Search

Background: On an average 30-50% of patients who undergo incision and drainage (I and D) of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal abscess and fitula-in-ano at the same time. Materials and Methods: In this cross-sectional descriptive study 49 from 77 patients with anal abscess whose internal orifice was not identified by pressing on the abscess, diluted hydrogen peroxide (2%) and methylene blue was injected into the abscess cavity and the anal canal was inspected to find out the internal opening. Once the opening was distinguished, an incision was given from the anal verge to the internal opening. Results: The internal orifice was identified in 44 out of 49 patients (90%) who underwent this new technique. Up to 18 months during follow-up, only 2.5% of patients with primary fistulotomy developed fistula on the site of a previous abscess. Conclusion: Conventional method to seek the internal orifice of anal abscesses is successful in about one-third of cases. By applying this new technique, surgeons would properly find the internal opening in >90% of patients. Needless to say, safe identification of the anal gland orifice in anal abscess disease best helps surgeons to do primary fistulotomy and in turn it would significantly decrease the rate of recurrence in anal abscess and fistula formation. [ABSTRACT FROM AUTHOR]

C-C motif chemokine 22 (CCL22) C16A genetic variation (rs4359426) and C-C chemokine receptor type 4 (CCR4) C1014T variation (rs2228428) have been suggested to affect the expression level of the cognate proteins. Here we tried to investigate the plausible association of these polymorphisms with development of colorectal cancer. 165 patients with colorectal adenocarcinoma (age 54.4±13.4) and 150 age- and sexmatched healthy individuals were enrolled. Genotyping was performed by PCR-RFLP methods. Results indicated the frequency of 16A allele in CCL22 gene to be 31/330(9.4%) and 33/300(11%) in patients and controls, respectively (p=0.59). The frequencies of CC, CA, and AA genotypes at this locus were not significantly different between patients and controls (135/165; 81.8%, 29/165; 17.6%, 1/165; 0.6% in the patients and 121/150; 80.1%, 25/150; 16.6% and 4/150; 2.6% in the control group, p= 0.34). At the locus 1014 in CCR4, T allele was observed with the frequency of 107/330 (32.4%) and 83/300 (27.7%) in patients and controls, respectively (p=0.22). Analyses indicated no significant differences in the frequencies of CC, CT and TT genotypes at this locus between patients and controls (77/165; 46.7%, 69/165; 41.8% and 19/165; 11.5%; versus 83/150; 55.0%, 51/150; 33.8% and 16/150; 10.6%, respectively, p= 0.29). The presence of individual genotypes was not associated with clinicopathological characteristics of the disease, including tumor size, tumor grade and LN involvement (all with p>0.05). These findings collectively suggested that CCR4 C1014T and CCL22 C16A genetic variations were neither associated with the risk, nor with the progression of colorectal cancer in Iranian population. [ABSTRACT FROM AUTHOR]

Correction to: BMC Surgery (2022) 22:142 https://doi.org/10.1186/s12893-022-01591-2 Following publication of the original article [[1]], the author name "Seyed Vahid Hosseini" was incorrectly written as "Seyed Vahid Hoseini". Report of 13-year survival of patients with colon and rectal cancers; lessons from Shiraz colorectal cancer surgery registry system of a level three medical center. [Extracted from the article]

Colorectal cancer is the third most common cancer in the world. Ubiquitin–proteasome system has shown to be activated in colorectal and other malignancies. UBE2Q1 is a novel human gene that encodes a putative E2 ubiquitin conjugating enzyme. Here, we investigated the expression pattern of UBE2Q1 gene in cell lines and tissues from human colorectal tumors. Quantitative (q) RT-PCR were employed to evaluate the expression levels of the mRNA for UBE2Q1 in colorectal cancer cell lines (HT29/219, LS180, SW742, Caco2, HTC116, SW48, SW480 and SW1116). Expression of UBE2Q1 at the protein levels were assessed by Western blotting in cell lines as well as in 43 human colorectal tumor tissues. All cell lines tested expressed UBE2Q1 gene at the level of both mRNA and protein, with the SW1116 line representing the lowest level of expression. The cell lines HT29/219 and SW742 showed the highest levels of UBE2Q1 protein and mRNA respectively. When compared to corresponding normal tissues, malignant parts of colorectal tumors showed increased levels of UBE2Q1 immunoreactivity in 32 (74.42 %) of cases. These data suggest that UBE2Q1 is differentially expressed in colorectal cell lines and shows overexpression in colorectal tumors. [ABSTRACT FROM AUTHOR]

A Correction to this paper has been published: https://doi.org/10.1007/s11695-021-05582-9 [ABSTRACT FROM AUTHOR]

A correction to this paper has been published: https://doi.org/10.1007/s11695-021-05562-z [ABSTRACT FROM AUTHOR]

The prevalence of inflammatory bowel diseases (IBDs) is set to stabilize in Western Europe and North America, as opposed to its increasing trend in developing countries in Asia. The epidemiology of IBDs in areas where the incidence and prevalence are relatively low provides an opportunity for researchers to determine the unknown aspects of them. In this review article, the PubMed and MEDLINE databases were searched from 1970 to 2012 and the epidemiological aspects assessed in Iranian articles were compared with identical subjects in other Asian countries. During this period, there were 21documented articles on IBD epidemiology in Iran and 52 in Asia. According to the present review, CTLA-gene polymorphism and male/female ratio in ulcerative colitis (UC), incidence of extraintestinal manifestations, extent of intestinal involvement, and family history in both UC and Crohn's disease (CD) seemed to be different between Asia and Iran. In contrast, the incidence of primary sclerosing cholangitis in IBD patients and association between NO2/CARD15 mutation and CD as C3435-T allele and UC were nearly the same. The rate of IBD has increased significantly in Iran, as has that of other Asian countries during the last decade. A thorough, well-designed, population-based, multi-regional epidemiologic study seems mandatory due to the substantial demographic and characteristic variability in IBD patients in our region. [ABSTRACT FROM AUTHOR]

BACKGROUND Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), are debilitating and chronic disorders with unpredictable courses and complicated treatment measures. Therefore, an efficient treatment protocol seems necessary as therapeutic prophylaxis for these disorders. This study aims to determine the healing effect of Teucrium polium (T. polium) in acetic acid-induced UC in an experimental dog model. METHODS From September to December 2010, eight male (20-25 kg) crossbred dogs were used for induction of UC by 6% acetic acid, transrectally. After one week, three biopsies (10, 20 and 30 cm proximal to the anal verge) were taken from the colon of each animal for histological studies. In the presence of UC, 400 mg/kg/day of T. polium extract was administered orally and transrectally (via enema) for 30 days in six of the dogs. The remaining two dogs were used as controls and did not receive T. polium. Multiple biopsies were taken 7, 14, and 30 days after discontinuation of T. polium in the same manner as before treatment. RESULTS After administration of acetic acid, we noted the presence of multiple ulcers, diffuse inflammation, PMN infiltration in the lamina propria, glandular destruction and goblet cell depletion. Treatment with T. polium restored the colonic architecture with an increased number of healthy cells and a reduction in inflammatory cells. Damage of the surface epithelial cells and mucosal layer of the lumen were reversed, which lead to faster ulcer healing. CONCLUSION T. polium may be a treatment choice for UC and can broaden the current therapy options for UC. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1, also known as von Recklinghausen disease, is an autosomal dominant disorder with an incidence of 1 per 4000. Neurofibromas are benign, heterogeneous tumors arising from the connective tissue of peripheral nerve sheaths, especially the endoneurium. Visceral involvement in disseminated neurofibromatosis is rare. Neurofibroma occurs most frequently in the stomach and jejunum, but the colon and anorectal canal may also be involved. Gastrointestinal neurofibromas may lead to bleeding, obstruction, intussusception, protein-losing enteropathy and bowel perforation. We present a case of diffuse involvement of the anorectal area by a huge neurofibroma, with pelvic pain, watery diarrhea and urgency. [ABSTRACT FROM AUTHOR]

Aim Patients and methods Results Conclusion Very few studies have compared laparoscopic pelvic organ prolapse suspension (POPS) and laparoscopic ventral mesh rectopexy (LVMR) in the treatment of rectal prolapse, particularly regarding the comparison of improvement rates in obstructed defecation syndrome (ODS). This study aimed to compare the anatomical and functional outcomes of these two methods over a long‐term follow‐up period.This retrospective study was conducted on 120 female patients diagnosed with rectal prolapse who underwent surgery at the Colorectal Surgery Department of Shahid Faqihi Hospital in Shiraz, Iran, between October 2015 and October 2022. The patients were categorised into two groups based on their surgical procedures: 58 underwent LVMR in the first group, and 62 underwent POPS in the second group.Recurrence of prolapse occurred in 7 (12.1%) patients in the LVMR group and 5 (8.1%) patients in the POPS group (P = .550). The mean operation time, mean length of hospital stay, Visual Analogue Scale score, early and late post‐operative complications, Cleveland Clinic Incontinence Score, ODS symptoms, and Wexner Constipation Scores did not differ significantly between the two groups.Both laparoscopic POPS and LVMR techniques significantly improved the anatomical and functional outcomes in the treatment of rectal prolapse and obstructed defecation. LVMR and POPS can each be considered first‐line treatment options for rectal prolapse, depending on the specific case. [ABSTRACT FROM AUTHOR]

Objective: Diabetes is an important risk factor for cardiovascular disease. The purpose of this study was to explore the role of diabetes and prediabetes in the risk of cardiovascular disease. Methods: This prospective study was performed on three groups of non-diabetic (n = 7291), prediabetic (n = 438), and diabetic (n = 1713) in the age range of 40–70 years in Kharameh (Iran) in 2014–2021. The participants were followed for 4 years. Demographic information, chronic disease history, behavioral habits, and laboratory parameters were examined. Initially, the incidence density was calculated and the difference between the risk of cardiovascular disease in the three groups was examined using the log-rank test. The Cox regression model was performed to investigate the association between prediabetes and diabetes with the risk of cardiovascular disease. Results: The mean age of the participants was 51.47 years. The density incidence in the three groups of non-diabetic, prediabetic, and diabetic individuals was estimated to be 1.5, 1.5, and 3.9 cases per 100,000 person-days, respectively. There was no statistically significant relationship between prediabetes and the incidence of cardiovascular disease. However, the incidence of cardiovascular disease in diabetics was 2.55, 2.16, and 2 times higher than in non-diabetics in the simple, adjusted for age and sex, and in multiple Cox regression, respectively. Conclusion: Due to the independent role of diabetes in the incidence of cardiovascular disease, diabetic individuals should be screened periodically for cardiovascular conditions. Furthermore, it is very important for these individuals to control the important risk factors that contribute to the incidence of cardiovascular disease. [ABSTRACT FROM AUTHOR]

A correction to this paper has been published: https://doi.org/10.1007/s00268-021-06069-5 [ABSTRACT FROM AUTHOR]

Background: This study assessed the prevalence of gastroesophageal reflux disease (GERD) in a general adult population in Iran. The association between GERD and various factors was also evaluated. Methods: We performed a cross-sectional study on 163,018 individuals aged over 35 who were enrolled in the PERSIAN cohort. GERD was defined as the occurrence of heartburn and/or regurgitation symptoms at least several days a month. Survey design analysis for pooled data was performed and multiple regression analysis was conducted to determine the independent risk factors for GERD. Results: The prevalence of GERD in our study was estimated at 21.86% (95% confidence interval:17.4%-36.4%). The mean age of the participants was 49.84 years±9.25 (35–70) and 44.75% of the participants were male. Symptoms of heartburn and regurgitation were reported in 18.65% (n: 29,170) and 6.06% (n: 9,717) of participants, respectively. In the multivariate analysis, several factors were found to be associated with a higher prevalence of GERD: female sex, age >50, current smoking, opium use, weekly consumption of fried foods, frequent consumption of hot tea, less than 6 hours of sleep per night, psychiatric disorders, usage of NSAIDs, and poor oral hygiene, were associated with a higher prevalence of GERD. Conversely, higher education levels and average physical activity were found to be less commonly associated with GERD. Conclusion: We found a relatively high prevalence of GERD (21.86%) in this population-based study in Iran. By identifying modifiable risk factors, this research offers opportunities for targeted interventions and lifestyle modifications to reduce the burden of GERD. [ABSTRACT FROM AUTHOR]

Background: Anastomotic leakage (AL) is the main complication of colorectal surgeries. Recent studies have assessed the effects of the ghost ileostomy on preventing complications related to a defunctioning stoma (DS) in high-risk anastomoses. In this study, we aimed to review patients who underwent ghost ileostomy and assess their colon leakage score (CLS) and Dutch leakage score (DULK) to evaluate their preoperative AL risk and post-operative AL diagnostic score, respectively. We examined whether the suggested cut-off points of these scores (>11 for CLS and >4 for DULK) could be appropriate criteria for determining when to insert ghost ileostomy and when to convert it to a DS. Methods: All patients from three referral hospitals in Shiraz, Iran who underwent colorectal surgery with ghost ileostomy during 2019-2020 were enrolled in this retrospective case series. We calculated preoperative CLS and post-operative DULK scores for all patients and assessed what diagnostic and therapeutic measures were performed for them based on their scores. Results: AL was diagnosed in two of 34 patients. Eight patients had a total CLS score of 11 and above, but only one of them experienced AL. The other case of AL had a CLS score of 10. The DULK score of these two patients increased during hospitalization. Conclusion: Because of the importance of accurately identifying high-risk patients for ghost ileostomy, it is imperative to undertake additional research aimed at determining the optimal cut-off value for CLS or devising alternative valid scoring systems. DULK score could be an appropriate post-operative monitoring tool to reduce morbidity. [ABSTRACT FROM AUTHOR]

Hydrogen is one of the most promising options being considered as the fuel of future. However, injection of hydrogen into modern gasoline fueled engines can cause some issues such as power loss. This study, therefore, aims to address this challenge in a simulated hydrogen/gasoline dual-fueled engine by developing a novel and innovative approach without possible side effects such as NOx increment. To achieve this goal, the impacts of water injection and the start of the combustion (SOC) modification in a gasoline/hydrogen duel fueled engine have been rigorously investigated. In current methodology, an engine is simulated using AVL BOOST software and the model is validated against the experimental data. The Latin Hypercube design of experiments method was employed to determine the design points in 3-dimensional space. Due to the existing trade-off between NOx and BMEP, multi-objective optimization using genetic algorithm (GA) was implemented to determine the optimum values of water injection and SOC in various hydrogen energy shares and the effects of optimum design parameters on the main engine performance and emission parameters were investigated. The results showed that the proposed solution could recover the brake mean effective pressure (BMEP) and in some hydrogen energy shares even increase it above the level of single fueled gasoline engine with the added benefit of there being no increase in NOx compared to the original level. Furthermore, other emissions and engine performance parameters are improved including the engine equivalent Brake specific fuel consumption (BSFC) which was shown to increased up to 4.61%. • Water injection and SOC modification improved hydrogen/gasoline engine performance. • BMEP was recovered by optimized SOC and water injection. • Engine BSFC was reduced up to 4.61%. • A significant NOx reduction of up to 59% was achieved. [ABSTRACT FROM AUTHOR]

Purpose: Sleeve gastrectomy (SG) is an effective treatment for patients with severe obesity and it leads to significant weight loss and promotes the quality of life. The aim of this study was evaluating the relationship between self-efficacy, happiness and psychological well-being after sleeve gastrectomy. Methods: One hundred patients that underwent SG were participated in this study. They were asked to fill questionnaires 12 months after surgery. To assess self-efficacy, Sherer and et al. scale, for happiness, oxford happiness scale and for psychological well-being, Ryff scale were used. Regression analysis was used on psychological well-being and happiness for evaluating the prediction of self-efficacy. Results: The results showed that 44% of happiness and 4% of psychological well-being were determined by self-efficacy after surgery. Conclusion: Based on these findings, self-efficacy is a significant predictor of psychological well-being and happiness. [ABSTRACT FROM AUTHOR]

Environmental crisis requires using cleaner energy sources for different sectors including the transportation. Hydrogen can support the transition of the automotive industry from petrol and diesel into a sustainable fuel. It could be the main source of energy or the auxiliary fuel in vehicles. As an auxiliary fuel, it has recently been considered in hydroxyl (HHO) form for reducing the emissions from transportation fleet. In this study, an HHO generator with the optimum power consumption was utilised for HHO injection into the intake manifold of a petrol engine as the case study. High concentration of CO is expected to be produced during idling, so the experiments were designed to inject ultra-low HHO for reducing CO emissions. The results were very promising, and it was shown that the CO emission could be reduced by about 98%. Furthermore, a novel design was developed based on the concept of waste heat recovery (WHR) for powering the HHO unit. Engine was simulated in AVL software to design a thermo-electric generators (TEG) for running the HHO unit. Based on the results, TEG can provide the energy required for HHO unit as the energy output of the TEG was between 91 kJ and 169 kJ for the case study while the energy consumption of the proposed HHO generator was just about 22.5 kJ. The results of this study are recommending a practical solution for bringing HHO injection from laboratory research into the real practice. • Novel HHO system powered by TEG was proposed. • Ultra-low HHO was injected into a petrol engine during idling. • Pulsed DC power supply was used for the HHO unit. • A significant reduction of CO emissions was observed during the experiments. • Based on the AVL results, TEG can cover the required energy for running HHO unit. [ABSTRACT FROM AUTHOR]

Covering surgical wounds with biomaterials, biologic scaffolds, and mesenchymal stem cells (MSCs) improves the healing process and reduces postoperative complications. This study was designed to evaluate and compare the effect of MSC-free/MSC-seeded new collagen/poly(3-hydroxybutyrate) (COL/P3HB) composite scaffold and human amniotic membrane (HAM) on the colon anastomosis healing process. COL/P3HB scaffold was prepared using freeze-drying method. MSCs were isolated and characterized from rat adipose tissue. After biocompatibility evaluation by MTT assay, MSCs were seeded on the scaffold and HAM by micro-mass seeding technique. In total, 35 male rats were randomly divided into five groups. After the surgical procedure, cecum incisions were covered by the MSC-free/MSC-seeded scaffold or HAM. Incisions in the control group were only sutured. One month later, the healing process was determined by stereological analysis. The Kruskal-Wallis followed by Dunn's tests were utilized for statistical outcome analysis (SPSS software version 21). COL/10% P3HB scaffold showed the best mechanical and structural properties (7.86 MPa strength, porosity more than 75%). MTT assay indicated that scaffold and especially HAM have suitable biocompatibility. Collagenization and neovascularization were significantly higher, and necrosis was considerably lower in all treated groups in comparison with the controls. MSC-seeded scaffold and HAM significantly decrease inflammation and increase gland volume compared with other groups. The MSC-seeded HAM was significantly successful in decreasing edema compared with other groups. Newly synthesized COL/P3HB scaffold improves the colon anastomosis healing; however, the major positive effect belonged to HAM. MSCs remarkably increase their healing process. Further investigations may contribute to confirming these results in other wound healing. • The novel COL/P3HB composite scaffold has a suitable biocompatibility. • COL/P3HB scaffold and HAM significantly improve the healing of colon anastomosis. • MSCs significantly improve the healing effect of both COL/P3HB scaffold and HAM. • The maintenance condition of COL/P3HB scaffold is simpler (4 °C) than HAM (−80 °C). [ABSTRACT FROM AUTHOR]

Background: Bowel obstruction is a disorder in the passage of bowel contents, the etiology of which varies depending on temporal and geographical conditions. This study investigated the etiology of bowel obstruction in a large number of patients at an adult surgery referral center in southern Iran. Methods: In this cross-sectional study, we reviewed the medical records of all patients admitted to Shahid Faghihi hospital (Shiraz, Iran) between 2014 and 2020 with a diagnosis of small or large bowel obstruction. Patients with missing or obscure data on etiology were excluded. Data was collected on the patients' age, gender, history of relevant surgeries, comorbidities, cause of obstruction, site/type of obstruction, treatment, intensive care unit (ICU) admission, length of hospital stay, and outcome. Statistical analyses were made using SPSS v. 25.0. Results: A total of 2781 bowel obstruction patients (61.4% males, 38.6% females) with a median age of 58 (IQR 43-71) years were studied. Most responded to non-surgical treatment (61.3%). While the obstruction was mostly partial (65.5%), 94.4% of patients with complete obstruction required surgery. Small bowel obstruction (SBO) was almost three times more prevalent than large bowel obstruction (LBO). Adhesion bands were the leading cause of SBO (66.77%), while LBO was primarily due to colorectal tumors (33.9%). Conclusion: The predominant etiology of LBO was colorectal cancer, suggesting that policymakers should improve surveillance programs to detect the condition earlier. Regarding SBO, the leading cause was adhesion bands, indicating the necessity of further efforts to reduce the rate of adhesions following intra-abdominal operations. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal cancer remains a significant health challenge, particularly in its advanced Stage III. Timely forecasting of recurrence and metastasis in these patients is crucial for optimizing postoperative care and treatment strategies. The aim of this study is to predict the likelihood of recurrence and metastasis in stage III colorectal cancer patients who have undergone laparoscopic surgery and laparotomy. Material and Methods: In this retrospective analysis, a total of 528 patients with Stage III colorectal cancer were included. Among them, 386 underwent laparoscopy, and 142 underwent laparotomies. logistic regression was employed to assess the influence of the surgical approach on the binary outcomes of recurrence and metastasis. The data were analyzed using SPSS 25, and Odds Ratios along with significance testing were performed with a threshold of p < 0.05 to determine statistical significance. Results: In the laparoscopy group, the recurrence rate was 23.7%, and although older patients (61-98 years) exhibited a higher risk of recurrence (Odds Ratio:1.88, 95% CI:0.92-3.84, p=0.083), this difference did not reach statistical significance. Gender did not significantly impact recurrence. In the laparotomy group, the recurrence rate was 29.6%, and neither age nor gender had a significant influence on recurrence. Notably, in the laparoscopy group, metastasis was significantly associated with age (Odds Ratio:5.044, 95% CI:2.08-12.23, p=0.001), while gender did not play a significant role in metastasis. Similarly, in the laparotomy group, neither age nor gender significantly affected metastasis. Conclusion: This study underscores age's influence on recurrence and metastasis rates in laparoscopic treatment for stage III colorectal cancer, highlighting the need for tailored approaches in elderly patients. In contrast, laparotomy seems to be less affected by age, with tumor size emerging as a crucial predictor of disease progression. Surgical approach significantly impacts outcomes in stage III colorectal cancer, with age affecting laparoscopy outcomes more than laparotomy. These findings emphasize the importance of personalized treatments and call for further research to validate results and enhance patient outcomes in advanced colorectal cancer. [ABSTRACT FROM AUTHOR]

Obesity is an increasing problem that can lead to noncommunicable diseases. The role of dietary factors on one's obesity is confirmed in many studies. One nutritional approach that can be used for assessment of the foods and diets is the Index of Nutritional Quality (INQ). Our study is aimed at exploring the association between INQ and obesity. Our hypothesis is that enriched and high-quality diets reduce the risk of overweight or obesity. This study was carried out on 6248 overweight and obese participants, from whom 4356 (69.7%) and 1892 (30.3%) were overweight and obese, respectively. To assess the dietary intake for the participants, a valid food frequency questionnaire (FFQ) with 130 food items was utilized. The analysis revealed an inverse association between the overweight and the INQ of iron, thiamin, riboflavin, B6, folate, zinc, magnesium, calcium, and vitamin C and E. For the obese group, this inverse association was found for iron, B6, folate, zinc, magnesium, calcium, and vitamin C and E. These results approved our hypothesis that a rich nutrition diet may lead to a lower risk of obesity. [ABSTRACT FROM AUTHOR]

A multi-fidelity micro combustor design approach is developed for a small-scale combined heat and power CHP system. The approach is characterised by the coupling of the developed preliminary design model using the combined method of 3D high-fidelity modelling and experimental testing. The integrated multi-physics schemes and their underlying interactions are initially provided. During the preliminary design phase, the rapid design exploration is achieved by the coupled reduced-order models, where the details of the combustion chamber layout, flow distributions, and burner geometry are defined as well as basic combustor performance. The high-fidelity modelling approach is then followed to provide insights into detailed flow and emission physics, which explores the effect of design parameters and optimises the design. The combustor is then fabricated and assembled in the MGT test bench. The experimental test is performed and indicates that the designed combustor is successfully implemented in the MGT system. The multi-physics models are then verified and validated against the test data. The details of refinement on lower-order models are given based on the insights acquired by high-fidelity methods. The shortage of conventional fossil fuels and the continued demand for energy supplies have led to the development of a micro-turbine system running renewable fuels. Numerical analysis is then carried out to assess the potential operation of biogas in terms of emission and performance. It produces less NOx emission but presents a flame stabilisation design challenge at lower methane content. The details of the strategy to address the flame stabilisation are also provided. [ABSTRACT FROM AUTHOR]

Background and Aims. Nonalcoholic fatty liver disease (NAFLD) is common in severely obese individuals undergoing bariatric surgery. Assessing the prevalence and severity of NAFLD seems crucial since it may affect the prevention or development of more severe forms of fatty liver. Methods. This cross-sectional study was conducted on 228 severely obese individuals undergoing bariatric surgery. Abdominal ultrasonography was done, and clinical and biochemical factors (liver enzymes, lipid profile, and fasting blood sugar (FBS)) were assessed. Results. The mean body mass index (BMI) was 43.45 ± 5.92 kg/m2. The prevalence of NAFLD was 49.12% (mild steatosis: 37.5%, moderate steatosis: 36.6%, and severe steatosis: 25.8%). The main risk factors of NAFLD were weight (p = 0.002), BMI (p = 0.003), alanine aminotransferase (ALT) (p < 0.001), aspartate aminotransferase (AST) (p < 0.001), serum triglycerides (TGs) (p = 0.004), and FBS (p = 0.039). The results revealed a statistically significant decrease in the mean level of high-density lipoprotein cholesterol (HDL-C) (p = 0.044). However, no significant association was found between the severity of liver steatosis and the presence of comorbidities such as hypertension, diabetes, hypothyroidism, and dyslipidemia. Conclusions. More severe NAFLD was associated with increased weight and BMI. Elevated ALT, AST, TG, and FBS levels and decreased HDL-C levels were also the risk factors of NAFLD and its progress to more severe conditions. [ABSTRACT FROM AUTHOR]

Background: Colectomy is considered as a part of therapeutic armamentarium in ulcerative colitis. The availability of new biologic treatments might have affected the trend of using this modality. Methods: The hospital records of all tertiary centers in Shiraz, which are the main centers for the treatment of ulcerative colitis (UC) in southern Iran, were reviewed to estimate the total number of admissions for the treatment of severe UC and colectomy among patients from 2009 to 2019. In this historical cohort study, information about the current status of the patients was collected by phone calls during December 2019. Results: Totally, 111 (4%) UC patients, out of 2933 admissions, underwent colectomy. Sixty-five (54.6%) UC colectomy patients were female. The results revealed an upward trend for the ratio of the frequency of colectomies to total UC admissions (Z = 3.39, P < 0.001). Colectomy complications occurred in 44 patients (40%), and most of the patients 38 (34%) had late complications, leading to readmission. Seven patients (6.3%) had died from colectomy during the follow-up calls. Most of the dead patients underwent urgent surgery and were young. Conclusion: Despite the use of biologics during the past decade in southern Iran, there was a rising trend among the UC patients' colectomies. The frequencies of post-operative complications and mortality was considerable, highlighting the need for refinement of UC care in this region. [ABSTRACT FROM AUTHOR]

Number of hybrid vehicles has increased around the world significantly. Automotive industry is utilizing the hybridization of the powertrain system to achieve better fuel economic and emissions reduction. One of the options recently considered in research for hybridization and downsizing of vehicles is to employ waste heat recovery systems. In this paper, the addition of a turbo-compound system with an air Brayton cycle (ABC) to a naturally aspirated engine was studied in AVL BOOST software. In addition, a supercharger was modeled to charge extra air into the engine and ABC. The engine was first validated against the experimental data prior to turbo-compounding. The energy and exergy analysis was performed to understand the effects of the proposed design at engine rated speed. Results showed that between 16 and 18% increase in engine mechanical power can be achieved by adding turbo-compressor. Furthermore, the recommended ABC system can recover up to 1.1 kW extra electrical power from the engine exhaust energy. The energy and exergy efficiencies were both improved slightly by turbo-compounding and BSFC reduced by nearly 1% with the proposed system. Furthermore, installing the proposed system resulted in increase in backpressure up to approximately 23.8 kPa. [ABSTRACT FROM AUTHOR]

Unfolded protein response (UPR) pathway is a promising target for cancer treatment because of its over-activation in different cancers and its role in tumorigenesis and chemotherapeutic drug resistance. Endoplasmic Reticulum Metallo Protease 1 (ERMP1) is overexpressed in cancers such as colorectal cancer. The ERMP1 role in UPR activation was previously reported in breast cancer. We aimed to investigate the ERMP1 role in the UPR activation in colorectal cancer. In this regard, ERMP1 gene was silenced in colorectal cancer HCT116 cell line using specific small hairpin RNA (shRNA). Then, UPR associated protein markers including inositol requiring enzyme 1 (IRE1α), activating transcription factor 6 (ATF-6), eukaryotic initiation factor 2α (eIF2α) and phosphorylated eIF2α (P- eIF2α) were evaluated using western blot. We found that ERMP1 gene expression and all of the above UPR associated protein markers were significantly decreased after ERMP1 gene silencing. Therefore, it seems that ERMP1 plays an important role in UPR activation. Since the overexpression of ERMP1 as a potential oncogene can highly activate the UPR pathway in colorectal cancer, it can be considered as a promising target for colorectal cancer treatment. However, further investigations are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to correlate the connection between self-management behaviors and anthropometric indices after Roux-en-Y gastric bypass (RYGB). Methods: A sample of 180 patients suffering from obesity were treated with RYGB in 2019; 6 and 18 months after surgery, anthropometric indices, including weight, waist circumference, waist- to-height ratio, body mass index (BMI), and waist-to-hip ratio, were gauged, and participants completed the post-bariatric surgery self-management behaviors questionnaire. Results: Correlation matrix results showed that all anthropometric indices had a significant positive relationship with self-management behaviors after RYGB; the results of the 18-month post-surgical follow-up exhibited no significant difference between anthropometric indices and self-management behaviors, 6 and 18 months after surgery. Conclusion: Therefore, the more self-management behaviors increase, the greater decrease in anthropometric indices will happen after RYGB. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type-1 (NF1), also known as Von Recklinghausen disease, is an autosomal dominant disorder with incidence of one per 4000. Neurofibromas are benign, heterogeneous, peripheral nerve sheath tumors coming up from the connective tissue of peripheral nerve sheaths, particularly the endoneurium. Visceral involvement in disseminated neurofibromatosis is considered rare. Neurofibroma occurs most frequently in the stomach and jejunum, but colon and anorectal canal may also be involved. Gastrointestinal neurofibromas may lead to bleeding, obstruction, intussusception, protein-losing enteropathy and bowel perforation. We encountered a case of diffusely involving the anorectal area by huge neurofibroma, which resulted in pelvic pain with watery diarrhea and urgency. [ABSTRACT FROM AUTHOR]