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Background: Statins are the main lipid-lowering drugs and are used in the prevention of cardiovascular diseases (CVDs). Since the results have been, to some extent, inconsistent in the clinical trials concerning different types of CVDs, a systematic review and meta-analysis was performed to prove the effect of statins on decreasing elevated levels of total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in patients with CVDs. Methods: Literature search was performed on major electronic databases (MEDLINE/ PubMed, Scopus, and ISI Web of Science) from inception up to July 2021 to find randomized controlled trials (RCTs) evaluating the effect of different statins on different types of CVDs. The effect size was determined using weighted mean difference (WMD) and corresponding 95% confidence interval (CI). Results: Statin therapy significantly decreased levels of total cholesterol (WMD = -33.37 mg/dl, 95% CI: -45.98 to -20.76, P Conclusion: Statin therapy was found effective in lowering levels of total cholesterol, LDL-C, and TG, and increasing levels of HDL-C in patients with different CVDs.

To impart electromagnetic interference (EMI) shielding in cementitious composites, electrically conductive and electromagnetic absorbing additives are generally used. This research examined the effect of adding electric arc furnace slag (EAFS) or heavyweight aggregates (HWA), alone and in combination with carbon fibre (CF), on the EMI shielding properties of cementitious composites. Different percentages of both additives were added to a control mix to study the effect on mechanical properties, electrical conductivity and EMI shielding. Optimal shielding was produced for aggregate contents of 1.5 wt%, with values of 5.18 dB for the EAFS mixes and 3.25 dB for the HWA mixes, within the frequency range 30 MHz to 1.5 GHz. Hybrid mixes were fabricated using 0.7 wt% of 12 mm long CF and three different percentages of each aggregate. In combination with the CF, the optimal level of shielding was produced with EAFS and HWA contents of 1 wt%. These optimal shielding levels were 34.21 dB and 36.78 dB, respectively, within the 30 MHz to 1.5 GHz frequency range. A further increase in either type of aggregate produced a gradual reduction in EMI shielding effectiveness.

Background. Used oil is a problematic waste containing hazardous and toxic components. This study aimed to investigate the quantity of used oil produced by motor vehicles in Iran and offer management solutions based on health and environmental principles. Methods. First, the conversion ratio of motor oil into used oil was determined. The mass balance method and the conversion ratio were used to estimate the used oil produced in the past 14 years. The amount of used oil produced over the following 15 years was also predicted using an artificial neural network. The current status of used oil management in Iran was assessed through checklists, observations, field visits, and interviews. Finally, an appropriate management solution was provided for it. Results. According to the results, 151.2 to 315.2 kilotons (kt) of used oil were produced annually in Iran between 2003 to 2017, and it would reach 250 kt by 2031 according to prediction. In Iran, approximately 77% of the used oil was collected and recycled, about 5% was used in construction, and the rest was disposed and managed without following the scientific principles. Conclusion. The lack of principled management of used oil may have had a significant adverse impact on the environment. Taking into account the fact that about 55% of used oil was produced by vehicles, and assuming that the remaining 45% of used oil was produced by other sources, it was concluded that the overall percentage of used oil production in Iran was probably two-fold approximately. Therefore, it was recommended that the current situation and its principled management should be minitored.

After the inscription of the Historic City of Yazd on UNESCO’s World Heritage List in 2017, the number of tourists visiting increased. The area is formed of several neighborhoods. This study aims to propose a conservation plan for the oldest, the Shah Abul-Ghasem Neighborhood, using the urban design qualities suggested by Golkar. The study based on a field survey in the neighborhood was carried out in such a way that items related to urban design qualities were photographed and categorized into environmental, functional and aesthetic-experimental components. Proposed measures and recommendations for the development of tourism in the area are presented based on the field survey results. Po wpisaniu historycznej części miasta Jazd na listę światowego dziedzictwa UNESCO w 2017 r. liczba odwiedzających miasto turystów wzrosła. Omawiany w artykule obszar składa się z kilku dzielnic. Niniejsze badanie ma na celu przedstawienie propozycji planu ochrony najstarszej z nich, czyli dzielnicy Shah Abul-Ghasem, stworzonego na podstawie podziału elementów zagospodarowania przestrzennego zaproponowanego przez Golkara (2000). Analiza została przeprowadzona w oparciu o badania terenowe w rzeczonej dzielnicy. Obiekty będące elementami zagospodarowania przestrzennego zostały sfotografowane, a następnie podzielone na kategorie jako środowiskowe, funkcjonalne oraz estetyczno-eksperymentalne. Na podstawie zebranych wyników zaproponowano rekomendacje dla rozwoju turystyki w badanym obszarze.

Different factors, such as inflammation, oxidative stress, extracellular matrix degradation and apoptosis, affect the pathophysiology of chronic obstructive pulmonary disease (COPD), as a progressive disease characterised by permanent airflow limitation. Herbal supplements with anti-inflammatory and antioxidant properties can help treat certain chronic diseases. The current study aimed at investigating the preventive effects of crocin supplementation on the serum concentrations of IL-6, TNF-α, exercise capacity and pulmonary function tests (PFT) in patients with COPD. The present prospective randomised clinical trial equally divided fifty-seven patients with COPD into a placebo and an intervention group, who respectively received a placebo and crocin (15 mg twice day for 12 weeks) as a supplement. ELISA was used to measure serum levels of IL-6 and TNF-α, also PFT and exercise capacity based on 6-min walking distance test (6MWD), which was performed at the beginning and end of the study. Crocin improved the results of PFT (P < 0·05) and 6-MWD (P < 0·001) and exerted preventive effects by increasing the serum levels of IL-6 in patients with COPD compared with those in the placebo group (P < 0·05). Intervention with crocin significantly lowered serum levels of TNF-α at the end of the study (P < 0·01). The present findings suggest crocin supplementation improves exercise capacity and PFT in patients with COPD by reducing serum levels of inflammatory factors.

Background Circumferential liposuction may cause dilution anemia due to a high volume of infiltrated tumescent. Studies analyzing the percentage of absorbed tumescent and the safe limit of tumescent infiltration are currently lacking. Objectives The aim of this study was to calculate the average volume uptake of administered fluids in power-assisted liposuction, and to calculate a practical formula to determine the amount of fluid that can safely be administered without inducing symptomatic dilution anemia or hypervolemia. Methods Patients undergoing circumferential liposuction with power-assisted tumescent infiltration were included in a prospective clinical study. All relevant administered and excreted volumes during and after the operation were collected. Preoperative vs postoperative hemogram results were compared and the hemodynamic parameters were followed for 24 hours. The average volume uptake was calculated based on the measured volumes, and on the ratio between administered volumes and the patient's blood volume. Results Thirty patients were included during September 2021. The average volume uptake was 58% for a calculated 1.11:1 infiltration to aspiration ratio. There was a mean drop of 1.9 g/dL and 4.6% for the postoperative hemoglobin and hematocrit, respectively, with a stable red blood cell level. All patients remained hemodynamically stable without the need for blood transfusion or prolonged oxygen administration. The average tumescent vs blood volume ratio was 85.0%. Conclusions In circumferential liposuction with power-assisted infiltration, the infiltrated tumescent volume should remain below 85% of the patient's blood volume to minimize the risk of symptomatic dilution anemia or hypervolemia. Level of Evidence: 4

Porous structure, biocompatibility and biodegradability, large surface area, and drug-loading ability are some remarkable properties of zeolite structure, making it a great possible option for bone tissue engineering. Herein, we evaluated the potential application of the ZSM-5 scaffold encapsulated GEN with high porosity structure and significant antibacterial properties. The space holder process has been employed as a new fabrication method with interconnected pores and suitable mechanical properties. In this study, for the first time, ZSM-5 scaffolds with GEN drug-loading were fabricated with the space holder method. The results showed excellent open porosity in the range of 70–78% for different GEN concentrations and appropriate mechanical properties. Apatite formation on the scaffold surface was determined with Simulation body fluid (SBF), and a new bone-like apatite layer shaping on all samples confirmed the in vitro bioactivity of ZSM-5-GEN scaffolds. Also, antibacterial properties were investigated against both gram-positive and gram-negative bacteria. The incorporation of various amounts of GEN increased the inhibition zone from 24 to 28 (for E. coli) and 26 to 37 (for S. aureus). In the culture with MG63 cells, great cell viability and high cell proliferation after 7 days of culture were determined.

Programmed cell death 1 (PD-1) is an immune checkpoint and has been reported to be associated with several autoimmune diseases. We aimed to investigate the association between human PD-1 gene (

Background. In today’s industrialized world, coronary artery disease (CAD) is one of the leading causes of death, and early detection and timely intervention can prevent many of its complications and eliminate or reduce the resulting mortality. Machine learning (ML) methods as one of the cutting-edge technologies can be used as a suitable solution in diagnosing this disease. Methods. In this study, different ML algorithms’ performances were compared for their effectiveness in developing a model for early CAD diagnosis based on clinical examination features. This applied descriptive study was conducted on 303 records and overall 26 features, of which 26 were selected as the target features with the advice of several clinical experts. In order to provide a diagnostic model for CAD, we ran most of the most critical classification algorithms, including Multilayer Perceptron (MLP), Support Vector Machine (SVM), Logistic Regression (LR), J48, Random Forest (RF), K-Nearest Neighborhood (KNN), and Naive Bayes (NB). Seven different classification algorithms with 26 predictive features were tested to cover all feature space and reduce model error, and the most efficient algorithms were identified by comparison of the results. Results. Based on the compared performance metrics, SVM (AUC = 0.88, F-measure = 0.88, ROC = 0.85), and RF (AUC = 0.87, F-measure = 0.87, ROC = 0.91) were the most effective ML algorithms. Among the algorithms, the KNN algorithm had the lowest efficiency (AUC = 0.81, F-measure = 0.81, ROC = 0.77). In the diagnosis of coronary artery disease, machine learning algorithms have played an important role. Proposed ML models can provide practical, cost-effective, and valuable support to doctors in making decisions according to a good prediction. Discussion. It can become the basis for developing clinical decision support systems. SVM and RF algorithms had the highest efficiency and could diagnose CAD based on patient examination data. It is suggested that further studies be performed using these algorithms to diagnose coronary artery disease to obtain more accurate results.

Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers. Prognostic factors, such as tumor thickness, play a crucial role in the management of these patients. Peritumoral inflammatory infiltration has been shown to influence the prognosis of malignancies. This study aimed to determine different prognostic factors and investigate peritumoral inflammatory infiltration in patients with cSCC.The study population consisted of 272 patients with a diagnosis of cSCC. Clinical data, such as age and tumor location, were extracted from pathology reports, and other information was gathered by contacting the patients via phone calls. All pathology slides were reviewed by an expert dermatopathologist, and the histopathological features and prognostic factors were evaluated.The highest number of tumors was found in the scalp and forehead (21.3%), while the lowest number was found in the trunk and thighs (3.31%). The highest mean tumor thickness was observed in the group with no inflammatory cells; on the other hand, the lowest tumor thickness was found in the group of lymphocytes and plasma cells. The group with severe eosinophilic infiltration had the highest mean tumor thickness, while the group with no eosinophilic infiltration had the lowest mean tumor thickness.Depending on the type of peritumoral inflammatory cells, the prognosis of cSCC may be predictable.

Fat grafting is the favored option for buttock augmentation by most surgeons, and buttock implants are mostly regarded as second choices. Accepted options for buttock implant pocket dissection are subfascial, intramuscular, and submuscular. To overcome the limitations of both intramuscular and submuscular pockets, and combine the benefits of both, the authors present a novel dual-plane pocket dissection. The dual-plane pocket involves a submuscular plane in the cranial half of the pocket and switching to an intramuscular plane in the caudal half. With this study, the authors describe their experience with this technique and analyze the dissection of the pocket on human cadavers.The authors reviewed 82 consecutive composite gluteal augmentation cases from March of 2019 to November of 2019. In all cases, the implant was placed in the "dual plane." The clinical study was supplemented by 10 hemigluteal dissections in five cadavers following the surgical technique, with assessment of the anatomical components of the implant pocket created.Patients who underwent this technique showed excellent soft-tissue coverage over the implants. The main complications observed were seroma formation in five of 82 patients and temporary sciatic pain in four of the patients. The anatomical study confirmed double muscle coverage of both gluteus maximus and partial medius in the upper pocket pole and intramuscular gluteus maximus implant position in the lower pole.The authors present the dual-plane dissection technique as a valuable innovation to improve soft-tissue cover for the upper implant pole in buttock implant surgery.

This study set out to evaluate the wound healing properties of brittle star extracts in vitro and in vivo. Due to the great arm regeneration potential of the brittle star, Ophiocoma cynthiae, the present study aimed to evaluate the wound healing effect of hydroalcoholic extracts of brittle star undergoing arm regeneration in wound healing models. The brittle star samples were collected from Nayband Bay, Bushehr, Iran. After wound induction in the arm of brittle stars, hydroalcoholic extracts relating to different times of arm regeneration were prepared. The GC-MS analysis, in vitro MTT cell viability and cell migration, Western blot, and computational analysis tests were performed. Based on the in vitro findings, two BSEs were chosen for in vivo testing. Macroscopic, histopathological and biochemical evaluations were performed after treatments. The results showed positive proliferative effects of BSEs. Specifically, forty-two compounds were detected in all groups of BSEs using GC-MS analysis, and their biological activities were assessed. The MTT assay showed that the 14 d BSE had a higher proliferative effect on HFF cells than 7 d BSE. The cell migration assay showed that the wound area in 7 d and 14 d BSEs was significantly lower than in the control group. Western blot analysis demonstrated an increase in the expression of proliferation-related proteins. Upon the computational analysis, a strong affinity of some compounds with proteins was observed. The in vivo analysis showed that the evaluation of wound changes and the percentage of wound healing in cell migration assay in the 7 d BSE group was better than in the other groups. Histopathological scores of the 7 d BSE and 14 d BSE groups were significantly higher than in the other groups. In conclusion, the hydroalcoholic extract of O. cynthiae undergoing arm regeneration after 7 and 14 days promoted the wound healing process in the cell and rat skin wound healing model due to their proliferative and migratory biological activity.

Objectives: The purpose of present study was the investigation of reliability and validity of the knee injury and osteoarthritis outcome score in the Iranian population. Methods: The method of the present study was non-experimental and methodological. The statistical population of the present study was patients with osteoarthritis of the knee. Patients with osteoarthritis of the knee referred to the Akhtar Center were selected from 127 people by available sampling for sample adequacy. In data analysis, Cronbach's alpha test to determine internal agreement, test-retest method to determine stability in reliability, item impact method to determine face validity, CVI and CVR indicators to determine content validity, and to determine structural validity two convergent and divergent validities as well as confirmatory factor analysis were used. Results: The results showed that if the fourth question "symptoms" is removed, the questionnaire has acceptable reliability and validity. Conclusion: The analysis of the findings indicated that the Persian version of the questionnaire (KOOS) was a reliable tool for assessing the health status and impact of various treatments on patients with osteoarthritis in the country, which had high validity and reliability.

Background No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. Methods The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. Findings 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7–9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46–0·99]), obesity (0·50 [0·34–0·74]) and invasive mechanical ventilation (0·42 [0·23–0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74–1·00]), at 5 months (0·74 [0·64–0·88]) to 1 year (0·75 [0·62–0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. Interpretation The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. Funding UK Research and Innovation and National Institute for Health Research.

Rituximab is widely used for treatment of pemphigus patients. B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) play key roles in B cell survival, maturation, and differentiation. Here, the effect of rituximab on BAFF and APRIL in patients with pemphigus vulgaris (PV) was studied.Fifty PV cases and 56 healthy individuals were recruited. Patients received rituximab for a period of 6 months. The levels of BAFF and APRIL were measured in the serum samples. The frequency of CD19+ B cells was measured by flow cytometry.The level of BAFF was significantly higher in the patients at the baseline level than controls (P = 0.0005). The level of BAFF was significantly higher at the 3rd month follow-up compared to the baseline (P = 0.033). There was a significant increase in the BAFF level at the 6th month follow-up compared to baseline (P = 0.0134). There was no significant difference in the CD19+ B cells/total lymphocytes ratio in the PV patients between the 3rd and 6th month follow-ups.Elevated BAFF in the sera could be associated with PV immunopathogenesis. Inhibition of BAFF after rituximab therapy might interfere with repopulation of B cells and confer a therapeutic approach in PV.