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Introduction: Castleman's disease is a rare nonclonal lymphoproliferative disorder of unknown etiology that most commonly affects the mediastinum. It is classified into two clinical subtypes: A localized (unicentric) subtype and a multifocal (multicentric) subtype. This case report presents an adolescent with unicentric mesenteric Castleman's disease, which is very rare. Case Presentation: A 14-year-old girl presented to our center with chronic left flank pain. She also reported frequent episodes of small-volume vaginal bleeding outside her menstrual period. Initially, she was treated for several weeks with a possible diagnosis of dysmenorrhea due to an ovarian cyst. However, due to the lack of response to treatment and persistent symptoms, further investigation was conducted. Abdominal and pelvic ultrasonography revealed a round, hypoechoic, and heterogeneous mass measuring 22 x 35 mm in the left mesentery with regular margins. Pathological examination confirmed Castleman's disease of the hyaline-vascular type. The patient was discharged in good general condition and with stable vital signs. During follow-up, her abdominal symptoms and bleeding resolved, and no lesions were detected on ultrasonography and CT scans at 6 and 12 months. Conclusions: Mesenteric Castleman's disease is rare and presents a diagnostic challenge. This disease should be included in the differential diagnosis of abdominal tumors, even in symptomatic cases. The treatment of choice for unicentric cases is surgery. [ABSTRACT FROM AUTHOR]

Background: According to the hypothesis, COVID-19 is less prevalent in regions with warm climates. Contradictory results have led us to investigate the correlation between temperature and the cumulative COVID-19 incidence rate. Methods: We obtained COVID-19 data from CRONALAB, COVID-DASHBOARD, and MCMC databases of Fars Province, Iran, linked the data and finalized daily COVID-19 cases. The daily data on the temperature was gotten from meteorological stations’ reports from March 21, 2020, to March 21, 2021, for each county of Fars Province, Southern Iran. The daily weighted cumulative incidence rate of COVID-19 cases was calculated for all counties, separately. Initially, for uniform data visualization, the average air temperature data were transformed into ranked percentiles. Then, to visually assess the study hypothesis, the distribution of COVID-19 cumulative incidence was visualized on percentiles of temperature. Given the non-linear distribution of the data, we performed exploratory analyses using the generalized additive models and locally weighted (polynomial) regressions to choose the best response function. Then, the generalized linear models were used to parametrically build the model. Results: The generalized additive models showed a small decreasing, near horizontal, linear pattern for COVID-19 incidence rate as the function of temperature (pseudo R² : 0.001, deviance explained: 0.13%, coefficient: -0.02). The GLMs showed head-to-head results (deviance explained: 0.13%, coefficient: -0.02], supported by similar Akaike information criteria (AICs) (34945). However, according to the locally weighted regressions model’s curve, lower COVID-19 incidence rates were recorded on days when the temperatures ranged from 60 to 80 percentiles, equal to 20°C to 25°C in a cold climate and 25°C to 35°C in a warm climate. This is while the rates increased at lower and upper temperatures. Conclusion: Daily COVID-19 incidence rate cannot be explained as a function of daily temperature in Southern parts of Iran. Higher rates of disease transmission out of the range of 20°C to 25°C for cold temperatures and 25°C to 35°C for warm climates might be linked to people’s indoor gatherings, coupled with insufficient ventilation. [ABSTRACT FROM AUTHOR]

This study aims to fill the gap between gamification features and their impacts on practical marketing activities in The Covid-19 era by providing a comprehensive analysis between gamification features: immersion (storytelling), achievement (reward), and social (competition) on customer experience (CX) and engagement (CE). In this study, a Quasiexperimental design method was used to examine the relationship of the gamification features on CX and engagement. To investigate, an online survey was distributed to 200 students and they were exposed to three different scenarios randomly. Structural equation modeling, Analysis of variance (ANOVA), t-test, regression, path analysis and Sobel test were used to evaluate the impacts of gamification on CX and engagement. The results reveal that gamification has positive effect on CE and CX while, achievement has a more substantial impact than immersion and social on CX, competition has a stronger positive effect than storytelling but weaker positive effect than reward. [ABSTRACT FROM AUTHOR]

Background: The health-related quality of life (HRQOL) in the before liver transplantation (LT) stage has not been studied as much as that after the LT stage. We aimed to assess HRQOL and its determinants before the LT stage. Methods: As a cross-sectional study, HRQOL of all adult patients (n=632) referred to the LT center of Shiraz, Iran in 2018- 2019 were assessed. Demographic, socioeconomic, medical, and paraclinical data were requested. Physical (PCS) and mental (MCS) aspects of HRQOL were assessed using the SF36 questionnaire. Univariable, multivariable (linear regression), and confirmatory factor analysis were performed utilizing SPSS 20 and Mplus 6.1 software. P<0.05 was considered to be significant. Results: The mean age of the patients was 47.6±12.3 years, while 414 (65.6%) were men, and the mean, score of the model for end-stage liver disease (MELD) was 18.36±5.58. The mean score of QOL, PCS, and MCS was 50.01±21.73, 46.23±23.23, and 53.78±23.91 (out of 100), respectively. Vitality had the most association with HRQOL, while role limitations had the lowest. The multivariable analysis revealed that unemployment (P<0.001), anemia (P=0.005), weight loss (P=0.005), diabetes mellitus (DM) (P=0.009), low MELD score (P=0.027), and drug use (P=0.03) were the significant determinants of HRQOL, respectively. Conclusion: The present study showed that HRQOL in the LT candidates was at the intermediate level, while their PCS and MCS are at the low and moderate levels, respectively. Furthermore, physical performance, job status, anemia, weight loss, MELD score, DM, and drug use should be considered as the significant determinants of HRQOL in the LT candidates. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread use of opioids to manage severe pain, its systemic administration results in side effects. Among the subcutaneous and transdermal drug delivery systems developed to deal with adverse effects, microneedles have drawn attention due to their rapid action, high drug bioavailability, and improved permeability. SUF is an effective injectable opioid for treating severe pain. In this study, we investigated the analgesic effects of SUF using dissolvable microneedles., Methods: SUF polymeric dissolvable microneedles were constructed through the mold casting method and characterized by SEM and FTIR analysis. Its mechanical strength was also investigated using a texture analyzer. Fluorescence microscopy was applied in vitro to measure the penetration depth of microneedle arrays. Irritation and microchannel closure time, drug release profile, and hemocompatibility test were conducted for the validation of microneedle efficiency. Hot plate test was also used to investigate the analgesic effect of microneedle in an animal model., Results: Local administration of SUF via dissolving microneedles had an effective analgesic impact. One hour after administration, there was no significant difference between the subcutaneous and the microneedle groups, and the mechanical properties were within acceptable limits., Conclusion: Microneedling is an effective strategy in immediate pain relief compared to the traditional methods.