Proposal of graphene band-gap enhancement via heterostructure of graphene with boron nitride in vertical stacking scheme.

Since the discovery of graphene and other two-dimensional (2D) materials in recent years, heterostructures composed of multilayered 2D materials have attracted immense research interest. This is mainly due to the potential prospects of the heterostructures for basic and applied applications related to the emerging technology of energy-efficient optoelectronic devices. In particular, heterostructures of graphene with 2D materials of similar structure have been proposed to open up the band gap to tune the transport properties of graphene for a variety of technological applications. In this paper, we propose a heterostructure scheme of band-gap engineering and modification of the electronic band structure of graphene via the heterostructure of graphene-boron nitride (GBN) based on first-principles calculations. For a comparative analysis of the properties of the proposed GBN heterostructure, we employ Kohn-Sham density functional theory (DFT) using local density and generalized gradient approximations within Perdew-Burke-Ernzehof parameterization. To account for weak interlayer van der Waals interactions, we employ the semi-empirical dispersion-corrected DFT scheme of Grimme, called the DFT-D2 approximation. In the vertical stacking arrangement of boron-nitride-doped graphene with hexagonal boron nitride, we predict a band-gap opening of 1.12 eV which, to our knowledge, is the largest value attained for this kind of system. The impact of interlayer spacing on the band-gap opening arising from the interlayer coupling effect is also analyzed. The band-gap enhancement supports the widely proposed promise of GBN heterostructure in design of high-performance optoelectronic devices such as field-effect transistors for potential applications.

Probabilistic health risk assessment of occupational exposure to isoflurane and sevoflurane in the operating room.

Risk assessment is an important tool in predicting the possible risk to health. It heightens awareness by estimating the probability of adverse health effects in humans who are exposed to chemicals in the course of their work. Therefore, the present work aims to determine the occupational exposure of operating room staff to the volatile anesthetic gases, isoflurane and sevoflurane, and estimates non-cancer risk using the United States Environmental Protection Agency method. Air samples from the breathing zone of staff members were collected using the Occupational Safety and Health Administration Method 103 and analyzed using gas chromatography-mass spectroscopy. The results indicate that the measured concentrations of isoflurane and sevoflurane are below the National Institute of Occupational Safety and Health standard (2 ppm) for technicians and nurses, but not for anesthesiologists and surgeons. Moreover, the estimated non-cancer risk due to isoflurane is above the acceptable value for anesthesiologists (but acceptable for other occupational categories). A sensitivity analysis indicates that exposure time has the most effect on calculated risk (53.4%). Occupational exposure to anesthetic gases may endanger the health of operating room personnel. Therefore, control measures, such as daily testing of anesthetic devices, ensuring the effectiveness of ventilation systems, advanced scavenging methods, and regular training of staff are highly recommended.

Health risk assessment of occupational exposure to heavy metals in a steel casting unit of a steelmaking plant using Monte-Carlo simulation technique.

The present work aimed to evaluate the health risks of occupational exposure to heavy metals in a steel casting unit of a steel plant. To determine occupational exposure to heavy metals, personal air samples were taken from the workers' breathing zones using the National Institute for Occupational Safety and Health method. Noncancer and cancer risks due to the measured metals were calculated according to the United States Environmental Protection Agency procedures. The results indicated that the noncancer risks owing to occupational exposure to lead (Pb) and manganese were higher than the recommended value in most of the workstations. The estimated cancer risk of Pb was also higher than the allowable value. Moreover, the results of sensitivity analysis indicated that the concentration, inhalation rate, and exposure duration were the most influencing variables contributing to the calculated risks. It was thus concluded that the present control measures were not adequate and further improvements were required for reducing the exposure levels.

Detection of Intestinal Tissue Perfusion by Real-Time Breath Methane Analysis in Rat and Pig Models of Mesenteric Circulatory Distress.

OBJECTIVES: Methane (CH4) breath test is an established diagnostic method for gastrointestinal functional disorders. Our aim was to explore the possible link between splanchnic circulatory changes and exhaled CH4 in an attempt to recognize intestinal perfusion failure. DESIGN: Randomized, controlled in vivo animal study. SETTING: University research laboratory. SUBJECTS: Anesthetized, ventilated Sprague-Dawley rats (280 ± 30 g) and Vietnamese minipigs (31 ± 7 kg). INTERVENTIONS: In the first series, CH4 was administered intraluminally into the ileum before 45 minutes mesenteric ischemia or before reperfusion in non-CH4 producer rats to test the appearance of the gas in the exhaled air. In the porcine experiments, the superior mesenteric artery was gradually obstructed during consecutive, 30-minute flow reductions and 30-minute reperfusions achieving complete occlusion after four cycles (n = 6), or nonocclusive mesenteric ischemia was induced by pericardial tamponade (n = 12), which decreased superior mesenteric artery flow from 351 ± 55 to 182 ± 67 mL/min and mean arterial pressure from 96.7 ± 18.2 to 41.5 ± 4.6 mm Hg for 60 minutes. MEASUREMENTS AND MAIN RESULTS: Macrohemodynamics were monitored continuously; RBC velocity of the ileal serosa or mucosa was recorded by intravital videomicroscopy. The concentration of exhaled CH4 was measured online simultaneously with high-sensitivity photoacoustic spectroscopy. The intestinal flow changes during the occlusion-reperfusion phases were accompanied by parallel changes in breath CH4 output. Also in cardiac tamponade-induced nonocclusive intestinal ischemia, the superior mesenteric artery flow and RBC velocity correlated significantly with parallel changes in CH4 concentration in the exhaled air (Pearson's r = 0.669 or r = 0.632, respectively). CONCLUSIONS: we report a combination of in vivo experimental data on a close association of an exhaled endogenous gas with acute mesenteric macro- and microvascular flow changes. Breath CH4 analysis may offer a noninvasive approach to follow the status of the splanchnic circulation.

Probabilistic risk assessment of occupational exposure to volatile organic compounds in the rendering plant of a poultry slaughterhouse.

In this study, occupational exposure to volatile organic compounds (VOCs) in the rendering plant of poultry slaughterhouse was determined and subsequently, carcinogen and non-carcinogenic risks were assessed using the US Environmental Protection Agency (USEPA). National Institute for Occupational Safety and Health (NIOSH) methods of 1501 and 1600 were used to measure VOCs in the breathing zone of the workers. Samples were analyzed by GC/MS. Carcinogenic and non-carcinogenic risks and sensitivity analysis were carried out using Monte Carlo simulations technique. The concentration of benzene and CS2 was higher than the occupational exposure limits (OEL). The hazard quotient (HQ) values for all measured compounds was more than 1, which indicating the high potential for non-carcinogenic risks. Furthermore, the calculated Lifetime Cancer Risks (LCR) for carcinogenic compounds revealed that cancer risk due to benzene is higher than the maximum acceptable level provided by USEPA (10-6). Based on the sensitivity analysis, the concentration and exposure frequency are the most important variable influencing both carcinogen and non-carcinogenic risks. Therefore, the concentration levels of the VOCs and exposure frequency should be controlled using engineering control measures.

Effects of short- and long-term regular exercise on reproductive tissue in streptozotocin-induced diabetic male Wistar rats.

OBJECTIVE: Reproductive disorders are one of the complications of diabetes mellitus. Since conflicting results have been obtained from different studies, which examined serum levels of cytokines in patients with diabetes, and considering the fact that the origin of cytokines cannot be accurately determined from their serum changes, attempts were made in the present study to study histological changes and testicular tissue levels of TNF-α and IL-1 in rats treated with exercise. Considering the effects of exercise in reducing blood sugar level and its complications, two types of short-term and long-term regular exercises were also considered to evaluate their effects on male reproductive tissues. METHODS: In this study, 60 male rats with the weight range of 250±50 g were used and were randomly divided into six groups (10 rats each). Healthy groups included sedentary control group, and groups treated with two and eight weeks of exercise. Rats with type 1 diabetes (induced by streptozotocin) included sedentary control group, groups treated with two and eight weeks of exercise (six groups). All groups were evaluated in terms of testicular tissue levels of TNF-α and IL-1 using ELISA and the histometry of spermatogonia, primary spermatocytes, Sertoli cells, epithelial thickness, diameter of veins, and thickness of the seminiferous tubule. RESULTS: Histological changes resulting from diabetes, particularly in the diameter of testicular veins and a number of cells, including Sertoli, highlights the important fact that tissue perfusion in patients with diabetes is especially crucial, in a way that exercise proved useful for tissue structures by offsetting this complication. Measurement of the cytokines IL-1 and TNF-α in the current study showed that perfusion problems are more important in diabetic complications than inflammatory factors. CONCLUSIONS: The main result of this research is recommendation of investigating the tissue of interest for diagnosis of diabetes complications, measuring inflammatory mediators of tissue rather than evaluating their serum concentrations, and focusing on vascular complications as a major complication of diabetes. Furthermore, regular exercise could help improve the function of reproductive organs in healthy groups and prevent diabetes infertility complications to an acceptable degree in diabetic groups.

Kinetics of biogas production and chemical oxygen demand removal from compost leachate in an anaerobic migrating blanket reactor.

In this study, laboratory anaerobic migrating blanket reactor (AMBR) with four units was used to reduce and remove COD leachate of composting process; it was also used to determine the kinetic coefficients of COD removal and biogas and methane gas production in several different OLRs. The maximum concentration of organic matter entering the reactor was 100,000 mg/L and the reactor was under operation for 319 days. The results showed that the COD removal efficiency of AMBR in all concentrations of substrate entering the reactor was above 80%. First-order model and Stover-Kincannon were used to investigate the kinetics of COD removal via AMBR biological process; in addition, the two models of Modified Stover-Kincannon and Van der Meer and Heertjes were used to check the kinetic constants of biogas and methane gas production. The results obtained from the models showed that the experimental data on COD removal were more consistent with the results obtained from Stover-Kincannon model (R2 = 0.999) rather than with the First-order model (R2 = 0.926). Kinetic constants calculated via Stover-Kincannon model were as follows: saturation value constant (KB) and maximum utilization rate constants (Umax), respectively, were 208,600 mg/L d and 172,400 mg/L d. We investigated the linear relationship between the experimental data and the values predicted by the models; as compared with the values predicted by the First-order model, the values predicted by Stover-Kincannon model were closer to the values measured via experiments. Based on the results of the evaluation of kinetic coefficients of Stover-Kincannon model, with the migration of the leachate flow from unit 1 to unit 4, Umax value has fallen significantly. The values of maximum specific biogas production rate (Gmax) and proportionality constant (GB) obtained from the Stover-Kincannon model, respectively, were 35,714 ml/L d and 42.85 (dimensionless) and value of kinetic constant of Van der Meer and Heertjes (ksg) was 0.0473 ml CH4/mg COD.

Pyrethroid resistance in Iranian field populations of Rhipicephalus (Boophilus) annulatus.

Resistance to acaricides in ticks is becoming increasingly widespread throughout the world; therefore, tick control requires resistance monitoring for each tick species. The aims of this study were to monitor the susceptibility status of the cattle tick, Rhipicephalus (Boophilus) annulatus (Acari: Ixodidae), against pyrethroid acaricides from Mazandaran Province, northern Iran, and where resistance was evident, and establish the possible underlying mechanisms. Fully engorged adult R. (B.) annulatus females collected on cattle from Mazandaran Province. Twenty-nine tick populations produced 10-18days old larvae and bioassayed with cypermethrin and λ-cyhalothrin by larval packet test and the levels of detoxification enzymes were measured. Population AM-29 had a maximum resistance ratio (RR99) of 20.21 to cypermethrin and 53.57% of the tick populations were resistant at LC99 level. With λ-cyhalothrin, 17.86% of the tick populations were resistant and AM-29 was the most resistant population with RR99=4.54. AM-29 also showed significant elevation of cytochrome P450 monooxygenase (P450) and glutathione S-transferase (GST) (2.76- and 2.39-fold, respectively) (P<0.001). Rhipicephalus (Boophilus) annulatus showed resistance to pyrethroid insecticides with elevated levels of P450, GST and para-nitrophenyl acetate (p-NPA) in resistant populations. Operational failure was noted in controlling R. (B.) annulatus by pyrethroid insecticides, therefore alternative pest management measures should be adopted in Iran. For the first time, a new estimate of insecticide resistance based on effective dose recommended by the pesticide manufacturer termed Operational Dose Ratio (ODR) is defined and discussed.

Health-related quality of life questionnaire for polycystic ovary syndrome (PCOSQ-50): development and psychometric properties.

PURPOSE: The determinants of the health-related quality of life of women with polycystic ovary syndrome are not fully understood. The aim of this study was to develop a comprehensive instrument to assess the health-related quality of life of Iranian women with PCOS and to assess its psychometric properties. METHODS: We used a mixed-method, sequential, exploratory design including both qualitative [in-depth interview to define the components of health-related quality of life questionnaire (PCOSQ)] and quantitative approaches (to assess the psychometric properties of PCOSQ). RESULTS: A preliminary questionnaire was developed including 147 items which emerged from the qualitative phase of the study. Considering the optimum cutoff points for content validity ratio (CVR), content validity index (CVI), and impact score, items of the preliminary questionnaire were reduced from 147 to 88 items. Finally, by excluding highly correlated items using the exploratory factor analysis, a 50-item questionnaire was obtained. The Kaiser criteria (eigenvalues >1) and Scree plot tests demonstrated that six factors were optimum with an estimated 47.3 % of variance. Assessment of the psychometric properties of the questionnaire demonstrated a mean CVI = 0.92, CVR = 0.91, Cronbach's alpha for whole questionnaire = 0.88 (0.61-0.88 for subscales), Spearman's correlation coefficients of test-retest = 0.75, and the intra-class correlation coefficient for the PCOS questionnaire subscales ranging from 0.57 to 0.88. Eventually the final questionnaire included 50 items in six domains, 'psychosocial and emotional,' 'fertility,' 'sexual function,' 'obesity and menstrual disorders,' 'hirsutism,' and 'coping' and rated on a 5-point Likert scale. CONCLUSION: The PCOSQ-50 is a valid and reliable instrument for the assessment of quality of life of women with PCOS, capable of assessing some obscure aspects overlooked by previous HRQL questionnaires.

Postoperative Perfluro-N-Octane tamponade for complex retinal detachment surgery.

AIM: To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without sclera buckling for complex rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs) or retinal detachment with extensive proliferative vitreoretinopathy (PVR). METHODS: A prospective study was carried out where in 43 patients (Group 1) PFO was exchanged with silicon oil in the same surgical procedure and in 22 patients (Group 2) PFO was kept for 3 days and then exchanged with silicon oil by a separate surgical procedure. The respective surgeon took the decision whether to exchange PFO on the same day or after 3 days. The patients were followed up for 6 months to analyze the anatomical attachment rates, visual acuity gain, and postoperative complications in both the groups. RESULTS: There were 33 male and 10 female patients in group 1 and 18 male and 4 female patients in group 2. Mean age distribution in group 1 was 38.88 years (SD ± 21.45) and in group 2 was 38.09 years (SD ± 16.36). Mean preoperative best corrected visual acuity in group 1 was 2.02 ± 0.58 and in group 2 was 2.01 ± 0.53 logarithm of the minimum angle of resolution (LogMAR). The LogMAR Visual acuity in group 1 improved to 1.76 ± 0.43 after 1 month (P = 0.01, paired t test) and to 1.62 ± 0.62 after 6 months (P = 0.01, paired T test). This visual acuity in group 2 improved to 1.85 ± 0.42 after 1 month (P = 0.24, paired T test) and 1.90 ± 0.72 after 6 months (P = 0.49, paired T test). There was no difference regarding visual improvement in between two groups after 1 month and 6 months of follow-up (P = 0.125, independent sample T test). The retina was detached in 6 patients (14%) in group 1 and in 7 patients (31%) in group 2 after 6 months of follow-up. There was no statistically significant difference in between two groups regarding final attachment of retina (P = 0.109, Fisher exact test). There was also no significant complication. like increased posterior capsular opacification or glaucoma found after retaining PFO for 3 days. Conclusion: Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs or with extensive PVR. But keeping perfluoro-n-octane for 3 days does not significantly reduce the risk of re-detachment with complex rhegmatogenous retinal detachment cases.

Association between quality of life and religious coping in older people.

AIM: To examine the association between quality of life (QoL) and religious coping in older people living in their own homes. METHOD: A descriptive analytical study was undertaken in Iran with 200 older people aged over 60 living in their own homes who were selected for inclusion by systematic random sampling. Data were collected by use of the Short Form 36 (SF-36) QoL questionnaire and a religious coping questionnaire developed previously by the authors. RESULTS: There was no significant association between QoL and religious coping. However, mental health (r=0.20, P=0.003) and social function (r=0.20, P=0.004) had a significant association with the total score for religious coping. An association between a high level of religious coping and QoL was significant only for the mental health domain of the SF-36 (P=0.04). CONCLUSION: In light of these results, it can be suggested that older people's mental health and social function may be improved by strengthening their religious beliefs. Mental health and social function are associated with other QoL domains and so their promotion may also improve overall QoL.

Performance evaluation of Anaerobic-Aerobic Hybrid Baffled Reactor Coupled with an Anaerobic Filter treating Landfill Leachate.

The Anaerobic Baffled Reactor (ABR) is an effective solution for landfill leachate treatment using an anaerobic fermentation process, which helps to reduce operating costs and sludge volume. To better understand the biological, chemical, and physical processes involved, especially when combining the ABR with an aerobic component, the study aimed to investigate the performance of an Anaerobic-Aerobic Hybrid Baffled Reactor (AABR) that includes an Anaerobic Filter (AF) for treating landfill leachate. This research utilized two glass reactors. The first reactor, designated as AABR-AF, consisted of six independent rectangular glass chambers arranged side by side. The third and sixth chamber designed for aerobic treatment and AF, respectively. The second reactor was used as a control reactor and did not include any aerobic chamber. The highest Removal Efficiencies (REs) for turbidity, COD, BOD, TP, TKN, nitrate, TOC, and TSS in the AABR-AF and ABR-AF were found to be (65.4% and 56.3%), (98.3% and 94.1%), (98.1% and 93.2%), (86.4% and 65%), (89.2% and 76.7%), (81.2% and 64.4%), (88.2% and 79.4%), and (72.4% and 68.5%), respectively. These optimal REs were achieved at an HRT of 48 h and an OLR of 10 kg/m3.d. Also, the highest and the lowest REs in Heavy Metals (HMs) were 89.57% for manganese in AABR-AF and 6.59% for nickel in ABR-AF, in an OLR of 10 kg/m3.d, respectively. The effective removal of Organic Matters (OMs) from landfill leachate using the AABR-AF and ABR-AF was found to be strongly influenced by HRT and OLR. The AABR-AF configuration, featuring a single aerobic chamber in the reactor, exhibited a higher efficiency in removing OMs compared to the ABR-AF configuration.

Cerebral protection in acute type A aortic dissection surgery: a systematic review and meta-analysis.

Background: Acute type A aortic dissection (ATAAD) still challenges physicians and warrants emergent surgical management. Two main methods to reduce cerebrovascular events in ATAAD surgeries are antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). We conducted a systematic review and meta-analysis to compare the outcomes of ACP and RCP methods during the ATAAD surgery. Methods: In this study, we searched the databases until March 29th, 2023. Studies that reported the data for comparison of different types of brain perfusion protection during aortic surgery in patients with ATAAD were included. Results: Twenty-six studies met the eligibility criteria. All studies had a low risk of bias as they were evaluated by the Joanna Briggs Institute (JBI) critical appraisal tool. Eventually, we included 26 studies in the current meta-analysis, and a total of 13,039 patients were evaluated. The calculated risk ratio (RR) for permanent neurologic dysfunction (PND) in ACP and RCP comparison was RR =1.23, 95% confidence interval (CI): (0.84, 1.80) (P value =0.2662), and in unilateral ACP (uACP) and bilateral ACP (bACP) was RR =1.2786, 95% CI: (0.7931, 2.0615) (P value =0.3132). When comparing the ACP-RCP and uACP-bACP groups, significant differences were found between ACP-RCP the groups in terms of circulatory arrest time (P value =0.0017 and P value =0.1995, respectively), cardiopulmonary bypass time (P value =0.5312 and P value =0.7460, respectively), intensive care unit (ICU)-stay time (P value =0.2654 and P value =0.0099), crossclamp time (P value =0.6228 and P value =0.2625), and operative mortality (P value =0.9368 and P value =0.2398, respectively), and when comparing the u-ACP and b-ACP groups for transient neurologic deficit (TND), an RR of 1.32, 95% CI: (1.05, 1.67) (P value =0.0199). The results showed high heterogeneity and no publication bias. Conclusions: This study demonstrated that the ACP and RCP are both safe and acceptable techniques to use in emergent settings. The uACP technique is equivalent to bACP in terms of PND and mortality, however, uACP is preferred over bACP in terms of TND.

Ecological risk assessment of trace elements (TEs) pollution and human health risk exposure in agricultural soils used for saffron cultivation.

Contamination of farmland soils by trace elements (TEs) has become an international issue concerning food safety and human health risks. In the present research, the concentrations of TEs including cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), zinc (Zn) and iron (Fe) in soils of 16 farmlands were determined in Gonabad, Iran. In addition, the human health risks due to exposure to the TEs from the soils were assessed. Moreover, the soil contamination likelihood was evaluated based on various contamination indices including contamination factor [Formula: see text]), enrichment factor (EF), geo-accumulation index (Igeo), and pollution load index (PLI) calculations. The soil mean concentrations for Cd, Co, Cr, Cu, Mn, Ni, Pb, Zn and Fe ranges as 0.102, 6.968, 22.550, 29.263, 475.281, 34.234, 13.617, 54.482 and 19,683.6 mg/kg in farmland soils. The mean concentrations of the TEs decreased in the order of Fe > Mn > Zn > Ni > Cu > Cr > Pb > Co > As > Cd. Levels of all metals in this study were within the FAO/WHO and Iranian soil standards. The HQ values from investigated elements for adults and children in the studied farms were less than the limit of 1, indicating no health risks for the studied subpopulations. The results of the present research indicated no significant carcinogenic health hazards for both adults and children through ingestion, skin contact and inhalation exposure routes. [Formula: see text] values of Ni and Zn in 100% and 6.25% of farmlands were above 1, showing moderate contamination conditions. EF values of metals in farmlands were recorded as "no enrichment", "minimal enrichment" and "moderate enrichment" classes. Furthermore, it can be concluded that the all farms were uncontaminated except Ni (moderately contaminated) based on Igeo. This is an indication that the selected TEs in the agricultural soils have no appreciable threat to human health.

C-Reactive Protein and D-dimer as Prognostic Markers for Clinical Outcomes in Patients with Mild Traumatic Brain Injury: A Cross-Sectional Study.

Objective: To investigate the use of prognostic markers such as C-reactive protein (CRP) and D-dimer for clinical outcomes in patients with mild traumatic brain injury (TBI). Methods: This cross-sectional study was conducted on patients with mild head trauma who were admitted to the Emergency Department of Imam Khomeini Hospital (Sari, Iran). Data were collected from 2018 to 2019. Age, sex, the time of injury hospitalization, length of hospitalization, length of unconsciousness, blood pressure, heart rate, respiratory rate, and concomitant symptoms were all recorded using a pre-designed checklist. The patient's Glasgow Coma Scale (GCS), CRP, and D-dimer were also measured. Moreover, all patients underwent CT scan. Results: This study included 74 patients with TBI. The mean age of the participants was 36.92±3.54. The mean CRP and D-dimer values were 5.69±0.77 and 0.58±0.11 in these patients, respectively. At the cut-off point of 11.50 for CRP, the sensitivity and specificity to detect the pathological lesions in CT scan were 75% and 95.50%, respectively (p<0.001). Additionally, with a D-dimer cut-off point of 0.90, the sensitivity and specificity for diagnosing pathological lesions in CT scan were 100% and 98.50%, respectively (p<0.001). Conclusion: In general, the CRP and D-dimer levels of patients with mild TBI (GCS≥13) can be assessed to protect against CT-induced radiation exposure and subsequent disorders; if they do not exhibit clinical signs to increase the risk of adverse brain damage, such as reduced level of consciousness, drowsiness, and prolonged periods of unconsciousness.

Evaluation of Clinical, Laboratory, and Radiologic Findings of Pulmonary and Extrapulmonary Involvement in Sarcoidosis.

Background: Sarcoidosis is a systemic disease with unknown etiology that is characterized by the presence of granuloma in various organs with diverse pulmonary and extrapulmonary manifestations. Regarding differences in the presentation of sarcoidosis in different geographical areas, the present study aimed to determine clinical, laboratory, and radiologic findings of patients with sarcoidosis in the north of Iran. Materials and Methods: In a cross-sectional study, patients with sarcoidosis were enrolled, and demographic data in addition to disease manifestations including clinical, laboratory, and imaging findings were recorded. Results: A total of 58 patients with sarcoidosis were enrolled in the study. The mean age and disease duration were 51.10±10.2 and 3.07±2.7 years, respectively. 62.1% of patients were female. Clinical manifestations were: cough and dyspnea (55.2%), fever and weight loss (11%), arthritis (15.5%), dermatologic presentation (15.5%), and ophthalmic involvement (17.2 %). Abnormalities in liver, renal, and calcium levels are found in approximately 1-8% of cases. The ACE level was increased in 56.9 % of patients, especially in those who presented in summer and autumn. Chest CT abnormalities were found in 94.8 % of patients, more predominantly hilar and paratracheal lymphadenopathy in 84.5% and 74.1%, respectively. Conclusion: Although sarcoidosis presents with varying clinical, radiological, and laboratory features, knowledge of its epidemiology and the incidence of these features in different populations can aid in its diagnosis in a particular geographic area.

Evaluation of the Salivary Matrix Metalloproteinase-9 in Women With Polycystic Ovaries Syndrome and Gingival Inflammation: A Case-Control Study.

Background Polycystic ovary syndrome (PCOS) is an endocrine disease of women of reproductive age that impacts their oral and systemic well-being. This study aimed to compare the gingival inflammation indices and matrix metalloproteinase-9 (MMP-9) of non-obese women with PCOS. Materials and methods This is a case-control study in which 78 women were referred to the Babol Clinic Hospital in Northern Iran between 2018 and 2019. They were divided into three groups: 26 women with PCOS and gingivitis, 26 women with PCOS with no gingivitis, and 26 women with no PCOS and no gingivitis as a control group. After recording the anthropometric and demographic variables, fasting saliva samples were taken from all participants before any periodontal intervention. These samples were transferred to Babol Molecular Cell Research Center under highly guaranteed cold-chain conditions to measure the serum levels of MMP-9. Periodontal status was evaluated for Gingival Index (GI), Plaque Index (PI), and Bleeding on Probing (BOP). Analysis of variance was used to compare the mean results for these indices. The significance level was considered when p ≤ 0.05. Results All the gingival indices were significantly higher for women with PCOS with gingivitis compared to the results for women from the other two groups. Similarly, women with PCOS showed high salivary MMP-9 levels but were within the normal reference ranges. Conclusion The gingival indices (GI, PI, and BOP) and salivary MMP-9 are higher in women with PCOS, regardless of the gingival status.

Bisphosphonates and Prevention of the Perimenopausal Breast Cancer Recurrence: A Systematic Review and Meta-Analysis.

PURPOSE: Bisphosphonates (BPs) have a powerful effect on reducing bone resorption and improving the survival of patients with breast cancer. We aimed to investigate the impact of BP treatment on the prevention of recurrence, metastasis, and death of breast cancer survivors in the perimenopausal period. METHODS: The search strategy aimed to identify both published and unpublished studies in PubMed, Web of Science, Scopus, Embase, ProQuest, and Google Scholar in March 2021. Two independent reviewers assessed quantitative papers selected for retrieval for methodological validity before being included in the review using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Statistical meta-analysis was performed using Review Manager (RevMan) 5.4 statistical software when the data were homogenous. Meta-analysis was performed by calculating the effect size (hazard ratio; HR) and 95% confidence intervals (CIs). RESULTS: Twenty-one studies were eligible for this systematic review and meta-analysis. The overall The HRs for disease-free survival (DFS) and overall survival (OS) in women who received BPs were 0.89 (95% CI, 0.83-0.97; p = 0.005), and 0.75 (95% CI, 0.63-0.89; p = 0.001), respectively. The results showed that BPs had a significant effect on the prevention of locoregional (HR, 0.64; 95% CI, 0.42-0.97; p = 0.04), bone (95% CI, 0.74-0.95; p ≤ 0.001), and distant metastases (HR, 0.77; 95% CI, 0.62-0.94; p = 0.01). In the subgroup analysis based on study design, the only insignificant HR in the included randomized controlled trials (RCTs) was that of locoregional metastasis. CONCLUSION: Although BPs have a promising effect on DFS, OS, and bone metastasis of perimenopausal women survivors of breast cancer, more RCTs are needed to evaluate their effect on other survivors' outcomes.

Paternal postpartum depression's relationship to maternal pre and postpartum depression, and father-mother dyads marital satisfaction: A structural equation model analysis of a longitudinal study.

BACKGROUND: Fathers' depression is an understudied subject, and the increasing participation of fathers on the care of their children, this is an issue of great importance. This study aimed to determine the relationship of paternal postpartum depression with prenatal and postpartum depression of mothers and their marital satisfaction. METHODS: This longitudinal study was conducted among 352 expecting couples in 28-40 weeks of pregnancy and 6-8 weeks after delivery from April to September 2019. Eligible participants were selected from primary health care centers in northern Iran using a two-stage sampling method. Socio-demographic information, Edinburgh Postpartum Depression Scale, and ENRICH Couple Scale were used for data collection. The primary basis of data analysis was cross-lagged structural equation modeling to explore the underlying mechanism for paternal postpartum depression. RESULTS: The results showed that a) maternal prenatal depression indirectly (ßstand = 0.32, p = 0.004); b) maternal postpartum depression directly (ßstand = 0.56, p <0.001); c) paternal prenatal depression indirectly (ßstand = 0.11, p = 0.028) were associated with paternal postpartum depression. Also, marital satisfaction directly (ßstand = -0.19, p = 0.002) and indirectly (ßstand = -0.11, p = 0.007) had a relationship to paternal postpartum depression. LIMITATIONS: Culturally-sensitive measures of marital satisfaction, especially in conservative context of developing countries, along with self-reported data of psychological problems may lead to under-reported findings. CONCLUSION: The major contribution of marital satisfaction and maternal depression during prenatal period on the paternal postpartum depression, emphasizes on the prenatal period as the ideal time for fathers' mental health improvement.

Anger expression and suppression among patients with essential hypertension.

OBJECTIVE: Hypertension (HTN) is among the seven psychosomatic diseases for which mental etiologies were proposed in 1950s. The objective of this study was to evaluate the rate of anger suppression and expression in individuals with hypertension referred to the heart clinic of "Fatemeh Zahra" Hospital, Sari, Iran. METHODS: 200 patients with primary hypertension were categorized as the case group. One hundred healthy individuals older than 30 years without previous history of arterial hypertension and severe mental disorders were considered as the control group. Both groups were matched in terms of age, gender and level of education. The Spielberger questionnaire was used to assess the trait anger, anger in and anger out. The data were analyzed using SPSS software with statistical tests such as t-test, chi-square and regression. RESULTS: The trait anger and anger suppression in patients with hypertension were significantly higher than the control group (P < 0.001); however, anger out was not significantly different between the two groups (P = 0.984). CONCLUSION: Considering the fact that trait anger and anger suppression is more prevalent among people with hypertension than healthy individuals, it seems suitable to provide education concerning anger management and emotional expression for these patients with regard to the anger issue which is a psychosomatic aspect of the disease.