Benefit In Prevention Research Articles

Coral reef restoration can reduce coastal contamination and pollution hazards

Coral reef restoration can reduce the wave-driven flooding for coastal communities. However, this protection has yet to be assessed in terms of the reduced risk of flood-driven environmental contamination. Here we provide the first high-resolution valuation of the reduction of flood-related land-based environmental pollution provided by potential coral reef restoration. Along Florida’s 460 km-long coral reef-fringed coastline, coral reef restoration could reduce the risk of sewage and petrochemical contamination by preventing the flooding of petroleum storage tank systems (-9%), onsite sewage treatment and disposal systems (-4%), and wastewater treatment plants (-10%). The present value of critical infrastructure protection and contamination prevention benefits provided by coral reef restoration is $3,413,503, with some areas exceeding $1,500,000/km. Annually, 48,403 U.S. gal of petrochemicals, 10,404 GPD of wastewater treatment capacity, equivalent to $281,435, could be protected from flooding, demonstrating that coral reef restoration can provide environmental risk reduction and previously undocumented additional socioeconomic benefits.

Lutein and inflammation: a comprehensive review of its mechanisms of action

Lutein, a natural dihydroxy carotenoid and a member of the non-vitamin A carotenoids family, is abundant in yellow-colored fruits and green leafy vegetables such as spinach and lettuce. As the second most common type of carotenoid found in human serum, lutein offers a plethora of medicinal benefits, including anti-cancer, anti-inflammatory, and anti-oxidative properties. It is well-absorbed and systemically localized to the liver, lung, and retina, where it can cross the blood-retina barrier and accumulate in the macular pigment. Due to its anti-oxidative and singlet oxygen quenching properties, lutein is reported to reduce the risk of age-related macular degeneration (AMD). Higher concentrations of fasting plasma carotenoids and enhanced skin yellowing after lutein consumption indicate its presence in various regions of the human body, including the skin, breast, brain, and cervix. Lutein has remarkable benefits for neurodegenerative diseases, cardiovascular health, liver protection, and bone disease prevention. In the central nervous system (CNS), lutein supports brain homeostasis through its antioxidant and anti-inflammatory properties, increasing interleukin-10 (IL-10) and reducing tumor necrosis factor-α (TNF-α). It reduces the risk of coronary artery disease and exerts anti-inflammatory effects on peripheral blood mononuclear cells (PBMCs). Lutein protects against alcohol-induced liver damage by modulating the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway. Additionally, lutein promotes bone health by enhancing mineralized bone nodule development and inhibiting osteoclast production, reducing bone resorption, and suppressing soluble receptor activator of nuclear factor kappa B ligand (RANKL). These multifaceted benefits make lutein a valuable agent in disease prevention and health promotion. This review discusses the comprehensive profile of lutein as a phytochemical activity, including anti-inflammatory, antioxidant, anti-cancer, hepatoprotective, neurological, and cardioprotective effects. Additionally, it discusses lutein’s beneficial impact on macular degeneration and eye diseases, showcasing its potential as a natural, plant-based therapeutic agent.

Factors influencing participation and engagement in post-stroke cardiac rehabilitation and exercise: an exploratory qualitative study.

The secondary prevention benefits of cardiac rehabilitation and similar exercise classes for stroke survivors are well established, however post-stroke exercise participation remains low. This research aimed to explore the factors affecting participation and engagement in UK-based post-stroke cardiac rehabilitation and exercise, from the perspective of the service user and service provider. An exploratory study, using semi-structured interviews, was conducted (n = 8, service user = 4), adopting a phenomenological approach. All interviews applied a topic guide informed by the Health Belief Model and the International Classification of Functioning, Disability and Health, and were analysed using inductive thematic analysis. Post-stroke cardiac rehabilitation and exercise participation was influenced by numerous factors, encompassed into three themes: Accessibility (describing the environmental pre-class limiting factors), Programme Structure (valuing in-class supervision, socialisation and adaptations) and Patient Characteristics (encompassing the influence of the service user's personality and experiences). Effective secondary prevention of stroke through cardiac rehabilitation and other exercise-based rehabilitation requires policy development and commissioning to ensure appropriate delivery. Further research should determine the feasibility of novel exercise class formats, in addition to larger trials investigating their clinical benefit and cost effectiveness.

Government and farmer responses to the fall armyworm outbreak in mainland Southeast Asia

IntroductionNative to the Americas and highly polyphagous, the fall armyworm (FAW), Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae) has garnered attention for causing significant damage, primarily to maize.MethodsThis study synthesizes FAW emergence, government responses, and farmer reactions in mainland Southeast Asia (MSEA), and assesses the feasibility of government-recommended measures in terms of efficacy and cost-efficiency.ResultsFrom late 2018 to the rainy season of 2019, FAW infestations extensively emerged in MSEA maize fields. MSEA governments promptly issued strategies and guidelines through plant protection divisions/departments, which involved international organizations, foreign governments, and private web portals. Alongside the foliar application of emamectin benzoate (EMB), which is the most frequently mentioned method, MSEA governments advocated for integrated pest management (IPM)-oriented approaches. These include application methods of chemical insecticides, use of host plant resistance, biological control, cultural and interference methods, and local measures aimed at reducing chemical usage. Despite comprehensive recommendations, maize farmers primarily rely on EMB foliar treatment for FAW control.DiscussionWe highlight the need for further research and dissemination regarding the widely accepted foliar application of chemical insecticides, specifically in relation to human safety, improvements in application technology, and clear guidelines for large-scale outbreaks. On the other hand, the concentrative foliar application of chemical insecticides raises concerns about resistance evolution. Alternatives to foliar treatment with chemical insecticides, mainly EMB, such as seed treatment with diamides and neonicotinoids, genetically modified maize seeds approved only in Vietnam, and biological control, have demonstrated efficacy. Seed treatment provides cost and labor benefits for early-stage FAW infestation prevention. Validation of natural enemy rearing costs may prove advantageous as preliminary estimates suggest they could be relatively low. Not all strategies recommended by the government or widely discussed are necessarily relevant at farm-level. This study provides the following suggestions for the proposal of more acceptable strategies. 1) Studying the actual responses of governments and farmers with special emphasis on cost efficiency; 2) Making alternatives to EMB foliar application more cost-effective inclusive of the cost of labor; and finally, 3) Verifying the effectiveness of the alternative techniques.

Long-Term Efficacy and Safety of Denosumab: Insights beyond 10 Years of Use.

Osteoporosis management in post-menopausal women focuses on fracture prevention, with denosumab as a key therapeutic option. Despite its proven efficacy in reducing fracture risk and increasing bone mineral density (BMD) over 10 years, its long-term impact remains uncertain. We evaluated the literature on its efficacy and safety beyond the initial decade. Clinical trials and real-world studies confirm denosumab's sustained efficacy, especially in lumbar spine BMD, with hip BMD stabilizing. Concerns about adverse events (AEs) like hypocalcemia and osteonecrosis of the jaw necessitate vigilant monitoring. Risks of atypical femoral fractures and malignancies also require attention, despite unclear links to treatment duration. Clinical guidelines for denosumab beyond 10 years are limited, emphasizing the need for careful monitoring. In certain scenarios, such as advanced chronic kidney disease, prolonged denosumab may be required to balance AE risks with fracture prevention benefits. Denosumab shows potential for long-term efficacy in augmenting BMD; however, monitoring for AEs is crucial to guide clinical decision-making effectively.

Comparative Efficacy of Intramuscular Oxytocin and Carboprost Tromethamine in Postpartum Hemorrhage Prophylaxis: A Randomized Controlled Trial

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality worldwide, despite the preventive benefits of active management in the third stage of labor. Oxytocin is widely used for PPH prevention; however, its effectiveness is sometimes limited, necessitating alternative or additional uterotonics. Carboprost tromethamine, a prostaglandin analogue, offers potential advantages, but comparative studies are limited. This study aimed to compare the efficacy of intramuscular oxytocin (10 units) versus intramuscular carboprost tromethamine (125 µg) in reducing blood loss during the third stage of labor and in minimizing the need for additional uterotonics. Methods: In a randomized controlled trial, 266 women undergoing vaginal delivery were assigned to receive either oxytocin (Group A) or carboprost tromethamine (Group B) as PPH prophylaxis. Primary outcomes included the duration of the third stage of labor and estimated blood loss, with secondary outcomes of additional uterotonic requirement, hemoglobin change, and side effects. Results: Mean third-stage duration was significantly shorter in the carboprost group (6.18 min) than the oxytocin group (6.71 min, p < 0.05). Mean blood loss was also significantly lower with carboprost (183.44 ml) compared to oxytocin (285.77 ml, p < 0.001). Additional uterotonics were needed less frequently in the carboprost group (3%) versus the oxytocin group (15.8%, p < 0.05). Diarrhea was more common in the carboprost group. Conclusion: Carboprost tromethamine demonstrated superior efficacy in reducing blood loss and third-stage duration compared to oxytocin, with a manageable side effect profile. These findings support carboprost as an effective alternative for PPH prophylaxis.

Oral Lipids/Fatty Acids Supplements and Eczema: What Is Known?

The pathogenesis of atopic dermatitis (AD) points to skin barrier dysfunction as a critical piece of the puzzle. Deficiencies in fatty acids and ceramides-key elements of the skin barrier-have been linked to AD. Fatty acids can be separated into omega-3 and omega-6, which can be found in a variety of foods such as fish, nuts, seeds, and even plants. In dogs, supplementation with oral fatty acids has shown promising benefits. This review aims to explore whether humans can similarly benefit from these supplements based on current literature. The results of our search varied by compound type. For borage oil and evening primrose oil, evidence of their effectiveness is mixed, though they may offer some preventative benefits. Fish oil supplements appear to be effective in treating AD, as they reduce clinical scores and symptom severity. Oral ceramides, blackcurrant seed oil, and hempseed oil have yet to be thoroughly studied, but preliminary results are promising. Among the studies, the supplementation doses and duration of treatment varied extensively. The literature did not provide comparative analysis between the supplements, and data on the overall safety and tolerability of these supplements are limited. While some evidence is promising, the reliability of these products, as well as their optimal dosage and frequency, remains uncertain.

Impact of CGRP monoclonal antibody treatment on blood pressure in patients with migraine: A systematic review and potential clinical implications.

Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) or the CGRP-receptor have revolutionized the prevention of migraine. Despite their effectiveness, worries have surfaced regarding potential unwanted cardiovascular effects linked to the vasodilation function of CGRP, suggesting a potential influence on blood pressure (BP). Studies were systematically retrieved from PubMed, Cochrane Database of Systematic Reviews, Web of Science, MEDLINE and EMBASE up to 1 May 2024. We focused on randomized controlled trials and observational cohort or case-control studies examining the impact of anti-CGRP(R)-monoclonal antibodies (mAbs) compared to control treatments on BP in patients with migraine. Two reviewers independently conducted study selection, data extraction and risk of bias assessment. The literature search yielded 693 articles. After removing duplicates and conducting screening, 22 full-text articles were evaluated, with only four studies meeting the inclusion criteria. Among these, only one study had a low risk of bias and reported elevated BP following initiation of anti-CGRP(R)-mAb treatment. Although anti-CGRP(R)-mAbs offer substantial benefits for migraine prevention, the potential risk of increased BP requires attention. Despite the current limited evidence, clinicians are urged to monitor BP of migraine patients undergoing treatment with anti-CGRP(R)-mAbs and to remain aware of the increased risk of cardiovascular events in these patients.

Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders.

Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events. In this review article, we discuss current evidence regarding the management of elderly patients with hypertension and common neurological disorders, including stroke and neurodegenerative diseases. In elderly patient with a history of stroke, the blood pressure management strategy is generally similar to that for young patients, however the benefits of stroke prevention from blood pressure control are less significant. For patients with neurodegenerative disorders such as cognitive dysfunction and Parkinson's disease, achieving adequate blood pressure control may be beneficial in reducing cardiovascular risks, although the higher risk of adverse events from antihypertensive treatment may offset some of these benefits. Special considerations for factors such as orthostatic hypotension, risk of falls, polypharmacy, and significant drug-drug interactions are required but frequently neglected in clinical practice. More efforts are warranted to determine the optimal treatment strategy for elderly populations with neurological disorders.

Antioxidative and Anticancer Potential of Luteolin: A Comprehensive Approach Against Wide Range of Human Malignancies.

Luteolin is widely distributed phytochemical, a flavonoid, in kingdom plantae. Luteolin with potential antioxidant activity prevent ROS-induced damages and reduce oxidative stress which is mainly responsible in pathogenesis of many diseases. Several chemo preventive activities and therapeutic benefits are associated with luteolin. Luteolin prevents cancer via modulation of numerous pathways, that is, by inactivating proteins; such as procaspase-9, CDC2 and cyclin B or upregulation of caspase-9 and caspase-3, cytochrome C, cyclin A, CDK2, and APAF-1, in turn inducing cell cycle arrest as well as apoptosis. It also enhances phosphorylation of p53 and expression level of p53-targeted downstream gene. By Increasing BAX protein expression; decreasing VEGF and Bcl-2 expression it can initiate cell cycle arrest and apoptosis. Luteolin can stimulate mitochondrial-modulated functions to cause cellular death. It can also reduce expression levels of p-Akt, p-EGFR, p-Erk1/2, and p-STAT3. Luteolin plays positive role against cardiovascular disorders by improving cardiac function, decreasing the release of inflammatory cytokines and cardiac enzymes, prevention of cardiac fibrosis and hypertrophy; enhances level of CTGF, TGFβ1, ANP, Nox2, Nox4 gene expressions. Meanwhile suppresses TGFβ1 expression and phosphorylation of JNK. Luteolin helps fight diabetes via inhibition of alpha-glucosidase and ChE activity. It can reduce activity levels of catalase, superoxide dismutase, and GS4. It can improve blood glucose, insulin, HOMA-IR, and HbA1c levels. This review is an attempt to elaborate molecular targets of luteolin and its role in modulating irregularities in cellular pathways to overcome severe outcomes during diseases including cancer, cardiovascular disorders, diabetes, obesity, inflammation, Alzheimer's disease, Parkinson's disease, hepatic disorders, renal disorders, brain injury, and asthma. As luteolin has enormous therapeutic benefits, it could be a potential candidate in future drug development strategies.

Exploring the Therapeutic Potential of Bottle Gourd-Bael-Triphala Churna in Cancer Treatment

This study aims to investigate the anticancer activity of the herbal formulation using a hepatocellular carcinoma (HepG2) cell as an in vitro model system. Bael leaves (Aegle marmelos) In the same study, bael may be related to antioxidant and anti-inflammatory effects that protect cells. It is an ancient Ayurvedic formulation of three fruits (Amalaki, Bibhitaki, and Haritaki), known to promote detoxification and maintain gut integrity. Bottle gourd (Lagenaria siceraria) is hydrating, which could enhance the defenses of the body due to its nutrient profile. Each of these ingredients is believed to have synergistic benefits for cancer prevention and fighting ability, infectious disease immunity, and maintenance of overall health. In this context, this combination could represent a complementary option of therapy to standard cancer treatments and should be tested in preclinical in vitro and in vivo experiments and subsequently by clinical trials for the evaluation of efficacy and safety in oropharyngeal cancer

Current Prospective of Hypertension Disease and their Future Aspects in Different Stage of Female Health

Cardiovascular disease is the primary cause of mortality in women. Due to age and worsening of risk factors over the menopausal transition, risk of coronary heart disease events increases in postmenopausal women with diabetes. Randomized studies have conflicted regarding the beneficial impact of estrogen therapy upon intermediate cardiovascular disease markers and events. Therefore, estrogen therapy is not currently recommended for indications other than symptom management. However, for women at low risk of adverse events, estrogen therapy can be used to minimize menopausal symptoms. The risk of adverse events can be estimated using risk engines for the calculation of cardiovascular risk and breast cancer risk in conjunction with screening tools such as mammography. Use of estrogen therapy, statins, and anti-platelet agents can be guided by such calculators particularly for younger women with diabetes. Risk management remains focused upon lifestyle behaviors and achieving optimal levels of cardiovascular risk factors, including lipids, glucose, and blood pressure. Use of pharmacologic therapies to address these risk factors, particularly specific hypoglycemic agents, may provide some additional benefit for risk prevention. The minimal benefit for women with limited life expectancy and risk of complications with intensive therapy should also be considered.

A systematic review and meta-analysis assessing the impact of pentoxifylline on the healing and recurrence of venous leg ulcers.

Venous leg ulcers (VLU) are the most severe manifestation of venous insufficiency and carry a poor prognosis because of delayed healing and recurrent ulceration. Pentoxifylline (PTX) is an example of a vasoactive medication that can be used alongside compression therapy to help improve ulcer healing rates. A previous review highlighted improved healing of VLU with PTX, although no analysis was made for complete ulcer healing and recurrence following treatment. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The EMBASE, MEDLINE and Cochrane databases were searched for all relevant English-language human studies between January 1980 and August 2023. Two independent authors screened and reviewed all articles for inclusion, performed data extraction and assessed methodological quality according to Cochrane's risk of bias tool. Primary outcomes included complete ulcer healing and recurrence rates in the ipsilateral limb. Ten studies were eligible for analysis, of which nine were randomised trials and one was an observational cohort study. There were a total of 1,025 participants, with 515 having received PTX. In those receiving 1200mg PTX, venous leg ulcers healed in 62% (315 participants). Compared to controls, PTX administration was associated with a significantly higher likelihood of complete ulcer healing (OR 2.56, 95% CI 1.97-3.32, p < .001). The rate and time of ulcer recurrence were not recorded in any of the studies included. The evidence demonstrates that PTX may have a significant beneficial impact on the rate of complete ulcer healing. Little evidence is currently present in the literature evaluating the recurrence rates of ulcers following PTX treatment. Large scale, high quality RCTs with an adequate follow-up period are needed to evaluate this and assess whether treatment with PTX shows a significant benefit in prevention of recurrence in venous ulcers.

Patients' perspectives regarding health professionals contacting their relatives about genetic risk directly (with patient consent).

Genetic testing of blood relatives of individuals at high risk of dominant conditions has significant preventive health benefits. However, cascade testing uptake is <50%. Research shows increased testing uptake when health professionals (HPs) contact at-risk relatives directly, with patient consent. Despite international support, this is not standard practice in Australia. We aimed to gather perspectives of genetic testing patients about direct-contact methods. Using an online survey, we surveyed Australian adults with genetic results of relevance for relatives, including patients who (i) self-categorised as being directly contacted by a clinical service, (ii) self-categorised as being referred by a HP, and (iii) received genetic results through a research study. Overall, 442 patients responded (clinical n = 363; research n = 79). Clinical patients self-categorised as 49.0% directly-contacted and 51.0% referred. Overall, the majority of patients had no privacy concerns about direct-contact methods (direct-contact 97%; referred 77%; research 76%). Less than 5% of the combined cohort (n = 19/442) reported significant concerns. The most prevalent concerns were the need for consent to provide HPs with relatives' contact details, and a patient preference to notify relatives before HP contact. Other key findings include preferences about contact methods, including that most patients who received a letter from a genetics service preferred a letter with specific information about the familial genetic condition (n = 141/149; 94.6%) than one with general information about genetic risk. Our findings indicate Australian patients support HPs using direct-contact methods to assist with risk communication to relatives. Findings also identify concerns to be addressed in the design of direct-contact programs.

Protective Effects of Cereal-Based Fermented Beverages Against 5-Fluorouracil-Induced Intestinal Damage in Mice.

5-Fluorouracil (5-FU) is a common chemotherapeutic medication used to treat cancer. However, the intestinal tract may sustain oxidative damage as a result. The purpose of this study was to clarify the underlying molecular mechanisms and examine the preventive benefits of cereal-based fermented drinks (CFBs) against intestinal injury in mice caused by 5-FU. The mice were injected intraperitoneally with 5-FU to induce intestinal mucosal and treated with CFB. The factors for intestinal barrier integrity, oxidative stress and inflammation were measured. The findings demonstrated that CFBs had high levels of polyphenol, flavonoids, and peptides and had in vitro high free radical scavenging capacity. Furthermore, CFBs effectively ameliorated 5-FU-induced intestinal epithelium damage, characterized by increasing intestinal tight junctions and reducing apoptosis in intestinal cells. These protective effects may attribute to the increased activity of antioxidant-related enzymes (SOD, CAT, and GSH) as well as decreased amounts of inflammatory and oxidative damage markers (IL-1β, TNF-α, and MDA) in the intestinal tract. Overall, these results show that CFBs can mitigate intestinal damage caused by 5-FU by reducing oxidative stress, suggesting the potential utility of CFBs for therapeutic treatment against intestinal mucositis.

Early orthodontic treatment need over a 10-year period and evaluation of short-term intervention stability

ObjectiveEarly orthodontic treatment with cost reimbursement within the framework of the German statutory health insurance (GKV) is only possible for a strictly defined malocclusion group as defined by the orthodontic indication groups (KIG). It is not yet clear whether the application of the KIG criteria and corresponding successful early orthodontic interventions result in no or significantly less need for treatment in the late mixed dentition or in the permanent dentition. This study therefore investigated short-term intervention stability from a 10-year-period.Materials and methodsBetween 2009 and 2019, n = 661 patients were diagnosed with indication groups D (increased overjet), M (reversed overjet), B (scissors bite), K (crossbite), or P (lack of space) including orthodontic treatment need. N = 70 patients (35 female, 35 male) met the inclusion criteria of the study and had received early orthodontic treatment with a mean duration of 15.44 ± 2.20 months. Orthodontic indication groups (KIG) were evaluated at the beginning (aged 7.99 ± 1.44 years) and the end of early orthodontic treatment (aged 9.63 ± 1.49 years) and at a voluntary control or the beginning of additional orthodontic treatment (aged 11.85 ± 1.72 years). The evaluation included established procedures for categorization of orthodontic indication groups and their respective classification. Statistics included Chi-square test and Kendall´s tau-b. The level of significance was set at p < 0.05.ResultsThe results showed reversed overjet in 44.3% and crossbites in 41.4% of the patients as most common indication for early orthodontic treatment. At the end of early orthodontic treatment, no orthodontic treatment need was present in 87.1%. At the late mixed dentition, the treatment result of early orthodontic treatment was stable in N = 61 out of N = 70 patients.ConclusionsThe results of our study confirm preventive benefits of early orthodontic treatment, especially in patients with transverse anomalies or reversed overjet.Clinical relevanceA short-term orthodontic intervention with correct indication during primary or early mixed dentition can prevent or reduce further treatment need during late mixed or permanent dentition, and should therefore not be postponed.

HPV Vaccines Among University Students: Understanding Barriers and Facilitators of Vaccine Uptake.

Human papillomavirus (HPV) is the most common sexually transmitted infection and plays a significant role in cervical, penile, anal, vaginal, vulvar, and oropharyngeal cancers as well as non-cancerous genital warts and genital dysplasia. In the United States, there are approximately 46,000 new HPV-related cancers a year. There is an effective vaccine to prevent over 90% of these cancers and other HPV-related diseases; however, those that are aged 18-26 have the lowest vaccine rates among eligible age groups. The objective of this study was to examine student knowledge and perceptions about HPV vaccine hesitancy in university students and their notions of barriers and facilitators for HPV vaccine uptake. We aimed to identify components for an evidence-based community-oriented educational intervention to increase HPV vaccination uptake. The researchers recorded 10 focus groups featuring students from a Northeastern United States university, aged 18-26, which were analyzed using grounded theory and inductive thematic analysis to identify recurring themes. The participants mentioned many barriers and facilitators for attaining the HPV vaccine, with health literacy being prominent for both. They demonstrated some knowledge of what HPV is and ways to avoid it. They also expressed a desire for further information and felt that the way in which this information is presented to the public is vital for increasing vaccine uptake and designing future interventions. In order to increase HPV vaccination rates in the general population and overcome barriers such as family, religious, and cultural values, it is important to emphasize the link between HPV and cancer and its preventative benefits.

Assessment of Inflammatory Biomarkers and Incident Atrial Fibrillation in Older Adults.

Available evidence supports the importance of inflammation in atrial fibrillation (AF) pathogenesis, yet general anti-inflammatory therapies have failed to show benefit for prevention of the arrhythmia. Better understanding of the specific inflammatory pathways involved is necessary to advance therapeutics. We evaluated 9 circulating markers of inflammation measured by immunoassays and incidence of AF in a population-based older cohort. Biomarkers included measures of general inflammation and the NLR (nucleotide-binding oligomerization domain-like receptor) family pyrin domain containing 3 inflammasome, TNF-α (tumor necrosis factor α), monocyte activation markers, and sIL-2 (soluble interleukin-2). Among 5726 participants (median age 72 years), 1836 developed AF over median follow-up of 11.5 years. After adjustment for conventional risk factors, 5 biomarkers were positively associated with incident AF: IL-6 (interleukin-6), hazard ratio (HR), 1.14 (95% CI, 1.07-1.21); hs-CRP (high-sensitivity C-reactive protein), HR, 1.05 (95% CI, 1.01-1.09); white blood cell count, HR, 1.18 (95% CI, 1.04-1.35); sTNFR1 (soluble TNF receptor 1), HR, 1.21 (95% CI, 1.05-1.39); and sIL-2Rα (sIL-2 receptor α), HR, 1.16 (95% CI, 1.05-1.29) (all per doubling of biomarker). sCD14, sCD163, IL-18, and IL-1 receptor antagonist showed no association with AF. Upon concurrent adjustment for all biomarkers, only IL-6 remained significantly associated with the arrhythmia, HR, 1.17 (95% CI, 1.07-1.26). Among older adults, IL-6, hs-CRP, white blood cell count, sTNFR1, and sIL-2Rα were positively associated with incident AF, but only IL-6 retained significance on concurrent adjustment. These findings newly document associations for sTNFR1 and sIL-2Rα and lend support to a preeminent role for IL-6 in development of this arrhythmia. The efficacy of IL-6 blockade for AF prevention awaits completion of appropriate clinical trials.

Mitochondrial DNA Damage and Its Repair Mechanisms in Aging Oocytes.

The efficacy of assisted reproductive technologies (ARTs) in older women remains constrained, largely due to an incomplete understanding of the underlying pathophysiology. This review aims to consolidate the current knowledge on age-associated mitochondrial alterations and their implications for ovarian aging, with an emphasis on the causes of mitochondrial DNA (mtDNA) mutations, their repair mechanisms, and future therapeutic directions. Relevant articles published up to 30 September 2024 were identified through a systematic search of electronic databases. The free radical theory proposes that reactive oxygen species (ROS) inflict damage on mtDNA and impair mitochondrial function essential for ATP generation in oocytes. Oocytes face prolonged pressure to repair mtDNA mutations, persisting for up to five decades. MtDNA exhibits limited capacity for double-strand break repair, heavily depending on poly ADP-ribose polymerase 1 (PARP1)-mediated repair of single-strand breaks. This process depletes nicotinamide adenine dinucleotide (NAD⁺) and ATP, creating a detrimental cycle where continued mtDNA repair further compromises oocyte functionality. Interventions that interrupt this destructive cycle may offer preventive benefits. In conclusion, the cumulative burden of mtDNA mutations and repair demands can lead to ATP depletion and elevate the risk of aneuploidy, ultimately contributing to ART failure in older women.

A Systematic Analysis of Pharmacoeconomic Insights into Antimicrobial Use for Sustainable Pharmacy Practices

The escalating global challenge of antimicrobial resistance, combined with increasing healthcare costs, demands a thorough understanding of pharmacoeconomic principles in antimicrobial use. The integration of pharmacoeconomics with antimicrobial stewardship has emerged as a crucial factor in promoting sustainable pharmacy practices. Recent evidence from the past decade demonstrates that well-structured antimicrobial stewardship programs achieve significant cost savings through reduced drug expenditure, decreased length of hospital stay, and improved clinical outcomes. Targeted interventions, including prospective audit with feedback and formulary restriction, consistently yield substantial returns on investment. The implementation of clinical decision support systems and rapid diagnostic technologies, despite requiring initial capital investment, has proven cost-effective in long-term healthcare settings. Both direct and indirect costs play vital roles in antimicrobial therapy decisions, encompassing resistance-related expenses and broader societal impact. Preventive strategies and appropriate antimicrobial selection significantly reduce healthcare-associated costs while maintaining therapeutic efficacy. This information provides healthcare administrators and clinical practitioners with essential information for developing economically sustainable antimicrobial use practices while ensuring optimal patient care. The economic value of implementing comprehensive antimicrobial stewardship programs extends beyond immediate cost savings to include long-term benefits in resistance prevention and resource optimization