Diversity of macrophytes and microphytes in an urban wetland, Babol, Mazandaran Province, Iran; toward a conservation policy

Despite to its importance for retaining biodiversity and human health, urban wetlands have received much less attention than other wetland types in northern Iran. This study deals with the floristic characteristics of one of the largest urban wetlands in Central Mazandaran, Roshanabad wetland in Babol. All vascular plants were collected during two growing seasons of 2014 and 2015 and water sampling was performed seasonally (autumn 2014 to summer 2015). We encountered 102 plant species belonging to 80 genera and 39 families. The largest families in the studied area were Poaceae with (11.7%) followed by Cyperaceae and Asteraceae (9.8%) and Fabaceae and Polygonaceae (5.9%). Genera represented by the greatest number of species were Cyperus (7 sp.), Polygonum (4 sp.), Ranunculus (3 sp.) and Typha (3 sp.). Classification based on life form, indicated that the therophytes (47%) comprised the largest proportion of the plants in the studied area. From chorological point of view, the largest proportion of the flora belonged to the pluriregional elements (62.3%). Various habitats of the wetland are discussed. Moreover, 63 genera of fresh water algae, belonging to eight phyla were identified in the study area. Cholorophyta with 28 genera was the most abundant phylum followed by Bacillariophyta (19 genera), Cyanophyta (6 genera), Euglenophyta (4 genera), Chrysophyta, Dinophyta (2 genera), and Charophyta, Xanthophyta (each with one genus). Moreover, a comparison between the data as well as ratios of species/genera and genera/families collected from this wetland and from the other wetlands in north Iran has been provided. Roshanabad wetland had fewer aquatic species compared to some other wetlands in north of Iran, because of anthropogenic effects such as penetration of agricultural and urban sewage which has large quantities of nitrate and phosphate, and distribution of exotic aquatic plant, Azolla filiculoides. Moreover, Palmer Index of pollution shows that the wetland has high ratio of pollution in all seasons. This urban wetland site may be considered as a pilot site for the interaction of human effects and biodiversity pool. This is among the first attempts for restoration of such an important and sensitive ecosystem in north of Iran

Scotopic contrast sensitivity and glare after accelerated corneal cross-linking

Background: The aim was to assess one-year changes in uncorrected and corrected contrast sensitivity (CS) and glare under scotopic conditions after accelerated cross-linking (CXL) using the 18 mW/cm2 protocol for the treatment of progressive keratoconus and compare results with unoperated controls. Methods: In this non-randomised clinical trial, 30 eyes were enrolled in the CXL group and 30 were assigned to the control group. Scotopic CS at spatial frequencies (SFs) of 0.5, 1.1, 2.2, 3.4, 7.1 and 15 cycles per degree (cpd) were assessed using the MonCv3System (Metrovision, Pérenchies, France) under scotopic conditions (0.5 lux) at baseline and at six and 12 months. Results: The mean ages of the participants in the CXL and control groups were 24.32 ± 5.17 and 30.93 ± 7.43 years, respectively (p < 0.001). After adjusting for age, changes in uncorrected and corrected CS and glare were similar in the two groups (all p > 0.05) except for corrected CS at SF 7.1 cpd (1.45 ± 4.31 versus 3.21 ± 4.69 dB, p = 0.010) and 15 cpd (1.12 ± 4.63 versus 3.03 ± 5.48 dB, p = 0.007), which were reduced as an effect of CXL. Based on covariate analyses, among corrected CS indices, corrected CS7.1 and CS15 were related to CXL and their baseline values (all p < 0.050). Uncorrected CS in all SFs and uncorrected and corrected glare were related to their pre-operative values (all p < 0.001). Conclusion: Accelerated CXL can reduce scotopic corrected CS at SFs higher than 7.0 cpd in cases with better baseline values of these parameters. Changes in uncorrected CS and glare are only a factor of baseline values and the indices reduce in cases with better baseline values after one year. © 2017 Optometry Australi

Comparison of corneal thickness measurement with the Pentacam, the PARK1 and an ultrasonic pachymeter

Purpose: The aim was to determine the agreement between PARK1 pachymetric readings and measurements made with the Pentacam and ultrasonic pachymetry. Methods: In this prospective study, we enrolled refractive surgery patients free of other ocular conditions and performed Pentacam and PARK1 acquisitions followed by ultrasonic pachymetry. We recorded pachymetric readings on the centre, apex and thinnest point with the Pentacam, corneal thickness values of the apex and minimum readings from the PARK1, and the central corneal thickness with the ultrasonic system. Data were compared using t-tests, and the Pearson correlations and 95 limits of agreement (LoA) of all pairs were determined. Results: The mean age of the 47 participants was 32 ± 10.4years and data from their right eyes were used. Overall, ultrasonic measurements were significantly higher than all readings from the PARK1 and the Pentacam. The smallest difference was between the PARK-apex and Pentacam-apex readings (0.2 ± 11μm); the 95 LoA of this pair gave a width of 43.7μm (-21.7 to 22.0μm). The smallest width pertained to the Pentacam-centre and ultrasound-centre paired readings; the width was 32.5μm (-21.8 to 11.8μm), while the mean difference was -5.54 ± 8μm. Conclusion: The PARK1 measurements of the apical corneal thickness can be a substitute for central corneal pachymetry with an ultrasonic device, provided that the range of agreement is taken into consideration in the interpretation of the results. Similar studies on populations with different corneal conditions such as keratoconus are needed. © 2011 Optometrists Association Australia

Physicians' role in the development of inappropriate polypharmacy among older adults in Iran: A qualitative study

Objectives The use of unnecessary or excessive medications (inappropriate polypharmacy) is a major health challenge among older adults which is driven by several factors. This study aims to provide in-depth descriptions of the physician's role in the development of inappropriate polypharmacy among older adults in Iran. Design Qualitative content analysis of interviews, field notes and other relevant documents available (eg, medical records). Data collection and analyses were done concurrently to guide the sampling process. Setting Three purposively selected referral hospitals in Tehran, Iran. Participants A total of 7 physicians, 10 older adults, 3 caregivers and 3 pharmacists with a median age of 54 (IQR 23) years were recruited through convenience sampling. Results Emerged categories included misdiagnosis, inappropriate prescribing, insufficient patient education, poor communication, unprofessional behaviour and limited perspectives which highlight the role of physicians in the development of inappropriate polypharmacy among older adults in Iran under the main concept of poor medical practice. Conclusion This study provides valuable insight on the role of physicians in the development of inappropriate polypharmacy among the elderly in the healthcare setting in Iran by exploring the viewpoints of physicians, patients, caregivers and pharmacists. Physicians can be an influential factor in tackling this challenge through proper diagnosis, prescription, patient education and follow-up. In Iran, physicians' practice styles are affected by potentially adverse factors such as the novelty of geriatric medicine, lack of a referral system, patient unfamiliarity with the system and lack of a monitoring system for multiple prescriptions. Furthermore, clinics tend to be overcrowded and visit fees can be low; in this setting, lack of physician assistants leads to limited time allocation to each patient and physician dissatisfaction with their income. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ

Neratinib plus trastuzumab is superior to pertuzumab plus trastuzumab in HER2-positive breast cancer xenograft models

Lapatinib (L) plus trastuzumab (T), with endocrine therapy for estrogen receptor (ER)+ tumors, but without chemotherapy, yielded meaningful response in HER2+ breast cancer (BC) neoadjuvant trials. The irreversible/pan-HER inhibitor neratinib (N) has proven more potent than L. However, the efficacy of N+T in comparison to pertuzumab (P) + T or L + T (without chemotherapy) remains less studied. To address this, mice bearing HER2+ BT474-AZ (ER+) cell and BCM-3963 patient-derived BC xenografts were randomized to vehicle, N, T, P, N+T, or P+T, with simultaneous estrogen deprivation for BT474-AZ. Time to tumor regression/progression and incidence/time to complete response (CR) were determined. Changes in key HER pathway and proliferative markers were assessed by immunohistochemistry and western blot of short-term-treated tumors. In the BT474-AZ model, while all N, P, T, N + T, and P + T treated tumors regressed, N + T-treated tumors regressed faster than P, T, and P + T. Further, N + T was superior to N and T alone in accelerating CR. In the BCM-3963 model, which was refractory to T, P, and P + T, while N and N + T yielded 100% CR, N + T accelerated the CR compared to N. Ki67, phosphorylated (p) AKT, pS6, and pERK levels were largely inhibited by N and N + T, but not by T, P, or P + T. Phosphorylated HER receptor levels were also markedly inhibited by N and N + T, but not by P + T or L + T. Our findings establish the efficacy of combining N with T and support clinical testing to investigate the efficacy of N + T with or without chemotherapy in the neoadjuvant setting for HER2+ BC

Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients

\ua9 2024, European Respiratory Society. All rights reserved.Background Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design. Methods A systematic review was performed identifying studies that reported in-hospital mortality, postdischarge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement. Results Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 1.8%, 5.5% and 10.9%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 7.1%, 12.6% and 32.1%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisation

Distribution of angle kappa measurements with Orbscan II in a population-based survey

PURPOSE: To determine the mean angle kappa and its determinants in the population of Tehran, Iran. METHODS: In a cross-sectional survey with random cluster sampling, a total of 442 participants aged >14 years were selected from 4 municipality districts of Tehran for Orbscan acquisitions. Exclusion criteria were history of eye surgery for refractive errors, cataract or glaucoma, and use of topical medication or any type of contact lens at the time of the study. Mean angle kappa in different age and gender groups and its association with other factors was assessed. Considering the high correlation between the right and left eyes, only results of the right eyes are presented. RESULTS: After applying exclusion criteria, 800 eyes (399 right eyes and 401 left eyes) were examined. Mean participant age was 40.6±16.8 years (range: 14 to 81 years), and 38.8 of eyes were from men. Mean angle kappa was 5.46±1.33° in total; 5.41±1.32° in men and 5.49±1.34° in women (P=.558). It decreased significantly with age; 0.015°/year (P<.001). In individuals with myopia, emmetropia, and hypermetropia, the mean value was 5.13±1.50°, 5.72±1.10°, and 5.52±1.19°, respectively (P=.025); the post-hoc test indicated this was due to the difference between emmetropes and myopes. CONCLUSIONS: According to our results, angle kappa reduces with age, and the inter-gender difference is not significant. Largest angle kappas were seen among individuals with emmetropia. Angle kappas were larger in the hypermetropic population compared to the myopic population. Copyright © SLACK Incorporated

Scotopic contrast sensitivity and glare after accelerated corneal cross-linking

Background: The aim was to assess one-year changes in uncorrected and corrected contrast sensitivity (CS) and glare under scotopic conditions after accelerated cross-linking (CXL) using the 18 mW/cm2 protocol for the treatment of progressive keratoconus and compare results with unoperated controls. Methods: In this non-randomised clinical trial, 30 eyes were enrolled in the CXL group and 30 were assigned to the control group. Scotopic CS at spatial frequencies (SFs) of 0.5, 1.1, 2.2, 3.4, 7.1 and 15 cycles per degree (cpd) were assessed using the MonCv3System (Metrovision, Pérenchies, France) under scotopic conditions (0.5 lux) at baseline and at six and 12 months. Results: The mean ages of the participants in the CXL and control groups were 24.32 ± 5.17 and 30.93 ± 7.43 years, respectively (p &lt; 0.001). After adjusting for age, changes in uncorrected and corrected CS and glare were similar in the two groups (all p &gt; 0.05) except for corrected CS at SF 7.1 cpd (1.45 ± 4.31 versus 3.21 ± 4.69 dB, p = 0.010) and 15 cpd (1.12 ± 4.63 versus 3.03 ± 5.48 dB, p = 0.007), which were reduced as an effect of CXL. Based on covariate analyses, among corrected CS indices, corrected CS7.1 and CS15 were related to CXL and their baseline values (all p &lt; 0.050). Uncorrected CS in all SFs and uncorrected and corrected glare were related to their pre-operative values (all p &lt; 0.001). Conclusion: Accelerated CXL can reduce scotopic corrected CS at SFs higher than 7.0 cpd in cases with better baseline values of these parameters. Changes in uncorrected CS and glare are only a factor of baseline values and the indices reduce in cases with better baseline values after one year. © 2017 Optometry Australi

Distribution of cataract surgical rate and its economic inequality in Iran

Purpose. To determine the distribution of the cataract surgical number per million population per year (CSR), the CSR in the population older than 50 years (CSR 50+) in the provinces of Iran, and their economic inequality in 2010. Methods. As part of the cross-sectional 2011 CSR survey, the provincial CSR and CSR 50+ were calculated as the total number of surgeries in major and minor centers divided by the total population and the population older than 50 years in each province. Economic inequality was determined using the average province income, the average urban and rural household incomes, and the percentage of urban and rural population in each province. Results. Tehran and Ilam provinces had the highest and lowest CSR (12,465 vs. 359), respectively. Fars and Ilam provinces had the highest and lowest CSR 50+ (71,381 vs. 2481), respectively. Low CSR (5000) was observed in 14 provinces (45.2) where rates were 0.6 to 59.9 higher than the global target. Cataract surgical rate increased at higher economic quintiles. Differences between the first, second, and fifth (poorest) quintiles were statistically significant. The CSR concentration index was 0.1964 (95 confidence interval, 0.0964 to 0.2964). Conclusions. In line with the goals of the Vision 2020 initiative to eliminate cataract blindness, more than 70 of geographic areas in Iran have achieved the minimum CSR of 3000 or more. However, a large gap still exists in less than 30 of areas, mainly attributed to the economic status. Copyright © 2015 American Academy of Optometry

Anopheline species composition in borderline of Iran-Azerbaijan

Malaria is still one of the most important health-problems in the world and is endemic in Iran. Since 1994, after collapse of former Soviet Union, a new threat of malaria importation emerged from those countries into the northern Iran. This work was carried out to provide further evidence on the status of anopheline species composition, the malaria parasite species, and natural infectivity of mosquitoes distributed in Pars-Abad district, on the borderline of Azerbaijan in northwestern Iran. Mosquitoes were collected from May to December 2008 in anopheline seasonal activity and were identified at the species level. The genus- and species-specific primers against Plasmodium ssrDNA gene were used for specific amplification on female mosquito head. +. thorax. Members of the Anoheles maculipennis complex were identified by sequence analysis of the ribosomal internal transcribed spacer II (ITS2-rDNA). Morphological character-based identification showed that out of 1455 anopheline female specimens, 1121 (77) were of A. maculipennis s.l. and 334 (23) were of Anoheles hyrcanus. Molecular analysis of the species complex indicated the presence of Anoheles sacharovi 984 (67.6) and A. maculipennis 137 (9.4) in the region. None of themosquito's head-thorax was found to be naturally infected by malaria parasite. Results of this study, particularly high dominance of A. sacharovi, suggest a potential risk of malaria epidemic in the region, and the need for a continuous epidemiological surveillance. © 2011 Elsevier B.V