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Post-Liver transplantation (LT) survival rates stagnate, with biliary complications (BC) as a major cause of death. We analyzed longitudinal data with a median 19-month follow-up. BC was diagnosed with ultrasounds and MRCP. Missing data was imputed using mean and median. Data preprocessing involved feature scaling and one-hot encoding. Survival analysis used filter (Cox-P, Cox-c) and embedded (RSF, LASSO) feature selection methods. Seven survival machine learning algorithms were used: LASSO, Ridge, RSF, E-NET, GBS, C-GBS, and FS-SVM. Model development employed 5-fold cross-validation, random oversampling, and hyperparameter tuning. Random oversampling addressed data imbalance. Optimal hyperparameters were determined based on average C-index. Features importance was assessed using standardized regression coefficients and permutation importance for top models. Stability was evaluated using 5-fold cross-validation standard deviation. Finally, 1799 observations with 40 outcome predictors were included. RSF with Ridge achieved the highest performance (C-index: 0.699) for BC prediction, while RSF with RSF had the highest performance (C-index: 0.784) for mortality prediction. Top BC predictors were LT graft types, IBD in recipients, recipient's BMI, recipient's history of PVT, and previous LT history. For mortality, they were post-transplant AST, creatinine, recipient's age, post-transplant ALT, and tacrolimus consumption. We identified BC and mortality risk factors, improving decision-making and outcomes. [ABSTRACT FROM AUTHOR]

Objective: Self-report of the use of complementary and integrated medicine by patients with Multiple Sclerosis (MS) can minimize the risk of possible side effects and drug interactions. This study aimed to survey the self-reported use of complementary and integrated medicine by patients with MS in Iran. Methods: This is an analytical cross-sectional study conducted in spring 2020 on 577 patients with MS who were selected from the Fars MS Disease Registry using a simple random sampling method. Data were collected using a standardized questionnaire and interview, and analyzed in SPSS v. 12 software. Results: There was a significant difference between the self-reported use of complementary and integrated medicine and patients’ gender, marital status, employment status, level of education and the complications of the disease (P≤0.05). Overall, 97% of participants had used at least one of the complementary and integrated medicine items, however, only two-thirds of them declared their use to the physician. The most common used complementary and integrated medicine items were herbal medicines and dietary supplements. Conclusion: Most of MS patients in Shiraz use complementary and integrated medicine. The declaration of the use of these treatments by MS patients may play a role in strengthening the physician-patient relationship as well as strengthening evidence-based policy and better management of MS.

Background: Bacterial infections are the leading cause of death in newborns. The growing resistance of bacteria to antibiotics is a major concern. In this study, we identified isolates from blood cultures in the neonatal intensive care unit (NICU) of a major referral hospital in Shiraz in southwest Iran and determined antibiotic resistance patterns. Methods: All newborns admitted to the NICU were evaluated in a four-year study. The blood samples were cultured using a BACTEC system. From May 2015 to March 2020, 5937 blood culture samples were analyzed. The antibacterial sensitivity test was conducted using the disk diffusion method, following the guidelines of Clinical & Laboratory Standards Institute (CLSI) 2018. Results: In this study, 507 isolates were obtained from 5937 specimens. The most commonly isolated gram-negative bacteria were Acinetobacter (8.7%), Escherichia coli (5.7%), Klebsiella (1.6%), Enterobacter (1.4%), and Pseudomonas (0.9%). Among the gram-positive bacteria, coagulase-positive staphylococci (51.1%), coagulase-negative staphylococci (15.4%), Staphylococcus epidermidis (10.2%), non-hemolytic streptococci (2.4%), alpha-hemolytic streptococci (1.4%), and Streptococcus pneumonia (1.3%) were the most frequently isolated bacteria. Of the 318 Staphylococcus aureus isolates, 88.5% were resistant to methicillin. Conclusion: Staphylococcus, with a high frequency in the NICU, can be an alarm for medical centers. Also, in dead infants, the most observed bacterial infection was Acinetobacter infection, which requires the serious attention of the hospital infection control unit. [ABSTRACT FROM AUTHOR]

Primary biliary cholangitis (PBC), formerly known as primary biliary cirrhosis, is a liver disease. This is a chronic autoimmune disease, which can worsen over time and recur periodically. If left untreated, biliary cirrhosis may lead to liver failure. Considering that PBC is a rare disease in all age groups, especially in children, the purpose of this report was to describe a girl with hepatitis A virus (HAV) who was then diagnosed with PBC. This child is the first case reported in Iran. The patient is a 7-year-old girl with a pale complexion and eyes with a yellowish cross who was referred to the doctor. Considering that this patient had hepatitis, a blood test was requested to check the level of cholesterol and liver enzymes. The absence of cholestatic liver enzymes was observed in tests. Then, an anti-mitochondrial (AMA) test was requested for the patient, the result of which was negative. Finally, with imaging and biopsy, the diagnosis of PBC was confirmed for the patient. After the definite diagnosis of the disease, the child was treated with ursodeoxycholic acid (UDCA). The child in question is suffering from two medical and immunological diseases, HAV and PBC. Since this child was first infected with HAV, it is possible that the cause of PBC was HAV. [ABSTRACT FROM AUTHOR]

Patient variants in Tubby Like Protein-3 (TULP3) have recently been associated with progressive fibrocystic disease in tissues and organs. TULP3 is a ciliary trafficking protein that links membrane-associated proteins to the intraflagellar transport complex A. In mice, mutations in Tulp3 drive phenotypes consistent with ciliary dysfunction which include renal cystic disease, as part of a ciliopathic spectrum. Here we report two sisters from consanguineous parents with fibrocystic renal and hepatic disease harboring a homozygous missense mutation in TULP3 (NM_003324.5: c.1144C>T, p.Arg382Trp). The R382W patient mutation resides within the C-terminal Tubby domain, a conserved domain required for TULP3 to associate with phosphoinositides. We show that inner medullary collecting duct-3 cells expressing the TULP3 R382W patient variant have a severely reduced ability to localize the membrane-associated proteins ARL13b, INPP5E, and GPR161 to the cilium, consistent with a loss of TULP3 function. These studies establish Arginine 382 as a critical residue in the Tubby domain, which is essential for TULP3-mediated protein trafficking within the cilium, and expand the phenotypic spectrum known to result from recessive deleterious mutations in TULP3. [ABSTRACT FROM AUTHOR]

The esophagus is the gastrointestinal tract's primary organ that transfers bolus into the stomach with peristaltic motion. Therefore, its lesions cause a significant disturbance in the nutrition and digestive system. Esophageal disease treatment sometimes requires surgical procedures that involve removal and circumferential full-thickness replacement. Unlike other organs, the esophagus has a limited regeneration ability and cannot be transplanted from donors. There are various methods of restoring the esophageal continuity; however, they are associated with certain flaws that lead to a non-functional recovery. As an exponentially growing science, tissue engineering has become a leading technique for the development of tissue replacement to repair damaged esophageal segments. Scaffold plays a significant role in the process of tissue engineering, as it acts as a template for the regeneration of growing tissue. A variety of scaffolds have been studied to replace the esophagus. Due to the many tissue quality challenges, the results are still inadequate and need to be improved. The success of esophageal tissue regeneration will finally depend on the scaffold's capability to mimic natural tissue properties and provide a qualified environment for regeneration. Thereby, scaffold fabrication techniques are fundamental. This article reviews the recent developments in esophageal tissue engineering for the treatment of circumferential lesions based on scaffold biomaterial engineering approaches. [ABSTRACT FROM AUTHOR]