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Globally, the availability and delivery of cognitive pharmaceutical services (CPS) by pharmacists has expanded over time. Australia has been no exception to this trend, with government funding to support the provision of certain CPS significantly increasing over the last two decades. Whilst medication management services have been consistently funded by the government for more than 15 years, fluctuations in the funding of other CPS have been observed; for example, certain disease state management CPS and introduction of funded MedsChecks. Furthermore, legislative changes have broadened pharmacists’ scope of practice and the CPS provided, contributing to an increase in user-pay services. Although the literature to date has highlighted positive impacts associated with CPS on economic, clinical and/or humanistic outcomes, context-specific, real world evidence for the benefits of CPS is much needed to ensure the profession engages in evidence-based practice. The aim of this commentary is to outline the changes in CPS provision and funding within the Australian context, the existing evidence for CPS, and highlight the implications for future research.

Purpose: Diabetes mellitus, especially type 2, is conceived as a devastating chronic metabolic disease globally. Due to the existence of an extensive vascular network in the pulmonary tissue, it is suggested that lungs are sensitive to the diabetic condition like other tissues. This study was designed to address the possible effect of type 2 diabetes mellitus on the promotion of pathological changes via vascular injury. Methods: Sixteen male Wistar rats were randomly allocated to the two of Control and T2D groups. To induce type 2 diabetes, rats were received high-fat and a single dose of STZ. On week 12, rats were euthanized and lungs samples were taken. Using Hematoxylin and Eosin staining, the pathological changes were monitored. The expression of vascular ICAM-1 and VCAM-1, and IL-10 was monitored using real-time PCR assay. The level of TNF-α was detected using ELISA assay. Nitrosative stress was monitored using the Griess assay. Results Pathological examination in bronchoalveolar discharge revealed the existence of mild to moderate interstitial bronchopneumonia and increased neutrophilic leukocytosis compared to the control. Enhanced ICAM-1 and VCAM-1 expression and suppression of IL-10 was found using real-time PCR analysis (p

BACKGROUND Although abdominoplasty is a mainstay of the plastic surgeon, the safety of the Brazilian butt lift (BBL) has been questioned, effectively being prohibited in some countries. The central rationale for the safety concern over the BBL stems from a publication stating a mortality rate of one in 3000. The question remains: What is the real safety of these procedures? METHODS Focusing on mortality, literature searches were performed for BBL and for abdominoplasty. The 2017 Aesthetic Surgery Education and Research Foundation survey data and publication were examined and analyzed. Additional data from the American Association for Accreditation of Ambulatory Surgical Facilities were obtained independently. RESULTS Abdominoplasty and BBL appear to have similar safety based on mortality; however, the nature of their mortalities is different. Although most abdominoplasty deaths are secondary to deep venous thrombosis/pulmonary embolism-inherent circulatory thrombotic abnormality-BBL mortality is associated with iatrogenic pulmonary fat embolism. BBL mortality rates from more recent surveys on BBL safety demonstrate a mortality of one in 15,000. CONCLUSIONS Although deep venous thrombosis/pulmonary embolism will always remain an abdominoplasty risk, intraoperative BBL pulmonary fat embolism has the potential to be reduced dramatically with a better understanding of dynamic anatomy, surgical instrumentation, and technique. The authors are now presented with a better lens with which to view a more accurate safety profile of BBL surgery, including its place among other commonly performed aesthetic procedures.

This work investigates the effect of 3D-printing parameters on surface roughness in polylactic acid printed material by adopting Taguchi's design of experiments approach. The control parameters under study were: number of shells, printing temperature, infill rate, and printing pattern. As the response, mean surface roughness (Ra) was selected. The control parameters were assigned to an L9 orthogonal array to organize the experiments and obtain the mean surface roughness results. It is concluded that printing temperature is the dominant parameter that affects surface roughness when it comes to 3D printing of polylactic acid material followed by printing pattern, infill rate, and the number of shells.

The benefits of resistance training (RT) for migraineurs appears to be lacking although beneficial of aerobic training have been shown in previous studies. The aim of the current study, therefore, is to investigate the influence of RT on migraine headache indices, upper and lower-body strength, and quality of life (QOL) in women with migraine disorders. Twenty female migraine patients who were referred by a neurologist were randomly assigned to two groups including RT group (n = 10) and control (CON) group (n = 10). The RT protocol consisted of 8 weeks, 3 sessions per week, 45–60 min per session. Visual Analog Scale (VAS) and pain diary were utilized to measure the subjects’ migraine indices including duration, pain severity, and frequency within 48 h pre- and post-training protocol. Patients in the Control group (CON) have been refrained from regular exercise during this study. The quality of life (QOL) and muscular strength were measured by the Headache Impact Tests (HIT) and one-repetition maximum (1RM) test, respectively, for 48 h pre- and post-training protocol. The RT resulted in a significant decrease in the migraine indices (headache intensity, frequency, and duration) (p = 0.02, p = 0.001, p = 0.04, respectivetly). Increased quality of life and chest and leg muscular strength significantly (p = 0.001 for all) were also showed after 8-week RT protocol. However, there were not any significant differences between groups considering, BMI and waist-hip ratio (WHR) after executing RT protocol (p > 0.05). Based on the results of the current study that mainly had a positive trend, it could state that RT protocol with special consideration for migraine patients is probably an alternative therapy or augmentative complement to established interventions for migraine treatment.

This study investigated the capacity of finite element modelling (FEM) approaches to predict the experimentally obtained behaviour of concrete-filled spiral-welded stainless-steel tube (CF-SWSST) short and long columns. Using the ABAQUS software, FEM was carried out of 24 CF-SWSST column tests. Nominal outside diameter to thickness ratios, effective length to diameter ratios and load eccentricity to diameter ratios equal to 51–114.5, 4.5–12.0, and 0–0.4 had been considered for the tests that were modelled. The distinct spiral weld seam geometry of the SWSST was explicitly considered in the FEM. Widely reported and accepted FEM modelling approaches and material models were adopted for this work. The concrete damaged plasticity model was utilised for the concrete core, while the stress–strain behaviour of stainless-steel was modelled using a modified Ramberg-Osgood relationship. On average, the capacities predicted by the FEM for the CF-SWSST columns were found to be non-conservative. The non-conservativeness was higher for specimens under concentric axial loading and increased with column and section slenderness. The actual to predicted capacity ratios were much closer to 1.0 for eccentrically loaded CF-SWSST columns, with conservative capacities predicted for eccentrically loaded specimens with the smallest section slenderness. For load eccentricity to diameter ratios of 0.15 and 0.4, there was negligible difference in the prediction conservativeness. Compared to analogous concrete-filled spiral-welded mild-steel tube columns, the FEM predictions obtained for the CF-SWSST columns were notably less conservative. This suggested that separate material constitutive models may be warranted for the FEM of CF-SWSSTs compared to their mild-steel counterparts. For the modelled eccentrically loaded specimens, the FEM predicted globally flexurally deformed states which agreed with those obtained experimentally, though the local buckling patterns were not replicated. In addition, the FEM qualitatively captured the experimentally obtained bending stiffness and strain variations. A modelling sensitivity study found that the FEM results were effectively equivalent even when the SWSSTs were modelled as plain seamless tubes.

This manuscript summarizes the capabilities of the new DIAD beamline for dual imaging and diffraction (DIAD) at Diamond Light Source, dedicated to quasi-simultaneous, time-resolved imaging/tomography and powder diffraction for 3D microstructure and phase identification/strain analysis studies., The Dual Imaging and Diffraction (DIAD) beamline at Diamond Light Source is a new dual-beam instrument for full-field imaging/tomography and powder diffraction. This instrument provides the user community with the capability to dynamically image 2D and 3D complex structures and perform phase identification and/or strain mapping using micro-diffraction. The aim is to enable in situ and in operando experiments that require spatially correlated results from both techniques, by providing measurements from the same specimen location quasi-simultaneously. Using an unusual optical layout, DIAD has two independent beams originating from one source that operate in the medium energy range (7–38 keV) and are combined at one sample position. Here, either radiography or tomography can be performed using monochromatic or pink beam, with a 1.4 mm × 1.2 mm field of view and a feature resolution of 1.2 µm. Micro-diffraction is possible with a variable beam size between 13 µm × 4 µm and 50 µm × 50 µm. One key functionality of the beamline is image-guided diffraction, a setup in which the micro-diffraction beam can be scanned over the complete area of the imaging field-of-view. This moving beam setup enables the collection of location-specific information about the phase composition and/or strains at any given position within the image/tomography field of view. The dual beam design allows fast switching between imaging and diffraction mode without the need of complicated and time-consuming mode switches. Real-time selection of areas of interest for diffraction measurements as well as the simultaneous collection of both imaging and diffraction data of (irreversible) in situ and in operando experiments are possible.

While the 3D printing technology for cementitious composites has developed rapidly, a combination of 3DP technology and lightweight engineered cementitious composites (LWECCs) could improve many aspects of the construction industry. In this study, a fibre-reinforced high-performance LWECC for extrusion-based printing was proposed. First, six LWECCs were prepared, incorporating two kinds of hollow glass microspheres (HGMs) in varying replacement ratios of fly ash (FA) at 60 wt%, 80 wt%, and 100 wt%. In addition, polyvinyl alcohol (PVA) fibre was introduced given its shrinkage resistance and improvement in printability performance. Thereafter, fresh property (slump loss and setting time), unconfined compression strength (UCS), and flexural strength experiments thoroughly investigated the optimised LWECC design, which was later calibrated for the printing procedure via a printability assessment, including extrudability and buildability. The UCS, flexural strength, and densities of the printed and cast specimens were compared. Lastly, a microstructural investigation using a scanning electron microscope described the reinforcement mechanism of PVA fibre upon the performance of the printed structures and HGMs. The addition of HGMs significantly improve the lightweight property that reaches a value at 1384 kg/m3 but inevitably negates mechanical properties. The printed LWECC obtains 33.6 MPa for UCS and 9.29 MPa for flexural strength. When the printed filament was perpendicular to loading direction, superior toughness was observed, creating a 63% and 40% increase for UCS and flexural strength, respectively.

Support vector machines (SVMs) are powerful classifiers that have high computational complexity in the training phase, which can limit their applicability to large datasets. An effective approach to address this limitation is to select a small subset of the most representative training samples such that desirable results can be obtained. In this study, a novel instance selection method called border point extraction based on locality-sensitive hashing (BPLSH) is designed. BPLSH preserves instances that are near the decision boundaries and eliminates nonessential ones. The performance of BPLSH is benchmarked against four approaches on different classification problems. The experimental results indicate that BPLSH outperforms the other methods in terms of classification accuracy, preservation rate, and execution time. The source code of BPLSH can be found in https://github.com/mohaslani/BPLSH .

Complement dysfunction results in impaired ability in clearing apoptotic cell debris that may stimulate autoantibody production in systemic lupus erythematosus (SLE). Herein, we provided a comprehensive search to find and meta-analyze any complement gene polymorphisms associated with SLE. The ITGAM, C1q, and MBL gene polymorphisms were included in this meta-analysis to reveal the exact association with SLE risk. Electronic databases, including Scopus, PubMed, and Google Scholar, were searched to find studies investigating the ITGAM, C1q, and MBL gene polymorphisms and SLE risk in different populations. The pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) were used to analyze the association between ITGAM, C1q, and MBL gene polymorphisms and susceptibility to SLE. According to inclusion criteria, a total of 24 studies, comprising 4 studies for C1QA rs292001, 5 studies for C1QA rs172378, 9 studies for ITGAM rs1143679, 8 studies for MBL rs1800450, 3 studies for MBL2 rs1800451, and 3 studies for MBL2 rs5030737, were included in the final meta-analysis. A significant positive association was found between rs1143679 and SLE risk, while rs1800451 significantly associated with decreased SLE susceptibility. In summary, ITGAM gene rs1143679 SNP and MBL gene rs1800451 SNP were positively and negatively associated with SLE risk, respectively.

In recent decades global warming has turned into an international concern. Anthropogenic Greenhouse gases (GHG) are produced through burning fossil fuel leading to an increase in the global warming effect; thus, GHG reduction contributes to mitigating climate change. Utilizing renewable energies, increasing efficiency of and capacity factor (CF) of existing power plants, and recycling waste energy in various industries are convenient solutions to improve the energy systems performance to reduce fossil fuel consumption, leading to GHG emission. So, there is a substantial need for planning and evaluating the energy systems in which various technologies are used, technically and economically. Theis study's main objectives are utilizing the capacity of renewable energies such as biomass, wind, solar, hydropower, and enhancement of CF and efficiency of the power plants in the Mazandaran region in the south of the Caspian Sea. The energy system considered for the region is modeled and analyzed by six scenarios in this paper. The results indicated that the share of renewable energies in electricity production could be increased from 5.4% to 47.7%. The results of cost analysis show that by applying the sixth scenario, which is integrated policies of increasing RER share and improvement of efficiency and capacity factor. The trends of total annual cost, CO2 emission, and fossil fuel consumption are reduced compared to the business as usual (BAU) scenario. The average cost saved by this scenario is about 220 MUSD/year. The average amount of fossil fuels and CO2 emission save are 11 TWh/year and 2.438 Mt/year between 2020 and 2030, respectively.

Introduction Sprengle deformity is the most common congential anomaly of shoulder complex that is the result of scapular placement in cephalad abnormal position. The purpose of this study is the evaluation of clinical and radiological results of vertical corrective scapular osteotomy and comparision of these results with previous studies. Methods We retrospectively reviewed the results of the vertical corrective scapular osteotomy (VSO) with or without clavicular osteotomy and wake-up test in 31 consecutive patients at an average duration of follow up of 30 month (6 month-15 years). 22 patients were girls and 9 were boys. The average age of the patients was 7.3 years (3-13) at the time of surgery. We evaluated the clinical and radiological results of this method in last fallow-up. No funding was used for this study and there are no conflicts of interest. Results 31 surgical procedures were performed. All osteotomies were healed. No neurovascular complication. Postoperative the mean shoulder flexion and abduction were improved 30 and 36° respectively (p, Highlights • Sprengle deformity is the most common congential anomaly of shoulder complex. • Surgical options can vary from excision of the angle to some major procedures such as subtotal scapulectomy. • Vertical scapular osteotomy (VSO) is considered a relocation procedure that can provide cosmetic and functional improvement. • More cosmetic scapular lowering with little chance of neurovascular problems can be achieved after VSO. • Scapular rotation can be corrected using this technique.

In this paper, a secure and efficient Blind Source Separation (BSS) based cryptosystem is presented. The use of BSS in audio and image cryptography in wireless networks has attracted more attention. A BSS based cryptosystem consists of three main parts: secret data, secret keys, and mixing matrix. In this paper, we propose a new design to create a proper mixing matrix in BSS based cryptosystem. We offer a mathematical criterion to select mixing matrix elements before encryption. The proposed criterion gives a simple way to attach the secret sources to keys, which makes source separation very hard for the adversary. Versus, we show that using the random mixing matrix can lead to data security loss. The attacks used for security tests in this paper are "Differential Attack" and "Denoising Attack," which are among the most effective in this field. These attacks will apply to cryptosystems based on the random and the proposed mixing matrix. The visual results of the attacks in the experiments will show that the "proposed mixing matrix based cryptosystem" will be more secure than the "random mixing matrix based cryptosystem." We also used the correlation coefficient criterion to compare the two cryptosystems more accurately. According to the experiments of this paper, the "proposed mixing matrix based cryptosystem" vs. the "random mixing matrix based cryptosystem" was able to reduce the adversary's source extraction quality rate from about 76% to 16%, on average.

Ovarian cancer is the seventh most common form of cancer among women worldwide. The aim of the study was to determine the accuracy of a frozen section and the factors affecting the accuracy of frozen diagnosis of ovarian neoplasms. This retrospective, cross-sectional study was conducted on 401 patients with ovarian masses with frozen section diagnosis in Shahid Faghihi Hospital affiliated to Shiraz University of Medical Sciences between 2014 and 2018. Each ovarian tumor sample was evaluated for histopathologic diagnosis using frozen and paraffin-embedded sections, which were reviewed by an expert gynecologic pathologist. Accuracy and diagnostic values were estimated by comparing the results of the 2 techniques, using the paraffin section as the gold standard. The overall accuracy of the frozen section was 94.5%. Its sensitivity was 85.3% for malignant, 88.2% for borderline, and 99.6% for benign tumors. Its specificity was also 99.7% for malignant, 98.0% for borderline, and 90.9% for benign tumors. The positive predictive value was 98.9% for malignant, 86.5% for borderline, and 94.6% for benign tumors. Most false negatives occurred in mucinous and borderline tumors. The sensitivity of malignant tumors of germ cell and sex cord-stromal cell types were 64.3% and 95.5%, respectively. The specificity of germ cell and sex-cord stromal tumors were 100% and 93.8%, respectively. Frozen section seems to be a precise technique for histopathologic diagnosis of ovarian tumors. However, borderline and mucinous tumors are the most problematic issues during frozen section diagnosis and malignant germ cell tumors have the lowest sensitivity.

Purpose The purpose of this paper is to present and evaluate the performance of innovation systems by considering two indicators of efficiency and effectiveness. The scope of the evaluation is globally and due to the situation of each country, the suggested strategies are proposed to maintain the status quo or move toward the desired situation for countries. Design/methodology/approach The approach is to compare and benchmark the countries in terms of the efficiency and effectiveness of their innovation system. The Global Innovation Index report’s input-to-output ratio and the global competitiveness report are used for the assessment. Findings The findings indicate that countries such as China, Switzerland and the USA have an efficient and effective innovation system. However, the innovation systems in countries such as Brazil and Zimbabwe are not only inefficient but also ineffective. The findings also indicate that the innovation systems of countries such as Iran, Armenia and Egypt are efficient but ineffective. Finally, the authors can name Australia, Qatar and Russia as countries with effective but inefficient innovation systems. Originality/value Assessment of national innovation system using efficiency and effectiveness performances is done for the first time at the global stage.

The aim of this study was to determine the relationship between carbohydrate quality intake and menopausal symptoms.This is a cross-sectional study of 393 postmenopausal women attending municipality health houses and health centers in the south of Tehran, Iran, from September 2016 to January 2017.The dietary intake and menopausal symptoms of the participants were assessed with a validated food frequency questionnaire and a menopause rating scale (MRS) carbohydrate quality index (CQI) was calculated using three indices: dietary fiber, glycemic index, and the ratio of solid carbohydrates to total carbohydrates. Linear and logistic regressions were used to assess the relationship between CQI and menopausal symptoms.After adjustment for age, education, time passed since menopause, body mass index, physical activity and energy intake, an inverse association was found between CQI and total MRS score (TMRSS) (β -0.61; p0.001), somatic score (SS) (β -0.27; p0.001) and psychological score (PS) (β -0.37; p0.001) in multivariable linear regression. In addition, logistic regression analysis revealed that compared with the lowest quartile of CQI, participants in the highest quartile of CQI had a lower TMRSS (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.19-0.68). Moreover, CQI was inversely related to SS (OR 0.34; 95% CI 0.17-0.68) and PS (OR 0.32; 95% CI 0.16-0.61). However, there was no significant association between CQI and urogenital score (US).Higher-quality carbohydrate intake was found to be associated with lower somatic and psychological symptoms of menopause. These findings suggest that CQI may be an important basis for developing an effective dietary modification for reducing menopausal symptoms.

Background & Objective: Acral melanoma (AM) is a common type of cutaneous melanoma that occurs in the skin of the palms, soles, and nail beds. This malignancy, like other types of cancer, has different genetic alterations. To date, despite decades of research the roles of oncogenic BRAF mutations in the pathogenesis of AM has not been fully clarified. The present study was designed to identify V600E mutation in patients with AM from the south of Iran. Methods: The samples were collected from the pathology lab archive of Shiraz University of Medical Sciences (2015-2020). A total of 41 patients with primary invasive AM underwent excisional biopsy or amputation were collected to evaluate BRAF V600E mutation using Polymerase Chain Reaction (PCR) and Sanger sequencing.Results: Total number of 41cases (21 male and 20 female) and age range of 34-87 years were enrolled. The histological subtypes were 24 acral lentiginous melanomas (ALM), 10 cases of nodular melanoma (NM), and 7 cases of superficial spreading melanoma (SSM). In our study, only one case (a 44-year-old male with nail bed AM and the histological subtype of acral lentigenous melanoma) showed BRAF-V600E mutation. Conclusion: These findings suggest that the population of our interest showed a very low prevalence of this mutation providing novel insights into the pathobiology of AM and its related treatment.

Background Dispensed prescription medicine labels (prescription labels) are important information sources supporting safe and appropriate medicines use. Objective To develop and user test patient-centred prescription label formats. Methods Five stages: developing 12 labels for four fictitious medicines of varying dosage forms; diagnostic user testing of labels (Round 1) with 40 consumers (each testing three labels); iterative label revision, and development of Round 2 labels (n = 7); user testing of labels (Round 2) with 20 consumers (each testing four labels); labelling recommendations. Evaluated labels stated the active ingredient and brand name, using various design features (eg upper case and bold). Dosing was expressed differently across labels: frequency of doses/day, approximate times of day (eg morning), explicit times (eg 7 to 9 AM), and/or explicit dosing interval. Participants' ability to find and understand medicines information and plan a dosing schedule were assessed. Results Participants demonstrated satisfactory ability to find and understand the dosage for all label formats. Excluding active ingredient and dosing schedule, 14/19 labels (8/12 in Round 1; 6/7 in Round 2) met industry standard on performance. Participants' ability to correctly identify the active ingredient varied, with clear medicine name sign-posting enabling all participants evaluating these labels to find and understand the active ingredient. When planning a dosing schedule, doses were correctly spaced if the label stated a dosing interval, or frequency of doses/day. Two-thirds planned appropriate dosing schedules using a dosing table. Conclusions Effective prescription label formatting and sign-posting of active ingredient improved communication of information on labels, potentially supporting safe medicines use. Patient and public involvement Consumers actively contributed to the development of dispensed prescription medicine labels. Feedback from consumers following the first round was incorporated in revisions of the labels for the next round. Patient and public involvement in this study was critical to the development of readable and understandable dispensed prescription medicine labels.

Background Patients need medication and medical condition‐related information to better self‐manage their health. Health‐care professionals (HCPs) should be able to actively provide information outside of one‐on‐one consultations; however, patient consent may be required. Objective To investigate the Australian public's preferences, and factors that may influence their preferences, towards an opt‐in versus an opt‐out approach to health communication. Design A cross‐sectional study using a structured questionnaire administered via Computer‐Assisted Telephone Interviewing. Setting and participants Participants across Australia who were adults, English‐speaking and had a long‐term medical condition. Main outcome measures Preferences for opt‐in vs opt‐out approach to receiving follow‐up tailored information. Results A total of 8683 calls were made to achieve the required sample size of 589 completed surveys. Many (346/589; 58.7%) indicated that they were interested in receiving tailored, ongoing follow‐up information from their HCP. Nearly half (n = 281; 47.7%) preferred an opt‐in service and 293/589 (49.7%) an opt‐out service for receiving follow‐up information. Reasons for preferring an opt‐in service were being in control of the information received (n = 254); able to make a decision that is best for them (n = 245); opt‐in service would save time for HCPs (n = 217); they may not want or need the information (n = 240). Many (n = 255) felt that an opt‐out service should be part of the normal duty of care of their HCP and believed (n = 267) that this approach would ensure that everyone has access to information. Conclusions Respondents were interested in receiving tailored information outside of consultation times. However, preferences for an opt‐in or opt‐out approach were divided.

The fabric-reinforced cementitious matrix (FRCM) has been extensively studied and applied for the strengthening of masonry structures. Special attention needs to be given to the bonding properties between the FRCM and masonry substrate for strengthening applications. This paper presents a statistical analysis of the bonding properties based on the available literature. First, the collected test results were discussed in terms of the interfacial failure mode. Second, the factors influencing the ultimate bond load were analysed based on the different failure modes, and a corresponding prediction formula was further determined via regression analysis for interfacial debonding and slippage failures. Then, the characteristic values of the ultimate bond load were determined via a probabilistic method. Finally, the fracture energy for the slippage failure at the fabric-matrix interface was analysed, and a corresponding prediction formula was obtained via regression analysis. Additionally, some of the collected test results present higher dispersion due to the large variability of the FRCM material properties and the differences in the testing procedures used by different institutions. More studies are needed to improve the reliability of the proposed procedure.

Background and Aim: Silymarin is used for the treatment of liver disease due to its hepatoprotective effects. however, the use of its extract is limited due to poor aqueous solubility and low bioavailability. This study aimed to prepare a new formulation of silymarin and to evaluate its hepatoprotective effect after liver injury induced by carbon tetrachloride in rats. Materials and Methods: In an experimental study, a new form of silymarin was prepared. A total number of 24 rats were divided into 4 groups. The two treatment groups were administered with silymarin extract and silymarin nanomicelle for 14 days before being damaged by CCl4. At the end of the study, blood samples were collected to determine serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and lipid profile. Moreover, antioxidant and oxidative stress enzyme activities were assessed in hepatic tissue. A one-way ANOVA test was used for statistical analysis. Results: The activity of ALT and AST liver enzymes and the level of lipid profile parameters were significantly decreased in nanomicelle treated group compared to the silymarin-treated group (P

Background Adherence to ADHD medication is a complex phenomenon as the decision to adhere is influenced by a range of factors. To design tailored interventions to promote adherence, it is important to understand the factors that influence adherence in the context of its three phases: initiation, implementation and discontinuation. Objective The objective of this study was to explore the phase‐specific factors that influence adherence to medication in adults who have a diagnosis of ADHD. Methods Three focus groups (FGs) were conducted with twenty adults with ADHD in different metropolitan areas of Sydney, Australia. FGs were transcribed verbatim and thematically analysed. Results Participants’ decision to initiate medication (the initiation phase) was influenced by their perceived needs (desire to improve academic and social functioning) and concerns (fear of side‐effects) about medication following a similar process as defined by the Necessity‐Concerns Framework (NCF). The balance between benefits of medication (needs) and side‐effects (concerns) continued to determine participants’ daily medication‐taking (the implementation phase) and persistence (or discontinuation) with their medication. Forgetfulness and stigma were reported as concerns negatively impacting the implementation phase, while medication cost and dependence influenced the discontinuation phase of adherence. Conclusions Adults’ decision to initiate, continue or discontinue medication is influenced by a range of factors; some are unique to each phase while some are common across the phases. Participants balanced the needs for the medication against their concerns in determining whether to adhere to medication at each phase. It appears that the NCF has applicability when decision making about medication is explored at the three phases of adherence.

The capability of finite element modelling (FEM) to predict the experimentally observed behaviour of concrete-filled spiral-welded mild-steel tube (CF-SWMST) columns was assessed in this study. FEM was carried out of 24 previously reported CF-SWMST short and long column tests using the ABAQUS software. The tube length to outside diameter ratio (L/D) of the short and long columns were 3.0–3.3 and 9.0–10.0 respectively while the nominal outside diameter to thickness ratios (D/t) of the specimens were in the range 51–114.5. Load eccentricities of 0, 0.15D, and 0.4D had been considered for the specimens in the respective tests. Widely used and well-established modelling procedures, previously reported for concrete-filled steel tube (CFST) columns, were adopted for the analyses. The concrete damaged plasticity model in ABAQUS was used as the constitutive model for concrete. The specimen geometries were represented using solid hexahedral elements, while the spiral weld seam was also explicitly modelled. With respect to the reported experimental axial capacities, the FEM provided conservative load capacity predictions for the CF-SWMST specimens with D/t ratios less than 100. The prediction conservativeness increased with increasing load eccentricity and decreasing section slenderness. For the eccentrically loaded CF-SWMST columns, the predicted globally deformed states agreed with those observed experimentally, though the local buckling patterns were not replicated in the FEM. The results indicated that the decrease in strength enhancement of the concrete core due to confinement with increasing section slenderness was possibly underestimated by the material models that were used. The FEM results were also found to be negligibly sensitive to the explicit consideration of the spiral weld seam geometry with equivalent behaviour being predicted even when the spiral welded tubes were modelled as plain tubes.

Background: Genetic polymorphisms in the Endoplasmic reticulum aminopeptidase (ERAP) 2 gene has been attributed with the Ankylosing spondylitis (AS) etiopathogenesis. Here we assessed the association of ERAP2 gene single nucleotide polymorphisms (SNPs) with AS predisposition in Iranian patients and determined their effect on the inflammatory state of the patients.Methods: For genotyping of rs2548538, rs2287988, and rs17408150 SNPs using Real-time allelic discrimination approach, DNA was extracted from the whole blood of 250 AS patients and 250 healthy subjects. RNA of the peripheral blood mononuclear cells (PBMCs) was separated, cDNA was synthesized, and transcriptional levels of cytokines, including interleukin (IL)-17A, IL-23, IL-10, and transforming growth factor (TGF)-β were measured. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentration on the cytokines.Results: Three ERAP2 gene SNPs were not associated significantly with AS risk. Nonetheless, rs2287988 and rs17408150 SNPs showed statistically significant association with susceptibility to the disease in those AS subjects who were positive to Human leukocyte antigen (HLA)-B27. Transcriptional level and serum concentration of IL-17A and IL-23 were higher, while those of IL-10 were lower in both AS patients and HLA-B27 positive patient group relative to control group. Nevertheless, ERAP2 gene SNPs in the HLA-B27 positive AS patients did not affect the transcriptional level and serum concentration of cytokines.Conclusions: ERAP2 gene rs2287988 and rs17408150 SNP are associated with susceptibility to AS, but they probably are not determining the levels of IL-17A, IL-23, and IL-10 in this disease.

Background: The main objective of this study was to investigate the logics behind tendencies towards bottled drinking water usage in spite of availability of treated tap water. The amount of waste bottle is also estimated in Iran and managing principles for resolving the issue presented. Methods: A questionnaire was used to survey the logics behind tendencies toward bottled drinking water consumption among 120 participants. In order to estimate the quantities of the PET wastes produced in the country, data about bottled water production rate as well as volume of the imported and exported drinking bottled water were collected from 1962 to 2015 and applied in the calculations. Results: Findings suggested that about 0.026 to 3.86 billion liters (about 1.04 billion literson average) of bottled water was consumed annually between 2000 and 2015. Furthermore, bottled water consumption increased from 0.41 to 48.9 L/capita-year within the same time period. In the meantime, the plastic bottle waste generation rate rose from 12.84 to 1519.38 g/capita-year. There is no efficient and suitable system for managing and recycling waste bottles in the country. The perceived unreliability of tap water quality was the main reason of bottled water consumption among 74% of the respondents. Conclusion: To reduce bottled water consumption and the associated harmful environmental and health consequences, measures such as informing people, validating public water supply quality, preventive rules enactment, and establishing extended producer responsibility (EPR) are highly recommended.

Interleukin (IL)-33, a member of IL-1 cytokine family, is produced by various immune cells and acts as an alarm to alert the immune system after epithelial or endothelial cell damage during cell necrosis, infection, stress, and trauma. The biological functions of IL-33 largely depend on its ligation to the corresponding receptor, suppression of tumorigenicity 2 (ST2). The pathogenic roles of this cytokine have been implicated in several disorders, including allergic disease, cardiovascular disease, autoimmune disease, infectious disease, and cancers. However, alerted levels of IL-33 may result in either disease amelioration or progression. Genetic variations of

BACKGROUND: Evidence from various studies suggest that vitamin D receptor (VDR) gene polymorphisms are associated with type 2 diabetes (T2D); However, these results have been disputable. Here we conducted a meta-analysis to comprehensively evaluate the effect of VDR gene polymorphisms and susceptibility to T2D. METHODS: All relevant studies reporting the association between VDR gene polymorphisms and susceptibility to T2D published up to August 2020 were identified by comprehensive systematic database search in web of science, Scopus, and Medline. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to measure strength of association. The methodological quality of each study was assessed according to the Newcastle–Ottawa Scale. Subgroup and meta-regression analysis were also performed. RESULTS: A total of 47 case–control studies were included in this meta-analysis. The overall population results revealed a significant association between FokI, and BsmI (heterozygote model) polymorphisms and T2D in the overall analysis. However, no association was found with the TaqI and ApaI polymorphisms. Moreover, the pooled results of subgroup analysis by ethnicity suggested significant association between FokI, TaqI, and BsmI polymorphisms and T2D in some subgroups. Meta-regression analyses indicated that none of the publication year, ethnicity, and genotyping method were the source of heterogenicity in all four polymorphisms. CONCLUSIONS: This meta-analysis suggested a significant association between VDR gene FokI, and BsmI (heterozygote model) polymorphisms and T2D susceptibility in overall population and ethnic-specific analysis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-020-00704-z.

In novel coronavirus disease 2019 (COVID-19), the increased frequency and overactivation of T helper (Th) 17 cells and subsequent production of large amounts of proinflammatory cytokines result in hyperinflammation and disease progression. The current study aimed to investigate the therapeutic effects of nanocurcumin on the frequency and responses of Th17 cells in mild and severe COVID-19 patients. In this study, 40 severe COVID-19 intensive care unit-admitted patients and 40 patients in mild condition were included. The frequency of Th17 cells, the messenger RNA expression of Th17 cell-related factors (RAR-related orphan receptor I³t, interleukin [IL]-17, IL-21, IL-23, and granulocyte-macrophage colony-stimulating factor), and the serum levels of cytokines were measured in both nanocurcumin and placebo-treated groups before and after treatment. A significant decrease in the number of Th17 cells, downregulation of Th17 cell-related factors, and decreased levels of Th17 cell-related cytokines were found in mild and severe COVID-19 patients treated by nanocurcumin compared to the placebo group. Moreover, the abovementioned parameters were significantly decreased in the nanocurcumin-treated group after treatment versus before treatment. Curcumin could reduce the frequency of Th17 cells and their related inflammatory factors in both mild and severe COVID-19 patients. Hence, it could be considered as a potential modulatory compound in improving the patient's inflammatory condition.

Several studies have evaluated the association between killer-cell immunoglobulin-like receptors (KIR) genes and susceptibility risk to tuberculosis (TB) infection. Nonetheless, their outcomes have not been conclusive and consistent. Here we implemented a systematic review and meta-analysis of KIR genes association to susceptibility risk of pulmonary TB (PTB) infection to attain a clear understanding of the involvement of these genes in susceptibility to PTB infection. A systematic search was conducted in the MEDLINE/PubMed and Scopus databases to find case-control studies published before November 2020. Pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated to determine the association between KIR genes and risk of PTB infection. After comprehensive searching and implementing the inclusion and exclusion criteria, 10 case-control studies were included in the meta-analysis. Four KIR genes were found to have significant positive association with PTB susceptibility risk of infection, including 2DL3 (OR = 1.454, 95% CI = 1.157–1.827; P = 0.001), 2DS1 (OR = 1.481, 95% CI = 1.334–1.837; P

Background The prevalence of mental health disorders is increasing globally, and the prevalence of COVID-19 has made it worse. Evidence has indicated a major mental health burden and elevated anxiety associated with the new coronavirus outbreak in the general population. This study aims to evaluate an evidence-based web application (Naranj) for stress management among Iranian college students. Methods and design This study aims to present a protocol related to a randomized controlled trial among Iranian college students. The study will be conducted on 100 students from two colleges of Shiraz University of Medical Sciences in Iran. The participants will be randomly assigned to the intervention and control groups. The intervention group participants will be provided with a web application, whereas the control group ones will be provided with an app unrelated to stress management. The primary outcome for this study will be the Perceived Stress Scale, and the two groups will be compared with respect to stress level and sleep quality. Discussion A web application will be developed according to psychological theories and will be scientifically approved for managing college students’ stress and improving their sleep quality during the COVID-19 outbreak. Trial registration Iranian Registry of Clinical Trials IRCT20160427027647N2. Registered on 14 May 2020

Introduction: Identification and promotion of diagnostic methods has been a continuous effort to reduce disease and its complications and reduce costs associated with treatment. Despite all these efforts and improving our knowledge of diseases and diagnostic tools, pediatric appendicitis remains part of the diagnostic challenge in the surgical field. The aim of this is to compare the two diagnostic criteria of appendicitis (Children's Appendicitis Score [PAS] Versus Pediatric Appendicitis Score [CAS]) and evaluation of the diagnostic features of them. Methods: A retrospective cohort study was conducted on all children admitted to the hospital's emergency center with a possible diagnosis of appendicitis (270 patients) during 2018 and 2019 at Tabriz Pediatric Hospital. Based on the clinical examinations and para-clinical findings some of the patients were underwent the surgical intervention (220 cases) and some discharged and followed up for a period of 2 and 4 weeks later (50 cases). The data were analyzed through SPSS ver. 16 software. Results: The results of the present study indicated that if CAS was associated with ultrasound, the specificity of these criteria would improve and could be more acceptable compared with the PAS. In addition, it was revealed that WBC≥11000, as well as PMN≥65% and guarding were very specific for diagnosis and complication of acute appendicitis. There was a significant relationship between US findings and pathology reports (P

Aim Interventions based on adopting a healthy lifestyle have been less successful. The aim of this study was to investigate the effectiveness of healthy lifestyle interventions on weight gain in overweight pregnant women. Design A cluster randomized controlled trial. Methods Health centres were selected by simple random sampling; then, 66 overweight pregnant women were enrolled by convenience sampling and divided into intervention and comparison groups. Intervention group received individual nutritional counselling and physical activity training. The data were collected in several stages with the demographic and obstetric questionnaire, maternal weight record, food frequency and international physical activity questionnaire. Results Pregnancy weight gain‐4.75(CI 95%: −4.02, −5.48) was significantly lower in the intervention group (p

Environmental concerns related to fossil fuels utilization has developed different energy/environmental policy tools that Carbon tax is one of the important ones. There are huge debates among different political parties related to the positive and negative effects of the carbon tax on the energy and environmental policies of the countries. However, carbon tax not only can have effects on the utilization and consumption of energy sources portfolios, but it may also have negative or positive effects on the economy, industry, and social welfare of the countries that should be identified and analyzed, in particular for countries with high energy-intensive industries such as Finland. The purpose of this research is to answer the question: “How does Carbon Tax affect social welfare and emission reduction in Finland?” We use the computable general equilibrium model to analyze the impact of the carbon tax on social welfare and the rate of emission reduction. Considering the fact that Finland has several years of carbon tax policy application background, evaluation of the impact of this policy on Finland’s social-environmental structure is very valuable for other countries, especially newcomers. Our results show that despite carbon tax policy in Finland has been successful in the reduction of carbon dioxide emissions, however, it has negative effects on the social welfare of Finns. Therefore, an optimum level of the carbon price is recommended for future policy revision

MicroRNAs (miRNAs) are single-strand endogenous and non-coding RNA molecules with a length of about 22 nucleotides, which regulate genes expression, through modulating the translation and stability of their target mRNAs. miR-146a is one of the most studied miRNAs, due to its central role in immune system homeostasis and control of the innate and acquired immune responses. Accordingly, abnormal expression or function of miR-146a results in the incidence and progression of immune and non-immune inflammatory diseases. Its deregulated expression pattern and inefficient function have been reported in a wide spectrum of these illnesses. Based on the existing evidence, this miRNA qualifies as an ideal biomarker for diagnosis, prognosis, and activity evaluation of immune and non-immune inflammatory disorders. Moreover, much attention has recently been paid to therapeutic potential of miR-146a and several researchers have assessed the effects of different drugs on expression and function of this miRNA at diverse experimental, animal, besides human levels, reporting motivating results in the treatment of the diseases. Here, in this comprehensive review, we provide an overview of miR-146a role in the pathogenesis and progression of several immune and non-immune inflammatory diseases such as Rheumatoid arthritis, Systemic lupus erythematosus, Inflammatory bowel disease, Multiple sclerosis, Psoriasis, Graves' disease, Atherosclerosis, Hepatitis, Chronic obstructive pulmonary disease, etc., discuss about its eligibility for being a desirable biomarker for these disorders, and also highlight its therapeutic potential. Understanding these mechanisms underlies the selecting and designing the proper therapeutic targets and medications, which eventually facilitate the treatment process.

Anabolic androgens have been reported to be associated with cardiovascular complications. One study revealed that increase in vascular stiffness in bodybuilders is associated with anabolic androgens and improvement in vascular function may occur following anabolic androgens discontinuation. The aim of this study was to investigate any possible relation between aortic elastic properties and anabolic androgens. Study population was divided into 3 groups: Group-1 [n = 35] consisted of bodybuilders who denied any current or previous use of anabolic androgens. Group-2 [n = 18] was bodybuilders with regular using of anabolic androgens for at least 2 year prior to the start of our study. Group-3 was 13 healthy age-matched sedentary men as a control group. Cardiac echocardiography was performed in the bodybuilders and controls and indexes of aortic function were calculated. Aortic stiffness was approximately twofold higher in anabolic androgens user bodybuilders compared with drug-free bodybuilders [P

Aim The global obesity pandemic is a major health problem with adverse effects on physical and mental health. The aim of this study was to investigate the prevalence of obesity and the association between BMI and different aspects of lifestyle. Design A cross‐sectional study. Methods Data collected from 380 medical sciences students using demographic characteristics and Eating Behavior, Physical Activity and Perceived Stress Questionnaires were analysed using descriptive and inferential statistics, namely analysis of variance (ANOVA), t test, Pearson's test and multivariate linear regression model. Results The prevalence of obesity and overweight was 3.2% and 25.3%, respectively. There was a positive and significant statistical association between emotional eating (r = .542), extrinsic eating (r = .488) and perceived stress (r = .489) with BMI, also significant and an inverse association was obtained between emotional eating (r = −.488) and total physical activity score (r = −.394) with BMI. Factors such as sex, total physical activity score and leisure time activity, external eating behaviours, emotional eating, restricted eating and perceived stress had a significant role in explaining BMI changes. Conclusion There is a need to develop interventions to improve dietary behaviours, management stress and access to sports facilities by health‐promoting activities and the provision of online health resources.

The intrinsic brittleness of concrete in tension and shear is the principal reason for the weak performance of reinforced concrete (RC) connections under seismic loads. A viable way to overcome this challenge is the replacement of concrete in the joint area by Engineered Cementitious Composites (ECC) which typically show pseudo strain-hardening and multiple cracking behaviours. In the present study, at first, a finite element model to analyse RC/ECC connections is developed and validated by available experimental data. Then, the efficacy of using ECC in the joint area and the end part of the beam or column is investigated. The results show that the proposed model is acceptably able to predict the initial stiffness, the ultimate strength, and the cracking pattern of RC/ECC joints. By replacing ECC in the joint zone, the connection shows 27.5% and 52.6% increase in the ultimate strength and performance factor, respectively. Moreover, replacing concrete by ECC materials only in the vicinity of the joint zone is effective in enhancing the seismic performance of the connection. Although using ECC materials can enable one to reduce transverse reinforcements in the joint area, removing all stirrups in this area is not recommended when considering the results of this study.

Arsenic (As) is a toxic metalloid that can cause significant health issues through drinking water. The present study was aimed to evaluate As distribution and the related health risks from drinking groundwater in rural areas of Hashtroud, Iran. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were also applied to better explain relationship pattern between different resources. The samples were taken from 51 locations in 37 villages. Arsenic concentration was determined by a polarograph device, and the corresponding carcinogenic and non-carcinogenic health risks were calculated based on US Environmental Protection Agency (EPA) guideline. PCA analysis extracted four main components that explained nearly 62% of data variance. Results pointed severe As contamination in the studied area, where As was detected in 78% of the samples ranging from less than 0.001 to 0.250 mg/L. Forty percent of the contaminated places violated guideline value of 10 μg/L suggested by EPA and institute of standards and industrial research of Iran (ISIRI). Based on our findings, 1329 people including 239 children were living in the areas with higher As contamination. Hazard quotient (HQ) in 72%, 59%, and 33% of the samples was higher than one for children, adolescent, and adult age groups, respectively. Excess life time cancer risk (ELCR) in almost 80% of all age groups was significantly higher than EPA recommended guideline (10−4 or 10−6). In summary, from the view point of arsenic HQ and ELCR, water resources in the studied areas were not appropriate for drinking and hygienic purposes; necessary and urgent management strategies to guarantee water supply and health safety for local residents should be considered.

Background: Delayed bleeding after percutaneous nephrolithotomy (PCNL), which may occur within the first 3 weeks postoperatively, is a life-threatening complication that may result from arteriovenous fistula and arterial pseudoaneurysm. Angioembolization is the standard treatment when these patients develop hemodynamic instability despite conservative measures. Contrast hypersensitivity and renal insufficiency, however, contraindicate angiogram and subsequent embolization; in these patients, alternative methods such as the one described in this study may help in resolving the renal hemorrhage. Case Presentation: In this case series, we report the effective management of post-PCNL hemorrhage with nephroscopy and nephrostomy and drainage and tamponade because angioembolization was not feasible. Conclusion: Delayed bleeding after PCNL may be managed conservatively with nephrostomy drainage and tamponade when angioembolization is not feasible.

Background and aims Today, it has been shown that diabetes mellitus (DM) can affect male fertility. Glucose metabolism is a vital process in spermatogenesis that is impacted by diabetes condition. But the mechanisms by which DM causes male infertility are not wholly clarified. The aim of this review is to provide brief information about the influence of hyperglycemia on male fertility and specific emphasis on the molecular signaling pathway that is involved. Methods Broad literature search in the electronic database “Pubmed”, “Google Scholar”, the website of “World Health Organization” (WHO) and Control Disease and Prevention (CDC) took place. There was no time restriction. A key criterion for the selection of articles was English and language. Finally, one hundred thirty seven articles were included in the review. Results Diabetes mellitus affects many signaling pathways that involved in the spermatogenesis. It seems that increased ROS and oxidative stress in the diabetes is the beginning of all fertility problems and affects all of involved signaling pathways in the spermatogenesis. Conclusions It seems that there was strong interconnected between oxidative stress and all of involved signaling pathways in the reproductive problems in diabetes. So, approaches that diminish oxidative stress in the testis can be effective in improving diabetes related infertility complications.

In this paper, we propose a system model for cellular vehicle-to-everything (C-V2X) networks mode-3, with two user groups: cellular users and vehicular users. Cellular users communicate with each other through the base station (BS). Vehicular users communicate through direct vehicular links while sharing the spectrum of an orthogonal frequency division multiplexing (OFDM) system with cellular users. In particular, we focus on the underlay approach, in which vehicular users can transmit at the same time in a sub-carrier that is being used by a cellular user. Assuming a limited number of sub-carriers, the number of allowed vehicular links is limited by the quality of service (QoS) requirement for cellular users because of the interference from vehicular links. Our goal is to maximize the number of vehicular links while satisfying the QoS for cellular users. To achieve this goal, we state the optimization problem of resource allocation in C-V2X networks mode-3, assuming high mobility of vehicular users, which results in Doppler effect for them. We also assume that the global channel state information (CSI) of mobile links is not available for the BS. We propose a novel scheme for the BS to jointly allocate resources, such as power and sub-carriers, to cellular and vehicular users, while minimizing the number of non-allowed vehicular links, considering high data rate requirements for cellular users and high reliability requirements for vehicular users. Using numerical results, we obtain the maximum number of vehicular links that can be established for a given available bandwidth and cellular user distribution.

Background The currently available data with respect to the association between vitamin D receptor (VDR) gene polymorphism and risk to urolithiasis are inconclusive and inconsistent. Hence, an exhaustive meta-analysis can solve the discrepancies and provide a hint for upcoming investigations. Herein, a meta-analysis was carried out to attain a conclusive estimate of the association between VDR gene single nucleotide polymorphisms (SNPs) and urolithiasis risk. Methods The major databases, including ISI Web of science, Scopus, and PubMed/MEDLINE were searched systematically from until June 2020 to retrieve all relevant studies. Association between VDR gene polymorphisms, including FokI (rs2228570), TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232), and urolithiasis risk was evaluated using pooled odds ratio (OR) and their corresponding 95% confidence interval (CI). Additionally, to seek for the potential source of heterogeneity, meta-regression analyses were exerted. Results Literature search led to finally finding of 33 studies evaluating the VDR gene SNPs and urolithiasis risk. It was observed that none of the four SNPs were significantly associated with urolithiasis predisposition. However, subgroup analysis confirmed higher risk of urolithiasis in East-Asian and Caucasian population with ApaI and TaqI gene polymorphism. The analyses of sensitivity acknowledged the results stability. Conclusion Although this meta-analysis did not support the association of FokI, TaqI, BsmI, and ApaI in the overall polled analysis, it suggests that ApaI and TaqI SNPs is associated with increased risk of urolithiasis in East-Asian and Caucasians populations.

In modern medicine, natural products have aided humans against their battles with cancer. Among these products, microorganisms, medicinal herbs and marine organisms are considered to be of great benefit. In recent decades, more than 30 fungal immunity proteins have been identified and proved to be extractable from a wide range of fungi, including mushrooms. Although chemotherapy is used to overcome cancer cells, the side effects of this method are of great concern in clinical practice. Fungal products and their derivatives constitute more than 50% of the clinical drugs currently being used globally. Approximately 60% of the clinically approved drugs for cancer treatment have natural roots. Anti-tumor immunotherapy is prospective with a rapidly growing market worldwide due to its high efficiency, immunity, and profit. Polysaccharide extracts from natural sources are being used in clinical and therapeutic trials on cancer patients. This review aims to present the latest findings in cancer treatment through isolated and extraction of fungal derivatives and other natural biomaterials.

Background Indications and diagnostic yield of small-bowel video capsule endoscopy (SB-VCE) are communicated in recent clinical academic guidelines. However, guidelines are based mainly on relatively few, small, selection-biased studies at experienced centers, and thus we lack information on indications and diagnostic yield of SB-VCE in the real-world community setting. The aim of the study was to evaluate indications and diagnostic yield of SB-VCE in the real-world community setting. Methods Our local VCE clinical database was used to identify patients undergoing SB-VCE procedures over a 7-year period (2011–2018). Patients were broadly referred and underwent SB-VCE using PillCam™ SB 2 and SB 3 capsule systems. Procedures were reviewed by local endoscopists, who had undergone similar formal SB-VCE review training. Medical reports of the procedures were composed as such. We retrospectively reviewed all reports and gathered data regarding indications and findings. Diagnostic yield was considered positive if SB-VCE visualized any type of clinically significant pathological finding. Results 536 SB-VCE procedures in 516 patients were included in final assessment. Patient mean (± SD) age was 50 ± 20 years with approximately even female/male ratio (275:241). The overall proportion of positive findings was 42% (225/536). The two main indications were obscure gastrointestinal bleeding (occult/anemia or overt/active, OGIB) of 46% (246/536) and definite/suspected Crohn’s disease (CD) of 39% (210/536). Positive SB-VCE findings were obtained in 44% (108/246) of procedures with indication of OGIB and in 50% (104/210) of procedures with indication of CD. Conclusions The indications for SB-VCE are largely consistent with guidelines but with an apparently relatively low diagnostic yield in our real-world community setting.

Objective: Adipolin/C1q/TNF-related protein-12 is a family of CTRPs highly expressed in adipose tissue with glucose-lowering and anti-inflammatory effects. Various risk factors have been suggested in the incidence of cardiovascular diseases, such as a decrease in anti-inflammatory or an increase in inflammatory factors. The purpose of the present study was to investigate the correlation of adipolin with anthropometric, angiographic, echocardiographic, and biochemical parameters. Subject and Methods: A total of 90 patients who were candidates for angiography were included in the study and divided into 3 groups: 30 patients with acute myocardial infarction (AMI), 30 patients with stable angina pectoris (SAP), and 30 subjects as a control group with a history of chest pain but normal angiography. Anthropometric, angiographic, echocardiographic, and biochemical parameters were measured in all subjects. Results: Serum adipolin levels were significantly decreased in patients with AMI compared with the SAP and control groups (p < 0.001 for both). In addition, there was a negative association between serum levels of adipolin and epicardial fat thickness (EFT) and Gensini score in CAD patients. The results of multivariate linear regression analysis revealed that EFT values were independently associated with serum adipolin levels. Conclusion: The current study showed an independent association of adipolin with EFT for the first time in patients with AMI. Decreased adipolin levels in patients with AMI may be involved in the process of atherosclerosis, which requires further study.

Background Several studies have reported the association between polymorphisms in Matrix metalloproteinases (MMPs) gene family and risk of Multiple sclerosis (MS). However, the results have been inconsistent and inconclusive. To resolve this issue, here we performed a systematic review and meta-analysis of the MMP-91562 C/T (rs3918242), MMP-3 (− 1612 5A/6A), and MMP-2 (− 1306 C/T) polymorphisms and susceptibility to MS. Methods We conducted a comprehensive systematic search in the major electronic database, including Scopus and PubMed to look up for relevant studies published before December 2019 that surveyed the association between the MMP-91562 C/T (rs3918242), MMP-3 (− 1612 5A/6A), and MMP-2 (− 1306 C/T) polymorphisms and susceptibility to MS. The level of association between the polymorphisms and susceptibility to MS in the polled analysis was determined by calculating the odds ratio (OR) and the corresponding 95% confidence interval (CI). Results We found 15 studies containing 2430 MS subjects and 2304 controls. A statistically significant association was observed in the all five comparisons of the MMP-91562 C/T polymorphism and MS risk as follows: dominant model (OR = 1.62, 95% CI = 1.03–2.53, P = 0.03), recessive model (OR = 2.69, 95% CI = 1.68–4.29, P P = 0.04), TT vs. CC model (OR = 3.20, 95% CI = 1.87–5.46, P P = 0.04). Conclusions Our meta-analysis revealed significant association of MMP-9 (− 1562 C/T) Single-nucleotide polymorphism (SNP) with MS susceptibility that increased the disease risk.

Background/aim The serum fatty acid binding protein 4 (FABP-4) level increases in chronic inflammatory diseases. The present study aimed to examine serum FABP-4 and interleukin (IL)-6 levels in patients with stable and acute exacerbation of chronic obstructive pulmonary disease (COPD) and the correlation of these markers with airflow limitation. Materials and methodsS We measured serum FABP-4 and IL-6 levels in 60 COPD patients [30 stable COPD (SCOPD), and 30 acute exacerbation of COPD (AECOPD)], and 30 healthy subjects and compared them with airflow limitation according to the COPD stage in the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) criteria, peripheral O2 saturation (SpO2), and COPD Assessment Test (CAT) score. We also tested the association between serum FABP-4 levels and some characteristics of study parameters. Results Both serum FABP-4 and IL-6 levels increased with increasing severity of GOLD grades in SCOPD (P < 0.01 for both) and AECOPD groups (P < 0.001 and P < 0.01, respectively). It also increased in patients with AECOPD group compared with SCOPD group in GOLD grades I-II (P < 0.01) and GOLD grades III-IV (P < 0.05). In addition, there was a significant positive correlation between serum FABP-4 level with IL-6, CAT score, and smoking history and inversely with FEV1 and SpO2. Conclusion The study revealed that serum FABP-4 level was elevated with increasing GOLD grades in COPD patients, markedly in acute exacerbation phase. The increase was associated with elevated serum levels of IL-6 and severity of hypoxia. Thus, it seems that FABP-4 may be involved in the pathogenesis of COPD.

Context Although etiopathogenesis of frontal fibrosing alopecia (FFA) is not fully discovered, it seems that hormonal factors play a role. Aims The aim of this study was to investigate the serum level of sex hormones in patients with FFA compared to a control group. Settings and design This was a case-control study. Subjects and methods All patients who referred to the Dermatology Clinic of Faghihi Hospital, Shiraz University of Medical Sciences, between 2013 and 2018 and were pathologically and clinically diagnosed with FFA were considered as the case group. The control group was selected from community people who did not have alopecia, and each was matched with its counterpart in the case group in terms of gender, age, and menstrual status. Both the groups were evaluated for serum level of sex hormones. Statistical analysis used SPSS software version 23 was used in this study. Results Of 20 patients, who were all female, 8 were postmenopausal and 12 were cyclic. There was no significant difference between sex hormone levels of the case and control groups regardless of their menstrual statuses. Similarly, there was no significant difference between hormonal levels in postmenopausal women of both the groups. However, follicle-stimulating hormone (FSH) was significantly lower in the case group cyclic women. Moreover, postmenopausal patients with premenopausal onset of FFA had lower levels of FSH and luteinizing hormone than those with postmenopausal onset. Free testosterone correlated inversely with duration of FFA. Conclusions It seems that the pathogenesis of FFA is not associated directly with serum concentrations of sex hormones. Therefore, future studies are recommended to investigate possible tissue mechanisms of hormonal factors involved in its pathogenesis.

Background: Regarding the leukocytes infiltration into the synovium of Rheumatoid Arthritis (RA) patients is mostly mediated by chemokine ligands and receptors, and following the efficient and motivating results of international Phase III clinical trial of β-D-Mannuronic acid (M2000) patented EP067919 (2017), as a novel anti-inflammatory drug, in patients with RA, the present research was designed. Objectives: This study aimed to assess the oral administration effects of this new drug on gene expression of some chemokine receptors and ligands, including CXCR4, CXCR3, CCR2, CCR5 and CCL2/MCP-1 in PBMCs of patients with active form of RA. Methods: Twelve patients suffering from RA, with inadequate response to conventional drugs were selected (Clinical trial identifier IRCT2017100213739N10) and 1000mg/day of M2000 was orally administrated to them for 12 weeks. The mRNA expression of target molecules was then evaluated in PBMCs of the patients before and after treatment with M2000 using real-time PCR and was compared to healthy controls. Patents related to this study were also reviewed. Results: The results showed that M2000 was able to significantly down-regulate the mRNA expression of CXCR4, CCR2 and CCL2/MCP-1 in the PBMCs of the RA patients. It should be noted that the gene expression situation of the target molecules was in coordinate with the clinical and paraclinical assessments in the patients. Conclusion: Taken together, the results of this investigation revealed the part of molecular and immunological mechanisms of drug Mannuronic acid (M2000) in the treatment of RA, based on chemokine ligands and receptors mediated processes.