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Background and purpose A wide range of neuroradiological findings has been reported in patients with coronavirus disease 2019 (COVID-19), ranging from subcortical white matter changes to infarcts, haemorrhages and focal contrast media enhancement. These have been descriptively but inconsistently reported and correlations with clinical findings and biomarkers have been difficult to extract from the literature. The purpose of this study was to quantify the extents of neuroradiological findings in a cohort of patients with COVID-19 and neurological symptoms, and to investigate correlations with clinical findings, duration of intensive care and biomarkers in blood. Material and methods Patients with positive SARS-CoV-2 and at least one new-onset neurological symptom were included from April until July 2020. Nineteen patients were examined regarding clinical symptoms, biomarkers in blood and MRI of the brain. In order to quantify the MRI findings, a semi-quantitative neuroradiological severity scale was constructed a priori, and applied to the MR images by two specialists in neuroradiology. Results and conclusions The score from the severity scale correlated significantly with blood biomarkers of CNS injury (glial fibrillary acidic protein, total-tau, ubiquitin carboxyl-terminal hydrolase L1) and inflammation (C-reactive protein), Glasgow Coma Scale score, and the number of days spent in intensive care. The underlying radiological assessments had inter-rater agreements of 90.5%/86% (for assessments with 2/3 alternatives). Total intraclass correlation was 0.80. Previously reported neuroradiological findings in COVID-19 have been diverse and heterogenous. In this study, the extent of findings in MRI examination of the brain, quantified using a structured report, shows correlation with relevant biomarkers.

The vitality of clinical research and the health of the public relies on continued efforts to engage children in clinical research in a fully protected and ethically robust manner. Parents serve as proxy decision-makers assessing the risks and benefits of any given study in order to do what is in the best interest of their child. This study investigated maternal perceptions of research safeguards and mothers’ willingness to enroll their children in clinical research studies. We hypothesized that mothers’ perceptions of the protectiveness of safeguard procedures utilized in clinical research would be associated with mothers’ willingness to enroll their children in research studies with such safeguards. Through a survey conducted via Amazon Mechanical Turk, mothers were asked to rate the perceived protectiveness of four safeguard procedures (confidential data coding, data and safety monitoring boards (DSMBs), institutional review boards (IRBs), and informed consent) and the degree to which they were willing to have their child participate in research studies in the presence of each of the four safeguard procedures. Respondents generally perceived safeguard procedures to be protective. Mothers’ trust in researchers’ honesty positively impacted perceptions of the protectiveness of research safeguard procedures and willingness to enroll children in research. Mothers of only healthy children perceived research safeguards to be more protective than mothers with at least one child with at least one health issue. This study provides insight into whether maternal perceptions of the protectiveness of different safeguard procedures are associated with mothers’ willingness to enroll their children in research.

The influence of fatigue on landing biomechanics in anterior cruciate ligament deficient (ACLD) patients is poorly understood. The purpose of this study was to examine the effect of fatigue on hip and knee joint biomechanics in deficient patients. Twelve ACLD males and 12 healthy control subjects participated in the study. The ACLD patients landed with increased peak knee flexion angle (F = 15.71, p < .01) and decreased peak knee flexion moment (F = 9.13, p < .01) after fatigue. Furthermore, ACLD patients experienced lower vertical ground reaction forces compared with controls regardless of fatigue state (F = 9.75, p < .01). It seems that ACLD patients use protective strategy in response to fatigue in order to prevent further injury in knee point.

Background As a main challenge in paramedical faculties of medical sciences, freshmen lose interest in their academic field of study and then job motivation. Lack of developed knowledge about their academic field and unfamiliarity with their future job’s tasks and roles contribute to freshmen’s job motivation loss. Various interventional programs have been implemented to improve students’ job motivation by familiarizing them with their future job’s duties and responsibilities. Methods This was one-group pretest-posttest design study in 2019–2020. Students grouped into pairs of a freshman (shadowee) with a senior (shadower) in a clinical setting during shadowing program. This program helps freshmen to comprehend and discover realities of their academic field and can help them change their perspectives regarding their future job’s duties and responsibilities. The shadowees’ main task was reflective observation on operating room events and interactions and to be active in the program, several tasks e.g., how to wear gloves, guns, and disinfect equipment were assigned to them exclusively under the supervision of senior students. The Hackman and Oldham’s Job Diagnostic Survey (JDS) questionnaire and a novel Job Motivation Survey (JMS) questionnaire were distributed among participants. Results Fifty freshmen majoring in operating room participated in the shadowing program from November 2019 to January 2020. Before and after the program, they completed Hackman and Oldham’s job diagnostic survey and researcher-made job motivation survey questionnaires. Results were indicative of a significant difference in job diagnostic survey questionnaire score, where overall pre-test and post-test scores before and after the intervention were 57.78 (±9.78) and 68.58 (±5.02), respectively; the score difference was statistically significant (P P Conclusion Shadowing program improved freshmen’s realistic perception of their future job’s duties and responsibility, and hence enhancing their job motivation and job recognition. As future work, in various disciplines, further studies need to evaluate the impact of such interventional programs in providing early insights for freshmen as well as in providing guidance on their plans for education, and future job.

Risk genes for Mendelian (single-gene) disorders (SGDs) are consistent across populations, but pathogenic risk variants that cause SGDs are typically population-private. The goal was to develop “QChip1,” an inexpensive genotyping microarray to comprehensively screen newborns, couples, and patients for SGD risk variants in Qatar, a small nation on the Arabian Peninsula with a high degree of consanguinity. Over 108 variants in 8445 Qatari were identified for inclusion in a genotyping array containing 165,695 probes for 83,542 known and potentially pathogenic variants in 3438 SGDs. QChip1 had a concordance with whole-genome sequencing of 99.1%. Testing of QChip1 with 2707 Qatari genomes identified 32,674 risk variants, an average of 134 pathogenic alleles per Qatari genome. The most common pathogenic variants were those causing homocystinuria (1.12% risk allele frequency), and Stargardt disease (2.07%). The majority (85%) of Qatari SGD pathogenic variants were not present in Western populations such as European American, South Asian American, and African American in New York City and European and Afro-Caribbean in Puerto Rico; and only 50% were observed in a broad collection of data across the Greater Middle East including Kuwait, Iran, and United Arab Emirates. This study demonstrates the feasibility of developing accurate screening tools to identify SGD risk variants in understudied populations, and the need for ancestry-specific SGD screening tools.

Supplemental material, sj-docx-1-cll-10.1177_09636897231163212 for Comparable Outcomes of Pre- Versus Post-Tyrosine Kinase Inhibitor Era Treatment in Chronic Myeloid Leukemia: A Retrospective Cohort Study With Long-term Follow-up by Sahar Tavakoli, Fattaneh Khalaj, Amir Kasaeian, Seyed Ali Mousavi, Amir-Hossein Mousavian, Fatemeh Arabi, Soroush Rad, Shahrbano Rostami, Maryam Barkhordar, Mohammad Biglari, Heydar Ali Mardani-Fard, Hediyeh Alemi, Naghmeh Khavandgar, Hossein Kamranzadeh Fumani, Ghasem Janbabai, Seied Asadollah Mousavi, Ardeshir Ghavamzadeh and Mohammad Vaezi in Cell Transplantation

Objective(s): This study aimed to review Persian biomedical literature on psychometric properties of health literacy measures in Iran. Methods: The Scientific Information Database (SID) and Google Scholar were searched using the keyword ‘health literacy’ in the titles of the articles. First, duplicate articles were removed from the search list. Then, articles that met the inclusion criteria were included in the study. Finally, information about the health literacy measures including development or psychometric evaluation in Persian literature were extracted and presented in relevant tables. Results: In all, 600 articles were identified. After excluding duplicates and papers that did not meet inclusion criteria, 26 articles were included in the review. Of these, 17 articles reported on the development of a health literacy measure. These measures assessed health literacy among general populations, specific populations, or specific topics. The remaining nine articles reported translation and psychometric properties of a number of known measures, including the TOFHLA, the STOHFLA, the NVS, the FCCHL, the OHLI, the MHLAP, the RELAM, and the Health Literacy Scale for Women of Reproductive Age. Conclusion: The results indicated that the development of a new health literacy measure was more prevalent among Iranian investigators instead of using existing measures. In addition, improper reporting on the development and psychometric evaluation of measures was evident.

Introduction: Due to the side effects of drugs, the development of nanoscale drug delivery systems has led to a significant improvement in medicinal therapies due to drug pharmacokinetics changes, decreased toxicity, and increased half-life of the drug. This study aimed to synthesize tamoxifen (TMX)-loaded L-lysine coated magnetic iron oxide nanoparticles as a nano-carrier to investigate its cytotoxic effects and anti-cancer properties against MCF-7 cancer cells. Methods: Magnetic Fe3O4 nanoparticles were synthesized and coated with L-lysine (F-Lys NPs). Then, TMX was loaded onto these NPs. The characteristics of synthesized nanoparticles (F-Lys-TMX NPs) were evaluated by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), dynamic light scattering (DLS), differential scanning calorimetry (DSC), vibrating sample magnetometer (VSM), and thermogravimetric analysis (TGA). The drug release was analyzed at pH 5.8 and pH 7.4. The MCF-7 cells were exposed to F-Lys-TMX NPs, F-Lys NPs, and TMX for 24, 48, and 72 hours. To evaluate the cytotoxic potential of designed nanoparticles, MTT and apoptosis assays, real-time PCR, and cell cycle analysis was carried out. Results: The F-Lys-TMX NPs had spherical morphology with a size ranging from 9 to 30 nm. By increasing the nanoparticles concentration and treatment time, more cell proliferation inhibition and apoptosis induction were observed in F-Lys-TMX NPs-treated cells compared to the TMX. The expression levels of ERBB2, cyclin D1, and cyclin E genes were down-regulated and expression levels of the caspase-3 and caspase-9 genes were up-regulated. Studies on the drug release revealed a slow and controlled pH-dependent release of the nanoparticles. Cell cycle analysis indicated that F-Lys-TMX NPs could arrest the cells at the G0/G1 phase. Conclusion: The findings suggest that F-Lys-TMX NPs are more effective and have the potential for cell proliferation inhibition and apoptosis induction compared to the TMX. Hence, F-Lys-TMX NPs can be considered as an anti-cancer agent against MCF-7 breast cancer cells.

The South American tomato pinworm, Tuta absoluta Meyrick (Lepidoptera: Gelechiidae), a devastating pest of tomato plants, originates from South America but it has been considered an invasive pest for Iran since 2010. To assess crop loss caused by this pest, a study was conducted in a 600 m2 field under a randomised complete block design. The impact of different initial densities of T. absoluta, including control (without infestation), one, two, four, and eight T. absoluta eggs on each host plant in the first and second year was investigated with an additional treatment (16 pinworm eggs per host plant) used in the second year. Yield attributes including length and width of fruits, numbers of infested and intact fruits along with their weights were sampled and assessed on a weekly basis. In addition, the correlation between the number of galleries and these characteristics was also investigated. Crop loss data demonstrated that the effect of different infestation levels on fruit size and the weight of intact fruits was not significant over both years. However, the effect of treatment on the percentage and weight of infested fruits was shown to be significantly different in 2014 and 2015. Furthermore, there was a negative significant correlation between the number of galleries and weight of infested fruits in both years. Collectively, these results will be useful for enhancing pest management programs of T. absoluta in Iran.

Wheat flour is one of the most important food ingredients containing several essential nutrients including proteins. Gluten is one of the major protein components of wheat consisted of glutenin (encoded on chromosome 1) and gliadin (encoded on chromosome 1 and 6) and there are around hundred genes encoding it in wheat. Gluten proteins have the ability of eliciting the pathogenic immune responses and hypersensitivity reactions in susceptible individuals called “gluten-related disorders (GRDs)”, which include celiac disease (CD), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS). Currently removing gluten from the diet is the only effective treatment for mentioned GRDs and studies for the appropriate and alternative therapeutic approaches are ongoing. Accordingly, several genetic studies have focused on breeding wheat with low immunological properties through gene editing methods. The present review considers genetic characteristics of gluten protein components, focusing on their role in the incidence of gluten-related diseases, and genetic modifications conducted to produce wheat with less immunological properties.

Background We discovered that pure positive electrostatic charges (PECs) have an intrinsic suppressive effect on the proliferation and metabolism of invasive cancer cells (cell lines and animal models) without affecting normal tissues. Methods We interacted normal and cancer cell lines and animal tumors with PECs by connecting a charged patch to cancer cells and animal tumors. many biochemical, molecular and radiological assays were carried out on PEC treated and control samples. Results Correlative interactions between electrostatic charges and cancer cells contain critical unknown factors that influence cancer diagnosis and treatment. Different types of cell analyses prove PEC‐based apoptosis induction in malignant cell lines. Flowcytometry and viability assay depict selective destructive effects of PEC on malignant breast cancer cells. Additionally, strong patterns of pyknotic apoptosis, as well as downregulation of proliferative‐associated proteins (Ki67, CD31, and HIF‐1α), were observed in histopathological and immunohistochemical patterns of treated mouse malignant tumors, respectively. Quantitative real‐time polymerase chain reaction results demonstrate up/down‐regulated apoptotic/proliferative transcriptomes (P21, P27, P53/CD34, integrin α5, vascular endothelial growth factor, and vascular endothelial growth factor receptor) in treated animal tumors. Expression of propidium iodide in confocal microscopy images of treated malignant tissues was another indication of the destructive effects of PECs on such cells. Significant tumor size reduction and prognosis improvement were seen in over 95% of treated mouse models with no adverse effects on normal tissues. Conclusion We discovered that pure positive electrostatic charges (PECs) have an intrinsic suppressive effect on the proliferation and metabolism of invasive cancer cells (cell lines and animal models) without affecting normal tissues. The findings were statistically and observationally significant when compared to radio/chemotherapy‐treated mouse models. As a result, this nonionizing radiation may be used as a practical complementary approach with no discernible side effects after passing future human model studies., The effect of pure electrostatic charges has been investigated on cultured normal and cancerous breast cell lines for the first time. The selective effect of positive electrostatic charges (PECs) on metastatic cell lines and animal tumors has been reported with no effect on normal tissues. PECs induce apoptosis in metastatic breast cancer cell lines and tumors by suppressing proifration pathways. More than 400 mouse models have been tested to investigate the effects of PECs on cancerous tumors and animal organs by different analyses. Survival analyses depict a high survival rate of treated mice with positive electrostatic charges compared to other conventional cancer treatments such as chemotherapy and radiotherapy.

PURPOSE Work-related musculoskeletal disorders (WMSDs) are common occupational problems affecting the health and productivity of workers worldwide. Ergonomic intervention programs (EIPs) can play an effective role in preventing these disorders in the workplace. Assessing the effectiveness of an EIP is a challenge faced by both industries and researchers. This study was aimed at assessing the effectiveness of an EIP on human resources productivity (HRP), musculoskeletal disorders (MSDs), general health and occupational fatigue in a steel industry. METHODS This study was conducted in a steel industry in Isfahan, Iran, between 2018 and 2021. To assess the effectiveness of the EIP with a participatory approach, training and redesign of workstations, the criteria of HRP, MSDs, general health and occupational fatigue were investigated before and after the intervention, using HRP Questionnaire, Nordic musculoskeletal questionnaire (NMQ), 28-item General Health Questionnaire (28-GHQ), Swedish Occupational Fatigue Inventory (SOFI-20) and Occupational Fatigue/Exhaustion Recovery (OFER-15) Questionnaire, as data collection tools, respectively. RESULTS The implementation of EIP in the studied industry significantly led to an increase in HRP (p

Background Males are more likely to die from COVID-19 than females. In addition, the mortality rate among positive and suspected COVID-19 patients were reported in many studies. The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results. Research design In a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as positive, negative and suspected cases. Age group, sex and hospital wards were also assessed in the analysis. Results A total of 25481 cases (14791 males) were included in the study with a mortality rate of 12.0%. The mortality rates in positive, negative and suspected cases were 20.55%, 9.97% and 7.31%, respectively. Although the mortality in negative test group was considerable, sex was not associated with the death rate in this group. Using a Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adult and senior male patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with a negative PCR test in different age groups. Conclusions Regardless of other risk factors, we found that the effect of sex on COVID-19 mortality varied significantly in different age groups. Therefore, appropriate strategies should be designed to protect adult and senior males from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched to increase the accuracy of diagnosis tests.

Introduction: Theta-Beta Ratio (TBR) has been claimed as a biomarker to diagnose Attention Deficit and Hyperactivity Disorder (ADHD). However, the effectiveness of this index to differentiate between different groups of disorders is still under discussion. The primary purpose was to determine to what extent active TRB can differentiate between children with ADHD and specific Learning Disorder (sLD) as the most common comorbid disorder. Methods: Two groups of school-aged children with sLD (N=15) and ADHD (N=15) were diagnosed through a process of clinical interview and observation. Electroencephalography (EEG) was recorded in both groups during active condition. The implemented cognitive task was the visual continuous performance task (VCPT). TBR in sites of CZ and Fz, and cognitive measures of VCPT were calculated in the aforementioned groups. Results: There was no significant differences in cognitive measures (containing Commission, Omission, Reaction Time, and Variability of Reaction Times) shown in two matched groups of children with sLD and ADHD. According to TBR, two groups demonstrated no significant results in comparison. Conclusion: TBR cannot be considered as a reliable biomarker to differentiate between those groups of psychological disorders that contain primary cognitive deficits and require the allocation of attention and working memory loads.

BACKGROUND Echinacea is a perennial and herbaceous herb containing the most active phenolic compounds and valuable antimicrobial and antioxidant content, such as chicoric acid, which increases the body immune function. The root of this plant is mainly used in pharmaceutical fields to treat inflammation, kidney infections and colds. In the present study, we investigated the drying of echinacea root in an infrared dryer with airborne ultrasonic pretreatment aiming to determine shrinkage, color changes, extraction, total phenolic content, flavonoid content and radical inhibition of 2,2-diphenyl-1-picrylhydrazyl (DPPH). The experiments were performed in an infrared dryer at three temperature levels of 40, 45 and 50 °C, with ultrasonic pretreatment at frequencies of 2000, 3000 and 4000 Hz and a time duration of 20, 40 and 60 min in three replications. RESULTS Shrinkage and color changes of the samples varied in the range 27.2-6.3% and 39.82-39.64%, respectively. According to all of the evaluated physical and chemical factors, the optimal conditions for echinacea root processing were a drying temperature of 40 °C, a frequency of 3000 Hz and an ultrasound duration of 60 min, in which case shrinkage was 3.35% and color changes were 38.25%. Total phenolic content was 27.41 mg g-1 , flavonoid content was 39.36 mg g-1 and DPPH radical inhibition was 34.87%. CONCLUSION Therefore, the use of airborne ultrasound pretreatment demonstrates increased chemical properties compared to the optimal state when drying the echinacea root with an infrared dryer by 54/21-81/64%. Hence, ultrasound pretreatment preserves the quality and quantity of active ingredients in the therapeutic root of Echinacea. © 2021 Society of Chemical Industry.

Background. Metabolic syndrome (MetS) is known to increase the risk of cardiovascular diseases and diabetes. Diet is a key factor in prevention and development of MetS. This study aimed to determine the association between dietary patterns and MetS among Canadians 12–79 years old using the Canadian Health Measures Survey (CHMS) combined Cycles 1 and 2 data from 2007–11. We hypothesized that MetS varies among different sociodemographic and lifestyle factors and that Canadians who have less healthy dietary patterns are more likely to have MetS. Methods. In the CHMS, MetS was determined using objective health measures. The principal component analysis method was used to determine the dietary patterns. Using logistic regression, the association between MetS and dietary patterns, controlling for potential covariates, was investigated for age groups of 12–19, 20–49, and 50–79 years. Survey data were weighted and bootstrapped to be representative at the national level. Results. The prevalence of MetS was 16.9% for ages 12–79 y (n = 4,272, males = 49.6%), representing 26,038,108 Canadians aged 12–79 years. MetS was significantly different across sociodemographic variables; Canadians with less education, income, and activity had higher MetS prevalence than their counterparts. In older adults (50–79 years of age), the “fast-food” dietary pattern was associated with 26% (odds ratio = 1.26; 95% CI: 1.04 to 1.54; p = 0.0195 ) higher likelihood of having MetS. Conclusions. Among older Canadians, MetS is associated with a “fast-food” dietary pattern after adjustment for socioeconomic/lifestyle factors. Findings suggest the importance of diet quality/composition in the development of MetS among older Canadians and the need for further longitudinal studies on MetS and diet across the lifespan.

Objectives: Birth of an infant with very low birth weight (VLBW) (weight less than 1500 grams) is a major cause of deaths and complications in infancy and childhood. Despite recent progressions in medical care and treatment for VLBW children, the mortality rate is high in this group of children. The present study was performed to better identify the survival rate of these children and the problems that affect the survival of this group of infants in the short and long term. Methods: The study population was all infants weighing less than 1500 grams or infants who borne at less than 32 weeks of pregnancy. Infants whom birth occurred from the beginning to the end of 2018 in hospitals in Tehran were included. Information about these children was provided by the Family and Population Health Office of the Ministry of Health and Medical Education. Sampling was non-random and all information about the infants under study was recorded in a questionnaire. All data from the study were entered into SPSS-22 software and the results were presented using descriptive and analytical statistics. Survival analysis was performed by Kaplan-Meier test and the effect of variables on survival was evaluated using multivariate Cox model. Results: A total of 338 children were studied. Based on the results of cox regression models, the probability of one-month survival of children was about 68% and the probability of one-year survival was about 60%. Of the 10 variables affecting the survival of VLBW infants and children under study, 6 variables of maternal education, number of pregnancies, parent and infant insurance, gestational age, birth weight and maternal vaccination before pregnancy were significantly related with the death of infant (P ≤0.05). Conclusion: The findings suggest one of the effective strategies for improving VLBW infant survival rate is encouraging women to continue their education, vaccinating mother before pregnancy, insuring family members and preventing multiple pregnancies.

Soft clays are problematic soils as they present high compressibility and low shear strength. There are several methods for improving in situ conditions of soft clays. Based on the geotechnical problem’s geometry and characteristics, the in situ conditions may require reinforcement to restrain instability and construction settlements. Granular columns reinforced by geosynthetic material are widely used to reduce settlements of embankments on soft clays. They also accelerate the consolidation rate by reducing the drainage path’s length and increasing the foundation soil’s bearing capacity. In this study, the performance of encased and layered granular columns in soft clay is investigated and discussed. The numerical results show the significance of geosynthetic stiffness and the column length on the embankment settlements. Furthermore, the results show that granular columns may play an important role in dissipating the excess pore water pressures and accelerating the consolidation settlements of embankments on soft clays.

Cerium oxide (CeO2) has potential applications in medicine and various consumer products. This study investigated the effect of CeO2 on the expression of genes associated with apoptosis and testicular development in mouse embryos. The experimental groups of pregnant mice were injected intraperitoneally with CeO2 at a concentration of 10 mg/kg on days 7 and 14 of pregnancy. Six days after birth, the testicles of neonatal male mice were collected for mRNA expression determination using real-time PCR, protein expression analysis by immunohistochemistry, and apoptotic cell population determination using the TUNEL assay. The results showed that the mRNA expression of the Bax, Caspase-3, and Gsk3-β genes, unlike the Bcl2 gene, decreased significantly in the experimental group compared to the control group. The expression ratio of Bax/Bcl2 in the experimental group was lower than in the control group. A similar trend was observed in the population of apoptotic cells. In the experimental group, the expression levels of, Gata4, Sox8, and Rad54 at both the mRNA and protein levels increased significantly compared to the control group. Based on the results of this study, CeO2 at a concentration of 10 mg/kg, in addition to producing anti-apoptotic effects on the testicular cells of neonatal mice, can increase the expression of genes involved in testicular development and performance. The current experimental study proved the protective effects of 10 mg/kg CeO2 in developmental and apoptosis genes of testicular tissue in 6-day-old NMRI mice fetuses; however, more experiments are required to evaluate the possible side effects and interactions.

BACKGROUND: This study examines the changes in segmental and global cervical sagittal parameters after single-level anterior cervical discectomy and fusion (ACDF) in patients with cervical radiculopathy or myelopathy. We also investigate whether these changes have any relation with postoperative pain and functional outcome of the patients. METHODS: Sixty patients (37 females and 23 males) with a mean age of 45.9 ± 9.5 years who were candidates of single-level ACDF due to cervical myelopathy or radiculopathy participated in the study. At baseline, 1 month, and 6 months after ACDF, outcomes of the study including sagittal balance parameters, pain intensity, and Neck Disability Index (NDI) were measured among the patients. Intensity of pain and neck disability were measured using the visual analog scale (VAS) and validated version of NDI, respectively. Using a standard lateral cervical radiography, the Cobb angle for occiput–C2, C1–C2, and C2–C7 as well as operation-level angle (OA; Cobb's angle at the level of discopathy), the thoracic inlet angle, and C7 and T1 slope angles were measured. RESULTS: The intensity of pain and neck disability of patients improved significantly during the follow up of the study comparing with baseline measurements (P < .001). There was a significant correlation between the increase of C2–C7 angle, C1–C2 angle, and OA and improvement in neck pain and NDI at 1- and 6-month follow ups. CONCLUSIONS: We found that changes at C2–C7 angle, C1–C2 angle, and OA have positive significant correlation with clinical outcome including pain improvement and decrease of disability in patients who undergo ACDF. LEVEL OF EVIDENCE: 3. CLINICAL RELEVANCE: The results of this study might be beneficial in selection of cervical cages with appropriate size during ACDF surgery, as our findinds showed that larger cages could lead to better functional outcome in patients.

Ambient particulate matter (PM) is the major environmental concern in Tehran, Iran. Exposure to such particles is a serious global health concern and substantial evidence indicates that exposure to particulate matter contributes to cardiovascular and respiratory disease. Here, we provide a detailed health impact of ambient air pollution in Tehran by linking PM pollution with mortality caused by cardiovascular and respiratory disease. Air quality data of PM obtained from Tehran Air Quality Monitoring Stations (TAQMSs) during 2012–2017. Data mining methods conducted by Spatio-temporal outlier detection and “Air Pollution and Health: a European Approach (APHEA) project” was applied to impute missing values. Time-series data were analyzed to estimate the associations between PM pollution and cause-specific mortality at different lags in Tehran. Based on descriptive analysis, PM2.5 is expected to be a major influencing factor in the increased cardiovascular-related death (CVD) and respiratory dysfunction related death (RD) deaths. The cross-correlation analysis showed the same source for PM2.5 and PM10 in the ambient air of Tehran. Also, the results indicated delays of about 7–15 days from the increased concentrations of PMs and the observed rising in CVD and RD death. Trend analysis showed a more decreasing trend for PM2.5 pollutions than PM10 pollution and a slightly increasing trend for cause-specific deaths during 2012–2017. Long term exposure to high PM levels increases the CVD and RD deaths and control strategies along with control regulations should be considered to control PM.

The applications of translational modelling of local drug concentrations in various organs had a sharp increase over the last decade. These are part of the 'Model-Informed Drug Development' (MIDD) initiative, adopted by the pharmaceutical industry and promoted by drug regulatory agencies. With respect to the kidney, the models serve as a bridge for understanding animal versus human observations related to renal drug disposition and any consequential adverse effects. However, quantitative data on key drug-metabolizing enzymes and transporters relevant for predicting renal drug disposition are limited. Using targeted and global quantitative proteomics, we determined the abundance of multiple enzymes and transporters in 20 human kidney cortex samples. Nine enzymes and twenty-two transporters were quantified (eight for the first time in kidney). In addition, >4000 proteins were identified and used to form an open database. CYP2B6, CYP3A5 and CYP4F2 showed comparable, but generally low expression, whereas UGT1A9 and UGT2B7 levels were the highest. Significant correlation between abundance and activity (measured by mycophenolic acid clearance) was observed for UGT1A9 (Rs=0.65, p=0.004) and UGT2B7 (Rs=0.70, p=0.023). Expression of P-gp ≈ MATE-1 and OATP4C1 transporters were high. Strong inter-correlations were observed between several transporters (P-gp/MRP4, MRP2/OAT3 and OAT3/OAT4); no correlation in expression was apparent for functionally related transporters (OCT2/MATEs). This study extends our knowledge of pharmacologically-relevant proteins in the kidney cortex, with implications on more prudent use of mechanistic kidney models under the general framework of quantitative systems pharmacology and toxicology.

Background: Uterine cervical malignancy is one of the commonly detected malignancies related to the human papillomavirus (HPV) and is increasing incidentally in developing countries. Therefore, the use of an efficient diagnostic method is required as an effectual step for cervical cancer prevention and treatment. The purpose of the study was to diagnose various types of HPV in the cervical cytology specimens in the South-East of Iran. Methods: This cross-sectional study was performed on 1079 cervical fluid cytology specimens referred for two years, between 2018-2020. Polymerase chain reaction (PCR) and hybridization (INNO-LiPA HPV Genotyping EXTRA II assay) were used to determine HPV DNA and their genotypes, respectively. Results: HPV was positive in 37.7% (407 of 1079) patients with a mean age of 34.62 ± 8.82. Among positive cases, 252 (62%) had only one HPV genotype and 155 (38.05%) had multiplex HPV genotypes, which included 94 (60.7%), 38 (24.6%), 18 (11.6%) and 5 (3.2%) cases with two, three, four and five or more genotypes, respectively. The samples with multiple strains revealed 31 HPV genotypes with the four most prevalent being HPV6 (14.7%), HPV16 (10.9%), HPV53 (9.6%) and HPV51 (5.9%). Conclusion: HPV infection is the main health challenge for women that requires improved health service programs and appropriate epidemic vaccination.

Introduction: The location of sanitary landfills is one of the most important environmental issues in cities. If the design of landfills is not appropriate, it will threaten human health. This study aimed to detect a suitable location for a landfill in Ilam, Iran. Materials & Methods: A questionnaire and consultation with experts were used to conduct the research. For this purpose, three main criteria of the environment (e.g., vegetation, surface water resources, and habitats of animal species), hydrology (e.g., groundwater depth, and distance from springs, wells, as well as aqueducts), and access roads/population centers (e.g., distance from protected areas, the prevailing wind direction, and distance from the main roads) were considered in this study. The data were then weighted based on Analytic Network Process, and Super Decision software was used to integrate the information layers. Subsequently, based on the studied criteria and sub-criteria, four areas were proposed for waste disposal in Ilam. Finally, based on the weight and ranking of criteria, their coefficient, and the paired comparison matrix tables, the most appropriate option was selected for landfilling. Findings: According to the results, location 1 with a weight of 0.419 and a consistency ratio of 0.05 is the most suitable place for landfilling in Ilam among the four selected options. Discussions & Conclusions: The results showed that Super Decision software has a good ability to locate the landfill.

ObjectiveWe aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.DesignThe study comprised three adult cohorts. Cohort 1: 740 patients assessed in the specialist CD clinic at a UK centre; cohort 2: 532 patients with low suspicion for CD referred for upper GI endoscopy at a UK centre; cohort 3: 145 patients with raised tTG titres from multiple international sites. Marsh 3 histology was used as a reference standard against which we determined the performance characteristics of an IgA tTG titre of ≥10×ULN for a diagnosis of CD.ResultsCohort 1: the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 54.0%, 90.0%, 98.7% and 12.5%, respectively. Cohort 2: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 50.0%, 100.0%, 100.0% and 98.3%, respectively. Cohort 3: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 30.0%, 83.0%, 95.2% and 9.5%, respectively.ConclusionOur results show that IgA tTG titres of ≥10×ULN have a strong predictive value at identifying adults with intestinal changes diagnostic of CD. This study supports the use of a no-biopsy approach for the diagnosis of adult CD.