The Effect of Oral Gabapentin and Pregabalin as a Prodrug in Pain Control after Orthopedic Surgery on the Upper Limb: A Double-Blind Parallel Randomized Clinical Trial Study.

Objective: To compare the effects of oral gabapentin (GBP) and pregabalin (PGB) in pain control after orthopedic surgery on the upper limb. Methods: In this double-blind randomized clinical trial study, 80 patients who were the candidates for elective orthopedic surgery on one of the parts of the upper limb were divided into two groups using balance-block randomization. For the first group, a 150 mg capsule of PGB (one hour before the surgery) and for the second group, a 300 mg capsule of GBP (two hours before the surgery) were prescribed. Patients were subjected to standard monitoring at the beginning and during surgery. The pain scores were evaluated at before surgery, in PACU (postanesthesia care unit), and 6 and 12 hours after the surgery by VAS (visual analog scale). Results: In this study, 37 subjects were allocated to each group. The participation rate was 92.5%. The mean with 95% confidence interval (CI) of pain scores over 4 times in the PGB group was 4.03 (3.25-4.79), 3.76 (3.02-4.49), 3.65 (3.06-4.23), and 3.41 (2.88-3.93) and in the GBP group was 4.08 (3.33-4.83), 2.78 (2.11-4.45), 2.3 (2.05-2.54), and 2 (1.51-2.50), respectively. The within-group comparisons showed a significant decrease in the pain score over time (P < 0.001). Also, the between-group comparison showed significant differences between the two groups in terms of pain score (P < 0.001). In the end, results showed that there is a significant interaction between time and intervention for pain score (P=0.042). Conclusion: Although two medicines led to a reduction in the pain score, but the rate reduction in the PGB group was significantly more than that in the GBP group. This trial is registered with IRCT20211013052759N1.

Investigation of Epstein-Barr virus, Cytomegalovirus, Human herpesvirus 6, and Polyoma viruses (JC virus, BK virus) among Gastric cancer patients: A cross sectional study.

Background and Aims: Gastric cancer is a significant global issue with a high death rate. This malignancy could be associated with several viral agents such as EBV, CMV, HHV-6, JCV, and BKV. Objective: Evaluation of EBV, CMV, HHV-6 ,and JCV, BKV frequency among gastric cancer patients. Methods: In this cross-sectional study, a total number of 60 gastric cancer specimens (32 male, 28 female) were retrieved from the pathology lab. Formalin-fixed paraffin-embedded tissue was used for molecular testing. DNA was extracted from samples, according to protocol, and used for PCR reaction. Polymerase chain reactions were used to assess CMV, EBV, HHV-6, JCV, and BKV frequency. Results and Conclusion: The mean age of the participants was 61 years and 53.3% (32) of the participants were Male. A total number of 5 samples (8.34%) were infected with viral agents. Four male gastric samples were infected with EBV (6.67%) and only one female sample contained the BKV genome (1.67%). Totally 8.34% of the samples were infected with EBV and BKV. The CMV, HHV-6, and JCV genome was not detected in the samples. In conclusion, the presence of two viral agents including EBV and BKV among male and female samples respectively, and the genome of other viruses were not detected.

The global prevalence of gastric cancer in Helicobacter pylori-infected individuals: a systematic review and meta-analysis.

BACKGROUND: Helicobacter pylori is a gastrointestinal pathogen that infects around half of the world's population. H. pylori infection is the most severe known risk factor for gastric cancer (GC), which is the second highest cause of cancer-related deaths globally. We conducted a systematic review and meta-analysis to assess the global prevalence of GC in H. pylori-infected individuals. METHODS: We performed a systematic search of the PubMed, Web of Science, and Embase databases for studies of the prevalence of GC in H. pylori-infected individuals published from 1 January 2011 to 20 April 2021. Metaprop package were used to calculate the pooled prevalence with 95% confidence interval. Random-effects model was applied to estimate the pooled prevalence. We also quantified it with the I2 index. Based on the Higgins classification approach, I2 values above 0.7 were determined as high heterogeneity. RESULTS: Among 17,438 reports screened, we assessed 1053 full-text articles for eligibility; 149 were included in the final analysis, comprising data from 32 countries. The highest and lowest prevalence was observed in America (pooled prevalence: 18.06%; 95% CI: 16.48 - 19.63; I2: 98.84%) and Africa (pooled prevalence: 9.52%; 95% CI: 5.92 - 13.12; I2: 88.39%). Among individual countries, Japan had the highest pooled prevalence of GC in H. pylori positive patients (Prevalence: 90.90%:95% CI: 83.61-95.14), whereas Sweden had the lowest prevalence (Prevalence: 0.07%; 95% CI: 0.06-0.09). The highest and lowest prevalence was observed in prospective case series (pooled prevalence: 23.13%; 95% CI: 20.41 - 25.85; I2: 97.70%) and retrospective cohort (pooled prevalence: 1.17%; 95% CI: 0.55 - 1.78; I 2: 0.10%). CONCLUSIONS: H. pylori infection in GC patients varied between regions in this systematic review and meta-analysis. We observed that large amounts of GCs in developed countries are associated with H. pylori. Using these data, regional initiatives can be taken to prevent and eradicate H. pylori worldwide, thus reducing its complications.

Effect of alcohol consumption on breast cancer: probabilistic bias analysis for adjustment of exposure misclassification bias and confounders.

PURPOSE: This study was conducted to evaluate the effect of alcohol consumption on breast cancer, adjusting for alcohol consumption misclassification bias and confounders. METHODS: This was a case-control study of 932 women with breast cancer and 1000 healthy control. Using probabilistic bias analysis method, the association between alcohol consumption and breast cancer was adjusted for the misclassification bias of alcohol consumption as well as a minimally sufficient set of adjustment of confounders derived from a causal directed acyclic graph. Population attributable fraction was estimated using the Miettinen's Formula. RESULTS: Based on the conventional logistic regression model, the odds ratio estimate between alcohol consumption and breast cancer was 1.05 (95% CI: 0.57, 1.91). However, the adjusted estimates of odds ratio based on the probabilistic bias analysis ranged from 1.82 to 2.29 for non-differential and from 1.93 to 5.67 for differential misclassification. Population attributable fraction ranged from 1.51 to 2.57% using non-differential bias analysis and 1.54-3.56% based on differential bias analysis. CONCLUSION: A marked measurement error was in self-reported alcohol consumption so after correcting misclassification bias, no evidence against independence between alcohol consumption and breast cancer changed to a substantial positive association.

Epidemiological aspect of retinoblastoma in the world: a review of recent advance studies.

AIM: To collect and present updated evidence about epidemiological aspects of retinoblastoma (Rb) in the world. METHODS: A comprehensive search without the time and language restrictions was conducted in international databases, including MEDLINE, Scopus, Web of Science, and PubMed. The search keywords were "retinoblastoma" OR "retinal Neuroblastoma" OR "retinal glioma" OR "retinoblastoma eye cancer" OR "retinal glioblastoma". RESULTS: The worldwide incidence of Rb is 1 in 16 000-28 000 live births, but was higher in developing compared to developed countries. Several attempts for improving early detection and treatment had increased the Rb survival rate from 5% to 90% in developed countries over the past decade, but its survival was lower in developing countries (about 40% in low-income countries) and the majority of mortalities occurred in developing countries. The etiology of Rb could be viewed as genetics in the heritable form and environmental and lifestyle factors in the sporadic form. Some environmental risk factors such as in vitro fertilization; insect sprays; father's occupational exposure to oil mists in metal working, and poor living conditions might play a role in the occurrence of the disease. Although ethnicity might affect Rb incidence, sex has no documented effect and the best treatment approaches were now ophthalmic artery chemosurgery and intravitreal chemotherapy. CONCLUSION: Determining the role of genetics and environmental factors helps to accurately predict the prognosis and identify the mechanism of the disease, which can reduce the risk of tumor development.

Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis.

Today, in the modern world, people are often exposed to electromagnetic waves, which can have undesirable effects on cell components that lead to differentiation and abnormalities in cell proliferation, deoxyribonucleic acid (DNA) damage, chromosomal abnormalities, cancers, and birth defects. This study aimed to investigate the effect of electromagnetic waves on fetal and childhood abnormalities. PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, and Google Scholar were searched on 1 January 2023. The Cochran's Q-test and I 2 statistics were applied to assess heterogeneity, a random-effects model was used to estimate the pooled odds ratio (OR), standardized mean difference (SMD), and mean difference for different outcomes, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. A total of 14 studies were included in the analysis, and the outcomes investigated were: change in gene expression, oxidant parameters, antioxidant parameters, and DNA damage parameters in the umbilical cord blood of the fetus and fetal developmental disorders, cancers, and childhood development disorders. Totally, the events of fetal and childhood abnormalities were more common in parents who have been exposed to EMFs compared to those who have not (SMD and 95% confidence interval [CI], 0.25 [0.15-0.35]; I 2, 91%). Moreover, fetal developmental disorders (OR, 1.34; CI, 1.17-1.52; I 2, 0%); cancer (OR, 1.14; CI, 1.05-1.23; I 2, 60.1%); childhood development disorders (OR, 2.10; CI, 1.00-3.21; I 2, 0%); changes in gene expression (mean difference [MD], 1.02; CI, 0.67-1.37; I 2, 93%); oxidant parameters (MD, 0.94; CI, 0.70-1.18; I 2, 61.3%); and DNA damage parameters (MD, 1.01; CI, 0.17-1.86; I 2, 91.6%) in parents who have been exposed to EMFs were more than those in parents who have not. According to meta-regression, publication year has a significant effect on heterogeneity (coefficient: 0.033; 0.009-0.057). Maternal exposure to electromagnetic fields, especially in the first trimester of pregnancy, due to the high level of stem cells and their high sensitivity to this radiation, the biochemical parameters of the umbilical cord blood examined was shown increased oxidative stress reactions, changes in protein gene expression, DNA damage, and increased embryonic abnormalities. In addition, parental exposure to ionizing and non-ionizing radiation can lead to the enhancement of different cell-based cancers and developmental disorders such as speech problems in childhood.

Clinical outcomes of off-pump coronary artery bypass graft in patients with diabetes and non-diabetics: A systematic review and meta-analysis.

BACKGROUND AND AIM: Diabetes mellitus is a prevalent risk factor for developing coronary artery disease which worsens the clinical outcomes of patients undergoing coronary artery bypass grafting (CABG). This study aimed to determine the clinical outcomes of patients with diabetes and non-diabetic patients who underwent off-pump CABG surgery. METHOD: Medline, Scopus, Proquest, Embase, Web of Science, and Google scholar were searched until September 10, 2021. The effect sizes including unstandardized mean difference and odds ratio with 95% confidence interval were calculated using "Metan" package. The Cochran's Q-test and I2 statistic were used to assess heterogeneity, a random-effects model was applied to estimate the pooled effect sizes, and meta-regression was used to investigate the factors affecting heterogeneity between studies. RESULTS: 10 studies with 6200 sample sizes were included in the study. In groups with diabetes, Summary odds ratio (SOR) and 95% confidence interval of infection was 2.18 more than non-diabetic groups. Also, odds renal complication was 1.74 more than non-diabetic groups, and the odds cardiovascular complication in groups with diabetes was 1.30 more than non-diabetics. There were no differences in mortality, neurologic, respiratory and surgical complications between groups with diabetes and non-diabetics. Based on meta-regression results, age (Coefficient: 0.942; p = 0.009) had a significant direct relationship and sample size (Coefficient: 0.001; p = 0.009) had an indirect significant relationship with heterogeneity of neurologic outcomes. There was no significant publication bias in our results. CONCLUSION: Our study revealed that off-pump CABG led to some significant outcomes in patients with diabetes compared to non-diabetics. Renal and infection complications were higher in patients with diabetes but no significant differences were seen in most of other postoperative outcomes between the two groups.

Prevalence of ocular trauma in 6-12-year-old children living in Shahroud, Iran.

AIM: To determine the prevalence of ocular trauma in Iranian children aged 6-12 years. METHODS: This population-based cross-sectional study, comprised the first phase of the Shahroud Schoolchildren Eye Cohort Study on primary school children using cluster sampling in urban areas and census in rural areas. The students underwent the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic, cycloplegic, and subjective refraction. The history of trauma, hospitalization, and surgery due to trauma was collected from parents using a questionnaire. RESULTS: The data of the trauma history was recorded for 5267 out of 5620 students. The mean age of the students was 9.7 ± 1.7 years (range: 6-12 years), 53.7% of them were boys, and 79.3% were from urban areas. A positive history of ocular trauma was found in 285 participants, and the lifetime prevalence of ocular injury (95% CI) was 5.2% (4.6-5.9). Blunt trauma was the most common ocular injury with a prevalence of 66.2%. There was a significant positive assocation between ocular trauma and living in rural areas (OR: 1.49, p: 0.012), older age (OR: 1.17, p < 0.001), and male sex (OR: 1.62, p: 0.002). Furthermore, 9.3% and 4.7% of the traumas required hospitalization and surgical intervention, respectively. CONCLUSION: This study found a marked prevalence of ocular trauma compared to previous studies. Male sex, older age, and living in rural areas were associated with ocular trauma, which could be due to differences in lifestyle preference, outdoor exposure, and dangerous situations. Educational programs and safety instructions should be encouraged.

Dietary total antioxidant capacity and its association with renal function and kidney stones: Results of a RaNCD cohort study.

There is evidence to support the hypothesis that dietary antioxidants have shown protective effects against chronic kidney disease (CKD). The purpose of this study was to determine the association between the dietary total antioxidant capacity (DTAC), renal function, and development of CKD and kidney stones in Ravansar Non-Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran. This cross-sectional study was conducted using the recruitment baseline data of the RaNCD cohort study on 9,777 individuals aged 35-65 years. Food frequency questionnaire (FFQ) was performed to assess diet. DTAC scores were calculated using the ferric reducing antioxidant power (FRAP) of selected foods. Renal function was assessed by the estimated glomerular filtration rate (eGFR), blood urea nitrogen, and serum creatinine concentration. Prevalent CKD was based on an eGFR less than <60 ml/min per 1.73 m2. Incidence of kidney stones was also assessed by self-reporting. Out of 9,777 participants, 1,747 subjects (eGFR: 18.50 ml/min per 1.73 m2; 95% confidence interval (CI): 17.72-19.30) had CKD. The mean DTAC score in this study was 0.24 ± 0.16 µmol TE/100 g (micromole of Trolox Equivalents). We showed a significant trend for eGFR across quartiles of DTAC, i.e., participants in the fourth quartile had a higher glomerular filtration rate (GFR) than those in the first one (DTAC Q4 vs Q1 = 82.20 versus 72.20 ml/min per 1.73 m2, p < .001). Another finding is that high DTAC scores were not associated with having kidney stones after adjusting for confounders. We revealed that higher DTAC scores have positive effects on the renal function. Interestingly, our findings showed that a high DTAC score had nonsignificant correlation with odds of kidney stones.

Comorbidities and mortality rate in COVID-19 patients with hematological malignancies: A systematic review and meta-analysis.

INTRODUCTION: The global pandemic of coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It seems that there is an association between blood cancer and an increased risk of severe COVID-19. This study aimed to review the literature reporting the COVID-19 outcomes in patients with hematological malignancies. MATERIAL AND METHODS: In this systematic review and meta-analysis, Pubmed, Embase, and Web of Science databases were searched using the following keywords: COVID-19, SARS-CoV-2, blood cancer, myeloma, lymphoma, and leukemia. All the published articles in English from January 1, 2019, until March 10, 2021 were collected and evaluated. RESULTS: In total, 53 studies with 2395 patients were included based on inclusion criteria. Most of these studies took place in Spain (14.81%), followed by the USA (11.11%), China (9.26%), and the UK (9.26%). More than half of COVID-19 patients with hematological malignancy were male (56.73%). Oxygen therapy played an important role in COVID-19 treatment. Moreover, anticoagulant therapies such as enoxaparin and heparin were two great assists for these patients. Fever (74.24%), cough (67.64%), and fatigue (53.19%) were the most reported clinical manifestations. In addition, hypertension and dyslipidemia were the most common comorbidities. The mortality rate due to COVID-19 in patients with hematological malignancies was 21.34%. CONCLUSION: This study demonstrated that hematologic cancer patients were more susceptible to a severe COVID-19 than patients without blood cancer. Thus, the management of COVID-19 in these patients requires much more attention, and their screening should perform regularly.

Serum level and tumor tissue expression of Ribonucleotide-diphosphate Reductase subunit M2 B: a potential biomarker for colorectal cancer.

BACKGROUND: This study explored the applicability of serum level and tissue expression of Ribonucleotide-diphosphate Reductase subunit M2 B (RRM2B) as reliable biomarkers for colorectal cancer (CRC) progression and metastasis. METHODS AND RESULTS: The present descriptive-analytic cohort study was conducted on 50 newly diagnosed CRC patients (stage II, III) and 50 healthy individuals. The new cases had not received any therapeutic intervention and underwent surgery immediately after the initial diagnosis. Tumorous tissues and marginal healthy tissues (as control) were excised to determine the mRNA tissue expression of RRM2B by Real-Time PCR. Serum RRM2B protein was measured using an ELISA method once in the control group. In the patients, serum RRM2B protein was evaluated before, 1 and 3 months after surgery. The tumor metastasis node (TMN) classification system and liver metastasis were evaluated in CRC patients. The results showed significantly lower RRM2B serum levels in 1 and 3 months after surgery compared with the pre-surgery condition (P = 0.014, P < 0.001 respectively). The mean RRM2B gene expression was 51% lower in tumor tissue than its adjacent normal tissue (P < 0.001). No significant relationship was found between serum level of RRM2B and tumor staging and metastasis in patients before surgery (P = 0.373, P = 0.189), 1 month after surgery (P = 0.960, P = 0.088), and 3 months after surgery (P = 0.407, P = 0.724). RRM2B expression in tumor tissue is not associated with tumor staging and metastasis (P = 0.254, P = 0.721). CONCLUSION: These data suggest measuring serum protein level of RRM2B could have a role in CRC progression, although this study should be considered preliminary due to small sample size and short follow-up duration.

Decomposition of Economic Inequality in Cataract Surgery Using Oaxaca Blinder Decomposition: Tehran Geriatric Eye Study (TGES).

PURPOSE: The aim of this study was to investigate economic inequality in cataract surgery and to decompose it into its determinants using Oaxaca-Blinder decomposition. METHODS: The Tehran Geriatric Eye Study is a population-based cross-sjal study that was done on individuals above 60 years using stratified cluster random sampling. All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, after pupil dilation, the history of cataract surgery, including PC and AC IOL, was determined. RESULTS: The age and sex-standardized prevalence of cataract surgery was 33.51% (95% CI: 31.45 to 35.62). Cataract surgery had a significant positive association with age (OR: 14.06; p < .001 for >80 vs 60-64 years) and a significant inverse association with education level (OR: 0.55, p: 0.006 for college education vs being illiterate) and economic status (OR: 0.64, p: 0.003 for rich vs poor). A significant difference was found in cataract surgery between the rich and poor (26.22%) disfavoring the poor (p < .001). The explained and unexplained portions comprised 95.99% and 4.01% of the difference (p < .001 and p = .336, respectively). Among study variables, age (p < .001), education (p = .003), economic status (p = .002), insurance (p = .011), and eye examination (p < .001) were significant determinants of inequality in the explained portion. CONCLUSION: There was a marked difference in the prevalence of cataract surgery between the rich and poor that was mostly caused by the explained portion. Age, economic status, and education had the largest effects on increasing the inequality and history of eye examination by an ophthalmologist and insurance coverage had the largest effects on reducing this inequality.

Hypoxia-Induced miR-210 Overexpression Promotes the Differentiation of Human-Induced Pluripotent Stem Cells to Hepatocyte-Like Cells on Random Nanofiber Poly-L-Lactic Acid/Poly (ε-Caprolactone) Scaffolds.

An alternative treatment to liver transplantation includes the use of differentiated stem cells. Hypoxia has been shown to endow human-induced pluripotent stem cells (hiPSCs) with enhanced hepatic differentiation. We have investigated a new strategy for hepatocyte differentiation from hiPSCs using a three-step differentiation protocol with lentiviral overexpression of hypoxia-microRNA-210 of cells grown on a hybrid scaffold. We analyzed the transduction of the miR-210 lentiviral and definitive endoderm and pluripotency gene markers, including SRY-box 17 (SOX17), forkhead box A2 (FOXA2), and octamer-binding transcription factor 4 (OCT-4) by Real-Time PCR and fluorescent microscope. The scanning electron microscopy (SEM) examined the 3D cell morphological changes. Immunocytochemistry staining was used together with assays for aspartate aminotransferase, alanine aminotransferase, and urea secretion to analyze hepatocyte biomarkers and functional markers consisting of α-fetoprotein (AFP), low-density lipoprotein (LDL) uptake, fat accumulation, and glycogen. The flow cytometry analyzed the generation of reactive oxygen species (ROS). Compared to cells transfected with the blank lentiviral vectors as a control, overexpressing miR-210 was at higher levels in hiPSCs. The expression of endodermal genes and glycogen synthesis significantly increased in the differentiated lentiviral miR-210 cells without any differences regarding lipid storage level. Additionally, cells containing miR-210 showed a greater expression of ALB, LDL, AST, ALT, urea, and insignificant lower AFP and ROS levels after 18 days. However, SEM showed no significant differences between cells under the differentiation process and controls. In conclusion, the differentiation of hiPSCs to hepatocyte-like cells under hypoxia miR-210 may be a suitable method for cell therapy and regenerative medicine.

The prevalence of anterior blepharitis in an elderly population of Iran; The Tehran geriatric eye study.

PURPOSE: To determine the age and sex-standardized prevalence and risk factors of anterior blepharitis in a geriatric population in "…". METHODS: This population-based study was conducted on the elderly population (over 60 years of age) of Tehran, the capital of "…" in 2019. Examinations included visual acuity assessment, refraction, and complete slit lamp examination. After the diagnosis of anterior blepharitis, its type (staphylococcal vs. seborrheic) was also determined. Multiple logistic regression was used to determine the risk factors of the disease. RESULTS: 3310 individuals participated in this study. The data of 3284 participants were available for this report. The mean age of the participants was 68.6 ± 24.5 years, and (57.8 %) were female. Age and sex-standardized prevalence of anterior blepharitis was 33.5 % (95 % CI: 30.6-36.5%) of which 96.5 % were bilateral. The prevalence of seborrheic and staphylococcal types was 22.4 % (95 % CI: 19.9-25.2%) and 11.3 % (95 % CI: 9.2-13.5%), respectively. According to the multiple logistic regression, the prevalence of anterior blepharitis was positively related to age over 80 years (P < 0.001) and male gender (P < 0.001), and inversely related to education level (P = 0.033). No significant relationship was found between anterior blepharitis and other variables including systemic hypertension, diabetes mellitus, hyperlipidemia, smoking, socioeconomic status, and history of the previous eye examination. Sex had the greatest effect on developing anterior blepharitis (standardized coefficient: 0.325). CONCLUSION: The results of this study showed a relatively high prevalence of anterior blepharitis in the elderly population which requires special attention of the health system to inform and control this disease through continuous training of the media and regional health centers.

The Distribution of Vertical Cup-to-Disc Ratio and its Determinants in the Iranian Adult Population.

PURPOSE: To determine the distribution of vertical cup-to-disc ratio (VCDR) and its relationship with ocular biometric indices. METHODS: This study was conducted in 4737 individuals aged 45-69 years living in Shahroud who participated in the second phase of Shahroud Eye Cohort Study in 2014. All participants underwent eye examinations including the measurement of visual acuity and refraction, slit-lamp biomicroscopy, retinal examination, and fundoscopy. Normality index was used to describe data distribution, and a multiple beta regression, with adjustment for the effect of cluster sampling, was applied to explore the relationship between VCDR and the study variables. RESULTS: The mean [95% confidence interval (CI)] VCDR was 0.297 (0.293-0.301) in all participants; 0.296 (0.291-0.302) in men and 0.297 (0.292-0.302) in women. The highest mean VCDR was seen in the age group 55-59 years (0.299, 95% CI: 0.292-0.307). The 97.5th percentile was 0.600. According to multiple beta regression analysis, VCDR had a positive association with the female sex (P = 0.028), spherical equivalent (P < 0.001), cigarette smoking (P = 0.020), and axial length (P < 0.001), and had a negative association with hypertension (P = 0.001), best corrected visual acuity (P < 0.001), hyperlipidemia (P = 0.029) and anterior chamber depth (P = 0.001). CONCLUSIONS: The mean VCDR and the 97.5th percentile were lower than most other studies. Although ethnicity and race may play a role in this difference, this difference should be considered in clinical decisions in the current population.

Effect of Smoking on Breast Cancer by Adjusting for Smoking Misclassification Bias and Confounders Using a Probabilistic Bias Analysis Method.

PURPOSE: The aim of this study was to determine the association between smoking and breast cancer after adjusting for smoking misclassification bias and confounders. METHODS: In this case-control study, 1000 women with breast cancer and 1000 healthy controls were selected. Using a probabilistic bias analysis method, the association between smoking and breast cancer was adjusted for the bias resulting from misclassification of smoking secondary to self-reporting as well as a minimally sufficient adjustment set of confounders derived from a causal directed acyclic graph (cDAG). Population attributable fraction (PAF) for smoking was calculated using Miettinen's formula. RESULTS: While the odds ratio (OR) from the conventional logistic regression model between smoking and breast cancer was 0.64 (95% CI: 0.36-1.13), the adjusted ORs from the probabilistic bias analysis were in the ranges of 2.63-2.69 and 1.73-2.83 for non-differential and differential misclassification, respectively. PAF ranges obtained were 1.36-1.72% and 0.62-2.01% using the non-differential bias analysis and differential bias analysis, respectively. CONCLUSION: After misclassification correction for smoking, the non-significant negative-adjusted association between smoking and breast cancer changed to a significant positive-adjusted association.

Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs.

OBJECTIVES: Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival. METHODS: The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design. RESULTS: The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity. CONCLUSIONS: Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.

Pentacam Accuracy in Discriminating Keratoconus From Normal Corneas: A Diagnostic Evaluation Study.

OBJECTIVES: This study aims to determine the diagnostic ability of Pentacam indices for keratoconus and identifying the best index for differentiating diseased from normal cases. METHOD: In this study, 150 keratoconus patients and 150 refractive surgery candidates with a definitive diagnosis of normal healthy corneas were enrolled. Initially, the placido disk topography imaging was performed. The keratoconus and normal corneas were defined based on placido disk topographic data from Rabinowitz-McDonnell. After complete eye examinations for all participants, they underwent Pentacam imaging, and corneal surface topographic indices were extracted. Multiple logistic regression was used to determine the best indices for differentiating diseased from healthy corneas, and the receiver operating curve was calculated to determine the diagnostic capability of each index. RESULTS: Among the studied indices, the keratoconus index (KI), index of vertical asymmetry (IVA), thinnest point (TP), and maximum keratometry (Kmax) were found capable of detecting keratoconus. Among these, IVA was the best index, with an area under curve (AUC) of 95.24%. The best cutoff point for IVA was 0.20 µm, and its sensitivity and specificity were 87.50% and 96.30%, respectively. Comparison of the AUC of different indices showed that only TP and IVA significantly differed (P=0.002). The combination of KI, IVA, Kmax, and TP indices leads to correct detection in 78% of cases. CONCLUSION: Measuring corneal topographic indices using Pentacam can be helpful in the diagnosis of keratoconus. According to the results of this study, IVA is the best diagnostic index for keratoconus. However, it is recommended to use a combination of Pentacam indices for more accurate differentiation of keratoconus from normal cases.

Hybrid poly-l-lactic acid/poly(ε-caprolactone) nanofibrous scaffold can improve biochemical and molecular markers of human induced pluripotent stem cell-derived hepatocyte-like cells.

A suitable alternative strategy for liver transplantation is the use of nanofibrous scaffolds together with stem cells. In this study, a random hybrid of poly-l-lactic acid (PLLA) and poly(ε-caprolactone) (PCL) was used as a three-dimensional (3D) culture for differentiation of hepatocyte-like cells and compared with routine culture (two-dimensional [2D]). The expression of the endodermal marker, forkhead box A2 (FOXA2), was assessed on Day 3 and the hepatic markers; albumin (ALB), α-1 antitrypsin (AAT), and cytokeratin-18 (CK-18) were evaluated on Day 18 using quantitative polymerase chain reaction qPCR. As well as, ALB, α-fetoprotein (AFP), and low-density lipoprotein (LDL) uptake were evaluated using immunocytochemistry; moreover, periodic acid-Schiff and Oil Red were done by cell staining. In addition, AFP and urea production were evaluated by chemiluminescence and colorimetric assays. Light and scanning electron microscopy (SEM) showed changes in the cells in 2D and 3D models. The gene expression of hepatic markers was significantly higher in the 3D cultures. In addition, immunocytochemistry and cell staining showed that ALB, AFP, LDL-uptake, periodic acid-Schiff, and Oil Red were expressed in both cells derived on 2D and 3D. Furthermore, the evaluation of AFP and urea secretion was significantly different between 2D and 3D strategies. These findings suggest that functionally cells cultured on a PLLA/PCL scaffold may be suitable for cell therapy and regenerative medicine.

Three-dimensional nanofiberous PLLA/PCL scaffold improved biochemical and molecular markers hiPS cell-derived insulin-producing islet-like cells.

Nanofibrous scaffolds are considered as a new strategy for Type 1 diabetes mellitus therapy. We used a hybrid of poly-l-lactic acid (PLLA) and polycaprolactone (PCL) as three-dimensional (3D) culture models for differentiation of human induced pluripotent stem cells (hiPSCs) to beta islet-like cluster cell compared with routine culture (2D). Morphological changes of cells were checked by microscope. mRNA endodermal SOX-17 on day 7 and pancreatic gene markers Pdx1, glucagon and Glut2 were evaluated on day 23 by qPCR. As well as, insulin and C-peptide protein expression was evaluated by immunocytochemistry staining. In addition, insulin and C-peptide secretion in various glucose concentrations was evaluated by ELISA. Light and scanning electron microscopy (SEM) microscope showed changes in induced cells. In tandem, these modifications were more evident in 3 D culture. Pdx1, Glucagon and Glut2 markers in PLLA/PCL were significantly higher in 3 D culture. In addition, qualitative immunochemistry showed that insulin and C-peptide were expressed in 2 D and 3 D culture medium. Furthermore, evaluation of insulin and C-peptide clarified that secretion of these proteins in PLLA/PCL scaffold were statistically different in 2 D and 3 D strategies. These findings suggest that functional matured induction cells on PLLA/PCL scaffold can be used for islet beta cell therapy and regenerative medicine.