Displaying publications 1 - 20 of 261 in total

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  1. Choudhury BP, Roychoudhury S, Sengupta P, Toman R, Dutta S, Kesari KK
    Adv Exp Med Biol, 2022;1391:83-95.
    PMID: 36472818 DOI: 10.1007/978-3-031-12966-7_6
    Arsenic (As) is one of the most potent natural as well as anthropogenic metalloid toxicants that have various implications in the everyday life of humans. It is found in several chemical forms such as inorganic salt, organic salt, and arsine (gaseous form). Although it is mostly released via natural causes, there are many ways through which humans come in contact with As. Drinking water contamination by As is one of the major health concerns in various parts of the world. Arsenic exposure has the ability to induce adverse health effects including reproductive problems. Globally, around 15% of the couples are affected with infertility, of which about 20-30% are attributed to the male factor. Arsenic affects the normal development and function of sperm cells, tissue organization of the gonads, and also the sex hormone parameters. Stress induction is one of the implications of As exposure. Excessive stress leads to the release of glucocorticoids, which impact the oxidative balance in the body leading to overproduction of reactive oxygen species (ROS). This may in turn result in oxidative stress (OS) ultimately interfering with normal sperm and hormonal parameters. This study deals with As-induced OS and its association with sex hormone disruption as well as its effect on sperm and semen quality.
  2. Sengupta P, Nwagha U, Dutta S, Krajewska-Kulak E, Izuka E
    Afr Health Sci, 2017 Jun;17(2):418-427.
    PMID: 29062337 DOI: 10.4314/ahs.v17i2.16
    PURPOSE: This meta-analysis, following our previous reports those documented an overall 57% diminution in mean sperm concentration around the globe over past 35 years and 32.5% decline in past 50 years in European population, attempts to report the declining trend of sperm concentrations in African population between 1965 and 2015.

    METHODS: In the course of retrieval of data following MOOSE guidelines and PRISMA checklist, we found a total of fourteen studies that have been conducted during that period on altering sperm concentration in the African male.

    RESULTS: Following analysis of the data, a time-dependent decline of sperm concentration (r = -0.597, p = 0.02) and an overall 72.6% decrease in mean sperm concentration was noted in the past 50 years. The major matter of concern is the present mean concentration (20.38×106/ml) is very near to WHO cut-off value of 2010 of 15×106/ml. Several epidemic diseases, genital tract infection, pesticides and heavy metal toxicity, regular consumption of tobacco and alcohol are reported as predominant causative factors.

    CONCLUSION: This comprehensive, evidence-based meta-analysis and systematic review concisely presents the evidence of decreased sperm concentration in the African male over past 50 years with possible causative factors to serve the scientific research zone related to male reproductive health.

  3. Sengupta P, Dutta S, Krajewska-Kulak E
    Am J Mens Health, 2017 07;11(4):1279-1304.
    PMID: 27099345 DOI: 10.1177/1557988316643383
    Reports regarding the changes in sperm concentration in different counties of the world are inconsistent. Furthermore, the reports that sprung up from specific epidemiological and experimental examinations did not include data of prior studies or geographical variations. The current study, following a previous report of massive fall in semen volume over the past 33 years, attempts to delineate the trend of altering sperm concentrations and factors responsible for this by reviewing article published from 1980 to July 2015 with geographic differences. The current study identified an overall 57% diminution in mean sperm concentration over the past 35 years ( r = -.313, p = .0002), which, when analyzed for each geographical region, identified a significant decline in North America, Europe, Asia, and Africa. An increasing trend of sperm concentration was identified only in Australia. The association of male age with such a trend ( R2 = .979) is reported. The authors also correlated male fertility with sperm concentration. Thus, this comprehensive, evidence-based literature review aims to concisely and systematically present the available data on sperm concentration from 1980 to 2015, as well as to statistically analyze the same and correlate male health with the declining pattern of sperm count in a single scientific review to serve the scientific research zone related to reproductive health. It points to the threat of male infertility in times ahead.
  4. Agarwal A, Leisegang K, Panner Selvam MK, Durairajanayagam D, Barbarosie C, Finelli R, et al.
    Andrologia, 2021 Apr;53(3):e13961.
    PMID: 33491204 DOI: 10.1111/and.13961
    In 2020, the COVID-19 pandemic led to the suspension of the annual Summer Internship at the American Center for Reproductive Medicine (ACRM). To transit it into an online format, an inaugural 6-week 2020 ACRM Online Mentorship Program was developed focusing on five core pillars of andrology research: scientific writing, scientific methodology, plagiarism understanding, soft skills development and mentee basic andrology knowledge. This study aims to determine mentee developmental outcomes based on student surveys and discuss these within the context of the relevant teaching and learning methodology. The mentorship was structured around scientific writing projects established by the team using a student-centred approach, with one-on-one expert mentorship through weekly formative assessments. Furthermore, weekly online meetings were conducted, including expert lectures, formative assessments and social engagement. Data were collected through final assessments and mentee surveys on mentorship outcomes. Results show that mentees (n = 28) reported a significant (p 
  5. Dutta S, Henkel R, Agarwal A
    Andrologia, 2021 Mar;53(2):e13718.
    PMID: 32628294 DOI: 10.1111/and.13718
    Male infertility has a complex etiology, and many times, the cause is unknown. While routine semen analysis provides an overview of basic semen parameters, such as sperm concentration, motility, viability and morphology, a significant overlap of these parameters has been reported in fertile and infertile men. Moreover, conventional semen parameters do not reveal the cellular or molecular mechanisms of sperm dysfunctions leading to infertility. Therefore, sperm functional parameters, including sperm chromatin integrity, are evaluated to provide information on subtle sperm defects that are not routinely identified. Incomplete or defective sperm chromatin condensation increases the susceptibility of the sperm DNA to oxidative damage or other factors. To evaluate sperm chromatin integrity, different methods with varying degrees of diagnostic and prognostic capabilities are available. Among these assays, SCSA, TUNEL and SCD assays are most commonly used. While these assays rather evaluate the DNA directly for damages, the aniline blue and chromomycin A3 stains test for the quality of chromatin condensation. Thus, this review discusses and compares different methods used to evaluate sperm chromatin integrity and condensation, and their inclusion in the routine evaluation of the male infertility.
  6. Leisegang K, Dutta S
    Andrologia, 2021 Feb;53(1):e13595.
    PMID: 32330362 DOI: 10.1111/and.13595
    Alongside an increasing prevalence of couple and male infertility, evidence suggests there is a global declining trend in male fertility parameters over the past few decades. This may, at least in part, be explained through detrimental lifestyle practices and exposures. These include alcohol and tobacco consumption, use of recreational drugs (e.g., cannabis, opioids and anabolic steroids), poor nutritional habits, obesity and metabolic syndrome, genital heat stress (e.g., radiation exposure through cell phones and laptops, prolonged periods of sitting, tight-fitting underwear and recurrent hot baths or saunas), exposure to endocrine-disrupting chemicals (e.g., pesticide residue, bisphenol A, phthalates and dioxins) and psychological stress. This review discusses these lifestyle practices and the current evidence associated with male infertility. Furthermore, known mechanisms of action are also discussed for each of these. Common mechanisms associated with a reduction in spermatogenesis and/or steroidogenesis due to unfavourable lifestyle practices include inflammation and oxidative stress locally or systemically. It is recommended that relevant lifestyle practices are investigated in clinical history of male infertility cases, particularly in unexplained or idiopathic male infertility. Appropriate modification of detrimental lifestyle practices is further suggested and recommended in the management of male infertility.
  7. Darbandi M, Darbandi S, Agarwal A, Baskaran S, Sengupta P, Dutta S, et al.
    Andrologia, 2019 Feb;51(1):e13159.
    PMID: 30298637 DOI: 10.1111/and.13159
    Kelch-like ECH-associated protein 1 (keap1)-nuclear factor-erythroid 2-related factor 2 (Nrf2) pathway is one of the master regulators of cellular defence against oxidative stress. Epigenetic alterations like hypermethylation of keap1 gene impair keap1-Nrf2 system in several oxidative stress-associated diseases. The objective of this study was to evaluate the epigenetic status of keap1 in sperm DNA of normozoospermic subjects, having different levels of reactive oxygen species (ROS) in seminal plasma. Semen samples were obtained from 151 apparently healthy male partners of couples who attended the Avicenna infertility clinic. Samples were categorised into four groups according to their ROS levels: group A (n = 39, ROS s per 106 spermatozoa), group B (n = 38, 20 ≤ ROS s per 106 spermatozoa), group C (n = 31, 40 ≤ ROS s per 106 spermatozoa) and group D; (n = 43, ROS ≥ 60 RLU/s per 106 spermatozoa). Keap1 methylation status was assessed using methylation-specific PCR along with seminal total antioxidant capacity. The results showed no significant alterations in keap1 methylation in any groups, whereas the total antioxidant capacity enhanced with increasing levels of ROS exposure. These results indicate that keap1 was not methylated during ROS elevation and oxidative stress, suggesting that the cells have adopted other mechanisms to elevate antioxidant level.
  8. Dutta S, Majzoub A, Agarwal A
    Arab J Urol, 2019;17(2):87-97.
    PMID: 31285919 DOI: 10.1080/2090598X.2019.1599624
    Objective: To review and present the most distinct concepts on the association of reactive oxygen species (ROS) with male reproduction. Methods: The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines were used to search PubMed, Medline, EMBASE, and the Cochrane electronic databases for studies investigating the role of oxidative stress (OS) on sperm function. Results: The literature search yielded 1857 studies, of which 1791 articles were excluded because of irrelevance of data, non-English language, non-human nature or because they were case reports or commentaries. All included studies were reviews (46), meta-analyses (one), original research studies (18) and guideline articles (one). The studies were published between 1984 and 2018. Under normal physiological conditions, ROS are vital for sperm maturation, hyperactivation, capacitation, acrosome reaction, as well as fertilisation. However, a number of endogenous and exogenous causes may induce supra-physiological levels of ROS resulting in lipid peroxidation, sperm DNA fragmentation and apoptosis, and consequently infertility. Several laboratory testing methods can be used in infertile men to diagnose OS. Treatment usually involves antioxidant supplementation and, when possible, elimination of the causative factor. Conclusion: OS is an important cause of male factor infertility. Its assessment provides essential information that can guide treatment strategies aimed at improving the male's reproductive potential. Abbreviations: bp: base-pair; CAT: catalase; LPO: lipid peroxidation; MDA: malondialdehyde; MiOXSYS: Male Infertility Oxidative System; mtDNA: mitochondrial DNA; NAD(PH): nicotinamide adenine dinucleotide (phosphate); NO: nitric oxide; 8-OHdG: 8-hydroxy-2'-deoxyguanosine; ORP: oxidation-reduction potential; OS: oxidative stress; PKA: protein kinase A; PLA2: phospholipase A2; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PUFA: poly-unsaturated fatty acid; ROS: reactive oxygen species; SOD: superoxide dismutase; TAC: total antioxidant capacity; TBA: thiobarbituric acid.
  9. Sengupta P, Dutta S, Liew FF, Dhawan V, Das B, Mottola F, et al.
    Biomolecules, 2023 Dec 07;13(12).
    PMID: 38136630 DOI: 10.3390/biom13121759
    Recent advancements in the understanding of how sperm develop into offspring have shown complex interactions between environmental influences and genetic factors. The past decade, marked by a research surge, has not only highlighted the profound impact of paternal contributions on fertility and reproductive outcomes but also revolutionized our comprehension by unveiling how parental factors sculpt traits in successive generations through mechanisms that extend beyond traditional inheritance patterns. Studies have shown that offspring are more susceptible to environmental factors, especially during critical phases of growth. While these factors are broadly detrimental to health, their effects are especially acute during these periods. Moving beyond the immutable nature of the genome, the epigenetic profile of cells emerges as a dynamic architecture. This flexibility renders it susceptible to environmental disruptions. The primary objective of this review is to shed light on the diverse processes through which environmental agents affect male reproductive capacity. Additionally, it explores the consequences of paternal environmental interactions, demonstrating how interactions can reverberate in the offspring. It encompasses direct genetic changes as well as a broad spectrum of epigenetic adaptations. By consolidating current empirically supported research, it offers an exhaustive perspective on the interwoven trajectories of the environment, genetics, and epigenetics in the elaborate transition from sperm to offspring.
  10. He M, Zhu X, Dutta S, Khanal SK, Lee KT, Masek O, et al.
    Bioresour Technol, 2022 Jan;344(Pt B):126395.
    PMID: 34822987 DOI: 10.1016/j.biortech.2021.126395
    Hydrothermal carbonization (HTC) provides a promising alternative to valorize food waste digestate (FWD) and avoid disposal issues. Although hydrochar derived from FWD alone had a low calorific content (HHV of 13.9 MJ kg-1), catalytic co-HTC of FWD with wet lignocellulosic biomass (e.g., wet yard waste; YW) and 0.5 M HCl exhibited overall superior attributes in terms of energy recovery (22.7 MJ kg-1), stable and comprehensive combustion behaviour, potential nutrient recovery from process water (2-fold higher N retention and 129-fold higher P extraction), and a high C utilization efficiency (only 2.4% C loss). In contrast, co-HTC with citric acid provided ∼3-fold higher autogenous pressure, resulting in a superior energy content of 25.0 MJ kg-1, but the high C loss (∼74%) compromised the overall environmental benefits. The results of this study established a foundation to fully utilize FWD and YW hydrochar for bioenergy application and resource recovery from the process water.
  11. Dutta S, Singh G, Sreejith S, Mamidi MK, Husin JM, Datta I, et al.
    CNS Neurosci Ther, 2013 Jan;19(1):5-11.
    PMID: 23253099 DOI: 10.1111/cns.12027
    Neurodegenerative diseases are devastating because they cause increasing loss of cognitive and physical functions and affect an estimated 1 billion individuals worldwide. Unfortunately, no drugs are currently available to halt their progression, except a few that are largely inadequate. This mandates the search of new treatments for these progressively degenerative diseases. Neural stem cells (NSCs) have been successfully isolated, propagated, and characterized from the adult brains of mammals, including humans. The confirmation that neurogenesis occurs in the adult brain via NSCs opens up fresh avenues for treating neurological problems. The proof-of-concept studies demonstrating the neural differentiation capacity of stem cells both in vitro and in vivo have raised widespread enthusiasm toward cell-based interventions. It is anticipated that cell-based neurogenic drugs may reverse or compensate for deficits associated with neurological diseases. The increasing interest of the private sector in using human stem cells in therapeutics is evidenced by launching of several collaborative clinical research activities between Pharma giants and research institutions or small start-up companies. In this review, we discuss the major developments that have taken place in this field to position stem cells as a prospective candidate drug for the treatment of neurological disorders.
  12. Hari P, Dutta S, Hanapi NSBM, Ali TBT, Thomas B, Tang TH, et al.
    Can J Dent Hyg, 2021 06 01;55(2):101-109.
    PMID: 34221034
    Objective: To evaluate the clinical efficacy and safety profile of a novel-designed isosceles-configured (SUN Teeth™) toothbrush in comparison to a standard reference toothbrush with end-rounded bristles (approved by the American Dental Association [ADA]).

    Methods: The sample size was determined using the G-Power-software, version 3.1.2 and, accordingly, 104 subjects (ages 19 years to 25 years) were recruited and randomized into either the test group (n = 54) or the control group (n = 50). Prior to study commencement, scaling was performed followed by abstinence from oral hygiene for 24 hours. Baseline pre-brushing gingivitis scores (Lobene) and plaque scores (Turesky modification of Quigley Hein) were recorded. Brushing was performed for 3 minutes and post-brushing scores were recorded on days 1, 14, and 28 without refraining from regular brushing. Data were analysed with Statistical Package for Social Sciences (IBM-SPSS, v.25.0).

    Results: Post-brushing plaque scores showed significant reduction in both groups at all time intervals. However, no significant differences between the test and control brush groups were achieved at any time points.

    Conclusion: The isosceles-configured SUN TeethTMtoothbrush is equivalent in plaque removal to the conventional flat-bristled ADA reference brush.

  13. Ahammed KS, Pachal S, Majumdar P, Dutta S
    Chembiochem, 2023 Apr 17;24(8):e202200715.
    PMID: 36747378 DOI: 10.1002/cbic.202200715
    The dynamic topological states of chromosomal DNA regulate many cellular fundamental processes universally in all three domains of life, that is, bacteria, archaea, and eukaryotes. DNA-binding proteins maintain the regional and global supercoiling of the chromosome and thereby regulate the chromatin architecture that ultimately influences the gene expression network and other DNA-centric molecular events in various microenvironments and growth phases. DNA-binding small molecules are pivotal weapons for treating a wide range of cancers. Recent advances in single-molecule biophysical tools have uncovered the fact that many DNA-binding ligands not only alter the regional DNA supercoiling but also modulate the overall morphology of DNA. Here we provide insight into recent advances in atomic force microscopy (AFM) acquired DNA structural change induced by therapeutically important mono- and bis-intercalating anticancer agents as well as DNA-adduct-forming anticancer drugs. We also emphasize the growing evidence of the mechanistic relevance of changes in DNA topology in the anticancer cellular responses of DNA-targeting chemotherapeutic agents.
  14. Alahmar AT, Calogero AE, Singh R, Cannarella R, Sengupta P, Dutta S
    Clin Exp Reprod Med, 2021 Jun;48(2):97-104.
    PMID: 34078005 DOI: 10.5653/cerm.2020.04175
    Male infertility has a complex etiopathology, which mostly remains elusive. Although research has claimed that oxidative stress (OS) is the most likely underlying mechanism of idiopathic male infertility, the specific treatment of OS-mediated male infertility requires further investigation. Coenzyme Q10 (CoQ10), a vitamin-like substance, has been found in measurable levels in human semen. It exhibits essential metabolic and antioxidant functions, as well as playing a vital role in mitochondrial bioenergetics. Thus, CoQ10 may be a key player in the maintenance of biological redox balance. CoQ10 concentrations in seminal plasma directly correlate with semen parameters, especially sperm count and sperm motility. Seminal CoQ10 concentrations have been shown to be altered in various male infertility states, such as varicocele, asthenozoospermia, and medical or surgical regimens used to treat male infertility. These observations imply that CoQ10 plays an important physiological role in the maintenance and amelioration of semen quality. The present article thereby aimed to review the possible mechanisms through which CoQ10 plays a role in the regulation of male reproductive function, and to concisely discuss its efficacy as an ameliorative agent in restoring semen parameters in male infertility, as well as its impact on OS markers, sperm DNA fragmentation, pregnancy, and assisted reproductive technology outcomes.
  15. Alahmar AT, Sengupta P, Dutta S, Calogero AE
    Clin Exp Reprod Med, 2021 Jun;48(2):150-155.
    PMID: 34078008 DOI: 10.5653/cerm.2020.04084
    OBJECTIVE: Oxidative stress (OS) plays a key role in the etiology of unexplained male infertility. Coenzyme Q10 (CoQ10) is a potent antioxidant that may improve semen quality and OS in infertile men with idiopathic oligoasthenoteratospermia (OAT), but the underlying mechanism is unknown. Therefore, the present study was undertaken to investigate the effect of CoQ10 on OS markers and sperm DNA damage in infertile patients with idiopathic OAT.

    METHODS: This prospective controlled study included 50 patients with idiopathic OAT and 50 fertile men who served as controls. All patients underwent a comprehensive medical assessment. Patients and controls received 200 mg of oral CoQ10 once daily for 3 months. Semen and blood were collected and analyzed for sperm parameters, seminal CoQ10 levels, reactive oxygen species (ROS) levels, total antioxidant capacity, catalase, sperm DNA fragmentation (SDF), and serum hormonal profile.

    RESULTS: The administration of CoQ10 to patients with idiopathic OAT significantly improved sperm quality and seminal antioxidant status and significantly reduced total ROS and SDF levels compared to pretreatment values.

    CONCLUSION: CoQ10, at a dose of 200 mg/day for 3 months, may be a potential therapy for infertile patients with idiopathic OAT, as it improved sperm parameters and reduced OS and SDF in these patients.

  16. Sirunyan AM, Tumasyan A, Adam W, Ambrogi F, Bergauer T, Dragicevic M, et al.
    Comput Softw Big Sci, 2020;4(1):10.
    PMID: 33196702 DOI: 10.1007/s41781-020-00041-z
    We describe a method to obtain point and dispersion estimates for the energies of jets arising from b quarks produced in proton-proton collisions at an energy of s = 13 TeV at the CERN LHC. The algorithm is trained on a large sample of simulated b jets and validated on data recorded by the CMS detector in 2017 corresponding to an integrated luminosity of 41 fb - 1 . A multivariate regression algorithm based on a deep feed-forward neural network employs jet composition and shape information, and the properties of reconstructed secondary vertices associated with the jet. The results of the algorithm are used to improve the sensitivity of analyses that make use of b jets in the final state, such as the observation of Higgs boson decay to b b ¯ .
  17. Dutta S, Singhal S, Shah RB, Haque M
    Crit Rev Oncog, 2022;27(4):23-37.
    PMID: 37199300 DOI: 10.1615/CritRevOncog.2022046361
    Oral cancers (OCs), being one of the frequent malignancies in the head and neck region, need prompt diagnosis and treatment. Apart from basic therapeutic modalities, immunotherapy has now been utilized as a novel approach to combat the disease. With the comprehension of the strategies adopted by cancer cells to evade the immune elimination by the body's immune system, targeted immunotherapies have now become the core area of research. The immune expression of epidermal growth factor receptor (EGFR), programmed cell death protein ligand-1 (PDL-1), etc., are enhanced in OC and have been associated with evasion of the immune system. Targeted immunotherapies now include monoclonal antibodies targeting EGFR like cetuximab and panitumumab, programmed cell death-1 (PD-1) inhibitors like pembrolizumab, cemiplimab, and nivolumab, and PD-L1 inhibitors like atezolizumab, avelumab, and durvalumab. Targeted immunotherapies like chimeric antigen receptor T-cell treatment and small molecule inhibitors are in several clinical trials tried as monotherapy and adjuvant immunotherapy and have shown promising results. Other immunothera-peutic approaches such as cytokines like interferons or interleukins, vaccines, and gene therapy have also been an area of research for the management of OC. However, the cautious selection of appropriate patients with specific immune characteristics as a candidate for immunotherapeutic agents is a crucial component of targeted immunotherapy. This article elaborates on the immune contexture of oral cancer cells, the mechanism of immune evasion by cancer cells, targets for immunotherapies, existent immunotherapeutic agents, and prospects in the field of immunotherapy.
  18. Chowdhury K, Ahmad R, Sinha S, Dutta S, Haque M
    Cureus, 2023 Feb;15(2):e35154.
    PMID: 36819973 DOI: 10.7759/cureus.35154
    Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.
  19. Godman B, Haque M, Kumar S, Islam S, Charan J, Akter F, et al.
    Curr Med Res Opin, 2021 09;37(9):1529-1545.
    PMID: 34166174 DOI: 10.1080/03007995.2021.1946024
    INTRODUCTION: Prevalence rates for diabetes mellitus continue to rise, which, coupled with increasing costs of complications, has appreciably increased expenditure in recent years. Poor glycaemic control including hypoglycaemia enhances complication rates and associated morbidity, mortality and costs. Consequently, this needs to be addressed. Whilst the majority of patients with diabetes have type-2 diabetes, a considerable number of patients with diabetes require insulin to help control their diabetes. Long-acting insulin analogues were developed to reduce hypoglycaemia associated with insulin and help improve adherence, which can be a concern. However, their considerably higher costs have impacted on their funding and use, especially in countries with affordability issues. Biosimilars can help reduce the costs of long-acting insulin analogues thereby increasing available choices. However, the availability and use of long-acting insulin analogues can be affected by limited price reductions versus originators and limited demand-side initiatives to encourage their use. Consequently, we wanted to assess current utilisation rates for long-acting insulin analogues, especially biosimilars, and the rationale for patterns seen, across multiple Asian countries ranging from Japan (high-income) to Pakistan (lower-income) to inform future strategies.

    METHODOLOGY: Multiple approaches including assessing utilization and prices of insulins including biosimilars among six Asian countries and comparing the findings especially with other middle-income countries.

    RESULTS: Typically, there was increasing use of long-acting insulin analogues among the selected Asian countries. This was especially the case enhanced by biosimilars in Bangladesh, India, and Malaysia reflecting their perceived benefits. However, there was limited use in Pakistan due to issues of affordability similar to a number of African countries. The high use of biosimilars in Bangladesh, India and Malaysia was helped by issues of affordability and local production. The limited use of biosimilars in Japan and Korea reflects limited price reductions and demand-side initiatives similar to a number of European countries.

    CONCLUSIONS: Increasing use of long-acting insulin analogues across countries is welcomed, adding to the range of insulins available, which increasingly includes biosimilars. A number of activities are needed to enhance the use of long-acting insulin analogue biosimilars in Japan, Korea and Pakistan.

  20. Barton MA, Simha P, Magri ME, Dutta S, Kabir H, Selvakumar A, et al.
    Data Brief, 2021 Apr;35:106794.
    PMID: 33604424 DOI: 10.1016/j.dib.2021.106794
    We present here a data set generated from a multinational survey on opinions of university community members on the prospect of consuming food grown with human urine as fertiliser and about their urine recycling perceptions in general. The data set comprises answers from 3,763 university community members (students, faculty/researchers, and staff) from 20 universities in 16 countries and includes demographic variables (age bracket, gender, type of settlement of origin, academic discipline, and role in the university). Questions were designed based on Ajzen's theory of planned behaviour to elicit information about three components of behavioural intention-attitudes, subjective norms, and perceived behavioural control. Survey questions covered perceived risks and benefits (attitudes), perceptions of colleagues (injunctive social norm) and willingness to consume food grown with cow urine/faeces (descriptive social norm), and willingness to pay a price premium for food grown with human urine as fertiliser (perceived behavioural control). We also included a question about acceptable urine recycling and disposal options and assessed general environmental outlook via the 15-item revised New Ecological Paradigm (NEP) scale. Data were collected through a standardised survey instrument translated into the relevant languages and then administered via an online form. Invitations to the survey were sent by email to university mailing lists or to a systematic sample of the university directory. Only a few studies on attitudes towards using human urine as fertiliser have been conducted previously. The data described here, which we analysed in "Willingness among food consumers at universities to recycle human urine as crop fertiliser: Evidence from a multinational survey" [1], may be used to further understand potential barriers to acceptance of new sanitation systems based on wastewater source separation and urine recycling and can help inform the design of future sociological studies.
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