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Myocardial infarctions (MIs) are a major cause of death worldwide, and both high and low temperatures (i.e. heat and cold) may increase the risk of MI. The relationship between health impacts and climate is complex and influenced by a multitude of climatic, environmental, socio-demographic and behavioural factors. Here, we present a machine learning (ML) approach for predicting MI events based on multiple environmental and demographic variables. We derived data on MI events from the KORA MI registry dataset for Augsburg, Germany, between 1998 and 2015. Multivariable predictors include weather and climate, air pollution (PM10, NO, NO2, SO2 and O3), surrounding vegetation and demographic data. We tested the following ML regression algorithms: decision tree, random forest, multi-layer perceptron, gradient boosting and ridge regression. The models are able to predict the total annual number of MIs reasonably well (adjusted R2=0.62–0.71). Inter-annual variations and long-term trends are captured. Across models the most important predictors are air pollution and daily temperatures. Variables not related to environmental conditions, such as demographics need to be considered as well. This ML approach provides a promising basis to model future MI under changing environmental conditions, as projected by scenarios for climate and other environmental changes.

Toxocara canis and Toxascaris leonina are the most important ascaridoid nematodes of the family Toxocaridae. The present study was aimed to characterisation and analysis of genetic variation within and among T. canis and T. leonina isolates obtained from Iran by sequencing partial mitochondrial cytochrome c oxidase subunit 1 (pcox1) and partial NADH dehydrogenase subunit 1 (pnad1) genes. A total number of 134 adult nematodes belonging to Toxocaridae family were collected from stray dogs in Alborz province, Iran during 2015 and 2016. Polymerase chain reaction (PCR) was performed and products were sequenced. Sequences of two mitochondrial cox1 and nad1 genes were compared with other sequences in the GenBank, while multiple sequences alignment analysis was performed using the Bioedit and MEGA6 software and phylogenetic tree was plotted. For all isolates, amplicons of about 450 and 350 base pairs (bp) were successfully produced by PCR for cox1 and nad1, respectively. All sequences of T. canis isolates from present study were 100% homologous across the nad1 gene but not in the cox1 gene. The results indicate that the PCR method based on sequence of cox1 and nad1 genes is a suitable technique for the differentiation of T. canis and T. leonina species and that mtDNA regions could be used as genetic markers for the identification and differentiation of Toxocara species.

In this paper, a novel two output nine switch-inverter is proposed in order to increase the synchronization speed of induction motors used in electric vehicles (EVs) while improving the efficiency and controllability of the system. The number of switches in the proposed inverter is reduced by 25% compared to double six-switch inverters which conventionally used in EVs. The main characteristics of the considered inverter can be noted as follows: sinusoidal input and outputs, unity output power factor, and specifically, low construction cost due to active switch number reduction. The classical direct torque control method causes torque ripple and speed fluctuations. Therefore, in order to increase accuracy and dynamics of drive system, the SVM-DTC method is proposed, leading to less torque ripple and constant switching frequency. The obtained torque ripple is 2% which is less than the existing structures In order to illustrate advantages of the proposed approach, performance of the EVs in the standard cycles is evaluated.

In this paper, a new method based on combination of the natural transform method (NTM), Adomian decomposition method (ADM), and coefficient perturbation method (CPM) which is called “perturbed decomposition natural transform method” (PDNTM) is implemented for solving fractional pantograph delay differential equations with nonconstant coefficients. The fractional derivative is regarded in Caputo sense. Numerical evaluations are included to demonstrate the validity and applicability of this technique.

It has been more than half a century that plant geneticists and breeders have been trying to assemble a combinationof genes in crop plants, in order to make them as suitable and productive as possible. Plant transformation technology incrop plants was first undertakenin the 1980s based on the ability of foreign gene integration into host plant genome andregeneration of transformed plant cells into whole plants. Soon after, transgenic plants were to be grown by farmers.Statistics show that farmers have started to cultivate genetically modified plants (GMPs) commercially since 1996.Between 1996 and 2012, the total surface area of land cultivated with GM crops has increased from 2 million hectaresto more than 170 million hectares in 29 countries. To this extent, some concerns have been raised by ecologists andconsumer organizations in West European countries based on the possibilities of horizontal and vertical gene flow ofantibiotic or herbicide resistance from transgenic plants into human intestinal bacteria and some weeds via outcrossing,respectively. Due to consumer and ecologist concerns, different approaches have been developed to eliminate marker(and/or reporter) genes from the nuclear or chloroplast genome after selection. Some of these proposed methods are:1. Replacing selectable markers with screenable ones.2. Elimination of marker genes by co-transformartion followed by classic recombination and selection.3. Excision of marker gene by some site-specific recombinases.4. Separation of the transgene and selectable marker by transposable elements.5. Avoiding gene pollution by chloroplasts genetic engineering followed by elimination of selectable marker.

Starch is one of the most widely used biopolymers in water based drilling fluids to control fluid loss. The thermal stability of starch in common drilling fluids is low (93 °C). In this study, the thermal stability of starch has been evaluated in sodium/potassium formate and potassium chloride fluids. Samples of mud were prepared by formate salts (sodium and potassium) and potassium chloride with the same formulations. The rheological and filter loss properties and shale recovery were studied at different temperatures. The results showed that despite the relatively low concentration of starch (4 gr⁄350cm3 ) and low density of mud, the sodium and potassium formate salts increased the thermal stability of starch up to 150 °C for 16 hours. The rheological and fluid loss properties of formate fluid after 16 hours hot rolling slightly changed compared with potassium chloride fluid. Also, the results showed that the shale recovery of formate fluid is better than that of potassium chloride fluid. Thus, formate salts improved the thermal stability of starch in water based drilling fluids

In this study, synthetic sulfonated polymers were used in order to enhance the rheological properties of drilling fluids. The capability of these polymers in reducing the effects of environmentally friendly, but harmful, pollutants such as cement, calcium chloride, gypsum as well as pH changes were investigated. In the present work, two sulfonated synthetic polymers, namely Polythin and Polydrill, which are considered to be environmentally friendly polymers, were used. Polydrill controls the fluid loss and is resistant to high temperatures and also pollutants. The injection of this polymer into drilling fluid slightly increases the viscosity levels. Polythin prevents the precipitation of bentonite at high temperatures and facilitates fluid pumping by reducing its rheological and static shear strength. Polythin polymer also prevents the formation of bentonite gelation (precipitation of bentonite) at higher temperatures and is stable up to 260 °C. This polymer is also capable of completing the effects of fluid loss additives and reduction of filtration in HTHP drilling fluids. Furthermore, this polymer reduces rheology, strength, and static shearing values and facilitates pumping of the drilling fluid. The combination of aforementioned polymers improves the thermal resistance of drilling muds while maintaining the rheology and reducing the amount of filtrate for HTHP drilling fluids. In these experiments, the rheological properties of the fluid including apparent viscosity (AV), plastic viscosity (PV), yielding point (YP), gelation resistance or gel strength (GEL), fluid loss (FL), and the pH of the fluid were studied before and after the addition of the pollutants. The results indicate that certain proportions of these two polymers increase the rheological properties of drilling fluids and can significantly change the weight percentages of pollutants. It is also notable that the rheological properties were normally constant. However, in some cases, smaller values of rheological parameters enhanced the efficiency in the presence of pollutants. In the case of calcium chloride, rheological parameters (AV, PV, YP, and gel strength) are almost constant, while fluid loss greatly increases.

Laboratory tests and two field experiments were conducted in RCB design in 2006 and 2007 at the Research Farm of the University of Tabriz, Iran, to evaluate the effects of hydro and osmo - priming (PEG: Polyethylene glycol 6000 at -0.8MPa ) on seed germination and field emergence of lentil. Analysis of variance for laboratory data showed that hydropriming significantly improved germination rate and root weights, compared to other seed treatments. However germination percentage for seeds primed with water and PEG were statistically similar, but higher than those for unprimed seeds. Over all, hydropriming treatment was comparatively superior in laboratory tests. Invigoration of lentil seeds by hydropriming resulted in higher seedling emergence in the field, compared to control and seed priming with PEG. Seedling emergence rate was also enhanced by priming seed with water. Thus, hydropriming could be used as a simple method for improving seed germination and seedling emergence of lentil in the field.

Background: After radiation therapy (RT), some health hazards including DNA damages may occur where melatonin can play a protective role due to free radical generation. On the other hand, serious accidental overexposures may occur during RT due to nuclear accidents which necessitate the need for study on exposure to highdose radiations during treatments. Objective: The aim of this study was to study the expression level of two genes in non-homologous end joining (NHEJ) pathways named Xrcc4 and Xrcc6 (Ku70) in order to examine the effect of melatonin on repair of DNA double-strand breaks (BSBs) caused by 8Gy ionizing radiation. Methods: One hundred eight male Wistar rats were irradiated with a whole body gamma radiation dose of 8Gy with or without melatonin pretreatments. They were divided into six different groups of control, 100 mg/kg melatonin alone, 8Gy irradiation alone, vehicle alone, vehicle plus 8Gy irradiation and 100 mg/kg melatonin plus 8Gy irradiation. Peripheral blood samples were collected at 8, 24 and 48 h after irradiation. Ku70 and Xrcc4 gene expression were evaluated by real-time quantitative polymerase chain reaction (qPCR) technique and analyzed by one-way ANOVA test. Results: Expression of Ku70 and Xrcc4 genes normalized against Hprt gene showed significant difference in melatonin plus irradiation group at 8h compared to the control group (p<0.05). At 24h post irradiation, gene expression changes were significantly upregulated in irradiation-alone group as well as melatonin plus irradiation group (p<0.05). No significant change was found in any groups compared to control group at 48 h time point. Conclusion: We concluded that, by increasing expression level of Ku70 and Xrcc4 genes, 100 mg/kg melatonin administration 8 and 24 h before 8 Gyionizing radiation can significantly affect the repair of DNA DSBs in NHEJ pathway. [ABSTRACT FROM AUTHOR]

Walnut (Juglans regia L.).is an important nut crop with a "difficult-to-root" characteristic. In this study, the rooting ability of. low-vigour and precocious seedlings of 3-year-old Persian walnut was compared with semi-vigorous and high-vigour seedlings using the stool layering method. The results indicated that low-vigour seedlings rooted more (40%) than semi-vigorous (31.42%) and high-vigour (17.14%) seedlings. The average number of roots per shoot (layer) and rooting score (on a scale of 1 - 5) in the low-vigour group were 7.83 and 4.19, respectively, which differed significantly from the high-vigour group. Moreover, most of the high quality adventitious roots formed on low-vigour seedlings appeared to originate from internal tissues compared to the low quality and brittle roots that originated from callus in high-vigour seedlings. Improved rooting of low-vigour seedlings, together with a significant negative correlation between layer size and root number (r = -0.29), reflects substantial structural or hormonal differences among seedlings of different vigour. Approx. 70% of rooted layers survived after transferring to field condition. Our results provide more support for the possibility of vegetative propagation of walnut by conventional stool layering, as well as the selection of easy-to-root, dwarf walnut cultivars or rootstocks on their own roots. [ABSTRACT FROM AUTHOR]

Background: Ornithobilharziosis as one of the parasitic infections may give rise to serious economic problems in animal husbandry. The Aim of the study was to prepare and compare the somatic and excretory-secretory (ES) antigens of O. tur­kestanicum in gel diffusion test. Methods: Excretory-secretory (ES) and somatic antigens of Ornithobilharzia turkestanicum were prepared from collected worms from mesentric blood vessels of infected sheep. The laboratory bred rabbits were immunized with antigens and then antisera were prepared. The reaction of antigens and antisera was observed in gel diffusion test. Results: ES antigens of this species showed positive reaction with antisera raised against ES and also somatic antigens. Somatic antigens also showed positive reaction with antisera raised against somatic and also ES antigens. Conclusion: The antigenicity of O. turkestanicum ES and somatic antigens is the same in gel diffusion test.

Background: Ornithobilharziosis as one of the parasitic infections may give rise to serious economic problems in animal husbandry. The Aim of the study was to prepare and compare the somatic and excretory-secretory (ES) antigens of O. tur­kestanicum in gel diffusion test. Methods: Excretory-secretory (ES) and somatic antigens of Ornithobilharzia turkestanicum were prepared from collected worms from mesentric blood vessels of infected sheep. The laboratory bred rabbits were immunized with antigens and then antisera were prepared. The reaction of antigens and antisera was observed in gel diffusion test. Results: ES antigens of this species showed positive reaction with antisera raised against ES and also somatic antigens. Somatic antigens also showed positive reaction with antisera raised against somatic and also ES antigens. Conclusion: The antigenicity of O. turkestanicum ES and somatic antigens is the same in gel diffusion test.

Abstract: Titanium dioxide nanoparticles were modified using a sacrificial organic acid carrier at low pH values where the zeta potential of the TiO2 nanoparticles was found to be highly effective forming 0.05, 0.1, 0.5wt.% Ag/TiO2 nanocomposites. The organic carrier was acting both as an Ag ion carrier and a hole scavenger enhancing the photodeposition of Ag atoms. The formed nanocomposites were calcined at 300 and 400°C under controlled atmosphere and later examined for photocatalytic performance using a 125 medium pressure mercury lamp decomposing formic acid as an organic pollutant. Morphological, crystallographical and UV–vis spectroscopy analyses were used to characterize the synthesized nanocomposites. The studies have revealed that non-calcined 0.5wt.% Ag/TiO2 nanocomposite has the best photocatalytic activity compared with other synthesized nanocomposites and that of the non-modified TiO2 (P25). Further calcination of the synthesized nanocomposites has shown to be effective in lower Ag concentrations where 0.1wt.% Ag/TiO2 nanocomposite has the best photocatalytic activity at the 400°C. [Copyright &y& Elsevier]

Introduction: Obesity is a known risk factor for chronic kidney disease (CKD), but the impact of obesity severity and duration on CKD incidence is unclear., Methods: Cumulative Excess Weight (CEW) and Cumulative Excess Waist Circumference (CEWC) scores were calculated, which represent the accumulation of deviations from expected body mass index and waist circumference values over time until the development of CKD or the end of the follow-up period. Time-dependent Cox models were used to investigate the sex-stratified association of CEW and CEWC with CKD incidence while controlling for confounding variables., Results: Out of the 8697 participants who were evaluated in this study, 56% (4865) were women and the mean age was 40 ± 14. During the 15-year follow-up period, 41.7% (3629) of the participants developed CKD. Among the CKD patients, 65.4% (829) of men and 77.9% (1839) of women had a BMI higher than 25, and high WC was found to be 73.7% (934) and 55.3% (1306) for men and women, respectively. We found a significant association between one standard deviation change of CEW and the development of CKD in both sexes (fully adjusted hazard ratios and 95% CI of CEW in men and women were 1.155 [1.081-1.232) and 1.105 (1.047-1.167)]. However, the association between CEWC and CKD development was only significant among men participants [HR = 1.074 (1.006-1.147)]., Conclusion: Over a 15-year follow-up, the accumulation of general and central obesity was associated with an increased incidence of CKD development., (© 2024. The Author(s).)

Background: This study aimed to evaluate the 3-year outcomes of sleeve gastrectomy in non-diabetic individuals with class I obesity., Methods: A total of 78 participants with class I obesity and 78 participants with class II obesity, matched in terms of age, sex (93.6% female), and the rates of dyslipidemia and hypertension, were included in this prospective cohort study. Follow-up data, including metabolic features, body composition, nutritional characteristics, and surgery complications, were gathered at the baseline and 6, 12, 24, and 36 months post-bariatric surgery. Micronutrient deficiencies and comorbidities (hypertension and dyslipidemia) were evaluated in both groups using conditional logistic regression analysis, and Clavien-Dindo classification was used to compare surgical complications., Results: Baseline characteristics of the participants in both groups were similar (n = 78, mean age: 36.4 ± 8.5). The two groups were also comparable in terms of weight loss, cardiovascular risk factors, and remission of obesity-related comorbidities 3 years following sleeve gastrectomy. Overall values of Δ total weight loss (TWL)%, Δ excess weight loss (EWL)%, and β (95% CI) were - 1.86 (1.19), and - 2.56 (4.5) with a P value of 0.118 and 0.568, respectively. The occurrence of surgical complications and undesirable outcomes were also similar between the two study groups., Conclusion: Bariatric surgery is an effective and safe method to achieve weight loss and alleviate cardiovascular risk factors and obesity-related comorbidities in non-diabetic individuals with class I and class II obesity., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Definitions of childhood and adolescent hypertension (HTN) do not precisely elucidate the relationship between HTN and cardiovascular outcomes. Carotid intima-media thickness (CIMT), as a substitute for cardiovascular outcomes, enables the early identification of cardiovascular events throughout early adulthood., Purpose: This study aimed to compare the ability of childhood HTN definitions to predict a high CIMT in early adulthood., Methods: This prospective cohort study included 921 individuals aged 10-17 years from the Tehran Lipid and Glucose Study (TLGS). The CIMT was measured after 18 years of follow-up. Participants were categorized into normal blood pressure (BP), high-normal BP, HTN stage 1, and HTN stage 2 groups based on the childhood HTN definitions of the 4th report, European Society of Hypertension (ESH), and American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG). Akaike's information criterion (AIC) and relative efficiencies (RE) were calculated to compare the ability of each to predict a high CIMT (≥95th percentile) during early adulthood., Results: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. According to the RE values, the highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively. In all models, the 4th report's pediatric HTN definition had the lowest AIC value and offered the best predictive ability., Conclusion: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG. Because the reference population of the 4th report includes overweight, obese, and normal-weight individuals, our findings suggest that excessive adiposity is among the main predictors of early adulthood atherosclerosis risk.

Background: Obesity and hypothyroidism are common medical conditions that are associated with each other. Bariatric surgery (BS) is a common approach used to achieve substantial weight loss in obese patients. However, there is limited evidence regarding the need for postsurgery levothyroxine (LT4) dose adjustment in patients with hypothyroidism undergoing BS. Methods: This was a three-year prospective cohort study assessing postsurgery LT4 requirements with attention to body composition changes. The current study included 1030 patients with hypothyroidism, who underwent sleeve gastrectomy (SG) ( n = 707, 88.3% women) or one anastomosis gastric bypass (OAGB) ( n = 323, 92% women). Patients were followed for 36 months after surgery. A bioelectrical impedance analyzer was used for body composition assessment. LT4 requirements were assessed by generalized estimating equation (GEE) methods adjusted for weight as a time-varying covariate. Results: During the follow-up, TSH (mIU/L) and T4 (ng/dL) measurements did not significantly change in the OAGB group over time. However, in the SG group, TSH measurement decreased over time ( p trend = <0.001). In the third year of the follow-up, 56.1% and 33.3% of patients in the SG and OAGB groups experienced LT4 (μg/day) dose reduction, while 24.4% and 9.1% of the participants experienced LT4 dose increments, respectively. GEE analysis showed a significant increase in the LT4/fat mass (FM) (μg/kg) ratio after 36 months of follow-up compared with the baseline in both the SG [1.8 (1.5-2.2) to 2.7 (2.0-3.5), p trend = 0.039)] and OAGB [1.7 (1.4-2.2) to 3.2 (2.7-4.8), p trend = <0.001)] groups. Moreover, patients who underwent OAGB experienced greater LT4/FM (μg/kg) dose adjustments compared to those undergoing SG ( p between = 0.060). In both groups, after the first year, the increase in LT4/FM (μg/kg) plateaued ( p interaction = 0.009). Conclusion: Most hypothyroid patients experienced either a reduction or no change in LT4 (μg/day) dosage after 36 months in both surgical groups. The LT4/FM (μg/kg) was significantly increased in patients undergoing either SG or OAGB with greater alterations in the latter. Further studies on larger populations and with longer duration of follow-up are needed to confirm our results.

Battery power is crucial for wearable devices as it ensures continuous operation, which is critical for real-time health monitoring and emergency alerts. One solution for long-lasting monitoring is energy harvesting systems. Ensuring a consistent energy supply from variable sources for reliable device performance is a major challenge. Additionally, integrating energy harvesting components without compromising the wearability, comfort, and esthetic design of healthcare devices presents a significant bottleneck. Here, we show that with a meticulous design using small and highly efficient photovoltaic (PV) panels, compact thermoelectric (TEG) modules, and two ultra-low-power BQ25504 DC-DC boost converters, the battery life can increase from 9.31 h to over 18 h. The parallel connection of boost converters at two points of the output allows both energy sources to individually achieve maximum power point tracking (MPPT) during battery charging. We found that under specific conditions such as facing the sun for more than two hours, the device became self-powered. Our results demonstrate the long-term and stable performance of the sensor node with an efficiency of 96%. Given the high-power density of solar cells outdoors, a combination of PV and TEG energy can harvest energy quickly and sufficiently from sunlight and body heat. The small form factor of the harvesting system and the environmental conditions of particular occupations such as the oil and gas industry make it suitable for health monitoring wearables worn on the head, face, or wrist region, targeting outdoor workers.

This retrospective study reports on the survival of two-piece angulated prosthetic platform (APP) implants consecutively placed at a specialist periodontics clinic with a mean follow-up of 28.2 ± 15.6 months (range: 4.0 to 71.0). For 183 returning patients who received 239 implants, the survival rates at follow-up (up to 71 months) were 99.2% and 91.1% at the patient and implant levels, respectively. A majority of patients were nonsmokers and did not have diabetes, with a quarter having a history of treated periodontitis. Eighty percent of patients received a single APP implant. Of the implants, 63% supported a single crown, 28% a fixed partial denture, and 9% a fixed complete denture. Nearly all implants were placed either at tooth extraction or after complete bone healing, in approximately equal numbers. Of the implant sites, approximately 75% received bone grafting, with approximately 25% receiving adjunct soft tissue grafting. For 210 surviving and restored implants with satisfactory intraoral radiographs taken at the last recall (mean follow-up: 28.4 ± 15.5 months; range: 4.0 to 71.0 months), the mean radiographic bone levels were -0.70 ± 0.87 mm (range: -3.60 to 2.15 mm). The results demonstrated clinically successful use of this unique geometry implant for multiple applications with acceptable short- to medium-term clinical outcomes.

Background: Cushing's syndrome (CS) poses diagnostic challenges, particularly in distinguishing pituitary-dependent Cushing's syndrome, Cushing's disease (CD), from the ectopic ACTH syndrome (EAS). This study evaluated the diagnostic value of the desmopressin stimulation test (DST) in patients with ACTH-dependent CS in helping this discrimination., Methods: Twenty-three ACTH-dependent CS patients underwent sequential DST, bilateral inferior petrosal sinus sampling (BIPSS), and transsphenoidal surgery (TSS). Two definitions of a positive DST results were applied. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios. To avoid bias from predetermined criteria, we generated univariate receiver-operating characteristic (ROC) curves, plotting sensitivity against 1-specificity at various percentage cortisol and ACTH response levels., Results: Against BIPSS, DST demonstrated robust sensitivity (Definition 1: 90.0%, Definition 2: 76.2%) and overall accuracy (Definition 1: 87.0%, Definition 2: 73.9%). PPV was high (Definition 1: 95.0%, Definition 2: 94.1%), but NPV indicated potential false negatives. Compared to TSS, DST showed good sensitivity (Definition 1: 90.9-77.3%) and PPV (100.0%) but limited NPV (16.7%). The likelihood ratios emphasized the diagnostic value of the test. Notably, against TSS, DST showed perfect discriminatory power (AUC 1.000 for percent ACTH, 0.983 for percent cortisol)., Conclusion: The desmopressin test shows promise in accurately identifying the underlying cause of ACTH-dependent CS, potentially reducing the reliance on invasive procedures and providing a practical solution for managing complex cases. Further research with larger cohorts is required to validate the utility of the DST in routine clinical practice.

Cushing's syndrome (CS) is a rare disorder, once exogenous causes have been excluded. However, when diagnosed, the majority of cases are adrenocorticotropic hormone (ACTH)-dependent, of which a substantial minority are due to a source outside of the pituitary, ectopic ACTH syndrome (EAS). Differentiating among pituitary-dependent CS, Cushing's disease (CD) and an ectopic source can be problematic. Because non-invasive tests in the evaluation of CS patients often lack adequate sensitivity and specificity, bilateral inferior petrosal sinus sampling (BIPSS), a minimally invasive procedure performed during the investigation of ACTH-dependent CS, can be extremely helpful. BIPSS is considered to be the gold standard for differentiating CD from the EAS. Furthermore, although such differentiation may indeed be challenging, BIPSS is itself a complex investigation, especially in recent times due to the widespread withdrawal of corticotrophin-releasing hormone and its replacement by desmopressin. We review current published data on this investigation and, in the light of this and our own experience, discuss its appropriate use in diagnostic algorithms., (© 2024 The Association for the Publication of the Journal of Internal Medicine.)

Apoptosis can be known as a key factor in the pathogenesis of neurodegenerative disorders. In disease conditions, the rate of apoptosis expands and tissue damage may become apparent. Recently, the scientific studies of the non-coding RNAs (ncRNAs) has provided new information of the molecular mechanisms that contribute to neurodegenerative disorders. Numerous reports have documented that ncRNAs have important contributions to several biological processes associated with the increase of neurodegenerative disorders. In addition, microRNAs (miRNAs), circular RNAs (circRNAs), as well as, long ncRNAs (lncRNAs) represent ncRNAs subtypes with the usual dysregulation in neurodegenerative disorders. Dysregulating ncRNAs has been associated with inhibiting or stimulating apoptosis in neurodegenerative disorders. Therefore, this review highlighted several ncRNAs linked to apoptosis in neurodegenerative disorders. CircRNAs, lncRNAs, and miRNAs were also illustrated completely regarding the respective signaling pathways of apoptosis., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: The Bruton tyrosine kinase (BTK), an important element for the production of several inflammatory cytokines, may play a role in the pathogenesis of COVID-19. The aim of this study was to investigate the level of BTK gene expression in COVID-19 cases based on the severity and the outcome of the disease., Methods: In this study, 33 hospitalized patients with COVID-19 were recruited and were divided into two groups based on the severity of the disease: "mild to moderate" and "severe to critical". A blood sample was taken from each patient, peripheral blood mononuclear cells (PBMCs) were extracted, and BTK gene expression was measured. The level of BTK gene expression was compared based on the demographic data, laboratory results, and the severity and outcome of the disease., Results: Among 33 patients, 22 (66.7%) were male. Nearly half of the cases had at least one underlying disease. According to the severity of the disease, 12 patients were in the "mild to moderate" group, and 21 were in the "severe to critical" group; eight (24.2%) eventually died. Age, weight, and BMI had no significant relationship with BTK expression. BTK expression was significantly lower in "severe to critical" and ICU-admitted cases and in subjects with low O2 saturation. There was no significant difference in BTK expression between cured and dead patients (p=0.117)., Conclusion: BTK gene expression in PBMCs had an inverse relationship with the severity of the disease of COVID-19. However, no correlation between BTK expression and disease outcome was observed., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Nowadays with the increase of high-rise buildings, emergency evacuation is an indispensable part of urban environment management. Due to various disaster incidents occurred in indoor environments, research has concentrated on ways to deal with the different difficulties of indoor emergency evacuation. Although global navigation satellite systems (GNSSs) such as global positioning system (GPS) come in handy in outdoor spaces, they are not of much use in enclosed places, where satellite signals cannot penetrate easily. Therefore, other approaches must be considered for pedestrian navigation to cope with the indoor positioning problem. Another problem in such environments is the information of the building indoor space. The majority of the studies has used prepared maps of the building, which limits their methodology to that specific study area. However, in this study we have proposed an end-to-end method that takes advantage of BIM model of the building, thereby applicable to every structure that has an equivalent building information model (BIM). Moreover, we have used a mixture of Wi-Fi fingerprinting and pedestrian dead reckoning (PDR) method with relatively higher accuracy compared to other similar methods for navigating the user to the exit point. For implementing PDR, we used the sensors in smartphones to calculate user steps and direction. In addition, the navigational information was superimposed on the smartphone screen using augmented reality (AR) technology, thus communicating the direction information in a user-friendly manner. Finally, the AR mobile emergency evacuation application developed was assessed with a sample audience. After an experience with the app, they filled out a questionnaire which was designed in the system usability scale test (SUS) format. The evaluation results showed that the app achieved an acceptable suitability for usage., 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., (© 2024 The Authors. Published by Elsevier Ltd.)

This study evaluates the potential use of discarded plasterboard paper as fibers from buildings to reinforce concrete. Various concentrations of wastepaper fibers (0.5%, 1%, 1.5%, 2%, and 2.5% by weight of the binder) were investigated in this research. To mitigate the water absorption effect of the paper fibers, metakaolin was employed as a partial cement replacement. The results demonstrate that the inclusion of the wastepaper fiber enhances the mechanical and durability performance of the concrete. The optimal fiber proportion was identified as 1%, leading to a 29% increase in the compressive strength, a 38% increase in the splitting tensile strength, a 12% decrease in the water absorption, and a 23% decrease in the drying shrinkage with respect to the concrete containing 20% metakaolin. However, exceeding this optimal fiber content results in decreased mechanical and durability properties due to the fiber agglomeration and non-uniform fiber distribution within the concrete matrix. Based on the microstructural analysis, the improved performance of the concrete is ascribed to decreased porosity, more refined pore structure, and reduced propagation of microcracks within the concrete matrix in the presence of wastepaper fiber. According to the results, concrete containing 20% metakaolin and 1% wastepaper fiber exhibits durability and mechanical properties comparable to those of the traditional concrete. This finding highlights the significant promise of reducing dependency on conventional cement and incorporating suitable recycled materials, such as discarded plasterboard, and secondary by-products like metakaolin. Such a strategy encourages the preservation of resources, reduction in carbon dioxide emissions, and a decrease in the ecological footprint resulting from concrete production.

Interpretability in machine learning has become increasingly important as machine learning is being used in more and more applications, including those with high-stakes consequences such as healthcare where Interpretability has been regarded as a key to the successful adoption of machine learning models. However, using confounding/irrelevant information in making predictions by deep learning models, even the interpretable ones, poses critical challenges to their clinical acceptance. That has recently drawn researchers' attention to issues beyond the mere interpretation of deep learning models. In this paper, we first investigate application of an inherently interpretable prototype-based architecture, known as ProtoPNet, for breast cancer classification in digital pathology and highlight its shortcomings in this application. Then, we propose a new method that uses more medically relevant information and makes more accurate and interpretable predictions. Our method leverages the clustering concept and implicitly increases the number of classes in the training dataset. The proposed method learns more relevant prototypes without any pixel-level annotated data. To have a more holistic assessment, in addition to classification accuracy, we define a new metric for assessing the degree of interpretability based on the comments of a group of skilled pathologists. Experimental results on the BreakHis dataset show that the proposed method effectively improves the classification accuracy and interpretability by respectively 8 % and 18 % . Therefore, the proposed method can be seen as a step toward implementing interpretable deep learning models for the detection of breast cancer using histopathology images., (© 2024. The Author(s).)

Background: Obesity is a worldwide health concern with serious clinical effects, including myocardial infarction (MI), stroke, cardiovascular diseases (CVDs), and all-cause mortality. The present study aimed to assess the association of obesity phenotypes and different CVDs and mortality in males and females by simultaneously considering the longitudinal and survival time data., Methods: In the Tehran Lipid and Glucose Study (TLGS), participants older than three years were selected by a multi-stage random cluster sampling method and followed for about 19 years. In the current study, individuals aged over 40 years without a medical history of CVD, stroke, MI, and coronary heart disease were included. Exclusions comprised those undergoing treatment for CVD and those with more than 30% missing information or incomplete data. Joint modeling of longitudinal binary outcome and survival time data was applied to assess the dependency and the association between the changes in obesity phenotypes and time to occurrence of CVD, MI, stroke, and CVD mortality. To account for any potential sex-related confounding effect on the association between the obesity phenotypes and CVD outcomes, sex-specific analysis was carried out. The analysis was performed using packages (JMbayes2) of R software (version 4.2.1)., Results: Overall, 6350 adults above 40 years were included. In the joint modeling of CVD outcome among males, literates and participants with a family history of diabetes were at lower risk of CVD compared to illiterates and those with no family history of diabetes in the Bayesian Cox model. Current smokers were at higher risk of CVD compared to non-smokers. In a logistic mixed effects model, odds of obesity phenotype was higher among participants with low physical activity, family history of diabetes and older age compared to males with high physical activity, no family history of diabetes and younger age. In females, based on the results of the Bayesian Cox model, participants with family history of diabetes, family history of CVD, abnormal obesity phenotype and past smokers had a higher risk of CVD compared to those with no history of diabetes, CVD and nonsmokers. In the obesity varying model, odds of obesity phenotype was higher among females with history of diabetes and older age compared to those with no history of diabetes and who were younger. There was no significant variable associated with MI among males in the Bayesian Cox model. Odds of obesity phenotype was higher in males with low physical activity compared to those with high physical activity in the obesity varying model, whereas current smokers were at lower odds of obesity phenotype than nonsmokers. In females, risk of MI was higher among those with family history of diabetes compared to those with no history of diabetes in the Bayesian Cox model. In the logistic mixed effects model, a direct and significant association was found between age and obesity phenotype. In males, participants with history of diabetes, abnormal obesity phenotype and older age were at higher risk of stroke in the Bayesian Cox model compared to males with no history of diabetes, normal obesity phenotype and younger persons. In the obesity varying model, odds of obesity phenotype was higher in males with low physical activity, family history of diabetes and older age compared to those with high physical activity, no family history of diabetes and who were younger. Smokers had a lower odds of obesity phenotype than nonsmokers. In females, past smokers and those with family history of diabetes were at higher risk of stroke compared to nonsmokers and females with no history of diabetes in the Bayesian Cox model. In the obesity varying model, females with family history of diabetes and older ages had a higher odds of obesity phenotype compared to those with no family history of diabetes and who were younger. Among males, risk of CVD mortality was lower in past smokers compared to nonsmokers in the survival model. A direct and significant association was found between age and CVD mortality. Odds of obesity phenotype was higher in males with a history of diabetes than in those with no family history of diabetes in the logistic mixed effects model., Conclusions: It seems that modifications to metabolic disorders may have an impact on the heightened incidence of CVDs. Based on this, males with obesity and any type of metabolic disorder had a higher risk of CVD, stroke and CVD mortality (excluding MI) compared to those with a normal body mass index (BMI) and no metabolic disorders. Females with obesity and any type of metabolic disorder were at higher risk of CVD(, MI and stroke compared to those with a normal BMI and no metabolic disorders suggesting that obesity and metabolic disorders are related. Due to its synergistic effect on high blood pressure, metabolic disorders raise the risk of CVD., (© 2024. The Author(s).)

Background: The relationship between adiposity indicators and thyroid cancer (TC) risk has garnered increasing attention due to the rising prevalence of obesity and its potential impact on cancer incidence. We conducted a comprehensive meta-analysis to investigate this association across various effect measures., Method: Until July 2022, a comprehensive search of databases was conducted to identify cohort studies that assessed the association between adiposity and the development of TC. Meta-analysis was performed using random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Begg's tests., Results: A systematic literature search identified 27 eligible studies reporting odds ratios (OR), relative risks (RR), or hazard ratios (HR) as effect measures. Pooling the studies irrespective of the effect measure, a significant positive association between adiposity indicators and TC risk was observed, yielding an effect estimate of 1.16 (95% CI 1.12-1.21). The combined effect estimate for OR/RR studies was 1.10 (95%CI 1.04-1.17), while HR studies yielded an effect estimate of 1.20 (95%CI 1.13-1.26). Subgroup analyses revealed associations across different age groups, obesity indices, and regions, with some variations based on effect measure. Meta-regression identified follow-up duration as a confounding factor only in HR studies., Conclusion: The synthesis of 27 studies with diverse designs and populations underscores a robust positive association between adiposity and TC risk, providing compelling evidence for the potential role of increased adiposity in TC development., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01425-3., Competing Interests: Competing interestsNot applicable., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

In this work, an analytical model to study graphene-based spatiotemporal modulated structures is developed and verified through comparison with full wave numerical simulations. Graphene is an ideal material for realizing spatiotemporal modulated structures at high frequencies of THz and optics. In this analysis, the electromagnetic response of studied structures is expressed in terms of weighted Floquet-Bloch modes supported by the structure, while graphene is modeled by a spatiotemporal modulated surface current that imposes certain boundary conditions on the modes. The developed analytical technique is a comprehensive tool and can be used for accurate modeling of different kinds of spatiotemporal devices including lossy, guided, and leaky wave structures. To demonstrate the accuracy of the model, two plasmonic waveguides with space and time modulated graphene conductivity are analyzed and their interband and intraband transition between modes are thoroughly investigated. Using the developed analytical model, spatiotemporal modulation phenomena such as mode conversion, wave amplification and nonreciprocal response are explored and discussed for the studied structures., (© 2024. The Author(s).)

This study explored the effectiveness of mobile-assisted vocabulary learning through digital flashcards on receptive and productive aspects of academic vocabulary knowledge among Iranian EFL university students. In a quasi-experimental design, 86 participants were divided into three groups: a digital flashcard group (DFs), a traditional paper flashcard (PFs) group, and a control group using word lists, to assess the impact of these methods on vocabulary acquisition over five weeks. The findings revealed that students utilizing DFs exhibited significant improvements in both receptive and productive vocabulary knowledge compared to those using PFs and the control method. Notably, the increase in receptive vocabulary was more substantial than in productive vocabulary, highlighting the differential effects of DFs on various aspects of vocabulary learning. This finding underscores the need for targeted strategies to enhance productive aspects of academic vocabulary specifically. The study supports the integration of DFs into English for Academic Purposes (EAP) programs to leverage their potential in boosting vocabulary acquisition effectively. However, the lesser gains in productive vocabulary suggest the necessity for complementary instructional methods, which focus on more active vocabulary learning tasks. Based on these findings, the study argues that mobile-assisted vocabulary learning should be considered a practical strategy for supporting academic vocabulary development among university students., 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., (© 2024 The Authors.)

Introduction: Breast cancer is a prevalent and significant contributor to cancer-related mortality among women worldwide. Its increasing incidence, especially in regions like North-West Iran, necessitates a deeper understanding of genetic factors contributing to its development. Genetic alterations, particularly single nucleotide polymorphisms (SNPs), are implicated in breast cancer susceptibility, making investigation in this context crucial. This study explores the role of CYP1A2-rs17861162 and ADSL-rs3788579 SNPs in breast cancer risk among Iranian women., Methods: This study involved 200 female breast cancer patients and 200 healthy controls in North-West Iran. DNA was extracted from blood samples, and PCR-RFLP was used for genotyping the CYP1A2 and ADSL genes., Results: The CYP1A2-rs17861162 SNP exhibited a shift from the C allele to the G allele in breast cancer patients, resulting in a 21.7% decrease in CC genotype frequency and a 21.6% and 77.8% increase in CG and GG genotypes, respectively, compared to controls. In ADSL-rs3788579 SNP, breast cancer patients had a significantly higher prevalence of the T allele, with a 28.5% increase compared to controls. In healthy participants, CC was most common, while in the breast cancer group, TT was most common., Conclusion: This study highlights significant genetic alterations in CYP1A2-rs17861162 and ADSL-rs3788579 SNPs among breast cancer patients in North-West Iran, suggesting their potential as diagnostic and prognostic biomarkers. Further research is warranted to elucidate the precise mechanisms underlying their contributions to breast cancer susceptibility in this population., (© 2024. The Author(s).)

The expression of costimulatory molecules such as MHC-II, CD86 and CD83 on dendritic cells (DCs) are strongly regulated during cellular activation. Ubiquitination of some of these markers by the E3 ubiquitin ligase MARCH-I affects the maturation state of DCs and subsequently modulates immune responses. The effects of MARCH-I gene overexpression on the functional activity of human DCs is not well understood. Here, we investigate how MARCH-I, regulates maturation of DCs. We now provide evidence that MARCH-I transduced DCs secrete high levels of IL10 despite low secretion of IL 6 and IL 12 in response to LPS stimulation. They are weak stimulators of T lymphocyte cells but skewed T cell polarization toward T regulatory subset. These results exhibit that reduced expression of surface costimulatory molecules suppresses DC activation. It can be concluded that overexpression of MARCH-I gene in DCs leads to the production of tolerogenic DC., Competing Interests: Declaration of competing interest The authors declared no conflict of interest regarding the publication of this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Developing regenerative endodontic treatment (RET) is an exciting approach to managing immature permanent teeth with pulp necrosis. RET is usually performed in two clinical steps: disinfection (first step) and tissue engineering (second step). Recently, laser therapy has entered the field of RET. This study aimed to provide an overview of the literature that employed laser therapy for root regeneration. Methods: A comprehensive search was performed on four databases, including PubMed, Web of Science, Scopus, and Google Scholar. The searched keywords were laser, regenerative endodontics, immature permanent teeth, and dental pulp necrosis, and related English-published articles were included up to October 2023. Results: Thirteen studies utilized a laser for RET. In the first step of RET, both high-power and low-level lasers (through photodynamic therapy [PDT]) may be applied for canal disinfection. In contrast, regenerative procedures in the second step of RET are just accelerated by low-power lasers (biostimulation). The literature does not support the benefit of laser-assisted irrigation in improving the clinical success of RET. There is some evidence that laser-assisted disinfection with a diode laser may provide comparable results to triple antibiotic paste in reducing bacterial counts in root canals while providing slightly better clinical and radiographic outcomes. PDT may be an effective and suitable adjunct to conventional disinfection methods in immature, necrotic teeth. Conclusion: Low-power lasers may be beneficial tools for improving the results of regenerative endodontics through chemical disinfection in the first step (PDT) or by biostimulation in the second step of RET., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2024 J Lasers Med Sci.)

Objectives: It has not been established whether vitamin D deficiency is associated with anthropometric state; therefore, this systematic review examined the relationship between serum vitamin D levels with anthropometrics and adiposity across different ages., Methods: Studies that examined vitamin D deficiency with adiposity measures in different age groups were searched in the PubMed, Scopus, Embase, and Google Scholar databases until November 2023. Two investigators independently reviewed titles and abstracts, examined full-text articles, extracted data, and rated the quality in accordance with the Newcastle-Ottawa criteria., Results: Seventy-two studies, with a total of 59,430 subjects, were included. Of these studies, 27 cross-sectional studies and one longitudinal study (with 25,615 participants) evaluated the possible link between 25(OH)D serum concentrations and anthropometric/adiposity indices in the pediatric population. Forty-two cross-sectional studies and two cohort investigations (with 33,815 participants) investigated the relationship between serum 25(OH)D levels and adiposity measures in adults and/or the elderly population. There is evidence supporting links between vitamin D deficiency and obesity, and revealed an inverse association between vitamin D and adiposity indicators, specifically in female subjects. However, the effects of several confounding factors should also be considered., Conclusion: Most published studies, most of which were cross-sectional, reported a negative association between vitamin D and female adiposity indicators. Therefore, serum vitamin D levels should be monitored in overweight/obese individuals.

Background: The combination of estradiol cypionate (ECA) and medroxyprogesterone acetate (MPA) is used to prevent pregnancy in women. The analysis of the ECA and MPA combination reveals a challenge due to the strong overlap of the spectra of these compounds., Objective: Spectrophotometry techniques along with chemometrics methods are simple, fast, precise, and low-cost for the simultaneous determination of ECA and MPA in a combined pharmaceutical dosage form., Methods: Two developed approaches, the least-squares support vector machine (LSSVM) and fuzzy inference system (FIS), along with a spectrophotometric method were proposed to solve such a challenging overlap., Results: Based on the cross-validation method, the regularization parameter (γ) and width of the function (σ) in the LSSVM model were optimized and the root mean square error (RMSE) values were found to be 0.3957 and 0.2839 for ECA and MDA, respectively. The mean recovery values were 99.87 and 99.63% for ECA and MDA, respectively. The FIS coupled with principal component analysis (PCA) showed mean recovery percentages equal to 99.05 and 99.50% for ECA and MDA, respectively. Also, the RMSE of both components was lower than 0.3., Conclusion: The analysis results of a real sample (injection suspension) using the proposed methods were compared with HPLC by a one-way analysis of variance (ANOVA) test, and no significant differences were found in the results., Highlights: Intelligent methods were proposed for the simultaneous determination of ECA and MPA. The least-squares support vector machine and fuzzy inference system along with spectrophotometry were used. HPLC as a reference method was performed and compared with chemometrics methods. The benefits of the proposed approaches are that they are rapid, simple, low-cost, and accurate., (© The Author(s) 2023. Published by Oxford University Press on behalf of AOAC INTERNATIONAL. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: To evaluate sex- and age-stratified body composition (BC) parameters in subjects with wide age range of 20-79 years., Design: Cross-sectional., Setting: Participants of Tehran Lipid and Glucose Study (TLGS)., Participants: Two thousand nine hundred seventy participants met our inclusion criteria. They were divided into five age groups, and BC parameters were analysed based on sex and age using a bioelectrical impedance analyser (BIA)., Result: The mean age of the participants was 42·1 ± 12·5 years, and 54 % of them were males. The mean BMI was 26·7 ± 3·7 kg/m 2 . Obesity indices were significantly higher in females ( P < 0·001); however, skeletal muscle mass (SMM) and fat-free mass (FFM) were significantly higher in males ( P < 0·001). Both SMM and FFM decreased significantly after the age of 50 years. Obesity indices significantly increased from the age group of 20-29 to 30-39 years in males and the age groups of 30-39 to 40-49 years and 40-49 to 50-59 years in females. The fat mass ratio (fat mass/SMM) showed two peaks in both sexes (after the ages of 30 and 50 years in males and 40 and 50 years in females). A strong correlation was found between BMI and percentage of body fat ( r = 0·823 in females v . r = 0·768 in males)., Conclusion: This is the first community-based study in the MENA region identifying sex- and age-stratified BC values using BIA. Our findings can be used as a reference for comparison in appropriate settings.

Background: Considering the lack of a standardized definition for weight recurrence (WR), the prevalence and predictors of WR remain inconsistent., Methods: The prospective study was conducted on 1939 individuals who underwent bariatric surgery;66.8% underwent sleeve gastrectomy (SG), 33.2%, underwent gastric bypass (GB)[of them 87% one-anastomosis gastric bypass (OAGB), and 13% Rue and Y gastric bypass (RYGB)]. During a follow-up of 72 months, the prevalence of WR ranged from 13.5% to 35.5% according to five different definitions. The generalized estimated equation method was used to assess weight changes, excess weight loss (EWL%), and body composition (fat mass (FM), fat-free mass (FFM)and FFM loss/weight loss% (FFML/WL%)) by a bioelectrical impedance analyzer. Stepwise logistic regression models were applied to determine the independent predictors of WR., Results: Among 1939 participants followed up for 72 months, WR definitions were applied to 650 patients (75.4% females) with an average BMI of 44.3 ± 5.4 kg/m 2 ,491 (75.5%) and 159 (24.5%) of whom underwent SG and GB, respectively. WR group had relatively higher weights and FM and lower EWL%. A WR turning point was observed at 24 months post-surgery (Ptime before & after 24 months<0.001). The most significant risk factors for WR included SG (in all WR definitions), a younger age (in four out of five definitions), and a higher baseline BMI (in three out of five definitions)., Conclusion: The prevalence and predictors of WR varied greatly depending on the definition applied. The prominent risk factors of WR included SG, younger age, and a higher baseline BMI., Competing Interests: Declaration of Competing Interest The authors declare that they have no financial or non-financial competing interests., (Copyright © 2024 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Introduction: We evaluate which screening and diagnostic approach resulted in the greatest reduction in adverse pregnancy outcomes due to increased treatment., Research Design and Methods: This study presents a secondary analysis of a randomized community non-inferiority trial conducted among pregnant women participating in the GULF Study in Iran. A total of 35 430 pregnant women were randomly assigned to one of the five prespecified gestational diabetes mellitus (GDM) screening protocols. The screening methods included fasting plasma glucose (FPG) in the first trimester and either a one-step or a two-step screening method in the second trimester of pregnancy. According to the results, participants were classified into 6 groups (1) First-trimester FPG: 100-126 mg/dL, GDM diagnosed at first trimester; (2) First trimester FPG: 92-99.9 mg/dL, GDM diagnosed at first trimester; (3) First trimester FPG: 92-99.9 mg/dL, GDM diagnosed at second trimester; (4) First trimester FPG: 92-99.9 mg/dL, healthy at second trimester; (5) First trimester FPG<92 mg/dL, GDM diagnosed at second trimester; (6) First trimester FPG<92 mg/dL, healthy at second trimester. For our analysis, we initially used group 6, as the reference and repeated the analysis using group 2, as the reference group. The main outcome of the study was major adverse maternal and neonatal outcomes., Results: Macrosomia and primary caesarean section occurred in 9.8% and 21.0% in group 1, 7.8% and 19.8% in group 2, 5.4% and 18.6% in group 3, 6.6% and 21.5% in group 4, 8.3% and 24.0% in group 5, and 5.4% and 20.0% in group 6, respectively. Compared with group 6 as the reference, there was a significant increase in the adjusted risk of neonatal intensive care unit (NICU) admission in groups 1, 3, and 5 and an increased risk of macrosomia in groups 1, 2, and 5. Compared with group 2 as the reference, there was a significant decrease in the adjusted risk of macrosomia in group 3, a decreased risk of NICU admission in group 6, and an increased risk of hyperglycemia in group 3., Conclusions: We conclude that screening approaches for GDM reduced the risk of adverse pregnancy outcomes to the same or near the same risk level of healthy pregnant women, except for the risk of NICU admission that increased significantly in groups diagnosed with GDM compared with healthy pregnant women. Individuals with slight increase in FPG (92-100 mg/dL) at first trimester, who were diagnosed as GDM, had an even increased risk of macrosomia in comparison to those group of women with FPG 92-100 mg/dL in the first trimester, who were not diagnosed with GDM, and developed GDM in second trimester TRIAL REGISTRATION: IRCT138707081281N1 (registered: February 15, 2017)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The lack of readily available methods for estimating high-resolution near-surface relative humidity (RH) and the incapability of weather stations to fully capture the spatiotemporal variability can lead to exposure misclassification in studies of environmental epidemiology. We therefore aimed to predict German-wide 1 × 1 km daily mean RH during 2000-2021. RH observations, longitude and latitude, modelled air temperature, precipitation and wind speed as well as remote sensing information on topographic elevation, vegetation, and the true color band composite were incorporated in a Random Forest (RF) model, in addition to date for capturing the temporal variations of the response-explanatory variables relationship. The model achieved high accuracy (R 2  = 0.83) and low errors (Root Mean Square Error (RMSE) of 5.07%, Mean Absolute Percentage Error (MAPE) of 5.19% and Mean Percentage Error (MPE) of - 0.53%), calculated via ten-fold cross-validation. A comparison of our RH predictions with measurements from a dense monitoring network in the city of Augsburg, South Germany confirmed the good performance (R 2  ≥ 0.86, RMSE ≤ 5.45%, MAPE ≤ 5.59%, MPE ≤ 3.11%). The model displayed high German-wide RH (22y-average of 79.00%) and high spatial variability across the country, exceeding 12% on yearly averages. Our findings indicate that the proposed RF model is suitable for estimating RH for a whole country in high-resolution and provide a reliable RH dataset for epidemiological analyses and other environmental research purposes., Competing Interests: Declaration of competing interest 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., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The COVID-19 pandemic has raised global health concerns and posed challenges for postoperative follow-up care for patients undergoing bariatric surgery due to social distancing rules., Methods: This was a cohort study on patients with morbid obesity who underwent bariatric surgery and had been enrolled in Tehran Obesity Treatment Study. Patients who had surgery between March 2020 and March 2021 were classified as those undergoing the procedure amid the COVID-19 pandemic, while those who had surgery between March 2017 and March 2018 were categorized as the pre-pandemic group., Results: The study included 982 patients in the pre-COVID-19 pandemic group and 602 patients in the COVID-19 pandemic group, with mean ages of 39.61 and 39.51 years, respectively. After adjusting for preoperative body mass index (BMI) and surgery type, the patients who underwent surgery during the COVID-19 pandemic demonstrated comparable results to the pre-COVID-19 group in terms of total weight loss %, excess weight loss %, BMI reduction, and fat mass reduction during the 12-month postoperative period. Additionally, the rate of complications with a grade≥III based on the Clavien-Dindo classification was significantly lower in patients who underwent surgery during the COVID-19 pandemic. Notably, there were no deaths reported in either group., Conclusion: Despite social isolation and unfavorable lifestyle modifications, bariatric surgery-induced weight loss after one year was the same in patients undergoing the procedure either before or after the implementation of social distancing measures. More research is needed to analyze the influence of the COVID-19 pandemic on the long-term outcomes of bariatric surgery., (© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.)

Background: Chronic kidney disease (CKD) is a major global health concern with increasing prevalence and associated complications. Metabolic syndrome (MetS) has been linked to CKD, but the evidence remains inconsistent. We conducted a systematic review and meta-analysis to investigate the association between MetS and kidney dysfunction., Method: We conducted a comprehensive search of databases until December 2022 for cohort studies assessing the association between MetS and incident kidney dysfunction. Meta-analysis was performed using fixed and random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Egger's and Begg's tests., Result: A total of 24 eligible studies, involving 6,573,911 participants, were included in this meta-analysis. MetS was significantly associated with an increased risk of developing CKD (OR, 1.42; 95% CI, 1.28, 1.57), albuminuria or proteinuria (OR, 1.43; 95% CI, 1.10, 1.86), and rapid decline in kidney function (OR, 1.25; 95% CI, 1.07, 1.47). Subgroup analyses showed a stronger association as the number of MetS components increased. However, gender-specific subgroups demonstrated varying associations., Conclusion: Metabolic syndrome is a significant risk factor for kidney dysfunction, requiring close renal monitoring. Lifestyle changes and targeted interventions may help reduce CKD burden. Further research is needed to understand the connection fully and assess intervention efficacy., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01348-5., Competing Interests: Competing interestsNone., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background and Aims: Childhood and adolescence overweight/obesity is an important predictor of obesity and increased long-term cardiometabolic abnormalities in adulthood. In this study, we aimed to investigate the association of body mass index (BMI) and waist circumference (WC) trajectories among children and adolescents with adulthood carotid intima-media thickness (cIMT) as a determinant of subclinical atherosclerosis., Methods: In this prospective cohort study, 1265 participants aged 3 to 18 were followed up for 18 years. By using Latent Class Growth Analysis, three groups of BMI and WC trajectory were defined; low stable, moderate-increasing, and high-increasing. Linear and logistic regression analysis were used to investigate the association of each lifetime BMI and WC trajectory group with cIMT., Results: Although the high-increasing BMI trajectory group was significantly associated with higher cIMT (ß=0.0464, P < 0.001), moderate-increase was not (ß=0.0096, P = 0.102); in reference to the low-stable BMI trajectory group. Among WC trajectory groups, both moderate- (ß=0.0177, P = 0.006) and high-increasing (ß=0.0533, P < 0.001), in reference to the low-stable group, were significantly associated with higher cIMT. The results did not change after adjustment for baseline BMI. The ORs of high-increasing BMI, moderate-increasing WC, and high-increasing WC trajectories were 3.24, 1.92, and 3.29, respectively for high cIMT., Conclusion: Our study resulted that a high-increasing trajectory of childhood BMI and moderate- and high-increasing trajectories of childhood WC are associated with higher cIMT and higher risk of high-cIMT. Regular monitoring and screening of BMI and WC trajectory from childhood may improve identifying individuals with high risks of cardiovascular disease, more accurately., (© 2023. The Author(s).)