Search

Abstract Background We aimed to determine the association of neutrophil-to-lymphocyte ratio (NLR) with non-arteritic anterior ischemic optic neuropathy (NAION). Methods We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus and Web of Science were searched from the establishment of the database to May 5, 2022 to find the relevant studies. The quality of the included literature was evaluated with the Newcastle–Ottawa scale (NOS). The results are reflected in the form of standard mean difference (SMD) and 95% confidence interval (CI). Results Finally, six articles were included in our study. Compared with healthy controls, patients’ NLR levels were significantly higher (SMD = 0.47; CI 95% = 0.30–0.65, p

Government policies in the United States and the European Union promote standardization and value creation in the use of FAIR (findability, accessibility, interoperability, and reusability) data, which can enhance trust in digital health systems and is crucial for their success. Trust is built through elements such as FAIR data access, interoperability, and improved communication, which are essential for fostering innovation in digital health technologies. This Viewpoint aims to report on exploratory research demonstrating the feasibility of testing a patient-centric data flow model facilitating semantic interoperability on precision medical information. In this global trend, the interoperable interface called Sync for Science-J (S4S-J) for linking electronic medical records (EMRs) and personal health records was launched as part of the Basic Policy for Economic and Fiscal Management and Reform in Japan. S4S-J controls data distribution consisting of EMR and patient-generated health data and converts this information into QR codes that can be scanned by mobile apps. This system facilitates data sharing based on personal information beliefs and unlocks siloed Internet of Things systems with a privacy preference manager. In line with Japanese information handling practices, the development of a mobile cloud network will lower barriers to entry and enable accelerated data sharing. To ensure cross-compatibility and compliance with future international data standardization, S4S-J conforms to the Health Level 7 Fast Health Care Interoperability Resources standard and uses the international standardized logical observation identifiers names and codes (LOINC) to redefine medical terms used in different terminology standards in different medical fields. It is developed as an applied standard in medical information intended for industry, health care services, and research through secondary use of data. A multicenter collaborative study was initiated to investigate the effectiveness of this system; this was a registered, multicenter, randomized controlled clinical trial, the EMBRACE study of the mobile health app M♡Link for hyperglycemic disorders in pregnancy, which implements an EMR–personal health record interoperable interface via S4S-J. Nevertheless, the aforementioned new challenges, the pivotal Health Level 7 Fast Health Care Interoperability Resources system, and LOINC data mapping were successfully implemented. Moreover, the preliminary input of EMR-integrated patient-generated health data was successfully shared between authorized medical facilities and health care providers in accordance with the patients’ preferences. The patient-centric data flow of the S4S-J in Japan is expected to guarantee the right to data portability, which promotes the maximum benefit of use by patients themselves, which in turn contributes to the promotion of open science.

Abstract This study investigates the lifetime costs associated with concrete barriers and steel guardrails. We introduce a cost analysis methodology that incorporates critical factors such as construction costs, maintenance costs, exposure risks during maintenance activities, and the costs imposed to traveling public through the increased traffic and the crash outcomes. We integrate various parameters including economic factors, road geometry, general weather condition, and traffic mix to estimate a location-dependent cost for each type of barrier accurately. A software tool, named CalBarrier, was developed during this study to carry out the calculations and the comparison of lifetime cost of aforementioned barriers. An inherent strength of this research is its reliance on recent real data extracted from various databases of California Department of Transportation (Caltrans), ensuring precision and relevance in accounting for various influential factors. Drawing insights from Caltrans practices and interviews with their personnel, this study emphasizes the intricate decision-making process involved in mitigating safety risks and reducing operational expenses. Although our data originates from California, the methodology for life cycle cost analysis, and our software are applicable for regions with different socio-economic conditions by deploying user input costs, making our findings a valuable resource for other areas facing comparable challenges.

Background. Severe caries in early childhood is a concern for both children receiving dental treatment and their parents. This dental disease progresses rapidly and quickly damages the coronal part of the tooth. When there is insufficient coronal structure to support a coronal restoration, using intracanal components following root canal treatment increases tooth resistance and helps provide retention for the coronal restoration. This study compared the shear bond strength of three types of intracanal posts (composite resin post, reverse metal post, and fiber post) in severely damaged primary anterior teeth. Methods. This in vitro study was conducted on 30 extracted anterior primary teeth with at least two-thirds of healthy roots and no prior pulp treatment. The teeth were randomly divided into three groups of 10: group 1: composite resin post with 8th generation universal bonding, group 2: reverse metal post with GC restorative glass cement, and group 3: fiber post with GC restorative glass cement. After placing the post, the samples were restored with a height of 3 mm from cementoenamel junction (CEJ) using an Anterior GC Gradia Packable composite resin. All the samples underwent 500 cycles of thermocycling in a hot water bath at 55±2 °C and a cold water bath at 5±2 °C. The shear strength of the samples was then evaluated using an electromechanical universal testing machine at a rate of 1 mm/min and at a location 2 mm coronal to the CEJ in terms of megapascals. Results. The average shear bond strength of composite resin posts with 8th generation bonding application was 8.02220 MPa, reverse metal posts with glass ionomer application was 13.8600 MPa, and fiber posts with glass ionomer application was 9.7400 MPa. Conclusion. Based on these findings, it can be concluded that the highest shear bond strength in this study was related to the reverse metal post, and the lowest shear bond strength was related to the composite resin post. According to the results, reverse metal posts demonstrated better shear bond strength than composite resin posts and fiber posts (P

Abstract Introduction The inflammatory response to burn injuries can lead to organ dysfunction that ultimately results in increased mortality and morbidity. This meta-analysis was conducted to determine the efficacy of inflammatory biomarkers, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), procalcitonin (PCT), and C-reactive protein (CRP) as predictive tools of mortality among burn patients. Material and methods The biomarker levels of survivors and non-survivors were consolidated according to guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three main databases were searched electronically: PubMed, Web of Science, and Scopus, on December 8, 2022. The Newcastle–Ottawa Quality Assessment Scale (NOS) was used to evaluate and score the methodological quality of the included studies. The standard mean difference (SMD) with a 95% confidence interval (CI) was utilized. Results Twenty-four studies were included in our systematic review and meta-analysis, (3636 total burn patients), of whom 2878 survived. We found that deceased burn patients had elevated levels of NLR (SMD = 0.60, 95% CI; 0.19–1.00, P

Cancer stem cells (CSCs) are one of the cell types that account for cancer heterogeneity. The cancer cells arrest in G0 and generate non-CSC progeny through self-renewal and pluripotency, resulting in tumor recurrence, metastasis, and resistance to chemotherapy. They can stimulate tumor relapse and re-grow a metastatic tumor. So, CSCs is a promising target for eradicating tumors, and developing an anti-CSCs therapy has been considered. In recent years competing endogenous RNA (ceRNA) has emerged as a significant class of post-transcriptional regulators that affect gene expression via competition for microRNA (miRNA) binding. Furthermore, aberrant ceRNA expression is associated with tumor progression. Recent findings show that ceRNA network can cause tumor progression through the effect on CSCs. To overcome therapeutic resistance due to CSCs, we need to improve our current understanding of the mechanisms by which ceRNAs are implicated in CSC-related relapse. Thus, this review was designed to discuss the role of ceRNAs in CSCs' function. Targeting ceRNAs may open the path for new cancer therapeutic targets and can be used in clinical research.

Cement Emulsified Asphalt Mortar (CEAM) has gained prominence as a vital material for its energy and noise damping properties between the concrete roadbed and track slab in a high-speed railway system. Therefore, it is evident that CEAM properties need to be better understood and optimized. Since cracking caused by traffic loading and atmospheric conditions is one of the primary causes of failure in CEAM, addressing this issue is of great importance. Furthermore, there is a growing need for more environmentally friendly and durable CEAM due to the environmental impact of cement production in the form of greenhouse effect. The objective of this study is to assess the impact of partially replacing cement content in CEAM Type II (CRTS II) specimens with pozzolanic materials such as silica fume, metakaolin, and granite sludge to investigate how these pozzolans affect the fracture toughness (Mode I) performance under both normal (water curing) and sulfuric acid exposure conditions with the main focus on evaluating the pozzolans ability to resist acid attack from a fracture toughness perspective as the research novelty. For this purpose, specimens containing pozzolans at 5 %, 10 %, and 15 % substitution level (by weight of cement) were subjected to Semi-Circular Bending (SCB) test both under normal and exposure to 5 % sulfuric acid solution conditions. Moreover, water absorption test was conducted on specimens in normal condition as a durability index. The test results of this study revealed that substitution of these pozzolanic materials enhanced the fracture toughness in normal condition. Specifically, at a 10 % substitution as the optimal level, silica fume and metakaolin resulted in 18 % and 15 % increase in fracture toughness performance compared to the control specimen in normal condition. However, granite sludge exhibited almost the same performance as the control specimen at 5% substitution as its optimal level. In acid exposure condition, the detrimental effect of acid on the fracture toughness performance of specimens was reduced by 61 %, 55 % and 13 % for samples containing silica fume, metakaolin and granite sludge at 15% substitution level, respectively. Furthermore, water absorption test results showed that inclusion of silica fume and metakaolin at a substitution level of 15 % results in 56 % and 47 % reduction in water absorption compared to the control specimen, respectively, while for granite sludge, it was almost the same as control specimen. These results were also confirmed by SEM studies. Since the use of these pozzolans as cement substitution not only improves the fracture toughness in normal condition but also provides protection against acid-induced degradation, this study contributes to the development of a more durable and environmentally friendly CEAM.

Abstract The Food and Drug Administration (FDA) has licensed many antiretroviral medications to treat human immunodeficiency virus type 1 (HIV-1), however, treatment options for people with multi-drug resistant HIV remain limited. Medication resistance, undesirable effects, prior tolerance, and previous interlacement incapacity to deliver new drug classes all lead to the requirement for new medication classes and drug combination therapy. Fostemsavir (FTR) is a new CD-4 attachment inhibitor medicine that was recently authorized by the United States FDA to treat HIV-1. In individuals with multidrug-resistant (MDR) HIV-1, FTR is well tolerated and virologically active. According to recent investigations, drug combination therapy can positively affect MDR-HIV. The mechanism of action, resistance, interaction, pharmacokinetics, pharmacodynamics, and safety of FTR has been highlighted in this review.

Abstract Background This systematic review and meta-analysis aimed to determine the potential value of neutrophil to lymphocyte ratio (NLR) as an assessment tool in the clinical distinction between uterine sarcoma and uterine leiomyoma. Methods We comprehensively searched Web of Science, Scopus, and PubMed for relevant papers published before March 19, 2023. The standardized mean difference (SMD) was provided, along with a 95% confidence interval (CI). The random-effects model was employed to derive pooled effects due to the high levels of heterogeneity. The Newcastle-Ottawa scale was used for the quality assessment. Our study was registered in PROSPERO (CRD42023478331). Results Overall, seven articles were included in the analysis. A random-effect model revealed that patients with uterine sarcoma had higher NLR levels compared to those with uterine myoma (SMD = 0.60, 95% CI = 0.22–0.98; p = 0.002). In the subgroup analysis according to sample size, we found that patients with uterine sarcoma had elevated levels of NLR compared to those with uterine myoma in either large studies (SMD = 0.58, 95% CI = 0.04–1.13; P

Abstract Background Considering cultural influences, it is important to study the perceptions and stress of conscience in different contexts. This study aimed to investigate the association between perceptions of conscience, stress of conscience, and burnout among nursing staff working in older people care settings in Tehran. Methods This was a descriptive, cross-sectional study. A total of 161 participants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire, and Oldenburg Burnout Inventory, 2019. All nursing staff working at the 20 contacted nursing homes agreed to participate in the study. The descriptive and inferential analysis was conducted through SPSS, using T-tests and one-way between-groups analysis of variance, Chi-square and t-tests, Cohen's d (d), Eta-squared (η2), and Phi coefficient (φ), Partial least squares regression (PLSR), jackknife approximate t-tests of the regression coefficients, and jackknife 95% confidence intervals of the regression coefficients. Results The nursing staff perceived their conscience mainly as an authority, asset, and warning signal. Impact of workload on family life was the most common source of stress for the nursing staff. Dealing with incompatible demands, the impact of workload on family life, witnessing insulated patients, inability to meet one’s standards in providing care, and perception of conscience as a burden were strongly associated with the burnout. Conclusions Perceiving conscience as a warning signal or authority may serve as a buffer against burnout among nursing staff. This study highlights the need for further exploration of perceptions of conscience in different cultural and social backgrounds.

Further testing of the second-moment closure employed in Part I is made. The present part considers the effects of streamline curvature and spanwise system rotation. As expected, the exact stress production terms broadly account for these effects. In addition, the present model, which is applied right up to a wall, successfully captures the laminarization in the rotating boundary layer. Attention is also given to the capability to reproduce the recovery process from curvature.

The purpose of this two-part paper is to assess the performance of a second-moment closure applicable up to a wall. In the present part, the turbulence model is applied to the boundary layers with periodic pressure gradient, with wall transpiration and with free-stream turbulence. The predictions are shown to be in good agreement with experiments and a direct simulation. In particular, a tendency towards relaminarization and a subsequent retransition in the oscillating boundary layer are faithfully reproduced, and the effect of the length scale of free-stream turbulence is correctly captured.

Background: Curcumin present in turmeric has been considered due to its cancer-preventive features, antioxidant and anti-inflammatory properties. This double-blind, randomized, controlled clinical trial with a reasonable sample size and longer intervention period was conducted to investigate how oral curcumin affected cardiac and hepatic T2*MRI and liver enzymes in patients with β‐thalassemia major.Method: This clinical trial study was conducted on 171 patients over 5 years old. The subjects were randomly divided into a curcumin-treatment group and a placebo group to receive either curcumin capsules twice daily or placebo for 6 months. Patients were examined once a month for 6 months to receive capsules and measure the levels of alanine aminotransferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), direct and total bilirubin, ferritin and cardiac and hepatic T2*MRI.Result: There was a significant decrease in levels of AST, ALT, ALP, and bilirubin (direct and total) in the curcumin group compared with the placebo group by the end of the study (p < 0.05). The levels of serum ferritin remained unchanged in both groups at the end of the follow‐up period (p > 0.05). No significant differences were observed between the curcumin and placebo groups at baseline values or at the end of the study of cardiac and hepatic T2*MRI and serum magnesium.Conclusion: Administration of curcumin has some beneficial effects on liver function by reducing liver enzymes in patients with beta-thalassemia major.

Background: Self-care is an indicator of power and independence among older adults. Family can increase older adults’ motivation and desire for engagement in self-care activities. This study aimed to determine the effects of self-care education based on the family-centered empowerment model (FCEM) on functional independence and life satisfaction among community-dwelling older adults. Methods: This randomized clinical trial was conducted on 126 community-dwelling older adults from local sociocultural centers in 2021. They purposively recruited and randomly allocated to control (n = 63) and intervention (n = 63) groups. The intervention group received FCEM-based self-care education in six 1.5-hour weekly sessions. The education focused on the physical, psychoemotional, social, and spiritual aspects of self-care and was based on the 4 steps of FCEM: perceived threat, problem-solving, educational participation, and evaluation. Katz Index of Independence in Activities of Daily Living (Katz ADL Index) and Zest Life Satisfaction Index were respectively used for independence and satisfaction assessments before and 8 weeks after the study intervention. The data were analyzed using SPSS version 16 and through the Kolmogorov-Smirnov, Mann-Whitney U, Wilcoxon, and chi-square tests. Results: The mean age was 67.57 ± 4.62 years in the intervention group and 67.08 ± 4.62 years in the control group. There were no significant differences between the intervention and control groups respecting the pretest mean scores of life satisfaction (16.54 ± 4.46 vs 16.68 ± 4.23; P = 0.963) and functional independence (4.78 ± 1.15 vs 5.11 ± 1.00; P = 0.107). The posttest mean score of functional independence was also insignificant (5.52 ± 0.692 vs 5.24 ± 0.911; P = 0.92) between the 2 groups. However, the Mann-Whitney U test showed that the posttest mean score of life satisfaction was significantly greater in the intervention group than in the control group (18.95 ± 4.36 vs 16.13 ± 4.41; P = 0.001). Conclusion: FCEM-based self-care education effectively improves life satisfaction among community-dwelling older adults.

Abstract Background Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as hypertension, hyperlipidemia, dyslipidemia, diabetes mellitus, and family history of non-communicable disease. Premature Coronary Artery Disease (PCAD) is more endemic in Iran than before. This study sought to assess the association between ethnicity and lifestyle behaviors in eight major Iranian ethnic groups with PCAD. Methods In this study, 2863 patients aged ≤ 70 for women and ≤ 60 for men who underwent coronary angiography were recruited in a multi-center framework. All the patients’ demographic, laboratory, clinical, and risk factor data were retrieved. Eight large ethnicities in Iran, including the Farses, the Kurds, the Turks, the Gilaks, the Arabs, the Lors, the Qashqai, and the Bakhtiari were evaluated for PCAD. Different lifestyle components and having PCAD were compared among the ethnical groups using multivariable modeling. Results The mean age of the 2863 patients participated was 55.66 ± 7.70 years. The Fars ethnicity with 1654 people, was the most subject in this study. Family history of more than three chronic diseases (1279 (44.7%) was the most common risk factor. The Turk ethnic group had the highest prevalence of ≥ 3 simultaneous lifestyle-related risk factors (24.3%), and the Bakhtiari ethnic group had the highest prevalence of no lifestyle-related risk factors (20.9%). Adjusted models showed that having all three abnormal lifestyle components increased the risk of PCAD (OR = 2.28, 95% CI: 1.04–1.06). The Arabs had the most chance of getting PCAD among other ethnicities (OR = 2.26, 95%CI: 1.40–3.65). While, the Kurds with a healthy lifestyle showed the lowest chance of getting PCAD (OR = 1.96, 95%CI: 1.05–3.67)). Conclusions This study found there was heterogeneity in having PACD and a diverse distribution in its well-known traditional lifestyle-related risk factors among major Iranian ethnic groups.

Background and Objective: Tooth decay and periodontal problems are among the most common human diseases which are considered unsolved health problems in most countries of the world. This study aimed to investigate and compare the shear bond strength of the fiber post with three different types of cement, including Glass ionomer, as well as Universal and Flowable composites. Materials and Methods: This in-vitro study was conducted on 30 extracted anterior deciduous teeth with at least two-thirds of healthy roots. The teeth were randomly divided into three groups of 10. The teeth were mounted from the root part inside the self-curing acryl. Group 1 includes G-Premio Bond and Universal Composite, group 2 includes G-Premio Bond and flowable composite, and group 3 includes Glass ionomer without bond. Immediately, the fiber post was placed in the cemented material in the canal and was light-cured according to the manufacturer's instructions. Shear bond strength was performed by an electromechanical universal testing machine at a speed of 1 mm/min. Results: The shear bond strength mean values in the Universal composite, Glass ionomer, and Flowable composite groups were 15.29±4.82, 9.74±2.82, and 13.71±4.91 MPa, respectively, and the difference among them was significant (P=0.022). The shear bond strength mean value of the Universal composite was significantly higher than that of the Glass ionomer (P=0.020); however, this difference was not significant for comparing other groups (P

Net primary production is a sensitive index to changes in climatic factors and human activities. The present study was conducted with the aim of quantitatively evaluating the relative role of climate change and human activities on the development of desertification in Torbat Heydarieh and Bojnoord based on the spatio-temporal variations of net primary production. First, primary net production was estimated by ground measurement. Subsequently, it was simulated using the CASA model in statistical period between 1986 and 2017. Six scenarios were designed to determine the relative role of climate change and human activities in the expansion or inversion of desertification. The results of the research showed that net primary production has declined over the 31-year period and that the trend in its changes is negative. An examination of different desertification scenarios showed that the city of Bojnord is under the scenario of expansion of desertification due to climate change, and Torbet Heydarieh city is under the scenario of desertification expansion due to the interaction between climate change and human activities. Based on this, the trend of changes in actual and potential primary net production in Bojnord and Torbat Heydarieh cities was negative and its intensity was classified in the low to medium decline category. Also, the slope trend of changes in primary net production caused by human activities in Torbat Heydarieh city was positive and in the low to medium increase class, and in Bojnord city, it was negative and in the low decrease class.The study of the development or return of desertification scenarios showed that 61.23% of the total area of the study area was affected by the expansion and development of desertification due to the impacts of climatic factors, and 38.77% of those affected by the interaction of climatic factors and human activities in expansion of desertification.

Statement of the Problem: Squamous cell carcinoma (SCC) comprises over 90% of oral malignancies. Cisplatin, as a selective chemotherapy agent to treat SCC, has many side effects despite its high effectiveness. There are some studies on the effects of bromelain derived from pineapple stems on different malignancies.Purpose: The aim of this study was to investigate the effect of bromelain alone and in combination with Cisplatin on oral squamous cell carcinoma (OSCC) and fibroblast cell lines.Materials and Method: In this interventional study, the HN5 cell line of OSCC and fibroblast cell line were treated with different concentrations of bromelain alone and in combination with cisplatin. Cell viability test was performed after 24, 48 and 72 hours using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. In the final stage, the drug-treated cells underwent flow cytometry to assess apoptosis patterns. Data were analyzed using SPSS 17, ANOVA (for general comparison of groups) and LSD post hoc tests (for comparison two groups). p< 0.05 was considered statistically significant.Results: The findings suggested that although bromelain showed toxic effects on HN5 cancer cells, its combination with Cisplatin resulted in little improvement in its effectiveness. Bromelain alone and in combination with Cisplatin presented cytotoxic effects against fibroblasts, which depended on the dosage and time exposure (p˂ 0.05). The flow cytometry results did not support the superior effect of the combination of two medications over Cisplatin alone (p> 0.05).Conclusion: According to the findings, although adding bromelain to Cisplatin reduced toxicity on normal tissues, the combination of these two drugs did not increase the anticancer effect of Cisplatin. Thus, bromelain in combination with Cisplatin is not recommended as an adjuvant drug for OSCC.

Due to the fact that bacterial contamination of wounds is the cause of increased morbidity and mortality today, various antimicrobial wound dressings are developing to prevent wound contamination. In addition, an ideal wound dressing should have proper mechanical and hemostatic properties to maintain wound healing conditions. Here, a double-layer sponge hydrogel nanocomposite wound dressing was designed and manufactured by combining zinc oxide nanoparticles (ZnONPs) with different concentrations in the hydrogel layer and green carbon dots in the sponge layer. The surface morphology of two layers was investigated using a scanning electron microscope. X-ray diffraction proved the presence of ZnONPs. Physical tests showed a decrease in water absorption and water vapor transmission rate and an increase in blood absorption in the presence of ZnO. The sponge layer showed suitable absorption support in the presence of carbon dots. By combining nanoparticles in both layers, the mechanical properties were greatly enhanced. The sponge hydrogel with the highest concentration of ZnO showed excellent inhibition of 41 mm against Pseudomonas aeruginosa bacteria and 25 mm of inhibition against Staphylococcus aureus. Finally, in vitro blood clotting and animal tests confirmed the increase in the hemostatic power of the sponge hydrogel with the maximum concentration of ZnO.

Many Iranian gardens, especially those registered nationally and internationally, are full of pure Iranian art. One of the most beautiful gardens is Eram Botanical Garden. Available studies and visual evidence show no proper effort has been made for this garden to preserve and reproduce its visual heritage. Findings taken from motifs are shown in the form of logos and graphic images. The results of this study show that this garden, with a clear graphic identity based on its values and modern graphic designs, will increase the prosperity of Iranian art, and the development of tourism attracts and guides the audience.

Abstract Background Type 2 Diabetes mellitus is one of the most common chronic diseases in the world and has many complications. Due to the importance of using alternative therapies in managing symptoms of this disease, the present study was designed and conducted to investigate the effect of co-supplementation of berberine and fenugreek in patients with type 2 diabetes mellitus. Methods A randomized controlled clinical trial was conducted on 50 patients with type 2 diabetes mellitus. Participants were randomized in the intervention group, which received 3 capsules/day of 500 mg (300 mg of berberine + 200 mg of fenugreek seed powder) or placebo for 12 weeks. Biochemical and anthropometric variables were measured at the beginning and end of the study. Results We observed that fasting insulin, HbA1C, and hs-CRP significantly decreased in the intervention group compared to the baseline. The mean difference in insulin resistance (-0.32 vs. 0.15), fasting blood sugar (-14.40 vs. 1.68), and fasting insulin (- 2.18 vs. 1.34) were clinically significant in comparison to the control group. Almost all domains of SF-12 scores were significantly higher in the intervention group than in the placebo group. Conclusions The combination of berberine and fenugreek seed can improve cardio-metabolic status in patients with diabetes and support the anti-diabetic and anti-inflammatory role of herb in the improvement of quality of life.

Abstract A new multi-component reaction for the synthesis of novel and diverse spiro-imidazo pyridine-indene derivatives named spiro[imidazo[1,2-a]indeno[2,1-e]pyridine-5,1′-indene and indenylidene-1H-spiro[imidazo[1,2-a]pyridine-7,1′-indene was successfully developed by the reaction between heterocyclic ketene aminals (generated from 1,1-bis(methylthio)-2-nitro ethylene and diamine) and [1,2′-biindenylidene]-1′,3,3′-trione (bindone) (in situ generated from self-condensation of 1,3-indandion) by using malononitrile as a promoter or as one of the precursors respectively in the presence of p-TSA as the acid catalyst in EtOH as reaction medium under reflux conditions. Depending on whether the reaction is single-step or two-step, malononitrile can act as a promoter or reactant. The convenient one-pot operation, straightforward isolation without using additional purification methods, and the use of a variety of diamines and cysteamine hydrochloride causing a variety of structural products are attractive aspects of the present approach. The synthesized bindone and final product contains active methylene and this active site can be involved in further reactions to synthesize more complex heterocycles.

Abstract Background Providing long-term home care to older adults with chronic diseases may endanger the physical, mental, social, and spiritual health of caregivers and lead to care strain. Objective This study aimed to assess the relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease. Methodology This cross-sectional correlational study was conducted in 2020–2021 in Tehran. Participants were 230 family caregivers randomly recruited from 8 urban health care centers. Data were collected using a personal characteristics questionnaire, the Modified Caregiver Strain Index, Connor-Davidson Resilience Scale, Family Hardiness Index, and the data were analyzed by using SPSS 22 version. Pearson’s correlation coefficient was applied for data analysis. P-values ≤0.05 were considered significant. Results A total of 230 caregivers participated in the study. The mean age of participants was (46.65 ± 13.63) years and most of them were female (73.9%). Mean scores of caregiver strain, resilience, and hardiness in family caregivers were 16.23 ± 4.5, 39.89 ± 10.9, and 31.21 ± 7.79, respectively. Pearson correlation showed a significant and inverse correlation between caregiver strain and resilience (r = -0.310, P = 0.002), and also a significant and inverse relationship between caregiver strain and hardiness (r = -0.276, P = 0.001). Conclusion In this study, family caregivers had moderate caregiver strain, low resilience, and high hardness. Caregiver strain in family caregivers of older adults with chronic disease is an important health issue associated with resilience and hardiness. To promote health, effective adaptation to long-term care, and reduce caregiver strain, designing effective interventions to increase resilience and hardiness in family caregivers seems necessary.

Abstract Background The quality of care has a significant impact on the condition of elderly patients. Many factors affect the quality of care, including ethical considerations. Ethical considerations, such as moral sensitivity, change in times of crisis. The present study was conducted to assess the relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. Methods This was a cross-sectional descriptive correlational study. The participants included 445 nurses that were selected by quota sampling method from hospitals admitting COVID-19 patients. The data were collected using the Moral Sensitivity Questionnaire (MSQ) and Quality Patient Care Scale (QUALPAC) as self-reports. We used the SPSS software v.16 for statistical analysis. Results The total score of moral sensitivity and quality of care was 52.29 ± 16.44 and 2.83 ± 0.23, respectively. Moral sensitivity negatively correlates with psychological, social, and physical aspects (P

Abstract This study is aimed to unravel the status of local and circulating β-catenin in different primary bone tumors and its relevance to tumor types, severity, and chemotherapy. The β-catenin mRNA expression level and the expression of the protein (intensity level) were evaluated in tumor tissue and peripheral blood mononuclear cells of 150 patients with different types of primary bone tumors (78 malignant and 72 benign tumors) using Real-Time PCR and immunohistochemistry. The β-catenin mRNA expression level and the expression of the protein were increased in bone tumors which was positively correlated with the tumor malignancy. Amongst osteosarcoma, Ewing's Sarcoma, chondrosarcoma, osteochondroma, Giant Cell Tumor, and exostosis tumors, the osteosarcoma, and Giant Cell Tumor groups showed the highest level of β-catenin expression. The β-catenin expression in malignant bone tumors was significantly correlated with tumor grade, size, metastasis, tumor recurrent, and the level of response to chemotherapy. A similar pattern of β-catenin gene expression and its association with tumor characteristics was detected in the patient's peripheral blood cells. The simultaneous increase in the expression of the β-catenin gene and protein in tumor tissue and in circulating blood cells and its relationship with tumor severity indicates the possible promoting role of β-catenin in primary bone tumor pathogenesis.

Abstract Background There are many studies on high-sensitivity C-reactive protein (hs-CRP) association with cardiovascular disease (CVD); however, just a few studies investigated whether the low-density lipoprotein cholesterol (LDL-C) could participate in hs-CRP prognostic strength. This study aimed to determine the alliance of hs-CRP and LDL-C in different concentrations in occurrence cardiovascular events in the Isfahan Cohort Study (ICS). Methods 3277 participants aged 35 and above were included in the current analysis. We evaluated the association of elevated hs-CRP levels (≥ 3 mg/dL) and CVD events including myocardial infarction, ischemic heart disease, stroke, CVD, CVD mortality, and all-cause mortality in those with LDL-C ≥ or