Validity of the Adrogué-Madias Formula for the Management of Acute Dysnatremias in Critically Ill Children: A Prospective Multicenter Analysis.

OBJECTIVE: Current conventional formulas do not predict the expected changes in serum sodium after administration of various fluids to correct serum sodium abnormalities. The Adrogué-Madias formula is currently the preferred and widely used fluid prescription for adult patients with dysnatremias, but its therapeutic efficacy has not been validated in pediatric patients. METHODS: In this prospective study, we used the Adrogué-Madias formula for calculating the appropriate rate of various fluids administration to correct serum sodium abnormalities in 7 critically ill children with acute dysnatremias. RESULTS: After administration of various intravenous fluids using the Adrogué-Madias formula, the anticipated as well as the achieved sodium concentrations were almost similar. CONCLUSIONS: This study demonstrates that the use of the Adrogué-Madias quantitative formula allows to calculate the appropriate rate of administration of various fluids. The calculated fluid administration resulted in the subsequent actual laboratory values and clinical changes.

Unpacking Chinese EFL Students' Academic Engagement and Psychological Well-Being: The Roles of Language Teachers' Affective Scaffolding.

Over the past decade, there has appeared a surge of research interest in language learners' academic engagement and psychological well-being as important factors in improving the quality of education. However, research on the roles of English as a foreign language (EFL) teachers' affective scaffolding in enhancing the academic engagement and psychological well-being of their students is relatively scant. Inspired by this gap, the current study aimed to investigate the impact of Chinese EFL teachers' affective scaffolding on their learners' academic engagement and psychological well-being. To this end, a total number of 1968 Chinese EFL learners participated in this questionnaire survey. The results of the study showed that EFL teachers' affective scaffolding positively and significantly predicted students' academic engagement and psychological well-being. More specifically, it was found that teachers' affective scaffolding explained about 73% and 65% of variances in EFL students' academic engagement and psychological well-being. Moreover, it was found that psychological well-being and academic engagement were positively correlated and predicted 56% of each other's variances. In accordance with these findings, educators are recommended to build up a harmonious teacher-student relationship to foster students' psych-emotional development.

Prevalence of reflux nephropathy in Iranian children with solitary kidney: results of a multi-center study.

BACKGROUND: Given the importance of the function of the remnant kidney in children with unilateral renal agenesis and the significance of timely diagnosis and treatment of reflux nephropathy to prevent further damage to the remaining kidney, we aimed to determine the prevalence of reflux nephropathy in this subgroup of pediatric patients. METHODS: In general, 274 children referred to pediatric nephrologists in different parts of Iran were evaluated, of whom 199 had solitary kidney and were included in this cross-sectional study. The reasons for referral included urinary tract infection (UTI), abnormal renal ultrasonography, being symptomatic, and incidental screening. Demographic characteristics, including age and gender were recorded. History of UTI and presence of vesicoureteral reflux (VUR) were evaluated. RESULTS: Of the 274 children evaluated in this study with the mean age (SD) of 4.71 (4.24) years, 199 (72.6%) had solitary kidney. Among these, 118 (59.3%) were male and 81 (60.7%) were female, 21.1% had a history of UTI, and VUR was present in 23.1%. The most common cause of referral was abnormal renal ultrasonography (40.2%), followed by incidental screening (21.1%), being symptomatic (14.1%), and UTI (5.5%). In 116 children (58.3%), the right kidneys and in 83 (41.7%) the left kidneys were absent. Besides, 14.6% of the participants had consanguineous parents and 3% had a family history of solitary kidney. Upon DMSA scan, the single kidney was scarred in 13.1%, of which only 7.5% were associated with VUR. In addition, proteinuria and hematuria were observed in 6.5% and 1.5% of children, respectively. CONCLUSIONS: The prevalence of reflux nephropathy was 7.5% in children with solitary kidney with a male predominance. Given the relatively high prevalence of reflux nephropathy in these children, screening for VUR in the remnant kidney appears to be essential in this population.

Concomitant BK virus infection and visceral Leishmaniasis in a pediatric liver transplant recipient.

BACKGROUND: Solid organ transplant recipients are vulnerable to various unusual infections. Visceral Leishmaniasis (VL) is a protozoal opportunistic infection, which may affect the immune-suppressed hosts and solid organ transplant recipients. The BK virus infection is an evolving challenge in kidney transplant recipients. However, there are very few reports of BK virus (BKV) nephropathy involving the native kidney in liver transplant recipients. To the best of our knowledge, this is the first report of the simultaneous occurrence of these rare infections in a liver transplant recipient. CASE REPORT: The patient was a 9-year-old girl, a case of liver transplantation who presented with the incidental finding of proteinuria, azotemia, and cytopenia. Investigations revealed that she had concomitant BKV nephropathy and visceral leishmaniasis. Both infections were successfully treated. CONCLUSION: BK virus should be considered as a cause of nephropathy in liver transplant recipients. The presenting features of fever, cytopenia, and splenomegaly in a post-transplant patient should remind of unusual infections such as VL other than the common post-transplant conditions.

Acute necrotizing glomerulonephritis associated with COVID-19 infection: report of two pediatric cases.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is thought to cause kidney injury via a variety of mechanisms. The most common reported kidney injury following COVID-19 infection is acute tubular injury (ATI); however, the procoagulant state induced by the virus may also damage the kidneys. CASE-DIAGNOSIS/TREATMENT: Herein, we report two cases of acute necrotizing glomerulonephritis (GN) with fibrinoid necrosis in the context of COVID-19 infection. The one with more chronic features in the kidney biopsy progressed to permanent kidney failure but the second one had an excellent response to glucocorticoid pulse therapy with subsequent normal kidney function at 2-month follow-up. CONCLUSIONS: Both reported cases had an acute presentation of kidney injury with positive nasopharyngeal PCR test for COVID-19. Based on the data review by the researchers, this is the first report of acute necrotizing GN associated with COVID-19 infection.

Effect of immobilization on urine calcium excretion in orthopedic patients with pelvic fracture treated by skin traction.

OBJECTIVES: To determine the effects on urine calcium excretion of immobilization by skin traction in patients with pelvic fracture. METHODS: In a prospective study, a consecutive series of patients with pelvic fracture treated by skin traction were enrolled. Serum (calcium, phosphorous, alkaline phosphatase, sodium, potassium, uric acid, BUN, creatinine) and fasting urine calcium, creatinine, sodium, potassium and uric acid were checked within 48 hours of hospitalization and at 7, 14 and 21 days of immobilization and then after 3 months of mobilization. Trends in changes of variables were recorded. RESULTS: Fifty five patients were enrolled in this study; they were 45 (81.8%) males and 10 (18.2%) females with a mean age 19.4 ± 12.7 years. We found that serum levels of calcium (p = 0.004), phosphorous (p = 0.047) and alkaline phosphatase (p = 0.001) increased significantly during the 3 weeks of immobilization. In the same way, urine calcium/ urine creatinine ratio increased significantly in the study period (p = 0.004). No symptomatic renal stone formation was observed during the study period. CONCLUSIONS: Immobilization even in short term causes hypercalciuria in orthopedic patients. Although it is transient and improves with subsequent mobilization, it is needed to be considered specifically by the team caring for this group of patients.

Exercise test in pediatric renal transplant recipients and its relationship with their cardiac function.

Pediatric kidney transplant recipients are at increased risk of CVD. Exercise test is a good method to evaluate exercise capacity, cardiorespiratory fitness, and risk of potential CVDs. The aim of this study was to assess the exercise capacity in this population and determine its relationship with their cardiac function using conventional and tissue Doppler echocardiography. Exercise test, conventional and tissue Doppler echocardiography were performed on 44 kidney transplant children (age ranging 11-20, 59% male) with acceptable renal function, and the results were compared with their normal healthy counterparts. Our transplant patients achieved significantly lower maximal heart rate, maximal heart rate ratio, total energy expenditure during the exercise, and maximal O2 consumption (Max VO2 ) than the normal group (p < 0.05). No correlation was found between hemoglobin (Hb) level, dialysis duration, kidney function, and the exercise test parameters. Kidney transplant patients had preserved systolic despite diminished diastolic cardiac function compared to the normal children. Our pediatric renal transplant recipients had severely impaired diastolic dysfunction and significantly reduced MaxVO2 compared with their healthy counterparts. No correlation was found between MaxVO2 and measured indices of systolic and diastolic cardiac function.

The Interrelationship Between Chinese English as a Foreign Language Teachers' Immediacy and Clarity With Learners' Boredom.

Since boredom significantly contributes to diminished motivation among learners of English as a Foreign Language (EFL), there is a need to identify factors that influence boredom. Amidst various elements that can precipitate students' boredom, educational-related concepts have garnered particular attention, with the learning environment emerging as a chief focal point due to its consequential importance to learners. Specifically, the role of teachers' clarity and immediacy in manipulating learners' performance, enthusiasm, and involvement has been widely recognized. Consequently, in this study, we scrutinized the impact of EFL teachers' immediacy and clarity in mitigating learners' boredom. To this end, we collected data from 383 Chinese students through the administration of three scales measuring their perceptions of teacher clarity, teacher immediacy, and learners' boredom. We identified significant associations between teachers' clarity and immediacy and learners' boredom. In Structural Equation Modeling (SEM) analysis, both teacher immediacy and clarity were robust predictors of students' boredom, with about 48% of the variance in students' boredom accounted for by teachers' immediacy, and 53% of this variance attributed to teachers' clarity. We elaborate upon the implications of these findings in our discussion.

On the Role of Academic Buoyancy and Self-Efficacy in Predicting Teachers' Work Engagement: A Case of Chinese English as a Foreign Language Teachers.

A plethora of scientific evidence has pinpointed that teaching English as a foreign or second language (EFL) is difficult, challenging, and emotionally burdensome. Nevertheless, most English language teachers remain committed to the teaching profession and actively engage in the instructional environment. This has inspired several scholars worldwide to explore what personal, emotional, and psychological factors motivate English language teachers to engage enthusiastically in their workplace. While a large body of studies have to date examined the personal, emotional, and psychological predictors of English language teachers' work engagement, to our knowledge, no inquiry has investigated the role of academic buoyancy and self-efficacy in predicting EFL teachers' work engagement. Furthermore, the potential impact of demographic variables on the interplay between EFL teachers' academic buoyancy, self-efficacy, and work engagement has been disregarded. To bridge this gap, we examined the interplay of these three constructs among Chinese EFL teachers. To do so, we administered three pre-designed questionnaires to 242 EFL teachers working in Chinese schools and universities. The collected data were then analyzed using structural equation modeling (SEM). The outcomes of SEM divulged positive and strong relationships between Chinese EFL teachers' academic buoyancy, self-efficacy, and work engagement. The SEM results also indicated that academic buoyancy and self-efficacy could strongly and favorably predict Chinese EFL teachers' work engagement. Additionally, the study outcomes disclosed that demographic variables, including gender, educational degree, and teaching experience, directly impacted the interplay between Chinese EFL teachers' academic buoyancy, self-efficacy, and work engagement. These results may have significant implications for English teachers, teacher trainers, and educational principals.

Spinacia Oleracea: Exploring the Therapeutic Potential in Persian Medicine and Modern Pharmacology.

BACKGROUND: Spinach is a widely cultivated dark leafy vegetable highly regarded for its medicinal properties in traditional Persian medicine. It is rich in vitamins, minerals, flavonoids, carotenoids, and other bioactive compounds, and this review aims to explore the historical applications of spinach in Persian medicine and juxtapose them with current scientific evidence. Despite its historical significance, there remains a need to comprehensively evaluate and integrate traditional knowledge with modern research on the therapeutic benefits of spinach. METHODS: To achieve this, a comprehensive search was conducted in Persian medicine references and scientific databases to gather information on the traditional uses, chemical composition, and pharmacological effects of spinach. Studies that met the inclusion criteria were meticulously categorized, and relevant data were analyzed to draw insightful comparisons. RESULTS: Persian medicine describes spinach as a nutrient-rich, laxative, and fast-digesting agent with therapeutic effects on inflammation, lung diseases, back pain, sore throats, jaundice, urinary disorders, joint pain, eye inflammation, insomnia, dementia, and more. Modern studies have substantially corroborated these traditional uses, revealing that spinach possesses antioxidant, anti-inflammatory, anti-cancer, blood sugar-lowering, lipid-lowering, anti-obesity, neurological, ocular, and musculoskeletal effects. CONCLUSION: Spinach exhibits a wide range of beneficial effects on various health conditions. Its widespread availability, low cost, and exceptional nutritional richness position it as a promising candidate for further investigation. Future studies should explore the clinical effectiveness of spinach in various diseases, while taking into consideration the principles emphasized in Persian medicine to guide research and inform therapeutic strategies.

The Impact of Altruistic Teaching on English as a Foreign Language (EFL) Learners' Emotion Regulation: An Intervention Study.

The second language acquisition (SLA) field has recently seen heightened interest in the study and application of positive psychology (PP). Emotion regulation is one of the concepts that has been stressed in PP. Several studies in PP have delved into how controlling one's emotions improves second language learning/teaching. One of the concepts that has slipped the minds of researchers in the field is altruistic teaching. Unlike egocentric acts, altruistic teaching acts are performed to improve others' well-being. Despite their importance in causing positive emotional effects, no study has investigated the impact of altruistic teaching acts on learners' emotion regulation. To bridge this gap, the present study sought to investigate the effect of learners' altruistic teaching on their emotion regulation. The study followed a sequential explanatory comparison group pre-test-post-test design. One hundred forty-one English as a Foreign Language (EFL) learners were recruited for this intervention study and were divided into experimental and control groups. Learners in the experimental group performed altruistic teaching by teaching their peers how to write essays in English, whereas learners in the control group did group work tasks on English essay writing. The results of independent-sample t-tests and repeated-measures ANOVA showed that altruistic teaching significantly impacts EFL learners' emotion regulation. The results of qualitative data pointed to five themes, including enjoyment, self-esteem, bonding, devotion, and progress. Overall, the results suggested that altruistic teaching impacts learners' emotion regulation by enhancing their enjoyment, self-esteem, bonding, devotion, and progress. The paper has theoretical and pedagogical implications for SLA research and practice.

Relationship between H. pylori infection and some other risk factors in the incidence and recurrence of idiopathic nephrotic syndrome in children.

Background: Idiopathic nephrotic syndrome (INS) is one of the chronic diseases in children and it is important to identify its related factors. The present study aimed at investigating the relationship between H. pylori infection and the incidence and recurrence of idiopathic nephrotic syndrome in children. Methods: The total number of case participants was 40 and the total number of control participants was 41. Based on the number of cases of nephrotic syndrome (NS), the same number of healthy children of the same age and gender were selected as the control group. The information and data collected include demographic characteristics of patients, duration of disease, number of recurrences, blood pressure and blood excretion in urine, height, and weight, and presence of gastrointestinal symptoms on the checklist. The data were entered into SPSS and analyzed at a significance level of 05. Results: From 81 participants in the study, 11 (13.75%) cases were H. pylori positive, of whom 7 (17.5%) cases were in the control group and 4 (10%) cases were in the patients' group. There was no significant difference between the two groups in terms of H. pylori infection rate (P = 0.863). Moreover, there were no significant differences between the patients suffering from the nephrotic syndrome in terms of height, weight, blood pressure, hematuria, duration and recurrence of the disease (p>0.05). Conclusion: According to the evaluations performed in the present study, there was no relationship between low birth weight, blood pressure, disease duration, and disease recurrence with NS.

Positioning an Agenda on a Loving Pedagogy in Second Language Acquisition: Conceptualization, Practice, and Research.

Second/foreign language teaching has been found as one of the most emotional professions worldwide. To generate optimal academic outcomes and run an effective education, teachers and students' emotions and feelings must be positively cared for. Given the significance of emotions in L2 education, many studies have followed positive psychology (PP) and examined various positive constructs. Nevertheless, love, as a PP variable, has been ignored in education due to its cultural/religious sensitivities. Trying to dispel the myths, recently, a new trend called a "loving pedagogy" has started to find itself a place in second language acquisition (SLA) research and practice. Yet, proposing a model of its application and an agenda for its research has been overlooked by scholars in this domain. Motivated by this lacuna, this research article provided the conceptualization, definitions, research bases, practical models, and implications of a loving pedagogy for SLA practitioners and future researchers.

Graft and Patient Survival Rate among Iranian Pediatric Recipients of Kidney Transplantation: A Systematic Review and Meta-Analysis.

Background: The End Stage Renal Disease (ESRD) is irreversible impairment of renal function, to the extent that the patient becomes permanently dependent on alternative therapies, especially in children. We aimed to evaluate the graft and patient survival rate among iranian pediatric recipients of kidney transplantation through a systematic review and meta-analysis. Methods: National (SID, MagIran, IranMedex, IranDoc) and international (Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science) databases of, were searched to find studies published electronically from 1985 until Nov 2019. Heterogeneity between the collected studies was determined using the Cochran's test (Q) and I2. Meta-regression was used to investigate the factors affecting statistical heterogeneity in 1, 5, and 10-year survival of kidney transplantation in addition to subgroup analysis based on cities. Results: Ten studies were qualified to enter the meta-analysis. The total participants in the study were 2673 people with an average age of 13.71±3.65 years. In the random-effects model, the survival rate of 1, 3, 5 and 10 yr of kidney transplantation were 91, 88, 81 and 70%, respectively. Conclusion: By providing the documented and comprehensive evidence, can be the basis of many plans, policies, and decisions of various sectors of development. These sectors include the evaluation of treatment programs and health interventions in the pediatric kidney transplantation. The results of the present study can provide an acceptable estimate of the survival rate of transplanted children in Iran and will be useful for planning prevention and treatment programs.

Improving the purification of aqueous solutions by controlling the production of reactive oxygen species in non-thermal plasma; a systematic review.

Treatment with non-thermal plasma is a reliable technology to oxidize chemical impurities that exist in polluted water, wastewater, and leachate, those degradation-resistant and cannot be removed by conventional treatment methods. In this study, the effective factors affecting in the formation ofreactive oxygen species in non-thermal plasma treatment process, as a new advanced oxidation process method explianed. In this manner, all associated manuscripts existed in the main databases including Google Scholar, Science Direct, PubMed, and Open Access Journal Directory from 1990 until 2022 were explored. The utilized keywords were involved non-thermal plasma, Cold plasma, Measurement, •OH, O3 and UV. Overall, 8,813 articles were gathered and based on the relevance titles and abstracts, 18 paper were selected for further reviewing. In several studies, plasma techniques have been used to treat water, wastewater and leachate, but few studies have evaluated the factors influencing the production of ROS species by non-thermal plasma. The non-thermal plasma destroys pollutants by reactive free radicals spices (hydroxyl, hydrogen atoms, etc.) a combination effect of strong electric fields, energetically charged particles, and ultrasound. Some factors such as water vapor, hydraulic retention time, inter-electrode spacing, discharge power density, and aeration of the effluent as well as use of catalyst have direct effect on the reactive oxygen species formation. If these factors controlled within the best ranges, it will promote the oxidizing radical production and system performance. Also, high-energy electrons and oxidizing species produced in the cold plasma system can well degrade most of pollution in water and wastewater.

The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial.

Objectives: Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics. Methods: The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed. Results: The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial. Conclusion: In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

Evaluation of a Polyherbal Formulation on the Management of Migraine Headaches due to Functional Dyspepsia: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.

A holistic concept based on traditional Persian medicine (TPM) describes a headache with a gastrointestinal (GI) origin (gastric-headache). Although the neurological manifestations of this headache are similar to those of other headaches, its etiology is different. Considering its simultaneous effects on the brain and GI system, a formulation was designed based on this concept. This study aimed to determine the safety and efficacy of the designed formulation on migraine headache (MH) associated with functional dyspepsia (FD). A total of 75 diagnosed cases of MH patients with concurrent FD were randomly divided equally into 3 groups: (i) the polyherbal formulation, sodium valproate (VPA), and amitriptyline group, (ii) VPA, amitriptyline, and polyherbal formulation placebo group, and (iii) the polyherbal formulation and VPA placebo group. The primary outcomes, including frequency, duration, and severity of MH attacks, were measured at baseline and weeks 4, 8, and 12. However, secondary outcomes, including the Headache Impact Test 6 (HIT-6) Questionnaire and Parkman's score, were evaluated at baseline and end of treatment. The frequency, duration, and severity of migraine (P < 0.001 for all cases), HIT-6 (P < 0.001 for all cases), and FD (P < 0.001 for all cases) scores at the end of treatment showed a significant decrease in the 3 groups compared to the baseline. However, the differences in those variables between the 3 groups were not significant at the end of the study. The polyherbal formulation alone may improve the symptoms of migraine patients and other groups. This effect could be due to improving digestion and FD in migraine patients.