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Introduction. Former research studies have demonstrated controversial associations between dietary indices and oxidative stress biomarkers including oxidized low-density lipoprotein (ox-LDL) and malondialdehyde (MDA). So, in this cross-sectional study, we aimed to assess the association of dietary total antioxidant capacity (DTAC), oxidative balance score, and phytochemical index (PI) with ox-LDL/MDA in a healthy adult population of Shiraz, Iran. Methods. 236 individuals participated in this cross-sectional study. DTAC, OBS, and PI were calculated using a 168-item food frequency questionnaire (FFQ), which was previously validated in Iran. We measured ox-LDL and MDA in blood samples of the participants using commercially existing kits. Crude and adjusted models of linear regression were used to evaluate the relation of dietary indices with ox-LDL and MDA. Results. There was a significant association between ox-LDL and DTAC in both crude (β = −1.55; 95% CI: −2.53, −0.58; P-trend = 0.002) and adjusted (β = −1.65 95% CI: −2.66, −0.64; P-trend = 0.001) models. Also, a negative association was observed between ox-LDL and PI in the crude (β = −1.26 95% CI: −2.33, −0.29; P-trend = 0.01) and adjusted (β = −1.36 95% CI: −2.38, −0.34; P-trend = 0.01) models. Conclusion. Results of this study showed that DTAC and PI were inversely associated with ox-LDL as markers of lipid peroxidation. But no correlations were seen between MDA and dietary antioxidant indices.

Background: Autosomal recessive primary microcephaly-2 (MCPH2) is a rare genetic disorder with clinical and genetic heterogeneity. This study aimed to perform high-throughput whole-exome sequencing (WES) to facilitate the diagnosis of the genetic variants responsible for MCPH2 and the comorbidities. Materials and Methods: The WES was performed for a 3-year-old boy with primary microcephaly-2 and homocystinuria-megaloblastic anemia in a consanguineous family. Sequencing and variant calling was conducted by standard bioinformatics tools. Filtering was performed to prioritize novel variants. Finally, the effect of variants on the protein structure and function was assessed using web prediction tools. Results: Using WES, two novel homozygous variants and three novel homozygous variants were identified in the WDR62 and MTR genes as the causes of MCPH2 and homocystinuria-megaloblastic anemia in the affected child, respectively. These frameshift insertion variants are classified as pathogenic and affect the structure and feature of the WDR62 and MTR proteins by changing amino acid sequence and causing nonsense-mediated RNA decay (NMD). Conclusion: Magnetic resonance imaging (MRI) supported polymicrogyria and impaired cerebral cortical development in the affected child. WDR62 as a causative gene plays an essential role in cerebral cortical development, and its pathogenic disease-causing variants are considered as causing factors for MCPH2. Homocystinuria-megaloblastic anemia was a comorbidity associated with microcephaly in this patient, and its variants were confirmed by WES. Overall, performing WES is a necessary and accurate way to rapidly identify the exact causative genetic variants in MCPH2 and the homocystinuria-megaloblastic anemia and manage the disease.

The purpose of this cross-sectional study was to examine the association between ultra-processed foods (UPFs) intake and lipid profile in Iranian people. The study was performed on 236 individuals with the age range of 20–50 years in Shiraz, Iran. Food intakes of the participants were evaluated using a 168-item food frequency questionnaire (FFQ) which was previously validated in Iranian populations. In order to estimate the ultra-processed foods intake, classification of NOVA food group was used. Serum lipids including total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured. The results showed that mean of age and body mass index (BMI) of the participants were 45.98 years and 28.28 kg/m2, respectively. Logistic regression was used to evaluation the relation between UPFs intake and lipid profile. Higher UPFs intake was associated with increased OR of TG and HDL abnormality in both crude (OR 3.41; 95% CI 1.58, 7.34; P-trend = 0.001 and OR 2.99; 95% CI 1.31, 6.82; P-trend = 0.010) and adjusted models (OR 3.69; 95% CI 1.67, 8.16; P-trend = 0.001 and OR 3.38 95% CI 1.42, 8.07; P-trend = 0.009). But, there were no association between UPFs intake and other indices of lipid profile. Also, we found significant associations between UPFs intake and dietary nutrient profiles. In conclusion, UPFs consumption could worsen the nutritional profile of the diet and lead to negative changes in some indices of the lipid profile.

A broad spectrum of neurological side effects has been reported after immunisation for COVID-19, including functional neurological disorders, cerebral vascular events, cerebral venous thrombosis, intracerebral haemorrhage, neuroleptic malignant syndrome, cranial nerve palsies, and otologic manifestations. Multiple cranial neuropathies have also been reported following vaccination in which involvement of VII nerve is the most prevalent, followed by the VI, III, and IV nerves. We describe two male patients, one with with facial nerve palsy and the other with abducens nerve palsy following COVID-19 vaccination. The patient with facial nerve palsy received the AstraZeneca vaccine 2 days before the symptoms began. In contrast, the patient with the abducens palsy had received his first dose of the Sinopharm vaccine 7 days previously. Both patients demonstrated a gradual recovery within the next 2 months. Further studies are required to investigate the proper relationship between cranial nerve palsies and vaccinations.

Objective: Dual x-ray absorptiometry (DXA) is gold standard of bone densitometry, but quantitative ultrasound (QUS) of bone is less expensive and portable. This study was designed to assess its usefulness in secondary osteoporosis diagnosis. Materials and Methods: There were 200 secondary osteoporosis cases (rheumatoid arthritis, hemodialysis, kidney transplant patients, and levothyroxine users) and of those, their phalanx QUS results were compared with normal controls. Also, the QUS and DXA results were compared to find any correlation of these methods for diagnosing osteoporosis. Results: There was not significantly different results compared with normal controls, except for those of hemodialysis patients ( P = .00). Also, the comparison of QUS with DXA results showed no significant correlation except in hemodialysis patients, in both spinal and femoral regions ( P = .023 and .21, respectively), as well as the levothyroxine group’s spinal region ( P = .005). Conclusion: These results suggest that QUS of phalanx may be useful in screening secondary osteoporosis but for establishment of diagnosis, DXA measurements are still needed.

Background: Online language learning has recently gained a reputation in educational research, holding specifically true in English for specific purposes (ESP) courses. However, ESP online learning has not been sufficiently examined in particular disciplines such as medicine. Objectives: This study investigated the effects of teaching English medical vocabulary through a virtual learning platform (Adobe Connect) on Iranian medical students’ learner factors, including their self-regulation and self-concept. Methods: This quasi-experimental study was conducted on 60 female and male medical students learning English for Medicine at Kashan University of Medical Sciences in 2021. An Oxford Placement Test (OPT) was administered to ensure the sample’s homogeneity. Then, the participants were categorized into Adobe Connect (experimental) and conventional face-to-face (control) groups. Data were collected using the Academic Self-concept Questionnaire (ASCQ) and the Self-regulation Questionnaire (SRQ). An ANCOVA test was run to compare the possible role of the two instructional methods on medical students’ self-regulation and self-concept. Results: Adobe Connect, as the experimental group, had a higher median score than the control group regarding the self-regulation posttest (P = 0.000). Therefore, using Adobe Connect virtual platform significantly improved the self-regulation of ESP medical students. Additionally, the results revealed that the experimental participants outperformed the control group regarding their self-concept (P = 0.000). Conclusions: Based on the results, the online platform positively affected self-regulation and self-concept among medical students.

The purpose of this cross-sectional study is to examine the association between UPFs intake level and lipid profile in Iranian people. This is a cross-sectional study which was performed on 236 individuals with the age range of 20 to 50 years in Shiraz, Iran. Food intakes of participants were evaluated by food frequency questionnaire (FFQ) which was previously validated in Iranian populations. For estimating the ultra-processed food, the classification of NOVA food group was used. Serum lipids including TC, TG, HDL-C and LDL-C were measured in blood samples. Logistic regression was used to evaluation the relation between UPF score and lipid profile. Higher UPFs intake was associated with increased OR of TG, LDL and HDL in both crude (OR: 2.60; 95% CI: 1.24–5.46 and OR: 2.05; 95% CI: 1.01–4.17 and OR: 4.34; 95% CI: 1.89–9.91 and adjusted model (OR: 2.76; 95% CI: 1.29–5.89 and OR: 2.08; 95% CI: 1.01–4.26 and OR: 4.91; 95% CI: 2.05–11.74). Thus, our results show significant associations between ultra-processed foods intake and dietary nutrient profiles that result in dyslipidemia as a risk factor of chronic diseases. In conclusion, UPF consumption worsen the nutritional profile of the diet and lead to negative changes in the lipid profile parameters.

PurposePlant-based diets have been related to decreasing morbidity and mortality of many non-communicable diseases. The purpose of this study was to investigate the relationship between plant-based diets and lipid profiles and anthropometric indices.Design/methodology/approachThis cross-sectional study was performed on 236 men and women selected from Shiraz health-care centers. This study used a 168-item food frequency questionnaire to calculate plant-based diet index (PDI), healthy plant-based diet index (hPDI) and unhealthy plant-based diet index (uPDI). Total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol and triglycerides were measured. Furthermore, body mass index, a body shape index and conicity index (CI) were calculated after measuring weight, height and waist circumference.FindingsHigher score of PDI was significantly related to higher triglycerides level (OR = 2.16; 95% CI: 1.04, 4.48;P= 0.03). In the fully adjusted model, there was a significant association between ABSI and hPDI (OR = 4.88; 95% CI: 1.17, 20.24;P= 0.03). A significant inverse association was observed between uPDI and high-density lipoprotein (HDL) (OR = 0.45; 95% CI = 0.21, 0.98;P= 0.03). Also, this study found a decreasing, but insignificant trend in relation of ABSI (OR = 0.72; 95% CI = 0.22, 2.34) and CI (OR = 0.41; 95% CI = 0.06, 0.56) with PDI.Research limitations/implicationsFurther studies are needed to explore the association of PDI with anthropometric indices and lipid profile and also to assess the potential causality of the observed associations. Plant-based diets according to their contents could affect triglycerides, HDL and anthropometric properties.Practical implicationsHence, dietitians should consider the findings of this study such as the inverse effect of unhealthy plant-based diets on HDL and the relation between healthy plant-based diets and WC and abdominal obesity.Originality/valueThis study showed that adherence to a plant-based diet was related to higher triglycerides levels. Also, uPDI was inversely associated with HDL level. Furthermore, participants who adhered more to a healthy plant-based diet had higher abdominal adiposity.

Neuronal ceroid lipofuscinoses type 2 (CLN2), the most common form of Batten disease, is caused by TPP1 loss of function, resulting in tripeptidyl peptidase-1 enzyme deficiency and cerebral accumulation of lipopigments. Clinical hallmarks include epileptic seizures, vision loss, progressive movement disorder, ataxia, and eventually death. Diagnosis is often delayed due to the rarity of the conditions. Results: Here, we report a case presenting with clinical features of CLN2, carrying a homozygous novel nonsense variant in

DRG1 is a highly conserved member of a class of GTPases implicated in ribosome biogenesis and translation. The expression of mammalian DRG1 is elevated in the central nervous system during development, and its function has been implicated in fundamental cellular processes including protein synthesis and cellular proliferation. Using exome sequencing, we identified rare and likely pathogenic germline DRG1 variants including three stop-gained p.Gly54*, p.Arg140*, p.Lys263* and a p.Asn248Phe missense variant. These alleles segregate recessively in four affected individuals from three unrelated families and cause a neurodevelopmental disorder with global developmental delay, microcephaly, short stature and craniofacial anomalies. Using functional assays, we show that these loss-of-function variants: 1) severely disrupt DRG1 mRNA/protein stability in patient-derived fibroblasts, 2) impair it’s GTPase activity in vitro and 3) compromise it’s binding to partner protein ZC3H15. Consistent with the importance of DRG1 in humans, targeted inactivation of Drg1 in mice resulted in pre-weaning lethality. Our work highlights the importance of DRG1 GTPase activity for normal development and underscores the significance of translation factor GTPases in human physiology and homeostasis.

Background Results of studies on the effects of plant and animal proteins on lipid profile are controversial. So we aimed to assess the relationship between plant and animal protein intake with lipid profile and novel anthropometric indices in healthy individuals. Method In this cross-sectional study, 236 participants have selected from Shiraz medical centers (Iran) through random cluster sampling. Food intakes were assessed using a 168-items food frequency questionnaire (FFQ). Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were measured. Anthropometric indices including a body shape index (ABSI), abdominal volume index (AVI), buddy roundness index (BRI), and conicity index (CI) were calculated. Results In the crude and fully adjusted models, more consumption of plant proteins was associated with TG levels (OR = 2.31; 95% CI: 1.08, 4.95; P = 0.03 and OR = 2.39; 95% CI: 1.03, 5.15; P = 0.04). Also, there was a significant direct association between plant proteins and BRI in the curd model (OR = 3.55; 95% CI: 1.32, 9.54; P = 0.01), and after adjusting for age and energy intake (OR = 3.32; 95% CI: 1.21, 9.14; P = 0.01). More consumption of plant proteins was related to higher CI in the crude model (OR = 3.06; 95% CI: 1.12, 8.31; P = 0.03), but not in the fully adjusted model. Conclusion We found that a higher intake of plant proteins was associated with a higher TG level, BRI, and CI index. However, more research is needed to confirm these relations and provide the evidence needed to exert these findings into clinical practice.

Summary Objective Cardiovascular diseases (CVDs) are the major causes of death, worldwide. Although for decades the associations between individual foods and nutrients and CVDs have been investigated, little attention has been paid to dietary patterns. Therefore, this study was conducted to examine the association between dietary patterns and CVD risk factors among Iranian adults. Methods This cross-sectional study was performed on 236 adults who attended public health centers. Dietary intakes were collected using a valid food frequency questionnaire. Sociodemographic characteristics, anthropometric measures, and biochemical biomarkers were measured using standardized methods. Dietary patterns derived using the factor analysis. Logistic regression assessed the odds of CVD risk factors across tertiles of data-driven dietary patterns. Results We identified three dietary patterns. After adjusting for possible confounders, we observed that participants in the third category of the healthy dietary pattern (HDP) had lower odds of low HDL-C (OR = 0.26; 95% CI: 0.10–0.64) compared to those in the first category. Adherence to the mixed pattern was associated with increased odds of high serum TC in men only (OR = 3.69; 95% CI: 1.06–12.81). However, women with higher adherence to the Western dietary pattern (WDP) had higher odds of high serum TG (OR = 5.61; 95% CI: 1.69–18.59), and those with a greater adherence to HDP had lower odds of low HDL-C (OR = 0.25; 95% CI: 0.07–0.98). Conclusion This study showed that adherence to HDP may protect against a low level of HDL-C, whereas mixed and Western-type diets may contribute to high serum TG levels. Future longitudinal studies are needed to assess the potential causality of the observed associations.

Chatron et al. describe a novel syndrome caused by bi-allelic loss-of-function mutations in GAD1, the gene encoding the GABA synthetic enzyme GAD67. The syndrome is characterized by the unique association of developmental and epileptic encephalopathy, cleft palate, joint contractures and/or omphalocele., Developmental and epileptic encephalopathies are a heterogeneous group of early-onset epilepsy syndromes dramatically impairing neurodevelopment. Modern genomic technologies have revealed a number of monogenic origins and opened the door to therapeutic hopes. Here we describe a new syndromic developmental and epileptic encephalopathy caused by bi-allelic loss-of-function variants in GAD1, as presented by 11 patients from six independent consanguineous families. Seizure onset occurred in the first 2 months of life in all patients. All 10 patients, from whom early disease history was available, presented with seizure onset in the first month of life, mainly consisting of epileptic spasms or myoclonic seizures. Early EEG showed suppression-burst or pattern of burst attenuation or hypsarrhythmia if only recorded in the post-neonatal period. Eight patients had joint contractures and/or pes equinovarus. Seven patients presented a cleft palate and two also had an omphalocele, reproducing the phenotype of the knockout Gad1−/− mouse model. Four patients died before 4 years of age. GAD1 encodes the glutamate decarboxylase enzyme GAD67, a critical actor of the γ-aminobutyric acid (GABA) metabolism as it catalyses the decarboxylation of glutamic acid to form GABA. Our findings evoke a novel syndrome related to GAD67 deficiency, characterized by the unique association of developmental and epileptic encephalopathies, cleft palate, joint contractures and/or omphalocele.

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Quantitative ultrasound (QUS) is a bone densitometry method that is less expensive and more portable than DXA. It is also noninvasive. QUS parameters include speed of sound (SOS), broad band ultrasound attenuation (BUA), and stiffness index (SI). This study defined normal values of QUS parameters in Iranian men and women.QUS of heels measured in 258 Iranian men and women, aged 20-76 y/o. They were participants of Iranian Multicenter Osteoporosis study (IMOS), selected by randomized sampling. QUS device was an Achilles+ (GE-Lunar) device.Percentiles of SI (2.5%, 50%, and 97.5%) determined. We found a good agreement between the Iranian reference values and western reference (used by device) value in defining normal and osteoporotic people (κ = 0.875).Results from this study suggest that QUS of the heel may be a good method for diagnosis of low bone mass in different regions.

Neuronal ceroid lipofuscinoses type 2 (CLN2), the most common form of Batten disease, is caused by TPP1 loss of function, resulting in tripeptidyl peptidase-1 enzyme deficiency and cerebral accumulation of lipopigments. Clinical hallmarks include epileptic seizures, vision loss, progressive movement disorder, ataxia, and eventually death. Diagnosis is often delayed due to the rarity of the conditions. Results: Here, we report a case presenting with clinical features of CLN2, carrying a homozygous novel nonsense variant in TPP1 (NM_000391:c.C832T, (p.Q278*), rs1352347549). Moreover, we performed a comprehensive literature review regarding previously identified disease-causing TPP1 mutations and genotype-phenotype correlations. Conclusion: Depending on the type of mutation, different phenotypes are observed in patients with CLN2, suggesting that the severity of phenotypes is related to the genotype of the patients.

To determine the roundness of recipient corneal cuts after mechanical trephination and to investigate possible factors that could affect the corneal bed configuration in deep anterior lamellar keratoplasty (DALK). This study enrolled 85 eyes with keratoconus that underwent DALK. Recipient corneas were partially trephined using a new, unused, disposable Hessburg-Barron suction trephine. Photographs that best represented the recipient corneal cut were selected, and ImageJ software was used to evaluate the roundness of recipient bed. The effect of potential variables on the roundness of cuts was investigated using the univariate analyses. The mean patient age was 31.0 ± 9.0 years. The mean recipient trephine size was 8.04 ± 0.29 mm (range 7.5–8.50 mm). The recipient cut roundness was 0.922 ± 0.070, varying from 0.78 to 1.0. The roundness of the corneoscleral limbus (0.874 ± 0.074) which represented the shape of recipient cornea was the main predictor of the configuration of recipient cut (r = 0.84, P

NTNG2 encodes netrin-G2, a membrane-anchored protein implicated in the molecular organization of neuronal circuitry and synaptic organization and diversification in vertebrates. In this study, through a combination of exome sequencing and autozygosity mapping, we have identified 16 individuals (from seven unrelated families) with ultra-rare homozygous missense variants in NTNG2; these individuals present with shared features of a neurodevelopmental disorder consisting of global developmental delay, severe to profound intellectual disability, muscle weakness and abnormal tone, autistic features, behavioral abnormalities, and variable dysmorphisms. The variants disrupt highly conserved residues across the protein. Functional experiments, including in silico analysis of the protein structure, in vitro assessment of cell surface expression, and in vitro knockdown, revealed potential mechanisms of pathogenicity of the variants, including loss of protein function and decreased neurite outgrowth. Our data indicate that appropriate expression of NTNG2 plays an important role in neurotypical development.

Vehicular Ad hoc Network (VANET) is a wireless technology dedicated to vehicular communications. VANET is unsecure because of its lack of central administration and is also vulnerable due to its unique characteristics. Therefore, security is one of the most critical issues in this type of network. For a high level of safety, we need a method to evaluate vehicular communications’ trust and measure nodes’ reliability. This article presents a decentralized reputation model, where the activity of each node (i.e., vehicle) is observable for adjacent nodes. Our model enables nodes to detect malicious vehicles and avoids interacting with them. We propose to use the Bayesian filter to measure the trust scores of vehicles accurately. Different from conventional trust models, we study the concept of classification and misclassification. We then analyze the accuracy of our Bayesian filter by computing the factors of Node Recall and Node Precision. The extensive simulations have shown that the proposed filter can assign an accurate trust score to nodes under various network conditions and misbehavior rates.

Human 4-hydroxyphenylpyruvate dioxygenase-like (HPDL) is a putative iron-containing non-heme oxygenase of unknown specificity and biological significance. We report 25 families containing 34 individuals with neurological disease associated with biallelic HPDL variants. Phenotypes ranged from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spasticity and global developmental delays, sometimes complicated by episodes of neurological and respiratory decompensation. Variants included bona fide pathogenic truncating changes, although most were missense substitutions. Functionality of variants could not be determined directly as the enzymatic specificity of HPDL is unknown; however, when HPDL missense substitutions were introduced into 4-hydroxyphenylpyruvate dioxygenase (HPPD, an HPDL orthologue), they impaired the ability of HPPD to convert 4-hydroxyphenylpyruvate into homogentisate. Moreover, three additional sets of experiments provided evidence for a role of HPDL in the nervous system and further supported its link to neurological disease: (i) HPDL was expressed in the nervous system and expression increased during neural differentiation; (ii) knockdown of zebrafish hpdl led to abnormal motor behaviour, replicating aspects of the human disease; and (iii) HPDL localized to mitochondria, consistent with mitochondrial disease that is often associated with neurological manifestations. Our findings suggest that biallelic HPDL variants cause a syndrome varying from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spastic tetraplegia associated with global developmental delays.

Contains fulltext : 237881.pdf (Publisher’s version ) (Open Access) Human 4-hydroxyphenylpyruvate dioxygenase-like (HPDL) is a putative iron-containing non-heme oxygenase of unknown specificity and biological significance. We report 25 families containing 34 individuals with neurological disease associated with biallelic HPDL variants. Phenotypes ranged from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spasticity and global developmental delays, sometimes complicated by episodes of neurological and respiratory decompensation. Variants included bona fide pathogenic truncating changes, although most were missense substitutions. Functionality of variants could not be determined directly as the enzymatic specificity of HPDL is unknown; however, when HPDL missense substitutions were introduced into 4-hydroxyphenylpyruvate dioxygenase (HPPD, an HPDL orthologue), they impaired the ability of HPPD to convert 4-hydroxyphenylpyruvate into homogentisate. Moreover, three additional sets of experiments provided evidence for a role of HPDL in the nervous system and further supported its link to neurological disease: (i) HPDL was expressed in the nervous system and expression increased during neural differentiation; (ii) knockdown of zebrafish hpdl led to abnormal motor behaviour, replicating aspects of the human disease; and (iii) HPDL localized to mitochondria, consistent with mitochondrial disease that is often associated with neurological manifestations. Our findings suggest that biallelic HPDL variants cause a syndrome varying from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spastic tetraplegia associated with global developmental delays.

Background: The professional life has been frequently made by social interactions in which different forms of professional collaboration appear. Everybody has different attitudes through his/her life that could influence on choosing profession and probably the approach towards inter professional work. In order to study the current attitude towards planning educational courses and assess efficiency of the ongoing educational courses, the present study has normalized the Persian version of the ‘Attitudes to Health Professionals Questionnaire’ (AHPQ).Method: After permission from questionnaire developers, in order to confirm face and content validity, the process of translation and back translation was performed. Then it was sent to ten scholars (Delphi Technique) and their comments were considered for providing the final copy. The questionnaire was back translation from Persian into English. The final version was compared with the original questionnaire in terms of concepts. Reliability confirm by test-retest and internal consistency (intra class correlation and Cronbach alpha coefficient).The construct validity was confirmed by exploratory factor analysis. Results: According to the first phase (67 participants), wide range has caused unnecessary variations in answers; so reliability has been confirmed in larger sample size (104 participants) after decreasing the extent of scale from 10 to 5 points. Exploratory factor analysis was used by main construct and rotation of maximum variance. Final reliability was confirmed by Cronbach alpha as 0. 899. Three underlying constructs of professional ethics, professional autonomy and patient-centered care had been revealed in the questionnaire.Conclusion: In addition to confirmation of AHPQ construct validity, reveals that such a tool is able to specify the attitude of health team members based on their perceived importance towards the basis of inter professional collaboration. Thus, recognizing and directing priorities of health care team in inter professional collaboration enables us to manage establishment, integrity, sustainability and coordination of group activities.

BACKGROUND: Critical thinking is one of the goals of education. It is a criterion for academic accreditation in medical education by concentration on students' soft skills. Due to lack of basic information on critical thinking tendency in undergraduate medical program, this study aimed to determine the trend of tendency toward critical thinking of medical students in two phases: basic science (year 1) and preinternship (year 5) at Tehran University of Medical Sciences. MATERIALS AND METHODS: This longitudinal descriptive–analytic study has been conducted in two phases (2010 and 2015); all 105 medical students were selected by accessible sampling method. Years of entrance to college was the inclusion criterion. The psychometric properties of The California Critical Thinking Dispositions Inventory (CCTDI) were confirmed, and then, the instrument was completed twice by participants. Data were analyzed by SPSS: 16 using student t-test, and paired t-tests. RESULTS: There was a significant difference between genders of students (P < 0.05). Males were more disposed toward critical thinking than females. The significant increase was found between mean of truth-seeking in the second test compared to the first test; instead, the mean of inquisitiveness, analyticity and self-confidence and inquisitiveness was significantly decreased (P < 0.05). However, in other subscales, there were no significant differences between the 1st and the 5th year students (P > 0.05). The total score of the test in the second phase was lower than the first phase, which was not significant. CONCLUSION: According to the findings, there is necessary to consider the critical thinking dispositions in medical students training programs and break down the barriers. Tendency toward critical thinking seems to be as prerequisite of critical thinking skills in undergraduate medical program.

Background: Exercise training and vitamin D consumption are separately reported to be effective on improving health. However, the simultaneous effect of resistance training and vitamin D is not clear yet. However, there is no information available on the resistance training and the amount of vitamin D prescription. In addition, it is important to examine this issue in women who are known as an active and effective part of society. Methods: The participants (n = 40) of this study were randomly divided into four groups as follows: (1) placebo, (2) resistance training, (3) vitamin D, and (4) resistance training + vitamin D. In this study, interventions were performed for an 8-week period (3 D/W) consisting of resistance training protocol (60% 1-RM) and daily consumption of vitamin D (1000 IU). Anthropometric and laboratory measurements were collected 48 hours before and after the intervention. Results: Changes in HDL-C (P = 0.001, F = 6.3), total cholesterol (P = 0.001, F = 7.8), and leptin concentration (P = 0.001, F = 11.4) were significant. Accordingly, these changes in the study variables showed a better improvement in the resistance training + vitamin D group compared to the other groups (P = 0.001). Conclusions: Probably the most important factor for the observed changes was the reduction of adipose tissue caused by resistance training, as well as the enhancement of signaling pathways resulting from the consumption of vitamin D. However, maintaining muscle tissue caused by resistance training can be effective. Moreover, HDL change due to resistance training and its effect on reverse cholesterol transport may occur faster than LDL-C changes. Also, the improvement in LDL-C appears in response to longer periods of exercise along with drug therapy.

Objective(s): Nowadays, ionizing radiation (IR) has a significant contribution to the diagnostic and therapeutic medicine, and following that, health risks to individuals through unexpected exposure is greatly increased. Therefore, biological and molecular technology for estimation of dose (biodosimetry) is taken into consideration. In biodosimetry methods stimulation of cells to proliferation is routine to achieve more sensitivity of techniques. However, this concept has recently been challenged by new molecular methods such as gene expression analysis. This study aims to investigate the stimulation effects on gene expression biodosimetry.Materials and Methods: The blood samples were taken from15 patients who were irradiated by TC-99 MIBI, before radiopharmaceutical injection and 24 hr after injection. Lymphocytes were extracted immediately and activated by (phytohemagglutinin) PHA for 24 hr and XPA and FDXR expression levels were investigated by employing relative quantitative Real-Time PCR.Results: The results of this study show a significant increase in the FDXR expression level and a significant decrease in the XPA after stimulation of irradiated lymphocytes. Interestingly, a significant increasing trend in the FDXR expression level (at 0.05 significance level) following cell stimulation to the division was observed.Conclusion: Our results suggest that the PHA activation role in gene expression-based biodosimetry is strongly depended on the target genes and the relevant protein pathways. Finally, cell stimulation looks to be useful for some specific genes, such as FDXR, due to the increasing trend in expression and improvement of sensitivity of gene expression-based biodosimetry method.

To investigate the correlations between preoperative, operative, and postoperative factors and corneal graft topographic parameters after deep anterior lamellar keratoplasty (DALK) performed in keratoconus-affected eyes. This prospective, interventional study enrolled 44 eyes. Graft topographic parameters, including keratometric astigmatism and the surface regularity index (SRI), were assessed after complete suture removal. Univariate analyses were used to evaluate the effects of preoperative factors (donor quality, donor and recipient age, keratoconus severity), operative factors (graft size, donor button roundness, roundness and centration of the donor-recipient junction), and postoperative factors (time point of suture removal) on postoperative topographic parameters. The roundness of the donor-recipient junction after complete suture removal had a significant association with the roundness of the donor button after trephination (P = 0.04) and the amount of graft decentration relative to the limbus (P = 0.03). A significant correlation was found between the value of graft decentration relative to the limbus and postoperative keratometric astigmatism (P = 0.001) and between the roundness of the donor-recipient junction and the postoperative SRI (P = 0.02). The flat axis of the keratometric astigmatism and the longer axis of the graft lay in the direction of graft displacement. Other investigated factors had no significant association with postoperative topographic indices. Graft displacement relative to the limbus and roundness of the donor-recipient junction were the main predictors of graft astigmatism and regularity, respectively, after DALK. Noncircularity of the donor button after trephination could increase the graft surface irregularity indirectly by influencing the roundness of the surgical wound.

Background: To describe the protocol for developing a national inherited retinal disease (IRD) registry in Iran and present its initial report. Methods: This community-based participatory research was approved by the Ministry of Health and Medical Education of Iran in 2016. To provide the minimum data set (MDS), several focus group meetings were held. The final MDS was handed over to an engineering team to develop a web-based software. In the pilot phase, the software was set up in two referral centers in Iran. Final IRD diagnosis was made based on clinical manifestations and genetic findings. Ultimately, patient registration was done based on all clinical and non-clinical manifestations. Results: Initially, a total of 151 data elements were approved with Delphi technique. The registry software went live at www. IRDReg.org based on DHIS2 open source license agreement since February 2016. So far, a total of 1001 patients have been registered with a mean age of 32.41±15.60 years (range, 3 months to 74 years). The majority of the registered patients had retinitis pigmentosa (42%, 95% CI: 38.9% to 45%). Genetic testing was done for approximately 20% of the registered individuals. Conclusion: Our study shows successful web-based software design and data collection as a proof of concept for the first IRD registry in Iran. Multicenter integration of the IRD registry in medical centers throughout the country is well underway as planned. These data will assist researchers to rapidly access information about the distribution and genetic patterns of this disease.

Diclofenac (DIC) is administrated to treat pain, inflammatory disorders, and dysmenorrhea but kidney problems are the main worries of the agent. The literature has revealed that quercetin (QR) has anti-inflammatory and antioxidant attributes. This study aims to highlight the possible nephroprotective effects of QR on DIC-exposed rats. In this study, the animals after exposure to DIC (50 mg/kg, i.p) were administrated to QR (100 mg/kg, p.o). Then, the levels, as well as the activity of several oxidant and anti-oxidant mediators, were evaluated. Our results showed that DIC treatment was coupled with the elevation in the levels of malondialdehyde (MDA), nitric oxide (NO), and some pro-inflammatory factors such as TNF-α, NF-κB, and IL-1β, suggesting that probably this agent exert its toxicity in the kidney tissue through inducing both oxidative stress and inflammation. Interestingly, QR was successful in restoring the activity of antioxidant compounds such as GSH, GPx, SOD, and CAT in the kidney tissue of DIC-treated rats. Moreover, in the presence of QR, DIC was unable to increase the expression of pro-inflammatory cytokines, suggesting that perhaps QR might have anti-inflammatory properties. In agreement with this, the results of the histopathological evaluation also showed that while DIC increased the lymphocyte infiltration into the kidney tissue, QR reduced the number of lymphocytes in DIC-treated rats. The results revealed that QR exerted a supportive effect against diclofenac-induced renal injury in male rats through modulation of oxidative stress and mitigation of inflammatory response.

Pterygium is a common ocular surface disease characterized by the abnormal epithelial proliferation, matrix remodeling, vascularization and the migration of the lesion. Although the etiology of pterygium is elusive, recent studies have focused on the role of limbal stem cells (LSCs) damage and effects of UVB. This study aimed to determine the expression levels of pluripotent markers of SOX2 and OCT4 in primary pterygium and normal conjunctiva. Using real time polymerase chain reaction (PCR), the SOX2 and OCT4 expressions were compared in primary pterygium and normal conjunctiva. This study assessed the correlation between SOX2 mRNA expression and OCT4 mRNA expression, as well as the association between the clinicopathological indices and both gene expression levels. The relative mRNA expression levels of OCT4 genes in primary pterygium were significantly reduced compared to the normal conjunctiva tissues. The association between OCT4 gene expression and the clinicopathological indices reported significant laterality (P = .004) and marginal growth activity indices (P = .063). The univariate correlation between the SOX2 and OCT4 expressions was statistically significant (P = .001). The present study emphasized the downregulation of pluripotent marker OCT4 genes in the pterygium. It is speculated that these results may predict a new avenue for exploring the role of stem cell deficiency in the development of pterygium.

Dear Editor, Education is a complex issue and there is a need to consider a several factors to provide an effective training program. Regarding the issue of road traffic crashes, there are some contradictory findings about the efficacy of education, which may cause mistrust among professional circles and experts. Some scientists believe that most of the training programs do not necessarily cover all aspects of crashes and only address some of the concerns. Road traffic crashes are a multidimensional issue and can be influenced by various political, economic, social and cultural factors, and thus the efficacy of an education program can be reduced. The low efficiency of educational programs can have several reasons, which are mentioned below: 1.Non-use of Specific Educational Theory The efficacy of some educational interventions poses a serious challenge for researchers. A simple search in scientific databases will result in various studies aiming to offer educational programs for different road users about the road traffic safety. These educational programs are sometimes designed and implemented without sufficient scientific evidence or without relying on specific educational theory. Some researchers believe that designing an educational intervention without considering the guiding theory in education is like prescribing a medication to a patient regardless of his/her physiology. The use of educational theories entails identifying the audience properly, presenting the educational content in an appropriate manner, and evaluating its feedback. It also helps audiences to gain a better understanding about the safety in relation to their own behavior as road users. 2.Non-use of Various Methods for Providing the Educational Content Some educational interventions are based on learning context-dependent methods. However, learning context-dependent methods is not easily generalized among the target group. This type of educational delivery method is not adequately effective for some age groups, including children. Adopting various training methods tailored to the content and target groups such as role-playing, as well as using animation, cartoons, computer games, simulators, virtual reality technologies and augmented reality in training of traffic safety can increase the efficacy of such educational methods. 3.Insufficient Attention to the Causation Network of Traffic Crashes Some believe that educational programs only emphasize on one topic, and generally fail to take into account the effect of other interventions. On the other hand, the designed educational intervention may focus on the wrong variable (as a factor influencing the occurrence of traffic crashes or the resulting injuries). For example, some drug abuse resistance education interventions focus on peer pressure as a variable with a direct causal effect, while the effect of the peer pressure in some studies is pale and other factors have a stronger causal effect. As for the road safety issue, some educational interventions focus on a number of factors, such as vehicle control skills, while these factors may or may not be the main factors responsible for some of the road traffic crashes. The road safety educational programs may focus only on traffic behaviors such as driving speed and may neglect other behavioral aspects such as smoking, alcohol, and drug consumption. In such cases, and even if the trainees demonstrate the positive aspects of driving speed in their behavior, the impact of the negative aspects of other behaviors such as alcohol consumption causes the risk of road traffic crashes to remain in the target group. 4.Insufficient Knowledge of Audience Gaining sufficient knowledge about the target group, as well as paying due attention to the characteristics of individual receiving an education are important factors for deepening learning in the audience. Recognition of the audience usually takes place over a long period of time. However, it has been shown that educational activities are often short-lived, and short-term interventions may be less effective for the audience. Some educational interventions only provide safety information without giving the drivers an accurate understanding of their behavior as road users. On the other hand, some educational interventions focus on high-risk behaviors of the drivers without considering the underlying reasons for these behaviors. Many drivers who display an unsafe behavior are aware of the fact that their behavior is not safe; however, they keep displaying the unsafe behavior. The issue of education has conflicting aspects that should be addressed. For example, raising risk awareness may strongly discourage some people to follow educational topics; while it may be attractive for others and may even encourage them to include their acquired education in their behavior. For instance, education providers focus on quitting high-risk health behaviors such as smoking, alcohol consumption, and speeding that culminate in adolescence, while some training recipients may be curious and think about following these behaviors. It is argued that sometimes extensive financial resources to run inefficient educational program may deviate the resources from more effective community-based initiatives. Therefore, it is recommended that the researchers and policymakers in this field consider the theoretical and scientific principles when designing and implementing the educational interventions in order to increase their efficacy. Ethical Approval Not applicable. Conflict of Interest Disclosures None.

This paper aimed at examining and comparing the effects of different humor-based strategies (joke, pun, and limerick) on vocabulary learning of EFL learners at intermediate and advanced levels. To this end, 120 EFL learners in a private institute were asked to serve as the participants of the study. They were then divided into two groups according to their proficiency levels (i.e. advanced and intermediate). Each group contained four subgroups: three experimental groups (joke, pun, and limerick groups) and one control group. Before the treatment, the participants took part a pretest, which aimed to ascertain the homogeneity of the participants. The treatment for the three experimental groups then commenced, and it was followed by a vocabulary posttest. The data were gathered and analyzed via one-way between-groups ANOVA. The results revealed that for the intermediate learners, joke was more effective (although not significantly) than pun, which was (not significantly) more effective than limerick. The difference between joke and limerick, however, was statistically significant. For the advanced learners, the joke group outperformed both pun and limerick groups significantly. However, the difference between pun and limerick groups did not reach statistical significance. There was thus not a considerable difference between intermediate and advanced learners in terms of how they were affected by the treatments.

To evaluate the outcomes and complications of deep anterior lamellar keratoplasty (DALK) performed for pediatric keratoconus. This retrospective study enrolled 44 consecutive eyes of 39 keratoconus-affected children (≤ 18 years of age). All patients underwent big-bubble DALK from March 2004 to June 2016. The outcome measures included postoperative best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometry readings, and complications. The mean participant age was 16.8 ± 1.4 years, and the mean follow-up period was 68.5 ± 39.9 months. Successful big bubble was achieved in 33 eyes (75.0%), while the surgical technique was predescemetic DALK in 11 (25.0%). The mean BSCVA changed from 1.34 ± 0.49 LogMAR preoperatively to 0.24 ± 0.10 LogMAR postoperatively (P

Curcumin, a category of phenolic compound derivatives from the base of Curcuma longa (Zingiberaceae), represent a variety of beneficial effects on health and on events that succor in hampering certain diseases. The present research explains an efficient procedure for the synthesis of pyrano[2,3-d] pyrimidine-2,4(3H)-diones in high yields and short response times via a three-ingredient reaction of curcumin, aromatic aldehydes and 1,3-dimethylbarbituric acid in the presence of NiCo2O4@OCMC@Zn(BDC) nanocomposite. The catalyst was determined by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Fourier transform infrared, (FT-IR) X-ray powder diffraction (XRD) and Brunauer–Emmett–Teller (BET). Moreover, the NiCo2O4@OCMC@Zn(BDC) catalyst can be recovered and reused several times without significant loss of its activity.

Next‐generation sequencing (NGS) has been instrumental in solving the genetic basis of rare inherited diseases, especially neurodevelopmental syndromes. However, functional workup is essential for precise phenotype definition and to understand the underlying disease mechanisms. Using whole exome (WES) and whole genome sequencing (WGS) in four independent families with hypotonia, neurodevelopmental delay, facial dysmorphism, loss of white matter, and thinning of the corpus callosum, we identified four previously unreported homozygous truncating PPP1R21 alleles: c.347delT p.(Ile116Lysfs*25), c.2170_2171insGGTA p.(Ile724Argfs*8), c.1607dupT p.(Leu536Phefs*7), c.2063delA p.(Lys688Serfs*26) and found that PPP1R21 was absent in fibroblasts of an affected individual, supporting the allele's loss of function effect. PPP1R21 function had not been studied except that a large scale affinity proteomics approach suggested an interaction with PIBF1 defective in Joubert syndrome. Our co‐immunoprecipitation studies did not confirm this but in contrast defined the localization of PPP1R21 to the early endosome. Consistent with the subcellular expression pattern and the clinical phenotype exhibiting features of storage diseases, we found patient fibroblasts exhibited a delay in clearance of transferrin‐488 while uptake was normal. In summary, we delineate a novel neurodevelopmental syndrome caused by biallelic PPP1R21 loss of function variants, and suggest a role of PPP1R21 within the endosomal sorting process or endosome maturation pathway.

Introduction: In the present study, the radioadaptive role of the immune system induced by low dose (LD) was investigated for its in vivo protective activity. Materials and Methods: Quantitative analysis of cytokine gene expression was assessed for their in vivo activity in BALB/c mice. To evaluate the adaptive response induced by LD on the mice spleen lymphocyte, the cytokine interleukin (IL)-4, interferon (IFN)-γ, and transforming growth factor (TGF)-β expression was measured by a real-time quantitative polymerase chain reaction. To verify the radioadaptive effect of LD, animals were preirradiated at 10 cGy from a 60 Co source and then challenge dose at 200 cGy was delivered. Independent sample student's t-test was employed to compare cytokine gene expression in radioadaptive (10 + 200 cGy), LD (10 cGy), high-dose (HD, 200 cGy), and control groups of animals. Results: Following the HD, the cytokine gene expression of IFN-γ, IL-4, and TGF-β was significantly decreased compared to the control group (P = 0.0001). However, TGF-β expression was also decreased significantly in the LD and adaptive groups compared to the control group (P = 0.0001). IFN-γ/IL-4 ratio in the adaptive group was significantly decreased compared to the HD group (P = 0.0001). Conclusion: These results indicate that the immune system plays an important role for radioadaptive response induction by LD radiation to adjust the harmful effects of HD irradiation.

Aims: With advances in computer technology, the recent decade has witnessed a growth in resources and an increase in the availability of devices for language learning and teaching. This study aimed at investigating the effect of Adobe Connect virtual classrooms on technical vocabulary learning of students of medicine as well as to explore their attitudes toward Adobe Connect virtual classrooms. Materials and Methods: This quasi-experimental study was performed on 60 EFL students of medicine studying at Kashan University of Medical Sciences, Kashan, Iran. To ensure the participants' homogeneity in terms of language proficiency, the Oxford Quick Placement Test was used. The participants were randomly divided into two groups (n = 30): conventional teacher-centered and Adobe Connect virtual groups. Data were collected using pre- and post-tests of technical medical vocabularies to evaluate vocabulary knowledge and a five-point Likert scale to evaluate the students' attitudes toward Adobe Connect virtual classrooms. Data were analyzed using an independent t-test and a paired t-test by SPSS version 22. Results: The results revealed no significant difference in the mean scores of the vocabulary test between the conventional teacher-centered and Adobe Connect virtual groups before training (P = 0.757); however, the mean vocabulary scores after training in the Adobe Connect virtual group was significantly higher than the conventional group (P < 0.001). Conclusion: The findings of the present study show the effectiveness of the Adobe Connect virtual classrooms and students' satisfaction with such a virtual environment in terms of technical medical vocabulary learning.

The expression of GLI1 as a downstream gene of sonic hedgehog (Hh) pathway, studied in a variety of cancers including esophageal squamous cell carcinoma (ESCC). However, the interaction of Hh with other developmental pathways needs to be elucidated. In this study, we aimed to investigate the correlation of GLI1 expression with transcription factors (TFs) of stem cell signaling pathways, and their association with clinico-pathological data of ESCC. Using real-time PCR, we assessed the expression of GLI1 mRNA in 49 ESCC patients, and analyzed the correlation between GLI1 and selected TFs. The results showed overexpression of GLI1 in ESCC tissues in significant correlation with lymph node metastasis. The GLI1 up-regulation was also correlated to the SOX2 and SIZN1 (Smad-interacting zinc finger protein) expression. These correlations may confirmed the role of GLI1 in crosstalk among different cell signaling pathways in ESCC. To our knowledge, this is the first study to demonstrate the correlation of GLI1 expression with stemness marker and BMP signaling in ESCC.

The aberrant DNA methylation of the tumor suppressor genes involved in DNA Damage Response (DDR) signaling and cell cycle regulation may lead to the tumorigenesis. Our purpose here is to analyze the promoter methylation and mRNA expression levels of LATS1 and LATS2 (LATS1/2) genes in OSCC. Promoter methylation status of LATS1/2 genes was evaluated in 70 OSCC paraffin-embedded tissues and 70 normal oral samples, using Methylation Specific PCR (MSP). LATS1/2 mRNA expression profiles were also investigated in 14 OSCC patients and 14 normal samples, using real-time PCR. In both candidate genes, promoter methylation assessment revealed significant relationship between cases and controls (OR = 2.24, 95 % CI = 1.40–3.54, P = 0.001; LATS1 and OR = 15.5, 95%CI = 3.64–64.76, P

Purpose. Pterygium is a serious eye problem in countries with high exposure to UV. However, despite numerous studies, the molecular etiology of pterygium is unclear. Recent studies have indicated thatLATS1andLATS2genes are involved in DDR signaling pathways against continuous UV exposure. Our aim was to evaluate theLATS1andLATS2promoter methylation with the risk of pterygium formation.Methods. We evaluated the promoter methylation status ofLATS1andLATS2using methylation-specific PCR technique. Also, mRNA expression ofLATS1andLATS2was assessed in 14 cases of pterygium and 14 normal specimens by real-time PCR.Results. Promoter methylation ofLATS1andLATS2was detected significantly between pterygium tissues and normal tissues [LATS1; OR = 4.9; 95% CI: 1.54 to 15.48,P=0.003;LATS2; OR = 7.1; 95% CI: 1.53 to 33.19,P=0.004]. The gene expression analysis showed a statistically significant difference between pterygium tissues and healthy controls for bothLATS1andLATS2(P<0.05).Conclusions. The data of this study is the first report regarding the effect of promoter methylation of theLATS1andLATS2in the pterygium. To confirm these data, doing further studies in various genetic populations with large sample sizes using advanced molecular techniques is proposed.

Background: Nephropathic Cystinosis, the most common cause of renal Fanconi syndrome, is a lysosomal transport disorder with an autosomal recessive inheritance pattern. A large number of mutations in CTNS have been identified as causative to date. A 57 kb deletion encompassing parts of CTNS is most commonly identified in Caucasians but this allele has not been identified in individuals of Eastern Mediterranean, Middle Eastern, Persian, or Arab origin to date. Methods and Results: Implementing whole exome sequencing (WES) in a consanguineous Iranian family, we identified this large deletion affecting CTNS in a patient initially presenting with hypokalemic metabolic alkalosis symptoms and considerable proteinuria. Conclusion: We show WES is a cost and time efficient genetic diagnostics modality to identify the underlying molecular pathology in Cystinosis individuals and provide a summary of all previously reported CTNS alleles in the Middle east population. Our work also highlights the importance to consider the 57-kb deletion as underlying genetic cause in non-European populations, including the Middle East. Limited diagnostic modalities for Cystinosis in developing countries could account for the lack of previously reported cases in these populations carrying this allele. Further, our findings emphasize the utility of WES to define genetic causes in clinically poorly defined phenotypes and demonstrate the requirement of Copy number variation (CNV) analysis of WES data.

The dietary determinants of adolescent blood pressure (BP) are not well understood. We determined the association between major dietary patterns and BP in a sample of Iranian adolescents. This cross-sectional study was conducted among a representative sample (n = 557) of Shirazi adolescents aged 12–19 years. Participants’ systolic and diastolic BP was measured using a validated oscillometric BP monitor. Usual dietary intakes during the past 12 months were assessed using a valid and reproducible 168-item semiquantitative food frequency questionnaire through face-to-face interviews. Principal component factor analysis was used to identify major dietary patterns based on a set of 25 predefined food groups. Overall, three major dietary patterns were identified, among which only the Western pattern (abundant in soft drinks, sweets and desserts, salt, mayonnaise, tea and coffee, salty snacks, high-fat dairy products, French fries, and red or processed meats) had a significant association with BP. After adjusting for potential confounders in the analysis of covariance models, multivariable adjusted means of the systolic and mean BP of subjects in the highest tertile of the Western pattern score were significantly higher than those in the lowest tertile (for systolic BP: mean difference 6.9 mmHg, P = 0.001; and for mean BP: mean difference 4.2 mmHg, P = 0.003). A similar but statistically insignificant difference was observed in terms of diastolic BP. The findings suggest that a Western dietary pattern is associated with higher BP in Iranian adolescents. However, additional large-scale prospective studies with adequate methodological quality are required to confirm these findings.

Oromandibular dystonia (OMD) is a rare focal neurological disorder that affects mouth, face, and jaws. This comprehensive literature review aimed to summarize the current evidence for etiology, diagnosis, and management of OMD and assess the possibility of dental origin of the disease and dental treatment plans for these patients. Different online databases namely PubMed, Google scholar, and Scopus were searched. The keywords “oromandibular dystonia”, “orofaciomandibular dystonia”, “orofacial-buccal dystonia”, “lingual dystonia”, “jaw dystonia”, “cranial dystonia”, and “adult-onset facial dystonia” were searched in the title and abstract of publications from 1970 to 2016. The inclusion criterion was the dental etiology and/or dental treatment. Out of 1260 articles, only 37 articles met the inclusion criteria. OMD can be caused or exacerbated through different dental treatments within which anyone is likely to be involved due to various reasons. Some novel methods employed to relieve this syndrome have led to certain cure or improvement of symptoms in several cases. OMD patients may refer to dentists with involuntary jaw movements and intraoral presentations. Thus, the dentists should be aware of the symptoms and signs and refer the suspicious cases. Dentists should also be familiar with special considerations when managing OMD patients.

In this paper, we investigate the performance of a dual-hop block fading cognitive radio network with underlay spectrum sharing over independent but not necessarily identically distributed (i.n.i.d.) Nakagami-$m$ fading channels. The primary network consists of a source and a destination. Depending on whether the secondary network which consists of two source nodes have a single relay for cooperation or multiple relays thereby employs opportunistic relay selection for cooperation and whether the two source nodes suffer from the primary users' (PU) interference, two cases are considered in this paper, which are referred to as Scenario (a) and Scenario (b), respectively. For the considered underlay spectrum sharing, the transmit power constraint of the proposed system is adjusted by interference limit on the primary network and the interference imposed by primary user (PU). The developed new analysis obtains new analytical results for the outage capacity (OC) and average symbol error probability (ASEP). In particular, for Scenario (a), tight lower bounds on the OC and ASEP of the secondary network are derived in closed-form. In addition, a closed from expression for the end-to-end OC of Scenario (a) is achieved. With regards to Scenario (b), a tight lower bound on the OC of the secondary network is derived in closed-form. All analytical results are corroborated using Monte Carlo simulation method.