Is prior use of renin-angiotensin system (RAS) inhibitors associated with more favourable outcome in COVID-19 hospitalized patients?

Objective: We aimed to investigate the extent of pulmonary involvement and adverse outcomes in patients receiving angiotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARB) versus who did not, in hospitalized coronavirus infectious disease 2019 (COVID-19) patients. Methods: All COVID-19 patients with a positive polymerase chain reaction (PCR) test, who were admitted to our tertiary referral hospitals in Tehran, Iran between January 2021 and May 2021, and had an on-admission chest computed tomography (CT) scan, were included. The patients were divided into two groups (receiving ACEI/ARB and who did not) for further analysis. The outcomes of interest in our study were the extent of pulmonary involvement, intensive care unit (ICU) admission, and death. Results: A total of 893 participants (mean age of 58.6±15.4 years; female, 522 (58.4%)) were enrolled. Among them, 368 (41.2%) participants had hypertension, and use of ACEI/ARB was reported in 183 (20.5%) participants. Of all, 409 (45.8%) participants required ICU admission, and 259 (29%) participants succumbed to death. We found that participants who received ACEI/ARB were less likely to progress critical disease and experienced significantly lower ICU admission (P=0.022) and death (P<0.001). On multivariable analysis adjusting for age, sex, and comorbidities, this relationship remained statistically significant for death [OR: 0.23 (0.14-0.38); P<0.001] and ICU admission [OR: 0.49 (0.32-0.73); P=0.001]. Conclusion: Our findings showed that COVID-19 patients who receiving ACEI/ARB prior to hospitalization vs. those who did not, had more favorable outcomes

Seed Germination Plasticity of Two Endangered Species of Ferula in the Context of Climate Change

Ferula assa-foetida and F. gummosa, Apiaceae, are important endemic and endangered medicinal plants. Survival of the species is threatened by climate change, overexploiting (as source of oleo-gum resin and for-age) and lack of organized cultivation. Cultivation of these valuable medicinal plants is restricted by insuffi-cient domestication knowledge. Germination characteristics of different populations of Ferula taxa were studied with the aim of describing and comparing their responses to continuous cold stratification condition. Germination cues for the species were complex, with dormancy mechanisms present to restrict germination until cold stratification are fulfilled. Results indicated that a period of 4 weeks of stratification is sufficient for germination of F. assa-foetida, but optimal germination of F. gummosa require stratification for periods of 8 weeks. Both species were able to germinate at very low temperatures (4°C). Within-taxon differences in dor-mancy breaking and seedling emergence may interpret as local adaptations. The continued regeneration and propagation of the species in the wild will depend on the temperature and moisture status of the soil during winter and the maintenance of conditions suitable for stratification for an appropriate length of time

Modulation of Different Phases of Formalin Test by Force Swim Stress

Introduction: The formalin test is the most accepted chemical test for evaluation of nociception. It requires the injection of an adequate amount of formalin into the surface of the hindpaw. Formalin test consists of phase 1 (0-7 min) and phase 2 (15-60) in which the animal shows painful behaviors. These phases are separated with a quiet phase named interphase, in which the nociceptive responses are decreased or completely disappeared. Methods: The goal of the current study was to evaluate the effects of swim stress at different heights of water on different phases of the formalin test in male rats. Results: Swim stress decreased nociceptive behaviors in first phase and prolonged interphase or delayed the start of second phase in a water height dependent manner. Swim stress in 25 and 50cm completely abolished the nociceptive behaviors in phase 1. Discussion: The present results showed different pain modulation during different phases of the formalin test and elucidated the impact of swim stress on duration of interphase. Interphase considered as an inactive period, but a recent research has shown that active inhibitory mechanisms are involved in the modulation of pain during this period. Therefore, swim stress may be considered as a useful tool for study of the basic inhibitory mechanisms underlying attenuation of nociceptive behaviors between phase 1 and 2 of the formalin test

Seed Germination Plasticity of Two Endangered Species of Ferula in the Context of Climate Change

Ferula assa-foetida and F. gummosa, Apiaceae, are important endemic and endangered medicinal plants. Survival of the species is threatened by climate change, overexploiting (as source of oleo-gum resin and forage) and lack of organized cultivation. Cultivation of these valuable medicinal plants is restricted by insufficient domestication knowledge. Germination characteristics of different popula-tions of Ferula taxa were studied with the aim of describing and comparing their responses to continu-ous cold stratification condition. Germination cues for the species were complex, with dormancy mechanisms present to restrict germination until cold stratification are fulfilled. Results indicated that a period of 4 weeks of stratification is sufficient for germination of F. assa-foetida, but optimal germi-nation of F. gummosa require stratification for periods of 8 weeks. Both species were able to germi-nate at very low temperatures (4°C). Within-taxon differences in dormancy breaking and seedling emergence may interpret as local adaptations. The continued regeneration and propagation of the species in the wild will depend on the temperature and moisture status of the soil during winter and the maintenance of conditions suitable for stratification for an appropriate length of time

Effect of intravenous acetaminophen versus fentanyl on postoperative pain after transurethral lithotripsy

Background: Postoperative pain is the most common postoperative complication. This study was conducted to assess the effect of acetaminophen versus fentanyl on postoperative pain relief in patients who underwent urologic surgeries. Methods: This clinical trial was conducted on patients aged 18–65 years. Patients were randomly assigned to receive either 2000 mg acetaminophen (propacetamol) or 2 mcg.kg−1 fentanyl intravenously, 15 min before the end of surgery. The postoperative pain was evaluated every 6 h for 24 h using the Visual Analog Scale. Total morphine dose taken in 24 h and hemodynamic status were evaluated. Results: Eighty patients were enrolled into the trial. The mean score of pain in 6, 12, 18, and 24 h after surgery was lower in the acetaminophen group than in the fentanyl group but the difference was not statistically significant except in 12 and 18 h after surgery (p < 0.05). The amount of administered morphine was higher in the fentanyl group than in the acetaminophen group, but the difference was not statistically significant. The hemodynamic status including systolic and diastolic blood pressure and heart rates were nearly the same in the two groups but the SpO2 mean was significantly higher in the acetaminophen group than the fentanyl group. Conclusions: This trial indicated that intravenous acetaminophen is as effective as intravenous fentanyl in pain relief after urologic surgeries (transurethral lithotripsy). Resumo: Justificativa: A dor pós-operatória é a complicação mais comum no período pós-operatório. Este estudo foi realizado para avaliar o efeito de acetaminofeno versus fentanil no alívio da dor pós-operatória em pacientes submetidos a cirurgias urológicas. Métodos: Este ensaio clínico foi realizado com pacientes cujas idades variou entre 18 e 65 anos. Os pacientes foram randomicamente designados para receber 2.000 mg de acetaminofeno (propacetamol) ou 2 mcg.kg−1 de fentanil por via intravenosa 15 min antes do final da cirurgia. A dor pós-operatória foi avaliada a cada 6 horas por 24 horas, utilizando a escala visual analógica. A dose total de morfina administrada em 24 horas e o estado hemodinâmico foram avaliados. Resultados: Oitenta pacientes foram incluídos no estudo. O escore médio de dor em 6, 12, 18 e 24 horas após a cirurgia foi menor no grupo acetaminofeno que no grupo fentanil, mas a diferença não foi estatisticamente significativa, exceto em 12 e 18 horas após a cirurgia (p < 0,05). A quantidade de morfina administrada foi maior no grupo fentanil que no grupo acetaminofeno, mas a diferença não foi estatisticamente significativa. O estado hemodinâmico, incluindo pressão arterial sistólica e diastólica e frequência cardíaca, foi quase o mesmo nos dois grupos, mas a média de SpO2 foi significativamente maior no grupo acetaminofeno que no grupo fentanil. Conclusões: Este estudo indicou que acetaminofeno intravenoso é tão eficaz quanto fentanil intravenoso no alívio da dor após cirurgias urológicas (litotripsia transuretral). Keywords: Acetaminophen, Fentanyl, Morphine, Postoperative pain, Hemodynamic parameters, Transurethral lithotripsy, Palavras-chave: Acetaminofeno, Fentanil, Morfina, Dor pós-operatória, Parâmetros hemodinâmicos, Litotripsia transuretra

Assessing and mapping urban ecological resilience using the loss-gain approach A case study of Tehran, Iran.

In the face of growing urban populations and their increasing demand for land and natural resources, the assessment of urban ecological resilience has emerged as an imperative aspect of sustainable urban governance. This study introduces an assessment framework with the potential to substantially augment urban management practices. It is focused on the formulation of a comprehensive framework for assessing ecological resilience, which is applied to Tehran, the capital of Iran. Our proposed Urban Ecological Resilience Mapping (UERM) framework adopts the Loss-Gain approach, encompassing both environmental risks and capacities related to Tehran's urban landscape. this framework incorporates an array of seven distinct indicators and twenty-five variables meticulously designed to gage the mettle of ecological resilience. The findings underscore that Tehran's central districts exhibit notably low ecological resilience, owing to high population density and the concentration of deteriorated and unstable areas. The localized nature of our assessment framework and its inherent ability to discern spatial dynamics and contributing factors to ecological resilience position it as an indispensable tool for informed urban planning and management decisions. the UERM framework not only facilitates the identification of areas requiring targeted interventions but also empowers urban stakeholders to foster a more resilient and sustainable urban landscape.</p

An experimental in silico study on COVID‐19: Response of neutrophil‐related genes to antibiotics

Abstract Background and Aims All components of the immune system are involved in alleviating severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Further research is required to provide detailed insights into COVID‐19‐related immune compartments and pathways. In addition, a significant percentage of hospitalized COVID‐19 patients suspect bacterial infections and antimicrobial resistance occurs following antibiotics treatment. The aim of this study was to evaluate the possible effects of antibiotics on the response of neutrophil‐related genes in SARS‐CoV‐2 patients by an experimental in silico study. Methods The two data sets GSE1739 and GSE21802 including 10 SARS positive patients and 35 influenza A (H1N1) patients were analyzed, respectively. Differentially expressed genes (DEGs) between these two data sets were determined by GEO2R analysis and the Venn diagram online tool. After determining the hub genes involved in immune responses, the expression of these genes in 30 COVID‐19 patients and 30 healthy individuals was analyzed by real‐time polymerase chain reaction (PCR). All patients received antibiotics, including levofloxacin, colistin, meropenem, and ceftazidime. Results GEO2R analysis detected 240 and 120 DEGs in GSE21802 and GSE1739, respectively. Twenty DEGs were considered as enriched hub genes involved in immune processes such as neutrophil degranulation, neutrophil activation, and antimicrobial humoral response. The central nodes were attributed to the genes of neutrophil elastase (ELANE), arginase 1 (ARG‐1), lipocalin 2 (LCN2), and defensin 4 (DEFA4). Compared to the healthy subjects, the expression of LCN2 and DEFA4 were significantly reduced in COVID‐19 patients. However, no significant differences were observed in the ELANE and AGR‐1 levels between COVID‐19 subjects and the control group. Conclusions Activation and degranulation of neutrophils were observed mainly in SARS, and H1N1 infection processes and antibiotics administration could affect neutrophil activity during viral infection. It can be suggested that antibiotics can decrease inflammation by restoring the expression of neutrophil‐related genes in COVID‐19 patients