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Objective: Preoperative assessment of rectal damage in digestive endometriosis requires rectal endoscopic ultra-sonography an invasive exam that is not well received by the patients. A standardized approach using an Ultrasound-Based Endometriosis Staging System (UBESS)could be an interesting tool in this indication. This article aims to evaluate the performance of UBESS in the prediction of rectal involvement and the type of surgical procedure., Materials and Methods: This monocentric retrospective study was conducted on patients with rectal endometriosis who underwent a curative surgical procedure, evaluated by UBESS ultrasound between January 2016 and December 2019 at the Poissy referral centre. The main analysis of the study was to assess the adequacy of the UBESS ultrasound stage, the presence of rectal involvement during surgery and the surgical technique required. The secondary objective was to determine the correlation between UBESS stages and RCOG levels of surgical difficulty., Results: A total of one hundred and twenty-two patients were included and one hundred were analysed. Of these, thirty-nine had rectal involvement. There was a statistically significant association between the UBESS stage and the presence of a digestive lesion(P<0.0001). The ultrasound's parameters of thickness(P=0.0007), width(P=0.0082) and volume(P=0.0013) of the digestive lesion were significantly correlated with the extent of the surgical procedure. The correlation between the UBESS and RCOG classifications was very weak., Conclusion: UBESS is a powerful diagnostic tool for digestive damage allowing to give clear information to patients before surgery and optimizing the management plan of the surgery., (Copyright © 2023. Published by Elsevier Masson SAS.)

This study evaluated how daily vitamin C administration impacts systemic oxidative stress and inflammation and its safety in T2D patients. This randomized, double-blinded, placebo-controlled, parallel-arm clinical trial included 70 patients with T2D. They were allocated to receive either 500 mg/day of vitamin C or a matching placebo for 8 weeks. Of the 70 subjects assigned to the trial, 57 were included in the statistical analysis (vitamin C: n  = 32, placebo: n  = 25). Inflammatory and oxidative markers, including advanced glycation end products (AGEs), malondialdehyde (MDA), advanced oxidation protein products (AOPP), oxidized low-density lipoprotein (ox-LDL), highly sensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and ferric reducing ability of plasma (FRAP) were measured at baseline and the end of the trial. In addition, vitamin C tolerance was evaluated. A nutritionist visited all participants for a standard diabetic regimen. Following vitamin C supplementation, the serum levels of MDA ( p -value < .001) and AGEs ( p -value = .002) demonstrated a significant decrease after controlling for multiple confounders, including age, blood pressure, waist circumference, HbA1C, TG, and LDL-C, while no significant changes were observed for AOPP ( p -value = .234) and ox-LDL ( p -value = .480). The FRAP showed an increasing trend as an antioxidant marker but was not statistically significant ( p -value = .312). The hs-CRP and TNF-α had no significant changes ( p -value: .899 and .454, respectively). Also, no major adverse events were observed. Vitamin C supplementation may be beneficial in reducing AGEs and MDA in patients with T2D., Competing Interests: There is no conflict of interest to declare., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Introduction: The relation between physical well-being and chronic pain is complex and involves several subjective and objective covariates. We aimed to assess the role of mediator, confounder, or interactor played by covariates, including sleep quality, physical activity, perceived stress, smoking, and alcohol drinking in the relation between physical well-being and chronic pain. Method: We used Poisson regression to obtain incidence rate ratios (IRR) of the association between physical well-being and chronic pain in a cohort study carried out among university students. We applied General Structural Equation Modeling (GSEM) to assess mediation and stratum-specific analyses to distinguish confounding from interaction. We computed Relative Excess Risks due to Interaction (RERI), Attributable Proportion (AP), and the Synergy index (S) to measure additive interaction. Results: High physical well-being is related to a large decrease in the risk of chronic pain (IRR Total Effect = 0.58; 95% CI: 0.50-0.81). Perceived stress mediates 12.5% of the total effect of physical well-being on chronic pain. The stratum-specific IRRs of current smokers and non-current smokers were different from each other and were larger than the crude IRR (IRR = 1.49; 95% CI: 1.24-1.80), which indicates that smoking could be both confounder and interactor. Interaction analyses showed that physical activity could act as a potential interactor (RERI = 0.25; 95% CI: 0.13, 0.60). Conclusions: Perceived stress is an important mediator of the relation between physical well-being and chronic pain, while smoking is both a confounder and an interactor. Our findings may prove useful in distinguishing high-risk groups from low-risk groups, in the interventions aimed at reducing chronic pain.

Background: Chronic pain and depression represent two global health problems with considerable economic consequences. Although existing literature reports on the relation between depression and pain conditions, meta-analytic evidence backing the mediating role of sleep disturbance as one of the main symptoms of depression is scarce. To examine the extent to which sleep disturbance mediates the depression-chronic pain association, we conducted a systematic review and meta-analysis of the associations of chronic pain, depression, and sleep quality., Methods: We systematically searched for literature in MEDLINE and other relevant databases and identified cohort and case-control studies on depression, sleep disturbance, and chronic pain. Forty-nine studies were eligible, with a total population of 120 489 individuals. We obtained direct and indirect path coefficients via two-stage meta-analytic structural equation modelling, examined heterogeneity via subgroup analyses, and evaluated primary studies quality., Results: We found a significant, partial mediation effect of sleep disturbance on the relation between depression and chronic pain. The pooled path coefficient (coef.) of the indirect effect was 0.03 (95% confidence interval [CI]: 0.01-0.05) and accounted for 12.5% of the total effect of depression on chronic pain. This indirect effect also existed for cohort studies (coef. 0.02; 95% CI: 0.002-0.04), European studies (coef. 0.03; 95% CI: 0.004-0.05), and studies that adjusted for confounders (coef. 0.04; 95% CI: 0.01-0.09)., Conclusions: Sleep disturbance partially mediates the association between depression and pain. Although plausible mechanisms could explain this mediation effect, other explanations, including reverse causation, must be further explored., Systematic Review Protocol: PROSPERO CRD42022338201., (Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

The exploitation of symbiotic interactions between fungi and plants, coupled with the application of osmoprotectants such as trehalose (Tre), presents a promising strategy for mitigating environmental stress. To determine the mechanism of Serendipita indica and Tre-mediated cold stress tolerance, a comparative experiment was designed to study the impact of S. indica, Tre and their combination on tomato plants grown under cold stress. The results showed that cold stress significantly decreased biomass, relative water content, photosynthetic pigments and elements concomitantly with increasing antioxidant activities, malondialdehyde (MDA), electrolyte leakage, hydrogen peroxide and proline content. Meanwhile, S. indica and Tre treatments promoted biomass and enhanced carbohydrate, protein, proline, potassium, phosphorous, antioxidant enzymes and photosynthetic pigments content under cold stress. Furthermore, single or dual application of endophyte and Tre mitigated physiological disorders induced by cold stress and increased the integrity of cell membranes by decreasing hydrogen peroxide, MDA, and electrolyte leakage (EL). Our findings suggest that S. indica and Tre combination could significantly promote cold stress tolerance compared with single treatment. This study is novel in showing the cold adaptation of tomato plants by combination use of S. indica and Tre, which can be a promising strategy for improving cold tolerance. The underlying molecular mechanisms of sugar-fungus interaction must be further investigated., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences., Method: This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire., Results: 2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%)., Conclusions: High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (© 2023 Published by Elsevier Ltd.)

Suitably configured allyl ethers of unsaturated cyclitols act as substrates of β-glycosidases, reacting via allylic cation transition states. Incorporation of halogens at the vinylic position of these carbasugars, along with an activated leaving group, generates potent inactivators of β-glycosidases. Enzymatic turnover of these halogenated cyclitols (F, Cl, Br) displayed a counter-intuitive trend wherein the most electronegative substituents yielded the most labile pseudo-glycosidic linkages. Structures of complexes with the Sulfolobus β-glucosidase revealed similar enzyme-ligand interactions to those seen in complexes with a 2-fluorosugar inhibitor, the lone exception being displacement of tyrosine 322 from the active site by the halogen. Mutation of Y322 to Y322F largely abolished glycosidase activity, consistent with lost interactions at O5, but minimally affected (7-fold) rates of carbasugar hydrolysis, yielding a more selective enzyme for unsaturated cyclitol ether hydrolysis., (© 2023 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Purpose: The decision regarding the timepoint of a return to sports after anterior cruciate ligament (ACL) reconstruction is complex and depends on many factors, including objectively tested physical and psychological readiness as well as biological healing. The aim of this study was to investigate the influence of repetitive extracorporeal shockwave therapy (ESWT) on return-to-sports duration, clinical results and MRI results after ACL reconstruction with hamstring tendons (HT)., Material and Methods: In this prospective controlled study, all patients with acute ACL ruptures were treated by ACL reconstruction with HT. Patients were randomized into two groups (Group A: ESWT group; Group B: control group). Patients in the ESWT group received focused shockwave therapy 4, 5 and 6 weeks after ACL surgery. Follow-up investigations including IKDC score, Lysholm score, VAS and evaluation regarding return-to-sports timepoints that were conducted 3-, 6-, 9- and 12-months post-operation. An MRI investigation was performed 12-months post-operation and graft maturation (signal intensity ratio (SIR)) as well as femoral and tibial tunnel characteristics (bone marrow oedema, tunnel fluid effusion) were assessed., Results: In total, 65 patients (27.65 ± 7.07 years; 35 male/30 female) were included in this study. The mean timepoint for "return-to-pivoting-sports" was 27.92 weeks (±2.99) in the ESWT group as well as 42.64 weeks (±5.18) in the control group ( p < 0.001). In the ESWT group 31 patients (vs., Control Group: n = 6) attained the "pre-injury activity level", whereas 6 patients (vs., Control Group: n = 22) did not reach this level within 12 months post-operation. The IKDC score, Lysholm score, and VAS showed significant improvement in the ESWT group compared with the control group for all time-points ( p < 0.001). The mean SIR in the ESWT group revealed 1.81 (±0.88), whereas the control group showed a mean SIR of 2.68 (±1.04) ( p < 0.01)., Discussion: In conclusion, this is the first study investigating the effect of repetitive ESWT on ACL reconstruction with clinical outcome measurements, including the duration of return-to-sports activity and an MRI follow-up examination. Return-to-sports parameters, clinical scores and graft maturation were significantly improved in the ESWT group. This study may support an earlier return-to-sports timepoint by ESWT and is of high clinical relevance as ESWT is a cost-effective treatment option with no relevant side effects.

The primary objectives were to investigate the effects of feeding a new rumen-protected glucose (RPG) on uterine involution and ovarian follicular dynamics in recently calved dairy cattle. From 4 to 30 days after calving, 16 Holsteins (first to third lactation, mean parity 1.75) were randomly assigned to be fed either a basal diet top-dressed with either 600 g RPG (RPG group) or 600 g of the coating material and glucose (CONT group). Based on transrectal ultrasonography, conducted every 3 days starting 20 days after calving, the interval from calving to complete uterine involution was shorter in RPG versus CONT (27.1 vs. 30.4 days, p < .01). Furthermore, based on transrectal ultrasonography conducted every 2 days, cattle fed RPG had smaller (3.0-4.9 mm) ovarian follicles (2.96 vs. 0.9, p < .001) and more total follicles (5.26 vs. 2.85, p < .01). Feeding RPG had increased serum insulin concentrations (4.59 ± 0.54 vs. 3.13 ± 0.57, p < .05), but had no significant effects on serum glucose concentrations, dry matter intake or milk yield. In conclusion, we inferred that cattle fed RPG had increased glucose turnover that was responsible for higher insulin concentrations, faster uterine involution, and more ovarian follicles., (© 2023 Wiley-VCH GmbH.)

Heavy metals from contaminated seafood can have serious consequences for human health. Several studies on the amount of heavy metals in Caspian Sea fish have been conducted to ensure their food safety. This meta-analysis aimed to investigate the levels of five toxic heavy metals; Lead (Pb), Cadmium (Cd), Mercury (Hg), Chromium (Cr), and Arsenic (As) in muscles of commercial fishes of the Caspian Sea with assessing their health risk of developing oral cancer in terms of fish collection place and fish type. A systematic search was performed, and the random effect model was applied for meta-analysis. Finally, 14 studies with 30 different sets of results were included. Our results showed that the pooled estimates for Pb, Cd, Hg, Cr, and As were 0.65 mg/kg (0.52, 0.79), 0.08 mg/kg (0.07, 0.10), 0.11 mg/kg (0.07, 0.15), 1.77 mg/kg (1.26, 2.27), and 0.10 mg/kg (- 0.06, 0.26) respectively. The levels of Pb and Cd were higher than their (FAO/WHO) maximum limits. The Estimated Daily Intake (EDI) of Pb and Cd in Mazandaran, and Hg in Gilan were more than Total Daily Intake (TDI) limits. The consumers' non-carcinogenic risk (THQ) for Hg in Mazandaran and Gilan, and As in Gilan, was unsafe. Carcinogenic risk (CR) for Cr and Cd in all three provinces, and for As in Mazandaran and Gilan, was greater than 1*10 - 4 and was unsafe. The lowest and highest risk levels of oral cancer were for Rutilus kutum and Cyprinus carpio respectively., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background and Aim: Adipocytokines play an important role in obstructive sleep apnea (OSA) by mediating inflammatory responses. Previous studies have reported that OSA is related to a change in the serum levels of adipocytokines; however, the results are still controversial. This meta-analysis aimed to assess the relationship between OSA and circulating level of adipocytokines in adults and children., Methods: A comprehensive search was conducted in databases of Medline/PubMed and Scopus for pertinent articles published since their inception to July 2022. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to assess the strength of the relationship between the concentrations of adipocytokines with OSA., Results: In the overall analysis, contrary to IL-10, which showed a significant reduction, IL-1β, IL-4, IL-8, IL-17, and IFN- gamma showed higher levels in OSA patients in comparison with control groups (p <0.05). For adults, IL-1β, IL-8, IL-17, IL-18, vaspin, visfatin, and chemerin were linked to a greater serum levels in patients with OSA, while, IL-5 and IL-10 were detected significantly lower in adults with OSA in comparison with healthy adults (p <0.05). In children with OSA, the serum levels of IL-4, IL-8, IL-12, IL-17, IL-23, and IFN-gamma were significantly higher than healthy children (p <0.05)., Conclusion: The levels of inflammatory markers were found to be higher in OSA patients compared with control individuals, suggesting that adipocytokines may contribute to the pathology of OSA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background/aim: We investigated the association of noninvasive oxygenation support [high flow nasal cannula (HFNC) and BiPAP], timing of invasive mechanical ventilation (IMV), and inpatient mortality among patients hospitalized with COVID-19., Methods: Retrospective chart review study of patients hospitalized with COVID-19 (ICD-10 code U07.1) and received IMV from March 2020-October 2021. Charlson comorbidity index (CCI) was calculated; Obesity defined as body mass index (BMI) ≥ 30 kg/m2; morbid obesity was BMI ≥ 40 kg/m2. Clinical parameters/vital signs recorded at time of admission., Results: 709 COVID-19 patients underwent IMV, predominantly admitted from March-May 2020 (45%), average age 62±15 years, 67% male, 37% Hispanic, and 9% from group living settings. 44% had obesity, 11% had morbid obesity, 55% had type II diabetes, 75% had hypertension, and average CCI was 3.65 (SD = 3.11). Crude mortality rate was 56%. Close linear association of age with inpatient-mortality risk was found [OR (95% CI) = 1.35 (1.27-1.44) per 5 years, p<0.0001)]. Patients who died after IMV received noninvasive oxygenation support significantly longer: 5.3 (8.0) vs. 2.7 (SD 4.6) days; longer use was also independently associated with a higher risk of inpatient-mortality: OR = 3.1 (1.8-5.4) for 3-7 days, 7.2 (3.8-13.7) for ≥8 days (reference: 1-2 days) (p<0.0001). The association magnitude varied between age groups: 3-7 days duration (ref: 1-2 days), OR = 4.8 (1.9-12.1) in ≥65 years old vs. 2.1 (1.0-4.6) in <65 years old. Higher mortality risk was associated with higher CCI in patients ≥65 (P = 0.0082); among younger patients, obesity (OR = 1.8 (1.0-3.2) or morbid obesity (OR = 2.8;1.4-5.9) (p<0.05) were associated. No mortality association was found for sex or race., Conclusion: Time spent on noninvasive oxygenation support [as defined by high flow nasal cannula (HFNC) and BiPAP] prior to IMV increased mortality risk. Research for the generalizability of our findings to other respiratory failure patient populations is needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Kasarabada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Ionizing radiations are a helpful technique and have improved financial potential in developing new and unique commercially important fruit tree varieties. The 'Yaghouti' grape cuttings were treated with 0 (control), 10, 20, 30, 40, 50, 60, 70, 80, 90, and 100 Gy gamma ray (γ) doses. The objectives of this study were to (1) investigate the effects of γ radiation on the survival rate, leaves, shoots, and root morphometric traits after γ irradiation; (2) Measurement of the 25, 50, and 75% lethal dose and 25, 50, and 75% growth reduction dose based on leaves, shoots, and root morphometric characteristics to estimate grape radiosensitivity; (3) Ultimately, determining the optimum dose of γ irradiation based biological responses (LD 25, 50, 75 and GR 25, 50, 75 ) in Yaghouti grape. The findings demonstrate that the lethal dose of the 'Yaghouti' was 18 Gy for LD 25 , 30 Gy for LD 50 , and 48 Gy for LD 75 , respectively. Furthermore, our findings showed that increasing the γ dose had a harmed ngative effect on vine growth, as evidenced by a decrease in plant height, root number, root volume, leaf area, aerial biomass, root biomass, and internode number of the 'Yaghouti' grape plants. Our results showed that between the aerial parts of vines, the leaf area and aerial biomass had higher radiosensitivity than plant height and other aerial parts of the plants based on data from GR 25 , GR 50 , and GR 75 . Moreover, GR studies of root characteristics revealed that root number and biomass root had higher radiation sensitivity than root volume. According to biological responses (LD 25, 50, 75 and GR 25, 50, 75 ) in the 'Yaghouti' grape, 30 Gy of γ radiation is the optimum dose for preliminary mutagenesis investigations., (© 2023. The Author(s).)

Background: Obsessive-compulsive disorder (OCD) is a common psychiatric disorder. The Food and Drug Administration (FDA) approved repetitive transcranial magnetic stimulation (rTMS) to treat OCD in 2018. So far, various approaches to treat this disorder have been evaluated. We evaluated the effect of adjunctive low-frequency rtMS over the left dorsolateral prefrontal cortex in patients with OCD refractory to treatment., Methods: The present clinical trial was done on 37 patients with OCD referring from the psychiatry clinic, 22 Bahman Hospital, Qazvin province, between 2018 and 2020 and patients were randomly divided into two groups. The intervention group received rTMS treatment at 1 Hz for 20 min (1200 pulses/day) over the left DLPFC area as adjunctive to the medical treatment three times a week and for five weeks, whereas those in the control group were subjected to only the sham condition plus their medical treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOC.S) was completed by patients before the study, following sessions 5 and 10 during the intervention, at the end of the intervention, and three to six months after the intervention under the direct supervision of a psychiatrist. SPSS software version 26 was used to compare the results between the two groups., Results: The intervention group showed significantly lower mean Y-BOCS scores after the intervention and at follow-up (P < 0.05) and all patients of the intervention group showed significantly lower Y-BOCS scores than their own baseline scores (P < 0.05). Also, using antipsychotic agents along with the serotonergic agents yielded significantly lower scores in the intervention group at the end of the intervention (P < 0.05). All the patients were found with higher follow-up scores than their scores at the end of the intervention; however, this difference was not significant (p > 0.05)., Conclusion: Adjunctive low-frequency (1 Hz) rTMS over the left DLPFC is able to effectively reduce Y-BOCS score in OCD patients refractory to treatment following 15 sessions, and the reduction was durable even after three to six months. Using antipsychotic agents as an adjuvant with serotonergic agents was identified as a possible predictor for response to adjunctive rTMS therapy., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Metastasis is a devastating complication of breast cancer. Cancer relapse and metastasis are associated with cancer stem cells. CicBIRC6 is a circular RNA that is proposed to be involved in the stemness of stem cells. In breast cancer, metastatic tumor cells have higher stem cell properties. In the present study, we evaluate the expression of cicBIRC6 in these cells., Methods: After the development of a syngeneic animal model of TNBC, primary breast cancer cells named 4T1T were isolated from the tumor mass. Highly metastatic tumor cells named 4T1B and 4T1L were isolated and expanded from brain metastasis lesions and lungs of cancerous mice respectively. Sphere formation ability in metastatic and primary tumor cells was evaluated separately. The quantitative real-time polymerase chain reaction was performed to analyze the expression of cicBIRC6 in primary and metastatic tumor cells., Results: Our data revealed that, sphere formation ability among metastatic tumor cells was significantly higher. Surprisingly expression of cicBIRC6 was significantly upregulated in these metastatic tumor cells. In comparison with 4T1T, cicBIRC6 was upregulated 5.7 and 3.5 times in 4T1B and 4T1L respectively., Conclusion: These findings provided important insights regarding the molecular properties of metastatic tumor cells and can be used for designing a targeted therapeutic strategy in combat with these cells., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Statins use is the most important treatment for high LDL cholesterol in patients with premature coronary artery disease (CAD). Previous reports have shown racial and gender differences in statin use in the general population, but this wasn't studied in premature CAD based on different ethnicities., Methods and Results: Our study includes 1917 men and women with confirmed diagnosis of premature CAD. Logistic regression model was used to evaluate the high LDL cholesterol control in the groups and the OR with 95% confidence interval (CI) was reported as the effect size. After adjustment for confounders, the odds of controlling LDL in women taking Lovastatin, Rosuvastatin, and Simvastatin were 0.27 (0.03, 0.45) lower in comparison with men. Also, in participant who took 3 types of statins, the odds of controlling LDL were significantly different between Lor and Arab compared with Fars ethnicity. After adjustment to all confounders (full model), the odds of controlling LDL were lower for Gilak in Lovastatin, Rosuvastatin, and Simvastatin by 0.64 (0.47, 0.75); 0.61 (0.43, 0.73); 0.63 (0.46, 0.74) respectively and higher for Arab in Lovastatin, Rosuvastatin, and Simvastatin by 4.63 (18.28, 0.73); 4.67 (17.47, 0.74); 4.55 (17.03, 0.71) respectively compared to Fars., Conclusions: Major differences in different gender and ethnicities may have had led to disparities in statin use and LDL control. Awareness of the statins impact on high LDL cholesterol based on different ethnicities can help health decision-makers to close the observed gaps in statin use and control LDL to prevent CAD problems., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: DNA probes have been widely used as diagnostic tools for translocations. This study sought to design a screening tool using ssDNA probes and chromosome conformation capture (3C) library fragment hybridization. Method: The authors focused on developing a probe for the juxtaposed region of MYC and TRD . Fragments of the MYC gene with a thiol modification (MYC-Au NP probe) were functionalized by gold nanoparticles (Au NPs). Then TRD  probes were immobilized on a nitrocellulose surface. Hybridization between DNA probes and 3C library fragments of SKW3 cells was determined by color intensity. Results: Optimal hybridization of the 3C library sample of the cell line to probes showed higher color intensity than human umbilical vein endothelial cells. Conclusion: Combining 3C-based techniques and DNA-DNA hybridization can identify rearrangements in cancer cells.

Introduction: Human endometrial mesenchymal stem cells (hEnMSCs) are a rich source of mesenchymal stem cells (MSCs) with multi-lineage differentiation potential, making them an intriguing tool in regenerative medicine, particularly for the treatment of reproductive and infertility issues. The specific process of germline cell-derived stem cell differentiation remains unknown, the aim is to study novel ways to achieve an effective differentiation method that produces adequate and functioning human gamete cells., Methods: We adjusted the optimum retinoic acid (RA) concentration for enhancement of germ cell-derived hEnSCs generation in 2D cell culture after 7 days in this study. Subsequently, we developed a suitable oocyte-like cell induction media including RA and bone morphogenetic protein 4 (BMP4), and studied their effects on oocyte-like cell differentiation in 2D and 3D cell culture media utilizing cells encapsulated in alginate hydrogel., Results: Our results from microscopy analysis, real-time PCR, and immunofluorescence tests revealed that 10 µM RA concentration was the optimal dose for inducing germ-like cells after 7 days. We examined the alginate hydrogel structural characteristics and integrity by rheology analysis and SEM microscope. We also demonstrated encapsulated cell viability and adhesion in the manufactured hydrogel. We propose that in 3D cell cultures in alginate hydrogel, an induction medium containing 10 µM RA and 50 ng/mL BMP4 can enhance hEnSC differentiation into oocyte-like cells., Conclusion: The production of oocyte-like cells using 3D alginate hydrogel may be viable in vitro approach for replacing gonad tissues and cells., Competing Interests: The authors declare no conflict of interest., (© 2023 The Author(s).)

Reconstruction of the anterior cruciate ligament (ACL) is one of the most popular orthopedic surgical procedures. To date, numerous studies are available focusing on different reconstruction techniques using established autografts, such as hamstrings, bone patellar-tendon bone (BPTB), quadriceps tendon, or allograft tendons. In the present article, we describe a minimally invasive ACL reconstruction technique using a fascia lata autograft in combination with FiberTape (Arthrex, Naples, FL) augmentation using the TightRope II (Arthrex). The minimally invasive harvesting procedure is performed by using the new QuadPro Tendon Harvester (Arthrex). This technique is recommended for acute and chronic complete ACL ruptures or bundle ruptures in athletes or patients with high physical activity. The technique might allow early full weight bearing due to less donor site morbidity, early free range of motion, and early active rehabilitation due to the use of FiberTape as a augmentation device to reinforce the autograft. Clinical studies are necessary to prove the principle., (© 2022 The Authors.)

Introduction There has been a recent increase in the number of spinal procedures that can be performed in ambulatory surgical centers (ASCs). Studies have found that patients who undergo procedures at ASCs tend to have lower complication rates following procedures, including lower infection rates. Furthermore, ASCs offer significantly lower costs of procedures to patients and health insurance companies as compared to the costs of procedures performed in a hospital. Despite precautions and screening in place by ASCs, patients may be hesitant to undergo procedures outside of the hospital. Conversely, the ongoing COVID-19 pandemic has created hesitancy for many to go to the hospital for care due to the presence of COVID patients.  Objective To assess patient preferences in the location of elective spine procedures between ASCs and hospitals, the authors conducted a survey of spine surgery candidates in a single practice. Methods A survey measuring patient age, vaccination status, fear of contracting COVID-19, and preference of surgery location was given to spinal surgery candidates at a single practice between fall 2021 and winter 2022. Statistical differences between the means of response groups were measured by a two-sample Z-score test. Results A total of 58 surveys were completed by patients. No difference in preference was observed by age. A difference was observed between genders, with 66% of females preferring ASCs to 40% of males (α=0.03). Patients with a fear of contracting COVID-19 preferred to have their procedure performed in an ASC. No difference was observed in location due to vaccination status, but unvaccinated patients had a significantly lower fear of contracting COVID-19 (α=0.02). Conclusion The differences in patient preferences have no clear cause, highlighting the need for better patient education in regard to the risks and benefits of each location of surgery. The fear of contracting COVID-19 on the day of surgery appears to be more ideological than rational for unvaccinated patients, who had less fear of contracting COVID-19 than vaccinated patients, despite being more likely to contract COVID-19 than vaccinated patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Cassimatis et al.)

Periodontitis is a chronic inflammatory disease characterized by the release of matrix metalloproteinases (MMPs) from resident connective tissue cells in tooth-supporting tissues (periodontium). Platelet activation, and the attendant release of pro-inflammatory chemokines such as platelet factor 4 (CXCL4/PF4), are associated with periodontitis although the associated biochemical pathways remain undefined. Here we report that recombinant PF4 is internalized by cultured human gingival fibroblasts (hGFs), resulting in significant (p < 0.05) upregulation in both the production and release of MMP-2 (gelatinase A). This finding was corroborated by elevated circulating levels of MMP-2 (p < 0.05) in PF4-overexpressing transgenic mice, relative to controls. We also determined that PF4 induces the phosphorylation of NF-κB; notably, the suppression of NF-κB signaling by the inhibitor BAY 11-7082 abrogated PF4-induced MMP-2 upregulation. Moreover, the inhibition of surface glycosaminoglycans (GAGs) blocked both PF4 binding and NF-κB phosphorylation. Partial blockade of PF4 binding to the cells was achieved by treatment with either chondroitinase ABC or heparinase III, suggesting that both chondroitin sulfate and heparan sulfate mediate PF4 signaling. These results identify a novel pathway in which PF4 upregulates MMP-2 release from fibroblasts in an NF-κB- and GAG-dependent manner, and further our comprehension of the role of platelet signaling in periodontal tissue homeostasis., (© 2022. The Author(s).)

The impact of Algae supplements and its extract on blood pressure has not concluded yet. The aim of this systematic review meta-analysis is to evaluate the antihypertensive activity of this group marine organism on human. Alga was used in some studies as capsules (from 500-mg to 8-g) and the follow-up duration changed from 17 days to 9 months. The difference in standardized mean and its corresponding 95% confidence interval (CI) was applied as the effect size of algae supplementation on systolic and diastolic blood pressure. Based on the results, a meta-analysis of 10 studies with baseline effect control demonstrated that there was no difference in the mean systolic blood pressure in the 2 groups SMD (95%CI): -1.05 (-2.85,0.76), but a significant difference in the mean diastolic blood pressure was observed and showed that the mean diastolic blood pressure in the treatment group was lower than the control group SMD(95%CI): -2.23 (-4.35,-0.11). A meta-analysis of 4 studies with no baseline control effect did not show significant results on both blood pressure. The evidence to support this systematic review meta-analysis requires more investigation and future large scale RCT clinical trial to confirm the results., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Diabetic retinopathy is a severe microvascular problem in diabetes mellitus. Silymarin is a flavonoid compound, and according to previous studies, it is a bioactive compound with potent antioxidant and anti-inflammatory properties. This investigation aims to peruse the impact of silymarin against diabetic retinopathy in streptozotocin (STZ)-provoked rats. Thirty-two adult male Wistar rats were randomly allocated into the control group, STZ group, STZ + silymarin (50 mg/kg), and STZ + silymarin (100 mg/kg). STZ rats received silymarin every day until 2 months after diabetes induction. The serum and retinal tissues were collected 2 months after silymarin treatment to determine biochemical and molecular analyses. Silymarin markedly lowered the serum glucose concentration in diabetic rats. Silymarin reduced the increased levels of advanced glycosylated end products (AGEs), the receptors for AGEs (RAGE), and reactive oxygen species (ROS) in diabetic rats. Silymarin also attenuated the phosphorylation of p38 MAP kinase and nuclear factor (NF)-κB p65 and diminished diabetes-induced overexpression of inflammatory cytokines, vascular endothelial growth factor (VEGF), adhesion molecules, and extracellular matrix proteins in STZ rats. Our data suggested that silymarin has protective effects against diabetic retinopathy, which might be related to the inhibition of the AGEs/RAGE axis and its antioxidant and anti-inflammatory activities., (© 2022. The Author(s).)

Introduction: Chronic pain represents a global health problem with a considerable economic burden. The relation of alcohol intake and chronic pain conditions was assessed in several studies with conflicting results. We used dose-response meta-analysis techniques to answer the question of whether alcohol intake is related to chronic pain occurrence., Methods: We searched MEDLINE, Embase, and other databases to identify cohort and case-control studies on alcohol consumption and chronic pain. Sixteen studies were eligible with a total population of 642 587 individuals. Fixed-effects and random-effects pooled estimates were obtained by weighting log odds ratios (ORs) in case-control studies and log incidence rate ratios in cohort studies by the inverse of their variance. A heterogeneity assessment and a dose-response analysis were carried out. Quality scoring was also performed., Results: Our results show that any alcohol consumption was related to lower odds of chronic pain (pooled OR=0.76; 95% confidence interval [CI], 0.61-0.95). The association was non-linear. The ORs by quartile of alcohol doses were as follows: OR 2nd quartile =0.74; 95% CI, 0.64-0.87; OR 3rd quartile =0.67; 95% CI, 0.53-0.86; and OR 4th quartile=0.75; 95% CI, 0.50-1.14. This association was observed for cohort studies (OR=0.77; 95% CI, 0.61-0.98) and European studies (OR=0.65; 95% CI, 0.48-0.87) only. Studies with complete adjustment for confounding factors showed a stronger relation than those with incomplete adjustment (OR=0.69; 95% CI, 0.48-0.99 and OR=0.85; 95% CI, 0.65-1.11, respectively)., Conclusion: Alcohol consumption presents a non-linear inverse association with the occurrence of chronic pain. Although plausible mechanisms could explain this protective effect, other explanations, including reverse causation, are probable., (Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Bacillus bacteria are a group of plant growth stimulants that increase plant growth and resistance to plant pathogens by producing various metabolites. With their large surface area and small size, nanoparticles can be used in controlled-release formulations and increase the efficiency of the desired product. Encapsulation of biological agents in combination with nanoparticles can be an essential step in increasing the performance of these agents in adverse environmental conditions. In this study, which is the result of a collaboration between scientists from Italy and Iran, Bacillus velezensis was encapsulated in alginate combined with whey protein and zedo, mastic, and tragacanth gums in the presence of silica and titania nanoparticles to obtain two-layer and multilayer assemblies acting as novel, smart micro-encapsulation systems. The results of laboratory studies showed that the B. velezensis could produce protease, lipase, siderophore, auxin, and a dissolution of mineral phosphate. Scanning electron microscopy images (SEM) showed that the studied microcapsules were almost spherical. Moisture affinity, swelling, and efficiency of each microcapsule were examined. The results showed that the highest encapsulation efficiency (94.3%) was related to the multilayer formulation of alginate-whey protein-zedo. XRD and FTIR spectroscopy showed that the alginate, whey protein, and zedo were mixed properly and no incompatible composition occurred in the reaction. This study aimed to provide a suitable formulation of biofertilizers based on biodegradable compounds as an alternative to chemical fertilizers, which is low cost and very effective without harming humans and the environment.

The related neurologic complications of SARS-CoV-2 infection in COVID-19 patients and survivors comprise symptoms including depression, anxiety, muscle pain, dizziness, headaches, fatigue, and anosmia/hyposmia that may continue for months. Recent studies have been demonstrated that chemokines have brain-specific attraction and effects such as chemotaxis, cell adhesion, modulation of neuroendocrine functions, and neuroinflammation. CCL11 is a member of the eotaxin family that is chemotactic agents for eosinophils and participate in innate immunity. Eotaxins may exert physiological and pathological functions in the central nerve system, and CCL11 may induce neuronal cytotoxicity effects by inducing the production of reactive oxygen species (ROS) in microglia cells. Plasma levels of CCL11 elevated in neuroinflammation and neurodegenerative disorders. COVID-19 patients display elevations in CCL11 levels. As CCL11 plays roles in physiosomatic and neuroinflammation, analyzing the level of this chemokine in COVID-19 patients during hospitalization and to predicting post-COVID-19-related neurologic complications may be worthwhile. Moreover, using chemokine modulators may be helpful in lessening the neurologic complications in such patients., (© 2022. The Author(s) under exclusive licence to Belgian Neurological Society.)

The central mechanism in ferroptosis linking lipid hydroperoxide accumulation with cell death remains poorly understood. Although lipid hydroperoxides are known to break down to reactive lipid-derived electrophiles (LDEs), the ability of cells to detoxify increasing LDE levels during ferroptosis has not been studied. Here, we developed an assay (ElectrophileQ) correlating the cellular retention vs. excretion of a fluorogenic lipophilic electrophile (AcroB) that enables live-cell assessment of the glutathione-mediated LDE conjugation and adduct export steps of the LDE detoxification pathway. This method revealed that during ferroptosis, LDE detoxification failure occurs through decreased conjugation or export impairment, amplifying cellular electrophile accumulation. Notably, ferroptosis susceptibility was increased following exacerbation of LDE-adduct export impairment through export channel inhibition. Our results expand understanding of the ferroptosis molecular cell death mechanism to position the LDE detoxification pathway as a ferroptosis-relevant therapeutic target. We envision the ElectrophileQ assay becoming an invaluable tool for studying ferroptosis and cellular health., Competing Interests: The authors declare no conflicts of interest., (This journal is © The Royal Society of Chemistry.)

This study aimed to compare the effectiveness of NAC plus low dose contraceptive with low dose contraceptives alone. This was a randomised trial on a sample of women who underwent conservative laparoscopic surgery for ovarian endometrioma. Patients were randomly assigned either to the NAC plus low dose contraceptive group ( n  = 48) or low dose contraceptive alone ( n  = 52). To evaluate the recurrence rate transvaginal ultrasound was performed. Pelvic pain was assessed using a visual analogue scale (VAS). All assessments were performed at two points in time: 3 and 6 months post-surgery and compared between the two regimens. The findings indicated that reduction in the recurrence rate of endometrioma and pelvic pain were similar between both groups. The findings showed that adding N-acetylcysteine to low dose contraceptive treatment has a similar effect in reducing the recurrence rate of endometrioma and pelvic pain when compared to low dose contraceptives alone.Impact statement What is already known on this subject? Endometriosis is a frequent benign disease-producing inflammatory response with mild to severe symptoms. Although surgical removal of ectopic lesions is the first-line intervention, the recurrence rate of the disease is high. Thus this study aimed to compare the effectiveness of N-acetylcysteine plus low dose contraceptive with low dose contraceptive alone. What do the results of this study add? The findings showed that adding N-acetylcysteine to low dose contraceptive treatment has a similar effect in reducing the recurrence rate of endometrioma and pelvic pain when compared to low dose contraceptives alone. What are the implications of these findings for clinical practice and/or further research? It is recommended to increase the duration of drug administration in future studies.

Introduction and Importance: Esophageal achalasia is a motility disorder of the esophagus with unknown etiology characterized by the failure of lower esophageal sphincter relaxation. Diagnosis is made by barium esophagography, endoscopy, and esophageal manometery. Heller Esophagomyotomy along with Dor's fundoplication is the treatment of choice. Persisting undiagnosed cases may lead to malnutrition., Case Presentation: We present a case of an 8-year-old child suffering from dysphagia and regurgitation. The child was misdiagnosed and maltreated for the suspicion of respiratory tract and gastrointestinal problems in the local clinics. During this time, he remained unresponsive to the mentioned treatments, and the local physician advised him to have an upper gastrointestinal (GI) endoscopy, which revealed esophageal achalasia (EA). On admission to our pediatric surgery ward, the patient had coexistent parotitis, which was treated conservatively. Following recovery, the patient was prepared for surgery and underwent esophageal myotomy along with Dor's fundoplication., Clinical Discussion: Esophageal achalasia is rare in children, but poses major health challenges to children if left untreated. Symptomatic treatment may mask the actual picture of the problem and last for years. Following surgery and discharge from the hospital in a three-month follow-up interval of time, our patient exhibited full recovery, with gaining 4 kg weight., Conclusions: Respiratory and gastrointestinal conditions with similar signs and symptoms should always be considered in differential diagnosis of esophageal achalasia, especially where there is no direct access to a pediatric specialized complex. On-time evaluation and treatment will further prevent children from malnutrition in long-lasting undiagnosed patients., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The effects of foliar spray of methyl jasmonate (MJ; 0, 50 and 100 µM) on phytochemical changes and nutritional balance of two grapevine (Vitis vinifera L.) cultivars ['Sultana' (as moderately salt-tolerant) and 'Rishbaba' (as a least salt-tolerant)] were evaluated under different saline conditions (NaCl; 0 and 75 mM). To explore optimum concentration of MJ treatment, grapevine plants were sprayed with MJ twice a day at 12-h intervals during the second week of salinity stress. The results showed that foliar spray of MJ especially at 100 µM was effective in alleviating deleterious effects of NaCl-induced salinity stress on both cultivars. The MJ at 50 and 100 µM significantly decreased ion leakage and production of malondialdehyde and hydrogen peroxide, but increased photosynthetic pigments, soluble carbohydrate, proline, and total phenol and flavonoid contents, especially in 'Sultana' compared with 'Rishbaba'. Moreover, application of 100 µM MJ was associated with enhanced the activities of catalase, guaiacol peroxidase, and ascorbate peroxidase, resulting in greater leaf cell biomembranes stability in vines under saline condition compared with control plants (no treatment). The MJ was also associated with decreased accumulation of sodium and chlorine in leaves, but increased leaf minerals and trace elements compared with control vines. These findings suggest that foliar application of MJ, especially at 100 µM, might be useful to reduce negative effects of salinity stress in vineyards and nurseries., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: The Accreditation Council for Pharmacy Education (ACPE) offers certification for interested pharmacy programs outside the United States. This study aimed to explore the reported impact of this certification on the quality of pharmacy education among ACPE-certified pharmacy programs outside the US., Methods: This cross-sectional study was based on highly structured, standardized interviews. A predetermined questionnaire was designed to include both quantitative and qualitative items, which assessed participants' thoughts on the impact of ACPE certification on the quality of pharmacy education as well as programmatic and student learning outcomes. A total of 15 pharmacy colleges and schools outside the US have received the ACPE certification as of July 2020. After IRB approval, these programs were invited to participate in online live interviews, which were scheduled from May to July 2020 via Zoom®, and lasted approximately 45 min each., Results: Administrators from 13 programs participated in this study (87% respondent rate). The majority of these international pharmacy programs reported that the ACPE certification had promoted the quality of pharmacy education at their institutions. However, there were different views on how the ACPE certification has affected the operation of these international pharmacy programs. There was little or no impact of the certification on financial resources, such as salaries and development funds., Conclusion: Despite being confined to little or no change in certain areas of their programs, all the interviewees believed the ACPE certification had an overall positive impact on the quality of their programs, particularly in the area of assessment, preceptor quality and development, improving teaching and learning methods in both didactic and experiential curricula, and developing an inclusive feedback system to receive input from various stakeholders., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Reza Karimi serves on ACPE Board of Directors and the presented information does not represent ACPE or the boards’ opinions or views., (© 2021 Published by Elsevier B.V. on behalf of King Saud University.)

In this study, the effect of γ-aminobutyric acid (GABA) at 0 (control), 20 and 40 mM on maintaining postharvest quality, chilling tolerance and fungal decay of 'Sahebi' grapevine (Vitis vinifera L.) was investigated during 60 days storage at 1 °C. GABA-treated fruits especially at 40 mM showed less weight loss (35%), rachis browning (30%) and decay incident (63%) compared to the control. GABA-induced abscisic acid was linked to lower membrane electrolyte leakage (13%) in treated grapes. Moreover, at the end of 60 days, GABA treatment at 40 mM resulted in higher activities of antioxidant enzymes including superoxide dismutase (50%), catalase (35%), guaiacol peroxidase (65%), and ascorbate peroxidase (47%) and lower malondialdehyde (21%) compared to control samples. The highest soluble sugars and organic acids were related to 40 mM GABA-treated grape clusters. Phenolic compounds (phenolic acids, stilbenes, flavonoids and anthocyanidins) and antioxidant capacity increased in 40 mM GABA-treated grape due to lower polyphenol oxidase activity. Therefore, GABA is recommended for maintaining internal quality and reduction in fungal decay and chilling injury of grapes during postharvest storage., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Recent advancements in Electroencephalographic (EEG) sensor technologies and signal processing algorithms have paved the way for further evolution of Brain Computer Interfaces (BCI) in several practical applications, ranging from rehabilitation systems to smart consumer technologies. When it comes to Signal Processing (SP) for BCI, there has been a surge of interest on Steady-State motion Visual Evoked Potentials (SSmVEP), where motion stimulation is used to address key issues associated with conventional light flashing/flickering. Such benefits, however, come with the price of being less accurate and having a lower Information Transfer Rate (ITR). From this perspective, this paper focuses on the design of a novel SSmVEP paradigm without using resources such as trial time, phase, and/or number of targets to enhance the ITR. The proposed design is based on the intuitively pleasing idea of integrating more than one motion within a single SSmVEP target stimuli, simultaneously. To elicit SSmVEP, we designed a novel and innovative dual frequency aggregated modulation paradigm, called the Dual Frequency Aggregated Steady-State motion Visual Evoked Potential (DF-SSmVEP), by concurrently integrating "Radial Zoom" and "Rotation" motions in a single target without increasing the trial length. Compared to conventional SSmVEPs, the proposed DF-SSmVEP framework consists of two motion modes integrated and shown simultaneously each modulated by a specific target frequency. The paper also develops a specific unsupervised classification model, referred to as the Bifold Canonical Correlation Analysis (BCCA), based on two motion frequencies per target. The corresponding covariance coefficients are used as extra features improving the classification accuracy. The proposed DF-SSmVEP is evaluated based on a real EEG dataset and the results corroborate its superiority. The proposed DF-SSmVEP outperforms its counterparts and achieved an average ITR of 30.7 ± 1.97 and an average accuracy of 92.5 ± 2.04, while the Radial Zoom and Rotation result in average ITRs of 18.35 ± 1 and 20.52 ± 2.5, and average accuracies of 68.12 ± 3.5 and 77.5 ± 3.5, respectively.

Background: Despite the importance of self-esteem in cancer patients and the potential role of spiritual care programs in its promotion, no interventional study was found in this field in Iran. The aim of this study was therefore to investigate the effect of a spiritual care program on the self-esteem of patients with various types of cancer., Materials and Methods: This study was quasi-experimental with two groups using a before and after design which was conducted in 2019 in a selected hospital in Isfahan, Iran. A convenience sample of 64 patients randomly assigned into the experimental ( n = 32) and the control group ( n = 32). Data collection was conducted through a two-part questionnaire including Demographic characteristics and the Coopersmith Self-Esteem Inventory (SEI). The spiritual care program consisted of six sessions based on four domains including individuals' relationship with God, themselves, others, and with the environment. To analyze the data, Chi-square, Fisher's exact test, independent t test, and paired t test were performed., Results: The total self-esteem mean score and its domains were not significantly different between the two groups before the intervention ( p > 0.05). However, after conducting the intervention, the total self-esteem mean score and its domains were significantly higher in the intervention group compared with the control group ( p < 0.001)., Conclusions: The spiritual care program used in this study was effective in promoting the self-esteem of patients with cancer. It is suggested that similar studies are conducted to provide fertile grounds for using such programs in the oncology clinical area., Competing Interests: Nothing to declare., (Copyright: © 2022 Iranian Journal of Nursing and Midwifery Research.)

Background: Choledochal cyst is an uncommon congenital biliary tract abnormality of unknown etiology. Its classical symptoms are jaundice, abdominal pain, and right upper quadrant mass. However, the disease may present with a vague and non-specific chronic abdominal discomfort. Delay in diagnosis and management may increase the risk of complications particularly the malignancy, which can directly affect the prognosis and outcome. Complete excision of the extra-hepatic duct, cholecystectomy, and Roux-en-Y hepaticojejeunostomy through the open surgical intervention or laparoscopic procedure is the mainstay of treatment., Case Presentation: A 14-year-old male was presented to our hospital complaining of vague abdominal pain for 5 years. The radiologic imaging showed the features of a type IVa choledochal cyst. He underwent complete excision of the extra-hepatic duct, cholecystectomy, and Roux-en-Y hepaticojejeunostomy. Although the bile leakage occurred as a complication of the procedure, our team best managed the patient in the post-operative period until full recovery., Discussion: The Choledochal cyst was first described by Vater, which is a congenital anomaly that sometimes may remain asymptomatic till adulthood. Surgical intervention is the mainstay of treatment. However, postoperative complications including bile leakage need a close follow-up of the patient., Conclusion: Diagnostic delay (antenatal and postnatal) and non-specific symptoms will mask the real feature of the disease, especially in low-resource settings. Technical facilities and professional care of the patient may preclude complications., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Improving the nutritional condition of grapevine in spring to regulate bloom, fruit set, and yield is among the management goals of vineyards., Methods: In the present study, the early season spray of calcium sulfate (C; 0.00 and 2.00%), potassium sulfate (K; 0.00 and 3.00%), and agricultural grade mineral oil (V; 0.00 and 1.00%) on flower and fruit phenology, nutrient concentration, and cluster biophysical indices and yield of Sultana grapevine (Vitis vinifera L.) were investigated for two consecutive years., Results: Based on the results, the spray of this nutrient combined with mineral oil significantly affected all the treatments except cluster length, berry length, and phosphorus concentration. The highest concentrations of potassium, calcium, and magnesium were obtained in the vines treated with V 0 K 1 C 1 , and the highest concentrations of zinc and iron were obtained only in the vines treated with mineral oil. In treatments containing mineral oil, especially in combination with the second level of calcium and potassium (V 1 K 1 C 1 ), bloom time, berries pea-sized time, and harvest time were delayed by 3, 3, and 6 days compared with control vines. While in vines treated with a combination of the second level of potassium and calcium (V 0 K 1 C 1 ), bloom time, berries pea-sized time, and harvest time were advanced by 5, 4, and 1.50 days, respectively, compared with control vines. Regarding the biophysical indices of the cluster, it was found that the vines treated with V 1 K 1 C 1 had higher cluster weight, berry weight, fruit, and raisins yield than other treatments. Also, the highest berry quality, including total soluble solids, titratable acidity, and total phenol content, were obtained in the vines treated with V 0 K 1 C 1 . However, the lowest berry quality was observed in the vines treated with mineral oil., Conclusions: Therefore, the combination of nutrients with mineral oil can alleviate the adverse effect of mineral oil solely on some phenological indices and berry quality-related traits in vineyards., (© 2021. The Author(s).)

Magnesium may reduce the risk of lung cancer by affecting cell proliferation, inflammation and by preserving lung function; however, the results of epidemiological studies on the potential benefits of magnesium in lung pathology are inconclusive. We conducted this meta-analysis to investigate the association between magnesium intake and the risk of lung cancer. A total of 5 studies were extracted from PubMed, SCOPUS, and the Cochrane Review (to May 2018). These studies involved 58,5821 participants with 8,977 lung cancer cases. The pooled relative risk (RR) indicated a significant association between lung cancer incidence and magnesium intake (RR = 0.88, 95% CI = 0.79 to 0.98; p  = 0.018). To investigate the cause of heterogeneity of these studies (I 2  = 75.8%, p < 0.001), we performed a subgroup analysis which was affected by the mean dose of magnesium intake, where doses of magnesium intake lower than 300 mg/d significantly decreased lung cancer risk (RR = 0.83, 95% CI = 0.70 to 0.99; p  = 0.034). Increasing magnesium intake doses to over 300 mg/d did not reduce the incidence of lung cancer (RR = 0.89, 95% CI = 0.78 to 1.01; p  = 0.076). Our meta-analysis suggests that magnesium intake of less than 300 mg/d may have protective effects in lung cancer.

Background and Purpose: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is associated with hypercoagulability. We sought to evaluate the demographic and clinical characteristics of cerebral venous thrombosis among patients hospitalized for coronavirus disease 2019 (COVID-19) at 6 tertiary care centers in the New York City metropolitan area., Materials and Methods: We conducted a retrospective multicenter cohort study of 13,500 consecutive patients with COVID-19 who were hospitalized between March 1 and May 30, 2020., Results: Of 13,500 patients with COVID-19, twelve had imaging-proved cerebral venous thrombosis with an incidence of 8.8 per 10,000 during 3 months, which is considerably higher than the reported incidence of cerebral venous thrombosis in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI, 36-62 years; range, 17-95 years). Only 1 patient (8%) had a history of thromboembolic disease. Neurologic symptoms secondary to cerebral venous thrombosis occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging. Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%., Conclusions: Early evidence suggests a higher-than-expected frequency of cerebral venous thrombosis among patients hospitalized for COVID-19. Cerebral venous thrombosis should be included in the differential diagnosis of neurologic syndromes associated with SARS-CoV-2 infection., (© 2021 by American Journal of Neuroradiology.)

Type 1 diabetes is a metabolic disorder caused by the loss or dysfunction of β-cells in the pancreas. Organ shortage is a critical concern of diabetic patients in need of beta islet transplantation. Tissue engineered islets are promising alternatives to traditional organ transplantation. Recent progress in stem cell biology and gene cloning techniques has raised hopes for the generation of insulin producing cells (IPCs) without the need of immunosuppression. The purpose of this study was to produce IPCs using human adipose-derived stem cells (hADSCs) and human endometrial-derived stem cells (hEnSCs) and also to compare the level of insulin secretion by these cells in 2D and 3D culture systems on fibrin scaffolding. Stem cells differentiation was carried out through transduction with an insulin over expression lentiviral vector. Real-time PCR and immunocytochemistry confirmed the successful transduction of both cell types. Both cell types showed comparable insulin secretion by ELISA.3D culture resulted in higher amounts of insulin secretion of the two cell types versus 2D as control. This study showed that insulin gene delivery to the stem cells could be an efficient method for producing IPCs and fibrin encapsulation enhances the functionality of these cells., (© 2020 Wiley Periodicals LLC.)

There are conflicting reports regarding circulating leptin and its relationship between pregnancy outcomes in infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). We performed a systematic review and meta-analysis to assess the association between serum or follicular fluid (FF) leptin concentrations reported for infertile women and their IVF outcome. A systematic search was undertaken in available databases (PubMed, Scopus, Web of Science, The Cochrane Library and Embase) to find studies published up to Aug 2020 and the standardized mean difference with 95 % confidence interval was taken from 14 eligible studies. Both graphical (funnel plots) and test methods (Egger's regression test and the Begg) assessed the presence of publication bias. Subgroup analysis was used to investigate the source of heterogeneity. Pooled effect sizes based on the eligible papers indicated that of there is no statistically significant correlation between leptin levels in follicular fluid and serum on the day of ovum pick-up (OPU) and day of HCG (human chorionic gonadotrophin) administration in pregnant and non-pregnant women who underwent IVF/ICSI cycles. However, combination of leptin in serum and/or FF with other parameters may be a useful marker to predict IVF outcome., Competing Interests: Declaration of Competing Interest The authors stated there is no conflict of interest to declare, (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Heart failure (HF) is the number one cause of death in the world. B-type natriuretic peptide (BNP) is a recognized biomarker for HF and can be used for early detection. Field effect transistor (FET) biosensors have the ability to sense BNP in much shorter times than conventional clinical studies. The lowest limit of detection (LOD) of state-of-the-art HF FET biosensors is 100 fM and detection ranges are short, being less than 4 orders of magnitude. In this work, a B/N co-doped graphene oxide (GO) gel (BN-GO) was used as the channel material in an FET biosensor targeting BNP. The sensor was able to sense BNP in as little as 2 min, with an LOD as low as 10 aM and a wide linear detection range of 10 aM-1 μM, stretching over 11 orders of magnitude. The biosensor showed great selectivity and minimal response towards K + and OH - ions and the human epidermal growth factor receptor (HER2) protein. This biosensor serves as a proof-of-concept of the ability of BN-GO gel FETs to be used for ultrasensitive biosensors., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Actin, the primary component of the cytoskeleton, is the most studied semiflexible filament. Yet, the dynamics of actin filamentous network is still a subject of debate. Here we show that hydrodynamic interactions may significantly alter the time scale of actin network deformation. The alteration may be easily in the range of 2-20 fold depending on the structural conformations and scales of interest. We show that for a single fiber, hydrodynamic interactions between the cytoskeletal mesh-sized segments can change the net force by up to 7 folds. We also demonstrate that cytoskeletal relaxation times are underestimated if hydrodynamic interaction effects are ignored, but bending mode shapes are not appreciably influenced. Ignoring hydrodynamic interactions can result in up to 20-fold overestimation of shear loss modulus in the 2 μm range we investigated. Moreover, in agreement with experimental studies, our models explain a highly length scale dependent loss modulus. Taken together, our data suggest that including hydrodynamic interactions is key to proper modeling and analysis of actin dynamics at any scales and dimensions, and therefore must not be neglected in future models and experimental analyses of cytoskeletal dynamics., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Description Chemical colitis is defined as inflammation of the large intestine or colon as a result of exposure from a harsh chemical through an enema or other procedure. In this case, the chemical is hydrogen peroxide, which is commonly used as an antiseptic for minor abrasions. Hydrogen peroxide enemas were once popular for difficult to treat constipation. However, resultant colitis and proctitis limited its use. When administered rectally in a high enough concentration, intense abdominal pain and transient bloody diarrhea can occur, with the majority of affected patients making a full recovery with supportive management. Here we discuss a case of an accidental low concentration hydrogen peroxide enema in an otherwise healthy young adult that emphasized the dangers of hydrogen peroxide damage to mucosal membranes., Competing Interests: Conflicts of Interest The authors declare they have no conflicts of interest., (© 2021 HCA Physician Services, Inc. d/b/a Emerald Medical Education.)

The objective of this pilot study was to gather and analyze data on radon concentrations in workplaces in three buildings of Granada University (Southern Spain) constructed in different centuries. All measurements were made at basement or ground floor level under normal use conditions except for one space (mineral store), in which measurements were compared between the door closed and open. Measurements were conducted during different time periods between October 2013 and March 2019 with a Radon-Scout PLUS portable Radonmonitor. The duration of continuous recordings at different sites ranged between 42 and 1104 h. Mean accumulated radon concentrations ranged between 12 and 95 Bq/m 3 , below the maximal level of 300 Bq/m 3 set by the World Health Organization (WHO). Relatively high values were recorded in the oldest building (15th century), which was also poorly ventilated. Ventilation appeared to be an important factor in reducing radon levels, especially in areas less exposed to radon, such as Southern Spain.

Objectives: This study aimed to assess the effect of photodynamic therapy (PDT) on expression of CASP3, NRAS and HRAS genes at mRNA levels, and apoptosis of head and neck squamous cell carcinoma (HNSCC) cell line., Materials and Methods: In order to complete the present in vitro study, HNSCC cell line (NCBI C196 HN5) purchased from Pasteur Institute. Cells were divided into four groups; Group 1: photodynamic treatment (laser + methylene blue (MB) as photosensitizer), group 2: MB, group 3: laser (with 660 nm wavelength), and group 4: control (without any treatment). To determine the optimal concentration of MB, in a pilot study, toxicity of MB in different concentration was assessed using MTT assay. Cells in group 1, 2 and 3 was treated at optimal concentration of MB (1.6 μg/mL). Gene expression at mRNA levels was assessed after 24 h incubation, using real-time (qRT)-PCR. The expression of BAX and BCL2 genes at the mRNA levels was analyzed to evaluate apoptosis. 2 -ΔΔCt values of BCL2, BAX, CASP3, NRAS, and HRAS in groups was analyzed using ANOVA. Tukey's HSD and Games Howell test was used to compare between two groups., Results: Over-expression of BAX (p < 0.001), CASP3 (p < 0.001) and down-regulation of BCL2 (p = 0.004), HRAS (p = 0.023) and NRAS (p = 0.045) were noted in group 1 (PDT), compared with the control group. Treatment by laser alone induce down-regulation of CASP3 (p < 0.05), BAX (p < 0.05), BCL2 (p > 0.05), HRAS (p > 0.05) and NRAS (p > 0.05)., Conclusion: PDT caused down-regulation of NRAS, HRAS and BCL2 and over-expression of CASP3 and BAX genes at mRNA levels in HNSCC cell line. The present study raises the possibility that the role of MB on BCL2 down-regulation and BAX and CASP3 over-expression was higher than laser alone while it seems that laser alone was more effective than MB in HRAS and NRAS down-regulation., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The presence of biological cues to promote the attachment, proliferation, and differentiation of neuronal cells is important in the process of nerve regeneration. In this study, laminin as a neurite promoting protein, has been used to modify poly-lactide-co-glycolide/carbon nanotube (PLGA/CNT) electrospun nanofibrous scaffolds by means of either mussel-inspired poly(dopamine) (PD) coating or via direct physical adsorption as a simple route for the functionalization of biomaterials. The laminin-modified scaffolds were characterized by a combination of field emission scanning electron microscopy (SEM), X-ray photoelectron spectroscopy, and contact angle measurements. Subsequently, various properties of scaffolds such as degradation time, amount of attached laminin and the rate of CNT release were investigated. The synergistic effect of topographical and biological cues for PC12 cell attachment, proliferation, and differentiation were then studied by SEM and confocal microscopy. The results of degradation study showed that laminin-modified scaffolds were biodegradable with good structural integrity that persisted about 4 weeks. The amount of laminin attached to the PLGA/CNT and PLGA/CNT-PD scaffolds was 3.12 ± 0.6 and 3.04 ± 071 μg per mg of the scaffold, respectively. Although laminin-modified scaffolds could improve cell proliferation identically, neurite extensions on the PLGA/CNT scaffold modified via PD coating (PLGA/CNT-PD-lam scaffold) were significantly longer than those observed on PLGA/CNT scaffold modified via physical adsorption (PLGA/CNT-lam scaffold) and unmodified scaffolds. Together, these results indicated that surface modification via PD coating could be a promising strategy to fabricate biomimetic scaffolds capable of sustaining longer neuronal growth for nerve tissue engineering., (© 2020 Wiley Periodicals LLC.)

Background: Cardiovascular diseases, obesity, and insulin resistance demonstrate elements of functional impairment of the endothelium. Treatment of endothelial dysfunction with natural products, such as pomegranate, can open new ways in the treatment of cardiovascular diseases., Purpose: The present meta-analysis provides information in highlighting the role of pomegranate in endothelial dysfunction., Methods: Various databases, such as PubMed, Scopus, Web of Science, Cochrane, and Google Scholar, were searched up to July 2020 using relevant keywords. We have selected the studies that investigated the effects of pomegranate on vascular adhesion factors, including intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), E-selectin, and interleukin-6 (IL-6). MD with 95% CrI with 100,000 iterations by using Markov chain Monte Carlo code were used., Results: Pooled effect size of articles in human studies indicated that pomegranate juice was not significantly effective on ICAM-1 [MD: -0.42; CrI: (-1.01, 0.17)], VCAM-1 [MD: -0.20; CrI: (-1.95, 1.40)], and E-selectin [MD: -0.21; CrI: (-1.62, 1.21)] compared to the control group. But it can significantly reduce IL-6 [MD: -1.07; CrI: (-1.90, -0.19)]., Conclusion: Generally, present study showed that pomegranate juice has no significant effect on vascular adhesion factors, ICAM-1, VCAM-1, and E-selectin, but can reduce IL-6 significantly. Future prospective randomized clinical trials with longer intervention duration are warranted to obtain a precise conclusion., (Copyright © 2020 Elsevier GmbH. All rights reserved.)

In this review, we have investigated how fasting promotes an adaptive cross-talk between different hormones and metabolic pathways to supply and meet the body's daily energy demands. We highlight in biochemical terms and mechanisms how fasting impacts four metabolic pathways-glycogenolysis, gluconeogenesis, amino acid oxidation, and fatty acid β-oxidation-that are actively engaged in the metabolism of carbohydrates, proteins, and lipids. Fasting results in reduced insulin secretion and increased glucagon and epinephrine release to prevent or stimulate metabolic reaction(s). Fasting stimulates glycogenolysis, amino acid and glucose oxidation, aminotransferase reactions in skeletal muscle, and promotes gluconeogenesis and urea production in the liver. In addition, fasting promotes gene expression of lipid metabolism in skeletal muscle, the synthesis of ketone bodies in the liver, and intracellular hormone-sensitive lipase activity in adipose tissue. Furthermore, the impact of fasting on reducing cellular damage by mitochondrial reactive oxygen species is discussed. Lastly, we briefly describe the impact of fasting on the four steps of pharmacokinetics-the absorption, distribution, metabolism, and excretion of a few select drugs-with an emphasis on the elimination of drugs related to the cytochrome-P450 family of enzymes.

The importance of fish consumption as the primary pathway of human exposure to mercury and the establishment of fish consumption advisories to protect human health have led to large fish tissue monitoring programs worldwide. Data on fish tissue mercury concentrations collected by state, tribal, and provincial governments via contaminant monitoring programs have been compiled into large data bases by the U.S. Environmental Protection Agency's Great Lakes National Monitoring Program Office (GLNPO), the Ontario Ministry of the Environment's Fish Contaminants Monitoring and Surveillance Program (FMSP), and many others. These data have been used by a wide range of governmental and academic investigators worldwide to examine long-term and recent trends in fish tissue mercury concentrations. The largest component of the trend literature is for North American freshwater species important in recreational fisheries. This review of temporal trends in fish tissue mercury concentrations focused on published results from freshwater fisheries of North America as well as marine fisheries worldwide. Trends in fish tissue mercury concentrations in North American lakes with marked overall decreases were reported over the period 1972-2016. These trends are consistent with reported mercury emission declines as well as trends in wet deposition across the U.S. and Canada. More recently, a leveling-off in the rate of decreases or increases in fish tissue mercury concentrations has been reported. Increased emissions of mercury from global sources beginning between 1990 and 1995, despite a decrease in North American emissions, have been advanced as an explanation for the observed changes in fish tissue trends. In addition to increased atmospheric deposition, the other factors identified to explain the observed mercury increases in the affected fish species include a systematic shift in the food-web structure with the introduction of non-native species, creating a new or expanding role for sediments as a net source for mercury. The influences of climate change have also been identified as contributing factors, including considerations such as increases in temperature (resulting in metabolic changes and higher uptake rates of methylmercury), increased rainfall intensity and runoff (hydrologic export of organic matter carrying Hg II from watersheds to surface water), and water level fluctuations that alter either the methylation of mercury or the mobilization of monomethylmercury. The primary source of mercury exposure in the human diet in North America is from the commercial fish and seafood market which is dominated (>90%) by marine species. However, very little information is available on mercury trends in marine fisheries. Most of the data used in the published marine trend studies are assembled from earlier reports. The data collection efforts are generally intermittent, and the spatial and fish-size distribution of the target species vary widely. As a result, convincing evidence for the existence of fish tissue mercury trends in marine fish is generally lacking. However, there is some evidence from sampling of large, long-lived commercially-important fish showing both lower mercury concentrations in the North Atlantic in response to reduced anthropogenic mercury emission rates in North America and increases in fish tissue mercury concentrations over time in the North Pacific in response to increased mercury loading.

Purpose: Boarding is a common problem in the emergency department (ED) and is associated with poor health care and outcome. Imam Khomeini Hospital is the main healthcare center in Urmia, a metropolis in the northwest of Iran. Due to the overcrowding and high patient load, we aim to characterize the rate, cause and consequence of boarding in the ED of this center., Methods: All medical records of patients who presented to the ED of Imam Khomeini Hospital from August 1, 2017 to August 1, 2018 were retrospectively analyzed. Patients with uncompleted records were excluded. Boarding was defined as the inability to transfer the admitted ED patients to a downstream ward in ≥2 h after the admission order. Demographic data, boarding rate, mortality and triage levels (1-5) assessed by emergency severity index were collected and analyzed. The first present time of patients was classified into 4 ranges as 0:00-5:59, 6:00-11:59, 12:00-17:59 and 18:00-23:59. Descriptive, parametric and non-parametric statistical tests were performed and the risk of boarding was determined by Pearson Chi-square test., Results: Demographic data analysis showed that 941 (58.5%) male and 667 (41.5%) female, altogether 1608 patients were included in this study. Five patients (0.3%) died. The distribution of patients with the triage levels 1-5 was respectively 79 (4.9%), 1150 (71.5%), 374 (23.3%), 4 (0.2%) and 0 (0%). Most patients were of level 2. Only 75 (4.7%) patients required intensive care. The majority of patients (84.2%) were presented at weekdays. The maximum patient load was observed between 12:00-17:59. Of the 1608 patients, 340 (21.1%) experienced boarding within a mean admission time of 13.70 h. Among the 340-boarded patients, 20.1% belonged to surgery, 12.1% to orthopedics, 10.9% to neurosurgery and 10.3% to neurology. The boarding rate was higher in females, patients requiring intensive care and those with low triage levels. Compared with the non-boarded, the boarded patients had a higher mean age., Conclusion: The boarding rate is higher in the older and female patients. Moreover, boarding is dependent on the downstream ward sections: patients requiring surgical management experience the maximum boarding rate., (Production and hosting by Elsevier B.V.)