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Alveolar rhabdomyosarcoma (ARMS), an invasive subtype of rhabdomyosarcoma (RMS), is associated with chromosomal translocation events resulting in one of two oncogenic fusion genes, PAX3-FOXO1 or PAX7-FOXO1. ARMS patients exhibit an overexpression of the pleiotropic cytokine transforming growth factor beta (TGF-β). This overexpression of TGF-β1 causes an increased expression of a downstream transcription factor called SNAIL, which promotes epithelial to mesenchymal transition (EMT). Overexpression of TGF-β also inhibits myogenic differentiation, making ARMS patients highly resistant to chemotherapy. In this review, we first describe different types of RMS and then focus on ARMS and the impact of TGF-β in this tumor type. We next highlight current chemotherapy strategies, including a combination of the FDA-approved drugs vincristine, actinomycin D, and cyclophosphamide (VAC); cabozantinib; bortezomib; vinorelbine; AZD 1775; and cisplatin. Lastly, we discuss chemotherapy agents that target the differentiation of tumor cells in ARMS, which include all-trans retinoic acid (ATRA) and 5-Azacytidine. Improving our understanding of the role of signaling pathways, such as TGF-β1, in the development of ARMS tumor cells differentiation will help inform more tailored drug administration in the future.

Background: The group discussion method is one of the student-centered and active teaching methods in which learners actively participate in educational activities using discussion, and they are given the opportunity to share their opinions and experiences with others.Objectives: The present study was conducted to compare the effects of the group discussion method and the lecture method on health workers’ knowledge and attitudes.Methods: In this quasi-experimental study, 70 health workers working in Baft, Kerman province, were selected by census method and divided into two groups of 35 people. Asthma-related educational content was presented for one group as a lecture and the other as a group discussion. Before and after the intervention, health workers’ knowledge and attitudes scores were evaluated and compared using a researcher-made questionnaire.Results: The mean age of participants was 38 ± 2.7 years. After the intervention, the mean score of attitude was 65.86 ± 6 in the lecture group and 68.66 ± 4.7 in the group discussion group, indicating a significant difference (p = 0.04). The mean score of knowledge after the intervention was 11.4 ± 1.66 in the lecture group and 11.28 ± 1.6 in the group discussion group, which was not statistically significant (p = 0.77). In both groups, the mean scores of knowledge and attitude increased significantly after the intervention (p

The electrochemical behavior of captopril at the surface of a carbon-paste electrode (CPE) modified with gold nanoparticles (GNPs) is described. The prepared electrode shows an excellent electrocatalytic activity toward the oxidation of captopril, which is leading to marked considerable improvement of sensitivity. Whereas at the surface of unmodified electrode an electrochemical activity for captopril cannot be observed, a very sharp anodic wave with an anodic peak potential about 1.0V (versus Ag/AgCl) is obtained using the prepared modified electrode. Captopril oxidation on CPE/GNPs proceeds at pH between 4.0 and 10.0. Under the optimized conditions, the electrocatalytic oxidation peak current of captopril showed two linear dynamic ranges with a detection limit of 8.28×10-2 µM captopril. The linear calibration range was 1.14-16.98 and 21.49-62.1 µM using amperometric. Finally, the sensor was examined as a selective, simple, and precise new electrochemical sensor for the determination of captopril in pharmaceutical samples including tablets and satisfactory results were obtained.

Currarino syndrome is an autosomal dominant hereditary disease defined as a triad of anorectal abnormality, sacral dysgenesis, and a presacral mass, primarily an anterior sacral meningocele. It is often seen in children and considered rare in adults. It is mostly found as an incidental finding. We present a 21-year-old man who presented with acute flank pain. He had a history of Hirschsprung's disease and therefore had undergone surgery in his infancy. He also had a history of prolonged constipation and had an episode of admission due to suspected obstruction. On physical examination, he had a severe costovertebral angle tenderness. urine exam revealed microscopic hematuria. Laboratory tests were otherwise unremarkable. Computed tomography scan revealed renal stones as well as a horseshoe kidney. Incidental findings included a large simple cystic structure in the presacral area suggestive of an anterior meningocele and sacral dysgenesis associated with scimitar sacral appearance. These findings suggested a diagnosis of Currarino syndrome. Urinary complications of this disease are reported in few articles. An important takeaway note for physicians is to have a high level of suspicion when encountering patients with gastrointestinal, neurologic, or urologic signs and symptoms and consider a thorough history taking and physical examination alongside proper imaging evaluation.

Abstract Background Exercise and some pre-AKI diets have been shown to improve injury, apoptosis, and lipid profile. In this study, the effect of two different diets along with exercise training on acute kidney injury (AKI) was investigated. Materials and methods Laboratory rats were randomly divided into four groups of control, standard diet + exercise, exercise + calorie restriction (CR) and exercise + time restriction (TR). Each group was divided into two subgroups of AKI and no AKI. The animals received endurance training and diet regimens before AKI. Fasting blood glucose, serum creatinine, Bcl-2-associated X protein (Bax), B-cell lymphoma 2 (Bcl2) and histopathological outcome of renal tissue as well as serum lipid profile of animals were assessed 24 h after AKI. Results The percentage of changes in renal Bcl2 and Bax after AKI in the group with previous exercise was lower than the group without previous exercise (p

We demonstrate that 6 distinct Peromyscus rodent species are permissive to experimental infection with Sin Nombre orthohantavirus (SNV). Viral RNA and SNV antibodies were detected in members of all 6 species. P. leucopus mice demonstrated markedly higher viral and antibody titers than P. maniculatus mice, the established primary hosts for SNV.

Abstract The aim of this study was to evaluate the prognostic value of the Lactate to Albumin (L/A) ratio compared to that of lactate and lactate clearance in predicting outcomes in patients with septic shock. This was a multi-center observational study of adult patients with septic shock, who admitted to intensive care units (ICUs) at Shohada and Imam Reza Hospitals, Tabriz, Iran, between Sept 2018 and Jan 2021. The area under the curve (AUC) of receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to explore associations of the L/A ratio, lactate and lactate clearance on the primary (mortality) and secondary outcomes [ICU length of stay (LOS), duration of mechanical ventilation (MV), need of renal replacement therapy (RRT) and duration of using vasopressors] at baseline, 6 h and 24 h of septic shock recognition. Best performing predictive value for mortality were related to lactate clearance at 24 h, L/A ratio at 6 h and lactate levels at 24 h with (AUC 0.963, 95% CI 0.918–0.987, P

Background: The present study aimed to evaluate the effectiveness of ultra-low-dose (ULD) chest computed tomography (CT) in comparison with the routine dose (RD) CT images in detecting lung lesions related to COVID-19.Methods: A prospective study was conducted during April-September 2020 at Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In total, 273 volunteers with suspected COVID-19 participated in the study and successively underwent RD-CT and ULD-CT chest scans. Two expert radiologists qualitatively evaluated the images. Dose assessment was performed by determining volume CT dose index, dose length product, and size-specific dose estimate. Data analysis was performed using a ranking test and kappa coefficient (κ). P

This study presents the synthesis of glucosamine-modified mesoporous silica-coated magnetic nanoparticles (MNPs) as a therapeutic platform for the delivery of an anticancer drug, methotrexate (MTX). The MNPs were coated with mesoporous silica in a templated sol–gel process to form MNP@MSN, and then chloropropyl groups were added to the structure in a post-modification reaction. Glucosamine was then reacted with the chloro-modified structure, and methotrexate was conjugated to the hydroxyl group of the glucose. The prepared structure was characterized using techniques such as Fourier transform infrared (FT-IR) spectroscopy, elemental analysis (CHN), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), dynamic light scattering (DLS), a vibrating sample magnetometer (VSM), and X-ray diffraction (XRD). Good formation of nano-sized MNPs and MNP@MSN was observed via particle size monitoring. The modified glucosamine structure showed a controlled release profile of methotrexate in simulated tumor fluid. In vitro evaluation using the 4T1 breast cancer cell line showed the cytotoxicity, apoptosis, and cell cycle effects of methotrexate. The MTT assay showed comparable toxicity between MTX-loaded nanoparticles and free MTX. The structure could act as a glucose transporter-targeting agent and showed increased uptake in cancer cells. An in vivo breast cancer model was established in BALB/C mice, and the distribution of MTX-conjugated MNP@MSN particles was visualized using MRI. The MTX-conjugated particles showed significant anti-tumor potential together with MRI contrast enhancement.

Aqueductal stenosis can be a silent disease that can present in a patient for years without any signs and symptoms. This silence can occur due to CSF flow dynamics compensation, and it can continue until the increase in CSF production so that the symptoms may appear during adolescence or even later. In this study, we report an aqueduct obstruction by web, who had no symptoms except a headache and was referred for MRI in his early thirty. The patient was referred to find the cause of his episodes of headaches. If he did not follow up on his headache, he might never know about his disorder.

Schwannomas are nerve sheath tumors that arise from Schwann cells and are mainly benign. The likelihood of endobronchial schwannoma amongst all intrapulmonary tumors is up to 0.2% and mainly presents late. This study described a pediatric endobronchial schwannomas case discovered incidentally during rigid bronchoscopy. This case is uncommon, and its report can help physicians diagnose the same cases. The case was a 7-year-old girl presenting with fever and cough who had no history of pulmonary disease or relevant family history. Physical examination, chest radiography, CT scan, and bronchoscopy were performed on the patient. A biopsy was taken from the observed mass obstructing the bronchus during bronchoscopy. The mass was resected. Pathology revealed low-grade spindle cell neoplasm and confirmed schwannoma in immunohistochemistry. Endobronchial schwannomas can happen in children presenting with simple symptoms. For benign lesions, the prognosis is generally good. Due to the slow growth of these tumors and the potential for recurrence after resection, long-term follow-up may be needed.

Background: Neuroprotective effects of L-carnitine on damage caused by fetal exposure to ethanol have been demonstrated. The purpose of this study was to evaluate the effects of different doses of L-carnitine at different stages of pregnancy on the memory of two month old offsprings whose mothers consumed alcohol during pregnancy.Methods: For the purpose of this study, 55 pregnant female rats were randomly divided into 11 groups of 5, including control group, which received drinking water, and the ethanol group which received drinking water containing 10 % (w/v) ethanol. L-Carnitine treated group received L-carnitine in doses of 50, 100, or 150 mg/kg in addition to the ethanol, in the first 10 days or the second 10 days of pregnancy. For modeling the third trimester of pregnancy, doses of L-carnitine were gavaged to the rat neonates for 10 days. After two months of birth, the memories of offsprings were evaluated using Passive Avoidance Task (PAT) and Novel Object Recognition Test (ORT).Findings: Administration of L-carnitine significantly increased discrimination of the ORT index and the escape latency of entry to dark compartment in PAT by two month old offspring compared to the ethanol group. The mentioned indices were significantly increased at a dose of 150 mg/kg compared to the dose of 50 mg/kg throughout all pregnancy periods. These indices were significantly different when l-carnitine was administered in the second 10 days of pregnancy compared to any other periods.Conclusion: The administration of L-carnitine during pregnancy can prevent alcohol-induced memory impairment in rat offsprings. This effect was more significant at higher doses of L-carnitine. The best response was seen when L-carnitine was administered to mothers in the second 10 days of pregnancy.

Background: Inadequate health literacy (HL) in dialysis patients increases the risk of poor self-care and decreases severe self-care and severe negative health outcomes in these patients. This study aimed to investigate HL and its related factors in dialysis patients in Kerman, Iran, in 2021. Methods: This cross-sectional study was performed on 280 dialysis patients who referred to Kerman (Iran) dialysis centres. The participants were selected through multi-stage sampling method. The study was conducted using the Iranian Health Literacy Questionnaire (IHLQ). The higher score shows a better HL. Results: The mean age of the subjects was 57.75 ± 13.87 years. The mean score of HL was 9.12 ± 4.54 out of 20 points. During multivariate regression, there was a significant relationship between HL and age (β = -0.08, P = 0.02) and level of education (elementary/literacy (β = 4.607, P < 0.001), middle school (β = 6.38, P < 0.001), high school (β = 8.573, P < 0.001) and academic education (β = 9.410, P < 0.001), and there was a significant relationship between HL and eye disease (β = -0.903, P = 0.001). Conclusion: Most participants did not have adequate HL, while HL as the most important determinant of self-care can improve patients’ quality of life and reduce their health care costs. Therefore, in order to increase self-care, planning and necessary interventions, the HL of these patients seems to be necessary

Background and Aim: Sperm cryopreservation is an important assisted reproductive technique. However, due to increased production of reactive oxygen species and oxidative stress, it can impair sperm function and reduce quality of fertility. The aim of this study was to investigate the effects of nicotinic acid and folic acid on maintenance of sperm function during cryopreservation by evaluation of sperm parameters and chromatin concentration. Material and Methods: Thirty samples were collected from normozoospermic men and examined for chromatin quality, viability, membrane integrity, morphology and motility. The samples were frozen and placed in 4 groups: control, folic acid (50 nM), nicotinic acid (10 mM) and a combination of both. After cryopreservation, the four groups were compared with one another in regard to the sperm parameters. Also the sperm parameters were compared before and after freezing in every group. We assessed chromatin quality by TB staining, viability by eosin-nigrosin staining, membrane integrity by hypo osmotic swelling test, and morphology and movement by CASA software. Results: Before cryopreservation chromatin quality, membrane integrity, normal morphology, sperm motility were lower and immotile sperms were higher in all groups compared to those after cryopreservation (p

Propose: In this study, we re-assessed the criteria defined by the radiological society of North America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 from pulmonary contusion. Methods: All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to Group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between Group P and Group PP; statistically significant ones were re-evaluated between Group Pa and Group Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between Group P and Group PP. Results: In the Group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected (p

Acute disseminated encephalomyelitis (ADEM) is an acute demyelinating disorder of the central nervous system that is ordinarily monophasic. ADEM can develop following infection or vaccination. Here, we present a 37 y/o male patient with progressive muscle weakness in all limbs along with dysphagia following COVID-19 vaccination. Brain magnetic resonance imaging (MRI) revealed typical imaging findings which presented as multifocal T2-FLAIR signal changes in the corticospinal tract, pons, and temporal lobe with diffusion restriction. Magnetic resonance spectroscopy (MRS) further confirmed the diagnosis by the typical elevation of the Choline and Myoinositol peaks. Neurologic impairments have been reported as the potential side effects of COVID-19 vaccines. Appropriate imaging modalities together with a thorough clinical examination are essential for making a correct diagnosis.

Background: The present study was conducted to examine the possibility of detecting different types of lung lesions, such as cancer, using ultra-low dose (ULD) chest computed tomography (CT) images. Method: In this basic (experimental) study with CT images, 20 patients with different lung disease indications were scanned with ULD and routine dose chest CT protocols. ULD and routine dose CT images were reconstructed utilizing iDose and iterative model reconstruction. CT images were evaluated by two expert radiologists. Volume CT dose index (CTDIvol), dose length product, and effective dose were used for dose assessment in both protocols. Results: CTDIvol and dose length product for ULD protocol were 98% less compared to those for routine chest CT. The chest CT images for ULD and routine dose were diagnosed as normal in three patients with lung lesions, such as nodules, masses, plural effusion, fibrosis, diffuse ground glass opacities, bronchiectasis, and infiltration, in 17 patients. Patient dose of ULD chest CT (0.11mSv) is comparable to Poster-Anterior plus Lateral (0.1 mSv) chest radiograph, while the effective dose due to routine chest CT is about 5.1 mSv. Conclusion: Diagnostic findings regarding ULD chest CT images with 98% of dose reduction were compared to those for routine dose. We concluded that it may be utilized as a very useful tool for screening and the follow-up of different lung diseases, malignancy for instance. ULD chest CT with 98% of dose reduction could be a suitable substitute for chest radiograph, with higher diagnostic values.

PurposeThis study aimed to determine the effects of a nurse-led structured home visit program on quality of life and adherence to treatment in patients undergoing hemodialysis.MethodsThe study was quasi-experimental research in which 62 hemodialysis patients referred to Bu Ali hospital in Ardabil participated in two groups: Intervention (n = 31) and control (n = 31). The intervention included a structured and planned home visit program that was performed in five stages over 3 months. Data collection tools were a demographic information form, Kidney Disease Quality of Life Short Form (KDQOL–SF™) and End Stage Renal Disease Adherence Questionnaire (ESRD_AQ) which were completed by patients before, at the end of the first, second, and third month of intervention. SPSS v20 software and descriptive and analytical tests (Chi-square, t-test, ANOVA and repeated measure) were used for data analysis.FindingsExamining demographic characteristics showed that there is a negative and significant relationship between age and quality of life scores (P = 0.004), that is, with increasing age, the quality of life score decreases, but other demographic characteristics did not have a significant relationship with quality of life scores and adherence to treatment (P > 0.05).Also, the results showed that in the intervention and control groups, during the study, the scores of quality of life and adherence to treatment increased significantly, and this increase was significantly higher in the intervention group than in the control group (P < 0.001).The scores of quality of life and adherence to treatment increased significantly both during the study in each group separately and between groups during the study (P < 0.001).ConclusionsAccording to the significant improvement in quality of life and adherence to treatment in patients following a home-visiting program during 3 months, these interventions can be utilized to improve quality of life and adherence to treatment of patients undergoing hemodialysis.Practice implicationsHome visiting programs significantly improve the level of knowledge of patients undergoing hemodialysis and their family members, through their involvement in the care process. Having said that, it seems plausible to implement home visits in the standard care plans of hemodialysis patients.

BackgroundEarthquakes cause many casualties worldwide. Taking preventive measures and improving community preparedness is critical to reducing earthquake damage. The social cognitive theory explains how individual and environmental factors cause behavior. This review was conducted to identify the social cognitive theory structures, in research on the preparedness of households against earthquakes.Materials and methodsThis systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted from January 1, 2000, to October 30, 2021 in Web of Science, Scopus, PubMed, and Google Scholar. Studies were selected based on inclusion and exclusion criteria. The initial search yielded 9,225 articles, and finally, 18 articles were selected. Articles were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.ResultsEighteen articles about disaster preparedness behaviors based on the socio-cognitive constructs were identified and reviewed. The essential constructs used in the reviewed studies included self-efficacy, collective efficacy, knowledge, outcome expectations, social support, and normative beliefs.ConclusionBy identifying the dominant structures that have been used in studies related to the preparedness of households against earthquakes, researchers can implement appropriate and more cost-effective interventions by focusing on improving suitable structures.

IntroductionThis study aimed to perform an updated systematic review and meta-analysis to evaluate the effectiveness of saffron supplementation on oxidative stress markers [malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), glutathione peroxidase (GPx), superoxide dismutase (SOD), and prooxidant/antioxidant balance (PAB)] in randomized controlled trials (RCTs).MethodsWe searched PubMed/Medline, Web of Science, Scopus, Cochrane CENTRAL, and Google Scholar until December 2022. Trial studies investigating the effects of oral saffron supplements on MDA, TAC, TOS, GPx, SOD, and PAB concentrations were included in the study. To analyze the results, mean differences (SMD) and 95% confidence intervals (CI) were pooled using a random effects model. Heterogeneity was assessed using the Cochrane Q and I2 values. Sixteen cases were included in the meta-analysis (468 and 466 subjects in the saffron and control groups, respectively).ResultsIt was found that saffron consumption caused a significant decrease in MDA (SMD: −0.322; 95% CI: −0.53, −0.16; I2 = 32.58%) and TOS (SMD: −0.654; 95% CI: −1.08, −0.23; I2 = 68%) levels as well as a significant increase in TAC (SMD: 0.302; 95% CI: 0.13, 0.47; I2 = 10.12%) and GPx (SMD: 0.447; 95% CI: 0.10, 0.80; I2 = 35%). Subgroup analysis demonstrated a significant reduction in MDA levels in studies with a saffron dosage of >30 mg/day, age of

Background and Objectives: This cross-sectional study aims to explore the effect of vocal warm-up and cool-down exercises (VWCE) on the acoustic characteristics of speech and language pathologists (SLPs). Methods: This pilot study was conducted on 18 SLPs. The participants received VWCE for 6 weeks, 3 times per week, every other day. The acoustic characteristics, including jitter, shimmer, and harmonic to noise rat (HNR) were outcome measures. All outcome variables were measured before the exercise program (T0), after the end of the 9th session (T1), and after the end of the 18th session (T2). Results: A significant decrease was observed in jitter after the VWCE at T1 and T2. The shimmer showed significant decreases in T2 compared to T0 (P

Abstract The energy hub is considered one of the most important parts of the multi‐carrier energy distribution systems. One of the major challenges facing the energy hub idea is the optimal distribution and management of energy based on renewable and non‐renewable power generation resources in the presence of demand response programs and uncertainties. This study aims to present an optimal management and distribution model of energy based on uncertainties of probability modelling of renewable energy resources, uncertainties of electrical loads (electric vehicles (EVs)), operating and maintenance cost, cost modelling of greenhouse gas emissions, and electric and thermal demand response programs. Therefore, the proposed model is presented based on a robust optimization model and mixed‐integer linear programming. Uncertainties in this research are divided into two categories; technical and economic. The technical part includes the uncertainties caused by renewable energy resources and EVs, simulated based on the Monte Carlo method and their probability distribution function. The economic part includes modelling the uncertainty caused by the price of electricity. The operation model and the objective function of the optimization problem are modelled using the demand response models based on peak shaving and load shifting techniques.

Abstract Introduction Homelessness is increasing among young adults in large cities. According to the United Nations, there are more than one billion absolute or relative homeless people in the world. This study was conducted to explain the lived experiences of homeless youth in southeastern Iran. Materials and methods In this qualitative study, we recruited 13 participants in a big city, southeast Iran, in 2020. The participant was young homeless adults aged 18–29 years who were using homeless shelters provided by the municipality, sleeping in parks or on streets. Data were collected through in-depth and semi-structured interviews and three focus group discussions. Data were analyzed by conventional qualitative content analysis. Results The main category of “lonely, annoyed, and abandoned in society” and three subcategories of avoidance of/by society, comprehensive harassment, and lack of comprehensive support were extracted. The experiences of young homeless adults showed that they escaped from the community due to addiction, feeling like a burden to others, and social isolation, and not only have they been left without support in society, but they have also suffered from all kinds of physical and psychological harassments. Conclusion The lived experiences of homeless people show that in addition to appropriate facilities and living conditions, they require respect, reduced social stigma, discrimination, and favorable conditions for a return to life. Therefore, authorities should identify and settle their problems and needs.

Objective(s): Lifestyle and eating habits affect the health and function of the body’s organs, including the kidneys. The current study was carried out to determine the effects of two types of diet programs, including time restriction (TR) and calorie restriction (CR) on the histopathological changes and apoptotic molecules during acute kidney injury (AKI) in postmenopausal rats. Materials and Methods: In this study the female rats were divided into two groups of ovariectomized (OVX) and ovary-intact (sham), then they were placed on TR and CR diets for 8 weeks; afterward, AKI was induced by injection of glycerol. Functional indices, histopathological changes, Bax, and Bcl2 were measured before and after AKI. Results: After AKI, creatinine, serum urea, urinary albumin excretion, kidney tissue Bax, and Bax/Bcl2 ratio increased, while glomerular filtration rate (GFR) and kidney tissue Bcl2 decreased compared with before AKI. Histopathological indices (inflammation, cellular necrosis, cell vacuolization, tubular dilatation, intratubular cast, and congestion) also confirmed renal injury. TR and CR diets improved renal injury indices and prevented an increase in the Bax/Bcl2 ratio. However, in some indices, the effects of two diets on OVX animals were not observed. In addition, none of the diets could decrease kidney weight/body weight ratio (KW/BW). The histopathological finding also showed improvement of renal status in both groups, especially in the CR diet.Conclusion: The results indicated that TR and CR diets had renoprotective effects against AKI by reducing the Bax/Bcl2 ratio and improving apoptosis. The effects of CR were more than TR.

Objectives: Frailty is characterized by an increased vulnerability to stressors. Frail older patients are at increased risk of Emergency Department (ED) visits, hospitalization, and disability. The aim of this study was to determine the relationship between frailty syndrome and polypharmacy in the elderly referred to the emergency department of Ardabil teaching hospitals. Methods & Materials: In this cross-sectional descriptive study, 505 elderly people referred to the hospital emergency department were selected by convenience sampling method. Frailty syndrome was measured using the five-item criteria of fried which include: 1) slow walking, 2) muscular weakness, 3) exhaustion, 4) low physical activity and 5) unintentional weight loss. Polypharmacy considered the use of 5 or more drugs. Data were analyzed using descriptive statistics including mean and standard deviation and inferential analysis including analysis of variance, independent t-test, correlation, and multiple regression using spss v. 22 statistical software. Results: The mean age of participants was 70.91‌±‌7.49 and 255 (50.5%) were male, 318 (63%) were married and 271 (53.7%) were illiterate. the results of the study showed that 204 (40.4%) of the elderly who referred to the emergency department had frailty and 177 (35%) had pre frailty. In this population, we identified a 42.2% (n=98) of frail with polypharmacy, 37.1% (n=86) of prefrail with polypharmacy. The correlation test showed that there is a significant relationship between fertility and polypharmacy (P˂0.001). Linear regression analysis showed the variables of age, education, living arrangement, hospitalization, and the number of medications used by the patient as predictors of frailty syndrome in the elderly referred to the emergency department. Conclusion: Number of drugs used, age, education, living arrangement and number of hospitalizations were predictors of frailty syndrome in the elderly. Considering the living conditions of the elderly and the prevention of unnecessary hospitalizations can reduce polypharmacy and ultimately a preventive strategy to prevent and manage frailty. Of course, further research is needed to confirm the possible benefits of reducing polypharmacy in the development, reversion, or delay of frailty.

Background: Dynamic protein-protein interaction networks (DPPIN) can confirm the conditional and temporal features of proteins and protein complexes. In addition, the relation of protein complexes in dynamic networks can provide useful information in understanding the dynamic functionality of PPI networks. Objective: In this paper, an algorithm is presented to discover the temporal association rule from the dynamic PPIN dataset.Material and Methods: In this analytical study, the static protein-protein interaction network is transformed into a dynamic network using the gene expression thresholding to extract the protein complex relations. The number of presented proteins of the dynamic network is large at each time point. This number will increase for extraction of multidimensional rules at different times. By mapping the gold standard protein complexes as reference protein complexes, the number of items decreases from active proteins to protein complexes at each transaction. Extracted sub graphs as protein complexes, at each time point, are weighted according to the reference protein complexes similarity degrees. Mega-transactions and extended items are created based on occurrence bitmap matrix of the reference complexes. Rules will be extracted based on Mega-transactions of protein complexes. Results: The proposed method has been evaluated using gold standard protein complex rules. The amount of extracted rules from Biogrid datasets and protein complexes are 281, with support 0.2. Conclusion: The characteristic of the proposed algorithm is the simultaneous extraction of intra-transaction and inter-transaction rules. The results evaluation using EBI data shows the efficiency of the proposed algorithm.

Abstract As a powerful antioxidant compound, crocin can partially protect against renal ischemia/reperfusion (I/R) injuries. The encapsulation of components in niosomes (non-ionic surfactant-based vesicle) as nano-sized carrier systems has been proposed as they improve the solubility, stability, and bioavailability of drugs. Herein, the encapsulation of crocin in nano-niosomes and the effects of crocin-loaded nano-niosomes on renal ischemia/reperfusion-induced damages were evaluated. Nano-niosomes containing crocin were formulated by a modified heating method and were characterized for their physicochemical characteristics. Ischemia was induced by clamping the renal artery for 30 min followed by 1 or 24 h of reperfusion. Rats received an intra-arterial injection of nano-niosome-loaded crocin at the outset of reperfusion. Blood samples were taken after reperfusion to measure urea, creatinine (Cr), malondialdehyde (MDA), and superoxide dismutase (SOD) activity. The right kidney was removed for histological examination. The results showed that crocin-contain nano-niosomes have appropriate size and morphology, acceptable encapsulation efficiency, and a proper release pattern of crocin. I/R enhanced creatinine (Cr), urea, and malondialdehyde (MDA) serum levels and reduced SOD activity and histological damages in the renal tissue.

Abstract Background Wet-lab experiments for identification of interactions between drugs and target proteins are time-consuming, costly and labor-intensive. The use of computational prediction of drug–target interactions (DTIs), which is one of the significant points in drug discovery, has been considered by many researchers in recent years. It also reduces the search space of interactions by proposing potential interaction candidates. Results In this paper, a new approach based on unifying matrix factorization and nuclear norm minimization is proposed to find a low-rank interaction. In this combined method, to solve the low-rank matrix approximation, the terms in the DTI problem are used in such a way that the nuclear norm regularized problem is optimized by a bilinear factorization based on Rank-Restricted Soft Singular Value Decomposition (RRSSVD). In the proposed method, adjacencies between drugs and targets are encoded by graphs. Drug–target interaction, drug-drug similarity, target-target, and combination of similarities have also been used as input. Conclusions The proposed method is evaluated on four benchmark datasets known as Enzymes (E), Ion channels (ICs), G protein-coupled receptors (GPCRs) and nuclear receptors (NRs) based on AUC, AUPR, and time measure. The results show an improvement in the performance of the proposed method compared to the state-of-the-art techniques.

Background and aim: Cryopreservation is one of the common techniques in the management of infertility, which can damage the sperm cell and its function by producing reactive oxygen species. To determine health and fertility of cryopreserved sperm, we evaluated different markers in infertile men. The aim of this study was to investigate the effect of biotin and folic acid on motility, viablity, shape, chromatin density and membrane integrity of cryopreserved and thawed sperm in normozoospermic men. Material and Method: In this experimental study, 30 samples were collected from normozoospermic men. Every sample included fresh pre-cryopreservation group, cryopreserved control groups, biotin (10 mM), folic acid (50 nM), and combination of biotin (10 mM) and folic acid (50 nM) groups. Sperms were frozen for two weeks using the usual freezing technique at -196 ° C and then thawed. Samples were evaluated for motility before and after freezing using computer-aided sperm analysis software. We assessed sperm viability by eosin-negrosin staining, chromatin density by toluidine blue staining and membrane integrity by hypo osmotic swelling test. Results: Before cryopreservation, motility, viability, chromatin density, sperm membrane integrity were higher and the number of immotile sperms were lower in all groups (p

Abstract Background Improving anti-cancer drug delivery performance can be achieved through designing smart and targeted drug delivery systems (DDSs). For this aim, it is important to evaluate overexpressed biomarkers in the tumor microenvironment (TME) for optimizing DDSs. Materials and methods Herein, we designed a novel DDS based on magnetic mesoporous silica core–shell nanoparticles (SPION@MSNs) in which release of doxorubicin (DOX) at the physiologic pH was blocked with gold gatekeepers. In this platform, we conjugated heterofunctional polyethylene glycol (PEG) onto the outer surface of nanocarriers to increase their biocompatibility. At the final stage, an epithelial cell adhesion molecule (EpCAM) aptamer as an active targeting moiety was covalently attached (Apt-PEG-Au@NPs-DOX) for selective drug delivery to colorectal cancer (CRC) cells. The physicochemical properties of non-targeted and targeted nanocarriers were fully characterized. The anti-cancer activity, cellular internalization, and then the cell death mechanism of prepared nanocarriers were determined and compared in vitro. Finally, tumor inhibitory effects, biodistribution and possible side effects of the nanocarriers were evaluated in immunocompromised C57BL/6 mice bearing human HT-29 tumors. Results Nanocarriers were successfully synthesized with a mean final size diameter of 58.22 ± 8.54 nm. Higher cytotoxicity and cellular uptake of targeted nanocarriers were shown in the EpCAM-positive HT-29 cells as compared to the EpCAM-negative CHO cells, indicating the efficacy of aptamer as a targeting agent. In vivo results in a humanized mouse model showed that targeted nanocarriers could effectively increase DOX accumulation in the tumor site, inhibit tumor growth, and reduce the adverse side effects. Conclusion These results suggest that corporation of a magnetic core, gold gatekeeper, PEG and aptamer can strongly improve drug delivery performance and provide a theranostic DDS for efficient CRC therapy. Graphic abstract

IntroductionTeacher violence is defined as the intentional use of power by teachers against students in a variety of ways, including physical, verbal, psychological, and sexual assault. Victims of school violence are more anxious and insecure than other students. An in-depth and comprehensive study on the prevention of violence in schools is urgent and necessary. We conducted this study to determine teacher violence from the perspectives of schoolteachers and students and related factors.MethodsWe conducted this descriptive-analytical study on 313 teachers and 400 students in Ardestan, southern Iran, in 2019. We selected teachers and students using a census method and stratified random sampling, respectively. The research instrument was the school violence questionnaire.ResultsFrom the perspective of teachers, the mean score of teacher violence (5.7) was significantly lower than that of students (18.3). Male, young, single teachers with diploma and less work experience had significantly higher violence scores than other teachers (P < 0.001). We witnessed this trend in public boys’ schools as well (p < 0.001). The total mean score for teacher violence was not significantly different between male and female students. From the perspective of students, the mean score of teacher violence was significantly different (P < 0.001).ConclusionOur results suggest that education authorities and school principals should supervise public school teachers with less education, younger students, and boys’ schools and provide practical training to improve the communication and emotional skills among these teachers.

Introduction Complete cessation of breastfeeding (CCB) at the right time is as important as starting breastfeeding, as well as identifying the factors that affect the duration of breastfeeding, so that breastfeeding promotion programs focus on these causes, to increase mothers’ ability and desire to breastfeed. This study aimed to determine the time of CCB and its related factors. Methods This analytical cross-sectional study was conducted in 2020. This study was performed at all health centers and health homes affiliated to Kerman University of Medical Sciences, in Kerman province, Iran. A total of 802 urban and rural mothers with children aged from 30 to 36 months completed the questionnaire. The validity and reliability of the questionnaire were confirmed by Cronbach’s alpha of 85%. Data were analyzed using SPSS software version 16. Results The mean time of breastfeeding was 19.23 ± 7.09 months and the median was 22-month-year. About 41% of children were breastfed until 24-month. There was a significant relationship between the time of CCB with contraception, number of households, place of residence, and weight at 6-month at the level of 0.05. Conclusion Duration of breastfeeding is influenced by some demographic and cultural factors. The timing of the CCB is near to the suggestions of the World Health Organization (WHO) and religious teachings.

Background: This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran.Methods: Using convenience sampling and a standard questionnaire, we recruited 104 HIV-positive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma.Results: The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=

Background: Burn wound is one of the most common injuries worldwide. However, its management still remains a health concern and research is ongoing for more efficient therapies. Persian medicine has described different methods in this regard. Previous reviews have mostly focused on the herbal-based therapies for burn management. Hence, the current study aimed to review both non-herbal and herbal-based therapies used in Persian medicine for their burn healing properties, and to compare them with new evidence.Method: The most important texts of Persian medicine were reviewed for burn wound classification, managements and treatment approaches. Moreover, herbal, minerals, and animal-based products claimed to possess burn wound healing activity, were extracted. In the next step, digital databases were searched to find new supporting data for the extracted-traditional remedies and their healing mechanisms.Results: More than one hundred traditional medicinal herbs, minerals, and animal-based products have been recommended to treat burn wound in Persian medicine among them, the healing effect of thirty-five herbs and eight non-herbal treatments (mineral and animal-based compounds) were supported by new evidence. Otherwise, there was not new evidence reporting the healing effect of seventy-three herbs and sixteen non-herbal compounds extracted from Persian Medicine literature.Conclusion: Although some managements of burn wounds in Persian medicine have been confirmed by new evidence, the efficacy of a plenty of materials needs to be methodically evaluated. Hence, it could introduce new clues for future research.

Background: Since pulmonary angiography is the only non-invasive method for diagnosing pulmonary embolism, the use of radiation reduction methods without affecting the quality of images seems necessary. One of the simplest reasons for unnecessarily increasing of patient exposure is repetitive imaging due to poor image quality. Therefore, it is necessary to identify and eliminate the factors that reduce the image quality, which leads to duplication of imaging or reduced accuracy. In this study, the reasons for decreasing the image quality of pulmonary computed tomography (CT) angiography were investigated. Methods: This cross-sectional study was performed over a period of 6 months (May to November 2018) in a university-affiliated hospital. Data of 75 patients suspected of pulmonary embolism who were referred for CT angiography were collected. All CT scans were performed by a 16-slice CT scanner (Lights Speed, GE Healthcare) with fixed imaging parameters including 100 kVp and 100 mA. In order to evaluate the adequacy of pulmonary artery enhancement, the Hounsfield unit (HU) of the main pulmonary artery was measured in the aortic arch, upper, and lower segmental parts. Also, 8 factors affecting the image quality were examined. Results: The mean HU of the main pulmonary arteries was 312 in the range of 124 to 677. The mean HU in patients with and without pulmonary embolism was 358 and 302, respectively. Most CT images (61%) had poor quality for the diagnosis of pulmonary embolism. Only 2% of the images were acceptable compared to standard images and protocols. Late imaging was the most common quality confounding factor in this study. Conclusion: A low-quality image reduces the accuracy of the physicianchr('39')s diagnosis that leads to misdiagnosis. Besides, sometimes poor image quality leads to repetitive imaging, which results in increased patient exposure and therefore increased radiation hazards. Therefore, modifiable confounding factors must be identified and corrected which one of the most important ones is wrong imaging timing protocols after contrast injection.

Objective(s): Along with increased intracranial pressure (ICP) and brain damage, brain edema is the most common cause of death in patients with hepatic encephalopathy. Curcumin can pass the blood-brain barrier and possesses anti-inflammatory and antioxidant properties. This study focuses on the curcumin protective effect on intrahepatic and extrahepatic damage in the brain. Materials and Methods: One hundred and forty-four male Albino N-Mary rats were randomly divided into 2 main groups: intrahepatic injury group and extrahepatic cholestasis group. In intra-hepatic injury group intrahepatic damage was induced by intraperitoneal (IP) injection of acetaminophen (500 mg/kg) [19] and included four subgroups: 1. Sham, 2. Acetaminophen (APAP), 3. Normal saline (Veh) which was used as curcumin solvent, and 4. Curcumin (CMN). In extrahepatic cholestasis group intrahepatic damage was caused by common bile duct litigation (BDL) and included four subgroups: 1. Sham, 2. BDL, 3. Vehicle (Veh), and 4. Curcumin (CMN). In both groups, 72 hr after induction of cholestasis, brain water content, blood-brain barrier permeability, serum ammonia, and histopathological indicators were examined and ICP was measured every 24 hr for three days.Results: The results showed that curcumin reduced brain edema, ICP, serum ammonia, and blood-brain barrier permeability after extrahepatic and intrahepatic damage. The maximum effect of curcumin on ICP was observed 72 hr after the injection.Conclusion: According to our findings, it seems that curcumin is an effective therapeutic intervention for treating encephalopathy caused by extrahepatic and intrahepatic damage.

Background and Aims: The sedentary lifestyle in individuals with metabolic syndrome is a main threatening risk for their health. This study aimed to investigate the effects of aerobic exercise with 65% of maximal oxygen consumption on heart rate variability and vascular nitric oxide levels in middle-aged males with metabolic syndrome. Materials and Methods: In total, 30 middle-aged men with metabolic syndrome were randomly divided into control and aerobic training groups. At the pretest and posttest, the values ​​of metabolic risk indices, heart rate variability, and nitric oxide were measured in both groups. The aerobic training group performed aerobic exercise for eight weeks at 65% of maximal oxygen consumption. The data were analyzed using the independent and paired t-tests. Results: According to the results, after comparing the values obtained from the posttest and pretest, there was a significant difference between the training and control groups regarding the fasting blood glucose, triglyceride, metabolic Z score, Standard deviation of NN intervals (SDNN), Square root of the mean squared differences of successive NN intervals (rMSSD), very-low-frequency (VLF), High frequency (HF), and vascular nitric oxide levels. Total cholesterol and low-density lipoprotein levels were significantly different in the aerobic training group, compared to those of the control group and LF as well as LF/HF at the pretest (P=0.01). However, despite slight changes in high lipoprotein and blood pressure levels, there was no significant difference in the aerobic training group, compared to the control group and pre-test. Conclusion: Regular moderate-intensity aerobic exercise can be used as an appropriate exercise protocol to improve cardiovascular function for males with metabolic syndrome.

Fibroepithelial polyps of the vagina (FEPV) are rare entities which normally manifest as one or more painless polyps sometimes with symptoms such as bleeding, vaginal discharge, and discomfort regarding the size of the mass. Despite their benign nature, they can be confused with other vaginal tumors due to their abnormal histology. In this report, we present a case of a 44-year-old woman with a giant pedunculated and symptomatic polyp of the vagina with anterior vaginal wall prolapse. The treatment method included a simple local excision of the polyp and anterior vaginal compartment repair. Histopathological examination revealed a polypoid lesion covered by squamous epithelium containing a central fibrovascular core without atypia. The patient experienced an uneventful postoperative recovery, with no complication, which implies that surgery is the most effective modality for managing such tumors.

Abstract Background Lipoxygenases are one of the critical signaling mediators which can be targeted for human prostate cancer (PC) therapy. In this study, 4-methyl-2-(4-methylpiperazinyl)pyrimido[4,5-b]benzothiazine (4-MMPB) and its two analogs, 4-propyl-2-(4-methylpiperazinyl)pyrimido[4,5-b]benzothiazine (4-PMPB) and 4-ethyl-2-(4-methylpiperazinyl)pyrimido[4,5-b]benzothiazine (4-EMPB), were proposed to have anti-tumor properties in prostate cancer. Methods After synthesizing the compounds, cytotoxic effects of 4-MMPB and its two analogs against PC-3 cancerous and HDF normal cells were investigated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay and then mechanism of cell death was assessed by flow cytometry. Finally, the anti-tumor effects of the mentioned compounds were investigated in an immunocompromised C57BL/6 mouse model. Results 4-PMPB and 4-EMPB had similar anti-cancer effects on PC-3 cells as compared with 4-MMPB, while they were not effective on normal cells. Moreover, apoptosis and ferroptosis were the main mechanisms of induced cell death in these cancerous cells. Furthermore, in vivo results indicated that both analogs had similar anti-cancer effects as 4-MMPB, leading to delayed tumor growth without any noticeable side effects in weight loss and histological investigations. Conclusion Thus, our results suggest that specific targeting of lipoxygenases via 4-MMPB analogs can be considered as a treatment of choice for PC therapy, although it requires further investigations.

Abstract Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.