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Safe System has been the dominant approach to road safety in Victoria for over fifteen years, guiding the development and implementation of policy. Limited attention has been paid to the development and application of Safe System in a public policy setting. The aims of this research were to describe the intentions of Safe System in Victoria, and analyse how well this aligns with models of successful public policy. Using a qualitative approach, semi-structured interviews were undertaken with Australian and international experts (n = 10). These experts represented a range of organisations and leadership levels that were either directly involved in the development or had a detailed understanding of the development of Safe System in Victoria. The interview results were analysed using a policy success model. The findings suggested that Safe System can provide a framework to address road safety in Victoria, however successful public policy needs to ensure that the development of policy addresses the identified problem and that the results are maintained for some time. Safe System meets some of these requirements, but principally lacks explanation for how its overarching approach is meant to be understood and utilised. Practically, road safety professionals need to clarify the purpose of the Safe System concept in order for it to be successfully integrated into public policy. Whilst Safe System requires additional clarification, it has garnered additional interest and debate in road safety and from this perspective has advanced public policy.

Background The purpose of this study was to estimate prevalence of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients admitted to obstetric inpatient units throughout the United States as detected by universal screening. We sought to describe the relationship between obstetric inpatient asymptomatic infection rates and publicly available surrounding community infection rates. Methods A cross-sectional study in which medical centers reported rates of positive SARS-CoV-2 testing in asymptomatic pregnant and immediate postpartum patients over a 1–3-month time span in 2020. Publicly reported SARS-CoV-2 case rates from the relevant county and state for each center were collected from the COVID Act Now dashboard and the COVID Tracking Project for correlation analysis. Results Data were collected from 9 health centers, encompassing 18 hospitals. Participating health centers were located in Alabama, California, Illinois, Louisiana, New Jersey, North Carolina, Pennsylvania, Rhode Island, Utah, and Washington State. Each hospital had an active policy for universal SARS-CoV-2 testing on obstetric inpatient units. A total of 10 147 SARS-CoV-2 tests were administered, of which 124 were positive (1.2%). Positivity rates varied by site, ranging from 0–3.2%. While SARS-CoV-2 infection rates were lower in asymptomatic obstetric inpatient groups than the surrounding communities, there was a positive correlation between positivity rates in obstetric inpatient units and their surrounding county (P=.003, r=.782) and state (P=.007, r=.708). Conclusions Given the correlation between community and obstetric inpatient rates, the necessity of SARS-CoV-2–related healthcare resource utilization in obstetric inpatient units may be best informed by surrounding community infection rates., There was a significant positive correlation between SARS-CoV-2 positivity rates in obstetric inpatient units and their surrounding county and state. Healthcare resource utilization related to SARS-CoV-2 testing in obstetric inpatient units may be best informed by surrounding community infection rates.

Background: Celecoxib is widely used in post-operative cases because of its ability to reduce postoperative opioid drug use. Currently, the use of this drug is common in post-operative cases. In various studies, pregabalin was used for the management of pain after spinal surgery to reduce the need for opioids. Objectives: Since the treatment of tibia fractures and surgery is painful and has a long-term recovery, this study aimed to compare the effect of two drugs (pregabalin and celecoxib) on pain severity at 24 h postoperatively in patients having tibia fracture surgery. This would mark significant progress in taking the proper drug. Methods: In this probability clinical experiment, the sample consisted of 50 patients scheduled for tibia fractures, who were selected from the table of random numbers. Then, the patients were assigned into two groups: celecoxib (Group C) and pregabalin (Group P). In the first group, celecoxib was administered to patients at 1 h pre-operatively at a dose of 200 mg and 1 h post-operatively at a dose of 200 mg. In the second treatment group, patients received pregabalin at 1 h pre-operatively at a dose of 200 mg and 1 h post-operatively at a dose of 200 mg orally. Then VAS (visual analog scale) scores were recorded at 6, 12, and 24 h after surgery. Finally, using SPSS software, qualitative variables were compared according to their percentage by the Chi-square test. For quantitative analysis of variables, the mean value of each group was calculated. The comparison of means was made by t-test. Results: The VAS score was considerably lower at 24 hours after surgery in the pregabalin group than in the celecoxib-treated group. However, after 6 and 12 h of surgery, no statistically meaningful difference was observed. A less analgesic effect was observed in the group treated with celecoxib than pregabalin, which was statistically significant. Conclusion: Pregabalin improves postoperative pain, and it has more analgesic effects than celecoxib.

Longitudinal studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-induced immune responses in patients with cancer are needed to optimize clinical care. In a prospective cohort study of 366 (291 vaccinated) patients, we measured antibody levels [anti-spike (IgG-(S-RBD) and anti-nucleocapsid immunoglobulin] at three time points. Antibody level trajectories and frequency of breakthrough infections were evaluated by tumor type and timing of treatment relative to vaccination. IgG-(S-RBD) at peak response (median = 42 days after dose 2) was higher (P = 0.002) and remained higher after 4 to 6 months (P = 0.003) in patients receiving mRNA-1273 compared with BNT162b2. Patients with solid tumors attained higher peak levels (P = 0.001) and sustained levels after 4 to 6 months (P < 0.001) compared with those with hematologic malignancies. B-cell targeted treatment reduced peak (P = 0.001) and sustained antibody responses (P = 0.003). Solid tumor patients receiving immune checkpoint inhibitors before vaccination had lower sustained antibody levels than those who received treatment after vaccination (P = 0.043). Two (0.69%) vaccinated and one (1.9%) unvaccinated patient had severe COVID-19 illness during follow-up. Our study shows variation in sustained antibody responses across cancer populations receiving various therapeutic modalities, with important implications for vaccine booster timing and patient selection. Significance: Long-term studies of immunogenicity of SARS-CoV-2 vaccines in patients with cancer are needed to inform evidence-based guidelines for booster vaccinations and to tailor sequence and timing of vaccinations to elicit improved humoral responses.

PurposeShort-term rental option enabled via accommodation sharing platforms is an attractive alternative to conventional long-term rental. The purpose of this study is to compare rental strategies (short-term vs long-term) and explore the main determinants for strategy selection.Design/methodology/approachUsing logistic regression, this study predicts the rental strategy with the highest rate of return for a given property in the City of Philadelphia. The modeling result is then compared with the applied machine learning methods, including random forest, k-nearest neighbor, support vector machine, naïve Bayes and neural networks. The best model is finally selected based on different performance metrics that determine the prediction strength of underlying models.FindingsBy analyzing 2,163 properties, the results show that properties with more bedrooms, closer to the historic attractions, in neighborhoods with lower minority rates and higher nightlife vibe are more likely to have a higher return if they are rented out through short-term rental contract. Additionally, the property location is found out to have a significant impact on the selection of the rental strategy, which emphasizes the widely known term of “location, location, location” in the real estate market.Originality/valueThe findings of this study contribute to the literature by determining the neighborhood and property characteristics that make a property more suitable for the short-term rental vs the long-term one. This contribution is extremely important as it facilitates differentiating the short-term rentals from the long-term rentals and would help better understanding the supply-side in the sharing economy-based accommodation market.

Many companies, despite there being opportunities for automation in production and logistics (P&L) systems, still rely on human workers due to their cognitive and motor skills. Taking Human Factor ...

Considerable evidence suggests that mitochondrial dysfunction and oxidative stress contribute to the pathogenesis of Polycystic ovary syndrome (PCOS). We aimed to evaluate the effectiveness of mitochondria-targeted antioxidant, MitoQ10, on the redox signaling pathway’s component in PCOS. We assessed TXNIP, TRX, and ASK1 expression in granulosa cells (GCs) of the DHEA-induced PCOS mouse model. Female BALB/c mice in five groups of Control, DHEA, and DHEA + MitoQ10 in three doses of 250, 500, and 750 μmol/L MitoQ10 were treated for 21 days. Histological investigation showed a probable improvement in folliculogenesis; besides, ASK1 and TXNIP expression were significantly increased in GCs of the PCOS mouse F4Fmodel as compared to the control groups and decreased steadily in groups treated by MitoQ10. However, TRX expression showed a drop that was restored by MitoQ10 meaningfully (P ≤ 0.05). The work presented herein suggests mitochondria-targeted antioxidant, MitoQ10, have modulating effects on folliculogenesis in the ovary and also on the redox signaling pathway in GCs of PCOS mouse model which may have potential to attenuate oxidative stress and its relative damages.

Background Patellofemoral pain (PFP) is among the most common orthopedic complications afflicting active young people. Diminished coordination of the vastii, delayed activation of the vastus medialis obliquus (VMO), and decreased VMO-to-vastus lateralis (VL) activity ratio are well documented as underlying causes of PFP. This study compares the effects of VMO facilitatory kinesio tape (KT) versus VL inhibitory KT on electromyographic (EMG) activity of the vastii, balance, and pain in athletes with PFP. Methods In this single-blind randomized clinical trial, thirty-two female athletes with PFP (mean age 26.33 ± 5.93 years) were randomly assigned to VMO facilitatory KT (n = 16) or VL inhibitory KT (n = 16) groups. In the facilitatory group, a Y-shaped strip of KT at 25% of its available tension was attached from the origin of the VMO to its insertion and in the inhibitory group, an insertion-to-origin Y-shaped strip of KT at 15% of its available tension was applied on the VL. Pain intensity, dynamic balance, and EMG data were assessed respectively with a visual analogue scale, the modified Star Excursion Balance Test, and an EMG telemetry system, before and immediately after KT application. Results Pain intensity decreased and dynamic balance improved significantly after taping in both groups, and VMO: VL activity ratio increased significantly in the VL group. However, none of the parameters differed significantly between groups. Conclusions Both VMO facilitatory and VL inhibitory KT can improve pain and balance, while the inhibitory technique might be more effective in regulating the VMO to VL activity ratio in athletes with PFP.

Simulating an aircraft model using of high fidelity models of subsystems for its primary and secondary flight control actuators requires measuring or estimating aero-load data acting on flight control surfaces. One solution would be to incorporate the data recorded from flight tests, which is a time-consuming and costly process. This paper proposes another solution based on the validation of an aero-loads estimator or on the hinge moments predictor for fully electrical aircraft simulator benchmark. This estimator is based on an aerodynamic coefficient calculation methodology, inspired by Roskam’s method that uses the geometrical data of the wing and control surfaces airfoils. The hinge moment values are found from two-dimensional lookup tables where the deflections of the control surfaces, aircraft altitude, and aircraft angles of attack are the input vectors of the tables; and the resulting hinge moment coefficients are the output vectors. The resulting hinge moment coefficients of the Convair 880 primary flight control surfaces are compared to those of its recorded flight test data; the results from the new software solution were found to be very accurate. Hinge moment lookup tables are integrated in the Convair 880 high fidelity flight simulation benchmark using mathematical models of energy-efficient Electro-Hydrostatic Actuators (EHA). Autopilot controls are designed for the roll, pitch, attitude and yaw damper motions using Proportional Integral (PI) controller scheduled for different flight conditions. Several different aircraft simulation scenarios are evaluated to demonstrate the efficacy and accuracy of the predicted hinge moment results.

The enzymes and metabolic controllers of tumor cells are affecting by the regulation of physical activity and exercise training. The aim of this study was to investigate the role of preventive and treatment of aerobic interval training in colon cancer with determining the protein values of MCT1, GLUT1, PFK-1 and expression of the p53 gene in tumor cells in the animal model. Forty-eight male BALB/c mice (6–8 weeks old) participate in this study. Animals were equally randomized into 6 groups: I: control (C); healthy animals, II: Exercise (E), III: tumor induction (T); animals received AOM for inducing colon cancer, IV: AOM + exercise (TE); animals with colon cancer underwent 8 weeks of the exercise training protocol after tumor establishment, V: exercise + AOM (ET); animals received exercise protocol 1 week before AOM consumption, and (VI) exercise + AOM + exercise (ETE); animals received exercise protocol one week before and after AOM consumption (about 15 weeks) Groups III–VI were weekly-received AOM (as carcinogenic agent, 10 mg/kg s.c) in three consecutive weeks to induce colon cancer. Protein levels of GLUT1, MICT1 and PFK1 in solid colon tumor was measured by ELISA method. Also we used RTPcr for gene expression of P53. GAPDH were used as reference genes. The results showed that the tumor significantly increased MCT1 in the tumor group compared to the control group (p = 0.001), Also, exercise before and after tumor induction reduced MCT1 in the colon (respectively: p = 0.02 and p = 0.01). Levels of GLUT1 colon in the tumor group showed a significant increase compared to the control group (p = 0.001), that exercise after tumor induction was effective in reducing this protein (p = 0.01). PFK-1 had a significant decrease in ET and TE groups compare to T group (p = 0.02 and p = 0.01, respectively). While the p53 gene decreased significantly in the tumor group compared to the control group (p = 0.01) Exercise before tumor induction and after tumor induction increased significantly (p = 0.01 and p = 0.04, respectively) in this gene compared to the tumor group. Long-term aerobic training can act as a preventive or inhibitor of tumor progression by acting as an adjunct in the treatment of colon cancer. It seems that this preventive and treatment effects exercise training can attribute to regulation of lactate and glucose transporters by up-regulation of p53 colorectal cancer cell.

Objective:To investigate the impact of household food insecurity during the third trimester of pregnancy on the growth indicators of infants aged less than 6 months.Design:Retrospective longitudinal study.Setting:137 healthcare centres (15 cities) in Khorasan Razavi province, Iran. Data were extracted from the Sina Electronic Health Record System (SinaEHR®).Participants:This study was conducted on 2481 mother and infant dyads during November 2016–March 2019. The Household Food Insecurity Access Scale (nine-item version) was used to measure food insecurity in the third trimester of pregnancy. Women who delivered singleton infants were included in the study, and anthropometric indices of infants were measured throughout the first 6 months of life.Results:Approximately 67 % of the participants were food secure, while 33 % had varying degrees of food insecurity. The children born to the mothers in the food-insecure households were, respectively, 2·01, 3·03, and 3·83 times more likely to be stunted at birth (95 % CI 1·17, 3·46), 4 months (95 % CI 1·21, 7·61) and 6 months of age (95 % CI 1·37, 10·68) compared to their counterparts in the food-secure households. However, there were no significant differences in mean birth weight, birth height and head circumference at birth between the two groups.Conclusions:Household food insecurity during pregnancy is a risk factor for stunting in infants aged less than 6 months. Therefore, national nutrition programs could considerably support women in food-insecure households during and before pregnancy.

Introduction: Fast food consumption (FFC) has been raised as a risk factor for cardiometabolic outcomes and renal function disorders. The present study aimed to investigate the association between FFC and cardiovascular disease (CVD) risk factors and renal function among patients with diabetic nephropathy (DN). Methods: This cross-sectional study was conducted among 397 randomly enrolled patients with DN. A validated 168 food items food frequency questionnaire was used for measuring FFC. Weight, waist,height, fasting blood sugar (FBS), hemoglobin A1C (HbA1C), serum creatinine, blood urea nitrogen(BUN), hs-CRP, systolic blood pressure(SBP), diastolic blood pressure (DBP), and lipid profile concentrations were measured. Generalized linear model analysis of covariance was used to compare means of BP, biochemical and anthropometric factors across tertiles of FFC adjusted for potential confounders. Results: The mean weekly intakes of fast food were 130 ± 60 grams. Patients in the highest compared to the lowest tertiles of FFC were more likely to be overweight and obese, had higher levels of creatinine, SBP, and DBP in the unadjusted model (P

OBJECTIVE To characterize trends of an influenza diagnosis at delivery hospitalization and its association with severe maternal morbidity. METHODS We conducted a repeated cross-sectional analysis of delivery hospitalizations using the Nationwide Inpatient Sample from 2000 to 2018. We assessed the association between an influenza diagnosis at delivery hospitalization and severe maternal morbidity excluding transfusion per Centers for Disease Control and Prevention criteria. Secondary outcomes included maternal death and morbidity measures associated with influenza (mechanical intubation and ventilation, sepsis and shock, and acute respiratory distress syndrome [ARDS]) and obstetric complications (preterm birth and hypertensive disorders of pregnancy). We assessed trends of severe maternal morbidity by annual influenza season and the association between influenza and severe maternal morbidity using multivariable log-linear regression, adjusting for demographic, clinical, and hospital characteristics. RESULTS Of 74.7 million delivery hospitalizations, 23 per 10,000 were complicated by an influenza diagnosis. The rate of severe maternal morbidity was higher with an influenza diagnosis compared with those without influenza (86-410 cases vs 53-70 cases/10,000 delivery hospitalizations). Women with an influenza diagnosis at delivery hospitalization were at an increased risk of severe maternal morbidity compared with those without influenza (2.3 vs 0.7%; adjusted risk ratio 2.24, 95% CI 2.17-2.31). This association held for maternal death, mechanical intubation, sepsis and shock, and ARDS-as well as obstetric complications, including preterm birth and hypertensive disorders of pregnancy. CONCLUSION Pregnant women with influenza are at increased risk of severe maternal morbidity, as well as influenza-related maternal and obstetric complications. These results emphasize the importance of primary prevention and recognition of influenza infection during pregnancy to reduce downstream maternal morbidity and mortality.

Water resource management in the agricultural sector is a necessity that profoundly impacts water resources conservation for future generations. With the aim of rivers water abstraction (RWA) estimating for agricultural uses, the current research was implemented, in Hashtgerd and Zarand-Saveh sub-catchments of Iran; classified in Csa and Bsk-Csa climate categories with water scarcity situation. The RWA variables were estimated based on morphological, hydrological, and land-use characteristics and their combinations. Estimation of RWA was operated by applying single and integrated-wavelet (integrated-W with noise reduction) soft-computing methods, including Artificial Neural Networks (ANNs), Wavelet-ANN (WANNs), Adaptive Neural Fuzzy Inference System (ANFIS), Wavelet-ANFIS (WANFIS), Gene Expression Programming (GEP), and Wavelet-GEP (WGEP). The WGEP model's efficiency with the hybrid characteristics of river width (RW), river depth (RD), minimum flow rate (QMin), maximum flow rate (QMax), average flow rate (QMean), cultivated area (CA), and orchard area (OA) variables, was recommended as the best model to estimate RWA variables without climate conditions' effects. The obtained values of RMSE for hybrid characteristic of WGEP models were 26.310 and 61.256 (*103 m3), for estimating RWA in Hashtgerd and Zarand-Saveh, respectively. The efficiencies of WGEP were excellent (R > 0.900) in the estimation of RWA in both climatic classes for maximum extreme values. Extracting mathematical formulation as part of the study’s result profoundly impacts implementing policies related to integrated water resources management (IWRM). Also, the modeling of the variables affected the optimal rate of agricultural RWA for advance measures of balancing policies improvement in supply and demand of water resources in the agricultural sector, modification of cultivation patterns to save water consumption, providing food security to communities, and reforming the pattern of riverbeds that are recommended for reaching the goals of IWRM.

Arteriovenous malformation (AVM) results from development of abnormal connections between veins and arteries. This study reported anAVM case suffering from dysgraphia and dysprosody. According to the results after the trauma, the patient's handwriting was identified as macrographic and illegible, and written letters and verbs were neglected in free writing or dictation. Moreover, prosody of the patient's utterances was changed. Finally, an intervention was conducted to improve the writing impairments whereby they eventually enhanced. AVM can adversely affect communication opportunities and working life due to these impairments. Thus referring the patient to speech and language pathologists seems sensible and necessary.

Surgical procedures involving the manipulation of the airway structure have the potential to affect the quality of voice by changing the resonance properties. Regarding this, the present study was conducted to investigate the effect of rhinoplasty on the voice of professional voice users. This cohort study was conducted on 30 professional voice users. For the purpose of the study, the patients completed the Voice Handicap Index (VHI). In addition, they were subjected to voice analysis that included the measurement of nasality in speech production (i.e., nasalance), using the nasometer II. Computerized speech lab was also utilized to examine vowels /e/ and /a/, each of which was sustained for 5 sec by the participants. The mean VHI scores were 8.5 ± 1.98 and 7.36 ± 1.71 before and after the surgery, respectively, indicating no significant difference between the two investigated stages (Z = − 0.53, P = 0.59). However, there was a significant difference between the patients with and without preoperative obstruction in terms of the VHI score (χ2 = 11.06, P = 0.004). With regard to orality, it had the mean values of 16.86 ± 7.45 and 15.22 ± 7.37 before and after the surgery, respectively. Furthermore, the mean values of nasality at the pre- and post-operation stages were 59.42 ± 6.04 and 56.28 ± 10.07, respectively. The comparison between the pre- and post-surgical orality and nasality revealed no significant difference (t = 1.226, P = 0.23 and t = 0.93, P = 0.36, respectively). Although rhinoplasty is supposed to affect voice and vocal resonation, the induced changes are not problematic for the professional voice users. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Reactive oxygen species (ROS), involved in the pathogenesis of the polycystic ovary syndrome (PCOS), play a key role in the onset of apoptosis in follicles and granulosa cells (GCs). We aimed to investigate the antioxidant effects of AST and metformin separately and in combination on GCs using a PCOS mouse model. Forty-eight prepubertal female BALB C mice aged 25-30 days and weighing 12-14 g were studied. The PCOS model was created by subcutaneous injection of the dehydroepiandrosterone (DHEA) hormone in 8 mice of BALB C for 20 consecutive days. Apoptosis and the amount of ROS were evaluated in GCs of the ovaries via flow cytometry. The activity of AKT protein was measured by western blot, and the viability of GCs was investigated using spectrophotometry. Ovarian tissue sections were prepared, stained with H&E, and the morphology of the sections was examined. Statistical analysis was performed by SPSS v22.0 software using one-way ANOVA. We found that AST administration leads to a significant reduction in oxidative stress (P

Purpose This study aims to formulate exploratory scenarios of the textile industry in Iran based on MICMAC and soft operational research methods. Design/methodology/approach In this study, to formulate plausible scenarios, literature reviews and external experts’ opinions of this field have been gathered through the Delphi approach and uncertainty questionnaires. After the utilization of the most important uncertainties, the textile industry’s plausible scenarios have been mapped with the help of experts through co-thinking workshops. Results show that two factors, including the business atmosphere and membership in World Trade Organization (WTO), play a more important role than the other factors. These two factors were considered for the formulation of the scenario. To formulate plausible scenarios, soft systems methodology, which is a kind of soft operational research methods, is applied. Findings Based on the results, four scenarios are presented. These scenarios include the Elysium scenario, Hades scenario, Tatarus scenario and Sisyphus scenario. In the Elysium scenario, the business atmosphere has improved and Iran has been granted membership of the WTO. In Hades scenario, Iran has joined the WTO, but due to the government’s weakness and inactivity and key decision-makers, the required preparations have not been made. In the Tatarus scenario, Iran is not a WTO member and the business atmosphere is disastrous. In the Sisyphus scenario, the government takes reasonable actions toward a better business environment. Originality/value Formulating plausible scenarios of the textile industry is an excellent contribution to the key beneficiaries and actors of this industry so they can present flexible preparation-based programs in the face of circumstances. Future study of the textile industry familiarizes the actors and beneficiaries of this industry with the procedures and the driving forces that influence this industry’s future and it will ascertain various scenarios for the actors of this field.

Parvaneh Rezasoltani,1 Nahid Elliyoun,1 Tahereh Ziaie,2 Abdolrasoul Sobhani,3 Ehsan Kazemnezhjad Leyli,4 Soudabeh Kazemi Aski5 1Department of Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran; 2Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran; 3Department of Pharmacology, Gastrointestinal and Liver Diseases Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; 4Department of Biostatistics, Road Trauma Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran; 5Department of Obstetrics & Gynecology, Reproductive Health Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, IranCorrespondence: Parvaneh RezasoltaniDepartment of Midwifery, School of Nursing & Midwifery, Guilan University of Medical Sciences, Daneshjou Street, Shahid Beheshti Boulevared, Rasht, Guilan Province, 41469-39841, IranTel +98 13 33555058Fax +98 13 33550097Email soltanip769@gmail.comBackground: Menopause is associated with changes in lipid profile and is a known risk factor for oxidative stress. Different therapeutical strategies have been used to control menopause complications. Vitamin E, an important anti-oxidant, can possibly affect lipid peroxidation in menopausal women. Thus, we aimed to evaluate the effect of vitamin E supplementation on the lipid profile of menopausal women.Materials and Methods: This double-blind, placebo-controlled, randomized, cross-over, phase I/II trial study was designed in two 4-week intervention phases with an 8-day washout period in between. Eighty-three natural menopause women participated in the study. Randomized block allocation was used to divide women into group A (n = 41) and group B (n = 42). In phase I, one group received vitamin E capsule (400 IU/day) and another group received placebo capsule for 4 weeks. After an 8-day washout period, phase II was initiated for a period of 4 weeks, where the group that received vitamin E capsule was given placebo (E-P) and the group that received placebo was given vitamin E (P-E). Plasma lipid profile levels (LDL-C, HDL-C, TC, and TG) were assessed before and after intervention separately in each phase and in each group. Lipid profile was measured by enzymatic colorimetric method. Data were analyzed according to the intention-to-treat principle. All statistical analyses were performed using SPSS software.Results: The analysis indicated no significant difference in plasma TC, LDL-C, HDL-C, and TG levels between P-E and E-P groups before intervention in phase I and II (P > 0.05). There was no significant difference in plasma lipid profile levels within the P-E and E-P groups before and after intervention in phase I and II. There was a significant difference in plasma TG within the E-P group before [141.74 ± 53.52, 138.50 (94– 195)] and after [167.47 ± 71.32, 170 (108– 202)] intervention in phase II (P = 0.010). There was no significant difference in terms of the mean changes in plasma lipid profile between the P-E and E-P groups in phase I and II (P > 0.05).Conclusion: The study results revealed that vitamin E supplementation had no remarkable effect on the lipid profile in menopausal women.Keywords: vitamin E, lipid profile, menopausal women

Importance: The protein p53 is an unequivocal tumor suppressor that is altered in half of all cancers. The immune system produces systemic p53 autoantibodies (p53 Abs) in many cancer patients. Objective: This systemic review and meta-analysis focuses on the prognostic value of p53 Abs expressed in the serum of patients with solid tumors. Data Sources: All the clinical investigations were searched on PubMed from the first study dated 1993 until May 2021 (date of submission of the manuscript). Study Selection: Studies were included that met the following criteria: (1) participants with cancer, (2) outcome results expressed in relation to the presence of a p53 antibody, (3) a primary outcome (disease-free survival, overall survival or progression-free survival) expressed as hazard ratio (HR). The following exclusion criteria were used: (1) insufficient data available to evaluate outcomes, (2) animal studies, (3) studies with less than 10 participants. As a result, 12 studies were included in the analysis. Data Extraction and Synthesis: PRISMA guidelines were used for abstracting and assessing data quality and validity by three independent observers. The summary estimates were generated using a fixed-effect model (Mantel–Haenszel method) or a random-effect model (DerSimonian–Laird method), depending on the absence or presence of heterogeneity (I2). Main Outcome(s) and Measure(s): The primary study outcome was to determine the prognostic value of p53 Abs from a large population of patients with solid tumors, as determined before data collection. Results: In total, 12 clinical studies involving 2094 patients were included in the meta-analysis, and it was determined that p53 Abs expression in the serum significantly correlated with poorer survival outcomes of cancer patients (95% CI 1.48 [1.24, 1.77], p &lt, 0.00001). Conclusions and Relevance: This is the first meta-analysis proving the diagnostic utility of p53-Abs for cancer patients in predicting poorer outcomes. The serum-p53 value (s-p53-value) may be useful for future theranostics.

SummaryNon-small cell lung cancer (NSCLC) is one of the most frequent causes of mortality in the western world. v-raf murine sarcoma viral oncogene homolog B (BRAF) is a member of the Raf kinase family and plays a critical role in cellular growth, proliferation, and differentiation through the mitogen-activated protein kinase pathway. The incidence of BRAF mutations in NSCLC is low, accounting for 0–3% of all cases of lung cancer. Given the results obtained in metastatic melanoma, several studies have reported the efficacy of anti-BRAF therapies in NSCLC treatment. In this review, we describe changes in the landscape of BRAF-mutated lung cancer treatment and analyze insights from major clinical trials in the context of future therapeutic prospects.

Introduction Rituximab is a standard treatment for gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML). We sought to compare the effectiveness and safety of subcutaneous and intravenous rituximab in a retrospective case–control study. Patients and Methods All consecutive patients with GML treated with subcutaneous rituximab between January 2017 and December 2018 were included and compared to 3 matched control patients (based on Ann Arbor classification, presence of t(11;18) translocation, history of treatment, and type of current treatment) treated with intravenous rituximab between January 2000 and December 2018. Patients with t(11;18) translocation were treated with rituximab in combination with chlorambucil; the other patients were treated with rituximab alone. Effectiveness was assessed at week 52, and safety was assessed through weeks 0 to 52 and compared by the chi-square test. Results Twenty-five patients were included in the subcutaneous rituximab group and 75 in the intravenous group. There was no difference between the groups in complete remission (78% vs. 76%, P = .99) or overall response rates (91% vs. 89%, P = .99) at week 52. Safety profiles were similar in both groups, with a significant decrease in postinduction grade 2 injection-related reactions and outpatient hospital length of stay in the subcutaneous rituximab group. Conclusion In a small case–control study, we did not find any difference in the effectiveness or safety profiles between subcutaneously and intravenously delivered rituximab for the treatment of patients with GML. We found a decrease in postinduction grade 2 injection-related reactions and outpatient hospital length of stay in the subcutaneous rituximab group.

Advanced manufacturing (AM) represents an appealing approach for creating novel electrochemical systems for chemicals synthesis. In this work, we demonstrate AM for rapid development and testing for improved performance for the carbon dioxide reduction reaction across an evolution of vapor-fed reactor designs. In our final design, we observe activation- and mixed-control regimes for a variety of operating conditions via inlet CO2 flow rate and electrochemical potential. Furthermore, we define a dimensionless number (Da) to identify mass transport regimes by exploring the impact of hypothesized underlying mass transport mechanisms, including consumption of CO2via OH−, increased local temperatures, and partial penetration of electrolyte into gas diffusion layer. The accelerated pace of reactor design and development led to high geometric current densities (500 mA cm−2), heightened selectivity (85.5% FE C2+ products), and increased carbon dioxide conversion (16.6%) and cathodic energy efficiency (49.6% CO2R). Using AM vapor-fed reactors, we attain high ethylene (3.67%) and record ethanol (3.66%) yields compared to the literature. This work underscores the promise of AM for accelerating reactor design, understanding of governing phenomena, and improving the performance of catalytic systems.

Ziziphus jujuba Mill. belonging to the Rhamnaceae family, has been consumed since ancient times as a medicine and food. In the different traditional medical schools, Z. jujuba has been used to treat various diseases such as respiratory system diseases (asthma, cough, and laryngitis), gastrointestinal problems (constipation, colitis and liver diseases), as well as cardiovascular and genitourinary system diseases. From the perspective of Islamic traditional medicine (ITM), Z. jujuba fruit is an emollient, laxative, and maturative, it can purify blood and improve blood circulation, relieve internal heat and reduce inflammation. Some therapeutic uses of Z. jujuba such as antibacterial, antioxidant, sedative, hepato-protective, anti-hyperglycemic, and anti-hyperlipidemic activities have been shown in modern pharmacological studies. In the current study, traditional and ethno-medicinal uses, botany, phytochemistry and pharmacological activities of Z. jujuba were reviewed.

Crude oil and petroleum products can pollute soils during refining, transportation and operation processes. Because of physicochemical effects and reactions between these fluids and soils, geotechnical behavior and properties of soils change. Since these changes are mostly adverse, improvement and treatment of contaminated soils and sediments are necessary in many geotechnical projects and works. In present research, using lime as a traditional additive and nanosilica is considered for treating of gas oil contaminated clay. The polluted specimens were prepared by mixing the soil with gas oil in amounts of 0, 3, 6 and 9% by dry weight. The contaminant increased liquid limit (LL) and plastic limit (PL), and reduced maximum dry density (MDD) and optimum moisture content (OMC) of the soil. Unconfined compressive strength (UCS) of the soil showed an initial increase in 3% of contamination and then a decrease for the heavily contaminated samples (i.e., gas oil content greater than 3%). After adding 0, 1, 2 and 3 weight percent of lime and nanosilica, both independently and together; LL, PL, OMC and UCS of the samples increased and MDD of the treated soils decreased. Compared with lime and nanosilica, the mixture of them was considered more efficient in improving the UCS. By adding 3% of nanosilica-lime mixture and increasing curing time, considerable UCS gains occurred.

Introduction Doxycycline is a commonly used antibiotic that is also a potent inhibitor of matrix metalloproteinase (MMPs). The use of doxycycline in repairing tendon lesions has been previously investigated and conflicting findings have been reported on its effectiveness. In this study, we sought to evaluate the effects of exposure to doxycycline on Achilles tendon repair. Materials and methods Twenty healthy rats of the same breed and gender were randomly assigned to two groups of sham, and Doxycycline group therapy. The rats underwent a surgical intervention in which a 2mm incision was performed on the lateral sides of the right Achilles tendons. The treatment group received oral gavage administrations of 50mg/kg/day of doxycycline for 30 days. After this duration, tissue samples were taken from the site of the injuries, which were then histologically evaluated for alignment of the collagen fibres, inflammation reaction, cellular density, and fibroblastic activity. Results The histological assessment of the tissue samples, revealed significant changes in the repaired tissues of the treatment group in comparison to the sham group; namely more irregularity in the alignment of the collagen fibres, increased cellular density, and increased fibroblastic activity. However, only the alignment of the collagen fibres reached the statistical significance. Conclusion The results of this study indicate that exposure to doxycycline may result in the improvement of repair of the Achilles tendon injuries, especially collagen filament integrity.

Systemic vitamin C supplementation after wrist fracture has been suggested to reduce the incidence of complex regional pain syndrome (CRPS). This study aimed to evaluate the effect of regional vitamin C in Bier block in the early phase of fracture on CRPS occurrence following surgery for distal radius fractures. Seventy-four patients with isolated extra-articular distal radius fracture with the plan of fixation under Bier block were enrolled. Patients were assigned randomly into two groups: receiving either 500 mg vitamin C or sterile water as a Bier block adjuvant. Both groups received 500 mg of oral vitamin C for six weeks. The patients were evaluated for CRPS signs and symptoms at 2, 4, 6, and 12 weeks post-surgery. The overall incidence of CRPS 12 weeks after surgery in the vitamin C group was significantly less than the controls (22.9% vs 45.5%, p = 0.04). Logistic regression analysis showed that the only significant contribution in predicting the incidence of CRPS came from the intervention variable (OR 0.26, CI95% 0.08–0.85; P = 0.027). The findings suggest that adding vitamin C 500 mg to the local anesthetic in Bier block significantly reduces the incidence of CRPS following distal radius fractures.

As a response to rapidly increasing penetration of wind power generation in modern electric power grids, accurate prediction models are crucial to deal with the associated uncertainties. Due to the highly volatile and chaotic nature of wind power, employing complex intelligent prediction tools is necessary. Accordingly, this article proposes a novel improved version of empirical mode decomposition (IEMD) to decompose wind measurements. The decomposed signal is provided as input to a hybrid forecasting model built on a bagging neural network (BaNN) combined with K-means clustering. Moreover, a new intelligent optimization method named ChB-SSO is applied to automatically tune the BaNN parameters. The performance of the proposed forecasting framework is tested using different seasonal subsets of real-world wind farm case studies (Alberta and Sotavento) through a comprehensive comparative analysis against other well-known prediction strategies. Furthermore, to analyze the effectiveness of the proposed framework, different forecast horizons have been considered in different test cases. Several error assessment criteria were used and the obtained results demonstrate the superiority of the proposed method for wind forecasting compared to other methods for all test cases.

BackgroundEven though several studies reported donor autologous nerve grafts for digital nerve defects, there is no report in the literature regarding acceptable graft for thumb nerves. The purpose of this study is to provide guidelines for autologous nerve graft selection by detecting similarities between thumb nerve zones and donor nerve with regard to the number of fascicles and cross-sectional area.Materials and methodsFive cadavers were used in this study. An anatomical zoning system was defined for thumb nerves (zones 1, 2, 3). Sural nerve (SN), medial antebrachial cutaneous nerve (MABCN), lateral antebrachial cutaneous nerve (LABCN), posterior interosseous nerve (PIN), and anterior interosseous nerve (AIN) were selected as donor nerve grafts. The number of fascicles and surface area (mm2) was defined.ResultsThe mean of the fascicle number in zone 1, zone 2, zone 3, AIN, PIN, LABCN, MABCN, and SN were 3.8, 4.7, 6.1, 2.2, 1.8, 4.5, 3.1, and 6.4, respectively. The mean of the surface area in zone 1, zone 2, zone 3, AIN, PIN, LABCN, MABCN, and SN were 2.19, 6.26, 4.04, 1.58, 0.71, 5.00, 3.01, and 8.06, respectively.ConclusionsLABCN is the best choice for all zones that has fascicular matching with all three zones of thumb nerves and caliber matching with zones 2 and 3. In zone 1, the best nerve graft is MABCN which has both suitable caliber and fascicle count.

Background: The present study aimed to investigate the relationship between the serum vitamin D level and the severity of bronchiolitis in infants. Materials and Methods: The population of this descriptive-analytical study included all infants within the age range of 1 month to 24 months old with bronchiolitis hospitalized in Bandar Abbas children’s hospital in 2018-2019. According to the exclusion and inclusion criteria, patients were entered in the study and diagnosed with bronchiolitis by a pediatric infectious disease specialist. Then, their serum levels of vitamin D were measured as well. Results: Of the 85 patients, 62.4% and 37.6% were males and females, respectively. The mean serum level of vitamin D was 29.74±13.44 ng/mL. In addition, the mean age in groups with mild-, moderate-, and severe-intensity was 9.27±4.52 months, 5.12±3.95 months, and 3.16±1.16 months (P

Chromosomal abnormalities are associated with changes in complex aspects of chorionic villi histomorphology. This study used a simple scoring system to evaluate the association between atypical gross morphology and abnormal chromosomal testing on chorionic villus sampling (CVS). This retrospective cohort study included singleton pregnancies that underwent CVS at a single institution from 2006-2017. The degree of budding, branching, and vascularity (BBV) was scored from 0 to 3 for each CVS specimen, and individual scores were summed to calculate a composite BBV score. Scores were categorized into typical or atypical based on the cohort's distribution. The primary predictor was atypical BBV score, and the primary outcome was chromosomal abnormality. Fisher's exact test compared proportions, and logistic regression generated odds ratios. Among 1171 CVS specimens, 28% had chromosomal abnormalities. The chromosomally abnormal group had a higher rate of atypical BBV score than the normal group (7.3% vs 3.7%, P=0.009), a finding that remained statistically significant after controlling for maternal age, gestational age, and mode of CVS (aOR 2.2, 95% CI 1.24-3.82). Atypical chorionic villus morphology is associated with chromosomal abnormalities. This scoring system is simple, rapid, and easy to perform at the time of routine diagnosis.

Ali Reza Sobhani,1 Hossein Farshidi,2 Fariba Azarkish,3 Mahdiya Eslami,2 Ebrahim Eftekhar,4 Mansoor Keshavarz,5 Nepton Soltani6 1Clinical Pathology Department, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 2Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 3Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 4Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 5Physiology Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 6Physiology Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Nepton SoltaniPhysiology Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranTel +98 9133251067Fax +98 36688597Email neptun.soltani@med.mui.ac.irPurpose: Given the beneficial effect of MgSO4 on the cardiovascular system, this study was designed to investigate the effect of MgSO4 administration on suppressing some atherosclerotic risk factors in moderate coronary artery disease patients with one or two atherosclerotic vessels.Patients and Methods: In a randomized double-blind placebo-controlled clinical trial study, 64 patients with moderate coronary artery disease (55– 69% stenosis) were selected according to angiography findings. Patients were divided into four groups including patients with one or two atherosclerotic vessels treated with MgSO4 (Mg-treated-VR1, Mg-treated-VR2, respectively), placebo treated patients with one or two atherosclerotic vessels (Control-VR1, Control-VR2, respectively). The patients received either placebo or MgSO4 supplement capsule containing 300 mg MgSO4 for six months on a daily basis. ESR, Ca/Mg ratio, urine Mg level, serum Mg, fibrinogen, homocysteine, uric acid, Na, K, Ca, CRP, T3, T4, TSH, BUN, and Cr concentrations were measured at baseline and every three months.Results: Serum T3, Ca, K, homocysteine, CRP, and Mg concentrations were significantly improved in Mg-treated groups compared to placebo groups.Conclusion: The results of this study showed that despite the slight change in serum magnesium level, oral administration of MgSO4for six months could slightly reduce the serum levels of some inflammatory and vascular factors in moderate coronary artery disease patients.Keywords: atherosclerosis, MgSO4, fibrinogen, CRP, homocysteine, thyroid hormones

COVID-19 is a devastating global pandemic around the world. While the majority of infected cases appear mild, in some cases, individuals present respiratory complications with possible serious lung damage. There are no specific treatments for COVID-19 as yet. Many repurposed antiviral drugs have had disappointing outcomes. Angiotensin-converting enzyme 2 (ACE2), an enzyme that physiologically counters renin–angiotensin–aldosterone system activation, functions as a receptor for both SARS viruses. The current study discusses on vague role of ACE2 under physiologic/pathologic conditions. The catalytically inactive hrsACE2 has been also proposed as an efficient treatment of SARS-CoV-2 infection. Electronic supplementary material The online version of this article (10.1007/s13738-020-02049-z) contains supplementary material, which is available to authorized users.

Magnesium (Mg) deficiency is known to promote vascular and cardiac dysfunctions such as atherosclerosis. This study investigated the effect of oral MgSO4 therapy to improve lipid profile and serum oxidized LDL level and its receptor (LOX1) in moderate coronary atherosclerotic patients. In this randomized double-blind placebo-controlled clinical trial study, 64 patients with moderate coronary artery disease were selected according to angiography findings. Participants were divided into 2 groups including Mg-treated (n = 32) and placebo (n = 32) The patients received either placebo or MgSO4 supplement capsule, containing 300 mg MgSO4 for 6 months on a daily basis. Lipid profile, HbA1c, 2h postprandial (2hpp) blood glucose, fasting blood sugar, serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), oxidized low-density lipoprotein, and lectin-like ox-LDL receptor 1 (LOX1) concentrations were measured at baseline and every 3 months. HbA1c, serum LOX1, and oxidized low-density lipoprotein concentrations were significantly lower in the Mg-treated group than the placebo group 3 months after MgSO4 administration. 2hpp, serum low-density lipoprotein cholesterol, SGPT, SGOT levels, and HbA1c levels significantly improved in the Mg-treated group compared with the placebo-received group. Overall, the results of this study showed that magnesium treatment improved some of the major risk factors of atherosclerosis. According to the results of liver function tests (SGOT and SGPT), magnesium therapy seems to be safe in patients with moderate atherosclerotic plaque. Therefore, it is suggested that magnesium to be used along with other atherosclerosis control drugs.

This study analytically examines the effect of product market competition on the stability and bank capital ratio of Southeast Asian commercial banks. This paper use the sys-GMM dynamic panel data estimation technique in the study, based on data extracted from 63 unbalanced panels of commercial banks in ASEAN for the period 2009 to 2017, totaling 567 observations. The empirical findings reveal that the Lerner index has a positive and significant effect on stability at Malaysian and Singaporean banks. A negatively significant nexus between market competition and stability is reported for Indonesian and Thai banks. The competition–stability nexus shows no significant relationship at Filipino commercial banks. Further results show that product market competition has a positively significant influence on the capital ratio at banks in Malaysia, Singapore, Indonesia, and Thailand. By contrast, the nexus between product market competition and the capital ratio is negatively significant at banks in the Philippines. This empirical study has significant supervisory and regulatory implications in the ASEAN banking industry, especially in emerging and developing countries. The study provides support for the competition–stability view and suggests that banks in more competitive markets maintain a higher capital ratio in order to be able to absorb unexpected losses. The study gives credibility to the concept of a nexus between product market competition, stability, and the capital ratio using recent financial data from an emerging and developing economy perspective.

Background: Despite the advances in the methods of treating femoral neck fractures, treating some types of these fractures is still challenging. Therefore, understanding these fractures, their treatments, and the ways to control their complications are necessary for the orthopedists. Objectives: In this study, we evaluate patients with acute femoral neck fractures with respect to the type of fractures and complications. Methods: In a 4-year cross-sectional study, the patients with acute femoral neck fractures who were admitted to Rasoul Akram Hospital were selected. Anatomical features and the type of fracture were determined by using plain radiography and CT scan. Fractures were classified according to the Garden classification. The patients were also evaluated for any postoperative complications for at least 6 months. Results: A total of 124 patients were enrolled. The Mean±SD age of the patients was 64.9±12.7 years and 87 (74.4%) were male. Based on the Garden classification, 7 fractures (5.9%) belonged to type I, 10 fractures (8.5%) to type II, 48 fractures (41%) to type III, and 52 fractures (44.4%) to type IV. Avascular necrosis in 28 cases (23.9%), non-union in 14 cases (12%), and claudication and pain in 35 cases (29.9%) were noted. The mean age of patients was different between fracture groups (P=0.01). Conclusion: Our results showed that most of the patients with femoral neck fractures admitted to Rasoul Akram Hospital were associated with displacement. In this study, the most common complications were pain and claudication, avascular necrosis of the femoral head, and nonunion. In sum, further displacement of the fracture will result in more complications.

Investigation of temperature extremes is very important as one of the most important climate parameters in different parts. If exposed to enough heat, humans will suffer from extreme heat. Maximum temperature and heat can adversely affect many living organisms. The effects of extreme heat on people with chronic lung disease, including asthma and emphysema, are greater; even for people with healthy lungs, outdoor activities are not recommended during high ozone levels. The purpose of this study is to monitor and analyze the effects of atmospheric temperature extreme and extreme heat on human health in Central Iran. Therefore, the minimum and maximum data of 15 synoptic stations in the study area for the period (1988–2018) using hybrid artificial neural network (HANN) and adaptive neuro-fuzzy inference system (ANFIS) models were used. Finally, multi-criteria decision-making (MCDM) models TOSIS and SAW were used to prioritize the areas exposed to rising temperature. The results showed that according to ANFIS modelling for predicting extreme temperatures, the lowest mean training error and the mean error of validation for the minimum temperature were equal to 0.10 for the Yazd Station and 1.66% for the Damghan station. The lowest mean training error and the mean error of validation for the maximum extreme temperature obtained 0.016 for the Garmsar station and 9.39% for the Shahroud station. The maximum extreme temperature of two stations of Garmsar and Bafgh (1 and 0.9689, respectively) was more exposed to extreme temperatures based on the TOPSIS model. Garmsar and Salafchegan Stations (1 and 0.9873, respectively) were more exposed to extreme temperatures based on the SAW model. Climate change is fundamentally changing the Earth’s climate system in a way that directly and indirectly endangers human physical and mental health. Severe increase in temperature is directly associated with death from cardiovascular and respiratory diseases, especially in the elderly. Also in the study area, the house is a place for peace and comfort for every human being. Climatic and weather conditions have a direct impact on creating a sense of comfort in any architectural space. Proper heating and air conditioning in the interior of the building is another case of architecture that will not be easy because this architectural issue is related to the comfort or non-comfort of man, and the concepts of heat or cold are mostly due to the natural feeling of man and his physiological conditions. The rising trend of thermal stresses in the studied stations increases the need to pay attention to the issue of thermal stresses and the spread of diseases (heat attack, syncope, and muscle cramps) in terms of crisis planning and management.

The first long-acting release (LAR) formulation of octreotide was marketed in France in the late 1990s. An injectable formulation of Sandostatin LAR® (Novartis SAS) with a new diluent has been developed to facilitate its preparation and administration and to improve its use in practice. We conducted an observational, cross-sectional and multicenter study in France whose main outcome was to compare nurses’ satisfaction with the preparation and administration of both previous and new formulations of octreotide LAR. Secondary outcomes included assessment of patient satisfaction (quality of life and pain felt during the injection) and product tolerance. Data were collected at two time points (one for the first formulation group and one for the second formulation group) through paper questionnaires administered to physicians, patients and nurses including a visual analog scale (VAS) from 0 (unsatisfied) to 10 (very satisfied). Results showed that overall nurse satisfaction improved from 5.3 (95% CI 4.9–5.8) with the previous formulation to 7.5 (95% CI 7–7.9) with the new formulation (p

Unconventional modes of transport (UCMs) play a substantial role in many developing cities in meeting the mobility demand in spite of having negative image in the eyes of the authorities. This manuscript outlines a conjoint framework where various factors affecting sustainability and competitiveness of UCMs are identified through observation study and organized using PESTLE qualitative framework. Afterwards, it presents an AHP-TOPSIS based qualitative approach where inputs from experts as well as major stakeholders (owners/operators, drivers, conductors and passengers) are combined based on the PESTLE framework to fathom the competitiveness of UCMs. Along this process, the manuscript also unveils the business model of UCMs along with their area of operation, advantages and weaknesses. For this, the study uses Dhaka, the capital city of Bangladesh as study area and selects three popular UCMs – locally known as Rickshaw, Easy bike and Leguna. The findings suggest that economic, social and political factors respectively have the highest influence among all factors of PESTLE. Rickshaw was found to be the most competitive followed by Easy bike and Leguna. The study is expected to shed light into the perception and expectation of major stakeholders of UCMs which in turn will provide valuable insight for designing conventional public transport services, and/or, help in slowly integrating the UCMs into the mainstream transportation service through addressing their shortcomings.

Background Migraine without aura is the most common type of migraine headache, accounting for about 80% of all migraines. The aim of the present investigation was to determine the neurochemical metabolite alterations in the occipital lobe of patients suffering from migraine without aura using proton magnetic resonance spectroscopy (1H-MRS). Methods Fifteen patients suffering from migraine without aura with an occipital plaque and 16 healthy controls were included in this study. Changes in the neurochemical metabolites in the occipital lobe were assessed using 1H-MRS. The ratios of N-acetylaspartate (NAA) to creatine (Cr), choline (Cho) to Cr and myo-inositol (MI) to NAA were measured by voxel volume at 8 cm3. Results The mean NAA/Cr ratio decreased significantly in patients compared to controls. Cho/Cr and MI/NAA ratios increased significantly in patients. In addition, the duration of the disease and the frequency of headache attacks were significantly associated with a decrease in the NAA/Cr ratio and an increase in the Cho/Cr ratio. Conclusions Migraine without aura shows a significant association with changes in neurochemical metabolites detectable by 1H-MRS in the occipital lobe of patients. In addition, changes in metabolic ratios showed a significant relationship with the duration of the disease and the frequency of headache attacks.

Introduction: Alzheimer Disease (AD) is a neurological disorder associated with the progressive damage of memory and problems in communication and language skills. The examination of language in AD was less studied; therefore, this research aimed to compare linguistic characteristics between AD patients and their healthy counterparts.Materials and Methods: A total of 32 patients with AD (16 women and 16 men) with an Mean±SD age of 77±7.41 years, and their healthy peers (19 women and 13 men) with an Mean±SD age of 81.34±6.04 years participated in this study. Both groups were evaluated with the Persian bedside version of western aphasia battery. The results were assessed by the Independent t test. The significance level was set at less than 0.05.Results: The mean scores of each test and the general criterion for the adversity quotient index were significant between the two groups (P