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Abstract Background Poor ovarian response (POR) to controlled ovarian stimulation (COS) remains challenging, especially in advanced-age women with diminished ovarian reserve, resulting in low live birth rates. Many patients prefer to conceive with their eggs, underscoring the need for improved treatments. This study explores astaxanthin potential as a COS adjuvant to improve ovarian response and assisted reproductive technology (ART) outcomes, considering its impact on oxidative stress (OS), inflammation, and apoptosis, which are key factors in POR. Methods In this randomized, triple-blind, placebo-controlled trial, 60 infertile POR patients from POSEIDON Group 4 (the poorest prognosis category, age > 35 and poor ovarian reserve (anti-müllerian hormone

Abstract Background End-stage renal disease (ESRD) causes numerous physical and psychological problems in patients, so that they must adhere to their treatment regimen to recover their disease, alleviate these problems, and increase their lifespan. The present study aimed to determine the predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients. Methods This correlational cross-sectional study investigated some variables related to treatment adherence in 184 patients undergoing hemodialysis referred to two dialysis centers in Kerman, southeastern Iran. A census method was used to select the participants and data were collected using socio-demographic characteristics questionnaire, Adherence to Treatment Questionnaire (ATQ), Conner-Davidson Resilience Scale, Reef Psychological well-being Questionnaire, and Spiritual Well-Being Scale (SWBS). Results The overall treatment adherence score was 155.42 ± 27.98 and we found a positive significant correlation between spiritual health, resilience, psychological well-being, and treatment adherence (p

Objectives: Objectives: The current study was designed to evaluate the role of MTHFR gene (rs1801133 and rs1801131) polymorphisms and investigate the serum Homocysteine level in Iraqi patients with CKD. Materials and Methods: Blood samples were collected from fifty CKD patients and fifty healthy control group aged (20 –65) years who attended Lmamain Al Kadhemain Medical Teaching Hospital and Al-Numan Hospital in Baghdad, Iraq. The genotyping study of the MTHFR gene at rs1801133 and rs1801131 was determined using HRM-PCR, and the serum level of Homocysteine was measured using ELISA kits. Results: Serum Hcy concentration was significantly (p˂0.01) increased in CKD patients compared to apparently healthy individuals (2.918Umol/L versus 1.621 Umol/L respectively). The frequencies and genotypes of alleles for the MTHFR gene at rs1801133 SNP in CKD patients versus healthy subjects revealed that the TT genotype percentage was in CKD patients significantly higher than in control groups (30% versus 14%, respectively). At the same time, the CT genotype was a considerably more significant percentage in CKD patients than in control groups (46% versus 16%, respectively). The frequency of the T allele was 53% and 22% for CKD patients and healthy individuals, respectively. In contrast, C allele frequency values were 47% and 78% for CKD patients and control groups, respectively. The frequencies of genotypes and alleles for the MTHFR gene at rs1801131 SNP showed that the percentage of CC genotype was in CKD patients significantly higher than that of control groups, 46% versus 12%, respectively, while C allele frequency values were 55% and 19% for CKD patients and control groups. Also, allele frequency values were 45% and 81% for CKD patients and healthy individuals, respectively. In this study, four haplotypes (AC, AT, CT, CC), certain variations in the MTHFR gene, specifically the CT haplotype formed by rs1801133 and rs1801131, have been related to an increased risk of chronic kidney disease. Conversely, the AC and AT haplotypes may have a protective effect against CKD, with the AC haplotype showing significant protection (OR, 0.45, 95% CI 0.06–0.5, p=0.0009). Conclusions: It was concluded from the current study that variants of the MTHFR gene have a role in the pathogenesis of CKD.

Abstract The global concern over heavy metal pollution necessitates urgent measures to safeguard human health and the environment. This study focuses on employing triethylenetetramine (TETA)-functionalized MIP-206-OH (TMIP-206) as an effective adsorbent for removing Pb(II) from wastewater. TMIP-206 was synthesized via a hydrothermal method followed by functionalization with TETA. Kinetic studies demonstrate that lead removal on TMIP-206 conforms to the pseudo-second-order model, indicating an efficient removal process. Experimental results reveal that TMIP-206 aligns with the Langmuir isotherm, exhibiting a maximum removal capacity of 267.15 mg/g for lead ions. The sorption efficiency of TMIP-206 for Pb ions remains stable across six cycles, with a reduction of less than 15%. Optimal adsorption performance is observed at a pH of 6. These findings underscore the potential of TMIP-206 as an alternative for adsorbing Pb(II) from aqueous environments, addressing the global challenge of heavy metal pollution. Future research should explore the scalability and long-term stability of TMIP-206-based adsorbents to enhance their practical applicability in diverse environmental contexts and contribute to broader strategies for mitigating heavy metal contamination.

The ever-growing needs for writing ability in English in the global context has given priority to finding more effective ways to teach L2 writing. A thorough analysis of the pertinent literature indicated a dearth of empirical research in ELT regarding the effect of applying the ENGAGE model on the writing skills of L2 learners. Therefore, the current study sought to ascertain how the ENGAGE Model and Task-based Language Teaching (TBLT) method affected the complexity, accuracy, and fluency (CAF) of Iranian EFL learners' writing performance. Sixty-seven Iranian female EFL learners aged 18 to 25 at Urmia University language center were chosen for the quasi-experimental study based on their level of proficiency on the standard Oxford Quick Placement Test (OPT) in 2022. The participants were randomly divided into three groups and instructed based on the principles of the ENGAGE model (n = 22), TBLT model (n = 24), and control group (n = 21). Pretesting, intervention, and post-testing were all the processes that the study participants underwent. The null hypotheses were tested after the data were analyzed by applying multivariate ANCOVA (MANCOVA) measures. The study of the post-test data revealed that the ENGAGE model, as opposed to TBLT, had a more significant effect on the overall L2 CAF in Iranian EFL learners' ability to write essays. The results of the present study can be applied by ELT experts and curriculum designers in EFL and ESL settings. English learners and instructors can use the ENGAGE model to address linguistic and metalinguistic issues.

Diabetes and its complications are major diseases that affect human health. Diabetic cardiovascular complications such as cardiovascular diseases (CVDs) are the major complications of diabetes, which are associated with the loss of cardiovascular cells. Pathogenically the role of ferroptosis, an iron-dependent cell death, and cuproptosis, a copper-dependent cell death has recently been receiving attention for the pathogenesis of diabetes and its cardiovascular complications. How exposure to environmental metals affects these two metal-dependent cell deaths in cardiovascular pathogenesis under diabetic and nondiabetic conditions remains largely unknown. As an omnipresent environmental metal, cadmium exposure can cause oxidative stress in the diabetic cardiomyocytes, leading to iron accumulation, glutathione depletion, lipid peroxidation, and finally exacerbate ferroptosis and disrupt the cardiac. Moreover, cadmium-induced hyperglycemia can enhance the circulation of advanced glycation end products (AGEs). Excessive AGEs in diabetes promote the upregulation of copper importer solute carrier family 31 member 1 through activating transcription factor 3/transcription factor PU.1, thereby increasing intracellular Cu+ accumulation in cardiomyocytes and disturbing Cu+ homeostasis, leading to a decline of Fe–S cluster protein and reactive oxygen species accumulation in cardiomyocytes mitochondria. In this review, we summarize the available evidence and the most recent advances exploring the underlying mechanisms of ferroptosis and cuproptosis in CVDs and diabetic cardiovascular complications, to provide critical perspectives on the potential pathogenic roles of ferroptosis and cuproptosis in cadmium-induced or exacerbated cardiovascular complications in diabetic individuals.

BackgroundFrailty is a critical concern for older adults, impacting their susceptibility to adverse events and overall quality of life. This study aimed to determine the frailty status of patients 60 years or older in Abu Dhabi Ambulatory Healthcare Services (AHS) and assess its relation to the stress exerted by Ramadan fasting and the occurrence of any adverse outcomes.MethodsIn this prospective observational study, participants were included if the attending physicians used the IDF-DAR risk stratification assessment tool. A tele-interview was conducted to complete the FRAIL score within 6 weeks before Ramadan 1,444 (CE 2022). The outcome was assessed through another tele-interview and an electronic medical record review after Ramadan.ResultsAccording to the FRAIL assessment tool, among the 204 patients aged 60 years or older included in the study, 109 (53.4%) were classified as either frail or pre-frail. In total, 20 (9.8%) patients were frail, that is, 1 out of 10, and 89 (43.6%) were pre-frail. The remaining 95 (46.6%) patients were robust. Using logistic regression to assess the occurrence of adverse outcomes after Ramadan fasting, a higher frailty score was identified as the third independent risk factor [B = 0.4, OR = 1.5 (1–2.02–1.86), and p = 0.039] for experiencing an adverse event. The identified factors associated with frailty were age, increased albumin-to-creatinine ratio (ACR), chronic kidney diseases (CKDs), and ischemic heart diseases (beta = 0.27, p = 0.003; beta = 0.24, p = 0.004; beta = 0.2, p = 0.039; and beta = 0.18, p = 0.041, respectively). One-third of the frail patients had an event, while the incidence in pre-frail patients was 11.2%, and among the robust patients, the incidence was 6.3%. Physicians’ global assessment of frailty did not align well with the structured FRAIL scoring. Only five (25%) out of the 20 patients identified as frail by the FRAIL assessment tool were also judged as frail or having cognitive function impairment by the physicians’ global assessment tool.ConclusionFrailty is prevalent among elderly patients with diabetes. Disparity exists between subjective and objective frailty assessments, emphasizing the need for standardized evaluation methods. Using the FRAIL tool is recommended for patients aged 60 or older with diabetes in Abu Dhabi.

A well can be produced and exploited when it has production power, in other words, if the well does not have enough pressure, it will not be able to flow. Artificial production is a method to increase the lifespan of well production. The well studied in this article has a significant annual lower pressure drop; So now with the current pressure of the existing well, it is not possible to send the oil of this well to the separator of the first stage of the exploitation unit. Among the existing solutions to maintain or increase production and increase the flow pressure of the well, is the use of artificial extraction. In this article, an attempt has been made to simulate the effect of using a core pipe, gas pumping and installing an electric submersible pump (ESP) on the production flow rate and flow pressure of the well by using the well data and the static and current pressure test. The current production data with the PIPESIM software was checked, and then the best extraction method for the studied well. Finally, the installation of an ESP was determined and selected as the best method of artificial extraction.

Abstract As climate issues gradually attract public attention worldwide, the operation of crude oil pipelines has been attached with new emission‐reduction targets. Though previous studies concerning life cycle assessment (LCA) of oil and gas pipelines have estimated the carbon footprint to some extent, there is a lack of research on life cycle carbon emissions that take the process of crude oil pipelines transportation. the main objective of this study is to build a comprehensive LCA model of carbon footprint for crude oil pipeline systems. A gate‐to‐gate analysis is provided for the LCA model, which means that the entire pipeline's life cycle from the extraction to disposal is considered. The LCA approach used both midpoint and endpoint impact assessment methods to evaluate the environmental impacts of crude oil pipeline transportation in Iran. The study analyzed the major environmental impact categories, such as greenhouse gas emissions, energy consumption, water usage, and solid waste generation. The results showed that the crude oil pipelines transportation has significant environmental impacts in Iran. The three highest impacts on the midpoint scale are marine ecotoxicity by 61.54 kg 1,4‐DCB, terrestrial ecotoxicity by 52.26 kg 1,4‐DCB and fossil resource scarcity by 40.22 kg oil eq. The endpoint impacts of three stations were also compared. The Chamran, Abadan and Zanganeh stations have 95.44%, 94.22%, and 6% impacts on human health, respectively. Also, Abadan station has the largest amount of damage to ecosystems and resources with 96.65% and 80.02%, respectively. The findings of this study could be used by policymakers, oil companies, and other stakeholders to make informed decisions and implement strategies to reduce the environmental impact of oil transportation in Iran.

Abstract Background Total pelvic exenteration (TPE), an en bloc resection is an ultraradical operation for malignancies, and refers to the removal of organs inside the pelvis, including female reproductive organs, lower urological organs and involved parts of the digestive system. The aim of this meta-analysis is to estimate the intra-operative mortality, in-hospital mortality, 30- and 90-day mortality rate and overall mortality rate (MR) following TPE in colorectal, gynecological, urological, and miscellaneous cancers. Methods This is a systematic review and meta-analysis in which three international databases including Medline through PubMed, Scopus and Web of Science on November 2023 were searched. To screen and select relevant studies, retrieved articles were entered into Endnote software. The required information was extracted from the full text of the retrieved articles by the authors. Effect measures in this study was the intra-operative, in-hospital, and 90-day and overall MR following TPE. All analyzes are performed using Stata software version 16 (Stata Corp, College Station, TX). Results In this systematic review, 1751 primary studies retrieved, of which 98 articles (5343 cases) entered into this systematic review. The overall mortality rate was 30.57% in colorectal cancers, 25.5% in gynecological cancers and 12.42% in Miscellaneous. The highest rate of mortality is related to the overall mortality rate of colorectal cancers. The MR in open surgeries was higher than in minimally invasive surgeries, and also in primary advanced cancers, it was higher than in recurrent cancers. Conclusion In conclusion, it can be said that performing TPE in a specialized surgical center with careful patient eligibility evaluation is a viable option for advanced malignancies of the pelvic organs.

Amniocentesis is one of the known and accessible methods for prenatal diagnosis, which is performed for various reasons during pregnancy. The present study was performed to determine the most common reasons for amniocentesis to detect aneuploidy. This retrospective cohort study was performed on the records of 635 pregnant women who underwent amniocentesis guided by high-resolution ultrasound during 2010-2019 at Yas Hospital of Tehran University of Medical Sciences, Tehran, Iran. The study evaluated the indications for amniocentesis in order to investigate the relationship between each of these indications and fetal aneuploidy results. All participants were evaluated for genetic study results. The prevalence of aneuploidy was 8.2% and abnormal screening test was the most common reason for performing amniocentesis (68% of cases). Also, abnormal ultrasound results had the strongest correlation with the possibility of genetic abnormalities in the current pregnancy. Therefore, amniocentesis is highly recommended for women with indications, especially in cases of abnormal ultrasound results.

AbstractBackground: Mycobacterium tuberculosis is still one of the most dangerous human pathogens. Identification of the relationships between different clinical strains has remained a high priority for epidemiology research. Methods: In this study, we used MLSA (Multilocus sequence analysis) to generate a highly robust phylogeny of M. tuberculosis. MLSA, based on single nucleotide polymorphism (SNP) was performed on five genes fragments from the Rpsl (302 bp), MprA (559 bp), LipR (322 bp), KatG (488 bp) and Fgd1 (266 bp), in order to identify polymorphic nucleotide sites, and the discriminatory power of each locus for all genes was measured with Hunter‐Gaston Index (HGI). Results: In this study, a sequence type (ST) number was assigned to each unique allelic profile, and 9 sequence types were identified from 20 strains, these imply that there is a high diversity of strains in this area. Conclusion: Our results showed that the presence of high genetic diversity among clinical isolates of M. tuberculosis in Northeast of Iran. There is no evidence for recent transmission. Keywords: Mycobacterium tuberculosis, Multi-locus sequence analysis; Molecular epidemiology; Tuberculosis; KatG; Rpsl1. IntroductionMycobacterium tuberculosis (M. tuberculosis), the causative agents of tuberculosis (TB), is one of the most successful human pathogens, infecting nearly one-third of the people all around the world, causing over 9 million new cases and 1.7 million deaths each year [1-2]. Identification of the relationships between different clinical strains of M. tuberculosis has great significance to the public health [3].

Injection of surfactant and polymer at the same time is one of the challenges that reduce their performance in reservoirs. Using a polymeric surfactant (PS) as a single new material can be the best alternative to solve the existing challenges. Considering the basic problems of chemical injection, this work focuses on the surface adsorption of polymer/surfactant on carbonate reservoirs (CRs). In this work, polyacrylamide was synthesized using zwitterionic as a hydrophobic polymeric surfactant (i.e. HZPAA). For a better comparison, this substance was compared with hydrolyzed polyacrylamide (HPAA) in concentrations of 40 to 1000 mg in CRs. Examining the results states that with increasing polymer concentration, the surface absorption of HZPAA and HPAA on dolomite reservoir rocks (DRRs) with positive surface charge increases. The attendance of COO and SO3− functional groups in the matrix of the new polymer (i.e. HZPAA) creates electrostatic forces and superior surface absorption. Their mechanism works in such a way that negative functional groups attract positively charged surfaces and increase the surface absorption of the polymer. Investigations show that the new synthesized material (i.e. HZPAA) can provide a new approach to improving surface absorption in carbonate reservoirs.

This study delves into the intricate realm of public perception regarding urban parks, aiming to uncover key factors influencing this perception and offer insights for urban planning and park management in Isfahan City, Central Iran. A comprehensive survey was conducted across 63 urban parks, gathering subjective feedback from park visitors on park size, vegetation, and exposure to external disturbances. Objective metrics were the area of the park, the mean and stdev of the Sentinel-2 NDVI as measures of vegetation density and diversity, respectively, distance to other parks and the park perimeter-to-area ratio. Linear and non-linear regression analysis between subjective feedback and objective metrics revealed that satisfaction peaks in parks with sizes of 15 ha or more. Higher vegetation density maximizes satisfaction. Parks with simpler, more regular shapes tend to offer a greater sense of freedom from external disruptions. According to the Generalized Additive Model model (R2= 0.737, explained deviance = 77.1 %), lush and healthy vegetation is often associated with attractive and inviting parks, especially in parks with simpler, more regular shapes that minimize the exposure to (noise and visual) disturbances. Such green and circular park designs can guide urban planners and managers in creating inviting and user-friendly parks, aligning with public expectations.

Road accidents have always been one of the important reasons for fatalities and financial losses. Since road accidents on rural highways cause more serious injuries than those on urban highways, providing a suitable method to increase safety in the curves can be a significant contributor to preventing these damages. Although speed is one of the most important variables affecting highway safety, numerous studies have been performed on the reliability analysis of horizontal curves without taking the speed variable into account. The aim of this research is reliability (probability of noncompliance) assessment in the horizontal curve design using geometric design consistency criteria. The radius, superelevation, and operating speed of 19 horizontal curves were collected by field research on the Mashhad-Torbat Heydarieh highway in Iran. Three different approaches were defined based on the geometric design consistency criterion of a single horizontal curve, and consecutively, the probability of noncompliance was calculated using these approaches. According to the obtained results, this study showed that radius enhancement increases the probability of noncompliance and the consistency level of the geometric design. Finally, the high values of the probability of noncompliance (failure) indicate that the geometric design guidelines need calibration in the design of horizontal curves, especially for higher radii., Author(s): Hossein Saedi (corresponding author) [1]; Ali Abdi Kordani [1]; Seyed Mohsen Hosseinian [1] 1. Introduction Road accident is one of the important reasons for death in human societies [1, [...]

This article studies the competition between cancer cells within the human body depending on Gompertz’s growth. This model depends on two types of cancer cells, which grow to a certain extent, termed the carrying capacity. The carrying capacity is taken into account and defined as the number of cancer cells in which a certain density of cells eventually reaches stability. When this happens, the growth rate fluctuates, either it goes a little above or a little below the carrying capacity. This paper will cover the mathematical modeling aspects of Gompertz growth and a means to determine how competition creates growth and whether it leads to stability or instability. The paper includes growth equations that show two competing species which lead to extinction, coexistence or the emergence of one species superior to the other.

Due to concern regarding the consumption of high amount of sugar in diet and role of diet in combating overweigh and related disease, the aim of present study was to optimize a reduced calorie probiotic chocolate milk formula with suitable physicochemical properties. The formula comprising inulin, stevia (Stevia rebaudiana Bertoni), chia (Salvia hispanica L.) seed gum (CSG), and whey protein concentrate (WPC) which optimized using Box-Behnken design (BBD) and then enriched with an encapsulated probiotic strain Lactobacillus acidophilus (DSM1643). The independent variables included inulin (2–8%), CSG (0.1–0.5 %), stevia (50–100 % replacement of sugar), and WPC (1–3%). The dependent variables were selected as viscosity, average particle size, sedimentation percentage, and general acceptance. Optimization done toward achieving the highest viscosity and general acceptance and the lowest sedimentation percentage and average particle size. The optimal conditions were found to be 7.99 % inulin, 70 % stevia, 0.34 % CSG, and 1 % WPC. Under these conditions, the viscosity, sedimentation percentage, average particle size, and general acceptance of the product were equal to 40.69 mPa s, 2.2 %, 434.221 nm, and 5.1, respectively. Next, the chocolate milk was enriched with at 109 CFU/g probiotic bacteria and evaluated. The probiotic strain was resistant to simulated gastrointestinal conditions and under this condition the free bacterial cells count declined by 8 logCFU/g while the encapsulated cells decreased approximate 3 logCFU/g. The bacteria count did not undergo a significant change until the 5th day of storage. The results showed that the inulin, stevia, CSG, and WPC at optimal concentrations and encapsulated probiotic bacteria could be simultaneously applied to produce a product with good properties. This formula could be considered as a new product with health improving properties, low calorie which is suitable for people suffering from diabetes and obesity.

Abstract Graphene is a perfect 2D crystal of covalently bonded carbon atoms and constitutes the building block for all graphitic structures. Its superior properties make it an attractive material for a variety of technological applications. However, mass production does not meet the initial expectations. Chemical Vapor Deposition (CVD) is currently the only available method for large‐scale automated production, but the produced graphene sheets suffer from structural and morphological defects that degrade considerably the mechanical and other physical properties of synthesized graphene. Recently, the use of liquid metal catalysts (LMCat) has been proposed as an alternative platform for facile and high‐quality synthesis of single‐crystal graphene. Herein, simultaneous Raman spectroscopy combined with mechanical testing is adopted confirming that the reinforcing efficiency of the LMCat graphene is greatly improved. In fact, the effective Young's modulus of LMCat graphene has been found ≈630 GPa, which is significantly higher than the graphene grown on solid Cu substrate due to differences in the morphology of Cu substrate. Overall, this work paves the way for the development of defect‐free graphene of quality comparable to exfoliated flakes, and this will have a major technological impact for many applications.

Key Clinical Message In this study, we introduced one of the rarest concomitants of the absence of left pulmonary artery (LPA), which was seen in our patient along with patent ductus arteriosus (PDA) and ventricular septal defect (VSD). Abstract Unilateral absence of pulmonary artery (UAPA) is a congenital heart disease in association with other abnormalities such as tetralogy of Fallot and septal defects or isolated in 30% of cases and occurs in the right lung in two thirds of cases. Our case is a 33‐year‐old man who was hospitalized with symptoms of cough, shortness of breath, and hemoptysis. The echocardiography revealed a large ventricular septal defect, absent left pulmonary artery, and severe pulmonary hypertension (PH) along with patent ductus arteriosus. These findings were confirmed by CT angiography. This association has rarely been found in past studies. Due to PH and pulmonary infection, the patient was treated with intravenous prostaglandin and antibiotics. However, in cases of timely diagnosis and treatment of UAPA, fatal complications such as pulmonary hypertension, morbidity, and mortality are reduced. This case emphasizes the importance of awareness of this abnormality and its associated anomalies to enable early diagnosis and treatment.