Evaluation of elevated serum apelin-13 and D-dimer concentrations in individuals diagnosed with pulmonary embolism.

BACKGROUND: Given the limited specificity of D-dimer, there is a perceived need to discover a more precise marker for diagnosing individuals who are suspected of having pulmonary embolism (PE). In this study, by evaluating the increase in the serum level of Apelin-13 and D-dimer, we found valuable findings about Apelin-13, which can be suggested as an auxiliary and non-invasive diagnostic biomarker in individuals with suspected PE, based on the obtained results. METHODS: In this case-control study, 52 Iranian individuals were included, all of whom were suspected to have PE. These individuals were then divided into two groups based on the results of CT angiography, which is considered the gold standard imaging method for diagnosing PE. The two groups were patients with PE and patients without PE. Finally, the levels of certain markers in the serum were compared between the two groups. RESULTS: The mean serum D-dimer levels in patients with PE were significantly elevated (p < 0.001) in comparison to those without PE (1102.47 to 456.2 ng/ml). Furthermore, the mean level of Apelin-13 was significantly higher in patients with PE (49.8 to 73.11 ng/L) (p < 0.001). The cutoff point of Apelin-13 has been calculated at 58.50 ng/ml, with 90.9% sensitivity and 90% specificity. The D-dimer cutoff point was 500 ng/ml, with 95.5% sensitivity and 43.3% specificity. CONCLUSIONS: Based on the results of this study, the serum level of Apelin-13 can be used as a novel diagnostic and screening biomarker in patients with pulmonary thromboembolism.

The effects of intermittent fasting diet in comparison with low-calorie diet on lipid profile, glycemic status, and liver fibrosis in patients with non-alcoholic fatty liver (NAFLD): a study protocol for a randomized controlled clinical trial.

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease characterized by an increase in fat in liver cells. The outbreak of NAFLD is estimated to be 32.4% worldwide, with higher rates in Asia and Iran. Nutritional factors such as excessive calorie intake, high fructose intake, copper deficiency, and increased iron intake play an important role in NAFLD. Since there is no specific treatment for NAFLD, intermittent fasting (IF) diet has been suggested as an alternative treatment for obesity and related complications. Previous studies showed the potential positive effects of IF on metabolic health and the reduction of oxidative stress in NAFLD. This randomized controlled trial (RCT) will be aimed to examine the effect of the IF diet in comparison with a low-calorie diet (LCD) on lipid profile, glycemic status, and liver fibrosis in patients with NAFLD. METHODS AND ANALYSIS: This is a parallel randomized clinical trial conducted on 52 overweight and obese patients with NAFLD. Participants will be randomly assigned to receive either 16:8 IF (fasting from 8 P.M. to 12 P.M. the next day) or a low-calorie (55% carbohydrate- 30% fat, 15% protein) diet for 12 weeks. Anthropometric measurements, liver assessments, and metabolic evaluations will be assessed before and after the intervention. Primary outcomes include liver steatosis and fibrosis, while secondary outcomes include liver function enzymes, insulin resistance, lipid profile, and anthropometric measurements. DISCUSSION: Since obesity and insulin resistance are the most important risk factors of NAFLD, and there is no treatment for it, it seems that lifestyle changes such as low caloric diet like IF and exercise can improve lipid metabolism and liver enzymes. TRIAL REGISTRATION: Iranian registry of clinical trials (IRCT20170202032367N5).

Predictors of Core Decompression Success in Patients with Femoral Head Avascular Necrosis.

Background: Avascular necrosis of the femoral head typically occurs in the young population. Core decompression in the precollapse stage provides pain relief and preservation of the femoral head. The results of core decompression vary considerably despite the early diagnosis. Clinicians concur that primary treatment should focus on preserving the natural surface of the joint. This study investigated the predictive risk factors of failure in femoral head decompression. Methods: We retrospectively reviewed 135 patients and 207 hips (77 male (127 hips) and 58 female (80 hips)) who underwent core decompression (mean age: 34.7 years [age range: 21-71]) from April 2010 to December 2017. All patients were followed by a mean of 57 months. All hips were in the precollapse stage (Ficat I, II). Results: A total of 207 hips were treated with core decompression surgery, and the overall success rate was 58%. The higher grade of Kerboul, Ficat, ARCO classifications, multifocal avascular necrosis of the femoral head, smoking, opium, and corticosteroids were significantly associated with a higher failure rate after core decompression in univariate analysis. In multivariate logistic regression analysis, the Kerboul and Ficat classifications, alcohol consumption, and multifocal avascular necrosis of the femoral head were significantly correlated with core decompression failure. The most common predictive factors in core decompression failure were Ficat II, Kerboul stage 3, multifocal avascular necrosis of the femoral head, and alcohol consumption. Conclusion: In conclusion, we had an overall 58 % success rate in core decompression of femoral head avascular necrosis. Based on the results of this study, imaging evaluation and imaging-based classifications are the most valuable predictor factors for the success of core decompression. Consistent with previous reports, corticosteroid was not a significant predictor of core decompression failure.

The association between dietary diabetic risk reduction score with anthropometric and body composition variables in overweight and obese women: a cross-sectional study.

Dietary diabetes risk reduction score (DDRRs) is inversely associated with a lower risk of type 2 diabetes. Given the importance of the association between body fat and insulin resistance and the effect of diet on these parameters, this study aimed to investigate the association between DDRRS and body composition parameters, including the visceral adiposity index (VAI), lipid accumulation product (LAP), and skeletal muscle mass (SMM). This study was conducted on 291 overweight and obese women aged 18-48 years old recruited from 20 Tehran Health Centers in 2018. The anthropometric indices, biochemical parameters, and body composition were measured. A semi-quantitative food frequency questionnaire (FFQ) was used to calculate DDRRs. Linear regression analysis was used to examine the association between DDRRs and body composition indicators. The mean (SD) age of participants was 36.67 (9.10) years. After adjustment for potential confounders, VAI (ß = 0.27, 95% CI = - 0.73, 1.27, Ptrend = 0.052), LAP (ß = 8.14, 95% CI = - 10.54, 26.82, Ptrend = 0.069), TF (ß = - 1.41, 95% CI = 11.45, 17.30, Ptrend = 0.027), trunk fat percent (TF%) (ß = - 21.55, 95% CI = - 44.51, 1.61, Ptrend = 0.074), body fat mass (BFM) (ß = - 3.26, 95% CI = - 6.08, - 0.44, Ptrend = 0.026), visceral fat area (VFA) (ß = - 45.75, 95% CI = - 86.10, - 5.41, Ptrend = 0.026), waist-to-hip ratio (WHtR) (ß = - 0.014, 95% CI = - 0.031, 0.004, Ptrend = 0.066), visceral fat level (VFL) (ß = - 0.38, 95% CI = - 5.89, 5.12, Ptrend = 0.064), fat mass index (FMI) (ß = - 1.15, 95% CI = - 2.28, - 0.02, Ptrend = 0.048) decreased significantly over tertiles of DDRRs, and also there was no significant association between SMM and DDRRs tertiles (ß = - 0.57, 95% CI = - 1.69, 0.53, Ptrend = 0.322). The findings of this study demonstrated that participants with higher adherence to the DDRRs had lower VAI (ß = 0.78 vs 0.27) and LAP (ß = 20.73 vs 8.14). However, there was no significant association between DDRRs and VAI, LAP and SMM, which are mentioned as the primary outcomes. Future studies with larger sample of both genders are needed to investigate our findings.

PANX3 Channels Regulate Architecture, Adhesion, Barrier Function, and Inflammation in the Skin.

The channel-forming glycoprotein PANX3 functions in cutaneous wound healing and keratinocyte differentiation, but its role in maintaining skin homeostasis through aging is not yet understood. We found that PANX3 is absent in newborn skin but becomes upregulated with age. We characterized the skin of global Panx3-knockout (KO) mice and found that KO dorsal skin showed sex differences at different ages but generally had reduced dermal and hypodermal areas compared with age-matched controls. Transcriptomic analysis of the KO epidermis revealed reduced E-cadherin stabilization and Wnt signaling compared with that of wild-type, consistent with the inability of primary KO keratinocytes to adhere in culture and diminished epidermal barrier function in KO mice. We also observed increased inflammatory signaling in the KO epidermis and a higher incidence of dermatitis in aged KO mice compared with that in wild-type controls. These findings suggest that during skin aging, PANX3 is critical in the maintenance of dorsal skin architecture, keratinocyte cell-cell and cell-matrix adhesion, and inflammatory skin responses.

The association between glycemic index and glycemic load and quality of life among overweight and obese women: a cross-sectional study.

BACKGROUND: The association between different dietary approaches and quality of life (QoL) has been well-demonstrated in previous research. However, the relationship between glycemic index (GI) and glycemic load (GL) with different dimensions of QoL has not been established. Therefore, we aimed to investigate the relationship between GI and GL with QoL in overweight and obese women. METHODS: Two hundred seventy-six overweight and obese women (body mass index (BMI) ≥ 30 kg/m2), aged 18-64 years old, were included in this cross-sectional study. The amount of dietary intake and GI and GL indexes were established using a valid and reliable Food Frequency Questionnaire (FFQ) containing 147 items. Body composition (using bioimpedance analysis), anthropometrics, and physical activity were assessed. Insulin resistance (HOMA-IR) and hs-CRP were also measured, whilst QoL was measured using the SF-36 (short-form-36), self-administered, questionnaire. RESULT: Analyses were performed using multivariable linear regression, considering a wide range of confounding variables, such as age, physical activity, BMI, education, job, smoking, and marriage. We found a significant negative association between glycemic load and quality of life (ß = -0.07, 95%CI = -0.13_ -0.01, p = 0.01). No significant associations were observed between glycemic index and quality of life (ß = -0.03, 95%CI = -0.81_ 0.75, p = 0.93). CONCLUSION: We observed a significant negative association between QoL and GL, but not GI, among overweight and obese women in Iran. Our results need to be confirmed with further well-designed and adequately powered studies that control for clinical confounders.

Photocatalytic degradation of remdesivir nucleotide pro-drug using [Cu(1-methylimidazole)4(SCN)2] nanocomplex synthesized by sonochemical process: Theoretical, hirshfeld surface analysis, degradation kinetic, and thermodynamic studies.

The first ultrasonic synthesis of [Cu(L)4(SCN)2] (L = 1-methylimidazole) nanocomplex was carried out under ultrasonic irradiation, and its photocatalytic performance for the degradation of remdesivir (RS) under sunlight irradiation was comprehensively investigated for the first time in this study. The physicochemical properties of the synthesized photocatalyst were examined by Fourier-transform infrared (FT-IR), field emission scanning electron microscopy (FE-SEM), diffuse reflectance spectroscopy (DRS), and thermogravimetric analysis (TGA) techniques. The band gap of the synthesized [Cu(L)4(SCN)2] nanocomplex was determined to be 2.60 eV by the diffuse reflectance spectroscopy method using Kubelka-Munk formula. The photocatalytic performance of nanocomplex was examined for the removal of remdesivir under sunlight from water for which the results indicated that an amount of 0.5 gL-1 of the [Cu(L)4(SCN)2] nanocomplex was sufficient to remove more than 96% remdesivir from its 2 mg L-1 concentration within 20 min, at pH = 6. The kinetic data showed that the photodegradation onto the [Cu(L)4(SCN)2] nanocomplex has a high correlation (0.98) with the pseudo-second-order kinetic model. The decrease in chemical oxygen demand (COD) (from 70.5 mg L-1 to 36.4 mg L-1) under optimal conditions clearly confirmed the mineralization of the RS drug. The values of ΔS° (-0.131 kJ mol-1 K-1) and ΔH° (-49.750 kJ mol-1) were negative, indicating that the adsorption process was spontaneous and more favorable in lower temperatures. Moreover, the RS structure in the open shell state and the high HOMO and LUMO gaps based on the M06/6-31 + G (d) level of theory may be a confirmation of this fact. In addition, the Hirshfeld surface analysis (HSA) of the crystal packing of the prepared complex was discussed in detail to evaluate the interactions between the crystal packings. The results of this study confirm that the [Cu(L)4(SCN)2] nanocomplex can be successfully used for the photodegradation of pharmaceutical contaminants.

Amphiphilic hyperbranched polyester coated rod mesoporous silica nanoparticles for pH-responsive doxorubicin delivery.

Rod-like mesoporous silica nanoparticles with pH-responsive amphiphilic hyperbranched polyester shells were prepared for doxorubicin (DOX) delivery. First, rod-shaped mesoporous silica nanoparticles (MSNs) were obtained, then hydrophobic hyperbranched polyester Boltorn H40 (H40) was grafted on their surface. The H40 coated MSNs were next treated with amine-functionalized polyethylene glycol (PEG) to achieve the hydrophilic and pH-responsive material denoted as PEG-H40-MSNs. The experimental results showed that PEG-H40-MSNs were successfully synthesized. BET analysis showed that rod MSNs exhibits a type IV standard isotherm. TEM revealed that the thin gray polymer layer was formed around the SBA-15 particle with a diameter of around 150 nm. DOX was effectively loaded, which can be released according to the ambient pH inside the cell as follow: at pH 7.4, only 9.7% of the DOX was released after 48 h; as the pH decreased to 5.5, the cumulative release reached to 49% at the same time. PEG-H40-MSNs showed less than 1.6% of hemolytic activity and a slight effect on the liver and kidney of treated mice were observed at a high disposal dosage implying negligible toxicities were caused by PEG-H40-MSNs in both in vitro hemolysis analysis and in vivo biochemical in mice. However, the in vitro cytotoxicity evaluation of the DOX-PEG-H40-MSNs showed that the cell cytotoxicity of both pure DOX and DOX-loaded PEG-H40-MSNs generally enhanced by increasing the concentration of DOX. Graphical abstract Schematic of cellular uptake and DOX release of PEG-H40-MSNs nanoparticle.

Unapproved Weight Gain Supplement as a Cause of Avascular Necrosis: A Cautionary Report.

Avascular necrosis of the femoral head (AVNFH) is a leading cause of end-stage joint disease in the young population that can lead to total hip replacement in early life. There are various risk factors, including trauma, corticosteroids, thrombosis, hypertension, and alcohol. There is a growing number of patients with AVNFH and history of self-medication with herbal supplement used for weight gain in Iran. The present study aimed to demonstrate the prevalence rate of using unapproved weight gain supplements (UWGS) in patients with AVNFH. An observational and cross-sectional study was conducted to estimate the prevalence rate of using UWGSs in patients with osteonecrosis at Imam Khomeini Hospital, Tehran, Iran, from January 2012 to 2018. The data were analyzed in SPSS software (version 24) through descriptive statistics and tests of means. Out of 207 patients with AVNFH, 115 cases were male. In total, 44 patients (20.95%) had a history of using UWGSs, and there had no other risk factors of osteonecrosis of FH. In conclusion, UWGSs can be a risk factor for AVNFH, and it is necessary to develop educational programs to alert young population about the side effects of these supplements.

Molecular Identification and Phylogenetic Classification of Leishmania spp. Isolated from Human Cutaneous Leishmaniasis in Iran: A Cross-sectional Study.

BACKGROUND: In Iran, both forms of cutaneous (CL) and visceral leishmaniasis (VL) have been reported; so the accurate species identification of the parasite(s) and the analysis of genetic diversity are necessary. METHODS: The smears were collected from lesions samples of 654 patients with CL, who attended local health centers in 12 provinces of Iran during 2013-2015. The smears were checked for the presence of amastigotes by light microscopy. DNA of 648 Leishmania isolates, amplified by targeting a partial sequence of ITS (18S rRNA-ITS1-5.8S rRNA-ITS2) gene. Twenty-five of all the amplicons were sequenced and analyzed with restriction fragment length polymorphism (RFLP) using the Taq1 enzyme. RESULTS: All the smears were positive microscopically. The PCR-RFLP analysis revealed that 176 (27%) CL patients were infected with L. tropica and, 478 (73%) with L. major. The dominant species in all over Iran is L. major. The sequencing results of all CL patients and RFLP analysis confirmed each other. Based on our phylogenetic tree, 25 ITS DNA sequences were grouped into two clusters representing L. major and L. tropica species. Phylogenetic tree derived from the ITS sequences supports a clear divergence between L. major from the other species. CONCLUSION: Discrimination of Iranian Leishmania isolates using ITS gene gives us this opportunity to detect, identify, and construct the phylogenetic relationship of Iranian isolates.

Application of Deep Eutectic Solvent Modified Cotton as a Sorbent for Online Solid-Phase Extraction and Determination of Trace Amounts of Copper and Nickel in Water and Biological Samples.

Deep eutectic solvent (DES) was used as the extractant to improve the extraction properties of cotton. DES of choline chloride-urea (ChCl-urea) was prepared and immobilized on the surface of cotton fibers. The resulting sorbent was packed on a microcolumn, and a flow injection flame atomic absorption spectrometry was designed for the online separation and determination of trace amounts of copper and nickel. Various parameters affecting the extraction recovery of analytes such as pH, sample volume, sample loading rate, nature, volume, concentration, and flow rate of eluent were investigated and optimized. Under the optimum conditions, the method showed good linearity in the concentration range of 0.25-50.0 and 4.0-125.0 µg L-1 with the coefficient of determination (r 2) of 0.9991 and 0.9990 for copper and nickel, respectively. The method was very sensitive with the detection limits (defined as 3Sb/m) of 0.05 and 0.60 µg L-1 for Cu and Ni, respectively. It was successfully applied for the determination of Cu and Ni in water and biological samples. The accuracy of the method was evaluated through the recovery experiments and independent analysis by electrothermal atomic absorption spectrometry.

SBA-15 Functionalized with Naphthalene Derivative for Selective Optical Sensing of Cr2O7(2-) in Water.

A novel organic-inorganic hybrid optical sensor (NUS) was designed and prepared in two steps: the grafting of 3-(isocyanatopropyl)trimethoxysilane onto the surface of SBA-15, and then the attachment of naphthalene-1-amine. The obtained materials were characterized using low-angle XRD, N2 adsorption-desorption, TGA, FT-IR, and TEM techniques. A fluorescence study revealed that the NUS was a highly selective optical sensor for the detection of Cr2O7(2-) among various anions, including F(-), I(-), Cl(-), Br(-), CO3(2-), HCO3(-), NO3(-), H2PO4(-), CH3COO(-), and NO2(-) with a good linearity between the fluorescence intensity and the concentration of Cr2O7(2-) as well as a detection limit of 1.2 × 10(-7) M in a 100% aqueous medium. Moreover, the applicability of real samples of the sensor is also discussed.

A Single Fluorescent Sensor for Hg(2+) and Discriminately Detection of Cr(3+) and Cr(VI).

An iminocrown ether was synthesized and its fluorescence properties were studied in the presence of a variety of cations and anions in 99 % aqueous medium. The results revealed the interesting ability of the iminocrown ether in discriminately detection of Cr(III) and Cr(VI) ions in addition to detection of Hg(2+) ion. Among various environmentally relevant metal ions, Cr(3+) and Hg(2+) enhanced and quenched the fluorescence emission, respectively and among anions only dichromate ion, Cr(VI), quenched the emission while the rest of ions insignificantly influenced the fluorescence emission. Selectivity of the iminocrown ether was also investigated and proved in the presence of excess of common competing ions. Furthermore, the fluorescence intensity of the iminocrown ether was studied as a function of concentrations of the three ions by performing a titration experiment for each one of them. The detection limits of 5.36 × 10(-8), 2.06 × 10(-6), and 7.49 × 10(-8) mol L(-1) were also calculated for Hg(2+), Cr(3+), and Cr(VI), respectively.

Deep eutectic liquid organic salt as a new solvent for liquid-phase microextraction and its application in ligandless extraction and preconcentraion of lead and cadmium in edible oils.

Deep eutectic liquid organic salt was used as the solvent and a liquid phase microextraction (DES-LPME) combined with electrothermal atomic absorption spectrometry (ETAAS) was developed for separation, preconcentration and determination of lead and cadmium in edible oils. A 4:1 mixture of deep eutectic solvent and 2% nitric acid (200 µL) was added to an oil sample. The mixture was vortexed and transferred into a water bath at 50 °C and stirred for 5 minutes. After the extraction was completed, the phases were separated by centrifugation, and the enriched analytes in the deep eutectic solvent phase were determined by ETAAS. Under optimized extraction conditions and for an oil sample of 28 g, enhancement factors of 198 and 195 and limits of detection (defined as 3 Sb/m) of 8 and 0. 2 ng kg(-1) were achieved for lead and cadmium respectively. The method was successfully applied to the determination of lead and cadmium in various edible oils.

A Novel Naphthalene-Immobilized Nanoporous SBA-15 as a Highly Selective Optical Sensor for Detection of Fe(3+) in Water.

A novel organic-inorganic hybrid optical sensor (SBA-NCO) was designed and synthesized through immobilization of isocyanatopropyl-triethoxysilane and 1-amino-naphthalene onto the surface of SBA-15 by post-grafting method. The characterization of materials using XRD, TEM, N2 adsorption-desorption, and FT-IR techniques confirmed the successful attachment of organic moieties and preserving original structure of SBA-15 after modification step. Fluorescence experiments demonstrated that SBA-NCO was a highly selective optical sensor for the detection of Fe(3+) directly in water over a wide range of metal cations including Na(+), Mg(2+), Al(3+), K(+), Ca(2+), Cr(3+), Mn(2+), Fe(2+), Co(2+), Ni(2+), Cu(2+), Zn(2+), Cd(2+), Hg(2+), and Pb(2+) in a wide pH values.

Optimization of a novel improver gel formulation for Barbari flat bread using response surface methodology.

Nowadays, the use of bread improvers has become an essential part of improving the production methods and quality of bakery products. In the present study, the Response Surface Methodology (RSM) was used to determine the optimum improver gel formulation which gave the best quality, shelf life, sensory and image properties for Barbari flat bread. Sodium stearoyl-2-lactylate (SSL), diacetyl tartaric acid esters of monoglyceride (DATEM) and propylene glycol (PG) were constituents of the gel and considered in this study. A second-order polynomial model was fitted to each response and the regression coefficients were determined using least square method. The optimum gel formulation was found to be 0.49 % of SSL, 0.36 % of DATEM and 0.5 % of PG when desirability function method was applied. There was a good agreement between the experimental data and their predicted counterparts. Results showed that the RSM, image processing and texture analysis are useful tools to investigate, approximate and predict a large number of bread properties.

The prevalence of hyperprolactinemia and galactorrhea in patients with abnormal uterine bleeding.

BACKGROUND: Abnormal uterine bleeding is one of the most common gynecological problems in women aged 15-45 years. The relationship of hyperprolactinemia with reproductive disorders, amenorrhea and irregular menstrual cycles has been known. The aim of the present study was to determine the frequency of hyperprolactinemia and galactorrhea in 15-45-year-old females with abnormal uterine bleeding. METHODS: This analytic descriptive study was carried out on 100 women referred to a gynecology clinic for vaginal bleeding without any organic disorder. Consecutive sampling was performed. RESULTS: Among the cases 61% had hyperprolactinemia and galactorrhea was reported in 48% of these patients. There was a significant association between hyperprolactinemia and galactorrhea (p = 0.003); 46% of patients with galactorrhea and 75% of patients without galactorrhea had a high level of prolactin. Galactorrhea and hyperprolactinemia had no significant association with the type of abnormal uterine bleeding. Among patients with undiagnosed vaginal bleeding, hyperprolactinemia was present in more than 50% of them and in 46% it was associated with galactorrhea. CONCLUSION: Hyperprolactinemia that presents a gynecological problem may or may not be accompanied by galactorrhea, and galactorrhea cannot be a certain index for hyperprolactinemia.