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A tunable mechanical metamaterial is a type that can be altered or manipulated to change its physical properties in various situations. This study introduces a novel type of metamaterial, hydro-tunable metamaterials (HTMs), which can be dynamically adjusted in real-time by filling or draining it with water. The development of HTMs has significant implications for various fields, including mechanical engineering, biomedical applications, and energy absorption. The study involves designing and manufacturing HTMs using a Digital Light Processing (DLP) 3D printing process. The design process involves modifying an initial basic auxetic structure to create a closed and sealed structure accommodating fluid. The printed samples are then characterized using mechanical testing and finite element analysis (FEA). Experiments and simulations have found that a sample containing water behaves differently from a sample without water, resulting in an increase in stiffness. This difference can be leveraged to modify the stiffness and strength of the structure. This phenomenon is attributed to the incompressibility of water within the structure. Water exerts a hydrostatic pressure on the auxetic material, resulting in increased stiffness and resistance to compression. This technique highlights the potential of HTMs to be dynamically adjusted in real-time, leading to enhanced energy absorption and improved performance. An additional FEA was conducted to examine the impact of water pressure on the mechanical behavior of the structure. The results indicate that applying pressure or temperature to the water can significantly enhance the mechanical properties of the water-filled sample.

Polyethylene (PE) pipes are widely used for natural gas distribution due to their good durability and low costs. To ensure the integrity of PE pipelines, it is crucial to develop a comprehensive understanding of pipe failure mechanisms and to recognize the benefits and limitations of different pipeline monitoring strategies. This review provides an overview of different types of pipe failures in the context of their response to operational loads and material degradation. It also covers the details of mechanical tests for predicting the long-term performance of pipes, theoretical models for studying defect growth, examines different defect detection methods, and concludes with an assessment of pipe repair techniques. The findings highlight the importance of investigating the effects of existing defects on the operational performance of the pipeline. This indirectly emphasizes the need to develop time- and cost-efficient strategies to detect defects in the early stages. There is a clear gap in the inclusion of PE aging effects in the lifetime performance models. In addition, given the large number of inspection techniques, a regulated selection of pipeline inspection methods is highly desired, specific to the defect type. Further research in advancing adhesive-based repair of incipient defects is crucial to prevent catastrophic defect growth.

Elite controllers (ECs) defined as a small subclass of subjects with HIV capable of controlling human immunodeficiency virus (HIV) replication in the lack of antiretroviral treatment. One class of RNA molecules that serve as vital components in the network of HIV-related transcriptional regulation, are long noncoding RNAs (lncRNAs). The critical part that they take is in transcriptional regulation of HIV through monitoring various cellular signaling pathways. Reportedly, AKT and MAPK signaling pathways serve a crucial role in modulation of HIV infection. In the current investigation, we utilized bioinformatics tools to predict the lncRNAs that have the ability to interact with MAPK3, AKT, and FOXO1. Then, PBMC expression levels of lncRNAs and their target genes (AKT, FOXO1 and MAPK3) measured in the ECs (n = 15), HIV-positive (n = 40) patients and healthy control subjects (n = 40). We found a significant increase and decrease in the level of AKT and FOXO1 expression within the ECs group, respectively than in the HIV + group (P-value

Abstract Background and aims MicroRNAs (miRNAs) and long noncoding RNAs (lncRNAs) are well‐known types of noncoding RNAs (ncRNAs), which have been known as the key regulators of gene expression. They can play critical roles in viral infection by regulating the host immune response and interacting with genes in the viral genome. In this regard, ncRNAs can be employed as biomarkers for viral diseases. The current study aimed to evaluate peripheral blood mononuclear cell (PBMC) ncRNAs (lncRNAs‐homeobox C antisense intergenic RNA [HOTAIR], ‐H19, X‐inactive‐specific transcript [XIST], plasmacytoma variant translocation 1 [PVT‐1], and miR‐34a) as diagnostic biomarkers to differentiate severe COVID‐19 cases from mild ones. Methods Candidate ncRNAs were selected according to previous studies and assessed by real‐time polymerase chain reaction in the PBMC samples of patients with severe coronavirus disease 2019 (COVID‐19) (n = 40), healthy subjects (n = 40), and mild COVID‐19 cases (n = 40). Furthermore, the diagnostic value of the selected ncRNAs was assessed by analyzing the receiver‐operating characteristic (ROC). Results The results demonstrated that the expression pattern of the selected ncRNAs was significantly different between the studied groups. The levels of HOTAIR, XIST, and miR‐34a were remarkably overexpressed in the severe COVID‐19 group in comparison with the mild COVID‐19 group, and in return, the PVT‐1 levels were lower than in the mild COVID‐19 group. Interestingly, the XIST expression level in men with severe COVID‐19 was higher compared to women with mild COVID‐19. ROC results suggested that HOTAIR and PVT‐1 could serve as useful biomarkers for screening mild COVID‐19 from severe COVID‐19. Conclusions Overall, different expression patterns of the selected ncRNAs and ROC curve results revealed that these factors can contribute to COVID‐19 pathogenicity and can be considered diagnostic markers of COVID‐19 severe outcomes.

Abstract Greenhouse gas emissions into the atmosphere have had devastating environmental effects, including ozone depletion and global warming. Carbon dioxide (CO2) is widely used in oil and gas plants, the food industry, and as a working fluid in the power industry. Carbon dioxide is liquefied for long‐term storage, to be transported to remote areas, and is used for peak shaving in the power plants. Solar flat plate collectors and wasted heat from the CO2 liquefaction system can be used in power plant systems. Also, the use of nanoparticles in the collectors improves the thermal properties of the working fluid and increases the efficiency of solar collectors. This study has developed a new hybrid system for CO2 liquefaction using Linde–Hampson system, Kalina power generation unit, and flat plate solar collectors. The Linde–Hampson system's dissipated heat and solar collectors are used to supplying part of the power of the CO2 liquefaction system. The combined system produces 9416 kmol/h of liquid CO2 by absorbing 35.97 MW of power. The Kalina power generation unit provides 9.546 MW of power by absorbing 76.98 MW of the CO2 liquefaction cycle's dissipated heat and 91.18 MW from flat plate collectors. Based on the output of exergy assessment, exergy efficiency and exergy degradation of the developed integrated structure are 44.16% and 118.3 MW, respectively. Moreover, significant portions of exergy destruction in the combined process belong to solar collectors (74.68%), heat exchangers (12.47%), and compressors (7.157%), respectively. The use of Al2O3 nanoparticles in pure water has been investigated for heat transfer in flat panel solar collectors. According to the sensitivity analysis results, as the volume ratio of particles in nanofluid increases to 6%, the production capacity of the Kalina cycle and exergy efficiency improves to 9.56 MW and 9.522%, respectively. Also, as the pressure of the pumped fluid in the Kalina cycle increases from 800 to 1600 kPa, the exergy yield of the Kalina cycle and the exergy yield of the whole combined system increase to 36.34% and 44.26%, respectively.

Introduction: MicroRNAs, or miRNAs, with regulatory performance in inflammatory responses and infection are the prevalent manifestations of severe Coronavirus disease (COVID-19). This study aimed to evaluate whether PBMC miRNAs are diagnostic biomarkers to screen the ICU COVID-19 and diabetic-COVID-19 subjects. Methods: Candidate miRNAs were selected through previous studies, and then the PBMC levels of selected miRNAs (miR-28, miR-31, miR-34a, and miR-181a) were measured via quantitative reverse transcription PCR. The diagnostic value of miRNAs was determined by the receiver operating characteristic (ROC) curve. The bioinformatics analysis was utilized to predict the DEMs genes and relevant bio-functions. Results: The COVID-19 patients admitted to the ICU had significantly greater levels of selected miRNAs compared to non-hospitalized COVID-19 and healthy people. Besides, the mean miR-28 and miR-34a expression levels in the diabetic-COVID-19 group were upregulated considerably when compared with the non-diabetic COVID-19 group. ROC analyses demonstrated the role of miR-28, -miR-34a, and -181a as new biomarkers to discriminate the non-hospitalized COVID-19 group from the COVID-19 patients admitted to ICU samples, and also miR-34a can probably act as a useful biomarker for screening diabetic COVID-19 patients. Using bioinformatics analyses, we found the performance of target transcripts in many bio-processes and diverse metabolic routes such as regulating multiple inflammatory parameters. Discussion: The difference in miRNA expression patterns between the studied groups suggested that miR-28, miR-34a, and miR181a could be helpful as potent biomarkers for diagnosing and controlling COVID-19.

Abstract Background The possible association of human papillomavirus (HPV) and bladder cancer has been controversial. Older findings suggest a significant association between the virus and bladder cancer. The aim of this study was to evaluate the data from the last ten years to estimate the prevalence of the virus in bladder cancer patients and to assess the association between the virus and cancer. Method A search of major databases was conducted to retrieve published English language studies between January 2011 and March 2021. In the present study overall prevalence of the virus in bladder cancer patients was estimated along with the prevalence of subgroups. Also, the possible associations between the prevalence of the virus and bladder cancer and the possible impact of variables in the geographical area and the type of sample were measured by comprehensive meta-analysis software (V2.2, BIOSTAT). Results Unlike previous studies, despite the relatively high prevalence of the virus [pooled prevalence: 14.3% (95% CI 8.9–22.2%)] no significant association was found between HPV and bladder cancer (OR 2.077, 95% CI 0.940–4.587). No significant association was found between geographical area (except Asia) and type of sample with bladder cancer. Conclusions Given the significant prevalence, despite the insignificance of the association between virus and cancer, it seems that more studies with case–control design are needed to elucidate this association.

The regasification of liquefied natural gas provides considerable cold energy that would have practical potential in different industrial fields and makes a suitable option for integrating with cryogenic air separation systems that requires a significant amount of energy. In this research, two-column cryogenic air separation units are driven with solar photovoltaic panels to produce oxygen and nitrogen. The gaseous natural gas feeds a molten carbonate fuel cell (MCFC), producing electricity and heat. The heat is recovered by an absorption–compression refrigeration cycle (ACRC) to supply a high-intensity cooling load at −67 °C. The proposed scheme is designed to provide 1781 kmol/h oxygen, 8574 kmol/h nitrogen, 136 MW electrical power, and 13.09 MW cooling load. The thermal efficiency of the whole combined structure and the electrical efficiency of the fuel cell are 51.07% and 51.93%, respectively. The exergy analysis illustrates that the solar photovoltaic collectors and heat exchanges are the two most exergy destructive components compared to others. The exergy efficiency and irreversibility of the developed hybrid process are 52.77% and 160.5 MW, respectively. The effect of working temperatures has been studied on the performance of the molten carbonate fuel cell, including voltage, power density, and efficiency. The exergy and thermal efficiencies of the proposed system increase up to 56.18% and 55.05%, respectively with an increase of LNG molar flow rate from 892 to 992 kmol/h.

Treatment of Cutaneous leishmaniasis (CL) is based on using antimoniate derivatives; patients' compliance for systemic injections is low due to the pain and systemic complications. In this randomized open trial, the efficacy of intra-lesional (IL) injections of meglumine antimoniate (MA) once a week vs. twice a week in the treatment of Anthrpoponothic CL caused by L. tropica was studied. Eligible volunteer patients were selected according to inclusion/exclusion criteria. The included patients were randomly allocated to receive IL-MA injections once a week or twice a week. The primary outcome was set as complete healing of the lesion(s), and defined as complete re-epithelialization and absence of induration in the lesions. A total of 180 parasitologicaly proven CL patients caused by L. tropica were recruited, 90 patients were treated with weekly IL-MA and 90 patients received IL-MA twice a week. The complete cure was 87.9% vs. 89.2% in the group received weekly and twice a week IL-MA injections, respectively (P = 0.808). Patients' compliance was acceptable and side effects were limited to a few local allergic reactions to MA. Median time to healing was significantly shorter in patients who received IL-MA twice a week (median ± SE) 37±3.8, (CI: 29.6-44.4) days compared to whom received IL-MA once a week 60±2.3, (CI: 55.6-64.5) days (P< 0.001), however the number of injections was higher in group who received IL-MA twice a week (12 vs. 9 injections). In conclusion, the rate of cure in the group of CL patients with IL-MA twice a week was not significantly different from the group who received IL-MA once a week shorten, but the duration of healing was shorter in the group who received IL-MA twice a week while the group received more injections so is recommended to use IL-MA once a week due to the fact the compliance is acceptable with limited side effects. Clinical Trial Registration: IRCT20081130001475N13; https://en.irct.ir/.

The aim of this study is to characterize the performance of an inclination analysis for predicting the onset of heart failure (HF) from routinely collected clinical biomarkers extracted from primary care electronic medical records. A balanced dataset of 698 patients (with/without HF), including a minimum of five longitudinal measures of nine biomarkers (body mass index, diastolic and systolic blood pressure, fasting glucose, glycated hemoglobin, low-density and high-density lipoproteins, total cholesterol, and triglycerides) is used. The proposed algorithm achieves an accuracy of 0.89 (sensitivity of 0.89, specificity of 0.90) to predict the inclination of biomarkers (i.e., their trend towards a ‘survival’ or ‘collapse’ as defined by an inclination analysis) on a labeled, balanced dataset of 40 patients. Decision trees trained on the predicted inclination of biomarkers have significantly higher recall (0.69 vs. 0.53) and significantly higher negative predictive value (0.60 vs. 0.55) than those trained on the average values computed from the measures of biomarkers available before the onset of the disease, suggesting that an inclination analysis can help identify the onset of HF in the primary care patient population from routinely available clinical data. This exploratory study provides the basis for further investigations of inclination analyses to identify at-risk patients and generate preventive measures (i.e., personalized recommendations to reverse the trend of biomarkers towards collapse).

Introduction: One of the hallmarks of COVID-19 is overwhelming inflammation, which plays a very important role in the pathogenesis of COVID-19. Thus, identification of inflammatory factors that interact with the SARS-CoV-2 can be very important to control and diagnose the severity of COVID-19. The aim of this study was to investigate the expression patterns of inflammation-related non-coding RNAs (ncRNAs) including MALAT-1, NEAT-1, THRIL, and miR-155-5p from the acute phase to the recovery phase of COVID-19. Methods: Total RNA was extracted from Peripheral Blood Mononuclear Cell (PBMC) samples of 20 patients with acute COVID-19 infection and 20 healthy individuals and the expression levels of MALAT-1, NEAT-1, THRIL, and miR-155-5p were evaluated by real-time PCR assay. Besides, in order to monitor the expression pattern of selected ncRNAs from the acute phase to the recovery phase of COVID-19 disease, the levels of ncRNAs were re-measured 6‒7 weeks after the acute phase. Result: The mean expression levels of MALAT-1, THRIL, and miR-155-5p were significantly increased in the acute phase of COVID-19 compared with a healthy control group. In addition, the expression levels of MALAT-1 and THRIL in the post-acute phase of COVID-19 were significantly lower than in the acute phase of COVID-19. According to the ROC curve analysis, these ncRNAs could be considered useful biomarkers for COVID-19 diagnosis and for discriminating between acute and post-acute phase of COVID-19. Discussion: Inflammation-related ncRNAs (MALAT-1, THRIL, and miR-150-5p) can act as hopeful biomarkers for the monitoring and diagnosis of COVID-19 disease.

Peptide receptor radionuclide therapy (PRRT) has been recently established as a treatment option for progressive gastro-entero-pancreatic neuroendocrine tumors (NETs) including four 200 mCi induction cycles. The purpose of this phase 2 trial is to expand use of PRRT to different types of NETs with the application of dose adjustment and evaluate value of maintenance therapy in patients who had disease control on induction therapy. Forty-seven PRRT naïve NET patients with different primary origin received 177Lu-DOTATATE induction therapy, ranging from 75 to 150 mCi per cycle, based on patients’ clinical status such as liver and renal function, extent of metastases, and previous therapies. Thirty-four patients underwent additional maintenance therapy (50–100 mCi per cycle) following induction course until they developed disease progression. The estimated median progression-free survival (PFS) was 36.1 months. The median PFS in our MNET subgroup was 47.7 months, which is markedly longer than NETTER-1 trial with median PFS of 28.4 months. The median PFS was significantly longer in patients who received PRRT as first-line treatment after disease progression on somatostatin analogs compared to patients who received other therapies first (p-value = 0.04). The total disease response rate (DRR) and disease control rate (DCR) was 32% and 85% based on RECIST 1.1 and 45% and 83% based on Choi criteria. This trial demonstrates longer PFS with the addition of low dose maintenance therapy to induction therapy compared to NETTER-1 trial that only included induction therapy. Also, we observed considerable efficacy of PRRT in various types of advanced NETs.

Background: Bufavirus (BuV), Human Cosavirus (HCoSV), and Saffold (SAFV) virus are three newly discovered viruses and have been suggested as possible causes of gastroenteritis (GE) in some studies. The aim of the present study was to estimate the overall prevalence of viruses and their association with GE.Methods: A comprehensive systematic search was conducted in Scopus, Web of Science, PubMed, and Google scholar between 2007 and 2021 to find studies on the prevalence of BuV, HCoSV, and SAFV viruses.Result: Meta-analysis of the 46 included studies showed the low prevalence of BuV (1.%, 95% CI 0.6–1.5%), HCoSV (0.8%, 95% CI 0.4–1.5%), and SAFV (1.9%, 95% CI 1.1–3.1%) worldwide. Also, no significant association between these viruses and GE was observed. BuV was isolated from patients with GE in Africa, while SAFV was more common in Europe. BuV1 and BuV2 have the same prevalence between the three identified genotypes of BuV. HCoSV-C was the most prevalent genotype of HCoSV, and SAFV2 was the commonest genotype of SAFV. All of these viruses were more prevalent in children older than 5 years of age.Conclusion: This was the first meta-analysis on the prevalence and association of BuV, HCoSV, and SAFV with GE. While no significant association was found between infection with these viruses and GE, we suggest more studies, especially with case-control design and from different geographical regions in order to enhance our knowledge of these viruses.

Abstract Background Breast cancer is reported as one of the most common cancers among females worldwide. Infectious agents especially viruses have been considered as role players in the development of breast cancer. Although some investigations suggest an association between bovine leukemia virus (BLV) and breast cancer, the involvement of this virus as a risk factor remains controversial. The present study aimed to find out any possible association between BLV and breast cancer through conducting a systematic review and meta-analysis. Methods Systematic literature search was performed by finding related case-control articles from the PubMed, Google Scholar, Web of Science, Scopus, and EMBASE databases. The heterogeneity and the multivariable-adjusted OR and corresponding 95% CI were applied by meta-analysis and forest plot across studies. All statistical analyses were performed using Stata 14.1. Result Based on a comprehensive literature search, 9 case-control studies were included for meta-analysis. The combination of all included studies showed that BLV infection is associated with an increased risk of breast cancer [summary OR (95% CI) 2.57 (1.45, 4.56)]. Conclusion This is the first meta-analysis to analyze a potential association between BLV infection and the risk of breast cancer. Control of the infection in cattle herds and screening of the milk and dairy products may help to reduce the transmission of the virus to humans.

Background: Lichen planus (LP) is a chronic inflammatory disease of the skin. Currently, noninvasive techniques are used to evaluate biophysical properties of the skin in vivo. Objective: In this study, we aimed to evaluate skin biophysical properties in patients with LP and make a comparison between involved and uninvolved skin to provide a better understanding of the pathogenesis of LP. Methods: The stratum corneum hydration, transepidermal water loss, pH, erythema, melanin, sebum, friction, temperature, elasticity parameters (R0, R2, R5), and thickness and echo-density of the epidermis, dermis, and subepidermal low echogenic band were measured on lesions of classic LP in 21 patients and compared with the average of perilesional and symmetrical uninvolved skin (as control) with a paired t test. Results: Stratum corneum hydration (p = .002), sebum (p = .04), R0 (p = .005), and echo-density of the dermis (p = .005) were significantly lower, but pH (p = .007), melanin content (p < .001), erythema (p < .001), temperature (p = .01), thickness of dermis (p = .02), and subepidermal low echogenic band (p < .001) were significantly higher in LP lesions. Conclusion: An evaluation of its biophysical, biomechanical, and ultrasonographic characteristics showed that the skin is an objective, noninvasive, and quantitative measuring tool that can be used to provide valuable information about skin changes in classic LP. Keywords: Lichen planus, biophysical properties, biomechanical properties, ultrasonography

Background: Nowadays noninvasive techniques are performed to evaluate the biophysical properties of skin in vivo. Aims: The aim of this study was to evaluate the biophysical and ultrasonographic properties of skin in chronic contact or atopic dermatitis to provide better insight into pathogenesis, diagnosis, and treatment response. Materials and Methods: The stratum corneum hydration, transepidermal water loss (TEWL), pH, erythema, melanin, sebum, friction, temperature, elasticity parameters (R0, R2, and R5), the thickness and echo-density of epidermis, dermis, and subepidermal low-echogenic band (SLEB) were measured on lesional, perilesional, and symmetrical skin of 22 chronic dermatitis patients. The average of perilesional and symmetrical skin values (control) was compared with lesional values. Results: Stratum corneum hydration (P

In this paper, a novel process is developed to cogenerate 4741 kg/h of methanol, 297.7 kW of electricity, and 35.73 ton/h of hot water, including a hydrogen purification system, an absorption–compression refrigeration cycle (ACRC), a regenerative Organic Rankine Cycle (ORC), and parabolic solar troughs. The heat produced in the methanol reactor is recovered in the ORC and ACRC. Parabolic solar troughs provide thermal power to the methanol distillation tower. Thermal efficiencies of the integrated structure and the liquid methanol production cycle are 78.14% and 60.91%, respectively. The process’s total exergy efficiency and irreversibility are 89.45% and 16.89 MW. The solar thermal collectors take the largest share of exergy destruction (34%), followed by heat exchangers (30%) and mixers (19%). Based on the sensitivity analysis, D17 (mixture of H2 and low-pressure fuel gas before separation) was the most influential stream affecting the performance of the process. With the temperature decline of stream D17 from −139 to −149 °C, the methanol production rate and the total thermal efficiency rose to 4741.2 kg/h and 61.02%, respectively. Moreover, the growth in the hydrogen content from 55% to 80% molar of the feed gas, the flow rate of liquid methanol, and the total exergy efficiency declined to 4487 kg/h and 86.05%.

ABSTRACT: Objective: Non-parathyroid hormone (PTH) mediated hypercalcemia in young patients is rare. It encompasses a broad differential including malignancy, granulomatous diseases, Addison disease, and toxicity of vitamin A and D. We present an unusual case of non-PTH mediated hyper-calcemia in a previously healthy bodybuilder, secondary to multifocal granulomatous disease from paraffin oil injections. Methods: The patient was evaluated with laboratory tests including serum calcium, 25-hydroxyvitamin D, 1,25-hydroxyvitamin D, parathyroid hormone, and parathyroid hormone-related peptide. Imaging studies such as thorax computed tomography and bone scans were also performed. Results: A 31-year-old male bodybuilder presented with severe hypercalcemia (corrected calcium 3.1 mmol/L) and renal failure (creatinine 840 μmol/L), with suppressed PTH 1.0 pmol/L (normal, 1.6 to 6.9 pmol/L), and 1,25-vitamin D 205 pmol/L (normal, 60 to 208 pmol/L). He had used anabolic steroids for bodybuilding purposes for 8 years, with the possibility that he may also have used paraffin oil injections. Computed tomography imaging along with patient history suggested multiple paraffinomas in the pectoralis muscles causing granulomatous foreign body reaction as a potential cause for his hypercalcemia. He was prescribed a trial of prednisone, but he discontinued it due to symptoms of acne. Unfortunately, due to poor adherence with medical direction, management of his hypercalcemia remains challenging with inconsistent use of steroids and pamidronate infusions. Conclusion: Granulomatous foreign-body reactions are a rare side effect of paraffin oil injections used for muscle augmentation. These can lead to serious long-term side effects of severe hypercalcemia and renal failure, as seen in our patient. Prognosis is generally poor, with long term steroids as the preferred treatment. Abbreviations: CT computed tomography CYP24A1 24-hydroxylase ED Emergency Department PTH parathyroid hormone

Covalent closed circular RNAs (circRNAs) can act as a bridge between non-coding RNAs and coding messenger RNAs. CircRNAs are generated by a back-splicing mechanism during post-transcriptional processing and are abundantly expressed in eukaryotic cells. CircRNAs can act via the modulation of RNA transcription and protein production, and by the sponging of microRNAs (miRNAs). CircRNAs are now thought to be involved in many different biological and pathological processes. Some studies have suggested that the expression of host circRNAs is dysregulated in several types of virus-infected cells, compared to control cells. It is highly likely that viruses can use these molecules for their own purposes. In addition, some viral genes are able to produce viral circRNAs (VcircRNA) by a back-splicing mechanism. However, the viral genes that encode VcircRNAs, and their functions, are poorly studied. In this review, we highlight some new findings about the interaction of host circRNAs and viral infection. Moreover, the potential of VcircRNAs derived from the virus itself, to act as biomarkers and therapeutic targets is summarized.

The high transmissibility, mortality, and morbidity rate of the SARS-CoV-2 Delta (B.1.617.2) variant have raised concerns regarding vaccine effectiveness (VE). To address this issue, all publications relevant to the effectiveness of vaccines against the Delta variant were searched in the Web of Science, Scopus, EMBASE, and Medline (via PubMed) databases up to 15 October 2021. A total of 15 studies (36 datasets) were included in the meta-analysis. After the first dose, the VE against the Delta variant for each vaccine was 0.567 (95% CI 0.520–0.613) for Pfizer-BioNTech, 0.72 (95% CI 0.589–0.822) for Moderna, 0.44 (95% CI 0.301–0.588) for AstraZeneca, and 0.138 (95% CI 0.076–0.237) for CoronaVac. Meta-analysis of 2,375,957 vaccinated cases showed that the Pfizer-BioNTech vaccine had the highest VE against the infection after the second dose, at 0.837 (95% CI 0.672–0.928), and third dose, at 0.972 (95% CI 0.96–0.978), as well as the highest VE for the prevention of severe infection or death, at 0.985 (95% CI 0.95–0.99), amongst all COVID-19 vaccines. The short-term effectiveness of vaccines, especially mRNA-based vaccines, for the prevention of the Delta variant infection, hospitalization, severe infection, and death is supported by this study. Limitations include a lack of long-term efficacy data, and under-reporting of COVID-19 infection cases in observational studies, which has the potential to falsely skew VE rates. Overall, this study supports the decisions by public health decision makers to promote the population vaccination rate to control the Delta variant infection and the emergence of further variants.

Background: The aim of this study was to explore the experiences of patients who suffer from acute cutaneous leishmaniasis in Iran, focusing on quality of life.Methods: The study was conducted at two different sites in Iran in 2010–2011. Individual in-depth interviews were conducted with six men and six women parasitologically confirmed acute cutaneous leishmaniasis. Interviews were recorded, transcribed verbatim, and translated into English. Qualitative content analysis was used for data analysis.Results: The participants, aged 23 to 63yr, had mild to severe disease. Based on the analysis four main themes were developed. "Fearing an agonizing disease" reflects patients' experiences of disease development resulting in sadness and depression, "struggling to cope" and "taking on the blame" both illustrate how patients experience living with the disease, which included both felt and enacted stigma as major social concerns. "Longing for being seen and heard" refers to patients' experiences with healthcare as well as their expectations and demands from communities and healthcare to be involved in closing the knowledge and awareness gap.Conclusion: Mental and social dimensions of cutaneous leishmaniasis were complex and adversely affected patients' lives by causing psychological burden and limiting their social interactions. Health authorities have to plan programs to increase the disease awareness to prevent the existing stigma to improve patients' social condition and medical care.

Background: Cutaneous leishmaniasis (CL) is a major health problem in many parts of Iran, although diagnosis of CL especially in the endemic area is easy, but treatment and management of the disease is a global dilemma. Diagno­sis of CL in non-endemic area is not as simple as in endemic foci. In this study, the status and the proportions of CL induced by Leishmania major and L. tropica among CL suspected patients referred to the Center for Research and Training in Skin Diseases and Leprosy, (CRTSDL) during 2008 to 2011 are described.Methods: CL patients with suspected lesions were clinically examined. History of trip to zoonotic CL and/or anthroponotic CL endemic areas and the characte­ristics of their lesion(s) were recorded. Diagnosis of the lesion was done using direct smear microscopy, culture and conventional polymerase chain reaction (PCR).Results: A total of 404 (M=256, F=148) patients with 776 lesions were re­cruited and parasitologically examined. The results showed that 255 of the pa­tients with 613 lesions; patients with lesion(s) induced by L. major=147 (M=63, 43%, F=84, 57%) and lesion(s) induced by L. tropica=108 (M=35, 32%, F=73, 68%). History of travel to endemic area was not always correlated with isolated Leishmania species.Conclusion: Although travel history to endemic area is an important factor to be considered for diagnosis, but parasitological confirmation is necessary initia­tion of treatment.

Objectives: To assess the practicability of a new algorithm in decreasing the rate of incorrect diagnoses and inappropriate antibiotic usage in pediatric Acute Respiratory Tract Infection (ARTI). Materials and Methods: Children between 1 month to15 years brought to outpatient clinics of a children′s hospital with acute respiratory symptoms were managed according to the steps recommended in the algorithm. Results: Upper Respiratory Tract Infection, Lower Respiratory Tract Infection, and undifferentiated ARTI accounted for 82%, 14.5%, and 3.5% of 1 209 cases, respectively. Antibiotics were prescribed in 33%; for: Common cold, 4.1%; Sinusitis, 85.7%; Otitis media, 96.9%; Pharyngotonsillitis, 63.3%; Croup, 6.5%; Bronchitis, 15.6%; Pertussis-like syndrome, 82.1%; Bronchiolitis, 4.1%; and Pneumonia, 50%. Conclusion: Implementation of the ARTIs algorithm is practicable and can help to reduce diagnostic errors and rate of antibiotic prescription in children with ARTIs.

Herein, a 12-year-old Afghan boy with chronic cutaneous leishmaniasis on the face and verrucous lesions on the body and pleural effusion suspected of having co-existent tuberculosis has been presented. The cutaneous lesions were appeared for five years before his admission. Leishman-Donovan bodies were seen in H&E (Hematoxylin and eosin) slide of skin lesion specimens. The pathogenic species was proved to be Leishmania tropica using Polymerase Chain Reaction (PCR) method. Purified Protein Derivative (PPD) and Leishmanin Skin Test (LST) were strongly positive. The patient was treated with systemic and intralesional meglumine antimoniate (Glucantime) for cutaneous leishmaniasis and then with anti-tuberculosis drugs for pleural effusion. Afterwards, pleural effusion was disappeared and cutaneous leishmaniasis cured.

BACKGROUND: Cutaneous leishmaniasis (CL) is a neglected infectious disease and a major health problem in several developing countries. Despite some reasonable explanation for their potential benefits, there is only trace evidence regarding the role of dressings in the treatment of CL. METHODS: This randomized, assessor-blind, controlled, clinical trial was conducted in an endemic area for CL caused by Leishmania major in Iran to assess the efficacy of administration of weekly intralesional meglumine antimoniate (i.l.MA) either alone or combined with application of a silver or a non-silver polyester dressing on their lesions for 6 weeks. After screening of 241 patients with CL lesions, 83 eligible patients with 158 lesions were randomly allocated in three arms of the study. Eligibility criteria included parasitologically confirmed CL, age of 12 to 60 years; willingness to participate, duration of lesion