Healthcare utilization in patients with esophageal cancer in a high risk area in northeast of Iran

Introduction: Golestan, a province located north of Persian Gulf in northeastern part of Iran is a well known area for high risk of esophageal cancer (EC) in the world. There is no information about healthcare utilization in populations residing in the area. This study was conducted to assess utilization of healthcare and its associated factors among esophageal cancer patients in this region as well as to address ethical implication of this utilization. Methods: All new cases of EC in Golestan province during year of 2007 were recruited. Seven diagnostic and five therapeutic services were used to assess diagnostic utilization index (DUI), and therapeutic utilization index (TUI), respectively. Multivariate regression analysis was used to assess the relationship between variables and DUI or TUI. P-value of less than 0.05 was considered as statistically significant. Results: Tow hundred twenty three, patients were enrolled with mean (Standard Deviation) age of 64.3 (12.5) years with 57.8% male. We observed that occupation (P<0.01), ethnicity (P<0.01) and sex (P=0.03) were strongly associated with DUI. Insurance coverage (P<0.01), place of residency (P<0.01), and occupation (P=0.01) were associated with TUI. Conclusion: We concluded that several factors contribute to disparity in healthcare utilization in the studied population

Proposing a national ethical framework for animal research in Iran

Background: One of the domains of scientific activities is working on animals. Performing experiments on animals is permissible only with the purpose of obtaining necessary information for saving and improving life of human beings or animals. Principally, all religions believe that human life is more valuable than animal life and humans have a God-given authority over animals, but they should not be cruel to animals and cause their pain or suffering. Based on Islamic view points, although Allah has put the Man as the lord of all creatures, he has not the right to use other creatures for any conditions and does not respect their real statues. Because of the widespread use of experimental animals in our country, special ethical codes should be redefined for living conditions of experimental animals based on the present regulations in Iran and also other countries. Therefore, all our researchers should have enough information about ethical codes of treating experimental animals as well as Islamic principles in this regard.Methods: All Islamic and international sources related to treating animals and also valid international ethical guidelines were collected and classified in order to extract the aimed points. Then all extracted points were reviewed by experts familiar with Islamic and ethical rules of treating animals.Results: Finally the strategies for appropriate and complete implementation of the national ethical guidelines of animal research in Iran were suggested.Conclusion: It is obvious that the suggested principles are applicable only with appropriate planning of training courses based on the facilities and needs of our country

Coupling of a single-photon emitter in nanodiamond to surface plasmons of a nanochannel-enclosed silver nanowire

A finite element method is applied to study the coupling between a nitrogen vacancy (NV) single photon emitter in nanodiamond and surface plasmons in a silver nanowire embedded in an alumina nanochannel template. We investigate the effective parameters in the coupled system and present detailed optimization for the maximum transmitted power at a selected optical frequency (650 nm). The studied parameters include nanowire length, nanowire diameter, distance between the dipole and the nanowire, orientation of the emitter and refractive index of the surrounding. It is found that the diameter of the nanowire has a strong influence on the propagation of the surface plasmon polaritons and emission power from the bottom and top endings of the nanowire. © 2014 Optical Society of America

Surface functionalisation of nanodiamonds for human neural stem cell adhesion and proliferation.

Biological systems interact with nanostructured materials on a sub-cellular level. These interactions may govern cell behaviour and the precise control of a nanomaterial's structure and surface chemistry allow for a high degree of tunability to be achieved. Cells are surrounded by an extra-cellular matrix with nano-topographical properties. Diamond based materials, and specifically nanostructured diamond has attracted much attention due to its extreme electrical and mechanical properties, chemical inertness and biocompatibility. Here the interaction of nanodiamond monolayers with human Neural Stem Cells (hNSCs) has been investigated. The effect of altering surface functionalisation of nanodiamonds on hNSC adhesion and proliferation has shown that confluent cellular attachment occurs on oxygen terminated nanodiamonds (O-NDs), but not on hydrogen terminated nanodiamonds (H-NDs). Analysis of H and O-NDs by Atomic Force Microscopy, contact angle measurements and protein adsorption suggests that differences in topography, wettability, surface charge and protein adsorption of these surfaces may underlie the difference in cellular adhesion of hNSCs reported here

Doctor can I buy a new kidney? I've heard it isn't forbidden: what is the role of the nephrologist when dealing with a patient who wants to buy a kidney?

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments. In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties

Cultural Diversity and Bioethics

&quot;nMy main question in this article is as follows: &amp;quot;to which extent cultural diversity should be permitted to influence bio-ethical judgments?&amp;quot; There are cultural heritages, values and traditions which are acceptable and respectable and there are ones which are not so. In this article I concluded that our reasoning based on common ethical sense can guide us through such differentiations. Human dignity as a common notion among most alive cultures and religions thorough the world, can be relied for sketching a plan for further dialogues in this regard

Surface charge effects in protein adsorption on nanodiamonds

© The Royal Society of Chemistry. Understanding the interaction of proteins with charged diamond nanoparticles is of fundamental importance for diverse biomedical applications. Here we present a thorough study of protein binding, adsorption kinetics and structure on strongly positively (hydrogen-terminated) and negatively (oxygen-terminated) charged nanodiamond particles using a quartz crystal microbalance by dissipation and infrared spectroscopy. By using two model proteins (bovine serum albumin and lysozyme) of different properties (charge, molecular weight and rigidity), the main driving mechanism responsible for the protein binding to the charged nanoparticles was identified. Electrostatic interactions were found to dominate the protein adsorption dynamics, attachment and conformation. We developed a simple electrostatic model that can qualitatively explain the observed adsorption behaviour based on charge-induced pH modifications near the charged nanoparticle surfaces. Under neutral conditions, the local pH around the positively and negatively charged nanodiamonds becomes very high (11-12) and low (1-3) respectively, which has a profound impact on the protein charge, hydration and affinity to the nanodiamonds. Small proteins (lysozyme) were found to form multilayers with significant conformational changes to screen the surface charge, while larger proteins (albumin) formed monolayers with minor conformational changes. The findings of this study provide a step forward toward understanding and eventually predicting nanoparticle interactions with biofluids. This journal i

Multifunctional three-dimensional nanodiamond-nanoporous alumina nanoarchitectures

Hybrid composite nanomaterials provide an attractive and versatile material platform for numerous emerging nano- and biomedical applications by offering the possibility to combine diverse properties which are impossible to obtain within a single material. In this work, we present the fabrication of novel hybrid diamond and amorphous diamond-like carbon (DLC) coated nanoporous alumina materials that exhibit multiple functionalities, such as high surface area, quasi-ordered nanopore structure, tunable surface chemistry and electrical conductivity, excellent biological, chemical and corrosion resistance. These multifunctional nanohybrid materials are fabricated using the plasma-induced carbonization method that effectively modifies the surface and the inside of the nanopores of anodic alumina, producing a homogenous ultrathin DLC protecting layer over the whole external and internal surfaces of the membranes. We demonstrate that the interplay between internal and external carbon supply is a critical factor for the formation of the ultrathin sp3-bonded carbon layer in the nanopores. This study brings new insights in the DLC growth mechanisms in confined nanospaces and opens new avenues to fabricate hybrid, chemically resistant and biocompatible carbon-coated nanoarchitectures on other inorganic supports. © 2014 Elsevier Ltd. All rights reserved