Serum Vascular Endothelial Growth Factor (VEGF) levels in patients with alpha thalassemia

 Background: Alpha-thalassemia syndrome includes a group of hereditary anemia in which expression of alpha globin chains is decreased or absent. Impaired RBC in patients with thalassemia causes vessel involvement and endothelial cell vessel disturbance. Vascular Endothelial Growth Factor (VEGF) is the most important regulator for endothelial cell proliferation. So, the aim of this study is to compare the serum VEGF levels in patients with alpha thalassemia and normal control group.Materials and Methods: This case-control study was conducted on 17 patients with alpha thalassemia and 40 healthy people. Serum VEGF levels were measured by enzyme-linked immune sorbent assay (ELISA) kit. Then statistical analysis of results were performed using SPSS 16, value of P <0.05 was considered statistically significant.Results: Mean serum VEGF levels in case and control groups were 2294.19±1552.39 and 598.09±988.17pg/ml, respectively. Serum VEGF levels were higher in patients with alpha thalassemia (P <0.01). There was no significant correlation between serum VEGF levels and Hemoglobin. (P= 0.73).Conclusion: Our study revealed that patients with alpha thalassemia have elevated levels of serum VEGF than normal control group. Further studies with larger sample size are recommended to confirm these observations

Oral l-citrulline malate in patients with idiopathic pulmonary arterial hypertension and Eisenmenger Syndrome: A clinical trial

AbstractBackground and purposeCitrulline is an amino acid which is produced by the urea cycle and also a precursor for NO, that is, a vasodilator for normal function of pulmonary vasculature. Thereby, enhancing l-citrulline malate in patients with idiopathic pulmonary arterial hypertension and those with congenital heart disease identified as Eisenmenger Syndrome results in reduction of pulmonary hypertension.Methods and subjectsIn this clinical trial before and after study, we assigned 25 patients with arterial pulmonary hypertension (idiopathic or Eisenmenger Syndrome) to receive l-citrulline malate 1g three times daily for two weeks. The primary measurement was the change in exercise capacity, as considered as a result of the total distance walked in six minutes, from baseline to week 2. We also assessed mean pulmonary artery pressure, the change in the quality of life, and the change in pro-brain natriuretic peptide (BNP) level. The study was not powered to evaluate mortality.ResultsThe mean walking distance in six minutes was significantly increased by about 44m (p=0.005) after receiving l-citrulline malate. Mean pulmonary artery pressure significantly reduced from 83.34mmHg before receiving l-citrulline malate to 79.1mmHg after that (p=0.01). All dimensions of the quality of life had statistical differences after receiving l-citrulline malate except limit due to physical health, limit due to emotional health and social functioning (p>0.05). Finally, pro-BNP difference was not statistically significant (p=0.9).Conclusionl-Citrulline malate improves the distance walk in six minutes and also the quality of life of patients with idiopathic arterial pulmonary hypertension and Eisenmenger Syndrome and also reduced mean arterial pulmonary hypertension

Latest Advances in Acid Hydrolysis Technique for Production of Cellulose Nanocrystals (CNCs) as Reinforcing Component in Epoxy-Based Nanocomposites

Cellulose, as one of the most abundant natural polymers with a wide spectrum of applications, has drawn the attention of many researchers. In this regard, cellulose-base structures such as cellulose nanocrystals (CNCs) and nanocomposites are known as materials widely used in many fields. Therefore, development, production and use of cellulose-based structures by gaining the relevant insights are progressively increasing. In the present paper, the latest developments in the field of various extraction techniques of CNCs, their properties and dispersion methods in epoxy matrix to obtain desired mechanical properties in cellulose nano-crystals/epoxy nanocomposite structures are reviewed. First, cellulose nanocrystals are introduced as one of the most promising biodegradable and abundant nanomaterials widely used in various industries. The various production techniques of cellulose nanocrystals are briefly reviewed. Based on the various applications of cellulose nanocrystals in many fields, cellulose acid hydrolysis as one of the most practical and low-cost methods for cellulose nanocrystals preparation is described in details. In this regard, the source of cellulose, time and temperature of the acid hydrolysis, the concentration and type of acid as important factors of the hydrolysis process are investigated. Reinforcing epoxy-based nanocomposites using cellulose nanocrystals is the subject of another section. Dealing with problems associated with cellulose nanocrystals agglomeration phenomenon, the main challenge to achieve a homogeneous dispersion of cellulose nanocrystals within the epoxy matrix, is also thoroughly discussed. In this regard, various methods of chemical surface modification of cellulose nanocrystals are investigated. Finally, considering the investigated cases, the debate on the issue of appropriate methods for dispersing cellulose nanocrystals in the epoxy-based resin is comprehensively covered. It can be said that based on growing demands for high performance cellulose nanocrystals/epoxy nanocomposite structures, research on this field is ongoing. Therefore, in the present review, by providing a comprehensive discussion on the latest researche works conducted in this field, it has been attempted to present the new achievements of researchers and approaches to overcome the involved challenges. The most important achievement of researchers is the emphasis on selection of appropriate dispersion medium considering the cellulose nanocrystals surface energy to produce nanocomposites with suitable mechanical and thermomechanical properties

Publisher Correction:COVID-19-associated acute kidney injury: consensus report of the 25^th Acute Disease Quality Initiative (ADQI) Workgroup (Nature Reviews Nephrology, (2020), 10.1038/s41581-020-00356-5)

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Thiol-reducing agents abate cholestasis-induced lung inflammation, oxidative stress, and histopathological alterations

Cholestasis is not only influences the hepatic function but also damages many other organs. Lung injury is a critical secondary organ damage associated with cholestasis/cirrhosis. Pulmonary histopathological alterations, respiratory distress, and hypoxia are related to cholestasis/cirrhosis-induced lung injury. It has been found that oxidative stress plays a crucial role in this complication. The current study was designed to investigate the effect of N-acetyl cysteine (NAC) and dithiothreitol (DTT) as thiol-reducing and antioxidant agents against cholestasis-induced lung injury. Bile duct ligated (BDL) rats were monitored for the presence of inflammatory cells, TNF-α, and IgG levels in their broncho-alveolar fluid (BALF) at scheduled time intervals (3, 7, 14, and 28 days post-BDL surgery). These markers reached their highest level in the BALF of BDL rats on day 28 after the surgery. Therefore, in another set of experiments, the BDL animals were treated with NAC (100 and 300 mg/kg/day, i.p, for 28 consecutive days) and DTT (10 and 20 mg/kg/day, i.p, for 28 consecutive days). Meanwhile, a significant increase in the levels of TNF-α and IgG was detected in the BALF of BDL rats. The BALF level of neutrophils, monocytes, and lymphocytes was also significantly increased in cholestatic animals. A significant increase in lung tissue biomarkers of oxidative stress was detected in the BDL rats. It was found that NAC and DTT could significantly blunt pulmonary damage induced by cholestasis. The effects of these agents on oxidative stress biomarkers and inflammatory response seem to play a pivotal role in their mechanisms of protective properties

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality among Patients with COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial

Importance: Thrombotic events are commonly reported in critically ill patients with COVID-19. Limited data exist to guide the intensity of antithrombotic prophylaxis. Objective: To evaluate the effects of intermediate-dose vs standard-dose prophylactic anticoagulation among patients with COVID-19 admitted to the intensive care unit (ICU). Design, Setting, and Participants: Multicenter randomized trial with a 2 � 2 factorial design performed in 10 academic centers in Iran comparing intermediate-dose vs standard-dose prophylactic anticoagulation (first hypothesis) and statin therapy vs matching placebo (second hypothesis; not reported in this article) among adult patients admitted to the ICU with COVID-19. Patients were recruited between July 29, 2020, and November 19, 2020. The final follow-up date for the 30-day primary outcome was December 19, 2020. Interventions: Intermediate-dose (enoxaparin, 1 mg/kg daily) (n = 276) vs standard prophylactic anticoagulation (enoxaparin, 40 mg daily) (n = 286), with modification according to body weight and creatinine clearance. The assigned treatments were planned to be continued until completion of 30-day follow-up. Main Outcomes and Measures: The primary efficacy outcome was a composite of venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days, assessed in randomized patients who met the eligibility criteria and received at least 1 dose of the assigned treatment. Prespecified safety outcomes included major bleeding according to the Bleeding Academic Research Consortium (type 3 or 5 definition), powered for noninferiority (a noninferiority margin of 1.8 based on odds ratio), and severe thrombocytopenia (platelet count <20 �103/µL). All outcomes were blindly adjudicated. Results: Among 600 randomized patients, 562 (93.7) were included in the primary analysis (median interquartile range age, 62 50-71 years; 237 42.2% women). The primary efficacy outcome occurred in 126 patients (45.7%) in the intermediate-dose group and 126 patients (44.1%) in the standard-dose prophylaxis group (absolute risk difference, 1.5% 95% CI,-6.6% to 9.8%; odds ratio, 1.06 95% CI, 0.76-1.48; P =.70). Major bleeding occurred in 7 patients (2.5%) in the intermediate-dose group and 4 patients (1.4%) in the standard-dose prophylaxis group (risk difference, 1.1% 1-sided 97.5% CI,-� to 3.4%; odds ratio, 1.83 1-sided 97.5% CI, 0.00-5.93), not meeting the noninferiority criteria (P for noninferiority >.99). Severe thrombocytopenia occurred only in patients assigned to the intermediate-dose group (6 vs 0 patients; risk difference, 2.2% 95% CI, 0.4%-3.8%; P =.01). Conclusions and Relevance: Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days. These results do not support the routine empirical use of intermediate-dose prophylactic anticoagulation in unselected patients admitted to the ICU with COVID-19. Trial Registration: ClinicalTrials.gov Identifier: NCT04486508. © 2021 American Medical Association. All rights reserved

The Role of Corporate Governance in Investment Efficiency and Financial Information Disclosure Risk in Companies Listed on the Tehran Stock Exchange

This study’s primary purpose is to investigate corporate governance’s role in investment efficiency and financial information disclosure risk in companies listed on the Tehran Stock Exchange. A multivariate linear regression model based on the panel data model was used to test the research hypotheses. The results of the survey of 140 companies listed on the Tehran Stock Exchange from 2015 to 2021 indicate that investment efficiency has increased by increasing the quality of corporate governance. In addition, research findings show that improving the quality of corporate governance reduces the risk of financial information disclosure. The life cycle and firm size were used to evaluate the robustness of the results obtained in this study. It was observed that improving corporate governance in companies in the stages of growth and maturity increases investment efficiency and reduces the financial information disclosure risk. In contrast, in companies that are in the decline stage, it reduces investment efficiency and increases the risk of financial information disclosure. In terms of firm size, it was also observed that, in small firms, as corporate governance increases, investment efficiency decreases, and the risk of financial information disclosure increases. However, investment efficiency and financial information disclosure reduce risk by improving large companies’ corporate governance

Survey of Patients Satisfaction in the Faculty of Dentistry, Qom University of Medical Sciences in 2016-2017

  Abstract Background and Objectives: Evaluation of patient’s satisfaction level is an appropriate index of the quality of treatment and it can attract more patients and improve students' practical training process. The aim of this study was to determine the level of patients' satisfaction from the services provided by the Faculty of Dentistry of Qom University of Medical Sciences.   Methods: This descriptive cross-sectional study, was carried out on 388 patients referred to Faculty of dentistry Qom University of Medical Sciences in 2016-2017. A questionnaire including demographic information and patient’s satisfaction in four fields, was filled out by patients. Data were analyzed by analysis of variance, t-test, and Pearson and Spearman correlation coefficient tests.   Results: The mean total satisfaction score, was 74.68±8.79 (out of 100). The highest satisfaction score in different fields belonged to respectful treatment of students with patients (4.3±0.6), the observation of hygiene and infection control principles by students and professors (4.3±0.7), hygiene, cleanliness, and adornment of the environment of the wards (4.1±0.8), and lack of delay for payment of treatment (4.0±1.0). The first level of satisfaction was reported to be for the department of restorative dentistry (3.9±0.3). The satisfaction from the Faculty welfare facilities, the manner of dressing up and appearance of female students, the waiting time to enter the departments, and the time spent for the presence of professor to guide the students, were at unfavorable level. Total satisfaction score in the range of 80-100, was considered as favorable satisfaction, in the range of 60-80 as relatively favorable satisfaction, and the score under 60 as dissatisfaction.   Conclusion: According to the results of this study, the patients' level of satisfaction from the services of the Faculty of dentistry of Qom University of Medical Sciences was at relatively favorable level.   &nbsp

The role of corporate governance in investment efficiency and financial information disclosure risk in companies listed on the Tehran stock exchange

This study's primary purpose is to investigate corporate governance's role in investment efficiency and financial information disclosure risk in companies listed on the Tehran Stock Exchange. A multivariate linear regression model based on the panel data model was used to test the research hypotheses. The results of the survey of 140 companies listed on the Tehran Stock Exchange from 2015 to 2021 indicate that investment efficiency has increased by increasing the quality of corporate governance. In addition, research findings show that improving the quality of corporate governance reduces the risk of financial information disclosure. The life cycle and firm size were used to evaluate the robustness of the results obtained in this study. It was observed that improving corporate governance in companies in the stages of growth and maturity increases investment efficiency and reduces the financial information disclosure risk. In contrast, in companies that are in the decline stage, it reduces investment efficiency and increases the risk of financial information disclosure. In terms of firm size, it was also observed that, in small firms, as corporate governance increases, investment efficiency decreases, and the risk of financial information disclosure increases. However, investment efficiency and financial information disclosure reduce risk by improving large companies' corporate governance

Evaluation of Anemia Effect on HbA1c Level Measurement in Type 2 Diabetic People

Objective: For many years HbA1c used as diagnostic criteria for diabetes, however, measurement of HbA1 has some limitations that cannot be accurately assess blood glucose levels in conditions such as changes in red blood cell life. in this study, we evaluated and compared the levels of HbA1C in diabetic, pre-diabetic and non-diabetic individuals to understand the role and relationship of different values of RBC`s indices in these conditions. Materials and Methods: This study performed between august to December of year 2021, and the demographic information and hematologic indices of 706 individuals which referred to laboratories in Gorgan city were investigated. According to results of FBS and HbA1c, individuals categorized in three distinct healthy (H), pre-diabetic (PD), and diabetic (D) groups base on latest ADA criteria. Results: Evaluation of HbA1c level based on the presence or absence of anemia showed that in diabetic group with anemia significantly had a lower level 8.4 (± 1.5) than people without anemia 8.6 (± 1.5) (P= 0.045). Conclusion: In this study, it was shown that changes in RBC indices in anemia can lead to inaccurate measurement of HbA1c level