Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019.

OBJECTIVES: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. METHODS: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. RESULTS: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). CONCLUSIONS: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

Characterization of the mucosal microbiota in patients with nodular lymphoid hyperplasia with concurrent irritable bowel syndrome compared to healthy controls.

BACKGROUND: Nodular lymphoid hyperplasia (NLH) is known as a lymphoproliferative lesion in which multiple small nodules appear on the intestinal wall. It has been documented that patients who struggle with irritable bowel syndrome (IBS) are at greater risk of developing NLH. Here, we aimed to investigate the previously reported pathogens and the abundance of a selection of mucosal microbiota in IBS + NLH patients compared to IBS, and healthy controls. METHODS AND RESULTS: Terminal ileum biopsies were collected from 37 IBS + NLH, 37 IBS, and 29 healthy controls. Bacterial culture and PCR was performed to detect the presence of pathogens in biopsies. A qPCR assay was applied to assess the abundance of a selection of bacterial taxa. Totally, five bacterial isolates including two enteropathogenic and one enteroaggregative Escherichia coli (EPEC, EAEC), one enterotoxigenic Staphylococcus aureus (SEA), and one Yersinia enterocolitica strains were detected among the IBS + NLH cases. The relative abundance of Bacteroidetes and Streptococcus spp. in IBS + NLH patients was significantly less than IBS and healthy controls. Firmicutes, Pseudomonas spp., Haemophilus spp., and Campylobacter spp. were notably more abundant in IBS + NLH than in IBS patients. The abundance of Verrucomicrobia was higher in NLH + IBS than in healthy controls. Actinobacteria was also significantly more abundant among NLH + IBS patients than the controls. CONCLUSION: Our results demonstrated that mucosal microbiota composition in NLH + IBS patients slightly differs from that of IBS patients and healthy controls. Further research using large-scale cohorts are needed to enhance current understanding of the contribution of the mucosal microbiota to NLH pathogenesis with concurrent IBS.

Toxicity of green synthesized TiO2 nanoparticles (TiO2 NPs) on zebra fish.

Nanoparticles (NPs) is usually fabricated by physical and chemical methods which, consequently, may have adverse effects for human and environment. Therefore, novel environmentally friendly synthesis methods for are essential and preferred. The purpose of this study was to synthesize TiO2 NPs using Echinophora cinerea extract and evaluate its toxicity on zebra fish. In the work, extraction phase was performed using a water as solvent. FTIR, XRD, SEM, and DLS analyzes were performed to determine the characteristics of synthesized TiO2 NPs. The effect of different parameters such as pH, extract concentration, TiO2 concentration, and temperature were investigated on TiO2 NP and optimized. Then, the acute toxicity of synthesized TiO2 NPs at different concentrations was investigated for 96 h on zebra fish. The bioassay data was analyzed via probit regression technique. Based on the obtained results, the optimal conditions for the synthesized TiO2 NPs were 9, 20 g/L, 0.4 g/L, and 25 °C for pH, extract concentration, TiO2 concentration and temperature, respectively. Both FTIR and XRD analysis confirmed the stability and structure of the synthesized NPs. According to SEM and DLS analysis, the synthesized NPs were spherical in shape and about 244.7 nm in diameter. Based on bioassay, LC50 for green synthesized TiO2 NPs with Echinophora cinerea extract at 48 h was 300 mg/L, which revealed a less hazardous material.

Cytotoxic Effect of Portulaca Oleracea Extract on the Regulation of CDK1 and P53 Gene Expression in Pancreatic Cancer Cell Line.

The growth of pancreatic cancer has a high predominance in the world. Different therapeutic methods were unsuccessful due to tumor invasion and rapid metastasis. Plants have natural products that were used as therapeutic agents. Accordingly, the purpose of this research was to assess the cytotoxic effect of Portulaca Oleracea against PANC-1 cancer cell line. MTT technique and flow cytometry were done to evaluate the cytotoxicity of P.Oleracea extracts against PANC-1 cancer cell line. For finding the change of CDK and P53 expression levels, qPCR carries out. The findings of the MTT assay exhibited that P.Oleracea extracts had toxicity potential on PANC- one cancer cell line. Also, the results of gene expression showed the high expression of P53 and reduction of CDK gene expression following treatment of cancer cells with plant extracts in. The flow cytometry assay showed apoptosis induced after P.Oleracea extract treatment in PANC- one cancer cell line. Also, microscopic observation is in agreement with flow cytometry and MTT assay. Results of the current study indicated that P.Oleracea extracts significantly induce apoptosis by regulating P53 and CDK expression, consequently. Therefore, P.Oleracea may be considered as a novel finding for pancreatic cancer treatment consequently of its cytotoxic and apoptotic activity.

Inflammatory Myofibroblastic Tumor: Two Cases in Head and Neck Region.

Previously described as inflammatory pseudotumor, inflammatory myofibroblastic tumors (IMT) are now considered as distinct tumors of specific histopathologic features. This rare mesenchymal tumor consists of spindle shaped fibroblasts associated with various amounts of inflammatory cells. Head and neck region, is an unusual site of involvement. In this article, we will introduce two separate cases with the diagnosis of IMT involving the nasopharynx and the temporal bone which are both rare locations of presentation. Inflammatory myofibroblastic tumor should be considered in the differential diagnosis list of every mass in head and neck region.

Evaluation of the Status of Organizational Culture among Hospital Staff in Iran: A Systematic Review and Meta-Analysis.

organizational culture in health care organizations to improve staff performance and quality of care. This study was conducted as a systematic review meta-analysis. The required data was searched in the databases and search engines between 2000 and 2019. CMA: 2 software was used to perform the meta-analysis. A total of 16 studies were selected for Meta-Analysis. The mean score of organizational culture of hospital staff evaluated by Denison tool was 3.063 and the mean score of organizational culture of hospital staff evaluated by Robbins tool was 2.527. It is essential for hospital managers to create a healthy and creative environment.

Boosting Tat DNA vaccine with Tat protein stimulates strong cellular and humoral immune responses in mice.

The aim of the present study was to evaluate the efficacy of a novel DNA priming-protein boosting regimen in simultaneous enhancing humoral and cellular immunogenicity of the HIV-1-Tat-based candidate vaccines in mice. The experimental BALB/c mice were successfully immunized with the HIV-1-Tat DNA vaccine and boosted with the corresponding protein vaccine over a two-week interval and the elicitation of cellular and humoral immune responses were simultaneously assessed. The results showed that the prime-boost immunization has significantly given rise to lymphocyte proliferation and CTL responses, as well as the levels of both IgG and IgG antibodies compared to the other candidate vaccines. The results of the Th polarization also revealed that the Th1: Th2 indexes in the mice vaccinated with the HIV-1 Tat protein, Tat DNA, and the prime-boost vaccines were 1.03, 1.19, and 1.25, respectively. The results suggest that co-administration of the HIV-1-Tat DNA with the corresponding protein may serve as a potential formulation for enhancing of Tat vaccineinduced immunity and has measurable effects on shaping vaccines' induced Th polarization.

Optical bistability, amplification, and transparency in a one-dimensional photonic crystal with a nonlinear central layer.

In this paper, we investigate optical properties of a multilayer one-dimensional photonic crystal, where the central layer is doped with one of different kinds of three-level atomic systems, e.g., Vee, Λ, upper coupling ladder, and lower coupling ladder. Then, the control of optical bistability properties of the photonic crystal, by Rabi frequency of the coupling field, spontaneously generated coherence, and probe detuning, is studied. We discuss the advantages and disadvantages of different systems' optical properties. It is shown that the investigated photonic crystals have a bistability property as well as full transparency. Also, the photonic crystals show some amplification in transmission and even reflection of the probe field.

Simultaneous formulation of influenza vaccine and chitosan nanoparticles within CpG oligodesoxi nucleotides leads to dose-sparing and protects against lethal challenge in the mouse model.

Lack of efficient delivery systems for transporting antigenic molecules to the cytosol of antigen-presenting cells presents a major obstacle for antigen uptake by immune cells. To this end, influenza whole inactivated virus vaccines were formulated with chitosan nanoparticles and CpG oligonucleotide as a biodegradable delivery system and a Th1-specific adjuvant, respectively. Intradermal injections of a single high dose and low dose of formulated candidate vaccines were carried out. Thirty days after injection, cell proliferation assay (MTT), IFN-gamma and IL-4 ELISpot assays were conducted. Sera samples were collected 21 days after immunization to measure IgG1 and IgG2a levels. In addition, the mice challenged with mouse-adopted virus were monitored for weight loss. The results show a significant stimulation of both humoral and cellular immunities; also, weight gain and a decrease in mortality in the mice receiving both dosages of inactivated influenza virus vaccines with CpG and Chitosan coating were observed. Based on the results, it can be concluded that formulation of inactivated influenza virus with CpG and its delivery by chitosan as low-dose can return the same results as with high-dose balanced between cellular and humeral immune responses. This formulation could potentially lead to a significant saving in vaccine production.

The effects of CpG-ODNs and Chitosan adjuvants on the elicitation of immune responses induced by the HIV-1-Tat-based candidate vaccines in mice.

HIV1-Tat-based vaccines could elicit broad, durable and neutralizing immune responses and are considered as potential AIDS vaccines. The present study aims to formulate CpG-ODNs adjuvant and Chitosan with Tat protein to enhance the immunogenicity of HIV-1-Tat-based candidate vaccines and to investigate their efficacies in mice. To this end, we added CpG-ODNs, Chitosan and Alum as adjuvants to the Tat-based candidate vaccine formulations. Then, we compared frequency and magnitude of both humoral and cellular immune responses from mice immunized with the adjuvant-formulated Tat candidate vaccines against those obtained from mice immunized with recombinant Tat protein alone. Mice were subcutaneously immunized three times at 2-week intervals with the candidate vaccines. Measurements of anti-Tat immune responses showed that all vaccinated groups had a good immunity compared to the control groups and developed high levels of both humoral and cellular responses. However, immunized mice with CpG-ODNs, and Chitosan-adjuvanted Tat vaccines elicited stronger T-cell responses (both humoral and cellular immunity) compared to the others. These data suggest that co-administration of recombinant Tat protein with CpG-ODNs and Chitosan may serve as a potential formulation for enhancing of the Tat vaccine-induced immunity and might have effects on shaping Th polarization induced by HIV1-Tat protein vaccines.

A photon counting and a squeezing measurement method by the exact absorption and dispersion spectrum of Λ-type Atoms.

Recently, the master equations for the interaction of two-mode photons with a three-level Λ-type atom are exactly solved for the coherence terms. In this paper the exact absorption spectrum is applied for the presentation of a non-demolition photon counting method, for a few number of coupling photons, and its benefits are discussed. The exact scheme is also applied where the coupling photons are squeezed and the photon counting method is also developed for the measurement of the squeezing parameter of the coupling photons.