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Ilio-sacral screw is a technique for posterior pelvic fixation. In spite of its benefits, it had not performed commonly in Iran because of its difficulties. We changed this technique to insert the screw under CT-Scan guide with lical anesthesia to increase image quality and decrease neurological complications and performed it in two patients. In both cases the screws were inserted in correct position without any complication."n"n

Introduction: Inappropriate body composition represents impaired energy and nutrient intake and can be a risk factor for many diseases, especially for cardiovascular disease. Different methods have been suggested for the estimation of body fat volume and its distribution. However, they may be either expensive or hazardous for some groups of patients. Sonography is a very accessible technique, which may be used for the evaluation of visceral and subcutaneous fat volume. The purpose of this study was to evaluate the sonographic prediction of body fat and its distribution in subcutaneous and visceral compartments.Methods: During a three-month period, we conducted sonographic evaluations for visceral and subcutaneous fat in 106 patients who were admitted to our hospital. The subcutaneous fat was measured at the para-umbilical region and visceral fat was measured in the right para-renal space. The results were compared with the data obtained from the body mass index (BMI) and bioelectric impedance analysis.Results: The mean age of the patients was 58.8 years, and the mean BMI was26.48 +/- 0.33. The mean values of fat percent and fat mass obtained by the electric-method were 31.07 +/- 0.81% and 22.12 +/- 0.68 kg, respectively. The respective mean values of subcutaneous and visceral fat obtained by sonography were 20.50+/-0.56 mm and 24.14 +/- 0.58 mm. The correlation between BMI and subcutaneous fat was 0.85 (p value < 0.0001) and the correlation between BMI and visceral fat was0.46 (p value < 0.0001).Conclusion: Sonography is a reliable and available method for the estimation of body fat and its distribution in cardiovascular patients, in subcutaneous and visceral compartments. [ABSTRACT FROM AUTHOR]

Background: We sought to evaluate the routine echo-Doppler screening of carotid artery stenosis in patients undergoing coronary artery bypass grafting. Methods: A total of 2179 consecutive patients who underwent coronary artery bypass grafting alone or with other cardiac surgery at Tehran Heart Center, Tehran-Iran, between January 2005 and January 2006 were included in this retrospective study. Carotid Doppler was performed for 1604 (81.48%) of these patients. Results: The patients' age ranged between 20 and 84 years (mean: 58.33, SD: 10.08 years). Of the 1604 patients studied, 1186 (73.9%) were men, 592 (36.9%) had diabetes, 598 (37.3%) were smokers, and 194 (12.1%) cases had significant left main stenosis. Twenty-one (1.3%) patients had significant carotid stenosis (> 60% stenosis), which constituted 0.9% of all the bypass surgery candidates. Post-operative cerebrovascular accident was not detected in any of the patients with significant carotid stenosis, but cerebrovascular accident occurred in 22 (1.4%) of the patients without carotid stenosis. Magnetic resonance angiography (MRA) was conducted in 15 patients. In our univariate analysis, female gender (p value = 0.023), hypertension (p value = 0.055), peripheral vascular disease (p value < 0.001), and age (p value = 0.001) were significant in the development of carotid stenosis. Conclusion: Pre-operative duplex carotid screening seems to be necessary in patients when there is hypertension, peripheral vascular disease, female gender, and advanced age. [ABSTRACT FROM AUTHOR]

We used data from the baseline survey from the Isfahan Healthy Heart Programme to determine the prevalence of hypertension, dyslipidaemia and diabetes among a representative samples of 12 514 adults living in 3 cities in the Islamic Republic of Iran. The prevalence of hypertension, dyslipidaemia and diabetes was 17.3%, 66.3% and 5.6% respectively. Awareness, treatment and control of hypertension were 40.3%, 35.3%, and 9.1% respectively. The rates for dyslipidaemia were 14.4%, 7.1% and 6.5% respectively, and 54.6% of diabetics were aware of their disease and 46.2% were under treatment. [ABSTRACT FROM AUTHOR]

Background: The incidence of stroke after coronary artery bypass grafting (CABG) is between 0.9% and 6.7%, which significantly increases in-hospital and out-hospital costs. This study was designed to evaluate the prevalence of significant carotid stenosis and its risk factors in CABG.Methods: In total, 2044 consecutive patients undergoing elective CABG were investigated through a pre-operative duplex scanning of the carotid arteries. The relation of age, sex, smoking, hypertension, diabetes, dyslipidemia, and coronary disease with carotid stenosis was evaluated.Results: The prevalence of carotid stenosis was 7.6%. The multivariate analysis showed that age over 55 and left main coronary disease were significant independent risk factors for carotid stenosis. Female gender, smoking, hypertension, and diabetes were the risk factors in the univariate logistic regression model.Conclusion: Carotid stenosis is prevalent in CABG candidates. It seems that age >/=55 years and left main coronary disease are the independent risk factors for carotid stenosis in CABG patients. [ABSTRACT FROM AUTHOR]

Objectives: To establish a baseline of a hospital's problem, it is recommended to conduct a surveillance of clean (class I) surgical procedures. The present study was conducted to determine the infection rate of clean surgical procedures and to estimate the magnitude of nosocomial infection in some Iranian university hospitals. Materials and Methods: A total of 845 clean surgical wound cases were screened for infection by standard microbiological investigations during a 9-month period of time. Results: The overall clean wound infection rate was found to be 4.9%, which is comparable to the expected infection rate of 0.8%. The most common organisms isolated were Staphylococcus epidermidis (74%), Staphylococcus aureus (17%) and Enterobacter aerogenes (5%). The in-vitro sensitivity of Staphylococcus epidermidis and Staphylococcus aureus to the common antimicrobial drugs showed that they were resistant to penicillin, ampicillin and amoxicillin. Our study revealed that the efficacy of prophylactic antibiotics in preventing wound infection after clean surgical procedures is unquestioned. Conclusions: Having considered the high rate of clean wound infection, a high rate of hospital infection in the region might be inferred. This study calls for the need of a more organized and effective infection control program that includes active infection surveillance in Iran. [ABSTRACT FROM AUTHOR]

Identification of seizure sources in the brain is of paramount importance, particularly for drug-resistant epilepsy patients who may require surgical operation. Interictal epileptiform discharges (IEDs), which may or may not be frequent, are known to originate from seizure networks. Delayed responses (DRs) to brain electrical stimulation have been recently discovered. If DRs and IEDs come from the same location and the DRs can be accurately localized, there will be a significant step in identification of the seizure sources. The solution to this important question has been investigated in this paper. For this, we have exploited the morphology of these spike-type events, as well as the variability in their temporal locations, to develop new constraints for an adaptive Bayesian beamformer that outperforms the conventional and recently proposed beamformers even for identifying correlated sources. This beamformer is applied to an array (a.k.a mat) of cortical EEG electrodes. The developed approach has been tested on 300 data segments from five epileptic patients included in this study, which clinically represent a large population of candidates for surgical treatment. As the significant outcome of applying this beamformer, it is very likely (if not certain) that for an epileptic subject, the IEDs and DRs originate from the same location in the brain. This paves the way for a quick identification of the source(s) of seizure in the brain.

Randomized experiments are a powerful methodology for data-driven evaluation of decisions or interventions. Yet, their validity may be undermined by network interference. This occurs when the treatment of one unit impacts not only its outcome but also that of connected units, biasing traditional treatment effect estimations. Our study introduces a framework to accommodate complex and unknown network interference, moving beyond specialized models in the existing literature. Our framework, termed causal message-passing, is grounded in high-dimensional approximate message-passing methodology. It is tailored for multiperiod experiments and is particularly effective in settings with many units and prevalent network interference. The framework models causal effects as a dynamic process where a treated unit's impact propagates through the network via neighboring units until equilibrium is reached. This approach allows us to approximate the dynamics of potential outcomes over time, enabling the extraction of valuable information before treatment effects reach equilibrium. Utilizing causal message-passing, we introduce a practical algorithm to estimate the total treatment effect, defined as the impact observed when all units are treated compared to the scenario where no unit receives treatment. We demonstrate the effectiveness of this approach across five numerical scenarios, each characterized by a distinct interference structure., Competing Interests: Competing interests statement:The authors declare no competing interest.

This work proposes a new formulation for common spatial patterns (CSP), often used as a powerful feature extraction technique in brain-computer interfacing (BCI) and other neurological studies. In this approach, applied to multiple subjects' data and named as hyperCSP, the individual covariance and mutual correlation matrices between multiple simultaneously recorded subjects' electroencephalograms are exploited in the CSP formulation. This method aims at effectively isolating the common motor task between multiple heads and alleviate the effects of other spurious or undesired tasks inherently or intentionally performed by the subjects. This technique can provide a satisfactory classification performance while using small data size and low computational complexity. By using the proposed hyperCSP followed by support vector machines classifier, we obtained a classification accuracy of 81.82% over 8 trials in the presence of strong undesired tasks. We hope that this method could reduce the training error in multi-task BCI scenarios. The recorded valuable motor-related hyperscanning dataset is available for public use to promote the research in this area.

Purpose: This study is aimed at evaluating the efficacy of the gradient-spin echo- (GraSE-) based short tau inversion recovery (STIR) sequence (GraSE-STIR) in cardiovascular magnetic resonance (CMR) imaging compared to the conventional turbo spin echo- (TSE-) based STIR sequence, specifically focusing on image quality, specific absorption rate (SAR), and image acquisition time., Methods: In a prospective study, we examined forty-four normal volunteers and seventeen patients referred for CMR imaging using conventional STIR and GraSE-STIR techniques. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality, T 2 signal intensity (SI) ratio, SAR, and image acquisition time were compared between both sequences., Results: GraSE-STIR showed significant improvements in image quality (4.15 ± 0.8 vs. 3.34 ± 0.9, p = 0.024) and cardiac motion artifact reduction (7 vs. 18 out of 53, p = 0.038) compared to conventional STIR. Furthermore, the acquisition time (27.17 ± 3.53 vs. 36.9 ± 4.08 seconds, p = 0.041) and the local torso SAR (<13% vs. <17%, p = 0.047) were significantly lower for GraSE-STIR compared to conventional STIR in short-axis plan. However, no significant differences were shown in T 2 SI ratio ( p = 0.141), SNR ( p = 0.093), CNR ( p = 0.068), and SAR ( p = 0.071) between these two sequences., Conclusions: GraSE-STIR offers notable advantages over conventional STIR sequence, with improved image quality, reduced motion artifacts, and shorter acquisition times. These findings highlight the potential of GraSE-STIR as a valuable technique for routine clinical CMR imaging., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Sadegh Dehghani et al.)

Background: The presence of the severe thoracic aortic calcification (TAC) in cardiac surgery patients is associated with adverse post-operative outcome. However, the relationship between cardiovascular risk factors and aortic plaque burden remains unknown. The objective of this study was to determine the predictive factors of TAC in patients candidate for cardiac surgery., Methods: Patients who underwent thoracic CT scan prior to cardiac surgery between August 2020 to April 2021 were included. Of 556 patients, 209 (36.7%) had a thoracic aortic calcium score (TACS) ≥ 400 mm [3] and were compare with the remaining patients. Predictors of severe TAC were assessed through stepwise multivariable logistic regression analysis., Results: The patients with TACS ≥ 400 had a higher mean age (67.3 ± 7.1 vs. 55.7 ± 10.6; p < 0.001) with a higher frequency of diabetes mellitus (40.7% vs. 30.8%; p = 0.018), dyslipidemia (49.8% vs. 38.6%; p = 0.010), hypertension (60.8% vs. 44.7%; p < 0.001), opium addiction (18.2% vs. 11.2%; p = 0.023), peripheral vascular disease (PVD) (7.7% vs. 2.3%; p = 0.005) as compared with TACS < 400. The multiple determinants of TAC were PVD (OR = 2.86) followed by opium addiction, diabetes and age., Conclusions: Thoracic CT scan prior to cardiac surgery for patients with older age, diabetes, opium addiction and PVD is recommended. Our study could serve as a foundation for future research endeavors aimed at establishing a risk score for TAC., (© 2024. The Author(s).)

Background: In the current study, we aimed to report the short- and mid-term outcomes of patients undergoing valve-sparing aortic root reimplantation (VSARR) and our center's experience with the procedure., Methods: Forty patients with aortic root aneurysms underwent VSARR at our center from 2010 until 2022. We retrospectively reviewed the medical records of these patients and extracted the relevant data. After carefully examining the aortic valve, the surgeon decided to perform Bentall or David's procedure during the operation., Results: The study population comprised 31 (77.5%) men and nine (22.5%) women, with a mean age of 55.35 ± 15.40. One patient developed hemodynamic instability post-surgery in the hospital and died from multi-organ failure. Another patient had severe AI in the intraoperative echocardiography, and aortic valve replacement with a prosthetic graft was performed during the same operation. In pre-operation echocardiography, 25 (62.5%) patients had severe, nine (22.5%) had moderate, and six (15%) had mild AI. In the in-hospital post-operation follow-up echo, AI was improved, and no patients had severe AI (P < 0.001). Only eight patients had moderate AI in post-one-year follow-up echo exams, while the rest had mild AI., Conclusion: David's procedure showed excellent mid-term results in our center, with only one in-hospital mortality., (© 2024. The Author(s).)

Suppressor of Ty homolog-5 (SPT5) discovered in the yeast mutant screens as a suppressor of mutation caused by the insertion of the Transposons of yeast (Ty) element along with SPT4, with which it forms a holoenzyme complex known as DRB sensitivity-inducing factor (DSIF) and plays an essential role in the regulation of transcription. SPT5 is a highly conserved protein across all three domains of life and performs critical functions in transcription, starting from promoter-proximal pausing to termination. We also highlight the emerging role of SPT5 in other non-canonical functions, such as the regulation of post-translational modifications (PTM) and the transcriptional regulation of non-coding genes. Also, in brief, we highlight the clinical implications of SPT5 dysregulation., Competing Interests: No conflicts of interest exist, according to the authors., (© Copyright by the Author(s). Published by Cell Physiol Biochem Press.)

Delayed responses (DRs) to single pulse electrical stimulation (SPES) in patients with severe refractory epilepsy, from their intracranial recordings, can help to identify regions associated with epileptogenicity. Automatic DR localization is a large step in speeding up the identification of epileptogenic focus. Here, for the first time, an adaptive iterative linearly constrained minimum variance beamformer (AI-LCMV) is developed and employed to localize the DR sources from intracranial electroencephalogram (EEG) recorded using subdural electrodes. The prime objective here is to accurately localize the regions for the corresponding DRs using an adaptive localization method that exploits the morphology of DRs as the desired sources. The traditional closed-form linearly constrained minimum variance (CF-LCMV) solution is meant for tracking the sources with dominating power. Here, by incorporating the morphology of DRs, as a constraint, to an iterative linearly constrained minimum variance (LCMV) solution, the array of subdural electrodes is used to localize the low-power DRs, some not even visible in any of the electrode signals. The results from the cases included in this study also indicate more distinctive locations compared to those achievable by conventional beamformers. Most importantly, the proposed AI-LCMV is able to localize the DRs invisible over other electrodes.

Background: Limited findings are available on the relationship between dietary inflammation index (DII) and severe coronary artery disease (CAD). Considering the high prevalence of CAD and its complications, we examined the relationship between DII and CAD., Methods: This cross-sectional study was conducted on 275 adults who underwent elective angiography. Severe coronary artery disease was measured by the gensini scoring system. DII was measured by a valid semi-quantitative 168-item food frequency questionnaire (FFQ). Blood samples were collected after 12 h of fasting to measure serum lipid profile and quantitative C-reactive protein (q-CRP) levels. Binary logistic regression was used to calculate the odds (OR) and 95% confidence interval (CI)., Results: People in the last tertile of the DII had a higher chance of suffering from severe coronary artery disease (OR: 3.71; 95% CI: 1.97-6.98), hypercholesterolemia (OR: 2.73; 95% CI: 5.03-1.48), reduced HDL-cholesterol levels (OR: 3.77; 95% CI: 9.34-1.52), and hypertension (OR: 1.93; 95% CI: 3.49-1.06) compared to people in the first tertile. After adjusting for confounding factors, the relationship remained significant. A direct and significant relationship was observed between the DII and increased q-CRP levels, which disappeared after adjusting for confounding factors in the adjusted model (OR: 2.02; 95% CI: 0.86-4.73)., Conclusion: This cross-sectional study showed a direct and linear relationship between following an anti-inflammatory diet and decreasing the chance of severe CAD. Therefore, it seems necessary to implement community-based educational programs to promote healthy nutrition in order to prevent CADs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Dadaei, Bagherniya, Sadeghi, Khosravi, Shirani and Askari.)

Background: Ultra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD)., Methods: A case-control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression., Results: After adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97-3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16-3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models)., Conclusion: Higher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ansari, Mohammadifard, Haghighatdoost, Zarepur, Mahmoudi, Nouri, Nouhi, Alikhasi, Sharifianjazi, Tavamaishvili, Shirani, Kazemi, Azdaki, Salehi, Lotfizadeh, Solati, Ghaffari, Javanmardi, Salari, Dehghani, Cheraghi, Assareh, Haybar, Namayandeh, Madadi and Sarrafzadegan.)

Background: Hypertensive heart disease (HHD), one of the end-organ damage consequences of hypertension, is an important public health issue worldwide. Data on the HHD burden in the Eastern Mediterranean region (EMR) are scarce. We aimed to investigate the burden of HHD in the EMR, its member countries, and globally from 1990 to 2019., Methods: We used 2019 Global Burden of Disease (GBD) data to report the HHD age-standardised prevalence, disability adjusted life years (DALYs), years of life lost (YLLs), and mortality, as well as HHD risk factors attribution percent with their 95% uncertainty interval (UI). Global data are reported alongside EMR data, and its 22 respective countries. We compared the burden of HHD by socio-demographic index (SDI), sex, age groups, and countries., Findings: The age-standardised prevalence rate (per 100,000 population) of HHD was higher in the EMR (281.7; 95% UI: 204.5-383.4) in 2019, compared with the global prevalence (233.8; 95% UI: 170.5-312.9). The EMR age-standardised DALYs (per 100,000 population) for HHD in 2019 was 561.9 (361.0-704.1), compared with 268.2 (204.6-298.1) at the global level. There was an increase in HHD prevalence, reduction in mortality, and DALYs between 1990 and 2019 (4.01%, -7.6%, and -6.5%, respectively) in EMR. Among EMR countries, the highest versus lowest rates of age-standardised prevalence, mortality, and DALYs in 2019 [estimate (95% UI)] were in Jordan [561.62 (417.9-747.6)] versus Saudi Arabia [94.9 (69.5-129.0)]; Afghanistan [74.5 (23.7-112.3)] versus Saudi Arabia [4.3 (3.3-5.9)]; and Afghanistan [1374.1 (467.2-2020.7)] versus Qatar [87.11 (64.40-114.29)], respectively., Interpretation: HHD remains a significant problem in the EMR, with a higher burden than global levels. Serious efforts toward high-quality management and prevention are strongly recommended. Based on this study, our recommendation for the EMR is to adopt effective preventive strategies. For example, promoting healthy dietary patterns and prompt screening for undiagnosed HTN in public places, promoting regular blood pressure measurements at home, and creating community awareness about early detection of HTN., Funding: None., Competing Interests: We declare no competing interests., (© 2023 The Authors.)

Despite a century of research, our understanding of cement dissolution and precipitation processes at early ages is very limited. This is due to the lack of methods that can image these processes with enough spatial resolution, contrast and field of view. Here, we adapt near-field ptychographic nanotomography to in situ visualise the hydration of commercial Portland cement in a record-thick capillary. At 19 h, porous C-S-H gel shell, thickness of 500 nm, covers every alite grain enclosing a water gap. The spatial dissolution rate of small alite grains in the acceleration period, ∼100 nm/h, is approximately four times faster than that of large alite grains in the deceleration stage, ∼25 nm/h. Etch-pit development has also been mapped out. This work is complemented by laboratory and synchrotron microtomographies, allowing to measure the particle size distributions with time. 4D nanoimaging will allow mechanistically study dissolution-precipitation processes including the roles of accelerators and superplasticizers., (© 2023. The Author(s).)