The Potential of Anti-coronavirus Plant Secondary Metabolites in COVID-19 Drug Discovery as an Alternative to Repurposed Drugs: A Review.

In early 2020, a global pandemic was announced due to the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known to cause COVID-19. Despite worldwide efforts, there are only limited options regarding antiviral drug treatments for COVID-19. Although vaccines are now available, issues such as declining efficacy against different SARS-CoV-2 variants and the aging of vaccine-induced immunity highlight the importance of finding more antiviral drugs as a second line of defense against the disease. Drug repurposing has been used to rapidly find COVID-19 therapeutic options. Due to the lack of clinical evidence for the therapeutic benefits and certain serious side effects of repurposed antivirals, the search for an antiviral drug against SARS-CoV-2 with fewer side effects continues. In recent years, numerous studies have included antiviral chemicals from a variety of plant species. A better knowledge of the possible antiviral natural products and their mechanism against SARS-CoV-2 will help to develop stronger and more targeted direct-acting antiviral agents. The aim of the present study was to compile the current data on potential plant metabolites that can be investigated in COVID-19 drug discovery and development. This review represents a collection of plant secondary metabolites and their mode of action against SARS-CoV and SARS-CoV-2.

Neuroendocrine Neoplasms of the Pancreas: Diagnostic Challenges and Practical Approach.

Most pancreatic neuroendocrine neoplasms are slow-growing, and the patients may survive for many years, even after distant metastasis. The tumors usually display characteristic organoid growth patterns with typical neuroendocrine morphology. A smaller portion of the tumors follows a more precipitous clinical course. The classification has evolved from morphologic patterns to the current World Health Organization classification, with better-defined grading and prognostic criteria. Recent advances in molecular pathology have further improved our understanding of the pathogenesis of these tumors. Various issues and challenges remain, including the correct recognition of a neuroendocrine neoplasm, accurate classification and grading of the tumor, and differentiation from mimickers. This review focuses on the practical aspects during the workup of pancreatic neuroendocrine neoplasms and attempts to provide a general framework to help achieve an accurate diagnosis, classification, and grading.

Evaluation of Optimal Blood Culture Incubation Time To Maximize Clinically Relevant Results from a Contemporary Blood Culture Instrument and Media System.

Timely diagnosis of microorganisms in blood cultures is necessary to optimize therapy. Although blood culture media and systems have evolved for decades, the standard interval for incubation prior to being discarded as negative has remained 5 days. Here, we evaluated the optimal incubation time for the BacT/Alert Virtuo blood culture detection system (bioMérieux) using FA Plus (aerobic) and FN Plus (anaerobic) resin culture bottles in routine clinical use. Following institutional review board (IRB) approval, a retrospective review evaluated the outcomes of 158,710 bottles collected between November 2018 and October 2019. The number of positive blood bottles was 13,592 (8.6%); 99% of positive aerobic and anaerobic bottles flagged positive by 91.5 and 108 h, respectively. The mean (median) times to positivity were 18.4 h (15.6 h) for Staphylococcus aureus, 12.3 h (9.5 h) for Escherichia coli, 22.2 h (15.9 h) for Pseudomonas aeruginosa, and 48.9 h (42.9 h) for Candida spp. Only 175 bottles (0.1% of all bottles) flagged positive after 4 days of incubation; 89 (51%) of these bottles grew Cutibacterium (Propionibacterium) species. Chart review of blood cultures positive after 4 days (96 h) rarely had a clinical impact and sometimes had a negative impact on patient care. Finally, a seeded study of the HACEK group (i.e., Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella), historically associated with delayed blood culture positivity, demonstrated no benefit to extended incubation beyond 4 days. Collectively, these findings demonstrated that a 4-day incubation time was sufficient for the Virtuo system and media. Implementation of the 4-day incubation time could enhance clinically relevant results by reducing recovery of contaminants and finalizing blood cultures 1 day earlier.

Clinicopathologic Characteristics of Centrilobular Injury in Pediatric Liver Transplantation.

Centrilobular injury (CLI) is defined as the presence of perivenular mononuclear inflammation, hepatocyte dropout, and extravasated erythrocytes. In pediatric liver allografts, CLI has been associated with advanced fibrosis and chronic rejection (CR). We sought to better characterize the clinicopathologic features of CLI in the setting of T cell-mediated rejection (TCMR) and its association with complement component 4d (C4d) deposition. A total of 206 posttransplant pediatric patients (491 allograft liver biopsies) were available from 2000 to 2018, of which 63 patients (102 biopsies) showed evidence of TCMR and were included in the study. Of the patients, 35 (55.6%) had CLI on their initial episode of TCMR; those patients with CLI were significantly associated with the type of immunosuppression treatment (P = 0.03), severity of TCMR (P < 0.001), higher gamma-glutamyltransferase (P = 0.01), and advanced fibrosis (P = 0.03). There was a trend to shorter time interval from transplantation to presentation of CLI compared with those without CLI (P = 0.06). No difference was observed in graft or overall survival in the patients with CLI. In 20 patients with CLI, additional biopsies were available; in 45% of these patients, CLI was a persistent/recurrent finding. C4d deposition was noted in 12% of all biopsies (6 patients) with CLI. No significant correlation was noted in C4d deposition and CLI, CR, or graft/overall survival. In conclusion, CLI, although not significantly associated with worse graft survival, was significantly associated with severe TCMR and degree of fibrosis, which highlights the importance of active clinical management and follow-up for these patients.

Programmed Death Ligand 1 Expression and Related Markers in Pleuropulmonary Blastoma.

INTRODUCTION: Pleuropulmonary blastoma (PPB), a rare childhood neoplasm of the lung, is linked to pathogenic DICER1 variants. We investigated checkpoint inhibitor markers including Programmed Death Ligand 1 (PD-L1), PD1, CD8 and tumor mutational burden (TMB) in PPB. MATERIAL AND METHODS: Cases were collected from departmental archives and the International PPB/DICER1 Registry. Immunohistochemistry (IHC) for PD-L1, PD-1, CD8 and DNA mismatch repair (MMR) genes were performed. In addition, normal-tumor paired whole exome sequencing (WES) was performed in two cases. RESULTS: Twenty-five PPB cases were studied, consisting of Type I (n = 8, including 2 Ir), Type II (n = 8) and Type III (n = 9). PD-L1 combined positive score (CPS) of 1, 4 and 80 was seen in three (3/25, 12.0%) cases of Type II PPB with negative staining in the remaining cases. PD-1 and CD8 stains demonstrated positive correlation (P < .05). The density of PD1 and CD8 in the interface area was higher than within tumor (P < .05). The MMR proteins were retained. TMB was 0.65 mutations/Mb in type II PPB with high expression of PD-L1, and 0.94 mutations/Mb in one negative PD-L1 case with metastatic tumor. CONCLUSION: A small subpopulation of PPB patient might benefit from checkpoint immunotherapy due to positive PD-L1 staining.

Marital communication skills training to promote marital satisfaction and psychological health during pregnancy: a couple focused approach.

BACKGROUND: Studies showed that decreased marital satisfaction and increased risk of depression and anxiety were mutually related. Therefore, this study was conducted to evaluate the effect of communication skills training with a couple focused approach on marital satisfaction and psychological symptoms among pregnant women. METHODS: This experimental study was performed on 60 pregnant women with low marital satisfaction who were divided into two groups of intervention and control. The women in the intervention group and their husbands participated in a communication training program based on the couple focused approach. The levels of anxiety, depression, and marital satisfaction were evaluated before and then one and three months after the intervention using valid questionnaires. RESULTS: The results indicated that after the intervention, compared to the pre-intervention period, the levels of marital satisfaction increased while the levels of depression and anxiety decreased significantly in the intervention group (p < 0.05). The comparison of the groups revealed significant differences in the scores of marital satisfaction, depression, and anxiety in the intervention and control groups at the intervals of one month and three months after the intervention (p < 0.05). CONCLUSIONS: The research findings indicated that communication skills training program based on the couple focused approach and an emphasis on the needs of pregnant women during the pregnancy can improve the marital satisfaction and psychological health of pregnant women. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT2017012932264N2, Date of registration: 2017-06-28 Retrospectively registered.

Clinicopathologic determinants of pathologic treatment response in neoadjuvant treated rectal adenocarcinoma.

Neoadjuvant treatment (NAT) followed by total mesorectal excision is currently considered the standard of treatment for rectal adenocarcinoma. The degree of pathologic treatment response (pTR) correlates significantly with the recurrence free survival and overall survival (OS). However, it remains unclear which clinical and pathologic factors are associated with a more robust response to NAT, including showing pathologic complete response (pCR). Chemokine receptor 4 (CXCR4) overexpression has been associated with unfavorable OS in some studies. In this study, we sought to evaluate the clinicopathologic determinants of pTR in neoadjuvant treated rectal adenocarcinoma (NAT-RA). We retrospectively identified 91 patients who underwent pre-treatment diagnostic biopsy, NAT, and surgical resection at our institution. The archival slides were reviewed for pathologic features in the pre-treatment biopsies and for assessment of pTR in the resection specimens according to the current College of American Pathologist (CAP)'s guidelines. pCR was obtained in 16.5% of the cases, whereas 20.9% had near pCR, 30.8% had partial response, and 31.9% had a poor/no response. CXCR4 immunohistochemical analysis was also performed on the pre-treatment biopsies. Lower pre-treatment cT-stage (p = 0.019) and pre-treatment AJCC cTNM stage groups (p = 0.004), longer time interval between completion of NAT and resection (p = 0.022), and presence of tumor-infiltrating lymphocytes in the pre-treatment biopsies (p = 0.019) were significantly associated with a better pTR. CXCR4 nuclear expression was associated with a lower percentage of residual tumor (p = 0.036). Pre-treatment CEA levels, tumor differentiation, CAP treatment response groups and lower percentage of residual tumor were associated with a better OS.

Relationship Between Marital Quality, Social Support and Mental Health During Pregnancy.

The aim of this study was to investigate the relationship between marital quality and mental health during pregnancy. This cross-sectional study was conducted on 300 Iranian pregnant women. The ENRICH marital satisfaction subscales, levels of domestic violence, perceived social support, as well as depression and anxiety levels were assessed using a questionnaire. AMOS path analysis was used to explore the causal relationship and the mediating effect of social support among the variables of marital quality subscales and mental health. The results showed that, adjusted for age, the history of infertility and level of anxiety were related to marital satisfaction, marital relationships and level of depression which were related to the level of domestic violence. Sexual satisfaction and the level of perceived social support had a mediating role in such relationships. The study confirmed that marital quality is an important predictor of mental health. Improving the marital quality may lead to improvement in mental health.

Healing effects of Pergularia tomentosa L., a native medicinal plant in Bushehr province, Iran on burn, in animal model.

Burn injury is one of the most destructive events in the world. The Pergularia tomentosa L. is a medicinal plant that traditionally, applies for treatment of burning, in Bushehr province, Iran. Various bioactive compounds such as steroid glycosides, tannins, various vitamins, saponins, cardenolides and anthraquinones were identified into extract of the plant, which can be effective in burn wound healing. Twenty-one rats weighting every one 200±5 grams were divided equally into three groups. The second-degree burning induced on all groups. One of groups did not receive any treatment (The control group) and was treated locally with saline and eucerin. The Second group received the P. tomentosa L. as a topical ointment, and the third group received locally, a thin layer of silver sulfadiazine ointment 3% after washing the wound with saline. Afterward treatment period, the microscopic slides from histological sections were prepared. At that point, amounts of the fibroblast cells, blood vessels, wound area, necrotic tissues, and diameter of epidermis rate of wound healing were determined. Also the exterior status of wound in different days was considered. Results obtained from current study have revealed that the extract of P. tomentosa L. can significantly, cause qualitative and quantitative acceleration in healing of second degree burn wounds, due to their bioactive and vasoactive properties. In conclusion the P. tomentosa L. can is used as an overborne medicine with lower cost and side effect than the similar chemical medicines. Although, the further studies are needed on these plants, due to their some toxic effects.

Association of Serum Level of 25-Hydroxy Vitamin D Deficiency and Pulmonary Function in Healthy Individuals.

BACKGROUND: Besides the extensive regulatory role in growing number of biologic processes, vitamin D has been recently considered essential for lungs function as well as protective against exacerbation of chronic obstructive pulmonary diseases. We assessed the correlation between vitamin D serum levels with pulmonary function in healthy individuals. METHODS: In a cross-sectional study, healthy volunteer (n = 92) participants underwent the following laboratory procedures: a blood test, a 24-hour urine collection test, and the serum level of 25-hydroxy vitamin D before undergoing spirometry. Linear correlation coefficient was calculated to detect the association between serum level of 25-hydroxy vitamin D and pulmonary volumes. RESULTS: The mean age of participants was 39.95 ± 9.98 years. 48% of participants showed different levels of 25-hydroxy vitamin D deficiency. We recognized a consistent direct positive correlation between serum levels of 25-hydroxy vitamin D and lung function volumes. The coefficient for forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75%, and forced expiratory volume in 1 second/forced vital capacity ratio were 0.610, 0.509, 0.454, and 0.551, respectively. CONCLUSIONS: Our findings suggest correlation between higher serum levels of 25-hydroxy vitamin D and improved pulmonary function. Accordingly, supplemental vitamin D might significantly improve treatment response.

The most important risk factors affecting mental health during pregnancy: a systematic review.

BACKGROUND: Pregnant women comprise a vulnerable population owing to the changes they experience in various stages that affect their mental health. Mental health problems affects nearly one-fifth of pregnant women during the prenatal and postpartum periods. Millennium Development Goals 4 and 5 focus on maternal and child health and specify that overall health cannot be reached without mental health. AIMS: The aim of this comprehensive systematic review was to evaluate research evidence on the determinants of antenatal mental health disorders among Iranian women. METHODS: Using a systematic literature review of observational studies in English and Farsi we focused on Iranian women being evaluated for the determinants of antenatal mental health problems. PubMed, Scopus, ISI Web of Science, Scientific Information Databases (SID), Global Medical Article Limberly, Iranian Biomedical Journal and the Iranian Journal Database were independently searched to identify articles published during 2000-2016. RESULTS: Thirty-one studies met the inclusion criteria and the results showed a significant relationship between antenatal mental health risks and variables such as lack of social support, marital status, domestic violence, unintended pregnancy and socioeconomic status. The paucity of high quality research evidence limited proper evidenced-based planning and generating results deemed essential to address antenatal mental health issues for Iranian pregnant women. CONCLUSIONS: Our results showed that socioeconomic status and marital quality are the most important risk factors for disturbing mental health among Iranian pregnant women.

Application of short message service to control blood cholesterol: a field trial.

BACKGROUND: Despite recommendations, many middle-age adults neglect to check their blood cholesterol levels. Short message service (SMS, also known as texting) has been seldom studied for preventive education. We estimated how SMS can be a cost-effective method in encouraging people to check their blood cholesterol levels. METHODS: In a field trial, 3600 cell phone users (age > 30) were randomly assigned to the intervention (N: 1200) and the control groups (N: 2400). An SMS was sent to the intervention group for five rounds every two weeks, which targeted the cognitive and affective learning and finally advised the blood cholesterol level to be checked, if not checked during the past twelve months. Two weeks after the last round, both groups were asked for the time/level of their latest blood cholesterol, family history of early cardiac death and having a family member with coronary heart disease (CHD), and to report their attitude about whether annual blood sampling is worth the cost and time to prevent CHD. Moreover, the intervention group was asked if they remembered the SMS content. The cost-effectiveness was evaluated by estimating the "number needed to treat" (NNT) and calculating the cost of sending SMS to that number of people. RESULTS: In the intervention group, 629 individuals (72.0%) recalled the SMS content. The factors associated with cholesterol screening during the past two years were older age, diabetes, family history of coronary disease, higher education, female gender and being non-smoker. In both groups, women were significantly more aware of their blood cholesterol level (68.7% vs. 53.6%). The relative frequency of respondents who believed it was not worth checking their cholesterol annually was significantly lower in the intervention group (P < 0.001). The intervention group was significantly more likely to check its blood cholesterol levels (OR:1.22) after adjustment for age, diabetes, family history of CHD and smoking. The NNT was estimated ≈ 25 for the general population and ≈ 11 for those who received SMS and had a family member with CHD. CONCLUSIONS: We would postulate that SMS could affect people's adherence to preventive programs. Relatives of patients admitted with a diagnosis of CHD should be prioritized for superior cost-effectiveness and logistical feasibility.

Recently described types of dysplasia associated with IBD: tips and clues for the practising pathologist.

Longstanding inflammatory bowel disease (especially in patients with severely active disease or primary sclerosing cholangitis) is associated with an increased risk of developing dysplasia and adenocarcinoma. This review covers critical clinical aspects, such as risk factors and screening endoscopy basics, emphasising the SCENIC (Surveillance for Colorectal Endoscopic Neoplasia Detection in Inflammatory Bowel Disease International Consensus) guidelines. The histopathological and molecular features of both conventional (adenomatous) dysplasia and the non-conventional subtypes (hypermucinous dysplasia, goblet cell-deficient dysplasia, crypt cell dysplasia, serrated dysplasias) are discussed with an emphasis on challenging diagnostic areas and helpful tips to allow correct categorisation by the practising pathologist.

Characterization of Amyloidosis in the Gastrointestinal Tract With an Emphasis on Histologically Distinct Interstitial Patterns of Deposition and Misinterpretations.

Amyloidosis can involve the gastrointestinal (GI) tract, and deposition can present with varied histologic patterns that make recognition challenging. This retrospective observational study aimed to characterize the deposition patterns in the GI tract and evaluate key quality metrics, including discrepant cases, to improve recognition and provide insight for accurate diagnosis. Sixty-two patients (195 biopsies) with amyloid involvement of the luminal tract were reviewed. Amyloid subtyping by mass spectrophotometry was available for 59 patients. Immunoglobulin light chain (AL) was the most commonly identified subtype (60%), followed by serum amyloid A (AA; 19%) and transthyretin (ATTR; 16%). 150/195 biopsies (77%) were positive for amyloid deposition, with an average of 2.4 positive biopsies per every 3.1 taken per patient. The sites with the highest yield were duodenum (37/37, 100%) and colon (63/74, 85%). Gastric biopsies were most likely to involve the lamina propria (41/45, 91%, P < 0.001), with the background mucosa showing reactive epithelial changes in almost half of the biopsies (20/45, 44%). Several distinct histologic patterns of interstitial deposition were identified, including muscularis mucosae deposition (n = 40, 27% of positive biopsies), peri-Brunner gland (n = 6, 17% of duodenal biopsies), mass-forming (n = 4, 2.7% of positive biopsies, including 3 suspected cases with localized involvement), collagenous colitis-like (n = 3, 4.8% of positive colonic biopsies), and globular (n = 19, 12.7% of positive biopsies). Congo Red was ordered in 81% of cases in which it was requested clinically, with a positivity rate of 30%. Of the 34 cases in which an amyloid workup was requested (but Congo Red was not performed), 14 were positive on reevaluation. Several missed cases had deposition in multiple biopsies, and almost half were missed by subspecialist GI pathologists. Nine misinterpretations were from the stomach, with seven initially diagnosed as chemical or reactive gastropathy. Additional discrepant cases were identified from the duodenum (n = 2) and colon (n = 3), with the vascular-only deposition pattern (n = 3), muscularis mucosae-only deposition (n = 3), and globular pattern (n = 1) identified. Given the challenges of identifying amyloid on hematoxylin and eosin staining, Congo Red ordering percentage should be 100% in clinically suspicious cases unless deposition is definitively seen on hematoxylin and eosin staining.

Effects of White Noise Sound on the Severity of Muscle Vaccination Pain in Children Under Two Years.

Objectives: Pain and its control is a significant health problem worldwide. The present study aimed to determine the effects of white noise (bird sound) on the severity of muscle vaccination pain in children under two years old. Materials & Methods: This study was a case-control study conducted in 2021. The samples included seventy children under two years old referred to the health centers in Ramsar City, Iran. The samples were selected using the convenient sampling method and divided into experimental and control groups. The data were collected using the demographic characteristics questionnaire, facial expression, and pain assessment in pediatric patients (FLACC). They were then analyzed by SPSS16 using an independent t-test and analysis of covariance (P<0.05). Results: A significant difference was observed between the severity of muscle vaccination pain in children in the two groups (p=0.042); the pain intensity mean in the experimental group (6.45±2.01) was lower than the control group (8.94±1.28). Conclusion: This method can be a harmless and inexpensive intervention to reduce pain intensity and behavioral pain responses in infants during painful procedures, especially vaccination.

Perceived Barriers and Needs in Accessing Sexual Health Services for Iranian Couples: A Qualitative Research.

Background: Sexual and Reproductive Health (SRH) and access to related services are the most important issues and are part of reproductive health rights. Therefore, this study was designed and conducted to explain the perceived barriers and needs in accessing sexual health services for Iranian couples. Materials and Methods: We conducted this study on 14 subjects at the Navab Health Center in Isfahan and Behsa Counseling Center in Tehran from November 2015 to December 2016 by common qualitative content analysis approach through semi-structured interviews. Results: The results show that sub-subcategories "Therapist's Individual Traits" and "Specialized Skills of Therapist" formed "Need for Access to a Professional Therapist" subcategory and sub-subcategories "Provide specialized problem-based treatments" and "Rapid and Timely Therapy of Sexual Problems" formed the "Need for Timely and Comprehensive Access" subcategory and these two subcategories formed the main category of "Need to access a specialized, comprehensive and timely sexual health services system." Furthermore, sub-subcategories of "Failure to Prioritize Sexual Matters" and "Lack of sexual awareness" formed the "Individual Challenges of Search for Sexual Health Services" subcategory, and sub-subcategories of "Sexual Problems are a Taboo" and "Lack of awareness of the existence of sex therapists and sexual health service centers" formed "Sociocultural Challenges to Access Sexual Health Services" subcategory. Two subcategories formed the main category of "Obstacles to Access Efficient and Proper Sexual Health Services." Conclusions: The explored couple's experiences demonstrated that the need to receive timely and comprehensive specialized sexual health services because of the obstacles to access is not provided.

Lived sexual experience of health workers on the Iranian frontline of the fight against the COVID-19 pandemic: A qualitative content analysis.

Background: Lifestyle changes due to the COVID-19 pandemic may affect individuals' sexual lives and probably their sexual function. The present study aimed to explain the sexual lived experiences of health workers on the Iranian frontlines of the fight against the COVID-19 pandemic. Materials and methods: The present study was qualitative research using the conventional qualitative content analysis method. It was conducted in the city of Ramsar, Iran, in 2022. The data were collected using 12 in-depth personal interviews and a purposive sampling method. Lundman and Granheim's method was used to analyse the data. Results: The analysis of the data in the first phase of the research led to 60 initial codes, 7 subcategories, 3 main categories (concerns about health risks, sexual dissatisfaction, and sexual facilitators and barriers), and one theme (unhealthy lifestyle due to sexual dissatisfaction). Conclusion: The present study revealed new and different dimensions of the sexual experiences of health workers on the frontlines of the fight against the COVID-19 pandemic [concerns about health risks, sexual dissatisfaction, sexual facilitators, and sexual inhibitors]; these dimensions are based on the Iranian context and culture that can be considered to enhance sexual pleasure and the physical and mental health of health professionals that have an impact on improving patients' and people's health status in society.

An enzyme-free electrochemiluminescence insulin probe based on the regular attachment of ZnO nanoparticles on a 3-D nickel foam and H2O2 as an efficient co-reactant.

In this study, a highly sensitive, fast, and enzyme-free electrochemiluminescence (ECL) probe based on the decoration of zinc oxide nanoparticles on nickel foam is proposed for insulin determination. A silica film was employed as a size adjusting agent for the modification of the nickel foam surface with ZnO nanoparticles (ZnO NPs). The ECL of the ZnO NP/Ni foam was investigated in a natural medium in the presence of hydrogen peroxide (H2O2) as an efficient co-reactant. With increasing insulin concentration, a remarkable improvement in ECL signal was observed, which proved the enhancing effect of insulin on the ECL emission. The characterization of the ZnO-NP/Ni-foam electrode was performed via electrochemical impedance spectroscopy, Brunauer-Emmett-Teller (BET) surface area measurement, X-ray diffraction, field emission scanning electron microscopy (FESEM), and energy-dispersive X-ray analysis techniques. The fabricated electrode was applied for the trace analysis of insulin using the ultrasensitive ECL method in a phosphate buffer solution. Under the optimal conditions, the results showed excellent performance during insulin determination with a wide linear range of 3.57 × 10-15 M to 2.94 × 10-9 M, a low detection limit of 1.00 × 10-16 M, and a relative standard deviation of 1.03%. The proposed ECL sensor with excellent reproducibility, long-term stability, and high selectivity was used for insulin determination in real serum samples with acceptable outcomes.

The severity of COVID-19 among pregnant women and the risk of adverse maternal outcomes.

OBJECTIVE: To evaluate the relationship between the severity of coronavirus disease 2019 (COVID-19) during pregnancy and the risk of adverse maternal outcomes. METHODS: A descriptive-analytical cross-sectional study conducted on 258 pregnant women who were hospitalized due to confirmed COVID-19 from March 2020 to January 2021 at the Forghani Hospital in Qom, Iran. Demographic and obstetric characteristics, laboratory findings, and adverse maternal outcomes were recorded from the patients' medical records. The Fisher exact test, one-way analysis of variance, and regression logistics were used to assess the relationship between variables. RESULTS: Of the total study population, 206 (79.8%) pregnant women had mild to moderate disease, 43 (16.7%) had severe disease, and 9 (3.5%) were in the critical stage of the disease. Eight women (3.1%) died and 33 (12.8%) were admitted to the intensive care unit (ICU). The most important demographic factors associated with the severity of the disease were ethnicity, underlying conditions, maternal age, and parity. The severity of the disease was significantly associated with increased cesarean delivery and admission to the ICU. CONCLUSION: Pregnant women with severe and critical disease had a high rate of cesarean delivery and admission to the ICU. There were eight cases of maternal mortality.

The keys to a good and lasting marriage: Exploration of Iranian couple's experiences.

BACKGROUND AND AIM: Marital satisfaction is a multidimensional phenomenon, which refers to the quality of marital relationship, or the general view of marriage status and reflection of happiness and marital performance. Repetition of certain positive behaviors can make a huge difference in the success of continued married life, and that awareness of such behaviors seems to be critical to recognizing certain warnings. Therefore, this study with qualitative approach conducted to promoting long-term marital satisfaction by exploring couple's experiences. MATERIALS AND METHODS: This study was conducted using descriptive phenomenology method. The participants were 12 person (six couples) with a history of 20-30 years of married life expectancy and a marital satisfaction score of above 65. The data were collected by purposeful sampling and semi-structured interviews, analyzed using Colaizzi method. By categorizing the codes, subcategories, and main categories were extracted. RESULTS: An analysis of the experiences of the participants resulted in emergence of eight subcategories, and three main categories: "Strong Foundation For Living Together," "Mutual Commitment To Protecting Marital Cohesion," and "Striving To Improve Sexual Relations." CONCLUSIONS: A long-term marriage associated with a variety of variables, including a strong foundation for living together, a mutual commitment to protect marital cohesion, and an effort to improve sexuality. And the results showed that the type of relationship will change during the years after marriage in a way that takes on certain meanings and concepts and can be interpreted in physiological, cultural and other specific contexts.