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Abstract Objectives To enhance the identification of individuals at risk of developing clinically significant kidney stones. Methods In this study, data from the Fasa Adults Cohort Study were analyzed to explore factors linked to symptomatic and clinically significant kidney stone disease. After cleaning, 10,128 participants with 103 variables were studied. One outcome variable (presence of symptomatic kidney stones) and 102 predictor variables from surveys and tests were assessed. Five Machine learning (ML) algorithms (SVM, RF, KNN, GBM, XGB) were applied to examine kidney stone factors, with performance comparisons made. Data balancing was done using SMOTE, and metrics like accuracy, precision, sensitivity, specificity, F1 score, and AUC were evaluated for each algorithm. Results The XGB model outperformed others with AUC of 0.60, while RF, GBM, SVC, and KNN had AUC values of 0.58, 0.57, 0.54, and 0.52. RF, GBM, and XGB showed good accuracy at 0.81, 0.81, and 0.77. Top predictors for kidney stones were serum creatinine, salt intake, hospitalization history, sleep duration, and BUN levels. Conclusions ML models show promise in evaluating an individual’s risk of developing painful kidney stones and recommending early lifestyle changes to reduce this risk. Further research can enhance predictive accuracy and tailor interventions for better prevention/management.

Abstract Background Depression is a prevalent and serious mental health disorder that significantly impacts daily life and functioning. Neurofilament Light chain (NfL), associated with axonal neuronal damage, has been identified as a promising biomarker, potentially aiding in early diagnosis of depression, personalized treatment, and tracking disease progression. This study used meta-analysis to evaluate the potential of plasma NfL as a biomarker for depression patients. Methods A systematic search following the PRISMA guidelines was conducted across PubMed, Web of Science, Scopus, and Google Scholar databases to find relevant studies on plasma NfL levels in patients with depression. A random effects model meta-analysis was applied to determine its potential as a biomarker for differentiating patients from controls. Results Our meta-analysis, based on four articles with six datasets, revealed that plasma NfL levels were notably higher in individuals with depression (228 cases) compared to healthy controls (118 individuals). The weighted mean difference (WMD) was 8.78 (95% CI: 5.28, 12.28; P

Abstract Background In developing nations, myocardial infarction (MI) remains a significant contributor to deaths from sudden cardiac arrest, with diet playing a key role in its incidence through oxidative stress mechanisms. Although the connection between the Dietary Antioxidant Index (DAI) and cardiovascular diseases has been demonstrated in some studies, the relationship between DAI and MI has not been extensively explored. Therefore, this research aims to investigate this association. Methods We conducted a nested case-control study involving 156 MI cases and 312 healthy controls, utilizing data from the Fasa Adults Cohort Study (FACS), a population-based study of individuals aged 35–70 residing in Fasa, Iran, with 11,097 participants included at baseline. The DAI was determined by normalizing the intake values of six dietary vitamins and minerals, adjusting by subtracting the global mean, and then dividing by the global standard deviation. MI diagnosis was established by an experienced cardiologist using electronic medical records. Conditional logistic regression was employed to examine the association between DAI and MI. Results There were no significant differences between the case and control groups in terms of age (P = 0.96), gender distribution (P = 0.98), and education level (P = 0.38). In a multiple conditional logistic regression analysis, after adjusting for key variables—including body mass index (BMI), smoking status, education level, and serum levels of triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), fasting blood sugar (FBS), saturated fatty acids (SFA), and polyunsaturated fatty acids (PUFA)—an inverse association was found between DAI and the risk of myocardial infarction (MI) [adjusted Odds Ratio (Adj OR) = 0.88, 95% Confidence Interval (CI): 0.85–0.92; P

Not available.

Abstract Background MicroRNAs (miRNAs or miRs) are highly conserved non-coding RNAs with a short length (18–24 nucleotides) that directly bind to a complementary sequence within 3′-untranslated regions of their target mRNAs and regulate gene expression, post-transcriptionally. They play crucial roles in diverse biological processes, including cell proliferation, apoptosis, and differentiation. In the context of cancer, miRNAs are key regulators of growth, angiogenesis, metastasis, and drug resistance. Main body This review primarily focuses on miR-939 and its expanding roles and target genes in cancer pathogenesis. It compiles findings from various investigations. MiRNAs, due to their dysregulated expression in tumor environments, hold potential as cancer biomarkers. Several studies have highlighted the dysregulation of miR-939 expression in human cancers. Conclusion Our study highlights the potential of miR-939 as a valuable target in cancer diagnosis, prognosis, and treatment. The aberrant expression of miR-939, along with other miRNAs, underscores their significance in advancing our understanding of cancer biology and their promise in personalized cancer care.

Abstract Background Oxidative stress after ischemic stroke contribute to neuronal cell injury. Unhealthy and unbalanced dietary patterns can increase the risk of several diseases, including stroke and cardiometabolic ones. However, the association between dietary total antioxidant capacity (DTAC) of antioxidant and stroke is controversial. Our study aimed to establish a correlation between DTAC and its impact on the occurrence of stroke. Methods This nested case–control study included 79 stroke cases and 158 healthy controls. We used data from the Fasa Adults Cohort Study (FACS) comprising 10,035 individuals at baseline. To assess the nutritional status of each individual, a 125-item food frequency questionnaire (FFQ) has been used to evaluate their dietary habits and intakes over the past year. DTAC was calculated using the ferric-reducing antioxidant power (FRAP) international databases. The stroke was confirmed by an experienced neurologist using standard imaging methods. Conditional logistic regression analyses were performed to evaluate the association between DTAC and stroke. Results The assessment of DTAC revealed that there was no statistically significant distinction between cases (mean ± SD: 5.31 ± 2.65) and controls (5.16 ± 2.80) with a p-value of 0.95. Even after adjusting for the potentially important confounding factors such as age, sex, event time, energy intake, smoking, hypertension, and diabetes, the association remains non-significant (adjusted odds ratio (OR) = 1.06, 95% CI: 0.94, 1.20, p-value = 0.33). Conclusions Our results did not confirm a significant link between DTAC and stroke risk. These findings emphasize the intricate interplay of factors influencing stroke risk and highlight the need for further research to unravel these relationships more comprehensively.

Abstract Background Long non-coding RNAs, known as LncRNAs, have demonstrated a robust association with the pathogenesis of stroke. NRON and SNHG are among the most extensively studied lncRNAs in the context of atherosclerosis and inflammatory conditions. Given the absence of a current pathophysiological hypothesis regarding the potential relevance of the SNHG family and NRON lncRNAs in ischemic stroke (IS), this study aimed to investigate the altered expression of NRON and SNHG11 following atherosclerotic ischemic stroke (AIS) and their potential association with the risk of AIS. Methods Blood samples were collected from 65 AIS patients (with large artery atherosclerosis or small vessel disease) and 65 controls. The expression levels of NRON and SNHG11 were assessed within the first 24 h following the stroke using quantitative real-time PCR. Results NRON expression exhibited a significant decrease in patients compared to controls, while no substantial difference was observed in the expression level of SNHG11 between the two groups. Furthermore, logistic regression analysis revealed a significant negative association between NRON expression and the risk of AIS (adjusted odds ratio = 0.70; 95% confidence interval 0.55–0.89, P = 0.004). Conclusions These findings suggest that NRON may play a role in the pathogenesis of AIS and could potentially serve as a biomarker for the disease. To fully comprehend the mechanism underlying the association between NRON and AIS and to explore its potential therapeutic implications, further investigation is warranted.

Abstract Introduction The application of machine learning (ML) is increasingly growing in biomedical sciences. This study aimed to evaluate factors associated with type 2 diabetes mellitus (T2DM) and compare the performance of ML methods in identifying individuals with the disease in an Iranian setting. Methods Using the baseline data from Fasa Adult Cohort Study (FACS) and in a sex‐stratified manner, we studied factors associated with T2DM by applying seven different ML methods including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), K‐Nearest Neighbours (KNN), Gradient Boosting Machine (GBM), Extreme Gradient Boosting (XGB) and Bagging classifier (BAG). We further compared the performance of these methods; for each algorithm, accuracy, precision, sensitivity, specificity, F1 score, and Area Under Curve (AUC) were calculated. Results 10,112 participants were recruited between 2014 and 2016, of whom 1246 had T2DM at baseline. 4566 (45%) participants were males, aged between 35 and 70 years. For males, age, sugar consumption, and history of hospitalization were the most weighted variables regarding their importance in screening for T2DM using the GBM model, respectively; these variables were sugar consumption, urine blood, and age for females. GBM outperformed other models for both males and females with AUC of 0.75 (0.69–0.82) and 0.76 (0.71–0.80), and F1 score of 0.33 (0.27–0.39) and 0.42 (0.38–0.46), respectively. GBM also showed a sensitivity of 0.24 (0.19–0.29) and a specificity of 0.98 (0.96–1.0) in males and a sensitivity of 0.38 (0.34–0.42) and specificity of 0.92 (0.89–0.95) in females. Notably, close performance characteristics were detected among other ML models. Conclusions GBM model might achieve better performance in screening for T2DM in a south Iranian population.

Abstract Background This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. Main text We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane’s CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case–control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran’s Q test and the I 2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. Conclusions Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.

Statement of the Problem: Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement.Purpose: This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible.Materials and Method: This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time.Results: There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p< 0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36).Conclusion: According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement.

Introduction Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery.

Abstract Objective To evaluate the frequency and significance of brain imaging findings in methanol poisoning patients and to propose a criterion for prioritizing brain imaging. Methods We retrospectively reviewed the data of 306 patients (286 men and 34 women, mean age 32.10 ± 9.9 years) with confirmed methanol poisoning who were admitted to two hospitals in Iran during the COVID‐19 pandemic. We analyzed their demographic, clinical, laboratory, and brain imaging data. Results The main brain computed tomography (CT) scan findings were hypodensity in the putamen (11.1%), cerebellar nuclei (8.2%), diffuse cerebral edema (7.5%), and intracranial hemorrhage (ICH; 1.6%). These findings were associated with blood pH, Glasgow Coma Scale (GCS), renal failure, bicarbonate, oxygen, carbon dioxide, potassium, and glucose levels (p

Abstract Background Recently, the combination of venetoclax plus a hypomethylating agent (HMA; azacitidine ordecitabine) or low‐dose cytarabine (LDAC) showed promise in Phase III trials in previously untreated AML. In France at the time of this study, venetoclax was not yet approved for AML and there were therefore no formal usage recommendations. Here we report the first study in a French cohort that assessed venetoclax in combination with existing treatments for AML under real‐life conditions. Method This retrospective, real‐life study collected data on venetoclax use and management in a French cohort with acute myeloid leukemia (AML) ineligible for intensive chemotherapy. Result Of 118 patients, 81 were in second line/beyond (71.6% also hypomethylating agent [HMA]; 23.5% lowdose cytarabine [LDAC]) and 37 in first line. For venetoclax initiation, 57.3% underwent ramp up and 74.6% were hospitalized. Median venetoclax duration was 2.5 months (range 0.03‐16.2). With all treatment lines and regimens, most common grade 3/4 adverse events were hematologic (overall 96.4% of patients) and infections (57.1%). Dosage adjustments for drug interactions and safety varied between centers. In second‐line/beyond, median progression‐free survival was 4.0 months (95% confidence interval [CI] 2.7‐12.8) with venetoclax‐HMA and 3.4 months (1.3‐8.9) with venetoclax‐LDAC; overall response rate was 51.9% and 41.2%, respectively. Thus, we showed that venetoclax‐based treatment yields promising findings in patients with AML, but to address treatment complexity, practice harmonization is needed.

Abstract Background and Aims Traumatic brain injury (TBI) is a widespread global health issue with significant economic consequences. However, no existing model exists to predict the need for neurosurgical intervention in moderate TBI patients with positive initial computed tomography scans. This study determines the efficacy of machine learning (ML)‐based models in predicting the need for neurosurgical intervention. Methods This is a retrospective study of patients admitted to the neuro‐intensive care unit of Emtiaz Hospital, Shiraz, Iran, between January 2018 and December 2020. The most clinically important variables from patients that met our inclusion and exclusion criteria were collected and used as predictors. We developed models using multilayer perceptron, random forest, support vector machines (SVM), and logistic regression. To evaluate the models, their F1‐score, sensitivity, specificity, and accuracy were assessed using a fourfold cross‐validation method. Results Based on predictive models, SVM showed the highest performance in predicting the need for neurosurgical intervention, with an F1‐score of 0.83, an area under curve of 0.93, sensitivity of 0.82, specificity of 0.84, a positive predictive value of 0.83, and a negative predictive value of 0.83. Conclusion The use of ML‐based models as decision‐making tools can be effective in predicting with high accuracy whether neurosurgery will be necessary after moderate TBIs. These models may ultimately be used as decision‐support tools to evaluate early intervention in TBI patients.

Abstract Introduction Macro‐algae products have been shown to ameliorate the metabolic disorders state. Thus, highlighting their function as supplementary therapeutic agents can be a novel strategy for clinical therapies. This systematic review and meta‐analysis of clinical trials aimed to summarize the effect of macro‐algae consumption on serum lipid profile, glycaemic control and anthropometric factors. Methods In this systematic review and meta‐analysis, a comprehensive search was performed for relevant studies published up to May 2023. The Cochran's Q test and I‐square (I2) tests were used to evaluate heterogeneity across the included studies. The meta‐analysis was conducted using random‐effects model (DerSimonian and Laird), and weighted mean difference (WMD) was considered as the pooled effect size. Results Out of 8602 papers in the initial screening, eight clinical trials with a total of 438 participants were included into this meta‐analysis. The results indicated that macro‐algae supplementation significantly decreased serum levels of total cholesterol (TC) (WMD = −6.7 mg/dL; 95% CI: −12.59, −0.80; item = 0.026) and low‐density lipoprotein cholesterol (LDL‐c) (WMD = −8.25 mg/dL; 95% CI: −15.38, −1.12; p‐value = .023). There was an increase in level of high‐density lipoprotein cholesterol (HDL‐c) (WMD = 0.48 mg/dL; 95% CI: −2.05, 3.01; p‐value = .71) which was not statistically significant. Macro‐algae supplementation reduced body mass index (BMI) (WMD = −0.28 kg/m2; 95% CI: −0.96, 0.41; p‐value = .426), weight (WMD = −0.39 kg; 95% CI: −3.6, 2.83; p‐value = .81), waist circumference (WC) (WMD = −0.52 cm; 95% CI: −2.71, 1.66; p‐value = .64), fasting blood sugar (FBS) (WMD = −1.95 mg/dL; 95% CI: −5.19, 1.28; p‐value = .24) and HbA1c (WMD = −0.02%; 95% CI: −0.14, 0.09; p‐value = .66) in intervention group. Conclusions This meta‐analysis indicated that macro‐algae supplementation significantly decreased TC and LDL‐c level. It can also increase HDL‐c level and reduce anthropometric indices and glycaemic control factors.

Abstract Background Road traffic injuries (RTI) are one of the most prominent causes of morbidity and mortality, especially among children and young adults. Motorcycle crashes constitute a significant part of RTIs. Policymakers believe that safety helmets are the single most important protection against motorcycle-related injuries. However, motorcyclists are not wearing helmets at desirable rates. This study systematically investigated factors that are positively associated with helmet usage among two-wheeled motorcycle riders. Methods We performed a systematic search on PubMed, Scopus, Web of Science, Embase, and Cochrane library with relevant keywords. No language, date of publication, or methodological restrictions were applied. All the articles that had evaluated the factors associated with helmet-wearing behavior and were published before December 31, 2021, were included in our study and underwent data extraction. We assessed the quality of the included articles using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. Results A total of 50 articles were included. Most evidence suggests that helmet usage is more common among drivers (compared to passengers), women, middle-aged adults, those with higher educations, married individuals, license holders, and helmet owners. Moreover, the helmet usage rate is higher on highways and central city roads and during mornings and weekdays. Travelers of longer distances, more frequent users, and riders of motorcycles with larger engines use safety helmets more commonly. Non-helmet-using drivers seem to have acceptable awareness of mandatory helmet laws and knowledge about their protective role against head injuries. Importantly, complaint about helmet discomfort is somehow common among helmet-using drivers. Conclusions To enhance helmet usage, policymakers should emphasize the vulnerability of passengers and children to RTIs, and that fatal crashes occur on low-capacity roads and during cruising at low speeds. Monitoring by police should expand to late hours of the day, weekends, and lower capacity and less-trafficked roads. Aiming to enhance the acceptance of other law-abiding behaviors (e.g., wearing seat belts, riding within the speed limits, etc.), especially among youth and young adults, will enhance the prevalence of helmet-wearing behavior among motorcycle riders. Interventions should put their focus on improving the attitudes of riders regarding safety helmets, as there is acceptable knowledge of their benefits.

Abstract Introduction The antiinflammatory and antioxidative effects of melatonin have been established in recent years. Several studies indicate that oxidative stress and inflammation are key drivers of post-coronary artery bypass graft (CABG) surgery complications. In the present study, we aimed to investigate the effects of melatonin on cardiac injury and inflammatory biomarkers in CABG candidates. Methods Embase, Medline/PubMed, Web of Science, Scopus, and the Cochrane library were searched up to 5 June 2022. All randomized controlled trials examining cardiac injury and inflammatory biomarkers of CABG patients who received melatonin were included. The random-effects model was utilized to perform the analysis. Results A total of 947 citations were retrieved through database searches. Finally, five articles (six trials with 342 patients) were included after the screening. Melatonin supplementation led to a significant reduction in cardiac troponin I (CTnI) [weighted mean difference(WMD): −2.28 ng/ml; 95% CI −2.87, −1.69; P

Abstract Elham Jamali Objectives Acute myeloid leukemia (AML) is a blood malignancy characterized by the proliferation of aberrant cells in the bone marrow and blood that interfere with normal blood cells. We have investigated whether changes in the level of micro-ribonucleic acid (miR)-19b, miR-17, and miR-25, Wilms' tumor (WT1), and CCAAT enhancer-binding protein α (CEBPA) genes expression affect disease prognosis and clinical outcome in AML patients. Materials and Methods The expression level of miR-19-b, miR-17, and miR-25, as well as WT1 and CEBPA genes in a group of patients and controls as well as different risk groups (high, intermediate, and favorite risk), M3 versus non-M3, and graft-versus-host disease (GvHD) versus non-GvHD patients were assessed using a quantitative SYBR Green real-time polymerase chain reaction method. Results When compared with the baseline level at the period of diagnosis before chemotherapy, the expression of miR-19b and miR-17 in AML patients increased significantly after chemotherapy. The level of miR-19b and miR-25 expression in AML patients with M3 and non-M3 French–American–British subgroups differ significantly. MiR-19b and miR-25 expression was elevated in GvHD patients, while miR-19b and miR-25 expression was somewhat decreased in GvHD patients compared with non-GvHD patients, albeit the difference was not statistically significant. Also, patients with different cytogenetic aberrations had similar levels of miR-19-b and miR-25 expression. Conclusion MiR-19b, miR-17, and miR-25 are aberrantly expressed in AML patients' peripheral blood leukocytes, which may play a role in the development of acute GvHD following hematopoietic stem cell transplantation.

Statement of the Problem: Marginal bone loss (MBL) is an important factor in dental implant failure. The number of implants may affect MBL. Purpose: The aim of this study was to compare MBL in patients who received two or three implants for replacement of three missing teeth in the posterior mandible. Materials and Method: This prospective cohort study evaluated patients who required replacement of three missing teeth in the posterior mandible with dental implants. The patients were assigned to two groups. In the group 1, the edentulous area was restored with two implants and a pontic while three implants were placed for this purpose in the group 2. The MBL was compared between the two groups at 12 and 24 months after loading. Results: Forty-two implants were studied in group 1 and 36 implants in the group 2. The mean MBL was 0.90±0.12mm in the group 1 and 0.89±0.12mm in the group 2 at 12 months after loading. The mean MBL was 1.00±0.10mm in the group 1 and 0.98±0.10mm in the group 2 at 24 months after implant loading. The mean of MBL was not statistically different between the two groups at 12 months and 24 months (p> 0.05). Conclusion: It seems that the use of two or three implants for replacement of three missing teeth in the posterior mandible is not associated with an increase in MBL.

Statement of the Problem: Caffeine intake affects bone metabolism through inhibition of osteoblast proliferation. Purpose: This study aims to assess the effect of caffeine consumption on implant stability in the healing period of patients. Materials and Method: A prospective cohort study is designed to assess implant stability in the posterior of the maxilla. Patients were divided into two groups based on daily caffeine intake as group 1 with consumption of 400 mg/daily caffeine or more, and group 2 with consumption of 100 mg/daily caffeine or less. The implant stability was measured by resonance frequency analysis (RFA). The mean implant stability quotients (ISQs) were calculated. RFA measurements were made at 4, 6 and 8 weeks after implant placement. Results: A total of 102 patients were studied (51 in each group). The mean of ISQ was 43.49± 2.32 in the group 1 and 42.78±2.34 in the group 2 at four weeks after insertion. The mean of ISQ was 50.86±3.06 in group 1 and 51.37±2.44 in the group at six weeks after implant placement. At eight weeks after implant surgery, the mean of ISQ was 56.78±3.77 in the group 1 and 57.84±1.82 in the group 2. The mean of ISQ between the two groups at 4, 6 and 8 weeks after implant placement was not statistically different. (p= 0.13, p= 0.36 and p= 0.08 respectively) The repeated measure test indicated a similar increase in ISQ in various study times in the two studied groups (p=0.47, df=1, F=0.52). Conclusion: Acquired data suggest that caffeine intake may not have a negative effect on implant stability in the healing period at the posterior of the maxilla.

Objectives: This study assesses the opinions of health professionals in Malaysia on the disruption of non-communicable disease (NCD) services during the COVID-19 pandemic from March 2020 to January 2022.Methods: We conducted a cross-sectional online survey with 191 non-clinical public health workers and clinical health service workers in Malaysia from November 2021 to January 2022. Participants were recruited by the Malaysian Ministry of Health using major networks including key experts and practitioners. Secondary respondents were subsequently enrolled through snowballing.Results: The most notable issues raised by the survey participants relate to NCD service disruption, the redirection of NCD care resources, and NCD care being overburdened post-pandemic. Respondents also reported accounts of resilience and prompt reaction from the healthcare system, as well as calls for innovation.Conclusion: Most respondents perceived that the challenges arising from COVID-19 were mostly managed well by the healthcare system, which was able to provide the necessary services to NCD patients during this health emergency. However, the study identifies gaps in the health system response and preparedness capacity, and highlights solutions for strengthening NCD services.

Abstract Background The stability of the results remains a significant concern in orthognathic surgeries. This study aimed to assess the amount of relapse following mandibular advancement with/without maxillomandibular fixation (MMF). Materials and methods A single-blind clinical trial was conducted on patients with mandibular retrognathism who underwent BSSO for mandibular advancement and Lefort I maxillary superior repositioning. Patients were randomly divided into two groups of treatment (MMF) and control (no MMF). In the treatment group, MMF was performed for 2 weeks; meanwhile, MMF was not performed in the control group, and only guiding elastics were applied postoperatively. Lateral cephalograms were obtained preoperatively (T1), immediately after surgery (T2), and at 1 year postoperatively (T3). The distance from points A and B to the X and Y plane were measured to identify the amount of vertical and horizontal relapse in 1 year as a primary outcome. An independent t-test was applied in order to find differences in outcomes between the control and treatment groups. Results Fifty-eight patients were evaluated in two groups (28 patients in the MMF group and 30 in the no-MMF group). The magnitude of mandibular advancement following BSSO was 7.68±1.39 mm and 7.53±1.28, respectively, without significant difference among the groups (p= 0.68). The mean sagittal and vertical changes (relapse) at point B were significantly different between the two groups at 1-year follow-up after the osteotomy (p=0.001 and p=0.05, respectively). Conclusion According to the results of this study, patients with short-term MMF following BSSO for mandibular advancement benefit from significantly greater skeletal stability in the sagittal and vertical dimensions.

Statement of the Problem: Methemoglobinemia is a potentially life-threatening rare medical condition, which refers to an increase in the level of oxidized form of hemoglobin (methemoglobin). Excessive replacement of hemoglobin with methemoglobin leads to functional hypoxia and even fatal conditions. Purpose: The aim of this study was to evaluate the effect of two common local anesthetic agents namely lidocaine and articaine administered for hemostasis during surgery on methemoglobin level. Materials and Method: This prospective cohort study was conducted from January 2017 to December 2019. Demographic data including age, gender, and weight of patients were collected. Sixty patients were randomly divided into three groups (n=20) regarding the local anesthetic agent administered for hemostasis during surgery as lidocaine group (group 1), articaine group (group 2), and control group (no local anesthetic; group 3). The patients were candidates for orthognathic surgery, reconstruction of the maxillary and mandibular atrophic ridges with autogenous grafts, and reconstruction of maxillofacial fractures. The methemoglobin level was measured before surgery and six hours after the initiation of surgery. Results: The mean age and weight of patients were not significantly different among the three groups (p= 0.891 and p= 0.416, respectively). No significant differences were observed among the three groups regarding the gender distribution (p= 0.343) or type of surgery (p= 0.990). Statistical analysis did not show any significant difference in the mean baseline methemoglobin level among the three groups (p= 0.109). Although the mean methemoglobin values increased in the three groups, paired sample t-test did not show any significant change in the values at six hours after the initiation of surgery compared with baseline in any of the three groups (p= 0.083 for group 1, p= 0.096 for group 2, and p= 0.104 for group 3). Conclusion: The results demonstrated that administration of lidocaine and articaine plus epinephrine for hemostasis during general anesthesia are equally safe.

Abstract Background Multiple sclerosis (MS) is a chronic inflammatory disease. Various long non-coding RNAs (lncRNAs) appear to have an important role in the pathophysiology of MS. This study aimed at evaluating the expression levels of lncRNAs, MIAT, H19, and NRON in peripheral blood of MS cases to a healthy control group. We collected blood samples of 95 MS cases (76 relapsing–remitting (RR) and 19 secondary progressive (SP) MS) and 95 controls. We used quantitative real-time PCR for the evaluation of gene expression. The correlation between expression with clinical parameters was analyzed by a multiple linear regression model. Receiver operating characteristic (ROC) curve analysis was carried out to detect the diagnostic potential of lncRNAs levels according to the area under the curve (AUC). Results MIAT, H19, and NRON were significantly increased in the RRMS and SPMS subgroups compared to the controls. We found that the H19 and MIAT expression significantly were higher in SPMS compared with RRMS. Patients with RRMS had a greater level of the average NRON expression is compared with SPMS patients. The expression level of H19 significantly was higher in females relative to male patients. Based on the area under curve (AUC) values, NRON had the best performance in the differentiation of MS patients from controls (AUC = 0.95, P

Abstract Background High toll of traffic-related injuries, climate change, natural disasters, population aging, as well as chronic diseases have all made considerable demands on receiving physiotherapy services in Iran. Nevertheless, there is an assortment of complications facing utilization of such services, particularly poor insurance coverage. Therefore, the present study investigated and identified gaps in insurance coverage in order to inform future policy reforms and the design of a more comprehensive and universal benefits package for physiotherapy services in Iran. Methods This project was carried out in Iran, using a mix-methods (viz. qualitative-quantitative) approach. Within the first phase, a qualitative study was completed to find policy recommendations. Such recommendations were then prioritized through the Analytical Hierarchy Process (AHP), in the second phase, based on effectiveness, acceptability, cost, fairness, feasibility, and time. Results Within the first phase, a total number of 30 semi-structured interviews with health policy-makers, health insurers, faculty members, rehabilitation experts, and physiotherapists were completed. Several policy recommendations were also proposed by the study participants. Following the second phase, prioritized recommendations were provided to promote stewardship (e.g., informing policy-makers about physiotherapy services), collection of funds (e.g., placing value-added taxes on luxury goods and services), pooling of funds (e.g., moving allocated resources towards insurance (viz. third-party) mechanism), purchasing (e.g., using strategic purchasing), and benefit package (e.g., considering preventive interventions) as the main components of insurance coverage. Conclusion The study findings provided a favorable ground to improve insurance coverage for physiotherapy services in Iran. As well, decision- and policy-makers can place these recommendations on the agenda in the health sector to protect population health status, especially that of groups with disabilities.

Objective: This systematic review and meta-analysis was undertaken to estimate the effectiveness of motorcycle safety campaigns for increasing helmet use among motorcycle riders and passengers. Methods: PubMed, Scopus, EMBASE, and the Web of Science (WOS) databases were systematically searched up June 2020 for all relevant studies. The National Institute of Health (NIH) tool was used to assess the quality of all included studies. Inter-study heterogeneity was measured using the Chi-Squared and I2 statistics, with the odds ratio (OR) being used as a measure of the pooled effect size. Results: Out of the 561 records identified from the literature searches, eight articles (or 11 studies) were eligible for inclusion in the present meta-analysis. Using a random effects model, the results of the meta-analysis demonstrated statistically significant increases in helmet use among motorcycle riders (OR = 4.52, 95% CI: 1.01–20.14, I2 = 99.9%) and passengers (OR = 6.57, 95% CI: 1.41–30.56, I2 = 99.9%). The findings of sensitivity analyses, based on alternative levels of r for imputing the standard error (SE) of the ORs, showed the pooled OR of helmet use among motorcycle riders (r = 0.7; 3.49; 95% CI: 0.78, 16.44; r = 0.9; 3.49; 95% CI: 0.76, 16.11) was sensitive to different levels of r. However, no significant effect was detected on the pooled effect size for different correlation coefficients for motorcycle passengers (r = 0.7; 6.56; 95% CI: 1.59, 27.00; r = 0.9; 6.56; 95% CI: 2.25, 19.13). Increases in helmet use among motorcycle passengers were found in studies that: monitored pre and post campaign periods for longer than one year and were conducted in Thailand or Vietnam. However, the effect of motorcycle safety campaigns on helmet use among motorcycle riders remained significant for all of the different strata included. Conclusion: The present meta-analysis found that motorcycle safety campaigns can lead to a significant increase in helmet use among both motorcycle riders and passengers. Due to the high degree of inter study heterogeneity, these findings should be interpreted with some caution. Despite the apparent favourable influence of motorcycle safety campaigns, more robust research is required.

Introduction: The aim of this study was to assess various smile line problems and treatments and to assess the patients’ satisfaction after treatment. Methods: This cross-sectional study assessed patients who had smile line problems. Various smile line problems included vertical maxillary excess (VME), muscle hyperactivity, gingival hyperplasia, short lip, bimaxillary protrusion, asymmetric muscle hyperactivity, maxillary canting, and tooth deformity. All patients filled out a questionnaire one year after the procedures for 23 assessments of satisfaction. The level of satisfaction was evaluated using a visual analog scale (VAS): 0-3 dissatisfaction, 4-7 acceptable, and 7-10 desirable. Results: One-hundred thirty-seven patients were included in this study. The highest level of satisfaction was noted in patients who had tooth deformity, VME with passive eruption, and gingival hyperplasia or passive supra-eruption (7.75±0.46, 7.66±0.72, and 7.50±0.55, respectively). The lowest level of satisfaction was noted in patients who had asymmetric muscle activity, muscle hyperactivity, and VME+ muscle hyperactivity (4.25±0.96, 4.33±0.78 and5.00±1.09, respectively). Conclusion: Patients with soft tissue problems of the smile line may have low 41satisfaction especially when temporary treatments such as botulinum toxin are used for treatment. Surgery of the hard tissues may result in moderate to high satisfaction in patients with smile line problems.

Abstract Brucellosis is considered as the most common bacterial zoonosis in the world. Although the laboratory findings are the most reliable diagnosis today, the current laboratory methods have many limitations. This research aimed to design and evaluate the performance of a novel technique based on the localized surface plasmon resonance (LSPR) to eliminate or reduce existing shortcomings. For this purpose, smooth lipopolysaccharides were extracted from Brucella melitensis and Brucella abortus and fixed on the surface of the gold nanoparticles through covalent interactions. After some optimizing processes, dynamic light scattering was used to characterize the probe. The detection of captured anti-Brucella antibody was performed by measuring the redshift on LSPR peak followed by the determination of cutoff value, which indicated a significant difference between controls and true positive patients (P value

Background/objectivesThere are limited data on the association between dairy products consumption and nonalcoholic fatty liver disease (NAFLD). This study was conducted to evaluate the association between total intake of different dairy products and fatty liver index (FLI), a marker of subclinical fatty liver.MethodsA total of 7,540 adults were included in this population-based cohort study. Dairy products consumption was evaluated by a validated interview questionnaire for food intake frequency. The FLI was calculated using the standard formula. Liver enzyme levels, lipid profiles, glycemic profiles and demographic characteristics were recorded for all participants. Univariate and multiple logistic regression models were used to respectively assess the mean percentage difference of mean FLI and odds ratios (ORs) for subclinical NAFLD across quantiles of dairy consumption.ResultsThe mean age of all participants was 48.81 ± 9.631 years. FLI measurements for men and women were 26.71 ± 23.39 and 39.99 ± 26.64 respectively, which was significantly higher in women (P < 0.05). Multiple logistic regression analysis demonstrated that the amount of milk consumption was an independent preventive predictor of FLI (OR = 0.96; 95% CI: 0.94–0.99), conversely, it did not predict higher levels of liver enzymes. In term of cheese intake, participants in the third tertile of cheese intake had significantly lower FLI than lower tertiles (P = 0.01). However, there wasn't any significant association between cheese intake and the odds of FLI in the multivariate model (P > 0.05). We didn't find any significant association between yogurt consumption and NAFLD indicators (P > 0.05).ConclusionHigher milk consumption was inversely associated with FLI. However, there wasn't any significant association between other types of dairy products and NAFLD indicators.

This study assessed the correlation of radiomorphometric indices of the mandible and mandibular angle fractures (MAFs) in an Iranian population. This retrospective study was conducted on 3D computed tomography (CT) scans of 118 patients between 18 to 60 years. The images were divided into two groups with MAFs and other types of mandibular fractures (non-MAF). The gonial angle, ramus height, condylar neck width, minimum ramus width, and mandibular length were all measured using MARCO PACS software. Age, gender, and presence and eruption status of third molar at the fracture side were all recorded. The correlation between these parameters and MAF was analyzed using R software (alpha = 0.05). Of all patients, 41 samples had MAF. The two groups were not significantly different regarding the mean age and gender (P > 0.05). The mean size of gonial angle and ramus height in the MAF group were significantly larger, and smaller than the corresponding values in the non-MAF group, respectively (P < 0.001). The median minimum ramus width in the MAF group was significantly smaller than that in the non-MAF group (P = 0.001). Patients with a large gonial angle had 6.6 times higher odds of MAF compared with other fracture types (P = 0.046). Condylar neck width, mandibular length, and erupted third molars had no significant correlation with type of fracture. Presence of impacted third molar increased the odds of MAF by 5.55 times.Patients with a large gonial angle, short ramus height, minimum ramus width, and impacted third molar are more susceptible to MAF. Surgeons can use these indices to predict the risk of MAF in trauma patients with such facial characteristics, and make a diagnosis by radiographic modalities.

Background and Objectives: Candida auris (C. auris) is the first fungal pathogen considered a global health threat. Because, C. auris is associated with multidrug resistance and associated diseases such as diabetes, sepsis, lung and kidney disease. This study investigated the prevalence and mortality of C. auris infection during Covid-19 pandemic. Materials and Methods: Databases were searched for peer-reviewed articles published in the English language up to Jan 18, 2022. Heterogeneity across studies was evaluated using Cochrane’s Q test and the I2 index. The pooled point prevalences and their corresponding 95% confidence intervals (CIs) were estimated usingthe random-effects model. Results: In our meta-analysis, 11 eligible articles were included. The total pooled prevalence estimation of C. auris infection among COVID-19 patients was 13% (95% CI: 8%, 19%). The estimated pooled mortality rate of C. auris infection was 37% (95% CI: 15%, 61%). In terms of specific conditions, the pooled risk of mortality was higher in people with diabetes 65% (95% CI: 0.45%, 83%), in cases with >21 days admission inintensive care unit (ICU) 44% (95% CI: 21%, 0.68%), and after receiving steroids 43% (95% CI: 18%, 69%). Conclusion: Our study highlights the high prevalence rate of C. auris infection, particularly among people with a history of metabolic disorders.

Abstract Background The government is the main body in charge of controlling epidemics; hence, expectations from the intention and capacities of the government would affect the flexibility and behaviors of citizens. Given the severity of COVID-19 pandemic and the urgent need for cooperation of people in the prevention and combat processes, understanding the public perspectives would be crucial and instructive. This study aimed to explore such perspectives towards the current pandemic among the Iranian. Indeed, we sought to provide a favorable platform for effective policies in the face of the COVID-19 pandemic through recognizing public expectations. Methods This cross-sectional survey used an open-ended online questionnaire to investigate the common perspectives of the Iranian towards the response of government to COVID-19 pandemic. The participants were selected using snowball and convenient sampling techniques across the country. The collected data were analyzed and described using a thematic analysis. Results In general, 2547 participants agreed to participate in this study and completed the online questionnaire. According to the findings, the Iranian exhibited several expectations regarding the response of the government to COVID-19 pandemic. Three main themes were extracted based on these expectations: (1) health-related expectations, (2) policy-related expectations, and (3) Information-related expectations. In this study, a majority of participants highlighted the need to consider and follow-up the patients and their families, providing the financial and hygiene support during the pandemic, applying strict restrictions, and using close monitoring and controlling procedures. Furthermore, they mentioned that authorities and news agencies should observe the principals honesty and transparency. Conclusions Our findings revealed that people expect the government and other responsible institutions to minimize the burden of this pandemic through adopting effective policies. Also, they could help policy-makers become aware of the expectations of people and develop better strategies.

Abstract Background Efforts to identify potential biomarkers for the diagnosis of ischemic stroke (IS) are valuable. The H19 gene plays a functional role in increasing the prevalence of IS risk factors. We evaluated the correlation between H19 rs217727 polymorphism and the expression level of H19 lncRNA with susceptibility to IS among the Iranian population. Methods Blood samples were collected from IS patients (n = 114) and controls (n = 114). We concentrated on the expression pattern of H19 at different time points (i.e., 0–24, 24–48, and 48–72 h after stroke). The tetra-amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) method was applied for DNA genotyping. We used the quantitative real-time PCR to evaluate H19 expression levels. We used the receiver operating characteristic (ROC) curve to evaluate the diagnosis and prognosis of IS. Results The rs217727polymorphism of H19 was related with IS susceptibility in the co-dominant (OR = 2.92, 95% CI = 0.91–10.92, P = 0.04) and recessive models (OR = 2.80, 95% CI = 0.96–8.15, P = 0.04). H19 expression was significantly upregulated in IS and remained high for 72 h after stroke. ROC curves showed that H19 expression within the first 24 h from stroke onset might serve as a biomarker for the early diagnosis of IS with 79.49% sensitivity and 80.00% specificity. H19 expression in small vessel occlusion (SVO) and large-artery atherosclerosis (LAA) patients were 3.74 and 3.34 times higher than the undetermined (UD) subtype, respectively [OR = 3.74 95% CL (1.14–12.27) P = 0.030 and OR = 3.34 95% CL (1.13–9.85) P = 0.029]. Conclusion The rs217727 polymorphism of the H19 is correlated with IS susceptibility, and H19 expression levels were higher in SVO and LAA patients. The upregulation of H19 may be considered as a diagnostic biomarker in IS among the Iranian population, but it cannot serve as a useful prognostic marker.

Objectives: The development of effective targeted therapy and drug-design approaches against the SARS-CoV-2 is a universal health priority. Therefore, it is important to assess possible therapeutic strategies against SARS-CoV-2 via its most interaction targets. The present study aimed to perform a systematic review on clinical and experimental investigations regarding SARS-CoV-2 interaction targets for human cell entry. Methods: A systematic search using relevant MeSH terms and keywords was performed in PubMed, Scopus, Embase, and Web of Science (ISI) databases up to July 2021. Two reviewers independently assessed the eligibility of the studies, extracted the data, and evaluated the methodological quality of the included studies. Additionally, a narrative synthesis was done as a qualitative method for data gathering and synthesis of each outcome measure. Results: A total of 5610 studies were identified, and 128 articles were included in the systematic review. Based on the results, spike antigen was the only interaction protein from SARS-CoV-2. However, the interaction proteins from humans varied including different spike receptors and several cleavage enzymes. The most common interactions of the spike protein of SARS-CoV-2 for cell entry were ACE2 (entry receptor) and TMPRSS2 (for spike priming). A lot of published studies have mainly focused on the ACE2 receptor followed by the TMPRSS family and furin. Based on the results, ACE2 polymorphisms as well as spike RBD mutations affected the SARS-CoV-2 binding affinity. Conclusion: The included studies shed more light on SARS-CoV-2 cellular entry mechanisms and detailed interactions, which could enhance the understanding of SARS-CoV-2 pathogenesis and the development of new and comprehensive therapeutic approaches.

Abstract Background Clindamycin in low concentration (20 μg/mL) is safe for vitality and osteogenic potential of bone cells. The aim of this study was to evaluate the efficacy of local clindamycin (20 μg/mL) in two different exposure times, for microbial decontamination of particulate bone graft, collected during implant site preparation. This non-randomized parallel-group study was conducted on samples from 17 patients. The particulate bone collected during implant site preparation was divided into three portions by weight: in group S1, the particulate bone was immersed in thioglycolate broth without any antibiotic treatment; in group S2, the collected particulate bone was irrigated with 100 mL clindamycin solution (20 μg/mL); and in group S3, the collected particulate bone was soaked in one ml clindamycin solution (20 μg/mL) for 3 min. Samples in the three groups were cultured in aerobic and anaerobic media and species and CFU count of isolated bacteria were determined. Results Analysis of the data demonstrated a significant difference among the three groups in the mean count of total microorganisms (P = 0.001). The difference in the mean count of anaerobic and aerobic microorganisms in the three groups was statistically significant as well (P = 0.001). Pseudomonas aeruginosa was the only microorganism that was not affected with the mentioned antibiotic. Conclusions Local use of low-dose clindamycin (20 μg/mL)—irrigation or 3 min immersing—is effective for the decontamination of particulate bone grafts.

Abstract Background More severe cases of COVID- 19 are more likely to be hospitalized and around one-fifth, needing ICU admission. Understanding the common laboratory features of COVID-19 in more severe cases versus non-severe patients could be quite useful for clinicians and might help to predict the model of disease progression. This systematic review and meta-analysis aimed to compare the laboratory test findings in severe vs. non-severe confirmed infected cases of COVID-19. Methods Electronic databases were systematically searched in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar from the beginning of 2019 to 3rd of March 2020. Heterogeneity across included studies was determined using Cochrane’s Q test and the I 2 statistic. We used the fixed or random-effect models to pool the weighted mean differences (WMDs) or standardized mean differences and 95% confidence intervals (CIs). Findings Out of a total of 3009 citations, 17 articles (22 studies, 21 from China and one study from Singapore) with 3396 ranging from 12 to1099 patients were included. Our meta-analyses showed a significant decrease in lymphocyte, monocyte, and eosinophil, hemoglobin, platelet, albumin, serum sodium, lymphocyte to C-reactive protein ratio (LCR), leukocyte to C-reactive protein ratio (LeCR), leukocyte to IL-6 ratio (LeIR), and an increase in the neutrophil, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, blood urea nitrogen (BUN), creatinine (Cr), erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Procalcitonin (PCT), lactate dehydrogenase (LDH), fibrinogen, prothrombin time (PT), D-dimer, glucose level, and neutrophil to lymphocyte ratio (NLR) in the severe group compared with the non-severe group. No significant changes in white blood cells (WBC), Creatine Kinase (CK), troponin I, myoglobin, IL-6 and K between the two groups were observed. Interpretation This meta-analysis provides evidence for the differentiation of severe cases of COVID-19 based on laboratory test results at the time of ICU admission. Future well-methodologically designed studies from other populations are strongly recommended.

Abstract Background There is a growing body of evidence on low serum vitamin-D levels and the risk of uterine leiomyomas (UL). Therefore, this systematic review and meta-analysis was conducted to investigate the association between serum vitamin D levels and UL occurrence. Methods Searches were systematically conducted of the electronic databases PubMed, Scopus, EMBASE, Web of Science (ISI), Cochrane library, Ovid, and Google Scholar to identify relevant studies from inception until February 6, 2020. Heterogeneity across the included studies was examined using Cochran’s Q and I-square (I2). Data was pooled using random effects modeling and expressed as standardized mean differences (SMDs). Results Nine eligible studies with a total of 1730 participants (835 patients with UL and 895 controls) were included in the current meta-analysis. Pooled results with random effects modeling indicated that serum vitamin D levels were significantly lower in patients with UL than in the control group (n = 9, SMD = − 0.67; 95% CI, − 0.98, − 0.35, p

Objective: To investigate the association between attention-deficit/hyperactivity disorder (ADHD) score and driving behaviors among motorcycle drivers in Iran. Methods: This multi-center cross-sectional study was conducted on 1747 motorcyclists in three cities of Iran. We used a random sampling method in this study and gathered data using two standard questionnaires. Data were presented using descriptive statistics, also t-test, and ANOVA used for analysis. Results: The mean age of participants was 27.41±8.80 years. ADHD scores of the participants ranged from 0 to 87, with a mean score 31±15.86. All risky driving behaviors (RDBs) were significantly associated with a higher mean of ADHD score. For example, driving with illegal speed (pp=0.016), driving while exhausting (ppp=0.028), and maneuvering while driving (p Conclusion: All RDBs were significantly associated with the ADHD score among motorcyclists in Iran. In this regard, health care providers should inform people with ADHD about the negative consequences associated with driving and ADHD. Public health policymakers should consider management of ADHD through a comprehensive approach to improve driving performance and competencies among motorcyclists in order to decrease RDBs and traffic accidents.

Abstract Background The present study was conducted to jointly assess some specific factors related to body fat measures using a multivariate multilevel analysis in a representative sample of Iranian mid-adolescents. Methods This study was conducted among 2538 students (1286 boys) aged 14–20 years old, who were randomly selected among 16 public high schools by multi-stage random sampling procedure from all education districts of Shiraz, Iran. Data on demographic characteristics, family history of obesity, physical activity, socio-economic (SES) variables and screen time were collected. Height, weight, triceps (TST), abdominal (AST), and subscapular (SST) skinfold thickness were measured and their body mass index (BMI) was calculated. A multivariate multilevel approach was used to analyze the factors associated with obesity measures of the TST, AST, SST at the child and district levels. Results In this study, the prevalence of overweight and obesity was estimated to be 10.2 and 5.1%, respectively. Overall, the major portion of the total variance in TST (97.1%), AST (97.7%), and SST (97.5%) was found at the child level. The results of multivariate multilevel method revealed that being girls, having a family history of obesity, and SES were significantly associated with increasing of three body fat measures (all the p-values were less than 0.05). There were significant positive associations between moderate to vigorous physical activities with AST and SST (for AST: β =2.54, SE = 1.40, p = 0.05; for SST: β =2.24, SE = 1.20, p = 0.05). Compared to children in 14–16 age group, children in age group 16–18 years had less TST (β = − 0.67, SE = 0.34, p = 0.04). Furthermore, other age groups and screen time did not play an important role in three outcome variables. Conclusions The results showed some factors that contribute to three body fat measures. Therefore, it is necessary to develop effective interventions to prevent the effects of individual and environmental undesirable factors on childhood obesity in both family and community levels.

Abstract Background There are current trials investigating the effect of resveratrol supplementation on lipid profiles and liver enzymes among patients with metabolic syndrome (MetS) and related disorders; however, their findings are controversial. This systematic review and meta-analysis were aimed to determine the effects of resveratrol supplementation on lipid profiles and liver enzymes among patients with MetS and related disorders. Methods We performed a comprehensive search of the following online databases up to November 2018: Cochrane Library, PubMed, Embase, and Web of Science. The relevant articles were assessed for quality of studies using the Cochrane risk of bias tool. Results Out of 2459 citations, 31 articles were appropriate for including to the current meta-analysis. The pooled results indicated that resveratrol use significantly decreased total cholesterol [weighted mean difference (WMD) = − 7.65 mg/dL; 95% CI, − 12.93, − 2.37; P

Background: Vitamin D was reported to be associated with non−alcoholic fatty liver disease (NAFLD). This systematic review and meta−analysis aimed to investigate the effects of the vitamin D supplementation on anthropometric and biochemical indices in patient with NAFLD.Methods: PubMed, Web of science, Scopus, and Embase databases were explored to identify all randomized controlled trial (RCT) investigating the effects of vitamin D supplementation on anthropometric and biochemical indices in patients with NAFLD. A random−effects model was used to pool weighted mean difference (WMD) and corresponding 95% confidence intervals (CIs). The statistical heterogeneity among the studies was assessed using I2 statistic (high ≥ 50%, low < 50%) and Cochran’s Q−test.Results: Sixteen RCTs were included in this meta−analysis. The results identified that high−density lipoprotein−cholesterol (HDL−C) level significantly increased following vitamin D supplementation (P = 0.008). Vitamin D reduced body weight (P = 0.007), body mass index (P = 0.002), waist circumstance (WC) (P = 0.02), serum alanine transaminase (ALT) (P = 0.01), fasting blood sugar (FBS) (P = 0.01), homeostatic model assessment for insulin resistance (HOMA−IR) (P = 0.004), and calcium (P = 0.01). No significant changes were found on body fat, triglyceride (TG), total cholesterol, low−density lipoprotein−cholesterol (LDL−C), aspartate transaminase, alkaline phosphatase, gamma−glutamyl transferase, and adiponectin following vitamin D supplementation.Conclusion: Vitamin D had significant effects on anthropometric and biochemical indices including HDL−C, body weight, BMI, WC, serum ALT, serum FBS, HOMA−IR, and calcium. Vitamin D supplementation can be considered as an effective strategy in management of patients with NAFLD.Systematic Review Registration: [website], identifier [registration number]

Background and Objectives: Phytase has a hydrolysis function of phytic acid, which yields inorganic phosphate. Bacillus species can produce thermostable alkaline phytase. The aim of this study was to isolate and clone a Phytase gene (Phy) from Bacillus subtilis in Escherichia coli. Materials and Methods: In this study, the extracellular PhyC gene was isolated from Bacillus subtilis Phytase C. After purification of the bands, DNA fragment of Phy gene was cloned by T/A cloning technique, and the clone was transformed into Escherichia coli. Afterward, the pGEM-Phy was transferred into E. coli Top-10 strain and the recombinants were plated on LB agar containing 100 µg/ml ampicillin. The colonization of 1171 bp of gene Phytase C was confirmed by PCR. The presence of gene-targeting in vector was confirmed with enzymatic digestion by XhoI and XbaI restriction enzymes. Results: The Phytase gene was successfully cloned in E. coli. The result of cloning of 1171 bp Phytase gene was confirmed by PCR assay. Conclusion: Our impression of this article is that several methods, such as using along with microbial, plant phytase reproduction, or low-phytic acid corn may be the better way from a single phytase.

Abstract Recurrent herpes simplex virus or varicella zoster virus infection should be considered as one of the rare complications after AstraZeneca vaccination for COVID‐19.

Objective: Intraosseous Arteriovenous malformation (AVM) is a vascular hamartoma with almost 50% of cases occurring in the head and neck. These lesions are of great importance as they may cause massive bleeding during tooth extraction and surgeries. Case report: A 33 year old female complained of swelling and gingival bleeding on the right side of the maxilla and hard palate. The swelling was noticed during pregnancy and the patient underwent a surgical excision 6 months after labor. The specimen was submitted for histological examination. An intraosseous AVM presenting in maxilla was diagnosed. Conclusion: Although rare, intraosseous AVM may occur. The role of pregnancy and hormonal changes is still controversial. Clinical, radiographic and histological characteristics of AVM should be thoroughly assessed before surgical excision.

Abstract Background Socioeconomic status (SES) is associated with stroke incidence and mortality. Distribution of stroke risk factors is changing worldwide; evidence on these trends is crucial to the allocation of resources for prevention strategies to tackle major modifiable risk factors with the highest impact on stroke burden. Methods We extracted data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. We analysed trends in global and SES-specific age-standardised stroke incidence, prevalence, mortality, and disability-adjusted life years (DALYs) lost from 1990 to 2017. We also estimated the age-standardised attributable risk of stroke mortality associated with common risk factors in low-, low-middle-, upper-middle-, and high-income countries. Further, we explored the effect of age and sex on associations of risk factors with stroke mortality from 1990 to 2017. Results Despite a growth in crude number of stroke events from 1990 to 2017, there has been an 11.3% decrease in age-standardised stroke incidence rate worldwide (150.5, 95% uncertainty interval [UI] 140.3–161.8 per 100,000 in 2017). This has been accompanied by an overall 3.1% increase in age-standardised stroke prevalence rate (1300.6, UI 1229.0–1374.7 per 100,000 in 2017) and a 33.4% decrease in age-standardised stroke mortality rate (80.5, UI 78.9–82.6 per 100,000 in 2017) over the same time period. The rising trends in age-standardised stroke prevalence have been observed only in middle-income countries, despite declining trends in age-standardised stroke incidence and mortality in all income categories since 2005. Further, there has been almost a 34% reduction in stroke death rate (67.8, UI 64.1–71.1 per 100,000 in 2017) attributable to modifiable risk factors, more prominently in wealthier countries. Conclusions Almost half of stroke-related deaths are attributable to poor management of modifiable risk factors, and thus potentially preventable. We should appreciate societal barriers in lower-SES groups to design tailored preventive strategies. Despite improvements in general health knowledge, access to healthcare, and preventative strategies, SES is still strongly associated with modifiable risk factors and stroke burden; thus, screening of people from low SES at higher stroke risk is crucial.

Various treatment modalities have been reported for keratocystic odontogenic tumors (KOT), with different recurrence rates. Marsupialization and decompression are two different conservative surgical techniques for the treatment of KOTs. This study aimed at comparing the recurrence rate between marsupialization and decompression in the treatment of KOTs with or without adjunctive treatments. This is a systematic review study. The research sources utilized were PubMed (MEDLINE), Google scholar, Ovid MEDLINE and Cochrane Library. The keywords which were selected based on Medical Subject Heading (MeSH) terms and PICOS criteria were odontogenic keratocyst, keratocyst odontogenic tumor AND marsupialization OR decompression OR cystectomy OR enucleation OR curettage. Statistical analyses were performed to compare the recurrence rate between marsupialization and decompression with or without adjunctive treatments, regarding various follow-up times. The number of subjects that underwent marsupialization was 182. There was a significant difference for the recurrence rate between the marsupialization and decompression groups without considering adjunctive treatments (p= 0.001). However, considering adjunctive treatments, there was no difference between marsupialization and the decompression groups (p= 0.18). It appears that decompression without any adjuvant treatment may have a lower recurrence rate than marsupialization. The recurrence rate was not different when enucleation or cystectomy was performed after decompression and marsupialization.

Introduction: Temporomandibular disorder (TMD) related pain can affect the individual's daily activities, psychosocial functioning, and quality of life. The aim of the study is to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) on acute pain in patients with TMD. Materials and Methods: This is a double blind randomized clinical trial study. Patients were studied in two groups: In group1(Control group), patients received pharmacological agents with 7 sessions of passive TENS , patients in group 2 received the same protocol with 7 sessions of active TENS (Every session 15 min). Age and gender were variables and pain severity (based on visual analogue scale) and maximum mouth opening (MMO) 30 days after treatment were outcomes of the study. Results: Sixty patients were studied in two groups. Seven days after treatment, the mean of pain severity was 3.63±0.80 in group1 and 2.67±0.66 in group 2., The mean of MMO was 37.06±1.68 mm in group1 and 38.47±1.48 mm in group2.Analysis of the data showed a significant difference between the two groups for MMO. (P=0.001) Conclusion: It seems use of TENS may improve pain relief in conjunction with pharmacological agents in patients with TMD.

Introduction: The aim of the present study was to evaluate outcomes and complications related to pectoralis major mayocutaneous (PMM) flaps in the reconstruction of maxillofacial defects. Materials and Methods: Subjects who underwent pectoralis major mayocutaneous flaps to reconstruct maxillofacial defects due to trauma or tumor resection were studied. Complications were considered in two stages: early and late. A modified version of the University of Washington Quality of Life questionnaires, version 4, was used to evaluate the functional outcome of patients who underwent free flap or PMM flap reconstruction. The survey is composed of 6 domains: pain, appearance, activity, swallowing, chewing, and speech. We scored domains on a scale ranging from 0 (worst) to 100 (best). We considered scores higher than 70 in the normal range for appearance, activity, swallowing, chewing, and speech. Results: Thirty-one subjects were studied. The most common defect sites were oral floor (48.3%) and buccal soft tissue (32.2%). The least common was neck (19.3%). Immediate complications consisted of dehiscence in 3 cases (9.6%) and flap necrosis in 2 cases (6.4%). Late complications included dehiscence in 3 cases, partial necrosis of skin without muscle necrosis in 1 case, and donor site infection in one case. The most common complications seen in both stages were dehiscence (19.3%) and necrosis (9.6%).In the immediate phase, patients mostly complained of pain. In the late stage, pain significantly decreased. Activity, swallowing, and speech improved in the late stage. Conclusion: Our study indicated a significant improvement in patients' functional outcomes after discharge from the hospital. The pain was a major complaint of patients immediately after reconstruction with PMM flap, which should be considered as a significant concern for maxillofacial surgeons.

The current evidence regarding the association between vitamin D status and pelvic floor disorder (PFD) are inconclusive. This meta-analysis was aimed to summarize existing data demonstrating the association between Vitamin D status and PFD using published observational studies. All national and international databases including Web of Science, PubMed, Google Scholar, and Scopus were searched up until January 30, 2018, and related published studies retrieved for meta-analysis. The effect sizes of Vitamin D status were presented as standardized mean difference (SMD) with 95% confidence interval (CI), using random-effect models and inverse variance method. The Cochran Q statistic and I2 tests were used to evaluate the heterogeneity across included studies. Seven studies with 3219 women were included our meta-analysis. There was heterogeneity existing among included studies (I2 = 96.4%, P < 0.001), so a random-effect model was used. The findings of this meta-analysis revealed that the mean serum Vitamin D levels in women with PFD were significantly lower than healthy women (SMD −0.60; 95% CI, −1.06, −0.13; P = 0.01). This meta-analysis demonstrates lower levels of serum Vitamin D in women with PFD rather than healthy women. Additional prospective studies regarding the association between Vitamin D status and PFD are required to confirm our findings.

Introduction: Minor surgeries in the mouth region have been associated with a risk of temporomandibular disorders (TMDs). One of the most common surgeries is third molar removal. The aim of this study was to determine the prevalence of temporomandibular joint (TMJ) problems in candidate patients for impacted third molar surgery with and without previous temporomandibular problems. Materials and Methods: In this prospective cohort study, 15 to 30-year-old patients with and without TMD were chosen before third molar surgery. According to the clinical examinations and Research Diagnostic Criteria for TMD questionnaire, frequency of joint click, severity of TMJ pain using visual analog scale (VAS), and maximum mouth opening (MMO) were evaluated at before the surgery and 1 week, 1 month, and 6 months after the surgery. The changes in the click frequency at different times in the two groups were analyzed statistically by Chi-square test and the difference of the parameters of the MMO and VAS values in the two groups were analyzed by Student t test. Results: In the group with TMD, the click had a significant increase 1 week after the surgery. However, 6 months after the surgery, the incidence of click decreased significantly compared to 1 month after the surgery (P = 0.032). MMO at all the times was significantly higher in the group without TMD symptoms (P = 0.012). At all the times, VAS values were higher in the group with TMD symptoms (P = 0.024). The maximum VAS values were observed at 1 week after the surgery (P = 0.041). Conclusion: The reduction in MMO and increase in VAS score in patients with TMD were evident compared to patients without TMD. Furthermore, it seems that the surgical trauma resulting from the removal of the third molars is a predisposing factor for developing TMD.