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Cancer-associated fibroblasts (CAFs) play a key role in metabolic reprogramming and are well-established contributors to drug resistance in colorectal cancer (CRC). To exploit this metabolic crosstalk, we integrated a systems biology approach that identified key metabolic targets in a data-driven method and validated them experimentally. This process involved a novel machine learning-based method to computationally screen, in a high-throughput manner, the effects of enzyme perturbations predicted by a computational model of CRC metabolism. This approach reveals the network-wide effects of metabolic perturbations. Our results highlighted hexokinase (HK) as a crucial target, which subsequently became our focus for experimental validation using patient-derived tumor organoids (PDTOs). Through metabolic imaging and viability assays, we found that PDTOs cultured in CAF-conditioned media exhibited increased sensitivity to HK inhibition, confirming the model predictions. Our approach emphasizes the critical role of integrating computational and experimental techniques in exploring and exploiting CRC-CAF crosstalk.

Background: New York State implemented CFTR gene sequencing into the Cystic Fibrosis newborn screening (CF NBS) algorithm on 12/1/2017 to reduce false positive screens. With addition of sequencing, infants with 2 CFTR variants but low or intermediate sweat chloride levels classified as CFTR-related metabolic syndrome/CF screen-positive, inconclusive diagnosis (CRMS/CFSPID) are identified at a higher frequency, posing challenges to clinicians and families., Methods: Data from 375 screen-positive newborns between 12/1/2017 and 11/30/2020 were analyzed. We summarized 1-3 years of clinical follow-up for babies with CRMS/CFSPID following implementation of the IRT-DNA-SEQ algorithm., Results: Among 375 newborns referred, 223 (59.5 %) were classified as CRMS/CFSPID. Overall, 195/223 (87.4 %) had a CF-causing/pathogenic/likely pathogenic CFTR variant and a variant of varying clinical consequence (VCC) or uncertain significance (VUS). The most common VCC or VUS was 5T-12TG [n = 90/223 (40 %)]. All initial and repeat sweat chloride test (SCT) values for this cohort were <60 mmol/L after 1-3 years follow-up. Ninety-nine infants had ≥1 repeat SCT. Forty-two (18.8 %) had ≥1 SCT in the intermediate range (30-59 mmol/L) and 181 (81.2 %) were <30 mmol/L. Twenty-nine infants had sweat chloride increasing ≥5 mmol/L per year (29.3 % of infants with repeat testing). Fecal elastase was reported for 114/223 infants; none were abnormal. There were no conversions to CF during the 3-year follow-up period, however 2 infants have subsequently converted with diagnostic SCTs., Conclusions: The New York experience may help inform updates to clinical guidelines, which are needed to optimize care, management, counseling, and long-term follow-up of infants and children with CRMS/CFSPID., Competing Interests: Declaration of competing interest None., (Copyright © 2024 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.)

In this study, a series of chiral amido-oxazoline ligands was synthesized with a primary focus on immobilizing the most effective ligands on MCM-41 mesoporous material. Following several attempts, the para -nitro group of the chiral amido-oxazoline ligands was successfully reduced to amino group, enabling their immobilization on MCM-41. The resulting chiral heterogeneous amido-oxazoline ligands were characterized using various techniques, including FT-IR, XRD, TGA, SEM, TEM, EDX, and BET-BJH, confirming the successful immobilization of the amido-oxazoline ligands. A comparison of the efficiency of the homogeneous and heterogeneous amido-oxazoline-based ligands in the Kharasch-Sosnovsky and Henry reactions revealed better performance of the heterogeneous ligand. The immobilized amido-oxazoline-copper complexes exhibited remarkable catalytic activity, achieving excellent yields and enantioselectivities (up to 88 % ee ) in the Kharasch-Sosnovsky reaction, and delivering excellent yields with moderate enantioselectivities in the Henry reaction. Notably, the Henry reaction proceeded with moderate diastereoselectivity, favoring the syn diastereomer, under solvent-free conditions, highlighting the sustainability of the process. The heterogeneous nature of the catalysts facilitated effortless recovery and efficient reusability., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Acute coronary syndrome (ACS) is frequently reported in patients with coronavirus disease 2019 (COVID-19). Cytokine storm induced by interleukin-6 (IL-6) has been suggested to potentially cause myocardial injury in COVID-19. We investigated the association between baseline level of IL-6 and development of ACS in COVID-19 patients., Methods: Demographic and clinical data of hospitalized COVID-19 patients from 2020 to 2022 were reviewed. Extracted data including patient characteristics, laboratory biomarkers, and systemic inflammation indexes in patients with or without ACS were reviewed and analyzed. Logistic regression models were applied to analyze predictors of ACS development and receiver-operating characteristic (ROC) curves were used to assess discriminatory power of IL-6 and other risk factors for predicting ACS development., Results: Among 1,753 COVID-19 patients, 37 cases experienced ACS and 159 patients without main COVID-19 complications were randomly selected as controls. ACS patients were older (p = 0.001) and suffered from more comorbidities including diabetes (43% vs. 18%, p = 0.001), hypertension (40.5% vs. 24.5%, p = 0.050), ischemic heart disease (49% vs. 9%, p = 0.001), and hyperlipidemia (19% vs. 5%, p = 0.010). Also, decreased level of consciousness (31.6% vs. 2.5%, p = 0.001), ICU admission (65% vs. 2%, p = 0.001), and mortality events (70% vs. 0.6%, p = 0.001) were more prevalent in the ACS group. Baseline levels of IL-6 (p = 0.001), D-dimer (p = 0.026), troponin (p = 0.001), blood urea nitrogen (p = 0.002), and creatinine (p = 0.008) were higher in ACS patients but erythrocyte sedimentation rate (p = 0.013), hemoglobin (p = 0.033), and red blood cells (p = 0.028) were lower compared with controls. Also, age (OR: 1.06, p = 0.019), IL-6 (OR: 1.44, p = 0.047), and cardiovascular disease (CVD) (OR: 3.66, p = 0.043) were associated with ACS development. The area under the curve (AUC) of IL-6 and combined predictors respectively was 0.661 (p = 0.002) and 0.829 (p = 0.001)., Conclusions: High IL-6 concentration at baseline is a strong predictor for ACS development in COVID-19 patients. Also, elderly and concurrent CVD are significantly associated with ACS development., (© 2024. The Author(s).)

Objective: This study aims to compare the effects of two medicines, Escitalopram and Bupropion, on HF patients who have depression symptoms., Methods: This double-blind randomized clinical trial study was conducted on HF patients with depression symptoms at the Heart Failure Clinics affiliated with Babol University of Medical Sciences. In this study, 80 participants were examined for depression based on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS). They were randomly allocated into two groups of 40 participants treated with Bupropion 75 mg and Escitalopram 5 mg. Following the intervention, the individuals were assessed in terms of their depression score at 4, 8, and 12-week intervals. Finally, the data were analyzed using SPSS version 22.0., Results: In the examination of Beck and Hamilton scores in the two research groups during different follow-ups, a significant decrease was found over time ( P <0.001 for both medicines). While the effectiveness of the two medicines was the same at different times ( P >0.05 in all cases). Comparing the side effects between the two intervention groups, the orgasm disorder ( P =0.018) and sexual dysfunction ( P <0.001) were reported significantly more in the Escitalopram group than in the Bupropion group., Conclusions: The findings of this study showed that Escitalopram has the same efficacy as Bupropion in the treatment of depression symptoms in HF patients., Competing Interests: The authors declare no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Spinal cord infarction (SCI) is a rare disease representing nearly 1% of all strokes with a wide variety of symptoms at presentation. SCI diagnosis is very challenging owing to its low incidence and the variety of symptoms, and could be misdiagnosed with neuromyelitis optica spectrum disorders (NMOSD)., Case Presentation: We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities., Discussion: Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI., (© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.)

Modern genomic datasets, like those generated under the 1000 Genome Project, contain millions of variants belonging to known haplotypes. Although these datasets are more representative than a single reference sequence and can alleviate issues like reference bias, they are significantly more computationally burdensome to work with, often involving large-indexed genome graph data structures for tasks such as read mapping. The construction, preprocessing, and mapping algorithms can require substantial computational resources depending on the size of these variant sets. Moreover, the accuracy of mapping algorithms has been shown to decrease when working with complete variant sets. Therefore, a drastically reduced set of variants that preserves important properties of the original set is desirable. This work provides a technique for finding a minimal subset of variants S such that for given parameters α and δ , all substrings up to length α in the haplotypes are guaranteed to be still alignable to the appropriate locations with either Hamming or edit distance at most δ , using only S . Our contributions include showing the NP-hardness and inapproximability of these optimization problems and providing Integer Linear Programming (ILP) formulations. Our edit distance ILP formulation carefully decomposes the problem according to variant locations, which allows it to scale to support all of chromosome 22's variants from the 1000 Genome Project. Our experiments also demonstrate a significant reduction in the number of variants. For example, for moderately long reads, e.g., α = 1000, over 75% of the variants can be removed while preserving read mappability with edit distance at most one.

Background: Mortality has been indicated to be high in patients with underlying diseases. This study aimed to examine the comorbidities is associated with a higher risk of death during the hospital course., Methods: We retrospectively evaluated the risk of in-hospital death in 1368 patients with COVID-19 admitted to 5 academic hospitals in Tehran between February 20 and June 13, 2020. We also assessed the composite end-point of intensive care unit admission, invasive ventilation, and death. The Cox proportional survival model determined the potential comorbidities associated with deaths and serious outcomes., Results: The retrospective follow-up of patients with COVID-19 over 5 months indicated 280 in-hospital deaths. Patients with diabetes (risk ratio (RR), 1.47 (95% CI, 1.10-1.95); P = 0.008) and chronic kidney disease (RR, 1.72 (95% CI, 1.16-2.56); P = 0.007) showed higher in-hospital mortality. Upon stratifying data by age, patients aged ˂65 years showed a greater risk of in-hospital death in the presence of 2 (hazard ratio (HR), 2.68 (95% CI, 1.46-4.95); P = 0.002) or more (HR, 3.47 (95% CI, 1.69-7.12); P = 0.001) comorbidities, compared with those aged ≥ 65 years., Conclusion: Having ≥ 2 comorbidities in nonelderly patients is associated with a greater risk of death during hospitalization. To reduce the mortality of COVID-19 infection, younger patients with underlying diseases should be the focus of attention for prevention strategies., Competing Interests: The authors declare that they have no competing interests., (© 2024 Iran University of Medical Sciences.)

The regeneration of bone defects that exceed 2 cm is a challenge for the human body, necessitating interventional therapies. Demineralized bone matrices (DBM) derived from biological tissues have been employed for bone regeneration and possess notable osteoinductive and osteoconductive characteristics. Nevertheless, their efficiency in regenerating critically sized injuries is limited, and therefore additional signaling cues are required. Thanks to the piezoelectric properties of the bone, external physical stimulation is shown to accelerate tissue healing. We have implanted human DBM in critically sized cranial bone defects in rat animal models and exposed them to an external magnetic field (1 T) to enhance endogenous bone formation. Our in vitro experiments showed the superior cytocompatibility of DBM compared to cell culture plates. Furthermore, alkaline phosphatase activity after 14 days and Alizarin red staining at 28 days demonstrated differentiation of rat bone marrow mesenchymal stem cells into bone lineage on DBM. Computer tomography images together with histological analyses showed that implanting DBM in the injured rats significantly enhanced bone regeneration. Notably, combining DBM transplantation with a 2 h daily exposure to a 1 T magnetic field for 2 weeks (day 7 to 21 post-surgery) significantly improved bone regeneration compared to DBM transplantation alone. This research indicates that utilizing external magnetic stimulation significantly enhances the potential of bone allografts to regenerate critically sized bone defects.

Objective:  Firefighters are at risk of experiencing heightened anxiety and alcohol use perhaps due to occupational stress. Mindfulness is related to both anxiety and alcohol use; however, research on the relations of mindfulness with anxiety and alcohol use and drinking motives among firefighters is limited. This study examined (1) whether higher anxiety was positively related to alcohol use severity and drinking related motives (e.g., coping, enhancement, social, and conformity) and (2) whether higher mindfulness would moderate the association between anxiety symptom severity and alcohol use severity and alcohol use coping motives. Methods:  Participants included urban firefighters ( N  = 679; M age  = 38.6; SD  = 8.58; 93.5% male) who completed an online survey. Five hierarchical regression analyses were conducted to evaluate the main and interactive effects of anxiety symptom severity and mindfulness on all study outcomes (i.e., alcohol use severity and four drinking motives). Results:  Anxiety symptom severity was significantly and negatively associated with mindfulness and, incrementally, positively associated with all alcohol use-related outcome variables. Mindfulness was negatively correlated with alcohol use severity and all alcohol use motives except social motives. Mindfulness moderated the effects of anxiety symptom severity on coping alcohol use motives only. Conclusion:  Mindfulness moderated, or attenuated, the positive association between anxiety symptom severity and coping-oriented alcohol use motives among professional firefighters. Results have the potential to inform treatment development and wellness programming for the fire service.

Background: Mortality rate in rural areas is a useful measure of the health of the population and the function of the health system, which varies over space and time. The objective of this research is to explore the spatial and temporal variations in the rural mortality rate in Iran at the county level in 2006, 2011, and 2016., Methods: data were gathered from the rural population and mortality statistics published by the Statistical Centre of Iran (SCI) and the National Organization for Civil Registration (NOCR). Global spatial patterns were assessed using the global Moran's I and local clusters through the local Moran's I., Results: Spatial distribution of rural mortality rate shows that during the years under study the number of counties with a lower rate has increased. The counties with rate of less form continuous areas in the southwest, central and east regions. The excess risk map reveals significant variations in both value and extent. Also, the values of Moran's index increased from 0.1848 in 2006 to 0.4041 in 2016, which indicates the strengthening of the cluster spatial pattern of the overall rural mortality rate. Local patterns have undergone substantial changes over space and time., Conclusion: The findings indicate significant spatial and temporal variations in rural mortality rates in Iran. Policy-makers can use this information to plan and enhance healthcare infrastructure in specific counties. The findings serve for evaluating the effectiveness of health policies, enabling policy-makers to make informed decisions, allocate resources efficiently and design targeted interventions for improved public health outcomes., (© 2024 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background and Objectives: Aluminum phosphide (AlP), known as "rice tablet," is widely used as an effective pesticide. However, AlP poisoning is a common cause of mortality in many countries, such as Iran. Unfortunately, there is no specific antidote for AlP toxicity to date. AlP releases phosphine gas when it is exposed to moisture or acid. Phosphine is a potent mitochondrial toxin that could significantly inhibit cellular energy metabolism. AlP poisoning is an emergency condition that needs instant and effective intervention. Dihydroxyacetone (DHA) is a simple saccharide used for several pharmacological as well as cosmetic purposes. Previously, we found that DHA could significantly prevent mitochondrial impairment induced by toxic agents such as cyanide and phosphine in various in vitro and in vivo experimental models., Methods: Hospitalized patients (n = 111) were evaluated for eligibility criteria. Among these patients, n = 35 cases were excluded due to incomplete data (n = 11) and suspicion of poisoning with poisons other than AlP (n = 24). Meanwhile, n = 76 cases with confirmed AlP poisoning were included in the study. AlP-poisoned patients who did not receive DHA (n = 18) were used as the control group.Patients (n = 58) received at least one dose of DHA (500 ml of 5 % DHA solution w/v, i.v.) as an adjuvant therapy in addition to the routine treatment of AlP poisoning. Arterial blood gas (ABG), blood pH, bicarbonate levels, and other vital signs and biochemical measurements were monitored. Moreover, the mortality rate and hospitalization time were evaluated in DHA-treated and AlP-poisoned patients without DHA administration. Several biomarkers were assessed before (upon hospitalization) and after DHA treatment. The routine tests for AlP-poisoned patients in this study were the measurement of electrolytes (K + and Na + ), WBC, RBC, hemoglobin, INR, carbonate (HCO 3 ), blood pH, PaCO 2 , and PaO 2 and SGPT, SGOT, BUN, Cr., Results: Upon patients' admission, significant decreases in blood pH (acidosis), blood PaO 2 , and HCO 3 levels were the hallmarks of AlP poisoning. It was found that DHA significantly alleviated biomarkers of AlP poisoning and tremendously enhanced patients' survival rate (65.52 % in DHA-treated vs 33.34 % in the control group) compared to patients treated based on hospital routine AlP poisoning protocols (no DHA). No significant adverse effects were evident in DHA-treated patients in the current study., Interpretation and Conclusions: These data suggest that parenteral DHA is a novel and effective antidote against AlP poisoning to be used as an adjuvant in addition to routine supportive treatment., Trial Registration: IR.SUMS.REC.1394.102., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background:  Acute aortic dissection is the most common life-threatening disorder classically presenting with tearing chest pain radiating to the back yet can have deceiving clinical presentations. Case presentation:  The patient was a 22-year-old pregnant woman (gravida 6, para 4, abortion1) at 26 weeks of gestation. She was a known case of Marfan syndrome who developed acute type A aortic dissection during pregnancy. Repair of aortic dissection was done through the Bentall procedure with a composite mechanical valved conduit while Fetal heart rate (FHR) was simultaneously monitored during surgery. Three months after surgical repair, the newborn was delivered via cesarean, and both mother and baby survived without any complications. Conclusions:  In this case, we demonstrated that repair of type A aortic dissection can be done in pregnant women with preservation of fetus in the uterus through close cooperation among all members of a multi-disciplinary team.

Background: Effective communications and secure information exchange platforms during disasters and emergencies are among the significant factors in inclusive disaster management and can radically contribute to better preparedness, efficient and timely responsiveness, and, finally, maximal reduction of damages and fatalities. The present study was to compare communications and information exchange among disaster response organizations in selected countries., Materials and Method: This applied research, carried out in 2022, was a qualitative descriptive-comparative study pursuing a content analysis approach. Australia, Turkey, India, America, Japan, and Iran constituted the statistical population of the study. The sampling was based on the countries' disaster histories and response experiences. The note-taking tool was used to extract and collect data during the review of texts, documents, and articles, and the qualitative content analysis method was employed for data analysis., Results: The outcomes of the descriptive-comparative analysis fell into four main comparative axes of the selected countries, including comparing reference, authority, and coordinator organizations in the response phase, comparing planning records and histories in disaster and emergency management comparing the contribution or non-contribution of government, military institutions, and non-governmental organizations to disaster and emergency management, the commonalities of the selected countries' disaster and emergency management and dependence on government., Conclusion: The results revealed that all selected countries depended on the government in managing disasters and emergencies, and the four communication platforms, i.e., landline telephone, mobile phone, radio communications systems, and couriers, were the common communication and information acquisition sources., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Education and Health Promotion.)

Background The recent release of large language models (LLMs) for public use, such as ChatGPT and Google Bard, has opened up a multitude of potential benefits as well as challenges. Purpose To evaluate and compare the accuracy and consistency of responses generated by publicly available ChatGPT-3.5 and Google Bard to non-expert questions related to lung cancer prevention, screening, and terminology commonly used in radiology reports based on the recommendation of Lung Imaging Reporting and Data System (Lung-RADS) v2022 from American College of Radiology and Fleischner society. Materials and Methods Forty of the exact same questions were created and presented to ChatGPT-3.5 and Google Bard experimental version as well as Bing and Google search engines by three different authors of this paper. Each answer was reviewed by two radiologists for accuracy. Responses were scored as correct, partially correct, incorrect, or unanswered. Consistency was also evaluated among the answers. Here, consistency was defined as the agreement between the three answers provided by ChatGPT-3.5, Google Bard experimental version, Bing, and Google search engines regardless of whether the concept conveyed was correct or incorrect. The accuracy among different tools were evaluated using Stata. Results ChatGPT-3.5 answered 120 questions with 85 (70.8%) correct, 14 (11.7%) partially correct, and 21 (17.5%) incorrect. Google Bard did not answer 23 (19.1%) questions. Among the 97 questions answered by Google Bard, 62 (51.7%) were correct, 11 (9.2%) were partially correct, and 24 (20%) were incorrect. Bing answered 120 questions with 74 (61.7%) correct, 13 (10.8%) partially correct, and 33 (27.5%) incorrect. Google search engine answered 120 questions with 66 (55%) correct, 27 (22.5%) partially correct, and 27 (22.5%) incorrect. The ChatGPT-3.5 is more likely to provide correct or partially answer than Google Bard, approximately by 1.5 folds (OR = 1.55, P = 0.004). ChatGPT-3.5 and Google search engine were more likely to be consistent than Google Bard by approximately 7 and 29 folds (OR = 6.65, P = 0.002 for ChatGPT and OR = 28.83, P = 0.002 for Google search engine, respectively). Conclusion Although ChatGPT-3.5 had a higher accuracy in comparison with the other tools, neither ChatGPT nor Google Bard, Bing and Google search engines answered all questions correctly and with 100% consistency.

Objectives: The current study aimed to assess the cyclic fatigue resistance of two nickel-titanium (NiTi) rotary files after immersion in 5% sodium hypochlorite (NaOCl) and Deconex. Materials and Methods: In this in vitro study, 90 new M3 Pro Gold size 25.06 and size F2 SP1 files were tested. Forty-five files of the same brand were randomly distributed into three groups (n=15) and submitted to the following immersion protocol for 5 minutes at room temperature: no immersion (control group), immersion in 5% NaOCl, and immersion in Deconex. The cyclic fatigue resistance of the files was then measured in a custom-made tester. Two-way ANOVA was applied to compare the cyclic fatigue resistance of SP1 and M3 NiTi rotary files based on the type of disinfectant solution. Post-hoc LSD test was used for pairwise comparisons and P<0.05 was considered significant. Results: Two-way ANOVA indicated a significant difference in the mean cyclic fatigue resistance of M3 and SP1 NiTi rotary files. The M3 files immersed in NaOCL displayed the lowest and the SP1 files immersed in Deconex showed the maximum cyclic fatigue resistance. The effect of type of disinfectant solution (P<0.001) and type of NiTi file (P<0.001) on cyclic fatigue resistance was statistically significant. Conclusion: The cyclic fatigue resistance of NiTi rotary instruments can be affected by immersion in disinfectants, and the specific type of file and disinfectant used will ultimately determine the extent of this impact., Competing Interests: None declared., (Copyright © 2023 The Authors. Published by Tehran University of Medical Sciences.)

Background: Clinical trials were conducted on children on side effects after vaccination. We tried to assess the frequency and onset of the main symptoms in children who were vaccinated. We aimed to evaluate early and delayed adverse effects after coronavirus disease 2019 (COVID-19) vaccine among Iranian pediatrics and adolescents in a national survey., Methods: This cross-sectional study included people <18 years who received the Soberana (PastoCoVac) and Sinopharm vaccines since 2021. The basic information was gender, age, type of vaccine, and reaction after vaccination besides the main events that occurred for them. The required data were collected via a predetermined checklist by trained interviewers through phone calls by their parents or legal guardians. The independent t test and Fisher exact test were used. P values less than 0.05 were considered significant., Results: A total of 11,042 participants (age range, 10-18 years) consisting of 5374 boys (47.8%) and 5768 girls (52.2%) were studied and 88.1% of the children (n = 9727) were vaccinated by Sinopharm and 11.9% (n = 1315) by Soberana. The data of kidney-related side effects had delayed improvement of side effects after the Sinopharm compared with the Soberana vaccines ( P = 0.012). Cardiovascular and hematological side effects showed early-onset ( P = 0.006) and delayed improvement of side effects ( P = 0.002) after the Soberana vaccine compared with the Sinopharm vaccine. Neurological side effects showed delayed improvement of side effects after the Soberana vaccine compared with the Sinopharm vaccine ( P = 0.027). Joint-related side effects showed early-onset ( P = 0.004) and delayed improvement of side effects ( P = 0.023) after the Soberana vaccine compared with the Sinopharm vaccine. Respiratory side effects showed delayed improvement of side effects after the Soberana vaccine compared with the Sinopharm vaccine ( P = 0.013), and dermatological side effects showed early-onset ( P = 0.050) and delayed improvement of side effects ( P = 0.035) after the Soberana vaccine compared with the Sinopharm vaccine. There was not any statistically significant difference regarding gastrointestinal side effects between the 2 vaccines ( P > 0.05)., Conclusion: The cardiovascular and hematological, joint-related (non-neurologic musculoskeletal) and dermatological side effects after the Soberana vaccine appear earlier and end later compared with the Sinopharm vaccine. Improvement of renal side effects in the Sinopharm vaccine group and improvement of neurological and respiratory side effects in the Soberana vaccine group occurred with delay compared with other vaccines., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)

Background: Coronavirus disease 2019 (COVID-19) is currently one of the world's most critical health issues so far. Given the importance of appropriate treatment in pregnancy and the controversies about Remdesivir effectiveness and complications, the present study aimed to evaluate the impact of Remdesivir on maternal, fetal, and perinatal outcomes in pregnant women with COVID-19 diseases., Methods: A total of 189 pregnant women with positive polymerase chain reaction (PCR) results for SARS-COV-2, and oxygen saturation [SpO2] of < 95%) were admitted to 12 hospitals affiliated with the Iran University of Medical Sciences from March 1 st , 2020 to June 7 th , 2021, namely the first four COVID-19 Picks in Iran. They were enrolled in this retrospective cohort study by census method and categorized into case and control groups, based on the inclusion of Remdesivir in their treatment protocol. Demographics, clinical outcomes, and pregnancy-related complications of the mothers and the neonates were compared between the two study groups., Results: A comparison of 54 mothers in the case and 135 in the control group showed no demographic and clinical characteristics difference. Neonates whose mothers did not receive Remdesivir had a higher rate of positive PCR (10.2%), compared to the Remdesivir group (1.9%) with a relative risk of 0.91 reported for Remdesivir (95% CI: 0.85-0.98, P = 0.04); besides, Remdesivir resulted in fewer neonatal intensive care unit admission rates in mild/moderate COVID-19 group (RR = 0.32, 95% CI: 0.105-1.02, P = 0.03). Although neonatal death between the two groups was not statistically significant, from the clinical point seems important; 1(1.9%) in the case vs. 9(7.2%) in the control group. Interestingly LOS (Length of Stay) in the hospital was longer in the case group (median of 7 vs. 3 days; P < 0.0001)., Conclusion: The inclusion of Remdesivir in the treatment protocol of pregnant women with COVID-19 may reduce vertical transmission and improve perinatal outcomes, thus being suggested to be considered., (© 2023. The Author(s).)

Background: There is conflicting information about the effect of vitamin C on brain oxygenation during anesthesia., Objectives: The current study was designed and performed to assess the effect of vitamin C infusion and brain oxygenation with cerebral oximetry on improving brain perfusion during general anesthesia in vascular surgery of diabetic patients., Methods: This randomized clinical trial was performed on patients candidates for endarterectomy under general anesthesia and referred to Taleghani Hospital in Tehran, Iran, during 2019 - 2020. Considering inclusion criteria, the patients were divided into placebo and intervention groups. The patients in the placebo group received 500 mL of isotonic saline. In the intervention group, the patients received 1 g of vitamin C diluted in 500 mL of isotonic saline by infusion half an hour before anesthesia induction. Patients' oxygen levels were continuously measured by a cerebral oximetry sensor. The patients were put in a supine position for 10 minutes before and after anesthesia. At the end of the surgery, the indicators considered in the study were evaluated., Results: No considerable difference was observed between systolic and diastolic blood pressure, heart rate, mean arterial pressure, partial pressure of carbon dioxide, oxygen saturation, regional oxygen saturation, supercritical carbon dioxide, and end-tidal carbon dioxide in total and between the two groups in the three stages before and after anesthesia induction and at the end of surgery (P > 0.05). Additionally, there was no significant difference between blood sugar (BS) levels in the study groups (P > 0.05) but in BS levels at three stages before and after anesthesia induction and at the end of the surgery, with a significant difference (P < 0.05)., Conclusions: The amount of perfusion in the two groups and, therefore, in total at the three stages before and after anesthesia induction and at the end of surgery is not different., Competing Interests: Conflict of Interests: The authors declare no conflict of interests., (Copyright © 2023, Author(s).)

Introduction: Thousands of people die due to trauma all over the world every day, which leaves adverse effects on families and the society. The main objective of this study was to identify the factors affecting the mortality of trauma patients using data mining techniques., Methods: The present study includes six parts: data gathering, data preparation, target attributes specification, data balancing, evaluation criteria, and applied techniques. The techniques used in this research are all from the decision tree family. The output of these techniques are patterns extracted from the trauma patients dataset (National Trauma Registry of Iran). The dataset includes information on 25,986 trauma patients from all over the country. The techniques that were used include random forest, CHAID, and ID3., Results: Random forest performs better than the other two techniques in terms of accuracy. The ID3 technique performs better than the other two techniques in terms of the dead class. The random forest technique has performed better than other techniques in the living class. The rules with the most support, state that if the Injury Severity Score (ISS) is minor and vital signs are normal, 98% of people will survive. The second rule, in terms of support, states that if ISS is minor and vital signs are abnormal, 93% will survive. Also, by increasing the threshold of the patient's arrival time from 10 to 15 minutes, no noticeable difference was observed in the death rate of patients., Conclusion: Transfer time of less than ten minutes in patietns whose ISS is minor, can increase the chance of survival. Impaired vital signs can decrease the chance of survival in traffic accidents. Also, if the ISS is minor in non-penetrating trauma, regardless of vital signs and if the victim is transported in less than ten minutes, the patient will survive with 99% certainty., Competing Interests: Authors declare that they have no conflict of interest

Background: Misconceptions about adverse side effects are thought to influence public acceptance of the Coronavirus disease 2019 (COVID-19) vaccines negatively. To address such perceived disadvantages of vaccines, a novel machine learning (ML) approach was designed to generate personalized predictions of the most common adverse side effects following injection of six different COVID-19 vaccines based on personal and health-related characteristics., Methods: Prospective data of adverse side effects following COVID-19 vaccination in 19943 participants from Iran and Switzerland was utilized. Six vaccines were studied: The AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2, and the mRNA-1273 vaccine. The eight side effects were considered as the model output: fever, fatigue, headache, nausea, chills, joint pain, muscle pain, and injection site reactions. The total input parameters for the first and second dose predictions were 46 and 54 features, respectively, including age, gender, lifestyle variables, and medical history. The performances of multiple ML models were compared using Area Under the Receiver Operating Characteristic Curve (ROC-AUC)., Results: The total number of people receiving the first dose of the AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2, and mRNA-1273 were 6022, 7290, 5279, 802, 277, and 273, respectively. For the second dose, the numbers were 2851, 5587, 3841, 599, 242 and 228. The Logistic Regression model for predicting different side effects of the first dose achieved ROC-AUCs of 0.620-0.686, 0.685-0.716, 0.632-0.727, 0.527-0.598, 0.548-0.655, 0.545-0.712 for the AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2 and mRNA-1273 vaccines, respectively. The second dose models yielded ROC-AUCs of 0.777-0.867, 0.795-0.848, 0.857-0.906, 0.788-0.875, 0.683-0.850, and 0.486-0.680, respectively., Conclusions: Using a large cohort of recipients vaccinated with COVID-19 vaccines, a novel and personalized strategy was established to predict the occurrence of the most common adverse side effects with high accuracy. This technique can serve as a tool to inform COVID-19 vaccine selection and generate personalized factsheets to curb concerns about adverse side effects., (© 2022 The Authors.)

Background: Annually, over 131000 new cases of cancer have been identified in Iran, with an increasing trend that is predicted to grow by 40% by 2025. The most important contributing factors to this increase are the improvement of the health service delivery system, increased life expectancy, and the aging of the population. The aim of this study was to develop Iran's "National Cancer Control Program" (IrNCCP)., Methods: The present study is a cross-sectional study that was conducted in 2013 using the method of reviewing studies and documents and focused group discussions and a panel of experts. In this study, the available evidence related to cancer status and its care in Iran and other countries, as well as national and international upstream documents, were reviewed and analyzed. Then, by analyzing the current situation in Iran and other countries and conducting stakeholder analysis with the strategic planning approach, the IrNCCP was developed with a 12-year horizon consisting of goals, strategies, programs, and performance indicators., Results: This program has 4 main components, including Prevention, Early Detection, Diagnosis and Treatment, and Supportive and Palliative care, as well as 7 supporting components including Governance and policy-making, Cancer Research, Developing facilities, equipment, and service delivery network, Providing and managing human resources, Providing and managing financial resources, Cancer information system management and registry, and Participation of NGOs, charities, and the private sector., Conclusion: Iran's National Cancer Control Program has been developed comprehensively with cross-sectoral cooperation and stakeholder participation. However, like any long-term health intervention, strengthening its governance structure both in terms of implementation and achievement of expected goals and evaluation and modification during the implementation of the program is essential., Competing Interests: The authors declare that they have no competing interests., (© 2022 Iran University of Medical Sciences.)

Background: Health systems must have functional and efficient preparedness and response plans to manage pandemics. Moreover, it is essential to adjust to changing circumstances and the dynamic character of pandemics. The World Health Organization (WHO) introduced the Strategic Preparedness and Response Plan (SPRP), emphasizing 144 measures across 10 pillars, helping governments prepare and respond to the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine how the Iranian health system, based on the WHO-SPRP, addresses strategic preparedness and response plan in the COVID-19 pandemic at the national level. Methods: The WHO-SPRP was adopted and translated into Persian by 2 bilingual natives. The chief of the health office requested that authorized officers complete the SPRP. Then, a meeting was held by officers of related units involved in COVID-19 management to address the SPRP at regional and national levels. Results: Our findings suggest that up to August 2020, effective risk communication and community engagement were not fully established. Our response plan lacked evidence-based information and educational messaging to consistently shape public opinion and impression of a respiratory pandemic. Conclusion: The Iranian health care system and services were almost able to address the SPRP and perform the major indicators that the WHO had proposed. However, special attention should be paid to risk communication and community engagement to empower informed decision-making by individuals and communities., (© 2022 Iran University of Medical Sciences.)

In this study, an emulsion solvent evaporation method was used to produce Eudragit RL (ERL) nanoparticles (NPs) loaded with simvastatin (SIM) for the treatment of ulcerative colitis (UC). Accordingly, the effects of different formulation variables on the properties of NPs were evaluated using the Box-Behnken design. The optimized NPs were then coated by Eudragit FS30D (EFS30D). Drug release was studied in different physiological environments. Colitis was induced by 3% of acetic acid in rats, which received NPs of SIM (10 mg/kg/day), mesalazine (150 mg/kg/day), blank NPs and normal saline orally for 5 days. Macroscopic histopathological evaluation and biochemical analysis, including myeloperoxidase (MPO) activity and malondialdehyde (MDA) level in the colon tissues, were carried out in this study. The optimized SIM-ERL NPs showed the particle size of 182.48 ± 4.57 nm, the polydispersity index of 0.29 ± 0.12, the zeta potential of 26.45 ± 4.57 mV, drug loading % of 34.64 ± 0.48, the encapsulation efficiency % of 98.68 ± 0.69, and the release efficiency % of 35.78 ± 1.37. Coating the optimized NPs with EFS30D caused an increase in particle size and a decrease in the zeta potential of NPs. The optimized SIM-EFS30D/RL NPs improved the macroscopic and histopathological scores. Also, MPO activity and MDA level were reduced significantly by NPs, as compared to the control group. Therefore, this drug delivery system can be an alternative to the previous treatments of UC.

To determine the safety and efficacy profile of teenager COVID-19 vaccination. In this retrospective cohort study, contact numbers of parents of teenagers under 18 years of age referred to a teenager vaccination centers in Tehran-Iran to receive the corona vaccine were collected, and the following information was obtained via the phones: demographic information, type of vaccine, and the number of doses received, as well as additional information like complications and required treatments. Eleven thousand forty-two subjects aged 10-18 years, mean age 14.55 ± 1.83 year  including 5374 boys and 5768 girls were investigated. 88.1% received the Sinopharm and 11.9% the Soberana vaccine. General side effects, including fatigue, fever and chills, injection site pain and dizziness, and so forth happened in 2978 cases; 7421 children presented with at least one general or organ-specific side effect following vaccination, including potentially critical side effects, such as vascular injuries, respiratory complication, and so forth. 0.1% of the subject needed hospital admission. The breakthrough infection happened in 200 individuals. Our study shows that Sinopharm and Soberana (PastoCoVac) COVID-19 vaccines are generally safe with no serious side effects in less than 18 years old. COVID-19 infection and reinfection can occur after vaccination, but the incidence is actually tolerable and significantly lower than in the unvaccinated group., (© 2022 Wiley Periodicals LLC.)

Background: The prehospital emergency system is the first initiator of medical care as an alternative to hospitals and health care services that helps patients and injured people in critical situations and accidents. This study aimed to evaluate the cost-effectiveness of air ambulance versus ground ambulance regarding the patient's transportation and treatment. Methods: In this cost-effectiveness analysis study, 300 patients who were transferred to the Shohadaye HaftomTir hospital by air ambulance and 300 patients transferred by ground ambulance during the study period were selected in 2021-2022. This study examined the costs from the society's perspective. After drawing the decision tree model in TreeAge software, the incremental cost-effectiveness ratio was calculated; and to evaluate the strength of the analysis results, one-way and two-way sensitivity analyses were done on all costs and consequence parameters. Results: The effectiveness rate in the ground ambulance group and in the air ambulance group was 0.42591 and 0.5566, respectively, and the total cost of transportation and treatment by ambulance in these patients was $412.88 and for patients transported and treated by air ambulance was $11898.05. Therefore, air ambulance costs more and is more effective than ground ambulance, and the amount of incremental cost and effectiveness of air ambulance compared with ground ambulance was $11485.17 and 0.130773 units, respectively. The incremental cost-effectiveness ratio (ICER) of the 2 strategies was 87825.28, and the cost-effectiveness threshold was $7200. To determine the strength of the study results, one-way and two-way sensitivity analyses were done and the results of the cost-effectiveness analysis was not changed. Conclusion: Our study showed that ground ambulance is more cost-effective than air ambulance and the most important reason is that the total cost of air ambulance is 26 times more than ground ambulance, however, it is more effective than ground ambulance., Competing Interests: The authors declare that they have no competing interests., (© 2022 Iran University of Medical Sciences.)

Background: Disaster planning and management pose a serious challenge to most countries. These challenges point to insufficient planning to deal with these events. Therefore, it is necessary to pay attention to the methods and characteristics of the decision-making approaches in these events. In this study, we tried to identify most appropriate approaches for the Iranian health system by studying disaster planning approaches., Materials and Methods: This study was conducted using mixed methods in 2020-2021 in two phases: qualitative and quantitative. First, we reviewed at the research literature. Our goal was to identify studies that suggested approaches to disaster planning. The next step in this study was a qualitative study using semi-structured interviews. Participants in qualitative phase included managers and employees from different parts of the Iranian health system from the provinces of Golestan, Fars, Khuzestan, Lorestan, Kerman, Sistan, and Baluchestan., Results: By combining approaches taken from literature reviews and qualitative study, four main approaches were identified. The results of our study have shown that disaster response planning approaches include function, risk assessment, capability, and futuristic base., Conclusion: This study provides complete overview of disaster planning approaches that enable health professionals to use them to develop response plans. Our findings indicate that in complex and large-scale events such as floods and pandemics, it is necessary to combine the introduced methods for operational planning., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Background: To avoid skin necrosis, an 8 cm distance between the new and previous incision is recommended in patients undergoing total knee arthroplasty (TKA). It was hypothesized that making a new incision less than 8 cm of the prior scar does not increase the risk of skin complications, and the new incision can be made anywhere, regardless of the distance from the previous scar. This study investigated how making a new incision, irrespective of the previous scars, affects skin necrosis., Methods: In this parallel, randomized clinical trial, by simple randomization method using a random number table, 50 patients with single longitudinal knee scars were randomly assigned to two groups with a 1:1 ratio and 25 participants in each group. Patients with a minimum age of 60 and a single longitudinal previous scar on the knee were included. The exclusion criteria were diabetes mellitus, hypertension, morbid obesity, smoking, vascular disorders, cardiopulmonary disorders, immune deficiencies, dementia, and taking steroids and angiogenesis inhibitors. TKA was performed through an anterior midline incision, regardless of the location of the previous scar in the intervention group. TKA was performed with a new incision at least 8 cm distant from the old incision in the control group. Skin necrosis and scar-related complications were evaluated on the first and second days and first, second, and fourth weeks after the surgery. Knee function was assessed using the Knee Society Score (KSS) six months after the surgery., Results: The baseline characteristics of the groups did not differ significantly. The average distance from the previous scar was 4.1 ± 3.2 cm in the intervention group and 10.2 ± 2.1 cm in the control group. Only one patient in the control group developed skin necrosis (P-value = 0.31). Other wound-related complications were not observed in both groups. The mean KSS was 83.2 ± 10.2 and 82.9 ± 11.1 in the intervention and control groups, respectively (P-value = 0.33)., Conclusions: It is possible that in TKA patients, the new incision near a previous scar does not increase the risk of skin necrosis and other complications., (© 2022. The Author(s).)

We aimed to assess longitudinal changes in clinical indexes of corona disease 2019 (Covid-19) patients with mild pulmonary infection during 5 days of remdesivir therapy and determine the effect of age and gender on remdesivir adverse effects (AE). Patients' clinical data including inflammatory markers, liver and renal function tests, and heart rate (HR) were extracted from medical records. Linear mixed model (LMM) was used to analyze longitudinal changes in patients' clinical indexes. Gender and age were inserted in LMM as covariates to find their correlation with AE and clinical indexes. Of 84 patients, 35 patients met our criteria for the study. There were significant increases in mean levels of white blood cell (WBC; p = 0.005), alanine aminotransferase (ALT; p = 0.001), aspartate aminotransferase (p = 0.001), blood urea nitrogen (BUN; p = 0.001), and creatinine (p = 0.006), whereas mean levels of erythrocyte sedimentation rate (p = 0.005), C-reactive protein (p = 0.001), alkaline phosphatase (p = 0.001), and potassium (p = 0.003) decreased significantly. Estimated glomerular filtration rate (p = 0.001) and HR (p = 0.001) showed a notable decline over the course of treatment. LMM analysis showed that mean changes in WBC (β = 0.94, p = 0.029), creatinine (β = 0.12, p = 0.020), and HR (β = 6.47, p = 0.008) were greater in males than in females. Also, age of patients had a significant effect on the mean changes of WBC (β = -0.02, p = 0.023), sodium (β = -0.06, p = 0.010), BUN (β = 0.23, p = 0.001), and HR (β = -0.29, p = 0.001). Despite no renal and liver dysfunction, Covid-19 patients with mild pulmonary infection may develop some remdesivir AE and attributed side effects might be affected by gender and age of patients., (© 2022 Wiley Periodicals LLC.)

Background: Stress-induced mental illnesses (mediated by neuroinflammation) pose one of the world's most urgent public health challenges. A reliable in vivo chemical biomarker of stress would significantly improve the clinical communities' diagnostic and therapeutic approaches to illnesses, such as depression., Methods: Male and female C57BL/6J mice underwent a chronic stress paradigm. We paired innovative in vivo serotonin and histamine voltammetric measurement technologies, behavioral testing, and cutting-edge mathematical methods to correlate chemistry to stress and behavior., Results: Inflammation-induced increases in hypothalamic histamine were co-measured with decreased in vivo extracellular hippocampal serotonin in mice that underwent a chronic stress paradigm, regardless of behavioral phenotype. In animals with depression phenotypes, correlations were found between serotonin and the extent of behavioral indices of depression. We created a high accuracy algorithm that could predict whether animals had been exposed to stress or not based solely on the serotonin measurement. We next developed a model of serotonin and histamine modulation, which predicted that stress-induced neuroinflammation increases histaminergic activity, serving to inhibit serotonin. Finally, we created a mathematical index of stress, S i and predicted that during chronic stress, where S i is high, simultaneously increasing serotonin and decreasing histamine is the most effective chemical strategy to restoring serotonin to pre-stress levels. When we pursued this idea pharmacologically, our experiments were nearly identical to the model's predictions., Conclusions: This work shines the light on two biomarkers of chronic stress, histamine and serotonin, and implies that both may be important in our future investigations of the pathology and treatment of inflammation-induced depression., (© 2022. The Author(s).)

An 82-year-old female patient presented with a recent onset of painful skin lesions in unilateral distribution on the abdominal area following the lines of Blaschko; the initial diagnosis of Varicella-Zoster infection was made. However, because the individual lesions appeared as hyperkeratotic papules and were unresponsive to antiviral therapy, a skin biopsy was performed, which revealed hyperkeratosis, suprabasal acantholysis and dyskeratosis with corps ronds and grains, consistent with acantholytic dyskeratotic acanthoma. Since this entity has been associated with Darier disease, whole-transcriptome sequencing by RNA-Seq was performed on RNA isolated from a lesion and from adjacent normal appearing skin, and a recently developed bioinformatics pipeline that can identify both genomic sequence variants and the presence of any of 926 viruses was applied. Two pathogenic missense mutations in the ATP2A2 gene were identified in the lesional but not in normal appearing skin, and no evidence of Varicella-Zoster infection was obtained. These findings confirm the diagnosis of segmental Darier disease due to postzygotic mutations in the ATP2A2 gene, and attest to the power of a novel single-step application of RNA-Seq in providing correct diagnosis in this rare genodermatosis., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The present study investigated the prevalence of illness anxiety disorder and its relationship with social health in the elderly population., Materials and Methods: This cross-sectional study was conducted on 400 elderly people in Isfahan referred to the educational health service in 2020. In addition to demographic characteristics, they answered the 36-item Evans hypochondriasis questionnaire and the 28-item social health questionnaire., Results: Four hundred elderly participants with a mean age of 68.1 ± 6.6 (range: 60-89) were included in the study. One hundred and ninety-nine (49.8%) were female and 201 (50.3%) were male. Only 24.3% of the geriatrics were in the healthy group and 21.2% in the borderline category. Seventy-two of the geriatric population (18%) had poor social health and 299 of this population (74.8%) had moderate social health, and the social health status of 29 elderlies (7.3%) was favorable. There was an inverse relationship between hypochondriasis score and total social health score and its dimensions ( P < 0.05)., Conclusion: High prevalence of hypochondriasis was observed in the geriatrics compared to global studies. Most of the elderly population had moderate social health. Gender and education do not affect hypochondriasis and social health in the elderly. People with higher social health scores were clearly less likely to get hypochondriasis. Therefore, by improving the various dimensions of social health of the geriatrics, we can help reduce the prevalence of hypochondriasis in this age group., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Advanced Biomedical Research.)

Severe viral infections of the skin can occur in patients with inborn errors of immunity (IEI). We report an all-in-one whole-transcriptome sequencing-based method by RNA-Seq on a single skin biopsy for concomitantly identifying the cutaneous virome and the underlying IEI. Skin biopsies were obtained from healthy and lesional skin from patients with cutaneous infections suspected to be of viral origin. RNA-Seq was utilized as the first-tier strategy for unbiased human genome-wide rare variant detection. Reads unaligned to the human genome were utilized for the exploration of 926 viruses in a viral genome catalog. In 9 families studied, the patients carried pathogenic variants in 6 human IEI genes, including IL2RG, WAS, CIB1, STK4, GATA2, and DOCK8. Gene expression profiling also confirmed pathogenicity of the human variants and permitted genome-wide homozygosity mapping, which assisted in identification of candidate genes in consanguineous families. This automated, online, all-in-one computational pipeline, called VirPy, enables simultaneous detection of the viral triggers and the human genetic variants underlying skin lesions in patients with suspected IEI and viral dermatosis.

Thin, flexible, and invisible solar cells will be a ubiquitous technology in the near future. Ultrathin crystalline silicon (c-Si) cells capitalize on the success of bulk silicon cells while being lightweight and mechanically flexible, but suffer from poor absorption and efficiency. Here we present a new family of surface texturing, based on correlated disordered hyperuniform patterns, capable of efficiently coupling the incident spectrum into the silicon slab optical modes. We experimentally demonstrate 66.5% solar light absorption in free-standing 1 μm c-Si layers by hyperuniform nanostructuring for the spectral range of 400 to 1050 nm. The absorption equivalent photocurrent derived from our measurements is 26.3 mA/cm 2 , which is far above the highest found in literature for Si of similar thickness. Considering state-of-the-art Si PV technologies, we estimate that the enhanced light trapping can result in a cell efficiency above 15%. The light absorption can potentially be increased up to 33.8 mA/cm 2 by incorporating a back-reflector and improved antireflection, for which we estimate a photovoltaic efficiency above 21% for 1 μm thick Si cells., Competing Interests: The authors declare no competing financial interest., (© 2022 The Authors. Published by American Chemical Society.)

Rationale: Given the expanding number of COVID-19 cases and the potential for new waves of infection, there is an urgent need for early prediction of the severity of the disease in intensive care unit (ICU) patients to optimize treatment strategies. Objectives: Early prediction of mortality using machine learning based on typical laboratory results and clinical data registered on the day of ICU admission. Methods: We retrospectively studied 797 patients diagnosed with COVID-19 in Iran and the United Kingdom (U.K.). To find parameters with the highest predictive values, Kolmogorov-Smirnov and Pearson chi-squared tests were used. Several machine learning algorithms, including Random Forest (RF), logistic regression, gradient boosting classifier, support vector machine classifier, and artificial neural network algorithms were utilized to build classification models. The impact of each marker on the RF model predictions was studied by implementing the local interpretable model-agnostic explanation technique (LIME-SP). Results: Among 66 documented parameters, 15 factors with the highest predictive values were identified as follows: gender, age, blood urea nitrogen (BUN), creatinine, international normalized ratio (INR), albumin, mean corpuscular volume (MCV), white blood cell count, segmented neutrophil count, lymphocyte count, red cell distribution width (RDW), and mean cell hemoglobin (MCH) along with a history of neurological, cardiovascular, and respiratory disorders. Our RF model can predict patient outcomes with a sensitivity of 70% and a specificity of 75%. The performance of the models was confirmed by blindly testing the models in an external dataset. Conclusions: Using two independent patient datasets, we designed a machine-learning-based model that could predict the risk of mortality from severe COVID-19 with high accuracy. The most decisive variables in our model were increased levels of BUN, lowered albumin levels, increased creatinine, INR, and RDW, along with gender and age. Considering the importance of early triage decisions, this model can be a useful tool in COVID-19 ICU decision-making., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jamshidi, Asgary, Tavakoli, Zali, Setareh, Esmaily, Jamaldini, Daaee, Babajani, Sendani Kashi, Jamshidi, Jamal Rahi and Mansouri.)

The coronavirus pandemic has already caused plenty of severe problems for humanity and the economy. The exact impact of the COVID-19 pandemic is still unknown, and economists and financial advisers are exploring all possible scenarios to mitigate the risks arising from the pandemic. An intriguing question is whether this pandemic and its impacts are similar, and to what extent, to any other catastrophic events that occurred in the past, such as the 2009 Great Recession. This paper intends to address this problem by analyzing official public announcements and statements issued by federal authorities such as the Federal Reserve. More specifically, we measure similarities of consecutive statements issued by the Federal Reserve during the 2009 Great Recession and the COVID-19 pandemic using natural language processing techniques. Furthermore, we explore the usage of document embedding representations of the statements in a more complex task: clustering. Our analysis shows that, using an advanced NLP technique in document embedding such as Doc2Vec, we can detect a difference of 10.8% in similarities of Federal Open Market Committee (FOMC) statements issued during the Great Recession (2007-2009) and the COVID-19 pandemic. Finally, the results of our clustering exercise show that the document embeddings representations of the statements are suitable for more complex tasks, which provides a basis for future applications of state-of-the-art natural language processing techniques using the FOMC post-meeting statements as the dataset., (© The Author(s) 2022.)

Cancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15-0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis., (© 2021. The Author(s).)

Background: Investing in the R & D sector of new medical technologies is associated with the risk of being rejected by paying organizations because of the lack of value-for-money. The purpose of this study is to investigate the different methods of evaluating the impacts of emerging medical technologies. Methods: Using scoping review method, we analyzed studies that investigated methods for assessing the impacts of emerging medical technologies on development. To find these studies, the Cochran Library, ISI Web of Knowledge, Embase, Ebsco and Pubmed databases from 2000 to 2018 were searched. The methodological quality of the studies was assessed using the STROBE Checklist. Two reviewers independently selected the qualified studies. Charting and collating the data were used based on the method proposed by Arksey and O'Malley. Results: Overall, 38 studies met the inclusion criteria. Sixteen methods were identified and put in five distinct categories: forecasting, Pro-HTA, Early-HTA, priority setting, and HHS were found to measure the impact of emerging technologies. The quality of these studies was acceptable. Few studies were conducted on emerging pharmaceutical technologies, and they were mostly on emerging medical devices. The Early HTA methods were often used to measure the effects of pharmaceutical technologies and medical devices technologies. The Pro-HTA method used dynamic modeling to examine the impact of medical technologies on a broad range of dimensions, while the HTA and Early-HTA methods used cost-effectiveness techniques throughout the development process. The HHS method used a multivariate decision-making technique. Conclusion: Different methods were used to investigate the impacts of emerging medical technologies. Chronologically Pro-HTA methods are new ways for investigating emerging medical technologies beyond clinical and economic impacts. Assessing the feasibility of implementing Pro-HTA in real environments deserves further research., Competing Interests: Conflicts of Interest: None declared, (© 2021 Iran University of Medical Sciences.)

Background: The ultimate goal of development from the perspective of human capital development is to have a long, healthy, and creative life. This study aimed to identify the requirements for the effective human resource development in the health system. Methods: This mixed method study was performed on 20 managers of Iran's health sector in the qualitative part to reach data saturation in qualitative research. The standard questionnaire of the health system consisting of 15 questions was distributed and collected among 302 managers of the health sector (senior and intermediate managers) and faculty professors who were selected by the stratified random sampling method using the Morgan table. Finally, for data analysis in the quantitative part, confirmatory factor analysis and modeling with partial least squares were used. Results: The results showed that 4 of the requirements affecting human resource development were financial requirements with 13 components, service requirements with 14 components, educational requirements with 14 components, and partnership requirements with 7 components. Conclusion: According to the results, it is suggested that in order to develop effective human resources in the health system, it is necessary to pay attention to the 4 financial, service, educational, and partnership requirements., Competing Interests: Conflicts of Interest: None declared, (© 2021 Iran University of Medical Sciences.)

Working memory (WM) can be considered as a limited-capacity system which is capable of saving information temporarily with the aim of processing. The aim of the present study was to establish whether eccentricity representation in WM could be decoded from eletroencephalography (EEG) alpha-band oscillation in parietal cortex during delay-period while performing memory-guided saccade (MGS) task. In this regard, we recorded EEG and Eye-tracking signals of 17 healthy volunteers in a variant version of MGS task. We designed the modified version of MGS task for the first time to investigate the effect of locating stimuli in two different positions, in a near (6°) eccentricity and far (12°) eccentricity on saccade error as a behavioral parameter. Another goal of study was to discern whether or not varying the stimuli loci can alter behavioral and eletroencephalographical data while performing the variant version of MGS task. Our findings demonstrate that saccade error for the near fixation condition is significantly smaller than the far from fixation condition. We observed an increase in alpha power in parietal lobe in near vs far conditions. In addition, the results indicate that the increase in alpha (8-12 Hz) power from fixation to memory was negatively correlated with saccade error. The novel approach of using simultaneous EEG/Eye-tracking recording in the modified MGS task provided both behavioral and electroencephalographic analyses for oscillatory activity during this new version of MGS task., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: At the beginning of the COVID-19 pandemic, the Iranian Ministry of Health and Medical Education set up a 24-h call center, i.e., Center 4030, to mitigate people's worries and anxieties, create composure, increase people's trust, and answer their questions. This qualitative study aimed to identify the challenges of COVID-19-related-information among people in point of experts' views., Materials and Methods: This qualitative study was conducted to collect the opinions of experts on the identification of the Information challenges of COVID-19 during March-June 2020. The research population included all health professionals and experts. The sampling method was initially purposive and continued to saturate the data as snowball technique. In this study, 19 participants were interviewed. The data were collected using a semi-structured interview. After collecting the data, the audio files of the interviews were written down to extract their external and internal elements. MAXQDA version 12 software was used to organize qualitative analysis and coding data., Results: The results of this study involved eight themes, i.e., lack of planning, lack of social trust in government, lack of COVID-19-integrated scientific authority in the country, conflicts of interest, lack of integrated information sources, distracting public attention, infodemic, and poor information quality, classified into 16 categories., Conclusions: The main information challenges that people in Iran faced included the lack of a scientific reference source to access accurate information, the existence of a large volume of information in virtual networks, and a huge volume of statistics from various information channels that caused confusion among people., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Commonly prescribed selective serotonin reuptake inhibitors (SSRIs) inhibit the serotonin transporter to correct a presumed deficit in extracellular serotonin signaling during depression. These agents bring clinical relief to many who take them; however, a significant and growing number of individuals are resistant to SSRIs. There is emerging evidence that inflammation plays a significant role in the clinical variability of SSRIs, though how SSRIs and inflammation intersect with synaptic serotonin modulation remains unknown. In this work, we use fast in vivo serotonin measurement tools to investigate the nexus between serotonin, inflammation, and SSRIs. Upon acute systemic lipopolysaccharide (LPS) administration in male and female mice, we find robust decreases in extracellular serotonin in the mouse hippocampus. We show that these decreased serotonin levels are supported by increased histamine activity (because of inflammation), acting on inhibitory histamine H3 heteroreceptors on serotonin terminals. Importantly, under LPS-induced histamine increase, the ability of escitalopram to augment extracellular serotonin is impaired because of an off-target action of escitalopram to inhibit histamine reuptake. Finally, we show that a functional decrease in histamine synthesis boosts the ability of escitalopram to increase extracellular serotonin levels following LPS. This work reveals a profound effect of inflammation on brain chemistry, specifically the rapidity of inflammation-induced decreased extracellular serotonin, and points the spotlight at a potentially critical player in the pathology of depression, histamine. The serotonin/histamine homeostasis thus, may be a crucial new avenue in improving serotonin-based treatments for depression. SIGNIFICANCE STATEMENT Acute LPS-induced inflammation (1) increases CNS histamine, (2) decreases CNS serotonin (via inhibitory histamine receptors), and (3) prevents a selective serotonin reuptake inhibitor (SSRI) from effectively increasing extracellular serotonin. A targeted depletion of histamine recovers SSRI-induced increases in extracellular hippocampal serotonin., (Copyright © 2021 the authors.)

Motivation: Variation graph representations are projected to either replace or supplement conventional single genome references due to their ability to capture population genetic diversity and reduce reference bias. Vast catalogues of genetic variants for many species now exist, and it is natural to ask which among these are crucial to circumvent reference bias during read mapping., Results: In this work, we propose a novel mathematical framework for variant selection, by casting it in terms of minimizing variation graph size subject to preserving paths of length α with at most δ differences. This framework leads to a rich set of problems based on the types of variants [e.g. single nucleotide polymorphisms (SNPs), indels or structural variants (SVs)], and whether the goal is to minimize the number of positions at which variants are listed or to minimize the total number of variants listed. We classify the computational complexity of these problems and provide efficient algorithms along with their software implementation when feasible. We empirically evaluate the magnitude of graph reduction achieved in human chromosome variation graphs using multiple α and δ parameter values corresponding to short and long-read resequencing characteristics. When our algorithm is run with parameter settings amenable to long-read mapping (α = 10 kbp, δ = 1000), 99.99% SNPs and 73% SVs can be safely excluded from human chromosome 1 variation graph. The graph size reduction can benefit downstream pan-genome analysis., Availability and Implementation: : https://github.com/AT-CG/VF., Supplementary Information: Supplementary data are available at Bioinformatics online., (© The Author(s) 2021. Published by Oxford University Press.)

Background: Early prediction of symptoms and mortality risks for COVID-19 patients would improve healthcare outcomes, allow for the appropriate distribution of healthcare resources, reduce healthcare costs, aid in vaccine prioritization and self-isolation strategies, and thus reduce the prevalence of the disease. Such publicly accessible prediction models are lacking, however. Methods: Based on a comprehensive evaluation of existing machine learning (ML) methods, we created two models based solely on the age, gender, and medical histories of 23,749 hospital-confirmed COVID-19 patients from February to September 2020: a symptom prediction model (SPM) and a mortality prediction model (MPM). The SPM predicts 12 symptom groups for each patient: respiratory distress, consciousness disorders, chest pain, paresis or paralysis, cough, fever or chill, gastrointestinal symptoms, sore throat, headache, vertigo, loss of smell or taste, and muscular pain or fatigue. The MPM predicts the death of COVID-19-positive individuals. Results: The SPM yielded ROC-AUCs of 0.53-0.78 for symptoms. The most accurate prediction was for consciousness disorders at a sensitivity of 74% and a specificity of 70%. 2,440 deaths were observed in the study population. MPM had a ROC-AUC of 0.79 and could predict mortality with a sensitivity of 75% and a specificity of 70%. About 90% of deaths occurred in the top 21 percentile of risk groups. To allow patients and clinicians to use these models easily, we created a freely accessible online interface at www.aicovid.net. Conclusion: The ML models predict COVID-19-related symptoms and mortality using information that is readily available to patients as well as clinicians. Thus, both can rapidly estimate the severity of the disease, allowing shared and better healthcare decisions with regard to hospitalization, self-isolation strategy, and COVID-19 vaccine prioritization in the coming months., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Jamshidi, Asgary, Tavakoli, Zali, Dastan, Daaee, Badakhshan, Esmaily, Jamaldini, Safari, Bastanhagh, Maher, Babajani, Mehrazi, Sendani Kashi, Jamshidi, Sendani, Rahi and Mansouri.)

Background: The widespread occurrence of COVID-19 has caused people to seek information from various sources such as virtual social networks, which can positively or negatively affect one's mental status. In this article, we present the role of virtual social networks in shaping people's attitudes toward COVID-19 in Iran., Materials and Methods: This is an applied descriptive study, in which 1010 users of virtual social networks were surveyed through an electronic questionnaire. Data were analyzed with SPSS, Excel, and Rapid Miner software. The FP-growth technique was used to investigate the concurrence of choices in multiple-choice questions, and the Mann-Whitney and the Kruskal-Wallis tests were used to determine the correlation of the mean of each dimension with demographic data. Moreover, the Wilcoxon signed-rank, the Shapiro-Wilk, and the Kolmogorov-Smirnov tests were used., Results: Virtual social networks use increased significantly (40%) after the COVID-19 outbreak. According to users, the greatest psychological impact of virtual social networks was the induction of anxiety (46.43%) and the most common use was to learn about COVID-19 prevention and treatment (69.3%). Based on the findings, there were no significant differences between the "awareness," "behavior intention," and "attitude and trust" and the users' marital status, age group, educational degree, and gender., Conclusion: Although social networks have enriched the public knowledge, they increased the individuals' anxiety mostly because of controversial news and disperse of misinformation which in turn misled the users. The social networks play an important role in directing the behavioral inclinations. Accordingly, it is recommended that the authorities in healthcare system establish authentic and formal webpage in these social networks to manage controversial and voluminous information., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)