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BACKGROUND: Mother-to-child transmission is the primary cause of HIV cases among children. Antiretroviral therapy (ART) plays a critical role in preventing mother-to-child transmission and reducing HIV progression, morbidity, and mortality among mothers. However, after more than two decades of ART during pregnancy, the comparative effectiveness and safety of ART medications during pregnancy are unclear, and existing evidence is contradictory. This study aimed to assess the effectiveness and safety of different ART regimens among pregnant women living with HIV at preconception or during pregnancy. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. We included randomized trials that enrolled pregnant women living with HIV and randomized them to receive ART for at least four weeks. Pairs of reviewers independently completed screening for eligible studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool. Our outcomes of interest included low birth weight, stillbirth, preterm birth, mother-to-child transmission of HIV, neonatal death, and congenital anomalies. Network meta-analysis was performed using a random-effects frequentist model, and the certainty of evidence was evaluated using the GRADE approach. RESULTS: We found 14 eligible randomized trials enrolling 9,561 pregnant women. The median duration of ART uptake ranged from 6.0 to 17.4 weeks. No treatment was statistically better than a placebo in reducing the rate of neonatal mortality, stillbirth, congenital defects, preterm birth, or low birth weight deliveries. Compared to placebo, zidovudine (ZDV)/lamivudine (3TC) and ZDV monotherapy likely reduce mother-to-child transmission (odds ratio (OR): 0.13; 95% CI: 0.05 to 0.31, high-certainty; and OR: 0.50; 95% CI: 0.33 to 0.74, moderate-certainty). Moderate-certainty evidence suggested that ZDV/3TC was associated with decreased odds of stillbirth (OR: 0.47; 95% CI: 0.09 to 2.60). CONCLUSIONS: Our analysis provides high- to moderate-certainty evidence that ZDV/3TC and ZDV are more effective in reducing the odds of mother-to-child transmission, with ZDV/3TC also demonstrating decreased odds of stillbirth. Notably, our findings suggest an elevated odds of stillbirth and preterm birth associated with all other ART regimens.

Abstract Background Designing and preparing a co-delivery system based on polymeric micelles have attracted in recent years. Co-delivery of anti-cancer agents within pH-sensitive polymeric micelles could provide superior advantages over the co-administration of free drugs, since it enables simultaneous delivery of drugs to reach an optimum synergistic dose right to the tumor. Methods DOX was conjugated to the polymer through a hydrazine linker by Schiff’s base reaction. Then, DTX was encapsulated into the core of the polymer to the resulting DOX-Hyd-PM/DTX micelle with optimum molar ratios of 1:1 and 1:5 (DOX/DTX). Results The final formulations showed the desired particle size and increased release of DOX and DTX in acidic media (pH 5.5). The cytotoxicity assay of DOX-Hyd-PM/DTX indicated the highest synergistic effect on both 4T1 and TUBO cell lines over other formulations. Interestingly, in accordance with in vitro results, DOX-Hyd-PM/DTX revealed a promising anti-tumor activity in mice-bearing 4T1 breast cancer tumor with higher tumor accumulation of DOX and DTX after 24 h compared to free drugs combination. Conclusions These findings point to the potential use of such smart nanodrug delivery systems in cancer treatment, where the synergistic effect of both drugs may be used to enhance therapeutic response. Graphical Abstract

Background. Brain stroke is the second most common cause of death and the first cause of disability in Iran. Most stroke-related deaths occur in low- and middle-income countries. This epidemiological study was conducted due to insufficient studies and generally with a small sample size in the country, aiming at identifying the main risk factors for stroke in East Azarbaijan province. Methods. This cross-sectional study was performed using data gathered from 5430 patients with a definite diagnosis of brain stroke registered in the Tabriz Stroke Registration System (TSR) between February 2015 and June 2021 in the referral hospitals of East Azerbaijan. Analyses were performed using STATA software (version 17). Descriptive statistics were calculated, and a chi-square test was run. It is worth mentioning that any was considered statistically significant. Results. The epidemiological profile of the main risk factors was presented in the framework of clinical trials and findings, clinical risk factors, and behavioral risk factors associated with brain stroke. The mean age of the patients was 69.52±15.72 years; 47.15% were female and 52.85% were male. The most common risk factors include: having high blood pressure (67.81%), snoring (32.06%), diabetes mellitus (22.23%), familial history of stroke (18.78%), ischemic heart disease (17.55%), aspiration pneumonia (15.32%), smoking (13.65%), atrial fibrillation (10.15%), and hyperlipidemia (8.42%). Ischemic brain stroke (68.20%) was more common than hemorrhagic brain stroke (31.80%). Smoking was significantly higher in men than women. The prevalence of hypertension, atrial fibrillation (P=0.001), and hyperlipidemia was significantly higher in women than men. There was a direct and significant relationship between atrial fibrillation and age and female gender (P=0.001). Conclusion. The main risk factors for brain stroke include high blood pressure, snoring, diabetes mellitus, ischemic heart disease, aspiration pneumonia, smoking, atrial fibrillation, and hyperlipidemia, respectively. Hypertension is the most common risk factor among patients, so screening for asymptomatic cases is recommended. Educating people about common clinical manifestations can help expedite their early referral and treatment.

Abstract Background Mother-to-child transmission is the primary cause of HIV cases among children. Antiretroviral therapy (ART) plays a critical role in preventing mother-to-child transmission and reducing HIV progression, morbidity, and mortality among mothers. However, after more than two decades of ART during pregnancy, the comparative effectiveness and safety of ART medications during pregnancy are unclear, and existing evidence is contradictory. This study aimed to assess the effectiveness and safety of different ART regimens among pregnant women living with HIV at preconception or during pregnancy. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. We included randomized trials that enrolled pregnant women living with HIV and randomized them to receive ART for at least four weeks. Pairs of reviewers independently completed screening for eligible studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool. Our outcomes of interest included low birth weight, stillbirth, preterm birth, mother-to-child transmission of HIV, neonatal death, and congenital anomalies. Network meta-analysis was performed using a random-effects frequentist model, and the certainty of evidence was evaluated using the GRADE approach. Results We found 14 eligible randomized trials enrolling 9,561 pregnant women. The median duration of ART uptake ranged from 6.0 to 17.4 weeks. No treatment was statistically better than a placebo in reducing the rate of neonatal mortality, stillbirth, congenital defects, preterm birth, or low birth weight deliveries. Compared to placebo, zidovudine (ZDV)/lamivudine (3TC) and ZDV monotherapy likely reduce mother-to-child transmission (odds ratio (OR): 0.13; 95% CI: 0.05 to 0.31, high-certainty; and OR: 0.50; 95% CI: 0.33 to 0.74, moderate-certainty). Moderate-certainty evidence suggested that ZDV/3TC was associated with decreased odds of stillbirth (OR: 0.47; 95% CI: 0.09 to 2.60). Conclusions Our analysis provides high- to moderate-certainty evidence that ZDV/3TC and ZDV are more effective in reducing the odds of mother-to-child transmission, with ZDV/3TC also demonstrating decreased odds of stillbirth. Notably, our findings suggest an elevated odds of stillbirth and preterm birth associated with all other ART regimens.

Light olefins are critical chemical materials with high global demand. The syngas-to-olefins (STO) process offers a promising pathway for light olefin production due to the versatility of syngas production technologies from various energy sources. However, achieving high carbon monoxide (CO) conversion and selectivity for olefins remains a challenge in catalytic development. This review categorizes STO catalysts into conventional Fischer-Tropsch catalysts, including unsupported and supported metal-based catalysts (with supports such as carbon, graphene, graphene oxide, zeolites, and metal oxides), as well as bifunctional, hybrid, and emerging core@shell structured catalysts. Another type of catalyst is core@shell structure catalyst, which is a developing method widely used for FT reactions. The performance of these catalysts is influenced by their materials, chemical compositions, operating conditions, and synthesis techniques. Unsupported catalysts, especially Fe-based and Co-based, exhibit high CO conversion but face issues like rapid deactivation and complex processing requirements. Supported catalysts enhance surface area, metal dispersion, and stability, with promoters such as Na, Mg, K, Mn, Zn, V, Zr, and Cu oxides improving catalytic activity through better CO adsorption and bond modulation. Zeolites, due to their acidic properties, significantly impact reactant adsorption and activation. Catalyst preparation methods, including impregnation, co-precipitation, sol-gel, and hydrothermal synthesis, alongside post-synthesis treatments like calcination and reduction, critically affect catalyst performance. This review provides a comprehensive overview of the light olefin production from syngas, detailing the roles of various catalysts and the impact of material types, operating conditions, and synthesis techniques on catalyst activity, and selectivity. The insights aim to guide future research and development towards more efficient and sustainable light olefin production processes.

Background: Plant-origin foods are among the most important sources of food allergic reactions. An increase in the incidence of sesame seed allergy among children and adults has been reported in recent years. The aim of this preliminary study was to investigate the prevalence, importance and clinical manifestations of sesame allergy among Iranian patients.Methods: In a cross-sectional survey, 250 patients with suspected IgE-mediated food allergies completed a questionnaire and underwent skin prick tests with sesame extract as well as cross-reacting foods (walnut, soya and peanut). Total IgE and sesame-specific IgE levels were measured. Patients with positive skin test reactions and/or IgE specific for sesame without clinical symptoms were considered sensitive to sesame. The patients who also had clinical symptoms with sesame consumption were diagnosed as allergic to sesame.Results: Of the 250 patients enrolled in this study, 129 were male and 121 female, with a mean age of 11.7 years. The most common food allergens were cow's milk, egg, curry, tomato and sesame. Sesame sensitivity was found in 35 patients (14.1%). Only five patients (2%) had sesame allergy. Sesame-sensitive patients had a significantly higher frequency of positive prick test to cross-reacting foods when compared to non-sensitized patients (p=0.00). The type of symptom was independent of gender and age of the patients, but urticaria and dermatitis-eczema were significantly more frequent in sensitized patients (p=0.008).Conclusions: This is the first study addressing the prevalence of sesame seed allergy in Iranian population. We found sesame to be a common and important cause of food allergy. The panel of foods recommended for use in diagnostic allergy tests should be adjusted.

Background: Cow's milk protein allergy (CMPA) is the most common food allergy during the first year of life. Strict avoidance of specific foods is the only accepted treatment for food-induced allergic reactions. This is often an unrealistic therapeutic option, since cow's milk is a basic food that is extensively used in infant formula. The recent preliminary experience of oral desensitization to cow's milk by Meglio & Patriarca seems promising. The object of this study was to investigate the desensitization of children with CMPA to cow's milk.Methods: All the patients referred to the Allergology Department of the Children's Medical Center Hospital, Tehran from March 2004 to November 2005 suspected to have CMPA were evaluated. The patients were included in the intervention or control groups of the study. For the intervention group, Meglio's protocol was performed. We observed and examined the control group for at least 6 months. Eventually both groups were reevaluated for the symptoms and persistence of positive specific IgE for cow milk proteins.Results: We enrolled 20 patients for oral desensitization and 13 patients were enrolled in the control group. Both groups were similar with regard to the mean age, sex and clinical symptoms. In 18 (90%) of the intervention subjects, oral desensitization with cow's milk was successfully performed. The entire protocol was completed by 14 (70%) of the intervention subjects. At the end of the six-month observation period, all the patients in the control group were still symptomatic after ingestion of cow's milk. The levels of specific IgE for cow's milk in the intervention group decreased significantly, which was not observed in the control group.Conclusion: We successfully desensitized 90% of our CMPA patients. Considering that all the patients in the control group remained symptomatic after the period of observation and our promising results in oral desensitization with cow's milk, we can safely propose this protocol as a hopeful alternative in the treatment of CMPA. We speculate that oral desensitization to cow's milk does not alter the natural outcome of CMPA, but substantially increases the threshold dose necessary to elicit allergic symptoms.

Lung cancer is one of the leading causes of death among all cancer deaths. This cancer is classified into two different histological subtypes: non-small cell lung cancer (NSCLC), which is the most common subtype, and small cell lung cancer (SCLC), which is the most aggressive subtype. Understanding the molecular characteristics of lung cancer has expanded our knowledge of the cellular origins and molecular pathways affected by each of these subtypes and has contributed to the development of new therapies. Traditional treatments for lung cancer include surgery, chemotherapy, and radiotherapy. Advances in understanding the nature and specificity of lung cancer have led to the development of immunotherapy, which is the newest and most specialized treatment in the treatment of lung cancer. Each of these treatments has advantages and disadvantages and causes side effects. Today, combination therapy for lung cancer reduces side effects and increases the speed of recovery. Despite the significant progress that has been made in the treatment of lung cancer in the last decade, further research into new drugs and combination therapies is needed to extend the clinical benefits and improve outcomes in lung cancer. In this review article, we discussed common lung cancer treatments and their combinations from the most advanced to the newest.

Epidemiological studies have shown wide geographical and racial variation in the prevalence and patterns of immunodeficiency disorders. To determine the frequency of primary immunodeficiencies (PID) in Iran, the Iranian primary Immunodeficiencies Registry (IPIDR) was organized in 1999. the diagnosis of immunodeficiency in our patients was based on standard criteria. The patient’s data were extracted, by using a uniform questionnaire from their hospital records. Three hundred and twenty eight patients with PID have been registered in our registry till 2000. Among these patients, the following frequencies were found: predominantly antibody deficiency in 48.48% of patients (n=159), T-cell disorders in 25.91% (n=85), phagocytic disorders in 24.7% (n=81), and complement deficiencies in 0.91% (n=3). Common variable immunodeficiency was the most frequent disorder (n=73), followe by chronic granulomatous disease (n=55), ataxia telangiectasia (n=39), x-linked agammaglobulinemia (n=35), selective IgA deficiency (n=34). This study reveals that antibody deficiencies are the most frequent diagnosed primary immunodeficiency disorder in our patients, which is similar to that observed in other registries. A comparative study shows some differences between our results and other registries

Recurrent ear, nose, and throat (ENT) infections are common presenting symptoms in patients with primary antibody deficiencies , but sometimes they remain undiagnosed for many years and are subjected to different antibiotics because of a lack of experience in immunodeficiencies. In order to determin the frequency of ENT symptoms among the patients with antibody deficiencies, 83 antibody deficient patients were studied from 1980 during a 20-year period, and their ENT symptoms were registered.This historical cohort study comprised of 83 patients including 25 X link agammaglubulinemi, (XLA) 40 common variable immunodeficiency (CVID), 14 IgA deficiency (IgA-D); 50 male, 33 female. The average length of time between onset and diagnosis was 40 months in our patients. Seventy-two of our patients (86.7%), had recurrent ENT symptoms (sinusitis, otitis and/or mastoidits) during the course of their disease. Each XLA patient had experienced 3.6 episodes of otitis per year, but after diagnosis it decreased to 0.7 episode per year. This decrease was about 5.8 folds in CVID (3.8 to 0.65) and 1.4 folds in IgA (2.2 to 1.6) these results show that a significant number of antibody deficient patients can be present with ENT symptoms (48% in this study). Diagnostic dealy was not much different from other reports. Early diagnosisand treatment of immunodeficiencies significantly prevents recurrent infections hence preventing long time complications

Background. In vitro studies have shown some effects for Hydroxychloroquine (HCQ) against SARS-CoV-2 virus. Despite effective vaccination program, relatively large proportion of population remains unvaccinated. So, there still remains a need for other prophylactic measures. The present study aims to evaluate whether HCQ can prevent severe COVID-19 outcomes among health-care workers. Materials and methods. In this randomized, double blind placebo-controlled clinical trial 334 healthcare workers aged 18–65 years old were included of whom 278 individuals completed the study. Participants were randomly assigned to the HCQ group (800 mg at day one, followed by 400 mg weekly for the next 7 weeks); or the placebo group. Participants were followed three weeks after the last dose of drug or placebo (10 weeks from the first dose of drug or placebo). The primary outcome was hospitalization or death from COVID-19. Results. Of 148 people who received HCQ, none were hospitalized or died from COIVD-19, while of 130 people who received the placebo, 2 (1.5%) were hospitalized for COIVD-19 (p-value: 0.26). And, 22 (14.9%) people in the HCQ group and 15 (11.6%) people in the placebo group contracted COVID-19 (p-value: 0.99). Adverse reactions were reported by 5 (3.4%) of participants in the HCQ group and 5 (3.9%) of participants in the placebo group (p-value: 0.99). Conclusion. We found that HCQ has no significant prevention effect on the incidence of mild COVID-19. However, the low rate of hospitalization (the primary outcome) in this trial like most of the other clinical trials with HCQ would have required increasing the sample size considerably to be able to comment on the effectiveness of HCQ in prevention of severe forms including death rate. This justifies systematic reviews to include similar studies to further investigate the issue.

Background: Many studies have assessed the effect of music on driving. However, their results are very scattered and contradictory. Therefore, this systematic review is conducted to determine the effect of music on driving performance and drivers’ physiological and psychological indicators. Methods: Scopus, PubMed, and Web of Science databases were searched until July 2023. A manual search in Google Scholar for gray literature was conducted. The Simulation Research Rubric (SRR) tool was used to assess the reporting quality of the studies. Stata software (StataCorp, version 16) was used to perform a meta-analysis. Results: A total of 2650 records were identified. The findings of 19 studies were analyzed. Most of them were carried out in high-income countries (HICs) using simulators. The most frequently used music style was classic rock. The meta-analysis results indicated that music with high and medium volume increases the average driving speed, and music with low volume decreases it. Although music in every mood reduces the average reaction time, it positively reduces response delay and increases coherence. Music with high volume decreases the heart rate, but music with medium and low volume increases it. Listening to music increases the level of arousal and mental load. Conclusion: It was concluded that, in some indicators, listening to music has adverse effects on driving. However, in many indicators, music has a positive impact on improving driving safety. It is better to choose appropriate music for different driving conditions and to train the drivers about it.

Abstract By implementing the gravitational decoupling method, we find the deformed AdS-Schwarzschild black hole solution when there is also an additional gravitational source, which obeys the weak energy condition. We also deliberately choose its energy density to be a certain monotonic function consistent with the constraints. In the method, there is a positive parameter that can adjust the strength of the effects of the geometric deformations on the background geometry, which we refer to as a deformation parameter. The condition of having an event horizon limits the value of the deformation parameter to an upper bound. After deriving various thermodynamic quantities as a function of the event horizon radius, we mostly focus on the effects of the deformation parameter on the horizon structure, the thermodynamics of the solution and the temperature of the Hawking–Page phase transition. The results show that with the increase of the deformation parameter: the minimum horizon radius required for a black hole to have local thermodynamic equilibrium and the minimum temperature below which there is no black hole decrease, and the horizon radius of the phase transition and the temperature of the first-order Hawking–Page phase transition increase. Furthermore, when the deformation parameter vanishes, the obtained thermodynamic behavior of the black hole is consistent with that stated in the literature.

Abstract We investigate cosmological solutions of the chameleon model with a non-minimal coupling between the matter and the scalar field through a conformal factor with gravitational strength. By considering the spatially flat FLRW metric and the matter density as a non-relativistic perfect fluid, we focus on the matter-dominated phase and the late-time accelerated-phase of the universe. In this regard, we manipulate and scrutinize the related field equations for the density parameters of the matter and the scalar fields with respect to the e-folding. Since the scalar field fluctuations depend on the background and the field equations become highly non-linear, we probe and derive the governing equations in the context of various cases of the relation between the kinetic and potential energies of the chameleon scalar field, or indeed, for some specific cases of the scalar field equation of state parameter. Thereupon, we schematically plot those density parameters for two different values of the chameleon non-minimal coupling parameter, and discuss the results. In the both considered phases, we specify that, when the kinetic energy of the chameleon scalar field is much less than its potential energy (i.e., when the scalar field equation of state parameter is $$\simeq - 1 $$ ≃ - 1 ), the behavior of the chameleon model is similar to the $$\Lambda CDM$$ Λ C D M model. Such compatibility suggests that the chameleon model is phenomenologically viable and can be tested with the observational data.

Abstract Background Accurate segmentation of stroke lesions on MRI images is very important for neurologists in the planning of post-stroke care. Segmentation helps clinicians to better diagnose and evaluation of any treatment risks. However, manual segmentation of brain lesions relies on the experience of neurologists and is also a very tedious and time-consuming process. So, in this study, we proposed a novel deep convolutional neural network (CNN-Res) that automatically performs the segmentation of ischemic stroke lesions from multimodal MRIs. Methods CNN-Res used a U-shaped structure, so the network has encryption and decryption paths. The residual units are embedded in the encoder path. In this model, to reduce gradient descent, the residual units were used, and to extract more complex information in images, multimodal MRI data were applied. In the link between the encryption and decryption subnets, the bottleneck strategy was used, which reduced the number of parameters and training time compared to similar research. Results CNN-Res was evaluated on two distinct datasets. First, it was examined on a dataset collected from the Neuroscience Center of Tabriz University of Medical Sciences, where the average Dice coefficient was equal to 85.43%. Then, to compare the efficiency and performance of the model with other similar works, CNN-Res was evaluated on the popular SPES 2015 competition dataset where the average Dice coefficient was 79.23%. Conclusion This study presented a new and accurate method for the segmentation of MRI medical images using a deep convolutional neural network called CNN-Res, which directly predicts segment maps from raw input pixels.