bluuebunny/crossref_metadata_2025 huggingface dataset:
THE FESTIVAL TOURISM DEVELOPMENT PROSPECTS OF KHMELNYTSKY REGION
Authors:   Khmelnytskyi Humanitarian and Pedagogical Academy, Khmelnytskyi, Ukraine, Dolynska Olesya
Published: September 2023

The aim of the study. To investigate the current state and prospects of the festival tourism development in the Khmelnytskyi region. The development of tourism, particularly festival tourism, is important for the economy of the country and territorial communities, as it ensures the growth of tourist flows and the development of infrastructure. Method. The research uses general scientific research methods, namely, general logical methods: comparison, analysis, synthesis, generalization and analogy. The methods of analysis, synthesis and generalization were used in the study of the cause-and-effect relationship growth of the tourist activity in the region due to the use and preservation of tourist objects, cultural and historical local communities' traditions. Using the method of analogy, the probable positive results of the development of festival tourism in the Khmelnytskyi region were evaluated. Results. Examples of the development of festival tourism in Khmelnytskyi region are demonstrated. The prospects for the development of festival tourism in the Khmelnytskyi region have been determined. The scientific novelty. The scientific novelty of the obtained results lies in the fact that the potential of using festivals in the field of tourism of the Khmelnytskyi region has been determined. The directions for the development of festival tourism in Khmelnytskyi region are described in order to activate domestic tourism and improve the image of the region at the international level. Practical significance. The article provides examples of the festival tourism development in Khmelnytskyi region. The strengths and weaknesses of festival tourism in the region are analyzed. The development of this type of tourism has many positive aspects: popularization of the native region, development of local infrastructure, receipt of funds to the budget, creation of new jobs, attraction of new tourists to other tourist locations. The article argues that the festival tourism development potential of Khmelnytskyi region is very rich and needs development. The obtained scientific results are used in the educational process of future specialists in the direction of training «Tourism», with the educational qualification «Tourism expert, organizer of excursion and animation activities» when teaching the disciplines «Organization of tourist trips», «Professional competences in tourism business», «Organization of tourist activities». The obtained scientific results are used in the educational process of future specialists in the direction of training «Tourism», with the educational qualification «Tourism expert, organizer of excursion and animation activities» when teaching the disciplines «Organization of tourist trips», «Professional competences in tourism business», «Organization of tourist activities». The obtained data can be used for conducting student practices.
PRINCIPLES OF THE GEOSPATIAL ORGANIZATION OF THE TOURIST ENVIRONMENT IN THE CITY OF KYIV
Authors:   Taras Shevchenko National University of Kyiv, Ukraine, Skorostetska Olha
Published: September 2023

Purpose. Consider the principles as methodological aspects of the geospatial organization of the tourist environment of the city of Kiev, which includes the specifics of tourism activities in the capital city, factors of formation and methodological features of the formation of the tourist environment. Methodology. Analytical, historical, graphical and systematic methods of scientific research are used. Approbation. The main conceptual issues of the geospatial organization of the tourist environment in the capital city were studied by domestic scientists (M. Boyko, Yu. Zabaldina, A. Mazaraki, S. Melnichenko, I. Smirnov, T. Tkachenko and others) and found their place in the previous works of the author of this article . Scientific novelty. The relationship between tourism service providers and their consumers is dictated by the presence of modern approaches and methods of forming the tourism environment. Today, theoretical, methodological and practical studies of the process of tourism development in the capital city are debatable, given the fact that theoretical structures have not yet been clearly formed in the scientific literature that would make it possible to formulate the main components of relationships in the tourism environment. In this article, the author proposes to consider the theoretical aspects of the geospatial organization of the tourist environment in the capital city, which has a developed social, economic, political and infrastructural system, which makes it possible to consider it as a model of the geospatial organization of tourism. Practical significance. The article raises debatable issues related to the realities of modern life of people within the framework of innovative approaches to the activities of the tourism sector in Ukraine, with its problems, challenges and practical solutions. The materials of the publication can be used during the educational process in higher educational institutions that train specialists for the Ukrainian tourism industry, the practical activities of tour operators and agencies, in the process of work of departments and professional institutions involved in the tourism system of providing services or the processes of studying issues of introducing innovative technologies in the tourism sector of Ukraine.
PECULIARITIES OF STUDYING THE GEOGRAPHY OF THE ADMINISTRATIVE DISTRICT IN INSTITUTIONS OF GENERAL SECONDARY EDUCATION (ON THE EXAMPLE OF THE ZHYTOMYR DISTRICT OF THE ZHYTOMYR REGION)
Authors:   Zhytomyr Ivan Franko State University, Zhytomyr, Ukraine, Nesterchuk Inna , Demyanets Kateryna ,   Zhytomyr Ivan Franko State University, Zhytomyr, Ukraine
Published: September 2023

The purpose of the work. The purpose of the study is to develop a methodology for using materials that describe the geography of administrative districts in general educational institutions (on the example of the Zhytomyr district of the Zhytomyr region). The method of work. The research methodology is based on an integrated approach to scientific research, which involves the interaction of several scientific areas: geographical and historical, landscape-constructive, socio-economic, environmental and statistical. At the same time, the dialectical method was used, which makes it possible to analyze and interpret scientific data. The method of synthesis of the available material made it possible to study it in the physical-geographical, socio-economic and methodological directions, thereby revealing the problem in a comprehensive manner. As a result, it is possible to deepen and expand students' knowledge of the nature, population and economy of the region, to make them more accurate and complete. Scientific novelty Local history materials can be used in school geography curricula and there are a number of relevant lessons. Local folklore materials are the best visual aids for studying the curriculum in geography, their use allows you to consolidate the cognitive activity of students and develop a commitment to their native land. The use of local history materials is especially important when studying topics in physical geography, since they can show complex natural patterns, relationships and interdependencies between the components of the natural complex. This paper proposes a new research method and approach that takes into account the geographical features of the administrative districts of the Zhytomyr region. Practical meaning. The author of the study suggested using innovative teaching methods in teaching geography in secondary schools and studying local history. The practical significance of the study lies in the fact that the material and results can be used for further development of didactic means of using local history material in geography lessons in educational institutions, for students to comprehend the physical-geographical and socio-economic features of the territory of the Zhytomyr region, for the further development of theory and methodology Teaching Geography in General Educational Institutions.
ANTHROPOGENIC TRANSFORMATION OF FOREST ECOSYSTEMS IN THE MOUNTAINOUS AREA OF AGSUCHAY
Authors:   Institute of Geography named after academician H.A.Aliyev, Baku, Azerbaijan, Atakishiyev Samir
Published: September 2023

Aim: The purpose of the research is to determine the transformation characteristics of the forest ecosystems of the Agsuchay basin of the Greater Caucasus and to analyze the results of anthropogenic effects. The methodological basis For the study of anthropogenic effects in forests there were used satellite images, scientific literature and the results of observations in experimental areas. Results: The article analyzes the initial state of forest ecosystems in the upper reaches of the Agsuchay and the subsequent anthropogenic transformation. The causes, directions and consequences of anthropogenic transformation of forest ecosystems in the research areas are shown. Due to the mountainous nature of the study area (750-2200 m a.s.l.), the trees formed here have very important tree species in terms of composition. As a result of anthropogenic transformation, the formation, development and gradual expansion of landslides on bare slopes as a result of deforestation and destruction. Scientific novelty: The obtained scientific results can be used to prevent the transformation of forests and restore the forest cover in the study area. As a result of anthropogenic transformation, deforestation and deforestation, landslides were formed, developed and gradually spread on bare slopes. At the same time, the directions and dynamics of anthropogenic transformation are reflected in the altitudinal belts. On the plains of the Agsuchay basin, forests are cut down mainly for the construction of farms and public catering establishments, and in mountainous areas, forests are cut down for firewood. Grazing in forests also leads to the drying up and destruction of forests. At the same time, this area has been inhabited since ancient times due to its geographical location, climate, water and land resources. Over time, large cities were formed here. As the population grew, the economy expanded, the number of livestock increased, and the anthropogenic impact also increased. People who thought about increasing their income by increasing the amount of arable land and pastures and increasing the number of livestock did not take into account the natural landscape of the area. They began to use it blindly, unplanned and intensively.
Clinical outcome of surgical resection for multifocal T2-T3 hepatocellular carcinoma up to 3 nodules: a comparative analysis with a single nodule
Authors: Yu Sehyeon , Jo Hye-Sung , Yu Young-Dong , Choi Yoo jin , Kim Dong-Sik
Published: September 2023

Background/Aims: Although the Barcelona Clinic Liver Cancer staging system seems to underestimate the impact of curative-intent surgical resection for multifocal hepatocellular carcinoma (HCC), recent studies have indicated favorable results for the surgical resection of multiple HCC. This study aimed to assess clinical outcomes and feasibility of surgical resection for multifocal HCC with up to three nodules compared with single tumor cases.Methods: Patients who underwent surgical resection for HCC with up to three nodules between 2009 and 2020 were included, and those with the American Joint Committee on Cancer (AJCC) 8th edition, T1 and T4 stages were excluded to reduce differences in disease distribution and severity. Finally, 81 and 52 patients were included in the single and multiple treatment groups, respectively. Short- and long-term outcomes including recurrence-free survival (RFS) and overall survival (OS), were evaluated.Results: All patients were classified as Child-Pugh class A. RFS and OS were not significantly different between the two groups (P=0.176 and P=0.966, respectively). Multivariate analysis revealed that transfusion and intrahepatic metastasis were significantly associated with recurrence (P=0.046 and P=0.005, respectively). Additionally, intrahepatic metastasis was significantly associated with OS (hazard ratio, 1.989; 95% confidence interval, 1.040-3.802; P=0.038).Conclusions: Since there was no significant difference in survival between the single and multiple groups among patients with AJCC 8th stage T2 and T3, surgical resection with curative intent could be considered with acceptable long-term survival for selected patients with multiple HCC of up to three nodules.
Pre-treatment with cyproterone acetate plus ethinylestradiol enhances ovarian response in women with polycystic ovary syndrome
Authors: Chowdhury Priyanka , Banu Jesmine , Deeba Farzana , Debnath Rajib Chandra , Rani Chalontika , Sultana Sharmin , Ishrat Shakeela
Published: September 2023

Background: Anti-mullerian hormone (AMH) and androgen levels are higher in women with polycystic ovary syndrome (PCOS) than norm-ovulatory women. Cyproterone acetate plus ethinylestradiol (CPA+EE) reduces AMH and free androgen level. The aim of the study was to determine if the pretreatment with CPA+EE before ovulation induction with letrozole improves ovarian response in PCOS women.
Methods: The study comprised of 100 infertile PCOS women with serum AMH>5 ng/ml. The study participants were randomly allocated into women given CPA+EE pretreatment cyclically for 3 months before ovulation induction with letrozole 5 mg from day 2-6 of a menstrual cycle, and women given only letrozole from day 2-6 without any pretreatment. Follicular growth was monitored by transvaginal sonography on day 12. Women who attained maximum follicular size (18-25 mm) were given 5000 IU HCG injection. Ovulation was confirmed by serum progesterone assay on day 21-23 and pregnancy was confirmed by serum β-hCG level or by pregnancy test kit.
Results: Ovulation rate was higher (82.4%) in pre treatment group compared in letrozole only group to (43.0%) with relative risk 1.92. Pregnancy rate was higher in (23.5%) in pre treatment group than letrozole only (8.8%) with relative risk 2.68.
Conclusions: Pretreatment with CPA+EE before ovulation induction with letrozole has better outcome in terms of ovulation and pregnancy than letrozole alone in PCOS women with high serum AMH.
Navigating family planning: unveiling rural-urban disparities among women in India: insights from Indian demographic health survey-5
Authors: Kaur Manjot , Yadav Dharmendra Kumar , Narayan Raj , Singh Gurdeep
Published: September 2023

Background: Over the past few years, there has been an increase in the usage of family planning methods. Female sterilization remains the most commonly used method of contraception. However, there are still disparities in the use of family planning methods between urban and rural areas in India, which can be attributed to differences in education levels, cultural factors, and socio-economic factors. The study aimed to evaluate contraceptive prevalence and urban-rural disparities among married women in India.
Methods: The study was based on the data collected under the National family health survey 2019-21. The NFHS-5 covered 5,12,408 currently married women (women in the age group 15-49). Descriptive and analytical analyses were used. The chi-square test and Bivariate logistic regression model were used to find the association between background characteristics and contraception use.
Results: The study showed that 65.7% of the participants were using contraception, with female contraception being the most common method of contraception. The use of contraception in urban and rural settings was 67.9% and 65% respectively.
Conclusions: The use of contraception has increased, with woman’s age, religion, caste, educational level, wealth index, place of residence and other factors such as total children living, total children ever born, exposure to mass media, son preference and ideal number of children being significant determinants.
The efficacy of ranolazine in improving glycemic parameters in patients with type 2 diabetes mellitus: a meta-analysis
Authors: Dampil Oliver Allan C. , Luy Sybil Claudine R. , Lara Bayocot Jayson De , Rialyn Rojo , Raquel Tingchuy Avilyn
Published: September 2023

Ranolazine is an anti-anginal drug that mediates its effects by inhibition of cardiac late sodium current. Although it is not indicated for the treatment of type 2 diabetes mellitus (T2DM), several clinical trials have shown that ranolazine was associated with a reduction in HbA1c. The objective of this meta-analysis is to determine the efficacy and safety of ranolazine in improving glycemic control in patients with T2DM. A total of five randomized controlled trials involving 2,680 patients were included in the analysis. The pooled analysis showed that ranolazine may improve glycemic control with a modest decrease in HbA1c and FBS. The difference in HbA1c was -0.38% (95% CI -0.59 to -0.17), favoring ranolazine. Sensitivity analysis showed a difference of HbA1c of -0.49% (CI -0.67, -0.31), still favoring the ranolazine group. There was also a statistically significant difference in fasting glucagon, favoring the ranolazine group (-2.70 pg/ml: 95% CI -5.24 to -0.16). The risk of hypoglycemia with ranolazine was comparable with placebo (RR 1.27 95% CI 0.84 to 1.91). Overall, ranolazine appears to be a safe and effective option for improving glycemic control in patients with T2DM, with a modest decrease in HbA1c and FBS, and a lower risk of hypoglycemia compared to placebo. However, further studies are needed to confirm these findings and to investigate the long-term safety and efficacy of ranolazine in this patient population.
The use of low-dose computed tomography for lung cancer screening
Authors: Ahmad Doha Jamal , Alasmari Abdullah Ali , Alasmari Sahar Ali , Alanazi Mohammed Mufadhi , Qirati Bashayer Ahmed , Hassani Aeshah Abdullah , Hezam Sultan Nasser , Alzaidi Shatha Magboul , Domari Naif Ali , Sawa Layla Masoud , Alqahtani Waad Saleh
Published: September 2023

Around the globe, lung cancer is among the most prevalent cancers, accounting for significant morbidity and mortality. Compared to breast, cervical, and colorectal cancers combined, lung cancer is the leading cause of mortality. Higher survival rates are achieved with an early lung cancer diagnosis. The aggressiveness and heterogeneity of lung cancer have impeded endeavours to use screening to lower mortality from the disease. Due to studies showing that low-dose computed tomography may identify many tumors in their early stages, the development of low-dose computed tomography has significantly changed the landscape of lung cancer screening. Long-term research studies have demonstrated that low-dose computed tomography for the secondary prevention of lung cancer considerably lowers lung cancer mortality in high-risk populations. Screening with low-dose computed tomography reduces the mortality associated with it by 20-30%. Low-dose computed tomography is a fast and simple chest exam that does not involve the use of a contrast agent. Based on the current recommendations, eligible individuals with a history of heavy smoking will benefit from yearly low-dose computed tomography, but because of the risks involved, such as false-positive results, radiation exposure, and overdiagnosis, joint decision-making consultation is necessary. The purpose of this research is to review the use of low-dose computed tomography for lung cancer screening.
Recent studies on non-invasive biomarkers useful in biliary atresia – a literature review
Authors: Lew-Tusk Anna , Pęksa Marta , Stachowicz-Stencel Teresa
Published: September 2023

The aim of this review is to specify new potential reliable and non-invasive methods for the diagnosis of biliary atresia (BA) that could shorten the way to diagnose BA, and finally the surgical treatment. Apart from the biomarkers that have been proven helpful and are used nowadays in neonatal wards, there are several new potential biomarkers that researchers have found to be helpful in the diagnosis of biliary atresia. Circulating microRNAs, matrix metalloproteinase-7, stool proteins, interleukin-33, Th17-associated cytokines, urinary metabolomics, anti-smooth muscle antibodies, heat shock proteins 90 and positive biliary epithelial cells CD56 are among those presented in this summary. These markers may play a new significant role in BA diagnosis. The described methods include Nomogram, Circulating microRNAs (miRNAs), Matrix metalloproteinase-7 (MMP-7), Stool proteins, Interleukin-33 (IL-33), Th17-associated cytokines, Alpha-aminoadipic acid and N-acetyl-d-mannosamine in urine, Anti-smooth muscle antibodies (ASMA), Heat shock proteins 90 (HSP90), Positive biliary epithelial cells CD56.
Pheochromocytoma and paraganglioma in children and adolescents
Authors: Stachowicz-Stencel Teresa , Pasikowska Natalia , Synakiewicz Anna
Published: September 2023

Pheochromocytoma (PPC) and paraganglioma (PGL) are the tumors that rarely occur in the pediatric population (PPGL). Both originate from chromaffin cells, pheochromocytoma is localized in the adrenal gland, whereas paragangliomas are regarded as the tumors present in other localizations, from head to the pelvis. The clinical image is characterized by the presence of the sustained hypertension, headaches, sweating, palpitations. The symptoms are caused by the catecholamine secretion or are related to tumor mass pressure on different organs. The catecholamines and their metabolites levels in urine collection or plasma are necessary for further evaluation of the diagnosis. In pediatric population the tumors occur in multiple familial syndromes such as Multiple Endocrine type 2, Neurofibromatosis type 1, Von Hippel-Lindau syndrome, Familial Paraganglioma syndrome are related to specific mutations (SDHx, RET, VHL, NF1) leading to the characteristic phenotype. The radiological and nuclear imaging are an important part of the examination. Although CT and MR are reported to have overall good sensitivity for the tumor detection, further analysis with nuclear imaging is recommended for the specified diagnosis. Right now 68GA-DOTATATE is regarded as the tracer of choice, leading to the complex evaluation of patients with different mutations and metastatic disease. The treatment of choice is the tumor excision. Also, lately new therapeutic approaches including genetically targeted therapies are under investigation for more complex treatment of tumors with underlying genetic cause or metastatic disease. Long term follow-up after treatment to avoid recurrence or to detect it in early stadium must be performed.
Teucrium polium Extract Alleviates Pathological Features of Asthma via lL-12 and IFN-γ Modulation in Murine OVA-induced Allergic Asthma
Authors: Daneshvar-Ghahfarokhi Shole , Mohammadi-Shahrokhi Vahid , Rahnama Amir , Nosratabadi Reza
Published: September 2023

Asthma is a chronic disorder characterized by airway overreaction and remodeling, eosinophilia, and neutrophilic inflammation, accompanied by thickening of the airways and breathlessness. Teucrium polium (TP) is a plant with anti-inflammatory properties and is considered for the treatment of allergic disorders.
In this study, we examined the effects of TP extract on ovalbumin (OVA)-induced asthma. Thirty female mice (5–6 weeks old) were divided into 5 groups of 6 each, including a control group and 4 groups treated with OVA, OVA + TP extract (50 mg/kg), OVA + TP extract (150 mg/kg), OVA + TP extract (300 mg/kg). Twenty-four hours after the last treatment, lung, serum, and spleen samples were collected and used for the evaluation of leukocyte infiltration, serum cytokine Interferon-gamma (IFN-γ) levels, and the expression of the Interleukin-12A (IL12A) gene, respectively. Hematoxylin-eosin staining was used to evaluate pathological changes in the lung tissue sections.
Treatment with TP extract reduced inflammatory cells such as eosinophils and neutrophils in the airways. Furthermore, it increased serum levels of IFN-γ and IL-12A at a dose of 50, 150, and 300 mg/kg compared to the OVA group.
This study showed that the administration of TP extract could improve pathological features, such as airway inflammation, and reduce systemic inflammation.
Role of Long Noncoding RNA HSD17B3-AS1 in Trauma for COVID-19
Authors: Javanmard Marani Amir-Reza , Esmaeili Dorostkar Hadi , Dorostkar Ruhollah , Tat Mahdi
Published: September 2023

COVID-19, an acute respiratory syndrome caused by the SARS-CoV-2 virus, was first reported in late 2019 in Wuhan, China, and rapidly escalated into a global pandemic. The condition can lead to organ dysfunction and, ultimately, death through acute respiratory distress syndrome (ARDS). Disease severity has been linked to proinflammatory cytokines, which activate the NF-κB and STAT transcription factors in infected cells. It has been proven that lncRNAs play an essential role in reducing or increasing inflammatory factors. This makes them potentially valuable in recognizing pathogenesis pathways and therapeutic targets in COVID-19. Nanocurcumin is known as an antioxidant, tumor suppressor, and anti-inflammatory substance, and it can be effective in reducing inflammation caused by the disease of COVID-19.
This study analyzed Sequence Read Archive data from COVID-19 patients with acute versus milder symptoms, identifying dysregulated genes and noncoding RNAs. To verify this correlation, the expression of the candidate gene was evaluated with quantitative polymerase chain reaction (qPCR) in mouse models, while immunoglobulin (Ig) G titer was measured using enzyme-linked immunosorbent assay (ELISA) in mouse serum samples.
Here, we introduced a novel lncRNA called HSD17B3-AS1, suggested as a therapeutic target in COVID-19 patients with acute symptoms. Furthermore, we revealed that nanocurcumin reduces the expression of HSD17B3-AS1, which leads to reduced inflammation in mice.
These results suggest that HSD17B3-AS1 plays a significant regulatory role in managing COVID-19, and the downregulation of HSD17B3-AS1 by Nanocurcumin presents a promising treatment option for minimizing complications in COVID-19 patients.
Comparison of Plasma Levels of MicroRNA-155-5p, MicroRNA-210-3p, and MicroRNA-16-5p in Rheumatoid Arthritis Patients with Healthy Controls in a Case-control Study
Authors: Mohebi Nasrin , Damavandi Elia , Rostamian Abdol-Rahman , Javadi-Arjmand Maliheh , Movassaghi Shafieh , Choobineh Hamid , Kabuli Majid , Ghadami Mohsen
Published: September 2023

Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation and destruction of the joints. The objective of the current study was to evaluate the expression of microRNA (miR)-155-5p, miR-210-3p, and miR-16-5p in the plasma of patients with rheumatoid arthritis in comparison with a healthy control group to attain an expression profile for earlier diagnosis and treatment.
To carry out this study, 100 individuals were chosen as two equally sized groups of rheumatoid arthritis patients and healthy controls. Five milliliters of blood were drawn from each individual, and plasma RNA was extracted using Trisol solution. Complementary DNAs were synthesized using the Moloney leukemia virus (MMLV) and deoxynucleoside triphosphate (dNTP). Finally, real-time polymerase chain reaction (PCR) was implemented using the SYBR Green kit.
The mean expression of miR-155-5p, miR-210-3p, and miR-16-5p were 2.46±2.79, 1.97±1.90, and 69.62±88.44 in the rheumatoid arthritis group, and 0.34±0.33, 9.82±9.34, and 7.94±7.09 in the healthy group, respectively. Additionally, significant differences were revealed in the relativeexpression of the selected microRNAs in 4 subgroups of rheumatoid arthritis patients with different disease activities based on the disease activity score 28 (DAS28). ROC curve analysis showed that miR-155-5p (area under the curve, AUC=0.90, sensitivity=80%, specificity=81%), miR-210-3p (AUC=0.75, sensitivity=66%, specificity=71%), and miR-16-5p (AUC=0.96, sensitivity=89%, specificity=82%) could be potential biomarkers for rheumatoid arthritis diagnosis.
Increased expressions of miR-16-5p and miR-155-5p and decreased expression of miR-210-3p in rheumatoid arthritis patients compared with healthy individuals demonstrate the effectiveness of these microRNAs in disease incidence and progression. Thus, the expression levels of these microRNAs can be used for diagnostic and therapeutic purposes.
Differential Expression of miR-21-5p, miR-20a-5p, TGF-β1, and TGF-β Receptor 2 in Skin, Serum, and Lung Samples Exposed to Sulfur Mustard
Authors: Valizade Mohadeseh , Irani Shiva , Tavallaei Mahmood , Soleimani Masoud
Published: September 2023

Sulfur mustard (SM) or mustard gas is a blister chemical agent that causes pulmonary damage by triggering inflammation and oxidative injury. Alterations in microRNA (miR) transcript levels are found in pulmonary diseases and even inflammation. Therefore, we evaluated the expression levels of miR-20a-5p, miR-21-5p, and two target transcripts (transforming growth factor-beta [TGF-β1] and TGF-β receptor 2 [TGFR2]) in lung, serum, and skin samples from patients exposed to SM.
Total RNA was extracted from lung, serum, and skin samples of patients with moderate (n=10) and high (n=10) SM exposure, as well as 10 healthy subjects. Following the synthesis of complementary deoxyribonucleic acid using real-time polymerase chain reaction, we determined the expression levels of miR-20a-5p, miR-21-5p, TGF-β1, and TGFR2 transcripts. Furthermore, we evaluated the sensitivity and specificity of the chosen microRNAs by employing receiver operating characteristic (ROC) curves and calculating the area under the ROC curve.
The results showed that miR-20a-5p and miR-21-5p expressions in the groups with moderate and high SM exposure were significantly lower than the normal controls. The expression analysis demonstrated that TGFR2 was significantly less expressed in skin samples exposed to SM in both groups of patients compared with healthy controls. Furthermore, the TGF-β1 expression in the skin samples of the group with moderate SM exposure was lower than that of the control group.
Our findings suggest that miR-20a-5p, miR-21-5p, TGF-β1, and TGFR2 expressions could be used as potential biomarkers for discriminating SM-exposed patients from healthy individuals.
Impaired CD4+ Cytotoxic T Lymphocyte Activity in Polyomavirus BK Infected Kidney Transplant Recipients
Authors: Noshadi Nasrin , Yaghobi Ramin , Afshari Afsoon , Forouzanfar Mohsen , Soleimanian Saeede
Published: September 2023

The reactivation of polyomavirus BK (BKPyV) contributes to increased morbidity and mortality rates of transplant patients, especially kidney transplant recipients (KTRs). CD4+ T cells are important immune cells active during BKPyV infection in KTRs. This research tried to examine the phenotype of CD4+ T cells in the stage of BKPyV activation in KTRs.
The recipients were separated into 2 groups of BKPyV-active and nonactive KTRs (10 patients in each group) and were compared with 10 healthy control subjects. The viral load was evaluated by Taq-man quantitative real-time PCR. The frequency of different CD4+ T cell subsets was determined by analyzing markers such as CD45RO, CCR7, CD27, CD107a, perforin, and granzyme B using flow cytometry. The gene expression levels of transcription factors, including TBX21, GATA3, STAT3, and STAT6, contributing to CD4+ T cell activation, were also assessed.
A significantly higher proportion in CCR7+CD27+CD45RO-CD4+ T cell (naive Tcell) subsets was detected in BKPyV-active KTRs compared to nonactive ones. A significant increase was detected in the frequency of CD107a+, perforin+, and granzyme B+ CD4+ T cells in the BKPyV-active group compared to the nonactive group. In CD4+ T cells of KTRs, the mRNA expression of TBX21  and GATA3 was significantly increased in KTRs without BKPyV reactivation compared to BKPyV-active ones.
This investigation focused on the CD4+ T cell as an immunodominant T cell type with potential cytotoxicity. Based on these results, BKPyV may have a direct influence on the repertoire of CD4+ T cell subsets. Particularly, cytotoxic CD4+ T cells need further investigation to be considered as a therapeutic approach for BKPyV infection.
Prognostic Value of Admission Neutrophil Count in Asthma Patients with COVID-19: A Comparative Analysis with Other Systemic Inflammation Indices for In-hospital Mortality Prediction
Authors: Ghobadi Hassan , Mohammadshahi Jafar , Tarighi Aylin , Hosseini Seyed Amir Hossein , Garjani Kara , Aslani Mohammad Reza
Published: September 2023

Despite studies indicating that asthma patients do not exhibit a higher mortality rate or severity compared to the general population when infected with COVID-19, there have been few reports on predictive factors for mortality in this context. This study aimed to assess the predictive value of systemic inflammation indices, including neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), systemic inflammation response index (SIR-I), and systemic inflammation index (SII) in determining mortality rate among patients with COVID-19 and asthma.
In this prospective study, the laboratory parameters of 1792 COVID-19 patients were examined, comprising 112 patients with asthma and 1680 without asthma. Receiver operating characteristic (ROC) analysis was employed to assess the potential of inflammatory indices in indicating COVID-19 severity. Kaplan-Meier curves were utilized to analyze the survival probability with death as the outcome.
In deceased patients without asthma, leukocyte and differential cell counts and PLR, NLR, MLR, SII, and SIR-I values were higher than in survivors. In contrast, all the above values except PLR and MLR were significant in the asthma groups. The Kaplan-Meier survival curves were consistent with the ROC analysis. However, a multivariate Cox regression analysis revealed that neutrophil counts in patients without asthma and leukocyte and neutrophil counts in asthma patients were significant for survival.
In conclusion, while numerous inflammatory indices were associated with mortality in COVID-19 patients without asthma, neutrophil counts could independently predict mortality risk in asthma COVID-19 patients.
The Radiological Manifestations of Phagocytic Primary Immunodeficiencies in Children
Authors: Khalili Mitra , Chavoshzadeh Zahra , Darougar Sepideh , Mansouri Mahboubeh , Eslami Narges , Babaie Delara , Mesdaghi Mehrnaz , Karimi Abdollah , Armin Shahnaz , Fahimzad Alireza , Ghanaie Roxana Mansour , Tabatabaie Sedigheh Rafiee , Akrami Fatemeh
Published: September 2023

Primary immunodeficiencies are a diverse group of rare genetic disorders, among which phagocytic dysfunction impairs neutrophil function in a wide range of inherited disorders. Due to the heterogeneity of the disorders, a multidisciplinary approach is often required for early diagnosis and initiation of appropriate treatments. The aim of this study was to evaluate the imaging findings in children admitted with phagocytic primary immunodeficiencies.
Thirty-five children who fulfilled the inclusion criteria for phagocytic dysfunction were enrolled in this study. The patients were under close observation and monitoring from January 2011 until data locking in December 2017. The diagnosis of phagocytic immunodeficiency was confirmed by the patient’s clinical course, presentation features, and laboratory data.
Among the 35 patients studied, the most frequent condition was chronic granulomatous disease (CGD) (23 patients), followed by different types of neutropenia (8 patients) and Job’s syndrome (4 patients). Mediastinal and hilar lymphadenopathies and consolidation were the most frequent presentations. There was a significant relationship between mediastinal/hilar lymphadenopathies and fungal infections. A meaningful relationship was also found between pulmonary nodules without halo signs in patients with concomitant tuberculosis and fungal infections. A significant correlation was found between CGD, pulmonary fibrotic changes, and mediastinal lymphadenopathies.
The most frequent radiological manifestations in children included mediastinal and hilar consolidations. Physicians’ awareness of the radiological and clinical manifestations of these inherited diseases may be helpful in the early diagnosis and timely initiation of specific prophylaxis measures to prevent infections and also to initiate hematopoietic stem cell transplantation as the curative management modality.
A Rare Autoimmune Disease Detected in the Differential Diagnosis of Immunodeficiency: Histiocytosis-lymphadenopathy Plus Syndrome
Authors: Arik Elif , Keskin Ozlem , Kucukosmanoglu Ercan , Cesur Mahmut
Published: September 2023

Mutations in the SLC29A3 gene cause histiocytosis-lymphadenopathy plus (H) syndrome, a rare autosomal recessive genetic condition that affects numerous systems. We present a 7-year-old Syrian patient with pericardial effusion whose acute phase reactants did not decrease despite treatment. In order to emphasize the variety and raise awareness of H syndrome in the hopes of achieving an early diagnosis and appropriate treatment, molecular investigation of SLC29A3-related disorders is crucial. H syndrome is an uncommon genetic condition with a broad spectrum of phenotypes. Therefore, early genetic testing is essential for the accurate diagnosis of patients. Doctors should be aware of this condition and its symptoms and consider autoimmune diseases as a possible alternative diagnosis in patients with suspected immunodeficiency.
Case of Polyethylene Glycol Allergy Confirmed with Basophil Activation Test and Oral Challenge Successfully Immunized with SARS-CoV-2 Vaccine
Authors: Pasali Maria , Taka Styliani , Chliva Caterina , Katoulis Alexandros , Makris Michael
Published: September 2023

Polyethylene glycols (PEG) or macrogols are polymers of ethylene oxide widely used in drugs either as active substances or, more commonly, as excipients. We report a Caucasian 32-year-old woman with referred anaphylaxis almost instantly after oral intake of a macrogol-containing laxative. Despite an anaphylactic reaction, the patient showed negative results for both the skin test and specific IgE to the monomer, while the basophil activation test and oral challenge were positive. The patient was later successfully vaccinated with a polysorbate 80-containing SARS-CoV-2 vaccine following an additional work-up. As a result, the inactive form of PEG cannot be fully diagnosed, and it is considered a “hidden” allergen. PEG derivatives like polysorbates need special consideration due to their possible cross-reactivity.
Toxicity Mechanism of Dangerous Scorpion Stings in Iran
Authors: Dehghani Rouhullah , Ghorbani Ahmad , Varzandeh Masoomeh , Karami-Robati Fatemeh
Published: September 2023

Background: Considering the importance of scorpions and recognizing the mechanisms of toxicity caused by their medically important species in Iran and adopting the best therapeutic approach based on these mechanisms, this study was performed by reviewing the clinical manifestations of scorpion stings.
Methods: The research was conducted by searching for articles and researches in related websites (PubMed, EMBASE, Scopus, Web of Science and CINAHL) and using domestic and international authoritative journals using the keywords of scorpion, clinical manifestations, in a review method. Finally, 104 qualified sources were selected and after review­ing and criticizing these studies, the author's point of view was presented.
Results: Clinical manifestations of Scorpion sting toxicity vary due to the existence of two toxic classes of neurotoxins and cytotoxins or hemotoxins in these arthropods in Iran. The number and distribution of species with neurotoxic ven­om are higher than the scorpions with cytotoxic venom and are reported throughout Iran. Scorpions with cytotoxic ven­om are mostly widespread in south and southwest of Iran.
Conclusion: Treatment and prevention of scorpion stings in Iran and neighboring countries in the Middle East should be planned based on the mechanism of toxicity and the presence of toxic classes with neurotoxic or cytotoxic venoms.
Predatory Efficiency of Larvivorous Fish against Mosquito Larvae in Different Water Temperature Levels: Implication in Control Measure of Dengue Vector
Authors: Tyagnes-Hanindia Desca , Sumanto Didik , Sayono Sayono
Published: September 2023

Background: Reduction of the Aedes aegypti population is the priority effort to control dengue virus transmission in­cluding the use of larvivorous fish. Biologically, the predatory efficiency of fish will slow down when the water acidity and temperature change from normal conditions. This study aimed to determine the predatory efficiency of three species of larvivorous fish against the Ae. aegypti larvae in different water temperatures.
Methods: Three well-known species of larvivorous fish namely Poecilia reticulata, Betta splendens, and Aplocheilus panchax were placed into 12 cm diameter jars with three water temperature ranges namely 20–21 ºC, 27–28 ºC, and 34–35 ºC, and allowed to three days acclimatization. As many as one hundred 4th-instars larvae of Ae. aegypti were gradual­ly entered into each jar, and a longitudinal observation was made at 5, 10, 30, 60, 120, 240, 360, 480, 600, and 720 minutes. The predated larvae were recorded.
Results: In normal temperature ranges, the predatory efficiency of the larvivorous fish was 75%, 72.3%, and 32.8% for B. splendens. Aplocheilus panchax, and P. reticulata, respectively. The predation abilities decreased due to temperature changes. Betta splendens and A. panchax indicated the best predatory efficiency against Ae. aegypti larvae in different temperature conditions.
Conclusion: Betta splendens is the best larvivorous fish in the lower to normal, but A. panchax is the best in the normal to higher temperature ranges. This finding should be considered by public health workers in selecting larvivorous fish to control the Dengue vectors.
Absence of Asymptomatic Malaria Reservoirs in an Area with a Previous History of Local Malaria Transmission: A Successful Experience in Line with the Malaria Elimination Program in Iran
Authors: Hosseini Zainab , Azizi Kourosh , Moghadami Mohsen , Hassaniazad Mehdi , Shafiei Reza , Rezaee Elham , Turki Habibollah
Published: September 2023

Background: Asymptomatic malaria is a major challenge to be addressed in the implementation of the malaria elimina­tion program. The main goal of the malaria surveillance system in the elimination phase is to identify reliably all the positive cases of malaria reliably (symptomatic and asymptomatic) in the shortest possible time. This study focused on the monitoring of asymptomatic malaria reservoirs in areas where local transmission had been previously established.
Methods: It was a case-study approach that was conducted in the Anarestan area. A total of 246 residents and immi­grants living in the area at the age range of 4–60 years old were randomly selected to be tested for malaria by micro­scope, RDT, and nested-PCR techniques. The inclusion criterion for participants to be entered into the study was the absence of specific symptoms of malaria. Moreover, participants who have been taking antimalarials for the last month were excluded from the study.
Results: The results indicated no positive cases of asymptomatic malaria among the participants tested by all methods.
Conclusion: The results of this study have shown that, without concerns for asymptomatic parasitic patients, a malaria elimination program has been successfully implemented within the studies area. In addition, the findings emphasized the existence of a strong malaria surveillance system in this area.
Outreach Vector Control Worker’s Knowledge, Attitude and Practices Towards Mosquito Control and Associated Diseases
Authors: Saba Shafia , Naeem-Ullah Unsar , Saeed Shafqat , Rajwana Ishtiaq A. , Khan Alamgir Akhtar
Published: September 2023

Background: Mosquito Control Programs are articulated to control Mosquito Borne Diseases and success of such programs depends on the activities of field workers, and their adherence to the standard operating procedures (SOP’s) is governed by their knowledge, attitudes, and practices (KAP). Present study was intended to assess the KAP of mosquito control workers of Pakistan to get an exact depiction of prevailing situation.  
Methods: A cross-sectional descriptive study was conducted in March-April 2020. Questionnaire containing 30 closed and open-ended questions were administrated to participants. Knowledge and practices were evaluated using a scoring system i.e., by giving 1 point to each correct answer while attitude questions were analyzed individually and expressed in percentage for each response.
Results: Total 639 workers were interviewed, mean age was 29.8 (SD ±7.87) years, majority (65.1%) was in age group of 18–30 years. Mean knowledge score was 6.96±1.28 (range 0–9) with 77.36% correct answers (P= 0.073). Mean prac­tices score was 7.00±1.62 (range 2–9) with 77.83% appropriate answers (P< 0.001). Both knowledge and practices scores were higher for permanent employees, practices score increased with increase in job experience. Very weak posi­tive correlation (r= 0.127) was observed between knowledge and practice scores.
Conclusion: Appropriate practice correlates with better knowledge and positive attitude towards control activities. Hence, training on protection and protective measures for having a positive attitude among healthcare workers is neces­sary against the fight with mosquitoes.
Assessment of Knowledge, Attitude and Practice of Inmates, Prison Staff and Soldiers regarding Cimex lectularius (Hemiptera: Cimicidae) in Mazandaran Prisons
Authors: Nikookar Seyed Hassan , Jafari Ali , Fazeli-Dinan Mahmoud , Shabani-Kordshouli Razieh , Yazdani-Charati Jamshid , Talebi-Hajikolaee Nasir , Enayati Ahmadali
Published: September 2023

Background: Bed bugs (Cimex lectularius) are blood-sucking insects that bite humans usually at night and cause nui­sance, psychological and social problems. These insects are considered a health hazard in densely populated places such as prisons. The aim of this study was to evaluate the knowledge, attitude and practice of inmates, soldiers, and prison staff regarding bed bugs in Mazandaran prisons.
Methods: This is a descriptive-analytical study in which 450 inmates and 210 staff (105 personnel and 105 soldiers) from prisons of Mazandaran Province were included in the study. Data on knowledge, attitude, and practice of the par­ticipants regarding bed bugs were collected using a structured questionnaire. To determine the relative content validity coefficient, the questionnaire was assessed by 10 specialists in terms of difficulty, inappropriateness, and ambiguity of the phrases. The reliability of the questionnaire was measured using Cronbach's Alpha and then the data were analyzed using SPSS software version 20.
Results: The maximum mean scores of knowledges, attitude, and practice between the three target groups were 16.42%, 44.07% and 71.21% respectively. Prison staff had the highest knowledge and practice, and inmates showed the highest attitude regarding bed bugs. There was no significant difference between the knowledge and attitude of inmates, prison staff and soldiers (P> 0.05) but there was a significant difference in their practice (P< 0.05).
Conclusion: Results of this study confirmed that all three groups of people in the prisons need appropriate education regarding all aspects of bed bug including its control.