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Managing chronic, refractory nausea and vomiting in advanced cancer patients is challenging, especially when unrelated to cancer treatment. Mirtazapine, a tetracyclic antidepressant, effectively alleviates these symptoms, improving quality of life. It offers a promising palliative care alternative, addressing multiple symptoms and reducing polypharmacy, thereby enhancing patient satisfaction. [ABSTRACT FROM AUTHOR]

Purpose. To compare biometric and optical coherence tomography parameters as well as refractive status in preterm children aged 4–8 years with or without retinopathy of prematurity (ROP), and evaluate their correlations with age and gender‐matched full‐term children. Methods. Retrospective comparative cohort study of four groups of children. Children with a history of preterm birth, including ROP who received intravitreal bevacizumab (IVB) treatment, children with a history of ROP that regressed without treatment and those with no history of ROP were compared to age and gender‐matched full‐term children as a control group. Best corrected visual acuity (BCVA), spherical equivalent of refraction (SE), macular and choroidal thickness, as well as biometric parameters was measured. Results. A total of 120 eyes of 120 children (30 children in each group) were included. There was no significant difference in BCVA, SE, and subjective cylinder between groups (p = 0.05, p = 0.3, p = 0.6, respectively). Axial length was significantly shorter, and the cornea was steeper in both ROP groups than in other groups (p = 0.001, p < 0.001, respectively). The central macular thickness was significantly thicker in the treated, regressed ROP and preterm groups than in full‐term children (p < 0.001). The gestational age was negatively correlated with macular thickness in both treated and regressed ROP groups (r = −0.517; p = 0.003, r = − 0.490; p = 0.006, respectively). Conclusions. Children with a history of ROP had a shorter axial length, steeper cornea, and thicker macula that correlated with lower gestational age. [ABSTRACT FROM AUTHOR]

Introduction: Primary pulmonary angiosarcoma (PPA) is a highly aggressive and rare malignancy originating from the endothelial cells of blood vessels in the lungs. PPA is an extremely rare subtype, with less than 30 cases reported to date. PPA is not only challenging to diagnose but also has a poor prognosis, often resulting in a high mortality rate within a year of diagnosis, regardless of the treatment approach. Method: We present the case of a 33‐year‐old woman with no significant past medical history who presented with abdominal pain and was incidentally found to have a right hilar mass with pleural effusion and empyema. After undergoing surgery for a perforated gastric ulcer, her pulmonary lesions were further worked up. Despite an extensive diagnostic evaluation, including imaging, bronchoscopy, and thoracotomy, establishing a diagnosis was challenging. Ultimately, PPA was diagnosed on surgical lung biopsy, and the patient was started on pazopanib and paclitaxel chemotherapy but expired after 1 month due to multiple complications. Conclusion: This case highlights the difficulty in diagnosing this rare tumor and its poor prognosis regardless of therapy. Greater awareness of PPA and more research are needed to improve early detection and treatment options for this deadly disease. [ABSTRACT FROM AUTHOR]

Background and Aims: Vitamin D deficiency impacts a significant proportion of the world's population, and this deficiency has been linked to various conditions characterized by imbalanced serotonin regulation. The objective of this systematic review and meta‐analysis was to evaluate the effect of vitamin D supplementation on serum serotonin levels. Methods: We conducted a comprehensive search of PubMed, Scopus, Cochrane Central for Randomized Clinical Trials, and Web of Science up to September 2022, without any language restrictions. The effect sizes were calculated using the standard mean difference (SMD) and 95% confidence interval (CI). Results: Six randomized clinical trials involving 356 participants were included in the analysis. Our findings indicated no significant changes in serotonin levels between the intervention and control groups (SMD: 0.24 ng/mL, 95% CI: −0.28, 0.75, p > 0.10). Subgroup analysis also did not reveal any significant changes in serotonin levels among children, participants with autism spectrum disorders, interventions lasting 10 weeks or longer, or those receiving vitamin D doses below 4000 IU/day. Conclusion: Although the results obtained in this systematic review are inconclusive, they support the need for further well‐designed randomized trials to assess the potential role of vitamin D supplementation in regulating serotonin levels and potentially ameliorating depression and related disorders. [ABSTRACT FROM AUTHOR]

Background and Aims: Transient neurologic syndrome (TNS) is a postoperative pain in the back and buttock that can occur after spinal anesthesia. The spinal needle design may have an impact on the occurrence of TNS. We decided to compare the incidence of TNS and related factors between two spinal needle types. Methods: In this randomized clinical trial, 150 patients aged 18–60 years and American Society of Anesthesiologists (ASA) physical status I who underwent lower abdomen or lower extremity surgeries with spinal anesthesia and supine position were enrolled. They were randomly divided into two groups (25 G Quincke or Sprotte needle) with 0.5% bupivacaine (12.5 mg). After the operation, the patients were asked to report any pain in the lower back, buttock, and thigh areas. A Visual Analog Scale (VAS) was also used to record the severity of the pain. Results: Overall, 45 patients developed TNS. Twenty‐nine patients in the Sprotte group (38.7%) and 16 patients in the Quincke group (21.3%) developed TNS (p = 0.75). More patients in the Sprotte group (25.3%) had severe pain (VAS score of 8–10) when compared with the Quincke group (6.7%). There was no significant difference in TNS symptoms duration between the two groups. In about half of patients (51.9%) in the Sprotte group and 57.3% of patients in the Quincke group, the symptoms resolved after 2–3 h. Conclusion: Although the incidence of TNS did not differ significantly, patients for whom a Sprotte spinal needle had been used had more severe pain. This suggests that the Quincke needle caused less severe pain. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is associated with reproductive disorders and adverse cardiometabolic risk factors that can negatively impact the general health of women. Inulin‐type fructans (ITFs) are proposed to beneficially affect risk factors associated with metabolic disorders. Whether ITFs can help with the management of PCOS by modifying insulin resistance (IR) and androgen levels has not yet been explored. The aim of this study was to investigate the effects of ITFs with different degrees of polymerization on insulin resistance, blood lipids, anthropometric measures, and hormonal status in overweight and obese women with PCOS. In a randomized double‐blind placebo‐controlled trial, seventy‐five women with PCOS aged 18–40 years old were randomly assigned to receive 10 g/day of high‐performance inulin (HPI) or oligofructose‐enriched inulin (OEI) or maltodextrin for 12 weeks. Biochemical and clinical outcomes were measured at baseline and after the intervention. Participants in the HPI and OEI groups experienced improvements in waist circumference, total testosterone, free androgen index, sex hormone‐binding globulin, and triglycerides compared to the placebo group. Also, the number of women with irregular menses or oligomenorrhoea decreased significantly in both ITF groups. Participants in the HPI group reported lower body mass, fasting insulin, and HOMA‐IR, as well as a higher quantitative insulin sensitivity check index. ITF supplementation, especially with long‐chain ITFs, when given for 12 weeks may improve metabolic outcomes, androgen status and clinical manifestations in women with PCOS. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID‐19) affects both the respiratory system and the body as a whole. Natural molecules, such as flavonoid quercetin, as potential treatment methods to help patients combat COVID‐19. The aim of this systematic review and meta‐analysis is to give a comprehensive overview of the impact of quercetin supplementation on inflammatory factors, hospital admission, and mortality of patients with COVID‐19. The search has been conducted on PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library using relevant keywords until August 25, 2023. We included randomized controlled trials (RCTs) comparing COVID‐19 patients who received quercetin supplementation versus controls. We included five studies summarizing the evidence in 544 patients. Meta‐analysis showed that quercetin administration significantly reduced LDH activity (standard mean difference (SMD): −0.42, 95% CI: −0.82, −0.02, I2 = 48.86%), decreased the risk of hospital admission by 70% (RR: 0.30, 95% CI: 0.14, 0.62, I2 = 00.00%), ICU admission by 73% (RR: 0.27, 95% CI: 0.09, 0.78, I2 = 20.66%), and mortality by 82% (RR: 0.18, 95% CI: 0.03, 0.98, I2 = 00.00%). No significant changes in CRP, D‐dimmer, and ferritin were found between groups. Quercetin was found to significantly reduce LDH levels and decrease the risk of hospital and ICU admission and mortality in patients with COVID‐19 infection. [ABSTRACT FROM AUTHOR]

Metabolic acidosis (MA) may play a key role in the pathogenesis of protein‐energy wasting (PEW) in patients with chronic kidney disease (CKD). To present a comprehensive synthesis of the effect of oral sodium bicarbonate (SB) supplementation on anthropometric measures in patients with CKD, a systematic review was undertaken in PubMed/MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar, of relevant articles published prior to September 2022. The summary statistics of effect size, nonstandardized weighted mean difference (WMD), and 95% confidence interval (CI) were used to compare the effects of SB supplementation on anthropometric parameters vs. control group. To detect probable sources of heterogeneity, a series of predefined subgroup analyses were conducted. In total, 17 studies with 21 treatment arms, including 2203 participants (1149 cases, 1054 controls), met our inclusion criteria and were included in the meta‐analysis. SB supplementation had no significant effect on body weight (BW), midarm muscle circumference (MAMC), or lean body mass (LBM) in patients with CKD. There was a significant increase in body mass index (BMI) (MD: 0.59 kg/m2, 95% CI: 0.25 to 0.93, p = 0.001) after SB supplementation in the overall analysis. In subgroup analysis, LBM was increased in studies that were ≥ 24‐week duration (MD: 1.81 kg, 95% CI: 0.81 to 2.81) and in participants with BMI lower than 27 kg/m2 (MD: 1.81 mg/L, 95% CI: 0.81 to 2.81). SB supplementation may yield increases in BMI in predialysis CKD patients. However, our findings did not support the beneficial effects of SB supplementation on other anthropometric outcomes. There is an evident need for long‐term high‐quality interventions to confirm these findings. [ABSTRACT FROM AUTHOR]

The fish diet is one of the essential factors in the development of aquaculture. The purpose of present study was to evaluate using grape pomace as a main feed ingredient on growth performance, body chemical composition, survival rate, and morphological indices of the carp (Cyprinus carpio). 200 fish with an average weight of 7 ± 0.4 g were randomly distributed in four tanks for total of 56 days. The fish were fed with a diet containing 5%, 10%, and 15% grape pomace in different feeding groups designated as G1, G2, and G3. The average daily weight gain (g), weights gain (g), and specific growth rate (%) were significantly higher (p <.05) in G3 as compared to G1 and G2 groups. The lowest feed conversion ratio was recorded in G3 group. The morphological indices, condition factors, viscerosomatic index, and hepatosomatic index were significantly higher in G3 group as compared to other treatments. The protein, fat, moisture, and ash contents in the C. carpio fillets were significantly influenced by feeding rate. The results showed that grape pomace had a positive effect on growth, survival, and nutritional indices in the carp fish. According to the obtained results, grape pomace (150 g/kg food) can be considered as the diet component for the carp fish. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the utilization of Beta vulgaris powder as feed ingredient in the diet of Cyprinus carpio for a period of 56 days. Common carp fry with an average weight of 20 ± 0.2 g were fed using the diet containing B. vulgaris leaves with different concentrations. Fry of Cyprinus carpio were equally distributed in four feeding groups having three replicates each. The study was conducted indoors, in FRP tanks, and aeration was provided to individual rearing units, and it was a flow‐through system. The basal diet was replaced at 0.5%, 1%, and 2% with B. vulgaris powder. The basal diet without B. vulgaris powder (0%) served as control (T1). Significantly higher feed conversion ratio, protein efficiency ratio, and fat and protein indices were recorded in fish fed with B. vulgaris powder in treatments. Different feeding groups showed greater acceptability of B. vulgaris powder mixed diet without any adverse behavioral response. The protein and fat average percentages were 43.32 and 10.79 g, when fish reached commercial weight (48.02, 11.85 g) after 56 days for treatment 2%. After fish feeding with the B. vulgaris, for treatment 2% lower moisture than the control was recorded. The carp fish diet containing 1% B. vulgaris leaf powder caused a significant decrease in the fish fat content. It can be concluded that the diet containing 2% B. vulgaris leaf powder in the common carp led to better growth performance. The presence of B. vulgaris leaves in the fish diet increased the fillet protein and ash content. [ABSTRACT FROM AUTHOR]

The phase field approach is widely used to model fracture behaviors due to the absence of the need to track the crack topology and the ability to predict crack nucleation and branching. In this work, the asynchronous variational integrator (AVI) is adapted for the phase field approach of dynamic brittle fracture. The AVI is derived from Hamilton's principle and allows each element in the mesh to have its own local time step that may be different from others'. While the displacement field is explicitly updated, the phase field is implicitly solved, with upper and lower bounds strictly and conveniently enforced. In particular, two important variants of the phase field approach, the AT1 and AT2 models, are equally easily implemented. Several benchmark problems are used to study the performances of both the AT1 and AT2 models, and the results show that the AVI for the phase field approach significantly speeds up the computational efficiency and successfully captures the complicated dynamic fracture behavior. [ABSTRACT FROM AUTHOR]

Almond intake may be correlated with improvements in several cardiometabolic parameters, but its effects are controversial in the published literature, and it needs to be comprehensively summarized. We conducted a systematic search in several international electronic databases, including MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov until April 2021 to identify randomized controlled trials that examined the effects of almond consumption on cardiometabolic risk factors, inflammatory markers, and liver enzymes. Data were pooled using the random-effects model method and presented as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Twenty-six eligible trials were analyzed (n = 1750 participants). Almond intake significantly decreased diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein (LDL), non-high-density lipoprotein (HDL), and very LDL (p < 0.05). The effects of almond intake on systolic blood pressure, fasting blood glucose, insulin, hemoglobin A1c, homeostatic model assessment of insulin resistance, C-peptide, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, C-reactive protein (CRP), hs-CRP (high sensitivity C-reactive protein), interleukin 6, tumor necrosis factor-α, ICAM (Intercellular Adhesion Molecule), VCAM (Vascular Cell Adhesion Molecule), homocysteine, HDL, ox-LDL, ApoA1, ApoB, and lipoprotien-a were not statistically significant (p > .05). The current body of evidence supports the ingestion of almonds for their beneficial lipid-lowering and antihypertensive effects. However, the effects of almonds on antiinflammatory markers, glycemic control, and hepatic enzymes should be further evaluated via performing more extensive randomized trials. [ABSTRACT FROM AUTHOR]

Recently, the use of synbiotics for managing various diseases has dramatically increased. Synbiotics have been shown to be a good approach to influence the composition of the gut microbiota with positive health effects. Management of type 2 diabetes mellitus (T2DM) complications is one of the reasons for the ingestion of synbiotics and so the aim of the current study was to determine the effects of synbiotic bread intake on markers of lipid profile in T2DM patients. One hundred T2DM patients (age between 20 and 60 years) were randomly assigned to four groups to consume different types of synbiotic bread, three times/day, for 8 weeks: "synbiotic + lactic acid" (n = 25; IV), "synbiotic" (n = 25; III), "lactic acid brad" (n = 25; II), or "control" (n = 25; I). The measured outcomes included anthropometric characteristics, glycemic control parameters, blood lipids, and apolipoproteins. The consumption of "synbiotic + lactic acid bread" (group IV) and "lactic acid bread" (group II) led to a significant decrease in total cholesterol (TC) and glycated hemoglobin (HbA1c) compared to the "control bread." The HbA1c levels were also significantly lower when compared to group II. Additionally, apolipoprotein A (Apo A1) levels were significantly decreased in group IV, compared to control and other groups (post hoc analysis). No significant differences between groups were observed for triglyceride (TG), high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), and apolipoprotein B100 (Apo B100) levels. The observed results show that the synbiotic bread (with or without lactic acid) promoted a decrease in total cholesterol (TC) and Apo A1 in diabetic patients when consumed daily for 8 weeks. [ABSTRACT FROM AUTHOR]

Objectives. Lophomonas infection is a respiratory disease in humans that is associated with symptoms of cough, sputum, dyspnea, and sometimes hemoptysis, which shows the importance of differentiating this disease from tuberculosis and asthma. Methods. This study was performed on 216 participants suspected of having tuberculosis who had symptoms of fever, chronic cough, or sputum and were referred to tuberculosis laboratories in three cities in Golestan Province, northeastern Iran, during 2019-2020. A sputum sample was taken from the suspected patients. DNA was extracted from the frozen samples, and an in-house polymerase chain reaction was performed to detect the Lophomonas DNA. Results. Out of 216 subjects, 47 (21.75%) were infected with Lophomonas spp. Moreover, 9 patients (4.2%) were infected with tuberculosis. Also, 2 patients had a comorbidity of tuberculosis and Lophomonas infection P = 0.63 . There was no significant difference in the comparison of symptoms and the rate of Lophomonas infection P = 0.84 , but in the comparison of the set of symptoms of cough, sputum, and fever with those of cough and sputum, cough with fever, sputum with fever, and the rate of Lophomonas infection, there was a significant difference P = 0.012 . Conclusions. Lophomonas infection was relatively high in patients suspected of having tuberculosis and due to the similar clinical symptoms of Lophomonas infection and tuberculosis; it is recommended that the sputum samples of subjects suspected of having tuberculosis be examined for this parasite in order to make a correct diagnosis and the patients receive timely treatment and the appropriate medication. [ABSTRACT FROM AUTHOR]

The article discusses the importance of correcting corneal astigmatism in patients undergoing cataract surgery. It explains that uncorrected corneal astigmatism can lead to decreased visual acuity and other visual disturbances. The most common method for correcting astigmatism is the use of toric intraocular lenses (IOLs), which have been shown to provide greater spectacle independence. However, accurately measuring pre-existing corneal astigmatism and achieving optimal outcomes after toric IOL implantation can be challenging. The article highlights the need for ongoing research to refine measurement techniques and improve toric IOL calculations in order to reliably correct astigmatism after cataract surgery. [Extracted from the article]

Background: In recent years, cases of human visceral leishmaniasis (HVL) have been reported in some districts of Golestan Province, northeastern Iran, particularly in rural areas. Recent epidemiological evidence in Leishmania infantum endemic regions of in Iran indicates approximately 50%–80% of seropositive dogs are asymptomatic for Leishmania infection. Objectives: The goal in this study was to determine Leishmania species infecting domestic dogs in Golestan Province, Iran. Methods: Between 2015 and 2016, blood samples were obtained from 100 domestic dogs in rural regions of Golestan Province, northeastern Iran. All samples were tested for anti‐Leishmania antibodies using a direct agglutination test (DAT), and for Leishmania spp. kinetoplast DNA (kDNA) using PCR. Results: Seven (7%) dogs were antibody positive and 25 dogs (25%) were Leishmania spp. DNA positives by PCR positive for leishmaniasis. Four of the seven (71%) antibody‐positive dogs and 19 of the 25 (76%) PCR‐positive dogs were asymptomatic. The rate of infection detected by PCR was significantly higher in male dogs (21/75, 28%) than that in female dogs (4/25, 16%). The ITS1 PCR‐RFLP assay identified the presence of L. infantum, L. tropica or Crithidia spp. in the 25 PCR‐positive samples. Conclusions: The high proportion of asymptomatic dogs in the study areas represent they act as potential reservoirs in the transmission cycle of Leishmania spp. and also Crithidia fasciculata as an emerging agent for the first time. Moreover, our data showed that PCR is a more reliable assay than DAT for detecting Leishmania spp. infection among asymptomatic dogs. [ABSTRACT FROM AUTHOR]

Background. Male urethritis is one of the most common genital tract syndromes. Though the number of patients with urethritis is increasing worldwide, the cause of many cases of non-gonococcal urethritis (NGU) is still unknown. Objectives. This study aimed to delineate the association between Trichomonas vaginalis (T. vaginalis) infection and male urethritis. Methods. The literature was searched in PubMed, Scopus, and Web of Science databases using the search terms "urethritis," "Trichomonas vaginalis," "trichomoniasis," and "male urethritis" up to February 2020. Overall risk difference(RD) was applied to assess the relationship between T. vaginalis infection and male urethritis. Results. In total, seven articles were included in this systematic review and meta-analysis study. Our meta-analysis involved the review of case-control studies, including 2,242 urethritis cases and 929 individuals as controls. Among subjects examined for trichomoniasis, in the case group, 211 males were infected, and in the control group, 32 individuals were infected. The overall risk difference (RD) was 0.06, and the total reported p value was 0.00001. Although the result of our meta-analysis was not significant, it was shown that the risk of urethritis is 0.06 more in trichomoniasis patients than in the non-exposed group. Conclusion. Findings from the included papers showed that trichomoniasis is not a risk factor for male urethritis. Although trichomoniasis alone is not the main cause of urethritis, it can be considered one of the risk factors in male urethritis. Therefore, in the future, it is necessary to perform further studies to clarify the detailed association between T. vaginalis infection and urethritis risk in male patients. [ABSTRACT FROM AUTHOR]

Ermin is an actin‐binding protein found almost exclusively in the central nervous system (CNS) as a component of myelin sheaths. Although Ermin has been predicted to play a role in the formation and stability of myelin sheaths, this has not been directly examined in vivo. Here, we show that Ermin is essential for myelin sheath integrity and normal saltatory conduction. Loss of Ermin in mice caused de‐compacted and fragmented myelin sheaths and led to slower conduction along with progressive neurological deficits. RNA sequencing of the corpus callosum, the largest white matter structure in the CNS, pointed to inflammatory activation in aged Ermin‐deficient mice, which was corroborated by increased levels of microgliosis and astrogliosis. The inflammatory milieu and myelin abnormalities were further associated with increased susceptibility to immune‐mediated demyelination insult in Ermin knockout mice. Supporting a possible role of Ermin deficiency in inflammatory white matter disorders, a rare inactivating mutation in the ERMN gene was identified in multiple sclerosis patients. Our findings demonstrate a critical role for Ermin in maintaining myelin integrity. Given its near‐exclusive expression in myelinating oligodendrocytes, Ermin deficiency represents a compelling "inside‐out" model of inflammatory dysmyelination and may offer a new paradigm for the development of myelin stability‐targeted therapies. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is associated with several cardiovascular risk factors. Prebiotics were proposed to beneficially affect risk factors associated with metabolic disorders. The aim of this study was to investigate and compare the effects of inulin‐type fructans (ITFs), as well‐studied prebiotics, with different degrees of polymerization, on markers of inflammation, oxidative stress and endothelial dysfunction in PCOS patients. Design: A randomized, double‐blind, placebo‐controlled trial. Patients: Seventy‐five PCOS women were randomly assigned to receive 10 g/day of either high‐performance inulin (HPI) or oligofructose‐enriched inulin (OEI) or placebo for 12 weeks. Measurements: Biochemical indices and blood pressure levelswere assessed before and after the intervention. Results: In the intent‐to‐treat analysis, high‐sensitive C‐reactive protein (hs‐CRP) decreased in HPI and OEI groups, over the 12 weeks, and the changes were significant in the HPI group, compared to placebo (changes from baseline in the HPI group: −0.11 vs. placebo group: 0.004 mg/L [conversion factor to SI units (nmol/L): 9/5238]; p =.007). Serum levels of nitric oxide (NO) increased, and endothelin‐1 and total oxidant status decreased in HPI and OEI groups, at the end of the trial; however, these changes were not significantly compared to placebo (p =.07,.36 and.22, respectively). No differences in systolic and diastolic blood pressure were found. Per‐protocol analysis (n = 68) yielded consistent results for all endpoints, with the exception that the significant effect of ITFs on serum hs‐CRP levels in the unadjusted ITT analysis became nonsignificant in the per‐protocol analysis (p =.06). Conclusion: A 12‐week supplementation with long‐chain ITFs had favourable effects on inflammatory status among PCOS patients. [ABSTRACT FROM AUTHOR]

Objective: To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. Methods: In this case‐control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo‐reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle‐toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion‐eversion at initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing phase of the gait were measured. Results: In patients with CAI, the injured and uninjured ankles were significantly different regarding angle‐toe angle, inversion‐eversion RoM, dorsiplantar flexion in mid‐stance, inversion‐eversion at initial contact and terminal stance as well as the pre‐swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle‐toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing compared to the control group (p < 0.017). Conclusion: The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the effect of extracts of turmeric, cinnamon, and lemon on shelf life, macronutrients, and oxidative spoilage of the carp fish in cold storage at 4°C. Fishes were divided into five groups: control (NT); immersed fish in extracts of cinnamon, turmeric, and lemon (CTL); immersed fish in extracts of lemon and turmeric (LT); immersed fish in extracts of cinnamon and turmeric (CT); and immersed fish in extracts of lemon and cinnamon (LC). Results showed immersion of the carp fillet in extracts of turmeric, cinnamon, and lemon improved spoilage indices such as thiobarbituric acid, volatile nitrogen bases, and pH. The used extracts maintained the nutritional value and increased the fish's shelf life. The compounds existed in the studied extracts decreased the values of the spoilage indices during cold storage. The highest spoilage indices were found for CL and CT treatments, and the lowest was for CTL treatment. The total bacterial load as well as the number of psychrophilic bacteria in the fish fillet found a significant decrease compared to the NT. Therefore, the best treatment was CTL, and inappropriate treatments were CT and CL. The fish shelf life for nine days was extended with the used extracts because the total count of cryophilic bacteria was 0.41 × 104 ± 0.50, which was the lowest compared to other treatments. [ABSTRACT FROM AUTHOR]

Objectives: Complete cleaning of temporary cement before permanent cementation of cement‐retained implant‐supported prosthesis (CISP) when recementing the crown is critical. This study evaluated the effect of different cleaning methods for removing traces of temporary cement on the final tensile bond force (TBF) of CISP recemented with resin cement. Materials and Methods: Seventy computer‐aided design/computer‐aided manufacturing metal implant‐supported copings were prepared and distributed into seven groups (N = 10). Copings of six groups (60 samples) were cemented with temporary cement with eugenol and subjected to 5000 thermocycling. After debonding by a universal testing machine, the internal surfaces of the copings were cleaned using one of the six following methods: 1‐an ultrasonic water bath (UW), 2‐sandblasting, then washing with water (SW), 3‐sandblasting and an ultrasonic water bath (SUW), 4‐an ultrasonic isopropyl alcohol bath (UA), 5‐sandblasting, then washing with isopropyl alcohol (SA) or 6‐sandblasting and an ultrasonic isopropyl alcohol bath (SUA). Then the subjects were subsequently cemented by dual‐cure self‐adhesive resin cement. In the seventh group (control, N = 10), the copings were cemented by dual‐cure self‐adhesive resin cement without the temporization phase. The TBF was tested using a universal testing machine with a cross‐head speed of 1 mm/min. Two‐way analysis of variance (ANOVA) and post‐hoc Tamhane tests were used for statistical analysis at a significance level of α =.05. Results: The maximum mean of TBF value was observed in SUA group (845 ± 203 N), and the minimum was observed in the temporary cement group (49 ± 20 N). All groups which were cleaned with isopropyl alcohol showed significantly higher TBF values compared with those cleaned with water. Conclusions: Cleaning of the inner surface of metal copings after debonding with sandblasting and isopropyl alcohol results in the highest value of TBF by eliminating the effect of remaining eugenol and removing traces of temporary cements. [ABSTRACT FROM AUTHOR]

A novel series of 6‐methoxy‐1‐tetralone derivatives bearing N‐aryl pyridinium moiety were designed, synthesized, and evaluated as acetyl and butyrylcholinesterase inhibitors. The designed derivatives inhibited acetylcholinesterase (AChE) with IC50 values of 0.025–23.743 μM and butyrylcholinesterase (BChE) with IC50 values of 0.716–20.588 μM. The synthesized compounds were divided into two series. Derivatives containing N‐benzyl moieties generally were more potent anti‐AChE and anti‐BChE agents than compounds with N‐alkylphthalimide groups. Among them, the compound (E)‐1‐Benzyl‐3‐((6‐methoxy‐1‐oxo‐3,4‐dihydronaphthalen‐2(1H)‐ylidene)methyl)pyridin‐1‐ium bromide (5 a) and compound (E)‐1‐(3‐Chlorobenzyl)‐3‐((6‐methoxy‐1‐oxo‐3,4‐dihydronaphthalen‐2(1H)‐ylidene)methyl)pyridin‐1‐ium bromide (5 d) exhibited significant inhibitory activity against AChE and BChE with IC50 values of 0.025 and 0.716 μM in comparison to donepezil as a reference drug (0.029 and 0.948 μM, respectively). The results of kinetic and molecular modeling studies demonstrated that the synthesized compounds 5 a and 5 d derivatives can act as mixed and dual binding inhibitors, and bind to both CAS and PAS of AChE and BChE enzymes. Among the assessed compounds, the compound 5 a indicated significant neuroprotection against H2O2‐induced cell death in PC12 cells. So, these findings indicate the therapeutic potential of 6‐methoxy‐1‐tetralone derivatives bearing N‐aryl pyridinium moiety derivatives as anti‐AD agents. [ABSTRACT FROM AUTHOR]

Objectives. Lophomonas protozoan is an emerging pathogen transmitted through arthropods such as cockroaches. Lophomoniasis is still a mysterious disease with many unknown epidemiological aspects. The current study aimed to determine the prevalence of lophomoniasis among patients who were hospitalized in Hajar Hospital, Shahrekord, southwestern Iran, using a conventional PCR technique. Methods. In this retrospective study, 132 frozen bronchoalveolar lavage fluid (BALF) specimens from patients with respiratory disorders hospitalized in Hajar Hospital, Shahrekord district, southwestern Iran, were analyzed during 2020-2021. Samples are referred to the Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran Province, Northern Iran, for detecting Lophomonas spp. infection by a conventionally small subunit ribosomal RNA (SSU rRNA) PCR test. Results. A total of 132 frozen BALF specimens were examined, 36 (27.3%) tested Lophomonas spp. positive using the conventional PCR technique. Also, based on sequencing data and blast analysis, the presence of L. blattarum species was confirmed. The average age of Lophomonas spp.‐ positive patients was 67.02 ± 15.14 years. Out of the 36 positive subjects, 63.9% were male and 36.1% female. Male and Lophomonas infection had a significant correlation (p = 0.001). Our findings revealed that L. blattarum infected nonsmokers more than smokers (p = 0.001). The most common underlying disease was also bronchitis Conclusion. Our results showed, for the first time, that pulmonary lophomoniasis caused by L. blattarum is a common and emerging disease in the study area, southwestern Iran. Furthermore, our findings support the use of the PCR test to detect Lophomonas infection in archived frozen clinical samples. [ABSTRACT FROM AUTHOR]

Purpose. Lophomonas spp., is an emerging protozoan parasite that belongs to the Parabasalids (Parabasalia, lophomonadida) which infects the respiratory tracts of humans. Despite the presence of a few reports of human lophomoniasis, the true burden of Lophomonas infection is unknown. This systematic review aimed to elucidate the latest global status of publications reporting human cases of lophomoniasis as a new emerging protozoal disease. Methods. A comprehensive and systematic search was performed in 10 (five English and five Persian) databases for studies reporting cases of lophomoniasis between 1993 and March 2020 (27 years). Then, the selected articles were carefully reviewed and screened based on the inclusion and exclusion criteria. Results. Overall, 32 eligible publications reporting 307 lophomoniasis cases from around the world are included in this review. The patients were aged between 1 month and 84 (mean age = 23.7 years). The highest number of cases (n = 171; 55.7%, P < 0.04) significantly belonged to the juvenile age group (aged ≤18 years). The male to female ratio of the cases was almost equal, and no statistically significant difference between them was observed. The maximum number of cases (n = 237) was reported from Iran. Most cases (n = 196; 63.85%) had no history of underlying diseases/organ transplantation P < 0.001 . Moreover, the BAL specimen was the most commonly used clinical sample to diagnose lophomoniasis P < 0.001 . Conclusion. Our findings reveal that the prevalence of lophomoniasis is likely to be markedly underestimated when evaluated based on published case reports. Additionally, our data, at least for the time being, supports the idea that Lophomonas spp. should not be considered as an opportunistic infection. Thus, current work sheds light on some controversial issues regarding the epidemiological aspects of lophomoniasis. [ABSTRACT FROM AUTHOR]

Cut off walls are used under dams for the control of sub surfaces seepage and permeability of cut off wall was important. In the construction of cut off walls, plastic concrete is used and the amount of plastic concrete permeability is important. In this study, the permeability of plastic concrete was investigated and the effect of replacing nano silica instead of cement to reduce permeability was studied. So in this research, compressive strength, elastic modulus, and permeability parameters of plastic concrete specimens at different ages (7, 14, 28, and 56 days) and with different percentages of nano silica (0, 1.5, 3, 4.5, and 6%) were investigated. Also, scanning electron microscopy was used to investigate the effect of nano silica on plastic concrete specimens. The results show that as the age of the specimens increases, the compressive strength and elastic modulus increase, and the permeability of the plastic concrete decreases. Also, by adding nano silica to plastic concrete, the compressive strength of the plastic concrete increases and the plastic concrete permeability decreases significantly while its elastic modulus is almost constant. [ABSTRACT FROM AUTHOR]

Phytosterols (PSs), classified into plant sterols and stanols, are bioactive compounds found in foods of plant origin. PSs have been proposed to exert a wide number of pharmacological properties, including the potential to reduce total and low‐density lipoprotein (LDL) cholesterol levels and thereby decreasing the risk of cardiovascular diseases. Other health‐promoting effects of PSs include anti‐obesity, anti‐diabetic, anti‐microbial, anti‐inflammatory, and immunomodulatory effects. Also, anticancer effects have been strongly suggested, as phytosterol‐rich diets may reduce the risk of cancer by 20%. The aim of this review is to provide a general overview of the available evidence regarding the beneficial physiological and pharmacological activities of PSs, with special emphasis on their therapeutic potential for human health and safety. Also, we will explore the factors that influence the physiologic response to PSs. [ABSTRACT FROM AUTHOR]

Management of patients with congenital skull defects requires a multidisciplinary approach. Considering the defect's location and size, brain protection, and the cosmetic outcome makes such reconstructions challenging. Due to limited resemblance to skull contour and donor site morbidity of autogenous bone grafts, alloplastic materials are widely used for skull reconstructions. Titanium alloys have proper strength values, low infection rates, favorable osseointegration property, and excellent marginal adaptability when manufactured by computer-aided design (CAD) and computer-aided manufacturing (CAM). A 13-year-old female patient presented with congenital defects at the superior third of occipital bone and posterior thirds of the bilateral parietal bones. On CT scan, the exact size and shape of the defect were determined. Using CAD/CAM, a 3D virtual model of the prosthesis was designed and then printed with titanium alloy (TiAl6V4) via additive manufacturing method. The prosthesis was placed on the defect in a total surgery time of only 90 minutes. On 4.5 years of follow-up, the contour of the skull was ideal and the skin over the defect and neurologic status was intact. Due to their biocompatibility and rigidity, custom-made titanium prostheses are promising options for reconstructing complex skull defects. [ABSTRACT FROM AUTHOR]

Summary: Carbon dioxide conversion into beneficial products has received very much attention in recent years to decrease industrial CO2 emissions. In this context, integration of gas to liquids (GTL) process with an iron‐based Fischer‐Tropsch (FT) reactor with ammonia and urea synthesis plants was investigated. The main motivation of the proposed integration is to reuse a released CO2 stream from the GTL process and to enhance the commercial process economy. The required hydrogen for ammonia comes from polymer electrolyte membrane (PEM) electrolyzers running by solar power. Latin hypercube design (LHD) approach was applied to model the profitability and carbon efficiency of the process. Optimization was conducted to maximize the carbon efficiency and profit index of the overall process using the model‐based calibration (MBC) toolbox of MATLAB. The results demonstrated that at the optimum case, the proposed integration is capable of producing 48 t/h of urea and also utilizing about 35 t/h of CO2 produced in the GTL process. The results were compared with another configuration in which a cobalt‐based FT reactor was integrated with ammonia and urea processes. The results suggest that profitability, carbon efficiency, and urea production of the process configuration with a Co‐based FT reactor is higher than the iron‐based configuration while the wax production rate of the iron‐based configuration is higher than that of the Co‐based process. Techno‐economic feasibility study of the zero CO2 emission process represents that the carbon efficiency of around 100% could be obtained. [ABSTRACT FROM AUTHOR]

Vortex settling basin is an efficient continuous flushing system to remove the sediment in water and wastewater treatment plants. In the current study, computational fluid dynamics was implemented to study sophisticated flow field within the Vortex settling basin. The performance of 3‐D Reynolds‐averaged Navier–Stokes turbulence models including standard k−ε and SST k−ω models and a large eddy simulation, Smagorinsky model, were assessed. The 3‐D velocity field was also measured using Acoustic Doppler Velocimetry. The effects of vortex generation on basin performance and flow properties in the VSB were analysed. Secondary currents were identified as important phenomena in settling and flushing of sediment particles through the bottom orifice. The experimental data were used to evaluate the accuracy of the calculated flow field. The results of the numerical simulation confirmed the superiority of the Smagorinsky model. This model satisfactorily simulated the water surface and the overall pattern of secondary currents in the VSB. [ABSTRACT FROM AUTHOR]

Summary: This paper addresses the problems of relay selection, clustering, and routing to extend the lifetime of wireless body area networks. We first propose an efficient algorithm called "Energy‐aware Relay Selection and Cluster‐based Routing (ERSCR)" to develop a hybrid data aggregation tree in the network. ERSCR has three phases, including the relay selection, clustering and Cluster Head (CH) selection, and data transmission. It divides the biosensors into several clusters and selects an appropriate CH for each cluster. Each biosensor transmits data to its CH or relay node. The aggregated data are then routed to the sink through an energy‐balanced routing tree. The proposed scheme considers both residual energy and distance for routing data of biosensors. It not only reduces the energy consumption in the network but also balances the energy consumed by different biosensors. Subsequently, we improve the ERSCR algorithm and introduce the "Joint Relay Selection, Clustering, and Routing (JRSCR)" algorithm to achieve a better network performance. JRSCR benefits from the advantages of the ERSCR algorithm. Moreover, it reduces the number of transmissions with the direct use of the relay nodes as CH. As another advantage, both ERSCR and JRSCR algorithms are compatible with the natural physical states of the human body. Simulation results demonstrate the efficiency of the proposed algorithms in terms of energy consumption, network lifetime, and maximum hop count. [ABSTRACT FROM AUTHOR]

Literature concerning negative impacts of domestic violence (DV) against women on their children's health is growing; however, little is known about the long‐term effect of maternal exposure to DV before and/or during pregnancy on their children's growth. Using data from the MINIMat cohort, we have evaluated the association between maternal lifetime experience of DV, measured in late pregnancy, with their children's linear growth at 15 years (n = 2240) in rural Bangladesh. A modified version of conflict tactic scale was used to record the maternal experience of physical, sexual, emotional DV and controlling behaviour. Children's height was measured by trained nurses during their clinical visits at 15‐year follow‐up. Compared to the women with no experience of DV, children of women with experience of any physical, sexual or emotional DV before and/or during pregnancy had the significantly lower height for age Z‐scores (HAZs) at the age of 15. No significant association between maternal experience of controlling behaviour and their children's linear growth was observed in terms of HAZ. Results from this study suggest that maternal experience of DV before and/or during pregnancy might be associated with impaired long‐term linear growth within their children. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) is a major health problem in Iran, with a heavy burden on human health and society. There is little knowledge about the molecular epidemiology of the disease, as well as phylogenetic relationship of causative agents in south‐eastern Iran. The aim of the present study was to investigate the molecular aspects of CL, especially atypical CL in the Bam district, Kerman province, south‐eastern Iran, as an endemic region of CL in Iran. The smears were collected from lesion samples of 353 patients clinically suspected to CL, who attended local health centres in the Bam district during 2016–2017. Direct smears were examined for Leishmania parasites using the Giemsa staining technique. Amplification of kinetoplast DNA (kDNA) and the ribosomal internal transcribed spacer 1(ITS‐1) gene were carried out using polymerase chain reaction (PCR). Then, the ITS1‐PCR products were sequenced for phylogenetic analysis. Overall, 278 cases were confirmed as CL by microscopic examination of Giemsa‐stained slides. Clinical presentation of the lesions was basically of two types: (a) typical lesions and (b) atypical including lupoid ulcers, sporotrichoid, nodular and exudative lesions. The PCR assay on all specimens of skin lesions proved L. tropica as the main pathogenic agent. Phylogenic analysis revealed high similarity among isolates from the Bam district in the south‐east with isolates from Birjand in eastern Iran, as well as with isolates from Herat province in western Afghanistan. The study provided valuable information concerning the genetic diversity of the parasite as one of the factors influencing the clinical manifestations in CL in south‐eastern Iran, which could be the basis for planning future control strategies. [ABSTRACT FROM AUTHOR]

Background. Hydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patients who received hydroxychloroquine with or without azithromycin. Methods. This study was a retrospective cohort study. One hundred seventy-two confirmed COVID-19 patients were included in this study, hospitalized at Babol University of Medical Sciences hospitals between March 5, 2020, and April 3, 2020. Patients were divided into two groups: hydroxychloroquine alone and hydroxychloroquine with azithromycin. Electrocardiograms were used for outcome assessment. Results. 83.1% of patients received hydroxychloroquine plus azithromycin vs. 16.9% of patients who received only hydroxychloroquine. The mean age of patients was 59.2 ± 15.4.The mean of posttreatment QTc interval in the monotherapy group was shorter than the mean of posttreatment QTc interval in the combination therapy group, but it had no significant statistical difference (462.5 ± 43.1 milliseconds vs. 464.3 ± 59.1 milliseconds; p = 0.488). Generally, 22.1% of patients had a prolonged QTc interval after treatment. Male gender, or baseline QTc ≥ 450 milliseconds, or high-risk Tisdale score increased the likelihood of prolonged QTc interval. Due to QTc prolongation, fourteen patients did not continue therapy after four days. Conclusions. Hospitalized patients treated by hydroxychloroquine with or without azithromycin had no significant difference in prolongation of QT interval and outcome. The numbers of patients with prolonged QT intervals in this study emphasize careful cardiac monitoring during therapy, especially in high-risk patients. [ABSTRACT FROM AUTHOR]

Background. Bambusa vulgaris (Tabashir) has been shown to have antimicrobial, antioxidant, and anti-inflammatory effects due to the presence of ascorbic acid, vitamin B2, flavonoid, and phenolic compounds which can be beneficial in the process of wound healing. The current study aimed to evaluate the effects of topical Tabashir extract on cutaneous leishmaniasis (CL) caused by Leishmania major in BALB/c mice. Methods. Twenty-eight female BALB/c mice (4 weeks old, 18 ± 4 grams) were injected subcutaneously in tail-base with L. major amastigotes. Treatment started when the CL lesions were appeared and continued for 21 days. Mice were then divided into four groups: E1, treated daily with 5% of Tabashir extract gel; E2, treated daily with 10% Tabashir gel; C1, irrigated daily only with normal saline; and C2, received vehicle gel daily. The wounds' sizes were measured every 3 days, using vernier caliper. The volume densities of vessels, collagens, and hair follicles, vessels' length density, and mean diameter were soteriologically determined. Results. Tabashir enhanced wound closure rate through increasing the number of fibroblasts, collagen bundles, and vessels, according to histomorphometric evaluation while it did not affect the parasitic load. Findings of the in vitro study revealed that the extract has substantial mortality for the Leishmania promastigotes. Conclusion. Topical Tabashir showed promising effects on the healing process of skin wounds caused by CL in this experimental study. Further studies are suggested to find out the molecules which are involved in the healing process. [ABSTRACT FROM AUTHOR]

Summary: Although several observational studies have investigated the relationship between vitamin D deficiency and risk of central obesity, the results were inconsistent. We performed a dose–response meta‐analysis on epidemiologic studies that evaluated the association of vitamin D status and abdominal obesity in adults. A systematic search was carried out of all published articles, up to May 2020, in five electronic databases, including MEDLINE (Pubmed), EMBASE, Institute for Scientific Information (ISI) (Web of science), Scopus and Google scholar. Forty‐one observational studies reported odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs) for abdominal obesity in relation to serum vitamin D levels in adults were included in the analysis. Using a random effects model, the overall effect size was calculated. Combining 44 effect sizes from 36 cross‐sectional studies with 257,699 participants revealed that the highest versus the lowest serum vitamin D level was significantly associated with a 23% decreased odds of abdominal obesity (OR: 0.77; 95% CI [0.71, 0.83]). This inverse association was significant in almost all subgroups based on different covariates. Dose–response analysis showed that each 25 nmol/L increase in serum vitamin D was related to 8% reduced risk of abdominal obesity (OR: 0.92; 95% CI [0.85, 0.99]). When we confined the analysis to 23 effect sizes from 17 studies with representative population (242,135 participants), the same results were obtained (OR: 0.79; 95% CI [0.71, 0.87]). Dose–response analysis indicated that each 25 nmol/L increase in blood vitamin D levels was linked to 10% decreased central adiposity risk in representative populations (OR: 0.90; 95% CI [0.82, 0.99]). This meta‐analysis of epidemiologic studies revealed that serum vitamin D level was inversely associated with risk of abdominal obesity in adults, in a dose–response manner. The same findings were obtained in representative populations. Further prospective studies are required to examine the causal association between serum vitamin D levels and abdominal obesity. [ABSTRACT FROM AUTHOR]

Importance Determine phacoemulsification cataract surgery risk in a Covid‐19 era. Background: SARS‐CoV‐2 (Covid‐19) transmission via microdroplet and aerosol‐generating procedures presents risk to medical professionals. As the most common elective surgical procedure performed globally; determining contamination risk from phacoemulsification cataract surgery may guide personal protection equipment use. Design Pilot study involving phacoemulsification cataract surgery on enucleated porcine eyes by experienced ophthalmologists in an ophthalmic operating theatre. Participants: Two ophthalmic surgical teams. Methods: Standardized phacoemulsification of porcine eyes by two ophthalmologists accompanied by an assistant. Fluorescein incorporated into phacoemulsification irrigation fluid identifying microdroplets and spatter. Contamination documented using a single‐lens reflex camera with a 532 nm narrow bandpass (fluorescein) filter, in‐conjunction with a wide‐field blue light and flat horizontal laser beam (wavelength 532 nm). Quantitative image analysis using Image‐J software. Main Outcome Measures: Microdroplet and spatter contamination from cataract phacoemulsification. Results: With phacoemulsification instruments fully within the eye, spatter contamination was limited to <10 cm. Insertion and removal of the phacoemulsification needle and bimanual irrigation/aspiration, with irrigation active generated spatter on the surgeons' gloves and gown extending to >16 cm below the neckline in surgeon 1 and > 5.5 cm below the neckline of surgeon 2. A small tear in the phacoemulsification irrigation sleeve, presented a worse‐case scenario the greatest spatter. No contamination above the surgeons' neckline nor contamination of assistant occurred. Conclusions and Relevance: Cataract phacoemulsification generates microdroplets and spatter. Until further studies on SARS‐CoV‐2 transmission via microdroplets or aerosolisation of ocular fluid are reported, this pilot study only supports standard personal protective equipment. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the impact of supplementation with flaxseed on plasma lipoprotein(a) [Lp(a)] levels through a systematic review and meta-analysis of eligible randomized placebo-controlled trials. PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched for randomized controlled trials (RCTs) which have been published up to November 2019. RCTs that investigated the effect of flaxseed supplementation on plasma Lp(a) levels in adults were included for final analysis. The random effects model was used for calculating the overall effects. Meta-analysis of 7 selected RCTs with 629 individuals showed significant lowering effect of flaxseed supplementation on Lp(a) (MD -2.06 mg/dl; 95% CI: -3.846, -0.274, p = .024), without considerable heterogeneity between studies (p = .986, I2 = 0%). Subgroup analysis also revealed that longer duration only showed significant lowering effect of flaxseed supplementation on Lp(a). This meta-analysis has shown that flaxseed supplementation might significantly decrease plasma Lp(a) levels. Future well-designed and long-term clinical trials are required to confirm these results. [ABSTRACT FROM AUTHOR]

Summary: Improvement in the cooling system performance by making the temperature distribution uniform is an essential part in design of polymer electrolyte membrane fuel cells. In this paper, we proposed to use water‐CuO nanofluid as the coolant fluid and to fill the flow field in the cooling plates of the fuel cell stack by metal foam. We numerically investigated the effect of using nanofluid at different porosities, pore sizes, and thicknesses of metal foam, on the thermal performance of polymer electrolyte membrane fuel cell. The accuracy of present computations is increased by applying a three‐dimensional modeling based on finite‐volume method, a variable thermal heat flux as the thermal boundary condition, and a two‐phase approach to obtain the distribution of nanoparticles volume fraction. The obtained results indicated that at low Reynolds numbers, the role of nanoparticles in improvement of temperature uniformity is more dominant. Moreover, metal foam can reduce the maximum temperature for about 16.5 K and make the temperature distribution uniform in the cooling channel, whereas increase in the pressure drop is not considerable. [ABSTRACT FROM AUTHOR]

The vast oak‐dominated forests of the Zagros Mountains in southwestern Iran currently undergo large‐scale dieback driven by a combination of drought and increasing incidence of charcoal disease caused by the fungal pathogens Biscogniauxia mediterranea and Obolarina persica. Here, we explore the interactive effects between drought and charcoal disease agents on the physiology and biochemistry of Quercus infectoria and Quercus libani seedlings. The combination of pathogen attack and water limitation hampered plant development, especially in Q. libani seedlings, negatively affecting growth, biomass production, photosynthetic efficiency, and leaf water potential. An increase in markers of oxidative damage together with the upregulation of the antioxidant defense revealed that drought stress and pathogen infection led to pro‐oxidative conditions in both oak species, especially in Q. libani, where larger changes in malondialdehyde and hydrogen peroxide occurred. The upregulation of the antioxidant system was more prominent in Q. infectoria than in Q. libani, resulting in enhanced enzyme activity and accumulation of non‐enzymatic antioxidants. Fungal infection stimulated the activity of chitinase, phenylalanine ammonia lyase and β‐1,3‐glucanase in Q. infectoria leaves and this response became more pronounced under water shortage. Our study highlights that drought stress greatly intensifies the effects of the charcoal disease. Moreover, our findings imply superior stress resistance of Q. infectoria conferred by a highly efficient antioxidant system, strong osmotic adjustment (through proline), and increases in resistance enzymes and secondary metabolites (phenols and flavonoids). Future investigations should focus on adult trees in their natural habitat including interactions with soil factors and other pathogens like nematodes, bacteria and other fungi. Because the present research was conducted on oak seedlings, the findings can be considered by forest nursery managers. [ABSTRACT FROM AUTHOR]

Importance: Keratoplasty is a surgical procedure to create a more regular optical surface following biomechanical weakening of the cornea in keratoconus. The ideal keratoplasty procedure should also restore corneal biomechanics to that of the healthy cornea. Background: This study aimed to evaluate and compare the biomechanical properties of corneas following penetrating keratoplasty (PKP) and predescematic deep anterior lamellar keratoplasty (DALK) to those of healthy eyes. Design: Prospective cross‐sectional study. Participants: Two cohorts of post‐keratoplasty eyes (42 eyes with PKP and 27 eyes with DALK) with each other, and with a cohort of 152 healthy eyes. Methods: All eyes were examined by slit‐lamp biomicroscopy, tomography, anterior segment‐OCT and non‐contact tonometry CorVis ST (CST). Main Outcome Measures: CST biomechanical parameters, maximum corneal deformation (MCD) and corneal energy dissipation were compared between keratoplasty techniques, and with healthy eyes. Results: The mean age of participants with PKP and DALK were 35 ± 13.7 and 36.1 ± 12.6 years, respectively. None of the CST parameters were significantly different between PKP and DALK eyes. However, when compared to healthy corneas, numerous parameters were significantly different for both keratoplasty techniques. Of note, MCD was significantly higher in PKP compared to DALK and healthy corneas, after controlling for co‐factors. Conclusions and Relevance: Neither type of keratoplasty technique utilized in keratoconus completely restored corneal biomechanical properties to that of healthy corneas. However, PKP resulted in a greater number of parameters significantly different to healthy corneas, compared to DALK. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is a major health problem, worldwide, that is associated with increased morbidity and mortality. Several randomized controlled clinical trials (RCTs) have investigated the effect of nettle (Urtica dioica) supplementation on markers of glycemic status in patients with T2DM, with conflicting results. Therefore, the present study assessed the effect of nettle on some glycemic parameters in patients with T2DM. A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science, from database inception up to June 2019, to identify RCTs investigating the effect of nettle supplementation on glycemic markers, including fasting blood sugar (FBS) concentrations, insulin levels, homeostasis model assessment-estimated insulin resistance index, and glycosylated hemoglobin percentage in adults with T2DM. The Cochrane Collaboration tool was used to assess the methodological quality of the included studies. Results of this meta-analysis were reported based on the random effects model. Eight RCTs, comprising 401 participants, were included in the present systematic review and meta-analysis. Based on the Cochrane Collaboration risk of bias tool, five studies were considered as good quality, one was fair, and two studies were poor, respectively. The results of the meta-analysis revealed a significant reduction in FBS concentrations (weighted mean difference [WMD]: -18.01 mg/dl, 95% confidence interval [CI]: -30.04 to -5.97, p < .001, I2 = 94.6%) following nettle supplementation. However, no significant reduction was observed in insulin levels (WMD: 0.83 Hedges' g, 95% CI: -0.26 to 1.92, p = .13, I2 = 89.4%), homeostasis model assessment-estimated insulin resistance index (WMD: -0.22, 95% CI: -0.83 to 0.40, p = .49, I2 = 69.2%), or glycosylated hemoglobin percentage (WMD: -0.77%, 95% CI: -1.77 to 0.22, p = .12, I2 = 83.0%). The findings of the present study suggest that nettle supplementation may be effective in controlling FBS for T2DM patients. However, further studies are needed to confirm the veracity of these results. [ABSTRACT FROM AUTHOR]

Firefighters are exposed to both known and suspected carcinogens. This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle‐Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta‐analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non‐Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in‐depth exposure assessments are indicated. What's new? Firefighters are exposed to high levels of carcinogens during their work. Results regarding the impact of these exposures on cancer risk and mortality have been inconsistent, however. In this meta‐analysis, the authors found that firefighters have a significantly elevated risk of developing a number of cancers (colorectal, prostate, testicular, bladder, thyroid, and pleural cancers and malignant melanoma), while mortality rates are increased for rectal cancer and non‐Hodgkin's lymphoma. These results suggest that improved preventive measures and medical attention are needed for this group worldwide. [ABSTRACT FROM AUTHOR]

Importance: Keratoconus is a debilitating condition with a disproportionately high impact on health resources and vision‐specific quality of life. Background: This study aimed to compare 2‐year outcomes of epithelium‐off pulsed (p‐ACXL) and epithelium‐off continuous (c‐ACXL) accelerated corneal crosslinking in progressive keratoconus. Design: Prospective, interventional case series. Participants: Eighty eyes of 80 patients were included. Methods: The visual, refractive and tomographic results of the two crosslinking protocols were compared. Main Outcome Measures: Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE) and maximum keratometry (KMAX) on corneal tomography assessment. Results: The mean patient age was 22.51 ± 6.12 years (SD) and 22.08 ± 5.72 years in the p‐ACXL and c‐ACXL groups, respectively. The mean CDVA significantly improved from 0.30 ± 0.16 logMAR at baseline to 0.23 ± 0.17 logMAR at 24 months (P =.04) in the p‐ACXL group and from 0.36 ± 0.22 logMAR to 0.26 ± 0.27 logMAR (P =.02) in the c‐ACXL group. The mean induced change in MRSE (+1.79 ± 2.30 D vs +0.27 ± 3.19 D, P =.04) and KMAX (−1.75 ± 1.80 D vs −0.39 ± 1.95 D, P =.04) were superior in the c‐ACXL group compared to the p‐ACXL group at 24 months. No complications were encountered. Conclusions and Relevance: In this prospective study, both p‐ACXL and c‐ACXL treatments were safe methods to halt the progression of keratoconus within a follow‐up period of 24 months. c‐ACXL appeared to offer superior refractive and tomographic outcomes when compared to p‐ACXL but this did not translate into better visual outcomes. [ABSTRACT FROM AUTHOR]

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This paper endeavors to contribute to the field of optimal control via presenting an optimal fuzzy Proportional Derivative (PD) controller for a RPP (Revolute-Prismatic-Prismatic) robot manipulator based on particle swarm optimization and inverse dynamics. The Denavit-Hartenberg approach and the Jacobi method for each of the arms of the robot are employed in order to gain the kinematic equations of the manipulator. Furthermore, the Lagrange method is utilized to obtain the dynamic equations of motion. Hence, in order to control the dynamics of the robot manipulator, inverse dynamics and a fuzzy PD controller optimized via particle swarm optimization are used in this research study. The obtained results of the optimal fuzzy PD controller based on the inverse dynamics are compared to the outcomes of the PD controller, and it is illustrated that the optimal fuzzy PD controller shows better controlling performance in comparison with other controllers. [ABSTRACT FROM AUTHOR]