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In SOOREH Co, a significant amount of uranium-containing phosphoric acid wastewater from analytical operations is produced on a large volume of process samples. Uranium recovery and its optimal use in the UF6 gas production cycle is the most important goal of this research. To achieve this goal, two methods for the recovery of uranium from this wastewater have been investigated. The first method is to use TBP and D2EHPA extractant diluted with kerosene. The results of this study showed that up to 98% of uranium is extracted from laboratory wastewater, 95% of which can be stripped from the organic phase by ammonium bicarbonate solution. The second method is to precipitate uranium using sodium dithionite. In this study, the two-step process of uranium recovery from phosphoric acid wastewater has been studied. The results of this method show that using sodium dithionite with two-stage precipitation, the concentration of uranium in the filtered solution of sediments is reduced to less than 0.2 ppm and this reduction in concentration is equal to the efficiency up to 99.99%. Therefore, the use of the sedimentation method to recover uranium from phosphoric acid wastewater by sodium dithionite is a more appropriate method compared to the solvent extraction method and is recommended for this type of wastewater.

S‌u‌p‌e‌r‌s‌t‌r‌u‌c‌t‌u‌r‌e‌s m‌a‌y b‌e s‌u‌b‌j‌e‌c‌t t‌o l‌a‌t‌e‌r‌a‌l l‌o‌a‌d l‌i‌k‌e e‌a‌r‌t‌h‌q‌u‌a‌k‌e, w‌i‌n‌d, w‌a‌v‌e i‌m‌p‌a‌c‌t, a‌n‌d s‌h‌i‌p d‌u‌c‌k‌i‌n‌g. I‌n t‌h‌e‌s‌e c‌a‌s‌e‌s, e‌n‌g‌i‌n‌e‌e‌r‌s p‌r‌e‌f‌e‌r t‌o a‌p‌p‌l‌y p‌i‌l‌e‌s o‌r p‌i‌l‌e g‌r‌o‌u‌p‌s. T‌h‌e e‌x‌a‌c‌t p‌r‌e‌d‌i‌c‌t‌i‌o‌n‌s o‌f t‌h‌e l‌o‌a‌d-d‌e‌f‌l‌e‌c‌t‌i‌o‌n r‌e‌s‌p‌o‌n‌s‌e o‌f p‌i‌l‌e g‌r‌o‌u‌p‌s u‌n‌d‌e‌r l‌a‌t‌e‌r‌a‌l l‌o‌a‌d‌i‌n‌g h‌a‌v‌e a‌l‌w‌a‌y‌s b‌e‌e‌n a b‌i‌g c‌h‌a‌l‌l‌e‌n‌g‌e f‌o‌r e‌n‌g‌i‌n‌e‌e‌r‌s d‌u‌e t‌o t‌h‌e m‌a‌n‌y p‌a‌r‌a‌m‌e‌t‌e‌r‌s i‌n‌v‌o‌l‌v‌e‌d. T‌h‌e‌s‌e p‌a‌r‌a‌m‌e‌t‌e‌r‌s i‌n‌c‌l‌u‌d‌e s‌o‌i‌l r‌e‌l‌a‌t‌i‌v‌e d‌e‌n‌s‌i‌t‌y, t‌y‌p‌e o‌f s‌o‌i‌l a‌n‌d i‌t‌s c‌l‌a‌s‌s‌i‌f‌i‌c‌a‌t‌i‌o‌n, w‌a‌t‌e‌r t‌a‌b‌l‌e e‌l‌e‌v‌a‌t‌i‌o‌n, l‌e‌n‌g‌t‌h a‌n‌d d‌i‌a‌m‌e‌t‌e‌r o‌f p‌i‌l‌e, t‌y‌p‌e o‌f l‌o‌a‌d, r‌i‌g‌i‌d‌i‌t‌y o‌f p‌i‌l‌e a‌n‌d p‌i‌l‌e c‌a‌p, e‌t‌c. I‌n t‌h‌i‌s s‌t‌u‌d‌y, s‌o‌m‌e e‌x‌p‌e‌r‌i‌m‌e‌n‌t‌a‌l t‌e‌s‌t‌s w‌e‌r‌e p‌e‌r‌f‌o‌r‌m‌e‌d t‌o i‌n‌v‌e‌s‌t‌i‌g‌a‌t‌e t‌h‌e e‌f‌f‌e‌c‌t o‌f c‌r‌o‌s‌s-s‌e‌c‌t‌i‌o‌n s‌h‌a‌p‌e o‌f p‌i‌l‌e o‌n l‌a‌t‌e‌r‌a‌l r‌e‌s‌i‌s‌t‌a‌n‌c‌e o‌f p‌i‌l‌e g‌r‌o‌u‌p. T‌o c‌o‌n‌s‌i‌d‌e‌r t‌h‌e q‌u‌a‌n‌t‌i‌t‌y o‌f m‌a‌t‌e‌r‌i‌a‌l‌s u‌s‌e‌d t‌o c‌o‌n‌s‌t‌r‌u‌c‌t p‌i‌l‌e f‌o‌r o‌p‌t‌i‌m‌u‌m d‌e‌s‌i‌g‌n, f‌o‌u‌r d‌i‌f‌f‌e‌r‌e‌n‌t c‌r‌o‌s‌s-s‌e‌c‌t‌i‌o‌n s‌h‌a‌p‌e‌s o‌f p‌i‌l‌e‌s w‌i‌t‌h t‌h‌e s‌a‌m‌e s‌u‌r‌f‌a‌c‌e a‌r‌e‌a w‌e‌r‌e u‌s‌e‌d. T‌h‌e c‌r‌o‌s‌s-s‌e‌c‌t‌i‌o‌n s‌h‌a‌p‌e‌s o‌f p‌i‌l‌e‌s i‌n‌v‌o‌l‌v‌e‌d H p‌i‌l‌e, e‌n‌d c‌l‌o‌s‌e‌d p‌i‌p‌e, s‌q‌u‌a‌r‌e, a‌n‌d f‌i‌n p‌i‌l‌e. D‌i‌f‌f‌e‌r‌e‌n‌t c‌o‌n‌d‌i‌t‌i‌o‌n‌s s‌u‌c‌h a‌s p‌i‌l‌e a‌r‌r‌a‌n‌g‌e‌m‌e‌n‌t, p‌i‌l‌e s‌p‌a‌c‌i‌n‌g, a‌n‌d s‌o‌i‌l r‌e‌l‌a‌t‌i‌v‌e d‌e‌n‌s‌i‌t‌y f‌o‌r d‌i‌f‌f‌e‌r‌e‌n‌t c‌r‌o‌s‌s-s‌e‌c‌t‌i‌o‌n s‌h‌a‌p‌e‌s o‌f p‌i‌l‌e‌s w‌e‌r‌e a‌s‌s‌e‌s‌s‌e‌d. A p‌o‌o‌r‌l‌y g‌r‌a‌d‌e‌d s‌a‌n‌d‌y s‌o‌i‌l w‌a‌s u‌s‌e‌d. T‌h‌e l‌a‌t‌e‌r‌a‌l l‌o‌a‌d w‌a‌s a‌p‌p‌l‌i‌e‌d t‌o p‌i‌l‌e g‌r‌o‌u‌p‌s u‌s‌i‌n‌g a 2.5 k‌N c‌a‌p‌a‌c‌i‌t‌y j‌a‌c‌k a‌n‌d t‌h‌e d‌e‌f‌l‌e‌c‌t‌i‌o‌n o‌f p‌i‌l‌e c‌a‌p w‌a‌s m‌e‌a‌s‌u‌r‌e‌d b‌y a d‌i‌a‌l g‌a‌g‌e w‌i‌t‌h a‌c‌c‌u‌r‌a‌c‌y o‌f 0.01 m‌m. R‌e‌s‌u‌l‌t‌s r‌e‌v‌e‌a‌l‌e‌d t‌h‌a‌t t‌h‌e r‌a‌t‌i‌o‌s o‌f l‌a‌t‌e‌r‌a‌l r‌e‌s‌i‌s‌t‌a‌n‌c‌e o‌f f‌i‌n p‌i‌l‌e, s‌q‌u‌a‌r‌e p‌i‌l‌e, a‌n‌d H p‌i‌l‌e g‌r‌o‌u‌p‌s t‌o t‌h‌a‌t o‌f p‌i‌p‌e p‌i‌l‌e g‌r‌o‌u‌p w‌e‌r‌e 1.4, 1.19 a‌n‌d 0.85, r‌e‌s‌p‌e‌c‌t‌i‌v‌e‌l‌y. B‌y i‌n‌c‌r‌e‌a‌s‌i‌n‌g t‌h‌e n‌u‌m‌b‌e‌r o‌f p‌i‌l‌e‌s i‌n g‌r‌o‌u‌p, t‌h‌e a‌v‌e‌r‌a‌g‌e l‌a‌t‌e‌r‌a‌l l‌o‌a‌d p‌e‌r p‌i‌l‌e i‌n t‌h‌e p‌i‌l‌e g‌r‌o‌u‌p w‌a‌s r‌e‌d‌u‌c‌e‌d f‌o‌r a‌l‌l p‌i‌l‌e s‌h‌a‌p‌e‌s. A‌l‌s‌o, b‌y i‌n‌c‌r‌e‌a‌s‌i‌n‌g p‌i‌l‌e s‌p‌a‌c‌i‌n‌g f‌r‌o‌m 3$D_p$ t‌o 6$D_p$ , t‌h‌e l‌a‌t‌e‌r‌a‌l r‌e‌s‌i‌s‌t‌a‌n‌c‌e o‌f e‌a‌c‌h p‌i‌l‌e i‌n g‌r‌o‌u‌p a‌n‌d a‌l‌s‌o g‌r‌o‌u‌p e‌f‌f‌i‌c‌i‌e‌n‌c‌y o‌f a‌l‌l p‌i‌l‌e s‌h‌a‌p‌e‌s i‌n‌c‌r‌e‌a‌s‌e‌d s‌i‌g‌n‌i‌f‌i‌c‌a‌n‌t‌l‌y. A‌l‌t‌h‌o‌u‌g‌h t‌h‌e l‌a‌t‌e‌r‌a‌l r‌e‌s‌i‌s‌t‌a‌n‌c‌e o‌f p‌i‌l‌e g‌r‌o‌u‌p‌s i‌n‌c‌r‌e‌a‌s‌e‌d u‌p‌o‌n a‌n i‌n‌c‌r‌e‌a‌s‌e i‌n t‌h‌e s‌o‌i‌l r‌e‌l‌a‌t‌i‌v‌e d‌e‌n‌s‌i‌t‌y, t‌h‌e g‌r‌o‌u‌p e‌f‌f‌i‌c‌i‌e‌n‌c‌y w‌a‌s r‌e‌d‌u‌c‌e‌d b‌y 50\%.

Introduction According to the importance of energy and the impact of this input on the final price of a product, selection of materials and components of poultry saloons is very important. Poultry saloons are divided into two types: open saloons and closed saloons. In closed saloons, the choice of materials and components of the saloon (door, window, etc.) are more sensitive than the open type. Due to the climatic conditions of Khuzestan province, all of the used saloons in this province are almost closed. Poultry farms in Khuzestan province have a lot of cooling load in the warm seasons. If the materials and components of the saloons are not chosen properly, energy losses increase, and as a result, the price of meat increases. Therefore, investigating of heating and cooling loads of saloons and use of suitable components to prevent energy losses is necessary. Energy modeling of saloons and buildings is done by various software (Plast Energy, Design Builder, Trnsys, etc.). One of the most efficient and precise of this software is Carrier. Materials and Methods This study was conducted to calculate heating and cooling loads in different climates of Khuzestan province. In this research, the cities of Izeh, Shoosh, Abadan and Andimeshk were selected as corresponding to different climates in the province. Required data for software was collected in three categories: (a) Weather data (geographic information, location of the saloon, local time zone and local soil specifications), (b) Data about the physical properties of the building (general specifications of the space, internal sources of heat production (personslabors, poultry, equipment), (c) Specifications of walls, floor, windows and doors, ceiling and lighters, (d) Infiltration of air, (e) Systems, and (f) Information on power and fuel consumption. In this research, a rectangular saloon with dimensions of 85×16 meter was considered for all three types of conventional saloons in the province (block, brick and panel), which are the common dimensions and the capacity of these saloons is 20,000 broiler chickens. In this study, Carrier software was used to calculate heating and cooling loads. The results of software were verified by the amount of fuel and power consumption. Results and Discussion The sand and soil floors had the highest cooling load by 48828 and 53012 kJ h-1, respectively, while concrete and mosaic floors had lower cooling load than them. The heating load of these two floors (3906 kJ h-1) was less than that in the sand and soil floors. Concrete floor had better conditions to choose because of the less cost than the mosaic floor. Comparison of heating and cooling loads in different types of walls made of various materials showed that the block wall had the highest heating load of 429356 kJ h-1 and the highest cooling load by 658356 kJ h-1, while the sandwich panel wall had the lowest heating load by 116873 kJ h-1 and the lowest cooling load by 123618 kJ h-1. Three types of doors are commonly used in poultry houses: iron, fiberglass and aluminum. The results showed that the iron and fiberglass doors had the highest and lowest heating and cooling loads, respectively. The investigation of the effect of different types of windows on heating and cooling loads showed that iron and plastic windows had the highest and lowest heating and cooling loads, respectively. The results showed that Irannait ceiling had the highest heating and cooling loads by 371416 kJ h-1 and 787535 kJ h-1, respectively, while the ceiling made of sandwich panel had the lowest heating and cooling loads by 72756 kJ h-1 and 72429 kJ h-1, respectively, because of low heat transfer coefficient. Comparison of heating load of the saloons showed that the block saloon had the highest heating load by 891525 kJ h-1 and the suggested saloon in this study had the lowest heating load by 309068 kJ h-1. The block and suggested saloons also had the highest and lowest cooling loads by 1604828 kJ h-1 and 330795 kJ h-1, respectively. Conclusion The amount of heating and cooling loads for suggested saloon were 29.6% and 18.24% lower than that of brick and block saloons, respectively. The difference in the cost of constructing suggested and brick (the most common saloon in the province) saloons was 28.9 million tomans. By considering the difference in the cost of energy consumption of them (11.726 million tomans), this amount will be compensated after 2 years and 5 months and then will be returned on investment.

The purpose of this paper is to identify and prioritize environmental criteria of sustainable outsourcing model in Fajr Jam Gas refining company with hierarchical analysis procedure method. In order to identify environmental criteria, the identified strategic goals of the model are categorized in the most four aspects of the balanced scorecard and three dimensions of economic, social and environmental sustainability. to determine the importance of each environmental criteria in terms of four groups of experts (members of the outsourcing committee, managers, supervisors and experts in the company) are reported using Analytic Hierarchy Process (AHP) method and the results of research are reported through EXPERT CHOICE software. The findings indicated that in order to design sustainable outsourcing model using a balanced scorecard, seven strategic objectives in environmental dimension had to be considered two objectives in learning and growth aspect, two objectives in internal business processes aspect, two objectives in customer satisfaction aspect and a strategic environmental objective in financial performance aspect were identified. Finally, using a paired comparisons questionnaire, the importance of each strategic objective was calculated and prioritized.

Introduction: Financing decisions or capital structure is one of the main decisions of financial management due to influencing the risk and the return of Shareholders. Therefore, determining the optimal capital structure is one of the most important issues which the managers of economic agencies encounter in the process of financial decisions. Method: This is an applied research and it uses the quasi–experimental design and the prospective approach. In order to test the hypotheses and identifying the output variables of Data Envelopment Analysis, Pearson Correlation test has been used. The statistical population of the research include the food and Pharmaceutical companies listed on the Tehran Stock Exchange during 2008–2014. In this research, SPSS Software Version 19 and Frontier Analyst Software Version 3 have been used. Results: There is a significant relationship between the current ratio variables, the ratio of the operational earnings to sale, the return of assets, economic value added, market value added, and the ratio of price to earnings per share with financial leverage. But, there is not any significant relationship between the quick ratio and the ration of market price to the book value per share with financial leverage. According to the existence of the mentioned significant relationship between financial leverage and the criteria for measuring performance, financial leverage has been selected as the input variable and the criteria for measuring performance as the output variables in Data Envelopment Analysis technique, then by the application of the variable return to scale Data Envelopment Analysis Model, the optimal capital structure for the companies has been selected. Conclusion: The results of the research state that the food and Pharmaceutical companies which have similar efficiency, have used their debt instrument and investment instrument more effectively. This has caused companies to have a better performance. In the other words, these companies have used their accessible different financial resources more effectively and optimally than the other companies.

Use of dispersive clay as construction material requires treatment such as by chemical addition. Treatments to dispersive clay using pozzolan and Portland cement, singly and simultaneously, were carried out in this study. When used alone, the optimum amount of pozzolan required to treat a fully dispersive clay sample was 5%, but the curing time to reduce dispersion potential, from 100% to 30% or less, was 3 month long. On the other hand, also when used alone, a 3% cement content was capable of reducing dispersion potential to almost zero percent in only 7 days; and a 2% cement content was capable of achieving similar result in 14 days. However, treatment by cement alone is costly and could jeopardize the long term performance. Thus, a combined 5% pozzolan and 1.5% cement content was found capable of reducing dispersion potential from 100% to zero percent in 14 days. The results indicate that although simultaneous treatment with pozzolan and cement would extend the required curing time in comparison to treatment by cement alone of a higher content, the task could still be carried out in a reasonable period of curing time while avoiding the drawbacks of using either pozzolan or cement alone.

Predicting pandemic evolution involves complex modeling challenges, typically involving detailed discrete mathematics executed on large volumes of epidemiological data. Making them physics based provides added intuition as well as predictive value. Differential equations have the advantage of offering smooth, well-behaved solutions that try to capture overall predictive trends and averages. In this paper, the canonical susceptible-infected-recovered model is simplified, in the process generating quasi-analytical solutions and fitting functions that agree well with the numerics, as well as infection data across multiple countries. The equations provide an elegant way to visualize the evolution of the pandemic spread, by drawing equivalents with the similar dynamics of a particle, whose location over time represents the growing fraction of the population that is infected. This particle slides down a potential whose shape is set by model epidemiological parameters such as reproduction rate. Potential sources of errors and their growth over time are identified, and the uncertainties are mapped into a diffusive jitter that tends to push the particle away from its minimum. The combined physical understanding and analytical expressions offered by such an intuitive drift-diffusion model sets the foundation for their eventual extension to a multi-patch model while offering practical error bounds and could thus be useful in making policy decisions going forward., Competing Interests: Declaration of interests The authors declare no competing interests., (Published by Elsevier Inc.)

Study Question: How accurately can artificial intelligence (AI) models predict sperm retrieval in non-obstructive azoospermia (NOA) patients undergoing micro-testicular sperm extraction (m-TESE) surgery?, Summary Answer: AI predictive models hold significant promise in predicting successful sperm retrieval in NOA patients undergoing m-TESE, although limitations regarding variability of study designs, small sample sizes, and a lack of validation studies restrict the overall generalizability of studies in this area., What Is Known Already: Previous studies have explored various predictors of successful sperm retrieval in m-TESE, including clinical and hormonal factors. However, no consistent predictive model has yet been established., Study Design Size Duration: A comprehensive literature search was conducted following PRISMA-ScR guidelines, covering PubMed and Scopus databases from 2013 to 15 May 2024. Relevant English-language studies were identified using Medical Subject Headings (MeSH) terms. We also used PubMed's 'similar articles' and 'cited by' features for thorough bibliographic screening to ensure comprehensive coverage of relevant literature., Participants/materials Setting Methods: The review included studies on patients with NOA where AI-based models were used for predicting m-TESE outcomes, by incorporating clinical data, hormonal levels, histopathological evaluations, and genetic parameters. Various machine learning and deep learning techniques, including logistic regression, were employed. The Prediction Model Risk of Bias Assessment Tool (PROBAST) evaluated the bias in the studies, and their quality was assessed using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) guidelines, ensuring robust reporting standards and methodological rigor., Main Results and the Role of Chance: Out of 427 screened articles, 45 met the inclusion criteria, with most using logistic regression and machine learning to predict m-TESE outcomes. AI-based models demonstrated strong potential by integrating clinical, hormonal, and biological factors. However, limitations of the studies included small sample sizes, legal barriers, and challenges in generalizability and validation. While some studies featured larger, multicenter designs, many were constrained by sample size. Most studies had a low risk of bias in participant selection and outcome determination, and two-thirds were rated as low risk for predictor assessment, but the analysis methods varied., Limitations Reasons for Caution: The limitations of this review include the heterogeneity of the included research, potential publication bias and reliance on only two databases (PubMed and Scopus), which may limit the scope of the findings. Additionally, the absence of a meta-analysis prevents quantitative assessment of the consistency of models. Despite this, the review offers valuable insights into AI predictive models for m-TESE in NOA., Wider Implications of the Findings: The review highlights the potential of advanced AI techniques in predicting successful sperm retrieval for NOA patients undergoing m-TESE. By integrating clinical, hormonal, histopathological, and genetic factors, AI models can enhance decision-making and improve patient outcomes, reducing the number of unsuccessful procedures. However, to further enhance the precision and reliability of AI predictions in reproductive medicine, future studies should address current limitations by incorporating larger sample sizes and conducting prospective validation trials. This continued research and development is crucial for strengthening the applicability of AI models and ensuring broader clinical adoption., Study Funding/competing Interests: The authors would like to acknowledge Mashhad University of Medical Sciences, Mashhad, Iran, for financial support (Grant ID: 4020802). The authors declare no competing interests., Registration Number: N/A., Competing Interests: The authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Topologically protected magnetic skyrmions in magnetic materials are stabilized by an interfacial or bulk Dzyaloshinskii-Moriya interaction (DMI). Interfacial DMI decays with an increase of the magnetic layer thickness in just a few nanometers, and bulk DMI typically stabilizes magnetic skyrmions at low temperatures. Consequently, more flexibility in the manipulation of DMI is required for utilizing nanoscale skyrmions in energy-efficient memory and logic devices at room temperature (RT). Here, we demonstrate the observation of RT skyrmions stabilized by gradient DMI (g-DMI) in composition gradient-engineered CoPt single-layer films by employing the topological Hall effect, magnetic force microscopy, and nitrogen-vacancy scanning magnetometry. Skyrmions remain stable over a wide range of applied magnetic fields and are confirmed to be nearly Bloch-type from micromagnetic simulation and analytical magnetization reconstruction. Furthermore, we observe skyrmion pairs, which may be explained by skyrmion-antiskyrmion interactions. Our findings expand the family of magnetic materials hosting RT magnetic skyrmions by tuning g-DMI via gradient polarity and a choice of magnetic elements.

Background: Patients' missed appointments can cause interference in the functions of the clinics and the visit of other patients. One of the most effective strategies to solve the problem of no-show rate is the use of an open access scheduling system (OA). This systematic review was conducted with the aim of investigating the impact of OA on the rate of no-show of patients in outpatient clinics., Methods: Relevant articles in English were investigated based on the keywords in title and abstract using PubMed, Scopus, and Web of Science databases and Google Scholar search engine (July 23, 2023). The articles using OA and reporting the no-show rate were included. Exclusion criteria were as follows: (1) review articles, opinion, and letters, (2) inpatient scheduling system articles, and (3) modeling or simulating OA articles. Data were extracted from the selected articles about such issues as study design, outcome measures, interventions, results, and quality score., Findings: From a total of 23,403 studies, 16 articles were selected. The specialized fields included family medicine (62.5%, 10), pediatrics (25%, four), ophthalmology, podiatric, geriatrics, internal medicine, and primary care (6.25%, one). Of 16 articles, 10 papers (62.5%) showed a significant decrease in the no-show rate. In four articles (25%), the no-show rate was not significantly reduced. In two papers (12.5%), there were no significant changes., Conclusions: According to this study results, it seems that in most outpatient clinics, the use of OA by considering some conditions such as conducting needs assessment and system design based on the patients' and providers' actual needs, and cooperating of all system stakeholders through consistent training caused a significant decrease in the no-show rate., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Good health and well-being is one of the sustainable development goals (SDGs) that can be achieved through fruit consumption. This study measured cucumber (Cucumis sativus L.) heavy metal concentrations. Inductively coupled plasma-mass spectrometry (ICP-OES) was used to analyze the samples for heavy metal content. The uncertainty and sensitivity analyses of carcinogenic and non-carcinogenic heavy metal intake via cucumber ( Cucumis sativus L. ) consumption were assessed by Monte Carlo simulation. The mean ± SD levels of Cu, Pb, Zn, Cd, and As were determined to be 157.87 ± 128.54, 33.81 ± 6.27, 288.46 ± 114.59, 35.22 ± 18.67, and 33.6 ± 18.1 μg/kg, respectively. The 95th percentile of HI related to heavy metal intake via cucumber ( Cucumis sativus L. ) among children and adults were 2.64 and 1.75, respectively. Also, the 95th percentile of ELCR related to heavy metal were 8.26E-4 and 4.14E-3 among children and adults, respectively. The 95th percentile of LTCR of As among adults and As, Cd, and Pb among children were in the WHO target range (1E-04 to 1E-06) so reducing the concentration of them can help to reduce overall LTCR. When HQ and LTCR are below the cut limits, reducing heavy metals in high-consumption meals is a good way to lower them. In general, due to the wide consumption of various fruits, such as cucumber ( Cucumis sativus L. ), the concentration of environmental pollutants in their edible tissues should be monitored regularly, and the concentration of pollutants in these tissues should be minimized by proper planning., 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.)

Transport measurement of electron optics in monolayer graphene p-n junction devices has been traditionally studied with negative refraction and chiral transmission experiments in Hall bar magnetic focusing setups. We show direct signatures of Klein (monolayer) and anti-Klein (bilayer) tunneling with a circular "edgeless" Corbino geometry made out of gated graphene p-n junctions. Noticeable in particular is the appearance of angular sweet spots (Brewster angles) in the magnetoconductance data of bilayer graphene, which minimizes head-on transmission, contrary to conventional Fresnel optics or monolayer graphene which show instead a sharpened collimation of transmission paths. The local maxima on the bilayer magnetoconductance plots migrate to higher fields with increasing doping density. These experimental results are in good agreement with detailed numerical simulations and analytical predictions.

The role of inflammation has been proven in acute myocardial infarction (AMI) pathogenesis. Due to the effect of NLRP3 gene expression in the inflammation process of MI, we aimed to explore the expression changes and diagnostic power of four inflammation-related miRNAs including miR-17-3p, miR-101-3p, miR-335-3p, miR-296-3p and their potential target, NLRP3, in ST-segment elevation myocardial infarction (STEMI), and non-STEMI (NSTEMI) patients as two major classes of AMI. The expression level of these genes were evaluated in 300 participants equally divided into three groups of STEMI, NSTEMI, and control using quantitative real-time PCR. The expression level of NLRP3 was upregulated in STEMI and NSTEMI patients compared to control subjects. Besides, the expression levels of miR-17-3p, miR-101-3p, and miR-296-3p were significantly downregulated in STEMI and NSTEMI patients compared to controls. The increased expression of NLRP3 had a very strong inverse correlation with miR-17-3p in patients with STEMI and with miR-101-3p in the STEMI and NSTEMI patients. ROC curve analysis showed that the expression level of miR-17-3p had the highest diagnostic power for discrimination between STEMI patients and controls. Remarkably, the combination of all markers resulted in a higher AUC. In summary, there is a significant association between the expression levels of miR-17-3p, miR-101-3p, miR-335-3p, miR-296-3p, and NLRP3 and the incidence of AMI. Although the miR-17-3p expression level has the highest diagnostic power to distinguish between STEMI patients and control subjects, the combination of these miRNAs and NLRP3 could serve as a novel potential diagnostic biomarker of STEMI., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The microstructure design of multiblock copolymers is essential for achieving desired interfacial properties in submerged applications. Two major design factors are the chemical composition and polymer topology. Despite a clear relationship between chemical composition and wetting, the effect of polymer topology (i.e., linear vs cross-linked polymers) is not very clear. Thus, in this study, we shed light on the molecular origins of polymer topology on the wetting behavior. To this end, we synthesized linear and three-dimensional (3D) cross-linked network topologies of poly(ethylene glycol) (PEG)-modified polycarbonate polyurethanes with the same amount of hydrophilic PEG groups on the surface (confirmed by X-ray photoelectron spectroscopy (XPS)) and studied the wetting mechanisms through water contact angle (WCA), atomic force microscopy (AFM), and molecular dynamics (MD) simulations. The linear topology exhibited superhydrophilic behavior, while the WCA of the cross-linked polymer was around 50°. AFM analysis (performed on dry and wet samples) suggests that PEG migration toward the interface is the dominant factor. MD simulations confirm the AFM results and unravel the mechanisms: the higher flexibility of PEG in linear topology results in a greater PEG migration to the interface and formation of a thicker interfacial layer (i.e., twice as thick as the cross-linked polymers). Accordingly, water diffusion into the interfacial layer was greater in the case of the linear polymer, leading to better screening of the underneath hydrophobic (polycarbonate) segments.

A P-N junction engineered within a Dirac cone system acts as a gate tunable angular filter based on Klein tunneling. For a 3D topological insulator with a substantial bandgap, such a filter can produce a charge-to-spin conversion due to the dual effects of spin-momentum locking and momentum filtering. We analyze how spins filtered at an in-plane topological insulator PN junction (TIPNJ) interact with a nanomagnet, and argue that the intrinsic charge-to-spin conversion does not translate to an external gain if the nanomagnet also acts as the source contact. Regardless of the nanomagnet's position, the spin torque generated on the TIPNJ is limited by its surface current density, which in turn is limited by the bulk bandgap. Using quantum kinetic models, we calculated the spatially varying spin potential and quantified the localization of the current versus the applied bias. Additionally, with the magnetodynamic simulation of a soft magnet, we show that the PN junction can offer a critical gate tunability in the switching probability of the nanomagnet, with potential applications in probabilistic neuromorphic computing., (© 2023. The Author(s).)

Background: The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism., Methodology: The present non-interventional study was performed by a pre and a post survey each lasting 8 months before (March-October 2019) and after (March-October 2020) the onset of COVID-19 pandemic in three ICU's, not allocated to COVID-19 patients, in Nemazee Hospital, Shiraz, Iran. The rates of the following nosocomial infections were compared at pre- and post-pandemic period: ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and incidence of multiple drug resistance (MDR) pathogens., Results: Pre-pandemic and pandemic incidence of VAP was 23.5 and 17.2 cases per 1000 device-days, respectively; an absolute decrease of 27%. The main reason for the decrease in the rate of VAP during the pandemic was a significant decrease in the rate of VAP caused by Acinetobacter baumannii; from 39 to 17% in total VAP episodes. The rate of VAP associated with other microorganisms remained relatively unchanged from 14.2 cases in pre-pandemic period to 14.3 cases per 1000 MV-days during the pandemic (P = 0.801). Pre-pandemic incidence of CLABSI was 7.3 cases and, in pandemic period, was 6.5 cases per 1000 device-days (IRR = 0.88, 95% CI  0.43-1.73, P = 0.703). Pre-pandemic incidence of CAUTI was 2 and in pandemic period, was 1.4 cases per 1000 device-days (IRR = 0.70, 95% CI  0.22-1.98, P = 0.469)., Conclusion: The results of the present study showed a decrease in the incidence of VAP in critically ill non-COVID-19 patients during the pandemic compared to before the pandemic, especially regarding Acinetobacter baumannii., (© 2023. The Author(s).)

The surface state of a 3D topological insulator (3DTI) is a spin-momentum locked conductive state, whose large spin hall angle can be used for the energy-efficient spin-orbit torque based switching of an overlying ferromagnet (FM). Conversely, the gated switching of the magnetization of a separate FM in or out of the TI surface plane can turn on and off the TI surface current. By exploiting this reciprocal behavior, we can use two FM/3DTI heterostructures to design an integrated 1-transistor 1-magnetic tunnel junction random access memory unit (1T1MTJ RAM) for an ultra low power Processing-in-Memory (PiM) architecture. Our calculation involves combining the Fokker-Planck equation with the Nonequilibrium Green Function (NEGF) based flow of conduction electrons and Landau-Lifshitz-Gilbert (LLG) based dynamics of magnetization. Our combined approach allows us to connect device performance metrics with underlying material parameters, which can guide proposed experimental and fabrication efforts.

Background: In recent years, researchers have used many computerized interventions to reduce medical errors, the third cause of death in developed countries. One of such interventions is using differential diagnosis generators in primary care, where physicians may encounter initial symptoms without any diagnostic presuppositions. These systems generate multiple diagnoses, ranked by their likelihood. As such, these reports' accuracy can be determined by the location of the correct diagnosis in the list., Objective: This study aimed to design and evaluate a novel practical web-based differential diagnosis generator solution in primary care., Methods: In this research, a new online clinical decision support system, called DxGenerator, was designed to improve diagnostic accuracy; to this end, an attempt was made to converge a semantic database with the unified medical language system (UMLS) knowledge base, using MetaMap tool and natural language processing. In this regard, 120 diseases of gastrointestinal organs causing abdominal pain were modeled into the database. After designing an inference engine and a pseudo-free-text interactive interface, 172 patient vignettes were inputted into DxGenerator and ISABEL, the most accurate similar system. The Wilcoxon signed ranked test was used to compare the position of correct diagnoses in DxGenerator and ISABEL. The α level was defined as 0.05., Results: On a total of 172 vignettes, the mean and standard deviation of correct diagnosis positions improved from 4.2 ± 5.3 in ISABEL to 3.2 ± 3.9 in DxGenerator. This improvement was significant in the subgroup of uncommon diseases ( p -value < 0.05)., Conclusion: Using UMLS knowledge base and MetaMap Tools can improve the accuracy of diagnostic systems in which terms are entered in a free text manner. Applying these new methods will help the medical community accept medical diagnostic systems better., Competing Interests: None declared., (Thieme. All rights reserved.)

This research aims at determining some free amino acids in amino acid-based infant formulas and amino acid-modified medical foods for inborn errors of metabolism to prove their quality. A method based on high-performance liquid chromatography and diode array detection was developed and validated. Then, overall uncertainty was estimated by the bottom-up approach. Applying the weighted least squares regression method suggested good linearity with coefficient of determinations ≥ 0.9960. The limits of detection were calculated between 0.01 and 0.28 μg/mL. The most repetitive recovery values were obtained in the range of 91-108%, with RSDs ≤ 15%. The expanded uncertainties were below 20% for most amino acids. The contributions of linear regression and repeatability are two main factors in estimating overall uncertainty. The results offer this method as a simple and easy procedure for analyzing free amino acids in seven powdered medical foods designed for phenylketonuria, maple syrup urine disease, methylmalonic, and propionic acidemia., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: The Primary Percutaneous Coronary Intervention (PPCI) is the preferred therapeutic strategy for patients who experienced ST-Elevation Myocardial Infarction (STEMI)., Objective: We aimed to evaluate the association of hematological indices, including hemoglobin level, platelets, White Blood Cells (WBCs) count, and MPV before PPCI with the TIMI grade flow after PPCI., Methods: STEMI patients who experienced PPCI were included in the present retrospective crosssectional study. Then participants were divided into three groups based on their post-procedural TIMI flow grades. Demographic data and hematologic indices of patients before PPCI were collected and their association with the TIMI grade flow after PPCI was evaluated. To compare the quantitative and qualitative variables, chi-square and t-tests were performed, respectively., Results: We found that elevated levels of hemoglobin and decreased levels of MPV had a significant association with an advanced grade of TIMI flow. Interestingly, in the normal range, there was a significant association between higher platelet count and TIMI-flow grade 1. Besides, TIMI flow grades 2 and 3 had a significant association with low and moderate platelets count, respectively., Conclusion: In conclusion, evaluating MPV, platelets, and hemoglobin levels before PPCI as easy and accessible parameters may be able to identify high-risk STEMI patients undergoing PPCI., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: ST-elevation myocardial infarction (STEMI) is known to be associated with significant arrhythmia and consequent mortality. QT prolongation is a risk factor for arrhythmia in STEMI patients who underwent primary percutaneous coronary intervention (PPCI). The aim of this investigation was to evaluate the association of corrected QT interval (QTc), QT dispersion (QTd), T-wave peak to end (TPE), and fragmented QRS with mortality in these patients., Methods: Eligible patients with the characteristic symptoms of STEMI who underwent PPCI were included. QTc, QTd, TPE, and fragmented QRS were measured before and after the PPCI. These predictors were compared between patients who died during hospitalization and discharged patients., Results: After coronary angiography, 10 patients (4%) died during the hospitalization after PPCI. Comparing the non-survivers and discharged patients in terms of arrhythmia predictors showed that the mean QT dispersion and TPE before intervention were significantly higher in the non-survivors. Also, the number of patients who experienced fragmented QRS before and after the intervention was significantly higher in the non-survivors., Conclusion: These data suggested that evaluating such arrhythmia predictors, especially before PPCI, could be used as a predictor of mortality in STEMI patients who underwent PPCI., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: An important cause of Coronary Artery Disease (CAD) is Type 2 Diabetes Mellitus (T2DM). The aim of this study was the evaluation of copy number variations (CNVs) of hsa-miR-93, hsa-miR-122, hsa-miR-192 in CAD patients with or without T2DM., Methods: CNVs of three micro-RNAs in 50 CAD patients and 50 non-CAD subjects both with and without diabetes were evaluated by real-time PCR and compared in three comparison groups namely 1, 2 and 3 (including comparison between CAD and non-CAD, diabetic CAD and non-diabetic CAD and between diabetic CAD and diabetic non-CAD subjects, respectively)., Results: There were significant differences in CNVs of hsa-miR-93 between cases and controls in comparison groups 1 and 3 ( p  = .0310 and .0232, respectively), for hsa-miR-122 in all comparison groups, and for hsa-miR-192 in comparison group 3 ( p  = .0181)., Conclusion: We showed the association of these microRNA-CNVs with CAD, T2DM or both simultaneously.

Background: The coronary no-reflow phenomenon is an adverse complication of percutaneous coronary interventions (PCI) which significantly worsens the outcome and survival. In this study, we have evaluated the correlation of no-reflow phenomenon with demographic, biochemical and anatomical factors., Methods: We included 306 patients (193 male) with acute ST-elevation myocardial infarction (STEMI) who undergone primary PCI in our center. Demographic factors, as well as biochemistry test results were obtained. Also, the Thrombolysis in Myocardial Infarction (TIMI) grade and TIMI frame count (TFC) was measured. The correlation of no-reflow phenomenon with demographic, biochemical and anatomical factors was analyzed., Results: Patients with a mean age of 56.41 ± 11.8 years were divided into two groups depending on the TIMI score (Group 1 or Normal flow and Group 2 or No-reflow). Symptom-to-procedure time, door-to-procedure time, serum creatinine level, hs-CRP level, and Neutrophil to Lymphocyte Ratio (NLR) were significantly higher among group 2. TFC had negative significant correlation with male gender, and positive significant correlation with age, diabetes mellitus, hs-CRP level, WBC count, and NLR. Age of more than 62.5 years and serum creatinine level of more than 0.89 mg/dL can optimally predict the no reflow phenomena., Conclusions: According to our results, it seems that female gender, older ages, DM, multi-vessel involvement, delayed reperfusion, and increased NLR can predict the risk of no-reflow after primary PCI in the setting of Acute Myocardial Infarction.

Penetrating chest trauma can lead to the cardiac rupture and coronary artery damage, which causes a high mortality rate (1). Most of the patients with penetrating cardiac trauma die at the scene of the accident (1). Coronary artery (CA) injuries are rare but highly lethal (2). Also, CA injury may occur during repair of a ruptured heart as in our reported case., Competing Interests: None declared., (© 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Human (h) growth hormone (GH) production studies are largely limited to effects on secretion. How pituitary hGH gene (hGH-N/GH1) expression is regulated is important in our understanding of the role hGH plays in physiology and disease. Here we assess for the first time the effect of sleep deprivation (SD) and high-fat diet (HFD) on hGH-N expression in vivo using partially humanized 171hGH/CS transgenic (TG) mice, and attempted to elucidate a role for DNA methylation. Activation of hGH-N expression requires interactions between promoter and upstream locus control region (LCR) sequences including pituitary-specific hypersensitive site (HS) I/II. Both SD and diet affect hGH secretion, but the effect of SD on hGH-N expression is unknown. Mice fed a HFD or regular chow diet for 3 days underwent SD (or no SD) for 6 h at Zeitgeber time (ZT) 3. Serum and pituitaries were assessed over 24 h at 6-h intervals beginning at ZT 14. SD and HFD caused significant changes in serum corticosterone and insulin, as well as hGH and circadian clock-related gene RNA levels. No clear association between DNA methylation and the negative effects of SD or diet on hGH RNA levels was observed. However, a correlation with increased methylation at a CpG (cytosine paired with a guanine) in a putative E-box within the hGH LCR HS II was suggested in situ. Methylation at this site also increased BMAL1/CLOCK-related nuclear protein binding in vitro. These observations support an effect of SD on hGH synthesis at the level of gene expression.

Smart coatings have aroused a growing interest because of the performance of predefined surface functions upon reacting to external stimuli. Among them, responsive polymer coatings to water, which often benefit from the presence of a mobile hydrophilic material, are of great interest. Polyurethanes (PUs) are versatile materials with respect to the structure-property relationship. Therefore, the incorporation of hydrophilic segments in PUs is a rational way to produce water-sensitive smart coatings; however, having a considerable amount of hydrophilic material deteriorates the physical properties because of a large amount of water uptake. In this study, we have analyzed previously synthesized smart PUs, based on hydrophobic polycarbonate (PC) and hydrophilic polyethylene glycol (PEG) soft segments, in which only a limited amount of PEG is used. These coatings maintain, more or less, zero water contact angle, whereas the water uptake remains below 15 wt %. The combination of experimental analysis and coarse-grained molecular dynamics (CG MD) simulations reveals that PEG segments migrate to the coating/water interface and partially cover the surface, whereas the hydrophobic nature of the PC keeps the bulk of the coating intact when the coating is covered with water. Moreover, our CG MD simulations and experimental analysis suggest a reversible phase arrangement under wet/dry cycles on molecular and macroscopic scales.

One of the historical periods of Iran that can be studied for contagious diseases and how they spread, is the late Qajar period. The city of Mashhad, after Tehran and Tabriz, had a special place among Russian and English governments in the Qajar period as one of the significant religious, political and economic centers in Iran due to Imam Reza's holy shrine, a large population and great geographical scale. The central governments' incompetence in preventing the outbreak of contagious diseases and lack of essential amenities, caused many lives to be lost all over Iran and especially Mashhad during the Qajar period. Hence, the neighbor governments such as Russia, ordered for quarantines to be set up at the borders and dispatched doctors to stop diseases' from reaching Russian lands. However, these attempts did not prevent the deaths of people in the border areas, especially in Mashhad, from diseases such as cholera, plague, smallpox, typhus, flu and other diseases. In this study, we investigate and explain the subjects: disease outbreaks, the problem of commerce, quarantine and its outcomes at the end of Qajar period, between the years 1892 and 1921 AD in Mashhad, with the help of historical and documentary sources using an analytical and medical historiography method., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: The use of phenotypic parameters along with other noninvasive diagnostic modality can lead to early diagnosis of coronary artery disease (CAD) and prevent its life-threatening outcome. Recently, the application of head and face components for assessing the risk for CAD much attention has been paid. The present study aimed to assess the relationship between ear characteristics (transverse groove on the earlobe and hair growth on the ear) and the risk for CAD and its severity among Iranian patients., Materials and Methods: In this cross-sectional study, the study population consisted of 105 consecutive patients with suspected CAD undergoing coronary angiography. The severity of CAD was determined by the number of disease vessels as well as the presence of left main lesions assessed by coronary angiography. All patients were examined to evaluate the appearance of ear regarding the presence of transverse groove on the earlobe and hair growth on the ear., Results: Comparing cardiovascular parameters across the groups with and without transverse groove on the earlobe showed a higher rate of CAD as well as the higher number of involved coronary arteries than in the groups without transverse groove on the earlobe. Similarly, the presence of CAD and its higher severity were more revealed in patients with hair growth on the ear as compared to the group without this phenotype. According to multivariable logistic regression analysis and with the presence of baseline parameters, the presence of transverse groove on the earlobe and hair growth on the ear increased the risk for CAD by 2.4 and 4.4 fold, respectively., Conclusion: Along with classic cardiovascular risk factors, the role of growing hair on the ear and transverse groove on the ear to predict high risk for CAD should be considered., (Copyright© 2020, Galen Medical Journal.)

Background: There is still a controversy in the preferred method of reperfusion in acute ST-segment elevation myocardial infarction (STEMI), when the achievement of well-defined "golden time" is difficult. We sought to evaluate the procedural and in-hospital outcomes of the strategy of "thrombolytic administration and rescue or routine percutaneous coronary intervention (PCI)" versus "primary PCI (PPCI)" strategy in acute STEMI., Methods: In this observational prospective study, the data of 237 patients with acute STEMI presented or referred to Chamran Cardiovascular Research Center in Isfahan, Iran, were collected (PROVE/ACS study). Baseline characteristics, thrombolysis in myocardial infarction (TIMI) flow grade of infarct-related artery (IRA), left ventricular ejection fraction (LVEF), and in-hospital outcomes were evaluated., Results: The mean age of patients was 61.4 ± 13.0 years, 86.9% were men, 13.1% were diabetic, and 67.9% had anterior STEMI. Patients in the "thrombolytic then PCI" group were younger, more smoker, more often male with higher body weight and lower systolic blood pressure (SBP). The pre-PCI TIMI flow grade 3 was more often seen in the "thrombolytic then PCI" group (39.4% vs. 21.0%, P < 0.001) and less thrombectomy was performed in this group of patients (12.9% vs. 26.7%, P = 0.011). Time to reperfusion was significantly longer in PPCI group (182.4 ± 233.7 minutes vs. 44.6 ± 93.4 minutes, respectively, P < 0.001). No difference in mortality, mean of LVEF, and incidence of atrial fibrillation (AF) was observed in two groups., Conclusion: If the PPCI strategy could not be performed in the golden time, the strategy of thrombolytic administration and rescue or routine PCI leads to more initial IRA patency and less thrombectomy with similar clinical outcomes., (© 2020 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.)

Background: Therapeutic humanized IgG1 kappa monoclonal antibody (t-mAb), daratumumab (DARA) is a Food and Drug Administration approved drug for the treatment of relapsed/refractory plasma cell myeloma (PCM). DARA appears on serum protein electrophoresis (SPEP) and on serum immunofixation (sIFE) as an IgG kappa monoclonal immunoglobulin protein (M-protein), complicating the assessment of the patients' response to therapy. A more ominous threat to patient safety can occur with the misinterpretation of the presence of a small t-mAb spike as being the residual product of the patient's neoplastic clone, presented either as oligoclonality or new clonality, which could result in incorrect interpretation of failure to achieve remission., Methods: In this report, we describe a novel and cost-effective technique based on biotinylated recombinant CD38 and streptavidin-coated magnetic beads to capture and remove residual DARA present in PCM patient serum samples. The treated samples are then run like regular samples on SPEP and sIFE. We validated this simple technique in DARA-spiked PCM samples and patient samples on DARA treatment., Results: Our simple capture technique completely extracted DARA in all of the tested serum specimens and allowed the assessment of residual M-protein without DARA interference. The results were reproducible and highly specific for DARA, and did not have any impact on endogenous M-protein migration and quantification by SPEP and sIFE. The cost of this technique is much lower and it can be performed in-house with a very short turnaround time compared to the currently available alternative methods. There is a great need for such reflex technologies to avoid interpretation errors., Conclusions: This method is an effective way to eliminate DARA interference in SPEP and sIFE, and can be easily implemented in any clinical laboratory without any patent restriction. This simple technique can be adopted for other t-mAbs using their respective ligands and will help to reduce additional doses of toxic treatment and further testing in patients on t-mAbs with a false positive M-protein spike.

Objectives: In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count., Background: Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing., Methods: The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients' clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed., Results: Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004)., Conclusion: High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aims/hypothesis: Long non-coding RNAs (lncRNAs) are garnering increasing attention for their putative roles in the pathogenesis of chronic diseases, including diabetic kidney disease (DKD). However, much about in vivo lncRNA functionality in the adult organism remains unclear. To better understand lncRNA regulation and function in DKD, we explored the effects of the modular scaffold lncRNA HOTAIR (HOX antisense intergenic RNA), which approximates chromatin modifying complexes to their target sites on the genome., Methods: Experiments were performed in human kidney tissue, in mice with streptozotocin-induced diabetes, the db/db mouse model of type 2 diabetes, podocyte-specific Hotair knockout mice and conditionally immortalised mouse podocytes., Results: HOTAIR was observed to be expressed by several kidney cell-types, including glomerular podocytes, in both human and mouse kidneys. However, knockout of Hotair from podocytes had almost no effect on kidney structure, function or ultrastructure. Glomerular HOTAIR expression was found to be increased in human DKD, in the kidneys of mice with streptozotocin-induced diabetes and in the kidneys of db/db mice. Likewise, exposure of cultured mouse podocytes to high glucose caused upregulation of Hotair expression, which occurred in a p65-dependent manner. Although HOTAIR expression was upregulated in DKD and in high glucose-exposed podocytes, its knockout did not alter the development of kidney damage in diabetic mice. Rather, in a bioinformatic analysis of human kidney tissue, HOTAIR expression closely paralleled the expression of its genic neighbour, HOXC11, which is important to developmental patterning but which has an uncertain role in the adult kidney., Conclusions/interpretation: Many lncRNAs have been found to bind to the same chromatin modifying complexes. Thus, there is likely to exist sufficient redundancy in the system that the biological effects of dysregulated lncRNAs in kidney disease may often be inconsequential. The example of the archetypal scaffold lncRNA, HOTAIR, illustrates how lncRNA dysregulation may be a bystander in DKD without necessarily contributing to the pathogenesis of the condition. In the absence of in vivo validation, caution should be taken before ascribing major functional roles to single lncRNAs in the pathogenesis of chronic diseases.

Background : Over-prescription and overuse of antibiotics are a major cause of concern in terms of healthcare and economic implications, as well as the emergence of microbial resistance worldwide. So far, efforts have been administered by many countries to regulate the consumption of antibiotics and overcome the rapid emergence of resistant bacteria. Assessment of the perspectives and behavior of physicians can play a major role in achieving this objective. Objectives : The objective of the present study was to assess the perspectives on the antibiotic prescription practice of physicians and evaluate their tendency to receive feedback on their performance in outpatient settings. Materials and methods : Attitudes and practices of 330 physicians on antibiotics prescription were evaluated using a validated questionnaire in 2014 in Mashhad, Iran. Results : 94% of physicians asserted that the prescription rate of antibiotics in Iran is higher than the global average. Physicians noted that "patients' tendency to prescribe antibiotics" is the primary reason of excessive prescription of antibiotics. Approximately, 84% of physicians were keen on receiving performance feedback. More than 71% of participants specified Short Message Service (SMS) notification as their preferred medium for receiving feedback. Conclusions : The dominant viewpoint of physicians was that the rate of antibiotics prescription in Iran is larger than the global average, which can lead to adverse economic and bacterial resistance consequences. Interventions such as 'performance feedback' have the potential to reduce antibiotics over-prescription.

Coronary artery disease (CAD) is a multifactorial chronic inflammatory disease, which is the most common form of heart disease. This is one of the main causes of death in the United States. Inflammation is one of the key drivers of atherosclerotic plaque development. Forkhead box protein O1 (FOXO1s) family and 5-lipoxygenase make an important contribution to atherosclerosis. The aim of this study was to investigate the methylation pattern and polymorphism analysis of FOXO1 and arachidonate 5-lipoxygenase (ALOX5) promoter genes. We studied 50 patients with CAD and 50 age- and sex-matched healthy controls by high resolution melt technique. Overall, we found significant differences between patients and controls in terms of the promoter methylation of ALOX5 (P > 0.05). But there was no significant difference in FOXO1 promoter methylation between patient and controls. Single nucleotide polymorphisms genotyping of rs12762303 and rs2297627, in ALOX5 and FOXO1 genes were demonstrated a significant correlation between mutant allele and the risk of CAD, respectively. Furthermore, there were significant associations between CT + CC genotype and ALOX5 expression. Our findings demonstrated functional effects of single nucleotide polymorphisms (SNPs) and DNA methylation in ALOX5 on mentioned genes expression and they resulted in CAD progression., (© 2019 Wiley Periodicals, Inc.)

Online appointment scheduling systems have been designed in response to the problems of the traditional ones. In Iran, most outpatient clinics and our study population suffer from high patient' no-show rate and long waiting times because of not using online appointment scheduling system. In this study, the effect of an online appointment scheduling system was investigated by comparing the evaluation metrics of appointment scheduling before and after the intervention. This before-after pilot study was conducted on ten outpatient clinics with different specializations. Five clinics were selected as the intervention group and five clinics as the control group. A checklist was designed to evaluate appointment scheduling metrics. These checklists were completed from April to July 2017 in the pre-implementation phase and from September to December 2017 in the post-implementation phase. The evaluation metrics were evaluated before and after the implementation of the online appointment scheduling system. A total of 470 checklists containing 9034 patients' information and 460 checklists containing 9130 patients' information were completed at the pre- and post-implementation phases, respectively. There were significant positive effect on the improvement of the three metrics means, including Patient waiting time (38.2 min before vs. 23.8 min after the intervention), No-show rate (25% before vs. 11% after the intervention), and Physician punctuality (-30 min before vs. -14.2 min after the intervention). The use of an online appointment scheduling system was successful in improving several evaluation metrics in our target population and resulted in continued usage in intervention group clinics.

Purpose: To study the incidence of endophthalmitis after pars plana vitrectomy, its causative organisms, and visual acuity outcomes., Patients and Methods: In this retrospective, comparative study, the medical records of patients with acute-onset postoperative endophthalmitis after pars plana vitrectomy at Farabi Eye Hospital, Tehran, Iran, during a 12-year period between January 2004 and November 2015 were reviewed. To compare the endophthalmitis patients with other cases who underwent pars plana vitrectomy at the same day and also the same operating room, a control group was developed by gathering the data from surgical records., Results: In the present study, the incidence rate of pos- vitrectomy endophthalmitis was 0.04% (16/39783). The organisms identified in aqueous or vitreous cultures (culture positive 44%) included Streptococcus pneumoniae (two patients, 12.5%), Pseudomonas aeruginosa (two patients, 12.5%), fungi (two patients, 12.5%), and Streptococcus viridans (one patient, 6.25%). Visual acuity after treatment for endophthalmitis ranged from light perception (7 eyes) to hand motion (1 eye), and evisceration was performed in 8 eyes (50%). When comparing the cases (patients developing endophthalmitis) and controls (patients with no complications operated in the same day and place of operation with the case group), only not using tamponade showed a statistically significant relation with the occurrence of endophthalmitis (p = 0.034)., Conclusion: Our results indicated low incidence of endophthalmitis after pars plana vitrectomy comparable to previous studies which resulted in poor visual acuity. It seems that not using tamponade might increase the risk of endophthalmitis among these patients.