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Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men.Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men.Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ.Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.

ABSTRACTThe aim of this study was to investigate the prevalence rate and determinants of SU in adolescents based on the social development model (SDM). In 2018, applying a cross-sectional design, cluster multistage random sampling was employed to recruit 600 adolescents in Bam County, Iran, to participate in the study. A valid and reliable SDM-based instrument was used to collect data. The prevalence rate of using at least one substance was 42% (in girls 33.6% and in boys 50.3%). Adjusted for covariates, having close friends with SU was found as the factor with the highest risk. Higher scores in involvement in prosocial activities and interactions(OR: 0.47; 95% Confidence interval (CI): 0.33–0.66, p < 0.001), attachment and commitment to prosocial others (family and school)(OR: 0.73; 95% CI: 0.58–0.93, p < 0.05), and skills for interaction/involvement(OR: 0.51; 95%CI: 0.39–0.67, p < 0.001) reduced the odds of ever use of SU among adolescents. Also, higher levels of perceived rewards for antisocial interaction/involvement(OR: 2.22; 95% Confidence interval (CI): 1.53–3.22, p < 0.001) and belief in antisocial values(OR: 2.24; 95% CI: 1.67–2.94, p < 0.001) increased the odds of ever use SU among the respondents. In community-based interventions to prevent SU among adolescents, a great focus should be firstly on identifying the probability of SU in close friends. Moreover, the involvement of adolescents in prosocial activities and interactions, attachment and commitment to prosocial others (family and school), and skills for interaction/involvement should be core categories while designing community-based interventional studies.

Although considerable advances have been made in understanding the cellular effector mechanisms responsible for donor-specific antibody generation leading to antibody-mediated rejection (ABMR), the identification of cellular regulators of such immune responses is lacking. To clarify this, we used high dimensional flow cytometry to concomitantly profile and track the two major subsets of regulatory lymphocytes in blood: T regulatory (TREG) and transitional B cells in a cohort of 96 kidney transplant recipients. Additionally, we established co-culture assays to address their respective capacity to suppress antibody responses in vitro. TREG and transitional B cells were found to be potent suppressors of T follicular helper–mediated B-cell differentiation into plasmablast and antibody generation. TREG and transitional B cells were both durably expanded in patients who did not develop donor-specific antibody post-transplant. However, patients who manifested donor-specific antibody and progressed to ABMR displayed a marked and persistent numerical reduction in TREG and transitional B cells. Strikingly, specific cell clusters expressing the transcription factor T-bet were selectively depleted in both TREG and transitional B-cell compartments in patients with ABMR. Importantly, the coordinated loss of these T-bet+CXCR5+TREG and T-bet+CD21-transitional B-cell clusters was correlated with increased and inflammatory donor specific antibody responses, more extensive microvascular inflammation and a higher rate of kidney allograft loss. Thus, our study identified coordinated and persistent defects in regulatory T- and B-cell responses in patients undergoing ABMR, which may contribute to their loss of humoral immune regulation, and warrant timely therapeutic interventions to replenish and sustain TREG and transitional B cells in these patients.

There are limited data on the impact of COVID‐19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID‐19 in pediatric KT patients. Twenty‐two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS‐CoV‐2 by PCR. Testing indications included symptoms and/or potential exposures to COVID‐19 (N= 134, 47.7%) and/or testing per hospital policy (N= 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID‐19‐positive patients, 16 were managed as outpatients, six received non‐ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID‐19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID‐19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID‐19 disease and excellent short‐term outcomes. This report from the Improving Renal Outcomes Collaborative describes SARS‐CoV‐2 testing characteristics, indications, and positivity rate along with the symptoms and clinical outcomes of COVID‐19 for pediatric kidney transplant patients across 22 centers in the United States.

There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID-19 in pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures to COVID-19 (N= 134, 47.7%) and/or testing per hospital policy (N= 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID-19-positive patients, 16 were managed as outpatients, six received non-ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID-19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID-19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID-19 disease and excellent short-term outcomes.

BACKGROUND AND OBJECTIVE:The quantification of the density of macular vascular networks and blood flow areas in the foveal and parafoveal area in healthy subjects using optical coherence tomography angiography (OCTA).PATIENTS AND METHODS:Cross-sectional, prospective study in an institutional setting at the Retina Services of Farabi Eye Hospital. One hundred twelve normal volunteers with no known ocular or systemic disease were included, including patient numbers (one or both eyes), selection procedures, inclusion/exclusion criteria, randomization procedure, and masking. En face angiogram OCTA was performed on a 3 mm × 3 mm region centered on the macula. Automated thresholding and measuring algorithm method for foveal and parafoveal blood flow and vascular density (VD) were used. The density of macular vascular networks and blood flow area in the foveal and parafoveal area were measured.RESULTS:A total of 224 healthy eyes from 112 subjects with a mean age of 36.4 years ± 11.3 years were included. In the foveal region, the VD of the superficial capillary network (sCN) was significantly higher than that of the deep capillary network (dCN) (31.1% ± 5.5% vs. 28.3% ± 7.2%; A total of 224 healthy eyes from 112 subjects with a mean age of 36.4 years ± 11.3 years were included. In the foveal region, the VD of the superficial capillary network (sCN) was significantly higher than that of the deep capillary network (dCN) (31.1% ± 5.5% vs. 28.3% ± 7.2%; P< .001), whereas in the parafoveal area, VD was higher in the dCN (62.24% ± 2.8% vs. 56.5% ± 2.5%; P< .001). Flow area in the 1-mm radius circle in the sCN was less than in the dCN. Superficial foveal avascular zone (sFAZ) size was negatively correlated with the VD of the foveal sCN, but in the deep FAZ (dFAZ) was not correlated with VD or blood flow area of the fovea. There was no difference between measured VD and blood flow surface area in both eyes of the subjects.CONCLUSIONS:OCTA could be used as a noninvasive, repeatable, layer-free method in quantitative evaluation of VD and blood flow of macular area. The normal quantities of the vascular plexus density and flow will help in better understanding the pathophysiological basis of the vascular disease of retina.[[Ophthalmic Surg Lasers Imaging Retina. 2017;48:478–486.]

AbstractToll-like receptors (TLRs) recognizing the exogenous pathogen-associated molecular patterns (PAMPs) are part of the innate immune system that plays a role in various challenging interactions between the neurons and the immune system. Stroke as a major injury to the central nervous system (CNS) is one of the hot points of such cross-talk. The various roles of the different types of TLRs in stroke can be classified into three major categories: (1) the hazardous effect of TLRs with a focus on the part in poststroke neurodegeneration, (2) the beneficial effect of those types of TLRs that exert a neuroprotective effect following an ischemic insult, and (3) the role of TLRs in immunomodulation on one hand and the possible autoimmunity as a consequence of neuronal injury due to an ischemic attack on the other hand. However, the mentioned functions of TLRs, similar to many other parts of the immune system, might overlap in many aspects. The current review article, including both experimental and clinical studies, is an attempt to bring together the studies that have investigated the roles of TLRs in stroke while referring to the apparent controversies in this field, with pointing out the new ideas for further considerations.

The electromagnetic fields (EMF) have various behavioral and biological effects on human body. There are growing concerns about the consequences of exposure to EMF. However, some studies have shown beneficial effects of these waves on human. In this paper, we study the effect of acute, sub acute and long-term exposure to 50 Hz, 0.1 mT magnetic fields (MF) on the seizure induction threshold in mice. 64 mice are used and divided into four groups. Eight mice in any group were selected to be exposed to MF for specific duration and the others were used as a control group. The duration of the applied exposures was as follows: (1) 1 day (acute), (2) 3 days (sub acute), (3) 2 weeks (sub acute), (4) 1 month (long term). The mice were exposed 2 h for a day. After exposure, the pentylentetrazol (PTZ) is injected to the mice to induce seizure and the needed dose for the seizure induction threshold is measured. In the acute exposure, the threshold to induce seizure in the exposed and sham-exposed groups was 44.25 and 46.5 mg, respectively, while the difference was not significant (pvalue = 0.5). In the sub acute exposure (3 days), the mean amount of drug to induce seizure was 47.38 mg in the exposed and 43.88 mg in the sham-exposed groups, however, the difference was not significant (pvalue = 0.3). The results were 52.38 and 46.75 mg after 2 weeks of exposure which were not significantly different either (pvalue = 0.2). After 1 month of exposure to MF, the threshold for the induction of seizure was significantly increased (pvalue < 0.05). The mean dosage to induce seizure in the exposed and control group was 54.3 and 45.75 mg, respectively. However, considering the pvalue, the difference in the seizure induction threshold between the exposed and sham-exposed groups after acute and sub acute exposure was not significant, analyzing the effects of acute, sub acute and long-term exposures totally indicates that increasing the exposure time increases the seizure induction threshold.The electromagnetic fields (EMF) have various behavioral and biological effects on human body. There are growing concerns about the consequences of exposure to EMF. However, some studies have shown beneficial effects of these waves on human. In this paper, we study the effect of acute, sub acute and long-term exposure to 50 Hz, 0.1 mT magnetic fields (MF) on the seizure induction threshold in mice. 64 mice are used and divided into four groups. Eight mice in any group were selected to be exposed to MF for specific duration and the others were used as a control group. The duration of the applied exposures was as follows: (1) 1 day (acute), (2) 3 days (sub acute), (3) 2 weeks (sub acute), (4) 1 month (long term). The mice were exposed 2 h for a day. After exposure, the pentylentetrazol (PTZ) is injected to the mice to induce seizure and the needed dose for the seizure induction threshold is measured. In the acute exposure, the threshold to induce seizure in the exposed and sham-exposed groups was 44.25 and 46.5 mg, respectively, while the difference was not significant (pvalue = 0.5). In the sub acute exposure (3 days), the mean amount of drug to induce seizure was 47.38 mg in the exposed and 43.88 mg in the sham-exposed groups, however, the difference was not significant (pvalue = 0.3). The results were 52.38 and 46.75 mg after 2 weeks of exposure which were not significantly different either (pvalue = 0.2). After 1 month of exposure to MF, the threshold for the induction of seizure was significantly increased (pvalue < 0.05). The mean dosage to induce seizure in the exposed and control group was 54.3 and 45.75 mg, respectively. However, considering the pvalue, the difference in the seizure induction threshold between the exposed and sham-exposed groups after acute and sub acute exposure was not significant, analyzing the effects of acute, sub acute and long-term exposures totally indicates that increasing the exposure time increases the seizure induction threshold.

AbstractIn the present work, a rapid deposition anodic stripping voltammetry (ASV) for determination of uranium is presented. For this purpose, the uranyl hexacyanoferrate (K2UO2[Fe(CN)6]) is deposited electrochemically on a thin palladium-aluminum electrode (Pd-Al) from a UO22+solution in the presence of K3Fe(CN)6. Then, the well stable (K2UO2[Fe(CN)6]) on the electrode was stripped by anodic differential pulse voltammetry for measuring the UO22+ion concentration. The effect of operational parameters, including: concentration of K3Fe(CN)6, solution pH, deposition potential, and deposition time were studied. In optimum conditions, the calibration graph was linear in the concentration range 10−5−7×10−4mol L−1with a detection limit of 6.2×10−6mol L−1. The influence of some concomitant ions in K2UO2[Fe(CN)6] formation was investigated. The proposed method was used for the rapid determination of uranium in some uranium mineral ores.

AbstractDuring the autumn of 2007, two mass mortality events involving at least 152 small cetaceans were reported from southern Iran. Both events occurred on the Gulf of Oman coast near the town of Bandar Jask, and were separated by a month in time and more than 170 km in distance. The first event, on 20 September 2007, involved 79 animals, probably all Spinner Dolphins (Stenella longirostris). Dead animals, all exhibiting a similar degree of decomposition, drifted to shore along 13 km of coastline over a period of approximately 24 hours. These circumstances suggest that the mortality was caused by a single acute event at sea. Several carcasses had evidence of traumatic injuries, the stranding event was spatially and temporally coincident with an active fishing ground, and other potentially bycaught and discarded species were found on the beach. This pattern is generally consistent with the hypothesis that the Dolphin mortality was caused by fishing operations, although the available data are insufficient to confirm that hypothesis unequivocally. On 24 October 2007 there was a mass stranding of 73 live Striped Dolphins (Stenella coeruleoalba), a pelagic species believed to be rare in the Gulf of Oman. The most likely explanation for this mass stranding is that the Dolphin group was trapped by a falling tide among the complex sandbanks of the Kangan estuary. Striped Dolphins are not normally found in shallow water or near shore, and their occurrence in this area is considered unusual. The factor or factors that caused them to enter this atypical habitat remain unknown. The two mass mortality events involved different species and exhibited many different characteristics; there is no evidence to suggest that they were linked.

An electroanalytical strategy for the simultaneous determination of ascorbic acid (AA) and dehydroascorbic acid (DHA), is described. A palladized Al electrode is used for hydrodynamic amperometry of AA. While the decrease of anodic stripping voltammetry current of the K2UO2[Fe(CN)6]‐Pd/Al electrode prepared in the presence of DHA was the principal of the DHA determination. The calibration graph for both methods was linear over the concentration range 1–50 μM. The detection limit was found to be 0.5 μM. Some fresh fruit juices and vegetables of trace level of AA and DHA were analyzed as the typical example of application.