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OBJECTIVE Using anticoagulants and antiplatelet drugs in patients with cardiovascular and medical comorbidities is prevalent. Because of hyper vascular nature of kidney, physicians tend to stop using aspirin before percutaneous nephrolithotomy (PCNL). We have shown the effects of remaining on low dose aspirin in complete supine PCNL (csPCNL). MATERIAL AND METHODS The records of 643 patients who underwent csPCNL between 2012 and 2018 were analyzed. Surgical outcomes and complications of patients who were on aspirin therapy and continued it daily (group A) were compared with those not taking aspirin (group B). RESULTS Of the 643 csPCNLs, 40 (6%) were performed in patients of group A and the rest of 603 (94%) cases were in group B. The differences between the mean age of groups were statistically significant (60.08±9.45, group A and 48.66±12.32, group B) (P

Background: In the last decades, metformin (Met), an herbal anti-diabetic medicine, has been proposed as an anti-cancer agent. Objective: Thyroid cancers are the most common malignancy of the endocrine system. Therefore, the current study was performed to assess the effects of Met on cell proliferation and activation of the Phosphoinositide 3-Kinase (PI3K)/Protein kinase B (AKT)/Forkhead Box O1 (FOXO1) signaling pathway in the Medullary Thyroid Carcinoma (MTC) cells. The effects of Met on the expression of REarranged during Transfection (RET) proto-oncogene were also investigated. Methods: MTC cell line (TT) was treated with 0, 2.5, 5, 10, 20, 30, 40, 50, and 60 mM concentrations of Met for 24, 48, and 72h. The viability and apoptosis of the treated cells were measured by the 3-(4,5-Dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) and Annexin V- Propidium Iodide (PI) assays. The expression level of PI3K, AKT, FOXO1, and RET genes was investigated by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR), and phosphorylation of their proteins was determined by the Enzyme-Linked Immunosorbent Assay (ELISA). Results: Results showed that Met significantly decreased the viability of the MTC cells. Met also reduced the expression level of PI3K, AKT, and FOXO1 genes (P Conclusion : It seems that the Met has cytostatic effect on the TT cells. Our results showed that anti-tumoral effects of Met may be cell type-specific, and according to the induction of RET (as a proto-oncogene) and inhibition of FOXO1 (as a tumor suppressor gene), Met could not be an appropriate agent in treatment of MTC. The antineoplastic activity of Met has been confirmed against several malignancies in "in vitro" and "in vivo" studies. However, its molecular mechanisms in the treatment of different carcinomas particularly in thyroid cancers are not clearly understood and more studies are required to confirm its exact effect on the MTC.

Purpose The aim of this study was to determine the effect of mobile-based education on mothers' knowledge and decisions about prevention of foreign body (FBA) aspiration and to relieve choking in preschool children. Methods This is a quasi-experimental study in which 88 mothers whose children were registered in each selected kindergarten of the city of Rasht (in Iran) were selected by multi-stage cluster sampling. All mothers were educated through lectures. Then, in the control group, an educational booklet and CDs were used, and in the intervention group, a mobile application was used. Mothers' knowledge and decision were measured by a researcher-made questionnaire before and after the lecture and four weeks after providing the interventions. Mann-Whitney, Wilcoxon, and Friedman tests were used to analyze the data. The level of significance was p Results The results showed that the mean scores of knowledge (n = 44, M = 13.47, SD = 1.84) and decision (n = 44, M = 8.52, SD = 1.30) of participants immediately and mean scores of knowledge (n = 44, M = 14.68, SD = 1.98) and decision of participants (n = 44, M = 9.56, SD = 2.15) four weeks after the educational interventions, in the intervention group, were statistically significantly higher than the control group. Intragroup comparison of the mean scores of knowledge and decision immediately and four weeks after educational interventions, showed that only in the intervention group did the mean scores have statistically significant increase, (p Conclusion Mobile-based education was more effective in improving mothers' knowledge and decision about prevention of foreign body aspiration and to relieve choking in children than other educational methods. Practice implications Mobile applications may be a new and effective method for providing education to parents.

BACKGROUND AND AIMS The Mediterranean Diet (MD) represents a key player in cardiovascular disease prevention. Therefore, we aimed to assess the relationship between adherence to the MD and inflammatory, lipid and glycemic profile in patients affected by polyvascular atherosclerotic disease (PAD). We also investigated the incidence of long-term major adverse cardiovascular events (MACEs) according to MD adherence. METHODS AND RESULTS We enrolled 107 patients with PAD, defined as the simultaneous involvement of at least two vascular districts. Adherence to the MD was estimated through a 9-item simplified form of the Mediterranean Diet Score. Improved fasting glycemic and LDL-cholesterol levels were reported in the high-adherence group compared with the low-adherence group (p

Increasing power densities in future technology nodes is a crucial issue in multicore platforms. As the number of cores increases in them, power budget constraints may prevent powering all cores simultaneously at full performance level. Therefore, chip manufacturers introduce a power budget constraint as Thermal Design Power (TDP) for chips. Meanwhile, multicore platforms are suitable for implementation of fault-tolerance techniques to achieve high reliability. Task Replication is a known technique to tolerate transient faults. However, careless task replication may lead to significant peak power consumption. In this paper, we consider the problem of achieving a given reliability target while keeping the total power consumption under the chip TDP for a set of periodic soft real-time tasks. For this purpose, we propose a method for mapping and scheduling periodic soft real-time tasks in multicore embedded systems. The proposed method consists of three phases: (i) Reliability-Aware Lowest Utilization Mapping, (ii) Maximum-Power-Aware EDF Scheduling, and (iii) Reliability-and-Peak-Power-Aware Dynamic-Voltage-Frequency-Scaling. Our experiments show that our proposed method provides up to 38.4% (on average by 25%) peak power reduction compared to state-of-the-art methods.

Background: The combination of sofosbuvir (SOF) and daclatasvir (DCV) has shown preliminary efficacy for patients with COVID-19 in five open-label studies with small sample sizes. This larger trial aimed to assess if the addition of sofosbuvir and daclatasvir to standard care improved clinical endpoints in hospitalized patients with moderate or severe COVID-19. Methods: This was a placebo-controlled, randomized clinical trial in adults with moderate or severe COVID-19 admitted to 19 hospitals in Iran. Patients were randomized to SOF/DCV 400/60mg once-daily or placebo in addition to standard of care. Patients were included if they had positive PCR or diagnostic chest CT, O 2 saturation

This paper advances the concept of mutual path dependence by investigating the new-town and low-income housing initiatives in Iran. Seventeen new towns have been established in the country. Many of them have additionally become major sites for Iran’s low-income housing scheme. The study employs a flexible approach to policy research to assess the two related programs. According to its findings, the initiatives have been able to offer less expensive means to homeownership on a large scale, with the more successful new-town cases acting as dormitory communities next to large cities. Yet, the new towns and their housing projects exhibit various infrastructure and service shortcomings as well as a failure to link to regional or national plans concerned with territorial balance, industrial development, and employment. More importantly, as the main source of finance in the new towns is opaque land sales, it has given impetus to property speculation and corruption. Despite these major issues, the current policy is to continue both initiatives. The paper thus suggests that Iran’s new towns and housing schemes exhibit related path dependencies. The continuation and progression of each program depend on its previous path as well as that of the other initiative, rather than sound policy responses to the prevailing circumstances and their challenges.

Throughout gestation, the maternal immune system is tightly modulated to allow growth of a semiallogeneic fetus. During the third trimester, the maternal immune system shifts to a proinflammatory phenotype in preparation for labor. What induces this shift remains unclear. Cell-free fetal DNA (cffDNA) is shed by the placenta and enters maternal circulation throughout pregnancy. Levels of cffDNA are increased as gestation progresses and peak before labor, coinciding with a shift to proinflammatory maternal immunity. Furthermore, cffDNA is abnormally elevated in plasma from women with complications of pregnancy, including preterm labor. Given the changes in maternal immunity at the end of pregnancy and the role of sterile inflammation in the pathophysiology of spontaneous preterm birth, we hypothesized that cffDNA can act as a damage-associated molecular pattern inducing an inflammatory cytokine response that promotes hallmarks of parturition. To test this hypothesis, we stimulated human maternal leukocytes with cffDNA from primary term cytotrophoblasts or maternal plasma and observed significant IL-1β and CXCL10 secretion, which coincides with phosphorylation of IFN regulatory factor 3 and caspase-1 cleavage. We then show that human maternal monocytes are crucial for the immune response to cffDNA and can activate bystander T cells to secrete proinflammatory IFN-γ and granzyme B. Lastly, we find that the monocyte response to cffDNA leads to vascular endothelium activation, induction of myometrial contractility, and PGE2 release in vitro. Our results suggest that the immune response to cffDNA can promote key features of the parturition cascade, which has physiologic consequences relevant to the timing of labor.

Background Coronary angiography is used as a qualified method to diagnose coronary heart disease. However, patients undergoing coronary angiography experience a great deal of anxiety. The present study is aimed at investigating the effect of virtual reality on anxiety before coronary angiography. In a randomized controlled trial, 60 candidates for coronary angiography were randomly assigned to two intervention and control groups from April to July 2019. Data were collected by Spielberger’s situational anxiety questionnaire. The participants’ anxiety level and their heart rate, respiratory rate, and blood pressure were measured before and immediately after the intervention. The Intervention group received virtual reality intervention, and the control group was cared for based on the hospital routine. Data were entered into the SPSS version 24.0 software (SPSS Inc.) and analyzed using Chi-square, Paired samples, and independent sample t tests. Results The majority of participants were male (71.25%) and the Mean ± SD age of them in the intervention and control groups was 50.95 ± 4.120 and 52.08 ± 4.002 years, respectively. The mean score of anxiety (p p = 0.001), and systolic blood pressure (p = 0.016) after the intervention in the intervention group decreased significantly. Conclusions This study indicated the implementation of a VR distraction protocol in the patients could effectively reduce perioperative anxiety and its indices. It showed that VR is a safe method without any complications related to the device and with good acceptability. Registration code IRCT201 40515017693N3.

Today, decades after the emergence of the concept of sustainable development, the long-term positive effects of achieving sustainable development goals in all environmental, economic, and social dimensions on the quality of human life are undeniable. The purpose of this research is to explain the mechanism of effects of applying the social sustainability components on the level of residential satisfaction in the scale of residential complexes. The research uses a mixed (quantitative and qualitative) methodology in terms of the nature of the data and the research method is descriptive-analytical (causal and comparative). The conceptual model of the research, which includes the relationships between the variables of perceived quality of social sustainability components, residential desires associated with these components, perceived quality of housing architecture, and residential satisfaction, has been proposed based on the study of theoretical foundations through logical reasoning method. This model has been tested through obtained data from a questionnaire in a field study conducted in the Baghe Behesht residential complex in the Saadatabad neighborhood of Tehran. According to the results, the application of the components of social sustainability has a significant effect on residential satisfaction by improving the quality of housing architecture, and in conditions of qualitative deficiency in social sustainability components, residential desires associated with these components will reduce the perceived quality and the level of residential satisfaction.

Aim To evaluate Klotho and SIRT1 expression in the heart and kidneys of rats with acute and chronic renovascular hypertension. Methods Four and sixteen weeks after the induction of renovascular hypertension by clipping the left renal artery, systemic blood pressure, serum angiotensin II level, and the expression of Klotho and SIRT1 proteins and oxidative stress indices in the heart and kidneys were assessed. Results SIRT1 level was significantly reduced in the ischemic (left) kidney in acute and chronic phases of hypertension. In the heart, it decreased in the acute phase, but increased in the chronic phase. Klotho levels in the heart and kidneys did not change significantly in either hypertension phase. Superoxide dismutase (SOD) activity in the heart significantly decreased, and SOD, total antioxidant capacity, and malondialdehyde in the ischemic kidney significantly increased during the development of hypertension. Serum angiotensin II level significantly increased in the acute phase of hypertension. Conclusion Development of renovascular hypertension was associated with a reduction of SIRT1 expression in the heart and ischemic kidney. As angiotensin II and SIRT1 counteract each other's expression, a SIRT1 reduction in the heart and kidney, along with the influence of systemic/local angiotensin II, seems to be partly responsible for hypertension development. A combination of SIRT1 agonists and angiotensin II antagonists may be considered for use in the treatment of renovascular hypertension.

This paper aims at offering a review and assessment of various emerging technologies and their business applications and implications. The study focuses on nineteen emerging technologies categorized under five major themes: (1) automation and robotics; (2) data and connectivity; (3) interfaces and visualization; (4) materials; (5) energy and resources. For each theme, the associated technologies are examined, their business applications and implications are assessed, and some examples are provided. In the end, an integrative table of nineteen emerging technologies is offered, and some avenues for future research are discussed.

Recently, there is growing evidence that ambient temperature and seasonal changes are related to the incidence of gestational diabetes mellitus (GDM). Thereby, this study was conducted to evaluate the association between seasonal changes and ambient temperature and GDM. We conducted a systematic search in PubMed, ISI Web of Science, Scopus, Google Scholar, and Cochrane Collaboration for human studies available until the end of 2020. We used the following keywords to identify relevant articles: "Diabetes, Gestational" (MeSH), "Glucose Tolerance Test" (MeSH), "Glucose intolerance" (MeSH), "Pregnancy outcome" (MeSH), "Birth outcome", "Seasons" (MeSH), "Weather" (MeSH), "Ambient Temperature," "Climate Change" (MeSH). Meta-analyses by using STATA software were conducted for analyzing data. Due to the high heterogeneity between included studies, a random-effects model was used. Subgroup analysis, meta-regression, and sensitivity analysis were used to define a source of heterogeneity. We found 13 studies related to the association between ambient temperature and season changes and GDM, which 11 of them were included in meta-analyses. Despite inconsistencies in outcome assessment across studies, we found a significant positive association between seasons of GDM screening and risk of GDM (pooled OR=1.12; 95% CI (1.03, 1.21)). The funnel plot and Egger's test showed that there was no significant publication bias among these studies (p=0.51). In general, season changes showed a significant positive relationship with prevalence of GDM. However, due to the unknown exact mechanism on this association, further studies should be conducted.

The increasing trend of food waste is one of the serious challenges throughout the world. The purpose of this study is to investigate the status of edible oil waste (EOW) from farm to table using the SWOT (strengths, weaknesses, opportunities, and threats) analysis in Iran (2021). First, semi-structured, interviews were conducted with 11 experts in the edible oil industry. Then a cross-sectional study was done on 40 restaurant managers through telephone interviews about the restaurant’s discarded edible oils. Finally, an online study was undertaken among 121 households regarding their waste cooking oil at home. Two categories in five themes with 20 subthemes were explored based on the participant’s perspectives. Lack of up-to-date knowledge and appropriate technology were the main reasons for making waste from farm to factory. EOW is used optimally in other industries. The results showed that 92% of the restaurants sell the EOW for poultry feeds without refinement. The majority of the households [52%] throw EOW in the garbage and 21% dump their discarded oils in the sewage. By SWOT analysis, the challenges of EOW from farm to table were identified. There is no specific policy plan for collecting and recycling EOW. The waste oil used in poultry feed without refinement can enter the human body and the possible oxidation toxicity of this waste can pose public health risks. Policymakers can use the SWOT analysis for setting laws and regulations for EOW to ensure its safe disposal and promote its use for biodiesel to provide a healthy community.

Coenurosis is a parasitic disease in livestock animals caused by Taenia multiceps, whose adult parasite lives in the intestine of the Canidae and ruminants and the most important symptoms are nervous system involvement. Five Lori sheep from a flock with neurological symptoms, seizures, and fatalities were referred to the Veterinary Teaching Hospital of Lorestan University with a history of no antiparasitic treatment for the past 6 months. Clinical examination showed no significant changes in vital signs and further hematobiochemical investigation revealed eosinophilia and hyperproteinemia in affected sheep. For further studies, radiographs were taken from the animals’ heads at standard views, and then, two of the dead animals were autopsied and histopathologically examined for brain tissue. The results showed diffuse meningoencephalitis with infiltration of multinucleated inflammatory cells, perivascular inflammation, cerebrovascular thrombosis, cochlear necrosis, and destruction of a large part of brain tissue due to parasitic migration suggesting an acute form of the disease. The treatment protocol for control and eradication of Coenurosis cerebralis was performed at the herd level, which was associated with a successful therapeutic response. The economic damage caused by parasitic infections in undeveloped and developing countries continues to be high and making the need for control programs more serious.

Objective This study aimed to quantify and describe the characteristics of emergency department (ED) injury presentations and subsequent hospital admissions among residents of residential aged-care facilities (RACFs) in Victoria, Australia between 2008 and 2018. Methods This study comprised a single jurisdiction population-based study of consecutive injury-related ED presentations of RACFs residents using the Victorian Emergency Minimum Dataset (VEMD). Results The rate of ED injury presentations per 100,000 population decreased by .8% per year over 10 years ( P = .03); however, the rate per 100,000 RACF bed days increased by .6% per year ( P = .05). The proportion of presentations subsequently admitted to hospital increased 4.0% per year ( PDiscussion The increased rate of ED visits and hospital admissions in RACFs residents highlights the need to design specialized emergency care services and/or provide better direct access to hospital care for this vulnerable population.

Relatively recent increased computational power and extensive traffic data availability have provided a unique opportunity to re-investigate drivers’ car-following (CF) behavior. Classic CF models assume drivers’ behavior is only influenced by their preceding vehicle. Recent studies have indicated that considering surrounding vehicles’ information (e.g., multiple preceding vehicles) could affect CF models’ performance. An in-depth investigation of surrounding vehicles’ contribution to CF modeling performance has not been reported in the literature. This study uses a deep-learning model with long short-term memory (LSTM) to investigate to what extent considering surrounding vehicles could improve CF models’ performance. This investigation helps to select the right inputs for traffic flow modeling. Five CF models are compared in this study (i.e., classic, multi-anticipative, adjacent-lanes, following-vehicle, and all-surrounding-vehicles CF models). Performance of the CF models is compared in relation to accuracy, stability, and smoothness of traffic flow. The CF models are trained, validated, and tested by a large publicly available dataset. The average mean square errors (MSEs) for the classic, multi-anticipative, adjacent-lanes, following-vehicle, and all-surrounding-vehicles CF models are 1.58 × 10−3, 1.54 × 10−3, 1.56 × 10−3, 1.61 × 10−3, and 1.73 × 10−3, respectively. However, the results show insignificant performance differences between the classic CF model and multi-anticipative model or adjacent-lanes model in relation to accuracy, stability, or smoothness. The following-vehicle CF model shows similar performance to the multi-anticipative model. The all-surrounding-vehicles CF model has underperformed all the other models.

One of the complications that patients in need of home healthcare might experience is pressure injury. Given that a significant part of the care of these patients is performed by their family caregivers, they must have sufficient knowledge about prevention and treatment of pressure injuries. We investigated the knowledge related to pressure injuries among family caregivers of patients needing home care who were at risk of pressure injury. Family caregivers of patients in Iran who needed home care services and were at risk of developing pressure injuries based on the Braden scale were invited to participate. A special questionnaire designed by Arboledas and Pancorbo-Hidalgo was used to assess the caregivers' level of knowledge. This questionnaire consists of 23 items, and with total scores between 23 and 46. A higher score indicates a higher level of knowledge about pressure injuries. A total of 323 family caregivers participated, most of whom were female. The mean total score of caregivers' knowledge about pressure injuries was 34.5 ± 3.4 (ranging 23 to 42). Most of the participants (n = 290) stated they did not receive adequate education related to pressure injuries. Among the demographic variables, a significant relationship was observed between the level of caregivers' knowledge with the level of education, younger age, offspring, admission in intensive care units, and male sex (p < 0.005). Family caregivers did not have sufficient knowledge about pressure injuries. Most of them did not receive the necessary education during the time of their patient's hospitalization. This issue should be considered by healthcare providers, and the necessary interventions should be considered to improve the situation.

Objective: While stress reportedly impairs memory, saffron enhances it. This study investigated the therapeutic effects of saffron extract on different memory types, anxiety-like behavior, and expressions of BDNF and TNF-α genes in sub-chronically stressed rats.Methods: Rats were randomly assigned to control, restraint stress (6 h/day/7 days), two 7-days saffron treatments with 30 and 60 mg/kg, and two stress-saffron groups (30 and 60 mg/kg/7 post-stress days). Serum cortisol level and hippocampal BDNF and TNF-α gene expressions were measured. Open field, passive avoidance, novel object recognition, and object location tests were performed to assess anxiety-like behavior and avoidance as well as cognitive and spatial memories, respectively.Results: The low saffron dose in the sub-chronic stressed group led to a significant increase in passive avoidance latency from day 3 onward whereas this effect was observed after 7 days under the high-dose treatment that simultaneously led to a significant decline in serum cortisol level. While the low saffron dose led to a sharp drop in hippocampal TNF-α gene expression, the high dose significantly increased the hippocampal BDNF gene expression in the sub-chronic stress group. Finally, both saffron doses reduced anxiety in the stressed groups.Conclusion: Compared to the low saffron dose, the high dose had a latent but long-lasting impact. Cognitive and spatial memories remained unaffected by either stress or saffron treatment. In addition, only the high saffron dose reversed anxiety in the sub-chronically stressed group. These findings suggest that various doses of saffron act differently on different brain functions under sub-chronic stress conditions.Abbreviations: Brain derived neurotrophic factor (BDNF), tumor necrosis factor-α (TNF-α), hypothalamic-pituitary-adrenal axis (HPA), novel object recognition task (NORT), novel object location task (NOLT), open field test (OFT), passive avoidance (PA).

Bone marrow mononuclear cell therapy improves cardiac repair after myocardial infarction (MI), in-part through signaling to resident cardiac cells, such as fibroblasts, which regulate scar formation. The efficacy of cell therapy declines with age, as aging of both donor and recipient cells decreases repair responses. Autophagy regulates the microenvironment by both extracellular vesicle (EV)-dependent and independent secretion pathways. We hypothesized that age-related autophagy changes in bone marrow cells (BMCs) alter paracrine signaling, contributing to lower cell therapy efficacy. Here, we demonstrate that young Sca-1+ BMCs exhibited a higher LC3II/LC3I ratio compared to old Sca-1+ BMCs, which was accentuated when BMCs were cultured under hypoxia. To examine the effect on paracrine signaling, old cardiac fibroblasts were cultured with conditioned medium (CM) from young and old Sca-1+ BMCs. Young, but not old CM, enhanced fibroblast proliferation, migration, and differentiation, plus reduced senescence. These beneficial effects were lost when autophagy or EV secretion in BMCs was blocked pharmacologically, or by siRNA knockdown of Atg7. Therefore, both EV-dependent and -independent paracrine signaling from young BMCs is responsible for paracrine stimulation of old cardiac fibroblasts. In vivo, bone marrow chimerism of old mice with young BMCs increased the number of LC3b+ cells in the heart compared to old mice reconstituted with old BMCs. These data suggest that the deterioration of autophagy with aging negatively impacts the paracrine effects of BMCs, and provide mechanistic insight into the age-related decline in cell therapy efficacy that could be targeted to improve the function of old donor cells.

Background We sought to estimate the prevalence of diabetes mellitus (DM) and pre-DM and their associated factors among a sample of the Iranian urban population between 2017 and 2019. Methods The present investigation is a sub-study on the HAMRAH cohort study, a longitudinal population-based cohort study to assess the 10-year risk of cardiovascular diseases and their related risk factors in the adult population of the Iranian capital, Tehran. Via a multistage cluster randomized sampling method, 2123 adults aged between 30 and 75 years who had no history of cardiovascular diseases were selected for the study. With the aid of the 2010 American Diabetes Association criteria for the definition of DM and pre-DM, age and sex-specific prevalence rates were estimated. Results The estimated overall prevalence of DM was 14.3% (95% CI: 13.1%–15.8%): 10.4% known DM (95% CI: 9.1%–11.8%) and 4% newly diagnosed DM (95% CI: 3.1%–5.1%). Pre-DM was detected in about 29.2% of the study participants (95% CI: 22.9–36.3%). Our logistic regression analysis revealed that increasing age, higher systolic blood pressure, higher levels of triglycerides, and lower levels of high-density lipoprotein were significantly associated with DM. Conclusions DM and pre-DM follow a notable incremental pattern among the Iranian urban population. This finding underscores the significance of the need to improve prevention and screening strategies in the Iranian urban population.

Background Although, preliminary reports of Severe Acute Respiratory Syndrome (SARS)-CoV-2 infection suggest that the infection causes a less severe illness in children, there is now growing evidence of other rare or even serious complications of disease. Case presentation During the recent COVID-19 pandemic in Kerman, Iran, two children (an 8 year-old boy and a 6 year-old girl) were referred to outpatient Clinic of Pediatric Rheumatology with complaints of limping. Both children had experienced fever and mild respiratory tract infection. At the beginning of the second week of infection, they developed joint effusion. They both tested positive for coronavirus infection and were therefore diagnosed with post Coronavirus reactive arthritis. Both children were treated successfully with rest and Non-Steroidal Anti-Inflammatory Drugs (NSAID). They did not have any medical problems in the two months fallow up. Conclusions These two cases suggest that COVID-19 may be rheumatogenic. Highlighting the need for awareness of physicians, especially pediatricians, regarding the pathogenesis margins of this virus, as late presentations are of great importance.

Gastrointestinal cancer patients undergoing chemotherapy usually suffer from fatigue, which may affect different aspects of their lives. The current study aimed to investigate the effect of massage therapy on fatigue after chemotherapy in gastrointestinal cancer patients. In this quasi-experimental study, 88 gastrointestinal cancer patients were randomly allocated into two groups of intervention and control. Patients received the chemotherapy for 3 h. The intervention group received four sessions of foot massage with an interval of 40 min during the chemotherapy. The massage duration was 7 min for each foot. Fatigue was measured using the visual analogue scale to evaluate fatigue severity just after and 24 h after the chemotherapy. Friedman and Mann–Whitney U tests were used to analyze the data. The mean age of patients was 59/18 ± 9/35, and the most common type of cancer was gastric cancer (40%). There was a significant difference in the mean score of fatigue between the two groups immediately after (P > 0.001) and 24 h after chemotherapy (P

Prompt and accurate detection of SARS-CoV-2, the virus that causes COVID-19, has been important during public health responses for containing the spread of COVID-19, including in hospital settings (1-3). In vitro diagnostic nucleic acid amplification tests (NAAT), such as real-time reverse transcription-polymerase chain reaction (RT-PCR) can be expensive, have relatively long turnaround times, and require experienced laboratory personnel.* Antigen detection tests can be rapidly and more easily performed and are less expensive. The performance† of antigen detection tests, compared with that of NAATs, is an area of interest for the rapid diagnosis of SARS-CoV-2 infection. The Quidel Sofia 2 SARS Antigen Fluorescent Immunoassay (FIA) (Quidel Corporation) received Food and Drug Administration Emergency Use Authorization for use in symptomatic patients within 5 days of symptom onset (4). The reported test positive percentage agreement§ between this test and an RT-PCR test result is 96.7% (95% confidence interval [CI] = 83.3%-99.4%), and the negative percentage agreement is 100.0% (95% CI = 97.9%-100.0%) in symptomatic patients.¶ However, performance in asymptomatic persons in a university setting has shown lower sensitivity (5); assessment of performance in a clinical setting is ongoing. Data collected during June 30-August 31, 2020, were analyzed to compare antigen test performance with that of RT-PCR in a hospital setting. Among 1,732 paired samples from asymptomatic patients, the antigen test sensitivity was 60.5%, and specificity was 99.5% when compared with RT-PCR. Among 307 symptomatic persons, sensitivity and specificity were 72.1% and 98.7%, respectively. Health care providers must remain aware of the lower sensitivity of this test among asymptomatic and symptomatic persons and consider confirmatory NAAT testing in high-prevalence settings because a false-negative result might lead to failures in infection control and prevention practices and cause delays in diagnosis, isolation, and treatment.

The restaurant business has turned into a dynamic and ever‐growing industry. So, food safety must be a priority for these establishments, especially during the COVID‐19 pandemic. The aim of this study was to determine the effect of training intervention on the health and food safety knowledge, attitude, and self‐reported practice (KAP) of restaurant food handlers during the COVID‐19 pandemic. This quasi‐experimental study was conducted on 159 restaurant food handlers in Tehran, Iran. The training intervention was developed based on the latest global guidelines. The KAP of the subjects was measured before and after the training. Fisher's exact test, paired t test, and repeated measures ANOVA were used for statistical analysis. Data analysis was done using the IBM_SPSS software. The total knowledge scores of participants were low (17.6%), moderate (35.2%), and good (47.2%) before training, which were changed to 5% (low), 23.9% (moderate), and 71.1% (good) after training. The total pretraining attitude scores were 0.6, 77.4, 18.2, and 3.8% that were changed to 0% (strongly negative), 49.1% (negative), 33.3% (positive), and 17.6% (strongly positive), respectively. Also, the self‐reported practice scores of the participants before training were 1.3, 56, and 42.7 that were changed to 0% (weak), 26.4% (acceptable), and 73.6% (desirable) after the intervention, respectively. Paired t test results showed a statistically significant increase in all scores. The interaction of training with age and education was statistically significant in increasing the knowledge and attitude scores of the participants by the repeated measures ANOVA. Improving the KAP of food handlers by health and food safety training can improve the status of restaurants and minimize the outbreak of pandemic diseases, including COVID‐19, which is an effective step in community health. Thus, it is an urgent need for policymakers to design an online system of continuous food safety training for food handlers., This study aimed to determine the efficacy of health and food safety training in food services during the COVID‐19 pandemic.The present study revealed a significant improvement in the knowledge, attitude, and practice of food‐handlers after the health and food safety training that can minimize the COVID‐19 outbreaks. Accordingly, public health authorities should prioritize food‐handlers in the restaurants for training courses.

Non-obstructive azoospermia (NOA) is a severe form of male factor infertility resulting from the impairment of sperm production. Surgical sperm retrieval followed by intracytoplasmic sperm injection (ICSI) is the only alternative for NOA patients to have their own genetic children. Nevertheless, due to an approximately 50% chance of success, harvesting sperm from these patients remains challenging. Thus, discovering noninvasive biomarkers, which are able to reliably predict the probability of sperm acquisition, not only can eliminate the risk of surgery but also can lower the costs of NOA diagnosis and treatment. Seminal plasma is the non-cellular and liquid portion of the ejaculate that consists of the secretions originating from testes and male accessory glands. In past years, a wide range of biomolecules including DNAs, RNAs, proteins, and metabolic intermediates have been identified by omics techniques in human seminal plasma. The current review aimed to briefly describe genomic, transcriptomic, proteomic, and metabolomic profiles of human seminal plasma in an attempt to introduce potential candidate noninvasive biomarkers for sperm-retrieval success in men with NOA.

The automotive manufacturing industry responsible for a large share of fuel and electricity consumption and is a major source of greenhouse gasses emission. Considering the Global Climate Action, the estimation and reduction of greenhouse gasses are necessary for major industrial sectors. In this regard, greenhouse gas emission is calculated for the second-largest automaker in Iran (SAIPA automotive manufacturing company). Extensive data sets were collected from 2015 to 2019 including purchased electricity, the number of vehicle production, refrigerant gas leakage, water and fossil fuel consumption (gasoline, diesel oil, and natural gas). The energy consumption was fully assessed, and the indirect emissions estimated by tracing purchased electricity sources to enhance the accuracy of the carbon estimation Moreover, the Radial Basis Function (RBF) network model was employed as a novel approach for precise prediction of the CO2e emission. Results revealed that the carbon intensity was 0.69 tons of CO2e per produced vehicle and purchased electricity and production processes accounted for 50.5% and 49.5% of greenhouse gas emission, respectively. In addition, the average amount of water consumed, purchased electricity, and natural gas consumption per produced vehicle during the study period were 6.11 m3, 0.57 MWh, and 134.80 m3, respectively. Results demonstrate that the RBF network model successfully captured 88 percent of the variation of the CO2e emission. Three scenarios were proposed to project CO2e emission by 2030. The findings showed that CO2e emission was supposed to increase by 150%, 219%, and 285% under optimistic, realistic, and pessimistic scenarios, respectively. The assessment of energy consumption showed that the application of renewable energy sources could decrease the carbon intensity by 12.6%.

Domain adaptation is one of the machine learning approaches, which is very powerful and applicable especially when there is no labeled data on the target domain or there are unequal distributions a...

Objective Hepatitis B (HB) and C (HC) are two severe viral infectious diseases with a deleterious impact on global health. This study aimed to evaluate the prevalence of HB and HC in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study using immunological and molecular methods. Results The blood samples were obtained from 10,520 enrolled participants. Complete biochemical and hematological tests, as well as urine analysis, were assessed. The presence of HBsAg, anti-HBs, anti-HBc, and anti-HCV antibodies for all participant and HBeAg and anti-HBe antibodies for HB-positive patients were evaluated. Moreover, HB genomic DNA and HC genomic RNA were extracted from serum samples of HB-positive patients. The real-time PCR assay was employed to quantify the gene copies of hepatitis B and C viruses. HC genotyping was also performed. The prevalence of HB and HC was 0.24% (95% CI 0.16–0.35) and 0.11% (95% CI 0.06–0.19), respectively. Rural participants were significantly more HB-positive than the urban people (P = 0.045), while males were significantly more HC-positive than the females (P = 0.013). The prevalence of HB and HC in this area were lower than those of other geographical locations of Iran, which may be due to different lifestyles or other unknown reasons.

Background: Assessing the reduction of syndesmosis is highly recommended due to the complications occurring after the malreduction of the syndesmosis. This study evaluated the post-operative Computed Tomography (CT) scans and standard plain radiographs for assessing the reduction of syndesmosis post-operatively. Objectives: Evaluating the radiologic assessments of post-operative reduction of syndesmosis. Methods: In this retrospective cohort study, 45 patients presented with ankle fractures and syndesmosis failure to the emergency department of our hospital between 2015 and 2019 were evaluated by post-operative CT scans and plain radiographs. Results: Diastasis was demonstrated in 18 patients (40%) in plain radiographs, in 4 patients (8%) by tibial clear space, in 5 patients (11%) by medial clear space, in 10 patients (22%) by AP tibiofibular overlap, and in patients 8 (17%) by mortise tibiofibular overlap. Diastasis was demonstrated in 24 patients (53%) in CT scans, of whom 18 patients had abnormal radiographic parameters, while 6 patients had normal radiographic parameters. Conclusion: We found a post-operative CT scan more useful than standard plain radiographic measurement for assessing the reduction of the syndesmosis. We suggest the use of post-operative CT scan as a routine to evaluate the syndesmosis reduction.

Aim: The aim of this study was to examine the articles of the new use of engineered tissues in the treatment problems of joint temporomandibular jaw. Materials and methods: In order to carry out this study, a review of all articles source, books, Medline (PubMed) and Google scholar with a focus on the issue of the use of engineered tissues in the temporomandibular disorders in the period of time 1990 to 2018 done. Results: Using the approach of engineered tissue for the different treatment of defects of temporomandibular joint disorders can be helpful is that to them out of there. Ability to build cartilage similar to cartilage naturally by way of a new provision has been. Also, to help gene therapy, cell therapy, reconstruction defect of osteocondral, Ramus even part of the condyle of the left with the ability to comply with part of the left and doing function properly with the remaining part of the use of cells from stem mesenchymal (MSCs). There are factors of growth and cytokine are and provide a scaffold made of polymeric bio- compatible and industries can be differentiated cells from stem mesenchymal to cells of chondrocytes and osteoblasts to cause it. Although they are tried on this is that more regeneration of muscle - Skeletal with the use of the technology and rehabilitation of cells to patients without using scaffolds. Conclusion: As a result of this study, the review showed that gives the engineered tissue can be replaced by the old treatment of Temporomandibular joint (TMJ) and reconstructed it be, that benefits such as reducing damage to places of and reduce the risk of rejection of links.

Introduction: The number of major abdominal surgical procedures is increasing around the world. A large number of the patients complain about postoperative pulmonary complications (PPCs) after abdominal surgery and show symptoms of breathing pattern disorder. Therefore, this study aimed to investigate the effect of deep breathing exercise on the oxygenation of patients undergoing major abdominal surgery. Methods: This single-blind randomized clinical trial was conducted on 40 patients who needed major abdominal surgery in Qom, Iran, in 2014. The participants were divided into two equal experimental (n=20) and control (n=20) groups. The cases in both groups received routine care, however, those in the experimental group exercised repeated deep breathing four times per hour for two consecutive hours after the surgery as well. The condition of the patients in both groups was similar in terms of position, mobility, and oxygen therapy. The patient’s oxygen saturation, respiratory rate (RR), heart rate, and the severity of pain in the surgery site were measured. The collected data were analyzed in SPSS software (Version. 18) using paired t-test, independent t-test, Mann-Whitney U test, Wilcoxon rank-sum test, Multiple regression analyses, Chi-square test, and Fischer’s exact test. A p-value less than 0.05 was considered statistically significant. Results: Based on the study findings, the deep breathing exercise significantly reduced the surgery site pain and mean blood pressure and increased O2 saturation in the experimental group after the intervention (P

Background Coronavirus disease 2019 (COVID-19) is thought to cause kidney injury via a variety of mechanisms. The most common reported kidney injury following COVID-19 infection is acute tubular injury (ATI); however, the procoagulant state induced by the virus may also damage the kidneys. Case-diagnosis/treatment Herein, we report two cases of acute necrotizing glomerulonephritis (GN) with fibrinoid necrosis in the context of COVID-19 infection. The one with more chronic features in the kidney biopsy progressed to permanent kidney failure but the second one had an excellent response to glucocorticoid pulse therapy with subsequent normal kidney function at 2-month follow-up. Conclusions Both reported cases had an acute presentation of kidney injury with positive nasopharyngeal PCR test for COVID-19. Based on the data review by the researchers, this is the first report of acute necrotizing GN associated with COVID-19 infection.

This study provides a meta-analysis of renewable landscape energies in Iran. In order to do this effectively, we identify and estimate the amount of wind, solar, geothermal, biomass and tidal energy in Iran, identifying the potential for exchanging RE with neighboring countries, and methods for utilizing these energies in architectural design and landscape design. Data used are collecting from local and world databases and presented for analysis using descriptive and inferential statistics. The results show that the level of achievements of the stated goals is generally low. The plurality of RE documents and offices, lack of operational programs and sub-optimal use of private sector capacity are the main weaknesses. It is further concluded that if conditions were more conducive to private sector participation and appropriate operational and action plans were adopted, Iran could supply solar energy to Azerbaijan, wind energy to Turkmenistan and Afghanistan, and can supply Iraq with hydropower. Ultimately it is proposed that the adoption of a comprehensive and integrated RE policy which minimizes the number of policy documents and concentrates RE management in a small number of offices is an important factor in facilitating the success of renewable energies in Iran.

Background: Medullary thyroid cancer (MTC) accounts for 5%–10% of all thyroid cancers, but causes 13% of all thyroid cancer related deaths. MicroRNAs (miRs) have key functions in the development and progression of MTC. Altered expression of some miRs has been reported in many human cancers, including Thyroid cancer. Therefore, we aimed to analyze the expression of miR-154, miR-183 and miR-127 in MTC tumor tissues. Methods: In this case-control study, 15 MTC Formalin-fixed, paraffin-embedded (FFPE) tissue samples and 15 adjacent normal thyroid FFPE tissues, as a control group, were collected from Taleghani, and Loghman Hakim Hospitals, Tehran, Iran since 2005 till 2015. After RNA extraction and cDNA synthesis, the expression of miR127, miR-154 and miR-183 was measured by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). Results: Our data showed a significant increase in the expression of miR-127 in MTC samples in comparison with the control group (P

Background and Objectives: Road traffic accident is one of the leading causes of death in some countries such as Iran. Disability glare due to headlights of vehicles can increase the risk of crashes and make dangerous conditions. This study aimed to investigate the level of glare induced by the headlights of most common vehicles in Iran. Materials and Methods: This cross-sectional study was conducted in a suburban road of Ilam province in 2019. The disability glare resulted from the headlights of Pride Saba GTX, Pride 131SL, Samand Soren, Peugeot 405, Megan, and Peugeot Pars was measured at the distances of 10–100 m away from the headlights. The Threshold Elevation index under the high-beam and low-beam conditions (headlight's operation modes) was obtained for the background luminance condition including 1 and 50 cd/m2 for the age groups of 20, 35, 70, and 83 years old. Results: When the background luminance was 1 cd/m2, the mean glare level caused by the high-beam mode of illumination exceeded the recommended disability glare thresholds of all age groups. When the background luminance was 50 cd/m2, at certain longitudinal distances, glare level exceeded the disability glare thresholds of the elderly drivers (aged 70 and 83 years). At the background luminance of 1 cd/m2, low-beam mode of illumination caused disability glare at certain distances but not in general. At the background luminance of 50 cd/m2, low-beam mode of illumination did not cause disability glare at any distance. Conclusion: The results showed the mutual effect of luminance and the angle of line of sight with respect to glare source on the emergence of disability glare. The age also exhibited a significant association with the disability glare, as the highest glare levels were obtained for older drivers.

Context: Henoch-Schonlein purpura (HSP) is a significant cause of chronic renal disease in children. This review determines some risk factors associated with renal involvement in childhood HSP. Evidence Acquisition: Electronic databases, including Google Scholar, PubMed, and Scopus were searched using the following keywords: “children”, “Henoch-Schonlein”, “risk factor”, “renal involvement”, and “IgA vasculitis”. This review was designed to identify the relevant electronic studies published in the English language from December 1998 to August 2018. Results: This review revealed that clinically older age at presentation, persistent rash, atypical rash, rash on unusual location, and gastrointestinal bleeding were significant risk factors for renal involvement. In contrast, joint involvement was not associated with renal involvement. Among biochemical markers, high red blood cell distribution width is a risk marker of renal involvement in HSP. In contrast, peripheral blood immunoglobulin A, antinuclear antibody, anti-streptolysin O titer, erythrocyte sedimentation rate, and C-reactive protein were not associated with renal involvement. In several studies, leukocytosis, thrombocytosis, or thrombocytopenia have been mentioned as predictors for renal involvement. Still, other studies showed the white blood cell count or platelet count are not risk factors. The effect of corticosteroids as a predictive factor of renal involvement in HSP is challenging and controversial. Furthermore, their impact was dose-dependent. Conclusions: Demographic factors, clinical features, and some abnormal laboratory findings are significant predictive factors for renal involvement in HSP.

Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor skill learning (biMSkL) more than training under the active mode in stroke patients. Twenty-six healthy individuals (HI) and 23 chronic hemiparetic stroke patients with a detectable lesion on MRI or CT scan, who demonstrated motor deficits in the upper limb, were randomly allocated to two parallel groups. The protocol included a two-day training on a new bimanual cooperative task, LIFT-THE-TRAY, under either the active or active-assisted modes (where assistance decreased in a pre-determined stepwise fashion) with the bimanual version of the REAplan® robotic device. The hypothesis was that the active-assisted mode would result in greater biMSkL than the active mode. The biMSkL was quantified by a speed-accuracy trade-off (SAT) before (T1) and immediately after (T2) training on days 1 and 2 (T3 and T4). The change in SAT after 2 days of training (T4/T1) indicated that both HI and stroke patients learned and retained the bimanual cooperative task. After 2 days of training, the active-assisted mode did not improve biMSkL more than the active mode (T4/T1) in HI nor stroke patients. Whereas HI generalized the learned bimanual skill to different execution speeds in both the active and active-assisted subgroups, the stroke patients generalized the learned skill only in the active subgroup. Taken together, the active-assisted mode, applied in a pre-determined stepwise decreasing fashion, did not improve biMSkL more than the active mode in HI and stroke subjects. Stroke subjects might benefit more from robotic assistance when applied "as-needed." This study was approved by the local ethical committee (Comité d'éthique médicale, CHU UCL Namur, Mont-Godinne, Yvoir, Belgium; Internal number: 54/2010, EudraCT number: NUB B039201317382) on July 14, 2016 and was registered with ClinicalTrials.gov (Identifier: NCT03974750) on June 5, 2019.

Betatrophin known as pancreatic β-cell proliferation marker is secreted as a result of the muscle irisin's expression induced by exercise. The present study aimed to investigate the effect of endurance training on serum levels of irisin and betatrophin in diabetic rats. Twenty-four Wistar rats were randomly divided into three groups of (1) healthy control group (

BACKGROUND: Work-related musculoskeletal disorders are the most common occupational health hazards. In the flour production industry, the fast pace of work, high frequency of repetitive movements, manual handling of loads, and awkward postures put a lot of pressure on the worker’s body. OBJECTIVE: Given the high exposure of the workers of the flour production industry to ergonomic risk factors, this study aimed to reduce the rate of musculoskeletal disorders among a group of flour factory workers through ergonomic interventions. MATERIALS AND METHODS: This interventional study was performed using the census method on the eligible workers of a flour factory. An ergonomic intervention program was planned and implemented with the goal of reducing musculoskeletal disorders. The effectiveness of the program was evaluated by measuring the prevalence of musculoskeletal disorders before and six months after the interventions. RESULTS: Before the intervention, musculoskeletal disorders were most prevalent in the lower back, arms, shoulders, legs, thighs, knees, neck and wrists, respectively. Evaluation of the prevalence of musculoskeletal disorders after the intervention showed the positive effect of the ergonomic intervention program on musculoskeletal disorders in the neck, shoulders, lower back, thighs, knees, and legs (P

This article analyses the integration of green building with the largest low-income housing production programme in the US and the innovativeness of state housing agencies. Drawing on policy innova...

Background Frequent nightmares show signs of hyperarousal in NREM sleep. Nevertheless, idiopathic nightmare disorder is considered a REM parasomnia, but the pathophysiology of REM sleep in relation to frequent nightmares is controversial. Cortical oscillatory activity in REM sleep is largely modulated by phasic and tonic REM periods and seems to be linked to different functions and dysfunctions of REM sleep. Here, we examined cortical activity and functional synchronization in frequent nightmare recallers and healthy controls, during phasic and tonic REM. Methods Frequent nightmare recallers (N = 22) and healthy controls (N = 22) matched for high dream recall spent two nights in the laboratory. Phasic and tonic REM periods from the second nights’ recordings were selected to examine differences in EEG spectral power and weighted phase lag index (WPLI) across groups and REM states. Results Phasic REM showed increased power and synchronization in delta and gamma frequency bands, whereas tonic REM featured increased power and synchronization in the alpha and beta bands. In the theta band, power was higher during tonic, and synchronization was higher during phasic REM sleep. No differences across nightmare and control participants or patterns representing interactions between the groups and REM microstates emerged. Conclusions Our findings do not support the idea that abnormal REM sleep power and synchronization play a role in the pathophysiology of frequent nightmares. Altered REM sleep in nightmare disorder could have been confounded with comorbid pathologies and increased dream recall, or might be linked to more specific state factors (nightmare episodes).

According to the World Health Organization (WHO) the prevalence of obesity tripled worldwide since 1975. Obesity prevention and treatment is based upon lifestyle changes involving eating habits, physical activity and behaviour therapy. Various dietary patterns have been used as nutritional strategies and, in recent years, interest has been shown in very low calorie ketogenic diets (VLCKD) that provide less than 800 calories (kcal), no more than 20–50 g/day of carbohydrates and 0.8–1.5 g/kg ideal body weight of protein. We conducted a literature review of all clinical trials published between January 2014–November 2019 on people with obesity (PWO) that evaluated VLCKD effects on anthropometric parameters, body composition, satiety, lipid profile and microbiota. Findings from literature showed that VLCKD could be useful to ameliorate the quality of life and sleep of PWO. It leads to a rapid weight loss and results in improvements in body mass index (BMI = kg/m2), waist circumference and fat mass reduction preserving lean body mass and resting metabolic rate. This eating pattern reduced the desire to eat and increased satiety. Little is known regarding the effects of VLCKD on the microbiota of PWO for which it is important to conduct further studies.

Objectives: Endometrial receptivity is a complex event that occurs during the midluteal phase of the menstrual cycle known as the "window of implantation". During this period, the endometrium develops characteristics that allow the adhesion and invasion of the embryo to the uterine epithelium. Accordingly, the expressions of miR-31 and its target gene were evaluated to study the effect of miR-31 on FOPX3 gene expression in recurrent implantation failure (RIF) patients and normal fertile women. More precisely, the aim of this study was to understand the expression of miR-31 as one of the important regulators of the FOXP3 gene in the endometrium of RIF patients versus receptive endometria from fertile patients. Materials and Methods: This case-control study was conducted on 20 endometrial tissue samples of normal fertile women and RIF patients in order to evaluate miR-31 and its target gene expression. Results: According to the results of this study, a significant difference existed between RIF patients and normal fertile women (control group). The expression of the FOXP3 gene was more significant in the control group. miR-31 was also significantly expressed, which was due to the endometrial immunological disorder leading to the decreased expression of its target gene (FOXP3). Conclusions: In general, implant abnormalities and recurrent abortions were observed in RIF patients due to the decreased expression of the FOXP3 gene resulting from the inhibitory effects of miR-31.