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An individual's disease risk is affected by the populations that they belong to, due to shared genetics and environmental factors. The study of fine-scale populations in clinical care is important for identifying and reducing health disparities and for developing personalized interventions. To assess patterns of clinical diagnoses and healthcare utilization by fine-scale populations, we leveraged genetic data and electronic medical records from 35,968 patients as part of the UCLA ATLAS Community Health Initiative. We defined clusters of individuals using identity by descent, a form of genetic relatedness that utilizes shared genomic segments arising due to a common ancestor. In total, we identified 376 clusters, including clusters with patients of Afro-Caribbean, Puerto Rican, Lebanese Christian, Iranian Jewish and Gujarati ancestry. Our analysis uncovered 1,218 significant associations between disease diagnoses and clusters and 124 significant associations with specialty visits. We also examined the distribution of pathogenic alleles and found 189 significant alleles at elevated frequency in particular clusters, including many that are not regularly included in population screening efforts. Overall, this work progresses the understanding of health in understudied communities and can provide the foundation for further study into health inequities.

Multiwall carbon nanotubes (MWCNTs) were modified through deferoxamine mesylate and used as an adsorbent for separation and preconcentration of the trace amount of iron ions in food samples followed by a simple, fast and sensitive spectrophotometric method was developed for the termination. The proposed separation and preconcentration method was performed in short time by using a small amount of chemical solvent. Also, the used adsorbent was environmentally friendly and highly compatible with the human body.In this study iron was complex with deferoxamine. After extraction, the complex was eluted by HCl 2 % (v/v) and analyzed by a fast, straightforward, and inexpensive UV–Visible spectrometer method. The determination was performed with high selectivity, sensitivity and good accuracy. The calibration curve was linear in the range of 0.12 µg.L−1 to 500 µg.L−1. The detection limit was obtained 0.08 µg.L−1. The suggested method was used for measuring the trace amount of iron ions in the five food samples: spinach, parsley, cooked pinto beans, and cooked sheep's liver. Based on the obtained results, the proposed method has shown proper sensitivity, accuracy, and repeatability.

The increasing development of the competitive market has forced organisations to make great efforts in the processes of supply, production, and distribution to meet customer demand in the shortest time and at the lowest cost. A cross-docking (CD) system is one of the successful and practical strategies in this field considered by researchers in various fields. Also, business process management plays a key role in continuous improvement and increased productivity. In today's digital age, due to the ability to record all activities, process mining is an important method to identify the current situation and improve productivity. In this research, a newly established CD belonging to a chain store is studied to improve the current situation, in which different goods enter and then exit after different processes. The purpose of this study is to obtain the optimal number of doors and loaders as sources. First, helping an RFID system, all activities are recorded, and the current situation of the processes is monitored, and then, the real process model is identified using heuristic and inductive miner algorithms. After adapting to the event log by using the simulation process in Arena software, different scenarios are examined, and the best possible case is presented. [ABSTRACT FROM AUTHOR]

Sepsis is a life-threatening condition mainly caused by gram-negative and gram-positive bacteria. Understanding the type of causative agent in the early stages is essential for precise antibiotic therapy. This study sought to identify a host gene set capable of distinguishing between sepsis induced by gram-negative bacteria; Escherichia coli and gram-positive bacteria; Staphylococcus aureus in community-onset adult patients. In the present study, microarray expression information was used to apply the Least Absolute Shrinkage and Selection Operator (Lasso) technique to select the predictive gene set for classifying sepsis induced by E. coli or S. aureus pathogens. We identified 25 predictive genes, including LILRA5 and TNFAIP6, which had previously been associated with sepsis in other research. Using these genes, we trained a logistic regression classifier to distinguish whether a sample contains an E. coli or S. aureus infection or belongs to a healthy control group, and subsequently assessed its performance. The classifier achieved an Area Under the Curve (AUC) of 0.96 for E. coli and 0.98 for S. aureus-induced sepsis, and perfect discrimination (AUC of 1) for healthy controls from the other conditions in a 10-fold cross-validation. The genes demonstrated an AUC of 0.75 in distinguishing between sepsis patients with E. coli and S. aureus pathogens. These findings were further confirmed in two distinct independent validation datasets which gave high prediction AUC ranging from 0.72-0.87 and 0.62 in distinguishing three groups of participants and two groups of patients respectively. These genes were significantly enriched in the immune system, cytokine signaling in immune system, innate immune system, and interferon signaling. Transcriptional patterns in blood can differentiate patients with E. coli-induced sepsis from those with S. aureus-induced sepsis. These diagnostic markers, upon validation in larger trials, may serve as a foundation for a reliable differential diagnostics assay.

BackgroundMultiple sclerosis (MS) is a chronic neuroinflammatory disease of the central nervous system, characterized by demyelination and neurodegeneration, which has a profound impact on the quality of life. Dysregulated inflammatory processes are a major driver of MS progression, with many areas of research being dedicated to modulating inflammation in people with MS. Several dietary patterns have been associated with improvements in inflammatory biomarkers; although, the findings have been inconsistent. Thus, this study aims to evaluate the effects of dietary interventions on inflammatory markers in adults with MS.MethodsElectronic databases, including PubMed/MEDLINE, Web of Science, Scopus, and Cochrane/Central, will be searched. Screening, selection, and extraction of data, along with quality assessment of included studies, will be done by two separate reviewers, and any potential conflicts will be settled through discussion. Two reviewers will independently assess the risk of bias in included studies using the Cochrane Risk of Bias Tool. If plausible, the results will be synthesized and pooled for meta-analysis. The overall quality of evidence of each study will be evaluated using the NutriGRADE tool, which is a modification to the Grading Recommendations Assessment, Development, and Evaluation (GRADE) developed specifically for nutrition research.DiscussionStudies have demonstrated conflicting results regarding the effects of dietary interventions on serum levels of inflammatory biomarkers among people with MS. Thus, it is expected that the planned systematic review and meta-analysis will yield robust evidence on the effects of diet on inflammatory profile in the setting of MS.

In a systemic effort to survive environmental stress, organ systems fluctuate and adapt to overcome external pressures. The evolutionary drive back toward homeostasis makes it difficult to determine if an organism experienced a toxic exposure to stress, especially in early prenatal and neonatal periods of development. Previous studies indicate that primary human teeth may provide historical records of experiences related to stressors during that early time window. To assess the molecular effects of early life adversity on enamel formation, we used a limited bedding and nesting (LBN) mouse model of early life adversity (ELA) to assess changes in the enamel organ gene expression and enamel matrix mineralization. On average, postnatal day 12 (P12) ELA mice weighed significantly less than the controls. When adjusted for animal weight, ELA molar enamel volume was reduced as compared with the controls, and the relative mineral density of molar enamel was significantly increased. There were no obvious changes in enamel matrix crystal morphology or structure in ELA as compared with the control mouse enamel. RNAseq showed extracellular matrix organization to be the most significantly affected GO and reactome pathways, whereas butanote metabolism was the most significantly altered KEGG pathway. Transcripts expressing the enamel matrix proteins amelogenin (Amelx) and enamelin (Enam) were among the top 4 most differentially expressed genes. When evaluating molecular mechanisms for the changes in gene expression in ELA enamel organs, we found significantly increased expression of Dlx3, while transcripts for clock genes Per1 and Nrd1 were downregulated. These findings support the possibility that the developing enamel organ is sensitive to the pressures of early life adversity and produces molecular and structural biomarkers reflecting these challenges.

As the hardest tissue in the human body, tooth enamel formation is a highly regulated process involving several stages of differentiation and key regulatory genes. One such gene, tryptophan-aspartate repeat domain 72 (WDR72), has been found to cause a tooth enamel defect when deleted or mutated, resulting in a condition called amelogenesis imperfecta. Unlike the canonical genes regulating tooth development, WDR72 remains intracellularly and is not secreted to the enamel matrix space to regulate mineralization, and is found in other major organs of the body, namely the kidney, brain, liver, and heart. To date, a link between intracellular vesicle transport and enamel mineralization has been suggested, however identification of the mechanistic regulators has yet to be elucidated, in part due to the limitations associated with studying highly differentiated ameloblast cells. Here we show compelling evidence that WDR72 regulates endocytosis of proteins, both in vivo and in a novel in vitro ameloblast cell line. We elucidate WDR72's function to be independent of intracellular vesicle acidification while still leading to defective enamel matrix pH extracellularly. We identify a vesicle function associated with microtubule assembly and propose that WDR72 directs microtubule assembly necessary for membrane mobilization and subsequent vesicle transport. Understanding WDR72 function provides a mechanistic basis for determining physiologic and pathologic tissue mineralization.

INTRODUCTION: Cerebral ischemia and coronary artery disease (CAD), the major leading causes of mortality and morbidity worldwide, are pathophysiologically interrelated. Cerebral ischemic events are categorized as large or small vessels disease. The current study compares the factors related to CAD events incidence following ischemic large versus small disease CVA.METHOD: The current cohort study was conducted on 225 patients with ischemic stroke in two groups of large (n=75) and small (n=150) vessel disease during 2018-19. The patients’ demographic, medical, and clinical characteristics were recruited. They were followed for three years regarding the incidence of CAD events, including ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA), and sudden cardiac death (SCD). Data about the coronary angiography, computed tomography angiography (CTA), Single Photon Emission Computed Tomography (SPECT), and the therapeutic approach were gathered.RESULTS: There were insignificant differences between the patients with small versus large vessels CVA in terms of ACS incidence (P-value=0.105), type of the events (P-value=0.836), angiographic (P-value=0.671), SPECT (P-value=0.99) and CTA findings (P-value>0.99) and approached CAD (P-value=0.728). Cox regression assessments revealed an increased risk of CAD events due to large versus small vessels disease after adjustments for hypertension, diabetes mellitus, dyslipidemia, re-stroke, and the previous history of IHD (HR=2.005, 95%CI: 1.093-2.988, P-value=0.021).CONCLUSION: According to the findings of this study, large-vessel involvement in an ischemic stroke was associated with more than a two-fold increase in the three-year probability of ischemic heart disease incidencet.

BackgroundThe most prominent risk factor for atrial fibrillation (AF) is chronological age; however, underlying mechanisms are unexplained. Algorithms using epigenetic modifications to the human genome effectively predict chronological age. Chronological and epigenetic predicted ages may diverge in a phenomenon referred to as epigenetic age acceleration (EAA), which may reflect accelerated biological aging. We sought to evaluate for associations between epigenetic age measures and incident AF.MethodsMeasures for 4 epigenetic clocks (Horvath, Hannum, DNA methylation [DNAm] PhenoAge, and DNAm GrimAge) and an epigenetic predictor of PAI-1 (plasminogen activator inhibitor-1) levels (ie, DNAm PAI-1) were determined for study participants from 3 population-based cohort studies. Cox models evaluated for associations with incident AF and results were combined via random-effects meta-analyses. Two-sample summary-level Mendelian randomization analyses evaluated for associations between genetic instruments of the EAA measures and AF.ResultsAmong 5600 participants (mean age, 65.5 years; female, 60.1%; Black, 50.7%), there were 905 incident AF cases during a mean follow-up of 12.9 years. Unadjusted analyses revealed all 4 epigenetic clocks and the DNAm PAI-1 predictor were associated with statistically significant higher hazards of incident AF, though the magnitudes of their point estimates were smaller relative to the associations observed for chronological age. The pooled EAA estimates for each epigenetic measure, with the exception of Horvath EAA, were associated with incident AF in models adjusted for chronological age, race, sex, and smoking variables. After multivariable adjustment for additional known AF risk factors that could also potentially function as mediators, pooled EAA measures for 2 clocks remained statistically significant. Five-year increases in EAA measures for DNAm GrimAge and DNAm PhenoAge were associated with 19% (adjusted hazard ratio [HR], 1.19 [95% CI, 1.09-1.31]; P

In this work, gold nanoparticles coated with polyvinylpyrrolidone (PVP-AuNPs) were used as a colorimetric probe for the sensitive, selective, simple, and rapid determination of atenolol (ATN). Indeed, atenolol triggered the aggregation of PVP-AuNPs via hydrogen bonding, electrostatic interactions, and dipole-dipole forces with PVP on the surface of AuNPs, causing the colloidal solution's color to shift from red to blue. SEM, TEM, FT-IR, UV–Vis, zeta potential, and other methods were used to characterise the PVP-AuNPs that were created as well as their aggregates. An excellent linear relationship between the absorption ratio (A690/A521) and the concentration of ATN in the range of 0.07–3.0 μM with a detection limit of 0.023 μM was discovered by optimising the experimental settings. The influence of potential interfering species on the measurement of ATN was investigated, and it was discovered that the developed colorimetric sensor had satisfactory selectivity. Finally, the presented method was used to measure ATN in tablet and blood plasma samples, and the obtained recovery values showed great promise for the use of the proposed sensor in clinical applications.

BACKGROUND AND OBJECTIVES: Smart cities have been criticized for being too technologically driven and reinforcing entrepreneurial thinking rather than focusing on citizens and social sustainability. This paper aims to “define the implementing principles for Smart Cities in Tehran as a social construct”. In this regard, this study tries to develop smart city indicators and suggest a set of implementing principles for smart cities, citizens, and civic organizations in Tehran. Furthermore, this paper illustrates how in-progress smart city projects are meeting the citizens' needs in 22 districts of Tehran Municipality.METHODS: The present study has used a qualitative and quantitative methodology based on theoretical frameworks. In this paper, Maslow's hierarchy of needs acts as a meta-method for defining the principles of social sustainability to implement smart city projects. First, smart sustainable cities and associated indicators were evaluated based on Maslow’s hierarchy of needs. Second, a case study approach was utilized to assess Tehran’s smart city projects. Finally, the Strengths, Weaknesses, Opportunities, Threats and Quantitative Strategic Planning Matrix techniques were used to define strategies based on internal and external environmental factors and relation to social sustainability.FINDINGS: The results indicated that promoting innovation centers and living labs to create a vibrant, active, and healthy public realm was the most effective strategy for smart city development in Tehran (Weaknesses-Opportunities8=.1.323). Two important additional strategies were “involve stakeholders and focus on people and consider urban residents not only as recipients or users of smart cities but also as designers of smart cities” (Strengths-Opportunities3=1.075) and “promote community involvement in council decision-making by developing interactive platforms” (Strengths-Opportunities8=0.884).CONCLUSION: This paper contributes knowledge on how cities such as Tehran can achieve and implement social sustainability using a smart city approach. Plans and projects for a smart city in Tehran were deemed neither realistic nor sufficiently strategic, and they are assumed to satisfy neither policymakers nor citizens. Social sustainability-based principles and strategies are necessary to incorporate citizen perspectives into Tehran’s smart city plan and policies. The present study adds several significant insights to the existing frameworks for implementing smart city frameworks in Tehran.

Abstract Background The rapidly growing area of sequencing technologies, and more specifically bacterial whole-genome sequencing, could offer applications in clinical microbiology, including species identification of bacteria, prediction of genetic antibiotic susceptibility and virulence genes simultaneously. To accomplish the aforementioned points, the commercial cloud-based platform, 1928 platform (1928 Diagnostics, Gothenburg, Sweden) was benchmarked against an in-house developed bioinformatic pipeline as well as to reference methods in the clinical laboratory. Methods Whole-genome sequencing data retrieved from 264 Staphylococcus aureus isolates using the Illumina HiSeq X next-generation sequencing technology was used. The S. aureus isolates were collected during a prospective observational study of community-onset severe sepsis and septic shock in adults at Skaraborg Hospital, in the western region of Sweden. The collected isolates were characterized according to accredited laboratory methods i.e., species identification by MALDI-TOF MS analysis and phenotypic antibiotic susceptibility testing (AST) by following the EUCAST guidelines. Concordance between laboratory methods and bioinformatic tools, as well as concordance between the bioinformatic tools was assessed by calculating the percent of agreement. Results There was an overall high agreement between predicted genotypic AST and phenotypic AST results, 98.0% (989/1006, 95% CI 97.3–99.0). Nevertheless, the 1928 platform delivered predicted genotypic AST results with lower very major error rates but somewhat higher major error rates compared to the in-house pipeline. There were differences in processing times i.e., minutes versus hours, where the 1928 platform delivered the results faster. Furthermore, the bioinformatic workflows showed overall 99.4% (1267/1275, 95% CI 98.7–99.7) agreement in genetic prediction of the virulence gene characteristics and overall 97.9% (231/236, 95% CI 95.0–99.2%) agreement in predicting the sequence types (ST) of the S. aureus isolates. Conclusions Altogether, the benchmarking disclosed that both bioinformatic workflows are able to deliver results with high accuracy aiding diagnostics of severe infections caused by S. aureus. It also illustrates the need of international agreement on quality control and metrics to facilitate standardization of analytical approaches for whole-genome sequencing based predictions.

Background: Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention. This study aimed to compare the incidence of CIN in two groups of patients with and without metabolic syndrome (Mets) with baseline normal renal function. Materials and Methods: In this case − control study, 260 patient candidates for CAG, 130 patients with Mets and 130 patients without Mets participated, and their serum creatinine (Cr) level before and the 48 and 72 h after the angiography was measured. The incidence of CIN was compared in two groups. Two-way analysis of variance with repeated measures and univariate and multivariate logistic regression models. Results: The results showed a higher chance of being Mets with raising in triglyceride (adjusted odds ratio = 1.05, 95% confidence interval = (1.03–1.06), P < 0.001), Fasting blood glucose (1.010 [1.001–1.019], P = 0.025), and diastolic blood pressure (1.07 [1.07–1.20], P < 0.001), but declining in high-density lipoprotein-cholesterol (HDL-C) (0.91 [0.85–0.98], P = 0.008). Furthermore, blood urea nitrogen (BUN) and Cr level was raised in 48 and 72 h after contrast injection in both groups (All P < 0.001). Furthermore, in 48 h (3.11 [1.12–9.93], P = 0.016) and 72 h (2.82 [1.07–8.28], P = 0.021) after injection, a total of 25 patients had an increased Cr level and a significant difference between Mets and without Mets groups. The developing Mets had a significant association with the increased risk of AKI, which increased the chance of developing nephropathy (7.14 [2.27–22.5], P = 0.001). Conclusion: Mets, together with other risk factors, increased the overall risk of CIN development. Therefore, the incidence of CIN in patients Mets is significantly higher than that of patients without Mets, indicating a more important CIN risk factor.

Peripheral artery disease (PAD) is a form of atherosclerotic cardiovascular disease, affecting ∼8 million Americans, and is known to have racial and ethnic disparities. PAD has been reported to have a significantly higher prevalence in African Americans (AAs) compared to non-Hispanic European Americans (EAs). Hispanic/Latinos (HLs) have been reported to have lower or similar rates of PAD compared to EAs, despite having a paradoxically high burden of PAD risk factors; however, recent work suggests prevalence may differ between sub-groups. Here, we examined a large cohort of diverse adults in the BioMe biobank in New York City. We observed the prevalence of PAD at 1.7% in EAs vs. 8.5% and 9.4% in AAs and HLs, respectively, and among HL sub-groups, the prevalence was found at 11.4% and 11.5% in Puerto Rican and Dominican populations, respectively. Follow-up analysis that adjusted for common risk factors demonstrated that Dominicans had the highest increased risk for PAD relative to EAs [OR = 3.15 (95% CI 2.33–4.25), p < 6.44 × 10−14]. To investigate whether genetic factors may explain this increased risk, we performed admixture mapping by testing the association between local ancestry and PAD in Dominican BioMe participants (N = 1,813) separately from European, African, and Native American (NAT) continental ancestry tracts. The top association with PAD was an NAT ancestry tract at chromosome 2q35 [OR = 1.96 (SE = 0.16), p < 2.75 × 10−05) with 22.6% vs. 12.9% PAD prevalence in heterozygous NAT tract carriers versus non-carriers, respectively. Fine-mapping at this locus implicated tag SNP rs78529201 located within a long intergenic non-coding RNA (lincRNA) LINC00607, a gene expression regulator of key genes related to thrombosis and extracellular remodeling of endothelial cells, suggesting a putative link of the 2q35 locus to PAD etiology. Efforts to reproduce the signal in other Hispanic cohorts were unsuccessful. In summary, we showed how leveraging health system data helped understand nuances of PAD risk across HL sub-groups and admixture mapping approaches elucidated a putative risk locus in a Dominican population.

Vernacular buildings are known for their localized passive settings to provide comfortable indoor environment without air conditioning systems. One alternative is the consistent ground temperature over the year that earth-sheltered envelopes take the benefit; however, ensuring annual indoor comfort might be challenging. Thus, this research monitors the indoor thermal indicators of 22 earth-sheltered buildings in Meymand, Iran with a warm-dry climate. Furthermore, the observations are used to validate the simulation results through two outdoor and indoor environmental parameters, air temperature and relative humidity during the hottest period of the year. Findings indicated that the main thermal comfort differences among case studies were mainly due to their architectural layouts where the associated variables including length, width, height, orientation, window-to-wall ratio, and shading depth were optimized through a linkage between Ladybug-tools and Genetic Algorithm (GA) concerning adaptive thermal comfort model definition and could enhance the annual thermal comfort by 31%.

علی­رغم نقش مهم تهویه هوای طبیعی بر آتریوم، شرایط گرمایی درونی و کاهش بار استفاده از انرژی به مانند سیستم حیاط مرکزی، نقاط ضعفی که چگونه پارامترهای طراحی مختلف بر شرایط گرمایی تأثیر می­گذارد. پیچیدگی طراحی تهویه هوا طبیعی آتریوم که نیز شباهت ساختاری زیادی با حیاط مرکزی اقلیم گرم و خشک ایران دارد، نمی­توان به تنهایی به طراحی شبیه­سازی آن اکتفا نمود. در چند سال گذشته، محققان روش­های مختلفی از قبیل ارائه نمونه مدل، تحقیقات و محاسبات پیکره­بندی را مطرح نمودند تا عملکردهای گرمایی و تهویه هوای آتریوم را شناسایی کنند. با این حال تنوع در ارائه مدل­سازی، در نظر گرفتن همه پارامترهای مشترک موجود در طراحی آتریوم دستیابی به نتیجۀ مطلوب را مشکل می­سازد. این پژوهش به روش کمی و کیفی و با تکیه بر داده­های کتابخانه­ای انجام شده است. با مروری کوتاه بر مطالعات صورت گرفتۀ قبلی، در مورد نقش تهویه هوای طبیعی در ساختمان­های آتریوم در آب و هوای مختلف، پارامترهای طراحی مؤثر و کاربرد آنها برای ارتقا عملکرد گرمایی و کاهش مصرف انرژی را فراهم می­کند. این پارامترها شامل پیکربندی­ آتریوم­های مختلف و اجزای مختلف آن از قبیل هندسه، ویژگی­های دهانه، سقف، مصالح و داخل آن می­باشد. اندازه درزهای بیرونی تNثیرگذارترین پارامتری است که بر شرایط گرمایی درونی و عملکردهای تهویه هوای آتریوم و در نتیجه کاهش بار مصرف انرژی تأثیر می­گذارد.اهداف پژوهش: بررسی حیاط مرکزی در معماری موجود در فلات مرکزی ایران.بررسی نقش آتریوم در تهویه هوای طبیعی و تشابه برخی عملکرد و اجزای آن با حیاط مرکزی.سؤالات پژوهش: حیاط مرکزی چه نقشی در تهویۀ هوای درونی ساختمان داشته است و عملکرد آن به چه صورت بوده است؟در کارکرد بهینه تهویۀ ساختمان، چه پارامترهایی در طراحی آتریوم می­تواند تأثیرگذار باشد؟

BACKGROUND AND OBJECTIVES: Lack of paying attention of contemporary architecture and urban planning to the environment and adaptation to the climate of the region has caused many environmental problems. To solve a part of the problem, the present paper was conducted to achieve the proportions governing the exterior skin of open spaces of urban districts that have unique characteristics to adapt to the climate of their region, since about 2/3 of Iran is covered by arid climate, it was examined. The old texture of Yazd is one of the best architectural models compatible with arid climate of Iran, which its teachings can give suitable guidelines for contemporary architecture and urban planning. In this regard, three districts from the historical texture of Yazd were selected as research samples.METHODS: This research is of applied in terms of aim and its methodology is descriptive-analytical conducted by library method and field survey. The method of research and data analysis is a combination of quantitative and quantitative, in which the geometric properties of 143 plots were studied first and then, by comparing and analyzing the results, the fit was obtained.FINDINGS: The results showed that the average height of the exterior skin in the squares was more than that in the passages and entrances; this ratio is 1.22 for the entrances and 1.35 for the passages. The average width of the exterior skin is greater in the squares, followed by the passages and entrances, respectively, with ratios of about 2.3 and 12, respectively. The ratio of height to exterior skin width is 1 to 5.7 in the squares and 1 to 39 in passages, exterior skin width is about 6 times in the squares and 39 times in passages. These proportions are a sign of the influence of the region's climate, the generalization of which in similar climates will increase the harmony with the climate.CONCLUSION: Results suggest the existence of proportions and relations in the exterior skin that are affected by the climatic characteristics of the arid region of Iran and can be managed in the open spaces of urban districts.

BackgroundPreliminary dietary intervention trials with the low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets have shown favorable effects on fatigue among people with multiple sclerosis (MS); however, their impact on metabolic health is unknown.ObjectiveTo evaluate the impact of the Swank and Wahls diets on markers of metabolic health and to determine the association and mediation effect between changes in metabolic health and perceived fatigue among people with relapsing-remitting MS (RRMS).MethodsAs part of a randomized parallel-arm trial, vital signs, blood metabolic biomarkers, and the fatigue scale for motor and cognitive functions (FSMC) were collected from participants with relapsing-remitting MS (n = 77) at four study visits spaced 12 weeks apart: (1) run-in, (2) baseline, (3) 12-weeks, and (4) 24-weeks. Participants followed their usual diet at run-in, then were randomized at baseline to either the Swank or Wahls diets and followed for 24 weeks.ResultsBoth groups had significant reductions in weight, body mass index (BMI), total cholesterol, and low-density lipoprotein (LDL) at 12- and 24-weeks compared to respective baseline values (p ≤ 0.04 for all). The Swank group also had a significant reduction in high-density lipoprotein (HDL) at 12- and 24-weeks (p = 0.0001 and p = 0.02, respectively), while the Wahls group had significant reductions in diastolic blood pressure (DBP). In addition, both groups had significant reductions in FSMC total perceived fatigue and the motor and cognitive fatigue subscales at 12- and 24-weeks (p ≤ 0.01 for all); however, change in the cognitive subscale was not significant at 12-weeks in the Swank group (p = 0.06). Furthermore, the favorable effects, of both diets, on markers of metabolic health were not associated with and did not mediate the effect of the diets on perceived fatigue (p > 0.05 for all).ConclusionBoth diets lead to significant reductions in perceived fatigue, weight, BMI, total cholesterol, and LDL, but the significant reductions in perceived fatigue were independent of changes in markers of metabolic health.