The effects of choline supplementation in mothers with hypothyroidism on the alteration of cognitive-behavioral, long-term potentiation, morphology, and apoptosis in the hippocampus of pre-pubertal offspring rats.

The mother's thyroid hormone status during gestation and the first few months after delivery can play a crucial role in maturation during the brain development of the child. Transient abnormalities in thyroid function at birth indicate developmental and cognitive disorders in adulthood. Choline supplementation during gestation and the perinatal period in rats causes long-lasting memory improvement in the offspring. However, it remains unclear whether choline is able to restore the deficits in rats with maternal hypothyroidism. The aim of this study was to evaluate the effects of choline supplementation on the alteration of cognitive-behavioral function, long-term potentiation (LTP), and morphological changes as well as apoptosis in pre-pubertal offspring rats. To induce hypothyroidism, 6-propyl-2-thiouracil was added to the drinking water from the 6th day of gestation to the 21st postnatal day (PND). Choline treatment was started twice a day on the first day of the gestation until PND 21 via gavage. LTP recording and Morris water maze (MWM) test were conducted at PND 28. Then, the rats were sacrificed to assess their brains. The results revealed that developmental thyroid hormone deficiency impaired spatial learning and memory and reduced LTP (both: P < 0.001). Choline treatment alleviated LTP (P < 0.001), as well as learning and memory deficits (P < 0.01) in both male and female hypothyroid rats. However, no significant changes were observed in the number of caspase-3 stained cells in choline-receiving hypothyroid groups. The results revealed that developmental thyroid hormone deficiency impaired spatial learning and memory and reduced LTP. Choline treatment alleviated LTP, as well as learning and memory deficits in both male and female hypothyroid rats.

Comparison of machine learning algorithms to predict intentional and unintentional poisoning risk factors.

Introduction: A major share of poisoning cases are perpetrated intentionally, but this varies depending on different geographical regions, age spectrums, and gender distribution. The present study was conducted to determine the most important factors affecting intentional and unintentional poisonings using machine learning algorithms. Materials and methods: The current cross-sectional study was conducted on 658 people hospitalized due to poisoning. The enrollment and follow-up of patients were carried out during 2020-2021. The data obtained from patients' files and during follow-up were recorded by a physician and entered into SPSS software by the registration expert. Different machine learning algorithms were used to analyze the data. Fit models of the training data were assessed by determining accuracy, sensitivity, specificity, F-measure, and the area under the rock curve (AUC). Finally, after analyzing the models, the data of the Gradient boosted trees (GBT) model were finalized. Results: The GBT model rendered the highest accuracy (91.5 ± 3.4) among other models tested. Also, the GBT model had significantly higher sensitivity (94.7 ± 1.7) and specificity (93.2 ± 4.1) compared to other models (P < 0.001). The most prominent predictors based on the GBT model were the route of poison entry (weight = 0.583), place of residence (weight = 0.137), history of psychiatric diseases (weight = 0.087), and age (weight = 0.085). Conclusion: The present study suggests the GBT model as a reliable predictor model for identifying the factors affecting intentional and unintentional poisoning. According to our results, the determinants of intentional poisoning included the route of poison entry into the body, place of residence, and the heart rate. The most important predictors of unintentional poisoning were age, exposure to benzodiazepine, creatinine levels, and occupation.

COVID-19 Mass Vaccination and Flu Season: Concern for Decreased Public Health Measures and Worsening the Influenza Situation.

Reports show that other ordinary childhood infections like measles or influenza are likely to reemerge. The re-emergence of infectious diseases may happen due to the direct impact of the pandemic on the community because of decreased access to health and medical services, interrupted transport systems, weaknesses in the supply chain, flight restrictions, closings of the border, and international trade problems. The most prevalent cause (60.9%) for low vaccine uptake and coverage during the current pandemic was fear of exposure to the COVID-19 virus outside the home. The expectation and hope that the pattern of reduction in transmission and number of influenza cases will continue over the next flu season depend on continued adherence to nonpharmaceutical interventions and their long-term application. But there is always the fear and threat of increasing the spread of influenza by reducing the movement restrictions and low adherence to protective health measures due to vaccination. So far, not much information has been published about the interaction between different infectious diseases in the background of the coronavirus pandemic and related interventions. The purpose of this article is to examine the general effects of the COVID-19 vaccination on the spread of influenza in the coming seasons.

Immunogenicity of COVID-19 mRNA vaccines in hemodialysis patients: Systematic review and meta-analysis.

Background and Aims: Vaccine response is a concern in hemodialysis patients. Given that hemodialysis patients were not included in clinical trials, we aimed to synthesize the available evidence on the immunogenicity of coronavirus disease 2019 (COVID-19) mRNA vaccines in hemodialysis patients. Methods: We searched Scopus, PubMed, Sciencedirect, and finally google scholar databases for studies on COVID-19 mRNA-vaccines immunogenicity in hemodialysis patients up to December 1, 2021. Eligible articles measured antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike or Receptor-Binding Domain Antibody (S/RBD) postimmunization with COVID-19 mRNA vaccines. The immunogenicity of the vaccine was evaluated using seroconversion rates measured between 21 and 30 days after the first immunization and between 14 and 36 days post the second dose. We included studies including participants without a history of COVID-19 before vaccination. Healthy controls or health-care workers served as the control groups. After selecting eligible articles, the data were finally extracted from included articles. We used a random effects model to estimate the pooled seroconversion rate after COVID-19 mRNA vaccine administration. We assessed the heterogeneity between studies with the I 2 statistical index. Result: We selected 39 eligible citations comprising 806 cases and 336 controls for the first dose and 6314 cases and 927 controls for the second dose for statistical analysis. After the first dose of mRNA vaccines, the seroconversion rate was 36% (95% confidence interval [CI]: 0.24-0.47) and 68% (95% CI: 0.45-0.91) in hemodialysis patients and the control group, respectively. While seroconversion rate after the second dose of mRNA vaccines was 86% (95% CI: 0.81-0.91) and 100% (95% CI: 1.00-1.00) in hemodialysis patients and the control group, respectively. Conclusion: Although the immune response of hemodialysis patients to the second dose of the SARS-CoV-2 mRNA vaccine is very promising, the seroconversion rate of dialysis patients is lower than healthy controls. Periodically assessment of antibody levels of hemodialysis patients at short intervals is recommended.

COVID-19 Vaccination, Peltzman Effect and Possible Increase in Highrisk Behaviors: A Growing Concern Related to Risk Compensation and Reduced Compliance to Public Health Protective Measures after Vaccines Rollout.

The world is still faced with widespread dissemination and many unanswered questions related to Coronavirus disease (COVID-19). Several candidate vaccines have been introduced against COVID-19, mostly requiring the injection of two doses and some with nearly 90-95% efficacy. All strategies against the spread of infection have focused on breaking the chain of virus transmission through protective public health measures and mass vaccination. The current situation emphasizes the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory (Peltzman Effect) states that the decrease in perceived risk through access to preventive measures may lead to increasing frequency of risky behaviors. The current pandemic has exposed people to the sense of risk compensation and behavior change in response to the perceived risk. Risk compensation phenomenon may significantly reverse the benefits of COVID-19 vaccination, especially if the vaccine is not sufficiently effective in real life or among high-risk populations. Recognition and awareness of Peltzman risk compensation are of high importance in counteracting and neutralizing the false complacency of the community, which also lends more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important to encourage mass vaccination of the population, and other NPIs must be re-established and implemented to ensure education to live with COVID-19 in parallel with daily activities and job tasks.

The effect of vitamin D supplementation on flow-mediated dilatation, oxidized LDL and intracellular adhesion molecule 1 on type 2 diabetic patients with hypertension: A randomized, placebo-controlled, double-blind trial.

AIMS: Current study aimed to evaluate the effect of vitamin D supplementation on flow-mediated dilatation (FMD), oxidized LDL (oxLDL) and intracellular adhesion molecule 1 (ICAM1) in type 2 diabetic patients with hypertension. METHODS: In a double-blinded, placebo-controlled trial, 44 patients were randomly divided into vitamin D group (2000 IU/d, n = 23) and placebo group (control, n = 21) for 12 weeks. Vascular function with FMD, Serum 25-OH vitamin D, oxLDL and ICAM1 were assessed at the baseline and after the intervention. This clinical trial was registered at Iranian Registry of Clinical Trials (IRCT20191223045861N1). RESULTS: In intervention group serum level of vitamin D increased from 32.42 ± 10.56 to 40.45 ± 12.94 (p < 0.001). In the vitamin D group, oxLDL and ICAM1 significantly decreased and FMD increased significantly in both groups (p < 0.001). The level of oxLDL (p = 0.017) and ICAM1 (p < 0.001) were significantly lower in the vitamin D group than the placebo group and FMD (p < 0.001) was significantly higher in the vitamin D group. CONCLUSIONS: Vitamin D supplementation of 2000 IU/d for 12 weeks can improve endothelial function and decrease ICAM1 and oxLDL in type 2 diabetic patients with hypertension.

Prevalence and genetic characterization of Cryptosporidium in pre-weaned cattle in Urmia (Northwestern Iran).

INTRODUCTION: Cryptosporidiosis is a zoonotic disease causing digestive problems in pre-weaned calves. Considering the zoonosis of the parasite and its importance in veterinary medicine, we evaluated the prevalence and genotyping of Cryptosporidium spp. in diarrheic pre-weaned calves in the northwest of Iran. METHODOLOGY: A total of 100 stool samples of the infant calves with diarrhea were collected from industrial and conventional livestock farms in Urmia City. All the samples were tested with acid-fast staining, ELISA, and PCR. Positive samples of the PCR method were sequenced to determine the Cryptosporidium species. The obtained results were compared for the mentioned methods based on statistical factors, sensitivity, specificity, positive and negative predictive values, as well as duration of the experiment and the costs of testing. RESULTS: The results of this study showed that the prevalence of Cryptosporidium spp. in diarrheic infant calves in Urmia city was 5%, and C. parvum species of Cryptosporidium was detected in all the sequenced samples. According to the findings of the current study, the most appropriate method for the detection of the parasite is the ELISA that has a higher sensitivity and predictive value than acid-fast staining method and should be used in veterinary laboratories. CONCLUSIONS: In the current investigation, C. parvum was identified as the only infectious agent in the region and could be the main cause of human infection. More studies are needed to find the source of infection for establishing the control measures.

Neutrophil-to-Lymphocyte Ratio as a Poor Prognostic Factor in Iranian COVID-19 Patients.

BACKGROUND: We aimed to accumulate evidence that suggests the potential role of neutrophil-to-lymphocyte ratio (NLR) in determining the prognostic factor for COVID-19 patients. METHODS: A cohort of COVID-19 hospitalized patients at the Ilam University of Medical Sciences was analyzed. Logistic regression models were performed to identify the potential role of NLR in determining the prognostic factor for COVID-19 patients. RESULTS: The total number of in-hospital mortality was 43/328 (13.1%). Multivariate analysis identified that there was a 26% higher risk of in-hospital death for each unit increase in NLR (Odds ratio [OR] = 1.08; 95% confidence interval [95% CI], 1.01 to 1.14; p = 0.0147). Multivariate analysis identified that there was an 8% higher risk of in-hospital death for each unit increase in NLR (Odds ratio [OR] = 1.08; 95% confidence interval [95% CI], 1.01 to 1.14; p = 0.0147). Compared with patients in the NLR < 5 group, the NLR of patients in the NLR ≥ 5 group had a 16-fold higher risk of mortality (OR = 16.04; 95% CI, 1.14 to 224.95; p = 0.0395) after adjustment for potential confounders. CONCLUSIONS: NLR is an independent risk factor of mortality COVID-19 patients.

Are anemia, gastrointestinal disorders, and pregnancy outcome associated with pica behavior?

OBJECTIVE: This study was conducted to determine the relationship between pica and anemia, gastrointestinal disorders, as well as pregnancy outcomes in pregnant women. METHODOLOGY: This study was a prospective study carried out between January 2016 and June 2017 and was performed on 226 pregnant women who attended four different health care centers to receive routine prenatal care. Sampling was done considering the inclusion criteria, in two steps: cluster sampling and random sampling. Data collection was done using a researcher-made checklist. The significance level was set at p = 0.05. RESULTS: The average age of the participants was 26.10±6.27. The prevalence of pica in pregnant women in the first, second, and third trimesters was 9.3, 8, and 2.1%, respectively. The most common pica craving among pregnant women was for ice and frozen materials (68.2%). There was a statistically significant relationship between gastrointestinal disorders and anemia with pica (p < 0.001). There was also a significant relationship between birth weights of babies born to mothers with pica and those without pica (p = 0.005). CONCLUSION: Pica in pregnant women had a significant relationship with gastrointestinal disorders and anemia during pregnancy and pregnancy outcomes. Thus, in addition to providing healthcare services, health care professionals should consider patients' pica practices and make the necessary interventions.

Prenatal stress increased γ2 GABAA receptor subunit gene expression in hippocampus and potentiated pentylenetetrazol-induced seizure in rats.

OBJECTIVES: Stress during pregnancy is able to bring extensive effects on neurobehavioral development in offspring. The GABAergic system plays a pivotal role in neuronal excitability, which can be affected by prenatal stress (PS). This study aimed to evaluate impact of the PS on γ2 subunit of gamma-aminobutyric acid A (GABAA) receptor gene expression in the hippocampus and seizure induced by pentylenetetrazol (PTZ) in developing rats. MATERIALS AND METHODS: In this experimental study, female Wistar rats were exposed to restraint stress during gestation and their offspring were studied on postnatal days 14 and 21 (P14 and P21, respectively) for epileptic behaviors and γ2 GABAA receptor subunit gene expression. Quantitative real-time PCR was used for evaluating the γ2 GABAA receptor subunit gene expression in rat pups. Meanwhile, PTZ was injected into the pups, and seizure behaviors were recorded for 60 min. RESULTS: The results showed that γ2 subunit mRNA expression significantly increased in the hippocampus of the stressed pups. The expression level of γ2 subunit was higher on P21 compared to that on P14 in both groups. Number of seizures with tonic-clonic features increased in pups of stressed group compared to the control group. Prenatal stress significantly caused an increase in the total score of seizure on P21. CONCLUSION: The effect of PS on seizure susceptibility is age-specific; the increased γ2 subunit level in the hippocampus might be, at least in part, the underlying mechanism for PS-induced augmentation of seizures in immature rats.

Serum Levels of Interleukin-8 and Soluble Interleukin-6 Receptor in Patients with Stage-I Multiple Myeloma: A Case-Control Study.

OBJECTIVE: Multiple myeloma (MM) remains an incurable disease that needs better recognition and further research. Previous studies elucidated the interaction between myeloma cells and showed the necessity of bone marrow stromal cells for the initiation and progression of MM. Many chemokines and their receptors including interleukin-8 (IL-8) and soluble interleukin-6 receptor (sIL-6R) play important roles in this interaction. The main purpose of this study is evaluating the serum level of IL-8 and sIL-6R on stage-I of MM patients and healthy controls. METHODS: Serum samples from 30 stage-I MM  patients (13 males and 17 females) and 30 healthy subjects as controls (13 males and 17 females) were examined in this study. The protein concentrations of serum IL-8 and sIL-6R were assessed by enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean level of IL-8 and sIL-6R were significantly elevated in stage-I MM. The mean levels of IL-8 were 1246.57±279.22 ng/ml in stage-I MM and 902.53± 294.61 ng/ml in controls (P<0.001). The mean levels of sIL-6R were 5.39±1.38 ng/ml and 4.1±1.14 ng/ml in stage-I MM and controls, respectively (P<0.001). The mean levels of IL-8 were 1342.18±193.4 ng/ml in patient females and 859± 278.2ng/ml in control females (P <0.001). The mean levels of sIL-6R were 5.21±1.55 ng/ml and 3.91±1.22 ng/ml in patient females and control females, respectively (P=0.01). The mean level of sIL-6R in patient males and control males were 5.63±1.43 ng/ml and 4.34±1.04 ng/ml, respectively (P=0.01). A significant correlation (Pearson's correlation = 0.45, P=0.008) was observed in the population of females (patients and controls). CONCLUSION: The results of study suggest the possible involvement of IL-8 and the sIL-6R at stage-I MM and can better characterize the role of chemokines and their receptors in the disease process, especially in the early stages.

Parental pre-conception stress status and risk for anxiety in rat offspring: specific and sex-dependent maternal and paternal effects.

Prenatal stressful events have long-lasting consequences on behavioral responses of offspring. While the effects of gestational and maternal stress have been extensively studied on psychological alterations in the progeny, little is known about effects of each parent's pre-conception life events on emotional responses in offspring. Here, the effect of maternal and/or paternal pre-conception stress was investigated on anxiogenic responses of offspring. Male and female adult rats were subjected to predatory stress (contactless exposure to a cat for 1 + 1 h per day) for 50 (male, n: 12) and 15 (female, n: 24) consecutive days; controls were not exposed. After the stress procedure, the control and stressed rats were mated to create four types of breeding pairs: control female/control male, stressed female/control male, control female/stressed male, and stressed female/stressed male. On postnatal days 30-31, the offspring were tested on the elevated plus maze and plasma corticosterone concentration was measured. Half of the pups were exposed to acute predatory stress before the elevated plus maze test. In most subgroups, corticosterone and anxiety-like behaviors in the offspring with both or only one parent exposed to pre-gestational stress increased compared to their control counterparts. However, under acute stress conditions, a different sex-dependent pattern of anxiety responses emerged. The combined effects of maternal and paternal stress were not additive. Hence, individual offspring behaviors can be influenced by the former life stress experiences of either parent. Incorporation of genetic and epigenetic aspects in development of neurobehavioral abnormalities and reprograming of the hypothalamic-pituitary-adrenal axis may contribute to this phenomenon. Lay summary Early life stress (including during pregnancy) is known to have long-lasting effects on offspring, including emotional behaviors. Whether individual anxiety behaviors can be influenced by stress experiences of each parent even before a pregnancy is less well-understood. Our findings from this study on rats exposed to predator stress before mating suggest that maternal or paternal adult life events prior to pregnancy can lead to maladaptive behavior in their offspring later in life.

Spiritual Health and Physical Activity Among Iranian Pregnant Women.

This study was aimed to investigate the relationship between spiritual health and physical activity among Iranian pregnant women during 2015. A cross-sectional descriptive-analytic design was adopted. A total number of 411 participants were selected by convenience sampling from Iranian women who regularly attended health centers for prenatal care. Data were collected using demographic questionnaire and Health-Promoting Lifestyle Profile questionnaire, 2nd edition. (Spiritual health and physical activity are two components of health-promoting lifestyle.) The data were analyzed, using descriptive statistics, t test, one-way ANOVA, Pearson's correlation coefficient, and regression. p values <0.05 were considered significant. The mean age of pregnant women was 27.90 ± 6.03 years. Spiritual health had the highest score (25.86 ± 4.7) and physical activity had the lowest score (11.31 ± 3.27), among six Health-Promoting Lifestyle Profile subscales. In fact, there was a statistically significant correlation between spiritual health and physical activity (p = 0.000). According to results, pregnant women have higher spiritual health and lower physical activity scores. There was a statistically significant correlation between spiritual health and physical activity. The findings of this study can be used in prenatal care, midwifery education, and maternal health policies.

Identify Survival Predictors of the First Kidney Transplantation: A Retrospective Cohort Study.

BACKGROUND: The first kidney transplant survival is very important. We know that short-term survival of kidney transplantation is improved over the past two decades in Iran; however, no information is available on long-term survival and predictors. This study explored factors influencing long-term renal transplant survival at northwest of Iran. METHODS: In this single-center, study, survival rates and half-life of 201 the first kidney transplants between 1999 and 2008 were measured by a historical-cohort study in Imam Khomeini Hospital in Urmia, Iran. The log-rank test and Cox-regression model were used to compare survival curves and determine factor affecting graft survival time, respectively. RESULTS: First graft survival from one, five, and 10 years was 96%, 89%, and 46%, respectively. Mean±se and median±se of first graft survival time was 3061±105.01 day (95% CI: 2855.47-3267.11 day) and 3411±282.1 day (95%CI: 2858.08-3963.92), respectively. Predictors of first graft rejection were recipient age (P=0.001), LDL cholesterol (P=0.008), immunosuppressive drugs (P=0.047), serum creatinine three and six months (P=0.042 and 0.001, respectively) and related donor family (P=0.037). CONCLUSION: Patients with first graft transplantation had a moderate long-term survival. The study showed that small age at transplant, low LDL cholesterol before transplant, and relative to donor, could be decrease the risk graft loss.

QT Dispersion after Thrombolytic Therapy.

BACKGROUND: QT dispersion (QTd) is equal to longer QTc minus shorter QTc measured by 12-lead electrocardiogram (ECG). QTd reflects inhomogeneity in repolarization of ventricular myocardium and because of easy and fast measurement of QTd, it can be used to predict high-risk patients for dysrhythmia after Acute Myocardial Infarction (AMI). OBJECTIVES: This study aimed to assess the effect of thrombolytic therapy on QTd before and 1 hour and 4 days after beginning of thrombolytic therapy. PATIENTS AND METHODS: The patients with chest pain and ST Elevated Myocardial Infarction (STEMI) that underwent thrombolytic therapy were enrolled into this study. Streptokinase was the thrombolytic agent in all the patients. Standard 12-lead (ECG) was evaluated before beginning of thrombolytic therapy (QTd 1) and 1 hour (QTd2) and 4 days (QTd3) after thrombolytic therapy. First, ECG was magnified × 10 for exact calculation of QT and QTd. After all, the variables were compared using one-way analysis of variance (ANOVA). Besides, P ≤ 0.05 was considered as statistically significant. RESULTS: This study was conducted on 160 patients. The results revealed no significant differences among QTd 1, QTd 2, and QTd 3 (P > 0.05). At inferior AMI, however, a significant difference was observed among QTd1, QTd2, and QTd3 (P = 0.031). CONCLUSIONS: Thrombolytic therapy had no significant effects on QTd. Thus, thrombolytic therapy does not increase the risk of arrhythmia.

The effect of diabetes mellitus on short term mortality and morbidity after isolated coronary artery bypass grafting surgery.

BACKGROUND: This study was conducted to determine whether Diabetes Mellitus (DM) is a predictor of short term mortality ; morbidity, or early readmission to hospital after Coronary Artery Bypass Graft (CABG). METHODS: We analyzed a large cohort of 952 patients who had undergone isolated CABG. The preoperative, intera operative and postoperative risk factors as well as the complications and 30-day mortality rates were compared between the diabetics and non-diabetics. Among the 952 patients; 734 ones (77.1%) were in non-diabetic group and 218 (22.9%) were diabetics. RESULTS: Having DM did not increase the risk of 30-day mortality. In addition, DM did not affect the major complications; arrhythmia, Myocardial Infarction(MI), infective complications, neurological complications, Pulmonary Embolism (PE) except renal complications that was higher in the diabetics (5.5% vs 1.4%; P<0.001, OR=4.2) However reoperation for bleeding was higher in non-diabetic patients (7.9% vs 4.6%; P=0.009, OR=1.7). Nevertheless ,no significant difference was observed between the two groups regarding mechanical ventilation time (hour), reintubation, length of ICU stay (day), length of hospital stay (day), and readmitting as postoperative variables. CONCLUSIONS: Except for renal complications, DM was not associated with adverse outcomes in the patients undergoing isolated CABG.