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Abstract Background Epidemiologic findings suggest that measures of body fat distribution predict health outcomes independent of the overall body fat assessed by body mass index (BMI). This study aimed to evaluate the associations of overall and regional body fat with the severity of hepatic steatosis and fibrosis in type 2 diabetic patients with non‐alcoholic fatty liver disease. Methods Bioelectric impedance analysis and two newly developed anthropometric indices, namely, A Body Shape Index (ABSI) and Body Roundness Index (BRI), were used to estimate the body fat. Based on fibroscan parameters, significant hepatic fibrosis and severe steatosis were defined as ≥F2 and >66%, respectively. Results Higher total body fat (odds ratio [OR] 1.107, 95% confidence intervals (CI) 1.038–1.182, p = 0.002), trunk fat (OR 1.136, 95% CI 1.034–1.248, p = 0.008) and leg fat (OR 1.381, 95% CI 1.139–1.674, p = 0.001) were associated with liver fibrosis. However, in contrast to the total body fat (OR 1.088, 95% CI 1.017–1.164, p = 0.014) and leg fat (OR 1.317, 95% CI 1.066–1.628, p = 0.011), the trunk fat was not associated with severe hepatic steatosis. BRI performed better than trunk, leg and total body fat in predicting hepatic steatosis (OR 2.186, 95% CI 1.370–3.487, p = 0.001) and fibrosis (OR 2.132, 95% CI 1.419–3.204, p 0.05). Conclusion BRI revealed a superior predictive ability for identifying the degree of hepatic steatosis and stiffness than other obesity indices. Additionally, higher levels of adiposity in the trunk, legs, and overall body were linked to an increased risk of developing liver fibrosis. Although trunk fat did not show an association with severe hepatic steatosis, an increase in leg and total fat was related to liver steatosis.

Abstract Background Impact of Isocitrate dehydrogenase1 (IDH1) and O6-methylguanine-DNA methyltransferase (MGMT) in glioblastoma (GBM) have been of great interest due to their implications in prediction of prognosis of several types of cancer. It was aimed to investigate the clinical role of IDH1 mutation and MGMT methylation pattern among GBM patients versus non-neuro-oncological diseases (NND) patients and their impact on survival criteria. Methods Formalin-fixed paraffin-embedded (FFPE) tissue sections of 58 GBM and 20 non-neuro-oncological diseases patients were recruited and IDH1 mutation and MGMT methylation was detected using Cast-PCR technology and Methyl II quantitative PCR approach, respectively. Results were assessed with other clinicopathological criteria and survival patterns. Results IDH1 mutation was detected among 15 GBM cases (15/58) and it was not reported among NND (P = 0.011). Receiver operating characteristic (ROC) curve was plotted to discriminate between MGMT methylation among studied groups. Patients with MGMT methylation ≥ 66% were reported as high methylation, which was recorded significantly in 51.7% and 100% of GBM cases and NND, respectively. Both showed significant difference with performance status, while MGMT methylation was significantly related with tumor size and tumor location. IDH1 mutation and MGMT methylation reported significant increase with GB patients revealed complete response to treatment. Survival pattern was better for IDH1 mutation and MGMT high methylation as compared to IDH1 wild type or MGMT low–moderate methylation, respectively, and favorable survival was detected when both were combined than using either of them alone. Conclusion Detection of IDH1 mutation and MGMT methylation among GB patients could aid in prediction of their response to treatment and their survival patterns, and their combination is better than using any of them alone.

Purpose: Identify the effectiveness of the use of technology in university education.Method: Theory: Virtual Learning. Sample: (intentional) on (381) university students. Tool: questionnaire.Importance: attempting to find appropriate mechanisms for students, lecturers, and universities, for the correct activation of e-learning.Findings: Blended learning was the best choice for the respondents, as the use of technology in educational life has become an imperative necessity, which is currently represented in the (Distribution of the course on electronic CDs for students, instead of paper books _ Communication between students and the lecturer using social networks _ Electronic correction _ Using electronic management systems _ Developing digital libraries).Conclusion: Blended learning must be well-planned to change the negative thinking towards it, where: Preparing the necessary technical requirements for it, such as providing a laptop and fast and free internet for each student and for each university professor. Training professors and students on how to: use educational electronic programs, access digital libraries and trusted scientific websites, and conduct exams that are graded electronically. Training those in charge of designing electronic courses. Follow up on the performance of students, and they must be trained on the practical parts of the course. Professors show their interest in front of students to introduce technology in education and hold periodic seminars with students to identify the problems they face in order to work on solving them. Thus, blended learning has taken an (interactive) method instead of the method (of indoctrination), which was dominant over traditional education.

Abstract There is limited data on the prevalence of thyroid dysfunction in the older population. This study aimed to determine the prevalence of thyroid dysfunction among a sample of Iranian older adults. A cross-sectional analysis of older adults who aged 60 years and over was conducted. A total of 363 subjects were randomly selected from Birjand longitudinal aging study (BLAS) cohort study. Serum thyroid-stimulating hormone (TSH) level, total thyroxine (T4) and total triiodothyronine (T3) were measured by the enzyme-linked immunosorbent assay (ELISA). Based on thyroid function tests and history of taking medicines used to treat thyroid disorders, participants were classified into the following groups: euthyroid, overt/subclinical hypothyroidism, and overt/subclinical hyperthyroidism. Subsequently, the crude and World Health Organization (WHO) age-standardized prevalence were estimated for different thyroid function categories. A total of 171 men and 192 women, aged 60–94 years, were randomly selected. The crude prevalence of total hypothyroidism was 22.31% (subclinical [18.46%], overt [3.86%]), and that of hyperthyroidism was 1.66% (subclinical [1.38%], overt [0.28%]). The crude prevalence of total thyroid dysfunction was, therefore, 23.97%. A female preponderance was noticed in both total (P-value = 0.035) and overt (P-value = 0.035) hypothyroidism. An increasing trend with age was noticed in the prevalence of total hypothyroidism (P-value = 0.049). Age-standardized prevalence of total hypothyroidism and hyperthyroidism was 26.63% (95% confidence interval [CI] 20.58–33.69%) and 1.11% (95% CI 0.49–2.51%), respectively. A considerable proportion of our study population demonstrated evidence of thyroid dysfunction, particularly subclinical hypothyroidism. Our findings highlight the importance of further investigation of thyroid disorders among older Iranian adults.

Conjugated linoleic acid (CLA) is a geometrical isomer of linoleic acid, which has anti-inflammatory, anti-diabetic, anti-cancer, and anti-obesity properties. However, the studies reported inconstant results about the CLA-related effects on lipid profiles. As a result, meta-analysis and systematic review were performed to survey the CLA supplementation-related effect on lipid profile including high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG). To identify the relevant research, a systematic comprehensive search was initiated on the medical databases such as Scopus and PubMed/Medline until December 2022. The overall effect size was estimated by weighted mean difference (WMD) and 95% confidence interval (CI) in a random effect meta-analysis. In the final quantitative analysis, the meta-analysis considered 35 randomized controlled trials (RCTs) with 1,476 participants (707 controls and 769 cases). The pooled results demonstrated that CLA supplementation, compared with olive oil, significantly increased serum TG levels (WMD: 0.05 mmol/L; 95% CI: 0.01 to 0.1; p = 0.04; I2 = 0.0%, p = 0.91). With regard to TC level, CLA supplementation compared with placebo significantly reduced TC concentrations (WMD: −0.08 mmol/L; 95% CI: −0.14 to −0.02; p < 0.001; I2 = 82.4%). Moreover, the non-linear dose–response analysis indicated a decreasing trend of TC serum level from the 15th week of CLA supplementation compared with olive oil (Pnon-linearity = 0.01). The present meta-analysis and systematic review of 35 RCTs showed that the CLA intervention was able to raise the level of TG in comparison to olive oil; however, it can decrease TC level compared with placebo and olive oil.

Abstract Most civil structures exhibit nonlinear behavior during moderate to severe earthquakes. Consequently, inelastic analysis is needed for seismic design. Several dynamic and static analysis methods are available for the assessment and design of engineering structures. Two of the available methods in terms of nonlinear dynamic time history analysis and nonlinear static analysis, which is known as pushover analysis, are employed herein to comprehensively study and investigate the seismic performance of multi-story building structures with different floor systems. Moreover, the study is extended to assess the actual values of the response reduction/modification factor (R-factor) for each building model, then evaluate the values with the code-recommended design values. Three-dimensional finite element building models with 5, 10 and 15 stories are developed for the evaluation process. The advanced computer program ETABS is used for developing and analyzing the buildings considering material and geometrical nonlinearity. A suit of seven earthquake records is considered and scaled according to the ASCE-16 seismic design code to excite the building models. The obtained results evidently reveal that the type of floor slab significantly impacts the seismic response of the building. More specifically, the effects of floor slabs on seismic demands are more evident in low- and mid-rise buildings. In addition, the type of slab system and height of the building have more influence on the response modification factors, especially for low-rise building models.

Several studies have proven that COVID-19 is linked to a higher incidence of different thrombotic events. Thrombosis of the portal vein can result in portal hypertension and can extend to the mesenteric vein resulting in intestinal ischemia. A search of PubMed, Web of Science, and Scopus for relevant studies revealed an association between PVT and COVID-19. This review is structured according to PRISMA guidelines. Thirty-three studies met the inclusion criteria. Twenty-nine case studies/series and four cohort/cross-sectional studies were included. Age at diagnosis was lower when compared to PVT due to cirrhosis. In cohort/cross-sectional studies, males comprised 54.83% of subjects, whereas in case reports/series, males comprised 62.1%. Obesity, asthma, hypertension, and diabetes were the most common comorbidities identified. The majority of the thrombotic events occurred within two weeks. The treatment aimed to prevent thrombus progression and improve recanalization. According to the evidence, early intervention prevents the poor prognosis of intestinal ischemia and its propagation.

Abstract Polycystic ovary syndrome (PCOS) has significant metabolic sequelae linked to insulin resistance. This study aimed to compare clinical, metabolic, and hormonal characteristics of PCOS women with and without insulin resistance. The second aim was to compare the clinico-biochemical profiles of the various PCOS phenotypes. In this cross-sectional secondary analysis, we combined the baseline data from two separate randomized controlled trials (RCTs) in women diagnosed with PCOS. PCOS patients were categorized into the four Rotterdam PCOS phenotypes according to the presence of at least two criteria of oligomenorrhea/anovulation (O), hyperandrogenism (H), and polycystic ovary morphology (P): O–H–P, H–P, O–H, and O–P. Participants were categorized into two groups according to the homeostasis model assessment index of insulin resistance (HOMA-IR) levels:

Background. The effects of oligopin as an antioxidant on polycystic ovarian morphology (PCOM) have not yet been examined. Therefore, the objective of this study was to evaluate the oligopin supplementation on PCOM among patients with polycystic ovarian syndrome (PCOS). Methods. This randomized, placebo-controlled trial was carried out at Shariati Hospital, Arash Hospital, and Yas Hospital, Tehran, Iran, to determine the effect of oligopin (50 mg/d) or placebo in PCOS patients. The ultrasonographic ovarian morphology was assessed in women aged 18–40 years, before and after 3 months of intervention. Results. Among 45 randomized participants, 32 participants, of whom 17 were in the oligopin group and 15 were in the placebo group completed the trial. There was only one adverse event in the oligopin group. The mean (standard deviation) age of the patients was 30.47 (6.30) years and the median (interquartile range) BMI was 27.50 (23.42–33.55). Three months of oligopin therapy significantly decreased ovarian stromal area (p=0.01) and stromal/total area (p=0.003). However, no significant differences were observed in the ovarian volume, ovarian area, 2–9 mm antral follicle counts, or peripheral follicle distribution pattern at 3 months. Conclusion. Among participants with PCOS, the use of oligopin (50 mg) daily, as compared with a placebo, resulted in improvement of the stromal area and stromal/total area at the end of the 3 months of treatment. Further studies are, however, needed to evaluate the longer-term efficacy and safety. This trial is registered with IRCT20140406017139N3.

Osteoporosis has a significant economy, society, and health burden. The recent advancement of available therapies caused ethical questions regarding the use of placebo-controlled studies in osteoporosis. Some specialists believe it is not ethically to subject the study participants to any additional risk when there is already verified effective therapy for the disease and established therapies can significantly decrease the likelihood of osteoporotic fracture. Accordingly, researchers have expressed ethical concerns over placebo-controlled trials. Here, we have briefly addressed ethical and methodological aspects regarding conducting placebo-control trials as well as potential alternatives.

Background: Diabetes mellitus [DM] is a metabolic condition characterized by hyperglycemia caused by deficiencies in insulin action or secretion or both. Diabetes' persistent hyperglycemia is linked to long-term organ failure, including kidney loss of functions, leading to diabetic nephropathy [DN].Aim of the work: This study aims to assess the value of serum autotaxin [ATX], oxidized LDL [ox LDL], and β2-microglobulin [β2M] as biomarkers for DN patients.Patients and Methods: This cross-sectional study included 100 subjects divided into three groups. Group 1; control group [20 healthy subjects]. Patients were subdivided into two groups, group 2 [40 patients diagnosed with DN stages Ⅰ, Ⅱ, and Ⅲ], and group 3 which involved 40 patients diagnosed with DN stages Ⅳ and Ⅴ.Results: As regards the ATX, it was significantly higher in group 3 than in group 1 and group 2 with a statistically significant difference between every 2 groups [P value > 0.05 for all]. In terms of Ox LDL and β2M, the difference between the three groups was significant statistically [P value = 0.005, and 0.002 respectively], however the difference between group 2 and group 3 was not significant [P value = 0.44, and 0.98 respectively].Conclusion: Serum autotaxin, ox LDL, and β2M can be used as diagnostic noninvasive biomarkers in DN.

Abstract Considering the progressive prevalence and co-occurrence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD), as well as the current evidence suggesting the elevated levels of basal metabolic rate (BMR) among these individuals, the present study aimed to identify factors determining hypermetabolism in such subjects. This cross sectional study was conducted in 30 to 53-year-old individuals with concurrent T2DM and NAFLD (controlled attenuation parameter score ≥ 260 dB/m). Resting energy expenditure (REE) was determined by an indirect calorimetry device. Hypermetabolism was defined as an elevated measured REE > 110% of the predicted REE. The multivariate logistic regression test was used for detecting factors associated with hypermetabolism. Between September, 2017, and March, 2018, a total of 95 eligible participants (64.40% male) with both T2DM and NAFLD were included, while 32.63% of them were classified as hypermetabolic. Overall, the mean recruitment age ± standard deviation and median (interquartile range) body mass index were 44.69 ± 5.47 years and 30.20 (27.80–33.30) kg/m2, respectively. Demographic, anthropometric and biochemical variables did not vary significantly across two groups except for total body water, low-density lipoprotein cholesterol and dipeptidyl peptidase 4 (DPP-4) inhibitors (p

Background: Warts are viral cutaneous infections caused by human papilloma virus (HPV), presented by verrucous growth over the skin surface. The cell mediated immune response is considered to play a crucial role in HPV clearance. The viral load and number of lesions increase when there is an imbalance between the T-helper 1 and T-helper 2 immune responses. Interleukin (IL)-19 is a cytokine that belongs to interleukin 10 cytokines family and constitutes a sub-family with IL-20, IL-22 and IL-24. IL-19 is mainly produced by activated monocytes and to a lesser extent by B-cells, keratinocytes and fetal membranes. IL-19 was found to shift T-cell maturation away from the pro-inflammatory T-helper 1 cells toward the anti-inflammatory T-helper 2 cells. It induces IL-4 and IL-13 production in T cells and apoptosis in monocytes. Aim: This study aimed to measure serum level of IL-19 in patients with warts compared to healthy controls and to find out the correlation between this level and number, size and clinical types of warts. Methods: The study included 50 patients with warts and 50 control subjects. Serum concentration of IL-19 was measured by enzyme-linked immune sorbent assay. Results: Interleukin-19 serum level was significantly lower in patients with warts than in controls (P < 0.003). Moreover, there was a significant positive correlation between IL-19 serum level and the number of warts (P = 0.027). Conclusion: Serum level of IL-19 was significantly lower in patients with warts, and this low level might be crucial for an effective cell mediated immunological response to HPV.

Abstract Background Polycystic ovary syndrome (PCOS) is diagnosed based on chronic anovulation, androgen excess (clinical and/or biochemical), and polycystic ovaries in ultrasound. The aim of the present study was to evaluate which parameters in the transvaginal ultrasound (TVUS) of ovaries could be better associated with concurrent hormonal imbalance in the women with PCOS. Methods Using a cross-sectional design, this study focused on 61 subjects (18–40 years) with PCOS. Patients were recruited at three academic hospitals during the 2017–2019 period. PCOS was defined according to the Rotterdam criteria. The association of ovarian morphology with hormonal and metabolic feature was investigated using linear regression models, adjusted for a set of possible confounding variables including age, mensuration status and body mass index (BMI). Results The mean volume of both ovaries was positively associated with the total testosterone level (β = 0.025, P value