Comparison of cytotoxicity of IQOS aerosols to smoke from Marlboro Red and 3R4F reference cigarettes.

This study compared the cytotoxicity of IQOS aerosols to smoke from Marlboro Red (MR) and 3R4F reference cigarettes. Aerosol/smoke solutions were tested as the gas vapor phase (GVP), particulate phase (total particulate matter or TPM), or whole aerosol/smoke (WA), the latter being what smokers actually inhale. Cytotoxicities were evaluated using the LDH, MTT and neutral red uptake (NRU) assays in conjunction with eight different cell types, mainly from the respiratory system. Most test solutions did not compromise the plasma membranes of cells (LDH). However, mitochondrial activity (MTT) and dye uptake/lysosomal activity (NRU) were equally depressed by IOQS aerosols and cigarette smoke solutions at the high concentrations. Our NRU data with mouse NIH/3T3 transformed fibroblasts were similar to those previously reported by the IQOS manufacturer and showed little cytotoxicity in the NRU assay. In both studies with NIH/3T3 cells, the results were significantly different from 3RF4 cigarette smoke, suggesting reduced toxicity with IQOS. However, by expanding evaluations to a broader spectrum of cells that included respiratory system cells and by including higher concentrations of GVP, as well as WA, cytotoxicity equivalent to that of Marlboro Red and 3R4F cigarettes was frequently observed with IQOS aerosols in the MTT and NRU assays

Hypoxia Augments Outgrowth Endothelial Cell (OEC) Sprouting and Directed Migration in Response to Sphingosine-1-Phosphate (S1P)

Therapeutic angiogenesis provides a promising approach to treat ischemic cardiovascular diseases through the delivery of proangiogenic cells and/or molecules. Outgrowth endothelial cells (OECs) are vascular progenitor cells that are especially suited for therapeutic strategies given their ease of noninvasive isolation from umbilical cord or adult peripheral blood and their potent ability to enhance tissue neovascularization. These cells are recruited to sites of vascular injury or tissue ischemia and directly incorporate within native vascular endothelium to participate in neovessel formation. A better understanding of how OEC activity may be boosted under hypoxia with external stimulation by proangiogenic molecules remains a challenge to improving their therapeutic potential. While vascular endothelial growth factor (VEGF) is widely established as a critical factor for initiating angiogenesis, sphingosine-1-phosphate (S1P), a bioactive lysophospholipid, has recently gained great enthusiasm as a potential mediator in neovascularization strategies. This study tests the hypothesis that hypoxia and the presence of VEGF impact the angiogenic response of OECs to S1P stimulation in vitro. We found that hypoxia altered the dynamically regulated S1P receptor 1 (S1PR1) expression on OECs in the presence of S1P (1.0 mu M) and/or VEGF (1.3 nM). the combined stimuli of S1P and VEGF together promoted OEC angiogenic activity as assessed by proliferation, wound healing, 3D sprouting, and directed migration under both normoxia and hypoxia. Hypoxia substantially augmented the response to S1P alone, resulting in similar to 6.5-fold and similar to 25-fold increases in sprouting and directed migration, respectively. Overall, this report highlights the importance of establishing hypoxic conditions in vitro when studying ischemia-related angiogenic strategies employing vascular progenitor cells.University of California, DavisAmerican Heart Association (AHA)Univ Calif Davis, Dept Biomed Engn, Davis, CA 95616 USAUniversidade Federal de São Paulo, Dept Biophys, São Paulo, BrazilUniv Calif Davis, Dept Neurobiol Physiol & Behav, Davis, CA 95616 USAUniversidade Federal de São Paulo, Dept Biophys, São Paulo, BrazilAmerican Heart Association (AHA): 15PRE22930044Web of Scienc

Randomized trial of acupoints herbal patching in Sanfu Days for asthma in clinical remission stage

published_or_final_versio

Two Years versus One Year of Tianjiu Therapy in Sanfu Days for Chronic Asthma: A Clinical Efficacy Observation Trial

Background. Tianjiu therapy has established efficacy against chronic asthma with related symptoms or the medication need during asthma attack. This study aimed to explore the optimal duration of Tianjiu therapy for asthma. Methods. This study was a self-comparison-to-the-baseline study, which comparing treatment with Tianjiu therapy for 1 year and 2 years in the same 102 chronic asthma patients. Totally 6 sessions of Tianjiu treatment were provided, 3 sessions in a year as a course of treatment and totally two years treatment. The primary endpoint was the number of asthma related symptoms which frequently appeared in asthma patients and the frequency of bronchodilator used during asthma attack. Results. The frequency of bronchodilator used during asthma attack significantly improved (χ2=46.276, P=0.000). But the number of asthma related symptoms which frequently appeared in asthma patients added by 1.38 points (95% CI, 0.25 to 2.51), 2.93±0.41 in 1-year group and 4.31±0.41 in the 2-years group (P<0.05). Conclusions. The effect of 2 years Tianjiu therapy was not as effective as 1 year such treatment for asthma, but the second year Tianjiu therapy was still needed because it has a role to consolidate the curative effect of Tianjiu therapy for asthma

Erratum to: Preclinical activity of gefitinib in non-keratinizing nasopharyngeal carcinoma cell lines and biomarkers of response

published_or_final_versionSpringer Open Choice, 01 Dec 201

Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

Background Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye. Methods A randomised control trial was performed on patients with amblyopia aged 4–8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games). Results Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision. Conclusions There was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment

Towards a global partnership model in interprofessional education for cross-sector problem-solving

Objectives A partnership model in interprofessional education (IPE) is important in promoting a sense of global citizenship while preparing students for cross-sector problem-solving. However, the literature remains scant in providing useful guidance for the development of an IPE programme co-implemented by external partners. In this pioneering study, we describe the processes of forging global partnerships in co-implementing IPE and evaluate the programme in light of the preliminary data available. Methods This study is generally quantitative. We collected data from a total of 747 health and social care students from four higher education institutions. We utilized a descriptive narrative format and a quantitative design to present our experiences of running IPE with external partners and performed independent t-tests and analysis of variance to examine pretest and posttest mean differences in students’ data. Results We identified factors in establishing a cross-institutional IPE programme. These factors include complementarity of expertise, mutual benefits, internet connectivity, interactivity of design, and time difference. We found significant pretest–posttest differences in students’ readiness for interprofessional learning (teamwork and collaboration, positive professional identity, roles, and responsibilities). We also found a significant decrease in students’ social interaction anxiety after the IPE simulation. Conclusions The narrative of our experiences described in this manuscript could be considered by higher education institutions seeking to forge meaningful external partnerships in their effort to establish interprofessional global health education

Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care.

The aim of this Cochrane review was to find out if prescribing by health professionals other than doctors delivers comparable outcomes to prescribing by doctors. Cochrane researchers collected and analysed all relevant studies to answer this question and found 46 studies. Key messages With appropriate training and support, nurses and pharmacists are able to prescribe medicines as part of managing a range of conditions to achieve comparable health management outcomes to doctors. The majority of studies focus on chronic disease management in higher-income counties where there is generally a moderate-certainty of evidence supporting similar outcomes for the markers of disease in high blood pressure, diabetes, and high cholesterol. Further high-quality studies are needed in poorer countries and to better quantify differences in prescribing outcomes for adverse events, and to determine health economic outcomes. Further studies could also focus more specifically on the prescribing component of care. What was studied in the review? A number of countries allow health professionals other than doctors to prescribe medicines. This shift in roles is thought to provide improved and timely access to medicines for consumers where there are shortages of doctors or the health system is facing pressures in coping with the burden of disease. In addition, this task shift has been supported by a number of governments as a way to more appropriately use the skills of health professionals, such as nurses and pharmacists, in the care of patients. We compared the outcomes of any healthcare workers who were prescribing with a high degree of autonomy with medical prescribers in the hospital or community setting in low-, middle- and high-income countries. What are the main results of the review? This review found 45 studies where nurses and pharmacists with high levels of prescribing autonomy were compared with usual care medical prescribers. A further study compared nurse prescribing with guideline support with usual nurse prescribing care. No studies were found with other health professionals or lay prescribers. Four nurse prescribing studies were undertaken in the low- and middle-income settings of Colombia, South Africa, Uganda, and Thailand. The remainder of studies were undertaken in high-income Western countries. Forty-two studies were based in a community setting, two studies were located in hospitals, one study in the workplace, and one study in an aged care facility. Prescribing was but one part of many health-related interventions, particularly in the management of chronic disease. The review found that the outcomes for non-medical prescribers were comparable to medical prescribers for: high blood pressure (moderate-certainty of evidence); diabetes control (high-certainty of evidence); high cholesterol (moderate-certainty of evidence); adverse events (low-certainty of evidence); patients adhering to their medication regimeans (moderate-certainty of evidence); patient satisfaction with care (moderate-certainty of evidence); and health-related quality of life (moderate-certainty of evidence). Pharmacists and nurses with varying levels of undergraduate, postgraduate, and specific on-the-job training related to the disease or condition were able to deliver comparable prescribing outcomes to doctors. Non-medical prescribers frequently had medical support available to facilitate a collaborative practice model

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk