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Systemic sclerosis (SSc) is a rare immune-mediated rheumatic disease in which the skin, muscles, blood vessels, and internal organs are damaged through chronic inflammation. Interleukin-17 (IL-17) is a potent pro-inflammatory cytokine produced by T helper 17 (Th17) cells, and plays a critical role in many inflammatory conditions. This study aims to assess the salivary IL-17 levels in Iranian patients with SSc. In this cross-sectional study, unstimulated saliva samples were collected from patients with SSc (n=80) and age- and sex- matched healthy individuals (n=80). The salivary levels of IL-17 in all samples were measured using a commercially available enzyme–linked immunosorbent assay (ELISA) kit. The mean salivary levels of IL-17 in patients with SSc were significantly higher than the control group (199.6±38.9 pg/mL vs. 112.7±39.4 pg/mL, P

Introduction: Ischemic stroke (IS) is one of the three main fatal disorders and is a major health challenge. 4-methylumbelliferone (4-MU) is one of the coumarin derivatives (7–hydroxy‐4–methylcoumarin) with antioxidant and anti-inflammatory impact. This study was conducted to elucidate the neuroprotective effects and anti-inflammatory impact of 4-MU in a rodent model of IS. Methods: The IS model was induced by middle cerebral artery occlusion (MCAO) for 1 hour and reperfusion was established for 24 hours. 44 Male Wistar rats were assigned into four groups: (1) Sham, (2) MCAO (3) MCAO + Vehicle, and (4) MCAO + 4-MU (25 mg/kg). Evaluation of neurological deficit was performed using Garcia's score. 2,3,5-triphenoyl-2H-tetrazolium chloride (TTC) staining was employed to measure infarct size. Nissl staining was applied to determine neuronal loss. Moreover, western blotting was utilized to detect the expression of the proteins relevant to the TLR4/NF-κB/NLRP3 axis (p–NF–κB p65, TLR4, NLRP3, IL-1β, IL-10, IL-18, ASC, and Caspase-1). Results: It was observed that MCAO caused neurological deficit (P

Introduction The treatment of Behçet’s disease has improved significantly with the introduction of biologic therapies. However, there is still a need for more information about their use. This study aimed to evaluate the indications, response, and side effects of biologic agents in patients with refractory or severe Behçet’s disease in the south of Iran, their follow-up and reasons for changing the biologics. Material and methods A retrospective analysis was conducted on 44 patients aged 16–65 years who were prescribed biologic agents for at least 6 months. The clinical history, partial and complete remission at 6 and 12 months, occurrence of side effects, and need for switching to a second or third biologic agent were recorded. Results The most common indications for starting biologic agents were ophthalmic (68.2%), parenchymal brain involvement (15.9%), and arthritis (11.4%). Improvement was observed in various manifestations of Behçet’s disease, with complete remission in 86, 51.6, 92.8, 66.7, 42.9, 33.3, and 80.0% of oral aphthous lesions, ophthalmic activity, genital aphthous lesions, skin activity, arthritis, brain parenchymal lesions, and vascular activity, respectively, 6 months after starting biologic agents. These rates were unchanged or increased at the 12-month follow-up. In 25.0% of patients, a switch to a second biologic agent was necessary due to severe disease, side effects, or refractory disease. Side effects occurred in 16.3% and 33.3% of patients on the first and second biologic agents, respectively. The majority of side effects were not serious. Conclusions We found a promising improvement at 6-month and 12-month follow-ups with various biologic agents in treating Behçet’s disease with an acceptable safety profile.

Introduction: Lupus is a chronic systemic disorder with a complex etiology, and viral infections have contributed to its development and progression. Human herpesvirus-8 (HHV-8) has been diagnosed in many patients with autoimmune disorders; however, its role in lupus has not been well investigated. The present study aimed to compare the frequency and viral load of HHV-8 in patients with lupus and healthy population. Material & Methods: In this cross-sectional study, 70 patients with lupus and 70 healthy individuals who were matched for gender and age were included. After the extraction of viral DNA, the HHV-8 viral load was measured using the Real-time polymerase chain reaction (PCR) technique, and the results were analyzed by SPSS software. Results: Patients with lupus consisted of 59 females (84.3%) and 11 males (15.7%) with a mean age of 31.1±8.4 years, and the control group consisted of 58 females (82.9%) and 12 males (17.1%) with a mean age of 33.5±11.2 years, none of them were positive for HHV-8 genome. Discussion & Conclusion: To date, there is no report in this field from Iran, and this study is the first survey. Regarding the high accuracy of the Real-time PCR technique and lack of HHV-8 genome in the blood samples of Iranian patients with lupus, it seems that none of the individuals, even in the case of viral infection, were infected with the active form of HHV-8, which is compatible with the previous studies.

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease caused by genetic and environmental factors such as viral infections. Genomic and serologic tests were applied to detect significant blood-borne viruses in SLE patients to determine whether there was a possible association between viral infections and SLE. Methods: Antibodies (Abs) against HHV-8, HCMV, EBV, HIV, HBV, and HCV in SLE patients suffering from SLE were assessed by ELISA. In addition, HHV-8 DNA and HIV-1 RNA were quantified by real-time PCR, and the HCV and HBV genomes were detected using nested PCR. Results: Compared to those in the control group, a high prevalence of anti-HHV-8 (p

Introduction Overlap syndrome (OS) is a group of systemic connective tissue diseases (CTDs) that meet the criteria of two or more CTDs. In this study, we evaluated clinical, laboratory, and capillaroscopic manifestations of patients with scleroderma OS (SSc-OS) and its subgroups and follow-up progression compared to patients with limited SSc (LcSSc). Material and methods In a 10-year cross-sectional study, we evaluated 135 adult patients (70 with SSc-OS and 65 with LcSSc) with the same skin score for their baseline and follow-up clinical, laboratory, high-resolution chest tomography (HRCT), echocardiography, and nailfold capillaroscopy data and compared them. Results Of the 135 patients, 70 had SSc-OS, including 45 (64.3%) cases of SSc-SS (Sjögren’s syndrome), 11 (15.7%) of SSc-RA (rheumatoid arthritis), 9 (12.9%) of SSc-myositis and 5 (1.7%) of SSc-SLE (systemic lupus erythematosus), and 65 had LcSSc. Lung and heart involvement and pulmonary arterial hyper-tension (PAH) did not differ between the two groups ( p > 0.05). Musculoskeletal involvement and non-specific pattern of capillaroscopy were higher ( p = 0.035 and p = 0.001), and digital ulcer (DU) and scleroderma patterns of capillaroscopy were lower in the SSc-OS group ( p = 0.000). No significant relationship was found between capillaroscopic patterns and organ involvement in the two groups ( p -value > 0.05). In the follow-up (3.71 ±2.63 years), new DU and progression of lung involvement ( p = 0.002) and the progression in capillaroscopic patterns was lower in SSc-OS ( p = 0.000). In the follow-up, new DU was not seen in the SSc-OS, with lower progression of lung involvement, skin score, and capillary damage. Conclusions In SSc-OS patients, the most common subgroup was SSc-SS. Scleroderma OS was associated with lower major organ involvement and capillaroscopy progression than LcSSc. Major organ involvement in patients with SSc-OS was significantly lower than in LcSSc patients. In the follow-up, new DU was not seen in the SSc-OS with lower progression of lung involvement, skin score, and capillary damage.

As globalization increases and the international community moves toward greater interdependence, international learning experiences have become a core educational value for many American universities. Although there are various approaches to study abroad programming, the Semester at Sea (SAS) voyage is an understudied global education program. Using a sample of college students (N = 73), the present study examined differences between the cultural sensitivity and global mindedness scores of students prior to starting the SAS voyage and at the culmination of the voyage. The findings demonstrate significant increases in both global mindedness and cultural sensitivity at the completion of the program and support the positive role of cultural immersion experiences in student growth. Recommendations for future research and study abroad programming are also discussed.

BACKGROUND: Scleroderma is a complex multisystem disorder that could have effects on the quality of patients’ lives. This study was conducted by determining the psychometric properties of the Persian version of the systemic sclerosis questionnaire (SySQ) that specifically assesses indications and functional limitations of scleroderma patients. MATERIALS AND METHODS: In the present cross-sectional study, the method included: translation and back translation. Psychometric properties of the questionnaire including its content and face validity were assessed. Internal consistency with the SySQ (Cronbach’s alpha) and reproducibility was by test–retest method. The factor structure of the questionnaire was evaluated using exploratory factor analysis. The convergent validity of the SySQ was assessed using the General Health Assessment Scale (HAQ). RESULTS: Altogether 32 SySQ items, the internal consistency coefficient (Cronbach’s alpha) of the whole tool was 0.906. The content validity index was 0.98 and the content validity ratio was 0.796, there was a significant relationship between the questions and the relevant factors in the factor analysis. The correlation coefficient = 0.953 for the instrument. The correlation of SySQ dimensions with HAQ questionnaire dimensions in convergent validity showed that musculoskeletal dimensions, general condition, and cardiorespiratory of the questionnaire are correlated with all dimensions of the HAQ questionnaire. CONCLUSION: The Persian version of the questionnaire SySQ with competency is valid and reliable and is suitable for measuring specific changes in Persian systemic sclerosis patients.

This study aimed to design an educational guidance model for the students in the first period of secondary school students in Tehran. The field of research included experts in the field of academic guidance who were selected by purposeful sampling. The sample size after reaching the theoretical saturation stage was 21 people. A semi structure interview was applied to collecting data. Data analysis was through open, central and selective coding. The results revealed six dimentions and 18 components. In the first dimension (student), three components were identified include: 1- intelligence and talent 2- motivation, interest, desire and spirit of the student 3- abilities and skills. In the second (family) three components were identified include: 1- providing comprehensive information to parents 2- family economy 3- cultural and social background of parents. In the third dimension (the teacher) three components were identified include: 1- access to expert teachers 2- professional commitment of teachers in correct guidance 3- continuous training of teachers. In the fourth dimension (counselor) three components were identified include: 1- Desirable counseling and psychological services 2- Using an expert in the field of educational guidance planning 3- Improving the level of knowledge and qualification of educational guides. In the fifth identified dimension (school) three components were identified include: 1- Implementation of intelligence and talent tests 2- Academic records of students 3- Providing counseling and online tests. Finally in the sixth dimension (society) three components were identified include: 1- Considering the needs of the country 2- Guiding the student without compulsion, 3- Paying attention to the labor market. In general, our findings contribute to the development of an native model of educational guidance for use in the first period of secondary schools in Iran.

Post-collision Pliocene-Quaternary basaltic rocks outcrop in the Kerman Cenozoic Magmatic Arc (KCMA) to the northwest and east of Shahr-e-Babak city. These porphyritic and vesicular basaltic rocks are composed essentially of clinopyroxene, olivine, and plagioclase. These basalts display alkaline affinity and negative Ta, Zr, Rb anomaly, but slightly negative Nb anomaly, relative to elements with similar compatibility, and positive Ba, K, Sr anomaly, suggesting their magma source related to subduction-accretion with implication of subducted slab derived components to the source. In the primitive mantle and chondrite normalized diagrams, these rocks show trace elements (except depletion in Nb, Ta) and Rare Earth Element (REE) patterns similar to the Ocean Island Basalts (OIB) and share trace and major element characteristics similar to High-Nb Basalts (HNBs). Geochemical analyses for major and trace elements suggest that the Shahr-e-Babak HNBs have undergone insignificant crustal contamination and minor olivine + Fe-Ti oxide ±clinopyroxene fractional crystallization. These HNBs derived from a partial melting (~5%) of garnet-peridotite mantle wedge, which have already metasomatized by overlying sediments, fluids, and adakitic (slab-derived) melts as major metasomatic agents in post-collision setting in the KCMA. We conclude that asthenospheric upwelling arising from slab break-off followed by the roll-back of subducting Neotethys slab also triggered metasomatized peridotite mantle wedge and caused its partial melting in the subduction zone.

Abstract Background/objective Osteoporosis is a global health concern with an increasing prevalence worldwide. Denosumab is an antiresoptive agent that has been demonstrated to be effective and safe in osteoporotic patients. This study aimed to compare the efficacy and safety of the biosimilar denosumab candidate (Arylia) to the originator product (Prolia®) in postmenopausal osteoporotic patients. Methods In this randomized, double-blind, active-controlled, noninferiority trial, postmenopausal osteoporotic patients received 60 mg of subcutaneous Arylia or Prolia® at months 0, 6, and 12 and were followed up for 18 months. The primary endpoint was the noninferiority of the biosimilar product to the reference product in the percentage change of bone mineral density (BMD) in 18 months at the lumbar spine (L1-L4), total hip, and femoral neck. The secondary endpoints were safety assessment, the incidence of new vertebral fractures, and the trend of bone turnover markers (BTMs). Results A total of 190 patients were randomized to receive either biosimilar (n = 95) or reference (n = 95) denosumab. In the per-protocol (PP) analysis, the lower limits of the 95% two-sided confidence intervals of the difference between Arylia and Prolia® in increasing BMD were greater than the predetermined noninferiority margin of − 1.78 at the lumbar spine, total hip, and femoral neck sites (mean differences [95% CIs] of 0.39 [− 1.34 to 2.11], 0.04 [− 1.61 to 1.69], and 0.41 [− 1.58 to 2.40], respectively). The two products were also comparable in terms of safety, new vertebral fractures, and trend of BTMs. Conclusion The efficacy of the biosimilar denosumab was shown to be noninferior to that of the reference denosumab, with a comparable safety profile at 18 months. Trial registration ClinicalTrials.gov, NCT03293108 ; Registration date: 2017–09-19.

Study abroad programs have become increasingly popular in the United States and in other countries around the world. This descriptive study examines the impact of a short-term study abroad program on a group of ethnically diverse students in order to examine changes in global mindedness after participation in the program. The Hett (1993) Global Mindedness scale was administered before and after the study abroad program. The results suggest an increase in global mindedness scores at the conclusion of the program for ethnic minority students. The results also suggest that student grade point average (GPA) and student class level (senior, junior, or sophomore) were related to increases in global mindedness over the course of the study abroad experience. Recommendations and implications for educators, study abroad programs, and universities are summarized.

Background: Systemic lupus erythematosus is a systemic autoimmune disease that affects almost all organs of the body, and viral infections are involved in its development and progression. The present study aimed to evaluate the serological status of some viral infections in patients with systemic lupus erythematosus and a healthy population. Methods: This descriptive study conducted from May 2017 to April 2018 at Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran on 70 patients with systemic lupus erythematosus and 70 healthy individuals who had no autoimmune diseases and were matched with the patient group for age and sex. All patients had active records and were routinely visited in rheumatology clinic of Hafez hospital, affiliated with Shiraz University of Medical Sciences. The evidence of active disease was assessed by the physicians of this practice according to the American College of Rheumatology criteria. Peripheral blood samples were collected in tubes containing EDTA and centrifuged at 3000 rpm for 5 min. The plasma of study participants was evaluated for HBsAg, HCVAb, HIVAb, EBV-VCA-IgG, and CMV-IgG using a commercially available ELISA kit. Results: The seropositivity of CMV-IgG and EBV-VCA-IgG in the systemic lupus erythematosus group was 70 (100%) and 65 (92.9%), and in healthy individuals was 68 (97.1%) and 57 (81.4%), respectively. The prevalence of EBV-VCA-IgG in the systemic lupus erythematosus group was significantly higher than healthy ones (P=0.043). The optical density (OD) of CMV-IgG and EBV-VCA-IgG in patients with systemic lupus erythematosus was significantly higher than in healthy individuals (P

Lung disease is a common and important contributor to morbidity and mortality in rheumatoid arthritis (RA) patients. Studies have shown that diagnostic methods can reveal hidden pulmonary diseases even in RA patients with no respiratory symptoms. In this study, we assessed pulmonary function tests (PFTs) and chest radiographs (CXRs) in RA patients with more than three years of illness to find a suitable instrument for prospecting RA-induced lung diseases. We conducted a prospective cross-sectional study on 57 RA patients. Demographic, clinical, and CXR data were recorded. Residual volume (RV), total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC ratio was assessed. According to the FEV1/FVC ratio, patients were divided into three groups: FEV1/FVC below 70% (obstructive pattern) in 5% and between 70% and 85% (normal) in 50%, and above 85% (restrictive lung disease) in 45% of RA patients. Normal X-ray was the most common finding in CXR, and only cystic changes and reticular changes were found in 5% of patients. Analysis showed a significant relationship between abnormal chest images and the duration of disease (P=0.025), but PFT data did not result in any significance. Respiratory symptoms or clinical examinations are positive findings in the evaluation of asymptomatic patients, and using PFT is more rational than CXR. Our data show that there is no correlation between the disease duration and PFT data; hence, asymptomatic patients with a variety of risk factors should undergo further investigation.

Objective(s): Ischemic heart diseases (IHD) are one of the major causes of death worldwide. Studies have shown that mesenchymal stem cells can secrete and release conditioned medium (CM) which has biological activities and can repair tissue injury. This study aimed to investigate the effects of human amniotic membrane mesenchymal stem cells (hAMCs)-CM on myocardial ischemia/reperfusion (I/R) injury in rats by targeting oxidative stress. Materials and Methods: Male Wistar rats (40 rats, weighing 200–250 g) were randomly divided into four groups: Sham, myocardial infarction (MI), MI + culture media, and MI + conditioned medium. MI was induced by ligation of the left anterior descending coronary artery for 30 min. After 15 min of reperfusion, intramyocardial injections of hAMCs-CM or culture media (150 μl) were performed. At the end of the experiment, serum levels of cardiac troponin-I (cTn-I), myocardial levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx), as well as cardiac histological changes were evaluated.Results: HAMCs-CM significantly decreased cTn-I and MDA levels and increased SOD and GPx activities (p

Objective(s): Existing studies have demonstrated that intravenous and intramyocardial-administrated mesenchymal stem cells (MSCs) lead to tissue repair after cardiac disorders. We compared the efficiency of both administration methods.Materials and Methods: A rat model of isoproterenol-induced heart failure (ISO-HF) was established to compare the effects of intravenous and intramyocardial-administrated MSCs on cardiac fibrosis and function. The animals were randomly assigned into six groups: i) control or normal, ii) ISO-HF (HF) iii) ISO-HF rats treated with intramyocardial administration of culture medium (HF+IM/CM), iv) ISO-HF rats treated with intravenous administration of culture medium ( HF+IV/CM), v) ISO-HF rats treated with intravenous administration of MSCs (HF+IV/MSCs), vi) ISO-HF rats treated with intramyocardial administration of MSCs ( HF+IM/MSCs). Cultured MSCs and culture medium were administrated at 4 weeks after final injection of ISO. Heart function, identification of MSCs, osteogenic differentiation, adipogenic differentiation, cardiac fibrosis and tissue damage were evaluated by echocardiography, flow-cytometery, von Kossa, oil red O, Masson’s trichrome and H & E staining, respectively. Results: Both intravenous and intramyocardial MSCs therapy significantly improved heart function and reduced cardiac fibrosis and tissue damage (PConclusion: In sum, our results confirm the validity of both administration methods in recovery of HF, but more future research is required.