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1.
Nanotechnology ; 35(27)2024 Apr 18.
Article in English | MEDLINE | ID: mdl-38635294

ABSTRACT

The tuning of exchange bias (EB) in nanoparticles has garnered significant attention due to its diverse range of applications. Here, we demonstrate EB in single-phase CoO nanoparticles, where two magnetic phases naturally emerge as the crystallite size decreases from 34.6 ± 0.8 to 10.8 ± 0.9 nm. The Néel temperature (TN) associated with antiferromagnetic ordering decreases monotonically with the reduction in crystallite size, highlighting the significant influence of size effects. The 34.6 nm nanoparticles exhibit magnetization irreversibility between zero-field cooled (ZFC) and field-cooled (FC) states belowTN. With further reduction in size this irreversibility appears well aboveTN, resulting in the absence of true paramagnetic regime which indicates the occurnace of an additional magnetic phase. The frequency-dependent ac-susceptibility in 10.8 nm nanoparticles suggests slow dynamics of disordered surface spins aboveTN, coinciding with the establishment of long-range order in the core. The thermoremanent magnetization (TRM) and iso-thermoremanent magnetization (IRM) curves suggest a core-shell structure: the core is antiferromagnetic, and the shell consists of disordered surface spins causing ferromagnetic interaction. Hence, the EB in these CoO nanoparticles results from the exchange coupling between an antiferromagnetic core and a disordered shell that exhibits unconventional surface spin characteristics.

2.
Eur J Pharmacol ; 971: 176540, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38552938

ABSTRACT

Identification of concomitant miRNAs and transcription factors (TFs) with differential expression (DEGs) in MI is crucial for understanding holistic gene regulation, identifying key regulators, and precision in biomarker and therapeutic target discovery. We performed a comprehensive analysis using Affymetrix microarray data, advanced bioinformatic tools, and experimental validation to explore potential biomarkers associated with human pathology. The search strategy includes the identification of the GSE83500 dataset, comprising gene expression profiles from aortic wall punch biopsies of MI and non-MI patients, which were used in the present study. The analysis identified nine distinct genes exhibiting DEGs within the realm of MI. miRNA-gene/TF and TF-gene/miRNA regulatory relations were mapped to retrieve interacting hub genes to acquire an MI miRNA-TF co-regulatory network. Furthermore, an animal model of I/R-induced MI confirmed the involved gene based on quantitative RT-PCR and Western blot analysis. The consequences of the bioinformatic tool substantiate the inference regarding the presence of three key hub genes (UBE2N, TMEM106B, and CXADR), a central miRNA (hsa-miR-124-3p), and sixteen TFs. Animal studies support the involvement of predicted genes in the I/R-induced myocardial infarction assessed by RT-PCR and Western blotting. Thus, the final consequences suggest the involvement of promising molecular pathways regulated by TF (p53/NF-κB1), miRNA (hsa-miR-124-3p), and hub gene (UBE2N), which may play a key role in the pathogenesis of MI.


Subject(s)
MicroRNAs , Myocardial Infarction , Animals , Humans , Transcription Factors/genetics , Transcription Factors/metabolism , Gene Regulatory Networks , Gene Expression Profiling , MicroRNAs/genetics , MicroRNAs/metabolism , Myocardial Infarction/metabolism , Membrane Proteins/genetics , Nerve Tissue Proteins/genetics
3.
Biochem Biophys Res Commun ; 705: 149756, 2024 Apr 23.
Article in English | MEDLINE | ID: mdl-38460440

ABSTRACT

Exacerbated expression of TLR4 protein (foremost pattern recognition receptor) during obesity could trigger NF-κB/iNOS signaling through linker protein (MyD88), predisposed to an indispensable inflammatory response. The induction of this detrimental cascade leads to myocardial and vascular abnormalities. Molecular docking was studied for protein-ligand interaction between these potential targets and resveratrol. The pre-treatment of resveratrol (20 mg/kg/p.o/per day for ten weeks) was given to investigate the therapeutic effect against HFD-induced obesity and associated vascular endothelial dysfunction (VED) and myocardial infarction (MI) in Wistar rats. In addition to accessing the levels of serum biomarkers for VED and MI, oxidative stress, inflammatory cytokines, and histopathology of these tissues were investigated. Lipopolysaccharide (for receptor activation) and protein expression analysis were introduced to explore the mechanistic involvement of TLR4/MyD88/NF-κB/iNOS signaling. Assessment of in-silico analysis showed significant interaction between protein and ligand. The involvement of this proposed signaling (TLR4/MyD88/NF-κB/iNOS) was further endorsed by the impact of lipopolysaccharide and protein expression analysis in obese and treated rats. Moreover, resveratrol pre-treated rats showed significantly lowered cardio and vascular damage measured by the distinct down expression of the TLR4/MyD88/NF-κB/iNOS pathway by resveratrol treatment endorses its ameliorative effect against VED and MI.


Subject(s)
Myocardial Infarction , Stilbenes , Rats , Animals , NF-kappa B/metabolism , Myeloid Differentiation Factor 88/metabolism , Toll-Like Receptor 4/metabolism , Resveratrol/pharmacology , Stilbenes/pharmacology , Stilbenes/therapeutic use , Lipopolysaccharides/pharmacology , Ligands , Molecular Docking Simulation , Rats, Wistar , Myocardial Infarction/drug therapy , Diet
4.
Ther Adv Med Oncol ; 15: 17588359231216095, 2023.
Article in English | MEDLINE | ID: mdl-38107828

ABSTRACT

Background: Current standard-of-care first-line treatment of patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced breast cancer (ABC) is cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) + endocrine therapy. In the MONALEESA-2 trial, first-line ribociclib + letrozole demonstrated statistically significant overall survival (OS) benefit versus placebo + letrozole in postmenopausal patients with HR+/HER2- ABC. In the PALOMA-2 trial, first-line palbociclib + letrozole did not show OS benefit versus placebo + letrozole in a similar patient population. Understanding OS outcomes in the respective trials is critical for treatment decisions; however, there are no head-to-head clinical trial data comparing ribociclib and palbociclib. Objectives: To conduct a matching-adjusted indirect comparison (MAIC) to compare progression-free survival (PFS) and OS of first-line ribociclib + letrozole versus palbociclib + letrozole in postmenopausal patients with HR+/HER2- ABC. Design: Letrozole-anchored MAIC using individual patient data from MONALEESA-2 and published summary data from PALOMA-2. Methods: Using individual data, patients from MONALEESA-2 who matched inclusion criteria from PALOMA-2 were selected, and weighting was conducted to ensure baseline characteristics were similar to those in published aggregated data from PALOMA-2. The Bucher method was used to generate corresponding hazard ratios (HRs). Results: The final effective sample size compared n = 150 (ribociclib) and n = 112 (placebo) MONALEESA-2 patients with n = 444 (palbociclib) and n = 222 (placebo) PALOMA-2 patients. After matching and weighting, patient characteristics were well balanced. MAIC analysis showed a numerical PFS benefit [HR, 0.80; 95% confidence interval (CI), 0.58-1.11; p = 0.187] and significant OS benefit (HR, 0.68; 95% CI, 0.48-0.96; p = 0.031) with ribociclib + letrozole versus palbociclib + letrozole. Conclusion: Results of this cross-trial MAIC analysis showed a numerical PFS benefit and significantly greater OS benefit with first-line ribociclib + letrozole versus palbociclib + letrozole. These results support letrozole + ribociclib as the preferred first-line CDK4/6i for postmenopausal patients with HR+/HER2- ABC. Trial registration: NCT01958021; https://www.clinicaltrials.gov/study/NCT01958021 (MONALEESA-2) and NCT01740427; https://clinicaltrials.gov/study/NCT01740427 (PALOMA-2).

5.
J Pharmacopuncture ; 26(3): 257-264, 2023 Sep 30.
Article in English | MEDLINE | ID: mdl-37799617

ABSTRACT

Objectives: The study was designed to evaluate anti-arthritic activity of Ajmodadi Churna (AC) and its effect on Complete freund's adjuvant (CFA)-induced arthritis in Wistar rats. Methods: Arthritis was induced by injecting 0.2 mL CFA into sub plantar surface of left hind paw. Test sample AC-1 and AC-2, 200 and 400 mg/kg, respectively was given to the animals for 21 consecutive days. The increase in swelling was observed after induction of arthritis. The paw edema was measured on 0, 3, 7, 14 and 21 day using Vernier calliper after the induction of arthritis. The collected blood samples further used for the estimation of red blood cells (RBC), white blood cells (WBC), erythrocytes sedimentation rate (ESR), and hemoglobin (Hb), using hematology analyzer. Serum concentration of IL-6 and TNF-α were also measured using rat ELISA kits. Results: Results showed that a significant reduction in paw edema was observed in AC-2 treated rats. The paw edema was restored on day 21 was 4.48 mm for AC-2, which is near to the control group. The arthritis score in treated rats was found to be considerably lower than in the control group i.e. 0.83 for AC-2 and 1.50 for AC-1. A decrease in levels of RBC and hemoglobin were observed in arthritic rats. Inflammation was significantly reduced and serum levels of IL-6 and TNF-α were lowered after treatment with the test drug. Conclusion: It can be concluded from the study that AC possess significant anti-arthritic activity. Furthermore, this condition was linked to a reduction in abnormal humoral immune responses.

6.
Environ Sci Pollut Res Int ; 30(33): 79774-79788, 2023 Jul.
Article in English | MEDLINE | ID: mdl-36997778

ABSTRACT

Colloidal route synthesis of quaternary compound CZTS (Cu2ZnSnS4) has been anticipated with an inimitable combination of coordinating ligands and solvents using the hot injection technique. CZTS is recognized as one of the worthiest materials for photo-voltaic/catalytic applications due to its exclusive properties (viz., non-toxic, economical, direct bandgap, high absorbance coefficient, etc.). This paper demonstrates the formation of crystalline, single-phased, monodispersed, and electrically passivated CZTS nanoparticles using a distinctive combination of ligands viz. oleic acid (OA)-trioctylphosphine (TOP) and butylamine (BA)-trioctylphosphine (TOP). Detailed optical, structural, and electrochemical studies were done for all CZTS nanoparticles, and the most efficient composition was found using ligands butylamine and TOP. CZTS nanocrystals were rendered hydrophilic via surface-ligand engineering, which was used for photocatalysis studies of organic pollutants. Malachite green (MG) and rhodamine 6G (Rh) for water remediation have great commercial prospects. The unique selling proposition of this work is the rapid synthesis time (~ 45 min) of colloidal CZTS nanocrystals, cost-effective ligand-exchange process, and negligible material wastage (~ 200 µl per 10 ml of pollutant) during photocatalytic experiments.


Subject(s)
Environmental Pollutants , Nanoparticles , Water , Butylamines , Ligands , Solvents
7.
J Med Econ ; 26(1): 357-365, 2023.
Article in English | MEDLINE | ID: mdl-36797664

ABSTRACT

BACKGROUND AND AIMS: Combination of a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor and an aromatase inhibitor is the standard of care first-line (1L) treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). Updated clinical data have become available from the MONALEESA-2 and PALOMA-2 trials for ribociclib and palbociclib, respectively. This analysis with updated data assessed the cost-effectiveness of ribociclib versus palbociclib, both in combination with letrozole, in the setting of 1L therapy of postmenopausal women with HR+/HER2- ABC, from a United Kingdom (UK) National Health Service perspective. METHODS: A three state (progression-free, progressed disease, and death) partitioned survival model with a 1-month cycle was developed. Clinical data were derived from MONALEESA-2 (NCT01958021) and PALOMA-2 (NCT01740427). The treatment effect was modeled using hazard ratios (HRs) for progression-free survival and overall survival derived through a matched-adjusted indirect comparison. Trial data and published literature were used to derive utility values. Cost inputs included drug acquisition, disease monitoring, subsequent therapies, and adverse events. Costs and outcomes were discounted by 3.5%, over a 40-year lifetime horizon. One-way and probabilistic sensitivity analyses were performed. RESULTS: Ribociclib dominated palbociclib, and was both overall cost saving (-£3,273) and more effective (+1.251 quality-adjusted life years [QALYs]). Ribociclib total drug costs were £17,156 lower than palbociclib. At a £30,000 per QALY willingness-to-pay threshold, the probability of ribociclib being cost-effective was almost 100%. Ribociclib remained cost-effective when varying HRs, utilities, drug cost, and health state costs. CONCLUSIONS: Ribociclib is both cost-saving and cost-effective compared with palbociclib for the 1L treatment of postmenopausal women with HR+/HER2- ABC in the UK.


Subject(s)
Breast Neoplasms , Female , Humans , Breast Neoplasms/drug therapy , Aromatase Inhibitors/therapeutic use , Cost-Benefit Analysis , Postmenopause , State Medicine , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Receptor, ErbB-2
8.
Indian J Otolaryngol Head Neck Surg ; 74(Suppl 2): 1790-1796, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36452609

ABSTRACT

Verrucous carcinoma (VC) is a locally invasive uncommon histopathological variant of oral squamous cell cancer. There is paucity of literature regarding control rates in these cases. We intend to report the outcomes in terms of administered treatment and control rates. 28 patients of oral cavity verrucous carcinomas treated at our institute from March 2014 to December 2018 were reviewed retrospectively. Demographic profile, histopathological features and clinical outcomes were analyzed. Statistical analysis was performed with SPSS for Mac (version 23.0). Median age was 54 years (range 31-75) with M:F ratio of 25:3. Buccal mucosa was the most common site. All patients underwent surgical resection except one. Of these, 24 had neck dissection; 12 had supra-omohyoid neck dissection, eleven had modified neck dissection and one patient underwent radical neck dissection. Three patients had their histology upgraded to squamous cell carcinomas in the post-operative histopathology. The post-operative staging was as follows: 21% stage I and 35% stage II. One patient opted for non-surgical approach and received radical concurrent chemoradiotherapy. Median follow up was 12 months (range 6-36). Two patients had local failures and one had a regional failure. No distant metastasis was found. There was one death. 14-Months survival rate was 92%. Estimated 18 month loco-regional control rate was 92%. Curative surgical resection remains the cornerstone for VC of oral cavity. Any change of histopathology post-operatively to squamous cell carcinoma is a poor prognostic sign and needs appropriate adjuvant treatment.

9.
Indian J Community Med ; 47(3): 379-385, 2022.
Article in English | MEDLINE | ID: mdl-36438512

ABSTRACT

Context: Hypertension is an emerging public health problem due to its high prevalence and association with cardiovascular and overall morbidity and mortality. Police personnel constitute a special occupational group with exposure to violence and stress at work, which affects their health directly and indirectly. Methodology: A cross-sectional study was conducted to find out the prevalence of hypertension and its relation with respect to police duty profile along with other risk factors among the police personnel of the Gwalior district stationed at various police stations. Results: In total, 402 police personnel were included in the study. Forty (14.7%) participants reported that they had h/o hypertension, while 26 (9.5%) reported that they were diagnosed as hypertensive in recent 1-2 months. As per the findings of our study, 273 (67.91%) participants come out to be hypertensive; among them, 207 (75.8%) were diagnosed in the current study. With increase in hierarchy, more police personnel suffered with hypertension. Conclusions: Long duty hours, higher rank, prolonged service duration, and inappropriate eating habits are the significant factors for the high prevalence of hypertension in police personnel.

10.
Nanotechnology ; 34(3)2022 Nov 04.
Article in English | MEDLINE | ID: mdl-36228508

ABSTRACT

We report on the electrical and thermal transport properties of nickel nanoparticles with crystallite size from 23.1 ± 0.3 to 1.3 ± 0.3 nm. These nanoparticles show a systematic metal to insulator transition with the change in the conduction type fromn- to p-type, colossal Seebeck coefficient of 1.87 ± 0.07 mV K-1, and ultralow thermal conductivity of 0.52 ± 0.05 W m-1K-1at 300 K as the crystallite size drops. The electrical resistivity analysis reveals a dramatic change in the electronic excitation spectrum indicating the opening of an energy gap, and cotunneling and Coulomb blockade of the charge carriers. Seebeck coefficient shows transport energy degradation of charge carriers as transport level moves away from the Fermi level with decrease in crystallite size. The Lorenz number rising to about four orders of magnitude in the metallic regimes with decrease in crystallite size, showing a large violation of the Wiedemann-Franz law in these compacted nickel nanoparticles. Such an observation provides the compelling confirmation for unconventional quasiparticle dynamics where the transport of charge and heat is independent of each other. Therefore, such nanoparticles provide an intriguing platform to tune the charge and heat transport, which may be useful for thermoelectrics and heat dissipation in nanocrystal array-based electronics.

11.
J Environ Manage ; 322: 115945, 2022 Nov 15.
Article in English | MEDLINE | ID: mdl-36041298

ABSTRACT

The ever-growing concern of sustainability and survivability attracts academicians and practitioners to develop strategies and supply chain capabilities that cater to the challenges and helps in achieving the sustainability development goals. There is a need to develop a holistic model that facilitates understanding the relationships among supply chain practices, industry 4.0 technologies, and supply chain performance measures. Thus, this study examines the mediating effect of industry 4.0 technologies on supply chain management practices and supply chain performance measures. A survey-based data was collected from manufacturing organizations across India, and 361 complete responses were obtained. Structural equation modeling (SEM) was utilized for data analysis. This study has multiple contributions. First, the results indicate that the supply chain management practices influence the industry 4.0 technologies adoption. Second, the results also revealed that the industry 4.0 technologies significantly positively affect supply chain performance measures. Finally, industry 4.0 technologies mediated the relations between supply chain management practices and supply chain performance measures. Furthermore, the findings offer important insights into understanding the underlying mechanisms in successfully adopting and effectively using industry 4.0 technologies. The implications for theory and practices are also discussed.


Subject(s)
Commerce , Industry , India , Organizations , Technology
14.
J Maxillofac Oral Surg ; 21(4): 1218-1226, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36896061

ABSTRACT

Introduction: Temporomandibular joint subluxation is defined as self-reducing partial dislocation of the TMJ during which the condyle passes anterior to the articular eminence. Material and Method: The study consisted of 30 patients, 19 females and 11 males with 14 unilateral and 16 bilateral cases of chronic symptomatic subluxation. Treatment consisted of arthrocentesis followed by 2 ml of autologous blood injection into upper joint space and 1 ml into pericapsular tissues using an autoclaved soldered double needle with single puncture technique. Parameters evaluated were pain, maximum mouth opening, excursive jaw movements, deviation on mouth opening and quality of life, hard and soft tissue changes on X-ray TMJ view and MRI. Results: At 12 month follow-up, average reduction in maximum interincisal opening, deviation on mouth opening, range of excursive movements on right and left sides and VAS scores were 20.54%, 32.84%, 29.59%, 27.37% and 74.53%, respectively. Out of 93.3% who responded to therapy, 66.7%, 20% and 6.7% responded after 1st, 2nd and 3rd AC + ABI, respectively. Remaining 6.7% patients had persistent painful subluxation and underwent open joint surgery. 93.3% patients responded to therapy, 80% were relieved of painful subluxation, 13.3% had painless subluxation and kept on follow-up. X-ray TMJ and MRI did not show any hard and soft tissue changes. Conclusion: A soldered double needle, single puncture, AC + ABI are a simple, safe, cost-effective, repeatable and minimally invasive nonsurgical therapy for treatment of CSS without any permanent radiographically evident soft or hard tissue changes.

16.
Int J Integr Care ; 21(1): 3, 2021 Feb 08.
Article in English | MEDLINE | ID: mdl-33613135

ABSTRACT

BACKGROUND AND AIMS: Globally, hospital-based healthcare models targeting acute care, are not effective in addressing chronic conditions. Integrated care programmes for chronic diseases have been widely developed and implemented in Europe and North America and to a much lesser extent in the Asia-Pacific region to meet such challenges. We completed a scoping review aiming to examine the elements of programmes identified in the literature from select study countries in the Asia-Pacific, and discuss important facilitators and barriers for design and implementation. METHODS: The study design adopted a scoping review approach. Integrated care programmes in the study countries were searched in electronic databases using a developed search strategy and key words. Elements of care integration, barriers and facilitators were identified and charted following the Chronic Care Model (CCM). RESULTS: Overall the study found a total of 87 integrated care programmes for chronic diseases in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines and 1 in Fiji. Financial incentives were found to play a crucial role in facilitating integrated care and ensuring the sustainability of programmes. In many cases, the performance of programmes was found not to have been adequately assessed. CONCLUSION: Integrated care is important for addressing the challenges surrounding the delivery of long-term care and there is an increasing trend of integrated care programmes for chronic diseases in the Asia-Pacific. Evaluating the performance of integrated care programmes is crucial for developing strategies for implementing future programmes and improving already existing programmes.

17.
ACS Appl Mater Interfaces ; 12(49): 54742-54751, 2020 Dec 09.
Article in English | MEDLINE | ID: mdl-33258368

ABSTRACT

Identification of novel materials with enhanced thermoelectric (TE) performance is critical for advancing TE research. In this direction, this is the first report on TE properties of low-cost, nontoxic, and abundant core-shell Cu@Cu2O nanocomposites synthesized using a facile and cheap solution-phase method. They show ultralow thermal conductivity of nearly 10-3 of the copper bulk value, large thermopower of ∼373 µVK-1, and, consequently, a TE figure of merit of 0.16 at 320 K which is larger than those of many of the potential TE materials such as PbTe, SnSe, and SiGe, showing its potential for TE applications. The ultralow thermal conductivity is mainly attributed to the multiscale phonon scattering from intrinsic defects in Cu2O, grain boundaries, lattice-mismatched interface, as well as dissimilar vibrational properties. The large thermopower is associated with a sharp modulation in carrier density of states due to charge transfer between Cu and Cu2O nanoparticles and carrier energy filtering. They are tuned by varying the trioctylphosphine concentration.

18.
Growth Factors ; 38(2): 105-119, 2020 02.
Article in English | MEDLINE | ID: mdl-32957814

ABSTRACT

Quercetin on wounds could be favorable for healing based on its variety of biological effects. Eighty wounded rats were divided into four groups i.e. dimethyl sulfoxide, 0.03% quercetin, 0.1% quercetin, and 0.3% quercetin-treated. Different treatments were topically applied for 20 days. Quercetin (0.3%) caused the fastest wound closure and markedly improved the oxidative stress. Quercetin treatment increased the expressions of IL-10, VEGF, TGF-ß1, CD31, α-SMA, PCNA, and GAP-43, and decreased the expressions of TNF-α. Early infiltration of inflammatory cells and formation of good quality granulation tissue dominated by fibroblast proliferation, angiogenesis, and collagen deposition in quercetin treated groups was also evident. All these effects were more pronounced at 0.3% quercetin concentration. The earliest regeneration of epithelial layer was also observed in 0.3% quercetin-treated wounds. In conclusion, 0.3% quercetin accelerates wound healing efficiently by modulating antioxidant system of wound, cytokines, growth factors, other proteins and cells involved in healing.


Subject(s)
Antioxidants/pharmacology , Cytokines/metabolism , Intercellular Signaling Peptides and Proteins/metabolism , Quercetin/pharmacology , Wound Healing , Animals , Cell Proliferation , Collagen/metabolism , Fibroblasts/drug effects , Fibroblasts/metabolism , Fibroblasts/physiology , Male , Rats , Rats, Wistar , Skin/drug effects , Skin/metabolism
19.
J Med Econ ; 23(11): 1345-1355, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32815766

ABSTRACT

AIM: To characterize vaso-occlusive crises (VOCs) and describe healthcare costs among commercially-insured, Medicaid-insured, and Medicare-insured patients with sickle cell disease (SCD). MATERIALS AND METHODS: The IBM Truven Health MarketScan Commercial (2000-2018), Medicaid Analytic eXtract (2008-2014), and Medicare Research Identifiable Files (2012-2016) databases were used to identify patients with ≥2 SCD diagnoses. Study measures were evaluated during a 12-month follow-up period, stratified by annual number of VOCs (i.e. 0, 1, and ≥2). RESULTS: Among 16,092 commercially-insured patients (mean age = 36.7 years), 35.3% had 1+ VOCs. Mean annual total all-cause healthcare costs were $15,747, $27,194, and $64,555 for patients with 0, 1, and 2+ VOCs, respectively. Total all-cause healthcare costs were mainly driven by inpatient (0 VOC = 31.0%, 1 VOC = 53.1%, 2+ VOCs = 65.4%) and SCD-related costs (0 VOC = 56.4%, 1 VOC = 78.4%, 2+ VOCs = 93.9%). Among 18,287 Medicaid-insured patients (mean age = 28.5 years, fee-for-service = 50.2%), 63.9% had 1+ VOCs. Mean annual total all-cause healthcare costs were $16,750, $29,880, and $64,566 for patients with 0, 1, and 2+ VOCs, respectively. Inpatient costs (0 VOC = 37.2%, 1 VOC = 64.3%, 2+ VOCs = 72.9%) and SCD-related costs (0 VOC = 60.9%, 1 VOC = 73.8%, 2+ VOCs = 92.2%) accounted for a significant proportion of total all-cause healthcare costs. Among 15,431 Medicare-insured patients (mean age = 48.2 years), 55.1% had 1+ VOCs. Mean annual total all-cause healthcare costs were $21,877, $29,250, and $58,308 for patients with 0, 1, and ≥2 VOCs, respectively. Total all-cause healthcare costs were mainly driven by inpatient (0 VOC = 47.9%, 1 VOC = 54.9%, 2+ VOCs = 67.5%) and SCD-related costs (0 VOC = 74.9%, 1 VOC = 84.4%, 2+ VOCs = 95.3%). LIMITATIONS: VOCs managed at home were not captured. Analyses were descriptive in an observational setting; thus, no causal relationships can be inferred. CONCLUSIONS: A high proportion of patients experienced VOCs across payers. Furthermore, inpatient and SCD-related costs accounted for a significant proportion of total all-cause healthcare costs, which increased with VOC frequency.


Subject(s)
Anemia, Sickle Cell/economics , Insurance, Health/economics , Medicaid/economics , Adult , Anemia, Sickle Cell/physiopathology , Female , Health Expenditures , Health Services/economics , Health Services/statistics & numerical data , Humans , Male , Medicare/economics , Patient Acceptance of Health Care/statistics & numerical data , United States
20.
J Pharmacopuncture ; 23(2): 54-61, 2020 Jun 30.
Article in English | MEDLINE | ID: mdl-32685233

ABSTRACT

Inflammation is an immune response of the human body but excessive inflammation is taken as a major factor in the development of many diseases including autoimmune disorders, cancer and nerve disorders etc. In this regards the need is to suppress the inflammatory response. Suppression of extra or imperfect inflammatory response is not a big deal provided there is an exact knowledge of particular target in the body. Recent advancements in Pharmacological aspect made the therapy with improved outcomes in number of patients. Anticytokine therapy might be one of the important and novel approaches for inflammation and Arthritis. This can be achieved only when we go through the pathophysiology of expression and identification of mediators. Let's take an example of cytokine like interleukins (IL), chemokines, interferons (INF), tumor necrosis factors (TNF-α), growth factors, and colony stimulating factors) release pathway which is a major signalling protein in inflammatory response. In the present study we have reviewed the recent pharmacological therapeutic advancement, inflammatory mediators, receptors, and major signalling pathways. Such information will not only provide the idea about the mechanism of action of Pharmaceuticals and molecular targets but also it provides a new aspect for drug designing and new corrective approaches in existing clinical medicines. This study will be a source of good information for the researchers working in the area of drug designing and molecular Pharmacology especially in anti-inflammatory and anti arthritic medicines for target based therapy.

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