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Background and aims: By using the ideas of the personnel working in laboratory, it is possible to create valuable changes in the process of teaching for the laboratory sciences students. The aim of this study was to investigate application of laboratory sciences in work place. Methods: This cross-sectional descriptive study was performed in 2010 by census method. A questionnaire including two parts was fulfilled. The first part included demographic information (sex, educational document, and way of employment) and the second part was a questionnaire about teaching programs of different basic and specialized courses including theory and practical. It was filled by 70 employees of the personnel working in governmental laboratories. Results: Based on results, among the specialized courses, practical hematology and practical bacteriology had the maximum amount of application with 74.3% and 71.4%, respectively and practical pathology and theory of pathology had the minimum amount of application with 2.9%. The average of application of specialized courses by employees with Associate degree was significantly less than employees with Bachelor, and Master Science degree (P<0.05), but in other parameters was observed no significant difference. Among basic courses, practical general biochemistry and English had the maximum amount of application with 44.3% and 30% in work place, respectively, but histology, anatomy and practical physics had the minimum amount of application with 4.3%, 4.3% and 2.9%, respectively. The average of the amount of application of basic courses had no significant difference with observed parameters. (P<0.05) Conclusion: Based on this study, basic courses had the minimum amount of application in work place. Therefore, revising curriculum these courses is necessary to make them more useful. [ABSTRACT FROM AUTHOR]

Background and Purpose: Artificial intelligence (AI) has the potential to aid in the accurate diagnosis of hip fractures and reduce the workload of clinicians. We primarily aimed to develop and validate a convolutional neural network (CNN) for the automated classification of hip fractures based on the 2018 AO-OTA classification system. The secondary aim was to incorporate the model's assessment of additional radiographic findings that often accompany such injuries., Methods: 6,361 plain radiographs of the hip taken between 2002 and 2016 at Danderyd University Hospital were used to train the CNN. A separate set of 343 radiographs representing 324 unique patients was used to test the performance of the network. Performance was evaluated using area under the curve (AUC), sensitivity, specificity, and Youden's index., Results: The CNN demonstrated high performance in identifying and classifying hip fracture, with AUCs ranging from 0.76 to 0.99 for different fracture categories. The AUC for hip fractures ranged from 0.86 to 0.99, for distal femur fractures from 0.76 to 0.99, and for pelvic fractures from 0.91 to 0.94. For 29 of 39 fracture categories, the AUC was ≥ 0.95., Conclusion: We found that AI has the potential for accurate and automated classification of hip fractures based on the AO-OTA classification system. Further training and modification of the CNN may enable its use in clinical settings.

Background: The tumorigenesis of lung cancer is complicated, and genetic factor may have the role in the malignant transformation of lung cells. IL-10 gene polymorphisms have been evaluated for their potential roles in lung cancer. However, those studies results are controversial. To clarify the effects of IL-10 rs1800871, rs1800872 and rs1800896 polymorphisms on the risk of lung cancer, a meta-analysis was performed with eligible individual studies., Methods: Eligible publications were gathered by retrieving PubMed, Web of Science, Embase, Wan Fang, and CNKI up to September 01, 2023. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of such association., Results: A total of 23 studies, including 5950 patients with lung cancer and 8046 healthy controls, were identified in this meta-analysis.  Overall, there was no a significant association between the rs1800871, rs1800872 and rs1800896 polymorphisms at IL-10 gene and susceptibility to lung cancer globally when all studies in the pooled into this meta-analysis. Stratified analysis by ethnicity showed that rs1800872 polymorphism was associated with lung cancer among Asians and Caucasians. However, no significant association was identified between the rs1800871 and rs1800896 and risk of lung cancer., Conclusions: Pooled data showed that  IL-10 rs1800871, rs1800872 and rs1800896 polymorphisms were not associated with lung cancer globally. Future well-designed large case-control studies with different ethnicities are recommended.

Introduction: The study aims to investigate the characteristics, comorbidities, laboratory findings, and clinical manifestations of under 18-year-old patients who died with the diagnosis of COVID-19 and determination of the most prevalent risk factors., Method: This case-control study was performed at a referral hospital in Yazd from March 2020 to August 2021. All patients under 18 years who were diagnosed through real-time RT-PCR, chest computed tomography, and the World Health Organization definition were divided into deceased and survived groups. The characteristics (age and sex), disease severity, comorbidities, laboratory findings, and clinical manifestations of the two groups were compared and analyzed using SPSS, version 18 (SPSS Inc., Chicago, III., USA)., Results: A total of 24 patients in the deceased group and 167 patients in the survived group were compared. The highest mortality rate was observed in the age group of 1 month to 5 years, although no statistically significant relationship was found between age groups and the risk of mortality. Disease severity, dyspnea, low oxygen saturation on admission, length of hospital stays, and hospitalization history before the last admission were significantly correlated with mortality ( P  < 0.05). Lymphopenia increased the probability of mortality by more than two times (OR: 2.568; 95% CI (0.962-6.852)), but this was not the case for D-dimer and C-reactive protein. Furthermore, 27.5% of survived patients had normal chest CT scans, which was a statistically significant difference compared to the deceased patients ( P : 0.031)., Conclusion: Based on the findings of this study, dyspnea, low oxygen saturation, and lymphopenia are critical indicators for identifying high-risk children with COVID-19 and triaging them for better care and treatment., Competing Interests: The authors declare that there are no conflicts of interest in the publication of this paper., (Copyright © 2023 Behnam Shafaei et al.)

Introduction: COVID-19 prognostic risk factors, therapeutic protocols, and clinical outcomes in pediatric cases are still under investigation., Materials and Methods: This historical cohort study evaluated the survival time of hospitalized children (1 month-18 years old) with COVID-19 admitted from March 2020 to August 2021 to an educational hospital in Yazd, Iran. The follow-up of patients was performed at least one month after discharge., Results: From 183 hospitalized cases, 24 children were deceased. The median age of patients was 5.41, and 54.2% were male. The survival rate after one-month follow-up was 0.88, and the most significant predictors associated with survival time were the male sex, positive history of hospitalization, lymphopenia, hypoxia, and length of stay more than two weeks using Bayesian Cox regression analysis., Conclusion: Accurate estimation of the impact of predictors on poor outcomes may help healthcare providers use therapeutic protocols based on risk factors and healthcare requirements of each patient to improve their survival., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Farimah Shamsi et al.)

Background: Coronavirus disease 2019 (COVID-19) has spread quickly. Comorbidities, such as diabetes, have been determined as critical risk factors for COVID-19., Objectives: This study aimed to determine the frequency and severity of diabetic ketoacidosis (DKA) in children before and during the COVID-19 pandemic., Methods: This retrospective study examined children aged less than 18 years diagnosed with DKA hospitalized in Yazd Shahid Sadoughi Hospital from February 20, 2020, to November 21, 2021. The collected information was compared to those obtained during the same period in 2019 (pre-pandemic). According to the inclusion criteria, only children with suspected symptoms of COVID-19 or an infected family member underwent PCR., Results: The study included 70 children with confirmed DKA during the COVID-19 pandemic and 33 children hospitalized during the pre-pandemic period. The findings showed that the rate of DKA was higher during the pandemic than in the pre-pandemic period. In the DKA subgroups (during the COVID-19 pandemic vs. pre-pandemic), 35.7% vs. 21.2% were severe, 37.1% vs. 36.4% were moderate, and 27.1% vs. 42.4% were mild. Of 70 children, 30 underwent PCR tests for COVID-19, showing six positive cases. Among positive cases, five had mild symptoms, while one was hospitalized with signs of respiratory distress, polyuria, and polydipsia. All physical examinations of this patient were normal, except for the chest exam., Conclusions: A remarkable increase was observed in the frequency and severity of DKA in children during the pandemic., Competing Interests: Conflict of Interests: The authors declare no competing interests., (Copyright © 2023, International Journal of Endocrinology and Metabolism.)

Background: Prevalence for knee osteoarthritis is rising in both Sweden and globally due to increased age and obesity in the population. This has subsequently led to an increasing demand for knee arthroplasties. Correct diagnosis and classification of a knee osteoarthritis (OA) are therefore of a great interest in following-up and planning for either conservative or operative management. Most orthopedic surgeons rely on standard weight bearing radiographs of the knee. Improving the reliability and reproducibility of these interpretations could thus be hugely beneficial. Recently, deep learning which is a form of artificial intelligence (AI), has been showing promising results in interpreting radiographic images. In this study, we aim to evaluate how well an AI can classify the severity of knee OA, using entire image series and not excluding common visual disturbances such as an implant, cast and non-degenerative pathologies., Methods: We selected 6103 radiographic exams of the knee taken at Danderyd University Hospital between the years 2002-2016 and manually categorized them according to the Kellgren & Lawrence grading scale (KL). We then trained a convolutional neural network (CNN) of ResNet architecture using PyTorch. We evaluated the results against a test set of 300 exams that had been reviewed independently by two senior orthopedic surgeons who settled eventual interobserver disagreements through consensus sessions., Results: The CNN yielded an overall AUC of more than 0.87 for all KL grades except KL grade 2, which yielded an AUC of 0.8 and a mean AUC of 0.92. When merging adjacent KL grades, all but one group showed near perfect results with AUC > 0.95 indicating excellent performance., Conclusion: We have found that we could teach a CNN to correctly diagnose and classify the severity of knee OA using the KL grading system without cleaning the input data from major visual disturbances such as implants and other pathologies., (© 2021. The Author(s).)

Background: The effects of single nucleotide polymorphisms (SNPs) at nucleotide excision repair (NER) pathway on susceptibility to cutaneous melanoma (CM) are of great interest. To date, several epidemiological studies have evaluated whether the XPC, XPD, XPG and XPF polymorphisms are associated with CM. However, those studies results are controversial or inconclusive. Therefore, we conducted a study to evaluate the association of seven frequently investigated NER pathway polymorphisms with CM risk., Methods: A total of 150 patients dia-gnosed with CM and 150 healthy controls were enrolled in the study. Seven SNPs in the NER pathway including XPC (Lys939Gln and Ala499Val), XPD (Lys157Gln, Asp272Asn, and Arg751Arg), XPG (Asp1104His) and XPF (Arg415Gln) were analyzed by polymerase chain reaction restriction fragment length polymorphism assay., Results: There was no a significant association between XPC Lys939Gln, Ala499Val; XPD Asp272Asn, Arg751Arg, Arg751Arg; XPF Arg415Gln; and XPG Asp1104His polymorphisms and an increased risk of CM., Conclusions: This study results revealed that the XPC, XPD, XPG and XPF polymorphisms were not risk factor for susceptibility to CM. However, more well-designed with larger sample size studies in different populations are necessary to further evaluate and validate our results. Future studies which take into account gene-gene and gene-environment interactions are warranted for more precise evidence and further elucidation of the underlying mechanism of CM.

Background and Aim: The aim of this study was to evaluate the association of MC4R rs17782313 and FTO rs9939609 polymorphisms with childhood obesity., Methods: A universal search was performed up to May 2021., Results: A total of 31 studies including 13 studies with 9565 cases and 11956 controls on MC4R rs17782313 and 18 studies with 4789 cases and 15918 controls on FTO rs9939609 were selected., Conclusions: Pooled data showed that FTO rs9930506 and MC4R rs17782313 polymorphisms were significantly associated with obesity in children. Stratified analyses revealed that these genetic variants were associated with childhood obesity in Caucasian and Asian children., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Allergic rhinitis and eczema are two common global diseases that can lead to impaired quality of life. Determining the prevalence of these allergic disorders can be useful in planning prevention and treatment. This study aimed to investigate the prevalence and severity of allergic rhinitis and eczema in adolescents living in Yazd city. Using an electronic questionnaire based on the Global Asthma Network (GAN) core questionnaire, 5141 adolescents aged 13-14 years were cross-sectionally surveyed. The prevalence of current symptoms of rhinitis turned out to be 36.3%, proving significantly higher in boys (p=0.009). Moreover, the prevalence of allergic rhinitis and rhinoconjunctivitis in the past year leveled at 12.4% and 10.5%, respectively; however, the former was significantly higher in females (p=0.014). Additionally, severe rhinoconjunctivitis was observed in 0.2% of the participants with no gender preference (p=0.09). Confirmed hay fever by a doctor was reported in 13.2% of adolescents, significantly higher in males (p<0.001). The prevalence of current itchy rash and current eczema was found to be 5.5%, and 2.9%, respectively, with no difference in terms of gender. Severe atopic eczema and eczema confirmed by a doctor were seen in 0.4% and 5% of the participants, no gender preference was identified. Concurrent prevalence of current rhinoconjunctivitis and eczema was detected in 1% of the participants. Despite the increasing trend of allergic diseases in most parts of the world, the prevalence of rhinoconjunctivitis and eczema in adolescents has not increased in Yazd in the last two decades, and this city is located in a low to moderate prevalence area.

Background: Fractures around the knee joint are inherently complex in terms of treatment; complication rates are high, and they are difficult to diagnose on a plain radiograph. An automated way of classifying radiographic images could improve diagnostic accuracy and would enable production of uniformly classified records of fractures to be used in researching treatment strategies for different fracture types. Recently deep learning, a form of artificial intelligence (AI), has shown promising results for interpreting radiographs. In this study, we aim to evaluate how well an AI can classify knee fractures according to the detailed 2018 AO-OTA fracture classification system., Methods: We selected 6003 radiograph exams taken at Danderyd University Hospital between the years 2002-2016, and manually categorized them according to the AO/OTA classification system and by custom classifiers. We then trained a ResNet-based neural network on this data. We evaluated the performance against a test set of 600 exams. Two senior orthopedic surgeons had reviewed these exams independently where we settled exams with disagreement through a consensus session., Results: We captured a total of 49 nested fracture classes. Weighted mean AUC was 0.87 for proximal tibia fractures, 0.89 for patella fractures and 0.89 for distal femur fractures. Almost ¾ of AUC estimates were above 0.8, out of which more than half reached an AUC of 0.9 or above indicating excellent performance., Conclusion: Our study shows that neural networks can be used not only for fracture identification but also for more detailed classification of fractures around the knee joint., Competing Interests: The authors have read the journal’s policy and the authors of this manuscript have the following competing interests: MG, OS, and AS are co-founders and shareholders in DeepMed AB. While this puts us at a financial competing interest, the company has limited activity with currently no revenue stream, no external investors and no pending patents. There are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The objective of this meta-analysis was to estimate the association of ACE I/D, -240 A > T and AT1R 1166 A > C polymorphisms with breast cancer (BC) risk. A comprehensive search on databases was conducted to identify all eligible case-control studies. Finally, 35 case-control studies, including 20 studies for ACE I/D , seven studies for ACE 240 A > T , and eight studies for AT1R 1166 A > C were included. The pooled analysis showed a significant association between ACE I/D polymorphism and BC risk under three genetic models, i.e., heterozygote (ID vs. DD: OR = 0.707, 95% CI 0.528-0.946, p = 0.020), homozygote (II vs. DD: OR = 0.662, 95% CI 0.462-0.947, p = 0.024), and dominant (II + ID vs. DD: OR = 0.691, 95% CI 0.507-0.941, p = 0.019). A significant association was also observed in ACE I/D polymorphism with BC risk among Asians and Caucasians. However, ACE -240 A > T and AT1R 1166 A > C polymorphisms were not associated with BC. Stratified analyses by ethnicity showed a significant association of ACE -240 A > T and AT1R 1166 A > C polymorphisms with BC risk in Latinos populations, but not in Asians. This meta-analysis inconsistence with all previous meta-analyses suggests that the ACE I/D might be associated with BC in overall and by ethnicity. However, the ACE -240 A > T and AT1R 1166 A > C were associated with BC risk only among Latinos populations.

Background: The 4G5G polymorphism of Plasminogen activator inhibitor-1 (PAI-1) gene is reported to be associated with diabetes nephropathy and retinopathy (DNR) risk. However, the findings are conflicting. Herein, we conducted a case-control and meta-analysis study to explore the association of PAI-1 4G5G polymorphism with risk of DNR., Methods: We retrieved PubMed, EMBASE, Web of Knowledge, and CNKI databases and screened eligible studies up to August 15, 2020. The strength of associations was assessed by odd ratio (OR) and the corresponding 95% confidence interval (95% CI)., Results: A total of 27 case-control studies including 16 studies with 1,825 cases case and 1,731 controls on DN and eleven studies with 1,397 cases and 1,545 controls on DR were selected. Pooled data showed that the PAI-1 4G5G polymorphism was significantly associated with DN (allele model: OR = 0.674, 95% CI 0.524-0.865, p = 0.002; homozygote model: OR = 0.536, 95% CI 0.351-0.817, p = 0.004; heterozygote model: OR = 0.621, 95% CI 0.427-0.903, p = 0.013; dominant model: OR = 0.575, 95% CI 0.399-0.831, p = 0.003; and recessive model: OR = 0.711, 95% CI 0.515-0.981, p = 0.038) and DR (homozygote model: OR = 0.770, 95% CI 0.621-0.955, p = 0.0.017) risk. Stratified analyses by ethnicity indicated that PAI-1 4G5G polymorphism was associated with DN and DR risk in Asians and Caucasians, respectively., Conclusions: The present meta-analysis revealed that the PAI-1 4G5G polymorphism was associated with increased risk of DN and DR risk. However, well-designed large-scale clinical studies are required to further validate our results., Competing Interests: Conflict of interest The authors declare that they have no conflict of interests., (© Springer Nature Switzerland AG 2020.)

Background: the PAI-1 rs1799889 polymorphism has been reported to be associated with susceptibility to ischemic stroke. However, the results of previous studies have been inconsistent or controversial. Hence, we performed a systematic review and meta-analysis to evaluate the association of PAI-1 rs1799889 polymorphism with ischemic stroke risk., Methods: A comprehensive literature search was performed on PubMed, Web of Science, Scopus, SciELO, CNKI, and CBD databases up to November 05, 2019. Pooled odds ratio (OR) with 95% confidence interval (CI) were used to access the strength of this association in fixed- or random-effects model., Results: A total of 44 case-control studies with 8,620 cases and 10,260 controls were selected. Pooled data showed a significant association between PAI-1 rs1799889 polymorphism and ischemic stroke risk in the overall populations (GG vs. AA: OR = 0.791, 95% CI 0.633-0.988, p = 0.039; GA vs. AA: OR = 0.807, 95% CI 0.683-0.953, p = 0.012; and GG+GA vs. AA: OR = 0.795, 95% CI 0.637-0.993, p = 0.043). Subgroup analysis by ethnicity revealed a significant association in Asian and Mixed populations, but not in Caucasians. Moreover, stratified analysis by country of origin revealed an increased risk of ischemic stroke in Chinese populations, but not among Dutch (Netherlands) and Swedish., Conclusions: This meta-analysis result suggested that PAI-1 rs1799889 polymorphism was associated with an increased risk of ischemic stroke, especially in Asian and Mixed populations.

Background: A number of studies have reported that the xeroderma pigmentosum complementation group C (XPC) polymorphisms are associated with cutaneous malignant melanoma (CMM) susceptibility. But the results of those studies were inconsistent. Here, we performed a study to obtain a more conclusive result on the association of XPC polymorphisms with risk of CMM., Methods: The XPC Lys939Gln and Ala499Val polymorphisms were genotyped in 150 CMM cases and 150 controls by PCR-RFLP assay. Subsequently, all published relevant studies were identified through a comprehensive literature search in PubMed, Web of Science, and CNKI databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the strength of correlation., Results: There was no significant association between XPC Lys939Gln and Ala499Val polymorphisms and CMM risk in our population. A total of 15 case-control studies including ten studies with 5,990 cases and 7,697 controls on XPC Lys939Gln and five studies with 3,139 cases and 3,721 controls on XPC Ala499Val polymorphism were selected. Pooled data revealed that XPC Lys939Gln (C vs. A: OR = 1.108, 95% CI 1.008- 1.217; P = 0.033) and Ala499Val (C vs. A: OR = 0.918, 95% CI 0.850-0.992; p = 0.031; CC+CA vs. AA: OR = 0.904, 95% CI 0.819-0.997; p = 0.043) polymorphisms were significantly associated with an increased risk of CMM. Moreover, stratified analyses by ethnicity revealed that the XPC Ala499Val and Lys939Gln polymorphisms were significantly associated with risk of CMM in Caucasians and mixed populations, respectively., Conclusions: This meta-analysis result suggested that XPC Lys939Gln and Ala499Val polymorphisms were significantly associated with risk of CMM.

Background and Purpose: We have previously shown that during the first 2 years after total hip arthroplasty (THA), periprosthetic bone resorption can be prevented by 6 months of risedronate therapy. This follow-up study investigated this effect at 4 years., Patients and Methods: A single-center, double-blind, randomized placebo-controlled trial was carried out from 2006 to 2010 in 73 patients with osteoarthritis of the hip who were scheduled to undergo THA. The patients were randomly assigned to receive either 35 mg risedronate or placebo orally, once a week, for 6 months postoperatively. The primary outcome was the percentage change in bone mineral density (BMD) in Gruen zones 1 and 7 in the proximal part of the femur at follow-up. Secondary outcomes included migration of the femoral stem and clinical outcome scores., Results: 61 of the 73 patients participated in this 4-year (3.9- to 4.1-year) follow-up study. BMD was similar in the risedronate group (n = 30) and the placebo group (n = 31). The mean difference was -1.8% in zone 1 and 0.5% in zone 7. Migration of the femoral stem, the clinical outcome, and the frequency of adverse events were similar in the 2 groups., Interpretation: Although risedronate prevents periprosthetic bone loss postoperatively, a decrease in periprosthetic BMD accelerates when therapy is discontinued, and no effect is seen at 4 years. We do not recommend the use of risedronate following THA for osteoarthritis of the hip.

Background: Schizophrenia is a disorder of the executive function of both sensory and central nervous system. Recent studies suggest that immune mechanisms play a role in the pathophysiology of this disease. The variations in cytokine concentrations have been associated with psychopathology and treatment of schizophrenia., Objective: To investigate the changes in serum concentrations of TNF-α, IL-10, and IL-2 in schizophrenic patients before and 40 days after treatment., Methods: In a case-control study, 26 schizophrenic patients and 26 healthy individuals as a control group were enrolled. PANSS scale questionnaire was used for diagnosis and assessing the severity of the disease. All patients were then treated with risperidone or clozapine for 40 days. Serum concentrations of TNF-α, IL-10 and IL-2 were measured by ELISA before and after treatment in both groups. Paired t-test and Independent t-test were used for comparison of data., Results: Comparison of TNF-α and IL-10 concentrations in patients before and after treatment revealed a significance decrease of TNF-α and increase of IL-10 concentrations (p=0.002, and p=0.008, respectively). Serum concentrations of IL-2 were lower than the detection limit of assay and were not detectable. In comparison with healthy controls, serum concentrations of TNF-α in schizophrenic patients were higher, while IL-10 concentrations were lower before treatment although the differences were not significant (p=0.291 and p=0.375, respectively). There was no correlation between cytokine concentrations and the positive and negative scale (PANSS). Also no significant difference in the admission, relapses, and duration of illness before and after treatment was observed., Conclusions: Increase of TNF-α and decrease of IL-10 may have an important role in psychopathology of schizophrenia.

Background: The range of motion after a total knee arthroplasty is an important clinical outcome affecting the life of the patient. The aim of this study was to determine the most important factors influencing the postoperative knee flexion in Tehran, Iran., Methods: Between July 2007 and January 2009, on 95 cases of total knee joint replacement (89 patients), who were followed for 1 year postoperatively, the risk factors were assessed. Patient demographics (sex, age, body mass index, previous surgery, preoperative Knee Society System score, and preoperative range of motion) as well as radiographic measurement for preoperative tibiofemoral angle were statistically analyzed and the probable predictors entered into a linear regression model., Results: Univariate analysis showed that age, preoperative flexion angle, preoperative flexion arc and preoperative tibiofemoral angle had significant correlation with the postoperative flexion angle. The linear regression model on the other hand revealed that preoperative flexion angle and preoperative tibiofemoral angle were the true predictors of the postoperative flexion angle with coefficients of 0.64 and -0.21, respectively., Conclusion: Better range of motion before the surgery with a lower tibiofemoral varus/valgus angle were more likely to result in a better range of motion after the surgery, suggesting that an appropriate timing for the surgery when the knee joint is still in a better function can lead to a better outcome.