Search

Abstract Background The role of endogenous estrogen exposure (EEE) in shaping body composition and its implications for cardiometabolic health remain understudied despite its potential significance. This cross-sectional study aimed to investigate the association between EEE and body composition indices among postmenopausal women. Methods Data were obtained from the Tehran Lipid and Glucose Study (TLGS), including 960 women aged over 40 years. EEE was calculated based on reproductive events, and participants were categorized into tertiles. Anthropometric measurements and body composition were assessed using standardized protocols. Linear regression models were employed to evaluate associations, adjusting for potential confounders. Results It was revealed significant differences in body composition indices across EEE tertiles, with increasing EEE associated with decreased fat mass, skeletal muscle mass, and fat-free mass. Moreover, women with higher EEE exhibited lower anthropometric and body composition measurements compared to those with lower EEE, even after adjusting for confounding factors. Specifically, for each year of increasing EEE, fat mass decreased by 0.12 kg, skeletal muscle mass by 0.04 kg, fat-free mass by 0.07 kg, and fat mass ratio decreased by 0.003. Comparing tertiles, women with the highest EEE demonstrated significantly lower anthropometric and body composition measurements compared to those with the lowest EEE. Conclusion These findings suggest a link between EEE and favorable changes in body composition, highlighting the importance of considering reproductive history in health assessment.

Abstract Background Obesity is associated with the development of polycystic ovarian syndrome (PCOS), a complex endocrine disorder. However, the correlation between body composition and PCOS in women has not been thoroughly investigated. This study aimed to examine body composition using bioelectrical impedance analysis (BIA) in women with and without PCOS in a population-based study within the Tehran Lipid and Glucose Study (TLGS). Methods We conducted a cross-sectional study among non-menopausal women aged 18–45 who underwent BIA in phase VII of the TLGS. A total of 150 participants with PCOS and 240 without PCOS were included based on the Rotterdam criteria. Baseline demographic, anthropometric, laboratory, and body composition parameters were compared between the two groups. Results The mean age was 33.7 ± 7.45 years in the PCOS group and 35.49 ± 7.05 years in the control group. The mean BMI was 27.0 ± 4.0 kg/m2 in the PCOS group and 27.1 ± 4.4 kg/m2 in the control group. No significant differences were found in body composition parameters between the two groups as assessed by BIA. Additionally, there were no correlations between body composition and hormone parameters in PCOS patients. Conclusion In this sample of non-referral patients with PCOS, the use of BIA did not provide added value beyond conventional anthropometric measures for assessing body composition. Further longitudinal research is needed to determine whether body composition analysis can enhance PCOS evaluation.

Abstract The increasing penetration of the distributed energy resources (DER) in the power grid, which, while having significant advantages, also pose significant challenges. The behaviors of DERs differ from those of synchronous generators, particularly in abnormal conditions. For this reason, the power grid enforces grid codes to ensure that DERs perform properly in different conditions. For instance, short circuit faults and unbalanced grid voltage are severe transient events that inverters need to be able to pass through without disconnecting from the grid. Furthermore, the inverters are required to support the grid voltage by regulating the active and reactive power injections. This article proposes a voltage support control scheme to support grid voltage during asymmetrical voltage drop by utilizing an optimization problem. In this optimization problem, the active and reactive powers injected into the grid will be obtained optimally by considering constraints such as instantaneous active and reactive power oscillation magnitudes and peak current limitation. To aid in this purpose, the corresponding mathematical formulations such as instantaneous active and reactive power oscillation magnitudes will be obtained by using the currents and voltages in stationary reference frame. The proposed scheme will be verified by simulating it in MATLAB/Simulink under three different scenarios and tested on a real‐time experimental Opal‐RT platform.

Background: Pregnancies complicated by gestational diabetes are associated with an increased risk of adverse maternal and fetal outcomes.Objectives: This trial aimed to compare maternal and fetal outcomes in Iranian women with gestational diabetes treated with either metformin or insulin.Methods: In this open-label randomized clinical trial, eligible Iranian women referred to Shohada-e-Tajrish Hospital (Tehran, Iran) between January and September 2022 were enrolled through simple random sampling. Participants were randomly assigned to two groups: one receiving metformin (n=50) and the other receiving insulin (n=49). We measured HbA1c, fasting plasma glucose (FPG), and 2-hour plasma glucose (2 hrPG) in all participants. Maternal outcomes, including preeclampsia and cesarean delivery rates, were compared alongside neonatal outcomes such as respiratory distress, congenital disorders, small for gestational age (SGA), macrosomia, birth weight, gestational age at birth, shoulder dystocia, hypocalcemia, hypoglycemia, Apgar scores at 5 minutes, and neonatal intensive care unit (NICU) admissions. Data analysis was performed using SPSS 16 with t-tests, Mann-Whitney U tests, Chi-square tests, or Fisher's exact tests as appropriate.Results: Both metformin and insulin demonstrated similar efficacy in controlling FPG, 2-hrPG, and HbA1c levels in women with gestational diabetes (P>0.05). In the metformin group, there were slightly more cases of respiratory distress (P=0.73) and cesarean deliveries (P=0.35), although these differences were not statistically significant. Conversely, the insulin group showed higher, yet not statistically significant, rates of preeclampsia (P=0.70), congenital disorders (P=0.07), small for gestational age (SGA) infants (P=0.48), shoulder dystocia (P=0.31), hypocalcemia (P=0.31), hypoglycemia (P=0.31), and NICU admissions (P=0.21). Macrosomia, average birth weight, and gestational age at birth were similar between the two groups (P>0.05). The only significant finding was that the average Apgar score at 5 minutes was significantly higher in the metformin group compared to the insulin group (P=0.003). No mortality was reported in either group.Conclusion: The findings of this study indicate that metformin has effects comparable to those of insulin regarding maternal and neonatal outcomes in Iranian women with gestational diabetes.

As technology continues to advance and modern lifestyles become increasingly mechanized, the prevalence of heart disease is steadily growing. On the other hand, donor hearts ready for transplantation are limited worldwide. Therefore, blood pumps are a suitable alternative to help the patient during the waiting period and even until the end of life. Blood pumps must meet biological requirements, including adequate output pressure and flow rate, within an acceptable margin of safety in the event of blood damage. Reduction of pump size, blood exposure time, and blood damage such as hemolysis have been mentioned as important challenges in the design of blood pumps. Statistics show that 30% of the patients who use a left ventricular blood pump need a right ventricular blood pump due to right ventricular failure. The purpose of this research is to determine the effect of the geometrical shape of the impellers (flow passage) and the thrust tube geometry of the volute chamber on the pump’s hydraulic performance, the amount of axial and radial forces, and the amount of blood damage. So, for this study, six blades and two types of geometry for the volute chamber thrust tube were designed. This pump has been simulated using computational fluid dynamics used the Ansys CFX 17. Finally, the appropriate pump has been selected for low hemolysis index (HI). The HI calculated using the Lagrangian method is 0.00279 in the pump with a flow rate of 5 L per minute and 1100 rpm.

Introduction: Long-term survival following lung transplantation (LTx) faces impediments due to chronic lung allograft dysfunction (CLAD), while infections hinder short-term survival. Fungal colonization and invasive fungal infections (IFI) are common within the first year after LTx. There is ongoing debate regarding the impact of such events on CLAD development and mortality. This study aims to investigate this matter further. Methods: A total of 134 LTx recipients transplanted between 2011 and 2020 were included. The median follow-up time was 3.9 years. Fungal colonization and IFI were defined according to international consensus guidelines and were noted if present within the first 12 months after LTx. Results: Postoperative fungal colonization was found in 101 patients, and 14 patients had an IFI within twelve months of transplantation. Nineteen patients were neither colonized nor infected. Out of the 115 patients with colonization or IFI, 61 patients had growth of a yeast such as Candida species (spp.). Fifty-six patients were colonized prior to LTx. Being colonized with fungus before or within the first 12 months post-LTx did not significantly affect survival or CLAD development. Conclusions: The results of the current study indicate that fungal colonization either pre-transplantation or within the first 12 months after does not correlate with increased risks of mortality or CLAD development. These findings show that while fungal colonization is a common occurrence in LTx recipients, it does not predispose the patients of the cohort to adverse outcomes.

Background: This article explores the impact of managers' communication skills on the job satisfaction of health sector employees through a meta-analysis. The purpose is to determine how these communication skills influence job satisfaction and how strategic decisions can be improved for greater organizational efficiency. Methods: Using the meta-analysis method, studies on the impact of managers' communication skills on the job satisfaction of health sector employees were collected. Searches in databases like the Iran Documentation Center, Magiran, Noormags, and others led to the retrieval of 20 relevant articles, theses, and treatises. Of these, 13 studies provided suitable data for effect size calculation. The data was analyzed using SPSS software to assess the relationship between communication skills and job satisfaction among health sector employees. Results: The analysis showed that managers' communication skills significantly impact job satisfaction. The Q-test indicated significant heterogeneity in the studies, suggesting the presence of moderating variables. The I-squared index confirmed that 99% of the variance is real. Additionally, Egger’s regression test confirmed the heterogeneity, and publication bias was assessed using funnel plots and regression methods. The effect size analysis emphasized that extreme values could affect the validity of the results. Conclusion: Improving managers' communication skills directly enhances job satisfaction among health sector employees. The study confirms that the communication skills of managers have a significant and positive relationship with the job satisfaction of employees in the health sector.

ntroduction: The western whiteleg shrimp, Litopenaeus vannamei, is a euryhaline species, but fluctuated salinity can lead to stress. Hemolymph indices, such as total and differential hemocyte counts, are key indicators of immune status in shrimp. Using medicinal plants to feed farmed aquatic animals is a promising approach to enhance production performance and resilience to environmental stress. Alfalfa, Medicago sativa leaves are used in animal and human diets due to high protein content and nutritional value. This study evaluates the impact of alfalfa leaf powder (ALP) and extract (ALE) on the hemolymph indices of L. vannamei in low salinity stress conditions. Materials and methods: Shrimp were fed in seven treatments with three replications, including control (without ALP and ALE), ALP (60, 120, and 180 g/kg), and ALE (6, 12, and 18 g/kg) for nine weeks. Then, the shrimp were subjected to salinity stress at five ppt for 48 hours. Survival rates were recorded at the end of the feeding and stress period, and total and differential hemocyte counts were measured. Results: In non-stress conditions, the number of hemocytes in the control group was significantly lower compared to the other treatments. In the 5 ppt salinity, ALP180 and ALE18 showed significantly higher total hemocyte counts than the control group (p

Solid organ transplantation has progressed rapidly over the decades from the first experimental procedures to its role in the modern era as an established treatment for end-stage organ disease. Solid organ transplantation including liver, kidney, pancreas, heart, and lung transplantation, is the definitive option for many patients, but despite the advances that have been made, there are still significant challenges in meeting the demand for viable donor grafts. Furthermore, post-operatively, the recipient faces several hurdles, including poor early outcomes like primary graft dysfunction and acute and chronic forms of graft rejection. In an effort to address these issues, innovations in organ engineering and treatment have been developed. This review covers efforts made to expand the donor pool including bioengineering techniques and the use of ex vivo graft perfusion. It also covers modifications and treatments that have been trialed, in addition to research efforts in both abdominal organs and thoracic organs. Overall, this article discusses recent innovations in machine perfusion and organ bioengineering with the aim of improving and increasing the quality of donor organs.