Search

Kamran Baveicy,1 Shayan Mostafaei,2,3 Mitra Darbandi,4 Behrooz Hamzeh,4,5 Farid Najafi,4,6 Yahya Pasdar4,5 1Student Research Committee, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran; 4Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; 5Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; 6Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranCorrespondence: Yahya Pasdar Tel +98 83 38262005Fax +98 83 38263048Email yahya.pasdar@kums.ac.irBackground: The use of anthropometric indices is one of the new and low-cost diagnostic methods of metabolic syndrome (MetS). The present study aimed to determine optimal cutoff points for the visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (ABSI) in the prediction of MetS.Methods: This cross-sectional study was performed on 10,000 individuals aged from 35 to 65 years, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort study, in the west region of Iran, in 2019. MetS was defined according to International Diabetes Federation (IDF) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive anthropometric indices and determine optimal cutoff values.Results: The optimal cutoff points for VAI were 4.11 (AUC: 0.82; 95% CI: 0.81– 0.84) in men and 4.28 (AUC: 0.86; 95% CI: 0.85– 0.87) in women to prediction of MetS. The optimal cutoff points for BRI were 4.75 (AUC: 0.75; 95% CI: 0.74– 0.77) in men and 6.17 (AUC: 0.62; 95% CI: 0.61– 0.64) in women to prediction of MetS. The optimal cutoff points for ABSI were 0.12 (AUC: 0.49; 95% CI: 0.47– 0.51) in men and 0.13 (AUC: 0.49; 95% CI: 0.47– 0.51) in women to prediction of MetS. The risk of MetS in men and women with a VAI higher than the optimal cutoff point was, respectively, 9.82 and 11.44 times higher than that in those with a VAI lower than the cutoff point.Conclusion: Although VAI might not be very cost-beneficial compared to IDF, our study showed VAI is a better predictor of MetS than BRI in adults. ABSI was not a suitable predictor for MetS.Keywords: metabolic syndrome, body shape index, body roundness index, visceral adiposity index, ROC curve analysis

Objective: To develop a model based on factors available at the time of diagnosis of twin–twin transfusion syndrome (TTTS) for predicting the probability of dual twin survival following fetoscopic laser photocoagulation (FLP) using a machine‐learning algorithm. Methods: This was a retrospective study of data collected at two university‐affiliated tertiary fetal centers between 2012 and 2021. The cohort included monochorionic diamniotic twin pregnancies complicated by TTTS that underwent FLP. Data were stratified based on survival 30 days after delivery, and cases with dual survival were compared to those without dual survival. A random forest machine‐learning algorithm was used to construct a prediction model, and the relative importance value was calculated for each parameter that presented a statistically significant difference between the two study groups and was included in the model. The holdout method was applied to check overfitting of the random forest algorithm. A prediction model for dual twin survival 30 days after delivery was presented based on the test set. Results: The study included 537 women with monochorionic diamniotic twin pregnancy, of whom 346 (64.4%) had dual twin survival at 30 days after delivery and were compared with 191 (35.6%) cases that had one or no survivors. Univariate analysis demonstrated no differences in demographic parameters between the groups. At the time of diagnosis, the dual‐survival group had lower rates of estimated fetal weight (EFW) < 10th centile for gestational age in the donor twin (56.4% vs 69.4%; P = 0.004), intertwin EFW discordance > 25% (40.8% vs 56.5%; P = 0.001) and anterior placenta (40.5% vs 50.0%; P = 0.034). Comparison of Doppler findings between the two groups demonstrated significant differences in the donor twin, with a lower rate of pulsatility index (PI) > 95th centile in the umbilical artery and ductus venosus and a lower rate of PI < 5th centile in the fetal middle cerebral artery in the dual‐survival group. Relative importance values for each of these six parameters were calculated, allowing the construction of a prediction model with an area under the receiver‐operating‐characteristics curve of 0.916 (95% CI, 0.887–0.946). Conclusions: We developed a predictive model for dual survival in monochorionic twin pregnancies following FLP for TTTS, which incorporates six variables obtained at the time of diagnosis of TTTS, including donor EFW < 10th centile, intertwin EFW discordance > 25%, anterior placenta and abnormal PI in the umbilical artery, ductus venosus and middle cerebral artery of the donor twin. This clinically applicable tool may improve treatment planning and patient counseling. © 2022 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: To compare the perinatal outcomes of pregnancies complicated by chorioamniotic separation (CAS) vs septostomy following fetoscopic laser photocoagulation (FLP) for twin–twin transfusion syndrome (TTTS). Methods: This was a retrospective cohort analysis of monochorionic diamniotic twin pregnancies with TTTS that underwent FLP at one of two university‐affiliated tertiary medical centers between January 2012 and December 2020. CAS and septostomy were diagnosed either during the procedure or by ultrasonography within 24–48 h after FLP. Data on procedure and postprocedure parameters, pregnancy outcomes and survival were collected from the patients' electronic medical records. Pregnancies were stratified according to the presence of CAS, septostomy or neither. Patients diagnosed with both CAS and septostomy were analyzed separately. Results: Of the 522 women included in the cohort, 38 (7.3%) were diagnosed with CAS, 68 (13.0%) with septostomy and 23 (4.4%) with both CAS and septostomy. The remaining 393 (75.3%) women comprised the control group. Groups did not differ in demographic characteristics. The septostomy group had a lower rate of selective fetal growth restriction than did the CAS and control groups (24.2% vs 36.8% vs 42.7%, respectively; P = 0.017). Moreover, intertwin size discordance was lower in the septostomy group (15.1% vs 23.4% in the CAS group and 25.5% in the control group; P = 0.001). Median gestational age at FLP was significantly lower in the CAS group (19.3 weeks vs 20.4 weeks in controls and 20.9 weeks in the septostomy group; P = 0.049). The rate of delivery prior to 34 weeks was significantly higher in the CAS group (89.2%), followed by the septostomy group (80.9%), compared with the control group (69.0%) (P = 0.006). A secondary analysis demonstrated that patients with both CAS and septostomy presented the highest rates of delivery prior to 34 weeks (100%) and 32 weeks (68.2%). Conclusions: CAS and septostomy following laser surgery for TTTS are independently associated with higher rates of preterm delivery. The presence of these two findings in the same patient enhances the risk of prematurity. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

In this paper, it is aimed to perform clustering analysis on a large set of near-fault ground motions based on the intensity of velocity pulses. For this purpose, the velocity pulses of these ground motions are extracted based on the asymmetric Gaussian chirplet model (AGCM), the adapted dictionary-free orthogonal matching pursuit (ADOMP) algorithm, and the Newton method. The location of first AGCM atom is considered as the location of real velocity pulse, and its combination with adjacent atoms reconstructs the real velocity pulse of near-fault ground motions. In addition, hierarchical clustering and k -means clustering are used to cluster near-fault ground motions into two, three, and five groups based on the features of their velocity pulses. The results showed that the clustering results for two and three groups are more suitable than the results of five groups according to the silhouette and Davies-Bouldin measures. Also, the clustering results of five groups are shown to be appropriate for the design of structures with different importance factors. According to the results, agglomerative clustering with complete linkage provides more appropriate clustering results for moderate and strong pulselike ground motions. The k -means and agglomerative clustering with complete linkage provide more uniform clustering results for three and five groups, respectively. A sensitivity analysis showed that the k -means provides more stable clustering results when the records for the Chi-Chi earthquake are removed from the data. Also, the clustering results were used to extract the possible relation of the intensity of velocity pulses with the seismological parameters, which were in accordance with the results of previous research. [ABSTRACT FROM AUTHOR]

Objective Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease. Natural killer (NK) cells play a critical role in the pathogenesis of autoimmune disorders that mainly express killer cell immunoglobulin-like receptors (KIRs). The present study was undertaken to determine the association of the KIR alleles, genotypes, and KIR–human leukocyte antigen (HLA) ligand gene combinations with the susceptibility to SLE. Methods The genotyping of 17 KIR and 5 HLA loci was performed using the polymerase chain reaction-sequence specific primer (PCR-SSP) method. The study population consisted of 230 SLE patients and 273 ethnical-, age-, and sex-matched healthy controls. The association of the polymorphisms with the prevalence of 11 clinical criteria in patients was analyzed. Results The carrier frequency of HLA-A-Bw4 was modestly decreased in the SLE patients. The prevalence of hematological and renal disorders was significantly increased in patients with combination of KIR3DL1+; HLA-B-Bw4Thr80+ and KIR2DS1+; HLA-C2+ genes, respectively. Female patients with combination of KIR2DL2+; HLA-C1− genes were more likely to develop serositis. In addition the prevalence of renal disorders, oral ulcer and serositis was significantly increased in male patients with KIR3DP1+, KIR2DS1+, and KIR2DS3+ genotypes respectively. Conclusion Our results showed that the presence of activating KIR receptors alone or in combination with their HLA ligands and the absence of inhibitory KIRs in combination with their HLA ligands may activate NK cells and are significantly correlated with the prevalence of renal disease, hematologic disorders, serositis, and oral ulcer in SLE patients. [ABSTRACT FROM AUTHOR]

Background and Aim: Rheumatoid arthritis (RA) is an autoimmune disease. It seems that the function of regulatory T cells (Tregs) is compromised in RA. Foxp3 is a critical transcription factor of these cells. The aim of this study was to determine the relationship of vitamin D plasma level with Foxp3 gene expression in the patients with RA. Material and Methods: 18 untreated RA patients and 41 healthy people participated in this study. Plasma levels of vitamin D were measured by competitive ELISA method. Foxp3 gene expression was also determined by using realtime PCR technique. Results: The expression of Foxp3 gene was significantly lower in RA patients compared to that in the healthy controls (p