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Background: Retinopathy of prematurity (ROP) is a leading cause of irreversible blindness in infants. The Postnatal Growth and ROP (G-ROP) study proposed new screening criteria for ROP. This study aimed to validate the G-ROP screening criteria in a group of Iranian premature infants who were treated in the neonatal intensive care unit (NICU) for at least 40 days. Methods: In this retrospective study, we extracted the data pertaining to infants admitted to the NICU from January 2020 to December 2021. We screened all the included infants for ROP based on the Iranian national screening criteria. We applied the G-ROP criteria to our study population, and if no criterion was met, the infant was exempted from ROP screening. We determined the sensitivity and specificity of the G-ROP guidelines for ROP detection, along with its capacity for predicting the requirement for ROP treatment. Moreover, we compared the G-ROP guidelines with the Iranian and North American guidelines for ROP screening. Results: A total of 166 premature infants with complete datasets were included: 130 had ROP, of whom 61 were treated. There were 109 female infants (65.7%). The mean (standard deviation [SD]) birth weight and gestational age were 1080 (256) g and 28.28 (1.97) weeks, respectively. Applying the G-ROP criteria, 127 of 130 infants with ROP were identified (sensitivity, 97.69%; 95% confidence interval [CI], 95.11% – 100%), and of 36 infants without ROP, three were correctly excluded (specificity, 8.33%; 95% CI, 0% – 17.36%). The G-ROP criteria did not fail to identify infants who required treatment for ROP (sensitivity, 100%; 95% CI, 98.29 – 100) and had a specificity of 8.69% (95% CI, 2.04% – 15.34%). Although the Iranian and North American criteria had 100% sensitivity for infants with any stage of ROP, they could not detect infants without ROP (0% specificity). Conclusions: The G-ROP screening criteria had a sensitivity of 100% in identifying infants requiring treatment for ROP in our high-risk group; however, specificity was not sufficiently high. Further studies with larger numbers of referred infants could confirm a decrease in the burden of retinal examinations using these criteria.

The study aims to classify the eyes with proliferative diabetic retinopathy (PDR) and non-proliferative diabetic retinopathy (NPDR) based on the optical coherence tomography angiography (OCTA) vascular density maps using a supervised machine learning algorithm.OCTA vascular density maps (at superficial capillary plexus (SCP), deep capillary plexus (DCP), and total retina (R) levels) of 148 eyes from 78 patients with diabetic retinopathy (45 PDR and 103 NPDR) was used to classify the images to NPDR and PDR groups based on a supervised machine learning algorithm known as the support vector machine (SVM) classifier optimized by a genetic evolutionary algorithm.The implemented algorithm in three different models reached up to 85% accuracy in classifying PDR and NPDR in all three levels of vascular density maps. The deep retinal layer vascular density map demonstrated the best performance with a 90% accuracy in discriminating between PDR and NPDR.The current study on a limited number of patients with diabetic retinopathy demonstrated that a supervised machine learning-based method known as SVM can be used to differentiate PDR and NPDR patients using OCTA vascular density maps.

Millions of cataract surgeries with intraocular lens (IOL) implantation are performed worldwide. Although cataract surgery brings many benefits to the patients, the risk of various complications is still a concern. One of the infrequent adverse events but potentially affecting on patients’ visual acuity and contrast sensitivity is losing the transparency of IOL. IOL opacification may lead to IOL removal or exchange, which is unpleasant to both the patient and the surgeon. Several reports of acute IOL clouding are available in the literature describing various etiologies of this phenomenon, however, the exact mechanism remained unclear in some cases. Herein, we aimed to review the causes and outcomes of intraoperative and early postoperative IOL opacification.

There is an increasing demand for the performance optimization under the reliability constraints in various engineering problems. These problems are commonly known as reliability-based design optimization (RBDO) problems. Among different RBDO frameworks, the decoupled methods are widely accepted for their high efficiency and stability. However, when facing problems with high nonlinearity and nonnormally distributed random variables, they lose their computational performance. In this study, a new efficient decoupled method with two level quantile-based sampling strategy is presented. The strategies introduced for two level sampling followed by information reuse of nearby designs are intended to enhance the sampling from failure region, thus reducing the number of samples to improve the efficiency of sampling-based methods. Compared with the existing methods which decouples RBDO in the design space and thus need to struggle with searching for most probable point (MPP), the proposed method decouples RBDO in the probability space to further make beneficial use of an efficient optimal shifting value search strategy to reach an optimal design in less iterations. By comparing the proposed method with crude MCS and other sampling-based methods through benchmark examples, our proposed method proved to be competitive in dramatically saving the computational cost.

For the first time, alpha-ketoglutarate (AKG) was used to differentiate Spermatogonial stem cells (SSCs) in the presence of BMP-4 and Retinoic acid. So, SSCs were isolated from testis of 3-6 day-old mice by enzymatic digestion by collagenase and trypsin. The Cell suspension was cultured for one week in DMEM/F12 and 20% FBS in presence of GDNF growth factor. The proliferated cells were divided between control and treatment groups. In the control group, the cells were cultured for three weeks in DMEM/F12 containing 10% FBS in presence of 10-6 M retinoic acid and 40 ng/ml of BMP-4. A dose of 0.1 M AKG was added to the treatment group. The presence of Sertoli cells in culture system was confirmed by positive reaction of vimentin immunocytochemistry. The colonies that appeared on Sertoli cells also showed positive alkaline phosphatase activity and Oct4 immunocytochemistry reaction. qRT-PCR studies showed that the expression of Acrosin and Sycp3 genes was low in two groups after 7 days of culture. 21 days after culture, in the treatment group, the expression of Acrosin and Sycp3 genes was significantly increased rather than control group (p≤0.05). Large number of early spermatids were observed in the treatment group based on TEM studies.

Background: In sport context learning a skill, and performing it flawlessly is of great importance. There is a unanimous consensus among sport scientists, coaches, and athletes, that along with physical, technical and tactical skills, psychological skills are also necessary for an optimal sport performance. Objectives: The aim of the present study was to investigate the role of mental toughness in motor learning and sport performance in wrestling. Methods: This study was semi-experimental and its population were physical education students of the University of Tehran in 2018. Using intensive sampling method, 28 student-athletes, who never had any past wrestling skill practices, were selected. Subsequently, using Mental Toughness-48 questionnaires, they were divided into two equal groups of high and low in mental toughness. After that, all participants were randomly assigned into two groups of equal size and 30 wrestling skills were taught to them twice a week for 3 months by two professional wrestling coaches. Their motor learning was assessed by three other professional coaches in the last week of training and one week after the last session. Motor learning score was obtained by calculating the mean scores of acquisition and retention stages. Then, two groups with high and low levels of mental toughness were compared regarding their motor learning scores. Tools used in this study included demographic consent form, wrestling skills test and The Mental Toughness Questionnaire-48 (MTQ 48). Results: The results suggested that mentally tough student-athletes demonstrated significantly higher motor learning scores compared with their counterparts who had lower levels of mental toughness (P ≤ 0/05). This advantage was persistent both in the acquisition and retention stages (P ≤ 0/05). Conclusions: It was concluded that mental toughness could be considered as a key factor in motor learning. Therefore, it is recommended to coaches and athletes to develop mental toughness in order to enhance motor learning and achieve successful performance.

The purpose of current study was to evaluate different optical coherence tomography angiography (OCTA) metrics in eyes with diabetic retinopathy with and without diabetic macular edema (DME). In this retrospective study, macular OCTA images of eyes with non-proliferative or proliferative diabetic retinopathy were evaluated. Vascular density, vascular complexity and non-perfusion densities were compared between eyes with and without DME. One-hundred-thirty-eight eyes of 92 diabetic patients including 49 eyes with DME were included. In multivariate analysis, the presence of DME was positively associated with geometric perfusion deficit (GPD) in superficial capillary plexus (SCP), capillary non-perfusion (CNP) of SCP, and GPD in deep capillary plexus (DCP) (all P

Doi: 10.1007/s10658-021-02410-9

Combining genetic data with ecological niche models is an effective approach for exploring climatic and nonclimatic environmental variables affecting spatial patterns of intraspecific genetic variation. Here, we adopted this combined approach to evaluate genetic structure and ecological niche of the Indian gray mongoose (Urva edwardsii) in Iran, as the most western part of the species range. Using mtDNA, we confirmed the presence of two highly differentiated clades. Then, we incorporated ensemble of small models (ESMs) using climatic and nonclimatic variables with genetic data to assess whether genetic differentiation among clades was coupled with their ecological niche. Climate niche divergence was also examined based on a principal component analysis on climatic factors only. The relative habitat suitability values predicted by the ESMs for both clades revealed their niche separation. Between‐clade climate only niche comparison revealed that climate space occupied by clades is similar to some extent, but the niches that they utilize differ between the distribution ranges of clades. We found that in the absence of evidence for recent genetic exchanges, distribution models suggest the species occurs in different niches and that there are apparent areas of disconnection across the species range. The estimated divergence time between the two Iranian clades (4.9 Mya) coincides with the uplifting of the Zagros Mountains during the Early Pliocene. The Zagros mountain‐building event seems to have prevented the distribution of U. edwardsii populations between the western and eastern parts of the mountains as a result of vicariance events. Our findings indicated that the two U. edwardsii genetic clades in Iran can be considered as two conservation units and can be utilized to develop habitat‐specific and climate change‐integrated management strategies., Combining genetic data with ecological niche modeling is an effective approach for defining conservation units and exploring environmental variables that affect spatial patterns of genetic variation. We found two distinct genetic clades within H. edwardsii significantly correlated with different climate features. Niche‐based distribution models revealed that the two molecular clades occupy distinct environmental spaces, which are not similar, and equivalent.

To investigate the alteration of choroid in patients with very severe non-proliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP). Thirty-nine eyes of 21 patients with very severe non-proliferative diabetic retinopathy (NPDR) (19 eyes) and early proliferative diabetic retinopathy (PDR) (20 eyes) were recruited. Enhanced-depth imaging optical coherence tomography at baseline, 1, and 6 months after PRP was employed to measure choroidal parameters including total choroidal area (TCA) and choroidal vascular index (CVI). In eyes with very severe NPDR, subfoveal TCA decreased non-significantly at month 1, which increased significantly at month 6 (539 ± 131µm2, 502 ± 134µm2, and 598 ± 168µm2 at baseline and months 1 and 6, respectively; P = 0.003). Subfoveal CVI increased at month 1 and then decreased at month 6 (68.25 ± 3.05, 69.74 ± 3.62, and 67.84 ± 1.77 at baseline and months 1 and 6, respectively; P

There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID-19 in pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures to COVID-19 (N = 134, 47.7%) and/or testing per hospital policy (N = 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID-19-positive patients, 16 were managed as outpatients, six received non-ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID-19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID-19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID-19 disease and excellent short-term outcomes.

Purpose: To describe the optical coherence tomography (OCT) findings of toxoplasmic retinochoroiditis at different stages of activity.Methods: Observational case series.Results: A total of 32 eyes of 31 patients were included; 43 sets of OCT were reviewed. A total of 14 lesions were classified as active, 13 as partially active, and 16 as inactive. All active lesions demonstrated increased retinal thickness and reflectivity with blurring of details of retinal layers. Choroidal granuloma was detected in eight (61.5%) and serous retinal detachment in nine (64%). In partially active lesions, sustained thickening and/or attachment of posterior hyaloid face with fine epiretinal membrane was the hallmark. Scarified lesions showed decreased retinal and choroidal thickness starting from the periphery. Characteristic signs for decreased activity of a lesion seen in majority of both partially active and inactive lesions were RPE changes and retina-RPE approximation. We called this unique feature 'hourglass configuration'.Conclusion: Features in OCT are helpful to specify and monitor the activity of toxoplasmic retinochoroiditis.

Background: Remote ischemic preconditioning (RIPC) has been proposed as a possible potential treatment for ischemic stroke. This study aimed to investigate the frequency of micro-embolic brain infarcts after RIPC in patients with stroke who underwent elective carotid artery stenting (CAS) treatment. Methods: This study was managed at Shiraz University of Medical Sciences in southwest Iran. Patients undergoing CAS were randomly allocated into RIPC and control groups. Patients in the RIPC group received three intermittent cycles of 5-minute arm ischemia followed by reperfusion using manual blood cuff inflation/deflation less than 30 minutes before CAS treatment. Afterward, stenting surgery was conducted. Magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), was acquired within the first 24 hours after CAS. Results: Seventy-four patients were recruited (79.7% men, age: 72.30 ± 8.57). Both groups of RIPC and control had no significant difference in baseline parameters (P > 0.05). Fifteen patients (40.5%) in the RIPC group and 19 (54.1%) patients in the control group developed restricted lesions in DWI MRI. In DWI+ patients, there were no significant differences according to the number of lesions, lesion surface area, largest lesion diameter, cortical infarcts percent, and ipsilateral and bilateral infarcts between the two groups. Conclusion: Although RIPC is a safe and non-invasive modality before CAS to decrease infarcts, this study did not show the advantage of RIPC in the prevention of infarcts following CAS. It may be because of the small sample size.

Objectives High-risk behaviors (HRBs) represent significant health threats for adolescents and significantly affect adolescents’ mental health. Adolescents often engage in risky behaviors. The present study was conducted to investigate the relationship between high-risk behaviors (HRBs) and mental health in adolescents in Rabor. Content The present study was a cross-sectional analytical study that was performed on 334 girl and boy students aged 12–18 years in Rabor city in 2021. In this study, adolescents answered high risk behaviors and mental health questionnaires. Data were analyzed using SPSS-26 software and the spearman correlation coefficient and linear regression analysis (univariate and multivariate analysis) were used to analyze the data. Summary and Outlook In this study, the mean age was 15.25 ± 1.78. The findings indicate that smoking and hookah use were higher in boys than girls. Among the demographic variables, age and level of education had a positive and significant relationship with HRBs and mental health (p

Purpose: To investigate the presence of persistent ocular pain after 23-gauge pars plana vitreoretinal surgeryMethod: This is a prospective study including patients who underwent 23-gauge vitrectomy or silicone removal with local or general anesthesia. We evaluated the symptoms of ocular neuropathic pain before and two months after surgery using the Brief Pain Inventory (BPI) questionnaire, and the impact of reported ocular symptoms on quality of life. Correlation between ocular pain and factors such as patient demographics and underlying conditions were also assessed.Result: Seventy-five patients with a mean age of 58.93 ± 12.05 years were evaluated. Forty-four (58.7%) were males. Sixty-seven (89.3%) patients underwent vitrectomy and eight had silicone removal surgery, all using 23-gauge instruments. there was an increasing trend in eye pain scores at two months after surgery which did not reach a statistical significance. However, the analgesic consumption increased from 4% before surgery to 17.3% two months after surgery. Patients who reported increased analgesic usage two months after surgery, scored worse in items of the quality-of-life questionnaire. In addition, patients who reported ocular and facial pain and photophobia before surgery had higher chances of analgesic consumption after surgery (p-value: 0.03, 0.003, and 0.001, respectively). Those who reported migraine headaches had higher chances of reporting eye symptoms, postoperatively (p-value: 0.041). Conclusion: Surgeries involving 23-gauge incisions may not induce ocular neuropathic pain. However, increased use of analgesics after surgery was observed.

Carotid angioplasty and stenting (CAS) could be considered for preventing stroke in patients with carotid artery stenosis. This study aimed to determine the incidence and the risk factors of the early and mid-term complications associated with CAS.This is a retrospective cohort study conducted at Shiraz University of Medical Sciences from March 2011 to March 2019. Patients at high risk and standard risk for carotid endarterectomy were included. The primary composite outcome was defined as stroke, myocardial infarction (MI), and death in the first 30 days after CAS. All-cause mortality, vascular mortality, and stroke were investigated during mid-term follow-up.A total of 579 patients (618 CAS) were recruited (mean age: 71.52 years). Overall, 394 (68.40%), 211 (36.63%), 179 (31.07%), and 96 (16.72%) patients had hypertension, dyslipidemia, diabetes mellitus, or were cigarette smokers, respectively. Primary composite outcomes were observed in 2.59% of patients (1.55% stroke, 0.69% MI, and 1.72% death). Atrial fibrillation was a predictor of primary composite outcome in multivariate logistic regression (p = .048). The presence of total occlusion in the contralateral carotid artery was significantly associated with the risk of stroke in univariate logistic regression (p = .041). The patients were followed for a period ranging from 1 to 83 months. The overall survival rate for all-cause mortality was 93.48% at 1 year, 77.24% at 5 years, and 52.92% at 8 years. All-cause mortality was significantly higher among patients with symptomatic carotid stenosis (p = .014).CAS provides acceptable short-term and mid-term outcomes in a unique population of high- and standard-surgical-risk, symptomatic and asymptomatic, octogenarian, and nonoctogenarian patients.

Objectives: There are several reports of the association between SARS-CoV-2 infection (COVID-19) and cerebral venous sinus thrombosis (CVST). In this study, we aimed to compare the hospitalization rate of CVST before and during the COVID-19 pandemic (before vaccination program). Materials and methods: In this retrospective cohort study, the hospitalization rate of adult CVST patients in Namazi hospital, a tertiary referral center in the south of Iran, was compared in two periods of time. We defined March 2018 to March 2019 as the pre-COVID-19 period and March 2020 to March 2021 as the COVID-19 period. Results: 50 and 77 adult CVST patients were hospitalized in the pre-COVID-19 and COVID-19 periods, respectively. The crude CVST hospitalization rate increased from 14.33 in the pre-COVID-19 period to 21.7 per million in the COVID-19 era (P = 0.021). However, after age and sex adjustment, the incremental trend in hospitalization rate was not significant (95% CrI: -2.2, 5.14). Patients > 50-year-old were more often hospitalized in the COVID-19 period (P = 0.042). SARS-CoV-2 PCR test was done in 49.3% out of all COVID-19 period patients, which were positive in 6.5%. Modified Rankin Scale (mRS) score ≥3 at three-month follow-up was associated with age (P = 0.015) and malignancy (P = 0.014) in pre-COVID period; and was associated with age (P = 0.025), altered mental status on admission time (P

Purpose: Determine the risk of immunomodulatory therapy (IMT) for COVID-19 infection morbidity.Method: A telemedicine survey on patients of a referral uveitis clinic was performed. Signs of infection, habits, and hospitalizations during the 7 months of the COVID-19 pandemic prior to the study date were recorded. Suggestive findings in chest CT scan and/or positive RT-PCR were considered as confirmed COVID-19 infection while those with only suggestive symptoms were considered as suspected cases. Risk factors including sanitary measures and IMT were compared between patients with confirmed cases and patients without infection.Result: 694 patients were included. Eight patients were identified as confirmed cases and 22 patients as suspected cases of COVID-19 infection. Close contact with infected persons was the only significant risk factor for contracting COVID-19.Conclusion: Using IMT did not affect hospitalization and/or ICU admission and can thus be continued during the pandemic, provided that instructions for preventive measures are followed.