were assessed basedon a prepared checklist. Results: During the study period, 810 patients had an acute ischemic stroke, of which 177 hadAF heart rhythm (22%). The median age was 76 (IQR: 71-83), and 87 (52%) were male. Of these177 patients, 44 (25%) had a previous history of AF ("previous AF" group) and 133 (75%) werediagnosed with AF during the current hospital admission ("new AF" group). Among patients onwarfarin but with INR outside the therapeutic range (29 in all), 20 (69%) did not see a physicianregularly and/or did not take medication according to the physician’s instructions. Conclusion: The most common reason for INR being outside the therapeutic range was patientslack of awareness of their heart disease (unrecognized AF). Other reasons included irregularvisits to the physician and drug non-adherence

The association between fat mass and obesity‐associated ( FTO ) genotype and serum vitamin D level in breast cancer patients

Abstract: The preventive effect of vitamin D against breast cancer can be influenced by gene polymorphisms. This study aimed to investigate the association between serum level of 25(OH) vitamin D and FTO genotype in breast cancer patients. A cross‐sectional study was carried out on 180 newly diagnosed patients with breast cancer in Tehran, Iran. The blood samples were collected from the participants in order to assess the FTO gene rs9939609 polymorphism by the tetra‐primer amplification refractory mutation system (Tetra‐ARMS) PCR method. The serum level of 25(OH) vitamin D was measured using the direct competitive enzyme‐linked immunosorbent assay (ELISA) method. The association between vitamin D and the FTO genotype in patients with breast cancer was assessed after adjustment for cofounders. The frequency of TT, AT and AA genotypes in the breast cancer patients were 43% (n = 77), 49% (n = 89) and 8% (n = 14), respectively. All patients with higher than 40 ng/dl of serum 25(OH) vitamin D had one or two copies of FTO rs9939609 risk allele (p = 0.019). No linear association was found between the number of FTO risk allele and the level of serum vitamin D. All patients with high serum level of 25(OH) vitamin D had one or two copies of FTO rs9939609 risk allele. FTO gene polymorphisms may counteract the beneficial effects of vitamin D in breast cancer prevention. Further studies can help to better understand the genetic factors predisposing to breast cancer and their effect on the association between vitamin D and breast cancer

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95$7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95$43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and$37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained

IMECE2005-81602 A NEW HYSTERESIS MODEL FOR PIEZOELECTRIC ACTUATORS WITH APPLICATION TO PRECISION TRAJECTORY CONTROL

ABSTRACT Piezoelectric actuators with their sub-nanometer resolution and fast frequency response are becoming increasingly important in today&apos;s micro-and nano-positioning technology. Along this line, this paper undertakes the development of a nonlinear modeling, system identification and control framework for piezoelectric actuators used in such positioning systems. More specifically, a general nonlinear modeling framework for a single piezoelectric actuator combined with a novel method for describing its hysteretic nonlinearity is proposed. For the actuator generated force, a polynomial form of the nonlinearity is assumed, and the time-varying historydependent parameters of this polynomial are identified through the observed hysteretic characteristics of the actuator. Experimental results demonstrates the validity of the proposed the modeling and identification framework for an in-house high resolution piezoelectric-based stager with capacitive position sensor. Utilizing Lyapunov method and the sliding mode control strategy, the control force acting on the actuator is then designed such that the high frequency tracking control and the asymptotic stability of the system are attained. Simulation results indicate that controller suppresses the high frequency tracking error significantly, noticeably improving the tracking performance. INTRODUCTION Piezoelectric actuators with their sub-nanometer resolution and fast frequency response are becoming increasingly important in today&apos;s micro-and nano-positioning technology. Up-growing demand of research, development, and industrial applications, such as scanning probe microscopy, photonics