Exploration of the Quality of Life in Iranian Morbid Obese People: A Qualitative Study

Background: Morbid obesity (body mass index≥40 kg/m2 or >35 kg/m2 with co-morbidity) is an important factor in reducing the quality of life which is influenced by the characteristics of the individual, his social, cultural, and environmental conditions; also, each disease has unique effects on it. Although most of the studies have been conducted on obesity (25>BMI>40), how to prevent it and improve life quality, there is lack of knowledge about what morbid obese people really experience about their life quality. Thus, this qualitative study aimed to explore the viewpoints of morbid obese people about life quality. Methods: In this conventional content analysis, data were collected using semi-structured interviews with 20 morbid obese patients who were referred to nutrition and obesity clinics of Shiraz and Ahvaz Jundishapur University of Medical Sciences. Purposeful sampling was processed from May 2016 to January 2017. The sampling continued until data saturation. Each interview was recorded by audio recorder and typed in the MAXQDA10 software. Data were analyzed after each interview. The meaning units were encoded and the codes were categorized. This trend continued until the main and sub-categories emerged. Results: Data analysis indicated 1835 codes, 76 sub-subcategories, 26 subcategories and 6 main categories including physical changes, psychological experiences, socio-personal dysfunction, negative body image, financial pressure, and change in the spirituality. Conclusion: Final results indicated that life quality had a special definition in morbid obesity and includes very different dimensions. This study can promote health care providers’ knowledge (nurses) for supporting obese people and improving their quality of life by community-based care approaches

Assessment of the First Presentations of Common Variable Immunodeficiency in a Large Cohort of Patients

BACKGROUND: Common Variable Immunodeficiency (CVID) is a primary immunodeficiency syndrome resulting in recurrent infections, autoimmunity, and granulomatous manifestations. METHODS AND MATERIALS: This retrospective study was conducted on an Iranian national registry of immunodeficient patients from 2010 to 2021. The frequency of first presentations of CVID and its association with sex, age of onset, and family history of CVID was evaluated. RESULTS: A total of 383 patients entered the study, 164 of whom were female, and the rest were male. The mean age of the patients was 25.3 ± 14.5 years. The most frequent first presentations of CVID were pneumonia (36.8%) and diarrhea (19.1%). Patient sex, age of onset, and family history did not make significant differences in first presentations of this disease. CONCLUSION: pneumonia is the most common first presentation of CVID. Family history of CVID, the age of symptom onset, and sex made no differences in the first presentations of CVID

Mechanical and Thermal Stress Analysis of Cervical Resin Composite Restorations Containing Different Ratios of Zinc Oxide Nanoparticles: A 3D Finite Element Study

Due to an increase in prevalence of cervical lesions, it is important to use appropriate restorative materials to reduce the incidence of secondary lesions. Owing to having antibacterial properties, cervical composite restorations containing different ratios of Zinc Oxide nanoparticles (ZnO NPs) have been analyzed using the Finite Element method to determine the optimal incorporation ratio from mechanical and thermal perspectives. A numerical simulation is conducted for a mandibular first premolar with a cervical lesion (1.5 × 2 × 3 mm3) restored with composites containing 0 to 5% wt. ZnO NPs. Subsequently, the samples are exposed to different thermo-mechanical boundary conditions, and stress distributions at different margins are examined. The accumulated stress in the restoration part increases for the 1% wt. sample, whereas the higher percentage of ZnO NPs leads to the reduction of stress values. In terms of different loading conditions, the least and most stress values in the restoration part are observed in central loading and lingually oblique force, respectively. The change in the surface temperature is inversely correlated with the ratio of ZnO NPs. In conclusion, the composite containing 5% wt. ZnO NPs showed the most proper thermo-mechanical behavior among all samples

Effects of Process Control Agent Amount, Milling Time, and Annealing Heat Treatment on the Microstructure of AlCrCuFeNi High-Entropy Alloy Synthesized through Mechanical Alloying

This study was conducted to investigate the characteristics of the AlCrCuFeNi high-entropy alloy (HEA) synthesized through mechanical alloying (MA). In addition, effects of Process Control Agent (PCA) amount and milling time were investigated using X-ray diffraction analysis (XRD), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). The results indicated that the synthesized AlCrCuFeNi alloy is a dual phase (FCC + BCC) HEA and the formation of the phases is strongly affected by the PCA amount. A high amount of PCA postponed the alloying process and prevented solid solution formation. Furthermore, with an increase in the PCA amount, lattice strain decreased, crystallite size increased, and the morphology of the mechanically alloyed particles changed from spherical to a plate-like shape. Additionally, investigation of thermal properties and annealing behavior at different temperatures revealed no phase transformation up to 400 °C; however, the amount of the phases changed. By increasing the temperature to 600 °C, a sigma phase (σ) and a B2-ordered solid solution formed; moreover, at 800 °C, the FCC phase decomposed into two different FCC phases

Psychometric Properties of Quality of Life Assessment Tools in Morbid Obesity: A Review of Literature

Background: Since studies have demonstrated that morbid obesity can exponentially impair quality of life, the measurement of quality of life is paramount to monitoring the effects of treatment and influences the development of clinical pathways, service provision, healthcare expenditures, and public health policy. Accordingly, clinicians, researchers, and policy makers must rely on valid instruments. Aim: This study aimed to review and critique the psychometric properties of some specific tools by COSMIN checklist and their application among morbidly obese individuals. Method: We searched PubMed, Web of Science, PsycINFO, Ovid, Elsevier, and ScienceDirect by using the keywords related to the Quality of Life Questionnaire, namely “morbid obesity”, “tool”, and “scale”, to retrieve articles published during 1989-2017. Then, the psychometric properties of the selected tools were assessed using the COSMIN checklist. Results: Most of the tools had not reported complete and desirable psychometrics properties. Demonstration of responsiveness from independent randomized controlled trials was not available in two of the eight questionnaires. These tools also did not report proper definition of interpretability. However, the data obtained by COSMIN checklist showed that Laval questionnaire is a proper scale for measuring quality of life in obese individuals, which can be recommended to researchers. Implications for Practice: Although Laval questionnaire was found a proper tool for measuring the quality of life among morbid obese patients, developing an instrument suitable for different societies with varied cultural and social characteristics is suggested because socio-cultural factors can influence the quality of life

Mechanical and Thermal Stress Analysis of Cervical Resin Composite Restorations Containing Different Ratios of Zinc Oxide Nanoparticles: A 3D Finite Element Study

Due to an increase in prevalence of cervical lesions, it is important to use appropriate restorative materials to reduce the incidence of secondary lesions. Owing to having antibacterial properties, cervical composite restorations containing different ratios of Zinc Oxide nanoparticles (ZnO NPs) have been analyzed using the Finite Element method to determine the optimal incorporation ratio from mechanical and thermal perspectives. A numerical simulation is conducted for a mandibular first premolar with a cervical lesion (1.5 × 2 × 3 mm3) restored with composites containing 0 to 5% wt. ZnO NPs. Subsequently, the samples are exposed to different thermo-mechanical boundary conditions, and stress distributions at different margins are examined. The accumulated stress in the restoration part increases for the 1% wt. sample, whereas the higher percentage of ZnO NPs leads to the reduction of stress values. In terms of different loading conditions, the least and most stress values in the restoration part are observed in central loading and lingually oblique force, respectively. The change in the surface temperature is inversely correlated with the ratio of ZnO NPs. In conclusion, the composite containing 5% wt. ZnO NPs showed the most proper thermo-mechanical behavior among all samples

A Survey on the Frequency of Type 1 Diabetes Mellitus and its Related Factors from 2004-2014

Background & Objective: Since epidemiological information on type1 diabetes in children can help to control it, this study aimed to determine the frequency and characteristics of type1 diabetes patients during an 11-year period. Materials & Methods: In this retrospective study, records of all 0-39 years old diabetic patients admitted to Nemazee hospital 2004-14 were reviewed. Since most new cases are admitted to this hospital, the patient’s data might be a good representative of all patients in Shiraz. Gender, date of birth, age of onset and associated diseases were recorded. Data were analyzed, using SPSS 22.0.     Results: In this study, 546 diabetes patients were admitted, of which 52.4% were females. Two peak age was observed (5-9 Y/O and 10-14 Y/O). The mortality rate was 23%. Most of them had no family history of diabetes. Majority of patients (86.3%( did not have any other medical condition. Moreover, there was a significant relationship between age of onset with positive family history and mode of presentation. The frequency of diabetic patients had a rising trend during this eleven-year period. Conclusion: Incidence of type1 diabetes had a growing trend and peak age of presentation was similar to most previous studies. However, the percentage of diabetic ketoacidosis was more than that of developed countries. Therefore, people and physicians are recommended to have more information on type1 diabetes for early diagnosis to prevent further complications

Relationship between Body Image and Psychological Well-being in Patients with Morbid Obesity

Background: Morbid obesity is rising around the world. It can cause unpleasant appearance and body image. Most of the studies have aimed to evaluate the psychopathology of overweight and obesity and paying attention to mental well-being in morbid obese individuals is rare. Therefore, this study aimed to assess the relationship between body image and psychological well-being in morbid obese patients. Methods: This cross-sectional study, using simple random sampling method, was done on 124 morbid obese patients who referred to obesity clinic in Shiraz from 2016 to 2017. The data were collected by body image index and psychological well-being questionnaire. Results were analyzed using descriptive statistics, Pearson correlation coefficient test, ANOVA, and Regression analysis. Results: The results showed a significant relationship between body image and psychological well-being (r=0.43) (P0.05). Conclusion: Final results indicated that body image defects caused by obesity could lie in negative psychological well-being in all aspects. This study can promote health clinicians’ knowledge in supporting of mental status of obese individuals. It is suggested that preventing and supporting intervention should be performed as effective methods for encountering and coping with psychological effects of obesity

In-house Optimization Radiolabeling of Recombinant scFv with 99mTc-Tricarbonyl and Stability Studies: Radiolabeling scFv with technetium tricarbonyl

His-tagged scFv fragments of monoclonal antibodies have better pharmacokinetic properties than whole antibodies. Radiolabeled scFvs are considered for targeted imaging and treatment. Technetium tricarbonyl provides radiolabeling of scFvs without losing its biological activity in a fast and easy procedure. Technetium tricabonyl was prepared as follows: A freshly eluted solution of Na99mTcO4 was added to a mixture containing sodium carbonate, sodium potassium tartarate, boranocarbonate, sodium borohydride. The mixture was heated for 30 min at 100°C. Radiochemical purity was determined using radio thin lyer chromatography. Then, technetium tricarbonyl was added to a solution of scFv in PBS buffer and incubated for 2 h at 50°C, purified by PD-10 column and radiochemical purity was determined. Results showed that radiochemical purity of technetium tricarbony was over 98%. The best conditions for radiolabeling of scFv was: scFv concentration >2 mg/mL, PBS buffer, 2 h incubation at 50°C, pH 8-9, and high activity concentration of tricarbonyl. The best radiochemical purity of scFv was 70% before purificarion. Radiolabeled scFv was stable in PBS for 24 h incubation and there was no release of technetium in competition with histidine. In this study, we optimized radiolabeling of a scFv with technetium tricarbonyl using house made boranocarbonates. The results are promising and will be used for future studies. HIGHLIGHTS Radiolabeling of scFv was done directly by 99mTc-tricarbonyl. 99mTc-tricarbonyl was prepared in house from boranocarbonate. 99mTc-Radiolabeled scFv can be used for radioimmunoscintigraphy

Nivolumab plus ipilimumab combination therapy in cancer: Current evidence to date

Immune checkpoint inhibitors (ICIs) have revolutionized cancer immunotherapy, yielding significant antitumor responses across multiple cancer types. Combination ICI therapy with anti-CTLA-4 and anti-PD-1 antibodies outperforms either antibody alone in terms of clinical efficacy. As a consequence, the U.S. Food and Drug Administration (FDA) approved ipilimumab (anti-CTLA-4) plus nivolumab (anti-PD-1) as the first-ever approved therapies for combined ICI in patients with metastatic melanoma. Despite the success of ICIs, treatment with checkpoint inhibitor combinations poses significant clinical challenges, such as increased rates of immune-related adverse events (irAEs) and drug resistance. Thus, identifying optimal prognostic biomarkers could help to monitor the safety and efficacy of ICIs and identify patients who may benefit the most from these treatments. In this review, we will first go over the fundamentals of the CTLA-4 and PD-1 pathways, as well as the mechanisms of ICI resistance. The results of clinical findings that evaluated the combination of ipilimumab and nivolumab are then summarized to support future research in the field of combination therapy. Finally, the irAEs associated with combined ICI therapy, as well as the underlying biomarkers involved in their management, are discussed