Comparison of outcomes between off-pump and on-pump coronary artery bypass graft surgery using collaborative targeted maximum likelihood estimation.

There are some discrepancies about the superiority of the off-pump coronary artery bypass grafting (CABG) surgery over the conventional cardiopulmonary bypass (on-pump). The aim of this study was estimating risk ratio of mortality in the off-pump coronary bypass compared with the on-pump using a causal model known as collaborative targeted maximum likelihood estimation (C-TMLE). The data of the Tehran Heart Cohort study from 2007 to 2020 was used. A collaborative targeted maximum likelihood estimation and targeted maximum likelihood estimation, and propensity score (PS) adjustment methods were used to estimate causal risk ratio adjusting for the minimum sufficient set of confounders, and the results were compared. Among 24,883 participants (73.6% male), 5566 patients died during an average of 8.2 years of follow-up. The risk ratio estimates (95% confidence intervals) by unadjusted log-binomial regression model, PS adjustment, TMLE, and C-TMLE methods were 0.86 (0.78-0.95), 0.88 (0.80-0.97), 0.88 (0.80-0.97), and 0.87(0.85-0.89), respectively. This study provides evidence for a protective effect of off-pump surgery on mortality risk for up to 8 years in diabetic and non-diabetic patients.

The Study of Caspian Roach (Rutilus caspicus) Fry Health Fed with Phytobiotic-Supplemented and Salinity Stress Resistance with Emphasis on Gill Tissue Pathology.

Herbal treatment augments immune and antioxidant responses and suppresses stress in fish. Ginger (Zingiber officinale) is a popular plant with medicinal uses because of its immunostimulant, antimicrobial, and antioxidant characteristics. This study aimed to investigate the effects of ginger (Z. officinale) on growth, digestive enzymes activity, antioxidant and immune response, and salinity stress resistance of Caspian roach (Rutilus caspicus). Fish (0.98 ± 0.09 g) were divided into four treatment-fed diets containing 0 (control, Z0), 10 (Z10), 20 (Z20), and 30 (Z30) g/kg ginger powder for 56 days and then subjected to 2 g/L salinity stress for 48 hr. The highest final weight of specific growth rate (SGR), superoxide dismutase (SOD), and catalase activity and the lowest final weight of feed conversion ratio (FCR) and malondialdehyde (MDA) were observed in fish-fed diets containing 10 and 20 g/kg ginger inclusion. Intestinal protease activity significantly increased in Z10 treatment, and the highest amylase and lipase activities were related to control, including 10 g/kg ginger in the diet compared to the control group had a significant effect on immune indices such as immunoglobulin M (IgM) and ACH50 (p < 0.05). The highest lysozyme was obtained in Z20 treatment, which had a significant difference in the control (p < 0.05). Cortisol and glucose levels were significantly lower in ginger treatments than the control before and/or after salinity stress. Histopathologic results showed that hyperplasia, edema, expansion of secondary lamella, epithelial cells, and necrosis of gills were most common lesions. However, the results of this study demonstrate that using ginger powder in addition to improving of growth, it can be also effective in survival rate of Caspian roach fingerling as an endangered species exposed to salinity stress.

Population parameters of the non-indigenous invasive shrimp Palaemon macrodactylus Rathbun, 1902 (Caridea: Palaemonidae) from the southeastern Caspian Sea, with implications for range expansions, threats and conservation.

Knowledge on invasive species is critical for the conservation. This study is the first documentation on population parameters of oriental shrimp (Palaemon macrodactylus) in the southern Caspian Sea, where the occurrence of invasive species is of great importance. The samples were collected using a small beach seine (35 m long and 2.5 m height) monthly from April 2019 to March 2020, and a total of 1643 specimens of P. macrodactylus were sampled. The growth form of the males was negative and that of females positive allometric nature. From the size-frequency distributions, the shrimp's lifespan was estimated to be about 2 years for both sexes. High recruitment can take place over nearly all months of late summer and autumn. The VBGF parameters were L∞ = 65.00 mm, K = 0.82 y-1, and t0 = -0.80 for males, and TL∞ = 71.00 mm, K = 0.51 y-1 and t0 = -0.59 for females. The estimated Z was 3.65 and 3.10 year-1 for males and females, respectively. The total sex ratio was significantly biased toward females in the population. Length group analysis showed a clear pattern of female dominance in lengths larger than 29 mm. Based on the occurrence of ovigerous females, the reproductive period lasts for seven months (April-October). Fecundity, as the number of both eyed and non-eyed eggs per clutch of females, varied from 71 to 2308 eggs shrimp-1 with a mean of 1074 ± 553.8 (±SD) eggs shrimp-1. The estimated relative number of eggs in a clutch of ovigerous females varies between 1208.8 and 1714, with a mean value of 889.1 eggs. female-1. The egg diameter averaged 0.675 ± 0.063 mm (±SD), ranging from 0.512 to 0.812 mm. The relationships of the total and relative number of eggs in a clutch of ovigerous females with their size were statistically significant, while the egg diameter in ovigerous females was independent of shrimp size (length and weight). P. macrodactylus underwent a life-history strategy including high abundance, short life span, high mortality rate, long reproductive season, and female dominance that showed characteristics of r-strategist species, promoting the invasion of this shrimp in the Caspian Sea as a new area of introduction. We are convinced that P. macrodactylus established in the Caspian Sea it is in the last stage of invasion (impact on the ecosystem).

Antibiotic use and multiple sclerosis: A systematic review and meta-analysis.

BACKGROUND: Epidemiological studies have shown conflicting results between antibiotic use and multiple sclerosis (MS) risks. The present systematic review and meta-analysis were conducted to assess the association between antibiotic use and the risk of MS. METHODS: PubMed, Scopus, Embase, Web of Science, and Google Scholar as well as reference lists of retrieved studies were searched systematically to identify studies were assessed the relationship between antibiotic use and MS up to September 24, 2022. Random-effects model was used for the calculation of pooled Odds ratio (OR) and 95% confidence intervals (CI). RESULTS: Five independent studies containing 47,491 participants were included in the meta-analysis. The overall results of included studies showed a non-significant positive association between antibiotic use (OR overall=1.01, 95%CI: 0.75-1.37) and a non-significant negative association between penicillin use (OR overall= 0.83; 95%CI: 0.62-1.13) and MS risk. Heterogeneity was (I2=90.1, P heterogeneity < 0.001) and (I2=90.7, P heterogeneity < 0.001) in antibiotics and penicillin use groups respectively. CONCLUSION: Our meta-analysis did not show a significant association between antibiotic or penicillin use with the risk of MS. However, due to the limitations of this study, further well-designed studies are required to confirm our findings.

Quercetin Application for Common Carp (Cyprinus carpio): I. Effects on Growth Performance, Humoral Immunity, Antioxidant Status, Immune-Related Genes, and Resistance against Heat Stress.

This study was done to evaluate the effect of different quercetin levels on growth performance, immune responses, antioxidant status, serum biochemical factors, and high-temperature stress responses in common carp (Cyprinus carpio). A total number of 216 common carp with an average weight of 27.21 ± 53 g were divided into 12 tanks (four treatments × three replications) and fed 0 mg/kg quercetin (T0), 200 mg/kg quercetin (T1), 400 mg/kg quercetin (T2), and 600 mg/kg quercetin (T3) for 60 days. There were significant differences in growth performance, and the highest final body weight (FBW), weight gain (WG), specific growth rate (SGR), and feed intake (FI) were observed in T2 and T3 (P < 0.05). Different quercetin levels significantly increased complement pathway activity (ACH50) and lysozyme activity both before and after heat stress (P < 0.05). Catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) were significantly increased in fish exposed to heat stress, but fish fed with a supplemented diet with quercetin showed the lowest levels both before and after heat stress (P < 0.05). Superoxide dismutase (SOD) levels were significantly enhanced in fish fed diets supplemented with quercetin in both phases (P < 0.05). Different quercetin levels led to a significant decrease in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) before and after the challenging test (P < 0.05). Glucose and cortisol levels were significantly higher in the control group compared to the other treatments in both phases (P < 0.05). The expression of glutathione peroxidase (GPx) and lysozyme was markedly upregulated in fish fed with quercetin-supplemented diets (P < 0.05). No marked effects were observed for growth hormone (GR) and interleukin-8 (IL8) (P > 0.05). In conclusion, dietary quercetin supplementations (400-600 mg/kg quercetin) improved growth performance, immunity, and antioxidant status and increased tolerance to heat stress.

Effects of dietary Plantago ovata seed extract administration on growth performance and immune function of common carp (Cyprinus carpio) fingerling exposed to ammonia toxicity.

Medicinal plants are powerful antioxidants which can improve well-being and suppress oxidative stress caused by environmental toxins in aquatic animals. In this regard, the present research was designed to show the potential effects of psyllium (Plantago ovata) seed extract (PSE) on the growth, and immune responses of common carp Cyprinus carpio exposed to acute ammonia toxicity. To perform the study, fish were fed with diets containing 0 (T0), 0.25 (T1), 0.5 (T2), and 1% (T3) PSE for 60 days, and then exposed to ammonia (0.5 mg L-1) for 3 h. The findings showed that fish given the T1 diet outperformed the T3 and control groups in terms of ultimate weight, weight increase, and food conversion ratio. Additionally, the T1 group showed a significantly higher level of total protein and serum lysozyme activity than the other treatment groups. Moreover, the highest serum total immunoglobulin values were recorded in T1 and T2 groups. The results showed that PSE, especially at moderate levels, could successfully upregulate the transcription of immune-related genes (IFN-γ, Hsp70, TNF-ɑ, IL-1ß, IL-10, and IgE) compared to the control group after exposure to ammonia. Furthermore, improving ammonia-induced down regulations of antioxidant-related gene expressions (CYP1A, SOD, and GPX) was observed in fish fed with PSE-included diets compared to the control one. However, PSE-supplemented diets did not affect the mRNA expression level of CAT. Regarding tight junction-associated genes, the higher mRNA expression level of occludin was observed in the T1 group, whereas the downregulation of CLD3 gene occurred in all experimental groups. Conversely, significant upregulation of osmoregulation-associated gene (NKA) was recorded in all experimental groups compared to the control one. Therefore, the administration of PSE (0.25% of the diet) for 60 days is recommended to increase growth performance, improve health, and increase the resistance of common carp to oxidative stress caused by ammonia.

Effect of Stocking Density and Dietary Protein Level in Biofloc System on the Growth, Digestive and Antioxidant Enzyme Activities, Health, and Resistance to Acute Crowding Stress in Juvenile Common Carp (Cyprinus carpio).

This study is aimed at evaluating the effects of stocking densities and dietary protein levels in the biofloc system on the performance of common carp. Fish (12.09 ± 0.99 g) were transferred to 15 tanks: fish reared at 10 kg/m3 as medium density and fed 35% (MD35) or 25% (MD25) protein and fish reared at 20 kg/m3 as high density and fed 35% (HD35) or 25% (HD25) protein in the biofloc system and control fish reared at MD and fed 35% protein in clear water. After 60 days, fish were subjected to crowding stress (80 kg/m3) for 24 h. The growth of fish was highest in MD35. The feed conversion ratio was lower in MD35 compared to the control and HD groups. The amylase, lipase, protease, and superoxide dismutase and glutathione peroxidase activities in the biofloc groups were significantly higher than in the control. After crowding stress, cortisol and glucose levels in biofloc treatments were significantly decreased compared to the control. After 12 and 24 h stress, lysozyme activity in MD35 was significantly lower than in the HD treatments. Overall, the biofloc system with MD could improve growth and robustness against acute stress in fish. Also, biofloc could compensate 10% reduction of protein in common carp juvenile diet when reared in MD.

The Gene Regulatory Roles of Herbal Extracts on the Growth, Immune System, and Reproduction of Fish.

The crucial need for safe and healthy aquatic animals obligates researchers in aquaculture to investigate alternative and beneficial additives. Medicinal herbals and their extracts are compromised with diverse effects on the performances of aquatic animals. These compounds can affect growth performance and stimulate the immune system when used in fish diet. In addition, the use of medicinal herbs and their extracts can reduce oxidative stress induced by several stressors during fish culture. Correspondingly, aquatic animals could gain increased resistance against infectious pathogens and environmental stressors. Nevertheless, the exact mode of action where these additives can affect aquatic animals' performances is still not well documented. Understanding the mechanistic role of herbal supplements and their derivatives is a vital tool to develop further the strategies and application of these additives for feasible and sustainable aquaculture. Gene-related studies have clarified the detailed information on the herbal supplements' mode of action when administered orally in aquafeed. Several review articles have presented the potential roles of medicinal herbs on the performances of aquatic animals. However, this review article discusses the outputs of studies conducted on aquatic animals fed dietary, medicinal herbs, focusing on the gene expression related to growth and immune performances. Furthermore, a particular focus is directed to the expected influence of herbal supplements on the reproduction of aquatic animals.

Protective effects of black seed (Nigella sativa) diet supplementation in common carp (Cyprinus carpio) against immune depression, oxidative stress and metabolism dysfunction induced by glyphosate.

Sustainable aquaculture arises as key to increase food production in the coming years. However, the sector still faces many challenges such as the exposure of the cultured animals to pesticide-contaminated water. Pesticides used in agriculture can reach aquaculture systems either directly (integrated-agriculture aquaculture practices) or indirectly (soil leakage) and cause a broad range of ecotoxicological effects on cultured fish and shellfish. Here, we studied how glyphosate affects several haematological, biochemical, and immune parameters in common carp (Cyprinus carpio) fingerlings, the fourth most important cultured fish species worldwide. We also evaluated the potential of dietary supplementation with black seed (Nigella sativa, 0.25, 0.5 and 1%) to lower glyphosate-associated toxicity. Our results showed that 14-day sub-lethal exposure of common carp fingerlings to glyphosate increases oxidative stress, decreases antioxidant defences, affects several metabolic pathways, and induced immune depression. Furthermore, we showed that fish fed with N. sativa-enriched diets at 0.25, 0.5 and 1% for 60 days coped better with glyphosate exposure than control fish and displayed more stable levels of biochemical serum parameters (total protein, albumin, triglycerides, low-density lipoprotein LDL), cholesterol and high-density lipoprotein HDL), higher levels of immune defences (lysozyme and immunoglobulin) and higher antioxidant enzymes (superoxide dismutase SOD, glutathione peroxidase GPx) than control fish. Fish fed with all enriched diets also displayed lower lipid peroxidation (malondialdehyde MDA), lower metabolic enzymes (alanine aminotransferase ALT, aspartate aminotransferase AST and alkaline phosphatase ALP) levels in blood serum and lower cortisol levels than control fish. Altogether, our results show that dietary inclusion of black seed can be used as a sustainable bio-remediation strategy, mitigating many of the negative effects of glyphosate exposure in fish.

Economic cost of diabetes in the Eastern Mediterranean region countries: A meta-analysis.

BACKGROUND AND AIMS: Non communicable diseases including diabetes imposes substantial financial burden on households, societies and nations in both developed and developing countries. However, there is no information on the extent of diabetes expenditure in the Eastern Mediterranean Region (EMRO). Therefore, this study aimed to identify the treatment costs of diabetes in this area. To our knowledge, this is the first systematic review on treatment expenditures of diabetes in EMRO countries. METHODS: A comprehensive literature search was conducted in PUBMED, MEDLINE, EMBASE, SCOPUS and WEB OF SCIENCES databases to find out published manuscripts on treatment cost of diabetes. Information was extracted using data extraction sheets and then the data were imported into STATA software version.11. Mean annual treatment cost of diabetes per patient, annual treatment costs of diabetes per patient by Diabetes Mellitus (DM) complications and finally, cost of chronic diabetes complications per patient were pooled and reported. RESULTS: After reviewing title, abstract and the full text of identified articles; a total of seven studies were reported appropriate data for this meta-analysis. The pooled annual treatment cost per diabetes patient for EMRO countries was 1150 US$ (95% CI: 595-2221) which was 3358 US$ (95% CI: 2200-5124) in EMRO countries except of Iran compared to 255 US$ (92-708) in Iran. The treatment cost of diabetes was higher in males, insulin-used and in the patient with family history of diabetes. The cost of diabetes was significantly increased with the duration of diabetes (P = 0.001) as well. According to the results, the largest share of costs is related to medication costs. Finally, the pooled average annual treatment cost per patient by diabetes mellitus complications was varied from 2828 US$ in the patients that have cerebrovascular disease complication to 7261 US$ in the patients with Stroke complication. CONCLUSIONS: This study demonstrated that the annual treatment cost of diabetes is varied within EMRO countries. Qatar and Iran have spent the highest and lowest cost for diabetes, respectively. This may be due to the large socioeconomic differences between countries and special conditions of them such as currency value in the region.

Biofloc technology improves growth, innate immune responses, oxidative status, and resistance to acute stress in common carp (Cyprinus carpio) under high stocking density.

This study aimed to evaluate the effects of biofloc technology (BFT) on the performance of common carp under high stocking density. Fish (8.41 ±â€¯0.44 g) were stocked into 12 tanks (70 L) in a 2 × 2 factorial design consisting of clear water (CW) and BFT systems at two stocking densities. Fish were divided into four groups according to culture system and stocking density: CW6 (clear water, 6 kg m-3), CW12 (clear water, 12 kg m-3), BFT6 (biofloc, 6 kg m-3), and BFT12 (biofloc, 12 kg m-3). After 49 days, the fish were exposed to acute crowding stress (40 kg m-3) for 7 days to evaluate the fish performance to additional stressors. Total ammonia nitrogen (TAN) concentration was significantly lower in BFT groups at the end of the trial. The growth of fish was significantly higher and the feed conversion ratio was lower in BFT groups. The final density of fish was highest in BFT12 group (25.41 ±â€¯0.48 kg m-3). The amylase and protease activities in BFT groups were significantly higher than the CW12 group. The highest serum catalase, superoxide dismutase, and glutathione peroxidase activities, and malondialdehyde content (3.07 ±â€¯0.16 nmol mg-1 protein) were observed in CW12 group. Serum LDL, cholesterol, triglyceride, total protein, and albumin levels were significantly higher in CW6 and BFT6 groups, followed by BFT12 group, and lowest in CW12 group. Serum globulin level was lowest in CW12 group (0.68 ±â€¯0.06 g dL-1). After 49 days, serum lysozyme, alternative complement (ACH50) and ALP activities were significantly higher and serum cortisol and glucose levels and ALT and AST activities were lower in BFT groups than the CW12 group. After 7 days of acute stress, serum lysozyme activities were significantly lower and ACH50 and ALP activities were higher in BFT groups than the CW12 group. Also, fish in CW12 group were more sensitive to the acute stressor, showing higher cortisol and lower glucose levels. Overall, biofloc had the anti-stress effect, and the culture of common carp in the biofloc system at a stocking density of 12 kg m-3 could be recommended. BFT can also exert beneficial effects on the welfare of fish subjected to acute stress.

The survival rate of patients with beta-thalassemia major and intermedia and its trends in recent years in Iran.

OBJECTIVES: Thalassemia is a common genetic disease in Iran, especially in the north and south of Iran. The present study sought to determine the survival rate of patients with thalassemia in highly endemic regions of Iran and its variation in patients born before and after 1971. METHODS: The present historical cohort study extracted data from the health records of patients with beta-thalassemia major, beta-thalassemia intermedia, and sickle beta-thalassemia who had presented to thalassemia treatment centers in the past years. The collected data were analyzed using the Kaplan-Meier test, the log-rank test, and the chi-square test. RESULTS: Of the total of 5,491 medical records (2,647 men and 2,634 women; mean age, 23.81±11.32 years), 3,936 belonged to patients with beta-thalassemia major, and 999 and 89 to patients with beta-thalassemia intermedia and sickle beta-thalassemia, respectively. In 467 cases, the type of thalassemia was not clear. The cumulative survival rate was calculated as 0.92, 0.83, 0.74, and 0.51 by ages 25, 35, 45, and 55, respectively. The hazard ratio of death was 4.22 (p<0.05) for beta-thalassemia major and 0.77 for beta-thalassemia intermedia (p=0.70). It was calculated as 1.45 for men patients and as 3.82 for single patients. CONCLUSIONS: The present study showed relatively high survival rates in patients with thalassemia. The survival of patients was unfavorable in poorer regions (Zahedan and Iranshahr). Factors including women gender, a higher level of education, being married, and living in metropolises decreased the risk of death at younger ages and improved survival.

Relationship between musculoskeletal disorders and anthropometric indices among bus drivers in Zahedan city.

INTRODUCTION: Most work-related musculoskeletal disorders (MSDs) are associated with improper postures and poorly designed workstations. This study is an attempt to examine the prevalence and severity of MSDs as well as anthropometric dimensions among city bus drivers. METHODOLOGY: This cross-sectional study was carried out on 60 male bus drivers. A body discomfort chart was used to evaluate MSDs. Spearman correlation was employed to examine the relationship between body size and the severity of discomfort. RESULTS: Data analysis showed that discomfort reported in the lower back (33.3%), upper back (18.3%) and knee (15%) was severe and there was a direct and significant correlation between the body mass index and the severity of discomfort in the shoulder, arm and hip (p < 0.05). However, the results showed that eye sitting height and sitting height had significant inverse relationships with discomfort in the ankle and elbow (p < 0.05). CONCLUSION: The results of the study can be used to address ergonomic risk factors and reduce their associated disorders. The findings of the study can be used in training programs to educate drivers how to decrease the risk associated with work-related MSDs by adopting appropriate behavior strategies.