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Purpose: This study aimed to determine the effect of the probiotic Saccharomyces boulardii (S. boulardii) in patients with knee osteoarthritis (KOA). Methods: In this study, 70 patients with KOA were recruited via outpatient clinics between 2020 and 2021 and randomly assigned to receive probiotics or placebo supplements for 12 weeks. The primary outcome was a change in pain intensity according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Results: Sixty-three patients completed the trial. A linear mixed analysis of covariance (ANCOVA) model analysis showed that probiotic was better than placebo in decreasing the pain intensity measured by visual analogue scale (VAS) [−2.11 (−2.59, −1.62) in probiotic group and −0.90 (−1.32, −0.48) in placebo group, p = 0.002] and WOMAC pain score [−3.57 (−4.66, −2.49) in probiotic group and −1.43 (−2.33, −0.53) in placebo group, p < 0.001]. The daily intake of acetaminophen for pain management significantly decreased in the probiotic group [−267.18 (−400.47, −133.89) mg, p < 0.001] that was significantly better than placebo (p = 0.006). Probiotic significantly decreased the serum levels of high-sensitivity C-reactive protein (hs-CRP) inflammatory index [−2.72 (−3.24, −2.20) µg/ml] and malondialdehyde (MDA) oxidative stress index [−1.61 (−2.11, −1.11) nmol/ml] compared to the placebo (p = 0.002 and p < 0.001, respectively). Probiotic was better than placebo in increasing the scores of role disorder due to physical health (p = 0.023), pain (p = 0.048) and physical health (p = 0.031). Conclusion: Probiotic S. boulardii supplementation in patients with KOA significantly improved pain intensity, some dimensions of QoL, and inflammatory and oxidative stress biomarkers with no severe side effects. Trial registry: Registered on the Iranian clinical trial website (http://www.irct.ir: IRCT20161022030424N4) on 2019-09-02. [ABSTRACT FROM AUTHOR]

Safety concern among electric scooter riders drives them onto sidewalks, endangering pedestrians and making them uncomfortable. Regulators' solutions are inconsistent and conflicting worldwide. Widely accepted pedestrian safety metrics may lead to converging solutions. Adapting the time-to-collision from car traffic safety, we define projected time-to-collision and experimentally study pedestrians' objective and subjective safety. We design isolated and crowd experiments using e-scooter-to-pedestrian interactions to assess the impact of various factors on objective safety. In addition, we conducted a pedestrian survey to relate the subjective safety and the metric. We report a strong correlation between subjective safety and the projected time-to-collision when agents face each other and no relation when the e-scooter overtakes a pedestrian. As a near-miss metric correlated with pedestrian comfort, projected time-to-collision is implementable in policy-making, urban architecture, and e-scooter design to enhance pedestrian safety. Regulators' approach to electric scooters on sidewalks is inconsistent and conflicting worldwide. Maintaining a minimum projected time-to-collision as a near-miss metric provides a sufficient condition for pedestrian safety as well as improving pedestrian subjective perceived safety. [ABSTRACT FROM AUTHOR]

One of the factors that can affect the quality of life is the psychological status of people. Also, the psychological status of individuals can be affected by other variables. Therefore, this study was aimed to determine the role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting the quality of life in Iranian patients with type 2 diabetes. This cross-sectional study was conducted in Iran in 2021 among 300 patients with type 2 diabetes. The method of selecting the participants in this study was the proportional stratified sampling method. Data collection instruments included six questionnaires of demographic questionnaire and diabetes status, DASS-21 questionnaire (depression, anxiety, and stress), diabetes health literacy scale, self-care behavior questionnaire, satisfaction with life scale (SWLS), and quality of life questionnaire. Statistical methods such as independent sample t test, one-way analysis of variance, linear regression test, and Pearson correlation were used to analyze the data. Based on the results of Pearson correlation test, there was a positive and significant correlation between diabetes health literacy (r = 0.438, p < 0.001), depression (r = − 0.380, p < 0.001), anxiety (r = − 0.355, p < 0.001), stress (r = − 0.423, p < 0.001), and SWLS (r = 0.265, p < 0.001) with quality of life. Based on the results of linear regression, variables of diabetes health literacy, life satisfaction, self -care behaviors, depression, stress, anxiety, age of onset of diabetes and diabetes duration were able to predict 31% of the quality of life (p < 0.001). The results of this study indicated that diabetes health literacy, life satisfaction, stress and the duration of diabetes are able to predict the quality of life of patients with diabetes. Therefore, it is necessary to pay more attention to these effective variables training programs, especially health literacy, the effect of which is very obvious in this study. [ABSTRACT FROM AUTHOR]

Hyperuricemia as a risk factor for metabolic diseases is proved to be profoundly modified by dietary approaches. This systematic review and meta-analysis of randomized control trials (RCT) was conducted to investigate the effect of two nutritional interventions; dietary approaches to stop hypertension (DASH) diet and ketogenic diet (KD) on serum uric acid (UA) concentrations. Our systematic search was for RCTs in which KD or DASH diet were assigned to adults for at least 2 weeks or more. Until March 2023 in Embase, Web of Science, PubMed, and Scopus databases, 10 eligible RCTs that intervened with DASH diet (n = 4) or KD (n = 6) and had provided laboratory data on serum UA were found. Summary effect was calculated by random-effects model. Results from the meta-analysis of the 4 DASH diet RCTs with a total of 590 participants revealed significant decrease in serum UA after at least 4 weeks of interventions (mean difference (MD) = ‒0.25; 95% CI ‒0.4 to ‒0.1 mg/dL; p < 0.01; I2 = 0%). The pooled meta-analysis of the 6 included RCTs of KD reporting data of 267 participants showed no significant changes in serum UA (MD = 0.26; 95% CI ‒0.47 to 0.98 mg/dL, I2 = 95.32%). However, a non-significant reduction of UA in the subgroup analysis of very low-calorie KD (VLCKD) studies (MD = ‒0.04; 95% CI ‒0.29 to 0.22, I2 = 0%) was obtained. DASH diet has an ameliorating effect on serum UA and may be recommended for hyperuricemia states such as gout. In addition, we have shown that serum UA level following KD remained unchanged. Although, in view of the heterogeneity across the studies, further investigations are needed to determine the effect of KD and VLKD on serum UA concentrations. [ABSTRACT FROM AUTHOR]

Quality of life (QOL) in patients with diabetes is affected by multiple factors, and this study aimed to determine the effect of health locus of control points (HLOC) and diabetes health literacy (DHL) on QOL in Iranian patients with type 2 diabetes. This cross-sectional study was conducted between October 2021 and February 2022 among 564 people with type 2 diabetes. Patients were selected using proportional stratified sampling and simple random sampling methods. Data were collected using three questionnaires: (1) Multidimensional Health Locus of Control scale (form C), (2) World Health Organization Quality of Life Scale, and (3) Diabetes Health Literacy Scale. Data were analyzed by software's of SPSS V22 and AMOS V24. There was a positive and significant correlation between DHL and QOL. There was a positive and significant correlation between the subscales of internal HLOC, and doctors HLOC with QOL. According to the Path analysis results, all variables showed 58.93% of the direct effects and 41.07% of indirect effects of the final model. Numerate health literacy, informational health literacy, communicative health literacy, internal HLOC, other powerful people HLOC, chance HLOC, and doctors HLOC were able to predicted 49% variance of diabetes QOL (R2 = 0.49). The subscales of communicative health literacy, informational health literacy, internal HLOC, doctors HLOC, and chance HLOC had the greatest impact on QOL of people with diabetes. Based on the results of Path analysis, diabetes health literacy and HLOC play an effective role in QOL of diabetic. Therefore, there is a need to design and implement programs to improve the health literacy of patients as well as HLOC to improve QOL of patients. [ABSTRACT FROM AUTHOR]

bstract: Objective: The aim of this study was to determine the predictors of the use of complementary and alternative medicine (CAM) in patients with type 2 diabetes based on the health belief model (HBM). Methods: This cross-sectional study was performed in 2019 (from April to September) on 837 type 2 diabetic patients by multi-stage sampling method. Valid and reliable tools (questionnaire of using CAM modalities based on the HBM, self-care behavior section, and use of CAM section) were used to collect data. Data were analyzed using SPSS software version 24. Results: Based on the results, the constructs of the HBM were able to predict 37% of the variance of behavior using CAM. Constructs of perceived threat, perceived barriers, and cues to action had the most significant effect on predicting the behavior of using CAM (p < 0.001). In this study, the mean (±SD) of patients' self-care behaviors were 26.72 (±3.21) (out of a score of 40). Based on the results of the Pearson correlation, a significant positive correlation was observed between perceived threat (r = 0.374) and cues to action (r = 0.303) with using CAM modalities (p < 0.001). There was also a significant negative correlation between perceived barriers and using of CAM (r = −0.589, p < 0.001). Conclusion: Based on the obtained results, the HBM is useful in predicting the use of CAM, and due to the significant impact constructs of perceived threat, perceived barriers, and cues to action, it is better to pay more attention to these constructs in educational programs for patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

This global level ecological study aimed to investigate the correlation between environmental factors and the COVID-19 indices. This survey is an ecological study, so all studied variables are aggregate variables. To collect the variables in the study, a data set was provided, which includes the information of each country based on the cumulative deaths, case fatality rate, recovery rate, and the number of performed COVID-19 tests. Scatter plots of environmental factors for the studied countries were drawn based on cumulative incidence rate of cases, cumulative incidence rate of death, tests, recovery rate, and case fatality rate of COVID-19. Furthermore, Spearman correlation coefficient was also used to verify the correlation between environmental factors and indicators related to COVID-19. The results of this ecological study showed that among all countries surveyed, Montenegro (60,310.56 per million) and Luxembourg (54,807.89 per million) had the highest cumulative incidence rates of COVID-19 cases, when Tanzania (8.42 per million) and Vietnam (13.78 per million) had the lowest cumulative incidence rates of COVID-19. In addition, in this study, it was shown that the cumulative incidence rate of cases, the cumulative incidence rate of deaths, and performed COVID-19 tests had significant direct correlations with the access to drinking water and the access to sanitation services (p < 0.001). The findings of the present study showed an inverse correlation between the mortality rate due to unhealthy water consumption, poor health status, and a positive correlation between access to drinking water and health services with the cumulative incidence and mortality rates of COVID-19. The differences between our findings and many other studies could be due to the ecological nature of the study. Nevertheless, our findings will help health policymakers to develop timely strategies to reduce the mortality and incidence rate of COVID-19. [ABSTRACT FROM AUTHOR]

Background: This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. Results: The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively. Conclusions: The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of present study was to investigate eye care behaviors based on the BASNEF model and Health Locus of Control (HLOC) in patients with type 2 diabetes(T2D). Methods: This cross-sectional analytical study was carried out on 150 patients with T2D in Iran in 2019. The subjects were selected using simple random sampling. The data collection tools included demographic, eye self-care behavior inventory based on BASNEF model and health locus of control whose validity and reliability were confirmed. Data analysis was carried out using Independent samples-t test ANOVA, and linear regression in SPSS ver. 24. Result: The results of linear regression showed that knowledge, attitude, subjective norms, enabling factors, internal HLOC, chance HLOC and external HLOC were able to predict 17% of intention to eye self-care behaviors (P < 0.001) and attitude was the strongest construct in predicting intention of eye care behavior in patients with T2D (P < 0.05). In this study, most people had internal HLOC and mean (± SD) of their internal construct was 27.42(± 2.73). Also, the enabling factors construct showed a significant correlation with the internal HLOC (r = 0.283) and behavioral intention (r = 0.348) (P < 0.001). Conclusion: The results of this study showed that attitude and enabling factors are effective constructs in predicting the intention to perform preventive behaviors of ocular complications in T2D patients. Therefore, it is recommended to organize training classes, access resources, and educational information, facilitate access to physicians for eye examinations, create new skills for care and prevention of ocular complications. [ABSTRACT FROM AUTHOR]

Zinc oxide nanoparticles are used increasingly as antimicrobial and therapeutic agents, and the addition of metal ions such as silver may improve their potent cytotoxicity. However, there have been concerns about safety. In this work, we investigated the cytotoxic activity of newly synthesized silver/zinc oxide nanocomposites (Ag-ZnO NCs) versus ZnO nanoparticles (NPs) against human melanoma (A375) and gastric carcinoma (AGS). The cytotoxicity of Ag-ZnO NCs versus ZnO NPs was evaluated by cell viability assays and the cell cycle analyses were performed by flow cytometry using DAPI staining. Both ZnO NPs and Ag-ZnO NCs significantly reduced cell viability in a dose-dependent manner. We found that Ag-ZnO NCs cytotoxicity was lower than that of ZnO NPs in the same concentration range. Furthermore, the cytotoxicity caused by Ag-ZnO NCs and ZnO induced the accumulation of melanoma cells in S phase and gastric cancer cells in G2/M phase. It was concluded that Ag-ZnO NCs were less toxic than ZnO NPs. This approach provides a rational basis for evaluating the potential harm of ZnO NPs and Ag-ZnO NCs as food packaging materials and cancer therapy agents. [ABSTRACT FROM AUTHOR]

Objectives: Thalassemia patients present varying degrees of craniofacial characteristics, while the morphology of the upper airway is less studied. The purpose of this study was to compare the uvula-glossopharyngeal dimensions (UGDs) of patients with β-thalassemia major (BTM) with non-thalassemic subjects who had similarities in the maxillo-mandibular skeletal pattern. Subjects and methods: The material for this cross-sectional retrospective study consisted of lateral cephalograms of 40 BTM patients (23 males, 17 females, aged 9.5 ± 0.97 years). These were compared with lateral cephalograms of a control group of 40 non-thalassemic subjects (23 males, 17 females, aged 11.0 ± 0.87 years). The control group was chosen so that they had similarities with the BTM patients in the following cephalometric variables: SNA (in degree), SNB (in degree), ANB (in degree), and anterior facial height (N-Me). Results: The following UGDs in thalassemic subjects were significantly shorter in patients with BTM: tongue length ( P < 0.05), the distance between the hyoid bone and the mandibular plane ( P < 0.01), and the vertical distance between hyoid bone and the C3-RGN line (line connecting third vertebra and retrognathion) ( P < 0.05). The middle airway space in BTM patients was significantly wider ( P < 0.05), and a trend was observed for the wider inferior airway space ( P = 0.07). Conclusions: Based on this study, some UGDs in BTM patients were significantly different, compared to non-thalassemic subjects who had a similar maxillo-mandibular skeletal pattern. These findings may have implications for the long-term treatment of BTM patients; however, since groups were not exactly age-matched, the observed differences between groups could be attributed to either BTM, age, or both. Additional studies with age-matched subjects are needed to investigate the relationship between BTM and UGDs. [ABSTRACT FROM AUTHOR]

Modeling naturally fractured reservoirs (NFRs) requires an accurate representation of fracture network permeability (FNP). Conventionally, logs, cores, seismic, and pressure transient tests are used as a data base for this. Our previous attempts showed that a strong correlation exists between the fractal parameters of 2-D fracture networks and their permeability (Jafari and Babadagli, SPE 113618, Western Regional and Pacific Section AAPG joint meeting, ; Jafari and Babadagli, SPE Reserv Eval Eng 12(3):455-469, ). We also showed that 1-D well (cores-logs) and 3-D reservoir data (well test) may not be sufficient in FNP mapping and that 2-D (outcrop) characteristics are needed (Jafari and Babadagli, SPE 124077, SPE/EAGE reservoir characterization and simulation conference, ). This paper is an extension of those studies, where only 2-D (single-layer, uniform fracture characteristics in z direction) representations were used. In this paper, we considered a more complex and realistic 3-D network system. Two-dimensional random fractures with known fractal and statistical characteristics were distributed in the x- and y directions. A variation of fracture network characteristics in the z direction was presented by a multilayer system representing three different facieses with different fracture properties. Wells were placed in different locations of the model to collect 1-D fracture density and pressure transient data. In addition, five different fractal and statistical properties of the network of each layer were measured. The equivalent FNP was calculated using a commercial software package as the base case. Using available 1-D, 2-D, and 3-D data, multivariable regression analyses were performed to obtain equivalent FNP correlations for many different fracture network realizations. The derived equations were validated against a new set of synthetic fracture networks, and the conditions at which 1-D, 2-D and 3-D data are sufficient to map FNP were determined. The importance of the inclusion of each data type, i.e., 1-D, 2-D and 3-D, in the correlations was discussed. It was shown that using only 3-D data are insufficient to predict the FNP due to wide spatial heterogeneity of the fracture properties in the reservoir, which cannot be captured from single-well tests. Incorporating all types of data (1-D, 2-D, and 3-D) would result in better prediction. Also, it is recommended that the 2-D data of the most conductive layer in reservoir, which has longer fractures with a higher density, should be incorporated in the correlations. [ABSTRACT FROM AUTHOR]

lthough the incidence of ocular trauma has been clearly described in developed countries, few published data are available on the epidemiology and the effects of parameters that can influence the incidence and severity of ocular injuries in Iran. The present study tried to determine epidemiological aspects of ocular traumatic injuries and evaluate their effects on different types of ocular injury. The case series included 1950 consecutive patients with acute ophthalmic trauma presented to the emergency ward of Farabi Hospital in Tehran. Information was collected by interviewing patients and having them fill in a questionnaire. The final diagnosis was made by a medical resident. If there was a difficulty or doubt in diagnosis or classification, confirmation of diagnosis was made by senior faculty. Ocular injuries were classified into globe and non-globe injuries according to the site of injury. Mechanical globe injuries were classified according to Birmingham Eye Trauma Terminology (BETT) into closed and open injuries. The mean age of patients was 28.8 ± 12.8 years; 87.6% were male. The most common causes of injury were work-related (49.0%) and chance events (42.0%). The most frequent ocular injury was globe injury (95.6%), including mechanical (77.6% closed and 5.9% open), chemical (7.6%), photic (2.3%) and thermal (2.2%) injuries. Non-globe injury also occurred in 10.8% of patients; both globe and non-globe injuries occurred in 6.5% of patients. The hospitalization rate in all patients was 8.8%. Previous history of eye trauma was significantly more common in the group with isolated globe injuries ( P < 0.001). History of eye trauma is a risk factor for globe injuries and female gender is a risk factor only for non-globe injuries. These two factors may predict future eye injury and increase its risk by 5.2 and 1.6 times, respectively. [ABSTRACT FROM AUTHOR]