Molecular Simulation of Graphene Oxide (GO) Nanocarriers for Doxorubicin: Effects of PH and GO Pegylation on the Drug Loading, Retention, and Release

Molecular dynamics (MD) simulation as a powerful tool is used to investigate the graphene oxide (GO) based drug delivery system in the process of drug loading, drug carrying and drug release. Doxorubicin (DOX), a widely used anticancer drug, is used as a drug model. The effect of different parameters including pH levels and the oxidation level of GO sheets on the drug loading mechanism is broadly discussed in this study. The drug release from the GO sheet using pH stimulus is explored and results confirmed that GO can release DOX molecules at acidic pH level

Probing mechanism scheduling for connected coverage wireless sensor network.

Sensing coverage and network connectivity are two main requirements which maintain perfect operation of wireless sensor network. Joint scheduling method has considered both requirements by using random scheduling for sensing coverage, which divides sensor nodes to k subsets. Each sensor nodes randomly selects one defined subset. Then, the algorithm turns on extra sensor nodes, if necessary for network connectivity. As Extra-on sensor nodes participate in other nodes routing, some of them may be subject of many times transmission and reception. Furthermore, some of Extra-on nodes should be active the whole time to create network connectivity. Both mentioned reasons can drain out energy of those extra active nodes and may lead to network partitioning. Hence, reducing number of Extra-on nodes is important. In this study, we utilize probing mechanism scheduling in joint scheduling method to reduce the number of extra on sensor nodes. By using probing mechanism that some nodes change their working schedule, number of extra on nodes reduces by 20

Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia

Introduction: Trigeminal neuralgia (TN) is the most common neuralgia in the head and neck region and a common cause of orofacial pain. It is routinely treated with carbamazepine. Laser, acupuncture and radiofrequency are among other treatment modalities for this condition. This study sought to assess the efficacy of laser therapy in conjunction with carbamazepine for treatment of TN.Methods: A total of 30 patients who met the inclusion criteria were divided into 2 groups of cases and controls (n = 15) by double blind randomized controlled clinical trial. All patients received 100 mg carbamazepine at baseline and another 100 mg after 2 days for pain control. In the case group, low level laser therapy (LLLT) was also performed in addition to pharmaceutical therapy. Sham laser was used in the control group instead of LLLT. Treatment was continued for 9 sessions (3 days a week). The intensity of pain was measured and compared in the 2 groups using visual analog scale (VAS) in 3 period. The qualitative variables among the groups were compared using the repeated measures analysis of variance (ANOVA).Results: The severity of pain was lower at the end of treatment in the case compared to the control group so this difference was statistically significant (P = 0.003). The severity of pain decreased in both groups over time. Significant difference was noted in this regard between the 2 groups either (P = 0.003). At the end of treatment pain intensity dropped in the intervention group from 6/8 to 1/2 and control group from 6/6 to 2/7.Conclusion: Laser therapy did add to the value of pharmaceutical therapy for treatment of TN. Both groups experienced significant improvement over time. So it is better to used laser complementary therapy to reduce side effects and the medicine dosage

Happiness and its Relationship with Job Burnout in Nurses of Educational Hospitals in Tabriz, Iran

Background: Happiness is a positive feeling that is vital and significant to maintain health. Nurses are working in difficult conditions which may heavily affect their level of happiness and ability to provide care. Job burnout is a mental reaction against some persistent source of workplace stress. The purpose of this study was to identify happiness and its relationship with job burnout in nurses working at Tabriz’s educational hospitals. Methods: This descriptive-correlational study was conducted on 344 nurses working at Tabriz’s hospitals in 2018. The subjects were selected by means of proportionate stratified random sampling. Data were collected using three questionnaires (demographic information, job burnout with 22 items and three subscales and Oxford happiness with 29 items) and analyzed in SPSS version16 using descriptive statistics. Statistical tests such as Pearson correlation coefficient, independent t-test, one-way ANOVA, and multiple linear regression analysis were used to analyze the data. Results: The age range of the participants was 23–57 years with a mean of 35.9±7.5. The mean score of happiness was 64.2±11.5, (score range 35 to 116), which suggests an average level of happiness among the nurses. There was a negative correlation between happiness and total job burnout (r=-0.29, P<0.001). This negative correlation remained significant (B=-0.15, P<0.001) even when nurses’ perception of own health status (B=-5.24, P=0.01), history of illness (B=-4.47, P=0.04), job position (B=-6.61, P=0.001), and type of employment (B=3.56, P=0.03) as potential confounding factors were adjusted. Conclusion: Considering the reverse relationship between job burnout and happiness, it is suggested that managers try to improve the workplace by managing condition which could lead to job burnout, and therefore use the results to increase the happiness of nurses

Factors associated with disease severity and length of stay in hospitalized COVID-19 patients in Tabriz, Iran: A retrospective cohort study

Introduction: The novel coronavirus disease (COVID-19) has spread globally. Early and dynamic detection of prognostic factors is essential to improve the ability to treat COVID-19. The present study aimed to determine clinical characteristics and risk factors associated with the length of hospital stay and disease severity in hospitalized COVID-19 patients in Tabriz, Iran. Methods: This retrospective cohort study included 260 early diagnosed cases with COVID-19 hospitalized at two COVID-19 specialized hospitals in Tabriz, Iran, from April 20 to June 20, 2020. Patients’ medical records were used to collect the data. Severe COVID-19 outcomes included need for intubation, admission to the intensive care unit, or death. The data were analyzed using descriptive and analytical statistics, including chi-squared test, Mann-Whitney U test, and logistic regression analysis in SPSS 16. Results: The need for O2 therapy (adjusted odds ratio [AOR]=4.23; 95% CI: 1.15‒15.51; P=0.03), the increased creatinine levels (AOR=2.71; 95% CI: 1.25‒5.88; P=0.01), and the white blood cell counts (AOR=2.44; 95% CI: 1.12‒5.33; P=0.02) were the main risk factors associated with prolonged hospital stay. Also, having kidney diseases (AOR=7.33; 95% CI=1.94‒27.70; P=0.01), elevated the white blood cell counts (AOR=4.52; 95% CI=1.67‒12.26; P=0.003), and lung diseases (AOR=3.97; 95% CI: 1.18‒13.29; P=0.03) were significant among the predictors of the disease severity. Conclusion: According to the results, hypoxia and underlying diseases might lead to unwanted outcomes. The risk factors identified here confirm previous information and could be helpful to guide early clinical decision-making to reduce the mortality rates and improve the clinical outcomes of COVID-19

Human Umbilical Cord Mesenchymal Stem Cells-Derived Exosomes Can Alleviate the Proctitis Model Through TLR4/NF-Κb Pathway

Background: Proctitis is a significant concern of inflammatory bowel diseases, especially ulcerative colitis. Exosomes are a new method for treating many diseases by their immunosuppressive and tissue-repairing potential. Here, we tried Mesenchymal stem cells (MSCs)-derived Exosomes for treating the proctitis model of rats. Materials and Methods: Rats were assigned into four groups: sham, control group, rectal, and intraperitoneal exosome injection. The proctitis model was induced by rectal administration of 4% acetic acid. The exosome was derived from human MSCs isolated from human umbilical cords. After seven days, rectum samples were assessed for histopathological, IHC, and PCR analysis. Results: The histopathologic scores, collagen deposition, and the expression of NF-κB, TLR4, TNFα, IL-6, and TGFβ were decreased in intraperitoneal exosome compared to controls. The result was not promising for the rectal administration of exosomes. Conclusion: Exosomes can suppress the inflammatory response in the proctitis model and improve the rectum's healing process. Exosomes can inhabit the NF-κB/TLR4 pathway and downstream pro-inflammatory cytokines. This study implicates the therapeutic benefits of exomes in treating proctitis

Renal Function and Risk Factors of Moderate to Severe Chronic Kidney Disease in Golestan Province, Northeast of Iran

Introduction: The incidence of end-stage renal disease is increasing worldwide. Earlier studies reported high prevalence rates of obesity and hypertension, two major risk factors of chronic kidney disease (CKD), in Golestan Province, Iran. We aimed to investigate prevalence of moderate to severe CKD and its risk factors in the region. Methods: Questionnaire data and blood samples were collected from 3591 participants (≥18 years old) from the general population. Based on serum creatinine levels, glomerular filtration rate (GFR) was estimated. Results: High body mass index (BMI) was common: 35.0 of participants were overweight (BMI 25-29.9) and 24.5 were obese (BMI ≥30). Prevalence of CKD stages 3 to 5 (CKD-S3-5), i.e., GFR &lt;60 mL/min/1.73 m2, was 4.6. The odds ratio (OR) and 95 confidence interval (95 CI) for the risk of CKD-S3-5 associated with every year increase in age was 1.13 (1.11- 1.15). Men were at lower risk of CKD-S3-5 than women (OR = 0.28; 95 CI 0.18-0.45). Obesity (OR = 1.78; 95 CI 1.04-3.05) and self-reported diabetes (OR = 1.70; 95 CI 1.00-2.86), hypertension (OR = 3.16; 95 CI 2.02-4.95), ischemic heart disease (OR = 2.73; 95 CI 1.55-4.81), and myocardial infarction (OR = 2.69; 95 CI 1.14-6.32) were associated with increased risk of CKD-S3-5 in the models adjusted for age and sex. The association persisted for self-reported hypertension even after adjustments for BMI and history of diabetes (OR = 2.85; 95 CI 1.77-4.59). Conclusion: A considerable proportion of inhabitants in Golestan have CKD-S3-5. Screening of individuals with major risk factors of CKD, in order to early detection and treatment of impaired renal function, may be plausible. Further studies on optimal risk prediction of future end-stage renal disease and effectiveness of any screening program are warranted. © 2010 Najafi et al

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd