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Abstract Background The Patient Assessment of Chronic Illness Care (PACIC-5As) questionnaire has been designed to evaluate the healthcare experiences of individuals with chronic diseases such as diabetes. Older adults are at higher risk for diabetes and its associated complications. The aim of this study was transcultural adaptation and evaluation of the validity and reliability of the PACIC-5As questionnaire in older patients with diabetes residing in Qazvin City, Iran. Method In this validation study, we recruited 306 older patients with diabetes from Comprehensive Health Centers in Qazvin, Iran. The multi-stage cluster sampling technique was used to choose a representative sample. The PACIC-5As questionnaire was translated into Persian using the World Health Organization (WHO) standardized method. The validity (face, content, and construct) and reliability (Cronbach’s alpha) of the PACIC-5As were assessed. Data analysis was conducted using R software and the Lavaan package. Results The mean age of the older patients was 69.99 ± 6.94 years old. Most older participants were female (n = 180, 58.82%) and married (n = 216, 70.59%). Regarding face validity, all items of PACIC-5As had impact scores greater than 1.5. In terms of content validity, all items had a content validity ratio > 0.49 and a content validity index > 0.79. The results of confirmatory factor analysis demonstrated that the model exhibited satisfactory fit across the expected five factors, including assess, advise, agree, assist, and arrange, for the 25 items of the PACIC-5As questionnaire. The Cronbach’s alpha coefficient for the PACIC-5As questionnaire was 0.805. Conclusion This study indicates that the Persian version of the PACIC-5As questionnaire is valid and reliable for assessing healthcare experiences in older patients with diabetes. This means that the questionnaire can be effectively used in this population.

Description of the subject. The present study explains an Agrobacterium-mediated transformation method for chicory based on shoot regeneration medium containing no selective compounds (a non selection approach). Objectives. The aim of this experiment was to generate transgenic chicory plants on a shoot induction medium without selective compounds and study the inheritance of the integrated transgene. Method. Leaf explants were collected from in vitro grown seedlings of cultivar 'Melci'. Explants were inoculated with Agrobacterium harboring the pTJK136 plasmid. Callus induction and shoot regeneration were performed on the medium containing no antibiotics. Three separate transformation experiments were carried out. The presence of the transgene in regenerated plants (T0 and T1) was examined by PCR and RT-PCR. Furthermore, the regeneration frequency and transformation efficiency were separately calculated for each experiment. Results. Analytical results indicate that significant numbers of regenerated shoots recovered on a medium containing no selection agent are putative transformants. Screening of the regenerated plants from triplicate experiments revealed a remarkable transformation efficiency (up to 9%). Reverse transcription PCR (RT-PCR) analysis confirmed the correct expression of the transgene in the transformed plants and thus a stable integration in the genome. Additionally, to corroborate this last point, the transgene is successfully transmitted to the next generation (T1). Conclusions. Results confirmed the possibility of generating marker-free genetically modified plants in the form of a non-selection transformation system.

Abstract Background and aims A healthy diet play an important role in the prevention and even treatment of various diseases. Proper nutrition plays an important role in boosting of immune system. These include the consumption of macronutrients such as proteins, lipids, carbohydrates, and also micronutrients including vitamins. Here, we aimed to systematically review the effects of macronutrients and micronutrients on the prevention and treatment of COVID-19. Methods We searched the databases of PubMed, Scopus, Embase, and Web of Science on December 23, 2023. The records were downloaded into an EndNote file, the duplicates were removed, and the studies underwent a two-phase screening process based on their title/abstracts and full texts. The included articles were screened and underwent inclusion and exclusion criteria. We included the English systematic reviews and meta-analyses that concurred with the aim of our study. The selected articles were assessed by Cochrane's Risk of Bias in Systematic Reviews for the quality check. The data of the eligible studies were extracted in a pre-designed word table and were used for the qualitative synthesis. Results A total of 28 reviews were included in this study. Most studies have shown that micronutrients are effective in morbidity and mortality controlling in viral respiratory infections such as COVID-19 but some studies have shown that micronutrients are sometimes not effective in controlling severity. On the other hand, calcifediol was by far the most successful agent in reducing intensive care needs and mortality between studies. Conclusion Individuals without malnutrition had a reduced risk of SARS-CoV-2 infection and severe disease. The administration of Vitamin D is effective in reducing the morbidity and mortality of COVID-19 patients. Patients with vitamin D deficiency were more prone to experience severe infection, and they were at higher risk of morbidities and mortality. Other micronutrients such as Vitamin A, Vitamin B, and Zinc also showed some benefits in patients with COVID-19. Vitamin C showed no efficacy in COVID-19 management even in intravenous form or in high doses.

Background and Aim: Helicobacter pylori is one of the most common human infections. Although the association between H.pylori infection and Alzheimer's disease has been suggested in some studies, few studies have dealt with the association between Helicobacter pylori infection and memory function. The aim of this study was to evaluate the memory function in the students with H.pylori infection. Material and Methods: This case-control study was performed in Sanandaj universities. 106 H.pylori positive and 119 H. pylori negative students were compared using Wechsler memory test. In order to analyze the data, independent t-test and multiple regression were used. Results: The results of this study showed that there was no statistically significant relationship between Wechsler memory final score and H.pylori infection (p = 0.24). But there was a statistically significant relationship between the visual memory subscale (p = 0.01) and mental control (p =0.003). By controlling the confounding effect of age, H. pylori had a negative effect on mental control (P = 0.03). Also, male gender (p = 0.02) and Helicobacter pylori infection (p = 0.007) had a negative effect on the visual memory. Conclusion: In our study H.pylori infection was not significantly related to the overall memory function of the individuals, but due to the association of this infection with some subscales of memory, further studies are recommended.

Abstract Combination of different power cycle scenarios is of prime importance in achieving maximum energy utilization from solar‐driven multigeneration systems. To fulfill such objective, the present article proposes a novel energy distribution system, leveraging a combination of direct‐fed organic Rankine cycle (ORC) and a bottom‐cycled arrangement of Kalina cycle system (KCS) and double‐effect absorption refrigeration cycle (DEARC) within a parabolic trough solar collector powered trigeneration system. The study explores three different ORC configurations: simple ORC; ORC equipped with internal heat exchanger (ORC‐IHE) and regenerative ORC (RORC). It is shown that although higher efficiencies are achievable from a larger portion of PTSC energy absorbed by the ORC, the ORC energy absorption is limited by ORC evaporator temperature differences, and there is unused energy that can be recovered by the KCS, based on the proposed energy system. The results indicate that the addition of bottoming KCS leads to a considerable increase in the exergy efficiency of ORC, ORC‐IHE and RORC‐based systems by 11.7%, 30.7% and 32.6%, respectively. The impact of different ORC configurations, key ORC parameters and various organic working fluids on the energetic/exergetic efficiencies is also examined to find the optimal configuration. In terms of overall energetic/exergetic efficiencies, the highest performance belongs to ORC (78.4%/30.4%) while the lowest energetic and exergetic efficiencies belong to ORC‐IHE and RORC, respectively (56.3% and 25.65%). On the basis of a comparative study with the available literature, these values are higher than what is already reported for similar solar‐driven multigeneration systems. Appropriate thermal match and lower exergy destruction in the KCS, and bottoming cycle arrangement of the DEARC are the main reasons for such enhanced performance. This research not only contributes valuable insights into efficient solar‐driven systems but also sets a new benchmark for performance metrics in the existing literature.

Abstract Background Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic relapsing-remitting systemic disease of the gastrointestinal tract with rising incidence. Studies have shown that adipocytes play a crucial role in patients with IBD by actively participating in systemic immune responses. The present study was designed to investigate the correlation between the circulatory levels of resistin, as an adipokine, and active and remission phases of IBD in comparison with healthy controls. Methods Relevant articles were retrieved from PubMed, Embase, the Web of Science, and Scopus from inception until June 2023. Estimation of the standardized mean difference (SMD) and 95% confidence interval (CI) for comparison of plasma/serum resistin levels between IBD patients, patients in remission, and healthy controls were conducted through random-effect meta-analysis. Results A total of 19 studies were included, assessing 1836 cases. Meta-analysis indicated that generally, serum/plasma resistin levels were higher in IBD patients in comparison with healthy controls (SMD 1.33, 95% CI 0.58 to 2.08, p-value

Objective: To develop a predictive model of incidence of traumatic spinal cord injury (TSCI). Methods: The data for training the model included both the incidence data and the covariates. The incidence data were extracted from systematic reviews and the covariates were extracted from data available in the international road federation database. Then the feature processing measures were taken. First we defined a hyper-parameter, missing-value threshold, in order to eliminate features that exceed this threshold. To tackle the problem of overfitting of model we determined the Pearson correlation of features and excluded those with more than 0.7 correlation. After feature selection three different models including simple linear regression, support vector regression, and multi-layer perceptron were examined to fit the purposes of this study. Finally, we evaluated the model based on three standard metrics: Mean Absolute Error, Root Mean Square Error, and R2. Results: Our machine-learning based model could predict the incidence rate of TSCI with the mean absolute error of 4.66. Our model found “Vehicles in use, Total vehicles/Km of roads”, “Injury accidents/100 Million Veh-Km”, “Vehicles in use, Vans, Pick-ups, Lorries, Road Tractors”, “Inland surface Passengers Transport (Mio Passenger-Km), Rail”, and ''% paved” as top predictors of transport-related TSCI (TRTSCI). Conclusions: Our model is proved to have a high accuracy to predict the incidence rate of TSCI for countries, especially where the main etiology of TSCI is related to road traffic injuries. Using this model, we can help the policymakers for resource allocation and evaluation of preventive measures.

Abstract Background and objective Management of recurrent acromegaly is challenging for both neurosurgeons and endocrinologists. Several treatment options including repeat surgery, medical therapy, and radiation are offered for such patients. The efficacy of these modalities for the treatment of recurrence has not been studied previously in the literature. In this study, we aim to systematically review the existing cases of recurrence and come to a conclusion regarding the appropriate treatment in such cases. Method A systematic review was performed through PubMed, Scopus, Web of Science, and Cochrane database to identify studies reporting the treatment outcome of recurrent acromegaly patients. Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the included studies were reviewed for primary and secondary treatment, complications, and outcomes of the secondary treatment. Results The systematic review retrieved 23 records with 95 cases of recurrent acromegaly. The mean time of recurrence was 4.16 years after the initial treatment. The most common primary treatment was surgery followed by radiotherapy. The remission rate was significantly higher in medical and radiotherapy compared to surgical treatment. Conclusion In cases of recurrent acromegaly, the patient may benefit more from radiotherapy and medical therapy compared to surgery. As the quality of evidence is low on this matter feature studies specifically designed for recurrent patients are needed.

BACKGROUND: Clinical training in the internship unit is the heart of professional training, and teaching assistants can be considered an essential component in the clinical training program. Therefore the present study was conducted to investigate the effect of teaching assistants (TA) on the degree of satisfaction of undergraduate students of Anesthesia with training in the internship unit. MATERIALS AND METHODS: This descriptive-cross-sectional study was conducted in 2023. The sample of the research was the Anesthesia undergraduate students who were included by census method. First, a questionnaire was designed and psychometric to check the level of satisfaction (ICC = 0.992). then it was given to students who had completed at least 1 unit of internship with TAs. The results were analyzed with SPSS software Version 22 and one-way-ANOVA and independent t-statistical tests (P Value

Abstract People living with human immunodeficiency virus (HIV) (PLWH) appear to be at an increased risk of sarcopenia, which can have a devastating effect on their life due to consequences such as physical disability, poor quality of life, and finally death. This systematic review examined sarcopenia prevalence and its associated factors in PLWH. A systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, Embase and Cochrane databases from the dates of inception up to May 2022. The retrieved articles underwent a two‐step title/abstract and full‐text review process, and the eligible papers were selected and included in the qualitative synthesis. Data relating to the study population, purpose of study, gender, age, race, body mass index, medical history, paraclinical results and antiretroviral therapy as associated factors of sarcopenia were extracted. In addition, the prevalence of sarcopenia in PLWH and its promoting and reducing factors were also extracted. We reviewed the 14 related studies for identifying of sarcopenia prevalence and its associated factors in PLWH. The total number of PLWH in all the reviewed studies was 2592. There was no criterion for the minimum number of people with HIV and the lowest number of PLWH was 27, and the highest number was 860. Some studies reported a significantly higher prevalence of sarcopenia in HIV‐infected individuals compared with HIV‐negative controls as follows: 24.2–6.7%, 15–4% and 10–6%, respectively. We showed that, age (30–50 years), being female, >5 years post‐HIV diagnosis, multiple vertebral fractures, cocaine/heroin use and lower gamma‐glutamyl transferase level were the main promoting factors of sarcopenia. Higher educational level, employment, physical exercise, calf circumference >31 cm, and gait speed >0.8 m/s were also factors to reduce sarcopenia. Sarcopenia prevalence in PLWH is higher than HIV‐negative population. Given the importance and prevalence of sarcopenia among PLWH and its associated consequences (i.e., mortality and disability), determining its risk factors is of great importance.

Abstract Technically, residential energy management systems are fundamental sectors in the smart grids for implementing demand response programs in the layer of households for managing energy consumption and reducing energy bills. The paper proposes a novel energy management scheme that takes production and usage into account based on a heuristic searching operation. In addition to modelling the grid, renewable energy sources, batteries, and electric vehicles, various kinds of electrical and thermal devices have been examined, including air conditioners, water heaters, vacuum cleaners etc. A method is developed for solving the objective constraint issue in a smart home in order to reduce energy consumption and determine feasible operation states among the various loads. Moreover, this paper proposes a grey wolf optimization method for solving the issue over a longer simulation period. Various cases were examined to evaluate the effectiveness of this suggested robust optimization algorithm. The outcomes show that the suggested model could not only reduce energy costs significantly but has also shown good performance for energy management purposes.

AbstractObjectiveThe aim of this study is to optimize tomato as a suitable plant system for transient gene transformation for the production of pharmaceutical and industrial compounds.Materials and methodsIn order to investigate transient gene expression, three concentrations of Agrobacterium in OD600 (0.4, 0.6 and 0.8), three times after inoculation (4, 7 and 10 days) and two conditions with the presence of p19 gene and without p19 were selected as factors affecting the gene expression. The vectors used in this research pXK2FS7 and pCAMBIA1304 contained GFP and P19 genes, respectively. For transient GFP transformation, leaves of seedlings were inoculated using agroinfiltration method. In this way, different concentrations of Agrobacterium containing pXK2FS7 vector and P19 vector were mixed together and the expression of GFP gene was investigated. All the leaves of tomato plants at the appropriate stage were injected by insulin syringe without needle on the lower surface of the leaf. In order to confirm the transfection of the GFP and its expression, RNA extraction, cDNA synthesis and the analysis of expression by Real-Time PCR were performed and the expression of the GFP protein with a fluorescence microscope was finally detected.ResultsThe results showed that the concentration of Agrobacteria, the number of days after inoculation, and the expression of the p19 had significant effects on the GFP expression. The expression of p19 as a suppressor of gene silencing mechanism led to higher GFP expression in comparison with the absence of p19. Additionally, it was found that dilution of 0.6OD600 Agrobacterium was the most suitable concentration for high expression of GFP agroinfiltration. Furthermore, the highest level of GFP expression was obtained 7 days after leaf inoculation. The best combination for maximum GFP expression at transcript level obtained at 0.6 OD600, 7 days after inoculation and expression of p19. ConclusionsThe results of this research can be used in preliminary studies or optimization of recombinant protein production in tomato leaves.