Cardiac mass as the primary diagnostic clue of Edheim-Chester disease.

Key Clinical Message: We introduced one of the rare causes of intra-cardiac mass, that is, ECD and a new gene mutation (SLC29A3) that is probably related to this disease, and we noted the importance of using several diagnostic methods to rule out other intra-cardiac causes. Abstract: Edheim-Chester disease is a rare histiocytosis affecting multiple organs. The infiltration of lipid-laden histiocytes characterizes the disease. Most patients experience bone involvement; over 50% of cases involve the cardiovascular system and other extra-osseous organs. In this case report, we present the case of a 42-year-old man who complained of shortness of breath and bone pain. During echocardiography, a large, homogenous, and fixed mass was found in the right atrium free wall. Computed tomography and cardiac magnetic resonance imaging revealed an infiltrative mass in the RA with atrioventricular groove involvement but coronary sinus encasement, right coronary artery, and superior vena cava encasement. Abdominal CT scans also reported aortic wall involvement and bilateral renal cortical and perirenal involvement. A kidney biopsy confirmed the infiltration of histiocytes and the diagnosis of ECD. The treatment was initiated for him, and his symptoms improved. In this case report, we express the importance of considering the rare causes of cardiac tumors.

Characteristics, outcome, duration of hospitalization, and cycle threshold of patients with COVID-19 referred to four hospitals in Babol City: a multicenter retrospective observational study on the fourth, fifth, and sixth waves.

BACKGROUND: The aim of the present study was to compare the epidemiological patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections, hospitalizations, deaths, and duration of hospitalization during the fourth, fifth and sixth epidemic waves of coronavirus disease 2019 (COVID-19) in Iran. METHODS: A multicenter retrospective observational study was conducted on hospitalized patients in four hospitals in the Babol district of northern Iran. The study periods were during the fourth, fifth, and sixth waves of the epidemic in Iran, (March 2021 to March 2022). A total of 13,312 patients with suspected COVID-19 were included. Patient demographics, medical history, length of hospital stay, and clinical outcomes were obtained from the hospital information system. Data on the cycle threshold (Ct) and SARS-CoV2 variant were collected for SARS-CoV2-positive cases. RESULTS: The highest number of hospitalized patients was reported during the fifth (Delta) wave (5231; 39.3%), while the lowest number of hospitalized patients was reported during the sixth (Omicron) wave (2143; 16.1%). In total, 6459 (48.5%) out of 13,312 hospitalized patients with suspected COVID-19 had a positive rRT-PCR result. The fifth (Delta) wave had the highest number of SARS-CoV2 rRT-PCR-positive hospitalized patients (3573, 55.3%), while the sixth (Omicron) wave had the lowest number (835, 12.9%). Moreover, 238 (3.7%) patients with laboratory-confirmed COVID-19 died. The hospital mortality rate was 6.8% in the fourth (Alpha) wave, which reduced to 2.7 and 3.5% in the fifth (Delta) and sixth (Omicron) waves, respectively (p < 0.001). CONCLUSIONS: This is the most comprehensive study evaluating the epidemiologic characteristics of laboratory-confirmed SARS-CoV2 cases in Iran during the Alpha, Delta, and Omicron waves. The highest number of SARS-CoV2-positive hospitalized patients was in the fifth wave of COVID-19 (dominance of the Delta variant), while the sixth wave (dominance of the Omicron variant) had the lowest number. Comorbidities were similar, and cardiovascular disease, diabetes, kidney disease, and hypertension were the main risk factors in all waves.

Cardiac lipoma in a young lady.

Key Clinical Message: To confirm the diagnosis of cardiac lipomas, it is crucial to use multimodality imaging and also histopathology examination if the patient underwent surgery. But surgery is not needed in many cases unless there are life-threatening situations. Abstract: Cardiac lipoma is a rare condition which is believed as a benign tumor; here, we want to present a case of young adult lady who came to our hospital complaining of chest pain and diagnosed cardiac mass by echocardiography that underwent cardiac MRI which showed cardiac lipoma and managed conservatively by serial echocardiography.

Estimation of health-related and economic impacts of PM2.5 in Arak, Iran, using BenMAP-CE.

Ambient air quality is one of the most critical threats to human health. In this study, the health and economic benefits of reducing PM2.5 were estimated in the city of Arak during the period of 2017-2019. The concentration data were obtained from the Environmental Protection Organization of Central Province, while the demographic data were obtained from the website of the Iran Statistics Center. The number of premature deaths from all causes, ischemic heart disease, chronic obstructive pulmonary disease, and lung cancer, attributable to PM2.5 pollution was estimated using the Environmental Benefits Mapping and Analysis Program-Comprehensive Version (BenMAP_CE) to limit the guidelines of the World Health Organization. The results showed that improving air quality in 2017, 2018, and 2019 in Arak could prevent the deaths of 729, 654, and 460 people, respectively. The number of years of life lost (YLL) in 2017, 2018, and 2019 was 11383, 10362, and 7260 years, respectively. The total annual economic benefits of reducing the PM2.5 concentration in Arak under the proposed scenarios in 2017, 2018, and 2019 were estimated to be 309,225,507, 262,868,727, and 182,224,053 USD, respectively, using the statistical life method (VSL). Based on the results of this study, there are significant health and economic benefits to reducing PM2.5 concentrations in Arak City. Therefore, planning and adopting control policies to reduce air pollution in this city are necessary.

A Comparison between Single and Double-Dose Intravenous Ketamine Administration in Bipolar Mood Disorder: A Double-Blind Controlled Clinical Trial.

Objective: As glutamatergic system dysfunction is involved in bipolar depression pathophysiology, the glutamate receptor modulators such as Ketamine have been applied as complementary medication for mood stabilizers. While the treatment is currently just the intravenous injection of a single dose, and there is no robust conclusion on Ketamine effectiveness or its side effects in bipolar patients, this study aimed to consider single- and double-dose intravenous injections of Ketamine in bipolar patients compared to the placebo. Method : In a randomized, double-blind controlled clinical trial, 30 patients diagnosed with bipolar I and II disorders according to DSM-IV-TR (SCID-I) were randomly divided into three groups: the first group received an intravenous injection of Ketamine (0.5 mg/kg) and placebo with a three-day interval, the second group received two doses of Ketamine (0.5 mg/kg) in the same interval, and the third group received two placebo injections. Patients were assessed for depression, anxiety, and mania at various time points, including before the injection, 60 minutes after the injection, on the first, third, fifth, seventh, and 14th day, as well as at the end of the first month using the Hamilton Depression Rating Scale, Beck Anxiety Inventory, and Young Mania Scale, respectively. Data were analyzed using ANOVA and Repeated measure tests. Results: The mean age of patients was 36.8 ± 7.9 years, with 18 females (60%) and 12 (40%) males. Depression and anxiety showed significant differences in both the single- and double-dose Ketamine groups over time (P < 0.01). Moreover, mania displayed significant changes during the study time in the single- and double-dose Ketamine groups, as well as the in the control group. However, during the study time, there were no significant differences observed in depression, anxiety, and mania among the three groups (P = 0.198, P = 0.416, and P = 0.540, respectively). Patients did not indicate any side effects during the study. Conclusion: Intravenous Ketamine administration may relieve depressive manifestations in bipolar patients. The findings suggest that a double dose of Ketamine does not lead to greater improvement than a single dose.

Lead (Pb) deposition onto new and biofilm-laden potable water pipes.

Heavy metals' interactions with plumbing materials are complicated due to the differential formation of biofilms within pipes that can modulate, transform, and/or sequester heavy metals. This research aims to elucidate the mechanistic role of biofilm presence on Lead (Pb) accumulation onto crosslinked polyethylene (PEX-A), high-density polyethylene (HDPE), and copper potable water pipes. For this purpose, biofilms were grown on new pipes for three months. Five-day Pb exposure experiments were conducted to examine the kinetics of Pb accumulation onto the new and biofilm-laden pipes. Additionally, the influence of Pb initial concentration on the rate of its accumulation onto the pipes was examined. The results revealed greater biofilm biomass on the PEX-A pipes compared to the copper and HDPE pipes. More negative zeta potential was found for the biofilm-laden plastic pipes compared to the new plastic pipes. After five days of Pb exposure under stagnant conditions, the biofilm-laden PEX-A (980 µg m-2) and HDPE (1170 µg m-2) pipes accumulated more than three times the Pb surface loading compared to the new PEX-A (265 µg m-2) and HDPE pipes (329 µg m-2), respectively. However, under flow conditions, Pb accumulation on biofilm-laden plastic pipes was lower than on the new pipes. Moreover, with increasing the initial Pb concentration, greater rates of Pb surface accumulation were found for the biofilm-laden pipes compared to the new pipes under stagnant conditions. First-order kinetics model best described the Pb accumulation onto both new and biofilm-laden water pipes under both stagnant and flow conditions.

Effects of water chemistry and flow on lead release from plastic pipes versus copper pipes, implications for plumbing decontamination.

Despite being corrosion-resistant, plastic potable water pipes might accumulate heavy metals on their surface if they convey metal-contaminated tap water. This study examined the influence of water pH and flow conditions on lead (Pb) release from new and biofilm-laden potable water pipes to provide insights regarding decontamination. For this purpose, biofilms were grown onto new crosslinked polyethylene (PEX-A), high-density polyethylene (HDPE), and copper pipes for three months. Lead was then deposited onto the new and biofilm-laden pipes through 5 d exposure experiments under flow conditions. After that, lead release experiments were conducted by exposing the lead-accumulated pipes to lead-free synthetic tap water for 5 d, under both stagnant and water flow conditions. The metal accumulation study showed no significant difference in lead uptake by new pipes and their biofilm-laden counterparts under flow conditions. This could be attributed to the detachment of biofilms that have accumulated lead as water flows through the pipes. Water flow conditions significantly influenced the lead release from new and biofilm-laden water pipes. A lower water pH of 5.0 increased the release of lead from plastic pipes into the contact water, compared to pH 6.0 and 7.8. The greatest percentage of lead was released from biofilm-laden HDPE pipes (5.3%, 120 h) compared to biofilm-laden copper pipes (3.9%, 6 h) and PEX-A (3.7%, 120 h) and after exposure to lead-free synthetic tap water at pH 5.0, under stagnant conditions. On the other hand, under water flow conditions, the greatest lead release was found for new PEX-A pipes (4.4%, 120 h), new HDPE pipes (2.7%, 120 h), and biofilm-laden copper pipes (3.7%, 2 h).

Molecular Status of BRAF Mutation in Epithelial Ovarian Cancer: An Analysis of 57 Cases in the Northeast of Iran.

Background & Objective: Epithelial ovarian cancer (EOC) is the most prevalent type of ovarian cancer. Previous studies have elucidated different pathways for the progression of this malignancy. The mutation in the B-Raf proto-oncogene, serine/threonine kinase (BRAF) gene, a member of the MAPK/ERK signaling pathway, plays a role in the development of EOC. The current study aimed to determine the frequency of the BRAF V600E mutation in ovarian serous and mucinous tumors, including borderline and carcinoma subtypes. Methods: A total of 57 formalin-fixed paraffin-embedded samples, including serous borderline tumors (SBTs), low-grade serous carcinomas (LGSCs), high-grade serous carcinomas (HGSCs), mucinous borderline tumors (MBTs), and mucinous carcinomas, and 57 normal ovarian tissues were collected. The BRAF V600E mutation was analyzed using polymerase chain reaction (PCR) and sequencing. Results: While 40% of the SBT harbor BRAF mutation, we found no BRAF mutation in the invasive serous carcinoma (P=0.017). Also, there was only 1 BRAF mutation in MBT and no mutation in mucinous carcinomas. In addition, we found no mutation in the control group. Conclusion: The BRAF mutation is most frequent in borderline tumors but not in invasive serous carcinomas. It seems that 2 different pathways exist for the development of ovarian epithelial neoplasms: one for borderline tumors and the other for high-grade invasive carcinomas. Our study supports this hypothesis. The BRAF mutation is rare in mucinous neoplasms.

Partitioning of heavy metals in sediments and microplastics from stormwater runoff.

Microplastics could act as vehicles for transporting heavy metals from urban environments to water resources via stormwater runoff. Although the transport of heavy metals by sediments has been widely studied, there is a lack of mechanistic understanding of their competition with microplastics (MPs) for heavy metal uptake. Therefore, this study was conducted to examine the partitioning of heavy metals in microplastics and sediments from stormwater runoff. For this purpose, new low density polyethylene (LDPE) pellets were selected as representative MPs, and accelerated UV-B irradiation experiments were conducted for eight weeks to generate photodegraded MPs. The competition of Cu, Zn, and Pb species for the occupation of available surface sites on sediments and new and photodegraded LDPE MPs was examined through 48 h kinetics experiments. Additionally, leaching experiments were conducted to identify the extent of organics released into the contact water by new and photodegraded MPs. Moreover, 24 h metal exposure experiments were conducted to identify the role of initial metal concentrations on their accumulation onto the MPs and sediments. The photodegradation process altered the LDPE MPs' surface chemistry by creating the oxidized carbon functional groups [>CO, >C-O-C<], and it also enhanced their dissolved organic carbon (DOC) leaching into the contact water. The results showed significantly greater levels of Cu, Zn, and Pb accumulations on photodegraded MPs compared to the new MPs in either absence or presence of sediments. Heavy metal uptake by sediments when photodegraded MPs were present was significantly reduced. This might be due to the organic matter leached by photodegraded MPs into the contact water.

Cross-cultural validity of the Pulmonary Embolism Quality of Life questionnaire in the quality of life survey after pulmonary embolism: A Persian-speaking cohort.

Background: The Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire is the first disease-specific scale for assessing the quality of life in patients with a history of pulmonary embolism (PE). Objectives: To assess the cross-cultural validity and reliability of the disease-specific PEmb-QoL questionnaire. Methods: The Persian version was prepared through the forward and backward translation of the English questionnaire. Six months after the diagnosis of acute PE, consecutive Persian-speaking patients were asked to complete the PEmb-QoL, the generic 36-item Short Form (SF-36) questionnaires and undertake a 6-minute walk test (6MWT). Acceptability was assessed via item missing rate, reproducibility by the test-retest method, and internal consistency reliability by Cronbach's α and McDonald's ω coefficients. Convergence validity was assessed using the Spearman rank correlation between scores of PEmb-QoL, SF-36, and 6MWT. The questionnaire structure was evaluated through exploratory factor analysis. Results: Ninety-six patients with a confirmed diagnosis of PE completed the questionnaires. The Persian version of PEmb-QoL had good internal consistency (α = 0.95, 3-factor ω = 0.96), inter-item correlation (0.3-0.62), item-total correlation (0.38-0.71), reproducibility (test-retest ICC with 25 participants = 0.92-0.99), and good discriminant validity. Convergence validity was confirmed by the moderate-to-high correlations between PEmb-QoL and SF-36 scores, and a good correlation between the "limitation in daily activities" dimension of the PEmb-QoL questionnaire and 6MWT results. Exploratory factor analysis suggested a 3-component structure with functional (items 1h, 4b-5d, 6, 8, 9i, and 9j), symptoms (1b-h, 7, and 8), and emotional (5a, 6, and 9a-h) components. Conclusion: The Persian version of the PEmb-QoL questionnaire is valid and reliable for measuring the disease-specific quality of life in patients with PE.

Cumulative Effects of Paraoxon and Leptin on Oxidative Damages in Rat Tissues: Prophylactic and Therapeutic Roles of N-Acetylcysteine.

Exposure to paraoxon (POX) and leptin (LP) could cause an imbalance between oxidants and antioxidants in an organism, which can be prevented by introduction of exogenous antioxidants such as N-acetylcysteine (NAC). The aim of this study was to evaluate synergic or additive effects of administration of exogenous LP plus POX on the antioxidant status, as well as the prophylactic and therapeutic roles of NAC in various rat tissues. Fifty-four male Wistar rats were divided into nine groups treated with different compounds: Control (no treatment), POX (0.7 mg/kg), NAC (160 mg/kg), LP (1 mg/kg), POX+LP, NAC-POX, POX-NAC, NAC-POX+LP, and POX+LP-NAC. In the last five groups, only the order of administered compounds differed. After 24 h, plasma and tissues were sampled and examined. The results showed that administration of POX plus LP significantly increased biochemical indices in plasma and antioxidant enzymes activities and decreased glutathione content in the liver, erythrocytes, brain, kidney, and heart. In addition, cholinesterase and paraoxonase 1 activities in the POX+LP-treated group were decreased and malondialdehyde level was increased in the liver, erythrocytes, and brain. However, administration of NAC rectified induced changes although not to the same extent. Our study suggests that POX or LP administration engage the oxidative stress system per se; however, their combination did not produce significantly greater effects. Moreover, both prophylactic and therapeutic treatments of rats with NAC supported the antioxidant defense against oxidative damage in tissues, most probably through both its free radical scavenging ability and maintaining intracellular GSH levels. It can therefore be suggested that NAC has particularly protective effects against POX or/and LP toxicity.

Post-Pulmonary Embolism Impairment Six Months after Acute Pulmonary Embolism: A Prospective Registry.

BACKGROUND: Little evidence is available on post-pulmonary embolism impairment (PPEI), a recently defined complication of pulmonary embolism (PE) encompassing dysfunctional clinical and imaging parameters. In the present study, we sought to evaluate its frequency with a focus on the main components. METHODS: In this prospective registry, we included patients with a confirmed diagnosis of acute PE and focused on those with initial right ventricular (RV) dysfunction. Their baseline, pre-discharge, and 6 month follow-up clinical and imaging characteristics were recorded. The main study outcomes were incomplete RV functional recovery, exercise capacity limitations (based on the 6 minute walk test), and their combination, which defines PPEI, within six months of acute PE. RESULTS: Of 170 consecutive patients with a confirmed diagnosis of acute PE, 123 accepted to participate in the follow-up study, of whom 87 had initial RV dysfunction. The 6 month rates of incomplete RV functional recovery, signs of an intermediate-to-high echocardiographic probability of PH, and exercise limitations were observed in 58.6, 32.1, and 45.9%, respectively. A total of 22 (25.2%; 95% CI 15.5-34.4%) patients had PPEI. The RV/LV ratio and the fractional area change on discharge after acute PE were more often impaired among patients with incomplete RV recovery, exercise limitations, and a high probability of PH at 6 months. In contrast, an initial impaired RV diastolic function indices appeared to characterize patients with a limited exercise capacity at 6 months. DISCUSSION: PPEI affects one fourth of patients surviving acute PE with half of them presenting with RV dysfunction or exercise limitations.

Antioxidant activity in off and on-pump coronary artery bypass grafting and valve replacement surgery.

OBJECTIVES: Cardiac surgeries initiate oxidative stress, increasing organ dysfunction development and mortality. The present study investigated the superoxide dismutase (SOD) activity, as an antioxidant enzyme, in patients undergoing coronary artery bypass (CABG) and heart valve replacement surgeries. METHODS: A prospective study was performed on patients with proven coronary artery disease (CAD) or valvular heart disease (VHD) candidates for on- or off-pump CABG and valve replacement surgery. Serum SOD activity was measured preoperatively, at 24 h postoperatively, and at the time of discharge. In addition, echocardiography was performed before surgery and at discharge. RESULTS: A total of 48, 51, and 47 patients were enrolled in the on-pump, off-pump CABG, and valve replacement groups, respectively. Baseline serum SOD activity showed no significant association with BMI, age, and blood pressure in either CAD or VHD patients. The SOD values decreased at the 24 h postoperative time and then increased at the time of discharge in all groups, except for a slight decrease in the on-pump group. The changes in serum SOD values were not significantly different for the three surgical groups. CONCLUSIONS: The serum SOD activities fell significantly after CABG and valve replacement surgery. Further investigation is emphasized for the role of SOD in oxidative stress after cardiac surgery.

Expression Assessment of the Helicobacter pyloribabA and sabA Genes in Patients with Peptic Ulcer, Duodenal Ulcer and Gastric Cancer.

Helicobacter pylori as a common gastrointestinal (GI) pathogen must possess certain virulence characteristics to colonize the stomach, evade host immune responses, and subsequently induce GI diseases. This research aimed to investigate the expression level of two important genes, the sialic acid-binding adherence (SabA) and the blood group antigen-binding adhesion (BabA) in H. pylori strains isolated from adult patients living in the northern part of Iran, and their association with peptic ulcer disease (PUD) and gastric cancer (GC). This cross-sectional study was carried out on adult patients referring to the GI clinic of the hospitals affiliated to Babol University of Medical Sciences, Iran. New cases diagnosed with gastritis, peptic ulcer or gastric cancer were included. Endoscopic-guided gastric biopsies were examined and H. pylori positive colonies were analyzed to determine the expression of babA and sabA genes, utilizing specific primers and the SYBR Green dye. Among 175 patients with mean age of 51.6±15.6 years, 101 (57.7%) of the individuals tested positive for H. pylori infection. Statistical analysis revealed a significant correlation between sabA (P=0.003) and babA (P=0.002) gene expression and development of PUD and GC. Smoking (P=0.052), gender (P=0.004) and positive babA gene expression (P=0.009) had the greatest association with occurrence of PUD or GC in H. pylori positive patients.  In summary, the presence of the sabA gene in people infected with H. pylori increased the risk of GC compared to gastritis, while, the presence of the babA gene was significantly increased in gastric ulcer patients. Considering the diversity of H. pylori isolates and the varying results observed in different geographical regions, further comprehensive studies are required to evaluate the function of these genes in H. pylori pathogenesis and their relationship with clinical outcomes.

Evaluating the diagnostic value of multi-detector brain CT angiography in diagnosing acute cerebral venous thrombosis.

Cerebral venous sinus thrombosis (CVST) is a rare type of venous thromboembolism mostly affecting young adults. Despite improved imaging studies, the diagnosis is usually delayed by several days. An average diagnostic delay of seven days from the onset of symptoms is still reported for this condition, and it is crucial for radiologists to detect this potentially lethal condition in routine imaging studies. In this study we aimed to investigate the diagnostic value of multi-detector brain CTA in diagnosing acute CVT. We searched our Picture Archiving and Communicating System (PACS) of our tertiary-level academic hospital between March 2016 and March 2019, and collected all patients for whom both contrast-enhanced MRV and brain CTA were acquired at the same admission. A total of 242 patients were found on our PACS database who met our criteria. In the blinded multidetector-row computed tomographic angiography (MDCTA) evaluation, there was a sensitivity of 96.1%, specificity of 98.6% and accuracy of 98.3% for MDCTA in detecting CVST. In the emergency settings, and in centers in which MRI scanners are not available, MDCTA can be used instead of CE-MRV for diagnosis of CSVT with a good sensitivity and specificity.

Changes in serum zinc and copper concentrations in patients with cardiovascular disease following cardiac surgery.

The trace elements copper (Cu) and zinc (Zn) are essential for maintaining oxidative balance, and cardiac surgery is known to provoke an increase in oxidative stress. We investigated the variations in serum Zn and Cu concentrations before and after surgery in patients undergoing on- and off-pump CABG and heart valve replacement. We performed a prospective study on patients undergoing on- or off-pump CABG, or heart valve replacement surgery (48, 51, and 47 patients, respectively). Venous blood samples were obtained, and serum Cu and Zn concentrations were measured preoperatively, 24 h postoperatively, and the time of discharge. In addition, echocardiography was carried out on all patients before surgery and again on the day of discharge. We found the temporal changes in Cu, Zn, and Zn/Cu ratio were significantly different in all three groups of surgery (p < 0.05). In each group, Cu and Zn values and Zn/Cu ratio decreased at the 24-h postoperative time and rose at the discharge time. There were no significant differences between surgery groups in the changes induced in Zn or Cu values (p > 0.05). In conclusion, the concentrations of Cu and Zn were markedly reduced after on- and off-pump CABG and valve replacement surgery. This may suggest that supplementary Zn and Cu administration could be beneficial during open-heart surgeries. However, more long-term studies with more patients are needed to confirm this hypothesis.

The association between patellofemoral alignment and osteoarthritis in magnetic resonance imaging.

Objectives: Osteoarthritis (OA) is the most common joint disease in the world, becoming more prevalent with increasing age, and causes a significant burden on individuals and society. So far, several factors have been identified in association with OA of the knee joint. Age is the most crucial uncontrollable risk factor for OA. There are conflicting results regarding the relationship between patellofemoral joint orientation and OA. This study aims to elucidate the relationship between patellofemoral joint alignment and OA evidence. Material and methods: A total of 277 MRIs performed at Imam Reza Hospital during the first half of 2017 were included. Patients were divided into two groups, under 50 years old and over 50 years old. Femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), tibial tubercle-trochlear groove (TTTG), lateral patellofemoral angle (LPFA), and Insall-Salvati index were measured in axial and sagittal images. The morphology of the patellofemoral articular cartilage was evaluated and the grade of joint damage was determined. P-value < 0.05 was considered as significant. Results: Significant correlations between SA (p-value = 0.01), SD (p-value < 0.001), Insall-Salvati index (p-value < 0.001), LPD (p-value = 0.02) values and OA in patients less than 50 years old were observed. A weak correlation was observed between SD and Insall-Salvati index values with increasing grade of articular cartilage damage (r = 0.21 and r = 0.21, respectively). Conclusions: Patellofemoral joint asymmetry in the younger people was significantly associated with joint cartilage damage and premature patellofemoral joint OA. Joint misalignment by stressing the articular cartilage causes joint cartilage changes that may be congenital or due to bone injuries such as trauma and surgery.

Investigating the sustainability of agricultural plastic products, combined influence of polymer characteristics and environmental conditions on microplastics aging.

The accelerated use of plastic products for agricultural practices has raised global concern regarding their negative impacts on soil health. This study aims to better understand the combined influence of polymer characteristics and environmental conditions on microplastic photodegradation within the agricultural soil system. For this purpose, the photodegradation behavior of low density polyethylene (LDPE) microplastics was studied through accelerated UVA radiation experiments under two different relative humidity (RH10 and RH70) and soil deposition conditions. The variations of plastics' surface physiochemistry due to the accelerated photodegradation were studied using Attenuated Total Reflectance-Fourier Transform Infrared spectroscopy (ATR-FTIR), X-ray Photoelectron Spectroscopy (XPS), and Field Emission Scanning Electron Microscopy (FE-SEM). The carbonyl and vinyl indices were calculated using the ATR-FTIR information to compare the degree of microplastics' photodegradation. The plastics' bulk characteristics, including the percentage of crystallinity and molecular weight distributions, were examined using the Differential Scanning Calorimetry (DSC) and Gel Permeation Chromatography (GPC). Furthermore, the extent of UVA light interaction with the microplastics was studied by determining spectral quantum yield. The results demonstrated that new LDPE microplastics with a lower molecular weight (Mw = 233 kD) were subjected to a greater extent of photodegradation than those with greater molecular weight (Mw = 515 kD). Elevated relative humidity (RH70) limited the photooxidation process of microplastics and consequently reduced the surface chemistry alterations. Deposition of soil particles with respect to the plastic particles impacted the photodegradation behavior. The microplastics covered by soil particles were not degraded, unlike those deposited next to the soil particles. The knowledge developed through this study could encourage the farmers and agricultural stakeholders to apply more efficient practices to remove plastic residuals after harvesting and conduct proper plastic disposal practices to protect soil health.

A Large Retrospective Study of Epidemiological Characteristics of COVID-19 Patients in the North of Iran: Association between SARS-CoV-2 RT-PCR Ct Values with Demographic Data.

Objectives: To avoid worsening from mild, moderate, and severe diseases and to reduce mortality, it is necessary to identify the subpopulation that is more vulnerable to the development of COVID-19 unfavorable consequences. This study aims to investigate the demographic information, prevalence rates of common comorbidities among negative and positive real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) patients, and the association between SARS-CoV-2 cycle threshold (Ct) at hospital admission, demographic data, and outcomes of the patients in a large population in Northern Iran. Methods: This large retrospective cross-sectional study was performed from 7 March to 20 December 2020. Demographic data, including gender, age, underlying diseases, clinical outcomes, and Ct values, were obtained from 8,318 cases suspected of COVID-19, who were admitted to four teaching hospitals affiliated to Babol University of Medical Sciences (MUBABOL), in the north of Iran. Results: Since 7 March 2020, the data were collected from 8,318 cases suspected of COVID-19 (48.5% female and 51.5% male) with a mean age of 53 ± 25.3 years. Among 8,318 suspected COVID-19 patients, 3,250 (39.1%) had a positive rRT-PCR result; 1,632 (50.2%) patients were male and 335 (10.3%) patients died during their hospital stay. The distribution of positive rRT-PCR revealed that most patients (464 (75.7%)) had a Ct between 21 and 30 (Group B). Conclusion: Elderly patients, lower Ct, patients having at least one comorbidity, and male cases were significantly associated with increased risk for COVID-19-related mortality. Moreover, mortality was significantly higher in patients with diabetes, kidney disease, and respiratory disease.

Higher viral load of Epstein-Barr virus in gastric cancer compared with non-cancerous gastroduodenal tissues.

Introduction: Epstein-Barr Virus (EBV)-associated gastric cancer is a distinct molecular subtype of gastrointestinal carcinomas as defined by the Cancer Genome Atlas. Methods: In the present study 237 samples from Iranian patients diagnosed with gastric cancer and gastroduodenal disease were retrospectively examined for EBV infection by quantitative Real-Time PCR. Results: Of the 237 samples tested, EBV DNA was detected in 37 samples (15.6%), in 13 of the 81 gastric cancer cases (16%), and 24 of the 156 non-cancerous samples (15.4%). The EBV infection rate was found higher in patients with gastric ulcer (35%) and duodenal ulcer (21.9%) compared to patients with gastric cancer (16%) and gastritis (19.6%). The EBV-encoded small RNA (EBER) copy number in the gastric cancer group (mean = 2.14×10-1 with range of 2.14×10-2 to 4.10×10-1 copies/ cell) was higher than gastroduodenal diseases group (mean = 1.39×10-2 with range 1.11×10-3 to 2.35×10-2 copies/ cell), and this difference was statistically significant (P >0.001). Conclusion: The higher number of copies of EBV-EBER in the gastric cancer group compared to the non-cancer group confirmed the possible role of EBV in inducing cancer.