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It all started with the plastic chair, it is often found in Beirut’s urban settings without ever really being questioned. Inside the house, it’s an object you sit on. On the street, it prohibits parking. Like an unspoken and untaught language, everyone knows that if there’s a chair, you can’t park. Thinking about this specific urban phenomenon, it was about seeking instances in which the city creates solutions for itself. This collection of informalities formed a popular visual language worth being thought of, challenging the conventional ways we think of our own city. The plastic chair, the wheel, the concrete block, the fruit basket; those are a few ingredients of a creative recipe made of available, low-cost and repurposed materials, patched by a sense of utility. By considering those social occurrences, we attempt to reconsider our own cultural landscape, and by actually looking, we realize they are reflections of our times, struggles and daily obstacles. As urban artifacts, their whole is greater than the sum of their parts. The Beirut Street Museum is a conceptual museum that resists conventional forms of art and dismantles the exclusivity of museology. It operates on the ground, where every city walk becomes a museum walk. Rooted in concepts of the dérive, situationism and deconstructing museology, the BSM speaks the language of the street. It becomes a growing archive of collective evidence: people's marks on the space that surrounds them.

This study investigates the intersection of European Privacy Law (PL) and Collaborative Platforms (CP) in the context of mental health, examining their global impact on psychiatric care and the facilitation of work reintegration for individuals with mental health conditions. The research emphasizes the supportive role of PL and Business-to-Business (B2B) digital manufacturing platforms, such as CP, in enhancing the continuum of care. Specifically, it explores how these platforms can aid in societal and workplace integration for patients.Using a quantitative methodology, the study is based on an online survey completed by 167 healthcare professionals (HCPs) specializing in mental health services and psychiatric care. The survey assesses the potential benefits of CP beyond traditional manufacturing roles, focusing on their contributions to pharmaceutical therapy development, support mechanisms, and supply chain management improvements, all under the protections afforded by PL.The findings indicate that integrating PL with CP can significantly enhance efficiency, promote collaboration, and drive innovation in both pharmaceutical production and mental healthcare. This integration is crucial for delivering a comprehensive range of therapeutic services, including immediate crisis response and long-term rehabilitation, within a secure and legally compliant framework. The study highlights the urgent need for the development of robust governance and ethical standards to navigate the challenges and opportunities posed by CP in healthcare. It acknowledges the transformative potential of CP but stresses the necessity of a thorough examination of ethical, regulatory, and compliance issues to ensure their sustainable and ethical implementation.

Abstract Objective This study aimed to assess the service quality (SQ) for Type 2 diabetes mellitus (T2DM) and hypertension in primary healthcare settings from the perspective of service users in Iran. Methods The Cross-sectional study was conducted from January to March 2020 in urban and rural public health centers in the East Azerbaijan province of Iran. A total of 561 individuals aged 18 or above with either or both conditions of T2DM and hypertension were eligible to participate in the study. The study employed a two-step stratified sampling method in East Azerbaijan province, Iran. A validated questionnaire assessed SQ. Data were analyzed using One-way ANOVA and multiple linear regression statistical models in STATA-17. Results Among the 561 individuals who participated in the study 176 (31.3%) were individuals with hypertension, 165 (29.4%) with T2DM, and 220 (39.2%) with both hypertension and T2DM mutually. The participants’ anthropometric indicators and biochemical characteristics showed that the mean Fasting Blood Glucose (FBG) in individuals with T2DM was 174.4 (Standard deviation (SD) = 73.57) in patients with T2DM without hypertension and 159.4 (SD = 65.46) in patients with both T2DM and hypertension. The total SQ scores were 82.37 (SD = 12.19), 82.48 (SD = 12.45), and 81.69 (SD = 11.75) for hypertension, T2DM, and both conditions, respectively. Among people with hypertension and without diabetes, those who had specific service providers had higher SQ scores (b = 7.03; p = 0.001) compared to their peers who did not have specific service providers. Those who resided in rural areas had lower SQ scores (b = -6.07; p = 0.020) compared to their counterparts in urban areas. In the group of patients with T2DM and without hypertension, those who were living in non-metropolitan cities reported greater SQ scores compared to patients in metropolitan areas (b = 5.09; p = 0.038). Additionally, a one-point increase in self-management total score was related with a 0.13-point decrease in SQ score (P = 0.018). In the group of people with both hypertension and T2DM, those who had specific service providers had higher SQ scores (b = 8.32; p

Introduction: Somatic Symptom Disorder (SSD) is characterized by distressing somatic symptoms which are accompanied by disproportionate thoughts, feelings, and behaviors, has wide gender differences in prevalence, which has been less investigated in researches. Aim: The purpose of this study was to compare the physical (criteria A) and psychological symptom of SSD (criteria B) consist of cognitive, affective and behavioral in female and male patients. Method: This study was a descriptive and causal-comparative research. The participants included 60 Iranian women and 30 men with SSD in the age range of 18-60 years old who participated in the study based on the diagnosis of a psychiatrist by Convenience sampling method in 2021-2022. Data was collected by The Somatic Symptom Disorder-B (2017) Criteria Scale and The Somatic Symptom Scale8 (2014). For data analysis, MANOVA were applied by using SPSS-22. Results: The findings revealed that women with SSD generally showed more psychological symptoms compared to men and in the psychological subscales, affective (P=0.00) and behavioral (P=0.00) was more evident in them, however there was no significant difference between men and women in cognition of psychological subscales (P=0.18) and intensity of physical pain (P=0.13). Conclusion: According of the study, one of the factors of the difference in SSD prevalence can be from less expressing, not less suffering from the disorder in men. Studying the main causes of differences in the affective and behavior of psychological subscales such as cultural origin, can be effective in further studies.

Abstract Background and Aims Oral mucositis is one of the most serious complications due to chemotherapy and radiotherapy in head and neck cancer treatment. Oral mucositis causes a wide range of clinical signs and symptoms, such as ulcers, pain, and dysphagia. Additionally, because of speech limitations, patients' self‐esteem will decrease, ultimately causing reduced quality of life. The primary objective of this study was to investigate the role of diet in the onset and progress of mucositis induced by chemotherapy and radiation therapy in patients with cancers. Methods In this study, 121 patients with a mean age of 51.43 ± 13.08 years were selected randomly and referred to the cancer institute, where they underwent their first phase of chemotherapy. In this step, patients were examined and their severity of oral mucositis was graded according to the World Health Organization criteria. They completed a 3‐day allergen food recall and dietary recommendations were met. After completing the forms, four questionnaires were filled out for each patient, the patient's nutrition was analyzed using the N4 software, and the amount of macro‐ and micronutrients was measured. Results Micronutrients such as aspartic acid, glycine, serine, proline, alanine, arginine, glutamic acid, and vitamin B12 and macronutrients such as rose water, sausage, beverages, coffee, and lamb meat were examined, and a significant difference was observed between groups (grade 1 and 2 mucositis) (p

IntroductionIn Saudi Arabia, limited studies have evaluated factors including epidemiologic, clinical, and laboratory findings that are associated with COVID-19 disease. The aim of this paper was to identify laboratory parameters used in King Abdulaziz University Hospital which show an association with disease severity and patient outcome in the form of mortality.MethodsAge, gender, medical history, and laboratory parameters were all retrospectively assessed concerning disease severity and disease outcome in a total of 111 COVID-19 patients at King Abdulaziz University Hospital between July 2020 and August 2020. Patients were categorized into mild disease if they did not require ward admission, moderate if they met the Ministry of Health criteria for isolation ward admition, and severe if they were admitted to the ICU.ResultsAge but not gender was associated with the disease severity X2 (4, N = 110) = 27.2, p

Abstract Background Hepatotoxicity due to highly active antiretroviral therapy (HAART) has gained prominent attention since it can be affected by many factors. The aim of this study was to determine the prevalence of hepatotoxicity and related risk factors of severe hepatotoxicity following HAART initiation. Methods A total of 100 drug-naive patients aged between 18 and 61 years were recruited. They were put on Tenofovir/Lamivudine/Efavirenz [TDF/3TC/EFV] (64), Zidovudine/ Lamivudine/Efavirenz [AZT/3TC/EFV] (22), and Zidovudine/Lamivudine/Nevirapine AZT/3TC/NVP (14) and monitored for 6months and blood samples drawn.Alanine aminotransferases (ALT), aspartate aminotransferases (AST), and alkaline phosphatase (ALP) wereanalyzed by enzymatic methods and used to classify levels of hepatotoxicity. Results A total of 37(37%) and 49(49%) patients presented with hepatotoxicity while 15% and 28% had severe hepatotoxicity at 4 and 24 weeks respectively. Serum levels of all enzymes increased significantly (p = 0.001) with increased treatment duration. Univariate analysis revealed that the risk factor of developing severe hepatotoxicity was significantly greater in patients

Abstract Background and objective Because of the effect of vitamins on modulating the immune system function, we have evaluated the effect of supplementation with vitamins A, B, C, D, and E in ICU-admitted patients with COVID-19. Methods This study was a randomized and single-blinded clinical trial in which 60 subjects were randomly assigned to two groups. The intervention group (n=30) received vitamins, and the control group did not receive any vitamin or placebo. The intervention was included 25,000 IU daily of vitamins A, 600,000 IU once during the study of D, 300 IU twice daily of E, 500 mg four times daily of C, and one amp daily of B complex for 7 days. At baseline and after the 7-day intervention, the serum levels of inflammatory markers, vitamins, and the SOFA score were assessed. In addition, the mortality rate and duration of hospitalization were evaluated after the intervention (IRCT registration number: IRCT20200319046819N1/registration date: 2020-04-04, https://www.irct.ir/trial/46838 ). Results Significant changes were detected in serum levels of vitamins (p < 0.001 for all vitamins), ESR (p < 0.001), CRP (p = 0.001), IL6 (p = 0.003), TNF-a (p = 0.001), and SOFA score (p < 0.001) after intervention compared with the control group. The effect of vitamins on the mortality rate was not statistically significant (p=0.112). The prolonged hospitalization rate to more than 7 days was significantly lower in the intervention group than the control group (p=0.001). Regarding the effect size, there was a significant and inverse association between receiving the intervention and prolonged hospitalization (OR = 0.135, 95% CI 0.038–0.481; p=0.002); however, after adjusting for confounders, it was not significant (OR=0.402, 95% CI 0.086–1.883; p=0.247). Conclusion Supplementation with vitamins A, B, C, D, and E could improve the inflammatory response and decrease the severity of disease in ICU-admitted patients with COVID-19.

Abstract Objectives This study will evaluate the main hypothesis that supplementation with vitamins A, B, C, D, and E significantly improves the severity and mortality rate in ICU patients with COVID-19. Trial design This study is a randomized, single-blinded, two-arm (1:1 ratio) parallel group clinical trial. Participants We are conducting this study in patients with COVID-19 admitted to intensive care units at the Imam Khomeini Hospital Complex in Tehran, Iran. The inclusion criteria are as follows: (1) aged between 20 and 60 years, (2) both male and female patients with COVID-19, (3) clinical or definitive diagnosis (using polymerase chain reaction (PCR) test), (4) patients have not participated in other clinical trials, and (5) no renal or hepatic abnormalities. The exclusion criteria are as follows: (1) patients with specific and rare viral diseases such as HIV and (2) patients who have been undergoing chemotherapy for the past month. Intervention and comparator Duration of intervention: 7 days from randomization Intervention in the treatment group: Vitamin A 25,000 IU daily Vitamin D 600,000 IU once during study Vitamin E 300 IU twice daily Vitamin C is taken four times per day B vitamins are taken as a daily Soluvit [which included thiamine nitrate 3.1 mg, sodium riboflavin phosphate 4.9 mg (corresponding to vitamin B2 3.6 mg), nicotinamide 40 mg, pyridoxine hydrochloride 4.9 mg (corresponding to vitamin B6 4.0 mg), sodium pantothenate 16.5 mg (corresponding to pantothenic acid 15 mg), sodium ascorbate 113 mg (corresponding to vitamin C 100 mg), biotin 60 μg, folic acid 400 μg, and cyanocobalamin 5 μg] The control group will not receive any supplements or placebo. All supplements are made in Iran except for Soluvit (from Fresenius Kabi, New Zealand). Main outcomes 1. Weight, height, and BMI 2. Severity of pulmonary involvement according to CT scan 3. Respiratory support (invasive or non-invasive) 4. Percentage of oxygen saturation (SpO2 level) 5. Serum levels of WBC, CRP, ESR, IL6, IFN-G, and TNF-α 6. The patient’s body temperature 7. The presence or absence of involvement of organs other than the lungs (e.g., heart, liver, kidneys) 8. Duration of hospitalization 9. Mortality rate Randomization At baseline, eligible patients were randomly assigned to a 1:1 ratio to one of two groups: intervention and control. Block randomization is used based on the gender of patients. Blinding (masking) Patients are unaware of being placed in the intervention or control groups after signing consent. All treatment staff will be aware of which group each of the patients is in due to the specific conditions of the ICU and the absence of placebo for the control group. Numbers to be randomized (sample size) The researchers plan to include 60 patients in total, with 30 patients in each group. Trial status This is the first version of the protocol which started on April 2, 2020. Recruitment began April 2, 2020, and is expected to be complete by July 4, 2020. Trial registration The Iranian Registry of Clinical Trials IRCT20200319046819N1 . Registered on April 4, 2020 Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol (Fig. 1, Table 1).

Functional gastrointestinal disorders are characterized by absence of anatomical and biochemical alterations, and are diagnosed and classified based on symptomatology. We aim to explore the prevalence of functional abdominal pain disorders and Functional constipation using Rome IV criteria. An online questionnaire was distributed randomly via social media targeting the general population of the western region of Saudi Arabia. Parents who have at least 1 child in the age group 3 to 18 years were included. Children with mental disabilities, or any organic gastrointestinal disorder were excluded. Five hundred thirty-two responded and 215 were excluded. The overall prevalence of functional abdominal pain disorders was 3.1%. The prevalence of functional constipation was 4.7%. Conclusions : Rome IV criteria seems to give a lower functional abdominal pain prevalence than Rome III, online learning did not seem to affect the prevalence of both disorders, but a family stressor seems to increase functional constipation prevalence.

Vitamin D plays a variety of physiological functions, such as regulating mineral homeostasis. More recently, it has emerged as an immunomodulator player, affecting several types of immune cells, such as regulatory T (Treg) cells. It has been reported that vitamin D exerts some mediatory effects through an epigenetic mechanism. In this study, the impacts of calcitriol, the active form of vitamin D, on the methylation of the conserved non-coding sequence 2 (CNS2) region of the forkhead box P3 (Foxp3) gene promoter, were evaluated. Fourteen C57BL/6 mice were recruited in this study and divided into two intervention and control groups. The CD4+ T cells were isolated from mice splenocytes. The expression of Foxp3, IL-10, and transforming growth factor-beta (TGF-β1) genes were relatively quantified by real-time PCR technique, and the DNA methylation percentage of every CpG site in the CNS2 region was measured individually by bisulfite-sequencing PCR. Vitamin D Intervention significantly (p

Decreasing the population and activation of inflammatory T helper cells in multiple sclerosis (MS) patients using vitamin A derivatives (retinoic acids) has been well documented. The present study determined the effect of vitamin A supplementation on psychiatric signs in MS patients. The subjects were 101 relapsing-remitting MS patients enrolled in a placebo-controlled randomized clinical trial. The treatment group was administered 25000 IU/d retinyl palmitate (RP) for 6 months followed by 10000 IU/d RP for another 6 months. The results for baseline characteristics, modified fatigue impact scale and Beck Depression Inventory-II were recorded at the beginning and end of the one-year study. The non-normal distribution data was compared between groups using a nonparametric test and normal distribution data was analyzed using a parametric test. (ClinicalTrials.gov Identifiers: NCT01417273). The results showed significant improvement in the treatment group for fatigue (p=0.004) and depression (p=0.01). Vitamin A supplementation helped during interferon therapy in the treatment process and improved psychiatric outcomes for anti-inflammatory mechanisms.

Multiple Sclerosis (MS) is a chronic inflammatory disease that leads to degeneration of the brain and spinal tissue. Imbalances of CD4+ T cells including Thelper1 (Th1)/Thelper2 (Th2) and Thelper17 (Th17)/Tregulatory (Treg), their secreted cytokines and gene expressions, are important aspects of in immunopathogenesis of MS. Vitamin A and its metabolites can regulate the immune system and appears to be effective in preventing progression of the autoimmune disease such as MS. Disease progression was evaluated By Magnetic Resonance Imaging (MRI), Expanded Disability States Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) tests. Cytokine levels were measured using ELISA kits and gene expression was quantified by Real time PCR (RT-PCR) system. According to the difference between the epidemiological and clinical data on the relationship between vitamin A and immune system regulation, this study of the first time assesses Immune function as well as gene expression and progression of the disease following administration of vitamin A supplement.

A study was made of 19 male subjects, mean age 54.7, S.D. 7.5 years, exposed to risk of aluminium dust inhalation for 16, S.D. 9.7 years, awarded compensation by the local provincial branch of INAIL (National Institute for Insurance against Occupational Accidents) in the period 1975-1988, as prescribed by item 48 of Presidential Decree 482/1975. The workers were divided into two groups on the basis of radiological signs of lung fibrosis (3 1/1 cases and 7 1/0 cases according to the ILO classification) or of COPD (Chronic Obstructive Pulmonary Disease) (9 cases). Careful examination of the work histories confirmed the previous observations of aluminium pneumoconiosis with moderate functional alterations in alumina production, potroom and casting workers.

Short term angiotensin converting enzyme inhibition may induce a transient salt and water retention in patients with hypertension or heart failure. To verify the glomerular and tubular effects of short term converting enzyme inhibition, thirteen patients with mild to moderate essential hypertension (WHO I-II) were treated orally either with perindopril (4 mg o.d.) or captopril (25 mg b.i.d.) for one week. Both drugs reduced supine mean blood pressure significantly (p less than 0.01) (perindopril from 126 +/- 11 to 108 +/- 7 mmHg, mean +/- SD, and captopril from 132 +/- 12 to 121 +/- 16). Plasma volume (radio-iodinated albumin space) was unchanged while mean extracellular fluid volume (inulin space) increased although not significantly (from 5.05 +/- 1.32 l/sqm to 5.71 +/- 2.21 with perindopril and from 4.96 +/- 2.6 to 5.6 +/- 1.7 with captopril). Sodium clearance decreased (from 1.4 +/- 0.6 to 1.1 +/- 0.5 ml/min 1.73 sqm with perindopril, p less than 0.05, and from 0.97 +/- 0.44 to 0.88 +/- 0.51 with captopril, n.s.). In 9 patients (6 on captopril and 3 on perindopril) extra-cellular fluid volume increased simultaneously with reduction in glomerular filtration rate and in proximal tubule sodium re-absorption as well as an increase in distal tubule sodium reabsorption. In these patients the changes in proximal and distal tubule sodium reabsorption were significantly (p = 0.05) different from those of the patients with no extra-cellular fluid expansion.(ABSTRACT TRUNCATED AT 250 WORDS)

Essential hypertension is associated with increased intrarenal resistance that may go undetected unless the fractional distribution of cardiac output to the kidney is measured. Several hypotensive drugs induce a transient reduction of renal blood flow and glomerular filtration rate due to the reduction in renal perfusion. This may represent an untoward effect especially in subjects already presenting a clinically relevant reduction of renal function. Loop diuretics, cardioselective and intrinsic sympathomimetic activity (ISA) beta-blockers, calcium entry-blockers, and angiotensin-converting enzyme (ACE) inhibitors either do not significantly reduce or even increase renal perfusion. This is one more reason for considering these agents as first choice drugs for the treatment of hypertension.