Effects of physical training on coagulation parameters, interleukin-6, and angiotensin-converting enzyme-2 in COVID-19 survivors.

COVID-19 is a highly contagious virus that uses Angiotensin-converting enzyme 2 (ACE2) as a receptor to enter human cells. The virus leads to an increase in inflammatory cytokines (i.e. IL-6) and an impaired coagulation system, which can cause serious complications during and after the disease. Physical exercise has been shown to improve COVID-19 complications through various mechanisms, such as modulation of the immune and coagulation systems. Therefore, this study investigated the effects of 8 weeks of training on inflammatory, coagulation, and physical factors in patients with COVID-19 during the recovery phase. Twenty-seven male and female volunteers (age 20-45 years) who recently recovered from COVID-19 were assigned to the control (n = 13) or the training group (n = 14). Blood samples, aerobic capacity and muscle endurance were collected 24 h before the start of the interventions and 24 h after the final training session in week 4 and 48 h after the final training session in week 8. IL-6, ACE2, fibrinogen, and D-dimer were measured using ELISA. The training group showed a significant increase in muscle endurance (p = 0.004) and aerobic capacity (p = 0.009) compared to the control group. Serum levels of IL-6 and fibrinogen decreased in the training group but this decrease was not statistically significant (p > 0.05). Despite a slight increase in the quality of life and sleep in the training group, no statistically significant difference was observed between the training and the control group. It appears that physical training has beneficial effects on the coagulation system, inflammatory factors, and sleep quality and can facilitate the recovery of COVID-19 patients.

Thy-DAMP: deep artificial neural network model for prediction of thyroid cancer mortality.

PURPOSE: Despite the rising incidence of differentiated thyroid cancer (DTC), mortality rates have remained relatively low yet crucial for effective patient management. This study aims to develop a deep neural network capable of predicting mortality in patients with differentiated thyroid cancer. METHODS: Leveraging data from the Surveillance, Epidemiology, and End Results (SEER) database, we developed Thy-DAMP (Deep Artificial Neural Network Model for Prediction of Thyroid Cancer) to forecast mortality in DTC patients. The dataset comprised demographic, histologic, and staging information. Following data normalization and feature encoding, the dataset was partitioned into training, testing, and validation subsets, with model hyperparameters fine-tuned via cross-validation. RESULTS: Among the 63,513 patients, the mean age was 48.22 years (SD = 14.8), with 77.32% being female. Papillary carcinoma emerged as the predominant subtype, representing 62.94% of cases. The majority presented with stage I disease (73.96%). Thy-DAMP demonstrated acceptable performance metrics on both the test and validation sets. Sensitivity was 83.24% (95% CI 76.95-88.40%), specificity was 93.53% (95% CI 93.01-94.02%), and accuracy stood at 93.33% (95% CI 92.82-93.83%). The model exhibited a positive predictive value of 19.76% (95% CI 18.20-21.42%) and a negative predictive value of 99.66% (95% CI 99.53-99.75%). Additionally, Thy-DAMP demonstrated a positive likelihood ratio of 12.86 (95% CI 11.62-14.23), a negative likelihood ratio of 0.18 (95% CI 0.13-0.25), and an area under the receiver operating characteristic curve (AUROC) of 0.95. The model was externally validated on a separate dataset with nearly identical performance. CONCLUSION: Thy-DAMP showcases considerable promise in accurately predicting mortality in DTC patients, leveraging limited set of patient data.

The impact of exercise on growth factors in postmenopausal women: a systematic review and meta-analysis.

BACKGROUND: Aging results in many changes in health status, body composition, muscle strength, and, ultimately, functional capacity. These changes coincide with significant alterations in the endocrine system, such as insulin-like growth factor-1 (IGF-1) and IGF-binding proteins (IGFBPs), and may be associated with many symptoms of aging. The objectives of this study is to investigate the potential influence of different types of exercise, such as resistance training and aerobic training, on IGF-1 and IGFBP-3 levels in postmenopausal women. METHODS: Medline, Scopus, and Google Scholar databases were systematically searched up to November 2023. The Cochrane Collaboration tool was used to assess the risk of bias and the quality of the studies. The random-effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used to estimate the overall effect. Between-study heterogeneity was assessed using the chi-squared and I2 tests. RESULTS: Seventeen studies were included in the present systematic review and 16 studies were included in the meta-analysis. The pooled results from 16 studies (21 trials) with 1170 participants examining the impact of exercise on IGF-1 concentration showed a significant increase in IGF-1, and the pooled results among six studies (trials) showed a significant decrease in IGFBP-3 concentration (730 participants). In addition, resistance training and aerobic training had a significant effect on increasing IGF-1 concentration post-exercise compared with placebo. CONCLUSION: Based on this meta-analysis, Women who have completed menopause and followed an exercise routine showed changes in IGF-1 and IGFBP-3 levels that can indirectly be associated with risk of chronic age-related conditions.

Effect of FTO genotype on exercise training and diet-indued weight loss in overweight and obese adults: a systematic review and meta-analysis.

Our meta-analysis, encompassing 30 studies with 46,976 subjects, aimed to explore the impact of fat mass and obesity-associated protein (FTO) genotypes on weight response to exercise and dietary interventions in overweight and obese adults. Electronic databases including PubMed and Google Scholar were searched from 2020 to September 2023 to identify relevant studies. Results revealed a significant reduction in body weight among individuals with the FTO risk allele following exercise and diet interventions (standardized mean difference [SMD] = - 0.619, 95% CI: - 1.137, - 0.100; p = .01). When examining FTO variants, both AA (SMD = - 0.148, 95% CI: - 0.282, - 0.014, p = .03, I2 = 24.96) and TA genotypes (SMD = - 0.674, 95% CI: - 1.162, - 0.186, p = .007, I2 = 91.12) showed significant weight reduction compared to the TT genotype. Moreover, individuals with the high-risk genotype AA + TT achieved greater weight loss compared to those with the normal-risk genotype TT (SMD = - 0.419, 95% CI: - 0.655, -0.183, p = .0001, I2 = 92.08) in the dominant genetic model. Subgroup analysis indicated that FTO risk allele carriers (AA + AT) with exercise interventions lasting six months and a body mass index of 25 - 29 experienced greater weight loss compared to TT carriers. These findings emphasize the importance of genetic considerations in weight management interventions and suggest personalized approaches for combating obesity. Further clinical trials are warranted to validate our study's findings.

Effect of ADORA2A Gene Polymorphism and Acute Caffeine Supplementation on Hormonal Response to Resistance Exercise: A Double-Blind, Crossover, Placebo-Controlled Study.

Previous studies have reported that TT genotype carriers of the adenosine A2a receptor (ADORA2A) gene rs5751876 polymorphism have better ergogenic and anti-inflammatory responses to caffeine intake compared to C allele carriers. The aim of the present study was twofold: (1) to investigate the association of the ADORA2A rs5751876 polymorphism with acute caffeine supplementation on hormonal (growth hormone and testosterone) response to resistance exercise (RE); (2) to examine the relationship between the rs5751876 polymorphism and the resting levels of growth hormone and testosterone in athletes who are light caffeine consumers. A double-blind, crossover, placebo-controlled study involving 30 resistance-trained men (age 21.7 ± 4.1) was conducted to assess the impact of caffeine supplementation on serum growth hormone (GH) and testosterone (TS) levels before, immediately after, and 15 min post-RE. One hour before engaging in resistance exercise, subjects were randomly administered 6 mg of caffeine per kg of body mass or a placebo (maltodextrin). After a 7-day washout period, the same protocol was repeated. Resting testosterone and growth hormone levels were examined in the sera of 94 elite athletes (31 females, age 21.4 ± 2.8; 63 males, age 22.9 ± 3.8). Caffeine consumption led to significantly greater increases in GH and TS in men with the TT genotype compared to C allele carriers. Furthermore, in the group of athletes, carriers of the TT genotype had significantly higher testosterone (p = 0.0125) and growth hormone (p = 0.0365) levels compared to C allele carriers. In conclusion, the ADORA2A gene rs5751876 polymorphism may modify the effect of caffeine intake on the hormonal response to exercise.

The role of IL-2 cytokine family in asthma.

BACKGROUND: The interleukin-2 (IL-2) family of cytokines, including IL-2, IL-4, IL-7, IL-9, IL-15, and IL-21, are pivotal regulators of the immune response, impacting both innate and adaptive immunity. Understanding their molecular characteristics, receptor interactions, and signalling pathways is essential for elucidating their roles in health and disease. OBJECTIVES: This review provides a comprehensive overview of the IL-2 family of cytokines, highlighting their molecular biology, receptor interactions, and signalling mechanisms. Furthermore, it explores the involvement of IL-2 family cytokines in the pathogenesis of chronic respiratory diseases, with a specific focus on chronic obstructive pulmonary disease (COPD) and asthma. METHODS: A thorough literature review was conducted to gather insights into the molecular biology, receptor interactions, and signalling pathways of IL-2 family cytokines. Additionally, studies investigating the roles of these cytokines in chronic respiratory diseases, particularly COPD and asthma, were analysed to discern their implications in wider pathophysiology of disease. RESULTS: IL-2 family cytokines exert pleiotropic effects on immune cells, modulating cellular proliferation, differentiation, and survival. Dysregulation of IL-2 family cytokines has been implicated in the pathogenesis of chronic respiratory illnesses, including COPD and asthma. Elevated levels of IL-2 and IL-9 have been associated with disease severity in COPD, while IL-4 and IL-9 play crucial roles in asthma pathogenesis by promoting airway inflammation and remodelling. CONCLUSION: Understanding the intricate roles of IL-2 family cytokines in chronic respiratory diseases provides valuable insights into potential therapeutic targets for these conditions. Targeting specific cytokines or their receptors may offer novel treatment modalities to attenuate disease progression and improve clinical outcomes in patients with COPD and asthma.

What factors influence couples' decisions to have children? Evidence from a systematic scoping review.

BACKGROUND: One of the most significant demographic challenges over the past three decades has been the substantial reduction in fertility rates, worldwidely. As a developing country, Iran has also experienced a rapid decline in fertility over the past decades. Understanding factors influencing fertility is essential for development programs. Moreover, it's crucial to study the parameters that affect the intention for childbearing in any society. Therefore, through a systematic scoping review, the present study investigates the factors influencing couples' decisions toward childbearing. METHODS: This study was a systematic scoping review conducted in 2023. To design and conduct this scoping review, Joanna Briggs Institute's Protocol (Institute TJB, The Joanna Briggs Institute Reviewers ' manual 2015; methodology for JBI scoping reviews, 2015) was used and the framework presented by Levac et al. (2010) was also used as a guide for conducting this review. Studies were searched in three main databases including ISI Web of Sciences, PubMed, and Scopus, using a predefined search strategy. Google Scholar was also used for complementary search. The search period was from 2002 to 2022. RESULTS: A total of 18,454 studies were identified across three primary databases. After evaluating articles in three distinct phases based on title, abstract, and full-text, 46 articles were deemed eligible for inclusion in the scoping review. The qualitative analysis of the collected data from the selected studies through the scoping review led to classifying factors influencing households' desire for childbearing into eight main themes and 101 sub-themes. The main themes associated with factors impacting households' intention for childbearing encompass individual determinants, demographic and familial influencing factors, cultural elements, social factors, health-related aspects, economic considerations, insurance-related variables, and government support/incentive policies. CONCLUSIONS: Comprehensive and holistic attention from governments and officials toward the various factors affecting households' intention and behavior regarding childbearing appears beneficial and effective. Furthermore, given the relative ineffectiveness of some of the current government's supportive/incentive policies to increase couples' desire for childbearing, it seems necessary to review and amend these policies. This review should address the most significant challenges and factors contributing to couples' reluctance to childbearing or strengthen factors that can play a substantial role in fostering fertility and childbearing desires.

Psychosocial factors associated with lower extremity re-injury risk in soccer players: Contribution of self- confidence, functional attention, and re-injury anxiety.

CONTEXT: Despite the availability of specialized assessment tools, psychological readiness is usually not considered when deciding to return to sport (RTS) after sport injury. Re-injury anxiety, self-confidence, and functional attention may be associated with sport re-injury, making it important to evaluate these factors before RTS. OBJECTIVE: This study aimed to predict lower extremity re-injury in soccer players using self- confidence, functional attention, and re-injury anxiety as predictive variables. DESIGN: Prospective cohort study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Sixty-two male soccer players, who were older than 18 years of age, suffered from lower extremity injuries, had completed the rehabilitation program, and were ready to RTS. MAIN OUTCOME MEASURES: Prior to returning to the sport, participants completed a pre-season questionnaire on their previous injuries, self-confidence, re-injury anxiety, and level of functional attention. The primary outcome measured was the risk of re-injury during the upcoming competitive season, and logistic regression was utilized to calculate odds ratios (OR) with 95% confidence intervals to determine the association between each risk factor and re- injury. RESULTS: Overall re-injury rate was 5.56 injuries per 1000 hours of play. Self-confidence scores ≤ 47 increased the risk of re-injury by 2.26 times (relative risk, 2.26; 95% CI, 1.31-3.91; OR, 5.00; 95% CI, 1.56-16.04) and each unit increase in self-confidence score reduced the risk of re-injury by 10% (OR:0.90; CI: 0.82-0.99, p=0.03). Regarding re-injury anxiety, a score >22 was associated with 2.43 times the risk of re-injury (relative risk, 2.43; 95% CI, 1.44-4.13; OR, 6.46; 95% CI, 1.93-21.69) and each unit increase in re-injury anxiety score increased the risk of injury by 45% (OR:1.45; CI: 1.13-0.87, p=0.004). CONCLUSIONS: Increased re-injury anxiety and decreased self-confidence are associated with higher odds of lower extremity re-injury in male soccer players. To reduce the risk of re-injury, athletic trainers and sport psychologists should take these psychological factors into account when evaluating the psychological readiness of soccer players with a history of lower extremity injury to RTS.

Diagnostic Significance of Neutrophil to Lymphocyte Ratio in Recurrent Aphthous Stomatitis: A Systematic Review and Meta-Analysis.

INTRODUCTION: Recurrent aphthous stomatitis (RAS) is a prevalent ulcerative condition affecting oral mucosa. OBJECTIVES: A systematic review and meta-analysis was performed to compare the level of neutrophil to lymphocyte ratio (NLR) between individuals with RAS and those who are healthy. METHODS: A systematic search for relevant publications before June 21, 2022, was conducted using Web of Science, PubMed, and Scopus. The results were presented as the standardized mean difference (SMD) with a 95% confidence interval (CI), and a random-effects model was used to calculate pooled effects due to the presence of significant heterogeneity. Quality assessment was performed using the Newcastle-Ottawa scale. RESULTS: Overall, 13 article with were included in the analysis. NLR was higher among patients with RAS compared to healthy controls (SMD = 0.50, 95% CI = -0.20 to 0.79, P = 0.001, I2 = 91.5%). In the subgroup analysis based on the study design, it was found that retrospective studies showed higher levels of NLR in patients with RAS compared to healthy controls (SMD = 0.62, 95% CI= 0.16 to 1.08, P < 0.01), but these results were not applied to prospective studies (SMD = 0.35, 95% CI = -0.03 to 0.74, P < 0.07). CONCLUSION: Elevated neutrophil to lymphocyte ratio revealed crosstalk between systematic inflammation and RAS.

Impacts of an 8-week regimen of aged garlic extract and aerobic exercise on the levels of Fetuin-A and inflammatory markers in the liver and visceral fat tissue of obese male rats.

BACKGROUND & AIMS: Obesity-induced chronic low-grade systemic inflammation is linked to the development of numerous diseases. Fetuin-A is known to affect inflammation and insulin resistance in obesity conditions. Free fatty acid (FFA)-induced proinflammatory cytokine expression in adipocytes occurs only in the presence of both Fetuin-A and toll-like receptor 4 (TLR4) and removing either of them prevented FFA-induced insulin resistance. Aged garlic extract (AGE) and exercise training have anti-inflammatory effects; however, the impact of AGE on Fetuin-A is unknown. We examined the effects of AGE with or without aerobic training (AT) on Fetuin-A and inflammatory markers. METHODS: Forty healthy male Sprague Dawley rats were randomly assigned to normal diet (ND) (n = 8) or high-fat diet (HFD) groups (n = 32) and fed for 9 weeks. After 9 weeks ND group continued normal diet, and the HFD group was randomly assigned to the HFD, HFD + AGE (600 mg/kg, once daily), HFD + AT (5 days/week), and HFD + AGE + AT groups that were continued for 8 weeks (n = 8). The significance of differences among groups was assessed using one-way analysis of variance followed by the post-hoc Tukey test. Statistically significant differences were considered for p < 0.05. RESULTS: AGE, AT, and AGE + AT significantly decreased body weight, plasma Fetuin-A, HOMA-IR, mRNA and protein levels of Fetuin-A and NFƙB in the liver and mRNA and Protein levels of Fetuin-A, TLR4 and NFƙB in visceral adipose tissue (VAT) compared to HFD. However, only AGE + AT significantly decreased TLR4 protein levels in the liver. CONCLUSION: Although AT and AGE reduce Fetuin-A and inflammatory markers, a combination of the two may be more effective at lowering inflammation.

Natural Products Derived Porous Carbons for CO2 Capture.

As it is now established that global warming and climate change are a reality, international investments are pouring in and rightfully so for climate change mitigation. Carbon capture and separation (CCS) is therefore gaining paramount importance as it is considered one of the powerful solutions for global warming. Sorption on porous materials is a promising alternative to traditional carbon dioxide (CO2 ) capture technologies. Owing to their sustainable availability, economic viability, and important recyclability, natural products-derived porous carbons have emerged as favorable and competitive materials for CO2 sorption. Furthermore, the fabrication of high-quality value-added functional porous carbon-based materials using renewable precursors and waste materials is an environmentally friendly approach. This review provides crucial insights and analyses to enhance the understanding of the application of porous carbons in CO2 capture. Various methods for the synthesis of porous carbon, their structural characterization, and parameters that influence their sorption properties are discussed. The review also delves into the utilization of molecular dynamics (MD), Monte Carlo (MC), density functional theory (DFT), and machine learning techniques for simulating adsorption and validating experimental results. Lastly, the review provides future outlook and research directions for progressing the use of natural products-derived porous carbons for CO2 capture.

Effects of Vitamin D3 Supplementation and Aerobic Training on Autophagy Signaling Proteins in a Rat Model Type 2 Diabetes Induced by High-Fat Diet and Streptozotocin.

The aim of this study was to investigate the combined effects of vitamin D3 supplementation and aerobic training on regulating the autophagy process in rats with type 2 diabetic induced by a high-fat diet and streptozotocin. A total of 40 Wistar rats were divided into five groups: normal control (NC), diabetic control (DC), diabetic + aerobic training (DAT), diabetic + vitamin D3 (DVD), and diabetic + aerobic training + vitamin D3 (DVDAT). The rats underwent eight weeks of aerobic training with an intensity of 60% maximum running speed for one hour, along with weekly subcutaneous injections of 10,000 units of vitamin D3. The protein levels of different autophagy markers were assessed in the left ventricular heart tissue. The results showed that the protein levels of AMPK, pAMPK, mTOR, and pmTOR were significantly lower in the DC group compared to the NC group. Conversely, the levels of ULK, Beclin-1, LC3II, Fyco, and Cathepsin D proteins were significantly higher in the DC group. However, the interventions of aerobic training and vitamin D3 supplementation, either individually or in combination, led to increased levels of AMPK, pAMPK, mTOR, and pmTOR, and decreased levels of ULK, Beclin-1, LC3II, Fyco, and Cathepsin D (p < 0.05). Additionally, the aerobic capacity in the DAT and DVDAT groups was significantly higher compared to the NC, DC, and DVD groups (p < 0.05). These findings suggest that type 2 diabetes is associated with excessive autophagy in the left ventricle. However, after eight weeks of vitamin D3 supplementation and aerobic training, a significant reduction in excessive autophagy was observed in rats with type 2 diabetes.

Classification of cancer cells and gene selection based on microarray data using MOPSO algorithm.

PURPOSE: Microarray information is crucial for the identification and categorisation of malignant tissues. The very limited sample size in the microarray has always been a challenge for classification design in cancer research. As a result, by pre-processing gene selection approaches and genes lacking their information, the microarray data are deleted prior to categorisation. In essence, an appropriate gene selection technique can significantly increase the accuracy of illness (cancer) classification. METHODS: For the classification of high-dimensional microarray data, a novel approach based on the hybrid model of multi-objective particle swarm optimisation (MOPSO) is proposed in this research. First, a binary vector representing each particle's position is presented at random. A gene is represented by each bit. Bit 0 denotes the absence of selection of the characteristic (gene) corresponding to it, while bit 1 denotes the selection of the gene. Therefore, the position of each particle represents a set of genes, and the linear Bayesian discriminant analysis classification algorithm calculates each particle's degree of fitness to assess the quality of the gene set that particle has chosen. The suggested methodology is applied to four different cancer database sets, and the results are contrasted with those of other approaches currently in use. RESULTS: The proposed algorithm has been applied on four sets of cancer database and its results have been compared with other existing methods. The results of the implementation show that the improvement of classification accuracy in the proposed algorithm compared to other methods for four sets of databases is 25.84% on average. So that it has improved by 18.63% in the blood cancer database, 24.25% in the lung cancer database, 27.73% in the breast cancer database, and 32.80% in the prostate cancer database. Therefore, the proposed algorithm is able to identify a small set of genes containing information in a way choose to increase the classification accuracy. CONCLUSION: Our proposed solution is used for data classification, which also improves classification accuracy. This is possible because the MOPSO model removes redundancy and reduces the number of redundant and redundant genes by considering how genes are correlated with each other.

Dynamozones are the most obvious sign of the evolution of conformational dynamics in HIV-1 protease.

Proteins are not static but are flexible molecules that can adopt many different conformations. The HIV-1 protease is an important target for the development of therapies to treat AIDS, due to its critical role in the viral life cycle. We investigated several dynamics studies on the HIV-1 protease families to illustrate the significance of examining the dynamic behaviors and molecular motions for an entire understanding of their dynamics-structure-function relationships. Using computer simulations and principal component analysis approaches, the dynamics data obtained revealed that: (i) The flap regions are the most obvious sign of the evolution of conformational dynamics in HIV-1 protease; (ii) There are dynamic structural regions in some proteins that contribute to the biological function and allostery of proteins via appropriate flexibility. These regions are a clear sign of the evolution of conformational dynamics of proteins, which we call dynamozones. The flap regions are one of the most important dynamozones members that are critical for HIV-1 protease function. Due to the existence of other members of dynamozones in different proteins, we propose to consider dynamozones as a footprint of the evolution of the conformational dynamics of proteins.

Minimal access awake craniotomy for drainage of cerebral abscess in a patient with severe complex cardiac defects in resource-limited country: A case report.

INTRODUCTION AND IMPORTANCE: Brain abscess is an uncommon but potentially fatal infection of the brain parenchyma that can affect 5 % to 18.7 % of people with uncorrected complex congenital heart defects. In management of patients with complex cardiac defects, the main concern is that they are prone to develop perioperative complications. Hence such cases are a real challenge for surgeons and anesthesiologists. In this study we have reported a well-managed awake craniotomy (Awake-Asleep-Awake) for drainage of cerebral abscess in a patient with complex cardiac defect. CASE PRESENTATION: We present a case of a 13-year-old male patient with untreated cyanotic CHD-TOF with complete AV canal defect, who complained of right-side paralysis since 2 weeks; and has been suffering from headache, fever and vomiting for 25 days. Brain CT scan showed a large abscess in the left fronto-temporal lobes. Minimal access awake craniotomy with regional scalp nerve block and sedation was done and about 100-120 cc thick pus was drained. The patient's paralysis improved significantly and neurological deficit ceased on 3rd postoperative day. CLINICAL DISCUSSION: Pediatric population itself is a challenge for anesthesiologists and this manifolds when associated with complex cardiac defects and neurosurgery cases. CONCLUSION: Brain abscess is expected to be more common in patients following uncorrected complex congenital heart disease in developing countries. Physicians must hold a high index of suspicion for early diagnosis and well-management of these patients with multidisciplinary approach. Minimal access awake craniotomy with or without sedation for patients with large brain abscess is a safe surgical approach.

Predicting current and future high-risk areas for vectors and reservoirs of cutaneous leishmaniasis in Iran.

Climate change will affect the distribution of species in the future. To determine the vulnerable areas relating to CL in Iran, we applied two models, MaxEnt and RF, for the projection of the future distribution of the main vectors and reservoirs of CL. The results of the models were compared in terms of performance, species distribution maps, and the gain, loss, and stable areas. The models provided a reasonable estimate of species distribution. The results showed that the Northern and Southern counties of Iran, which currently do not have a high incidence of CL may witness new foci in the future. The Western, and Southwestern regions of the Country, which currently have high habitat suitability for the presence of some vectors and reservoirs, will probably significantly decrease in the future. Furthermore, the most stable areas are for T. indica and M. hurrianae in the future. So that, this species may remain a major reservoir in areas that are present under current conditions. With more local studies in the field of identifying vulnerable areas to CL, it can be suggested that the national CL control guidelines should be revised to include a section as a climate change adaptation plan.

Primary cervical hydatid cyst: A rare case report.

INTRODUCTION AND IMPORTANCE: Hydatid cyst is a zoonotic parasitic disease caused by Echinococcus granulosis. Occurrence in the head and neck is quite uncommon even in endemic areas. The diagnosis of an isolated cystic neck mass is still a challenge due to the presence of similar congenital cystic lesions and benign tumors in the neck. Imaging is useful, but sometimes they cannot identify a definitive diagnosis. The treatment of choice is exclusively surgical excision, combined with chemotherapy. Histopathology confirms the definitive diagnosis. CASE PRESENTATION: We present a case of an 8-year-old boy with no history of surgery or trauma, who complained of an isolated left posterior neck mass since one year. All radiological items lead to suspect a cystic lymphangioma. Excisional biopsy under general anesthesia was done. The cystic mass was totally resected and the diagnosis was further confirmed by histopathology. CLINICAL DISCUSSION: Cervical hydatid cyst is mostly a misdiagnosed condition, majority of hydatid cyst cases are asymptomatic and vary on the basis of their locations. The differential diagnosis includes cystic lymphangioma, branchial cleft cyst, bronchogenic, thoracic duct, esophageal duplication cysts, pseudocysts and benign tumors. CONCLUSION: Isolated cervical hydatid cyst is rarely reported yet, it must be considered in any cases of cystic cervical mass, particularly in endemic areas. Imaging modalities are sensitive in diagnosing cystic lesions, yet sometimes they cannot identify the exact etiology of the lesion. Furthermore, Prevention of hydatid disease is more favorable than surgical excision.

Efficacy of tDCS in chronic migraine: A multiprotocol randomized controlled trial.

OBJECTIVE: Given the prevalence and complicated pathophysiology of migraine, unknown or varied mechanisms of action of available monotherapies or add-on therapies, and their broad range of adverse effects, it is imperative to manage migraine symptoms using a non-invasive, multifunctional, and alternate monotherapy with no negative impacts. METHODS: We used a single-blind, randomized, sham-controlled design with baseline, post-test, and 24-weeks follow-up measurements to assess the efficacy of transcranial Direct Current Stimulation (tDCS) in chronic migraine. A total of 150 participants were randomly assigned to the five groups (i.e., allocation ratio of 1:1:1:1:1). Each group received tDCS-intervention for 11 consecutive-weeks (25 sessions; each session = two consecutive montages; each montage = a 20 min duration, 2000 µA intensity). RESULTS: The multivariate analysis of variance showed significant (p <.05) reductions in chronic migraine symptoms in the four intervention groups. Compared with the sham (η2 < 0.18) and other protocols (two = Î·2 > 0.42; three = Î·2 > 0.40; four = Î·2 > 0.51), protocol one [l. anode at the right ventrolateral prefrontal cortices, cathode at the left dorsomedial and superior frontal gyrus-first montage; anode at the right primary motor area, cathode at the medial crosstalk of hemispheres-second montage] showed a larger effect size (η2 > 0.59) in the present trial. CONCLUSIONS: With the applied protocols of the present trial, tDCS can be used as an effective intervention for the prophylactic and therapeutic treatment of chronic migraine. However, while the second protocol was the least effective, the first was the most effective at reducing migraine symptoms. SIGNIFICANCE: To our knowledge, the present trial is the first study to cover the gaps of the earlier ones, including the parameters like the site of stimulation, electrode range distribution and field intensity, number of sessions, session design, and sample size.

The ADORA2A TT Genotype Is Associated with Anti-Inflammatory Effects of Caffeine in Response to Resistance Exercise and Habitual Coffee Intake.

Caffeine is an adenosine A2A receptor (ADORA2A) antagonist with ergogenic and anti-inflammatory effects. Previous studies have reported that the ADORA2A gene regulates glutamate metabolism and immune responses, with the ADORA2A rs5751876 TT genotype (with high sensitivity to caffeine) showing larger ergogenic effect following caffeine ingestion. We therefore hypothesized that the TT genotype would be associated with greater anti-inflammatory effects of caffeine in response to exercise, and with higher coffee intake in physically active individuals. The aim of the present study was twofold: (1) to investigate the association of the ADORA2A variant with the anti-inflammatory effects of caffeine in response to intense resistance exercise (RE), and (2) to analyze the association of the rs5751876 with coffee intake in physically active individuals (n = 134). Fifteen resistance-trained athletes participated in a randomized, double-blind, placebo-controlled cross-over study, where they consumed 6 mg/kg of caffeine or placebo one hour prior to performing an RE protocol. Blood samples were taken immediately from the arterial vein before, immediately after, and 15 min after RE for the analysis of inflammatory markers myeloperoxidase (MPO) and acetylcholinesterase (AChE). We found that the ADORA2A TT genotype carriers experienced lower exercise-induced inflammatory responses (p < 0.05 for AchE) when compared to the C allele carriers (i.e., CC/CT) one hour following the ingestion of caffeine. Furthermore, the ADORA2A TT genotype was positively associated with coffee intake (p = 0.0143; irrespective of CYP1A2 rs762551 polymorphism). In conclusion, we found that the ADORA2A gene polymorphism is associated with anti-inflammatory effects of caffeine in response to resistance exercise, as well as with habitual coffee intake in physically active individuals.

What are the Effects of Climate Variables on COVID-19 Pandemic? A Systematic Review and Current Update.

The climatological parameters can be different in various geographical locations. Moreover, they have possible impacts on COVID-19 incidence. Therefore, the purpose of this systematic review article was to describe the effects of climatic variables on COVID-19 pandemic in different countries. Systematic literature search was performed in Scopus, ISI Web of Science, and PubMed databases using ("Climate" OR "Climate Change" OR "Global Warming" OR "Global Climate Change" OR "Meteorological Parameters" OR "Temperature" OR "Precipitation" OR "Relative Humidity" OR "Wind Speed" OR "Sunshine" OR "Climate Extremes" OR "Weather Extremes") AND ("COVID" OR "Coronavirus disease 2019" OR "COVID-19" OR "SARS-CoV-2" OR "Novel Coronavirus") keywords. From 5229 articles, 424 were screened and 149 were selected for further analysis. The relationship between meteorological parameters is variable in different geographical locations. The results indicate that among the climatic indicators, the temperature is the most significant factor that influences on COVID-19 pandemic in most countries. Some studies were proved that warm and wet climates can decrease COVID-19 incidence; however, the other studies represented that warm location can be a high risk of COVID-19 incidence. It could be suggested that all climate variables such as temperature, humidity, rainfall, precipitation, solar radiation, ultraviolet index, and wind speed could cause spread of COVID-19. Thus, it is recommended that future studies will survey the role of all meteorological variables and interaction between them on COVID-19 spread in specific small areas such as cities of each country and comparison between them.