Chemiluminescence data modeling using parallel factor analysis for the simple and sensitive determination of diphenoxylate in human plasma and tablets.

In this study, a chemiluminescence (CL) method was developed to determine diphenoxylate in tablets and human plasma. This is the first CL method proposed to determine diphenoxylate. Creating three-dimensional data caused the parallel factor analysis algorithm (PARAFAC) to be used for the first time in CL methods. The method is based on the fact that diphenoxylate enhances the weak CL produced in the reaction of Ru(phen)3 2+ and acidic Ce(IV), and the concentration of Ce(IV) solution has a different effect on the CL response of diphenoxylate and the blank plasma. The calibration curve was linear from 4.0 × 10-8 to 1.6 × 10-6 mol L-1 (R2 = 0.9954), and the detection limit was 1.3 × 10-8 mol L-1 (S/N = 3). The sampling rate was about 30 samples per hour, and the % RSD for 10 repeated measurements of 4 × 10-7 mol L-1 diphenoxylate was 5.4%. The interference effects of some ions, amino acids, and common additives were also investigated. The CL method was successfully used to determine diphenoxylate in tablets, and the results were statistically confirmed by the reference method. The proposed CL method and the PARAFAC algorithm were successfully used to determine the concentration of diphenoxylate in human blood plasma samples.

Evaluation the validity and reliability of persian short form of the literacy of suicide scale (LOSS): a methodological study in 2022.

INTRODUCTION: This research was conducted with the aim of evaluating the validity and reliability of Persian short version of the Literacy of Suicide Scale (LOSS) among the general population. METHODS: This methodological study was conducted to evaluate the validity and reliability of Persian short form of LOSS among the general population, using a sample of 1175 participants in Iran, 2022. Participants were entered to study using method of proportional stratified sampling. The validity of Persian short form of LOSS was checked by four measures of validity: qualitative face validity, qualitative content validity, EFA (exploratory of factor analysis), and CFA (confirmatory factor analysis). The measure of reliability of Persian short form of LOSS was checked by three reliability of McDonald omega coefficient, ICC (Intraclass Correlation Coefficient), and Cronbach's alpha coefficient. RESULTS: Based on the findings of EFA, 4 components with eigenvalues > 1 were extracted and these 4 factors were able to explain 57.96% of variance. In EFA section, only 1 question was deleted due to entry into the non -relevant sub -scale. Based on the results of CFA, all items had the factor loading greater than 0.4 and none of the items were removed at this stage. In CFA, based the results of goodness-of-fit indexes for example: χ2/df = 2.077, NFI: 0.957, IFI = 0.977, RMSEA = 0.030, GFI: 0.988, and PGFI = 0.569, the final mode was approved with 11 items and 4 factors. In this study for all items, Cronbach's alpha coefficient was 0.739, McDonald omega coefficient was 0.753, and ICC was 0.860. Finally, the Persian short form of LOSS was approved with 11 items and four dimensions of signs/ symptoms with 3 questions, the risk factors with 2 questions, treatment/ prevention with 2 questions, and causes/ triggers with 4 questions. CONCLUSION: The Persian short form of LOSS with 11 items and four subscales is a valid and reliable scale to survey the suicide literacy status in the general population.

Title page: psychometric properties of literacy of suicide scale (LOSS) in iranian population: long form.

INTRODUCTION: Suicide and suicide attempts are among the most important indicators of mental health in the world. In this research, the validity and reliability of Literacy of Suicide Scale (LOSS) was examined in general people over the age of 18. METHODS: This cross-sectional psychometric study was conducted in 2022 among 952 general population in Iran. Participants were selected by two methods of proportional stratified sampling and simple random sampling. The internal consistency of the tools was assessed using Cronbach's alpha coefficient, and McDonald omega coefficient. Also, test-retest reliability was checked by Intraclass Correlation Coefficient (ICC). RESULTS: In the confirmatory factor analysis section, the factor loading of all questions were above 0.4 and one questions were deleted and final model with four factors and 25 questions was confirmed (Some of goodness-of-fit indexes: AGFI = 0.910, RMSEA = 0.050, IFI = 0.901, and χ2/df = 3.333). For all questions, the Cronbach's alpha coefficient was 0.859, McDonald omega coefficient was 0.866, and ICC was 0.895. Finally, the Persian long version of LOSS was approved with 25 items and four subscales: causes/triggers (9 items), risk factors (7 items), signs and symptoms (5 items) and treatment/prevention (4 items). CONCLUSION: The Persian long version of LOSS with four subscales and 25 items is an appropriate tool to investigate the state of suicide literacy in the public population.

Vascular Regenerative Capacity and the Obesity Paradox in Coronary Artery Disease.

[Figure: see text].

The association between baseline circulating progenitor cells and vascular function: The role of aging and risk factors.

BACKGROUND: To investigate the cross-sectional and longitudinal relationships between vascular function and circulating progenitor cell (CPC) counts with respect to aging and exposure to risk factors. METHODS: In 797 adult participants, CPCs were enumerated by flow cytometry as CD45med mononuclear cells expressing CD34 epitope and its subsets co-expressing CD133, and chemokine C-X-C motif receptor 4 (CXCR4+). Arterial stiffness was evaluated by tonometry-derived pulse wave velocity (PWV) and microvascular function was assessed as digital reactive hyperemia index (RHI). RESULTS: In cross-sectional analyses, for every doubling in CD34+ cell counts, PWV was 15% higher and RHI was 9% lower, after adjusting for baseline characteristics and risk factors (p for all < 0.01). There were significant CPC-by-age-by-risk factor interactions (p <0.05) for both vascular measures. Among younger subjects (< 48 years), CPC counts were higher in those with risk factors and vascular function was better in those with higher compared to those with lower CPC counts (p for all < 0.0l). In contrast, in older participants, CPCs were not higher in those with risk factors, and vascular function was worse compared to the younger age group. A lower CPC count at baseline was an independent predictor of worsening vascular function during 2-year follow-up. CONCLUSION: A higher CPC count in the presence of risk factors is associated with better vascular function among younger individuals. There is no increase in CPC count with risk factors in older individuals who have worse vascular function. Moreover, a higher CPC count is associated with less vascular dysfunction with aging.

Estimating costs of hepatitis B vaccination in infants: experimental evidence of the expanded program on immunization in Southern Iran.

BACKGROUND: Health costs have increased significantly around the world, and cost assessments have become important. This study aimed to collect cost of the resources used in the national hepatitis B immunization program in Southern Iran. METHODS: Costs were calculated by investigating the available documents as well as consulting with knowledgeable personnel. These costs were collected using the data from Shiraz University of Medical Sciences. According to the health payer's perspective, the indirect costs of the people were not taken into account. All current and capital costs in year 2017 were calculated and converted to US dollars (USDs). RESULTS: In 2017, 33 204 children received hepatitis B vaccine. The total cost of the national hepatitis B vaccination program in Shiraz and the cost of vaccination per child were 473 506 and 14.26 USD, respectively. However, the cost of inoculation of hepatitis B vaccine per dose was estimated at 3.20 USD. Personnel costs constituted the highest proportion (53.84%) of total costs. CONCLUSIONS: The cost of hepatitis B vaccination in Iran was lower than other countries. Considering that personnel costs had the largest proportion, it is recommended that proper measures be taken to monitor and modify these costs if necessary.

Effects of Selenium and/or N-Acetyl-Cysteine Supplementation on Nonthyroidal Illness Syndrome in Hemodialysis Patients: A Factorial Randomized Controlled Trial.

INTRODUCTION: Nonthyroidal illness syndrome (NTIS) is common in hemodialysis patients (HPs). However, limited clinical trials have been conducted in this field. Therefore, the aim of this study was to investigate the effect of Se and/or N-acetyl-cysteine (NAC) on NTIS parameters in HPs. METHODS: In this factorial randomized controlled trial, 68 HPs were divided into four groups: group A received placebo of Se and NAC, group B received 600 µg per day of NAC and placebo of Se, group C received 200 µg of Se per day and placebo of NAC and group D received 200 µg of selenium and 600 µg of NAC per day for 12 weeks. Blood samples were taken at baseline and after 12 weeks to assess free tri-iodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), and reverse T3 (rT3) concentrations. RESULTS: Our finding demonstrated that rT3 levels were decreased in B, C, and D groups and increased nearly to baseline levels in the A group after 12 weeks, with a marked difference between the groups (p < 0.001) based on ANOVA. Although there were no significant differences in FT3 (p = 0.39), FT4 (p = 0.76), and TSH (p = 0.71) between the groups at the end of the trial. CONCLUSION: This trial showed that Se and/or NAC exert beneficial effects on rT3 levels in HPs. However, long-term clinical trials with a larger sample size using more appropriate biomarkers are recommended to evaluate the efficacy and safety of Se and/or NAC in HPs.

Flow injection chemiluminescence determination of ethion and computational investigation of the adsorption process on molecularly imprinted polymerized high internal phase emulsion.

The lack of sufficient selectivity is the main limitation of chemiluminescence (CL) methods; because the CL reagent is not restricted to a specific analyte. This study investigated the preconcentration and determination of ethion using a flow injection CL (FIA-CL) method using a molecularly imprinted poly high internal phase emulsion (MIP-polyHIPE) adsorbent. Preliminary studies showed that ethion could be determined with high sensitivity in the Ru(bipy)3 2+ -acidic Ce(IV) CL system. A MIP-polyHIPE adsorbent was synthesized and used for preconcentration to increase the selectivity and sensitivity of the method. The adsorption of ethion on the adsorbent was investigated using density functional theory (DFT) and molecular dynamics (MD), UV-vis and FTIR spectrophotometry and liquid chromatography-tandem mass spectrometry (LC-MS-MS). Response surface methodology (RSM) and central composite design (CCD) were used to find optimized concentrations of variables. The linear dynamic range (LDR) and limit of detection (LOD) for ethion in the FIA-CL method were calculated 1.0 ⨯ 10-9 to 2.0 ⨯ 10-7 and 6.0 ⨯ 10-10  mol L-1 , respectively. The percentage of relative standard deviation for five repetitive measurements of 5.0 ⨯ 10-8  mol L-1 ethion was 4.2%. The proposed method was successfully used to separate and preconcentrate ethion from drinking and surface water sources.

Pulsed-sonochemiluminescence combined with molecularly imprinted polymerized high internal phase emulsion adsorbent for determination of bentazone.

A small low-power humidifier with a simple programmable on/off switch was used as a pulsed ultrasound generator. Using this tool, a novel sonochemiluminescence (SCL) method was developed to determine bentazone. To the best of our knowledge, no chemiluminescence method has been proposed to determine this pesticide. Only five studies have been proposed for SCL quantitative applications so far. Therefore, revealing new aspects of SCL promises to develop analytical methods for the quantitative determination of different substances. A molecularly imprinted polymerized high internal phase emulsion (MIP-polyHIPE) was synthesized, bentazone separated from aqueous solutions, and pre-concentrated by the MIP-polyHIPE foam. The adsorption of bentazone on the MIP-polyHIPE adsorbent was theoretically studied by density functional theory through molecular dynamics simulation. Both experimental and simulation results indicated removal and pre-concentration of bentazone by the MIP-polyHIPE adsorbent. Using the proposed SCL method and without pre-concentration process, a linear dynamic range (LDR) of 2.5 × 10-7-5.0 × 10-5 mol L-1 and a limit of detection (LOD) of 8.4 × 10-8 mol L-1 were obtained for bentazone with a relative standard deviation of 2.64%. The LDR and LOD were improved to 2.6 × 10-9-2.0 × 10-7 mol L-1 and 8.8 × 10-10 mol L-1, respectively, using MIP-polyHIPE adsorbents. The method's application was evaluated by removing and pre-concentration of bentazone from water samples, including well, river, and tap water. The results showed that the pre-concentration factor and recovery percentages were 113-131 times and 93-106%, respectively, using the MIP-polyHIPE absorbent.

Dental caries experience and its relationship to demographic factors in 2- to 6-year-old children in Fars-Iran in 2018.

PURPOSE: Among oral conditions, tooth decay is the most common chronic childhood disease. Children's dental caries are influenced by several factors, among which diet is one of the most highlighted ones. The present study was conducted to examine the decayed, missing and filled teeth in primary dentition (dmft) and caries-free (CF) indexes as well as the impact of nutrition and demographic factors on oral health of 2- to 6-year-old children in Fars Province. METHODS: A cross-sectional study was conducted on children aged 2-6 years old to evaluate dmft and CF indices according to the latest WHO standards as well as their demographic characteristics in 2018. A questionnaire was used for data collection. RESULTS: A total of 2220 children were recruited. The mean dmft was 1.37 ± 2.69. The components of the dmft score included decay (1.23 ± 2.6), missing (0.03 ± 0.11) and filling (0.11 ± 0.7) in primary dentition, and the prevalence of caries-free children was 66.5%. The results showed that dmft had a significant positive relationship with breastfeeding termination time, maternal education level and maternal age. Birth weight, consumption of iron, vitamin A and D supplements, age at onset of complementary feeding and maternal occupation had no significant relationship with dmft. CONCLUSIONS: The tooth decay index of 2- to 6-year-old children in Fars Province is very different from WHO global standards. Therefore, educating mothers about the duration of breastfeeding is important to achieve standard values for the dental caries index.

Association of Routine Hepatitis B Vaccination and Other Effective Factors with Hepatitis B Virus Infection: 25 Years Since the Introduction of National Hepatitis B Vaccination in Iran.

Background: One of the main health problems in the world is hepatitis B virus (HBV) infection. Vaccination and other factors can affect HBV infection. As various effective factors have been reported in different regions and studies, this study aimed to investigate the association between HBV infection and routine vaccination and other effective factors 25 years since the launch of the national vaccination program in Iran. Methods: This cross-sectional study, conducted in 2017 in Shiraz (Iran), investigated factors such as demographic variables such as gender, education, and occupation, vaccination status, and the potential risk factors for HBV infection. Hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antibody (HBc Ab) tests were performed to determine HBV infection status. The data were analyzed using R software (version 3.5.2), using multivariate logistic regressions and machine learning methods. The level of significance was considered below 0.05. Results: A total of 2720 individuals were enrolled in the study (194 cases with HBV infection). Based on the logistic regression analyses, factors such as a family history of the disease (OR=2.53, P<0.001), vaccination (OR=0.57, P=0.004), a history of high-risk behaviors (OR=1.48, P=0.022), and occupation (OR=1.80, P=0.035) were significantly associated with HBV infection. Based on the conditional tree method, a family history of infection (P<0.001) and vaccination (P=0.023) were two important factors in classifying individuals for HBV infection. Conclusion: Based on the different methods applied in this study, HBV infection was affected by factors such as a family history of the disease, national HBV vaccination, and occupation. It appears that HBV vaccination, launched by the Iranian Ministry of Health and Medical Education in 1993, has reduced HBV infection.

Epidemiology of suicide attempts and deaths: a population-based study in Fars, Iran (2011-16).

BACKGROUND: Suicide is a critical psychological issue worldwide with an increasing trend. This study investigated suicide comprehensively. METHODS: In this cross-sectional study, we reviewed data of 28 552 suicide attempts during 2011-16, in Southern Iran. To calculate age-standardized incidence rates, population statistics were derived from the Statistical Center of Iran and the National Organization for Civil Registration. We used the standard population of World Health Organization 2012 to adjust the suicide attempts and deaths rates by age. RESULTS: The mean age of participants was 26.8 ± 10.6 years with the highest suicide attempts rates in the age groups of 15-24 and 25-34 years (48% and 32.5%, respectively); 58.7% were women and 52.9% were single. Case-fatality rate (CFR) was 6.27%. Annual age-standardized incidence rates of suicide attempts during the 6-year period has increased (P < 0.001), and that of deaths were not incremental (P > 0.05). Logistic regression model showed male sex, rural area, older age, psychological and somatic disorders, and family history of suicide as significant factors. CONCLUSIONS: In this comprehensive study, although the age-standardized mortality rate of suicide in southern Iran was lower than in other countries, the increasing trend of suicide attempts during the study period served as an alarming sign in this province.

Stopped-flow chemiluminescence determination of the anticancer drug capecitabine: Application in pharmaceutical analysis and drug-delivery systems.

Capecitabine is a chemotherapeutic agent used for the treatment of patients with metastatic cancers. This study aimed at determining the drug capecitabine in a simple chemiluminescence (CL) system of acidic potassium permanganate using the stopped-flow injection technique. Statistical methods were used to detect optimum conditions. The method showed two linear calibration ranges from 6.7 × 10-6 to 6.7 × 10-5 mol L-1 and from 6.7 × 10-5 to 2.7 × 10-3 mol L-1 with a detection limit of 1.5 × 10-6 mol L-1 . Chitosan-modified magnetic nanoparticles were studied in the drug-delivery experiments. According to the pH sensitivity of chitosan and low pH values in tumour cells, the chitosan-coated magnetic nanoparticles could provide a good targeting drug-delivery system to tumour sites. To evaluate the applicability of the method, the capecitabine-loaded magnetic chitosan nanoparticles were synthesized with two different cross-linkers; loading and releasing rates of the drug were investigated using the proposed CL method and an ultraviolet-visible light spectrophotometric method (absorption at 305 nm). The results showed a good correlation between the two methods, and it was found that the synthesized chitosan-modified magnetic nanoparticles could be used for pH-dependent release of capecitabine in cancer cells. Moreover, determination of capecitabine in tablets and synthetic samples was performed.

Determination of pholcodine in syrups and human plasma using the chemiluminescence system of tris(1,10 phenanthroline)ruthenium(II) and acidic Ce(IV).

Pholcodine is an opiate derivative drug which is widely used in pediatric medicine. In this study, a chemiluminescence (CL) method is described that determines pholcodine in human plasma and syrup samples. This method is based on the fact that pholcodine can greatly enhance the weak CL emission of reaction between tris(1,10 phenanthroline)ruthenium(II), Ru(phen)32+ , and acidic Ce(IV). The CL mechanism is described in detail using UV-vis light, fluorescence and CL spectra. Effects of chemical variables were investigated and under optimum conditions, CL intensity was proportional to the pholcodine concentration over the range 4.0 × 10-8 to 8.0 × 10-6  mol  L-1 . The limit of detection (LOD) (S/N = 3) was 2.5 × 10-8  mol  L-1 . Percent of relative standard deviations (%RSD) for 3.0 × 10-7 and 3.0 × 10-6  mol  L-1 of pholcodine was 2.9 and 4.0%, respectively. Effects of common ingredients were investigated and the method was applied successfully to the determination of pholcodine in syrup samples and human plasma.

Multiway analysis applied to time-resolved chemiluminescence for simultaneous determination of paracetamol and codeine in pharmaceuticals.

This method is based on the enhancing effect of codeine (COD) and paracetamol (PAR) on the chemiluminescence (CL) reaction of Ru(phen)3 (2+) with Ce(IV). In the batch mode, COD gives a relatively sharp peak with the highest CL intensity at 4.0 s, whereas the maximum CL intensity of the PAR appears at ~60 s after injection of Ce(IV) solution. Whole CL time profiles allowed use of the time-resolved CL data in combination with multiway calibration techniques, as multiway partial least squares (N-PLS), for the quantitative determination of both COD and PAR in binary mixtures. In this work, we found that the impact of Ce(IV) concentration on the CL intensity was different for COD and PAR. Therefore, a Ce(IV) concentration mode was added to the time and sample modes to obtain 3D data. The percent relative standard deviation (%RSD) values for 10 determinations of 1.0 × 10(-5)  mol/L of COD and 1.0 × 10(-4)  mol/L of PAR were 6.1% and 8.7%, respectively. The limit of detection (LOD) values (S/N = 3) were 0.9 × 10(-8)  mol/L and 1.0 × 10(-6)  mol/L for COD and PAR, respectively. The proposed method was successfully applied to the determination of PAR and COD in commercial pharmaceutical formulations. Acceptable recoveries (90-110%) were obtained for the quantification of these drugs in the real samples. Copyright © 2016 John Wiley & Sons, Ltd.

Chemiluminescence Determination of Local Anaesthetic Mepivacaine in Human Plasma and Pharmaceuticals.

In this study, a new method has been developed for the simple determination of mepivacaine (carbocaine). The method is based on the enhancement effect of mepivacaine in the chemiluminescence (CL) reaction of tris(1,10 phenanthroline) ruthenium(II) with cerium(IV). A mechanism for the CL reaction has been proposed on the basis of UV-Vis, fluorescent and CL spectra. Under optimum conditions, the CL intensity was proportional to the concentration of the drug in solution over the range 0.45-226.25 µg mL-1 (R2 = 0.9996). The LOD was 0.34 µg mL-1 (S/N = 3). LOD was about 10 times lower than the therapeutic concentration of mepivacaine. The percent of relative standard deviation for determination of 11 replicates at level of 9.05 µg mL-1 and 90.50 µg mL-1 of mepivacaine were 1.8 and 3.7%, respectively. The proposed method was applied successfully for the determination of mepivacaine in human plasma and injectable solutions.

Simple chemiluminescence determination of ketotifen using tris(1,10 phenanthroline)ruthenium(II)- Ce(IV) system.

A new method using chemiluminescence (CL) detection has been developed for the simple determination of ketotifen fumarate (KF). The method is based on the catalytic effect of KF in the CL reaction of tris(1,10 phenanthroline)ruthenium(II), Ru(phen)3 (2+), with Ce(IV) in sulfuric acid medium. The CL response was detected using a lab-made chemiluminometer. Effects of chemical variables were investigated and under optimum conditions, the CL intensity was proportional to the concentration of the drug over the range 0.34-34.00 µg mL(-1) KF. The limit of detection (S/N=3) was 0.09 µg mL(-1). Effects of common ingredients were investigated and the method was applied successfully for determining KF in pharmaceutical formulations and human plasma. The percent of relative standard deviation (n=11) at level of 3.4 µg mL(-1) of KF was 4.6% and the minimum sampling rate was 70 samples per hour. The possible CL mechanism is proposed based on the kinetic characteristic of the CL reaction, CL spectrum, UV-Vis and phosphorescence spectra.

Validity and reliability of anxiety literacy (A-Lit) and its relationship with demographic variables in the Iranian general population.

Introduction: Anxiety disorder is one of the most common mental disorders. This cross-sectional research aimed to determine anxiety literacy (A-Lit) psychometric properties among the Iranian population in 2022. Methods: This research was conducted on 690 people in Iran in 2022. In this study, people were selected by proportional stratified sampling, and the validity and reliability of the A-Lit designed by Griffiths were assessed. Validity of A-Lit was assessed by face validity, content validity, and confirmatory factor analysis. Reliability of A-Lit was evaluated by the McDonald's omega coefficient, Cronbach's alpha coefficient, and test- retest. In analytical sections, the tests of One-way ANOVA, Chi-squared test, and independent samples t-test were used. Results: The rates of S-CVI/Ave and CVR for A-Lit were 0.922 and 0.774, respectively. In confirmatory factor analysis, three items were deleted because the factor loading was less than 0.4, and goodness-of-fit indexes (Some of goodness-of-fit indexes: χ2/df = 4.175, GFI: 0.909, RMSEA = 0.068, PCFI = 0.745, AGFI = 0.883) were confirmed as the final model with 19 items. For all items, the Cronbach's alpha coefficient was 0.832, the McDonald's omega coefficient was 0.835, and the intraclass correlation coefficient was 0.874. According to the results of this study, 1.3% (n = 9) did not answer any questions correctly and 8.4% (n = 58) were able to answer 1-6 questions correctly. Approximately 72% (n = 495) were able to answer 7-12 questions, and eventually only 18.6% (n = 128) were able to answer 13 questions and more. There was a significant relationship between sex, age group, occupation status, marital status, and get information related to mental illness with A-Lit level (p < 0.05). Conclusion: The Persian version of A-Lit was confirmed with 19 items, and this scale is a reliable tool for measuring A-Lit in the general population. The results also showed that a few people have a higher level of anxiety literacy and that educational and intervention programs need to be designed and implemented for the public population.

Blood-based microRNAs as Potential Diagnostic biomarkers for Melanoma: A Meta-analysis.

INTRODUCTION: Circulating microRNAs (miRNAs) serve as noninvasive diagnostic markers in many cancers. This meta-analysis aims to evaluate the diagnostic efficacy of circulating microRNAs for melanoma. MATERIAL AND METHODS: The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and ROC curve were evaluated using the Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software packages. To investigate the heterogeneity, the I2 and Chi-square tests were used. The publishing bias was evaluated using Begg's rank correlation and Egger regression asymmetry tests. RESULTS: A total of 9 articles covering 13 studies (more than 50 miRs individually and in combination) were included, containing 1,355 participants (878 cases and 477 controls). The overall pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and AUC were 0.78 (95% CI: 0.76-0.81), 0.80 (95% CI: 0.77-0.83), 4.32 (95% CI: 3.21-5.82), 0.17 (95% CI: 0.09-0.32), 28.0 (95% CI: 15.34-51.09), and 0.91, respectively. According to Begg's and Egger's tests, there was no publication bias (Begg's p = 0.160 and Egger's p = 0.289). CONCLUSION: Circulating miRNAs can serve as fair and non-invasive diagnostic biomarkers for melanoma. Additionally, specific miRNAs still need to be discovered for diagnosing melanoma.

Circulating progenitor cells and outcomes in patients with coronary artery disease.

BACKGROUND: Low quantities of circulating progenitor cells (CPCs), specifically CD34+ populations, reflect impairment of intrinsic regenerative capacity. This study investigates the relationship between subsets of CPCs and adverse outcomes. METHODS: 1366 individuals undergoing angiography for evaluation of coronary artery disease (CAD) were enrolled into the Emory Cardiovascular Biobank. Flow cytometry identified CPCs as CD45med blood mononuclear cells expressing the CD34 epitope, with further enumeration of hematopoietic CPCs as CD133+/CXCR4+ cells and endothelial CPCs as vascular endothelial growth factor receptor-2 (VEGFR2+) cells. Adjusted Cox or Fine and Gray's sub-distribution hazard regression models analyzed the relationship between CPCs and 1) all-cause death and 2) a composite of cardiovascular death and non-fatal myocardial infarction (MI). RESULTS: Over a median 3.1-year follow-up period (IQR 1.3-4.9), there were 221 (16.6%) all-cause deaths and 172 (12.9%) cardiovascular deaths/MIs. Hematopoietic CPCs were highly correlated, and the CD34+/CXCR4+ subset was the best independent predictor. Lower counts (≤median) of CD34+/CXCR4+ and CD34+/VEGFR2+ cells independently predicted all-cause mortality (HR 1.46 [95% CI 1.06-2.01], p = 0.02 and 1.59 [95% CI 1.15-2.18], p = 0.004) and cardiovascular death/MI (HR 1.50 [95% CI 1.04-2.17], p = 0.03 and 1.47 [95% CI 1.01-2.03], p = 0.04). A combination of low CD34+/CXCR4+ and CD34+/VEGFR2+ CPCs predicted all-cause death (HR 2.1, 95% CI 1.4-3.0; p = 0.0002) and cardiovascular death/MI (HR 2.0, 95% CI 1.3-3.2; p = 0.002) compared to those with both lineages above the cut-offs. CONCLUSIONS: Lower levels of hematopoietic and endothelial CPCs indicate diminished endogenous regenerative capacity and independently correlate with greater mortality and cardiovascular risk in patients with CAD.