The role of growth factors in human sperm parameters: A review of in vitro studies

In vitro sperm preparation/incubation and cryopreservation are associated with oxidative stress as the main cause of sperm damage, and different strategies are used to improve sperm quality in in vitro conditions to treat male infertility. Growth factors (GFs) are biological molecules that play different roles in various cellular processes such as growth, proliferation, and differentiation. Many studies have shown that GFs and their receptors are expressed in the male reproductive system. In vitro supplementation of GFs to improve sperm parameters has yielded useful results. There are many studies on the effects of GFs on sperm quality improvement and subsequent assisted reproductive technology results. Hence, this study will review the in vitro results of various GFs including brain-derived neurotrophic factor, nerve growth factor, fibroblast growth factor, insulin-like growth factor I, and vascular endothelial growth factor to improve sperm quality. Key words: Growth factors, Sperm, ROS, Cryopreservation, In vitro

The Effect of Intra-Canal Posts on Diagnostic Accuracy of Cone Beam Computed Tomography and Digital Radiography in Detection of Vertical Root Fractures

Objective: Diagnosis of vertical root fractures (VRFs) is critical in endodontics. Cone Beam Computed Tomography (CBCT) has significantly enhanced image quality compared to digital radiography (DR) and greatly aids the diagnosis of VRFs but, metal artifacts has remained as a problem in VRF detection. This study evaluated the effect of intra canal posts on the diagnostic accuracy of CBCT and DR for detection of VRFs.Methods: In this experimental in vitro study eighty extracted human premolar teeth were cut at the cement-enamel junction .After root canal preparation, the casting posts were made. Samples were randomly divided into 2 groups of 40; group one with induced fracture and group 2 as the control group. Radiographs were taken for all specimens with and without posts with both imaging systems. Three observers assessed the presence or absence of VRF. Accuracy of the two imaging systems and the effect of post on VRF detection were assessed, using two-way ANOVA test and inter observer coefficient agreement was calculated.Results: Absolute diagnostic sensitivity and specificity of CBCT and absolute sensitivity of DR in the group with intracanal posts were significantly lower than those in the group without posts (p=0.023, p=0.034 and p=0.034 respectively). Absolute specificity of DR in the group with posts was significantly higher than that of the CBCT (p=0.014). The absolute and complete specificity of CBCT in the group without posts was significantly higher than those of DR (p=0.024, p=0.04). No statistically significant difference was found in inter observer agreement coefficient in presence or absence of posts or between the two imaging systems (p=0.119).Conclusion: Intra canal posts decreased the diagnostic accuracy of CBCT and DR for detection of VRFs and this reduction was greater in CBCT. However, absolute specificity of DR in the group with posts was significantly higher than that of the CBCT, where as CBCT images of teeth without posts still had higher diagnostic accuracy than DR

Prevalence of idiopathic osteosclerosis on cone beam computed tomography images

Objectives This study was performed to investigate the prevalence of idiopathic osteosclerosis on cone beam computed tomography (CBCT) images of patients.Methods In this descriptive, cross-sectional study, 240 CBCT scans of patients (125 women, 115 men) referred to a private oral and maxillofacial radiology clinic in Tehran in 2013 were selected and evaluated. Presence of idiopathic osteosclerosis and its features including its location in the jaw, its association with teeth, presence or absence of root resorption, number, shape and size of lesions and age and gender of patients were assessed. Descriptive statistics were reported. Chi-square test and independent t-test were used for statistical analysis.Results Idiopathic osteosclerosis was seen on CBCT images of 20 patients (8.33%). The lesion was more frequent in women than men, but the difference was not significant (P = 0.50). Also, the lesion was more common in the mandible than the maxilla (95.6% vs. 4.4%). Most lesions were observed in the molar (56.5%) and premolar (34.7%) areas of the lower jaw. Most lesions did not have any association with teeth (73.9%). More than half of the lesions (56.5%) were round in shape and the rest (43.4%) were irregular. The mean size of the lesions was 5.4 ± 1.8 and 5.7 ± 1.4 mm in the mesiodistal and superior-inferior aspects, respectively.Conclusion The prevalence of idiopathic osteosclerosis of the jaws on CBCT images of an Iranian population was within the range reported by other studies. The lesions were more common in the mandibular molar region with no relation to teeth

The role of central oxytocin in stress-induced cardioprotection in ischemic-reperfused heart model

Background and purpose: There is growing evidence that stress contributes to cardiovascular disease and triggers the release of oxytocin. Moreover previous studies confirmed oxytocin mimics the protection associated with ischemic preconditioning. The present study was aimed to assess the possible cardioprotective effects of the centrally released oxytocin in response to stress and intracerebroventricular (i.c.v.) administration of exogenous oxytocin in ischemic-reperfused isolated rat heart. Methods and subjects: Rats were divided in two main groups and all of them were subjected to i.c.v. infusion of vehicle or drugs: unstressed rats control: vehicle, oxytocin (OT; 100 ng/5 mu l), atosiban (ATO; 4.3 mu g/5 mu l) as oxytocin antagonist, ATO + OT] and stressed rats St: stress, OT + St, ATO + St]. After anesthesia, hearts were isolated and subjected to 30 min regional ischemia and 60 min reperfusion (IR). Acute stress protocol included swimming for 10 min before anesthesia. Myocardial function, infarct size, coronary flow, ventricular arrhythmia, and biochemical parameters such as creatine kinase and lactate dehydrogenase were measured. Ischemia-induced ventricular arrhythmias were counted during the occlusion period. Results: The plasma levels of oxytocin and corticosterone were significantly elevated by stress. Unexpectedly hearts of stressed rats showed a marked depression of IR injury compared to control group. I.c.v. infusion of oxytocin mimicked the cardioprotective effects of stress, yet did not elevate plasma oxytocin level. The protective effects of both stress and i.c.v. oxytocin were blocked by i.c.v. oxytocin antagonist. Conclusions: These findings suggest that i.c.v. infusion of exogenous oxytocin and centrally released endogenous oxytocin in response to stress could play a role in induction of a preconditioning effect in ischemic-reperfused rat heart via brain receptors. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved

Late cardiac perconditioning by phenylephrine in an isolated rat heart model is mediated by mitochondrial potassium channels

The present study was designed to investigate the effect of early and late administration of phenylephrine during ischemia against regional ischemia–reperfusion injuries in an isolated rat heart model. All animals were randomly divided into experimental groups: (I) IR (Ischemic/ reperfusion): the hearts underwent 35 min of regional ischemia followed by 60 min of reperfusion; (II) 5HD-IR-0: the hearts were perfused for 5 min with 5HD (5-hydroxydecanoate, specific mKATP channel blocker, 100 µM) at the onset of regional ischemia; (III) 5HD-IR-20: the hearts were perfused for 5 min with 5HD 20 min after regional ischemia; (IV) PE-IR-10: the hearts were perfused for 5 min with phenylephrine 10 min after regional ischemia; (V) PE-IR-30: the hearts were perfused for 5 min with phenylephrine (100 µM) 30 min after regional ischemia; (VI) PE-5HD-IR-10 group: the hearts were perfused for 5 min with 5HD at the onset of regional ischemia after which phenylephrine was administrated as in group IV; and (VII) PE-5HD-IR-30: the hearts were perfused for 5 min with 5HD 20 min after the ischemia and then phenylephrine was administrated as in group V. The hemodynamic parameters were recorded throughout the experiment. Ischemia-induced arrhythmias, myocardial infarct size (IS), creatin kinase-MB isoenzyme (CK-MB), plasma lactate dehydrogenase (LDH) activities, and coronary blood flow (CBF) were measured in all animals. Perfusion of phenylephrine 30 min after the regional ischemia curtailed the myocardial infarct size, reduced CK-MB, and improved cardiac function and CBF. Administration of 5HD 30 min after the ischemia abolished cardioprotective effects of phenylephrine in the late phase. These results suggest the involvement of mKATP in the mechanism of phenylephrine-induced late preconditioning

Synergistic effects of nitric oxide and exercise on revascularisation in the infarcted ventricle in a murine model of myocardial infarction

It has been shown that density of microvessels decreases in the left ventricular after myocardial infarction (MI). The change of angiogenic and angiostatic factors as the main factors in revascularisation after exercise training in area at risk is not determined yet in MI. Therefore, the aim of the present study was the effect of exercise training and L-arginine supplementation on area at risk angiogenesis in myocardial infarction rat. Four weeks after surgery (Left Anterior Descending Coronary artery Ligation), myocardial infarction rats were divided into 4 groups: Sedentary rats (Sed-MI); L-arginine supplementation (La-MI); Exercise training (Ex-MI) and Exercise + L-arginine (Ex+La). Exercise training (ET) lasted for 10 weeks at 17 m/min for 10–50 min day−1. Rats in the Larginine-treated groups drank water containing 4 % L-arginine. After ET and L-arginine supplementation, ventricular function was evaluated and angiogenic and angiostatic indices were measured at ~1 mm from the edge of scar tissue (area at risk). Statistical analysis revealed that gene expression of VEGF as an angiogenic factor, angiostatin as an angiostatic factor and caspase-3 at area at risk decrease significantly in response to exercise training compared to the sedentary group. The capillary and arteriolar density in the Ex groups were significantly higher than those of the Sed groups. Compared to the Ex-MI group, the Ex+La group showed a markedly increase in capillary to fiber ratio. No significant differences were found in infarct size among the four groups, but cardiac function increased in response to exercise. Exercise training increases revascularization at area at risk by reduction of angiostatin. L-arginine supplementation causes additional effects on exercise-induced angiogenesis by preventing more reduction of VEGF gene expression in response to exercise. These improvements, in turn, increase left ventricular systolic function and decrease mortality in myocardial infarction rats

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Jurisprudential and legal principles of criminal liability for injuries resulting from the treatment of crime

زمینه و هدف: یکی از مسائل مستحدثه و پرکاربرد قضایی، دادخواست‌هایی است که بزه‌دیده با ادعای جراحت‌های جدید و صدمات متعاقب درمان جنایت، علیه بزهکار جهت مطالبۀ دیۀ مضاعف اقامه می‌کند. اگر مجنی‌علیه اقدام به درمان نماید و در اثر درمان و به جهت ضرورت و تشخیص پزشکان صدمه دیگری متوجه وی شود، از مواردی است که تشخیص استناد عرفی دشوار می‌باشد. هدف این پژوهش، تبیین مسئولیت جانی در قبال صدمات ناشی از درمان جنایت، آشنا نمودن قضات با مستندات آن و ایجاد وحدت رویه در محاکم قضایی است. در صدمات ناشی از درمان جنایت (که گاه این صدمات از جراحاتی که توسط جانی وارد می‌شود، شدیدتر است) اگر دیه‌ای پرداخت نشود بیم تضییع حق مجنی‌علیه می‌رود، لذا ضرورت دارد این موضوع بررسی شود. نوشتۀ پیش‌رو در دو بخش، سامان یافته است. در بخش نخست به بررسی نظریۀ عدم مسئولیت جانی پرداخته ‌شده و در بخش دوم نیز با استفاده از قواعد كلى ضمان و استدلال به آیات قرآن و روایات ضمن پاسخ به شبهات، نظریۀ مسئولیت جانی تحلیل و بررسی می‌شود. مواد و روش‌ها: این جستار با بررسی مواد قانونی و اقوال فقیهان، مستندات و ادلۀ آنها با روش اسنادی تحلیلی و بررسی میدانی برخی پرونده‌های محاکم کیفری به نگارش درآمده است. در این راستا چون مهم‌ترین مستند، آیات قرآن کریم، روایت، بنای عقلا و قاعده تسبیب است، لذا این ادله به روش تحلیلی مورد مداقه قرار گرفته است. نتیجه‌گیری: بر اساس نتیجۀ تحقیق، جانی در جراحت‌های بی‌واسطه به مباشرت و در صدمات ناشی از درمانِ جنایت به تسبیب مسئولیت دارد.Background and Aim: One of the most commonly used issues in the judiciary is the lawsuits filed by the victim with claims of new injuries and injuries following the treatment of crimes against the criminal for demanding extra blood money. One of the difficult cases to diagnose customary citation is that victim seeks treatment and suffers another injury as a result of treatment and due to the necessity and doctors’ diagnosis. The purpose of this study is to explain criminal liability for injuries resulting from the treatment of crime, to acquaint the judges with its documents and to create a unified procedure in the judicial courts. In the case of injuries resulting from the treatment of a crime (which is sometimes more severe than the injuries inflicted by criminal), if the blood money is not paid, there is a fear of losing the right of the innocent, therefore, it is necessary to investigate this issue. The present stuudy is organized in two parts: in the first part, the theory of non-responsibility of criminal is examined and in the second part, using the general rules of guarantee and verses of the Qur'an and narrations, while answering doubts, the theory of criminal liability is analyzed and examined. Materials and Methods: This article has been written by examining the legal materials and jurists’ sayings, their documents and evidences by means of documentary-analytical method and field study of some cases of criminal courts. So, since the most important document is the verses of Quran, narrations, the foundation of reason and the rule of intercession, these arguments have been analyticaly studied. Conclusion: According to the study, criminal is responsible for direct injuries to the caretaker and for injuries resulting from the treatment of the crime.   Cite this article as: Azizi Y, Jahangiri M, Jurisprudential and legal principles of criminal liability for injuries resulting from the treatment of crime. Med Ethics J 2020; 12(42): e11

The effect of Progressive muscle relaxation on the Depression in patients with type 2 diabetes

Introduction:Depression is one of the most common psychiatric disorders in patients with diabetes that its incidence in addition to the impact on the course of treatment, can be changed the prognosis. This study aimed to determine the effects of progressive muscle relaxation on depression in patients with type 2 diabetes. Methods &amp; Materials: This study was a clinical trial that conducted on 77 patients who referred to Diabetes center of Sabzevar city. The participants completed the Beck Depression Inventory and if they earned 14-28 (mild to moderate depression), included to study. Then, participants after consent, were divided Randomly into two groups of progressive muscle relaxation (n= 37) and control (n= 40).relaxationperformed 2 times a week for 20-30 minuteswithin 6 weeks, under the supervision of a researcher. Beck Depression Inventory was completed at the end of the sixth week again.In analytic measurements of this study used of statistical analysis in SPSS software (Version 16). A P value of < 0.05 was considered to be statistically significant. Results: The mean depression score after intervention in relaxation group compared to control group was ranged from 20.91±4.20 to 11.29±2.85 and from 20.60±4.21 to 19.99±3.61, respectively.According to independent t-test, there was significant differencebetween case and control groups (P<0/001). Paired t-test showed statistically significant difference in terms of depression scores before and after intervention(P<0/001); while in control group had not any statistical significancy (p=0.204) Conclusion:Progressive Muscle Relaxation is effective way to reduce depression in patients with diabetes type 2