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- Ahmadi, Shahram, et al.
(författare)
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Similar immune responses to alpha1-oleate and Bacillus Calmette–Guérin treatment in patients with bladder cancer
- 2024
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Ingår i: Cancer Medicine. - 2045-7634. ; 13:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: The molecular content of urine is defined by filtration in the kidneys and by local release from tissues lining the urinary tract. Pathological processes and different therapies change the molecular composition of urine and a variety of markers have been analyzed in patients with bladder cancer. The response to BCG immunotherapy and chemotherapy has been extensively studied and elevated urine concentrations of IL-1RA, IFN-α, IFN-γ TNF-α, and IL-17 have been associated with improved outcome. Methods: In this study, the host response to intravesical alpha 1-oleate treatment was characterized in patients with non-muscle invasive bladder cancer by proteomic and transcriptomic analysis. Results: Proteomic profiling detected a significant increase in multiple cytokines in the treatment group compared to placebo. The innate immune response was strongly activated, including IL-1RA and pro-inflammatory cytokines in the IL-1 family (IL-1α, IL-1β, IL-33), chemokines (MIP-1α, IL-8), and interferons (IFN-α2, IFN-γ). Adaptive immune mediators included IL-12, Granzyme B, CD40, PD-L1, and IL-17D, suggesting broad effects of alpha 1-oleate treatment on the tumor tissues. Conclusions: The cytokine response profile in alpha 1-oleate treated patients was similar to that reported in BCG treated patients, suggesting a significant overlap. A reduction in protein levels at the end of treatment coincided with inhibition of cancer-related gene expression in tissue biopsies, consistent with a positive treatment effect. Thus, in addition to killing tumor cells and inducing cell detachment, alpha 1-oleate is shown to activate a broad immune response with a protective potential.
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- Ahmed, S., et al.
(författare)
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Effectiveness of health voucher scheme and micro-health insurance scheme to support the poor and extreme poor in selected urban areas of Bangladesh: An assessment using a mixed-method approach
- 2021
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:11
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Tidskriftsartikel (refereegranskat)abstract
- Background National healthcare financing strategy recommends tax-based equity funds and insurance schemes for the poor and extreme poor living in urban slums and pavements as the majority of these population utilise informal providers resulting in adverse health effects and financial hardship. We assessed the effect of a health voucher scheme (HVS) and micro-health insurance (MHI) scheme on healthcare utilisation and out-of-pocket (OOP) payments and the cost of implementing such schemes. Methods HVS and MHI schemes were implemented by Concern Worldwide through selected NGO health centres, referral hospitals, and private healthcare facilities in three City Corporations of Bangladesh from December 2016 to March 2020. A household survey with 1,294 enrolees, key-informant interviews, focus group discussions, consultative meetings, and document reviews were conducted for extracting data on healthcare utilisation, OOP payments, views of enrolees, and suggestions of implementers, and costs of services at the point of care. Results Healthcare utilisation including maternal, neonatal and child health (MNCH) services, particularly from medically trained providers, was higher and OOP payments were lower among the scheme enrolees compared to corresponding population groups in general. The beneficiaries were happy with their access to healthcare, especially for MNCH services, and their perceived quality of care was fair enough. They, however, suggested expanding the benefits package, supported by an additional workforce. The cost per beneficiary household for providing services per year was (sic)32 in HVS and (sic)15 in MHI scheme. Conclusion HVS and MHI schemes enabled higher healthcare utilisation at lower OOP payments among the enrolees, who were happy with their access to healthcare, particularly for MNCH services. However, they suggested a larger benefits package in future. The provider's costs of the schemes were reasonable; however, there are potentials of cost containment by purchasing the health services for their beneficiaries in a competitive basis from the market. Scaling up such schemes addressing the drawback would contribute to achieving universal health coverage.
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- Akhtar, Evana, et al.
(författare)
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A longitudinal study of rural Bangladeshi children with long-term arsenic and cadmium exposures and biomarkers of cardiometabolic diseases
- 2021
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Ingår i: Environmental Pollution. - : Elsevier. - 0269-7491 .- 1873-6424. ; 271
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Tidskriftsartikel (refereegranskat)abstract
- There is growing interest in understanding the contribution of environmental toxicant exposure in early life to development of cardiometabolic diseases (CMD) in adulthood. We aimed to assess associations of early life exposure to arsenic and cadmium with biomarkers of CMD in children in rural Bangladesh. From a longitudinal mother-child cohort in Matlab, Bangladesh, we followed up 540 pairs. Exposure to arsenic (U–As) and cadmium (U–Cd) was assessed by concentrations in urine from mothers at gestational week 8 (GW8) and children at ages 4.5 and 9 years. Blood pressure and anthropometric indices were measured at 4.5 and 9 years. Metabolic markers (lipids, glucose, hemoglobin A1c, adipokines, estimated glomerular filtration rate (eGFR) were determined in plasma/blood of 9 years old children. In linear regression models, adjusted for child sex, age, height-for-age z score (HAZ), BMI-for-age z score (BAZ), socioeconomic status (SES) and maternal education, each doubling of maternal and early childhood U–Cd was associated with 0.73 and 0.82 mmHg increase in systolic blood pressure (SBP) respectively. Both early and concurrent childhood U–Cd was associated with diastolic (D)BP (β = 0.80 at 4.5 years; β = 0.75 at 9 years). Each doubling of U–Cd at 9 years was associated with decrements of 4.98 mg/dL of total cholesterol (TC), 1.75 mg/dL high-density lipoprotein (HDL), 3.85 mg/dL low-density lipoprotein (LDL), 0.43 mg/dL glucose and 4.29 units eGFR. Each doubling of maternal U–Cd was associated with a decrement of 1.23 mg/dL HDL. Both maternal and childhood U–As were associated with decrement in TC and HDL. Multiple comparisons were checked with family-wise error rate Bonferroni-type-approach. The negative associations of arsenic and cadmium with biomarkers of CMD in preadolescent children indicated influence of both metal(loid)s on fat and carbohydrate metabolism, while cadmium additionally influenced kidney function and BP. Thus, fewer outcomes were associated with U–As compared to U–Cd at preadolescence.
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- Akhtar, Nadia, et al.
(författare)
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Uncovering Barriers for Industrial Symbiosis : Assessing Prospects for Eco-Industrialization through Small and Medium-Sized Enterprises in Developing Regions
- 2022
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 14:11, s. 6898-
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Tidskriftsartikel (refereegranskat)abstract
- Industrialization is indispensable for socio-economic development but poses far-reaching implications for resources and the environment. Consequently, industrial symbiosis-based collaborations are gaining recognition as a viable strategy to manage resource consumption for mitigating environmental distress. However, these types of synergistic collaborations are more prevalent in developed regions and are linked to larger-sized industries. Admittedly, such collaborative partnerships are less focused in developing regions and small- to medium-size enterprises (SMEs). This calls for discovering the potentials for synergistic partnerships among the small and medium scaled industrial entities in developing economies. Therefore, the study was designed to identify, assess and explore the prospects of symbiotic collaborations among SMEs in Pakistan. Moreover, the inputs are equally relevant for developing and expanding such productive associations in developing regions. Data regarding inputs and outputs was collected from sixty-one (61) SMEs through field survey during the year 2019. It was processed and analyzed to uncover existing and potential synergies among SMEs. The significant findings transpired that the majority of collaborative linkages are bilateral and are driven to maximize economic gains. However, informal networks of recyclers and absence of a stringent regulatory regime are the ground realities in developing/transforming economies. These factors symptomatically interfere with the process of formal/informal exchanges between and among firms. Furthermore, it was observed that the lack of awareness and impulsiveness of SMEs, as well as the inconsistent supply of by-products, act as barriers for such partnerships in developing countries. It calls for proactive engagements and facilitations from the state institutions through policy instruments. The study addresses a broad audience including industrialists, investors, policy makers and researchers engaged in IS studies. Moreover, the inputs will provide impetus for stimulating eco-industrial progress in developing regions such as Pakistan.
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