Designing an artificial neural network for prediction of pregnancy outcomes in women with systemic lupus erythematosus in Iran

Background: Pregnancy in women with systemic lupus erythematosus (SLE) is still introduced as a major challenge. Consulting before pregnancy in these patients is essential in order to estimating the risk of undesirable maternal and fetal outcomes by using appropriate information. The purpose of this study was to develop an artificial neural network for prediction of pregnancy outcomes including spontaneous abortion and live birth in SLE. Methods: In a retrospective study, forty-five variables were identified as effective factors for prediction of pregnancy outcomes in systemic lupus erythematosus. Data of 104 pregnancies in women with systemic lupus erythematosus in Shariati Hospital and 45 pregnancies in a private specialized center in Tehran from 1982 to 2014 in August and September, 2014 were collected and analyzed. For feature selection, information of the 149 pregnancies was analyzed with a binary logistic regression model in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). These selected variables were used for inputs of neural networks in MATLAB software, version R2013b (MathWorks Inc., Natick, MA, USA). A Multi-Layer Perceptron (MLP) network with scaled conjugate gradient (trainscg) back propagation learning algorithm has been designed and evaluated for this purpose. We used confusion matrix for evaluation. The accuracy, sensitivity and specificity were calculated from the confusion matrix. Results: Twelve features with P<0.05 and four features with P<0.1 were identified by using binary logistic regression as effective features. These sixteen features were used as input variables in artificial neural networks. The accuracy, sensitivity and specificity of the test data for the MLP network were 90.9, 80.0, and 94.1 respectively and for the total data were 97.3, 93.5, and 99.0 respectively. Conclusion: According to the results, we concluded that feed-forward Multi-Layer Perceptron (MLP) neural network with scaled conjugate gradient (trainscg) back propagation learning algorithm can help physicians to predict the pregnancy outcomes (spontaneous abortion and live birth) among pregnant women with lupus by using identified effective variables. © 2015, Tehran University of Medical Sciences. All rights reserved

Ramadan Fasting During the COVID-19 Pandemic; Observance of Health, Nutrition and Exercise Criteria for Improving the Immune System

Fasting is one of the religious rituals of Muslims worldwide who refrain from eating foods and liquids every year during Ramadan. This year (2020), Ramadan is very different from previous years due to the outbreak of a terrible microscopic giant called coronavirus disease 2019 (COVID-19). The pandemic COVID-19 has made Ramadan very important this year because the virus has infected millions of people around the world and killed thousands, especially people with immunodeficiency. In dealing with COVID-19, maintaining good hygiene and supporting the immune system are effective, preventive approaches. Moderate exercise training and proper nutrition are the most important factors to support immune function. Lack of facilities, poor health and many traditions that lead to public community gatherings have made many Islamic countries susceptible to this dangerous virus. In such an unprecedented situation, there are many Muslims who doubt whether they can fast or not. Therefore, the proposal of usable exercise programs and effective nutritional strategies is imperative. In this study, we will look at the proposed health effects of fasting and its impact on the immune system, the effects of Ramadan intermittent fasting on resting values and responses of immunological/antioxidant biomarkers in elite and recreational athletes, together with the important health, nutrition, and exercise advice that fasting people need to follow in the event of a COVID-19 outbreak. © Copyright © 2021 Moghadam, Taati, Paydar Ardakani and Suzuki

Ulk4 regulates GABAergic signaling and anxiety-related behavior

Excitation/inhibition imbalance has been proposed as a fundamental mechanism in the pathogenesis of neuropsychiatric and neurodevelopmental disorders, in which copy number variations of the Unc-51 like kinase 4 (ULK4) gene encoding a putative Serine/Threonine kinase have been reported in approximately 1/1000 of patients suffering pleiotropic clinical conditions of schizophrenia, depression, autistic spectrum disorder (ASD), developmental delay, language delay, intellectual disability, or behavioral disorder. The current study characterized behavior of heterozygous Ulk4(+/tm1a) mice, demonstrating that Ulk4(+/tm1a) mice displayed no schizophrenia-like behavior in acoustic startle reactivity and prepulse inhibition tests or depressive-like behavior in the Porsolt swim or tail suspension tests. However, Ulk4(+/tm1a) mice exhibited an anxiety-like behavioral phenotype in several tests. Previously identified hypo-anxious (Atp1a2, Ptn, and Mdk) and hyper-anxious (Gria1, Syngap1, and Npy2r) genes were found to be dysregulated accordingly in Ulk4 mutants. Ulk4 was found to be expressed in GABAergic neurons and the Gad67⁺ interneurons were significantly reduced in the hippocampus and basolateral amygdala of Ulk4(+/tm1a) mice. Transcriptome analyses revealed a marked reduction of GABAergic neuronal subtypes, including Pvalb, Sst, Cck, Npy, and Nos3, as well as significant upregulation of GABA receptors, including Gabra1, Gabra3, Gabra4, Gabra5, and Gabrb3. This is the first evidence that Ulk4 plays a major role in regulating GABAergic signaling and anxiety-like behavior, which may have implications for the development of novel anxiolytic treatments

Pelvic trauma : WSES classification and guidelines

Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.Peer reviewe