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This study aimed to evaluate chitosan (CS)-based formulations loaded with 5% sodium fluoride (NaF) and/or 10% nanohydroxyapatite (nHA) to remineralize the demineralized primary tooth enamel surface. Ninety enamel blocks were demineralized and were divided into six groups (n = 15): (1) CS-based hydrogel, (2) CS-based hydrogel loaded with NaF, (3) CS-based hydrogel loaded with nHA, (4) CS-based hydrogel loaded with NaF and nHA, (5) 5% NaF varnish, and (6) negative control with no intervention. After intervention, the specimens were pH cycled by 2 h immersion in demineralizing solution and 22 h immersion in remineralizing solution for 8 days. The remineralization effects were evaluated by Vickers microhardness measurements and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectrometry (FESEM-EDS). The best mean ± SD percentage microhardness recovery in remineralized enamel (%REMH) was found in group 4 (56.90 ± 5.49). The %REMH of groups 2 (30.74 ± 3.51) and 5 (29.23 ± 5.65) were statistically the same (p = 0.943). FESEM images confirmed partial coverage of the porous demineralized enamel with a newly formed mineralized layer. Based on EDS findings, the Ca/P ratio values of the treated enamel surfaces with CS-based hydrogels ranged between 1.71 and 1.87, and the highest F content was noticed in group 2 (1.02 ± 0.03). Although, all tested CS-based hydrogels demonstrated the potential to repair demineralized enamel, nHA- and NaF-containing CS-based hydrogel showed the highest remineralization effect. We infer that this new hybrid hydrogel is a potentially useful dental material for tooth biomineralization., (© 2024. The Author(s).)

The development of remineralizing smart biomaterials is a contemporary approach to caries prevention. The present study aimed at formulation preparation and characterization of a thermoresponsive oral gel based on poloxamer and chitosan loaded with sodium fluoride (NaF) and nanohydroxyapatite (nHA) to treat demineralization. The chemical structure and morphology of the formulation were characterized using FTIR and FESEM-EDS tests. Hydrogel texture, rheology, and stability were also examined. The hydrogel was in a sol state at room temperature and became gel after being placed at 37 °C with no significance different in gelation time with the formulation without nHA and NaF as observed by t -test. The FTIR spectrum of nHA/NaF/chitosan-based hydrogel indicated the formation of physical crosslinking without any chemical interactions between the hydrogel components. The FESEM-EDS results demonstrated the uniform distribution of each element within the hydrogel matrix, confirming the successful incorporation of nHA and NaF in the prepared gel. The hardness, hydrogel's adhesiveness, and cohesiveness were 0.9 mJ, 1.7 mJ, and 0.37, respectively, indicating gel stability and the acceptable retention time of hydrogels. The formulation exhibited a non-Newtonian shear-thinning pseudoplastic and thixotropic behavior with absolute physical stability. Within the limitation of in vitro studies, nHA/NaF/chitosan-based in situ forming gel demonstrated favorable properties, which could be trasnsorm into a gel state in oral cavity due to poloxamer and chitosan and can prevent dental caries due to nHA and NaF. We propose this formulation as a promising dental material in tooth surface remineralization., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Obesity is one of the major public health concerns, and its prevalence is increasing worldwide. This study aimed to investigate the effect of human development index on the prevalence of obesity across 152 countries., Methods: Country-level data on obesity prevalence and its influencing variables related to 152 countries were obtained during 2000-2019 from several sources. A Spatial Bayesian Hierarchical model was employed in this research, and the analyses were performed using R statistical software (version 3.6.1)., Results: We found a positive relation between HDI and obesity prevalence, in such a way if low HDI countries advance to high HDI countries, the obesity rate is expected to increase significantly by 7.45%. Moreover, the association between obesity prevalence and the percentage of people aged 40-59 (β=0.07), urbanization rate (β=0.11), percentage of internet users (β=0.01), percentage of alcohol users (β=0.16), milk consumption per capita (β=0.15) and Percentage of depression (β=0.58) was significantly positive. Conversely, per capita consumption of fruits and vegetables (β=-0.15), and smoking rate (β=-0.02) was negatively associated with obesity prevalence., Conclusion: The prevalence of obesity is growing across all countries, especially in the countries with high and very high HDI. Therefore, policymakers must also pay attention to the negative effects of development when trying to improve the welfare of society., Competing Interests: Conflict of Interest The authors declare that there is no conflict of interests., (Copyright © 2023 Shirvani Shiri et al. Published by Tehran University of Medical Sciences.)

The notion of foreign language teaching enjoyment (FLTE) has recently been introduced to the field of foreign language education as a positive emotion which influences teachers' professional and psychological growth. Due to the pure novelty of the concept, scant research attention has been paid to its antecedents in English as a foreign language (EFL) contexts. The present study aims to investigate the extent to which psychological wellbeing and emotion regulation can contribute to FLTE of Iranian EFL teachers. The participants ( N = 575) responded to three electronic questionnaires and the collected data were then analyzed through structural equation modeling (SEM). The SEM analysis indicated that Iranian EFL teachers' psychological wellbeing and emotion regulation significantly influenced their FLTE. The findings revealed that psychological wellbeing was a stronger predictor of EFL teachers' FLTE in the Iranian context. The findings were discussed regarding the causes of increasing teaching enjoyment. The results highlighted the importance of applying psychology in language teaching research. Finally, implications and suggestions for future research are offered., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Azari Noughabi, Fekri and Kazemkhah Hasankiadeh.)

Background: We investigated the impact of cancer incidence on CHE in Iran by considering spatial variation across provinces as well as temporal trends., Methods: Data from Household Income-Expenditure Survey were merged with cancer incidence rates during 2011-2016. We developed a Bayesian hierarchical model to explore the spatial and temporal patterns of CHE and its associated factors at provincial level. We used a Besag-York-Mollie2 prior and a random walk prior for spatial and temporal random effects respectively. All statistical analysis was carried out in R software., Results: All-type cancer incidence (OR per SD (95% CrI) = 1.16 (1.02, 1.32)), unemployment rate (1.08 (1.01, 1.15)) and income equity (0.88 (0.81, 0.97)) have important association with CHE. Percentage of urbanization and percentage of poverty were not statistically significant., Conclusion: The results suggest the development of new policies to protect cancer patients against financial hardship, narrow the gap in income inequality and solve the problem of high unemployment rate to reduce the level of CHE at provincial level., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2022 Fekri et al. Published by Tehran University of Medical Sciences.)

Rose-scented geranium, Pelargonium graveolens L'Hérit. (Geraniaceae), is an economically important plant. GC-MS analysis of the essential oil, prepared by hydro-distillation from this plant species, showed the presence of iso-menthone (15.71%), epi - α -cadinol (15.49%), iso -menthol (6.46%), geranyl formate (6.22%), geraniol (6.16%) and citronellol (5.53%). The composition of the absolute prepared by solvent extraction was compared to that of the essential oil. Change in citronellol to geraniol ratio in the absolute was monitored during leaf development. Estimation of the ratio of the two compounds was carried out using 1 H NMR spectroscopy. Geraniol content was highest in young leaves and citronellol content increased with increase in leaf age. Meta-analysis of the essential oil constituents reported from different countries was carried out. Menthone and isomenthone as well as citronellol and geraniol were negatively correlated. A significantly positive correlation was found between geraniol and linalool.

Background: The aim of this study was to define prognostic value and optimal threshold of first thyroglobulin (fTg) measured after thyroidectomy and just before radio-iodine therapy (RIT), in low/intermediate risk patients with differentiated thyroid cancer (DTC)., Methods: This is a retrospective study in 383 patients with DTC who were treated with surgery followed by RIT. Response to treatment was assessed 1 and 2 years after RIT. Odds ratio of different risk factors like age, sex, TNM stage, fTg and Anti-Tg Ab were compared between patients with and without incomplete response 1 and 2 years after treatment. Receiver operating curve analysis was used for definition of optimal fTg cut off for detection of incomplete response., Results: 218 female and 55 male with DTC had negative anti-Tg antibody (mean age: 37.5±14.5 years) and analyzed separately. fTg≥33.5 ng/mL and fTg/TSH ratio of ≥0.36 had the optimal sensitivity and specificity for detection of incomplete response 1 and 2 years after treatment. fTg<33.5 ng/mL had NPV of 98.5% for exclusion of distant metastases. Patients with fTg≥33.5 ng/mL had longer "time to excellent response" (3.6±2.3 vs. 2.0±1.8 yrs) and needed more additional treatments compared to patients with fTg<33.5 ng/mL. Multivariate analysis showed that fTg was the most potent risk factor for prediction of treatment failure 1 and 2 years after RIT., Conclusions: fTg of ≥33.5 ng/mL was the most important risk factor for prediction of treatment failure after RIT and could be included in decision algorithms regarding intensity of treatments in low/intermediate risk patients with DTC.

Background: We estimated the average numbers of years lived with and without cardiovascular disease (CVD) in normal weight, overweight, and obese individuals, aged ≥30 years., Methods: A total of 7529 participants were recruited. The multi-state Markov model was used to obtain hazard ratios (HRs) for three transitions (CVD free to nonfatal CVD, CVD free to all-cause death, and nonfatal CVD to all-cause death) stratified by body mass index (BMI) categories at baseline and adjusted for confounders including sex, age, smoking, family history of premature CVD, education and physical activity. Life expectancies (LEs) were also estimated for each transition stratifying by BMI categories and sex., Results: We found 986 incident cases of nonfatal CVD and 669 overall deaths (236 CVD deaths) after more than 18 years of follow-up. Overweight and obesity were associated with an increased risk of nonfatal CVD (HR, 1.42 (95% confidence interval (CI) 1.21-1.66) and (1.64, 1.37-1.96), respectively), compared with normal weight individuals. Overweight and obesity were also associated with lower risk of mortality without CVD (0.39, 0.20-0.77) and (0.35, 0.14-0.85), respectively. Among those with CVD, overweight compared with normal weight was associated with a lower risk of mortality (0.72, 0.56-0.94). Total LEs for both men and women with overweight and obesity were not significantly different from their normal weight counterparts. Compared with normal weight individuals, men and women with obesity lived 4.1 (CI: -6.3, -1.3) and 4.3 (-6.4, -2.0) fewer years free of CVD; however, they lived 3.9 (2.1, 6.0) and 3.7 (2.1, 5.6) longer years with CVD than their normal weight counterparts, respectively., Conclusions: We demonstrated that although total LE was not influenced by higher BMI; individuals with overweight and obesity could expect longer longevity after diagnosis of nonfatal CVD. These extra years of life impose financial burden on both patients and the health care system.

Background: The incidence and associated risk factors for premature death were investigated in a population-based cohort study in Iran., Methods: A total of 7245 participants (3216 men), aged 30-70 years, were included. We conducted Cox proportional hazards models to identify the risk factors for premature death. For each risk factor, hazard ratio (HR), 95% confidence intervals (95% CI) and population attributable fraction (PAF) were calculated., Results: After a median follow-up of 13.8 years, 262 premature deaths (153 in men) occurred. Underlying causes of premature deaths were cardiovascular disease (CVD) (n = 126), cancer (n = 51), road injuries (n = 15), sepsis and pneumonia (n = 9) and miscellaneous reasons (n = 61). The age-standardized incident rate of premature death was 2.35 per 1000 person years based on WHO standard population. Hypertension [HR 1.40, 95% CI (1.07-1.83)], diabetes (2.53, 1.94-3.29) and current smoking (1.58, 1.16-2.17) were significant risk factors for premature mortality; corresponding PAFs were 12.3, 22.4 and 9.2%, respectively. Overweight (body mass index (BMI): 25-29.9 kg/m 2 ) (0.65, 0.49-0.87) and obesity (BMI ≥30 kg/m 2 ) (0.67, 0.48-0.94) were associated with decreased premature mortality. After replacing general adiposity with central adiposity, we found no significant risk for the latter (0.92, 0.71-1.18). Moreover, when we excluded current smokers, those with prevalent cancer/cardiovascular disease and those with survival of less than 3 years, the inverse association between overweight (0.59, 0.39-0.88) and obesity (0.67, 0.43-1.04), generally remained unchanged; although, diabetes still showed a significant risk (2.62, 1.84-3.72)., Conclusions: Controlling three modifiable risk factors including diabetes, hypertension and smoking might potentially reduce mortality events by over 40%, and among these, prevention of diabetes should be prioritized to decrease burden of events. We didn't confirm a negative impact of overweight and obesity status on premature mortality events.

An active catheter intended for controllable intravascular maneuvers is presented and initial experimental results are shown. A commercial catheter is coated with polypyrrole and laser micromachined into electrodes, which are electrochemically activated, leading to bending of the catheter. The catheter's electro-chemo-mechanical properties are theoretically modeled to design the first prototype device, and used to predict an optimal polypyrrole thickness for the desired degree of bending within approximately 30 seconds. We compared the experimental result of catheter bending to the theoretical model with estimated electrochemical strain, showing reasonable agreement. Finally, we used the model to design an encapsulated catheter with polypyrrole actuation for improved intravascular compatibility and performance.

Introduction: Lutembacher syndrome refers to the rare combination of congenital atrial septal defect and acquired mitral stenosis. This condition is usually treated surgically by mitral valve operation with concomitant closure of the atrial septal defect., Materials and Methods: Between 1993 and 2003, 4 patients with congenital Lutembacher syndrome had percutaneous mitral commissurotomy without closure of the atrial septal defect at our institution. The 4 patients were very symptomatic with right-sided heart failure signs and NYHA functional class III-IV., Results: The procedure was carried out successfully for the four patients. Mitral valve area increased from 0.87 to 1.97 cm2 at mean; left atrial pressure decreased from 28.2 to 12.7 mmHg and the mean valve mitral gradient was reduced from 15.5 to 3.9 mmHg. Functional and clinical improvement was observed in all the cases. During a mean follow up of 55 +/- 29 months, our 4 patients remain pauci symptomatic under medical treatment., Conclusion: The percutaneous treatment of the Lutembacher syndrome is currently a possible alternative to the surgery among patients having an anatomy favourable to the procedure.