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Abstract Background Pediatric cow milk allergies (CMA) can occur in immunoglobulin (Ig) E and non-IgE-mediated forms. Unlike IgE-mediated allergies, the mechanisms of disease pathogenesis in non-IgE-mediated food allergy and an association with microbiome has not been well established. Previous studies have identified the presence of altered humoral responses to gut bacteria in IgE mediated allergies. Here, we analyzed IgA, IgE and IgG responses to gut bacteria in subjects with either IgE or non-IgE mediated CMA to identify relative proportions of Ig-coated bacteria and characterize unique disease specific microbial signatures. Methods Multi-parametric flow cytometry analysis was used to identify IgA, IgE and IgG responses to gut bacteria in CMA patients. Cell sorting of Ig coated gut bacteria was subsequently performed followed by high throughput 16S rRNA gene sequencing and specific patterns of humoral responses to gut bacteria assessed in each study group. Results We identified significant alterations in IgA and IgG gut bacterial coating patterns in CMA subjects. Proportions of IgA-coated bacteria were decreased in IgE mediated CMA subjects without atopic dermatitis (ALL) and non-IgE mediated CMA subjects (ENP), compared to healthy controls (CON). In comparison, IgG-coated bacteria was significantly elevated in CMA subjects with atopic dermatitis (AD). Alpha and beta diversities displayed significant differences in IgA-, IgE-, and IgG-coated bacteria in AD and ENP groups. Significant differences in bacteria coated by IgA, IgE and IgG were detected at Phyla, Genus and Species levels and associated bacterial dysbiosis in IgE and non-IgE mediated allergies were identified. Linear discriminant analysis (LDA) effect size (LEFse) revealed unique disease associated bacterial signatures, including several pathogenic bacteria namely Bacteroides fragilis, Ruminococcus gnavus, Eubacterium dolichum, Fusobacterium, Clostridium neonatale and Robinsoniella peoriensis. Receiver operating characteristic curve analysis confirmed the efficiency of using the bacterial signatures identified as biomarkers for disease. Conclusions Altered IgA and IgG responses to gut bacteria were identified in CMA subjects. The disease-specific responses were associated with alterations in bacterial diversity and concomitant dysbiosis of Ig-coated bacteria in IgE-mediated and non-IgE-mediated CMA pediatric subjects. The identification of pathogenic bacteria uniquely associated with different classes of allergic disease indicates a role of these bacteria in driving disease-specific pathological phenotypes.

Metabolic health is highly dependent on intestinal and hepatic handling of dietary and endogenous lipids and lipoproteins. Disorders of lipid and lipoprotein metabolism are commonly observed in patients with insulin resistant states such as obesity, metabolic syndrome, and type 2 diabetes. Evidence from both animal models and human studies indicates that a major underlying factor in metabolic or diabetic dyslipidemia is the overproduction of hepatic and intestinal apolipoprotein (apo)B-containing lipoprotein particles. These particles are catabolized down into highly proatherogenic remnants, which can be taken up into the arterial intima and promote plaque development. Several gut-derived peptides have been identified as key regulators of energy metabolism; one such peptide is the incretin hormone glucagon-like peptide (GLP)-1. Our laboratory has previously demonstrated that GLP-1 can signal both centrally and peripherally to reduce postprandial and fasting lipoprotein secretion. Moreover, we have demonstrated that GLP-1 receptor (GLP-1R) agonists can ameliorate diet-induced dyslipidemia. Recently, we published evidence for a novel vagal neuroendocrine signalling pathway by which native GLP-1 may exert its anti-lipemic effects. Furthermore, we demonstrated a novel role for other gut-derived peptides in regulating intestinal lipoprotein production. Overall, ample evidence supports a key role for GLP-1R on the portal vein afferent neurons and nodose ganglion in modulating intestinal fat absorption and lipoprotein production and identifies other gut-derived peptides as novel regulators of postprandial lipemia. Insights from these data may support identification of potential drug targets and the development of new therapeutics targeting treatment of diabetic dyslipidemia.

Abstract The construction of covalent organic frameworks with special geometery and optical properties is of high interest, due to their unique physicochemical and biological properties. In this work, we report on a new method for the construction of triazine frameworks with defined topologies using coordination chemistry. Ball milling and wet chemical reactions between cyanuric chloride and melamine were directed in spatial arrangements and opposite optical activity. Cobalt was used as a directing agent to drive reactions into special morphologies, optical properties and biological activity. The enantiorecognition ability of triazine frameworks that was manifested in their activities against bacteria, demonstrated a new way for the construction of materials with specific interactions at biointerfaces.

Objective(s): Genital warts, in addition to being important as a sexually transmitted disease, can alter the emotional support of affected women and threaten couples' emotional relationships. This study was designed with a qualitative approach to investigate the challenges of emotional support for women with genital warts. Methods: The present qualitative study was performed from January 2019 to February 2020 in the dermatology clinic of Razi Hospital in Tehran, Iran, with purposive sampling of 16 women with genital warts. Data were collected through unstructured interviews and analyzed using conventional content analysis approach. Results: After data analysis, a total of 182 codes, 8 subcategories, 3 main categories and 1 theme were obtained. The theme namely "Emotional Support Challenges" included the three main categories of "emotional relationship change", "disclosing the disease to seek support" and "worry for labeling and judgment". Conclusion: The results of the present study showed the challenges of emotional support for women after contracting genital warts. After contracting genital warts, women experienced emotional deterioration. However, receiving emotional support from family members or friends instead of their partner accompanied by the worry of being judged and stigmatization.

Background: Patients who have recovered from COVID-19 suffer from lasting symptoms such as numerous physical and mental disorders. It seems that these conditions can disturb the activities of daily living. Therefore, the aim of this study was to compare fatigue, quality of life and pulmonary function in recovered COVID-19 patients and healthy individuals. Materials and Methods: This experimental study was conducted on 25 recovered COVID-19 patients, discharged from Qom hospitals, Iran, in 2022, and 25 healthy people. The inclusion criteria for healthy people were a negative PCR test result and the age range of 35 to 59 years, and for recovered COVID-19 patients were at least one week of hospitalization due to COVID-19. Fatigue severity was assessed using the Fatigue Severity Questionnaire (FSS), quality of life through 36-question questionnaire (Sf-36) and pulmonary function through spirometry. The comparison of the mean data of the two groups was done using Mann-Whitney U test and independent t-test by SPSS-27 software. Results: Factors including fatigue (P0.001), physical health (P

Abstract Purpose Diabetes is the leading cause of kidney disease. Up to 40% of the population with diabetes experience diabetic kidney disease (DKD). The correlation of DKD with insulin resistance (IR) indices has been shown in previous studies. In this study, the objective was to evaluate surrogate IR indices, including the Triglyceride-Glucose (TyG) index, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to find the most valuable index for the correlation between albuminuria and IR in the type 2 diabetes (T2D) population. Albuminuria is defined as urine albumin excretion of > 30 mg/day. Methods In this cross-sectional study, 2934 participants were enrolled and evaluated for urinary albumin excretion, and albuminuria was detected in 526 of the entries. The logistic regression models and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the relationship of TyG index, VAI, LAP, and HOMA-IR's with albuminuria in patients with T2D. Results The TyG index had the highest association (OR 1.67) with the presence of albuminuria in patients with T2D, followed by HOMA-IR (OR 1.127), VAI (OR 1.028), and LAP (OR 1.004). These four indices remained independent after adjustment for multiple confounders. Based on the ROC curve, TyG revealed the best area under the curve (AUC) for revealing albuminuria with sufficient accuracy (AUC: 0.62) in comparison with other measured indices. The calculated TyG index cut-off point for the presence of albuminuria was 9.39. Conclusion Among the indices, TyG index had the most significant correlation with albuminuria in patients with T2D.

Objective To compare comorbidities, symptoms and end-of-life (EoL) palliative medication (antisecretories, opioids, antipsychotics and sedatives) use among decedents before and during the COVID-19 pandemic.Design In a retrospective cohort study, decedent records in three acute care hospitals were abstracted, generating a prepandemic (November 2019–February 2020) group (pre-COVID) and two intrapandemic (March–August 2020, wave 1) groups, one without (COVID-ve) and one with COVID-19 infection (COVID+ve). Control group decedents were matched 2:1 on age, sex and care service (medicine/intensive care unit (ICU)) with COVID+ve decedents.Setting Three regional acute care teaching hospitals in Ottawa, CanadaParticipants Decedents (N=425): COVID+ve (n=85), COVID-ve (n=170) and pre-COVID (n=170).Main outcome measures Data were abstracted regarding demographics, admission comorbidities and symptoms, and EoL medication use; opioid doses were standardised to parenteral morphine equivalent daily dose (MEDD), and the predictors of upper quartile MEDD in the last 24 hours of life were examined in multivariable logistic regression with adjusted ORs (aORs) and 95% CIs.Results The prevalence of dementia (41% vs 28% and 26%, p=0.03), breathlessness (63.5% vs 42% and 47%, p

Objective(s): One of the important interactions in controlling the human immune system is the reaction between checkpoint proteins such as programmed cell death-1 (PD-1) and its ligand, PD-L1. These are negative immunoregulatory molecules that promote immune evasion of tumor cells. PD-L1 expression is an immune-mediated mechanism used by various malignant cells in order to down-regulate the immune system. Checkpoint inhibitors (CPIs) are a new class of anti-cancer agents that stimulate immune cells to elicit an antitumor response by blocking the ligand and receptor interactions. Nanobody (Nb) as a new type of antibody fragment, has some potential as CPI.Materials and Methods: A female camel was immunized with recombinant PD-L1 protein, nanobody library was constructed and PD-L1 specific Nb was selected. The selected Nb was characterized in terms of affinity, specificity, and binding potency in ELISA, Western blotting, and flow cytometry. Results: Developed nanobody, A22 binds to its cognate target with high specificity and affinity. Western blot and flow cytometry techniques showed that nanobody A22 was able to specifically detect and attach to human PD-L1 protein on the cell surface and in the cell lysate. MTT assay showed the inhibitory effect of PD-L1 by specific Nb on A431 and HEK293 cells, with no cytotoxic effect on cell growth.Conclusion: The results highlighted the potential of anti-PD-L1 Nb as a novel therapeutic in cancer therapy without undesirable cytotoxicity.

Objective: Conditional valuation method is one of the methods of estimating the willingness to pay and is a cost-benefit analysis. The aim of the present study was to estimate the average willingness of individuals to pay for the Covid-19 vaccine with a one-year and long-term protection period and to assess its contributing factors. Methods: The present study was a descriptive research. The required data were collected from 370 two-dimensional online questionnaires at the end of November 2020 from Iranians. Conditional valuation method and logit model were used to estimate peoples’ willingness to pay. Results: The results showed that 65.67 percent of people are willing to pay for the vaccine. The household income, age, history of having chronic disease, history of Covid-19, attitude, recommended amount and having an elderly person in the family had a positive and significant effect on long-term vaccination and age, household income, history of having chronic disease, attitude and the amount offered had a positive and significant effect on annual vaccination. Also, the average willingness to pay was 3,750,000 Rials per person for long-term vaccination, and 1,130,000 Rials per year. Conclusion: In conditional valuation studies, individuals typically offer a lower bid for the policy under study. However, this study indicated that people are willing to pay more for vaccinations. The findings might have some implications for policy and planning.

Introduction: Human Immunodeficiency Virus infection is a prevalent infection occurring during pregnancy. The implementation of a program to screen and prevent vertical transmission is highly important in Public Healthcare. Pregnant crack users could face difficulties to test and adhere to the Highly Active Antiretroviral Therapy. Objective: The purpose of this research paper was to investigate whether crack cocaine abuse increases Human Immunodeficiency Virus perinatal transmission rates, as well as to evaluate the risk factors associated with such an increase. Methods: Design: A retrospective study. Setting: Department of Obstetrics and Gynecology, General Hospital of Universidade Federal do Paraná. Population: pregnancies of Human Immunodeficiency Virus-positive women who were using crack cocaine (n=64) were compared with that of non-users (n=826) from 2005 to 2013. Prenatal medical records, delivery records, and newborn records were analyzed. Main Outcome Measures: The vertical transmission of Human Immunodeficiency Virus in the group of crack cocaine users was 9.37% (6) versus 2.54% (21) among non-users (p=0.009744). Results: Over the years of the study, there was a decrease in the vertical transmission rate in non-users, while this number remained constant in the group of users. When analyzing the cases of perinatal transmission, it was found that 83.34% (5) had inadequate prenatal care, and 100% (6) had inadequate Human Immunodeficiency Virus treatment, compared to the group in which there was no vertical transmission, where 65.52% (38) had inadequate prenatal care and 70.86% (41) had inadequate treatment. Conclusion: Vertical transmission is higher among crack cocaine users and did not decrease over the years of the study, as occurred among non-users. Trends that explain this increase were non-adherence to adequate prenatal care, Human Immunodeficiency Virus diagnosis during pregnancy, irregular treatment, absence of intrapartum antiretroviral prophylaxis, and vaginal delivery route.

Abstract Paroxysmal dysarthria and ataxia (PDA) is a rare neurological manifestation of stereotyped attacks of sudden ataxic symptoms lasts for few seconds to minutes. We report a case of PDA in a 61‐year‐old male with a solitary homogenously enhancing solitary midbrain lesion and positive HLA‐B51 (Allele 2), controlled with lacosamide.

Abstract. Limited studies correlate allergic symptoms and associated outdoor biological particle exposure among schoolchildren globally. This study aimed to investigate the relationship between the seasonality of symptoms of allergic diseases among middle schoolchildren and the annual variation of airborne pollen and fungal spore in a hot and humid geographical region (Qatar). During November 2017 to January 2018, a self-reported study of middle schoolchildren living in the Doha capital city of Qatar was conducted, and data gathered were evaluated in relation to the collected monthly pollen and fungal spores. Participants’ data were collected by conducting a survey based on a modified questionnaire adopted from the International Study of Asthma and Allergy in Childhood (ISAAC). The airborne pollen and fungal spore in Doha's atmosphere were extracted from the Doha aerobiology project (2017–2020). Among the 1000 distributed questionnaires, 100 were excluded due to significant missing data and 644 middle schoolchildren living in Doha city responded and were included in the final analysis. The symptoms of allergic rhinitis (AR) pattern among the responders with positive symptoms were strongly linked with the higher airborne fungal spore incidence during the month of November. Out of 331 students with positive symptoms, the prevalence of AR, lifetime wheeze, and eczema was 62.8%, 28.1%, and 26.6%, respectively. Asthma was significantly higher in Qatari (39.8%) compared to non-Qatari (26.7%) middle schoolchildren (P = .02). Outdoor aeroallergen may be a contributing factor in addition to other environmental and genetic predisposing factors for childhood atopic diseases in the prevalence rate of allergic symptoms among middle schoolchildren in the peninsula of Qatar.

Objective To explore the role of student research training program(SRTP) in improving the scientific research interest, basic knowledge and basic ability of undergraduate-master's consecutive medical students. Methods A questionnaire survey was conducted among 69 medical students who were in the 2015 and 2016 clinical programs. They participated in and completed SRTP. And some situations was statistic analysis including students' SRTP team formation, project implementation, satisfaction, and academic results(published papers). Results 85% of the project direction was to be completed independently by the project team members under the guidance of the mentor.The comprehensive scientific research ability of students at the later stage of the project was obviously higher than the beginning of the project.More than 85% of students were satisfied with the completion of the SRTP course. SRTP had a significant improvement in students' scientific research thinking, communication and collaboration ability, experimental habits, and learning ability. There were shortcomings such as low student publications and low quality. Conclusions SRTP can be used as a pre-cultivation link for the improvement of scientific research ability of undergraduate-master's consecutive medical students. It plays a bridge role of scientific research ability in continuous cultivation of undergraduate-master degree, and which has important reference value for talent training in medical universities.

BackgroundThe increasing number of aerobiological stations empower comparative studies to determine the relationship between pollen concentrations in different localities and the appropriate distance, which should be established between sampling stations. In Qatar, this is basically the first aerobiological study for a continuous monitoring interval.ObjectivesThe study aimed to assess the abundance and seasonality of the most prevalent pollen types, plus identify potential differences between two sites within the country.MethodsAirborne pollen data were collected during 2017-2020 by using Hirst-type volumetric samplers in Doha capital city and Al Khor city in Qatar, placed 50 km apart.ResultsHigher total pollen indexes were recorded in the Al Khor station (2931 pollen * day/m3) compared to the Doha station (1618 pollen * day/m3). Comparing the pollen spectrum between the sampling stations revealed that ten pollen types were found in common. Amaranthaceae and Poaceae airborne pollen constituted 73.5% and 70.9% of the total amount of pollen detected at the samplers of Al Khor station and Doha station. In both sampling sites, a very pronounced seasonality was shown; August-October appeared as the period with the most intense incidence of atmospheric herbaceous pollen, with 71% and 51% of the annual total counts in Al Khor and Doha stations, respectively. August (Al Khor, 21%; Doha, 9%), September (Al Khor, 33%; Doha, 26%), October (Al Khor, 17%; Doha, 16%) were the months in which the herbs pollen concentrations were highest. Significant statistical differences between the two stations were observed in specific pollen types with local distribution in each trap's vicinity.ConclusionsComparison of data obtained by the two samplers running at a distance of 50 Km indicated that potential inter-site differences could be attributed to the vegetation surrounding the city having a decisive influence on data collected.

Abstract Due to SARS‐COV‐2 (COVID‐19) pandemic and its catastrophic impact on society, the FDA granted emergency use authorization for some vaccines. Possible rare side effects could not have been observed in this relatively short period. We are reporting an elderly lady with multiple comorbidities who presented with progressive lower limb weakness that started seven days after receiving the first dose of the COVID‐19 vaccine. The electrodiagnostic study showed demyelinating polyneuropathy with secondary axonal degeneration consistent with Guillain–Barré syndrome. We ruled out other possible causes for GBS, suggesting a postvaccine nature for her presentation. The patient received intravenous immunoglobulin (IVIG) for five days and gradually improved, which supports our initial diagnosis.

Background: Radial artery spasm (RAS) is one of the most common complications of radial coronary angiography. Several demographic and clinical factors increase the risk of RAS in this procedure. We aimed to evaluate the effect of various risk factors on the incidence and severity of RAS in radial coronary angiography. Methods: This cross-sectional study was performed on 120 patients who were randomly selected from candidates referred to Shahid Modarres Educational Medical Center for coronary angiography by the radial method. After angiography, radial arteriography was performed to diagnose spasms. The association of some demographic and clinical factors with the incidence and severity of RAS was evaluated. Results: 35 of the 120 patients (29.16%) developed RAS during angiography. Shorter height, shorter radius bone length, less radial artery diameter, longer procedure length, diabetes mellitus, more catheters used, and female sex were significantly associated with higher incidence. The predictive power of these factors for the occurrence of spasms was very good with AUC=0.88. Age, shorter height, higher body mass index, smaller radial artery diameter, longer procedure time, diabetes mellitus, failure of initial effort for puncture, number of catheters used, and female sex were significantly associated with the severity of spasms. Conclusions: The incidence or severity of spasms during the procedure can be reduced by examining the available risk factors for every patient before deciding to perform angiography.

Background: Radial artery spasm (RAS) is one of the most common complications of radial coronary angiography. Several demographic and clinical factors increase the risk of RAS in this procedure. We aimed to evaluate the effect of various risk factors on the incidence and severity of RAS in radial coronary angiography. Methods: This cross-sectional study was performed on 120 patients who were randomly selected from candidates referred to Shahid Modarres Educational Medical Center for coronary angiography by the radial method. After angiography, radial arteriography was performed to diagnose spasms. The association of some demographic and clinical factors with the incidence and severity of RAS was evaluated. Results: 35 of the 120 patients (29.16%) developed RAS during angiography. Shorter height, shorter radius bone length, less radial artery diameter, longer procedure length, diabetes mellitus, more catheters used, and female sex were significantly associated with higher incidence. The predictive power of these factors for the occurrence of spasms was very good with AUC=0.88. Age, shorter height, higher body mass index, smaller radial artery diameter, longer procedure time, diabetes mellitus, failure of initial effort for puncture, number of catheters used, and female sex were significantly associated with the severity of spasms. Conclusions: The incidence or severity of spasms during the procedure can be reduced by examining the available risk factors for every patient before deciding to perform angiography.

Abstract Owing to autoantibody production and thrombophilic disorders in COVID‐19, physicians must have low threshold to investigate secondary IIH and demyelinating disorders in patients with headache and decreased vision following recent COVID‐19 infection.

The Need to Update Respiratory Disease Surveillance System and Indigenization of the Pneumonia of Unknown Cause Surveillance System in Iran according to the COVID-19 Pandemic Seyed Hasan Adeli1, Mohammad Aghaali2 1 Associate Professor, Department of Internal Medicine, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran 2 Assistant Professor, Department of Epidemiology, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran dr.aghaali@yahoo.com E-mail: letter to Editor .

Objectives: Ischemic heart disease is the principal cause of mortality worldwide. Using natural strategies to prevent this disease is very important. Therefore, the current study aimed to evaluate the combined effects of the cinnamon extract and aerobic exercise on oxidative stress following myocardial ischemia/reperfusion (I/R) injury. Materials and Methods: Male Wistar rats weighing 250-300 g were randomly divided into 4 groups (6 rats each) including control, cinnamon extract, aerobic exercise, and a combination of cinnamon and exercise. The aerobic exercise was performed on a treadmill and the cinnamon extract was administered by gavage for a month. In addition, the isolated hearts of the rats received global ischemia (30 minutes) and reperfusion (60 minutes) in order to induce I/R injury. Lactate dehydrogenase (the indicator of tissue damage), the marker of lipid peroxidation (malondialdehyde), and antioxidative enzymes (i.e., superoxide-dismutase and glutathione-peroxidase) were measured with specific kits and spectrophotometric methods on samples obtained from the ischemic tissues. Results: Based on the results, lactate dehydrogenase level significantly decreased in the group receiving a combination of cinnamon and aerobic exercise compared to the control group (P

Asthma exacerbation can be a major life threatening event. Viruses have been pinned as the cause behind the vast majority of these exacerbations. The purpose of this short review is to explore the mechanisms behind these exacerbations, focusing mostly on viral infections as triggers. We will also be discussing the phenotypes prone to asthma exacerbation, the pathophysiology of viral induced asthma and ventilation patterns of asthmatic lungs. This manuscript will assist primary care physicians in delineating the proper pathophysiology of the disease as well as the management.

OBJECTIVE:To assess the effects of workplace exposure to hardwood dust on lung function and determine a prevalence of respiratory symptoms among wood workers. STUDY DESIGN:Cross-sectional observational study. SETTING:Tertiary referral center. SUBJECTS AND METHODS:Two hundred seventy-six, non-smoker male wood workers and equal number of non-smoker male office workers, referred to pulmonology clinic included in this study. Evaluation of study participants included completion of a questionnaire regarding respiratory symptoms and baseline spirometry was measured according to the actual recommendations. RESULTS:Respiratory symptoms including cough, phlegm, chest tightness, and wheezing were significantly higher in wood workers than office workers (40.2% versus 29.3% for cough, p = 0.0073; 40.6% versus 23.6% for phlegm, p

BACKGROUND AND OBJECTIVE: Kangaroo skin contact is an important factor in breastfeeding. However, in contrast to abdominal contact, it is considered timely. Therefore, while shortening the contact time, this study aims at comparing the effects of short abdominal skin-to-skin contact and Kangaroo skin contact on successful breastfeeding. METHODS: This clinical trial study was conducted among pregnant women in maternity hospitals of Torbat Heydarieh in 2015. Sixty-eight primigravida women with term pregnancy and aged 18-40 years were selected through convenience sampling and were divided into two groups of intervention (Kangaroo skin contact) and control (abdominal skin contact). Questionnaires about demographic, fertility and medical data were completed for both groups. Infants with 8-10 Apgar and birth weight of 2500 – 4000 g were exposed to Kangaroo skin and abdominal skin contact for 5-10 minutes. After delivery, The Infant Breastfeeding Assessment Tool (IBFAT) was completed and the mean values of feeding desire, searching, latch on and sucking pattern were analyzed (IRCT: 2014090419039N1). FINDINGS: The mean feeding desire in the intervention group was 2.63±0.6 and in the control group was 2.61 ± 0.6, searching was 2.76±0.43 and 2.73±0.44, latch on was 2.76±0.43 and 2.79±0.41, sucking pattern was 2.82 ± 0.54 and 2.64 ± 0.64, and total score was 11.84 ± 5.10 and 10.79 ± 1.82, respectively, indicating no significant difference in any of the dimensions. CONCLUSION: The results of the study showed that short abdominal skin-to-skin contact and Kangaroo skin contact did not differ significantly regarding their effect on initiation of successful breastfeeding.

Introduction and purpose: One of the problems of water distribution systems is loss of large volumes of water due to the occurrence of various events, which incurs a huge financial loss. Regarding this, the aim of the present study was to investigate the rate of events and water loss in the water distribution system and its related factors in Azna, Lorestan province, Iran, during 2008-2014. Methods: This cross-sectional study was conducted using census method, surveys, and field data collection. The amount of water production and consumption, the volumes of water loss, the number of accidents, type of pipe, pressure zone, as well as the age and length of the pipes recorded during 2008- 2014 were studied and analyzed. Results: According to the results, the highest (34.48%) and lowest (20.57%) amount of water losses happened in 2008 and 2014, respectively. High pressures in water systems had significant relationship with the number of events as well as the amount of water loss and water consumption. In addition, higher length and age of the pipes had a direct correlation with increased number of events and water loss. Furthermore, the maximum number of events were found to occur in the pipe embranchment and galvanized pipes. Conclusion: This study showed that of events was directly related to the length and age of the pipes, the water pressure, and number of branches. Also water loss quantity can be reduced by applying suitable management techniques in different sections. Furthermore, the water loss can be significantly controlled by taking such measures as reducing the pressure in the high-pressure zones, timely replacement of old and inappropriate pipes, appropriate fixing of the pipes, replacement of the galvanized pipe, and standard implementation of pipes and fittings.

Background: Hepatitis B virus is one of the transfusion transmissible infections. Despite the availability of hepatitis B virus (HBV) vaccine and screening tests but still danger of virus transmission via blood transfusion is high in some regions. The objective of this study was to determine the trend of seroprevalence of hepatitis B in over an 11-year period (2005–2015). Methods: In this study, 355,083 blood donors were estimated for hepatitis B surface antigen (HBs Ag) seropositivity during 2005–2015 who referred to blood infusion centers of Lorestan province. Third-generation ELISA method was used to detect HBs Ag. Results: The prevalence of HBs Ag in blood donors was 0.29% (1017). It was decreased steadily from 2005 to 2015 (0.68% to 0.12%) but increased in 2008 year. The trend prevalence of HBs Ag seropositivity significantly decreased over the study period (P < 0.001). The decline in HBV infection rates was more prominent in regular and repeated donor's groups compared to people who donated blood for the first time (P < 0.001). Conclusions: The result of present study was indicated, Lorestan city in west of Iran can be classified as a low-income region because the low prevalence of HBs Ag in blood donors. Also the prevalence of HBs Ag in first-time donors was higher than other groups.

The chamomile species of Anthemis triumfettii (L.) All is one of important medicinal plant belong to Compositae family and it grows as wild species in Zagros and Alborz Mountains, Iran. The aim of this study was to evaluation of morphological and phenological traits and their relationships with essential oil. Seeds of seven accessions were sown in jiffy pots and transferred to field using randomize block design with three replications in Alborz research station, Karaj, Iran during 2011-12. Data were collected and analyzed for canopy diameter, plant height, flower number, flowering date, maturity date, shoot fresh and dry weight, Essential oil percentage and GDD to flowering and maturity dates. Results showed significance differences for all traits (P

Background: Depending on the site of irradiation, about 40-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting. The current study aimed to investigate the efficacy of ondansetronas as a single agent and with a combination to aprepitant on preventing RT-induced nausea and vomiting (RINV). Materials and Methods: In a clinical randomized controlled trial (from September 2010 to September 2011), conducted in Radiation Oncology Department of Seyed-al-Shohada Hospital, Isfahan University of Medical Sciences, 40 abdominopelvic malignancies cancer patients were allocated into two aliquots using block randomization of size. Patients in the first group (group I) received ondansetron alone while those patients in the remaining group (group II) received ondansetron and aprepitant. Then, developing of RINV and its severity and benefit of adding aprepitant to ondansetron, in comparison with ondansetron as a single drug therapy were evaluated. Results: The average age of the patients in group I was 61.15 ± 12.27 years while in group II it was 50.1 ± 13.27 years. No statistically significant gender differences were found between the two groups. In patients treated with ondansetron single drug therapy (group I), frequency and grade of RINV were significantly more than the group treated simultaneously by aprepitant and ondansetron (group II) (odds ratio [OR] = 21.2; P < 0.01). Compared with RT alone, the patients whom underwent RT along with chemotherapy showed lower probability of experiencing RINV (OR = 0.13; P < 0.05). Conclusion: The present study indicated a significant superiority of combination of ondansetron and aprepitant in management of RINV, in patients undergoing RT, compared to ondansetron as a single agent therapy. More accurate follow-up studies are needed for the evaluation of the efficacy of ondansetron with combination to aprepitant on preventing the RINV.

Although suggested that "fetal" cell-free DNA (cfDNA) is derived from trophoblast cells, the exact origin is unclear. The studies in this report sought to demonstrate that placental tissue releases cfDNA in parallel with cell death, that the size range of cfDNA is similar to that found in maternal plasma, and that the cfDNA fragments are able to stimulate a proinflammatory cytokine response. Placentas were harvested from near term pregnant CD-1 mice and cultured in DMEM/Ham's F12/FBS media in 8% or 21% O2. After centrifugation to remove cells and cellular debris, the cfDNA was extracted from the media and quantified by DNA spectrophotometry. The cfDNA fragments were sized using a 1.5% TAE gel. Cell death was quantified by lactate dehydrogenase assay; and tissue homogenates were used to quantify caspase activity and BAX expression. Cultured RAW-264.7 macrophage cells were used to determine IL6 stimulation by cfDNA. The cfDNA levels released in 8% O2 (placental normoxia) were not significantly different from explants cultured in 21% O2 (placental hyperoxia). The cfDNA fragments ranged in size from < 100 -< 400 bp. The cfDNA release increased when cultured with LPS, whereas it decreased with trolox (vitamin E analog). Explant release of cfDNA increased in parallel with cell death. The cfDNA release and cell death of trophoblast appears to involve components of the apoptosis signaling pathway as suggested by LPS enhancement of placental caspase activity, suppression of cfDNA release by a pan-caspase inhibitor and the trend toward increased Bax protein expression. Studies with cultured macrophage cells confirmed the ability of cfDNA to stimulate an IL6 response. In summary, these studies have confirmed the ability of placental tissue to release significant amounts of cfDNA, a phenomenon that appears to be mediated, at least in part, by apoptosis; and that the cfDNA released by the placental explants is able to stimulate a significant proinflammatory response. Thus, these studies provide support for the hypothesis that cell-free fetal DNA released by placental tissue potentially plays a mechanistically important role during the events leading to the onset of parturition.

Background: Colorectal cancer is one of the most important causes of morbidity and mortality in the world. It has been suggested that tissue inhibitor of metalloproteinase-1 (TIMP-1) plays a particular role in cancer promotion. The objective of the present study was to compare the effect of repeated measurement of carcinoembryonic antigen (CEA) and TIMP-1 plasma levels in a follow-up response to chemotherapy treatment in patients with unresectable metastatic colorectal cancer by surgery. Materials and Methods: All consecutive patients between 18 and 75 years old in both genders with rectal adenocarcinoma who referred to Sayed Al-Shohada Medical Center, during 6 months of study period enrolled in the study. Level of CEA and TIMP-1 were assessed before and after two cycles of chemotherapy. Furthermore, patients underwent computed tomography scan to assess response to chemotherapy. The sensitivity, specificity, and areas under the receiver operating characteristic curves (AUC) calculated for baseline level of CEA and TIMP. Results: The mean age of the studied patients was 52.7 ± 7.5 years, 12 patients (48%) were male. Response to chemotherapy after two cycles was 80%. In patients who responded to chemotherapy level of TIMP after treatment was significantly decreased compared to before treatment (P < 0.0001). Before and after treatment in patients who responded to chemotherapy the level of TIMP was significantly lower than who did not response to chemotherapy (P < 0.05). The critical values for the prediction response to chemotherapy for CEA was >63 (AUC: 0.54) and for TIMP was ≤8823 (AUC: 0.68). Conclusion: The present study has identified a strong significant association between high plasma TIMP-1 levels and short survival in patients with colorectal cancer. In addition, results demonstrated that the TIMP-1 provides stronger prognostic information than CEA.