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Abstract Background Despite the development of various antiviral drugs, most of them are not effective in the treatment of coronavirus disease 2019 (COVID-19) as a hyperinflammatory disorder. Chemokine (C-C motif) ligand 2 (CCL2) is one of the critical CC chemokines involved in the pathogenesis and severity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This study aimed to investigate the expression of CCL2 and CC chemokine receptor 2 (CCR2) in COVID-19 patients. Methods Peripheral blood samples were collected from 60 confirmed COVID-19 patients and 60 age-matched healthy subjects. The ages of the subjects were categorized as follows: up to 20 years, 20 to 40 years, 40 to 60 years, and more than 60 years. CCL2 serum levels were measured using the enzyme-linked immunosorbent assay (ELISA). CCR2 gene expression in peripheral blood mononuclear cells (PBMCs) was measured employing real-time polymerase chain reaction (PCR). Results In all age groups, CCL2 serum levels were significantly elevated in patients compared to healthy controls (P

Abstract Introduction Clinical dishonesty is one of the components of academic dishonesty that deals with the unprofessional behavior of students in hospital and clinic environments (medical students, nursing students, etc.). Psychological distress and low moral intelligence among students can be known as predisposing factors in performing dishonest clinical behaviors. The present research addresses a gap in the scientific literature by investigating dishonest behavior among medical students. Methods This cross-sectional study examined medical students’ clinical dishonesty, psychological distress, and moral intelligence. Rafati et al.‘s questionnaire was used to investigate clinical dishonesty, Kessler’s Psychological Distress Questionnaire (K6) was used for psychological distress, and Lenik and Keil’s (2005) questionnaire was used to determine moral intelligence. Cochran’s formula was used to calculate the sample size and the simple random sample (SRS) method was used for sampling. Data were statistically analyzed in SPSS version 27 (SPSS Inc., Chicago, IL, United States). a P-value less than 0.05 was considered significant. Results 317 medical students were included in this study, of which 176 (55.5%) were male and 141 (44.5%) were female. We found a direct and significant statistical correlation between clinical dishonesty and students’ distress (Correlation Coefficient: 0.162, P-value

Abstract Background Evidence-based medicine is defined as searching for medical information, reviewing and comparing it to each patient’s situation, and then judging the optimal decision. We aimed to measure the psychometric properties of the Evidence-Based Performance Profile (EBP2) Questionnaire among the students of health-related fields at Shiraz University of Medical Sciences. Methods This cross-sectional study was conducted in 2021. The EBP2 questionnaire, which includes 74 five-Likert-scale items, was translated into the Persian language using the forward-backward translation method. A panel of five experts approved the face, content, and structural validity of the questionnaire. The Cronbach’s alpha and McDonald’s Omega coefficients were utilized to assess the questionnaire’s internal consistency. Furthermore, both confirmatory and exploratory factor analyses were used to assess the questionnaire’s construct validity. SPSS software version 25 and LISREL software version 8.8 were used for statistical analysis. Results Overall, 339 students participated in this study. The cultural adaptability, linguistic equivalence, and content validity of the Persian version of the EBP2 questionnaire were approved by a five-member team of medical experts. In addition, the results showed excellent internal consistency of the Persian version of the EBP2 questionnaire (Cronbach’s alpha = 0.962, McDonald’s Omega (ML) = 0.963). Moreover, all domains had acceptable reliability (> 0.7), except the Practice domain which had a marginally acceptable Cronbach’s alpha coefficient equal to 0.686. Exploratory factor analysis discovered six domains for the questionnaire. Moreover, the confirmatory factor analysis demonstrated that all indices except the comparative fit index (CFI) and adjusted goodness of fit (AGFI) confirmed the validity of the EBP2 questionnaire. Conclusion The study’s findings indicate that the Persian translated of the EBP2 questionnaire exhibited satisfactory validity and reliability for assessing students’ evidence-based performance in health-related fields.

Objective: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), have been associated with sleep disturbances as extra-intestinal manifestations. We aimed to evaluate sleep quality in a group of Middle Eastern IBD patients while assessing the links between disease characteristics, sleep disturbances, and related comorbidities. Materials and Methods: Outpatient IBD cases who attended our hospital clinic from 2019 to 2021 were recruited in this prospective study. The patients filled in verified translations of the insomnia severity index, Epworth sleepiness scale, Pittsburgh sleep quality index, Berlin questionnaire for obstructive sleep apnea (OSA), and restless legs syndrome (RLS) questionnaire by means of online or phone surveys. The chi-squared test and Student’s t-test were used for binary and continuous variables, respectively. The Mann-Whitney U test was used for non-normally distributed data. Results: The sleep quality of 82 IBD patients (13 CD and 69 UC) was assessed. Low sleep quality was observed in 52 cases (63.4%), and UC patients with pancolitis were significantly more likely to have sleep disturbances compared to patients with partial colitis (p=0.015). Moreover, patients with elevated C-reactive protein (CRP) displayed significantly higher frequencies of OSA and RLS (p=0.038 and p=0.040, respectively). Conclusion: Sleep impairment was identified in more than half of our IBD patient pool. Therefore, we suggest screening for sleep disturbances (particularly in UC patients with pancolitis) and related comorbidities, such as OSA and RLS (especially in patients with elevated CRP levels), in IBD patients to enhance their quality of sleep.

Hydrogels can improve the delivery of mesenchymal stromal cells (MSCs) by providing crucial biophysical cues that mimic the extracellular matrix. The differentiation of MSCs is dependent on biophysical cues like stiffness and viscoelasticity, yet conventional hydrogels cannot be dynamically altered after fabrication and implantation to actively direct differentiation. We developed a composite hydrogel, consisting of type I collagen and phase-shift emulsion, where osteogenic differentiation of MSCs can be non-invasively modulated using ultrasound. When exposed to ultrasound, the emulsion within the hydrogel was non-thermally vaporized into bubbles, which locally compacted and stiffened the collagen matrix surrounding each bubble. Bubble growth and matrix compaction were correlated, with collagen regions proximal (i.e., ≤ ∼60 μm) to the bubble displaying a 2.5-fold increase in Young's modulus compared to distal regions (i.e., > ∼60 μm). The viability and proliferation of MSCs, which were encapsulated within the composite hydrogel, were not impacted by bubble formation. In vitro and in vivo studies revealed encapsulated MSCs exhibited significantly elevated levels of RUNX2 and osteocalcin, markers of osteogenic differentiation, in collagen regions proximal to the bubble compared to distal regions. Additionally, alkaline phosphatase activity and calcium deposition were enhanced adjacent to the bubble. An opposite trend was observed for CD90, a marker of MSC stemness. Following subcutaneous implantation, bubbles persisted in the hydrogels for two weeks, which led to localized collagen alignment and increases in nuclear asymmetry. These results are a significant step toward controlling the 3D differentiation of MSCs in a non-invasive and on-demand manner.

Abstract Background Promoting prevalence of metabolic syndrome (MetS) in Rheumatoid arthritis (RA) patients might occur secondary to RA therapy as well as sedentary life style. However, conflicting observations have been reported on the correlation between MetS and RA. This study aimed to determine the frequency of MetS and association of its components in RA. Methods In this study, 500 RA patients and 500 age- and gender-matched healthy controls were enrolled. MetS was fulfilled through the International Diabetes Federation (IDF) criteria. A multivariate regression model was used to control for variables independently associated with the risk of MetS in RA patients. Results The prevalence of MetS was 58.8% on IDF criteria in RA patients that was higher than controls (20.4%). Higher incidence of cardiovascular disease (CVD), the familial history of CVD, hypertension, type 2 diabetes mellitus (T2DM), smoking, dyslipidemia, and higher levels of body mass index (BMI), waist circumference (WC), total cholesterol level, fasting blood sugar (FBS), triglyceride (TG) level, low-density lipoprotein (LDL) level, while lower levels of high-density lipoprotein (HDL) were associated with an increased risk of MetS in RA patients. Multivariate regression analysis indicated that age, WC, dyslipidemia, LDL, and DAS28 were independent predictors of MetS in the RA patients. Conclusions The prevalence of MetS is higher in RA patients. Our findings suggest an association between cardiovascular risk factors and the increased prevalence of MetS in RA patients.

Objective: The prevalence of inflammatory bowel diseases (IBDs) has increased in recent decades. The incidence of osteoporosis in the population with IBD is higher than in the normal population. Therefore, it seems necessary to carefully examine the risk factors associated with decreased bone mineral density (BMD) among these patients.Methods and Materials: Patients with IBD completed a questionnaire including demographic data, drug history, underlying disease (past medical history), and family history, then their bone density was measured with a DEXA device. Also, laboratory samples were prepared. Densitometry results were placed in three groups: normal, osteoporotic, and osteopenia. All of the data was analyzed by SPSS version 23 software.Results: This study was conducted on 63 patients (58 patients with ulcerative colitis (UC) and 5 patients with Crohn's disease (CD)). The bone density was normal in 40 patients, 16 had osteopenia and 7 had osteoporosis. There was a significant relationship between bone density and age (P < 0.001), smoking (P=0.049), past medical history (P< 0.001), extraintestinal involvement (P=0.008), duration (P=0.023) and menopause (P=0.002). Also, the amount of use of corticosteroid drugs (P=0.014), the level of calcium (P=0.017), and vitamin D (P< 0.001) in the blood had a significant relationship with bone density.Conclusion: In our study, we showed that age, smoking status, underlying conditions, extraintestinal involvement, corticosteroid use, levels of vitamin D and calcium, and menopause are risk factors for an increased risk for decreased BMD in IBD patients.

Abstract Acute myeloid leukemia (AML) is fatal in the majority of adults. Identification of new therapeutic targets and their pharmacologic modulators are needed to improve outcomes. Previous studies had shown that immunization of rabbits with normal peripheral WBCs that had been incubated with fluorodinitrobenzene elicited high titer antibodies that bound to a spectrum of human leukemias. We report that proteomic analyses of immunoaffinity-purified lysates of primary AML cells showed enrichment of scaffolding protein IQGAP1. Immunohistochemistry and gene-expression analyses confirmed IQGAP1 mRNA overexpression in various cytogenetic subtypes of primary human AML compared to normal hematopoietic cells. shRNA knockdown of IQGAP1 blocked proliferation and clonogenicity of human leukemia cell-lines. To develop small molecules targeting IQGAP1 we performed in-silico screening of 212,966 compounds, selected 4 hits targeting the IQGAP1-GRD domain, and conducted SAR of the ‘fittest hit’ to identify UR778Br, a prototypical agent targeting IQGAP1. UR778Br inhibited proliferation, induced apoptosis, resulted in G2/M arrest, and inhibited colony formation by leukemia cell-lines and primary-AML while sparing normal marrow cells. UR778Br exhibited favorable ADME/T profiles and drug-likeness to treat AML. In summary, AML shows response to IQGAP1 inhibition, and UR778Br, identified through in-silico studies, selectively targeted AML cells while sparing normal marrow.

As of December 2020, around 200 vaccine candidates for Coronavirus Disease 2019 (COVID-19) are being developed. COVID-19 vaccines have been created on a number of platforms and are still being developed. Nucleic acid (DNA, RNA) vaccines, viral vector vaccines, inactivated vaccines, protein subunit vaccines, and live attenuated vaccines are among the COVID-19 vaccine modalities. At this time, at least 52 candidate vaccines are being studied. Spike protein is the primary protein that COVID-19 vaccines are targeting. Therefore, it is critical to determine whether immunizations provide complete or fractional protection, whether this varies with age, whether vaccinated people are protected from reoccurring diseases, and whether they need booster shots if they’ve already been inoculated. Despite the enormous achievement of bringing several vaccine candidates to market in less than a year, acquiring herd immunity at the national level and much more so at the global level remains a major challenge. Therefore, we gathered information on the mechanism of action of presently available COVID-19 vaccines in this review and essential data on the vaccines’ advantages and downsides and their future possibilities.

Acoustic droplet vaporization (ADV) offers a dynamic approach for generating bubbles on demand, presenting new possibilities in biomedical applications. Although ADV has been investigated in various biomedical applications, its potential in tissue characterization remains unexplored. Here, we investigated the effects of surrounding media on the radial dynamics and acoustic emissions of ADV bubbles using theoretical and experimental methodologies. For theoretical studies, bubble dynamics were combined with the Kelvin-Voigt material constitutive model, accounting for viscoelasticity of the media. The radial dynamics and acoustic emissions of the ADV-bubbles were recorded via ultra-high-speed microscopy and passive cavitation detection, respectively. Perfluoropentane phase-shift droplets were embedded in tissue-mimicking hydrogels of varying fibrin concentrations, representing different elastic moduli. Radial dynamics and the acoustic emissions, both temporal and spectral, of the ADV-bubbles depended significantly on fibrin elastic modulus. For example, an increase in fibrin elastic modulus from ≈0.2 kPa to ≈6 kPa reduced the maximum expansion radius of the ADV-bubbles by 50%. A similar increase in the elastic modulus significantly impacted both linear (e.g., fundamental) and nonlinear (e.g., subharmonic) acoustic responses of the ADV-bubbles, by up to 10 dB. The sensitivity of ADV to the surrounding media was dependent on acoustic parameters such as driving pressure and the droplets concentration. Further analysis of the acoustic emissions revealed distinct ADV signal characteristics, which were significantly influenced by the surrounding media.

Abstract Introduction and aim Celiac disease is one of the most common autoimmune disorders. This study aimed to evaluate the relationship between celiac disease and wheat sensitization. Subjects and methods In the current study, children aged

Background: Before the arrival of patients at medical facilities, emergency medical teams often encounter numerous challenges in dealing with mass casualties resulting from road traffic accidents. This study examines the challenges that pre-hospital emergency medical services face during mass casualty incidents caused by road traffic accidents. Materials and Methods: This study presents three road accidents that caused significant numbers of casualties in Golestan Province, Iran. The data for this report was gathered from various sources, including recorded images and videos, analysis of hospital records, and pre-hospital care reports. In addition, group discussions were held with emergency medical technicians who were present at the accident scene. Results: Providing relief aid in three sections, namely first responders, emergency call centers, and emergency medical technicians faces significant challenges. The challenges related to the management of mass casualties were mainly in terms of the inability to manage the accident scene by the first responders, management of calls and sharing information in the dispatch center, and medical measures required to be done at the incident scene. Conclusion: To ensure a prompt and efficient response to mass casualty incidents, it is crucial to focus on managing the incident scene by the first responders, as well as optimizing the communication and information exchange during dispatches and field medical interventions. To enhance the quality of emergency medical services, it is vital to develop educational programs, communication strategies, and standardized policies that can be implemented across all mass casualty incidents.

Abstract Objective Mutations in the glucocerebrosidase (GBA1) gene and subthalamic nucleus deep brain stimulation (STN‐DBS) are independently associated with cognitive dysfunction in persons with Parkinson's disease (PwP). We hypothesized that PwP with both GBA1 mutations and STN‐DBS are at greater risk of cognitive dysfunction than PwP with only GBA1 mutations or STN‐DBS, or neither. In this study, we determined the pattern of cognitive dysfunction in PwP based on GBA1 mutation status and STN‐DBS treatment. Methods PwP who are GBA1 mutation carriers with or without DBS (GBA1+DBS+, GBA1+DBS−), and noncarriers with or without DBS (GBA1−DBS+, GBA1−DBS−) were included. Using the NIH Toolbox, cross‐sectional differences in response inhibition, processing speed, and episodic memory were compared using analysis of variance with adjustment for relevant covariates. Results Data were available for 9 GBA1+DBS+, 14 GBA1+DBS−, 17 GBA1−DBS+, and 26 GBA1−DBS− PwP. In this cross‐sectional study, after adjusting for covariates, we found that performance on the Flanker test (measure of response inhibition) was lower in GBA1+DBS+ PwP compared with GBA1−DBS+ PwP (P = 0.030). Interpretation PwP who carry GBA1 mutations and have STN‐DBS have greater impaired response inhibition compared with PwP with STN‐DBS but without GBA1 mutations. Longitudinal data, including preoperative scores, are required to definitively determine whether GBA1 mutation carriers respond differently to STN‐DBS, particularly in the domain of response inhibition.

Introduction: Simulation-based education (SBE) is an instructional approach that aims to accurately recreate real-life scenarios and engage learners in the practical application of lesson content. By replicating critical elements of clinical situations, SBE facilitates a deeper understanding and better preparation for managing such conditions in actual clinical practice. SBE offers promising prospects for improving medical education and patient care in various settings,such as outpatient clinics. Therefore, this scoping review aims to determine to what extent the most effective components and standards of the simulation have been considered in outpatient education.Methods: The present scoping review adheres to the guidelines outlined in the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) checklist” and the “Joanna Briggs Institute (JBI) Reviewers’ Manual”. This review focused on articles that specifically focused on the use of simulation in outpatient education. Google Scholar, PubMed, Scopus, Embase, and ERIC were searched for keywords related to simulation, ambulatory care, outpatient clinics, and medical education from January 1, 2001, to August 12, 2023.Results: The search indicated 513 articles, which were narrowed down by title and abstract relatedness. Twenty-nine articles entered the study’s second phase, and after reviewing their full text, nine articles that explicitly reported simulation use in outpatient education remained. Based on the findings of eligible articles, the ten most frequent components of SBE that should be considered and followed discussed. These features were training facilitators, pre-briefing sessions, the type of simulation techniques, the site of simulation participation, the simulation duration, unit of participation, extent of direct participation, Simulation fidelity, feedback, and debriefing and reflection.Conclusion: SBE is a contemporary method of practical training for medical students that involves realistic modeling or simulation of clinical situations. It enhances learning effectiveness andprovides a safe, educational atmosphere for teaching and learning. Designing simulations adhering to established standards and carefully considering essential components improves efficiencyand effectiveness.

Background: Ocular trauma is a debilitating condition and one of the most important and leading causes of visual impairments that have high socioeconomic consequences. Objectives: This study aims to investigate the epidemiology of ocular trauma in patients referred to a tertiary center in northern Iran. Materials & Methods: This cross-sectional study was carried out on 476 patients with ocular trauma referred to the eye emergency department of a teaching hospital in Guilan Province, north of Iran, in 2020-21. Personal and trauma-related information was extracted from the patient’s medical records using a checklist. Results: Most patients were in the 31-40 age group (28.8%), with a mean age of 41.5±17.4 years. Most of the injuries occurred at home (57.1%). Few of the patients had used eye safety glasses (5.3%). Most of the patients were living in the city. Closed globe injuries were the common types of traumas (96%), and the prevalence of open globe injuries was at a very low level (4%). Conclusion: Closed globe injuries are the most common types of ocular traumas in northern Iran. Most of the ocular traumas are preventable using eye protection equipment.

Abstract Immunity to infectious diseases is predominantly studied by measuring immune responses towards a single pathogen, although co-infections are common. In-depth mechanisms on how co-infections impact anti-viral immunity are lacking, but are highly relevant to treatment and prevention. We established a mouse model of co-infection with unrelated viruses, influenza A (IAV) and Semliki Forest virus (SFV), causing disease in different organ systems. SFV infection eight days before IAV infection results in prolonged IAV replication, elevated cytokine/chemokine levels and exacerbated lung pathology. This is associated with impaired lung IAV-specific CD8+ T cell responses, stemming from suboptimal CD8+ T cell activation and proliferation in draining lymph nodes, and dendritic cell paralysis. Prior SFV infection leads to increased blood brain barrier permeability and presence of IAV RNA in brain, associated with increased trafficking of IAV-specific CD8+ T cells and establishment of long-term tissue-resident memory. Relative to lung IAV-specific CD8+ T cells, brain memory IAV-specific CD8+ T cells have increased TCR repertoire diversity within immunodominant DbNP366 +CD8+ and DbPA224 +CD8+ responses, featuring suboptimal TCR clonotypes. Overall, our study demonstrates that infection with an unrelated neurotropic virus perturbs IAV-specific immune responses and exacerbates IAV disease. Our work provides key insights into therapy and vaccine regimens directed against unrelated pathogens.

Objectives To investigate the implementation of teleconsultation and assess the level of readiness for its adoption among various types of healthcare facilities Methods This cross-sectional study involved medical doctors working in a public hospital, a private hospital, and community health centers in Yogyakarta, Indonesia. We recruited 29 medical specialists from various departments in two hospitals and 27 heads of community health centers. The readiness items were categorized into sections that encompassed various readiness areas such as core, technological, motivational, learning, work culture, and policy readiness. Data were analyzed using a one-way analysis of variance and the Kruskal-Wallis test to evaluate differences in levels of readiness across healthcare facilities. A logistic regression analysis was conducted to further assess factors predicting the implementation of teleconsultation. Results Variations in technological readiness were observed between the community health centers and the public hospital ( p = 0.006) and the private hospital ( p = 0.007). Differences in learning readiness were found between the public hospitals and private hospitals ( p = 0.01). There were also disparities in cultural readiness between the public hospital and the private hospital ( p = 0.04) and between public hospital and community health centers ( p = 0.01). Logistic regression revealed an association between technological readiness and the use of video teleconsultation (OR = 1.13; p = 0.017). The private hospital was more likely to implement video-based teleconsultation than was the public hospital (OR = 2.68; p = 0.003) or community health centers (OR = 3.13; p ≤ 0.001). Conclusion Significant differences in technology readiness were identified among community health centers, public hospitals, and private hospitals. Future policy implementation should focus on customizing technology use and providing cultural training to help healthcare institutions with different technological readiness levels.

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

Osteoarthritis (OA) is characterized by a complex interplay of molecular signals orchestrated by the CCL2/CCR2 axis. The pathogenesis of OA has been revealed to be influenced by a multifaceted effect of CCL2/CCR2 signaling on inflammation, cartilage degradation, and joint homeostasis. The CCL2/CCR2 axis promotes immune cell recruitment and tips the balance toward degeneration by influencing chondrocyte behavior. Insights into these intricate pathways will offer novel therapeutic approaches, paving the way for targeted interventions that may redefine OA management in the future. This review article explores the molecular symphony through the lens of the CCL2/CCR2 axis, providing a harmonious blend of current knowledge and future directions on OA treatment. Furthermore, in this study, through a meticulous review of recent research, the key players and molecular mechanisms that amplify the catabolic cascade within the joint microenvironment are identified, and therapeutic approaches to targeting the CCL2/CCR axis are discussed.

Clobenpropit is a histamine H3 receptor antagonist and has developed as a potential therapeutic drug due to its ability to inhibit CXCR4, a chemokine receptor involved in autoimmune diseases and cancer pathogenesis. The CXCL12/CXCR4 axis involves several biological phenomena, including cell proliferation, migration, angiogenesis, inflammation, and metastasis. Accordingly, inhibiting CXCR4 can have promising clinical outcomes in patients with malignancy or autoimmune disorders. Based on available knowledge, Clobenpropit can effectively regulate the release of monocyte-derived inflammatory cytokine in autoimmune diseases such as juvenile idiopathic arthritis (JIA), presenting a potential targeted target with possible advantages over current therapeutic approaches. This review summarizes the intricate interplay between Clobenpropit and CXCR4 and the molecular mechanisms underlying their interactions, comprehensively analyzing their impact on immune regulation. Furthermore, we discuss preclinical and clinical investigations highlighting the probable efficacy of Clobenpropit for managing autoimmune diseases and cancer. Through this study, we aim to clarify the immunomodulatory role of Clobenpropit and its advantages and disadvantages as a novel therapeutic opportunity.

BackgroundHigh-calorie-expenditure training is common among endurance athletes and is an effective strategy for weight loss. Although many training protocols include walking, running, cycling, and swimming according to a target heart rate, there is limited research on high-calorie-expenditure interventions with multimodal training programs using quantitative methods. ObjectiveThe aims of this research protocol are to (1) develop a high-calorie-expenditure training program to cover target calorie expenditure according to the trainability of women classified as overweight (according to a BMI of 25-29.9 kg/m2); (2) determine the effect of high-calorie-expenditure workouts on conditioning, glycemic variables, and body composition; and (3) evaluate the implementation of the intervention and results in comparison with outcomes obtained under a standard-calorie-expenditure training program. MethodsThis is a randomized controlled trial with a pretest-posttest design. Participants include 33 women with a BMI in the overweight range (25-29.9) allocated to three groups: two intervention groups and one control group. The intervention will be conducted for 12 weeks. Participants in the first group will be assigned an exercise program with high energy expenditure of approximately 3000-3500 kilocalories/week in the form of 5 sessions per week with an intensity of 50%-75% maximum oxygen rate (VO2 max) and 60%-80% target heart rate. The second group will be assigned an exercise program with a standard energy expenditure of approximately 1200-1500 kilocalories/week with 3 sessions per week at an intensity of 60%-75% VO2 max, according to The American College of Sports Medicine guideline. The effects of the multimodal training program with daily tasks will be compared to those of the standard-calorie-expenditure and control (no exercise) conditions with respect to changes in glycemic indices and body composition. Daily calories will be calculated through the International Physical Activity Questionnaire and using Nutrition 4 software. ResultsPreliminary results show significant weight loss in both the high- and standard-calorie-expenditure groups (P=.003). Significant improvements were also found in muscle percentage (P=.05) and BMI (P=.05) for the high-calorie-expenditure group. Analyses are ongoing for glycemic indices, inflammation factors, and blood parameters. ConclusionsHigh-calorie-expenditure training can cause further weight loss than standard exercise, which can eventually lead to greater fat mass reduction and improvement in glycemic indices. These results demonstrate that, in some cases, it may be necessary to increase the activity of women and use multimodal exercise programs with increased volume and intensity to increase the expenditure of exercise and daily activity. We found a net effect of exercise and daily activity at the individual level, whereas the daily lifestyle and physical behaviors of the participants remained constant. Trial RegistrationIranian Registry of Clinical Trials IRCT20220202053916N1; https://tinyurl.com/c8jxfw36 International Registered Report Identifier (IRRID)DERR1-10.2196/51599

Abstract Introduction Designing, developing, and implementing a course without assessing and prioritizing instructional needs may result in inefficiency due to the disregard for the actual needs of the target population. The present study aimed to determine and prioritize medical students’ instructional needs regarding Massive Open Online Courses (MOOCs) at Shiraz University of Medical Sciences. Methods This survey study was carried out in three stages (2020–2021) using the Delphi technique. Purposive and snowball sampling methods were used to select the instructors. The students were selected through simple random sampling. The first round of the Delphi technique involved a questionnaire consisting of one open-ended question, completed by 49 basic/clinical faculty members and 47 senior medical students. In the second round, a 5-point Likert scale-based questionnaire was used to prioritize the instructional needs. The reliability of the questionnaire was verified by Cronbach’s alpha coefficient. In the third round, a focus group was used. A total of six expert faculty members and one senior medical student were invited to the focus group session to prioritize the needs. Data were analyzed using Friedman’s non-parametric ranking test in SPSS version 26. Results Ten instructional needs priorities were extracted, including common pharmacotherapies (antibiotics and narcotics), prescriptions, physiology, anatomy, physical examination, electrocardiography interpretation, radiography, computed tomography scans, serum electrolyte disorders, and cardiovascular and internal (endocrine and metabolic) diseases. The chi-squared calculated value (715.584) indicated a significant difference in the importance of the questionnaire’s questions (P

Abstract Background Interleukin-17 (IL-17) family plays a role in the pathogenesis of knee osteoarthritis (KOA) by contributing to the inflammatory and destructive processes in the affected joint. This study aimed to measure levels of IL-17 A and IL-25 (IL-17E) in serum of KOA patients and determine their roles in the disease severity of patients. Methods In this, 34 patients with KOA and 30 age and sex-matched healthy subjects (HS) were enrolled. Patients were categorized based on their Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), and Body Mass Index (BMI) scores. The enzyme-linked immunosorbent assay (ELISA) technique was employed to measure serum levels of IL-17 A and IL-25. Results Level of IL-25 was significantly higher (P

Key Clinical Message Cutis marmorata telangiectatica congenita (CMTC) presents as marbled erythema and may exhibit diverse associated anomalies. Thorough multidisciplinary evaluation is crucial. Treatment varies with inconclusive evidence, necessitating further research. Our case underscores CMTC's rarity and heterogeneous nature, advocating for comprehensive management approaches and ongoing research.

Summary: Background: The multifactorial nature of inflammatory bowel disease (IBD), which manifests differently in individuals creates a need for a better understanding of the behaviour and pattern of the disease due to environmental factors. The current study aimed to study the changes in IBD behaviour, presentation, and characteristics in patients over the past two decades with a goal of improving patients’ diagnosis, management and outcomes. Methods: During a 6-month period (1/02/2022–30/07/2022), the information of patients with IBD who attended IBD outpatient clinics of 11 referral centre's in six countries was collected, and based on the first time of diagnosis with IBD, they were allocated as group A (those who were diagnosed more than 15 years ago), group B (those who were diagnosed with IBD between 5 and 15 years ago) and group C (IBD cases who diagnosed in recent 5 years). Then the most prevalent subtypes and characters of the disease are evaluated and compared to make clear if the presenting pattern and behaviour of the disease has changed in the last 2 decades. Findings: Overall 1430 patients with IBD including 1207 patients with ulcerative colitis (UC) (84.5%) and 205 patients with Crohn's disease (CD; 14.3%) included. Mean age of participants at the first time of diagnosis with IBD was 30 years. The extra-intestinal involvement of IBD in groups A and B was more prevalent in comparison with group C. Most of those in groups A & B had academic education but in group C, the most prevalent educational status was high school or diploma (P = 0.012). In contrast to groups A and B, the relative prevalence of medium socioeconomic level in group C had decreased (65%). Relative prevalence of UC subtypes was similar among groups A and B (extensive colitis as most prevalent) but in group C, the most prevalent subtype is left side colitis (38.17%). The most prevalent subtype of CD in groups A and B was ileocolic involvement while in group C, upper GI involvement is significantly increased. The rate of food sensitivity among groups A and B was more than group C (P = 0.00001). The relative prevalence of patients with no flare has increased with a steady slope (P

Background and Objective: Some studies have investigated the quality of sleep among patients with irritable bowel syndrome (IBS); however, they are not comprehensive. The current study was conducted to predict quality of sleep among patients with IBS based on mindfulness, the mediating role of self-regulation, and rumination. Materials and Methods: This was a cross-sectional study in form of structural equation modeling (SEM). The samples included 231 patients with IBS, and the measures were Mindfulness, Self-regulation, Rumination, and Pittsburgh Sleep Quality Index (PSQI) scales. In addition, the SPSS and R software were used to analyze data. Results: Mindfulness, along with the mediating role of self-regulation and rumination could predict sleep quality among patients with IBS (P < 0.01), and the fit indices indicated the model fit. Conclusion: Mindfulness, rumination, and self-regulation had an important role in sleep problems among patients with IBS.

Salinity is one of the main environmental factors that limit plant growth and productivity. Humic acid (HA) can directly have positive effects on plant growth, and absorption of nitrogen, potassium, calcium, magnesium, and phosphorus by plants. This study aimed to concentrate on the impact of HA under salinity stress on Oxalis triangularis to use it as an ornamental plant in green spaces and landscaping. Treatments included three salinity stress levels (0, 40 and 80 mM NaCl) and four concentrations of HA (0, 200, 400, and 600 mg l-1) on O. triangularis with four replicates. Applying HA under salinity stress at 40 and 80 mM increased stem length compared to the control, but this increase was lower at medium and high salinity levels. HA at 400 mg l-1 had the best effect on rhizome length under salinity stress at 40 and 80 mM. The reduced trend on proline content in HA at 0, 200, 400, and 600 mg l-1 under salinity stress at 40 mM was 19.65, 18.45, 16.92, and 13.57 %, respectively. By increasing the concentrations of HA, anthocyanin content was raised when compared to the control. Leaf sodium and potassium decreased by applying HA with or without salinity stress.

Objective: Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive lipid accumulation in hepatocytes with no consumption of alcohol. Recently, curcumin is a natural polyphenol found in turmeric has been examined for the treatment of NAFLD. This study aimed to assess the efficacy of 160 mg/day nano-micelle curcumin on the amelioration of NAFLD by measuring liver enzymes.Materials and Methods: Patients with NAFLD were randomly divided into curcumin (intervention group n=33) and placebo (n=33) groups and at the end of the study, the data of 56 participants who completed the 2-month intervention were analyzed. Laboratory tests and questionnaires were used to gather information. Both groups received recommendations for lifestyle modification, and were advised to other necessary advices. Patients in the curcumin group received 160 mg/day of nano-micelle curcumin in two divided doses for 60 days. The 2 groups were followed up for two months and clinical and laboratory indices were compared.Results: Our data showed a significant decrease in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the curcumin group (p

Backgrounds: External dacryocystorhinostomy (DCR) failure is sometimes due to pathologies located within the nasal cavity. Preoperative computerized tomography (CT) scan is useful in the assessment of nasolacrimal drainage and adjacent anatomical structures; however, it is not routinely performed before DCR. The present study evaluates abnormal findings in CT scans of patients with nasolacrimal duct obstruction (NLDO) and its effect on changing treatment approaches.Methods: This prospective descriptive cross-sectional study included 162 patients with NLDO. All the patients underwent a supine axial CT scan. Patients with signs of rhinosinusitis, sinus mucositis, nasal septal deviation, nasal polyps or masses, and turbinate deformities were referred to an otolaryngologist. The rest of the patients underwent external DCR. The demographics and radiologic characteristics of the patients undergoing CT scans and their effect on changing treatment approaches were evaluated. Results: The study participants included 162 patients with a mean±SD age of 62.5±14.0 years (age range of 35-93 years). The percentage of endonasal DCR in cases with an abnormal nasal cavity on CT scan was almost 30% higher compared to those without this problem (59.6% vs. 30.2%). Septum deviation and turbinate deformity led to 3.6-fold and 3.9-fold changes in the surgical approach, respectively.ConclusionA significant association existed between the sinonasal pathologies in patients with NLDO and changing surgical approaches. It is believed that a preoperative CT scan is necessary to detect such pathologies and manage them appropriately.

Abstract Background When a couple experiences emotional divorce, it can lead to boredom, a decrease in their connection, feelings of sadness and despair, and reduced reliance on one another. These consequences can have a lasting impact on the entire family. Therefore, the present study was designed to assess the affecting related factors of emotional divorce among Iranian people during the Covid19 pandemic. Methods A descriptive-analytical study was performed on 900 men and women from 22 districts of Tehran who were selected by the available sampling methods from March to October 2021. Data collection tools are Guttmann demographic and Emotional Divorce Questionnaires. The Questionnaires were completed by the participants of the study. R 4.0.2 software was used to analyze the data, in addition, an independent t-test and chi-square were used to compare the subjects in terms of emotional divorce. Also, the multiple logistic regression method was used to determine the independent factors affecting emotional divorce. Results The results showed that the related factors of emotional divorce include age, marriage rank, and duration of the marriage, choosing the spouse by parents, the education level of the couple, the job of the couple, infection of Covid19, and having disputes before Covid19 infection outbreak. Conclusion Emotional divorce is considered as a social harm which could be the prelude to legal divorce. Therefore, studying affecting factors in any society can pave the way for culture-based interventions to reduce such social harms.

Abstract Background Despite the development of positron emission tomography (PET), single photon emission computed tomography (SPECT) still accounts for around 80% of all examinations performed in nuclear medicine departments. The search for new radiotracers or chelating agents for Technetium-99m is therefore still ongoing. O-TRENSOX and O-TRENOX two synthetic siderophores would be good candidates for this purpose as they are hexadentate ligands based on the very versatile and efficient 8-hydroxyquinoline chelating subunit. First, the radiolabeling of O-TRENOX and O-TRENSOX with 99mTc was investigated. Different parameters such as the quantity of chelating agent, type of reducing agent, pH and temperature of the reaction mixture were adjusted in order to find the best radiolabeling conditions. Then an assessment of the partition coefficient by measuring the distribution of each radiosynthesized complex between octanol and phosphate-buffered saline was realized. The complex’s charge was evaluated on three different celluloses (neutral, negatively charged P81 and positively charged DE81), and finally in vivo studies with biodistribution and SPECT imaging of [99mTc]Tc-O-TRENOX and [99mTc]Tc-O-TRENSOX were performed. Results The radiolabeling studies showed a rapid and efficient complexation of 99mTc with both chelating agents. Using tin pyrophosphate as the reducing agent and a minimum of 100 nmol of ligand, we obtained the [99mTc]Tc-O-TRENOX complex with a radiochemical purity of more than 98% and the [99mTc]Tc-O-TRENSOX complex with one above 97% at room temperature within 5 min. [99mTc]Tc-O-TRENOX complex was lipophilic and neutral, leading to a hepatobiliary elimination in mice. On the contrary, the [99mTc]Tc-O-TRENSOX complex was found to be hydrophilic and negatively charged. This was confirmed by a predominantly renal elimination in mice. Conclusions These encouraging results allow us to consider the O-TRENOX/99mTc and O-TRENSOX/99mTc complexes as serious candidates for SPECT imaging chelators. This study should be continued by conjugating these tris-oxine ligands to peptides or antibodies and comparing them with the other bifunctional agents used with Tc.

Abstract Growing prevalence of obesity among youth would have adverse consequences and increased risk of developing chronic diseases at older ages. This study explored the prevalence of obesity and its association with relevant risk factors in the Rafsanjan youth cohort population. This cross-sectional study was done on 3006 individuals from the 15–35-year-old population included in the Rafsanjan youth cohort study. The data were extracted from the youth cohort databases, which had been collected through in-person interview and standard questionnaires. Definition of general obesity was considered as body mass index ≤ 30 and that of central obesity as waist to hip ratio (WHR) ≥ 0.9 for men and ≥ 0.85 for women. Multivariate stepwise proportional odds model and multivariable stepwise logistic regression models were done to explore the factors associated with general obesity and central obesity. The mean age was 25.78 ± 6.06 years with 56% (n = 1683) female. The prevalence of general obesity was 15.80% (95% CI 14.50–17.11) and central obesity was 28.41% (95% CI 26.80–30.02). The risk of general obesity increased with increasing age (OR = 1.053, P

Abstract Background Even though a lot of scholars have been looking at outpatient education lately because it has become more popular and they want to know about its successes, failures, and problems, we have not been able to find a complete study. Therefore, our study aims to gain a deeper understanding of the various aspects of outpatient education based on the actual experiences of medical students, faculty, and residents. Methods Face-to-face and semi-structured interviews were used to collect data for this qualitative study. Until data saturation was reached, the interviews continued. A total of 21 participants from Shiraz University of Medical Sciences, including medical students, residents, and teachers, were enrolled. The Guba and Lincoln-first written standards for scientific accuracy in qualitative research were used to figure out how reliable the data were. Results Fourteen categories were extracted from four main themes. The results show that four categories: “physical space and equipment,” “prerequisites related to the curriculum,” “teaching skills development,” and “near-peer teachers” should be considered for outpatient education preparation. Theme 2, “implementation requirements,” included “student dimension,” “faculty’s commitment to planning,” and “program supervision.” Theme 3, “challenges of outpatient education,” was described by five related categories, including “curriculum implementation challenges,” “student challenges,” “faculty challenges,” “system-related challenges,” and “patient-related challenges.” Finally, two categories emerged about facilitators of outpatient education: internal and external facilitators. Conclusion Outpatient clinics represent a crucial aspect of medical practice. To effectively leverage this resource, preliminary planning, considering all the prerequisites, paying attention to the implementation requirements, getting to know the challenges, and trying to solve them, especially with incentives, are essential.

Background: Soil serves as the primary repository for microplastics, yet their impact on soil-dwelling organisms remains insufficiently understood. This study aims to investigate the influence of varying concentrations of microplastics in soil on the absorption of Cd and Cu by Eisenia fetida within an artificial soil matrix. Methods: The artificial soil consisted of kaolinite clay (20% dry weight), quartz sand (70% dry weight), and Sphagnum peat (10% dry weight). Microplastics, derived from worn-out tire rubber, were incorporated into the soil to establish four concentration levels: 5, 25, 50, and 100 grams of tire microplastics per 500 grams of dry soil. Each treatment was inoculated with ten mature earthworms, weighing between 3.0 and 5.0 grams. After 14 days, samples were collected for ICP analysis. Results: : The highest accumulation of both metals was observed in treatments with 25, 50, and 100 grams of tire microplastics. The results demonstrated significant disparities in copper and cadmium accumulation in the tissue samples following the introduction of tire wear particles, indicating an augmenting effect of tire particles on metal uptake by the samples. Statistically notable reductions (p < 0.05) in Cd and Cu concentrations were noted in both the control soil and soil containing microplastics, particularly in the 100-gram microplastic treatment for Cd and the 50-gram microplastic treatment for Cu. Conclusion: Exposure to a combination of microplastics, Cd, and Cu has more pronounced adverse effects on E. fetida, and microplastics enhance the bioavailability of heavy metal ions within the soil environment.

Abstract Objective The present study aims to develop and assess the psychometric properties of the Persian version of the Machiavellian Personality Scale (P-MPS), and evaluate its relationship with social adjustment and risky behaviors in Iranian college students. Methods Participants were 500 healthy college students (270 females and 230 males) from medical and non-medical universities in Sanandaj, Iran. They completed the P-MPS, the social adjustment subscale of the Bell Adjustment Inventory, and the Youth Risk Behavior Surveillance System (YRBSS) questionnaire. The factor structure of the P-MPS was evaluated by exploratory factor analysis followed by confirmatory factor analysis (CFA). Cronbach’s alpha coefficient was used to examine the internal consistency of the P-MPS and Pearson correlation test was used to investigate the relationship of the P-MPS score with the scores of social adjustment subscale and YRBSS. Results The P-MPS showed good content validity (Content validity ratio = 0.73, content validity index = 0.90), construct validity, and internal consistency (α = 0.802). The CFA results supported the four-factor solution of the questionnaire. The total score of P-MPS and its dimensions showed a significant negative relationship with social adjustment (p

Abstract Background Inflammasomes are a group of molecules that are strongly involved in causing inflammation. This study aimed to evaluate the expression of NLR family pyrin domain containing 1 (NLRP1), NLRP3, and Apoptosis-associated speck-like protein containing a CARD (ASC) as well as their association with serum level of interleukin (IL)-1β in patients with coronavirus disease 2019 (COVID-19). Methods Thirty COVID-19 patients and 30 healthy subjects (HS) were recruited. Peripheral blood specimens were collected from subjects to assess NLRP1, NLRP3, and ASC gene expression by Real time-PCR technique. Serum levels of IL-1β were also measured via the enzyme-linked immunosorbent assay (ELISA). Results The findings showed no significant differences in serum IL-1β level between COVID-19 patients and the HS group. mRNA expression of ASC (P = 0.008) and NLRP1 (P = 0.03) gene had a significant increase in COVID-19 patients compared to HS, while there was no significant increase in the expression of NLRP3 between the studied group. There were significant correlations between patient’s data and expression levels of NLRP1, NLRP3, IL-1β, and ACS. Conclusions NLRP1 and ASC may have a more critical role in the generation of the active form of IL-1β in COVID-19 patients compared to NLRP3. However, serum levels of IL-1β in patients did not show a significant increase, which may be due to the patient’s condition and the application of virus escape mechanisms through impaired NLRP3 expression and its malfunction.

Abstract Background Total serum protein (TSP) within the first few days of life in the neonatal calf has predictive value for subsequent growth and production in calves before and after weaning. Introduction The objective of this study was to evaluate the effect of TSP concentration 24‐h after birth (24‐h) on the performance and health of Holstein dairy calves. Methods A total of 152 female calves were enrolled in this study. Blood samples were collected at 24‐h, and TSP concentration was measured with a refractometer. Calves based on TSP concentration at 24‐h were allocated into three groups: 1 – TSP ≤6.5 g/dL, 2 – TSP between 6.6 and 6.9 g/dL and 3 – TSP ≥7 g/dL. The weighing was done at birth and at days 30 and 60. Starter feed intake was recorded from day 3 to weaning, and body structures were measured at birth and weaning day. Results Calves with TSP >6.5 g/dL had greater body weight at days 30 and 60 than calves with TSP ≤6.5 g/dL. Average daily gain during 1–30 and 1–60 days of life increased as TSP increased. Furthermore, starter feed intake during the first 60 days of life was greater in calves with TSP ≥7 g/dL than calves with TSP 6.5 g/dL calves had greater heart girth, hip width and body length than ≤6.5 g/dL calves. Moreover, odds ratio for pneumonia decreased as TSP increased, whereas diarrhoea was unaffected. Conclusion The TSP at 24‐h is an important contributing factor for the variation in growth performance and health of preweaning calves, and strategies to improve calf immunity and increase TSP lead to better animal health during preweaning period. Implications These results indicated that TSP ≥6.5 g/dL possibly was associated with greater performance, and this concentration could be considered a baseline for future analyses.

Background: Planning the waste management of all waste generated in healthcare facilities is a crucial task to reduce the hazards and risks to individuals and the community. Objectives: To assess the knowledge and practices regarding bio-medical waste management among paramedical staff and Group IV workers. Methods: In this cross-sectional study, 210 paramedical staff working at hospitals affiliated with Kasturba Medical College, Mangalore were assessed regarding their knowledge and practices regarding BMW. Institutional Ethics Committee permission was obtained before the commencement of the study. Data was analysed using IBM SPSS for Windows version 25.0, Armonk, New York, 25.0. Results: Among the total participants, there were 127 nurses, 6 lab technicians and 77 Group IV workers. 98.1% of healthcare providers were aware that their hospital has a waste management plan. 87.6% of healthcare providers follow hospital policies every time while disposing of waste. 92% of healthcare providers are aware of diseases transmitted by biomedical waste. The majority of the participants preferred using all five protective measures - gloves, goggles, masks, boots, and gowns while dealing with biomedical waste. Conclusion: The majority of the paramedical staff in our study were aware of the BMW management practices.

The development of phase-shift droplets has broadened the scope of ultrasound-based biomedical applications. When subjected to sufficient acoustic pressures, the perfluorocarbon phase in phase-shift droplets undergoes a phase-transition to a gaseous state. This phenomenon, termed acoustic droplet vaporization (ADV), has been the subject of substantial research over the last two decades with great progress made in design of phase-shift droplets, fundamental physics of bubble nucleation and dynamics, and applications. Here, we review experimental approaches, carried out via high-speed microscopy, as well as theoretical models that have been proposed to study the fundamental physics of ADV including vapor nucleation and ADV-induced bubble dynamics. In addition, we highlight new developments of ADV in tissue regeneration, which is a relatively recently exploited application. We conclude this review with future opportunities of ADV for advanced applications such as in situ microrheology and pressure estimation.

Abstract Background The clinical learning evaluation questionnaire can be used in the clinical trial period of medical students to measure the effectiveness of the clinical learning environment. The purpose of this study was to collect validity evidence of an adapted questionnaire to measure the transcultural adaptation of a Persian version of CLEQ. Methods A total of 200 questionnaires were completed by students who were at the end of their clinical rotation. The study instrument was the latest version of the CLEQ consists of 18 Items in four dimensions. The CLEQ was translated into Persian language through a four-step process of forward and backward translation. Data analysis was performed on two softwares, SPSS, version 22 and Lisrel, version 8.8. Results The results showed that the 18-question CLEQ could be applied to the Persian translation of the tool. The response process evidence of the Persian questionnaire was established through feedback from 15 students in the sample group. The content validity index (CVI) for the items were between 0.8 and 0.9, and the content validity ratio (CVR) for the entire questionnaire was 0.9. The 4-factor feature of CLEQ was good model fit. The internal consistency analysis indicated that the Cronbach's alpha values for all items of the 18-item questionnaire were equal to 0.87 and for the subscales were 0.68 to 0.79. Conclusion The Persian translation of the 4-factor CLEQ has sufficient validity evidence to measure the transcultural adaptability of clinical education activities by instructors and students. The validity evidence are content, response process and internal structure. We recommend that the English 6-factor and 6-factor versions of CLEQ be tested on medical students at multiple foreign academic institutions to assess their efficiency.

Abstract Background Medical undergraduates need to improve their techniques for learning in the different settings of learning in clinical rotations. Reflective learning, in which a person can learn from their experiences, is among the most well-known learning skills. In this study, we aim to translate the newly developed modified form of the motivated strategies for learning questionnaire (MSLQ) to Persian and evaluate its reliability and validity among medical students. Methods This study was performed on medical students in clinical stages at the Shiraz University of Medical Science in 2022. The modified MSLQ questionnaire was used in this study which is a 32-item tool measuring different aspects of self-reflecting, including self-orientation, feedback-seeking, critical thinking, and self-regulation. This questionnaire was translated into Persian properly. Cronbach’s alpha and confirmatory factor analysis were used to ascertain the reliability and validity of the tool. Results A total of 325 medical students consisting of 174 men and 151 women with an average age of 23.79 (± 2.21) were enrolled. Path diagrams of confirmatory factor analysis for both standardized regression coefficients and t-values and all the fitness indicators were in favor of the proper validation of the translated version. The overall Cronbach’s alpha for the questionnaire was 0.9, and the value for each of four subscales was above 0.7. Conclusions Our study showed that the Persian-translated version of the modified MSLQ is valid and reliable without taking too much time and effort to implement. We recommend that the developed tool be distributed to medical students from other Iran universities.

Abstract Background Electrocardiogram (ECG) remains an important medical diagnostic and screening tool. This study aimed to compare the effectiveness of online classes instead of traditional face-to-face or blended methods in medical students’ ECG learning. Methods Two hundred and fifteen medical students (including 105 (48.8%) males and 110 (51.2%) females) were studied from February 2021 to February 2022. Regardless of their grade, participants were divided into three groups: online, face-to-face, and blended. Then all participants sat for an ECG interpretation exam, and their results were compared. Results Twenty-six (12.1%) participants were residents, and 189 (87.9%) were interns. Thirty-five (16.3%), 85 (39.5%), and 95 (44.2%) participants were taught ECG through face-to-face, online, and blended methods, respectively. Regarding participants’ preferences on teaching methods, 118 (54.9%) preferred face-to-face learning, and the remaining 97 (45.1%) chose online learning (p

Background: Transperineal focal laser ablation (TPLA) treatment for prostate cancer (PCa) is an experimental focal ablative therapy modality with low morbidity. However, a dosimetry model for TPLA is lacking. Objective: To determine (1) the three-dimensional (3D) histologically defined ablation zone of single- and multifiber TPLA treatment for PCa correlated with magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) and (2) a reliable imaging modality of ablation zone volumetry. Design, setting, and participants: This was a prospective, multicenter, and interventional phase I/II pilot study with an ablate-and-resect design. TPLA was performed in 12 patients with localized prostate cancer divided over four treatment regimens to evaluate potential variation in outcomes. Intervention: TPLA was performed approximately 4 wk prior to robot-assisted radical prostatectomy (RARP) in a daycare setting using local anesthesia. Outcome measurements and statistical analysis: Four weeks after TPLA, ablation zone volumetry was determined on prostate MRI and CEUS by delineation and segmentation into 3D models and correlated with whole-mount RARP histology using the Pearson correlation index. Results and limitations: Twelve office-based TPLA procedures were performed successfully under continuous transrectal ultrasound guidance using local perineal anesthesia. No serious adverse events occurred. A qualitative analysis showed a clear demarcation of the ablation zone on T2-weighted MRI, dynamic contrast-enhanced MRI, and CEUS. On pathological evaluation, no remnant cancer was observed within the ablation zone. Ablation zone volumetry on CEUS and T2-weighted MRI compared with histology had a Pearson correlation index of r = 0.94 (95% confidence interval [CI] 0.74–0.99, p

Introduction: Studies have shown that patients with inflammatory bowel disease (IBD) have an increased risk for venous thromboembolism (VTE). VTEs causes significant morbidity and mortality.Methods: We carried out a comprehensive search through different online databases including PubMed, Google Scholar, Scopus, and Medline. We focused on some of patients-related factors that may affect the risk of VTE incidence among IBD patients and also reviewed current guidelines on the prophylactic regimen of the IBD patients.Results: Based on the previous studies, the hypercoagulable nature of the disease results from a complex interaction between the systems participating in the coagulation cascade, including endothelial cells, platelets, and coagulation factors. There are a number of clinical factors that increase the probability of VTE development which include disease activity, age, pregnancy, surgery, and medical treatment.Conclusion: Taken together, these data suggest to initiate prophylactic regimen in IBD patients and to adjust it regarding to the patient’s condition and the presence of other predisposing factors.

Summary: Blood-borne pathogens can cause systemic inflammatory response syndrome (SIRS) followed by protracted, potentially lethal immunosuppression. The mechanisms responsible for impaired immunity post-SIRS remain unclear. We show that SIRS triggered by pathogen mimics or malaria infection leads to functional paralysis of conventional dendritic cells (cDCs). Paralysis affects several generations of cDCs and impairs immunity for 3–4 weeks. Paralyzed cDCs display distinct transcriptomic and phenotypic signatures and show impaired capacity to capture and present antigens in vivo. They also display altered cytokine production patterns upon stimulation. The paralysis program is not initiated in the bone marrow but during final cDC differentiation in peripheral tissues under the influence of local secondary signals that persist after resolution of SIRS. Vaccination with monoclonal antibodies that target cDC receptors or blockade of transforming growth factor β partially overcomes paralysis and immunosuppression. This work provides insights into the mechanisms of paralysis and describes strategies to restore immunocompetence post-SIRS.

Phase-shift droplets are a highly adaptable platform for biomedical applications of ultrasound. The spatiotemporal response of phase-shift droplets to focused ultrasound above a certain pressure threshold, termed acoustic droplet vaporization (ADV), is influenced by intrinsic features (e.g., bulk boiling point) and extrinsic factors (e.g., driving frequency and surrounding media). A deep understanding of ADV dynamics is critical to ensure the robustness and repeatability of an ADV-assisted application. Here, we integrated ultra-high-speed imaging, at 10 million frames per second, and confocal microscopy for a full-scale (i.e., from nanoseconds to seconds) characterization of ADV. Experiments were conducted in fibrin-based hydrogels to mimic soft tissue environments. Effects of fibrin concentration (0.2 to 8 % (w/v)), excitation frequency (1, 2.5, and 9.4 MHz), and perfluorocarbon core (perfluoropentane, perfluorohexane, and perfluorooctane) on ADV dynamics were studied. Several fundamental parameters related to ADV dynamics, such as expansion ratio, expansion velocity, collapse radius, collapse time, radius of secondary rebound, resting radius, and equilibrium radius of the generated bubbles were extracted from the radius vs time curves. Diffusion-driven ADV-bubble growth was fit to a modified Epstein-Plesset equation, adding a material stress term, to estimate the growth rate. Our results indicated that ADV dynamics were significantly impacted by fibrin concentration, frequency, and perfluorocarbon liquid core. This is the first study to combine ultra-high-speed and confocal microscopy techniques to provide insights into ADV bubble dynamics in tissue-mimicking hydrogels.

Background and Aims Some studies have reported the coexistence of inflammatory bowel disease (IBD) and celiac disease (CD). However, the prevalence of anti-tissue transglutaminase antibodies (IgA and IgG) and their screening value in patients with IBD is not yet clear. This study aimed to assess the prevalence of IgA anti-tTG and its potential correlation with disease status in patients with IBD.

Oral health status can be affected by some factors including drug abuse, systemic conditions and environmental pollutants. The present study was designed to investigate the most important and prevalent dental and oral conditions in adult population of Rafsanjan with the age of 35–70 years. Dental and oral health cohort center as part of the Rafsanjan Cohort Study (RCS) included in the prospective epidemiological research studies in IrAN was established in 2015. Of 9991 subjects enrolled in the RCS, 8682 people participated in the Oral Health Branch of Rafsanjan Cohort Study (OHBRCS).The OHBRCS included 4021 men and 4661 women with the mean age of 49.94 ± 9.51. The most prevalent of oral lesion in total population was candidiasis and the least was aphthous lesion. The prevalence of candidiasis, white and red lesions, periodontal pocket, dental calculus, CAL and the mean of DMFT were higher in the male group than that of female group (p

Introdaction Heavy metals are one of the most important environmental contaminants, particularly in soil and water sources. Mining and metal mining activities are major factors in soil contamination and generally surface soil around mines contain high amounts of these metals. Lead (Pb) is one of the heavy metals and important pollutant in arid ecosystem. The use of plants to remove contaminated soil or phytoremediation is an economical method. Today, due to increasing the pollution of soil sources and resultant problems, identification of the resistant plant species against soil pollution is essential. Using lead-contaminated soils requires their decontamination and improvement. There are different methods to remove these pollutions, one of them is the use of phytoremediation to remove pollutants from water and soil or to reduce them. Among the plants that as an ornamental plant can have a covering role in the green space and also perform the work of phytoremediation is the ornamental cabbage plants (Brassica oleracea L.). In this regard, this study was conducted with the aim of investigating the effect of lead heavy metals and the use of brown algae (Polycladia indica) and spirulina (Arthrospira platensis) as biofertilizers on ornamental cabbage plants in the direction of plant treatment. In addition, due to the presence of polysaccharide compounds such as carrageenan and alginate in the cell wall, algae (seaweeds) have a higher ability to absorb many heavy metals. Materials and Methods The experiment was conducted as factorial based on a completely randomized design in 2020 at the research greenhouse of Zanjan University. The studied factors including lead from lead nitrate source Pb(No3)2 with three concentrations (0, 25 and 50 mg/kg) were applied to the potting soil in four replications in two stages with an interval of two weeks. The second factor was included no algae, brown algae (Polycladia indica) and spirulina (Arthrospira platensis), which occurred in four replications. The measured traits included morphological traits: number of leaves, leaf surface index. Wet and dry root weight, and physiological traits included total chlorophyll content, total leaf antioxidant, peroxidase enzyme, glycine betaine, malondialdehyde, and leaf lead and phosphorus content. Data analysis was performed using SAS software and means were compared by LSD method. Results The results of the variance analysis showed that different levels of lead and the application of algae had a significant effect on the number of leaves per plant, leaf area index, weight, and drying of roots, total chlorophyll, and antioxidants. Moreover, the interaction effect was significant for leaf area, root fresh and dry weight, antioxidants, and leaf lead content. The simple effect of lead at p≤0.01 significantly affected glycine betaine, malondialdehyde, and leaf phosphorus. When comparing the average mutual effects of lead and algae application, it was found that the treatment with no use of lead and spirulina algae resulted in the highest weight and dry weight of the root, with an average of 11.19 and 3.625 grams, respectively. Additionally, despite the decrease in dry weight of the root due to increased lead concentration, using algae, especially for ornamental cabbage (Brassica oleracea L.), increased the dry weight of the root. The presence of natural plant hormones, organic substances, carbohydrates, fiber and amino acids in algae accelerates rooting, reduces stress caused by heavy metals and absorbs more water due to the presence of o developed root system. Also according to the results of comparing the amount of leaf lead with increasing lead, algae as an auxiliary factor can reduce the amount of uptake in the plant. Leaf phosphorus was also significant due to the simple effect of lead and algae. The highest amount of phosphorus with an average of 0.56% was observed in spirulina and the lowest with 0.48% was observed in control. Conclusion In general, due to the toxicity of lead metal even in low concentrations, sufficient attention should be paid to the sources of this pollutant entering the environment. In this study, the effective parameters on the uptake of heavy metal lead from the soil by spirulina and brown algae were investigated. The findings of this study indicate that the ornamental cabbage plant is capable of sustaining its growth in the presence of lead and has a high resistance to this heavy metal while simultaneously absorbing it from the soil. Furthermore, the addition of algae as an auxiliary factor can improve the growth of ornamental cabbage under adverse conditions. Therefore, it is recommended that this plant be further examined for its potential to absorb other heavy metals.