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Multidrug pain control can be beneficial in relieving pain and limiting narcotic use in renal colic. The purpose of this study was to evaluate the effects of adding dexamethasone to ketorolac on pain control in acute renal colic.One hundred twenty patients with renal colic were randomized into comparison and intervention groups to investigate the effect of 8 mg of dexamethasone with 30 mg ketorolac administered immediately after the patient's admission. The primary outcome was pain intensity based on the visual analog scale (VAS), which was assessed at the baseline and after 30 and 60 min of drugs treatment. Also, grade of vomiting and narcotic or antiemetic requirement were measured at the baseline and after the 60-min intervention.A total of 120 patients were included in the final analysis, with 60 patients (50%) randomized to the comparison group (just ketorolac) and 60 (50%) randomized to the intervention group (ketorolac + dexamethasone). There were no significant demographic differences between groups (P0.05 for all). Differences in VAS scores were significantly lower in the intervention group after 30 min of drug administration (P = 0.009, compared with the control). However, there was not a significant difference in the median VAS score between groups at the baseline and end of the study (P0.05). At the end of the study, the percent of patients who need to narcotics (35% vs. 58%, P = 0.01) and/or antiemetic (12% vs. 28%, P = 0.022) were significantly lower in the intervention group compared with the controls.In comparison with the patients who just received ketorolac, adding dexamethasone provided improved pain control after 30 min of therapy. Furthermore, it decreased opioid requirements and decreased an antiemetic need at the end of the study. Dexamethasone should be considered an important multimodal adjunct for controlling pain and nausea in renal colic.

Aim: The present study aimed to find out the prevalence and any possible association between human herpesvirus (HHV-6) and primary brain tumors. Materials & methods: The systematic literature search was performed by finding related articles from major databases. Analysis was performed by comprehensive meta-analysis software. Results: A total of 13 (25 datasets) articles were included in the study, seven (15 datasets) of which were case/control and the rest (10 datasets) were cross-sectional studies. The pooled prevalence of HHV-6 among primary brain cancer patients was 29% (95% CI: 24–33%; I2 = 97.89%). An association was found between HHV-6 and primary brain cancer (summary odds ratio: 3.77% [95% CI: 2.59–5.49%; I2 = 19.0%]). Conclusion: Our analysis demonstrated that HHV-6 is associated with primary brain cancer. Reactivation of the virus could be triggered by the tumor, therefore, we cannot be certain that the virus appeared before the cancer development.

As statins decrease the progression of sepsis and its related mortality, this study aimed to evaluate the effect of atorvastatin on survival and symptom improvement in hospitalized patients with COVID-19. This randomized controlled trial was performed on 156 hospitalized patients with COVID-19 in Bojnourd city in 2021. Patients were randomly divided into comparison (standard therapy: hydroxychloroquine + Kaletra®) and intervention groups (atorvastatin 20 mg, SD, plus standard therapy). The main outcomes were the rate of symptom improvement, duration of hospitalization, need for intubation, and mortality rate. In this study, seven patients died, two patients (2.6%) in the comparison group and five (6.6%) in the intervention group. The mean hospitalization days (p = 0.001), the pulse rate (p = 0.004), and the frequency of hospitalization in the ICU ward (18.4% vs. 1.3%) were longer and greater in the intervention group. The remission probability in the comparison group was greater (p = 0.0001). The median hospitalization days in the intervention group was longer (p 0.001) and remission in the comparison group occurred 1.71 times sooner (hazard ratio = 1.70, 95% confidence interval = 1.22-2.38, p = 0.002). Totally, adding atorvastatin to the standard regime in this study increased hospitalization days and imposed negative effects on symptom improvement in hospitalized patients with COVID-19.

Background Substance using often cause a wide range of social, health, and psychological problems. This study aimed to develop and validate a questionnaire of barriers of treatment in substance users. Methods In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous studies. The preliminary tool including 35 Likert-scaled items. After assuring the face validity of the questionnaire, 13 experts’ opinions were obtained for assessing or improving the content validity. The reliability was investigated by internal consistency methods using Cronbach’s alpha. For measuring the structural validity, the exploratory factor analysis was performed to determine the dimensionality of the questionnaire using principal components extraction and Varimax rotation. Results The preliminary questionnaire consisted of 35 items. After completing the face validity and summarizing the experts’ suggestions, 8 items were removed. By calculating the content validity ratio and coefficient, 11 questions were deleted. The internal consistency was calculated to be 0.84 using Cronbach’s alpha. In the last stage and according to the results of the factor analysis, three factors fear of or unawareness of treatment, doubt or inefficiency, and social stigma were identified from the 10-items questionnaire, which explained 67.34% of the total variance. Conclusion Considering the necessity of using a validated tool for planning and evaluating effective interventions on people who use substance is inevitable. The Substance use Treatment Barriers Questionnaire is designed with 10 items and 3 dimensions, which has appropriate validity and reliability and can be used to determine the obstacles for treatment or factors that lead to discontinuing treatment.

This study aimed to identify the context-specific barriers of addiction treatment.This study followed an inductive qualitative content analysis approach to explore the barriers to drug addiction tr...

The aim of this study was to investigate the prevalence and potential association between the infection with some members of the polyomaviridae family of viruses and development of the brain tumors.A systematic literature search was performed by finding relevant cross-sectional and case-control studies from a large online database. Heterogeneity, OR, and corresponding 95% CI were applied to all studies by meta-analysis and forest plots. The analysis was performed using Stata Software v.14.Twenty-three articles (33 datasets) were included in the meta-analysis, four (four datasets) of which were case/control studies and the rest were cross-sectional. The pooled prevalence of polyomaviruses among brain cancer patients was 13% (95% CI: 8-20%; IThe present study showed a significant association between polyomavirus infection and brain tumors. Moreover, these results suggest that polyomavirus infection may be a potential risk factor for the development of brain cancer.

Substance dependent people are more likely to develop different disorders. This study aimed to compare the quality of life and general health between opium and non-opium users referred to addiction...

Geochemical exploration for rare metals, specifically lithium, is essential on a regional scale based on their demand and consumption in recent years. The main objective of this study was to delineate lithium anomalies in regional exploration utilizing the geochemical mapping prospectivity index (GMPI), staged factor analysis (SFA), and a concentration-number (C-N) fractal model based on stream sediments. The case study area is 26000 km2 and is located in the Khorasan Razavi province (NE Iran). In addition, rock samples were used to validate the Li anomalies identified. Results derived via the SFA show that Li was located on a factor denoted as F1-3 with Be, Cs, F, Nb, Sn, Th, U and W, which was used for calculation of the GMPI values. The GMPI data were classified by the C-N fractal method for determination of the Li anomalies. The main anomalies with GMPI ≥ 0.7 and Li ≥ 48 ppm were situated in the SE, SW, north and south parts of the study region. Li grades of rock samples were categorized by the C-N fractal technique for validation of F2-2 anomalies using a log-ratio matrix. The main anomalies were correlated with related lithological units of Li mineralization types. This correlation indicates that the main GMPI–Li anomalies are associated with granitic–pegmatitic units in the central and SE parts, and overlap with clay minerals in the northern and southern sectors of this region. There is good potential for Li mineralization as demonstrated by this hybrid method.

Background Breast cancer is reported as one of the most common cancers among females worldwide. Infectious agents especially viruses have been considered as role players in the development of breast cancer. Although some investigations suggest an association between bovine leukemia virus (BLV) and breast cancer, the involvement of this virus as a risk factor remains controversial. The present study aimed to find out any possible association between BLV and breast cancer through conducting a systematic review and meta-analysis. Methods Systematic literature search was performed by finding related case-control articles from the PubMed, Google Scholar, Web of Science, Scopus, and EMBASE databases. The heterogeneity and the multivariable-adjusted OR and corresponding 95% CI were applied by meta-analysis and forest plot across studies. All statistical analyses were performed using Stata 14.1. Result Based on a comprehensive literature search, 9 case-control studies were included for meta-analysis. The combination of all included studies showed that BLV infection is associated with an increased risk of breast cancer [summary OR (95% CI) 2.57 (1.45, 4.56)]. Conclusion This is the first meta-analysis to analyze a potential association between BLV infection and the risk of breast cancer. Control of the infection in cattle herds and screening of the milk and dairy products may help to reduce the transmission of the virus to humans.

As a health problem, obesity has several risk factors; it has been suggested that human adenovirus type 36 (HAdV-36) infections may possibly be associated with obesity. This updated meta-analysis was designed and conducted with an emphasis on articles published from 2015 to 2020. The PubMed, Web of Science, and Scopus databases were searched up to 1 December 2020. Overall, pooled prevalence and odds ratio of antibodies against HAdV-36 in people with obesity and controls was assessed among different ages. Case-control and cohort studies were included in the analysis. The overall prevalence of HAdV-36 infection in obese population was 31% (CI: 0.24%-0.38%) which was 32% in cases and 27% in controls, respectively; a significant association was found between the cases and the controls (OR, 1.84; 95% CI, 1.39-2.43), especially in children younger than 18 years of age (OR, 2.44; 95% CI, 1.85-3.22). A significant association between adenovirus infection and obesity was found, especially in adolescents.

Background The use of statins for primary prevention of cardiovascular diseases is associated with different benefit and harm outcomes. The aime of this study is how important these outcomes are for people and what people's preferences are. Methods We conducted a preference-eliciting survey incorporating a best–worst scaling (BWS) instrument in Iran from June to November 2019. The relative importance of 13 statins-related outcomes was assessed on a sample of 1085 participants, including 913 general population (486 women) and 172 healthcare providers from the population covered by urban and rural primary health care centers. The participants made trade-off decisions and selected the most and least worrisome outcomes concurrently from 13 choice sets; each contains four outcomes generated using the balanced incomplete block design. Results According to the mean (SD) BWS scores, which can be (+ 4) in maximum and (− 4) in minimum, in the general population, the most worrisome outcomes were severe stroke (3.37 (0.8)), severe myocardial infarction (2.71(0.7)), and cancer (2.69 (1.33)). While myopathy (− 3. 03 (1.03)), nausea/headache (− 2.69 (0.94)), and treatment discontinuation due to side effects (− 2.24 (1.14)) were the least worrisome outcomes. Preferences were similar between rural and urban areas and among health care providers and the general population with overlapping uncertainty intervals. Conclusion The rank of health outcomes may be similar in various socio-cultural contexts. The preferences for benefits and harms of statin therapy are essential to assess benefit-harm balance when recommending statins for primary prevention of cardiovascular diseases.

In this study, the effects of selecting water/silver nanofluid as both a coolant and a reactivity controller during the first operating cycle of a light water nuclear reactor are investigated. To achieve this, coupled neutronic–thermo-hydraulic analysis is employed to simulate the reactor core. A detailed VVER1000/446 reactor core is modeled in monte carlo code (MCNP), and the model is verified using the porous media approach. Results show that the maximum required level of silver nanoparticles is 1.3 Vol.% at the beginning of the cycle; this value drops to zero at the end of cycle. Due to substitution of water/boric acid with water/Ag nanofluid, reactor operation time at maximum power extends to 357.3 days, and the energy generation increases by about 27.3%. The higher negative coolant temperature coefficient of reactivity in the presence of nanofluid in comparison with the water/boric acid indicates that the reactor is inherently safer. Considering the safety margins in the presence of the nanofluid, minimum departure from nucleate boiling ratio is calculated to be 2.16 (recommendation is 1.75). Keywords: Fuel Cycle Period, Nanofluid, Neutronic–Thermo-Hydraulic, Porous Media, Reactivity Controller, Safety Margin

Partial discharge (PD) measurements are well-established under AC stress and their reproducibility is also quite good concerning partial discharge inception voltage (PDIV) and partial discharge extinction voltage (PDEV). Furthermore, correlation between PD activity and phase angle is very helpful for the evaluation and classification of the PD pattern and diagnosis as well. In contrast, for DC stress, neither zero crossing of the voltage nor a correlation between voltage shape and PD event exist. Accordingly, the determination of PDIV and PDEV and classification of PDs are not straightforward. Distinguishing different partial discharge signals from each other could provide useful information about failures in high voltage components. Classification of partial discharge under AC voltage is possible using phase resolved partial discharge (PRPD). However, lack of phase under DC voltage system allows no possibility of using PRPD. Recently some methods have been presented in order to remedy this issue, but more investigations are required in order to reach a proper method. In this paper, it is going to find a way to distinguish between different PDs from each other independent to the voltage type by comparing different measured PD signals (corona and internal discharge) in frequency and time domain. By implementation of different experiments and using analytical investigation of partial discharge signals, a method is presented in order to distinguish various partial discharges under AC, DC and combined AC/DC voltages.

Background Globally, hepatitis B and schistosomiasis (Mansoni) together affect about 300 million people; which cause hepatic disorders worldwide. Given that little is known about co-infections with hepatitis B and schistosoma mansoni, the present study investigates these two health problems alone and together and their possible correlation. Methods A search was conducted for reports published between January 1990 and October 2020 by using Embase, Scopus, PubMed, Web of Science databases; Out of a total of 20 studies, 14 cross-sectional studies (6329 people) and 6 case-control studies (2138 individual) were reviewed. The pooled prevalence of hepatitis B virus (HBV), S.mansoni infections, and their co-infections; heterogeneity and the Odds Ratio (OR) were evaluated by Stata 11.2. Findings Among the included studies in the inclusion criteria, the pooled prevalence of hepatitis B, S. mansoni was 34% (95% CI, 0.23–0.46), 41% (95% CI, 0.24–0.59) and their co-infections was 18% (95% CI, 0.11–0.25) by regions. The hepatitis B and S. mansoni correlation was significant in populations with schistosoma compared to control group (OR, 2.12; 95% CI, 1.36–3.30). Commentary Our results showed that in addition to the high global prevalence of hepatitis B- S. mansoni (co) infections in the included studies, there is a significant association between them, especially in people suffering from schistosoma. These results highlight the importance of integrated interventions measurements against coexistence of parasitic and viral diseases. We know that more research studies need to be done in this field and global monitoring should be considered for the co-infection of these two important complications.

A 3-D full reactor core simulation of VVER-1000/V-446 during full power normal operation is developed to investigate reactivity control and heat transfer improvements when using silver nanoparticles as the base coolant. Coupled neutronic/thermohydraulics analysis is performed using efficient coupling method in which the detailed neutronic model has been created in MCNP, and porous medium method has been used for the thermohydraulics simulation. Consistent with the porous medium approach, complexity of the thermohydraulics full core simulation fades away and reasonable radial and axial distributions of coolant temperature are obtained applying the distributions of power, which are related to the core neutronics. According to safety margins, the reactor operates safer with nanofluid in comparison with the traditional coolant owing to the higher negative temperature coefficient of reactivity. The outcomes indicate that minimum departure from nucleate boiling ratio using nanofluid is almost 9.5% higher, and nanofluid improves the reactor safety margins.

The destructive characteristics of partial discharges (PD) to insulation material are well known. PD in AC and DC stress has different behavior and characteristics. In the case of AC stress, phase-resolved partial discharge (PRPD) patterns, can be used for detection and evaluation of characteristic discharge parameters. However, for DC stress, no phase information is available. In this contribution the differences between AC and DC stresses and the influence of the temperature under DC stress by using analytical investigation and simulation results are discussed in order to achieve a better understanding about PD at DC stress Furthermore, by performing different experiments various effective parameters of PD activity at both AC and DC stress have been investigated.

Integration of a DC transmission system into the existing AC system is proposed in order to transmit more power from north to the south of Germany. Effects of such hybrid AC/DC fields on the dielectric characteristics of insulators, bushings and other power system components are unknown. The outdoor insulators of transmission lines and substations suffer from different pollution such as industrial contaminants, fog, drizzle and natural dust. These contaminations may affect the electrical performance of insulators or even lead to flashover of the insulators. There is a lot of researches about ac flashover of outdoor insulators. But in case of hybrid AC/DC voltage stress more detailed investigations are needed. In this paper the hybrid AC/DC flashover performance of insulators with various pollution layers are investigated. In order to have a comparative investigation between AC and hybrid AC/DC flashovers, four types of pollutions have been applied to the composite insulators and the flashover voltage have been measured under AC and hybrid AC/DC voltages with two different ratios of AC and DC voltages. The results show that the contribution of pollutant layer on the surface of insulator has a major effect on the flashover voltage unlike the conductivity of pollutant layer.

It is well known that partial discharges (PD) can generate chemical, acoustical, electrical and UHF signals. Acoustical detection methods have an advantage of immunity to electromagnetic noises, which makes their use very common for PD localization. Some new investigations showed that not all of the PDs during AC stresses could generate acoustic emission (AE) signals and were therefore called silent PDs [2]. Investigations under AC stresses have been done to find the effect of different configurations and situations on silent PDs, but still the exact reason of creation this kind of PDs is not clear. Therefore in this paper, investigations on the effect of DC stresses on this kind of PDs will be described, in order to better understand and explain their nature and to determine some characteristics of silent PDs. Special configurations under AC stress have been applied to create silent PDs inside an oil tank. After that, positive and negative DC voltages have been applied to investigate this phenomenon under different DC stresses. AE signals have been recorded by an oscilloscope and electrical PD signals via a standard PD measurement device. The results show different discharges at AC and DC stresses, thus the probable reason of this fact is discussed in details in the contribution.

Objective: Obesity and particularly abdominal obesity are strongly associated with insulin resistance and type 2 diabetes. The aim of this study was to quantify the association between three anthropometric measurements (body mass index, waist to hip ratio, waist circumference) and type 2 diabetes mellitus in the adult Yazd population, Iran. Methods: This case-control study conducted among diabetic patients and healthy subjects in the Yazd population, Iran. The study was conducted in a period from December 2012 to May 2013. Studied individuals consisted of 200 patients with Type 2 diabetes and 200 controls without Type 2diabetes. Student t-test was used to assess differences between mean values of two continuous variables. Chi-square analysis was performed to test the differences in proportions of categorical variables between groups and logistic regressions were performed separately for men and women to quantify the association between type 2 diabetes and Body Mass Index (BMI), Waist to Hip Ratio (WHR) and Waist Circumference (WC). Result: 50% of individuals in each group were female and %50 males, mean age of the subjects in the case & control groups were 53.18 yr. and 52.60 yr. respectively. Mean (SD) WC was 91.62 cm (8.9) in non-diabetics men and 97.58 cm (8.64) in diabetics ones, (p

Partial discharge (PD) detection is one of the most important issues in order to determine the insulation condition of power transformers; however the procedures for electrical partial discharge detecting are sometimes not so beneficial for onsite and on-line measurements due to excessive interferences. Acoustic emission (AE) PD detecting method may have some advantages in comparing electrical as well as optical and chemical methods. With this method it is possible to identify the type of PD from the collected information and with a set of sensors to locate the PD source and to evaluate the severity of PD activity. Using multiple sensors, the time delay between the sensors can be used in order to locate the PD source within the power transformer. Protection against electromagnetic interference (EMI) is another advantage of the acoustic method over the electrical method. However the acoustic emission signal from e.g. corona on a transformer bushing could cause some influence on acoustic emission signals due to the short distance between acoustic source and sensor. In this paper, the effect of this kind of acoustic noise has been measured with two different types of acoustic sensors (75 kHz and 150 kHz) at different PD activities and amount of apparent charges, in order to compare the sensitivity of the two sensors on the acoustic noise superimposed on the PD signal. The results are that the two sensors show different sensitivity and the sensor with the maximum frequency resonant at 150 kHz is more reliable for acoustic signals of PD inside the power transformer.