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Introduction: Death due to covid‐19 is one of the biggest health challenges in the world. There are many models that can predict death due to COVID‐19. This study aimed to fit and compare Decision Tree (DT), Support Vector Machine (SVM), and AdaBoost models to predict death due to COVID‐19. Methods: To describe the variables, mean (SD) and frequency (%) were reported. To determine the relationship between the variables and the death caused by COVID‐19, chi‐square test was performed with a significance level of 0.05. To compare DT, SVM and AdaBoost models for predicting death due to COVID‐19 from sensitivity, specificity, accuracy and the area under the rock curve under R software using psych, caTools, random over‐sampling examples, rpart, rpartplot packages was done. Results: Out of the total of 23,054 patients studied, 10,935 cases (46.5%) were women, and 12,569 cases (53.5%) were men. Additionally, the mean age of the patients was 54.9 ± 21.0 years. There is a statistically significant relationship between gender, fever, cough, muscle pain, smell and taste, abdominal pain, nausea and vomiting, diarrhea, anorexia, dizziness, chest pain, intubation, cancer, diabetes, chronic blood disease, Violation of immunity, pregnancy, Dialysis, chronic lung disease with the death of covid‐19 patients showed (p < 0.05). The results showed that the sensitivity, specificity, accuracy and the area under the receiver operating characteristic curve were respectively 0.60, 0.68, 0.71, and 0.75 in the DT model, 0.54, 0.62, 0.63, and 0.71 in the SVM model, and 0.59, 0.65, 0.69 and 0.74 in the AdaBoost model. Conclusion: The results showed that DT had a high predictive power compared to other data mining models. Therefore, it is suggested to researchers in different fields to use DT to predict the studied variables. Also, it is suggested to use other approaches such as random forest or XGBoost to improve the accuracy in future studies. [ABSTRACT FROM AUTHOR]

To derive and validate an effective machine learning and radiomics‐based model to differentiate COVID‐19 pneumonia from other lung diseases using a large multi‐centric dataset. In this retrospective study, we collected 19 private and five public datasets of chest CT images, accumulating to 26 307 images (15 148 COVID‐19; 9657 other lung diseases including non‐COVID‐19 pneumonia, lung cancer, pulmonary embolism; 1502 normal cases). We tested 96 machine learning‐based models by cross‐combining four feature selectors (FSs) and eight dimensionality reduction techniques with eight classifiers. We trained and evaluated our models using three different strategies: #1, the whole dataset (15 148 COVID‐19 and 11 159 other); #2, a new dataset after excluding healthy individuals and COVID‐19 patients who did not have RT‐PCR results (12 419 COVID‐19 and 8278 other); and #3 only non‐COVID‐19 pneumonia patients and a random sample of COVID‐19 patients (3000 COVID‐19 and 2582 others) to provide balanced classes. The best models were chosen by one‐standard‐deviation rule in 10‐fold cross‐validation and evaluated on the hold out test sets for reporting. In strategy#1, Relief FS combined with random forest (RF) classifier resulted in the highest performance (accuracy = 0.96, AUC = 0.99, sensitivity = 0.98, specificity = 0.94, PPV = 0.96, and NPV = 0.96). In strategy#2, Recursive Feature Elimination (RFE) FS and RF classifier combination resulted in the highest performance (accuracy = 0.97, AUC = 0.99, sensitivity = 0.98, specificity = 0.95, PPV = 0.96, NPV = 0.98). Finally, in strategy #3, the ANOVA FS and RF classifier combination resulted in the highest performance (accuracy = 0.94, AUC =0.98, sensitivity = 0.96, specificity = 0.93, PPV = 0.93, NPV = 0.96). Lung radiomic features combined with machine learning algorithms can enable the effective diagnosis of COVID‐19 pneumonia in CT images without the use of additional tests. [ABSTRACT FROM AUTHOR]

Background and Aim: Preterm birth (PTB) accompanies with morbidities and mortality among newborns. This study aimed to show that different factors such as economic (adjusted net national income and gross domestic product [GDP] per capita), human developmental (human developmental index), and health (overall health performance, pregnancy prenatal care rate, and modeled estimated maternal mortality rate) indexes might influence the prevalence of PTB. Methods: To this, the top 10 countries with the highest and lowest prevalence of PTB were extracted from the Global Burden of Disease report for PTB. Then, we have gathered some common indexes for economic (adjusted net national income and GDP per capita), health‐related (overall health performance, pregnancy prenatal care rate, and modeled estimated maternal mortality rate), and combined developmental (human developmental index) factors from different resources including World Bank and United Nations for those countries. The truncated Bayesian linear regression model, decision tree, and k‐means clustering algorithms were used for data analysis. Results: The results showed Pregnancy Prenatal Care Rate index has a significant effect on the PTB rate in the top 10 countries with the highest prevalence of PTB. Also, for the top 10 less prevalent countries for PTB, it was shown that modeled estimated maternal mortality rate, human developmental index rank, and pregnancy prenatal care rate have significant effects on PTB rate. In addition, the clustering based on the similarities in socioeconomic, human developmental, and health indexes were approximately like with the clustering of the countries based on the PTB rates (Rand index = 0.823). Conclusion: The results showed studies on the epidemiology of PTB (either worldwide or nation‐based) should consider these confounder factors to obtain accurate results. [ABSTRACT FROM AUTHOR]

To investigate the outcomes of asymptomatic stage I twin‐to‐twin transfusion syndrome (stage I TTTS) among patients treated with fetoscopic laser photocoagulation (FLP) versus expectant management. Databases such as PubMed, Web of Science and Scopus were systematically searched from inception up to March 1st, 2022. The primary outcome was at least one fetal survival at birth and secondary outcomes included gestational age at delivery, preterm premature rupture of membranes < 32 weeks, preterm birth < 32 weeks, and single and dual fetal survival. Five studies were included in the meta‐analysis. There was no significant difference in terms of at least one survival (odds ratio (OR) = 1.40, 95%CI= (0.26, 7.43), P = 0.70), single survival (OR = 0.87, 95%CI= (0.51, 1.48), P = 0.60) and dual survival (OR = 1.63, 95%CI= (0.74, 3.62), P = 0.23) among FLP and expectant groups. Gestational age at delivery (mean difference = 1.19, 95%CI= (−0.25, 2.63), P = 0.10), the risk of PTB<32 weeks (OR = 0.88, 95%CI= (0.50, 1.54), P = 0.65), and pPROM<32 weeks (OR = 1.80, 95% CI= (0.41, 7.98), P = 0.44) were also comparable between the groups. Routine FLP of the placental anastomoses before 26 weeks of gestation is unlikely to be beneficial among asymptomatic stable stage I TTTS patients without cervical shortening as the procedure does not offer a survival advantage compared with expectant management. Key points: What is already known about this topic? Controversies exist regarding the best management approach of stage I to twin transfusion syndrome (TTTS), so we sought to systematically investigate the outcomes of stage I TTTS cases who underwent laser versus expectant management. What does this review add? Routine fetoscopic laser photocoagulation (FLP) is unlikely to be beneficial among asymptomatic stable stage I TTTS patients as the procedure does not offer a survival advantage compared with expectant management. [ABSTRACT FROM AUTHOR]

This meta‐analysis aims to compare the perinatal outcome of twin‐twin transfusion syndrome (TTTS) pregnancies undergoing selective versus vascular equator (Solomon) fetoscopic laser photocoagulation (FLP). We performed a systematic search in PubMed and Web of Science from inception up to 25 July 2021. Studies comparing the Solomon and selective techniques of FLP for treatment of TTTS pregnancies were eligible. Random‐effects or fixed‐effect models were used to pool standardized mean differences (SMD) and log odds ratio. Seven studies with a total of 1664 TTTS pregnancies (n = 671 undergoing Solomon and n = 993 selective techniques) were included. As compared to the selective FLP, Solomon was associated with a lower risk of recurrent TTTS compared to the selective technique (Log odds ratio [OR]: −1.167; 95% credible interval [CrI]: −2.01, −0.33; p = 0.021; I2: 67%). In addition, Solomon was significantly associated with a higher risk of placental abruption than the selective technique (Log [OR]: 1.44; 95% CrI: 0.45, 2.47; p = 0.012; I2: 0.0%). Furthermore, a trend for the higher risk of preterm premature rupture of membranes was observed among those undergoing Solomon (Log [OR]: 0.581; 95% CrI: −0.43, 1.49; p = 0.131; I2: 17%). As compared to selective FLP, the Solomon technique for TTTS pregnancies is associated with a significantly lower recurrence of TTTS; however, it significantly increases the risk of placental abruption. Key points: What's already known about this topic? There are conflicting findings regarding adverse effects of different fetoscopic laser photocoagulation techniques, especially Solomon. What does this study add? The Solomon technique for twin‐twin transfusion syndrome (TTTS) pregnancies is associated with the lower recurrence of TTTS but significantly the increased risk of placental abruption. [ABSTRACT FROM AUTHOR]

Background: The external causes of death, including unintentional injuries, falls, suicide, and complications of medical and surgical care, in dementia are not well‐established, particularly in rare dementias. We compared risk of death from specific external causes in patients with dementia and control participants. Method: This was a nationwide population‐based cohort study in Sweden integrating 6 national registers from May 1, 2007, through December 31, 2018. We included all dementia patients aged 40 years or older identified from the Swedish Dementia Register‐SveDem and the national patient registry during the period and up to four control participants who were matched on the year of birth (± 3 years), sex and region of residence. Causes of death were obtained from death certificates compiled in the death registry. Hazard ratios (HRs) and 95% confidence intervals (CIs) of dementia on external cause‐specific mortality were calculated using Cox proportional models, adjusted for sociodemographic variables, comorbidity, and psychiatric disorders. Result: The study cohort included 241 569 patients with dementia (99 380 men [41.1%]; mean [SD] age, 81.5 [8.5] years) and 794 562 control participants (352 295 men [44.3%]; mean [SD] age, 79.9 [8.6] years), over 3 871 433 person‐years. People with dementia presented higher incident rates for unintentional injuries and falls during old age, and suicide in middle aged dementia patients, while the reverse trend for suicide in dementia was observed after 75 years. The association varied according to time since diagnosis. Compared with control participants, people diagnosed with dementia had an adjusted HR of 2.66 (95% CI, 2.58‐2.74) for unintentional injuries, 2.10 (95% CI, 2.01‐2.20) for falls, 0.48 (95%CI, 0.40‐0.58) for suicide, 0.94 (95%CI, 0.89‐1.00) for complications of medical and surgical care, and 2.61 (95%CI, 2.04‐3.34) for other external causes. Compared with control participants, patients with frontotemporal dementia had the highest risk of unintentional injuries and falls, while participants with mixed dementia were less likely to die from suicide and complications of medical and surgical care. Conclusion: Suicide risk screening in early‐onset dementia and early interventions for unintentional injuries and falls prevention in older patients with dementia should be provided. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the comparative efficacy of monotherapy and combined therapy of cholinesterase inhibitors plus memantine on cognition in AD and determine efficacy across doses for these pharmacological drugs. Method: The screening of 2,113 articles were initiated. Finally, forty randomized controlled trials (RCTs) from PubMed, Web of Science, and Scopus databases inception to the end of Dec. 2022 were finally included in this review. The included RCTs contain donepezil, rivastigmine, galantamine and memantine alone or in any combination of them were compared with placebo in terms of MMSE score. The mean difference (MD) in MMSE score was considered as the effect size of efficacy. The quality of the RCTs were appraised using the Cochrane risk‐of‐bias tool (RoB‐2). An additive network meta‐analysis (NMA) was applied to compare the efficacy of the drugs. Trends of efficacy across doses for each available treatment were checked using a dose‐response modeling. Finally, P‐score as a probability of being the most effective treatment, was used to rank the treatments. All statistical analyses were done using netmeta and dosresmeta R packages. The study protocol was registered in the PROSPERO (CRD42022358469). Result: These RCTs included 16,785 AD patients with mean age 73 (SD = 3.5) yrs., and weight 64.5 (SD = 5.55) kg. Of these patients, 65.15% were women. The median follow‐up time was 6 (range = 3‐48) months. The main NMA results showed that galantamine 32mg/day (MD = 3.71; 95% CI = 2.21, 5.21; P‐score = 0.89), donepezil 10mg/day combined with memantine 20mg/day (MD = 3.27; 95% CI = 1.79, 4.76; P‐score = 0.83), and then galantamine 24mg/day (MD = 3.02; 95% CI = 2.19, 3.84; P‐score = 0.79) were significantly the most effective treatments compared with placebo, respectively. According to the sub‐group analysis of stages, donepezil 10mg/day combined with memantine 20mg/day (MD = 4.78; 95% CI = 2.86, 6.71) and galantamine 32mg/day (MD = 3.81; 95% CI = 2.20, 5.34) were recommended for moderate to severe and mild to moderate AD patients, respectively. Moreover, we found there was a significant positive linear trend of efficacy across doses of galantamine. Conclusion: Monotherapy with a high dose of galantamine or the combination of donepezil plus memantine have the most favorable effects on cognition for 6 months follow up in AD patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate laparoscopy‐assisted fetoscopic laser photocoagulation (FLPC) of placental anastomoses in the treatment of twin‐to‐twin‐transfusion syndrome (TTTS). Study Design: We performed a retrospective cohort study analyzing pregnancies complicated by TTTS who underwent FLPC in a single university‐affiliated tertiary medical‐center. Outcomes were compared between patients who received laparoscopy‐assisted FLPC (study group) and patients who underwent the conventional FLPC technique (control group). Baseline characteristics, sonographic findings, procedure details, and neonatal outcomes were compared between groups. Results: The cohort included 278 women with 31 in the study group and 247 in the control group. Sonographic parameters, including fetal biometry and TTTS stage, were comparable between study groups. Gestational age at delivery did not differ between the groups (29.22 ± 4.55 weeks in the study group vs. 30.62 ± 4.3 weeks in the control group, p = 0.09). There were no differences in neonatal survival rates at birth and at 30 days between both groups. A subanalysis comparing the laparoscopy‐assisted group to only those patients with anterior placenta in the control group, showed a lower rate of incomplete Solomonization in the laparoscopy‐assisted study group (3.4% vs. 33%, p = 0.01). Conclusion: Laparoscopy‐assisted FLPC is a reasonable and safe option that may be offered in cases of FLPC where an anterior placenta restricts adequate surgical access. Key points: What's already known about this topic? Laparoscopic‐assisted fetoscopic laser photocoagulation should be considered in cases of twin‐to‐twin‐transfusion syndrome with inaccessible anterior placenta. What does this study add? When performed in the setting of a specialized fetal center with expertise, this surgical approach could increase the completion of Solomonization and laser photocoagulation of placental anastomoses. [ABSTRACT FROM AUTHOR]

Objective: Evaluate survival in twin twin transfusion syndrome (TTTS) with and without selective fetal growth restriction (sFGR) after fetoscopic laser surgery (FLS). Methods: Retrospective study of monochorionic diamniotic twins undergoing FLS. The cohort was classified as TTTS and TTTS with sFGR. Baseline, intra‐operative and postoperative variables were analyzed. Mann–Whitney U, Pearson chi‐square, Fisher's exact, t‐test and receiver operating characteristic (ROC) curve analysis were performed. Results: Four hundred and ninety‐two pregnancies were included, 304 (61.78%) TTTS and 188 (38.22%) TTTS with sFGR. No difference in donor outcomes. TTTS group had higher donor estimated fetal weight (EFW%) percentile (19.7 ± 18.8 vs. 2.2 ± 2.1, p < 0.001). Significant predictors for demise at 30 days were 37% intertwin weight discordance (IWD) with donor EFW% < first (area under ROC curve [AUC] = 0.85, p = 0.001) or IWD >25% and intertwin umbilical artery pulsatility index discordance (DUAPI) ≥0.4 (AUC = 0.71, p = 0.001). Conclusion: Combination of IWD of 37% and donor EFW% 25% was also associated with increased risk for donor demise. [ABSTRACT FROM AUTHOR]

Patients undergoing regular hemodialysis (HD) are at an extreme risk of acquiring bloodstream infections compared to the general population. Hepatitis E virus (HEV) infection is an important emerging health issue in these patients. To date, numerous studies have investigated the seroprevalence of HEV among HD patients across the world; however, the data are conflicting. The present study aimed to measure the exposure rate of HD patients to HEV infection by estimating the overall seroprevalence of HEV in this high‐risk group. A systematic literature search was carried out using five electronic databases from inception to January 10, 2020, with standard keywords. Pooled seroprevalence estimates with 95% confidence intervals (CIs) were calculated using a random intercept logistic regression model. The seroprevalence of HEV increased from 6.6% between the years of 1994 and 2000 to 11.13% from 2016 to 2020. Blood transfusion was associated with a nearly 2‐fold increase in the rate of HEV seropositivity (OR = 1.99; 95% CI: 1.50‐2.63, P <.0001, I2 = 6.5%). HEV seroprevalence among patients with HD for more than 60 months was significantly higher than those with HD for less than 60 months (27.69%, 95% CI: 20.69%‐35.99% vs 15.78%, 95%CI: 8.85%‐26.57%, respectively) (P =.06). Our results indicated increased exposure of HD patients with HEV infection over the last decade. We concluded that blood transfusion and duration of HD are considerable risk factors for acquiring HEV infection among HD patients. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has had a significant impact on healthcare systems worldwide, with many hospitals struggling to maintain the same level of care as before the pandemic. As a result, there is concern that the quality of stroke care for patients with dementia diagnoses may have worsened during the pandemic. Therefore, our aim was to study how the COVID‐19 pandemic has affected the quality of stroke care for patients with dementia versus without dementia after suffering a stroke. Methods: We conducted a register‐based study, retrieving data from the Swedish Stroke Register and The Swedish registry for cognitive/dementia disorders. We included adult patients diagnosed with/without? dementia who had also suffered a stroke between 2017 and 2022. The pre‐pandemic period was defined as January 1, 2017, to February 28, 2020, while the pandemic period was defined as March 1, 2020, to September 19, 2022. The quality indicators of care were defined as care provided at specialized stroke units and assessment for rehabilitation. Results: The study included 3205 patients with dementia and 32666 dementia‐free controls, all of whom suffered a stroke. The mean age at onset of stroke was 83 (±6.8) years for those with dementia and 74 (±15.1) years for those without. In addition, the dementia‐stroke group and stroke‐only group had 55% and 48% females, respectively. Compared to the pre‐pandemic period, a lower proportion of patients with dementia were admitted to specialized stroke units and received rehabilitation assessments during the pandemic period, with 64% versus 36% and 65% versus 36%, respectively. Additionally, a lower proportion of patients with dementia compared to stroke‐only controls were admitted to specialized stroke units (36% versus 45%) and received rehabilitation assessments (35% versus 44%) during the pandemic period. Conclusions: Our study indicate that the COVID‐19 pandemic had a negative impact on the quality of stroke care for patients with dementia as compared to stroke‐only controls. This was evidenced by the lower proportion of patients with dementia who were admitted for care to specialized stroke units and assessed for rehabilitation during the pandemic period, compared to the pre‐pandemic period. [ABSTRACT FROM AUTHOR]

Although an increasing number of studies have been conducted to evaluate the association between human papillomavirus (HPV) infections and distribution of HPV types worldwide with the risk of prostate cancer (PC), the results remain inadequate. Hence, we investigated the association between HPV infection and PC risk using a meta‐analysis. Relevant studies from January 1990 to December 2016 were searched in PubMed, Web of sciences, and Scopus databases. Pooled odds ratio (OR) and their corresponding 95% confidence interval (CI) were calculated to find the association between the prevalence of HPV and prostate cancer risk. To do so, data from 24 studies with 5546 prostate cancer cases were pooled in order to evaluate the heterogeneity of chief parameters including study region, specimen type, HPV DNA source, detection technique, publication calendar period, and Gleason score. All statistical analyses were performed using STATA 11 and MedCalc 13. A significant positive association was found between HPV infection and PC risk (OR = 1.281; P = 0.026). The genotype 16 was more frequently found in patients with PC which significantly increased the cancer risk (OR = 1.60; P < 0.001). Age 65 and older could significantly escalate PC risk (OR = 3.564; P < 0.001). Our results clearly favor the potential pathogenetic link between HPV infection and increased risk of PC affirming that HPV infections could play a part in the risk of PC. [ABSTRACT FROM AUTHOR]

Inflammatory cytokines have been established to be involved in the pathogenesis of rheumatoid arthritis (RA). The genetic polymorphisms in the interleukin (IL) 23 receptor (IL23R), IL21, and IL17 have been associated with RA risk. However, there is no conclusive understanding of the genes encoding the immunoinflammatory IL‐21–IL‐23R–IL‐17A pathway in RA aetiopathogenesis. This meta‐analysis was conducted to attain this goal. A comprehensive literature search was conducted in Scopus and PubMed to look for the relevant case–control studies up until 2018. A Bayesian hierarchical meta‐analysis was carried out to assess the association between the polymorphisms and the risk of RA. The association was estimated by calculating the logarithm of odds ratio (Log OR) and 95% credible interval (95% CI). In this meta‐analysis, 37 case–control studies comprising 23,506 RA patients and 25,984 healthy individuals were found for analyzing the IL23R, IL21, and IL1A gene polymorphism and risk of RA. In the IL23R gene rs1343151 SNP, the minor A allele significantly increased the risk of RA (Log OR = 0.085, 95% CI = 0.008, 0.156). Moreover, the minor AA genotype was significantly associated with increased RA risk (Log OR = 0.176, 95% CI = 0.028, 0.321). In addition, the C allele of the IL23R gene rs2201841 SNP significantly decreased the disease risk (Log OR = −0.544, 95% CI = −1.0, −0.065). Since Bayesian meta‐analysis is a powerful strategy to pool the data, it can be mentioned that genetic polymorphisms of IL23R, but not IL21 and IL17A, are involved in susceptibility to RA. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer is a common endocrine malignancy whose incidence has increased in recent years. Several internal and external risk factors are involved in the development of this cancer, such as infectious agents. Evidence supporting the role of viral infection as an etiology for the invasiveness of thyroid cancer is increasing. The aim of this study was to determine the presence of the Epstein–Barr virus (EBV) and the association between viral gene products and thyroid tumor development. Methods: Fifty‐seven thyroid cancer specimens were collected from the same number of patients as well as 18 samples from healthy controls. The presence of the EBV genome and the genotyping was examined by polymerase chain reaction (PCR). Also, an enzyme‐linked immunosorbent assay and real‐time PCR were used to measure the expression levels of viral and cellular genes. Results: The EBV DNA was detected in 71.9% of the samples, and it was also found that the presence of the EBV was associated with increasing development of thyroid tumor. Conclusion: Our results demonstrated that EBV infection may play a role in the development of thyroid tumor. [ABSTRACT FROM AUTHOR]

Background: Several genetic studies have assessed the association between polymorphisms in killer immunoglobulin‐like receptors (KIR) genes and susceptibility of individuals to ankylosing spondylitis (AS), but the findings have been inconclusive and incongruous. Therefore, we conducted this meta‐analysis of all case‐control studies meeting the inclusion criteria for obtaining an exact conclusion of the effect of KIR polymorphisms on the risk of AS. Methods: A systematic literature search was conducted in electronic databases, including Scopus web of science, ScienceDirect, and PubMed to find all eligible studies exploring the association between KIR polymorphisms and the risk of AS, prior to June 2017. Pooled odds ratios (OR) and their corresponding 95% CIs were used to evaluate the strength of the association between KIR polymorphisms and the risk of AS. Results: A total of 16 case‐control studies, encompassed in 12 papers, with 1770 cases and 2907 healthy subjects were included in the meta‐analysis. This meta‐analysis revealed three significant positive associations of 2DS1, 2DS5, and 3DS1 with susceptibility to AS, while two significant negative associations of 2DL2 and 2DS2 with susceptibility to AS were identified. In the subgroup analysis based on human leukocyte antigen (HLA)‐B*27 positive patients and healthy subjects, results indicated that there were four significant positive associations between 2DL5, 2DS4, 2DS5, 3DS1 polymorphisms and susceptibility to AS in HLA‐B*27‐positive patients; a significant negative association of 3DL1 in HLA‐B*27‐positive patients was found. Conclusions: While 2DS1, 2DS5, and 3DS1 polymorphisms increased AS risk, 2DL2 and 2DS2 polymorphisms were associated with reduced AS susceptibility. [ABSTRACT FROM AUTHOR]

Background: Systemic sclerosis (SSc) fibroblasts show resistance apoptosis mechanisms, which enhances the fibrosis stage of the disease. Impaired function of p53 upregulated modulator of apoptosis (PUMA) has been related to deficits in p53- dependant apoptosis pathway. This study aimed to evaluate the transcriptional levels of p53 and PUMA mRNAs in fibroblasts from SSc patients and compare it with healthy individuals. Methods: In this case-control study, skin biopsy samples were obtained from 19 patients with diffuse cutaneous SSc (DcSSc) and 16 healthy controls. Afterward, dermal fibroblasts were isolated and cultured. After extraction of total RNA from cultured fibroblasts, complementary DNA (cDNA) was synthesized. mRNA quantification was carried out using real-time PCR, SYBR Green PCR master mix, and specific primers for p53 and PUMA. Results: No significant alteration was observed in mRNA expression levels of p53 and PUMA (P = .99 and .23, respectively) in fibroblasts from SSc patients compared with controls. Conclusions: Apoptosis pathways are impaired in fibroblasts from patients with SSc, leading to chronic fibrosis. Nonetheless, PUMA/p53 pathway may not be involved in dysfunction of apoptosis mechanisms in fibroblasts of patients with SSc. [ABSTRACT FROM AUTHOR]

Objective: This systematic review and meta-analysis was performed to determine the prevalence rate of influenza virus from different parts of Middle East region, and present an overall relative frequency (RF) for this region. Methods: The authors performed a systematic literature review from several reliable databases such as PubMed, ISI Web of Science and Scopus during 2000-2016. Furthermore, the keywords of this research were 'Influenza', 'Subtype', 'Seroprevalence', 'Incidence', 'Seroepidemiology', 'H1N1', 'H3N2', 'H5N1', 'H9N2', 'Middle- East' and 'Meta-analysis'. The reported data were selected according to inclusion and exclusion criteria. Results: The authors selected 71 studies out of 1147 for the present review. The overall estimation of the prevalence of influenza virus was 10.2% [95% confidence interval (CI): 10.1%-10.3%]. However, based on our records, the evident heterogeneity of influenza virus was observed among the studies (Cochran Q test, P value <.001 and I-squared = 100%). It should be noted that influenza virus infection's RF varied from 0.5% in Qatar to 70% in Syria. Conclusions: The results of this review are remarkable, they show that influenza infection RF is variable due to several factors. Thus, further researches should be taken to minimize the emergence and transmission of influenza virus. [ABSTRACT FROM AUTHOR]

Abstract: Pilonidal disease (PD) is a chronic situation which may cause pain, discomfort, inflammation, discharges, and inability to do daily routines. Among two main methods of surgery, open healing is preferred by surgeons since it associates with lower risk of recurrence; however, it could complicate the wound condition by delaying the healing process. For this meta‐analysis, a search in Medline, Embase, and Scopus was performed in June 2017 with no restrictions placed on the publication date or languages. Then, time to healing was considered as the effect size and all the data from trials were extracted. The heterogeneity and the variation in pooled estimation were assessed using Cochran's Q test and I‐squared, respectively. Meta‐regression was used to examine the relationship between the effect size and year, studies' sample sizes, proportion of male gender and age with the cause of heterogeneity. From 11 selected articles finally 4 met our inclusion and exclusion criteria with the total number of 484 patients. Using a fixed‐effect model, pool effect was detected 0.642 (95% CI: 0.485–0.798). A homogeneity of pooled effect size estimate for the studies was also found (Cochran Q test, p‐value = 0.844, I‐square = 0.0%). Moreover, results of meta‐regression showed no statistically significant association between the effect size and patients' mean age, year of publication, total sample size, and sex proportion (0.51 < p‐values < 0.98). Platelet‐rich plasma therapy for PD wounds appeared more effective than classic wound dressing. [ABSTRACT FROM AUTHOR]

Objective The aim of the current study was to evaluate if methylation status of CpG sites of interferon regulatory factor 7 (IRF7) promoter in peripheral blood mononuclear cells (PBMCs) of systemic sclerosis (SSc) patients is involved in pathogenesis of the disease. Methods PBMCs were isolated from whole blood of 50 SSc patients and 30 controls. After the extraction of total RNA and DNA contents from PBMCs, complementary DNA (cDNA) was synthesized. Afterwards, quantitative analysis of IRF7 messenger RNA (mRNA) was conducted by real-time polymerase chain reaction (PCR). To evaluate the methylation status of the promoter region of IRF7 gene, PCR products of bisulfite-treated DNA from SSc patients and controls were sequenced. Results The mRNA expression of IRF7 in PBMCs from patients compared with controls was significantly upregulated. While limited cutaneous SSc patients expressed the mRNA of IRF7 higher than controls, the diffuse cutaneous SSc group did not demonstrate significantly increased expression in comparison to controls. Insignificant promoter hypomethylation of IRF7 was observed in SSc patients compared with the control group. However, CpG2 hypomethylation was significantly associated with increased SSc risk. Furthermore, overall promoter methylation and mRNA level of IRF7 were significantly correlated with each other. Nonetheless, none of them correlated with Rodnan score of SSc patients. There was significant difference in IRF7 mRNA expression between CpG8 methylated and unmethylated SSc patients. Moreover, the difference of methylation and expression was not significant between anti-nuclear antibody (ANA)-positive and ANA-negative SSc patients. Conclusions It is suggested that hypomethylation of the IRF7 promoter might play a role in SSc pathogenesis, probably through promoting the IRF7 expression in PBMCs of patients with SSc. [ABSTRACT FROM AUTHOR]